For those who leave religion, as Swift-Gosiz, Long, and Beuter all did. It's like “the rug being pulled out from under you,” Weinel said.
“Your life has to be gradually rebuilt,” she said. “It's a reframing of who you think you are and what you believe now. One of the new beliefs is that it's okay to be LGBTQ.”
When it comes to treatment, Weinell said he first helps patients learn to take care of themselves.
“Instead of handing over all care to God, we teach them how to self-reflect and manage their emotions from their own perspective rather than from a Biblical perspective,” she said.
From there, she teaches skills to help with trauma responses, such as writing down the negative messages you grew up believing and turning them into positive, hopeful messages.
“What used to be 'My life is a trial and then I die and go to hell' could change to 'My life is an adventure and a journey,'” she says.
She also works on relaxation for her patients by teaching them techniques such as breathing exercises and body scan meditation. In some cases, she recommends combining these tools with medications.
Discussion among mental health professionals
As more LGBTQ people share their experiences of religious trauma, the Diagnostic and Statistical Manual of Mental Disorders, the American Psychiatric Association's reference guide for coding, classifying, and diagnosing mental illnesses, explains how There is debate among mental health experts about how it should be characterized.
In the fifth and most recent edition of the decades-old manual, the DSM-5-TR classifies religious trauma as a Z-code in the category of “religious or spiritual problems,” rather than a formal mental illness. . The Z code is listed at the back of the DSM and is referred to as “other clinically noteworthy symptoms.” Other examples include various forms of “child psychological abuse,” “unsheltered homelessness,” and “victims of terrorism and torture.”
Koenig is currently working with a group of public health experts and psychiatrists at Harvard University. Expanding “religious or spiritual problems” as a Z code in the DSM to include “moral problems” such as moral injury.
Moral injury, although not currently listed in the DSM, can occur when an individual believes that he or she has acted in a way that is deeply contrary to his or her morals or values, thereby causing feelings of guilt, shame, or There is a deep sense of loss of trust. The measure has been applied to veterans and, more recently, to health care workers who they feel have failed to provide adequate care to people suffering from the coronavirus pandemic.
“For centuries, people have manipulated and weaponized religion by stigmatizing LGBTQ individuals,” Koenig said. “Moral injury, especially for religious LGBTQ people, can create a lifelong sense of shame and guilt. Over time, living with it can lead to suicide, depression, anxiety, and more. It can cause mental health problems because it's a moral injury and you can be stuck in that condition for years or even decades.”
Koenig said it was important that the combination of “religious or spiritual issues” and “moral issues” (currently under consideration by the DSM committee) be placed in the manual as a Z code. Adding moral injury allows health care providers to collect more specific data and prescribe more targeted treatments, including whether it is appropriate to recommend pastoral support to those who are suffering. He explained that it will be possible. It also helps better understand which parts of a patient's trauma stem from the religious beliefs of their family and community, and which parts stem from an alternative worldview that says being LGBTQ is immoral. It will be possible to document it in detail.
“For religious people who identify as LGBTQ, the problem is not just Christianity,” he says. “It is the entire moral structure of the culture that has been passed down through generations that has given rise to this accusation.”
To add a new disorder or code to the DSM, extensive proposals must be submitted to the manual's steering committee. The proposal will then be reviewed and sent to the American Psychiatric Association's Board of Trustees for approval.
“Having it as a Z-code will validate it, drive funding, and get more research funding. It's about how we can treat people who are experiencing moral injuries like religious trauma. “It will help us learn more deeply,” Koenig said.
A further step could be to change “religious or spiritual problem” from a Z-code to an official disorder in the DSM. Koenig is unsure of his position on the matter, as the process is more rigorous and could take years, but Weinel said “I think it definitely should be included” as an obstacle. Ta.
“Most therapists don't know much about this at this point. They will meet with new clients and talk about family, schooling, and substance abuse, but they won't touch on religion,” she said. “So if it's a real thing in the DSM, it will be covered and millions of people across this country who are struggling with this problem will have better support.”
Weinell said the DSM's classification of the disorder gives religious trauma more credibility in the eyes of medical professionals and allows people experiencing this type of trauma to name what they're going through. He added that it would be. She also predicted that this would further her research in this area and that religious trauma would become part of the curriculum for university psychology courses.
Drescher, who was part of the APA committee that changed gender identity disorder to gender dysphoria in the DSM in 2013 to reduce stigma, disagrees with Weinel on this issue.
“You don't need a diagnosis to understand what's going on. … Medicalizing a social problem is how homosexuality was originally classified as a mental disorder,” Drescher said, adding that homosexuality He noted that it was not officially removed from the DSM until 1973. The diagnosis doesn't suit me. ”
This could allow future generations to re-pathologize homosexuality “with the flip of a switch”, he added.
And while Dr. Drescher, who has practiced psychiatry for more than 40 years, is not optimistic about changing the hearts and minds of today's anti-LGBTQ church leaders who are “set in their ways,” he is nonetheless optimistic about the future. I have hope.
“Young religious people don't think of LGBTQ people as enemies; they know them as friends, neighbors, and fellow believers,” he said.
“So as new generations grow up, religious LGBTQ people will find more acceptance rather than being stigmatized or having to hide who they are. , if you no longer hide who you are, you will grow up feeling better about yourself and perhaps experience less anxiety, depression, and other mental health issues. ”
If you or someone you know is in crisis, contact the Suicide and Crisis Lifeline by calling or texting 988 or chat with us on Live Chat. 988lifeline.org.You can also visit SpeakerOfSuicide.com/Resources for additional support.
