Schizophrenia affects thousands of people worldwide. When examining the behavior and treatment options for individuals with schizophrenia all three areas of the person must be addressed: body, mind, and spirit. There are also cultural sensitivities when dealing with schizophrenics and their families. This paper will examine the nature of schizophrenia, cultural and religious perspectives regarding schizophrenia, and the relationship between schizophrenia and demon possession.
Description of Sympotomology
Before examining the cultural and religious issues involved in treating individuals with schizophrenia it is important to understand the illness itself. The first symptoms of schizophrenia occur in late adolescence to young adulthood (Roukema, 1997, p.55). The most recognizable symptoms include hallucinations, delusions, reduced emotional expressiveness, and problems in social functioning including self-care skills, interpersonal relationships, and work (Mueser & Gingerich, 1994, p.9). Symptoms of schizophrenia are divided into two categories, positive and negative. Positive symptoms are behaviors that are added to the individuals' normal functioning such as disturbance in thought and perceptual disturbance (Cromwell & Snyder, 1993, p.32). Hallucinations and delusions are classified as positive symptoms. Negative symptoms are behaviors that take away from a person's normal functioning. These symptoms include apathy, alogia (poverty of speech), social avoidance, and diminished facial expressions (Dassori, Miller, Velligan, Saldana, Diamond, & Mahurin, 1998).
Etiology of Schizophrenia
The majority of studies show that there is a biological link to schizophrenia, but the nature of this is not clear. An abnormal abundance of dopamine in specific areas of the brain may cause schizophrenia. An enlarged third ventricle of the brain may also cause schizophrenia (Cromwell & Snyder, 1993, p.32). There is a biological link to schizophrenia and researchers and scientists are working to find a conclusive answer.
Hallucinations and Delusions
Hallucinations and delusions are symptoms of schizophrenia that result in hospitalization and/or medication. It is not always easy to distinguish between them. Hallucinations occur when there are sensory deceptions. These include any false perceptions about touch, sound, taste, sight or hearing. Delusions are cognitive deceptions. This occurs when there are false beliefs about themselves or anything around them (Welch, 1991, p.253).
Hallucinations are fairly common among the general population. A survey in 1992 revealed that ten to fifteen percent of the U.S. population has experienced at least one hallucination in their lifetime (Kingdon, & Turkington, 1994, p.75). The hallucinations could be the result of a variety of factors, such as high fevers or drug abuse and not necessarily the symptom of a mental illness. The most common hallucinations in individuals with schizophrenia are auditory discrepancies (Mueser & Gingerich, 1994, p.32).
Delusions are less frequent among the general population. Delusions occur when schizophrenics hold false beliefs about themselves or others. There are four categories of delusions: grandiose, persecutory, somatic, or religious in nature (Cromwell & Snyder, 1993, p.32). In grandiose delusions the individual believes that he or she is someone special, rich, or famous. Persecutory delusions occur when the person is paranoid that someone will harm him or her in some way for no realistic reason (Mueser & Gingerich, 1994, pp.34-33). Somatic delusions occur when schizophrenics believe that parts of their bodies are not attached together or that they are outside of their bodies. Any delusion referring to the spirit world is considered to be a religious delusion. They are normally combined with the other types of delusions. A person may believe that they are Jesus Christ and this would be a grandiose and religious delusion. A person that believes he or she is being tormented by angels would be having a persecutory and religious delusion.
A study conducted in 1999 compared delusions among schizophrenics in Austria and Pakistan. This study found that persecution was the most frequent kind of delusion in both groups. Delusions of religious nature were more common among Austrian patients than among Pakistani patients (Stompe, Friedman, Ortwein, Strobl, Chaudhry, Najam, & Chaudhry, 1999). Another study compared the delusions of Japanese and German patients with schizophrenia. It revealed that delusions of sin and guilt were more common among German patients (Tateyama, Asai, Kamisada, Hashimoto, Bartels, & Heimann, 1993). These studies show that in countries where Christianity predominates there is a greater proportion of religious delusions. Another study conducted in the United Kingdom found that hospitalized schizophrenic patients with religious delusions were more difficult to treat and more severely ill than other schizophrenic patients (Siddle, Haddock, Tarrier, & Faragher, 2002).
Medical Treatments for Schizophrenia
Schizophrenia is a debilitating condition that requires treatment for the individual to function in society. There are many treatments for schizophrenia including medication, psychotherapy, and folk remedies. Medications prescribed by medical doctors are effective in reducing some schizophrenic symptoms. Prior to the 1950's there was no medication for individuals with schizophrenia. Antipsychotic medications are now the main treatment for this disorder (Mueser & Gingerich, 1994, p.47). The first antipsychotic medication used for treating schizophrenia was chlorpromazine, and it is still effectively used today (Whybrow, 1997, p.207). It is important to note that medication helps to relieve symptoms and prevent relapse. It does not "cure" schizophrenia (Mueser & Gingerich, 1994, p.).
