1. Is there a specific religious factor in psychopathology?
Dr. Samuel Pfeifer
Is there a specific religious factor in psychopathology?
Aarhus 2003

2. Psychiatry Religion Psychiatry Religion Psychiatry Religion Psychiatry
Four models
Psychiatry
Religion
Psychiatry
Religion
Psychiatry
Religion
Psychiatry
Religion

3. Three examples of religious conflict
19-year old secretary, mother died when she was 15. A few weeks before our interview she had been raped. "Maybe others do feel God's presence. I don't. I have believed in him; I have read my Bible; I have prayed. I thought that he loved me and watched over me. But why didn't he hear my prayers at the bedside of my mom? Why didn't he see the anguish of my father? If there is a God, he must have been sleeping! I don't want to hear anything about God anymore. Faith is making me sick!"
A 19-year old secretary consulted me with major depression. At the age of 15, she had lost her godly mother, whom she had loved very much. A few weeks before our interview she had been raped. In her first consultation she says: "Maybe others do feel God's presence. I don't. I have believed in him; I have read my Bible; I have prayed. I thought that he loved me and watched over me. But why didn't he hear my prayers at the bedside of my mom? Why didn't he see the anguish of my father? If there is a God, he must have been sleeping! I don't want to hear anything about God anymore. Faith is making me sick!"
A 28-year old teacher suffering from a severe anxiety disorder and a pervasive lack of energy was forced to give up his job. His father was a successful manager, a man without time for his family and no interest in religion. His mother was a rather sensitive, warm woman. Whereas his brother and sister both were able to fulfil their parents' expectations, he was "a failure". In a time of intense crisis and anxiety during his college years he found Christ. But despite his hopes, the anxiety did not abate, rather it now expanded into the area of religion. "I see God as a huge menacing being, constantly observing all my activities and thoughts. There is no way I can hide from him. He demands devotion, holiness and being a testimony for him, but I feel like a bundle, all corded up, without arms and legs. Faith is making me sick!"
A 36-year old nurse told me about her life: Both her father and her mother had been alcoholics, and she was placed with a catholic farmer's family in the country. She was a difficult and stubborn girl, and she did not receive much love either. When she was 13, her foster-father started to abuse her sexually. Plagued by feelings of guilt after each incident, he pleaded with her to forgive him. Finally, after 2 years, the foster-mother found out, and under terrible cursing, chased her from the farm. She eventually made her life, but she told me: "I don't want to hear anything about religion anymore. These pious hypocrites have destroyed my life! Religion has made me sick!"

4. Example of religious conflict - 2
28-year old teacher suffering from a severe anxiety disorder and a pervasive lack of energy was forced to give up his job. Hard father, caring mother (both non-religious). He was perceived as "a failure".
In a time of intense crisis and anxiety during his college years he found Christ. But despite his hopes, the anxiety did not abate, rather it now expanded into the area of religion. "I see God as a huge menacing being, constantly observing all my activities and thoughts. There is no way I can hide from him. He demands devotion, holiness and being a testimony for him, but I feel like a bundle, all corded up, without arms and legs. Faith is making me sick!"
A 19-year old secretary consulted me with major depression. At the age of 15, she had lost her godly mother, whom she had loved very much. A few weeks before our interview she had been raped. In her first consultation she says: "Maybe others do feel God's presence. I don't. I have believed in him; I have read my Bible; I have prayed. I thought that he loved me and watched over me. But why didn't he hear my prayers at the bedside of my mom? Why didn't he see the anguish of my father? If there is a God, he must have been sleeping! I don't want to hear anything about God anymore. Faith is making me sick!"
A 28-year old teacher suffering from a severe anxiety disorder and a pervasive lack of energy was forced to give up his job. His father was a successful manager, a man without time for his family and no interest in religion. His mother was a rather sensitive, warm woman. Whereas his brother and sister both were able to fulfil their parents' expectations, he was "a failure". In a time of intense crisis and anxiety during his college years he found Christ. But despite his hopes, the anxiety did not abate, rather it now expanded into the area of religion. "I see God as a huge menacing being, constantly observing all my activities and thoughts. There is no way I can hide from him. He demands devotion, holiness and being a testimony for him, but I feel like a bundle, all corded up, without arms and legs. Faith is making me sick!"
A 36-year old nurse told me about her life: Both her father and her mother had been alcoholics, and she was placed with a catholic farmer's family in the country. She was a difficult and stubborn girl, and she did not receive much love either. When she was 13, her foster-father started to abuse her sexually. Plagued by feelings of guilt after each incident, he pleaded with her to forgive him. Finally, after 2 years, the foster-mother found out, and under terrible cursing, chased her from the farm. She eventually made her life, but she told me: "I don't want to hear anything about religion anymore. These pious hypocrites have destroyed my life! Religion has made me sick!"

