Beyond Blue

Beyond Blue

Faith and Mental Illness: An Interview with Nancy Kehoe, Ph.D.

Faith and Mental Illness 2 Nancy.jpgEver since I came across Sr. Nancy Kehoe’s book, “Wrestling with Our Inner Angels,” I knew I had to interview her on Beyond Blue. Because her perspective is so unique: Nancy is a Society of the Sacred Heart sister and a psychologist in Cambridge, Massachusetts.


The topic of faith and religion within mental-health circles is awkward. Let’s face it. Several of my therapists in the past have categorized my intense faith as part of my neurosis. If I told them that I thought something was a sign from God, they would start scribbling on their pad, and I knew what that meant: “Client has had a relapse of aberrant behavior and psychotic visions.”


So I thought I’d invite a person who is well versed on both sides to help us better understand the relationship between religion and mental health.

walking with angels cover.jpg

1. Why are so many mental health professionals so opposed, reluctant, or uncomfortable talking about religion and faith with their clients?

Nancy: “Because of Freud’s unparalleled influence on the way psychodynamic training and mental health treatment has been practiced in this country since the early 20th c. his views on religion have been profoundly influential. Essentially he viewed religion as a symptom of immaturity or pathological disorder. Until the most recent edition of the DSM ( Diagnostic and Statistical Manual) all the references to religion were negative, symptoms of illness. In addition to the historical roots, the omission of the discussion of religion in treatment is also related to the fact that mental health professionals have higher rates of atheism and agnosticism than the general population.” (Wrestling with Our Inner Angels” p. xxi.)


What this brief paragraph does not address is the discomfort that clinicians feel in talking about religion and faith with their clients because of their own unresolved issues around their religious backgrounds. For many clinicians, psychiatry, psychology, psychoanalysis has become their religion. These disciplines have many of the characteristics associated with religion – a system of beliefs, an oral and written tradition, authority figures, rules, rituals and a community of fellow believers.   

Other factors exist that make it difficult to talk about religion and faith with clients. 

• Clinicians often feel uncertain as to what to ask, what questions may be perceived as intrusive or judgmental. For this reason I developed a religious history questionnaire to offer mental health providers ways of exploring a person’s religious/spiritual background. (A copy of this may be obtained from the author at
• Clinicians are anxious that a client may ask them about their beliefs.
• Judgment, proselytizing, dogmatism, an inability to have an open, respectful conversation about beliefs make it difficult to have a discussion in society at large and these same elements make it difficult to have a conversation in a therapeutic environment.


2. How would you advise a person seeking treatment from depression and anxiety to broach the topic of religion?

Nancy: When a person of faith, or a person with a strong spiritual practice, one for whom participation in a religious tradition is an important part of who they are, then he/she should ask the therapist if he/she is open to talking about this aspect of the client’s life. That does not mean that the therapist be a believer himself or herself, but that he or she can attend to this aspect of a client’s life respectfully and non-judgmentally. Asking questions that lead to a deeper understanding of the role a person’s faith or practice plays in his or her life are a vital part of therapy and do not suggest a negative attitude toward a person’s beliefs. 


Therapists do not need to know about every religion but they do need to have an attitude or respectful curiosity and the ability to withhold judgment. It is important to trust one’s own sense of whether the therapist seems open and willing to talk about a person’s religious beliefs.

3. How can you find a mental-health professional open to faith discussions?

Nancy: Finding the right therapist is often a challenge. Factors that affect the options are:

• the area in which one lives,
• the resources that are available,
• the insurance one carries,
• the networks one has

In some states a person can call the parent organization such as the American Psychiatric Association, the American Psychological Association, and the Association of Licensed Social Workers and ask if they have therapists on their lists that are open to the discussion of religion/faith/spirituality in the process of treatment. Word of mouth is always a useful resource – knowing someone who has had a successful therapy and who was able to talk about their beliefs or knowing religious professionals in the area who may know therapists who have or are respectful of a faith dimension.


If a person’s religious/spiritual beliefs are to be an integrated aspect of the therapy, the client must take responsibility for that and seek out a therapist that will honor that.

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  • george ebert

    In New York State most people are entered into the psychiatric involuntarilly and have no choice in how they are treated.

  • Adavance Cleanse

    nice post this is, and i think this is so helpful to all users,

  • Your Name

    I’m so thankful to have a Doctor/Psychiatrist who I can share faith talk with. Like Abraham or Moses talking to Lord God Adonai I respect him and he, myself. He uplifts my life within positive reinforcement of my beliefs! I don’t suffer great loss in other words to my self-esteem when the faith I live before him is broached. Being a Jew he understands Christianity is an outcrop of Judaism. Grafted in spiritually I as a born again believer worship God pentecostal tradition and we share a bond that is very much the love of God in affirmation of moi. I being diagnosed mild schizophrenia have had one hospitalization in 1975 need anitpychotic medication for the remainder of life but newer drugs help! I’m from New York by the way.

  • Sue Whelan

    Every human being has a need to answer the questions of why we are here, where did we come from, and what makes us tick. Historically, those questions have been answered by religious or spiritual practices and beliefs. Spirituality is inborn. We are hard-wired for wonder (in all it’s meanings)as anyone who has spent any time around children quickly realizes. That capacity can be driven out of us or die from neglect but that doesn’t mean it never existed. For any so-called healing professional to ignore, denigrate, or marginalize the spiritual side of human existence shows an incredible ignorance of humanity. It’s a bit like saying the colour red does not exist because I don’t like it, or it makes me uncomfortable, therefore I will ignore or disparage it no matter how often it confronts me. As grateful as I am for Freud’s ground-breaking body of work, hopefully, psychiatry and psychology will eventually evolve to the point where they can embrace all of the reality of human existence, not just what was deemed real or valid by a culture-bound, nineteenth century, Viennese doctor.

