Dr. Paulos Mar Gregorios

Mental Factors in Health Care / Dr. Paulos Mar Gregorios PDF File
1. Though mental health, peace and joy are by-products of religious faith, it does not follow that religion is merely a means of attaining mental peace. The purpose of religion is to find one’s grounding in God, and to work out that faith-grounding through worship and work.
2. The most fundamental problems of human existence are anxiety about the future and a sense of guilt about the past and the present. The two are interconnected. The anxiety factor includes an element of fear of punishment for the sins one committed.
3. The sense of guilt seems also the root of a great deal of hypocrisy, dissimulation, pretension and falsehood. Precisely because I have an anxiety that others may not accept me as I am, I try, unconsciously, to pretend that I am something else, something bigger and better than what I really am. This falseness in its turn creates the anxiety that someone may discover one’s true “self.” Thus guilt, anxiety, and falseness reinforce each other in human existence.
4. The combination of guilt, anxiety and falseness, seems what lies under the heightened phenomenon of stress, (The classical discussion of Stress is in Hans Selve M.D., The Stress of Life, (1956), Revised edition, Mc-Graw Hill, 1976) or as it is technically called in medical literature “stress syndrome” or “General Adaptation Syndrome.” Medically this relates to disease in which non-specific bodily or mental stress plays a decisive role.
5. The false distinction which medical science itself makes between “bodily” and “mental” in diagnosing the origin (aetiology) of diseases, belongs to the “total stress” of the civilisation which we have now adopted from the west. Its science and knowledge itself have been produced by the stress of a guilt-and-anxiety-lader culture – guilty about its colonial past, actrocities, exploitations, wars, concentration camps and holocausts. Mind and body cannot be thus distinguished. The mind is part, integral part, of a living body, and what affects the body affects the mind, and vice versa. We will not arrive at a healthy society until we overcome this false mind-body dualism, and the regarding of the body as inferior, which is an aspect of Indian culture.
6. The Stress Syndrome or the General Adaptation Syndrome, as described by Dr. Selye, affects the whole body and mind. When the Body-Mind confronts a general stress situation, the kidney has to work extra hard to maintain stability of blood pressure; there are changes in the walls of the arteries; it affects all connective tissues and can lead to inflammation; it affects also the lymphatic cells and eosinophil cells; it causes the pituitary, thyroid and adrenal gland tissues, the liver, the adrenaline medulla, and the whole nervous system, to produce chemical changes. The high incidence of stress and maladaptation of the body-mind system in coping with stress, accounts partially for increases in diseases like high blood pressure, diseases of the heart and blood vessels, diseases of the kidney, eclampsia in pregnant women, rheumatic and rheumatoid arthritis, inflammatory diseases of the skin and eyes, allergic and hypersensitivity diseases, sexual derangements, digestive diseases, cancer, and of course nervous and mental diseases. It increases general irritability in men and women and often wreck marriages. It can also create hyper-excitation as well as depression, both of which affect human relations and lead to various bodily and nervous diseases. Impulsive behaviour, emotional instability, inability to concentrate, loss of the joy of life, insomnia, predilection to fatigue, and hypermobility (inability to sit still, be silent, or relax), can all result from stress. And many patients who consult a physician, only to be told that they have no disease, experience even more stress. They feel that they have to prove that they are sick. And this only adds to the general stress syndrome, and could lead to increase in self-medication (pain killers and tranquillisers), increased smoking, loss of appetite, missed menstrual cycles in women, or increased pre-menstrual stress, migraine head-aches, and even alcohol and drug addiction. It makes people more self-hating and accident prone.
7. This brief and non-professional description of the General Adaptation Syndrome accounts for some 60% of the people coming to a hospital for treatment, sometimes with a localized and identifiable symptom but more often without. It is no use telling them that their disease is “psychological.” It has affected their physical body as well as their psychic equipment.
