Monday, December 28, 2015

The Complicated Relationship Between Religious Belief and Mental Illness

As many of you will know, I just published a book, Everybody Is Wrong About God, that is described on Amazon with the following,
A call to action to address people’s psychological and social motives for a belief in God, rather than debate the existence of God. (bold original) 
That said, it's perhaps unclear whether or not I am suggesting that theistic religious belief constitutes a kind of mental illness. I'm not. I am, however, pretty sure I had this coming and probably should have done something proactively before Everybody Is Wrong About God came out (but who would have read it, and who complaining about it would have cared?).

To begin, there is a relationship between mental illness and religion, and it's complicated. Everybody Is Wrong About God explores this delicate topic somewhat, but it boldly proclaims something that people are pretty likely not to like (or, perhaps, understand). To cut to that chase, I wrote,
Every time someone says that he believes in God, he’s saying that he
has psychological or social needs that he doesn’t know how to meet.
(p. 41, bold and italics in original)
It's punchy; I know. In fact, I'm fairly certain that statements like this garnered me a stunningly confused one-star review on Amazon (which, somewhat to my dismay, a majority of responders currently think is helpful, 60% of them in fact), one that I have no interest in addressing in depth here or anywhere else. You will find, if you follow the link, however, that I made a couple of substantive comments under that review.

Despite its stunning confusion, I will quote from the review just deeply enough to indicate what I haven't argued. I'm doing so as a way of opening a more careful discussion of an important topic that is actually more interesting than a rear-guard presentation against what appears to have been a gross misreading of what I wrote. The reviewer, Ian, after presumably having read my book, astonishingly believes,
James Lindsay's method of dealing with the belief in god seems to be, in essence, to call religious folks psychologically ill and to suggest that god is a coping mechanism. While it may be true that theists are mentally ill (though I doubt it), I'm not sure that's a good way of making religious folks open to atheism.
Well, that's not the case. I do have a rather nuanced view of the relationship between mental illness and religious belief, and I think I thread that ugly needle even more carefully than, say, Richard Dawkins has done. It may work best to quote myself a couple of times and then riff from there.

I'll start with a selection from the fourth chapter.
Even those who do not believe in a deity cannot escape the word “God” and thus its significance. It is easy, and not far from correct, to write it off as a kind of delusion, held en masse, but the danger in doing so is forgetting that the people using this word are normal ones. They also mean something so important by it that it can prove nearly impossible to free them from their beliefs, however delusion-like they may be.

It is time to lay the groundwork so that we can understand what this word means in how it is used, and to do so, we need to understand some of the basics of the psychology—not philosophy—of religion. To understand what good “God” might be to all of these people, we must start by trying to understand what religion does for them. As all theistic religions have “God” at their centers, it would be sheer pretense to imagine that the idea of the deity isn’t directly connected with what religion is doing for them. (emphasis original)
Continuing, here from a section, "On God and Delusion," in the fifth chapter that spells things out pretty clearly.
Religious belief, however, is not typically delusional belief. One somewhat unsatisfactory reason that delusion doesn’t quite describe religious beliefs is that there is some relationship between them and social norms.

Believing in God, lamentably, is still quite normal, and so belief isn’t, itself, an indication of mental illness so much as simply being mistaken. The main reason that delusion isn’t quite the right idea to describe religious belief, and that mistaken is a better term, is that while God does not exist, “God” does. It is the acceptance of theism (usually with attendant certainty, denial of death, and other issues in their own rights) that is the actual issue. That is, religious believers aren’t so much deluded; it’s more that they are confused about the meaning of the term “God.” It isn’t exactly a delusion to believe in something real, even if one goes on to misunderstand its nature via a mythological construct made to that purpose.

The distinction is subtle but consequential. Branding religious belief delusional tars billions of genuinely sane people with a pejoratively understood disorder. ...

People who believe in God do so because they don’t know how else to meet certain psychological and social needs. By labeling these people as delusional, we miss the opportunity to address the actual issues in play.  Probably more importantly, we also lose the nuance necessary to identify the legitimate delusions that arise from mistaking the mythological for the real. Of note, though, some of the beliefs that spring from this confusion  are genuinely delusional. That said, religious beliefs tend not to, but can be, delusional and they are likely to serve as the source of genuine  delusions that are unlikely to be recognized as such. It is delusional, for instance, to believe that prayers will heal someone or that a deity will protect one’s home in a natural disaster. This is a problem that deserves  serious attention.
I go on in the eleventh chapter to make an admittedly controversial suggestion, one that could be mistaken for a view indicating some core relationship between religious belief and mental illness that I don't actually think exists. I wrote,
My last suggestion for a transitional effort will be perhaps my most controversial. We should have therapists and counselors trained to specialize in the challenges associated with leaving behind one's religious beliefs, and we should have lots of them. People leaving their faith traditions are having to completely reconstruct much of the way in which they understand the world, including their own identities, and this is likely to be a difficult process. Trained professionals can facilitate the change via online resources, direct counseling, and, when needed, outreach hotlines.