5. Example of religious conflict - 3
36-year old nurse, parents both alcoholics; with 12 she was placed with a catholic farmer's family in the country. She was a difficult and stubborn girl, and she did not receive much love either.
When she was 13, her foster-father started to abuse her sexually. Plagued by feelings of guilt after each incident, he pleaded with her to forgive him. Finally, after 2 years, the foster-mother found out, and under terrible cursing, chased her from the farm. She eventually made her life, but she told me:
"I don't want to hear anything about religion anymore. These pious hypocrites have destroyed my life! Religion has made me sick!"
A 19-year old secretary consulted me with major depression. At the age of 15, she had lost her godly mother, whom she had loved very much. A few weeks before our interview she had been raped. In her first consultation she says: "Maybe others do feel God's presence. I don't. I have believed in him; I have read my Bible; I have prayed. I thought that he loved me and watched over me. But why didn't he hear my prayers at the bedside of my mom? Why didn't he see the anguish of my father? If there is a God, he must have been sleeping! I don't want to hear anything about God anymore. Faith is making me sick!"
A 28-year old teacher suffering from a severe anxiety disorder and a pervasive lack of energy was forced to give up his job. His father was a successful manager, a man without time for his family and no interest in religion. His mother was a rather sensitive, warm woman. Whereas his brother and sister both were able to fulfil their parents' expectations, he was "a failure". In a time of intense crisis and anxiety during his college years he found Christ. But despite his hopes, the anxiety did not abate, rather it now expanded into the area of religion. "I see God as a huge menacing being, constantly observing all my activities and thoughts. There is no way I can hide from him. He demands devotion, holiness and being a testimony for him, but I feel like a bundle, all corded up, without arms and legs. Faith is making me sick!"
A 36-year old nurse told me about her life: Both her father and her mother had been alcoholics, and she was placed with a catholic farmer's family in the country. She was a difficult and stubborn girl, and she did not receive much love either. When she was 13, her foster-father started to abuse her sexually. Plagued by feelings of guilt after each incident, he pleaded with her to forgive him. Finally, after 2 years, the foster-mother found out, and under terrible cursing, chased her from the farm. She eventually made her life, but she told me: "I don't want to hear anything about religion anymore. These pious hypocrites have destroyed my life! Religion has made me sick!"

