14. Religion and Mental Health: A Hermeneutic Reconsideration

By Richard N. Williams and James E. Faulconer

 Richard N. Williams and James E. Faulconer, “Religion and Mental Health: A Hermeneutic Reconsideration,” in Religion, Mental Health, and the Latter-day Saints, ed. Daniel K. Judd (Provo, UT: Religious Studies Center, Brigham Young University, 1999), 281–302.

Religion and Mental Health: A Hermeneutic Reconsideration​

Richard N. Williams and James E. Faulconer


Richard N. Williams was professor of psychology at Brigham Young University and James E. Faulconer was professor of philosophy at Brigham Young University when this was published. This article was originally published in Review of Religious Research 35:335–349; reprinted with permission.



In this chapter, Professors Williams and Faulconer offer a serious critique of the modernist methodology that is generally utilized in social science research. In addition to their critique, they also provide what they have defined as a “hermeneutical” alternative.


Inasmuch as modernistic research assumes a cause and effect relationship between variables, Williams and Faulconer assert that this traditional assumption denies the possibility of human agency and morality. Instead of comprehending behavior as being elicited by environmental factors, caused by unconscious “needs,” or being purely the product of body chemistry or genetics, Williams and Faulconer regard human behavior as an act of agency. They propose both religion and mental health not as variables, but as languages that give the individual perspective and meaning in the world.

The relationship between mental health and religious belief and practice is problematic, and recent psychological research has done little to explicate or clarify the issue. See, for example, Spilka, Hood, and Gorsuch (1985, chap. 12), Bergin’s (1983) review paper, and a series of papers by Ralph Hood and his associates in the Journal of Psychology and Theology (Watson, Hood, & Morris, 1988a, 1988b). Many of the issues raised in the exchange between Bergin (1980) and Ellis (1980) are also relevant. Though the recent set of papers, Religion and Mental Health (Schumaker, 1992), addresses a number of interesting and important issues in the psychology of religion, it perpetuates uncritically a theoretical perspective that we will argue is unsatisfactory. Gorsuch (1988) concludes from his review of the literature that research results in the area of religion and psychopathology are “mixed owing to a scarcity of theoretical guidance” (pp. 216–217). The relevant theoretical issues are nearly always recounted from a distinctly modern perspective, where we define modernism as characterized by at least the assumption that entities rather than actions or something else are the basic metaphysical elements of the world and its corollary assumption that some principle of necessity is part of any adequate account (Faulconer & Williams, 1985, 1987). From the modern perspective it seems clear that religious explanations of mental disturbance are primitive—impoverished and imperfect attempts to account for something, the true nature of which has become clear to us in the modern era. In other words, the contemporary psychological assumption is that modernism has a privileged understanding of mental health phenomena. [1]

In addition to noting that contemporary psychology is distinctly modernist, we also say that it is empiricistic. We have no quarrel with empiricism in the sense that an empirical explanation seeks to ground itself in, and take its explanatory task from the observable, experiential world. But contemporary psychology is not empirical in just this sense. It is empiricistic. Contemporary psychology assumes that its reading of the observable corresponds to an independent reality of which the assumptions of modernism are accurate descriptions. For our purposes, it is sufficient to say that empiricistic denotes reliance on necessity and simple causality in scientific explanations. [2]

In saying that contemporary psychology is modernist and empiricistic, we recognize that various alternatives, such as hermeneutic or narrative, phenomenological, existential, social constructionist, and various humanistic psychologies have been proposed and that these at least intend to avoid the modernist and empiricistic assumptions. Whether they do is a topic for another paper, but it remains true, nonetheless, that such alternatives are certainly not part of the mainstream (and there is legitimate question about whether they constitute scientific alternatives—Faulconer, 1995; Schrag, 1990). Our intent is not to create a straw man, but to take issue with the theoretical founda tions of what seems obviously to be the dominant view in psychology and, therefore, in the psychology of religion to the extent that the sub-discipline embraces the assumptions of mainstream psychology. Donald Capps (1984,1990) has recognized and articulated problems with the predominant theories of psychology similar to the ones to be treated here and has argued for the necessity of an alternative grounding for that part of the psychology of religion relevant to pastoral counseling. The arguments made here are in a similar voice. The criticisms we will make in our focus on the connection between religion and psychopathology are in line with a number of prominent criticisms currently made of psychological theory in general (see, for example, Faulconer & Williams, 1990; Messer, Sass, & Woolfolk, 1988; Polkinghorne, 1988; Robinson, 1992; Sass, 1992). (While we will concentrate specifically on psychology, it is important to note that the same criticisms and suggestions could be made for any social science—Schrag, 1980.)

