Author Topic: A Christian goes to see a Psychiatrist for a Diagnosis  (Read 7645 times)

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Offline HAL

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A Christian goes to see a Psychiatrist for a Diagnosis
« on: August 03, 2012, 07:41:15 AM »
This is not supposed to be a joke or to make fun of Christians. I'm serious about this scenario. I want to know what might happen.

Suppose a Christian went to a psychiatrist for evaluation, but the Christian talked in a manner that didn't make it obvious that they were a Christian, like this -

Doctor: "Tell me about yourself"

Patient: "Well, there's an invisible man I talk to."

Doctor: "Can you tell me more about this man?"

Patient: "He talks to me too. He tells me he will help me get through life."

Doctor: "I see. How does me help you get through life?"

Patient: "I lost my car keys once and he found them for me. He also cured my Mom's breast cancer when I asked him to. He's going to help me live forever."

Doctor: "How long have you been talking to this invisible man?"

Patient: "A few years. I started talking to him after my friend told me about him."

Doctor: "You have a friend who talks to this invisible man too?"

Patient: "Yes. Well he's not the only one. Theres' a bunch of people who talk to him."



My question at this point is, what does the doctor make of this person at this point. Does the doctor begin to form a diagnosis of the mental disorder of the patient? Doesn't the person seem to be having delusions?

Continuing with the analysis -


Doctor: "A bunch? Are these people invisible also?"

Patient: "No. They all meet in a big building in town."

Doctor: "So if I went to this building I would see all these people you claim talk to an invisible man?"

Patient: "Yes doctor. It's the church on the corner of Elm and Walnut."


My question is, what does the doctor make of this person at this point. Does the doctor, because the patient now reveals they are a theist, simply say everything is OK? Why does admitting being a theist make it not a mental disorder to talk to an invisible man, if you say the doctor isn't concerned?

If the doctor thinks it is a mental disorder, how is it treated? What drugs would he prescribe for this mental condition?


Offline Kimberly

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Re: A Christian goes to see a Psychiatrist for a Diagnosis
« Reply #1 on: August 03, 2012, 09:55:34 AM »
HAL,

This is an interesting question, one I too have wondered about. In your hypothetical is this patient going in because something is wrong, is he complaining of any other symptoms or is he purely going in to have a mental wellness exam?
Thank you for considering my point of view; however wrong it may be to you.

Offline HAL

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Re: A Christian goes to see a Psychiatrist for a Diagnosis
« Reply #2 on: August 03, 2012, 12:21:44 PM »
HAL,

This is an interesting question, one I too have wondered about. In your hypothetical is this patient going in because something is wrong, is he complaining of any other symptoms or is he purely going in to have a mental wellness exam?

Let's say he went in for depression. As the exam goes on, the doctor learns the information I presented.

I want to know people's opinions as to whether, before the doctor learns that the patient is religious like thousands of other people, the doctor should think that the patient has a mental condition when he learns the patient talks to an invisible man.

Seems to me it would be considered a mental problem. If not, why not?

Offline Kimberly

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Re: A Christian goes to see a Psychiatrist for a Diagnosis
« Reply #3 on: August 03, 2012, 12:47:36 PM »
I feel as though you are correct. I'd be curious to see what Gnu thought of this.
Thank you for considering my point of view; however wrong it may be to you.

Offline stuffin

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Re: A Christian goes to see a Psychiatrist for a Diagnosis
« Reply #4 on: August 03, 2012, 02:51:50 PM »
Having voices in your head or talking to invisible men are signs of insanity, except if they represent god, then its ok.

Personally, I feel it is at the very least its delusional.
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Offline Kimberly

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Re: A Christian goes to see a Psychiatrist for a Diagnosis
« Reply #5 on: August 03, 2012, 03:02:14 PM »
HAL, can I have side bar in your thread?

Do we have any ex theist who actually heard god? I mean a full on audible voice, not just a feeling that god planted a thought in your head. I often wonder if theist lie about hearing the word of god. Or at least exaggerate it's origins.
Thank you for considering my point of view; however wrong it may be to you.

Offline HAL

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Re: A Christian goes to see a Psychiatrist for a Diagnosis
« Reply #6 on: August 03, 2012, 05:21:42 PM »
HAL, can I have side bar in your thread?

