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Understanding Mental Health with Doc Ayomide: Are Mental Health Problems Really ‘Spiritual’?

Doc Ayomide

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dreamstime_l_30569376I’ll never forget the woman. She was middle-aged, visibly sick, and surrounded by a foul-smelling odour that on closer examination, emanated from her breasts. Her diagnosis: stage 4 breast cancer.

It had been diagnosed over a year earlier, at an earlier stage. Surgery had been advised then, but that had been the last anyone saw of her. The rest of the story had come out on her return. Alarmed at the prospect of going under the knife and losing her breast, the poor woman had gone seeking spiritual help. But the cancer went on rapidly ravaging her and she had returned, terrified, to the hospital to get the surgery after all.

The problem? The cancer had spread beyond the breast (which is what stage 4 means) and surgery wasn’t going to do.

Later, talking to us students, the surgeon was very vocal about his frustration with her (for fleeing treatment when the prognosis had been good) and with religion (for giving people false hope that was costing lives).

I couldn’t blame him. Not then, not since. I have often thought back, over my years of practising, to that moment and to his frustration. It’s a frustration I’ve come to know too well. I feel it when I see people shun medical care that works in favour of dubious traditional and spiritual remedies. I feel it when I hear religious leaders subtly (and sometimes not so subtly) discredit medical care. I feel it when friends and relatives who undermine the confidence of their loved ones in the healthcare system. I feel it when fellow medical doctors make careless statements that encourage the continued spiritualisation of illness.

And I feel this frustration doubly, because I am a person of faith myself.

Growing up, I was caught up in the conflict between faith and science. Both represented identities I was unable to reconcile, more so because people on both sides saw them as mutually exclusive: “true believers” didn’t get bogged down by what they didn’t know, my beloved science and science-fiction books disparaged faith. And just as I was beginning to reconcile the dichotomy, I started my specialisation in, psychiatry, the one medical field almost everyone (including fellow and senior doctors) agreed was really spiritual! I’ve actually had a fellow doctor friend say: “But, deep down you know it’s spiritual.”

But are mental illnesses really spiritual?

Here’s my answer, in 3 parts:

#1. Medications work. No, really
So if mental illnesses are spiritual, how come meds work? The general impression is that they don’t, but they do amazingly well, they’re even cheaper, generally, than medications for other long-term health conditions.

Makes you wonder: if mental illnesses are spiritual, then these are a very interesting variety of spirits. (Yes, I know medications don’t work all the time. But then, how many things in real life work all the time? And especially when it’s the complex machine that is the human body we’re talking about—maybe we should cut meds a bit of slack?)

I’ll tell you something—no, make that two things:

  • Medications work more frequently — and more reliably—than the trado-spiritual remedies people favour so much.
  • A number of trado-religious practitioners actually use medications (at least in mental health). This is from experience. Some give people “holy water” that induces sleep. (Sedatives, anyone?) Or explain the patients I’ve seen who came from such centres with side effects of over-medication — and hadn’t seen any doctor?

You know the funny thing? This isn’t even about knocking non-medical practitioners. I’m just saying, even they agree (if only tacitly) that medications work. Can we all just agree on that?

#2. We know more now. Much more
Let me explain with a familiar example. The idea of children who kept reincarnating only to die early is a well known one: in Yoruba, we call them abiku, while the Igbo call them ogbanje. They were the children who wouldn’t stay, and the practice then was to mark them (to know them when they came again) and pray that maybe this time, they could be persuaded to stay.

But now we know about Rhesus incompatibility which can cause baby after baby to die (learn more here). Now Rhesus negative mothers with positive fathers get RhoD injections—tell me when last heard of anyone with access to medical care who had abiku?

That’s just one example. There are others, in health and other fields. (“Monster” children and what we now know about causes of fetal malformations. Lightning and Sango. Rainmakers as the original “weathermen.” You get the idea.)

My point? We came up with “explanations” for strange phenomena because we didn’t know better. But as we have come to learn more about ourselves and our world, many of these phenomena are themselves disappearing. So here’s what I tell people: I won’t argue with you about whether or not mental illness is spiritual, as long we can agree that it’s no more spiritual than malaria is. What I have an issue with is making it specially spiritual.

