Some twenty years ago Professor Andrew Sims in his valedictory speech as President of the Royal College of Psychiatrists of the United Kingdom spoke of taboos in his own profession (which reflect, I suppose those of wider society, though in a heightened form):
The great taboo at the end of the start of this [the twentieth] century was sex, but it is now the last resort of the burnt out comedian. The unspeakable in the middle of the century was death, and now teaching about bereavement has come back into undergraduate medical education. What is unmentionable at the end of the century is personal experience of religious faith.
Because, many years ago, I had seen this passage quoted, I sought out Professor Andrew Sims as my fellow presenter in our joint seminar at Oxford on February 16 this year on “Psychiatry and the Soul”. It is interesting that he told me when we met and spoke before the Seminar, that he felt he could not say this to his colleagues at the beginning of his Presidency of the Royal College - but only at its end. At all events, here was an eminent Psychiatrist, the author of a standard text book of psychiatry, Symptoms in the Mind, which I found even some of my neighbouring psychiatrist friends in Melbourne had used. He is a person of unabashed religious belief, who had also published a book affirming his work as a believing psychiatrist, entitled (rhetorically) Is Faith Delusion?
I discovered also that he was an editor of a volume entitled Spirituality and Psychiatry, which explores the theme of the relationship of religion and psychiatry further. It is interesting that the title of the work is Spirituality and Psychiatry and not Religion and Psychiatry. That itself reflects the tentativeness even of this “Special Interest Group” within the Royal College about squarely identifying spirituality – with its fuzzy New Age end – with religion. At all events Professor Sims does not have any qualms about doing this.
The purpose of coming to Oxford and conducting a special seminar with him on “Psychiatry and the Soul” was simply, together with him, “to cut to the chase”. What does it mean to operate in psychiatry from the standpoint of traditional religious belief? Professor Sims began his talk by speaking of the troubled historical relationship between psychiatry and religion. First, there were the “reductionistic” prejudices of psychiatry, seeking to reduce psychiatry to physical phenomena of the brain. Then, when there emerged a realization that the human psyche is influenced by non-physical “mental” phenomena, there was still missing the vital dimension of soul and belief in the concept of the human psyche and practice of psychological healing. There was typically also a chasm between a largely non- or even anti-religious psychiatric fraternity, and the natural religiosity of so many of their patients.
Professor Sims noted a clear demarcation between the concerns of religion and psychiatry: religion has the task of the “cure of souls” while psychiatrists have the task “of treating psychological pain, and minimizing loss of the ability to function adequately”. At the same time it is important for psychiatry to have a working concept of the “soul”. Professor Sims in his talk went on to outline a psychiatric concept of the soul as (a) seeking meaning (b) possessing a sense of human solidarity and interrelatedness (c) as having to do with, and representing, the wholeness of the human being, and as in some sense “including” the other dimensions of the human personality, “body” and “mind”, (d) as having a moral dimension, in other words knowing what is good and bad, beautiful and ugly and (e) having an “awareness of G-d; [representing] the connection between G-d and man”.
The last feature, relating “the spiritual” to G-d is affirmed by Sims not simply because of his own traditional religious belief, but because “in my experience, that is how almost all patients use the word”. With this he distinguishes solid core human religiosity from mere spirituality, which in the words of Rabbi Jonathan Sacks whom he quotes, tends to be “escapist, shallow and self-indulgent”; and "Spirituality changes our mood, religion changes our life".
For those who do not want to take the objectivity of the soul on board, Professor Sims offers the overwhelming empirical findings of recent research that religious belief is correlated with improved mental health. That this news has not gotten out in a big way is probably to the residual anti-religious ideology which continues to overlay psychiatry, and indeed the thought and media of contemporary society. He quipped, “If the findings of the huge volume of research on this topic had gone in the opposite direction and it had been found that religion damages your mental health, it would have been front-page news in every newspaper in the land!”
Professor Sims advocates a “phenomenological” approach (elsewhere termed by Professor Sims a “descriptive psychopathology”), which he is able to marry with a genuine valuing of the spiritual life of the patient. Thus he cites a particular psychiatrist who encourages the patient to describe his or her belief world, and then “using his or her [the patient’s] own religious belief, to set up an internal argument to demonstrate that this pathological response was unnecessary, and false to what this person believed to be true”. This involves a certain virtuosity on the part of the therapist. Psychiatry is to take the beliefs – the healthy manifestation – of the beliefs of patient, and to help them the patient alsowith reference to his or her beliefs. Professor Sims himself offers a methodology, whereby the patient is invited to disclose his or her spiritual world and the way he or she would like to involve it in the therapy. Indeed Professor Sims concludes that there is a growing recognition of the integrality of the spiritual – let us frankly, call it religious - dimension to psychiatry; and this is measured simply in the growing membership of the “Special Interest Group” on “Spirituality and Psychiatry” in the Royal College of Psychiatrists. Whether, as believers we simply know that the spiritual is important, or for the sceptical we want to show that empirically it helps mental health, Professor Sims, in the final line of his talk, lays aside relativity: “Psychotherapy is incomplete if it ignores the soul.”
I shall describe my own contribution in much broader outline and less detail, and those who are interested will be able to follow its argument more closely in the video of the seminar which will in due course appear on the Oxford Chabad Society website. It was entitled “The human soul as an objective reality: historical agreements of religion and psychiatry”. Its task was, in terms of religious – and pre-eminently Chassidic thought – to set out the idea of the soul as that which “organizes” human identity in the fullest sense. Since I too wanted to claim objectivity for the human soul, perhaps more forcefully than Professor Sims, I also offered some “exercises” for the secularist to come to, or perceive, the idea (or the reality) of the soul. The next part of my paper showed how religious thought sets normative parameters – the ethical and spiritual parameters of the soul itself – for the different dimensions of the person: body, mind and soul. This is not simply a “phenomenological” and “descriptive” approach, which Professor Sims recommends based on the narrative of the patient. It is also universal normative “data” of the soul itself, drawn from religious tradition. These are normative parameters within which the empirical and practical science of psychiatry – acknowledging the objectivity of the soul - may (and if I may say so, should) wish to work.
The final part of my paper, which may be the most novel for readers or viewers, is the way in which two great religious figures, “Grand Rabbis” or “Rebbes” in the tradition of Lubavitch Chassidism within Judaism interacted with or related to two great figures in the history of psychiatry, Sigmund Freud and Viktor Frankl. In these remarkable connections, we see how psychiatry itself historically showed that it could align itself with requirements of religion, the soul.
This seminar is the first Sir Zelman Cowen Memorial International lecture, held in memory of my father of blessed memory, who was a Governor General of Australia from 1977 to 1982, after which he was Provost of Oriel College, Oxford, until 1990. I was invited by the Brackmans to address a Friday night Shabbat meal for the Oxford Chabad Society, on the topic of “A journey from the citadels of academia and government to Jewish tradition", in short my own “journey”, which had much to say also about my father.