It may be tempting for some to assume that making such a statement is tantamount to implying that religious belief is a kind of mental illness that needs to be cured, but that is not what is being said at all. Instead, it is merely a statement that a significant shift in worldview is likely to come with some psychological and social challenges that proper therapeutic intervention could mitigate. Importantly, this is not a call to train and employ therapists with the task of deconverting believers. Instead, it’s merely a recognition that people undergoing the psychological and social struggles associated with undergoing a deconversion could benefit from specifically trained help. Therapists could be of tremendous help for people transitioning from a state of faith-based life to one in which that has been outgrown, and it seems obvious that if this change can be made more smoothly in some ways than in others, then it should be.
Okay, as that should make most of my actual stated position in Everybody Is Wrong About God more clear--I don't think religious belief is a mental illness, at least not in general--I feel like I can move on to discussing the delicate relationship between the two ideas.


Karl Jaspers laid out in General Psychopathology three criteria for delusional belief states, and once you see them, it's hard to deny that the delusion shoe fits theistic religious beliefs pretty snugly. They are:
  1. Certainty of conviction: people with delusions are absolutely sure of their "truth;"
  2. Incorrigibility: people with delusions are not easily persuaded by argument, facts, or evidence to the contrary of their belief; and
  3. Impossibility or falsity of content: what they believe is either impossible or not actually true.
It's really, really hard to read those three criteria for delusion honestly and not see belief in God as meeting the criteria. In fact, I think it does meet them, and yet the delusion shoe doesn't fit (not least because the colloquial definition for 'delusion' includes that the beliefs are idiosyncratic, which belief in God isn't). I obviously argue that it isn't appropriate, despite the snugness of fit between delusion and theism.

Because a set of ideas called "God" exists and does real, observable things for people who believe in it, and because that set of ideas gets mythologized into an entity called by the same name, it is effectively impossible to disentangle whether a believer talking about his beliefs means "God," a real set of ideas, or God, a mythological entity in any generic application of the phrase "belief in God." (In fact, I think part of the power of mythological thinking lies specifically in blurring that line to the point where even the believer doesn't always know which thing he is talking about, although he's sure to side with the entity almost every time.) That is, I don't think believers in God are usually delusional for that belief. They're mistaken about what they're referring to because of mythological thinking.

That said, I do think most religious believers harbor delusions that arise directly from their religious beliefs. As I stated in the book, quoted above, it is delusional to believe that intercessory prayer will do anything for you. It is delusional to believe that an all-powerful entity is taking care of you. So far as we have any business talking about, it is delusional to believe that we will survive death or carry on otherwise in some heaven or hell. These are legitimate delusions that are very common, perfectly direct consequences of belief in God, even if belief in a mythological construct itself isn't.

As I said, I also think this is a big problem. The way it stands now, we have no way whatsoever to pull apart common religious delusions--like belief that a deity is in control, that death is an illusion, that life is eternal, or that intercessory prayer works--and attempt to do something about them. Normally, religious delusions have to be of such a grand nature to be diagnosed that huge amounts of smaller, consequential problems are overlooked as a matter of principle and an ethic of practice. This is unconscionable.

Of note, having the threshold on diagnosing religious delusions turned too far up is also a very significant issue where con artists fleece poor people (often literally poor) out of gobs of money they don't have on selling a "Prosperity" delusion. Offenders of this sort, like Joel Osteen, are a real problem, and this is just one tip of one iceberg in the sea of legitimate delusions that arise from religious beliefs.

Still, generally speaking, belief in God isn't delusional, though the more things a person thinks God does, the more real delusions are probably creeping out of the beliefs and becoming manifest--and potentially treatable.

Psychosocial needs

Everyone has psychological and social needs (collectively termed psychosocial needs). Everyone throughout life has difficulties with meeting these needs. Some we figure out; some we don't. This is part of the process of growing up. If there are major complexes of difficulties with these needs that interfere with normal life, then there's a possibility of some kind of underlying psychopathology that presents. Otherwise, having  psychological and social needs is just part of being human, as is having more and less effective ways to meet them.

