INDEX (Volume 6 Num 1)

Religious experiences and spirituality in Cultural Psychiatry Guest Editors: Simon Dein & Mohammed Rashed

This special issue on religious experiences and spirituality in cultural psychiatry - Editorial S. Dein, M. Rashed 1 - 2

Religious experience: Perspectives and research paradigms - Original Paper S. Dein 3 - 9

The subject of religious experience has been marginalised in the social sciences. Although authors such as James (1903) have suggested that religious experience is pre-cultural and pre-cognitive, this paper argues against the perennialist position, suggesting instead that religious experiece and its narration are both socially constructed. The ideological role of religious experience is discussed. The implications for future research on religious experience are outlined.

Neuroscience and cultural psychiatry – Part II. From the intuition of duality to the religious double register - Original Paper G. Bartocci 10 - 20

This article suggests an interdisciplinary synergy between neuroscience and cultural psychiatry in order to search through the role of detachment and transcendence dynamics in the economy of psychic functions. As neurosciences are currently researching some “normative” areas still obscure in psychiatry, as the spiritual experience, an interpretation in terms of evolutionary psychology and cultural neuroscience is being proposed. Data from neuroscience research suggest the existence of the intuition of duality as a fundamental psychic event during the course of the evolution of the mind. The intuition of duality appears to be the neural ground for the construction of the Self as well as possible psychopathological developments as derealition and dissociation. In an etiopathogenesis perspective, based on the study of cultural influences on the mind, the conditioning power of the culregister imposed by the modern world antinomy between science and monotheistic dogma is suggested.

Cultures and religions in the crisis of post-modernity - Original Paper G. Rovera 21 - 34

Among the anthropological foundations of society, the sacred/religious element makes the greatest contribution to developing value orientations, both at individual and community level. Upon these foundations lies the basis for the development of the notion of religion and religiosity, intertwined with concepts of cults and cultures. Comparative Individual Psychology (CIP) configures a network model that, already in the epistolary exchange between Alfred Adler and Rev. Jahn (1930-33), made a distinction between the “Idea of God” (Deism) and the “Revelation of God” (Theism). This approach can be developed and enriched also through the study of neuroscience, transculturalism and psychopathological/clinical/psychotherapeutic practice. The complexity of these concepts (especially in the current phase of the passing of post-modernity) is faithfully reflected by multiethnic, multicultural and multi-religious contexts. Above all, it is important to consider the impact that these might have on New Age philosophy, “new psychotherapies” and “psychotherapy cult”. The ensuing debate reveals the importance of cultural psychiatry and of Cultural Dynamic Psychotherapy, enabling the development of a New Humanism.

Psychology and psychopathology of messianic-prophetic movements - Original Paper W. Jilek, L. Jilek-Aall 35 - 41
This paper summarizes the authors’ information and observations on messianic-prophetic movements in New Guinea and their leaders. These so-called “Cargo Cults” arise from a syncretistic fusion of traditional Melanesian mythology with the Christian salvation message preached by church missionaries. Charismatic prophets, inspired by visions and dream revelations and entertaining grandiose ideas, proclaim the advent of apocalyptic events ushering in an earthly paradise for Melanesians and the return of their ancestors with all desired “cargo” believed to be withheld by the “Whites”. Perceived as messengers from the supernatural world, successful prophets initiate a cult movement by exerting suggestive influence on their followers, often leading to transient mass dissociation phenomena. Some cult prophets show manifest symptoms of psychiatric disorder. With the organizing help of able assistants, “Cargo Cults” may evolve into a religious congregation, a socio-economic or a political organization.

A gift that lasts? A prospective study of religion, cognition, mood and stress among Jews and Protestants - Original Paper K. Loewenthal, A. MacLeod, V. Goldblatt, G. Lubitsh, J. Valentine 42 - 51

In an earlier study of Protestants and Jews in the UK we found that specific religious coping beliefs were related to emotional outcomes, in individuals under stress. In this study, we followed up 84 of the original 126 participants (33 Protestants, 51 Jews) to see whether religious coping beliefs related to outcomes nine months later. Outcomes studied were distress, positive affect, and intrusive thoughts. Religious activity and orientation, and religiously-based cognitions (at time 1), had detectable effects on outcomes nine months later at time 2. The most robust effects of the religious factors examined were on positive mood. The effects on long-term negative outcomes – distress and intrusive thoughts - were less marked than the effects on positive mood, although there were some indirect effects. The study suggested that the long-term effects of religious coping were more marked on positive than on negative affect. The study indicated some of the cognitive routes by which religion may affect the emotional impact of stress, and offers some support for the possibility that the stress-moderating effects of religious coping beliefs may be causal.

Race, culture, ethnicity and personality disorder: Group Careif position paper - Original Paper M. Ascoli, T. Lee, N. Warfa, J. Mairura, A. Persaud, K. Bhui 52 - 60

This paper summaries the discussion points and conclusions from a UK Department of Health Funded exercise to develop a position statement on personality disorder and ethnicity. Unlike the significant literature on ethnicity and psychoses, detentions, admissions and pathways to care, there is little published on inequalities in access to and experience of effective mental health care for people with personality difficulties and personality disorders. Although notions of ethnicity, personality and personality disorders can each be contested as conceptually eterogenous categories, and that priority should be given to more in-depth validation work before considering practicalities, the development of personality disorder services, and the implications of overlooking the role of personality function in the planning and provisionwas produced using a critical enquiry method.