6. What were the factors leading to the conclusion:
Discussion
What were the factors leading to the conclusion:
“Faith is making me sick!”
A 19-year old secretary consulted me with major depression. At the age of 15, she had lost her godly mother, whom she had loved very much. A few weeks before our interview she had been raped. In her first consultation she says: "Maybe others do feel God's presence. I don't. I have believed in him; I have read my Bible; I have prayed. I thought that he loved me and watched over me. But why didn't he hear my prayers at the bedside of my mom? Why didn't he see the anguish of my father? If there is a God, he must have been sleeping! I don't want to hear anything about God anymore. Faith is making me sick!"
A 28-year old teacher suffering from a severe anxiety disorder and a pervasive lack of energy was forced to give up his job. His father was a successful manager, a man without time for his family and no interest in religion. His mother was a rather sensitive, warm woman. Whereas his brother and sister both were able to fulfil their parents' expectations, he was "a failure". In a time of intense crisis and anxiety during his college years he found Christ. But despite his hopes, the anxiety did not abate, rather it now expanded into the area of religion. "I see God as a huge menacing being, constantly observing all my activities and thoughts. There is no way I can hide from him. He demands devotion, holiness and being a testimony for him, but I feel like a bundle, all corded up, without arms and legs. Faith is making me sick!"
A 36-year old nurse told me about her life: Both her father and her mother had been alcoholics, and she was placed with a catholic farmer's family in the country. She was a difficult and stubborn girl, and she did not receive much love either. When she was 13, her foster-father started to abuse her sexually. Plagued by feelings of guilt after each incident, he pleaded with her to forgive him. Finally, after 2 years, the foster-mother found out, and under terrible cursing, chased her from the farm. She eventually made her life, but she told me: "I don't want to hear anything about religion anymore. These pious hypocrites have destroyed my life! Religion has made me sick!"

7. Labels suggesting faith-induced pathology: “Toxic Faith”
“Adult Children of Evangelicals”
“Spiritual Abuse”
“Ecclesiogenic Neurosis”

8. Possibly problematic aspects
church doctrine ("Churches That Abuse”, Enroth): legalism, authoritarian leadership, manipulation, excessive discipline and spiritual intimidation
faith-related parental behavior: stifling aspects of "holiness”, threatening religious consequences for wrong (“sinful”) behavior, denial of cultural activities (dancing, cinema), “Separation from the world”.
dysfunctional forms of personal faith -- cognitive distortions of obedience to God, holiness, guilt and grace, obligations toward others.

9. Critique
Tendency of (mono-)causal models of psychopathology in the religious patient
Over-generalisation of the effects of faith on an individual’s personality
Neglecting the fact that the same dysfunctional processes can also occur in those who are not committed to religion.
Often theological teachings and personality problems are not clearly kept apart. The desire to blend distorted religious content, dysfunctional religious behavior and depression and anxiety into a singular typology of "religious addiction" seems problematic.

10. Causality trap Sloan, Adult Children of Evangelicals
describes problem situations, behaviors and verbal exchanges without any religious content as evidence for the ACE syndrome, just because they occurred in a Christian family.
It may well be that a "Christian father" develops a brain tumor and exhibits difficult and even violent behavior (notably without religious overtones) due to a frontal lobe syndrome.
But does this allow the conclusion of faith-induced pathology in an adult daughter?

11. Causality trap
It is questionable to link a family's dysfunctional style to their faith alone.
Some are dysfunctional despite their Christian creed;
Some have become Christians because they suffered from the consequences of their dysfunctionality
A third group may use their Christian beliefs and values in a dysfunctional way

12. "Ecclesiogenic Neurosis" (1955)
Dr. Eberhard Schaetzing, gynecologist in Berlin
As a professing Christian he often encountered patients who had a Christian background and who struggled with their sexual problems (masturbation, impotence, frigidity, homosexuality and sexual deviations) within the context of their Christian faith.
His conclusion: restrictive Christian sexual ethics caused the problems
e.g. premarital sex: “You are not allowed to do it before marriage, and you are required to do it, when you are married.

13. Selective focus?
Christian therapists who are exclusively working with Christian clients seem to be especially prone to infer specific faith-related causes for their problems, neglecting the fact that the same dysfunctional processes can also occur in those who are not committed to religion. Their models of causality are often created out of a selective group of patients combined with a selective focus in problem definition.

14. Diagnosis: A closer look
- How is psychopathology in religious patients assessed?
- What is the nature and the definition of "Neurosis"?
- What is known about the causes and the development of neurotic disorders in the general population, outside the religious community?
- How are negative effects of religion in neurotic patients explained?
- In what way and in which personalities do religious issues cause tension?
- How can religion be understood as an element in a multi-causal model of the etiology of neurotic disorders?