Sure, but it's not just about the talking to the invisible man. It's also the granting of favors that the patient thinks is happening. What is the doctor to make of this before he realizes the patient is religious.

What I'm asking is this: Is religion an accepted excuse to have a mental disorder even in the medical community?

If religion wasn't an accepted excuse for believing that an invisible man talks to you or grants favors, if it was indeed considered a mental disorder, what medication would a doctor prescribe for such a patient

Offline jdawg70

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Re: A Christian goes to see a Psychiatrist for a Diagnosis
« Reply #7 on: August 03, 2012, 05:28:31 PM »
HAL, can I have side bar in your thread?

Sure, but it's not just about the talking to the invisible man. It's also the granting of favors that the patient thinks is happening. What is the doctor to make of this before he realizes the patient is religious.

What I'm asking is this: Is religion an accepted excuse to have a mental disorder even in the medical community?

If religion wasn't an accepted excuse for believing that an invisible man talks to you or grants favors, if it was indeed considered a mental disorder, what medication would a doctor prescribe for such a patient

So I may incorrect here, but my understanding is that the medical community incorporates the concept of social norms into the criteria for establishing a mental disorder such as delusions.  Which, if I have it right, means that the religion card does allow for people to believes things with no objective referent to reality just so long as that religion isn't too 'weird'.

However, I don't think the 'social norm' clause exists in DSM-IV so I don't know if it's something that the community/industry has accepted as 'de facto' appropriate or not.  If there is a headshrink on this board I'd like to get a better understanding of this whole thing and hear his/her take.
"When we landed on the moon, that was the point where god should have come up and said 'hello'. Because if you invent some creatures, put them on the blue one and they make it to the grey one, you f**king turn up and say 'well done'."
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Offline jetson

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Re: A Christian goes to see a Psychiatrist for a Diagnosis
« Reply #8 on: August 03, 2012, 05:32:32 PM »
I cannot imagine a theist describing God as an invisible man.  The scenario does not seem natural to me.  Or am I being pedantic?

Offline HAL

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Re: A Christian goes to see a Psychiatrist for a Diagnosis
« Reply #9 on: August 03, 2012, 05:38:05 PM »
I cannot imagine a theist describing God as an invisible man.  The scenario does not seem natural to me.  Or am I being pedantic?

^^^ Yes. I think you may need a vacation from the forum... Woops.

Offline Zankuu

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Re: A Christian goes to see a Psychiatrist for a Diagnosis
« Reply #10 on: August 03, 2012, 05:42:10 PM »
HAL, I work part time in a psych office. The conversation would go something like this:

Doctor: "So if I went to this building I would see all these people you claim talk to an invisible man?"

Patient: "Yes doctor. It's the church on the corner of Elm and Walnut."

Doctor: "Now that's crazy! I go to First Living Way Bible Church of Christ too!"
Leave nothing to chance. Overlook nothing. Combine contradictory observations. Allow yourself enough time. -Hippocrates of Cos

Offline Mr. Blackwell

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Re: A Christian goes to see a Psychiatrist for a Diagnosis
« Reply #11 on: August 03, 2012, 05:49:14 PM »
I would imagine that the good doctor's mission would be to determine precisely how literal the patients belief in his invisible friend really is.

If he is just doing it because everyone he knows does it, then it's just your average run of the mill herd mentality. If he is just giving credit to an abstract idea or karma for curing his momma then it's still not a huge deal. If, as you say, he truly believes that his supplications caused this invisible friend to intervene on his behalf, well...that strikes me as unstable.
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Offline Mr. Blackwell

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Re: A Christian goes to see a Psychiatrist for a Diagnosis
« Reply #12 on: August 03, 2012, 05:52:32 PM »
I cannot imagine a theist describing God as an invisible man.  The scenario does not seem natural to me.  Or am I being pedantic?

I thought the same thing at first too. I was going to say that the patient had a good sense of humor.
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Offline Backspace

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Re: A Christian goes to see a Psychiatrist for a Diagnosis
« Reply #13 on: August 03, 2012, 08:47:32 PM »
What I'm asking is this: Is religion an accepted excuse to have a mental disorder even in the medical community?