The Modernist View​

Each of the features of modernism—its focus on substantiality and its insistence on necessity and simple efficient causality—is inextricably related to the others, but the second of these is most important for our purposes. Contemporary psychology brings the modern, empiricistic view to the study of psychopathology in assuming that psychopathology can be understood on the model of medical pathologies: for every disorder there is a pathogen, some substance or set of substances, which causes the disorder, and the discovery of the pathogen is a sufficient explanation of the disorder. [3]

The assumption of most psychological theory is clear: mental illness is a species of or, at least, analogous to medical illness, so the same general techniques can be used in diagnosing and accounting for mental disorders as are used in diagnosing and accounting for medical ones. The same notion of causality supposedly used for medicine, namely simple efficient causality, is assumed to be appropriate to discussions of mental health. Though causality in psychopathology is often assumed to be substantially more complex (chiefly because it is so difficult to discover), seldom do psychotherapists question the assumption that psychological causality is at least analo gous to medical causality. To see one prominent example of this assumption, consider The Diagnostic and Statistical Manual of Mental Disorders, Third EditionRevised (1987; hereafter, DSM III-R). It assumes that mental illness is at least analogous to medical pathology when it says that the etiology of most disorders is unknown (p. xxiii) and when it preempts any other diagnosis in favor of the diagnosis of an organic disorder (pp. xxiv-xxv).

Regardless of the status of DSM III-R as a diagnostic tool or its applicability to a particular case, we believe that, in terms of its basic assumptions, it accurately reflects the widely held theoretical orientation that psychopathology is best understood on the medical model. The many criticisms of DSM III-R and any of its defenses are irrelevant to our use here. Our point is not that DSM III-R is inadequate either theoretically or practically; it is that DSM III-R, whatever its adequacy, reflects the dominant theoretical understanding of psycho-pathology in psychology and psychiatry by assuming a medical model. DSMIVis not likely to be any different in that regard. (See the prospectus of DSMIVin Frances, Pincus, Widiger, Davis, & First, 1990, where the connection to the medical model is explicit, p. 1440.) Here we question the use of the medical model. (For a related critique, see also Faust & Miner, 1986, and the discussion that followed in May and June of 1987.) [4]

With the modernist assumptions that underlie the medical model, phenomena are best analyzed in terms of relationships among variables, because that yields the best understanding of efficient causality. Similarly, most psychological theory assumes that all human phenomena, including religion, can be analyzed best in terms of relationships among variables. Since variables are so amenable to empirical study, they often draw us into modern, empiricistic assumptions. The temptation to apply the empiricistic conceptualization and its attendant focus on variables to religious phenomena has been largely irresistible.

The modernist perspective makes the question of the relationship between religion and mental health a question of how variables taken to represent one phenomenon can be shown to impact the variables assumed to represent the other. Empiricistic assumptions lead one to believe that all explanations must be in empiricistic terms—namely in terms of substances, connected chronologically and necessarily (for a critical discussion of such chronology and necessity see Slife, 1993). This assumption leads us to reduce all phenomena to variables which are, exactly, substances connected chronologically and necessarily—in other words, substances to be understood in terms of Humean causality. Consequently, the discussion of psychological causality in empiricistic terms is generated by the empiricistic assumptions of psychology rather than by the phenomena themselves.

