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Atheist Psychiatrists and Good Medicine

Posted on September 3, 2007 in Agnosticism Depression Grief

square340A new study out of the University of Chicago reports that psychiatrists are likely to be the least religious type of doctor and that religious doctors, especially Protestants, are more likely to send a potentially ill patient to a clergyman or a religious counselor than to a psychiatrist.

The atheist world should be abuzz with concern and I, an agnostic, am one to join them. I have seen what religious counselling does to patients with mood disorders. I do not recommend them:

“A patient presents to you with continued deep grieving two months after the death of his wife. If you were to refer the patient, to which of the following would you prefer to refer first” (a psychiatrist or psychologist, a clergy member or religious counselor, a health care chaplain, or other).”

Overall, 56 percent of physicians indicated they would refer such a patient to a psychiatrist or psychologist, 25 percent to a clergy member or other religious counselor, 7 percent to a health care chaplain and 12 percent to someone else.

Although Protestant physicians were only half as likely to send the patient to a psychiatrist, Jewish physicians were more likely to do so. Least likely were highly religious Protestants who attended church at least twice a month and looked to God for guidance “a great deal or quite a lot.”

“Patients probably seek out, to some extent, physicians who share their views on life’s big questions,” Curlin said. That may be especially true in psychiatry, where communication is so essential. The mismatch in religious beliefs between psychiatrists and patients may make it difficult for patients suffering from emotional or personal problems to find physicians who share their fundamental belief systems.

Personally, I wonder about the doctors who avoid referring them: are they up to snuff on their medicine or are these backwoods GPs whose suspicions of modern medicine manifest in other ways in their practice? I have known people to give up their meds on the advice of a faith healer and consequently end up arrested after embarking on wild sprees. The problem is that many patients are looking for magical answers and when they are offered reality-based somatic therapy (replete with side effects) they balk.

Curlin seems to promote a model where the patient sets the therapy. While I do not believe in forced medication except where the patient is gravely impaired by her/his illness, I also feel that a wise patient works with the psychiatrist on a series of experiments designed to find an effective treatment for the illness. Religious talk therapy alone just does not work that well for severe depression and bipolar disorder. It’s practitioners are either woefully ignorant of what psychiatry can do or deliberately hostile lest they lose “souls” — translation: paying customers.

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