Schizophrenia And Religion: A Brief History

For some people with schizophrenia, a disorder that can impact a person’s perception of reality and ability to function in daily life, religious beliefs may be helpful. Religion can help some individuals cope with their mental illness, potentially instilling a sense of hope and purpose. For others, religious beliefs may be detrimental, instilling troubling feelings and possibly worsening symptoms. Religious delusions tend to present with "more conviction and pervasiveness than other delusions," and environmental factors are believed to play a role in psychotic symptoms with religious themes, which usually reflect one's religious affiliation. Regardless of whether schizophrenia symptoms have religious themes, they can often be effectively treated with a combination of doctor-prescribed medication and regular therapy sessions.

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Schizophrenia and religion throughout history

The concept of schizophrenia as a disorder is relatively new. The disorder was introduced by Emil Kraepelin, who lived from 1856 to 1926 and sought to integrate various clinical features into a single unit named “dementia praecox.” Later, Eugen Bleuler, a Swiss psychiatrist who was born in 1857 and died in 1939, expanded and modified Kraepelin's original concept by claiming that it "did not evolve into the kind of 'terminal state' of deterioration," thus eliminating the classification of dementia from the diagnosis. 

Naming the disorder “schizophrenia,” which meant “splitting of the mind,” Bleuler noted that schizophrenia appeared to be a group of diseases rather than a single entity. This notion may more closely reflect the contemporary understanding of schizophrenia as a spectrum disorder. Historically, schizophrenia tended to be poorly understood and was often conflated with a general concept of "madness." Schizophrenia was also frequently associated with themes of demonic possession, evil spirits, and other religious concepts. 

Religious content in delusions and hallucinations

Religious faith in individuals with schizophrenia

Studies comparing religious practices in those with schizophrenia versus the general population often indicate that religious involvement tends to be higher among those with schizophrenia, although updated evidence may be needed. The same study found that "helpful religion was associated with better social, clinical and psychological status," whereas harmful aspects of religion "sometimes conflicted with psychiatric treatment." Another older study suggested that religion could have a positive impact on the quality of life of older adults with schizophrenia. 

Religion as a positive and negative coping skill

Religious practices in those with schizophrenia can be linked with social integration and better quality of life. Some studies suggest that positive religious coping may help people live with mental illness. However, findings can be contradictory. Positive coping strategies associated with religion can include religious purification, forgiveness, support seeking, collaborative religious coping, and a sense of spiritual connection. Meanwhile, negative strategies may involve demonic reappraisal, passive deference, and interpersonal religious discontent. 

Negative religious coping, which often involves a strong sense of guilt and beliefs about being a sinner, can be associated with a lower quality of life and higher distress levels, as well as substance use and potential suicide attempts. On the other hand, positive religious coping may reduce the risk of suicide attempts. Some studies suggest that individuals with schizophrenia may receive less support from religious communities, however.

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Some studies suggest that individuals with schizophrenia may receive less support from religious communities, however.

Religious themes in delusions and hallucinations

Delusions of possession are usually considered a subcategory of religious delusions in psychosis. A qualitative study involving four cases noted that the idea of evil spirits influencing humans may be prevalent in many cultures and could be used to explain various symptoms and experiences.

Moreover, the notion of evil spirits may also be present in psychotic delusions of possession. Researchers suggest that the content of psychotic symptoms appears to be connected to traumatic experiences. The study further noted that "beliefs in possession were induced or strengthened by family, clergy or media, and delayed diagnostic assessment and treatment."

The impact of environmental factors on hallucinations and delusions

Positive symptoms in schizophrenia generally refer to symptoms that distort one's perception of reality, including delusions and hallucinations. According to the glossary in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-V), a delusion can be defined as “a false belief based on incorrect inference about external reality that is firmly held despite what almost everyone else believes and despite what constitutes incontrovertible and obvious proof or evidence to the contrary. The belief is not ordinarily accepted by other members of the person's culture or subculture.” 

What mental health research says about religious delusions

Research has investigated the risk of religious activity influencing religious delusions in schizophrenia and schizoaffective disorder. The research suggests that one's cultural and societal environment and genetics may play a role in the prevalence of religious delusions. Moreover, he study notes that the risk of experiencing religious delusions is likely related to religious affiliation. 

One review of case histories of patients with paranoid schizophrenia suggested that the religious content of hallucinations may vary according to cultural and societal changes, although updated research may be needed. The review examined 100 case histories from 1932 to 1992 and found that religious themes largely shifted over the years. While religious content was present in nearly half of the reviewed cases, there seemed to be a progressive decrease in the number of religious topics. Moreover, apocalyptic themes generally became more prevalent in hallucinations and delusions after World War II, possibly reflecting what was happening in the world at the time. 

Religious beliefs, religious faith, and religious coping

An older study noted that religion could be important for many people with schizophrenia. However, it also suggested that the content of delusions and hallucinations may not always reflect religious beliefs. The study indicated that the discrepancy of belief systems between secular clinicians and those who hold religious beliefs may lead the latter to refrain from discussing religion, possibly due to a fear of beliefs being pathologized. Another study also suggested that the majority of those with schizophrenia held religious beliefs. The study found that "higher level of religiosity and more frequent use of religious coping" may positively influence an individual’s quality of life and can be associated with lower levels of psychopathology.

Seeking support for outpatients with schizophrenia symptoms

If religion is important to you, it may be helpful to work with a therapist who respects your religious beliefs while using evidence-based approaches to foster mental health. For many people, in-person therapy may not be convenient. An online platform like BetterHelp may enable you to connect with a licensed therapist who shares your beliefs and can offer sessions via phone, video, or online chat. 

A 2022 systematic review and meta-analysis of randomized controlled trials examined the effectiveness of telehealth versus face-to-face therapy for less common mental health disorders. The research indicated "no significant differences immediately after treatment between telehealth and face-to-face care delivery," suggesting that online and in-person therapy can be equally effective.