We are aware that most scholars in the psychology of religion do not overtly make the modernist assumptions and that they certainly do not assume that religious behavior is innately pathological. With James (1902), they have attempted to take religious phenomena on their own grounds (see also Wulff, 1991). Many have pointed out the necessity of understanding the theological contexts in which religious behaviors occur (see, for example, Donahue, 1989; Hertel, 1989; Hood, 1989; Spilka & Bridges, 1989; Williams, Taylor, & Hintze, 1989). Nevertheless, we suggest that a tension remains between taking religion seriously and the assumptions and methods that seem natural to mainstream psychological theory and practice (see Tjeltveit, 1989). Empiricistic understanding demands that all phenomena undergo a reduction from the phenomena as manifest to what is presumed to be the more fundamental, determinate structure, a structure of a metaphysical substance. But we argue that a psychology founded on a metaphysic of things (Williams, 1990), and thus invoking the usual empiricistic understanding of causality, cannot take religious phenomena seriously—in other words as meaningful in themselves. Since the metaphysical assumptions of empiricistic psychology themselves are the problem—and these assumptions permeate not only the theoretical underpinnings of psychology, including the psychology of religion, but also our supposedly natural attitude toward the world—it is not enough to avoid the most obvious and overt reductionist theory about religious phenomena as psychologists of religion have done for the most part.

This suggests that psychologists need to rethink the theoretical foundations of psychology and that we may well need to reexamine the assumptions we have made about religious phenomena to the extent that they are the same as the assumptions of modernism and, therefore, of contemporary psychology. It also suggests that the psy chology of religion is an excellent place from which to begin that rethinking since the tension can be clearly seen there. Thus, this paper is not so much a criticism of the psychology of religion as it is an attempt to lay a foundation for a response to modernism that, in many cases, is already sensed by those who study the psychology of religion.

We do not mean to suggest that by its very nature religion demands a special psychology, different from that which suffices for more ordinary phenomena. More radically, we argue that the current psychological perspective is generally inadequate for any human phenomenon, and that this is especially obvious in the study of mental health and religion. The full argument, outside the scope of this brief essay, has been made elsewhere (see, for example, Faulconer & Williams, 1985, 1987; and the essays in Faulconer & Williams, 1990). The basic insight, however, is this: psychology, like any attempt to give an adequate account with an artificially narrowed language (whether a psychological account or not), must be reductionist in that it “translates” the phenomena it observes into its own narrower terms for analysis. Psychology reduces phenomena to the language of efficient causation. The necessity of translating from one “language”—in this case, religious life—to that of psychology is not the question. [5] The question is whether the language into which psychology translates the phenomena is adequate to its observations. With many others (for example, Schrag, 1980,1990; Polkinghorne, 1983, 1988, 1990), we believe the answer is no.

A Hermeneutic Alternative​

Any point of view that professes to be a hermeneutic alternative requires clarification and explication so that the meaning of the word hermeneutic, and thus the nature of the alternative, is apparent. The species of hermeneutic alternative we prefer is that originally articulated by Martin Heidegger (1961, pp. 61–62), developed further by his student Hans-Georg Gadamer (1989) and also found in the work of those such as Paul Ricoeur (1992). [6] A hermeneutical psychology takes interpretation rather than reduction to causal accounts to be fundamental to explanation and understanding. Using the earlier analogy, hermeneutical psychology believes that accounts of psychological phenomena must be given, but not that they must be given in one specific, technically narrowed language, or that they can legitimately be given only in terms of cause and effect, narrowly conceived. Indeed, from a hermeneutic point of view, it may be that an adequate account must be given in a language at least as rich as the phenomenon of which it gives an account, if that is possible. (In spite of a variety of claims to the contrary, this recourse to interpretation does not necessarily mire one in a moral or epistemological relativism of the sort that is at odds with the moral judgments of religion—see, for example, the work of Gadamer, 1989; Levinas, 1969; Ricoeur, 1992; Taylor, 1989.)

Giving an etiology is still possible in a hermeneutic view. One does not dispense with discussing causes (see Faulconer, 1995). Unlike the medical model used by most of psychology, however, the hermeneutic view is not restricted to the assumption that cause is best thought of as efficient causation. Other models of causation may be more helpful (for example, Aristotle 1944, 194bl6–198a36; Winch, 1958; for more on Aristotle, see Robinson, 1985, 1989, chap. 2). Furthermore, from a hermeneutic view, non-causal accounts of events cannot be dismissed out of hand. They may give adequate accounts of psychological and other phenomena.