Think of the number of nut jobs who have murdered because god "told" them to.  Aren't they typically diagnosed as insane?
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Offline Mooby

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Re: A Christian goes to see a Psychiatrist for a Diagnosis
« Reply #14 on: August 03, 2012, 11:22:19 PM »
I'm not a psychiatrist, but perhaps I can offer some insight.  I'll keep "depression" from your later post because it adds a bit of depth.

If a patient walked in with a chief complaint of "depression" and opened with a line about an invisible man, the doctor would most likely be interested in this.  After all, religious people generally do not describe their deities as invisible men, and the patient is bringing this up as the first topic for discussion.  Medical professionals are trained to give follow-up questions to explore patients' symptoms more deeply, so this symptom would definitely warrant further questioning.

The first thought on my mind after "Well, there's an invisible man I talk to" would be to determine whether this is more a delusion or  hallucination, or both.  Is the patient actually hearing a voice?  Are they seeing anything (invisible to everyone else)?  If yes, is the voice telling them to do anything?  However, from the dialogue given, delusion would be the more likely consideration.

At this point the differential is still rather wide.  If hallucination is suspected, then the psychotic disorders are on the table.  This includes schizophrenia, schizoaffective (basically a combo of schizophrenia and depression), major depression with psychotic features, drug use (can cause both depression and hallucinations), multiple medical disorders, etc.  If delusion is suspected, then we'd be looking at stuff like bipolar, schizophrenia/schizoaffective, major depression with psychotic features, delusional disorder, etc.

Sticking with delusion, the important question here would be the timing of it.  Is the delusion always present?  Does it only appear when the patient is depressed?  Does it only appear when the patient is feeling energetic (and not sleeping, and buying expensive things)?  Does the delusion comes before the mood changes, or do the mood changes come before the delusion?

Also important is how the patient is behaving.  Are they very anxious with pressured speech?  Do they jump from topic to topic without forming coherent thoughts?  Are they flat and expressionless?  Are they talking like an otherwise rational human being?

So these would be some of the considerations going into the first break point.

The second part of the dialogue certainly changes the approach.  And no, the church comment is not a good reason to stop investigating.  The next most logical response would be to establish concretely whether "talking to an invisible man" is equivalent to "praying to God," (rather than just assuming it) and go from there.

Assuming that is what the patient meant, that doesn't mean the patient is delusion free.  Religious delusions are common enough that it's worth determining whether the patient is describing a religious delusion or a religious belief.  If it's the former, all our original considerations are back on the table.  If it's the latter, we're still not done.

If the patient is simply talking about religious belief, it's worth investigating why the patient brought that belief up immediately and in such an unconventional way, without clarifying that belief when it became clear the doctor didn't understand that they were describing God.  Is their religious belief causing some sort of life issue that's central to the depression?  Was the patient intentionally going on a tangent to avoid discussing their real underlying issues? 

After all, the patient is at the appointment for a reason, and that reason doesn't disappear simply because the person is religious.  If the belief isn't the reason they're there, then what brought them to the psychiatrist?  If it's the depression, and the patient intentionally wasted 15 minutes of the appointment to avoid talking about why they're depressed, then that gives the doctor some important information about the patient.

So yeah, it's definitely significant, delusion or not.  As for drugs, it would depend on what the final diagnosis is.  If it's not a delusion, then we're looking at treating the depression (or whatever it turns out to be.)  If it's a true delusion, then antipsychotics might be warranted, depending on the particulars of the case and the final diagnosis.
« Last Edit: August 03, 2012, 11:24:55 PM by Mooby »
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Re: A Christian goes to see a Psychiatrist for a Diagnosis
« Reply #15 on: August 04, 2012, 08:21:31 AM »
  If hallucination is suspected, then the psychotic disorders are on the table.  This includes schizophrenia, schizoaffective (basically a combo of schizophrenia and depression), major depression with psychotic features, drug use (can cause both depression and hallucinations), multiple medical disorders, etc.
Exactly. It seems that one of the most dangerous aspect of mental illness is the inability to tell the objective from the subjective.

For those people who abuse drugs or alcohol, not only does it change their perception, they see and hear weird things, which are mostly caused by the chemicals affecting their brains.

We may not be using any drugs, but our brains require a fairly delicately balanced, of chemicals to function properly. Without such a balance, we can see and hear things that are not there, and perceive things in a completely different way.

