The Biopsychosocialspiritual Model of Mental Illness

The Biopsychosocialspiritual Model of Mental Illness

A frequently aired criticism of psychiatry is that it places too much emphasis on the role of biological factors as determinants of mental illness. Many people believe that an exclusively biological model of mental illness is a reductionist approach and that mental health problems are caused by a complex range of factors. According to Dr. Lucy Johnstone (as quoted by the Guardian newspaper earlier this week), there is “overwhelming evidence that people break down as a result of a complex mix of social and psychological circumstances – bereavement and loss, poverty and discrimination, trauma and abuse”.

A model of mental illness that is increasingly subscribed to by mental health professionals and academicians is one that acknowledges the contribution and interplay of biological, psychological, and social factors. This is known as the ‘biopsychosocial’ model of mental illness. Whilst the biopsychosocial model appears to provide an encompassing explanation for why mental health problems arise, an important dimension seems to have been overlooked. There is increasing scientific evidence that spirituality plays a significant role in the etiology, maintenance, and treatment of mental health problems. Types of spiritual aptitudes that have been shown to be influential in this regard include (for example) dispositional mindfulness, faith, meditative insight, loving-kindness, compassion, death-awareness, and patience.

The Diagnostic and Statistical Manual of Mental Illness  (DSM) includes ‘Religious or Spiritual Problems’ as a V-code (V62.89). This means that a religious or spiritual problem could be the focus of clinical attention, but should not be confused with a mental illness. The DSM gives examples of religious or spiritual problems as “distressing experiences that involve loss or questioning of faith, problems associated with conversion to a new faith, or questioning of spiritual values that may not necessarily be related to an organized church or religious institution”.

Although the DSM (and mainstream clinical literature more generally) acknowledges that spiritual factors can cause personal conflict, the emphasis is placed on conflict that arises specifically due to loss of faith and/or questioning of spiritual values. Very little consideration is given to the wider role that spiritual factors play in the etiology of diagnosable mental illnesses.

Thus, we would argue that a ‘biopsychosocialspiritual’ model of mental illness – that acknowledges the importance of biological, psychological, social, and spiritual factors as determinants of psychopathology – represents a much more acceptable and inclusive model. This is consistent with the view of a growing number of transpersonal psychologists (and that of most of the world’s spiritual traditions).

From the Buddhist philosophical perspective in particular, a person’s levels of spiritual development (and therefore the risk of them experiencing mental health problems) relates not only to the amount of spiritual insight acquired during this lifetime, but also to the amount acquired during all previous lifetimes. In other words, Buddhism asserts that people are born into this life with a ‘karmic baggage’. This karmic baggage is an additional factor (i.e., in conjunction with the degree of spiritual progress made during this lifetime) that may account for any deficits in spiritual awareness.

We think there is quite a lot of progress to be made before mainstream health disciplines begin to accept that spiritual factors play a central causal role in the onset of mental pathologies. So perhaps now is not the right time to introduce a model of mental illness that requires clinicians not only to assess impairments in spiritual intelligence that relate to this life, but also those that relate to previous lifetimes!

 

Further Reading

1. Lukoff, D. From spiritual emergency to spiritual problem: The transpersonal roots of the new DSM-IV-TR category. Journal of Humanistic Psychology 1998;38:21-50 1998
2. Parks, T. How is your personality formed? The Guardian, 2013, 22^nd June.
3. Shonin E, Van Gordon W, Griffiths MD. Buddhist philosophy for the treatment of problem gambling. Journal of Behavioural Addiction, 2013;2:63-71.
4. Shonin E, Van Gordon W, Griffiths MD. Meditation Awareness Training (MAT) for improved psychological wellbeing: A qualitative examination of participant experiences. Journal of Religion and Health, 2013; DOI:10.1007/s10943-013-9679-0.
5. Yang C, Lukoff D. Working with spiritual issues. Psychiatric Annals, 1998;36:168-174.

Ven Edo Shonin and Ven William Van Gordon

Predicting Your Enlightenment

Predicting Your Enlightenment

It is not uncommon in Mahayana Buddhist sutras for the Buddha to prophesize the future enlightenment of his disciples. Probably the best example is the Lotus sutra where the Buddha makes such proclamations on several different occasions. Here is an example from chapter six of the Lotus Sutra where the Buddha predicts Maha-Maudgalyayana’s attainment of Buddhahood in a future era:

“This my disciple Maha-Maudgalyayana, after casting aside this body, will see eight thousand two hundred myriads of kotis of world-honoured Buddhas, and, for the sake of the Buddha-way, will serve and revere them. Among these Buddhas, ever practicing the brahma-life, for innumerable Kalpas, he will keep Buddha-law. After these Buddhas are extinct, he will erect stupas of the precious seven, displaying afar their golden spires, and, with flowers, perfumes, and music, pay homage to the Stupas of the Buddhas. Having gradually accomplished the bodhisattva-way, in the domain Glad Mind, he will become a Buddha, named Tamalapattra Sandal Fragrance”

Essentially, what the Buddha was communicating with these predictions is that the end result for anybody who perseveres in their Dharma practice over many many lifetimes is that of Buddhahood itself. Now then, let us share with you something that is not widely known. There is a shortcut to enlightenment that means that you don’t have to wait until eternity’s end before you recognise your self-existing Buddha nature. In fact, it’s a shortcut that can place in arm’s reach the prospect of enlightenment within this very lifetime. It’s a shortcut that is so utterly simple, so direct, and so primordially truthful, that most people lack the courage to take it.

If you wish to take this more expedient route to enlightenment then this is what you should do. From the very core of your being, unreservedly offer to the Dharma all of your body, all of your possessions, all of your mind, and all of your spirit. Offer all of your past lives, every moment of this present life, and all of your future lives. Offer all of your hopes and dreams. Offer all of your happiness and all of your pain. Offer every single breath, every single footstep, and every single word you utter. Offer every thought and every mind movement. Offer every ounce of your being and completely surrender your ego to the Buddha. Offer these things with such heartfelt sincerity, such unwavering conviction, that you, there and then, allow the Buddha’s blessings to enter and nourish your being. Offer these things at all times, day-in and day-out. No matter what obstacles or pleasures you encounter, never allow even a hair’s breadth of distance to come between you and the knowledge that you are a rightful heir to the Dharma throne.

When you resolve your mind in such a manner, and surrender yourself to the Dharma without ever looking back, then you don’t need any Buddha to predict your enlightenment. You can make that prediction yourself. You can know that you have been initiated into the inner Sangha of noble beings. What will happen next is that if you have already had the good fortune to meet with an authentic master, your pure faith will enable their blessings to flow forth. If you have not yet encountered or recognised the teacher, then your Vajra-devotion will cause you to swiftly do so.

Enlightenment is in the palm of your hands – you just have to decide whether or not you want to wake up!

Edo Shonin & Ven William Van Gordon