From a hermeneutical perspective we can now reformulate the question about the relationship between religion and psychopathology. We no longer pursue functional relationships between religious and psychological variables in the hope of establishing causality. Rather, we seek to understand how persons behave in the world constituted of religious and social contexts. We seek to “tell a story” which gives us understanding of human behavior, whether or not that story is a causal one and whether or not the causes of which it speaks are straightforwardly efficient causes. Freed from the compulsion to reduce psychological phenomena to the artificially narrowed terms that are the language of empiricistic psychology, we are able to take both religion and pathology seriously (i.e, nonreductively), in a way not otherwise possible in the discipline.

Religiosity and Psychopathology Reconsidered​

An interpretive, hermeneutic science of psychology regards humans as active agents and their behaviors as interpretive actions. [7] Such actions derive their motives and meanings from the innately social contexts which make up the world in which agents are grounded. On this view, people’s religious actions and beliefs are meaningful interpretations of their world and what it means. As a consequence, religion is not a variable, but a language which gives to the participant as well as to the observer a perspective or account of the world. By the same token, psychopathology is viewed, not as an end state following necessarily from causal chains of events and conditions, but as an interpretive act which discloses the way or manner of one’s situatedness in the social world. Psychopathology is an “expression” of one’s situation, an expression necessarily occurring in some language. (We use the word expression here to cover the gamut of human activity. This explains the earlier possibility of speaking of religion as a language. One of the fundamental insights of hermeneutics is the way in which human action can be understood as linguistic. See Gadamer, 1989, pp. 3085, 3313, 3316, and 3318; Ricoeur, 1992, pp. 197–221.)

We should note here that physiological or other powerful conditions in the life of any person may function as part, even a major part, of any psychological pathology. The pathology itself, however, is always more than these conditions—it is the agents’ expression of their condition, including the physical, in whatever way they are able to express it—in other words, using whatever language and elements of expression they have available.

We turn now to a hermeneutic analysis of the relationship between religious life and mental health. Whenever human beings are involved in the lived world in terms of important moral questions of the kind suggested by religion, and especially where those terms are not uniformly shared by all in the lived world in question, we can expect tension between competing moral systems or languages. By tension we mean more than that a person can simply hold contradictory beliefs. Contradictory beliefs within a particular belief system may or may not generate psychological tension, but we believe that when a person’s lived world includes belief systems that compete for the same ontological ground (for example, by giving competing readings of the same experiential phenomena) and so are incommensurable, then psychological tension is unavoidable—if the person takes both belief systems seriously. We call these belief systems “moral worlds” or “moral discourses,” where a moral world or discourse is that within which a belief or set of beliefs can occur, the “ground” of particular beliefs.

Three consequences of this tension seem obvious. First, the tension between moral worlds will manifest itself in the interpretive actions of the inhabitants of the lived world. If those tensions are sufficiently disruptive of ordinary life, they may show themselves, for example, as psychopathological, as sinful, as coping, as piety, or as fanaticism. The point is that however the response to tension is manifest, it is an interpretive response to one or another of the moral worlds in which the person finds himself. Even to decide what to call the response is to legitimize one or another moral discourse. This leads to the second consequence, namely that as observers whether we understand a behavior as psychopathology or sin depends on the lived world from within which we ourselves speak. In the world of the social scientist, as in any other lived world, there are competing moral discourses among which we must arbitrate in order not only to talk about another’s response but even to observe that response. The social scientist cannot escape the morality of his or her discourse and the tensions that attend it. In one way or another, the tensions inform social science itself.

The third point follows from the first two. Readings of actions that make sense in one moral discourse may be incomprehensible in another. Some aspects of the language of religion, which give the world a reasonable interpretation, cannot be translated into secular terms (especially into the narrowed terms of empiricistic psychology) except as psychopathology; conversely, sometimes what makes sense within secular language may make no sense within the language of religion except as sin. Thus the understanding of behavior from within religion may reasonably be incommensurable with the understanding of the same ostensible behavior from within psychology. These moral discourses are not fully translatable into one another.