15. Value Bias
hard variables are value-neutral or reflect consensually held values (e.g. descriptive diagnosis following the ICD-10 or the DSM-IV)
soft or "intrapsychic" variables sometimes reflect an implicit value bias as to what constitutes mental health.
Example: A young woman who wants to wait till marriage before having sex -- is she unhealthily inhibited or guided by Biblical ethics, of strong character and therefore healthy? Or is this topic relevant to her depressive condition at all?
Assessment should follow the general guidelines of applied psychopathology without prematurely implicating underlying causes, religious or otherwise.

16. What is “neurosis”?
applied to a wide range of psychological problems, from short-time adjustment disorders to severe chronic depressive and anxiety disorders.
With the introduction of the DSM-III the term "neurosis" has been taken out of the diagnostic vocabulary of the American clinician (Bayer & Spitzer, 1985), although it has retained its importance in a psychodynamic approach towards mental health.
The development of a more operationalized and descriptive system has many advantages, but there is still a value in using the term "neurosis", albeit without its implicit causal meaning in the framework of orthodox psychoanalysis.

17. Causes of depression and anxiety
Heredity (genetics)
childhood adversity and life events (stressors) during the development of a person from childhood to adult life.
Vulnerability to depression and anxiety
first episode is usually following a stressful life event.

18. Causes of depression Current life conditions STRESS childhood
stressful life events
Current life conditions
Causes of depression
Thinking
Belief systems
Basic assumptions
STRESS
BRAIN
heredity
Body functions
vegetative symptoms

19. Depression
„When I feel down, I have the impression that God has abandoned me. I do not feel his presence and cannot believe he is loving me any more. But I long for him and for his intervention in my difficult situation.”
(a 45 year old woman with severe depression)
What are the parallels in non-religious individuals?

20. Is depression more common in religous individuals?
The available data and clinical experience do not allow for the assumption that neurotic disorders (depression, anxiety, OCD etc.) are more common in any subcultural group, including religious subgroups.
However, it might be that more melancholic and highly sensitive individuals tend more towards religion as it answers basic questions of life
Jesus has called the weary and the burdened: “Come unto me, all ye that labour and are heavy laden, and I will give you rest” (Matthew 11:28)

21. Depression and religious life
Depression overshadows not only life in general, but also religious life, which is of special significance to the religious person. Depression is experienced as
Loss of faith and rejection by God.
Punishment for perceived sins / misdeeds
Darkening of spiritual life
For the religious patient, this subjective experience of abandonment by God weighs heavier than all other depression-related deficits and losses.
Recovery from depression includes religious life
Die Depression überschattet nicht nur das Leben allgemein, sondern auch das Glaubensleben, das für den religiösen Menschen von besonderer Bedeutung ist.
Von vielen Betroffenen wird dies als Glaubensverlust erlebt, als Verdunkelung des Lichtes, das sonst das Leben erhellte, als Versiegen der Lebensenergie, die über natürliche Ressourcen hinausging, als Rückzug Gottes aus der bisherigen Erfahrung des Getragen- und Geführt-Werdens. Diese subjektiv empfundene Gottverlassenheit wiegt für den religiösen Menschen oft schwerer als alle interpersonellen Defizite und Verluste.
Beipiel:
Dennoch ziehen manche Therapeuten den Schluß: Weil ein Mensch in einem christlichen Elternhaus aufgewachsen ist, darum ist er seelisch erkrankt. Weil er die Regeln und die Enge seiner Gemeinde nicht tragen konnte, darum leidet er an Ängsten und Hemmungen. Diesem vereinfachten "Weil-Darum"-Denken von Betroffenen und Therapeuten muß ich aus der klinischen Erfahrung deutlich widersprechen.
Als Beispiel möchte ich das Erleben einer Frau aus jüdisch-orthodoxer Tradition anführen. In einer Zeit der Depression empfand sie die vielen Regeln zur Einhaltung der Speisegebote und des Sabbaths als zunehmende Belastung. Es wäre einfach gewesen zu sagen: "Werfen Sie doch alle ihre Gesetze über Bord und leben sie ein befreites Leben! Ihre Probleme kommen von der Gesetzlichkeit der jüdischen Lehre!" Doch als sie sich wieder erholt hatte, sagte sie mir: "Jetzt kann ich mich wieder auf das Laubhüttenfest freuen. Ich habe wieder die Kraft, alle Vorbereitungen zu treffen. Ich freue mich auf die Gäste, die mit uns feiern werden und darauf, meinen Kindern etwas von der Schönheit und Freude unseres jüdischen Glaubens weiterzugeben." In ihrem Fall war es also nicht die Gesetzlichkeit, sondern die Erschöpfung in der Depression, die ihr das Einhalten der Gesetze zur Bürde machte.

