Allan Josephson: Integrating Faith and Psychiatry, Part 1

When Laity Leadership Institute Senior Fellow Allan Josephson, M.D. decided to study psychiatry 30 years ago, persons of faith often wondered how he would fare as a Christian in the field. The influence of Sigmund Freud’s atheism has waned, Josephson said, but it was pervasive then.

Josephson not only survived, but flourished and became an agent of change. Today, he is Vice Chairman for Child & Adolescent Psychiatry Services at the University of Louiseville School of Medicine in Louiseville, Kentucky, and author of three books. One of them is the Handbook of Spirituality and Worldview in Clinical Practice, a text he edited and contributed to that is used in psychiatric residency programs to help psychiatrists understand the diagnostic and therapeutic implications of their own and their patients’ worldviews.

When Josephson was early in his medical training, he was grappling with the Freudian notion that man creates God in his own image as a psychological crutch. He came across a C.S. Lewis essay that pierced this fiction. In the essay, Lewis described how he enjoyed listening to music on scratchy grammaphone records until he attended a live symphony performance in London. Incredibly, Lewis initially judged the symphony as inferior to the recordings.

“Only with considerable mental and emotional readjustment was he able to convince himself of the obvious—that what he had been hearing previously was a mere reflection of the real, rich, multifaceted sound he heard in the symphony hall. What he thought was real music was in fact a substitute for the true reality,” wrote Josephson in a 1994 paper that outlined his clinical theology of child development.

“Similarly, the view that our field obviously holds—that our religion is a childhood wish, a substitute—is simplistic and not consistent with accepted developmental theory. In fact I believe the evidence is overwhelming in the other direction. … The God of this creation, as revealed in Jesus Christ, is worthy of our faith,” he concluded.

“Everyone has a faith position,” Josephson explained when I talked to him in August. “The idea that developmental science is consistent with what Christians have always said is encouraging.”

Josephson tells medical students who want to understand psychiatry better, “Everything that happens in life is a combination of what you’re born with and what happens to you. If you forget either one, you’re going to get into big trouble.”

For example, not long ago a new patient asked him if he is the kind of psychiatrist that talks to people, because she’d been to several who didn’t.

"Are you sleeping? Are you eating? Can you concentrate?" are the questions she had been asked in these short clinical encounters. “You give the list of symptoms, they change your medication, and then you’re out the door,” she said.

Josephson explains that contemporary psychiatry must take the time to understand complex relationships. “Bodies are different and they respond differently. That’s the science of biological psychiatry. On the other hand, it makes a huge difference what choices you make and whether you’re raised in a conflictual environment or a supportive one, or an environment where you’re an only child or where there are eight children, or where you’re worshiped or you’re neglected, or a host of other things. The challenge of psychiatry is to understand these different aspects of life development and how they interact with one’s biology, and then develop a way to help.”

In this series we’re going to tap into Josephson’s wisdom to explore this theme as it relates to:

• How healthy child development mirrors Scriptural principles.
• What children need in the contemporary family for healthy development.
• Why there is an increase in people, particularly children and adolescents, who exhibit narcissistic behavior, and what can be done about it.
• The psychological effects of technology.
• How work defines the self.

Both psychology and theology have much to say about these topics. We hope you'll join us for the discussion.