From this perspective we might well predict a link between “pathology” and religious belief. But even if that relationship holds, we cannot reasonably conclude that religion is pathogenic. There are at least three possible alternative explanations for that relationship. First, some of the religious are unable to deal with the tensions between the multiple and overlapping moral systems within which they live—the secular and the religious. Second, given that a large majority in North American culture report at least a nominal religious belief and that religious language is fundamental to religious belief, in North America any supposed pathology may be experienced and expressed in religious terms. A third alternative is that secular language and understanding may consign certain acts and beliefs to the realm of the pathological although, when considered from the perspective of religious discourse, they are not at all pathological but rather expressions of life meanings. One begs the question by assuming the ontological priority of secular language and understanding (or secular life).

Of course, one could argue that religious life is negative in that without it there would not be the specific tensions sometimes reflected in pathology. But the argument applies equally well to the secular life and language which stands on the other side of the tensions, if the argument is made from the religious perspective. The mere existence of tension and consequent pathology doesn’t tell us which of the elements of that tension is “responsible” for the tension or the effects of the tension. In the first place, to assume that one side or the other of the tension must be the efficient cause of the tension is to assume, once again, the modernist causal perspective which is in question. In the second place, a religious person might argue that the negative effects of these moral tensions are often mitigated by the meaning enhancing qualities of religion as interpretation of the lived world (assuming that the supposedly negative effects are indeed negative—which is perhaps reasonable, but is no small assumption). Or, in at least some cases, the religious person could argue that the supposed negative effect is not actually negative.

Let us take up the third alternative, that secular and religious language may sometimes be mutually incompatible. Once again, reflecting what we believe to be a pervasive belief within psychology (in spite of the fact that DSM-III-R is not universally recognized as either a theoretical or practical authority), DSM-III-R cautions: “When an experience or behavior is entirely normative for a particular culture—e.g., the experience of hallucinating the voice of the deceased in the first few weeks of bereavement in various North American Indian groups, or trance and possession states occurring in culturally approved ritual contexts in much of the non-Western world—it should not be regarded as pathological” (p. xxvi).

Interestingly, this comment takes away with one hand what it seems to give with the other. By definition, a hallucination is an unfounded perception. It is a perception which has no cause that straightforwardly accounts for it in the way that the observer would expect it to be accounted for—in the way that those who are perceiving the situation “accurately” would account for it. Thus, to describe hearing the voice of the deceased as hallucination is to have already made a judgment as to the experience, and it is to have done so from a point of view which takes hearing the voice to be symptomatic of pathology. The chauvinism is unintended and probably inescapable, but it is apparent, and we believe what it reveals is important.

One wonders why DMS-III-R ‘s caution is confined to dealing with “the non-Western world,” whatever that is. (Anthropologists have pointed out the difficulty of giving that term any real meaning; cf. Leslie, 1976; Worsley, 1982). Why should we presume that such “nonstandard” behaviors may be legitimate among those in non- Western cultures, but that they will not be among some Western subcultures? It is conceivable that Baptists or Mormons or Catholics or members of the Unification Church or some other religious group within the Western world could have a particular nonstandard behavior which is nonetheless best understood as nonpathogenic within the context considered, even though from a secular point of view such behavior in an individual would be pathogenic.

Nevertheless, DSM-III-R’s caution seems to be a common sense recognition of the possibility that what appear to be pathologies may only appear to be so from within the language of empiricistic psychology but that the kinds of phenomena in question are not properly thought of as pathologies. [8] But that recognition is incompatible with the medical model invoked earlier. After all, if the symptoms of malaria were encountered universally or almost universally within a culture, it would be inappropriate to say we should disregard those symptoms in diagnosing the medical health of those in that culture. Instead we would say malaria is epidemic. [9]

Wisely, the editors of DSM-III-R have ignored the causal medical model in dealing with what might too hastily be taken for pathologies in other cultures. Our argument is that there are good theoretical as well as practical reasons for ignoring it. Those cases reveal the insufficiency of the medical model for understanding psychopathology. We also argue that what applies to other cultures in this regard applies also to religious life; just as voices or visions of the dead, trances, or possession may express a culture’s life in the world, religious life may also express itself through behaviors that otherwise might be taken as psychopathology. In an analogue to Whorf’s (1956) thesis that our world is given by language, culture, and religion are languages for having and expressing particular understandings of the world. Religion is that by means of which the world appears to the individual and by means of which the individual expresses his existence in the world. Therefore, religion is not simply one more of the attributes or properties of the person in question. Religion is the horizon within which particular attributes can occur; it is what makes a particular set of variables possible, and therefore, it is not itself a variable. As a result, a model which treats religious life simply as a variable denoting an attribute or set of attributes will fail to capture the phenomenon sufficiently. It will, therefore, fail as an adequate account.