Psychotherapy for Schizophrenia
There are many treatment options available for individuals with schizophrenia. The most effective treatments of schizophrenia include three areas: reducing biological vulnerability, reducing environmental stress, and improving coping skills (Mueser & Gingerich, 1994, p.23). All of these areas should be addressed in psychotherapy for successful treatment to take place.
Family therapy is an effective treatmentFamily therapy is an effective treatment that combines all three areas. It has been successful in reducing environmental stress among schizophrenic individuals. Schizophrenic patients discharged from the hospital have a more successful recovery when their families demonstrate positive emotional attributes and high levels of approval, sympathy, and emotional involvement (Lopez, Hipke, Polo, Jenkins, Karno, Vaughn, & Snyder, 2004). This therapy helps the family work through emotional issues ranging from resentment and hostility to hopelessness and sense of loss.
Folk Treatments for Schizophrenia
There are many folk treatments for schizophrenia used all over the world. A study conducted comparing Fillipino and Caucausian Americans' college students beliefs concerning the causes of mental illness showed that Fillipinos assigned more significance to supernatural or spiritual causes, whereas, Caucasuians assigned more significance to physical causes. The Fillipino culture says that psychological problems are caused by spirits, hot/cold imbalances, or a "weak soul." Many Fillipinos seek spiritualistic and shamanistic treatments for mental illnesses (Edman & Johnson, 1999). People suffering from a mental illness in some of these countries will go to the spiritual healer in their community. Exorcists are valued in these cultures for their ability to transfer the "spirit" of schizophrenia or other illness to an animal or object. This form of treatment alleviates the symptoms, but only temporarily. Another form of treatment is the possession cult. The person is encouraged to become possessed by a higher-level spirit that will control symptoms and subjugate lower spirits (Moreau, Adeyemo, Burnett, Myers, & Yung, 2002, p.254).
Demon Possession and Schizophrenia
Often the hallucinations and delusions of people suffering from schizophrenia will be of a religious nature. Individuals may even claim to be God or Satan. People in the Christian church may view these situations as demon possession. Although demon possession and demon oppression are reality and not fiction, schizophrenia is not synonymous with demon possession. Skip was a college student and a pastor's son. He was diagnosed with schizophrenia in college when he began hearing voices and became overwhelmingly paranoid. His symptoms subsided when he began medication, but his father was convinced that his son was demon possessed, and not suffering from a mental illness. The elders of the church prayed for him and his father refused to allow him to take his medication. Skip's delusions and hallucinations returned and he became confused and extremely paranoid (Carlson, 1994, p.15). Unfortunately this story is as true as it is disturbing. The voices Skip heard were diminished when medication was taken. If he were demon possessed medication would not have diminished his symptoms (June & Black, 2002, p.163).
Individuals can be schizophrenic and demon possessed. When people open themselves up to the occult, the likelihood of demon possession or oppression increases. It is important to note that very few individuals with schizophrenia have ever been involved in the occult (June & Black, 2002, p.163). Demon possession is when one or more demons invade a person's life and take residence there. They control the person completely. Demon oppression is more common than demon possession (Meier, Minirth, Wichern, and Ratcliff, 1991, p.261). It occurs when individuals surround themselves with satanic influences to the point that they are addicted and cannot escape without intervention. This sometimes comes in the form of pornography or flirtation with the occult.
There are differences between a person having schizophrenia and a person being demon possessed. Demons cringe at the name of Jesus. If a person is having a delusion and claiming to be Jesus, a demon would never say His name. Satan is out to "steal, kill, and destroy." He has no concern for the person. If a schizophrenic is in counseling and there is no progress being made it may be a sign of demon possession. Demons do not want the individual to receive healing. They will control the person to the point that the person's will is disregarded and the demon remains in control. If a demon speaks through the possessed person, the voice will be different than the individual's normal voice. A demon-possessed individual can only be delivered by the power of Jesus Christ.
What the Bible says about Schizophrenia
The Bible addresses issues of sickness extensively. Throughout the Old and New Testament God allowed sickness to occur in the world. Sickness implies physical and emotional disability. In Deuteronomy 28:27-28 God spoke through Moses to the Israelites and said, "The Lord will afflict you with madness, blindness and confusion of mind. At midday you will grope about like a blind man in the dark. You will be unsuccessful in everything you do; day after day you will be oppressed and robbed, with no one to rescue you." The Hebrew word for madness is shiggaon and it literally means strange, bizarre, and illogical. The word blindness in Hebrew means loneliness and darkness. Individuals with schizophrenia are indeed blinded in many ways. They live lives of loneliness and solitude. Many consider them outcasts of society. Confusion of mind refers to perceptual distortions (Welch, 1991, pp.234-235). All of these words can apply to schizophrenia.
The Church's Response to Schizophrenia
Jesus showed compassion to those afflicted with illnesses. Unfortunately the church as a whole has not played an active role in showing compassion to those suffering from schizophrenia. Dwight Carlson, author of the book Why Do Christians Shoot Their Wounded?(1994, p.9), states that in his years of being a Christian, doctor, and psychiatrist he found the majority of Christians to be intolerant and prejudiced towards individuals with mental illness. It is easy for the Christian community to place blame, but mental illnesses such as schizophrenia are complicated by the ignorance of others. Christians need to be educated from and a biological, emotional, and spiritual standpoint on the issue of schizophrenia. The bridge that can bring healing between individuals with schizophrenia and the church is to, "Therefore, confess your sins to one another, and pray for one another, so that you may be healed. The effective prayer of a righteous man can accomplish much." James 5:16.
