Hermeneutic Injustice, Metaphors & Spiritual Meaning-Making in Psychopathology
Kate Finley, Hope College, Holland, MI
For many, spirituality and/or religion is central to how they understand and experience mental disorder - in other words, a clinically significant disturbance(s) in an individual’s behavior, emotion regulation, or cognition, reflecting a dysfunction in the processes underlying mental functioning, which is often associated with significant disability or distress. For example, those in the US with concerns about their mental health are more likely to seek help from spiritual and/or religious leaders and clergy than from psychologists and psychiatrists combined - thus the former are often seen as ‘gatekeepers’ to mental health treatment and ‘frontline’ mental health care workers. This is unsurprising given that the majority of those in the US and globally identify as religious, spiritual, or both. While increased attention is being paid to this topic in psychology and psychiatry, there is a striking lack of work on it in philosophy and theology. One result of this has been less work on the underlying conceptual frameworks often (unconsciously) shaping how individuals and communities make sense of the relationship between experiences of mental disorder and their spiritual and/or religious identity.
Consequently, there are few nuanced conceptual frameworks available for making sense of mental disorder within a spiritual or religious worldview - and those available often either lead to ‘over-spiritualization’ (reducing them to merely spiritual phenomena e.g. ‘it’s not depression it’s spiritual warfare’) or ‘under-spiritualization’ (dismissing the possibility of spiritual and/religious meaning). Over-spiritualization in church communities often further harms those experiencing mental disorder - (e.g. increasing their sense of guilt, blame, and isolation from their religious community). On the other hand, under-spiritualization often goes hand-in-hand with a larger cultural shift towards ‘over-medicalization’ of mental disorder (according to which mental disorders are seen as primarily or solely biogenetic phenomena). While this shift towards medicalization and emphasis of the biological underpinnings of many instances of mental disorder has had some positive effects (e.g. decreased blame and some elements of stigma, treatment development) - it can also lead to an increased sense of helplessness in those who experience mental disorder, and increased fear towards them. Additionally, as mentioned above it often fuels outright dismissal of the possibility of spiritual and/or religious meaning in such experiences, thus flattening the potential for meaning-making.
This constitutes a kind of hermeneutic injustice, 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 especially the case for those who are deeply spiritual and/or religious as their religious beliefs, experiences, and practices profoundly shape how they understand themselves and the world; and is further compounded by the fact that suffering due to mental disorder is often uniquely distressing as it impacts capacities central to our ability to make sense of ourselves and the world. Meaning-making processes, and the narratives and conceptual frameworks that underpin them, are increasingly understood to play a crucial role in how people experience and deal with many kinds of suffering, including suffering as a result of mental disorder. Furthermore, while we most often think of these frameworks as merely reflecting, representing, or explaining an experience, in some instances, they may also filter and shape those experiences. Thus, more work acknowledging, challenging, and developing these conceptual resources is needed - especially that which can scaffold a more coherent understanding of the role of both biological and sometimes spiritual dimensions of experiences of mental disorder, while resisting 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.
Consequently, there are few nuanced conceptual frameworks available for making sense of mental disorder within a spiritual or religious worldview - and those available often either lead to ‘over-spiritualization’ (reducing them to merely spiritual phenomena e.g. ‘it’s not depression it’s spiritual warfare’) or ‘under-spiritualization’ (dismissing the possibility of spiritual and/religious meaning). Over-spiritualization in church communities often further harms those experiencing mental disorder - (e.g. increasing their sense of guilt, blame, and isolation from their religious community). On the other hand, under-spiritualization often goes hand-in-hand with a larger cultural shift towards ‘over-medicalization’ of mental disorder (according to which mental disorders are seen as primarily or solely biogenetic phenomena). While this shift towards medicalization and emphasis of the biological underpinnings of many instances of mental disorder has had some positive effects (e.g. decreased blame and some elements of stigma, treatment development) - it can also lead to an increased sense of helplessness in those who experience mental disorder, and increased fear towards them. Additionally, as mentioned above it often fuels outright dismissal of the possibility of spiritual and/or religious meaning in such experiences, thus flattening the potential for meaning-making.
This constitutes a kind of hermeneutic injustice, 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 especially the case for those who are deeply spiritual and/or religious as their religious beliefs, experiences, and practices profoundly shape how they understand themselves and the world; and is further compounded by the fact that suffering due to mental disorder is often uniquely distressing as it impacts capacities central to our ability to make sense of ourselves and the world. Meaning-making processes, and the narratives and conceptual frameworks that underpin them, are increasingly understood to play a crucial role in how people experience and deal with many kinds of suffering, including suffering as a result of mental disorder. Furthermore, while we most often think of these frameworks as merely reflecting, representing, or explaining an experience, in some instances, they may also filter and shape those experiences. Thus, more work acknowledging, challenging, and developing these conceptual resources is needed - especially that which can scaffold a more coherent understanding of the role of both biological and sometimes spiritual dimensions of experiences of mental disorder, while resisting 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.