In most fields of medicine, we don’t hold on so much to the old trado-religious beliefs. (Yes, I know they still persist in many other ways, but generally, yeah?) In mental health, we’ve not let go of them, but I’m saying: is that because we have actual proof in their favour—or because we simply aren’t aware of the increasing — and increasing available — knowledge about mental health and illness?

#3. What if there’s another way?
It sounds like I’m knocking spirituality, doesn’t it?

Yes, I am: I’m knocking the version of it that’s anti-medicine. Because it kills people. This thing is not theory: I’ve seen people die because of these misconceptions (the woman in the story I told at the start ended up not making it). But what if, instead of seeing spirituality as an alternate explanation, we saw it rather as just a different language for the same phenomena?

In my work with clients, and their various or no faiths, I neither ignore nor tackle the spiritual beliefs or unbelief of my clients. On the contrary, I work with them as they are. I use what I know of their beliefs to explain to them what I know of their illness. (Sometimes I’ve been asked if I shared their faith!)

In general, modern medicine has come to accept the big role spirituality plays in most people’s lives. In the early days of mental health, there were views of spirituality as a mental health problem in itself, but that’s changed. Now most psychiatrists won’t insist on an anti-spiritual view. If a client sees illness as spiritual, it’s fine: as long as they see it as medical as well. Nothing wrong with praying, as long as you also take your meds and take other medical advice seriously.

So, are mental illnesses spiritual? If by “spiritual” you mean “not physical”—NO. But if by “spiritual” you mean “in addition to physical”—then MAYBE.

What next?

Faith offers hope. So does medicine. But they offer it in different ways.The question is, can those ways be used complementarily? And I would say the answer is yes, even though their different approaches have often been portrayed as antagonistic. I will write more on this, but here are a few ideas, for starters:

  • Religious leaders can use their influence to combat stigma and misconceptions. Even the way they talk about it can make a difference.
  • Religious communities can be more deliberate about supporting people with mental health problems, including those who care for them. And do not be deceived: every community has some.
  • People of faith in general need to talk more about the intersection of faith and healthcare, and how we can translate from one “language” to the other, so the two views can understand each other.

What do you think?

Photo Credit: Dreamstime

Dr Ayomide Adebayo is a medical doctor, mind health consultant and founder of Maximise Your LIFE, a community for people who want to live to the full. Grab your copy of his FREE resources here — plus instant access to his potentially life-changing email course!He writes at DocAyomide.com and tweets @DocAyomide. To ask a question, book a session — or just say hello — simply e-mail him ([email protected]).

31 Comments

  1. DayoI

    May 2, 2016 at 4:16 pm

    You have nailed it right on the head!
    As a medical student who hopes to practice in Nigeria (at some point), the (over-)spirituality of Nigerians is definitely something that will make it doubly difficult. The other thing is the inability of the vast majority to afford suitable healthcare, but that’s a topic for another day.
    I have the belief that if you want to be helped spiritually, you first have to help yourself physically. If there is something that is not right, PLEASE go to the doctor first! Secondary to that, you can go to your imam/pastor/Babalawo or whoever later, or pray about it yourself to whatever God you believe in.
    If you sit at home with a serious illness, from generic infections to cancers, it is pretty impossible to avoid the inevitable.

    • Dayola

      May 2, 2016 at 6:00 pm

      If I was in the US or in Asia sef, oh yes I’ll run to the doctor if I notice something wrong, but in my country, Nigeria, I’d rather run to God, not necessarily to a pastor but I’m gonna run and plead with him cos more than half of Nigerian healthcare workers do not know what they are doing.

    • Doc Ayomide

      Doc Ayomide

      May 2, 2016 at 7:28 pm

      “If you want to be helped spiritually, you first have to help yourself physically.” Well said, And I completely agree with you about affordability being a major issue in this conversation, although to be honest, the trade-religious alternatives aren’t necessarily cheap. (I know one client who had “jazz” done for him for ₦250k!)

