By  - Dr. Khalid Sohail                             

There was a time in history when human psyche was believed to be a soul. Religious people believed that soul was independent and existed prior to the existence of the body. It entered human fetus at a certain stage of development, stayed in the body throughout life and left at the time of death to go back to the world of souls, so that it could be judged on the Day of Judgment and enter hell or heaven depending on its good and bad deeds. Such a concept of soul was predominantly popular in Christian, Jewish and Muslim communities.

          Alongside this Juda-o-Christian-o-Islamic belief in soul, there were many Hindus who followed the tradition of reincarnation and believed that human soul returned to earth again and again to purify itself and acquire a higher or lower level of existence depending upon the good and bad deeds, the karma of the previous incarnation. This cycle of existence and suffering continued until the soul acquired enlightenment and found nirvana and then transcended the cycle of suffering by joining the Ultimate Soul, God. After acquiring nirvana the soul found eternal life and did not have to return to earth for any more suffering.

          In these models, religious as well as spiritual, there was a desire, a wish, a hope, and a dream for humans to have eternal life and live forever. Since human body was mortal human beings believed in immortal soul and connected that belief with the belief of immortal and eternal God.

          In the last few centuries there have been a third model that is becoming more popular in the world. It is the secular model. Followers of such model call psyche, mind, not soul. In this model the mind is intimately connected with the body and does not exist independent of body. It is an extension of the body, related to the functioning of the brain and is connected with human personality that makes choices of human lifestyle.

          Secular model, in which human psyche is called human mind has been developed on the secular advances of

…biologists like Charles Darwin

…psychologists like Sigmund Freud

…sociologists like Karl Marx

and

…existentialist philosophers like Jean Paul Sartre

Since secular people do not believe in life after death, they try their best to make their lives more meaningful and create a paradise on earth.

Based on these secular models contemporary mental health disciplines of psychiatry, psychology, nursing and social work have adopted a model that we call a bio-psycho-social model. According to this model mental illness and emotional problems can be diagnosed and treated based on biological, psychological and social understanding of the problems.

          People suffering from schizophrenia and manic depressive illness might have a strong biological component as they might have inherited mental illness from their parents that have transmitted the illness through genes and these patients might have biochemical abnormalities at birth that were later on vulnerable to the psychological and social stresses. Similarly people with neurotic and personality disorders might have experience emotional abuse or trauma as children growing up in dysfunctional and unhealthy families. Similarly immigrants might have emotional and social problems because of their difficulties adjusting to a new culture and not being able to resolve social and cultural conflicts. Secular mental health professionals try to find different factors that contribute to the emotional conditions and then suggest a combination of

Medication for biochemical disorders

Psychotherapy for psychological problems

and

Family and group therapy for social conflicts.

Such bio-psycho-social model has been very effective in helping people suffering from mental illnesses and emotional problems.

In the last few decades there has been an ongoing dialogue between professionals and lay people, mental health workers and patients about the similarities and differences in their belief systems. Different professionals have adopted different attitudes. I know some psychiatrists and nurses who refuse to discuss their religious, spiritual and secular beliefs with patients as they feel it is not important for their treatment plan. In my clinical practice if my patients ask my views directly I share with them that I am a secular humanist that respects people from all religious, spiritual and secular traditions and support people in searching their own truth. I believe that there are as many truths as human beings and as many realities as pairs of eyes. Most of my patients are believers but we have mutually respectful relationship with each other. I share with them that my role in their life is not to get in any academic discussion about their ideology or philosophy. I am there to help them in reducing their emotional suffering whether depression, or anxiety, paranoia or marital problems, and increasing their quality of life.

          While there are some atheist psychiatrists who discourage their patients to attend church gatherings, I never object to it as I believe that their attending church services offer them emotional and moral support as long as their religious relatives and friends do not object to the psychiatric treatment they are receiving.

I remember the time when my aunt in Pakistan suffered from schizophrenia. She was seen by a psychiatrist and was prescribed Modecate injection and supportive therapy. My uncle, who was a religious man, asked my opinion about taking her to see a spiritual healer because she had a lot of faith in him. I told my uncle that I did not object her going to see the spiritual healer if that is what they wished, as long as she took her Modecate injection and followed her psychiatric care plan regularly. It was interesting that a time came when Modecate injections were not available in Pakistan. My aunt started to regress and started having her psychotic symptoms and inappropriate behaviour although she was still going to see her spiritual healer. My aunt’s illness became a great concern for the whole family. On my uncle’s request I sent them Modecate injections from Canada and when my aunt started taking the injections regularly she started to improve. After that experience my aunt and uncle agreed with me that the psychiatric treatment was the cake and the spiritual practices the icing.

          If we see the contemporary world we see all the religious, spiritual and secular practices existing side by side.

Some people believe in a soul and the Day of Judgment

Some people believe in a soul and re-incarnation

And

Some believe in a mind that exists as an extension of body and brain that dies when the person dies. They do not believe in life after death and Day of Judgment.