The inculcation/indoctrination of theism, stimulates the body thus over produces certain chemicals, causing the body to react as if, partaking in drugs or alcohol, and it's effects,  which produces, a kind of euphoria.
Which can cause them to be mentally unsound and extremely dangerous. 

I run a Science based business, for the above reasons I will not have a Theist, Junkie, or Alcoholic in my employ.


So Mooby how would you define the difference between a man who thinks he hears god and a man who hears voices. Given that the invisible and the non-existent are very much the same.
We theists have no evidence for our beliefs. So no amount of rational evidence will dissuade us from those beliefs. - JCisall

It would be pretty piss poor brainwashing, if the victims knew they were brainwashed, wouldn't it? - Screwtape. 04/12/12

Offline Mooby

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Re: A Christian goes to see a Psychiatrist for a Diagnosis
« Reply #16 on: August 04, 2012, 02:08:33 PM »
The inculcation/indoctrination of theism, stimulates the body thus over produces certain chemicals, causing the body to react as if, partaking in drugs or alcohol, and it's effects,  which produces, a kind of euphoria.
Which can cause them to be mentally unsound and extremely dangerous.
Am I to assume this is well-described in the medical literature?

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I run a Science based business, for the above reasons I will not have a Theist[. . .]in my employ.
That's illegal in your country.

Quote
So Mooby how would you define the difference between a man who thinks he hears god and a man who hears voices. Given that the invisible and the non-existent are very much the same.
Well, as I said, I'm not a psychiatrist.  So in the real world I'd refer to them and let them figure it out.  But if for some reason that wasn't feasible, as I mentioned above, my first step would be to determine if it actually involves hearing a physical voice, and then go from there.  I'd want to do a thorough H&P before jumping to any sort of conclusion.

Let's grab a textbook:

Hallucination - False sensory perception occurring in the absence of any relevant external stimulation of the sensory modality involved.

Auditory hallucination - False perception of sound, usually voices, but also other noises, such as music.


So not too much help there, other than establishing that the person has to actually hear sound.

Hallucinations are false sensory perception.  For patients with hallucinations, the full phenomenolgy of the hallucination should be explored.  The patient is asked to describe the sensory misperception as fully as possible.  For auditory hallucinations, this includes content, volume, clarity, and circumstances; for visual hallucinations, this includes content, intensity, the situations in which they occur, and the patient's response.  The evaluator should distinguish between true hallucinations, on the one hand, and illusions, hypnagogic and hypnopompic hallucinations, and vivid imaginings, on the other.  Hallucinations are perceived as real sensory stimuli and should not be dismissed as fanciful; however, the psychiatrist should ask questions about their fixity and the patient's level of insight.  "Does it ever seem the voices are coming from your own thoughts?" or "What do you think is causing the voices?" (244)

So again, even if the person says they're hearing a physical voice, that doesn't necessarily mean it's a hallucination.  I think for distinguishing religious experiences the key areas would be content and circumstance: if the voice is mainly heard during prayer/meditation/spiritual exercises and is congruent with the person's religious beliefs, it's probably not a true hallucination.  However, if the voice is heard randomly and tells the person to burn things, then that's more likely a true hallucination.

I wish I had a more thorough book, though.  That one's a little light on the explanation.
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Re: A Christian goes to see a Psychiatrist for a Diagnosis
« Reply #17 on: August 04, 2012, 03:28:32 PM »
The inculcation/indoctrination of theism, stimulates the body thus over produces certain chemicals, causing the body to react as if, partaking in drugs or alcohol, and it's effects,  which produces, a kind of euphoria.
Which can cause them to be mentally unsound and extremely dangerous.
Am I to assume this is well-described in the medical literature?
Yes! We know that Endorphins, Dopamine, and Serotonin cause euphoria, Dopamine's in particular are what we find in abundance in methamphetamine it is what the user calls a "high". Serotonin is the chemical we find in antidepressants, These drugs are known as SSRI - Selective Serotonin Re-uptake Inhibitors. They work by blocking the sending neuron, thereby increasing the available serotonin levels in the synapse.
Quote
I run a Science based business, for the above reasons I will not have a Theist[. . .]in my employ.
That's illegal in your country.
So what. Whats your point, I didn't say I would blatantly state to the person it was due to their drug, alcohol, theist addiction.
They would be discarded from my employ for a completely different reason, though the main factor would be their addition.
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So Mooby how would you define the difference between a man who thinks he hears god and a man who hears voices. Given that the invisible and the non-existent are very much the same.

