How to use psychiatry well: religious communities, medicalization, and the person

Abstract

How do members of religious communities determine when medicalization—the use of medical models to account for forms of experience and behavior previously understood using religious and spiritual categories—is appropriate? Psychiatry, as a discipline, lacks any consensual, conceptually valid method by which to demarcate the boundaries of its professional and clinical domain: although psychiatry understands itself as the medical discipline dedicated to the prevention, diagnosis, and treatment of “mental disorders”, psychiatry’s most widely accepted definition of “mental disorder” is both practically impotent and conceptually flawed. Psychiatry, therefore, lacks internal conceptual resources adequate to resist inappropriate medicalization. Considered as a social process, however, medicalization is rarely unidirectional: it frequently involves collaboration between clinicians and the individuals and communities affected by a new medical diagnosis or category. This has historically been true of the medicalization of forms of life previously regarded as religious or spiritual matters, as is made clear by the examples of the medicalization of problem drinking, the medicalization of emotional disturbances, and the medicalization of post-combat suffering. Religious communities, therefore, must discern for themselves when psychiatric medicalization is appropriate and when it is not. Four guiding questions can aid religious communities in developing a prudential approach to using psychiatry in the service of the person.