Making Psychological Referrels in the Parish
By Fr. George Morelli
In private correspondence an Orthodox scholar, responding to my article, "Orthodoxy and the Science of Psychology" (Morelli, 2006a), said that in parish life "the clergy know how to make referrals for medical problems but are clueless about using clinical psychology for the behavioral-emotional problems they encounter."
I replied: "Mental health practitioners must keep up with the scientific research in their field. Likewise, educators and parents should know the techniques shown to be effective with their families and children. Clergy should also be informed of methods to aid their pastoral ministry and make proper referrals."
When I taught pastoral theology at one of our Orthodox seminaries, I emphasized that parish priests are not clinical mental health practitioners but they must be able to recognize mental disorders and make appropriate referrals. A priest is a "first line responder." He needs to know enough to assess situations and then direct the person to the proper diagnostician.
One problem that priests face is the overlap between the content of what parishioners report as spiritual problems but are in fact psychological problems. A way that priests might distinguish between the two is by using the heuristic (a method by which knowledge about a problem or situation is uncovered) that clinical psychologists use, that is, start the analysis at the most basic level and eliminate possible variables as the questioning gets more complex.
In a clinical setting for example, if a patient complains of depressive symptoms, I start out by making sure all the physical elements that may be causing the problem are eliminated. I ask to see the report of their last physical examination including such things endocrinological tests and other physiological factors that may play a role in effecting mood.
Once the physiological factors are eliminated I move on to the cognitive-emotional elements (Morelli 2006) that might contribute to depression. Moreover, even in cases in which physiological factors are indicated, there may be psychological variables that need to be addressed. They may not be the primary cause of the depressive symptoms (dysphoria) but their treatment may significantly aid the healing and adjustment process, much like a person who underwent surgery needs physical therapy in order to regain proper functioning. Of course, if the primary cause of depression is psychological, then the appropriate psychotherapeutic procedures shown to be effective by scientific research would be the primary treatment process.
St. Maximus the Confessor said "grace builds upon nature" (Morelli, 2006b). For the Orthodox Christian this means that neither the spiritual or natural dimensions of human existence are ignored. A parish priest must be aware that many of the problems parishioners present to him have psychological components and that the spiritual healing of a person often involves psychological dynamics that require the aid of persons qualified to address and treat them. It is foolhardy and dangerous to assume all behavioral and cognitive problems have only a spiritual basis. Like St. Basil said, medicine, too, must be taken into account in the healing of persons. We should take his words to heart.
Morelli, G (2006a, May 08). Orthodoxy and The Science Of Psychology. http://www.orthodoxytoday....
Morelli, G (2006b, December 05). Understanding Clergy Stress: A Psychospiritual Response. http://www.orthodoxytoday....