Unpopular opinion – Survival mode is not a good time for starting spirituality.
When someone is facing mental illness such as depression, anxiety, constant panic attacks, stress or general dissatisfaction, it is common to be curious about spirituality and the zen life that everyone talks about. I have had countless encounters by family, friends and even clients who have approached me to discuss spirituality in their most darkest, difficult times. Knowing how much I love spirituality, I am always waiting for opportunities to express how it has helped me within my life. But I have come to learn that just because someone asks you about spirituality, it doesn’t mean we need to answer. In fact, we should be cautious of what we say because we may just make things worse!
Physical survival mode
I know in India and many other countries, many people living in poverty convert into religion because of the guarantee of daily food, shelter and even education. During our travels, we have met many such people of different religions. Honestly, very few have expressed a desire to learn more about their religion and spirituality. Rather, they are upfront about their daily struggles of survival, and say how do you expect us to go towards spirituality when we cannot even lead a comfortable life for ourselves or our children!
Living in developed countries such as Australia, I know this may not sound relatable… but hear me out. There are actually many Australians in a similar stage of physical survival who may come to you for therapy services. For example, immigrants, asylum seekers, refugees, the unemployed, homeless, homes of domestic violence, changing foster homes, uncertainty of the NDIS world… The list goes on.
For these clients, I feel it is really important to be sensitive about the use of spirituality. The best help you can offer for such individuals is to help them in whichever situation they are in, in whichever role you can. This might be advocacy, education, job skill training or safety interventions. Really put yourself in their shoes and consider what kind of help would you seek?
Now some of these individuals may still wish to reconnect with their religious group. Rather than jumping straight in, consider what type of spiritual goal does this achieve in your client? As a daughter of immigrant parents, I observed that for them, weekly visits to the Gurdwara served as a place of belonging, stability and culture in a foreign country. Once they became comfortable and beyond ‘just surviving’ they started to have the comfort to explore spirituality more deeply.
Similarly, many clients may seek spiritual comfort in an unsure environment and this is completely normal. What we need to remember as OTs however, is not to provide spiritual services that they may not be ready for or not be interested in! Instead, we should listen to their individual goals and help them accordingly. This could be reconnecting with religious/cultural groups, teaching skills to access religious resources online or help establish habits such as prayer routines – whatever their goal is!
Put yourself in their shoes and consider what kind of help would you seek?
Mental survival mode
Individuals with mental illness are in a sense also in survival mode. Everyday is a battle of survival – whether it be from depression and its downward spiral, anxiety and its racing thoughts to panic attacks, bipolar, dementia…these beings are constant surviving an inner battle. It is very appealing then to be offered such a type of therapy that will make all of these go away (think zen puppies). I would like to again suggest caution in the use of spiritual intervention as it can cause a lot more harm than good for this population if we do not start off on the right foot!
To start off with, I would suggest to really question the client about what they hope to gain from spirituality – What are their intentions, goals? How do they believe they will get there? What do they believe will happen?
Screening and having a clear discussion beforehand will really help you and the client get onto the same page. This is really important because it is such a sensitive area to work in and will also reduce the chance of spiritually bypassing important issues that need to be worked on for progress. Ensure you have clarified your role as helping the individual to make empowered and informed decisions for themselves.
I have this perspective because I have seen firsthand that there are many negative and harmful spiritual beliefs out in the world that can make mental illness worse.
I have heard so many people seek religious guidance only to be dismissed and be told ‘just pray, it will all work out.’ Further, starting a religious routine can also feel like a burden and/or trigger for those with mental illness, just as any occupation might. This is why it is so important to have a really clear intentions and spiritual goals from the get go so the therapist can provide the necessary support.
Worst still, I have seen cases where someone with a mental illness has reached out to their religious group for company, only to not be accepted due to close minded individuals. Of course we hope religious groups are a safe place but we cannot guarantee it, and must be aware of these very real challenges we might have to face! There may be taboos against mental illness, beliefs such as demonic possession, karma for bad deeds, and extremists who may groom, take advantage of and force radical beliefs on this vulnerable population.
So please, really take the time to have a transparent discussion with your client about their spiritual goals, what they hope to get out of it. That way you both can be prepared for possible challenges ahead. I talk more about different types of spiritual goals here.
To end, I will share a recent story of mine.
Last week I was speaking to a girl, who was interested in spirituality and meditation because she was going through mild depression. I spent a while understanding her and realised she had little physical activity, an unhealthy diet, no meaningful occupations and was feeling isolated due to a pandemic lock down in her area. I realised the girl had more primitive needs but was hoping to use spirituality to fill these voids. She had tried meditating but did not find it helpful. She wanted to exercise more but struggled to find motivation. She was interested in spirituality. Her family practised Islam, which she was also fond of. So after listening and understanding the situation, the following is what I suggested:
- First I provided education in the importance of sleep, exercise, healthy diet and routine for mental well-being. She found this very helpful.
- Then we discussed her current routine and small changes we could add.
- Serving of vegetables each day.
- Going to workout mat at least 3 x week (she liked HITT so I also gave a Youtube playlist suggestion). Emphasised it was not about actually doing the workout, just bringing herself to her mat.
- Getting drawing tools out and placing next to bed
- Praying with her family, reading the Quran
I also explained why her previous meditation attempt had not been helpful, which she absolutely loved and really resonated with. At the end of it, this girl was feeling so empowered, less lonely and gained a more wholesome perspective of spirituality.
So remember, we are here to make things easier for people. Don’t be afraid of using your own clinical judgement to ensure safety, but also make effort to include spiritual goals in your therapy.
How did you find this post? I would love to hear your thoughts in the comments below, or reach out on social media! I hope to connect with you soon.