I’ve embedded a number of links below, and I would urge you to explore them. I initially had included far more quoted material, but the post became too long, and I finally decided that links and brevity were best. However, the linked information is highly relevant. Most of the links are to summaries or small items I think you can investigate without too much time lost—so please review them if this topic interests you.
Dr. Poole’s abbreviated CV:
- Professor of Social Psychiatry, Bangor University, North Wales
- Co-Director, Centre for Mental Health and Society, North Wales
- Honorary Consultant Psychiatrist, Wrexham Maelor Hospital
- Chair of the Royal College of Psychiatrists in Wales
- Trained at St George’s Hospital, London and in Oxford
- Worked for many years in central Liverpool as a community psychiatrist
- Published on a range of subjects, including a standard textbook on psychiatric interviewing with Robert Higgo, work on alcohol misuse, creativity and mental illness. He also has a book coming out later this year on mental health and poverty.
The main reason I wanted to have him appear on TAE, is that he has unwittingly ended up in a British debate about religion, spirituality and professional boundaries. He has published more than he probably ever imagined he would on this subject as a result, and has also debated George Carey, former Archbishop of Canterbury, on this issue.
What makes Dr. Poole interesting to the atheist community?
In an e-mail response to me, he described a paper I’d stumbled upon as, “a written version of my presentation in a debate with George Carey (former Archbishop of Canterbury).” It was this paper that first motivated me to contact him with questions concerning a totally different matter I was researching that also involved ethics, religion, and healthcare. His paper was, “Secularism as a Professional Boundary in Psychiatry.”
Dr. Poole made it crystal clear his agenda has nothing to do with atheism, and everything to do with wanting to promote ethical practices in mental health care and patient treatment. After a few months of correspondence, I came to realize the issue he was confronting was every bit as relevant to the atheist community as the issue I’d initially been investigating—which was, in case anyone is curious, pharmacists refusing to dispense birth control due to personal, religious objections..
As noted above, Dr. Poole is acting as Chair for the Royal College of Psychiatrists in Wales. The Royal College is the UK professional association for psychiatry. They are a professional association with a peer-reviewed journal, and it may surprise you as much as it did me, to learn they are currently debating the ethics of using religious rituals as part of professional psychiatric therapy—specifically doctors praying with patients.
What struck me hardest about this initiative was that this isn’t a home-spun Christian “therapy” offered by pastors. This is a group of professionally licensed psychiatrists, expertly trained mental health professionals, strongly asserting they would like to make religious ritual part of their practice. In a 2009 article Poole described it this way:
There is a rather large Spirituality and Psychiatry Special Interest Group in the College that is pressing hard to make spirituality a central concern in everyday practice, not to mention that they want to make it a core competency for all psychiatrists. Many of my colleagues, some of whom have a religious faith, think this is wrong, and so do I.
The “prayer in therapy” debate in the BJP:
By 2011, a debate was published in the British Journal of Psychiatry, wherein Dr. Poole argued his case with Dr. Christopher C. H. Cook, who advocates “spirituality” as being key to mental well being. Dr. Cook is author of “Spirituality and Psychiatry,” and also the past chair (and current committee member) of the Spirituality Special Interest Group, at the Royal College of Psychiatrists. I very much encourage you to visit their page, and read the content under the heading, “What is spirituality?” It is an exercise in Failure to Elucidate.
The full text of the debate is not, as far as I am aware, available online, but it’s fair to summarize that Poole and Cook agree that if a patient requests, and could benefit from prayer support, they should have access to it. Poole advocates referrals to religious groups or clerics who most closely align with the patient’s expressed religious preferences. Cook wants the psychiatrist to be directly involved in the prayer ritual.
Both men seem to agree, as well, that introducing prayer into therapy opens the door for potential abuse. For me, then, the question becomes, “If the same benefit can be derived by an outside group that alleviates the risk of professional abuse by the doctor, why not provide the benefit and eliminate one more avenue of potential professional abuse?”
As Poole stated in the debate with Cook:
Most importantly, Cook can offer no mechanism to protect patients from religious abuse or unwitting harm, other than the practitioner’s judgement and good will. This question is important and should be the subject of wider debate.
Cook replies by stating he doesn’t see how not praying would avoid abuses—but then goes on to issue a caution to doctors to avoid abuses that could arise from offering prayer in therapy:
I cannot see how prohibiting prayer would prevent either religious abuse or unwitting harm. Rather, guidance is required which clarifies the nature of good practice. I would suggest that prayer with patients, like all good clinical practice, should not exploit their vulnerability, cause them harm or distress, or be judgemental. It should not be used by the psychiatrist as an opportunity to foist their own views and beliefs upon their patient, or to legitimise their authority, and should only take place if it is compatible with full respect for the views and beliefs of the patient. It should be documented in the notes and, if there is any doubt, discussed with a supervisor or colleague. It should only be undertaken with consent, normally by request of the patient, and no pressure should be exerted for it to occur.
