Exploring the links between spirituality, mental health

For decades, religion and psychotherapy -- like oil and water -- did not mix.

Clinical psychologists kept spirituality and religion out of their practice, while some religious people looked askance at psychotherapy.

Not anymore.

Mental health professionals and religious workers are breaking out of their traditional ways to adopt holistic approaches -- looking to see what they can learn, unlearn and cull from one another to better serve people who come to them for help. Also evident is mutual respect.

At the third national conference on spirituality and mental health, sponsored by Pasadena-based Pacific Clinics last week in Burbank, 400 people in caring professions and ministries spent a day together to talk about the importance of spirituality and religion in mental health.

Speakers and attendees included psychotherapists, social workers and parish nurses, along with rabbis, Protestant pastors and Catholic nuns and priests.

“Personally, I look upon Jesus as the great healer of our souls and bodies, but I am delighted to see this connection now of psychotherapy and religion,” said the Rt. Rev. Alexei Smith, head of Interreligious and Ecumenical Affairs for the Roman Catholic Archdiocese of Los Angeles. “It’s wonderful.”

With two plenary speakers and 10 experts conducting separate sessions -- topics included the classical Buddhist technique of “mindfulness” and the emerging practice of “positive psychology” -- there was something for everyone.

But one theme ran through “Spirituality and Mental Health: New Horizons, New Directions”: People with solid spiritual foundations tend to be healthier and recover better when their lives turn for the worse.

“You never see this in textbooks,” said plenary speaker and psychologist William R. Miller. He cited substance abuse as one example. Apart from family history, spiritual or religious involvement is one of the most consistently documented “protective factors” guarding against substance abuse or dependence, he said.

Conversely, people entering treatment for drug addiction tend to show alienation from religion, low involvement in spiritual practices or unusually low rates of religious affiliation, he said. Miller is regarded as a pioneer researcher on the use of spirituality in substance abuse treatment and recently retired as a professor of psychology and psychiatry at the University of New Mexico.

In the context of the conference, spirituality was viewed broadly -- encompassing not only religions, belief in God or some other higher power, but also thoughts, feelings, experiences and actions related to a search for the sacred.

In one well-attended session, the Rev. Siang-Yang Tan, a professor of psychology at Fuller Theological Seminary in Pasadena, talked about spiritually oriented psychotherapy.

Whatever spiritual intervention that therapists might choose -- Scriptures, prayer or silence -- must be relevant to the disorder under treatment, said Tan, a clinical psychologist and senior pastor of First Evangelical Church in Glendale.

“We have to be careful, because religious and spiritual interventions can be misused or abused,” he said. “You have to use it carefully, ethically, professionally and gently.”

Even when a therapist and client come from the same religious background, one cannot assume anything. Suppose a Christian therapist has a charismatic client who wants to pray in tongues, a practice that makes that therapist feel uncomfortable, Tan said.

“The best thing is to refer the client to a Pentecostal counselor,” he said.

But Tan said all mental health professionals must be sensitive to spiritual and religious clients and that aspect of their lives.

He also spoke of the new movement called positive psychology, being developed by researchers at the University of Pennsylvania.

Its direction is toward the “positive sides of human experiences,” emphasizing virtues, character strengths and learning to be grateful, he said.

For example, its practitioners ask clients to keep a “gratitude journal” and list at least three things they are grateful for each day.

Although not a religious movement, it overlaps with many religious and spiritual experiences, he said, noting that the emphasis on the positive comes straight from a popular hymn, “Count Your Blessings, Name Them One by One.”

Regardless of their religious affiliation, or lack of it, therapists must be spiritually sensitive, because an overwhelming majority of Americans believe in God, Tan said.

Surveys show that more than 90% of Americans say they believe in God and about 80% describe themselves as Christians.

For the majority of religious people, he said, their religious and spiritual resources are important coping mechanisms.

A 2002 revised Code of Ethics of the American Psychological Assn. includes religion as an important human diversity factor, Tan said.

“For a long time, we’ve been talking about being sensitive to cultural issues,” he said. “But how can you be culturally sensitive without being religiously sensitive? In almost all cultures, religion is a big part of the culture.”

In another session, conducted by Bhante Chao Chu, abbot of the Rosemead Buddhist Monastery, the message was simple: Slow down, meditate, be mindful of each moment with each breath you take.

Slowing down one’s reactions doesn’t mean being sluggish or lazy, said the Sri Lanka-born monk. Rather, it means being fully aware of “this very moment.”

Calm and looking as if on the verge of breaking into a gentle smile, the saffron-robe-clad monk talked about the importance of breathing and walking as meditation techniques.

One of the best ways to meditate is walking, he said. He then proceeded to demonstrate by standing erect, clasping his hands behind him and taking a few steps very slowly.

“When we walk, we walk slowly, keep the head straight. It’s very important to keep the head straight,” Chu said. “Holding hands behind you helps you walk in balance.”

When you reach a barrier during your walk, stop and relax there for 10 to 20 seconds before changing course, he advised.

“The mind is not something we can show you, but [it is] easy to contaminate,” he said. “It takes a lot of time and energy to purify. It’s like water. We need to take care of our mind.”

Before his walking demonstration, Chu had led another exercise, directing members of the overflow audience to put one hand on their abdomen.

“The rising and falling of your abdomen -- focus on that,” he said, standing still and surveying the group.

During the five-minute segments of this mindfulness training, when all closed their eyes and focused on breathing, it seemed as though time had stopped. Five minutes seemed longer than 300 seconds.

And when the monk called out softly that the five minutes were up, the audience members opened their eyes slowly as if waking from a dream.

connie.kang@latimes.com