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Spiritual Concerns

Updated: Jan 30, 2023

Spiritual Concerns

Religious beliefs and practices can both help and hurt a person with a mental illness. Harold Koenig states that “it is no longer possible to argue that religious involvement is usually neurotic, harmful, or incompatible with mental health, as once claimed. Furthermore, clinicians should view patients’ religious beliefs as not only having negative effects on the psyche, but also as a resource, especially when dealing with situational life stressors, health problems, severe loss, or trauma” (Koenig, 2005, 112).

Ways that Religion Helps:

Religion and spiritual practices can be a comfort, provide meaning, and be a source of coping for those with a mental illness. Harold Koenig in Faith and Mental Health describes a number of ways religion can help.

Promotes a positive worldview:
“Religious beliefs provide a worldview that is positive, coherent, optimistic, and caring” (Koenig, 2005, 134).

For example, the Judeo-Christian worldview holds to a God that is personal, and forgiving, merciful, just, and all-powerful.

Gives purpose and meaning:

For some people, religious beliefs and practices are at the core of what gives them purpose and meaning in the midst of difficult circumstances.

“Meaning is important because it provides a sense of purpose and direction or life that gives hope for better times ahead and gives significance to present difficulties” (Koenig, 2005, 136).

Enhances social support:

Persons with mental illness often feel isolated and alone, and without emotional support. When persons with mental illness are in regular contact with a religious community and practicing spiritual beliefs, this can help people feel connected. The religious community can provide caring and support during times of emotional stress. Phone calls and visits from faith leaders or caring individuals can help the person realize they belong to a community that supports them and is praying for them, and that they are loved and cared for by God (Koenig, 2005, 137).

Other ways:

Koenig also mentions that religious beliefs and practices promote other-directedness, discourages maladaptive coping, helps to release the need for control, provides and encourages forgiveness, and provides hope (Koenig, 2005, 134-139).

Loss of or Questioning Faith:

While religious belief and practices can be a great source of strength for people with mental illness, it can also be a source of agitation. Frequently people present a problem that centers on the loss of a firmly held faith. Both religious and psychiatric issues are associated with such loss. Shfranske (1991) described a well–respected professional man whose life was rooted in Roman Catholicism. He came to doubt the principles of his religion. Because of his doubts he lost his zest for life. In this case, the crisis was solely a spiritual one. Such a crisis can also happen with people who have a mental illness, but a crisis such as this one does not, in and of itself, point to mental illness.

Religious conversion:

If a person has recently converted to a particular faith or greatly intensified a faith connection, the faith leader should discern what potential conflicts exist between this person’s former and current lifestyle, beliefs, and attitudes. Spero (1987) writes about a case of a 16-year-old adolescent from a reform Jewish family who underwent a religious transformation to orthodoxy. The dramatic changes in her life, including long hours studying Jewish law, avoidance of friends, and sullenness at meals, led to her referral to a psychoanalyst. A mental status examination determined that she did not have a mental illness. The article goes on to discuss the impact of religious transformation on her self-image and relationships. The process of religious change challenged important areas of her stability. Spero notes, “to some degree the sense of historical dislocation represents a crisis for all nouveau-religionists” (Spero, 1987, 69).

Search for Spiritual Answers:

People in this situation may be searching for spiritual and religious answers to existential questions. They may be wrestling with the meaning of life, amid illness, including mental illness, and tragedy. Or, they can be attempting to change former patterns of behavior or thinking, and are searching for new possibilities. They might be trying to recover a sense of personal integration, or attempting to come to grips with the extent of their need for God. They may realize that their problems may never go away, but that God can be with them and with this connection to God, perhaps they can find support in dealing with these problems.

People in this group generally have a realistic perspective on their problems. They accept their illness, are rebuilding their lives and are willing to take responsibility for their behavior. For example, a woman with mental illness has started a Jewish spiritual support group for people who have a mental illness. It is called “Achraiyut” the Hebrew word which means “to take responsibility.” Although a spiritual connection is an essential element of the recovery process for many people, including those in this support group, it is only one component. People may also need the ongoing assistance of a mental health professional and/or program to continue their progress.

Some people may be searching for spiritual answers and meaning but may also be experiencing mental disorders, such as psychotic delusions or ritualistic behavior. They may have an exaggerated sense of guilt and are unable to accept forgiveness. They may have some strange religious ideas. They may also have other levels of concern. In this situation people may have more difficulty evaluating their concerns because of their mental illness which can lead to confusion and disordered thinking (Weisinger, 1991, 32). If people feel that their religious views are respected and valued by the mental health professional, this will keep lines of communication open. It is helpful when a mental health professional is able to coordinate care with the person’s faith leader. Faith leaders or other members of the individual’s faith community will not have difficulty recognizing religious delusions. The delusions will be strange and unusual, and are usually accompanied with other psychotic symptoms that help identify their true nature.


Koenig, Harold. Faith and Mental Health: Religious Resources for Healing, Templeton Foundation Press, 2005.

Spero, M. H. (1987) “Identity and Individuality in the Nouveau-Religious Patients: Theoretical and Clinical Aspects,” Psychiatry, 50, 55-71.

Weisinger, K. R. (Ed.) (1991) Manual for the faith leaders: Resources for Helping and Healing, Mental Health Association of Houston & Harris County, Houston, TX.

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