22. Anxiety Disorders / Neurotic Disorders
Anxiety leads to conflict-prone functioning
Conflicts between EGO, ID, and SUPER-EGO
Super-Ego (Ideal Ego) can be formed in a negative way by religion. Anxiety is the driving force.
Anxious conflicts with persons of authority (parents, teachers, priest, rabbi etc.)
Moral conflict enhanced through religion.
Compulsions and rituals can be superimposed by religious content and motivation.

23. Explaining negative findings
Neurotic patients tend to be more anxious, conflict-prone, and scrupulous, and less able to tolerate ambiguity
more struggles with issues of meaning.
Limiting aspects of religion (moral directions and prohibitions) as well as difficult passages of the Bible are experienced as a factor increasing inner conflict in the search of meaning.
Patients suffering from minor neurotic symptoms (personality problems) seem to struggle more with religious faith, some of them indicating a negative impact on their well-being.

24. Social support through religion
Patients with severe neurotic syndromes such as chronic anxiety syndromes or long-standing depression seem to find support and understanding through their faith.
although they are often handicapped in their desire to actively take part in religious activities.
"Our study confirmed the observation made in individual counseling and psychotherapy, that neurosis disturbs religious life, whereas positive religiosity contributes towards healing.” (Hark 1984)

25. Assessment a) Psychopathology and severity of disorder
b) Life events and coping abilities; stress and strain in general
c) Personal religious life of the client (extrinsic and intrinsic factors)
d) Social support associated with religious factors (e.g. church attendance, counseling opportunities)
e) Problematic aspects of the patient's Christian subculture (e.g. special teachings of the church, high social control)
f) Interpersonal relations with religious people (often patients do not make a clear distinction between the personal religiosity of a person and his or her behavior that is not necessarily linked with religion)
g) Intrapsychic attributional style and belief systems.
A 19-year old secretary consulted me with major depression. At the age of 15, she had lost her godly mother, whom she had loved very much. A few weeks before our interview she had been raped. In her first consultation she says: "Maybe others do feel God's presence. I don't. I have believed in him; I have read my Bible; I have prayed. I thought that he loved me and watched over me. But why didn't he hear my prayers at the bedside of my mom? Why didn't he see the anguish of my father? If there is a God, he must have been sleeping! I don't want to hear anything about God anymore. Faith is making me sick!"
A 28-year old teacher suffering from a severe anxiety disorder and a pervasive lack of energy was forced to give up his job. His father was a successful manager, a man without time for his family and no interest in religion. His mother was a rather sensitive, warm woman. Whereas his brother and sister both were able to fulfil their parents' expectations, he was "a failure". In a time of intense crisis and anxiety during his college years he found Christ. But despite his hopes, the anxiety did not abate, rather it now expanded into the area of religion. "I see God as a huge menacing being, constantly observing all my activities and thoughts. There is no way I can hide from him. He demands devotion, holiness and being a testimony for him, but I feel like a bundle, all corded up, without arms and legs. Faith is making me sick!"
A 36-year old nurse told me about her life: Both her father and her mother had been alcoholics, and she was placed with a catholic farmer's family in the country. She was a difficult and stubborn girl, and she did not receive much love either. When she was 13, her foster-father started to abuse her sexually. Plagued by feelings of guilt after each incident, he pleaded with her to forgive him. Finally, after 2 years, the foster-mother found out, and under terrible cursing, chased her from the farm. She eventually made her life, but she told me: "I don't want to hear anything about religion anymore. These pious hypocrites have destroyed my life! Religion has made me sick!"

