To the Editor: The article by Curlin and colleagues in the September issue interested me for several reasons. First, it illuminates an area that has been largely neglected by the psychiatric profession, although I am sure that many of us have private conversations about the interface between psychiatry and religion.
One particular conversation comes to mind. A colleague whose office was across the hall came into my office appearing frustrated. He said that he was no longer going to take any patients referred to him by Roman Catholic sources. "The patients know I'm a Catholic and subtly coerce me into agreeing that we do not explore their religious beliefs. If I refuse, they drop out of treatment."
In my experience, the other side of that coin, however, is that many psychiatrists not only have little use for religion but an alarming lack of knowledge about it. I was raised a minister's son, and although I emerged from the experience with a lack of belief, I have no lack of knowledge of religion. This may be why church leaders and seminary officials have referred many patients to me. I would be able to understand where the patients were "coming from."
People often call upon religious feelings to deal with psychological conflicts. Guilt, if real, is often relieved by prayer or confession. Irrational guilt, however, is not, and this is the bulk of the guilt we deal with in psychiatry. Here, religious belief may function as a defense reaction and become antitherapeutic.
In summary, I would recommend that psychiatric residency curricula include didactic courses in comparative religion. In more than 50 years of practice, I have known too many colleagues with little or no understanding of religion and its varieties.
Dr. Hicks, a psychiatrist who is retired from private practice, lives in San Rafael, California.