This may seem a bit of a dig, but Cook also mentions personally offering silent prayers on behalf of his patients, which inspires in me, at least, the image of the surgeon praying before the surgery, and the nervous patient wondering if they should have sought a surgeon with more confidence in their own skills. If I don’t trust my own skill and capacity, or if I doubt the efficacy of my profession’s tools to do the best that can be done for the patient, such that supernatural interventions must be invoked—why would I even be in the business? Would it be frightening at all, if I cut open a chicken to read the entrails before proceeding?
My letter to the BJP:
In support of patient protection against religious abuse, I sent the British Journal of Psychiatry a letter. Because I wasn’t sure I met their criteria for publication, I was happily surprised when it was published in November 2011.
In essence I asked how prayer in therapy could be fairly conducted without conflict of religious preferences for doctors and patients. What if the doctor is Muslim, and the patient requires a prayer in Jesus’ name? If praying with patients becomes standard practice, can the Muslim doctor refuse the prayer? If the doctor only offers prayers with Muslim patients—isn’t that discriminatory toward the patients from other religious traditions? And if the doctor is required to pray to accommodate all religious sects, regardless of his/her own affiliation, doesn’t that infringe on the doctor’s religious freedom? Ultimately, I cannot see how incorporating religious rituals into a secular therapy setting can avoid infringing on someone’s religious liberties at some point.
Maybe more information would help?
As part of the divide, both sides of the debate agreed to research the matter further to gain information and perspective. As far as I’m aware, that research will be moving forward, but I’m not sure progress has been made on that front quite yet.
In the meantime, a piece of unrelated research was published, “Religion, spirituality and mental health: results from a national study of English households,” based on a broad survey of more than 7,400 participants. The survey’s conclusion was brief:
People who have a spiritual understanding of life in the absence of a religious framework are vulnerable to mental disorder.
I found online that Dr. Cook had offered an interesting response to the research. He dismissed the conclusion. One line in particular interested me most, however:
Our post-modern culture is geared increasingly to a way of life that does not question deeply such things as the meaning of birth and death, why we are here and what it is all for.
Translation: We must ask “why?” And since “why?” means “for what reason or purpose?” We know there is intent. And since intent requires agency—well that must mean, an Intelligent Designer. He doesn’t seem aware this language is loaded. It’s dripping with bias. And we’re supposed to trust these professionals can self-regulate their religious privilege. Call me skeptical. And his language isn’t just spiritually loaded—it’s a declaration of a creator—one that has provided externally imposed purpose and meaning to our lives, and who has created all this for some reason we must seek to understand if we wish to have any hope of mental well being.
When “spirituality” goes bad:
An article I was recently sent, detailed how “loss of faith” is labeled as risky behavior, that can result in extra oversight of a marine—because, apparently, loss of religious faith is a sign of being mentally unwell. If you think this is hyperbolic, I suggest you go back to the Spirituality SIG page and see exactly how hard they are promoting that (a) all human beings are spiritual and (b) it’s a requirement in order to be mentally well.
Not spiritual and not suicidal? Can there be such folk?
As someone who is not theistic, not religious, and certainly not spiritual—as someone who does not have spiritual experiences—I support helping people who need mental support in whatever they need to get by. If a mentally unstable person is helped with a prayer group for now—then I would not deny them support.
But I have to draw a line where someone begins to insist I must believe this, accept this, or be dying for answers to questions, that frankly, I find to be biased at best, and incoherent at worst. I’ve come to see the phrase “The Big Questions” [in Life] as a screaming, red flag of Deepak Chopra speeches to follow. To paraphrase Matt, the idea of lacking externally imposed meaning or purpose in your life, is about as horrifying a prospect as lacking someone to tell you who you must marry or what vocation you must pursue. Why would anyone undertake to denigrate people who enthusiastically empower themselves with the rewarding responsibility of forging their own purpose and meaning—of fulfilling their own destinies, rather than simply working to fulfill the pre-fabricated, often ancient and long dead, destinies of others?
The most ironic part is that they march onward, with their agenda of incorporating this into mental healthcare, all the while declaring they would never oppress any patient with it. All the while, they’re already shoving their biases and privilege onto all humanity—without the slightest clue that anyone could possibly object. They’re not saying “If you accept spirituality, then…” What they’re doing is very similar to a page right out of the Theist Handbook, that tells us there is no such thing as an atheist—because everyone believes in god—it’s just we don’t want to admit it. The difference, in this case, is only that there is no such thing as a human being who is not spiritual, in their book. Bear in mind that there are religious theists who don’t agree that they’re spiritual, either. This is, in no way, an atheist-only objection. The Spirituality SIG is that offensive. And that blind to their offense. And they are promising you, they would never impose beliefs on a patient who didn’t ask to be imposed upon. Again, call me skeptical.
Here is where I force myself to stop:
I had so much more I could add, but I suppose I need to save something for Sunday. I just didn’t want our viewers to go into the show blind. It’s an issue with a history and with players. And this history and these players need to be understood a bit, in order to put the dialog into context.
I look forward to Sunday, and hope the technology cooperates, so that the atheist community in the U.S. can finally meet Dr. Poole and hear more about what he’s been dealing with.