26. Results of our own study
1) No significant correlation between religiosity and neuroticism, neither in the patient nor in the control group.
2) General life satisfaction is negatively correlated with neuroticism but positively with religiosity in the patient group. Religion as important factor in coping with depression and anxiety.
3) Anxiety concerning sexuality, super-ego conflicts (conscience) and childhood religious teaching is primarily associated with neuroticism and not with religiosity.
4) Religious individuals (control group) showed a very critical stance against psychotherapy. However, in the patient group this critical view was reduced, probably as patients had positive experiences with the supportive aspects of therapy.
Pfeifer S. & Waelty U. (1999): Anxiety, depression and religiosity – a controlled study. Mental Health, Religion & Culture 2:35-45.

27. Differences between groups
Individuals who are not struggling with the existential suffering of depression and anxiety, tend to experience religion in a different and potentially more conflictuous way.
Mentally healthy younger subjects (mostly students) experience the conflict between religious values and cultural limitations in opposition to their personal wishes, needs and drives, and they often tend to blame their inner conflicts on those limitations that might be represented by religious parents or authorities.
Patients with mental and physical illness derive comfort, meaning and hope from religion, helping them to cope with their limitations.
One of the suprising findings was the marked difference between the patient group and the clinically healthy control group in correlations concerning some key questions (Table 4). We interpreted this as an indication for different ways of causal attributions, values and conflict resolution in the area of religion, depending on the severity of psychological suffering. Individuals who are not struggling with the existential suffering of depression and anxiety, tend to experience religion in a different and potentially more conflictuous way. Gartner et al (1990) had already pointed out the difference between healthy subjects (e.g. students) filling out paper-and-pencil tests on theoretical constructs and "real life" patients with marked pathology that could be reliably observed and measured. Healthy subjects tend to experience the conflict between religious values and cultural limitations in opposition to their personal wishes, needs and drives, and they often tend to blame their inner conflicts on those limitations that might be represented by religious parents or authorities. In contrast, patients with mental and physical illness derive comfort, meaning and hope from religion, helping them to cope with their limitations (Koenig et al., 1992), resulting in a negative correlation between religiosity and psychopathology (Stark, 1971).

28. Areas of tension Inner Experience External Framework I D E A L S Needs
External or internalized, general, familial or religious ideals
Needs
Drives
Emotions
(Sub)cultural rules und limitations
R E A L I T Y
General life situation
Social network
Physical/emotional constitution
External Framework

29. Seven sources of conflict
1. General tendency towards conflictuous functioning
2. Conflicts involving family loyalty vs. perceived trauma or injustice
3. Conflicts between ideals and reality
4. A basic tendency toward increased anxiety
5. Feelings of guilt as part of the human condition
6. Dependence on God vs. taking personal responsibility
7. Human legalism vs. Christian freedom