Communication as magic: An ethnographic study on child-God communication in Northern Italy - Original Paper F. Zanatta, S. Dein, R. Littlewood 61 - 74

The research in children’s mental health and religion is a developing field. Most of the studies examine the religious developmental process either from a psychological, or from a religious point of view. The purpose of this research is to combine these two areas in order to understand more comprehensively the relationship between the child and God. The results are personal insights of this relationship, here conceived as determined by the encounter of inner and external forces and dynamics. Six common themes have been identified through the systematic analysis of the interviews and can be considered as shared features in the various personal relationships. The most interesting findings, obtained from the analysis of these themes, are related to child-God communication, defined by a child as the “magic action process”, an interaction activated by the child when asking for God’s help. As described in Elkind’s work (1970), in children’s hands the image of God becomes a tool used to solve problematic situations; this paper aims to analyse this interaction and its effects on the child’s life. Finally, the findings can also as material to critically analyse psychologically informed theories on religious development in children.

Philosophy’s role for guiding theory and practice in clinical contexts grounded in a cultural psychiatry focus: A case study illustration from southern Norway - Case Study V. deMarinis, D. Ulland, K. Karlsen 75 - 83

The purpose of this article, influenced by research in northern European contexts, is twofold. First, it is to make the case for, and provide a working model of, the importance of having a foundational philosophy of mental health care for consistency in clinical decision-making relating to theory and practice in cultural psychiatry; and second, to illustrate this model in action through a brief case study from a clinical context in southern Norway. In Part I, a brief presentation of one of the overarching challenges for cultural psychiatry is noted, that being the disconnection between theory and clinical contingencies and practices. Use is made of the Mezzich and Caracci volume: Cultural formulation: A reader for psychiatric diagnosis (2008) to illustrate some of the underlying concerns, and consequent confusions, raised by the ways in which an approach to culture and cultural information was included or excluded from the DSM-IV. The findings of this critical review have implications not only for understanding the place of culture in current and coming nosologies as well as the utility and potential limitations of DSM-IV as a clinical and research tool in multicultural settings. More than this, it provides a thorough and very valuable base for understanding the sociopolitical process, a dimension of culture in itself, of constructing the DSM-IV. What one is left with is certainly not seeing culture as a common core of analysis and a fundamental element of not only all psychiatric distress but also psychiatric resilience. Due to the very tangible reality of different, though not necessarily totally exclusive, operative mental health paradigms that result in different consequences for approaching both diagnostic and treatment processes, the paper’s attention is then focused on the importance of articulating a clear and foundational philosophy of mental health care with reference to how culture and cultural information are to inform theory and practice. A working model of interacting levels for a clinical mental health context is provided. If the role of culture is considered essential for the foundational level of the operative philosophy of mental health then this needs to consistently inform the levels of theory and practice for diagnosis and treatment. In Part II, the importance and consequences of the integration and interaction among the model’s three levels for cultural psychiatry, are illustrated through a brief case study example from an outpatient psychiatry context for children and adolescents: The Department of Child and Adolescent Mental Health [Avdeling for barn og ungdoms psykiske helse, (ABUP)] is part of the local public hospital, Southern Hospital [Sørlandet Sykehus HF] in southern Norway. This clinical context, with a culture-focused perspective, has a population of primarily though not exclusively ethnic Norwegians. The centrality of culture, cultural information, and cultural expression for mental health programmes in Norway is briefly outlined as a background for understanding the centrality of culture in the particular clinical context. Drawing from interview data with the department director and treatment team members, as well as documentation, the characteristics of the philosophy of mental health based on the centrality of understanding culture and the need to gain access to the patient’s and family’s cultural interpretations of illness and health are explored. At the theoretical level a necessary competency in pathogenic knowledge needs to be completed by knowledge and methods from the social science and other disciplines, and the all important patient/family knowledge in order to most accurately engage in the diagnostic and treatment processes. Cultural knowledge is understood from a meaning-making perspective that views existential meaning as central for understanding cultural constructions of health and illness. The individual patient expressions of meaning-making in general and existential meaning in particular can be very varied. However, building a safe therapeutic space for understanding these expressions of meaning is central to the culturally-based process for all patients. This clinical context can not be viewed as representative of Norwegian mental health contexts. However, it serves as a living illustration, in cultural context, of the importance of the philosophy of care in relation to understanding and implementing a multi-dimensional, culture-informed mental health programme.

Medieval enchantment techniques: St Christopher and the Siren - Images in Cultural Psychiatry G. Bartocci 84 - 92

Transcultural psychiatry has performed an in-depth study into the suggestive practices and different forms of transcendence techniques used among traditional peoples as healing practices or as a privileged means of achieving religious and ecstasy experiences. Despite the fact that also prevailing Western cultures savvily used and still use a plurality of psychological influencing and conditioning techniques based on figurative means and architectural techniques, there is a lack of documentation on the use made of enchantment techniques by these civilizations. This paper illustrates an example of a consolidated medieval religious influencing technique through the empirical use of perceptive detachment dynamics and the achievement of transcendence. Two frescoes portraying St Christopher, located in the Upper Valley of the Nera River in the Italian region of Umbria, are herein interpreted as an example of the savvily conceived instruments to induce special states of suspended consciousness which configure the natural groundwork for subsequent canonical devotion.

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