A 23-year-old female sits in front of me, depressed and anxious, filling in the details of how she ended up in her current state. She first asks me (as many patients do) if I believe in God. I inform her that I was raised in a fundamentalist religion and am very familiar with the Bible and Christianity. She then tells me that she is unsure if she is really ‘saved.’ She states that she knows she asked Jesus into her heart when she was eight but that lately she feels that she is no longer sure—and she desperately wants to feel sure. Otherwise, she is terrified that she will end up in Hell. She lies awake thinking about this every night and has been having trouble sleeping for weeks. It has started interfering with her graduate school as she can’t focus on her thesis. She has even tried ‘getting saved again,’ but this only alleviated the distress for a brief time and caused her to ask more questions. Her family tells her to pray more. Her pastor responded to her concerns with a generic email asking for ministry support. She is not sure why god is not making her feel more at peace. She used to think that she could tell when he answered her prayers, but the same doubts that are nagging her about her salvation are now nagging her about all of her prayers--who is on the other end, why do they have to be silent, why can’t they help with the growing doubt??
I have had versions of this conversation countless times, and I suspect that for each person seeking help, there are many who feel the same but do not recognize this as a mental health issue. Having been on the other side of the table, I know what she is feeling, and I know there is no answer or endpoint to this problem that will permanently calm that anxiety (at least not without a major change in her worldview, and that would likely be even more devastating to her at the moment). Trying to encourage her to dive deeper into her faith may help her temporarily, but it would only be a psychological band-aid, and it is precisely that those band-aids are no longer working that she is in distress. Her expectation that there is something on the other end of her beliefs is repeatedly being met with the reality that there is no response.
The normal therapy modality for anxiety, cognitive behavioral therapy, works well for phobias, generalized worry, and panic attacks, but it can hit the wall when someone believes that an eternity of torment is on the line. While psychiatry residency trains us to be sensitive to different cultures and religions, it is difficult to know how to help in cases like this without it feeling disingenuous at best or risk causing more damage at worst. As a former Christian, I feel anger at the indoctrination that created this problem. As a mental health provider, I feel frustration that that same indoctrination will likely undermine the possibility of genuine healing for my patient until and unless she can undergo a radical revamping of her worldview. While medications can help, they will be unable to erase and re-write the neuronal tracks that were laid in her brain during development (except for possibly psychedelics, but that is for another time). This is one of the most egregious aspects of religious trauma: it lays the foundation for distress and at the same time blunts all the potential tools that would provide relief.
My patient did not decide to walk away from her faith that day—in fact, that would have been a surprising occurrence. She did come away from that interaction recognizing that she was not alone in her experience, which provided a modicum of comfort, and she agreed to try and keep an open mind about the reality and possible non-reality of her worldview as she continued to ask questions and look for evidence. She was also open to the idea of reaching out to online communities of similar seekers.
The takeaway point from her story is that the ‘comfort’ offered by Christianity, and ultimately by any supernatural worldview, is only an illusion. The more one has church friends and church community, the easier this illusion can be maintained, as the real people of the community are stand-ins for the promise of an invisible, silent best friend in Jesus. If one finds themselves outside of their community and isolated, however, and they reach out through prayer to Jesus, to God, to the Holy Spirit, they will only ever be met with projections of their imagination, never an actual response. If they feel relief due to the prayer itself, it is guaranteed to be temporary and is simply the result of Pavlovian conditioning of their brains to feel slightly less anxious following prayer, an event that they witnessed and practiced repeatedly during development. If prayer actually worked, there would only ever be a need to pray once. ‘God, please relieve my doubt from now on’ or something similar would suffice. The fact that prayers always require repeating—in this case asking for relief for doubts--points to the tendency for them to become compulsory. As with any compulsive act, prayer may alleviate anxiety temporarily, but the anxiety will always return again until the next compulsion is performed.
If you have stories that you’d like to share that describe difficulties with faith or with leaving your faith, message me. I will be doing a regular series of God Damage! once a month and may be interested in using your story.