  2. mii

    May 2, 2016 at 4:44 pm

    Good write up, i believe spirituality and faith play big roles in recovery from medical conditions from what i have seen and heard,a naturally optimistic patient( or one who is optimistic based on faith in the healing ability of a higher power) sometimes has a better prognosis or outlook than a gloomy more pessimistic patient..
    I think it has to do with self affirmation for instance,when you talk to yourself and say I’m the best,I’m wonderful,I can do this. You are making an affirmation or declaration.For Muslims and Christians the believe is that these affirmations will come to pass based on their faith and believe in their respective holy books,while others who don’t subscribe to either base the affirmations on spiritual vibrations,energy of the universe,self ability or whatever other beliefs they have.

  3. mii

    May 2, 2016 at 4:49 pm

    p.S i was speaking about medicine in general, not specifically mental illness as my knowledge in that field is not as extensive as i would like it to be

  4. Bimbo

    May 2, 2016 at 4:53 pm

    The church seems to be in a fight for supremacy you with medicine! They want members to believe the church is a refuge for everything including illness ( especially stigma laden or seemingly difficult to diagnose diseases) . The church will not give up the strangle hold they have on their members who have been scared silly from the pulpit with tales of principalities causing strange illnesses, witches wanting to feast on your blood, agents of darkness trying to steal your destiny etc! All this because we have a piss- poor medical system, lack of basic infrastructure and an ailing economy. The simple process of going to hospital for good medical treatment or getting a job after graduation ( which shouldn’t be a herculean task in a well managed economy) Now assume miraculous proportions which we have to pray, fast and light candles for!

    • Lute

      October 16, 2018 at 10:24 am

      Very say :'(

  5. Aminat Mamman

    May 2, 2016 at 4:54 pm

    This is an excellent piece for my siblings to read & maybe would accept that spirituality & science can work together. Have a brother with mental illness, this subject has been a source of disagreement between us from inception. Instead of concentrating on the two types of medication, quite a number of us believe we should go spiritual only.’ This is not for the hospital ‘ This illness does not require injections’ they say & this attitude takes us back & forth resulting to relapses and having to start all over again! I pity the situation, more so when it is coming from well educated & exposed people like my siblings. Thank you Doctor, I’d pass on message.

    • Doc Ayomide

      May 3, 2016 at 8:33 am

      Aminat, I’m glad you found it helpful. Please do pass it on!

  6. Nicole

    May 2, 2016 at 5:10 pm

    It is high time someone tells me who this model is.. BN do something

  7. That worried sis

    May 2, 2016 at 5:21 pm

    I completely agree with doc, faith and medicine offers hope and both should work together. I have been thinking about my brothers’ issue lately. My brother is 26 years, he has worked in 3 different organisations after he graduated 3 years ago, he left does jobs without explanations. He is a compulsive thief, steals anything he sees around. he has stolen memory cards, neighbours shirts, people’s ATM and all sorts. I am beginning to believe he has mental issues as I just can’t imagine what goes on in his mind when he is doing all these. He’s been arrested several times but he just won’t stop stealing
    We have taken him to several men of God for counselling and prayers but no sign of change in him. Dad is hypertensive while mom was just diagnosed with anxiety. we are all fed up and sometimes I wish he will just die and let us rest. What do u advise we do?

    • Elizabeth

      May 2, 2016 at 5:36 pm

      You can take him for an assessment dear. They cost 25k that will allow him to address the issue. Also look at his diet. His Diet also can contribute to him getting better. Reduce gluten and sugar. Cut out white carbs. There is hope dear.

    • le coco

      May 2, 2016 at 6:19 pm

      ur brother seems to be suffering from kleptomania. He needs to seek help right away. .

    • Doc Ayomide

      Doc Ayomide

      May 2, 2016 at 7:26 pm

      Have you tried to have a mental health evaluation for him? I notice you didn’t mention anything like that. I strongly suggest you consider this.

  8. bruno

    May 2, 2016 at 5:25 pm

    who religion don epp?
    what illness has religion ever cured?

    when it comes to real life matters, religion should be out of the question.

    religion confuses and influences people to make poor decisions on very important issues.

    religion will make matters worse. stay away from it totally.

  9. Toluse

    May 2, 2016 at 5:36 pm

    For me I think you just nailed it. And this applies to every aspect of medicine. We need to understand that faith has her place as well as medication

    • Doc Ayomide

      Doc Ayomide

      May 2, 2016 at 7:32 pm

      Thanks, Toluse. And you’re right: it does apply across the board.