  • skylark

    Thanks Therese for introducing a most interesting topic….and to the
    comments offered by Sue Whelen …well said. Point delivered needs to
    be made.

  • Bill White

    I cannot for the life of me imagine why a counselor wouldn’t encourage a client to utilize his/her faith as they work toward meeting their goals. Yes, we all know the minefield of pathology “religion” often creates. But if the counselor senses his/her client’s spirituality isn’t making matters worse, what could possibly be the big deal? Sounds like a mighty case of countertransference to me. And I gotta’ tell ya’…so many graduate counseling and social work programs have become so liberal, tolerating very little outside of their “school” of thought.

  • Jill

    This was an interesting read thanks Therese.
    I am studying Psychology and I don’t think I would mention religion to my clients or ask them if they are interested in sharing their views on it in the course of treatment.
    As the old saying goes about how religion and politics never should be discussed. I would just leave well enough alone. I wouldn’t care what my patient’s religious background is,
    I’m not going to divulge things about my experiences with religion and they shouldn’t feel pressured to share or not share…it would be up to the patient on what they wanted to do.

  • Farouk

    finally a person who dares to talk about faith except of nature!! keep it up

  • Katie

    First, I want to thank you for taking the time to write your book. I picked it up today at Barnes and Noble and read some of it. I had to check out your blogs. I live in MD as well. And my mother also says ..and what gives me hope is “this too shall pass.” It always does. Not to mention that I always tell people that sometimes we have to “fake it to make it.” My motto too. LOL. I am starting a support group for those that suffer with anxiety coupled with depression…and I say that alot. I am also writing an “inspirational book” I guess, although I don’t know the first place to far as having it published.
    Enough about that. Many therapists look at faith and ones reliance on it as a symptom of OCD…I too look for “signs” and was always ..mostly told that was OCD. Hmmm…I will read more on what you have here. Thanks again. I know as I live with anxiety/depression every day how hard it is. Thank you for helping others. I hope to hear from you sometime.

  • Christina

    I guess I’m really lucky to have a therapist who’s open enough about her own spirituality — she has Mandalas as well as Jewish icons on her walls — that I never hesitated to discuss my own.
    So many problems we wrestle with are life-long situations that can’t be dealt with in any but spiritual terms.

  • mary

    years ago I took a test when I was seeing a Doctor for anxiety, and all the remarks to God were negative, the tests were also outdated, they asked “have you ever dropped the hankie? what is that? I think they were asking if I flirted but not sure.

  • Thomas

    ALCworld has profiles that do in one hour what a phychologist takes 5 to 10 years to do. You learn to not councel people in your own blocks and when a therapy ignores religion and politics that system is detrimental to a clients well-being. Often the nuns have a better understanding of the spirtual nature of the sacrament of penance than the priests, because they have the experience of working more directly with people. So Right On to Sr. Nancy!

  • dolores delgado

    i praise God everyday, he makes me strong i deal with my anxiety and depression as good as i can my therepist knows i love the lord and she respects my feelings for my religion beliefs and that makes me feel good.

  • Eric Lorentzen

    Thank you for your perspective. I agree with Freud. Religion is so steeped in guilt, fear, paranoia, and superstition that it just doesn’t apply. On the other hand faith, hope, courage, honesty, loyalty, compassion, and forgiveness do.

  • lisa gremore

    Thanks to all of you I enjoyed reading your ideas and thoughts. It seems healing could not occur if religion was not examined. Religion is the very way we look at life, how could one overlook this element in a human and hope to set him or her on the path to recovery. All people are on their way to recovery, in my opinion. Anyway, I do not see the mind and body as independent entities and I thought this stereotype was history. I’m sorry it still exists, its existence is a sign ignorance is still around concerning the human body.

  • Nancy Roberts

    I have often wondered how professionals in the mental health field view people who have a belief system like religion in place along with a true mental illness. I have experienced in my past in the nurse’s training a tendancy for mental illness to twist the belief system to the points of non reasoning. I think this may be what makes it difficult for a true discussion to take place. It is just that the professional has to be well set to have this too on their background to help the person find their way back to reality. Religion itself may be the only comfort a person has in their mencing world of confusion and chaos. In the professional world it is a defense mechanism. What if it is just love a person truly wants?

  • Leeannd

    I guess I am one of the lucky ones both my therapist and casemanager both respect and value the importance of my religion and how it applies to my life as well as my mental health. My Doc well I had a steady one and he also was resceptive to it but now b/c of where I go they are changing quite often. My point is that they understand for example I am part of a group in the church that we take care of funerals for perishoners and if I get called to help make something and asked if I can help the day of the funeral, if I call them up and have an appointment and tell them they understand because they know it helps me and my mental stability. It makes me feel good to help so in turn it helps me mentally which inturn works with my plan. I think that more practioners not just in mental health field should respect and learn more about the patients importance of their religion after all they know or should know about the patients needs and issues and well being.
    Excellent Article got to get the book she sounds like a great author
    God Bless you Therese
    Leeann D

  • Sheryl

    I have been in the same place with my faith and professionals. I have found most very open to Christian ideas and thought. My last counselor was a Christian herself and that only helped matters.

  • Mckinney32Henrietta

    All people deserve good life and loan or commercial loan would make it better. Because people’s freedom is grounded on money state.

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