Spirituality and secularity: professional boundaries in psychiatry

Abstract

Additional information:Use policyThe full-text may be used and/or reproduced, and given to third parties in any format or medium, without prior permission or charge, for personal research or study, educational, or not-for-prot purposes provided that:• a full bibliographic reference is made to the original source • a link is made to the metadata record in DRO • the full-text is not changed in any way The full-text must not be sold in any format or medium without the formal permission of the copyright holders.Please consult the full DRO policy for further details. AbstractSpirituality is assuming increasing importance in clinical practice and in research in psychiatry. This increasing salience of spirituality raises important questions about the boundaries of good professional practice. Answers to these questions require not only careful attention to defining and understanding the nature of spirituality, but also closer attention to the nature of concepts of secularity and self than psychiatry has usually given. Far from being "neutral ground", secularity is inherently biased against concepts of transcendence. Our secular age is preoccupied with a form of immanence that emphasises interiority, autonomy and reason, but this preoccupation has paradoxically been associated with an explosion of interest in the transcendent in new, often nonreligious and non-traditional forms. This context, as well as the increasing evidence base for spiritual and religious coping as important ways of dealing with mental stress and mental disorder, requires that psychiatry give more careful attention to the ways in which people find meaning in spirituality and religion. This in turn requires that more clinical attention be routinely given to spiritual history taking and the incorporation of spiritual considerations in treatment planning.3

Aspects of Spirituality in Medical Doctors and Their Relation to Specific Views of Illness and Dealing with Their Patients' Individual Situation

“…There is an evident shyness regarding explicit religious or spiritual elements which may be essential to physicians' professional identity and fulfilment [26] or which, however, might influence medical decisions and behaviour. This is probably due to religion and spirituality dealing with transcendent realities and thus transcending the borders of normal scientific, evidence-based, science on which modern health care is thought to be based [27]. This is—to some extent—different in the field of palliative medicine and care, also due to the explicit mention of spiritual aspects in the 2002 WHO-definition.…”

Approaching the religious psychiatric patient in a secular country: Does “subalternalizing” religious patients mean they do not exist?

“…This brings an aspect to the international debate within psychiatry on the “neutral” psychiatrist, that is, that the psychiatrist can approach the patient from a neutral or value free position, and considering whether identifying psychiatry as a secular discipline is not a biased position in itself (Cook, Powell, Sims, & Eagger, 2011). It is now generally acknowledged that a “neutral” position is untenable in the recognition that the individual is always speaking from some position and that this cannot be a neutral position (Greenberg 2001; Nissen, Gildberg, & Hvidt, 2018).…”

Charting Spiritual Care: Psychiatric and Psychotherapeutic Aspects

“…In scenario (i), there is neither a need nor an obligation (on the contrary: there is legal prohibition) to take into account spiritual care in the clinical context, at least officially. However, as in other European contexts, spiritual care is an increasingly important subject for "secularised" medicine (Cook et al 2011) in France (Frick 2006) and in the highly secularized Swiss Canton of Geneva (Huguelet 2017). The integration of a board-certified chaplain (ii) is somewhat the opposite of French secularism.…”