When Words Hurt. The Messages Judeo-Christian Faith Communities Give About Mental Suffering and How These Can Impact Acceptance of Mental Health Treatment  
Anne Emmerich, MD, Associate Director, Department of Psychiatry Center for Diversity, and Staff Psychiatrist, Division of Primary Care Psychiatry, Massachusetts General Hospital 

It can be argued that emotional pain hurts worse than physical pain. Depression and anxiety account for a large percentage of time lost from work and school and for time spent on disability status throughout the world. Despite the prevalence of these conditions, and the treatability of these conditions in many cases, the percentage of people who receive treatment remains small. For those with mental illness, and their loved ones, emotional pain can last for years. Traditional Judeo-Christian messages meant to console can sometimes instead make things worse. Many observant Christians and Jews avoid seeing a mental health clinician for fear it will be seen as a sign that their faith in God is not strong enough. Others have internalized messages that their mental pain is a punishment for sin or a cross they must bear.  Some seek treatment but stop taking their medication because of messages they get from their faith community that taking medication is a sign of lack of trust in God’s ability to cure. These messages can contribute to isolation and mental health stigma thus intensifying the individual’s emotional pain. Additionally, the tradition of mental health clinicians not revealing information about their own religious beliefs is often interpreted as meaning the clinician does not believe in God and this can cause additional mistrust and fear for some observant patients or for their support communities. This paper will explore the challenge of working with patients who struggle spiritually with the question of whether it is acceptable to receive treatment from a secular mental health clinician. A clinical case will be presented.