| Abstract|| |
The behavioral manifestations of psychotic disorders that are attributed to evil spirits in the Judeo-Christian scriptures as demonstrated by Jesus Christ have been narrated. The descriptions of false beliefs and the perceptual experiences that are consistent with the psychiatric terminologies "delusions and hallucinations" are briefly discussed. Attempt has been made to analyze the patterns of suicidal behaviors, guilt feelings, and, expressions of depressive symptoms in the Jewish culture. Of interest is the mass suicide by the Jews in the 1st century AD at the Fort Masada, perhaps the first of its kind recorded in the history. Noteworthy are alcohol and related mental health problems prevalent in the Jewish culture. While highlighting the descriptions of dreams and their revelations recorded in the Bible, it is suggested that such concepts about dreams might have influenced Sigmund Freud's classical works on dreams. The biblical messages and teachings that could be applied for psychotherapy and behavior modification strategies have been outlined. The mental concepts of Jewish culture and their relevance to Indian culture have also been discussed from a cross-cultural perspective.
Keywords: Alcohol, culture, depression, delusions, dreams, evil spirits, guilt, hallucinations, psychotherapy, suicide
|How to cite this article:|
Ponnudurai R. Judeo-Christian concepts related to psychiatry. Indian J Psychiatry 2013;55, Suppl S2:201-4
| Introduction|| |
Psychiatric research and practice are increasingly directed toward better understanding of spirituality and religion in response to the expressed wishes of service users and to achieve better outcomes following treatments. A series of short articles published in the British Journal of Psychiatry, "Psychiatry in the old Testament," brings the perspectives of modern psychiatry to bear upon a number of ancient texts which are regarded as scriptures within the Jewish and Christian traditions.  Even as the relevance of the texts of Judeo-Christian scriptures to psychiatry is examined in this study, it was also considered worthwhile to analyze them keeping in view of the Indian mental concepts, for, there is a conviction among a few of the Indians that they are of Jewish descent. Some of the Mizos say that they are Jewish descendants of the tribe of Manesseh, one of the 10 tribes of Israel that have been lost for the past 2400 years. On the contrary, according to the Jewish historian Josephus (37-100 AD), some Greeks had the belief that the Jews were descendants of the Hindus.  The present investigation of Judeo-Christian concepts could help to engage psychiatry in a critical and constructive way with these religious texts.
| Concepts of evil spirits and mental illness|| |
The clinical features of what we call as schizophrenia were recorded in Indian history nearly 3300 years ago by Charaka.  Folk or local healers served Indian community at the grass root level from times even earlier than the origin of Ayurveda. The songs, dances, and the weird rituals of the "Atharvans" drove away a great many "ghosts" of acute psychosis.  The concepts of "ghosts" and "spirits" besieging humans and causing the behavioral problems were prevalent not only in Indian culture, but also in several others including Judaism and Christianity.
Classical description of the features of patients suffering from psychotic disorders and other behavioral problems has been recorded in the Bible. One such patient who was so violent that he even tore off hand chains apart and broke the iron chains on his feet had been living in graveyards. Commanded by Jesus Christ, the evil spirit came out of him calling itself as "legion," meaning they were many. Permitted by Jesus, the evil spirits on coming out of this patient entered into a herd of 2000 pigs which rushed into a lake and got drowned. When the people came to Jesus, they saw the man who had been possessed by the legion of demons, sitting there dressed and in his "right mind." Furthermore, Jesus Christ had reportedly cured many other general medical conditions too, such as seizure disorder, deaf-mutism, paralytic attacks, and other disabilities, by driving out the "evil spirits." But biblical texts do not provide typical clinical description of cases of neurotic disorders attributed to "evil spirits or demons" that are healed by Jesus Christ. Nonetheless, it is still possible that a sizeable number of these cases, as per psychiatric nomenclatures, could be called as neurotic disorders including conversion/dissociative disorders.
Elsewhere, it has been mentioned that the driving of Chariot by King Jehu, son of Nimshi, was like a "madman." While declaring that Jerusalem's enemies will be destroyed, prophet Zechariah had warned that their horses will be struck with "panic" and their riders with "madness."
