Theology and psychiatry are often seen as sceptical of each other, the first for dealing with sin and the soul, and the second for its secular assumptions and emphasis on diagnostic evidence. George Stein is a community psychiatrist who suggests that what we call the Old Testament of the Christian Bible can – and even should – be used as a valuable store of psychiatric insights.
These can best be found in parts of the Bible where the feelings and dilemmas of key characters are most fully described, and include Job and Jeremiah, Ezekiel and Samuel (for the figure of Saul), Lamentations, Proverbs and the Psalms. He draws on a wide range of biblical texts, many still used in Judaism, and an equally wide range of psychiatric source material.
Modern medical and cultural interpretations of biblical narratives (like Ezekiel's vision of dry bones, heralding destruction) and messages (like Job's depression at being rejected by God) will always be suspect for believers in biblical inerrancy. Such approaches, too, can seem anachronistic because, as Stein says, although ancient Israeli writers knew human suffering, their descriptions differ from the symptoms of the DSM-5. Stein argues that the ‘suffering soul’ of religion and the ‘suffering psyche’ of modern psychiatry are not that far apart. The cultural importance of the Bible, and not only its relevance to believers, makes it a set of texts impossible to ignore.
The case is best made in key chapters on Job, Jeremiah and Ezekiel. In parallel texts, Stein indicates how psychiatric interpretations can be drawn from the narratives. He enumerates symptoms such as depression and guilt (for Job), panic and self-disgust (for Jeremiah), and psychotic behaviours and hallucinations (for Ezekiel), and then applies and tabulates DSM symptoms for each of them. Other chapters follow this pattern: affective disorder revealed in the Psalms, mania in Saul (in Samuel) and histrionic personality disorder in ‘the strange woman’ in Proverbs. Other more discursive thematic chapters deal with wider themes such as alcoholism and violence, psychosomatic disorders and men, women and children.
All this gives the book value in identifying how biblical characterisation can be re-framed in ways free from literalist belief. Stein admits that the intentions of biblical writers and modern psychiatrists diverge, yet human problems have always existed, implying collaborative approaches may be possible, or at least empathic understanding across disciplines.
The book is aimed at readers ‘with the knowledge of the medical student’, but this reviewer can see it being useful for psychiatrists and psychotherapists, above all those dealing with patients with strong religious beliefs (e.g. who may attribute their suffering or voices to God). As a partly self-published work, it sprawls at times, for all its conscientious evidence. The New Testament is not discussed, nor is a psychoanalytic approach included. In ‘revealing’ the ‘hidden psychiatry’, reminding readers that it is there and of value for treating patients, Stein has produced an original book.
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