The Rut: When Your Faith Becomes Bigger Than God’s

It was a Monday morning – about 8 am. All the seats at the Out-Patient Department (OPD) of the Psychiatric Unit were filled – clients without seats had formed a queue – about a dozen of them leaning against the wall. Most of the clients looked forlorn and despondent – others were displaying psychotic symptoms and behaviour.

The nurses and house-officers were already busy serving medications or carrying out one medical procedure or the other on clients who were on admission. At the other end of the Unit three men were seen approaching with a middle aged woman in a tight grip. She was about 30 years of age – may be even younger. She looked kempt but was whining and uttering certain words – clearly she had lost touch with reality. As they drew nearer she frowned and called out names: “Madam…Nurse Doreen…eeeeiiiii Matron Augustina are you also working with them against me?”.

She paused, smiled and continued. “Dr. Oppong…I know you are on my side. We shall win this war…it's…”. Her last words were inaudible. Matron Augustina gave some instructions to one of the nurses who rushed to prepare a bed for her admission. She looked at the client, shook her head and muttered: “Stella is here again”.

Stella had the names right. This was not her first time on admission – it was her eighth. Six years ago she was diagnosed with paranoia – a type of mental disorder characterized by thought processes that cause a person to have an irrational suspicion or mistrust of others. The condition is usually caused by personality disorders, paranoid schizophrenia or drug abuse. Each time on admission, she was seen by a psychiatrist and a psychologist and gets discharged when she gets better. But this was her eighth time on admission. Why?

Relapse, a return to a pretreatment state of a disease condition is one major challenge facing the mental health profession. In particular, high relapse rates are found among clients with addictive behaviors, such as among substance abusers. However, other chronic illnesses such as hypertension and diabetes are also persistent relapsing diseases.

A number of factors – from non-adherence to treatment through shortage of medication to lack of family support can act as precipitants to relapse among people with mental illness who were previously treated. Nonetheless, as in the case of Stella, one major cause (as recounted by most clients and relatives) has been client and relative's quest to find religious interventions for all medical problems (Please don't misconstrue me – I love God as much as you do!).

When Stella was first diagnosed with her condition, it was a difficult moment for her family. How could a young, pretty lady – a National Service personnel suddenly become afraid and suspicious of everyone – including her parents and Pastor? This could only be from the devil. She spent the first two months at a prayer camp. In the most part, just like the others, her legs were tied to a metal object when she became aggressive. She must fast all day – and pray if she can. After two months, her symptoms worsened. She started hearing voices commanding her to do certain things. Everyone was a threat. She 'knew' people were out there to harm her. The voices told her so. That confirmed everyone's theory that the condition was caused by a supernatural force. The voices became more irritable – unbearable. Her hands were also tied as she became more aggressive. The faith-healer said that was a sign the evil spirit will soon escape – then she'd become free! But it was day 63 at the prayer camp. Later a relative suggested they try the hospital. It was not easy for the other relatives and the healer to assent.

Stella was brought to the hospital – very aggressive. Her mother couldn't hold it anymore – she couldn't control her tears. Stella was saying things – things certain voices were telling her. Most were contextual – and made sense. Nonetheless the psychiatric nurses were calm. They see this type of condition each week. They instructed the men who brought her on how to handle her and send her to her bed. The psychiatrist came over to assess her condition, took some information from the relatives and prescribed some medication. After about five minutes the medication was injected – with much difficulty. She yelled all this while – the nurse, psychiatrist and the men holding her were all murderers. They were conspiring with some alien folks to harm her.

A couple of minutes later – about 30 minutes after the medication the ward became quiet. Stella was fast asleep. Because she was highly suspicious of everyone when her condition started, her sleep was always interruptive. She woke up four hours later. Her 'odd' behavior and symptoms were drastically reduced. She reported hearing less voices. The clinical psychologist later gave Stella and her relatives insight into the condition. Eight days later, Stella was discharged home – with medications and scheduled for additional psychotherapy and review two weeks later. Everyone was happy.

Two weeks after her discharge, Stella's name was on the review list for the day. But she didn't turn up. Why? She was taken back to the prayer camp. This sickness was strange. Someone evil wants to 'destroy' Stella. She needs to fast and pray now that she appears sane. She stopped her medication. She became very well…and then worse. She started experiencing the same symptoms again. “Who is doing this to my child?”, her mother kept asking. She consented with ease this time when it was suggested that Stella be taken to the hospital. Stella was again treated and discharged a little over a week on admission…and that became the cycle. Certainly they came directly from the prayer camp. Today is her eighth time for coming on admission – so the staffs are now a family. She knows everyone by name.

As a trainee Clinical Psychologist, this story is familiar. It makes sense. In our context, it makes sense to attribute mental illness and other psychological conditions to a supernatural cause. Granted! There are evil forces out there – and one must be prayerful! The only difference is that this idea places us back to the 3rd and 4th century. That's how many years ago when the Western world also considered as the cause of mental illness. Today, they can diagnose and manage almost all diseases! Today, we pray, fast and throw away all our medications given us from the hospital for our ailments.

The problem is not because we are Christians – the problem is because we limit God. We want a physical, mundane miracle! We want to pray for the candidiasis to disappear. We want to pray away the fibroid. We want to fast and melt away the cataract so we can see clearly. That would be what we can call a miracle. But what would you call an anti-fungal medication that treats your candidiasis? What would you call when a surgeon performs surgery to take away the fibroid, or the cataract, or stands for 6 hours to perform heart or brain surgery? I call these MIRACLES!

Religion (or spirituality) and science can co-exist. They should. When you need to take your anti-hypertensives or your psychotropics, or need to go for an appendectomy, remain thankful. That's your miracle! The right answer to Stella's mother when she asked: “Who is doing this to my child?”, is “You! Yourself!!” It's equally a miracle when someone manufactures a drug or performs a surgery to save a life – as it is when the priest 'cabod' and 'catat' your sickness away. But most often we miss the point.

We almost always attribute all diseases to spiritual forces. Yet we cannot verify that (Agreed – sometimes 'Antoa' does. 'Antoa' will always do). Yet the scan or laboratory analysis can pick up an infection in the meninges for your meningitis treatment to start. It is disheartening when a client wouldn't start her antiretroviral therapy because she believes her HIV infection was acquired spiritually. Granted that it was spiritual – could this virus respond to therapy whilst praying or requesting others to pray for you in addition? Yes! Often they respond. There are universal laws. An arm robber pushed from the 12th floor of a storey building may hit the ground and die…so may the Pope. God is Mighty and Powerful. He can save you through your Pastor or dentist or radiologist or physician or psychologist. Pray and fast when healthy. Adhere to medical treatment when unwell.