Physical Methods in Psychiatry and Spiritual Healing
On February 5th, 1954, the Spectator published an article by a distinguished psychiatrist on the physical treatment of mental illness. This article attracted a great deal of attention, and in the course of the ensuing correspondence a number of further questions in this field were raised. One of these questions is the relationship between physical methods of psychiatric treatment and some of the known techniques of spiritual healing. The writer of the article has therefore been invited by the Spectator to discuss this question. He will do so in two articles, the first of which is published this week.
WE have recently seen the convergence of varied forms of physical treatment of the mind, which can, among their other uses, change those tortured by feelings of guilt about past actions, the prey of endless moral scruples (and preoccupied. perhaps, day and night, with feelings of inadequacy in regard to their social and religious behaviour), into happy people again, able to practise their true religion and carry out their everyday social obligation in a much more normal way. Philosophical problems of a tremendous magnitude have been created, and I shall try to avoid most of these. I shall only take it as an assumption that no truly great religion in history has despised physical means to the attainment of spiritual grace – rather it has generally incorporated such means into its various disciplines. Fasting, exercises in breathing, the deliberate production of states of intense emotional and physiological excitement, and in more primitive religions the use of drugs, have all been put to religious uses to make people more amenable to the reception of better attitudes to life. or to fix more firmly in the mind certain basic truths imported by those in religious authority over them.
I want to examine first of all the physical aspects of some of these religious healing methods. For I believe that the Churches have lost much of their old power to change men’s lives because of their present neglect of the way in which Wesley, for instance, was able to change the face of a large part of England by the use of what I think were physiological as well as psychological aids to the attainment of spiritual grace. In some of the sudden and abrupt conversion phenomena produced, one may see, perhaps, a vital connecting link between our present physical methods of treatment in psychiatry and some of the really effective methods of mental healing which have been practised down the centuries by certain men of God.
My main qualification to speak on such matters lies in my own personal awareness of, and interest in, the possibilities of both the religious and the physical. approaches to the prevention and cure of psychiatric disorders, and the possible inter-relation of some of these. I witnessed in my own father the personal acquirement of a firm spiritual faith which enabled him to rise above business troubles which he would only have surmounted with great difficulty without this faith. I have seen what amounted to a conversion experience occur in one of my own brothers, which has left him years later perhaps the most level-headed and socially constructive member of my own family. He is working now as a bishop of one of the Churches of our Commonwealth. On my mother's side, many eminent preachers, and one President of the Methodist Conference, contributed to both my heredity and early upbringing. As a child I also met those who had been truly rescued by the old revival services from the depths of alcoholic despair and evil living, and given a new Christian faith that had kept them mentally stable and well for years after. In America, after the last war. I was therefore specially interested to study some of the religious revival methods. sometimes carried to that vast country from England and still practised there, though almost totally neglected now in this country by the very Churches which originally became so powerful because of their use. Their obvious power to help some of the mentally and spiritually ill should again make them specially important today to those who feel that their own present preaching methods are often achieving so very little.
My own professional life as a doctor, however, has been spent more in studying those physical and psychological methods of treatment which can often produce similar mental miracles, if they can be designated as such, while still continuing the search for common physical and psychological factors which I believe to be at work in many varied disciplines of mental healing. John Wesley himself speculated on such matters. He certainly often produced, consciously or unconsciously, older versions of psychological and physiological shock therapies to religious ends. He even commented on the part possibly played by physical factors in genuine spiritual conversion experiences. “How easy it is to suppose,” he wrote, “that strong, lively and sudden apprehension of the hideousness, of sin and the wrath of God and the bitter pains of eternal death should affect the body as well as the soul, suspending the present laws of vital union and interrupting or disturbing the ordinary circulation and putting nature out of its course.” Only one great religious leader has, in fact, discovered the secret of altering the face of England in a generation in the last three centuries. and this was John Wesley. We should therefore study afresh some of the forceful methods he employed. He often brought about physical effects by his preaching, which are now laughed at and scorned by his successors, but seem extremely pertinent in view of the recent successes of shock treatments in psychiatry. The eighteenth century has been called the Age of Reason, but paradoxically it needed Wesley, with his special techniques aimed at the emotions, to produce really dramatic changes in the outlook on life of so many of the ordinary people of Great Britain. I venture to predict that in this new era of attempted appeal to man’s religious reason rather than his emotions, it will again be only with a return to somewhat similar methods in modernised form that a true revival of the art of spiritual healing and conversion will occur. The real danger is that such methods can be so overwhelmingly powerful in their effects and that they can be used to assist the forces of evil as well as of good. For modern medical research is showing that alterations in a person's emotional and physiological state can, in fact, alter the whole functioning of mind and body, and also alter profoundly intellectual judgement and balance.
