Saturday, June 10, 2006

Religious nut? Or not.

Religious nut or not, that is the question.

There is very little about religion in the DSM IV except that clinicians are supposed to understand a person's world view/culture before assessing pathology.

Ideas of reference (God talks to me) are considered pathological. Mainly, we don't believe that God is talking to people directly via our thoughts or over the telephone lines.

When a patient believes that he or she is in direct communication with a Creator that is telling him to hurt himself or someone else, we worry about psychosis, that indeed, there is potential for danger. If God is telling you to take your own life or that of someone else's, well, who are you to object?

So we worry about ideas of reference as they are sometimes characteristic of some of the more the severe mental disorders.

But for many people, being in touch and having talks with God is not weird, dangerous, or pathological. Some people are simply very spiritual, very sensitive to what they see as evidence of God in the universe, and they maintain a working relationships with Him or Her, or the Higher Power, Cosmos or whatever.

Religious people have an important coping tool at their disposal. They can turn it over, a concept that Alcoholics Anonymous has widely disseminated to alcoholics, but hasn't shared with the rest of us.

Turn it over and Let go, let God, for me, evokes scenes like this, when I have to turn it over:

I've been pulled over for speeding. I want to start lying and tell the policeman that I'm in labor and I'm not even pregnant.

My kid just took the car for the first time. He promised he'd be home at 11:00. It's 11:30 and he's not answering his cell.

My mother's on a flight to Miami and it connects to Charlotte, NC. I hear there's a plane crash in Charlotte, same airline, same time of arrival.

In real time, it might work for a patient with an anxiety disorder, maybe it's mild, like test anxiety.

Joey has a test to take tomorrow. His LSATS. He's barely made it before through SAT's, ACT's GRE's, and other over-valued exercises in futility. But the test has potential to change Joey's future, for better or for worse. He's been worrying for days, studying, obsessing. People are telling him to chill, to quit worrying-- he'll do fine, to get a good night's sleep (ha!). He's still losing it. So much so that he drinks a little too much, when he's not studying, that is.

Lots of the addictions start out this way,alcohol, marijuana, irresponsible sex, computer games-- all help people detach from, avoid negative feelings. They work as coping tactics for awhile, until they don't work and things get a little funky.

If Joey gets dependent upon a dysfunctional coping strategy, it will be hard to lose the habit. Our brains like to go back over the same old pathways. Pleasure is hard to resist, even if there's risk. We're basically like mice sometimes, drawn to the cocaine. You should see the video of the mice choosing coke over cheese. You know people like this.

So Alcoholics Anonymous, essentially a support group with a Judeo-Christian credo, came up with a way to interrupt the compulsion to seek immediate pleasure rather than choose more functional coping strategies. I'm tempted to say like shopping, but there are definitely shopping addictions, too, okay?

So one of the AA interventions is this TURN IT OVER thing, and it is sincerely brilliant and does work.

I'm not going to say it works because a Higher Power actually takes over and helps the plaintiff, however. Sorry guys. You know I love religion. But it works anyway. Maybe He does take over. I honestly don't know. But there are biological reasons it might work.

First look at what you'd need for it to work:

All you need to turning it over is a belief that there might be a Creator or a higher power, one who is paying attention to your thoughts, your life. (If you can't do it, it's okay, we have other interventions for anxiety, seriously). BUT If you can entertain that notion, that there MIGHT be a personal god, an angel on your shoulder, whatever, then you can turn any problem over to that being.

LIFE MAGAZINE, by the way, ran an article a few years ago that polled Americans and found something like 90% pray every day.

So this is a no brainer for religious people. They merely converse with the Higher Power for a couple of minutes, say,

Uh, hello up there. If you're listening, could you do me a big favor. I've done my best and I can't deal with this anymore, would you take care of it for me please? It's your problem, now, not mine. It's in your hands

That's it. Divest of future responsibility and hope it works. After all, this is the Creator of the universe we're talking about, should certainly be able to help with the consequences of a test, job interview, illness, in-law interference, partner stress, etc.

Ol' Joey can quit worrying about the LSATS. He turns it over and his test anxiety dissipates. Frankly, I'd teach him some muscle contraction and breathing exercises, too.

But they're right, the AA people. The real reason it works? At some point, when you stop beating yourself up, unconsciously raising your own anxiety, you give the brain a chance to settle down. What goes up neurologically (adrenaline), must come down.

In Joey's case, when he stops studying, he actually gives his brain a better chance of integrating what he's already learned. Pressure about grades, you should know, is the number one cause of suicide in young people.

Recommending the AA intervention (probably their most powerful tool, and they have many) is not to suggest that religion is this wonderful cure for anxiety. But the communists didn't call it the opiate of the masses for nothing. I'll write more about anxiety and what works in another posts.

Meanwhile, for some, turning it over does seem to work. So that's why I'm reluctant to call religious people "religious nuts," . . . usually. There's much to be said for coping.

But the reason psychologists say that turning it over or Let go, let God works is that letting go of the process of having to have control is a tremendous relief. It frees up head space (when you relax there's less brain activity), probably releases seratonin that's locked into the walls of brain cells.

Oh, the thrill of that. MUCH better than any drug.

Copyright, Therapy Doc, 2006

1 comment:

Peetred said...

As a therapist, how do you help someone distinquish between seeing "spirits" and psychosis? What are your thoughts on this.

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