Religious Beliefs and Psychiatric Beliefs: Worlds Apart and Perhaps Best Left That Way

摘要

Religious Experience and Psy-chiatry: Analysis of the Conflict and Proposal for a Way Forward" is a compelling paper that challenges our moral intuitions-and self-perceptions-about the intersection of religious beliefs, culture, and psychiatric diagnosis. Rashed presents a case history of Femi, a 29-year-old British man of West African descent who had had an intense religious experience of being in direct contact with God. This spiritual revelation resulted in his social isolation, fasting, and purging of material possessions. Using Femi's story, Rashed illustrates that, although we may want to think of ourselves as tolerant of a variety of cultural and religious belief systems, when these differences come up against mainstream social and medical belief systems, we may not be so generous. Rashed also makes the subtler point that even well-motivated attempts to care for patients sensitively, using devices such as the DSM-IV's 'cultural criterion,' may result in harm to patients by stripping away the meaningfulness of specific experiences. Rashed argues that diagnosing Femi's religious experience as an acute psychotic episode transformed a positive existential moment into one of shame and sickness. Rather than adopting medical language, and indeed a medical framework to approach patients, Rashed asks psychiatrists to find common ground with patients by negotiating linguistic, moral, and explanatory terrain to describe subjective experiences. In this regard, his proposal is a more substantive and demanding version of patient-centered practice.