So again, even if the person says they're hearing a physical voice, that doesn't necessarily mean it's a hallucination.
In what way can you demonstrate whether that voice is real or imaginary, if you can't demonstrate it is real then your only course of action is to see it as imaginary?
I think for distinguishing religious experiences the key areas would be content and circumstance: if the voice is mainly heard during prayer/meditation/spiritual exercises and is congruent with the person's religious beliefs, it's probably not a true hallucination.  However, if the voice is heard randomly and tells the person to burn things, then that's more likely a true hallucination.
Same question above again?
We theists have no evidence for our beliefs. So no amount of rational evidence will dissuade us from those beliefs. - JCisall

It would be pretty piss poor brainwashing, if the victims knew they were brainwashed, wouldn't it? - Screwtape. 04/12/12

Offline fasi345

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Re: A Christian goes to see a Psychiatrist for a Diagnosis
« Reply #18 on: August 04, 2012, 03:32:35 PM »
seems like the patient is very close to God and may be he feel so due to his regard to God although the science need evidence to prove the existence of anything but there are many things which can only be explain through spiritual connection to God

Offline wright

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Re: A Christian goes to see a Psychiatrist for a Diagnosis
« Reply #19 on: August 04, 2012, 03:45:48 PM »
Welcome to the forum, fasi.

seems like the patient is very close to God and may be he feel so due to his regard to God although the science need evidence to prove the existence of anything but there are many things which can only be explain through spiritual connection to God

What would be something that can only be explained "through spiritual connection to God"?

As to the OP, it would seem to be a matter of how much the hypothetical patient's beliefs impact their day-to-day behavior. Most theists have worked out a series of compromises and rationalizations that allow them to function in modern society when their religious faith would get in the way. The minority that can't tend to have other mental / behavioral problems as well, and often get institutionalized or otherwise sidelined from the norm.
Live a good life... If there are no gods, then you will be gone, but will have lived a noble life that will live on in the memories of your loved ones. I am not afraid.
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Offline Gnu Ordure

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Re: A Christian goes to see a Psychiatrist for a Diagnosis
« Reply #20 on: August 04, 2012, 04:04:35 PM »
My bolding:
So again, even if the person says they're hearing a physical voice, that doesn't necessarily mean it's a hallucination.  I think for distinguishing religious experiences the key areas would be content and circumstance: if the voice is mainly heard during prayer/meditation/spiritual exercises and is congruent with the person's religious beliefs, it's probably not a true hallucination.
What exactly are you saying there? Your textbook distinguishes between true hallucinations and other hallucinations:
Quote
The evaluator should distinguish between true hallucinations, on the one hand, and illusions, hypnagogic and hypnopompic hallucinations, and vivid imaginings, on the other.
So what are voices heard during prayer and so on? You seem to be saying that they are one of the latter - "illusions, hypnagogic and hypnopompic hallucinations, and vivid imaginings".

Or are you saying they're real?

Please clarify.
 
« Last Edit: August 04, 2012, 04:29:40 PM by Gnu Ordure »

Offline Gnu Ordure

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Re: A Christian goes to see a Psychiatrist for a Diagnosis
« Reply #21 on: August 04, 2012, 04:54:04 PM »
Quote
Am I to assume this is well-described in the medical literature?
Yes! We know that Endorphins, Dopamine, and Serotonin cause euphoria, Dopamine's in particular are what we find in abundance in methamphetamine it is what the user calls a "high".
Bert, for your information, Mooby is a doctor and knows the effects of common medications. So you don't need to spell them out.


Excuse me, just trying to help...

Offline Mooby

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Re: A Christian goes to see a Psychiatrist for a Diagnosis
« Reply #22 on: August 04, 2012, 05:51:33 PM »
Yes! We know that Endorphins, Dopamine, and Serotonin cause euphoria, Dopamine's in particular are what we find in abundance in methamphetamine it is what the user calls a "high". Serotonin is the chemical we find in antidepressants, These drugs are known as SSRI - Selective Serotonin Re-uptake Inhibitors. They work by blocking the sending neuron, thereby increasing the available serotonin levels in the synapse.
Yes, these things have been shown to be involved in religious or spiritual activities.  Indeed, they are modulated in many activities of our daily lives.  But of course, day to day fluctuations generally are physiological, not pathological.

However, you likened religious experiences to "partaking in drugs or alcohol" and potentially leading to people becoming "mentally unsound and extremely dangerous."  It was this pathologic change to which I was directing my inquiries.  After all, if religious belief causes severe enough changes that it should be regarded as potentially detrimental to function as a drug or alcohol addiction, then given the prevalence of belief I'd think that it'd certainly be an important and exciting area for medical research.  Don't you agree?

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So what. Whats your point, I didn't say I would blatantly state to the person it was due to their drug, alcohol, theist addiction.
They would be discarded from my employ for a completely different reason, though the main factor would be their addition.
The point was to assess your level of bigotry so I can take it into account in future replies to you.  Checking to see whether you exercise it in ignorance or defiance of your country's laws was an easy way to do that.

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In what way can you demonstrate whether that voice is real or imaginary, if you can't demonstrate it is real then your only course of action is to see it as imaginary?
It's not up to a physician to determine whether the patient is hearing a deity's voice.  There are religious ministers to assist with that.  As I mentioned above, I'd be focusing on context and content.  Is the voice more consistent with the normal spectrum of religious experiences and practices, or is it more consistent with pathology?

I think you're confusing the physician's role in this.  A physician is not supposed to project his or her personal values onto the patient's condition.  Their job is to properly diagnose and treat the patient.  "I believe in God so the voice is real" and "I don't believe in God so the voice is imaginary" do not accomplish that.

\So what are voices heard during prayer and so on? You seem to be saying that they are one of the latter - "illusions, hypnagogic and hypnopompic hallucinations, and vivid imaginings".

Or are you saying they're real?

Please clarify.
They could be hypnagogic, hypnopompic, or vivid imaginings, depending on context.  Some spiritual experiences put people into states resembling sleep or hypnosis, where the first two could apply.  And no, I'm not saying they're real: it's not the doctor's job to pass judgement.
"I'm doing science and I'm still alive."--J.C.

Offline Gnu Ordure

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Re: A Christian goes to see a Psychiatrist for a Diagnosis
« Reply #23 on: August 04, 2012, 06:10:19 PM »
What I'm asking is this: Is religion an accepted excuse to have a mental disorder even in the medical community?

HAL, I tried to answer this question a couple of years ago, and if you'll forgive me I'll just re-post what I said then.

The thing is, where religion is concerned the definition of sanity is a numbers game ie it depends on what is normal.

If only a handful of people believed in Jesus and miracles and so on, they could be diagnosed by psychiatrists as suffering from Delusional Disorder; but if millions of people believe the same thing, the diagnosis does not apply; the beliefs have become normal, and respectable, and not insane at all.

This is not really the fault of the psychiatrists; they could stick to their guns, and declare that the majority of American citizens are technically suffering from a delusional psychosis ie the country is collectively insane. But this wouldn't be politic; it would damage, perhaps permanently, people's trust in medical opinion. So psychiatry bends with the wind.

Essentially, society defines insanity, not psychiatrists.

Wiki puts it like this, (here):
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Delusional disorder is a psychiatric diagnosis denoting a psychotic mental disorder that is characterized by holding one or more non-bizarre delusions[1] in the absence of any other significant psychopathology. Non-bizarre delusions are fixed beliefs that are certainly and definitely false, but that could possibly be plausible, for example, someone who thinks he or she is under police surveillance.
Note that in the US, normal christian beliefs qualify as non-bizarre, because they're normal. Wiki goes on:
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The DSM-IV, [Diagnostic and Statistical Manual of Mental Disorders] and psychologists, generally agree that personal beliefs should be evaluated with great respect to complexity of cultural and religious differences since some cultures have widely accepted beliefs that may be considered delusional in other cultures.[3] Specifically, to be a "delusion," a belief must be sustained despite what almost everyone else believes, and not be one ordinarily accepted by other members of the person's culture or subculture (e.g., it is not an article of religious faith)
That's the get-out clause; religious people are not to be defined as deluded if there are enough of them to form a culture.

I know it doesn't make sense medically (or logically); a delusion doesn't stop being a delusion if it's shared. But politically it does make sense.

I don't know what proportion of psychiatrists, psychoanalysts, psychologists and psychotherapists are atheists, but I guess it's pretty high, if only because Freud, the father of them all, was quite clear that religion was an illusion eg:

"Religion is an illusion and it derives its strength from the fact that it falls in with our instinctual desires." -- New Introductory Lectures on Psychoanalysis,1933.

"Religion is comparable to a childhood neurosis." -- The Future of an Illusion, 1927
 
"Religion is an attempt to get control over the sensory world, in which we are placed, by means of the wish-world, which we have developed inside us as a result of biological and psychological necessities. [...] If one attempts to assign to religion its place in man's evolution, it seems not so much to be a lasting acquisition, as a parallel to the neurosis which the civilized individual must pass through on his way from childhood to maturity." – Moses and Monotheism, 1939

Credit to Freud for the perception of his analysis, the clarity of his atheism and the logic of his thinking; unfortunately his message continues to be resisted.
« Last Edit: August 04, 2012, 06:15:13 PM by Gnu Ordure »

Offline Aspie

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Re: A Christian goes to see a Psychiatrist for a Diagnosis
« Reply #24 on: August 04, 2012, 07:18:09 PM »
I had myself pondered the psychological approach to religion when Richard Dawkins first made his observation on the subject. While on the surface it may seem like a discipline well-known in history for enforcing conformity is treating socially acceptable delusions with kiddy gloves, my understanding of the matter is that psychopathology is defined strictly in terms of impact on general functioning rather than the sum of one's mental oddities and the nature of their beliefs. Religious delusions or beliefs can certainly be relevant to the manifestation and assessment of mental disorders, but I'm not so sure I can agree with the idea that they are socially acceptable excuses on the grounds that the general application of such beliefs, especially among the more liberal sects, seem to be more about shared cultural identity and perspective rather than one's ability to assess reality. For example, the patient's anecdotes of God having helped him find his car keys and healed his mother's breast cancer are teleological ascriptions rather than observations of reality.

Where I'm coming from is that the human mind is grounded in subjectivity to the point where one might adopt beliefs for their utility without regard for their truth. According to the same line of research that brought you the well-known Dunning-Kruger effect, the happiest people tend to make use of a self-serving bias that causes them to overestimate their own competence, honesty, and generosity, attribute their successes to skill and failures to luck, project their weaknesses onto others, and take positive input from others at face value without consideration for what they're saying behind their backs. Moreover, research on eyewitness testimony and the split brain phenomenon suggests that our minds work to create narratives consistent with our beliefs and behaviors even when we're working with insufficient information.

To sum it up, perfectly healthy cognitive biases and defense mechanisms work to preserve irrational beliefs in order to maintain healthy functioning. To that end, the sets of beliefs that make up mainstream religions are more for the purpose of maintaining cultural identity and traditional viewpoints rather than describing reality. And in order to maintain such beliefs one might engage in such irrationality as thinking God has just talked to them. It's human nature to look to what best supports our biases, sometimes compromising our own better judgment to obtain confirmation. It's precisely why the scientific method is so effective - humans can't be trusted to be impartial or dispassionate with information. But the scientific information we glean through testing proves very useful in application even across entire fields of study.

Let's grab a textbook:

Hallucination - False sensory perception occurring in the absence of any relevant external stimulation of the sensory modality involved.

Auditory hallucination - False perception of sound, usually voices, but also other noises, such as music.


So not too much help there, other than establishing that the person has to actually hear sound.

Hallucinations are false sensory perception.  For patients with hallucinations, the full phenomenolgy of the hallucination should be explored.  The patient is asked to describe the sensory misperception as fully as possible.  For auditory hallucinations, this includes content, volume, clarity, and circumstances; for visual hallucinations, this includes content, intensity, the situations in which they occur, and the patient's response.  The evaluator should distinguish between true hallucinations, on the one hand, and illusions, hypnagogic and hypnopompic hallucinations, and vivid imaginings, on the other.  Hallucinations are perceived as real sensory stimuli and should not be dismissed as fanciful; however, the psychiatrist should ask questions about their fixity and the patient's level of insight.  "Does it ever seem the voices are coming from your own thoughts?" or "What do you think is causing the voices?" (244)

So again, even if the person says they're hearing a physical voice, that doesn't necessarily mean it's a hallucination.  I think for distinguishing religious experiences the key areas would be content and circumstance: if the voice is mainly heard during prayer/meditation/spiritual exercises and is congruent with the person's religious beliefs, it's probably not a true hallucination.  However, if the voice is heard randomly and tells the person to burn things, then that's more likely a true hallucination.

I wish I had a more thorough book, though.  That one's a little light on the explanation.

I wonder if just examining one's own thoughts meets the criteria for "true hallucination" they are using. Research on the brains of people while they were experiencing auditory hallucinations yielded some fascinating results: the most active regions weren't the ones associated with language comprehension, but with speech production, lending credibility to the idea that they were "hearing" their own thinking. It is, apparently, still auditory information being processed, just nothing being literally heard.

Offline HAL

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Re: A Christian goes to see a Psychiatrist for a Diagnosis
« Reply #25 on: August 04, 2012, 07:28:55 PM »
HAL, I tried to answer this question a couple of years ago, and if you'll forgive me I'll just re-post what I said then.


Essentially, society defines insanity, not psychiatrists.

...

I know it doesn't make sense medically (or logically); a delusion doesn't stop being a delusion if it's shared. But politically it does make sense.

Thank you very much for that. That's kindof what I was getting at with the OP. It just seems to me that religious thinking is an accepted form of delusion - nothing more. That's a shame really.

Now suppose the religious guy told his analyst that god (an agreed acceptable delusion) told him to kill 10 abortion doctors. Is that OK? Would the Doc report him to the cops? If so, why?

Offline Mooby

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Re: A Christian goes to see a Psychiatrist for a Diagnosis
« Reply #26 on: August 04, 2012, 07:39:59 PM »
Now suppose the religious guy told his analyst that god (an agreed acceptable delusion) told him to kill 10 abortion doctors. Is that OK? Would the Doc report him to the cops? If so, why?
No, it's certainly not ok.  Suicidal/homicidal ideation are serious concerns, and if a physician is concerned then she or he has an obligation to report it.  In fact, in some countries (including the US and Australia), they can be held legally liable for failure to report.
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Offline Gnu Ordure

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Re: A Christian goes to see a Psychiatrist for a Diagnosis
« Reply #27 on: August 04, 2012, 07:42:24 PM »
So what are voices heard during prayer and so on? You seem to be saying that they are one of the latter - "illusions, hypnagogic and hypnopompic hallucinations, and vivid imaginings". Or are you saying they're real? Please clarify.
They could be hypnagogic, hypnopompic, or vivid imaginings, depending on context.  Some spiritual experiences put people into states resembling sleep or hypnosis, where the first two could apply. 
Right. So those would be all unreal, correct? They still fit your definition of hallucination: False sensory perception occurring in the absence of any relevant external stimulation of the sensory modality involved...
So I still fail to understand what you meant when you said:
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if the voice is mainly heard during prayer/meditation/spiritual exercises and is congruent with the person's religious beliefs, it's probably not a true hallucination.
It's your example, Mooby: a person says they're hearing a physical voice. There are only two options: the voice is real (external), or it isn't. Whether a person is praying or meditating at the time seems irrelevant.
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And no, I'm not saying they're real: it's not the doctor's job to pass judgement.
Yes it is. Doctors pass judgment all the time. Here in the UK, you can be locked up in a hospital on the word of two doctors. If they judge that you're crazy enough.

Maybe it's different in America.
« Last Edit: August 04, 2012, 07:45:53 PM by Gnu Ordure »

Offline HAL

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Re: A Christian goes to see a Psychiatrist for a Diagnosis
« Reply #28 on: August 04, 2012, 07:42:51 PM »
No, it's certainly not ok.  Suicidal/homicidal ideation are serious concerns, and if a physician is concerned then she or he has an obligation to report it.  In fact, in some countries (including the US and Australia), they can be held legally liable for failure to report.

Hello troll.

If god said it was OK , and what god says is an accepted delusion, then why is the doctor concerned?