Abstract

In lieu of an abstract, here is a brief excerpt of the content:Deepening and Expanding Both–And ApproachesTasia Scrutton, PhDExcitingly for the topic of religion and mental health, both Gipps’ and Finley’s commentaries point to the emergence of a both-and consensus. Finley does this in a number of ways, for example by pointing to the ways in which her own brilliant research has provided further and more specific support for a “honeysuckle on a broken fence” model, and also inviting a renewed examination of Model 3 in response to studies on absorption, psychosis and religious experience. Gipps does this by putting forward an additional both-and model, according to which a potential or early-stage instance of mental illness, responded to by a grace-ful engagement with psychotherapy, becomes instead an instance of metanoia through which the person’s drives and emotions are integrated into a more rounded adult psyche.As well as pointing to the emergence of a both-and consensus, Finley and Gipps’ commentaries importantly reflect the fact that both-and accounts are likely to be diverse, complex and multi-faceted. As Gipps notes, my account focuses on spiritual guidance and medication, especially psychiatric medication; the therapeutically informed psychological perspective that Gipps provides is a very welcome addition to the discussion. In addition to both-and accounts being diverse, different psychiatric conditions and symptoms may invite different models, and multiple models may be in play in one person’s life at the same time. Finley gives an example of this possibility when she posits that a version of model 3 might fruitfully by understood as part of, or perhaps combined with, Model 4.Hopefully this paper and the two commentaries on it open the door to a deeper account of the “honeysuckle on a broken fence” model and potentially to other both-and models too. I want to see that door open—but perhaps not too open, and I think less open certainly than Finley and perhaps also Gipps would like. This is because of my view of the relationship between suffering and psychopathology, and suffering and evil (or badness), which I want to discuss in more detail below.Suffering, Badness, and PathologyThe first thing I want to say is that I think that suffering is bad, by which I mean that it is undesirable. This is true to the way we talk about suffering (if someone tells us that they are suffering, we express regret, not joy), and it is important [End Page 265] morally to remember that suffering is an evil if we are to work to prevent and overcome it (including in ways relevant to mental illness, such as through social justice, peace-building and medical care). It can be tempting to romanticize suffering and to try to justify its romanticization on the basis that sometimes good things come out of situations of suffering. However, to do this is to conflate what something is with other things it may become intertwined with. It is also to encourage masochistic and socially and politically conservative forms of spirituality that are antithetical to the Christian Gospel, since it baptizes suffering rather than seeing suffering as something people are called to be liberated from.The second thing I want to say is that I think that pathology, including psychopathology, involves suffering, and that if it does not involve suffering (either in a specific moment or over time) then it is not pathology. The centrality of suffering to pathology is indicated by the fact that the term ‘distress,’ which denotes suffering, appears in the DSM-5 618 times. The presence of either distress or impairment in social, occupational or important other areas of functioning (which, over time, is likely to lead to suffering) is a prerequisite of many psychiatric conditions, according to DSM-5. Homosexuality was rightly removed from the DSM and other psychiatric manuals when it became clear that same-sex attraction does not inherently involve distress (and so suffering). Significant for the shift towards demythologizing homosexuality was Evelyn Hooker’s 1957 study, which showed no similarities in the well-being and happiness of 30 homosexual and 30 heterosexual men (Ebacioni, 2014, p. 4). To take another example, hearing voices (with no...