Now consider the second alternative explanation of a possible link between religion and psychopathology. Given the fundamental importance of religion to the lived experience of religious people, they are likely to articulate all of their struggles and tensions in the language of religion because it is the central expression of their life in the world. Therefore, even when the tensions faced by those people are not specifically religious tensions, we should not be surprised to find them expressed in religious language. (Remember that language is used here for a particular way of life, a way of taking the world, and, therefore, living in it.) Indeed, religious language may be the language in which some people most carefully and passionately articulate human being. In other words, people whose pathology (from a certain abstract and objectivized point of view) may have nothing at all to do with religion may articulate their pathology and express the tensions inherent in their lived world in religious terms. What this means, of course, is that in one sense religion has everything to do with their pathology because it has everything to do with them as interpreting agents, but religion may not be the source of the tension which gives rise to the pathology. Rather, religion may be the language which makes possible the understanding (or failure to understand) that informs the particulars of the pathology in question. (Again, this discussion assumes that when we say pathology we mean something more than the imprecation of pathology to religious life consequent on empiricistic psychology’s inability to understand religious life in empiricistic terms.)

We conclude from this line of analysis that the literature on the relationship between mental health and religion is inconclusive for good reason. The question has been addressed from the wrong paradigm—the natural scientific or empiricistic paradigm of traditional psychology. The tradition has cast the problem in merely causal language (where language has its ordinary meaning as well as the broader meaning we have been using, namely a way of understanding the world). In the process, psychology has ignored a more basic question. Before we can make sense of the question of how religion and psychopathology might relate empirically, we need to question our understanding of the nature of both religion and pathology.

We must ask whether religion is best understood as the sort of thing which, as an efficient cause, can cause pathology—or anything else. And we must also ask whether it can best be understood as an effect of an efficient cause. We suggest the answer to both questions is no. We suggest that when understood by means of the efficient cause/effect metaphor, many important aspects of religion fall from consideration. As do all metaphors, the empiricistic social science metaphor has some utility, but it also has a tendency to omit from consideration the very things which would explain certain phenomena. To us, the metaphor appears to obviate the very understanding of religion which is vital to clarifying its relationship to mental health. If what is called religiosity is not an attribute or trait of an individual, but a fundamental way of interpreting the world, then it is neither appropriate nor productive to cast it in the role of either efficient cause or its effect, both of which are understood in terms of substance.

We must likewise ask whether psychopathology is best understood as something which can be produced as the net effect of discrete and autonomous variables. Is it best understood as a psychic state replete with constituting and defining categories? In other words, is it best understood as if it were a substance, an entity? We suggest that seeing pathology as an autonomous state with efficient causal power and a causal history may prevent our seeing it in the way that will cast sufficient light on it, not only on its relationship with religious life but also on its very nature. Within the framework provided by interpretive science, pathology is not the result of a particular concatenation of variables, but rather an articulation of the tension between cultures or languages—in the case of religious peoples, between the sacred and the profane. [10]

Implications for Therapy

In the world of interpretive agents, the imbrication of the sacred and profane produces the texture as well as the tension of human being. But instead of the conceptual overlapping of worlds, the modernist eye sees the autonomous interaction of variables; a religious account of pathology is merely a metaphorical overlay on the more precise causal psychological reality. However much a person may express the tension leading to pathology in religious terms, the treatment of choice is firmly psychological, making contact with the religious life only to enlist its strength and stability to enhance the effect of the “real” treatment or to eliminate religion as a cause of tension and thus pathology. We submit that this is to deny the nature of both pathology and religion as lived experience.