"God," and thus belief in God, is one strategy people have used since time immemorial to attempt to address, cope, meet, or ignore--yes, ignore--a variety of psychological and social needs. In that, "God" allows people to address them (or ignore them) on some level that (usually) enables more-or-less successful navigation of life and its stresses. Thus, possessing only an inadequate tool for genuinely meeting those needs (belief in God) doesn't constitute a kind of psychopathology, even if believers could do better by trading belief for more successful, real-world means.

When I say that declaring belief in God is tantamount to having psychological and social needs that the believer doesn't know how to meet (without relying upon superstitious attributions and a mythological construct to give them a false sense of reality), I am not saying a word more than I said. In other words, and specifically, I'm not saying that these people are mentally ill or mentally deficient. I'm saying that they're using a particular (relatively bad, though there are worse) strategy for managing those needs, belief in a non-existent God.


One of the specific needs I discuss in the book, particularly where it comes to prayer, relates to a need for coping mechanisms. These all show up under the heading of control-based needs, which all speak to a single psychological theme: human powerlessness. Death and dangerous uncertainty are the two biggest categories in which we need coping mechanisms for which people turn to beliefs in God.

Prayer is one religious coping mechanism. Prayer allows people to believe they can do something when they can't really do anything, or don't want to (in addition to a number of other functions of prayer, but here I'm talking about its use as a coping mechanism).

Prayer, then, gives people a sense of control, which may be enough to effect coping with a terrible stress--even if that sense is illusory (as is supported by evidence in the psychology of religion). Prayer is a cheap coping mechanism, though, and it's often used as such in the intercessory fashion, a belief in which is delusional. It's worth noting, however, that nuance is again important. Turning to a delusion in moments of peak stress probably shouldn't (and doesn't) constitute a legitimate mental illness. It's just human desperation in a bad situation.

Death is the other big religious coping arena, and thus by "death," I mean death's denial. It's easy to argue--as does Terror Management Theory--that the primary occupation of theistic religious belief is the denial of death (although I think it plays a close second to defining and codifying a moral framework, in practice).

Coping with death is hard. Very hard. It's one of the most monumental challenges of a human life. Religious beliefs that offer eternal life (usually through God) are an easy dodge, another cheap coping mechanism that lets people get by pretending to have met a need, perhaps indefinitely. The lines between mental illness, unhealthy coping, and healthy coping are particularly blurry where it comes to religious denial of death.


A special case worth mentioning is religious fundamentalism, which I think probably legitimately should constitute a recognizable psychopathology--a mental illness. I mention this point a couple of times in Everybody Is Wrong About God, and in it I try to also offer a suggestion by which we might understand religious fundamentalism as a subtype of a delusional belief structure. I wrote,
Incidentally, it is my opinion that whatever religious fundamentalism means—this being its own topic of important and complicated research—a key feature by which it can be distinguished is a preference for religious attributions over natural ones when naturalistic ones are available. It is not hard to see, if this conception of religious fundamentalism holds some merit, how it constitutes a kind of psychopathology, hopefully one that could be treated. It specifically manifests as adhering to a set of false beliefs about the world with such tenacity that established and available countervailing attributions are denied or rejected in an attempt to  prevent revision of the beliefs. That these beliefs are maintained in order to meet or ignore psychosocial needs that can certainly be met in other ways should qualify it as a kind of pathological mental state, fundamentalism as a subtype of delusion. (pp. 77-78, emphasis original)
This statement is a little bit technical, but what it is driving at is that when someone's adherence to a superstitious (religious) belief structure is so psychologically important that they will reject established facts about the world--say the biological theory of evolution--there's a legitimate problem going on. The ways in which religious beliefs are attending to someone's needs, at that point, have legitimately impinged upon her ability to deal with basic, well-established facts about the world, facts that are relevant in a variety of important ways, not least in terms of policy  making and choosing policy makers. The superstitious beliefs in such cases are more important than apprehending and accepting reality. That constitutes a pathological level of being unwilling or unable to deal with those needs.

Belief isn't mental illness

So, generally speaking, belief isn't mental illness, though theistic belief is very likely to evoke legitimate delusions, mask delusions that arise in religious contexts, inhibit meeting psychosocial needs, provide cheap but poor coping mechanisms, and potentially evolve into a legitimately psychopathological adherence to beliefs known broadly as "fundamentalism." And yes, ardent creationism is probably legitimately a symptom of a mental illness, not just a religious belief.

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