When I entered psychiatry, for instance, I was taught, among other theories, that schizophrenia or ‘split mind’ was a subconsciously motivated withdrawal from reality on the individual’s part because he wished to evade life’s problems. This attractive theoretical concept was very rudely shattered for me and many others when, after repeated periods of induced mental confusion and excitement leading on to deep unconsciousness, and brought about by a temporary lowering of the blood sugar with large doses of insulin. the individual might suddenly emerge from his fantasy world of delusion and horror, and seem very pleased indeed to be well again and to be able to set about the daily task of living. Of all the methods of treatment in use at the present time insulin coma treatment has now been shown to be perhaps the most effective way of obtaining the maximum number of remissions in early cases of schizophrenia. The time factor for treatment is also of supreme importance. While up to 70 per cent. of patients may be brought into remission in the first few weeks or months of the illness by insulin treatment, combined if necessary with electrical shock treatment, at the end of two years of continued illness the numbers of recoveries sink to a very much lower figure. These facts in regard to insulin are now reasonably well established and, therefore, a special burden is placed on all who use spiritual healing methods to recognise such illnesses and to help get them to hospital for insulin therapy as early as possible.
In schizophrenia, one sometimes comes very near to some of the ecstatic states reported by the saints of old. The individual may not only see the outside world through a distorting mirror, but becomes intensely preoccupied with his own internal feelings and thoughts. It is not strange, therefore, that some of the finest poetry, some of the eternal verities and some of the great contributions to art, science, religion and philosophy have been contributed by those who have had such illnesses, or in whom a few of the symptoms have been present without the full development of the disease. But to most ordinary sufferers, it may mean a life in which they seem finally at the mercy of apparently uncontrollable impulses or sinister influences from without or within themselves. Voices talk to them day or night, which may seem to be good or evil. God perhaps seems to be damning them, or the devil has taken them for his own. Much more rarely does a patient experience delusions and hallucination of a consistently pleasant type, so that happiness is achieved where it was absent before illness. Hell on earth is much too frequently their undeserved fate for up to thirty years or more.
Because of the commonness of symptoms of mental depression – including the sudden or gradual onset of guilt feelings, preoccupation with past sins, exaggerated feelings of unworthiness, mental rumination on worries in the past or possible disasters in the future-electric shock treatment is much more talked about by the public than is the insulin treatment of schizophrenia. I spent some years in psychiatry before the introduction of this treatment. One grimly remembers having to watch people, whose lives had been spent in helping others, who were the most conscientious of persons, whose good works were obvious to all who knew them. but who, nevertheless, had developed an attack of severe mental depression. They would start to torture themselves with remembrances of minor sins, and be filled with the most terrible forebodings about the future. Their suffering was often so unbearable that many attempted to destroy themselves after a time in full realisation that this might mean eternal damnation, which they now often felt they more than fully deserved. The cardinal feature of the illness – and many may have seen its occurrence in friends and relatives – is that it is completely unamenable to intellectual reasoning or spiritual Consolation. Whether the environment remains bad or good, the depressive ideas also persist. Now the introduction of electric shock therapy has meant that many such patients can be got well in as little as a month from the commencement of the treatment. The success of convulsion therapy in selected states of depression has led to its frequent and often unsuccessful use in other states of neurosis and psychosis.
Religion, like psychiatry, makes l similar mistakes in thinking that a method helpful to one special group can be applied too liberally to all and sundry. Why is it that an illness, in which ideas of guilt and past sins figure so largely, can now be so easily dispersed by a purely physical method of treatment, while proving so resistant to all other treatments provided by religion or psychotherapy; and why does the same treatment so often fail where anxiety rather than depression is more prominent in the total picture, and the sleep rhythm and mood show a different pattern of abnormality, even though some of the thought content may be similar? We are on very difficult philosophic ground here. We certainly do not yet know all the answers. John Wesley, however, sometimes produced what amounted to shock phenomena for the relief of spiritual depressions that had not reached the stage of melancholia, and there is no doubt that in the Southern States of America some revivalist methods can even produce physical shock and convulsive phenomena coming fairly near to what is achieved by passing an electrical current through the brain and producing a fit, which is the essence of the modern electric shock treatment of depression. While in the USA, I saw a patient who reported cure of two attacks of milder depression by such revival meetings, but who needed electrical shock treatment for a third more severe attack. Her faith was not destroyed because she knew that God had made this alternative method available to her.
(To be concluded in next week's Spectator)
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