This domination of the empiristic model in treatment leads to what we think is the fundamental question resulting from our consideration of the psychology of religion as an interpretive science: can religion heal, or has it rightly forfeited that function to psychology? The answer to this question revolves around what we take healing to be. If, as the modern psychological perspective suggests, healing is a mainly technological function best modeled on medical science, if healing is intervention in a causal chain, then it is best left to the technologists, and the efficient causal model will suffice. In fact, if the modernist perspective is right, the medical causal model is necessary to legitimate our healing technologies.

However, if psychological pathology is a moral problem—where any problem occurring in a social, historical world is necessarily moral in the broad sense—then healing is a moral activity, involving the reconciliation of people and worlds rather than causal intervention. If psychopathology is a moral problem, then healing is therapy in its root sense, the work of a servant rather than, as in empiricistic psychology, the work of a trained mechanic. [11] The articula tion of the world found in religion seems uniquely suited to this task, perhaps better so than psychotherapy.

The healing metaphor runs deep in the Jewish and Christian traditions. From the Psalmist we read:

Bless the Lord, O my soul: and all that is within me, bless his holy name. Bless the Lord, O my soul, and forget not all his benefits: who forgiveth all thine iniquities; who healeth all thy diseases; who redeemeth thy life from destruction; who crowneth thee with lovingkindness and tender mercies; who satisfieth thy mouth with good things; so that thy youth is renewed like the eagle’s. (Psalm 103:1–5)

And in what may have been his first public sermon, Jesus read from Isaiah 61:1:

The Spirit of the Lord is upon me, because he hath anointed me to preach the gospel to the poor; he hath sent me to heal the brokenhearted, to preach deliverance to the captives, and recovering of sight to the blind, to set at liberty them that are bruised. (Luke 4:18)

But in spite of the explicit claims to healing power made by Jewish, Christian, and other religions, the possibility that religion serves a crucial healing function seems not to be entertained seriously by traditional psychology. [12] Even many religious persons see religious healing as best translated into the secular terms of psychology. We see evidence that many religious persons are increasingly willing to entrust the healing function to the technically trained psychologist. But if we are right and psychology continues to think in empiricistic terms, doing so will implicitly deny the possibility of religious life and religious healing—whether or not the psychologist is herself a religious person and whether or not the patient is.

The empiricistic causal model makes any other causal explanation or understanding impossible by consistently excluding it. Therefore, anyone adopting that narrow model of psychological pathology must systematically, even if unintentionally, exclude religious life from genuine consideration, both in understanding pathologies and in healing them. But if we are right, religious life, and therefore pathologies occurring within the context of religious life, can only be understood outside the empiricistic model. The implication is that in a real sense empiricistic psychology will also deny healing to religious patients so long as religion is reduced to a causal substrate rather than understood as a life/language. In fact, this would render psychology ineffectual as healer, not only of the religious, but of anyone. For, if our understanding is right, psychology will systematically preclude healing as long as it excludes moral considerations, whether or not those considerations are explicitly religious. Morality is the language in which the human world is experienced and has its being; human experience is intimately moral. Psychopathology is part of that world, so it too is intimately moral. To refuse to take seriously the moral life—religious or otherwise—by reducing it to a relatively impoverished language, that of modern, empiricistic psychology, is to refuse to deal with humans as they are. It is to refuse to deal with them empirically by dealing with them empiricistically. It is to refuse to take seriously pathology as lived. With such an approach, at best psychology cannot heal. At worst, it maims.


In the sub-specialty of psychology of religion, there is an attempt to take both psychology and religion at face value; in other words, seriously and on their own terms. But to date, that has almost universally meant taking both psychology and religion from the modernist perspective. To the great relief of many in the field, the question of the compatibility of psychology and religion has been satisfactorily put to rest. However, when reintroduced from the hermeneutical perspective, the question must be reconsidered. If we do not consider it and continue to reconsider it, we may preclude ourselves as scholars from an important and adequate understanding of human beings. As therapists, we may preclude a more satisfactory healing for those whom we serve.