Individuals with schizophrenia live in solitude and loneliness. It is estimated that sixty to seventy percent of individuals suffering from schizophrenia will never marry (June & Black, 2002, p.163). It is commonly believed that individuals with schizophrenia are violent people. This is a false belief. As schizophrenia progresses in a person's life they tend to retreat from people, not seek out people to be violent towards. Occasionally a person with schizophrenia will become violent if they are experiencing a delusion (Mueser & Gingerich, p.6). This is a common excuse for not showing compassion towards these people.
The solitude and loneliness affects the individual and their family. Families often face financial, emotional, and spiritual needs, and the church can extend love and compassion in practical ways (June & Black, 2002, p.165). People want to be validated and heard. Walking with the family through their daily lives by listening, affirming, and loving them can bring healing. The list is endless for how people can help the individual with schizophrenia and his or her family. To name a few, people can send cards, volunteer to drive the individual to doctor appointments, take trips to the park, give financially towards needs, and more.
When Christians suffer from schizophrenia they should view the condition as a way of drawing closer to God and allowing Him to show His glory through them (Carlson, 1994, p.138). If God does not heal their disease as in the case of the Apostle Paul, they will also need God's grace to live with their difficulty (2 Corinthians 12:10).
References- Five Key Books
There are many valuable resources for mental health professionals and Christians working with individuals suffering from schizophrenia. Current research on the topic is finding many beneficial treatment approaches to administer in therapy. Any mental health professional, pastor, or Christian reaching out to individuals with schizophrenia should have these recommended resources in his or her library.
- Coping with Schizophrenia by Kim T. Mueser and Susan Gingerich
- Counselor's Guide to the Brain and Its Disorders by Edward T. Welch
- Schizophrenia: From Mind to Molecule edited by Nancy C. Andereasen
- The Religious Care of the Psychiatric Patient by Wayne E. Oates
- Why Do Christians Shoot Their Wounded? by Dwight L. Carlson
Individuals suffering from schizophrenia need to feel the love and compassion of Christ through His people. The hopelessness of schizophrenia can be overwhelming and paralyzing. When Christian professional counselors and Christ's church have the privilege of treating someone and walking with them through their schizophrenia, it is essential for them to see the person as God sees them- a whole person who is loved. Therapists must always strive to view the person as a unit: body, mind, and spirit. All three areas must be addressed if an individual is to receive complete healing and wholeness. Healing may occur here on earth or in heaven. "By His stripes we are healed." (Isaiah 53)
Andreasen, N. C. (Ed.). (1994). Schizophrenia: from mind to molecule. Washington, DC: American Psychiatric Press.
Cromwell, R. L., & Snyder C. R. (Eds.). (1993). Schizophrenia: origins, processes, treatment, and outcome. New York, NY: Oxford University Press.
Dassori, A. M., Miller, A. L., Velligan, D., Saldana, D., Diamond, P., & Mahurin, R. (1998).
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Jenkins, P. (2002). The next Christendom: the coming of global Christianity. New York, NY: Oxford University Press.
Kingdon, D. G., & Turkington, D. (1994). Cognitive-behavioral therapy of schizophrenia. New York, NY: Guilford Press.
Lopez, S. R., Hipke, K. N., Polo, A. J., Jenkins, J. H., Karmo, M., Vaughn, C., & Snyder, K. S. (2004). Ethnicity, expressed emotion, attributions, and course of schizophrenia: family warmth matters. Journal of Abnormal Psychology, 113(3), 428-439. Retrieved April 14, 2005, from PsycARTICLES database.
Meier, P. D., Minirth, F. B., Wichern, F. B., & Ratcliff, D. E. (1991). Introduction to psychology and counseling: Christian perspectives and applications. Grand Rapids, MI: Baker Book House.
Moreau, A. S., Adeyemo, T., Burnett, D. G., Myers, B. L., & Yung, H. (Eds.). (2002). Deliver us from evil: an uneasy frontier in Christian mission. Monrovia, CA: World Vision Publications.
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Roukema, R. W. (1997). The soul in distress: what every pastoral counselor should know about emotional and mental illness. Binghamton, NY: Haworth Press.
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Torrey, E. F., Bowler A. E., Taylor, E. H., & Gottesman, I. I. (1994). Schizophrenia and manic-depressive disorder. New York, NY: Basic Books.
Whybrow, P. C. (1997). A mood apart. New York, NY: Basic Books.
Yip, K. S. (2003). Traditional Chinese religious beliefs and superstitions in delusions and hallucinations of Chinese schizophrenic patients. International Journal of Social Psychiatry, (2), 97-111. Retrieved April 15, 2005, from the National Library of Medicine database.