8. The modern doctor recognizes this as a case calling for administering some placebo or palliative, some pink tablet or red ‘mixture’, and in some cases it works, because the very falling sick and going to hospital help to win the sympathy of the family and to relieve some of the stress.
9. It is at this point that the renewal of the patient’s religious faith can very effectively be used as a better cure than the placebo or palliative. It is therefore imperative that at least in all hospitals run under private auspices, and desirably in other hospitals as well, there should be more than just a chaplain or psychiatrist. We need in each major hospital a team of skilled, gifted and well-trained religious counsellors, who can help renew the patient’s faith without any pressure to impose the categories of another religion on the patient. If it is a Hindu patient, there are enough resources in the Hindu tradition itself for a substantial evocation of the patient’s faith within the categories of the Hindu tradition itself-using the Fita, the Vedas, Upanishads and Hindu rites and forms of worship. The same for a Muslim or a Christian patient. A Christian hospital should not impose a Christian religious categories on a Hindu or a Muslim patient. This is difficult to accept for Christians who have been brain-washed in one or other particular form of Christianity which emphasizes the “sacred duty” of converting everyone to Christianity.
10. I would like to see a Christian hospital taking the initiative in this area, by employing a team of three to five religious counsellors, perhaps starting with two Hindu and two Christians and a Muslim when a suitable person is available. These persons should have some elementary knowledge of the body including the nervous and glandular systems, of pathology, and of psychology, in addition to a good grounding in one’s own religious tradition. The Mandiram Hospital and Mandiram Mental Health Centre should do some pioneer work at this point and set a pattern for the other hospitals. I would like to be involved in the earlier stages of pioneering if a decision can be made to proceed in this direction and some funds set aside for the preliminary work. We should look around for a Hindu Chaplain, preferably a young sanyasi with some training in counselling. If necessary appropriate persons should be advertised for, recruited, sent for training in counselling at Vellore, and then given special training locally.
11. I shall conclude this paper by pointing to some of the beliefs and practices directly related to Christianity, but with parallels in other religions, which have direct relevance for mental and physical health. The “beliefs and practices” should not be understood as intellectual ideas or activistic exercises. They belong to a corpus of life within a religions tradition, and therefore demand changes not only in individual minds, but in collective practice as well. Religion should not be reduced to therapy, though the therapeutic function of good religion can never be ignored. Perhaps we should also think about the pathogenic function of bad religion, and make sure that these do not create new problems in the hospital. The kind of religion which the Christian hospital promotes should be therapeutic, healing, wholesome, whether it is Hindu, Muslim or Christian. Some Christian elements are highlighted in the following paragraphs, as a starting point for further discussion.
12. Freedom from anxiety is perhaps the most important single element which must ensue from any healthy religious tradition. In the Christian faith, freedom from anxiety is a consequence of a complete trust in God through Jesus Christ. “Do not be anxious about your life, what you shall eat or what you shall drink” (Mt. 6:25, Lk 12:22). “Do not be anxious about how you are to speak” (Mt. 10:19, MK 13:11, LK 12:11). “Do not be anxious about tomorrow” (Mt. 6:34). These negative injunctions of our Lord have to be transformed into a positive experience for the patient, who has to be helped “to cast all your care on Him, for He cares” (1 Pet. 5:7). Like Martha we are all basically “anxious and troubled” (LK 10:41), and the passage from anxiety to trust is a great healing experience. It is the duty of a hospital to provide opportunities for the patient to find this basic trust, which will remove half of the stress involved.
There are similar sources in other religions. The Gita as a whole is set in the context of Arjuna’s anxiety on the field of battle, and the stress situation. And the Gita solution is in the peroration of Lord Krishna’s words in the 18th chapter of the Gita.
“With the Lord in thy heart take refuge with all thy being; by His Grace thou shalt attain to the supreme peace and the eternal standing. …. Become Me-minded, devoted to Me, to Me do sacrifice and adoration. …. Put aside all laws of conduct. Seek refuge in me alone. I will release thee from all sin; do not be sad.”
I am sure that many similar texts can be found in all scriptures.