Between Over-Spiritualization and Over-Medicalization: Combatting Hermeneutic Injustice and Marginalization through Investigating Conceptual Frameworks for Mental Disorder in Religious Communities
Kate Finley, Hope College, Holland, MI
For many, spirituality and/or religion is central to how they understand and experience mental disorder—a significant disturbance in behavior, emotion regulation, or cognition that reflects dysfunction in mental processes and is often linked with substantial distress or disability. In the United States, individuals concerned about their mental health are more likely to seek support from spiritual or religious leaders than from mental health professionals, positioning these leaders as essential gatekeepers and frontline providers of mental health care. This is especially relevant given that the majority of people in the U.S. and worldwide identify as religious, spiritual, or both. While psychology and psychiatry are increasingly addressing this intersection, philosophical and theological inquiry remains limited, resulting in an underdeveloped understanding of the conceptual frameworks that (unconsciously) shape how individuals and communities reconcile their experiences of mental disorder with their spiritual or religious identity.
This scarcity of nuanced frameworks often leads to two problematic extremes: ‘over-spiritualization,’ where mental disorders are reduced to purely spiritual phenomena (e.g., “It’s not depression; it’s spiritual warfare”), or ‘under-spiritualization,’ where spiritual and religious meanings are dismissed outright. The former can exacerbate harm by amplifying feelings of guilt, blame, and isolation within religious communities. Conversely, under-spiritualization aligns with the broader cultural trend of ‘over-medicalization,’ which frames mental disorders primarily as biogenetic issues. Although this medical perspective has positive outcomes—such as reducing blame, decreasing some stigma, and advancing treatment—it can also foster a sense of helplessness among those affected and increase fear toward them. This approach often excludes the potential for finding spiritual or religious meaning, thus narrowing the scope for meaningful interpretation.
This gap contributes to a form of hermeneutic injustice and further marginalization of individuals, in which those who are spiritual or religious lack interpretive resources to understand or express important aspects of their experience of mental disorder - especially those which may enable them to derive spiritual or religious meaning out of the experiences (while avoiding over-spiritualization) - which can lead to confusion and further suffering. This is particularly detrimental for those whose beliefs and practices fundamentally shape their self-conception and worldview. The distress of mental disorder is often uniquely severe because it impacts capacities essential for making sense of oneself and the world. Meaning-making processes—along with their supporting narratives and conceptual frameworks—are increasingly recognized as crucial to how people cope with various forms of suffering, including mental disorder. Moreover, these frameworks do more than reflect or explain experiences; they can actively filter and shape them. Therefore, further work is needed to acknowledge, challenge, and expand these conceptual resources to support a balanced understanding that incorporates both biological and spiritual dimensions, while avoiding both over-spiritualization and over-medicalization.
I will draw on results from three past empirical studies of mine in which participants took part in in-depth interviews and questionnaires addressing their thoughts and experiences of mental disorder and religion (specifically Christianity, Islam, and Judaism). I will address themes that emerged in participants' understanding of the cause(s) and meaning of their mental disorder - highlighting the conceptual frameworks that seem to underlie them, including specific metaphors which often played a central role (e.g. computational vs. embodied metaphors). I will then draw on work from anthropology and cross-cultural psychiatry, as well as theology, to propose frameworks and conceptual resources which may help those experiencing (and/or treating) mental disorder to develop a deeper sense of coherence between the potentially biological, psychological, and spiritual dimensions of their experience as well as between different elements of their self-narrative which may have been undermined by their symptoms.
This scarcity of nuanced frameworks often leads to two problematic extremes: ‘over-spiritualization,’ where mental disorders are reduced to purely spiritual phenomena (e.g., “It’s not depression; it’s spiritual warfare”), or ‘under-spiritualization,’ where spiritual and religious meanings are dismissed outright. The former can exacerbate harm by amplifying feelings of guilt, blame, and isolation within religious communities. Conversely, under-spiritualization aligns with the broader cultural trend of ‘over-medicalization,’ which frames mental disorders primarily as biogenetic issues. Although this medical perspective has positive outcomes—such as reducing blame, decreasing some stigma, and advancing treatment—it can also foster a sense of helplessness among those affected and increase fear toward them. This approach often excludes the potential for finding spiritual or religious meaning, thus narrowing the scope for meaningful interpretation.
This gap contributes to a form of hermeneutic injustice and further marginalization of individuals, in which those who are spiritual or religious lack interpretive resources to understand or express important aspects of their experience of mental disorder - especially those which may enable them to derive spiritual or religious meaning out of the experiences (while avoiding over-spiritualization) - which can lead to confusion and further suffering. This is particularly detrimental for those whose beliefs and practices fundamentally shape their self-conception and worldview. The distress of mental disorder is often uniquely severe because it impacts capacities essential for making sense of oneself and the world. Meaning-making processes—along with their supporting narratives and conceptual frameworks—are increasingly recognized as crucial to how people cope with various forms of suffering, including mental disorder. Moreover, these frameworks do more than reflect or explain experiences; they can actively filter and shape them. Therefore, further work is needed to acknowledge, challenge, and expand these conceptual resources to support a balanced understanding that incorporates both biological and spiritual dimensions, while avoiding both over-spiritualization and over-medicalization.
I will draw on results from three past empirical studies of mine in which participants took part in in-depth interviews and questionnaires addressing their thoughts and experiences of mental disorder and religion (specifically Christianity, Islam, and Judaism). I will address themes that emerged in participants' understanding of the cause(s) and meaning of their mental disorder - highlighting the conceptual frameworks that seem to underlie them, including specific metaphors which often played a central role (e.g. computational vs. embodied metaphors). I will then draw on work from anthropology and cross-cultural psychiatry, as well as theology, to propose frameworks and conceptual resources which may help those experiencing (and/or treating) mental disorder to develop a deeper sense of coherence between the potentially biological, psychological, and spiritual dimensions of their experience as well as between different elements of their self-narrative which may have been undermined by their symptoms.