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[1] Stephen Daniel gives a reasonable list of at least some of the “constellation of positions . . . and beliefs” that characterize modernism: “a rational demand for unity, certainty, universality, and ultimacy” together with beliefs such as “the belief that words, ideas, and things are distinct entities; the belief that the world represents a fixed object of analysis separate from human discourse and cognitive representation; the belief that culture is subsequent to nature and that society is subsequent to the individual.”

[2] The notion of causality invoked in a modernist theory is ambiguous. It can mean that there is only one cause in a causal chain, or it can mean that, however many the number of causes, the relation of cause to effect in any chain is simple. We intend the latter meaning, where the model of causality is physical bodies impinging on one another, however many such bodies there might be. On such a view, whether causes and effects form a chain at all is in doubt. In addition, the question of how to think about causality is not a small question. Efficient causation, the motions of physical bodies impinging on one another, may not be the best model for causation. See Harre” (1985, pp. 168–183) and Faulconer (1995).

[3] There are certainly any number of possible reasons that contemporary psychology accepts the medical model. For example, there are almost certainly historical and social reasons. Though there is not a great deal of literature on the topic, there are provocative discussions of the emergence of psychology from medicine. See, for example, Ellenberger (1970) and Carter (1980, pp. 268–273). And though it is about the history of medicine, Foucault’s Birth of the Clinic (1973) has a great deal to offer anyone interested in the origins of contemporary psychology’s assumptions.

[4] The irony is that the medical model which seems usually to be assumed is probably not the best current: medical model. Medical understanding of the causation of disease seems to be undergoing change, dropping the demand for simple efficient causality in favor of other explanatory models, such as webs or networks of causation, where those webs cannot be thought of as merely a multiplicity of simple causes (cf. Harr6, 1985; Kunitz, 1987). So far, however, there does not seem to be a similar shift in psychology or psychiatry.

[5] Though we believe that translation from one language to another is not only necessary, but unavoidable, we do not think psychology sees itself as making such a translation. Rather, empiricistic psychology believes it uses its language to report the facts rather than to translate from one language to another. Psychology’s use of a narrowed and therefore inadequate language cannot be seen from within that psychological language.

[6] Our understanding of interpretation and its implications for science is also informed by the work of others, such as Jacques Derrida and Emmanuel Levinas, people not usually considered to be doing hermeneutics.

[7] For an early but clear discussion of how understanding actions requires interpretation, see Kaplan (1964, p. 42). To Kaplan’s insights, hermeneutics adds that actions are themselves to be understood as interpretations of living-in-the-world.

[8] Though not the thesis of this paper, we believe the same point can be applied more broadly. What appear to be pathologies among particular groups of individuals, such as women or teenagers, may only be so from within the language of standard empiricistic psychology.

[9] The question of whether psychopathology can be epidemic within a given culture is an interesting but knotty one. For example, we can ask whether psychopathology was epidemic in the religious community at Jonestown. We will not pursue the question in this paper, but suffice it to say that unlike Glynn (1990), we believe it is possible for psychopathology to be epidemic, but we also believe it is unusual.

[10] We use profane in its technical, nonpejorative sense: what is not concerned with the holy.

[11] The Greek word from which we get “therapy,” therapeia, means attendance or service, the service given freely rather than of necessity; the server in this case is neither slave nor hired-person. The therapon is more like a comrade in arms, as Patroclus was Achilles’s therapon (see Homer’s Iliad, beginning 1.306) and poets are the therapoi of the muses (see I Iesiod’s Theogony, 100). Both of these images portray the therapist as other than the paternalistic intervener we find in empiricisitic psychology. In the first case, the therapist is someone who fights alongside the person receiving therapy; in the second case, the therapist makes it possible for the other to speak. (Interestingly, because of its general meaning, therapeia also means “service to the gods, worship.”)

[12] Perhaps the possibility that religion serves a crucial healing function is not taken seriously in psychology because religion makes the explicit claim to heal. Though rarely—if ever—conscious, there may well be something like professional jealousy at work in psychology’s refusal to take religion’s claim seriously. Anthropological research has shown that the refusal to take folk-medicine seriously is much more than the mere choice of a better alternative for healing. (For a review of the discussion, see Worsley, 1982.) A similar play of social forces may be at work in the relation of psychology and religion.