  10. Osewa David Olawale

    May 2, 2016 at 5:43 pm

    Great stuff bro. Quite enlightening

  11. lolade

    May 2, 2016 at 6:13 pm

    Kudos to you Dr Ayo. That’s the point exactly. The bible even says that ‘prayer without works is vain’.
    Also ‘my people perish because of lack of knowledge’ . I wish this can be aired on the radio in English and other languages. May God bless your career doc.Amen.

  12. Dr. N

    May 2, 2016 at 6:46 pm

    I really like your conclusion.
    Faith is another language simple.
    In Nigeria, it is particularly hard bcos hospitals r poorly run esp d public ones. Patients feel intimidated by d attitude of health workers.
    Compare with pastors who call u up, visit, love u n all. The choice is clear.
    The trado ppl speak our indigenous lang, sell drugs on credit n give diagnosis that r easy to believe eg Yellow urine = typhoid. A doctor will argue n argue but d trado will take your money n run.
    I think health workers need to come off their high horses n treat patients the way hostels treat clients…as if they matter
    Cheers

    • jinkelele

      May 2, 2016 at 8:57 pm

      Hi DrN….was a little woHow have you been?

    • Dr. N

      May 2, 2016 at 9:44 pm

      Great. Thanks for asking

    • Wellsbaba

      May 3, 2016 at 4:32 am

      Great point of view. So it is also possible that medical practitioners are subconsciously deflecting, through their cold attitude, patients who need their help.

  13. Dr. N

    May 2, 2016 at 6:47 pm

    *hotels*

  14. Tunmi

    May 2, 2016 at 7:25 pm

    ????????????

  15. Jam

    May 2, 2016 at 8:49 pm

    [email protected] That Worried Sister: Your brother clearly has a problem and I am truly sorry; medications would definitely help so he needs to see a pysch. Or preferably if you can keep an open mind, TAKE HIM TO T.B. JOSHUA. I have seen much in my lifetime.

    The good Dr offers a half assed explanation for the phenomenon of ogbanje. He failed to offer any explanation about the ogbanje children could be reborn with the marks and amputations made on their bodiess after death during their previous birth? I have a sister born with a missing pinkie as a result of this. Our mother had lost 3 daughters before she was born. I believe the phenomenon became obsolete with the advent of Christianity. How many poor people have access to good medical services??? but we all know that most are extremely religious hence the disappearance of obganje although they still appear from time to time. There would be no need for exorcisms if spiritual interference did not exist however, the Catholic church usually undertakes extensive investigations to rule out mental illness before performing an exorcism.

  16. Onyinye

    May 6, 2016 at 6:44 pm

    Interesting and insightful read.welldone doc

  17. hah

    May 7, 2016 at 11:57 pm

    All illness are not physical. Pray say you will not see d one that will pass you. ogbanje full ground, witchcraft full ground, the devil has a version of all disease as afflictions.Of course i will not say this to a patient or student asking me questions in the ward.This world is full of pretense, When i want to be, i will be all medical like the writer and people will agree and say yes!!.But my people, things are not always what they seem.The family i come from is one of those families people watch in nollywood films, until you here people debating on how to jazz lawyer or judge causally while watching tv or people checking the lifespan of people before marriage like you are checking B,p then will understand that the spiritual controls the physical. There is no spiritual plot in nollywood film that has not happened in family, to me , or someone i know,it may seem far fetched but then again what is movie to people is real life to us,This is not hearsay,i have participated and seen things.The devil is real and God is supreme. Always view things from both angles.

  18. demashi

    October 31, 2016 at 1:57 pm

    Brilliant write-up. The Bible says “faith without works is dead” so we need to back up spirituality with action. I know this first-hand, younger brother couldn’t stay in school and displayed very weird demeanour most times. Year after year with my folks classifying it as a spiritual issue, I got tired and took him to see psychiatrists and psychologists. Eventually, he started treatment and has been progressively getting better. Someone who should have left medical school 5 years ago is now finally getting round his studies. I prayed more than most for his healing but I knew we also needed some action and help. Travail in prayer but please make available wisdom the Lord has given to the sons of men.

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