30. Conclusions
Studies do not support a correlation of neuroticism and faith.
Religious belief systems can “serve as vehicle for the expression of neurotic tendencies and needs.” (Meissner, 1991).
It is not faith or the church in general that causes psychopathology but the way in which a person deals with the teachings of his or her church or religion.
Not all psychopathology observed in a religious individual, even if presented in religious vocabulary or ritual, is faith-induced or "ecclesiogenic". Feelings of guilt, for example, seem to be a ubiquitous phenomenon in religious and non-religious individuals suffering from major depression.
Man könnte also sagen, die Religiosität sei eine inhaltliche Ausprägung eines grundlegenden neurotischen Prozesses, religiöser Inhalt eines pathodynamischen Gefäßes. Es wäre daher sinnvoll, den kausalen Begriff der "Ekklesiogenen Neurose" durch den Begriff "Ekklesiomorphe Neurose" zu ersetzen. Damit wird die Beziehung zwischen Religiosität von Neurose ausgedrückt, aber in einen breiteren Kontext gestellt. Der religiöse Konflikt ist nur eine Sonderform der allgemeinen neurotischen Konfliktsituation des einzelnen zwischen seinem inneren Erleben und der äußeren Welt
„Consideration should be given to how patients use their religious belief systems as a vehicle for the expression of neurotic needs and conflicts, in particular to identify patterns of symptomatic and characterological expression with their particular religious phenomenology“
Meissner W.W. (1991). The phenomenology of religious psychopathology. Bulletin of the Menninger Clinic 55:281–298.

31. Conclusions
Even churches that would be regarded as narrow or dysfunctional by average standards, do not necessarily produce psychopathology in their followers.
Rather, a tight belief system and forms of communitarian control can have a stabilizing effect as long as they are not challenged by conflicting drives, needs or experiences of the individual. It is at this point that the emotional stability of a person is subjected to the test of his or her conflict resolution potential.
Individual freedom may cause a person to rebel against church teaching and to leave a group.
Man könnte also sagen, die Religiosität sei eine inhaltliche Ausprägung eines grundlegenden neurotischen Prozesses, religiöser Inhalt eines pathodynamischen Gefäßes. Es wäre daher sinnvoll, den kausalen Begriff der "Ekklesiogenen Neurose" durch den Begriff "Ekklesiomorphe Neurose" zu ersetzen. Damit wird die Beziehung zwischen Religiosität von Neurose ausgedrückt, aber in einen breiteren Kontext gestellt. Der religiöse Konflikt ist nur eine Sonderform der allgemeinen neurotischen Konfliktsituation des einzelnen zwischen seinem inneren Erleben und der äußeren Welt
„Consideration should be given to how patients use their religious belief systems as a vehicle for the expression of neurotic needs and conflicts, in particular to identify patterns of symptomatic and characterological expression with their particular religious phenomenology“

32. „Ecclesiomorphous Neurosis“
Psychopathology may be forming, deforming and inhibiting a healthy development of religiosity.
It would, therefore seem more justified to call religious psychopathology "ecclesiomorphous" than "ecclesiogenic".
Faith or church teachings may shape the problems of an individual, but not as the only factor.
Narrow religiosity may be detrimental for the highly sensitive, causing distorted images of God and conflictuous interpersonal relationships.
Strong personalities will either adjust to the system or break up, looking for a different style of religion that fits them better.

33. Implications for counseling
Interpretative disentanglement: "to separate the intrapsychic conflict from its 'religious' defense system." (Moshe H. Spero)
As religious patients often suspect the therapist to devalue or even attack their faith, this will strengthen the therapeutic alliance.
Differentiate: functional and dysfunctional attributions within the religious framework of the client (Spilka, 1989).
Religion is assumed to be functional, if it meets the client's needs of meaning, control, and esteem.

34. Download this presentation from
Man könnte also sagen, die Religiosität sei eine inhaltliche Ausprägung eines grundlegenden neurotischen Prozesses, religiöser Inhalt eines pathodynamischen Gefäßes. Es wäre daher sinnvoll, den kausalen Begriff der "Ekklesiogenen Neurose" durch den Begriff "Ekklesiomorphe Neurose" zu ersetzen. Damit wird die Beziehung zwischen Religiosität von Neurose ausgedrückt, aber in einen breiteren Kontext gestellt. Der religiöse Konflikt ist nur eine Sonderform der allgemeinen neurotischen Konfliktsituation des einzelnen zwischen seinem inneren Erleben und der äußeren Welt
„Consideration should be given to how patients use their religious belief systems as a vehicle for the expression of neurotic needs and conflicts, in particular to identify patterns of symptomatic and characterological expression with their particular religious phenomenology“