Is Praying With Patients Okay?


Can we just forgo the fact that I’m not talented at verbal prayer, especially in front of, you know, people? Okay.

Oh, boy, this question has been on my mind for a while. As a psychiatrist, it is important to maintain a safe environment, a containing frame, where patients can talk about anything and everything without fear of judgment and/or feeling shame. (Wow. I rhymed. That’s the closest to poetry y’all will see me come. No, seriously.) I’ve said this before, but it precludes me from sharing personal information about myself—like my religious beliefs! Or the fact that I watch waaaay too much South Park and Family Guy. Really, no self-respecting, well, anybody would do that to themselves. Yeah. Moving on.

Keeping that “rule” in mind, please consider the following: I receive online updates from Psychiatric Times (a popular newsletter sent to shrink-types) and one of this week’s feature articles was titled: Should You Pray With Your Patients? Cool! Something I’m interested in!

Below is a link to the article including a podcast from ethicist and psychiatrist Cynthia Geppert, MD, PhD. Should you be so inclined to give a listen, she discusses situations where it is okay to pray with patients as well as situations where a psychiatrist needs to be careful.

Link to podcast: http://www.psychiatrictimes.com/display/article/10168/1483619?verify=0

The upshot is that primary care doctors (and really all other specialties) do not have the level of boundaries required in psychiatry. In the therapy session, people are vulnerable and every situation needs to be handled with care and empathy. Now, you may say, “What’s the harm in praying?” Well, it is considered a boundary violation (meaning, a crossing of the line). It may lead to collusion with the person’s illness—Ex. What if the patient is delusional or, gasp, hyper-religious from a manic episode? Praying in that case could, in fact, harm the relationship and lead to worse outcomes. Eep! Furthermore, what if the patient isn’t religious, what if the psychiatrist isn’t religious, what if the prayer is about winning the lottery? What if the patient and psychiatrist are of different religious backgrounds? (This is all covered by the podcast, by the way if you have eight minutes to listen.)

Um, as a believing Christian, winding my way through life, navigating the balance between interfacing with secular culture while at the same time sharing my beliefs without sounding like, ahem, Pat Robertson, the situation gets sticky. I don’t stop patients when they tell me about their belief systems and I am quite happy to listen when they bring it up. Actually, a belief system can be a support in and of itself—bonus! Or, it can lead to a lot of guilty feelings (Psst, what if you’re gay or an alcoholic and your religion doesn’t “allow” that?).

So, what to do? What to do?

Confession: I actually started a Bible Study class (haven’t done that since…college, a decade ago), specifically on “friendly evangelism.” Not the shove it down your throat, believe this or else kind of thing, but, hey, this is how I look at things…and why.

Eh, I don’t think it’s appropriate to spout off Bible verses in a therapy session. I’m not a Christian counselor, so it’s outside of my arena. But it is important for me to let people know that I am “working for God.”

How? How?

Ugh… …had to take a break. Checked my e-mail, and here’s a message from a friend:

May there be peace within you today. May you trust God that you are exactly where you are meant to be.

Okay, God. I’m listening. I need to stop fretting it and just keep my eyes and ears open for opportunity. Will do.

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8 comments on “Is Praying With Patients Okay?

  1. Cynthia says:

    Laura:

    I encounter similar situations in my talks with people (not as a psych, but an insatiable people lover) and I have reasoned to the idea that the foundation of virtually all religions and spirituality is love and the golden rule. I will meet a person in whatever “language” they speak be they Christian, Muslim, Jewish, Catholic, Buddhist, New Age or Kabbalist. I don’t worry about the details, God can handle that. In the context of mental illness the sands shift and I wouldn’t know what to do. My likely action would be fierce, but silent prayer.

    Thank you for giving me something to think about.

    Cynthia

  2. Nisa says:

    Life and religion sure seem complicated now-a-days. I have to wonder if there was ever a time when others stopped taking offense and just respected differing opinions on the subject. I’m sure your situation is particularly precarious! (Extra points for the alliteration? *grin*) I think you nailed it with your last sentence. The Lord will guide us in all that we do if we let Him. You’re doing great. *hugs*

  3. I’ve been to many, many shrinks in my lifetime. Most of them were utterly useless; two were life-savers.

    However, if either one of them had even mentioned “prayer”, I’d’ve been out the door so fast it would’ve set their carpet on fire. : )

  4. philangelus says:

    If a patient asks you to pray with them, it would no longer be a boundary violation. And I think it would be fine for you to ask if a patient thought it might be worthwhile to spend time in prayer, reflection or meditation of some sort every day just so they can get in touch with their inner self or their higher power.

    I think I would feel uncomfortable though (even as a Christian myself) if someone asked to pray WITH me when I hadn’t asked for it.

    • lbdiamond says:

      For sure, inquiring about a patient’s religious preferences is an important part of learning about who they are. I make it a point to encourage someone’s coping strategies, and prayer, reading the Bible (or whatever religious text they prefer), meditation (I even teach the techniques–they DO work, when practiced on a daily basis), and inner-reflection are all part of that. So, yes I agree with you.

      The example outlined in the Psychiatric Times article was of an elderly woman who was just diagnosed with breast cancer. She was so distraught, she asked her psychiatrist to pray with her. He was not a religious person, but recognized the value of offering that support to his patient, and so he did it. In those instances–serious life-threatening situations, when the patient requests it, and only if the clinician is comfortable–prayer with patients IS okay. 🙂

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