At Peace in Mind and Spirit: A Holistic Approach to Mental Health Care

August 30, 2018

by John Peteet, MD

I’ve always been fascinated by looking at things from different angles, trying to see what is really going on. I’m not sure why – maybe it comes from childhood growing up in the 60s in Atlanta where we experienced so many contradictions. There were the water fountains labeled white and colored in a culture that was supposed to be Christian, and there were the inspiring but odd people we knew from church (like characters from Flannery O’Connor’s short stories), and there was deep, unresolved ambivalence about the Civil War which my mother heard about from her grandfather who served in the Confederacy.

So I was excited to go North to college for a fresh, less parochial perspective. It turned out that my school had its own troubling inconsistencies (like a required pledge not to drink, dance or attend movies), but there I was captured by a vision that “all truth is God’s truth” – meaning to me not only that all ways of understanding the world have something to contribute, but that God is in the search for what is really true, and owns it all.

I don’t remember getting much help integrating my work with a vision of God’s truth during medical school or residency, but in my 40 years since as an academic psychiatrist, I’ve felt a continued pull to discover God’s beautiful and good truth beyond our human attempts to approach problems by reducing them to categories we can manage. For example – there are the distinctions we make between body and mind (or spirit). Depressed patients will sometimes ask “Do I have a chemical imbalance or a lack of faith?” As mental health professionals we often think dualistically in terms of mental, or psychological explanations rather disconnected from existential, moral or spiritual realities.  And we often further subdivide the psychological into cognitive behavioral, psychodynamic, sociocultural explanatory frameworks. Of course when your favorite tool is a hammer, everything can look like a nail. I regularly see psychiatrists in training focus on the psychiatric diagnosis rather than what is bothering the person most: a loss of hope that their life could work. At the same time I also recognize God’s work in the transformation and recovery that patients experience, and in the experience of trainees who can begin to see the existential dimensions of despair, and the importance of spiritual responses to existential and moral distress.

As I look back, this search for an integrative vision of persons and of what they can be has been central to a lot of my teaching and writing. Some examples are researching and writing about the importance of spiritual care for patients with life threatening illness; helping teach courses on the world views of Freud and C.S. Lewis, on spirituality and healing in medicine, or on Religion/Spirituality and psychiatry; writing or editing books like Depression and the Soul, and The Soul of Medicine; thinking about the role of psychotherapy in promoting virtues (If one of the core values of psychiatry is promoting healthy functioning, what do we think defines health?); calling attention to the importance of spiritually sensitive, or integrated mental health treatment. A few times it’s been possible to call attention to what seem to me the insights of a Christian perspective.

Fragmentation is so much a part of our culture (not only the one of the South in transition where I grew up), our systems of medical and psychiatric care, and of our own psyches — mine included. It seems to me that we’re all given glimpses, but need a clearer vision of God’s beautiful truth that transcends our parochial, flawed attempts to understand and heal ourselves.

I love the way that Christians have been praying for this for centuries. I expect you’ll recognize the words of this hymn written around the year 1000:

Be Thou my Vision, O Lord of my heart;
Naught be all else to me, save that Thou art.
Thou my best Thought, by day or by night,
Waking or sleeping, Thy presence my light.

Dr. John Peteet is a member at Reservoir and a psychiatrist in Brookline, Massachusetts and is affiliated with multiple hospitals in the area, including Brigham and Women’s Hospital and Dana-Farber Cancer Institute. Dr. Peteet is an Associate Professor in the Department of Psychiatry at Harvard Medical School