Skip to main content Accessibility help
×
Home
Hostname: page-component-99c86f546-zzcdp Total loading time: 0.4 Render date: 2021-11-27T15:59:07.719Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "metricsAbstractViews": false, "figures": true, "newCiteModal": false, "newCitedByModal": true, "newEcommerce": true, "newUsageEvents": true }

Holistic psychiatry

Published online by Cambridge University Press:  02 January 2018

Christopher C. H. Cook
Affiliation:
Durham University, email: c.c.h.cook@durham.ac.uk
Rob Poole
Affiliation:
Mental Health, Glyndwr University, Wrexham
Robert Higgo
Affiliation:
Mersey Care NHS Trust, Liverpool
Rights & Permissions[Opens in a new window]

Abstract

Type
Columns
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
Copyright © Royal College of Psychiatrists, 2012

David Crossley's paper on the self and holistic care Reference Crossley1 is timely in the context of the heated debate over the place of spirituality and religion in clinical practice. In a commentary on this paper, one of us (C.C.H.C.) raised the difficult matter of challenging unhealthy spiritual/religious beliefs. Reference Cook2 In the course of making a point about the difficulties this entails, reference was made to a letter from a previously published correspondence between us, Reference Poole, Higgo, Strong, Kennedy, Ruben and Barnes3 suggesting that one possible response might be to argue that ‘matters such as religion and spirituality should be excluded from all clinical practice’. This gave the unfortunate impression that the authors of that letter had taken this position. We would collectively like to correct this.

We are agreed that it would be impossible to completely exclude consideration of religion and spirituality from all aspects of clinical practice. Psychopathology often has religious content, and it can be important to understand the role of religion and spirituality in an individual patient's life. We are agreed that it is sometimes appropriate to involve chaplains and other religious advisors in helping people who have mental health problems. We are agreed that psychiatry cannot offer total solutions to mental illness and human unhappiness, and that in practice psychiatry is the application of a flawed science in the context of shared (but sometimes contended) professional values.

However, there are important differences between us as to best practice, and as to the proper approach to spirituality and religion when working with patients. Our fundamental disagreement concerns the extent to which it is appropriate or possible for psychiatrists to offer holistic care to patients, spirituality and religion being one important aspect of this.

C.C.H.C. believes that spirituality should routinely be considered as an important aspect of clinical practice, even where the patient does not directly raise it for discussion, and that a spiritual dimension to treatment renders it more meaningful and possibly more effective. He recognises that this creates real and complex challenges with regard to professional boundaries. However, he believes that the special expertise offered by psychiatry is at its best when actively engaged with a holistic perspective and that it is in such engagement that it becomes more apparent that psychiatry does not have all the answers. In this way, boundary issues are highlighted and the ensuing debate offers opportunities to reduce confusion and clarify good practice. Reference Cook, Powell and Sims4

R.P. and R.H. believe that the concept of holistic care takes psychiatrists out of a domain where they have special expertise and that ‘holism’ undermines the important role of other agencies and individuals in helping people with mental illness by implying that psychiatrists have all the answers. Reference Poole and Higgo5 They believe that holistic care invites serious boundary breaches because it creates intrinsic confusion as to appropriate professional behaviour and the limitations of psychiatric expertise.

So far, this debate has been polarised and somewhat abstract. It would not be helpful to deny our differences, but we share an aspiration to understand the centre of gravity of professional and service user opinion on this matter by reference to tangible dilemmas in real-life practice.

Footnotes

Declaration of interest

C.C.H.C. is Chair of the Spirituality and Psychiatry Special Interest Group of the Royal College of Psychiatrists. The views expressed here are his own and do not necessarily represent those of the Group. He is Director of the Project for Spirituality, Theology and Health at Durham University, and is an Anglican priest. R.P. is an atheist. R.H. is a Buddhist.

References

1 Crossley, DR. Holistic psychiatry without the whole self. Psychiatrist 2012; 36: 97100.Google Scholar
2 Cook, CCH. Self-belief: holistic psychiatry in a secular age. Commentary on … Holistic psychiatry without the whole self. Psychiatrist 2012; 36: 101–3.Google Scholar
3 Poole, R, Higgo, R, Strong, G, Kennedy, G, Ruben, S, Barnes, R, et al. Religion, psychiatry and professional boundaries. Psychiatr Bull 2008; 32: 356–7.Google Scholar
4 Cook, C, Powell, A, Sims, A (esd) Spirituality and Psychiatry. RCPsych Publications, 2009.Google Scholar
5 Poole, R, Higgo, R. Clinical Skills in Psychiatric Treatment. Cambridge University Press, 2008.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.
You have Access
Open access

Send article to Kindle

To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Holistic psychiatry
Available formats
×

Send article to Dropbox

To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

Holistic psychiatry
Available formats
×

Send article to Google Drive

To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

Holistic psychiatry
Available formats
×
×

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *