Pagan Therapy and Counseling for a Pagan World

I got to visit the grand re-opening of a drop-in center on Friday.  A drop-in center (sort of like the name implies) is a facility, usually run by other mental health clients, for the benefit of mental health consumers.  They play games, watch movies, generally hang out, and frequently get involved in educational and job-related activities as well.

Anyway, I walked into this drop-in center and shortly noticed 4-5 clients all wearing pentacles, dragons, tattoos, and all the usual status stuff that marks Pagans as Pagans.

This was interesting as I don’t generally encounter lots of Pagans in the more serious mental health settings.  (While not always true, people who choose to hang out with other mental health clients on their free time are often among the more seriously mentally ill.)

Well, apparently several of these Pagan folk attend the psychiatric rehab program (PRP) across town (ironically they don’t attend mine — where the management is Pagan).  Pretty soon I was hearing stories of astral battles, shamanic banishment of astral nasties, and the ways in which their PRP was now cleansed, warded, and protected courtesy of the Pagan clients.

All in all a rather normal Pagan conversation.  Except for the setting.

Which put me in both a state of cognitive dissonance and a thoughtful mood.

Cognitive dissonance because half of me approved and the other half of me was evaluating for possible delusions.  Thoughtful because of all the ideas and questions that came to me.  A sampling:

• How exactly would the typical psychiatric center staff react if they caught a banishment ritual going on?  How should they react?  Do they dare even consider allowing it?
• In a traditional culture (or a Pagan discussion environment) this problem would not even arise.  The shaman (or Pagan) would of course be allowed to proceed with the banishment.  It would not matter if he/she was really banishing nasties or just hallucinating it — the community support would make it no big deal and possibly be healing to the individual.
• But in a serious mental health center, when do you let clients run free with their paranormal experiences — especially if they are involving other clients?
• Hmmm… maybe I should ward and cleanse my PRP better too…

I’m intrigued how this all fits together.  I suspect these Pagan folks just quietly do their thing, with the psychiatric staff none the wiser.  Perhaps the staff overlook a certain amount of odd behavior.  I think there would need to be a treatment team ethic in place something to the effect that its healthy to allow clients to work through their own delusions if no one is being hurt.  (And of course, maybe its not delusion and the center is the safer for it…)

I’d be real curious to know how this balancing act plays out at their PRP — but of course if I ask I might upset the apple cart.

I sent the following memo out to my staff at a psychiatric rehabilitation day program today.   What are your thoughts on the proper role of religion and/or spirituality in a state-funded psychiatric environment?  When does it help with recovery?  When does it hurt?  Does the presence of ANY religion pressure nonbelievers?  Does its absence leave believers with a hole in their heart?  What if they don’t have the means to get out to their religious or spiritual community?

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Religion and spirituality has always been a touchy subject in mental health.  I’ve been sending strong signals lately that some religion and spirituality in the program is fine. Here’s why:

• Our institutional population is often not able to get to church or other religious activities and so are missing out on the spiritual/religious aspects of their lives.
• I believe in a holistic program approach encompassing mind, body, and spirit.  We bring in everything else the clients need.
• There are now several studies in the psych literature that show a link between spirituality and recovery – especially for depression and for drug/alcohol issues. (See Keating & Fretz, 1990; Propst et al., 1992; Worthington, Kurusu, McCullough, & Sandage, 1996).

 However, at the same time this is a secular, state-funded program which provides equal services to all clients – religious or not. 

 So a balance is needed – a way to provide spiritual and religious programming but in a totally optional way that pressures and evangelizes no one.

Here are the rules I’m flying by for spiritual and religious classes and activities:

• They are appropriate only if there is absolutely no pressure whatsoever on clients to attend.
• They are appropriate only when there are other attractive activities in the same timeslot of a secular nature.
• Spiritual/religious activities will usually be held in a side classroom rather than the community room in order to further emphasize that attendance is optional and so it does not by default grab up folks who just sit in the community room.
• There must be enough client interest to justify the programming strictly on client need (not evangelism).   This is pretty clear for Christianity right now.  For other religions like Buddhism, etc. I’d theoretically be just as happy to have classes if there was a need.  I suspect given smaller numbers of interested clients, such could be accommodated by client-run clubs.

 This is verbose, but I hope clear – please feel free to hit me with questions individually or at staff meeting.

I’ve recently accepted a new position as the director of a psychiatric rehabilitation day program. The hours are such that I can continue my private practice as well.

This means that I will be front-and-center in confronting (at least occasionally) attitudes towards Paganism in the institutional and medical model setting.

It’s alot easier to handle Pagan clients properly in private practice. There, decisions are mostly just between the therapist and the client. There too, clients are usually much more capable and self-sufficient. It’s easy to accept a client’s worldview that they talk with tree spirits when they hold down a job and have friends and function normally. It’s much more difficult when:

• The client has a 10-year history of psychotic behavior such as screaming at voices on the street corner, burning down houses, & attacking police as agents of the Martian invaders.
• Medications are proven to help control the above symptoms.
• The whole clinic system is primed to watch for and interpret any unusual behavior as illness.

Luckily, its darn rare (so far) to encounter a practicing Pagan client who is majorly psychotic like in the above example. But its terribly difficult to try and explain to a treatment team that certain beliefs and practices are okay when the client so obviously has problems. And who knows when such a client’s “Wiccan” behaviors will veer off in a bizarre direction having nothing to do with Wicca?

As usual, the criteria of whether or not Pagan beliefs (or any unusual beliefs and behaviors) are hurting or helping the client is at least a starting point. (Evaluation criteria is the subject for another post.)

I’m just sharing my concern, but also excitement, with being in a position to handle Pagan client issues as they come up from within an institutional setting.

In the past part of what I’ve done has been to run a spirituality and world religions class for psychiatric rehabilitation program clients. One of many reasons for the class was to be able to provide education on all manner of spiritual beliefs (occasionally including Pagan), a safe discussion place for clients to talk about their beliefs, and support for there being many paths to the Divine — or at least that tolerance of your neighbor’s beliefs is a Good Thing.

So — I’m opening the floor to ideas. What sorts of support would you like to see in institutional settings (hospitals, day programs, etc.) for Pagan beliefs? How do you think staff should handle such amongst patients who are profoundly mental ill (schizophrenia for example)? Do you have stories about someone’s treatment in such a setting? As usual, do not post any information that names institutions or individuals or is specific enough to trace and identify.  If you say something about yourself, make sure you are okay with the whole world knowing.