Psychiatry’s best-kept secret: faith and mental health

‘The fact that having a religious faith is good for you is psychiatry’s best-kept secret,’ says Andrew Sims, Past President of the Royal College of Psychiatrists, and Emeritus Professor of Psychiatry at the University of Leeds. In this interview, he talks to Nigel Bovey about the health benefits of faith.

Professor Sims, why did you choose psychiatry as a career?

My father was a GP and he had a few colleagues who were psychiatrists. He didn’t think much of psychiatry, but as a schoolboy I was interested in what makes people do the things they do. I had never heard of psychology but thought that if I studied medicine, I might be able to get into psychiatry, which is what I did.

Have you worked as a clinical psychiatrist?

Yes. After qualifying as a medical doctor, I trained in psychiatry in Manchester before working in a large mental hospital in West Bromwich. In my thirties, I took an academic job in Birmingham and combined teaching psychiatry to medical students and postgraduates with clinical work and research.

What is the function of the Royal College of Psychiatrists?

The college was established for the welfare of patients with mental health disorders. It achieves this through training psychiatrists, liaising with Government and pushing forward the interests of mentally ill people.

How does a person know whether they’re mentally ill?

A psychiatrist would know whether they’re mentally ill by looking for specific mental symptoms, such as depression or clinical levels of anxiety. Delusions and hallucinations would suggest a psychotic illness.

What part does guilt play in mental health?

Although often neglected, it is hugely important. Guilt and forgiveness are two themes that constantly recur in psychiatry. I can think of so many accounts of relationships going wrong and one of the parties having enormous feelings of guilt, which has ruined their life. Guilt results in someone becoming less of a person.

Is forgiveness a psychiatric technique? Would a patient be encouraged to forgive themselves or an offender?

They would be encouraged. Even psychiatrists who are not religious would still regard helping people to forgive and to accept that they are forgiven as important.

Are there particular forgiveness techniques?

There are techniques, but in general it is of great value to help people forgive another person and allow themselves to be forgiven. Forgiving oneself is particularly difficult. Guilt is a symptom of depressive illness and sometimes the depression has to be treated before the person is able to deal with their guilt.

Does Christianity offer a distinctive perspective on mental health?

Yes. All good psychiatrists have their patients’ interests at heart. The additional Christian insight is that God loves everyone, including people with mental illness. Being a Christian has enabled me to be a better psychiatrist than I would have been had I not had a faith.

How and when did you become a Christian?

I come from a Christian family and I went to a church school. At the age of 17 or 18, I believed myself to be an atheist. Having secured a place at university, I left school and went to work in a factory. After a few weeks of very grim work, I realised that factory work was not what I wanted out of life. At the time, I was reading Trevelyan’s English Social History. It made a profound impression on me. Over that summer, gradually, without telling anyone, I thought: ‘This is not the life that I want to lead’. God turned me around. I rediscovered the Jesus I had learnt about as a child.

What did that period of atheism give you?

It gave me a way of looking at things from the other person’s point of view, which I think has been useful ever since. It has made me argumentative, which sometimes has been a nuisance, but at other times is quite useful. It also made me look below the surface – it made me distrusting of people who say that if you only do such-and-such then everything will fall into place and life will be easy.

If it was so positive, why reject it?

Because I knew it was a mess. I had seen the hopelessness in the lives of people without faith. I recognised the faith of the Christians I had been brought up with. They had purpose. They valued life. They had hope.

Could your faith be a delusion?

No, because faith and delusion come from different realms. Delusion is a particular sort of belief that is not supported by argument. But my Christian faith, my belief that Jesus Christ is real and that he’s still active today is something that is shared by lots of other people. It is something that is based on sound evidence and not on delusional evidence. Faith can be accused of being false, but technically, it is not a delusion.

So the assertion that God is a delusion is itself false?

