A young mother struggling with bulimia was asked one day by her therapist if she ever prayed.
“She lived on a small farm, had a simple life and she was a wonderful mother,” said Michael Berrett, a psychologist who specializes in eating disorders. “But she hated herself with a passion. She was throwing up five times a day.”
The woman said she did pray, and went on to list all the people and things she prayed for. The list was long, and Berrett noticed that she left herself completely off it.
“I asked her, ‘Do you ever pray for yourself?’” Berrett said. "And she said, ‘No.’”
The woman decided to give it a try, and later said that was the turning point in her recovery.
Berrett and other LDS psychologists say the relationship between spirituality and mental health is both complex and important to understand for every person’s individual well being. A person's belief system is a vital part of coping with life’s problems, and many psychologists make it a central aspect of therapy.
Religiously devout have better mental health
Scott Richards, professor of counseling psychology at Brigham Young University, said there are occasionally news reports about how members of The Church of Jesus Christ of Latter-day Saints are more mentally unhealthy than other people. But, he has never seen evidence to support the claim.
Marleen Williams, a clinical professor of counseling physiology who served as president of the Association of Mormon Counselors and Psychotherapists, noticed a similar trend.
“You always see the stereotype about Mormon women being more depressed,” she said. “No study has ever shown Mormon women to be more depressed. In fact, spirituality is actually something that helps people.”
According to the Utah Department of Health, Utah has the highest number of antidepressants prescriptions in the country. In 2002, the Los Angeles Times published an article on this study. The article quoted several people stating that the pressure of perfection from the Mormon culture is what caused Utahns to be depressed, especially women.
Daniel K. Judd, who earned a doctorate in counseling psychology at BYU, said in a BYU forum in 2006 that perhaps one of the reasons Utah residents use more antidepressants than the rest of the nation is because they are more educated and aware of the symptoms and treatments of depression and are more likely to seek out help when they need it.
Though there have been few studies that have found any difference between LDS Church members and those of other religions, Richards said there have been hundreds of studies that have shown evidence that religiously devout people — in any denomination — enjoy more positive mental health and psychosocial adjustment than people who are less religious or not religious at all.
“Clearly the research has supported the idea that being involved in a religion is beneficial to a person’s mental health,” Richards said.
Tim Smith, department chair of counseling psychology at BYU, said the effect faith has on a person’s mental health depends on how they live it and how they internalize it. He named three main factors that change how a person’s beliefs affect their well being.
The first factor is how they live their beliefs. Someone who holds a certain set of beliefs but lives contrary to those beliefs is more likely to develop mental health problems. On the flip side, people who fully live their established beliefs have an increased chance for mental health.
The second factor is the motivation for participating in their religion. If a person goes to church to be seen by others, to make business connections or because they’re worried that others will judge them, these extrinsic motivations are more likely to contribute to mental health problems. However, if they attend church and follow the doctrine of their religion because they love it and truly believe in it, or in other words, they have intrinsic motivations, this contributes highly to their mental well being.
The final factor is how individuals use their religion to cope with their problems. If people use their religion to passively accept their problems as God’s will without trying to solve them, or if they blame God for all of their problems, it can be very unproductive for emotional health. If, however, people use their religion to take advantage of the social network it provides, or to participate regularly in meditative, sincere prayer, this has shown to help a person maintain their psychological health.
Mental illness happens to everyone, no matter their faith
The religious are not immune to mental health disorders any more than they are to cancer. Research has shown that many mental health problems are biological in nature and have more to do with genetics than behavior.
In the LDS culture, Berrett said, people often believe that if they’re living good lives, that should take care of everything.
“If it doesn’t take care of all their happiness, they feel like absolute losers; they feel like they’re unworthy and doing something wrong,” he said. “Really, they haven’t learned how to integrate the gospel into their lives.”
People of faith often know the rules but don’t understand the intention of the heart, he added. They don’t ascribe God to be a very loving God.
“We can be way too judgmental of each other and ourselves,” he said. “Until we learn to love ourselves and accept ourselves and embrace the goodness we have inside, we’re not really accepting the part of the gospel that can help us most.”
Religion’s role in mental recovery
Religion can help people cope when they are experiencing emotional difficulty.
One aspect of religion that encourages mental health is the social support people receive from being involved in a religious community, Richards said. Social support in general is important to help people do better emotionally.
Smith echoed that a church congregation is an instant social circle that is typically more permanent and more genuinely caring than other social groups would be.
A second aspect of religion Richards cites as helpful to emotional well being is the belief system that brings meaning and purpose to people’s lives.
“That really helps people emotionally when challenges and difficulties come along,” Richards said. “It helps them understand and cope with problems. It’s a way of making sense of life.”
Lastly, when people believe in a supreme being they can pray to and have a relationship with, they are able to face emotionally challenging situations and receive comfort, guidance and support from that relationship.
Smith agreed that this involves understanding “the why” of the doctrine rather than just following the teachings and expecting perfect results.
“If people have complete confidence that God loves them, they have comfort, cohesion and a sense of peace,” Smith said. “Just that belief in and of itself changes your perspective of the challenges you confront in life. You’re not doing it alone. You’re a team. Someone’s got your back.”
Religious people need religious therapy
For those who are religious, Richards said it is absolutely essential for their spirituality to be involved in their mental recovery.
He said with every client he first finds out what their belief system is, then works with it to discover ways that religion is either causing them stress or bringing them comfort and strength. In most cases, he said, it’s some of both. He then helps them resolve the areas that are bringing them stress, and builds on the resources their faith provides to deal with the problems they’re experiencing.
Berrett said people with mental illness tend to disconnect from the good things in their life — their family, their friends and their spiritual beliefs. In order for them to recover, they need to reconnect with these things.
“A lot of patients in mental illness feel unworthy and deficient and broken and don’t believe they can reconnect with God, because they don’t believe they deserve it,” he said.
Patients with eating disorders that Berrett works with can often begin to believe in their illness above anything else, and as a therapist he must help them to have faith in the things they had before, he said.
Williams emphasized that counselors are required by the ethical standards of the American Psychology Association to be respectful and informed about their client’s beliefs.
“If you get a counselor who is not respectful of your religious views, get a different one,” she said. “It’s important to work with a professional who you trust.”
It’s also important to receive professional treatment and medication when necessary, Williams said.
“Refusing to take medication is like praying for your garden to grow and refusing to plant the seeds,” she said. “Don’t be afraid to get help.”
Williams said there is plenty of helpful information on lds.org about mental illnesses and how individuals can deal with these issues. The information is out there, she said; we just need to be aware of it, read it and apply it. She called mental illness “the leprosy of our era.”
“If people will take the time and open their minds and hearts to understand these issues, it will be a lot easier to respond from a place of compassion,” she said.