Yes it is, because in terms of the symptom of mental illness, faith doesn’t have the form of a delusion. If a delusion is shared, it probably isn’t a delusion. A delusion is personal, not corporate, so Richard Dawkins is wrong to describe God or faith in terms of ‘delusion’.

In what respects is Christianity rational?

Faith is rational because it all fits together. Faith covers all circumstances.

How rational is it for a person to have a personal faith in God?

There’s a difference between someone with a mental illness saying that God told them to do something and a person of faith believing that God speaks to them. It is known as locus of control. A normal, healthy person believes that most of the circumstances of their life are more or less under their control. So, a believer describes God as a presence who is always there. The person with a neurotic condition believes that they are the victim of circumstance and are being controlled by something outside of themselves.

Can having faith be mentally destructive?

Faith itself is not destructive. Some forms of religion can be unhealthy, as in the case of a man killing his wife because he thought she had a demon. Some practices are unhelpful. I know of a woman who was told by her church leadership to ditch her boyfriend or she would be thrown out of the congregation. She was profoundly miserable because of this, because church was where her friends were and where she felt comfortable. Sadly, the incident precipitated a depressive illness in her.

To what extent does religious faith improve mental health?

For years, as a Christian working in psychiatry, it was frequently levelled at me that profound religious belief and regular churchgoing are bad for health to the point of being harmful.

Then practitioners started using the scientific methodology known as epidemiology, which is the application of statistical principles to ‘outcome studies’ with large numbers of people. Over the years, some 3,000 studies have compared people who have a religious belief with those who have none. They are published in The Handbook of Religion and Health, by Harold Koenig, Dana King and Verna Carson. The overriding finding is, in fact, that people with religious belief have better mental – and physical – health than those who have no faith.

The fact that having a religious faith is good for you is psychiatry’s best-kept secret.

Does this refer to faith in general, or Christianity in particular?

It is faith in general. The studies have mainly been carried out in North America and Europe. Most of the respondents are from Christian backgrounds, but there are studies on other religions, including Judaism.

It would be difficult to conduct such a study in a country where Islam is dominant. In Britain, it’s OK to say if you are a Christian or if you are not. But in an Islamic society, it is going to be hard to find that control group that says they’re not Muslims.

I have looked particularly at the relationship between faith and depression. One can definitely say that for people with depression, having a Christian faith rather than other faith or no faith shows better mental health outcomes.

With such overwhelming evidence of the benefits of faith on mental health, are psychiatrists allowed to recommend faith as a therapy?

These days, the spiritual dimension is pretty well accepted within psychiatry. One of the major preoccupations of my life has been in trying to draw Christianity and psychiatry together. I am a member of the Royal College of Psychiatrists Spirituality and Psychiatry Special Interest Group. Members of different backgrounds investigate the impact of spirituality on mental wellbeing.

The General Medical Council has ruled against a psychiatrist trying to impose their faith upon a patient. A psychiatrist, though, can ask a patient if they have considered faith. So a psychiatrist saying, ‘I have a faith. It’s important to me. I would recommend it to you and will say no more unless you want to talk about that’ is now wholly acceptable.

Likewise, whereas in the past, a psychiatrist could tell a patient they mustn’t go to church any more, because it was harming them, that would now be considered unacceptable.

Why is faith good for mental health?

First, studies show that there is more hope and optimism among people of faith. These are key factors in promoting better mental health. An optimistic person is less likely to become depressed or anxious. Hope is a factor in resisting illness, or, during illness, in helping recovery.

The other reason is the social aspect of faith. Being a member of a worshipping community, meeting people in church or at social events, knowing that somebody cares about you and feeling that you belong are all good for mental health. By contrast, isolation can be damaging to mental wellbeing.

This interview was conducted by Nigel Bovey and first appeared in The War Cry. It is used here with permission. ©The Salvation Army 2019

Main photo by Stefan Kunze on Unsplash

Photo of Andrew Sims: The War Cry / Nigel Bovey