In the last two centuries before Christian era, Judaism advanced the ideas they borrowed from the Zoroastrian belief in evil spirits.  Even today, it is not an uncommon practice that difficult or "incurable" cases drifted away, and often found shelter in religious shrines in India, where the magico-religious methods of treatment including prayers and rituals are practiced to drive away the "evil spirits." If people of faith in the scriptures believe in such divine forces, appropriate interpretation could be that such supernatural powers effect changes in human biology so as to cause the various diseases.
| Descriptions consistent with Delusions and Hallucinatory experiences|| |
P0 athological false beliefs, called as delusions in psychiatric terminology, were recognized in Jewish culture as noted by prophet Jeramiah, "How long will this continue in the hearts of these lying prophets, who prophesy the "delusions" of their own mind?" Further, Jeramiah has advised, "You should put any "madman" who acts like a prophet into the stocks and neck irons." Symptoms of delusional jealousy have been noted in Jewish scripture as mentioned, "and if feelings of jealousy come over her husband and he suspects his wife and she is impure - or, if he is jealous and suspects her even though she is not impure - then he is to take his wife to the priest."
At Mount Sinai, the smoke billowed up from it like smoke from a furnace, the whole mountain trembled violently, and the sound of the trumpet grew louder and louder, "Then Moses spoke and the voice of the Lord answered him." In fact, the "Ten Commandments" were the words thus spoken by God to Moses.
Prophet Zachariah heard the word of the Lord through angels. The priest Ezekiel's experience of hearing the voices of God associated with visions has been the subject matter of scrutiny by many. Stein has even gone to the extent of calling these experiences of Ezekiel as symptoms of schizophrenia and the periods of his immobile states as catatonia. ,,
When Jesus Christ took with him his disciples Peter, James, and John to a mountain side, he was "transfigured" there. His face shone like the sun, and his clothes became as white as the light. Also, there appeared before these disciples, Moses and Elijah talking with Jesus. The experience has been described as so real that Peter said to Jesus, "Lord, it is good for us to be here. If you wish, I will put three shelters, one for you, one for Moses, and one for Elijah." They also heard a voice from the cloud, "This is my son, whom I love, with him I am well pleased. Listen to him." Subsequently, as if confirming the incident, Jesus instructed them, "Don't tell anyone what you have seen, until the "Son of Man" has been raised from the dead."
Saul's (later known as St. Paul) sudden conversion to Christianity has been due to the incident that occurred on his way to Damascus to persecute Christians when he confronted with the visions and voices of Jesus Christ.There are several such instances noted in the Judeo-Christian scriptures where God either himself or through angels has revealed himself through "visions," and also conveyed "messages." The relevance of such experiences to psychiatric terminologies is highly debatable. At any rate, biblical texts provide no basis for the assertion that those who had such perceptual experiences were considered to be unwell by their contemporaries. But Hebrew prophets certainly were accused of madness, as the examples of Hosea, Elisha, and Jeremiah demonstrate.
Such acts of behavior are better understood within the cultural and historical context as a meaningful, rational, and dramatic attempt to get people to listen to a prophetic message which they seemed intent on ignoring. Van Nuys suggests that we must look at the prophetic message as a creative problem-solving process. 
| Suicide, Guilt, and Depression|| |
There is a class of suicide which is distinct from others, and which is the giving up of one's life voluntarily as a mark of sacrifice and self-dedication to a higher level of existence. Their sacrifice is considered as praiseworthy, and they are commended, revered, and venerated by generations of men and women.  Although such practices are reported in Indian culture, such suicides are not encountered in Jewish culture.
Suicide was chosen as an honorable way for death rather than suffering at the hands of enemies during the Judeo-Christian era. When Israelites were defeated by the Philistines, King Saul took his own sword and fell on it.
Jewish mass suicide
Mass suicide as an honorable way for death has been recorded in early Christian era. Following the failure of Jewish revolt in 70 AD, a remnant of 960 Jewish rebels took over the Herodian fortress of Masada and withstood a 3-year Roman Siege. On the eve of the final attack by the Roman army led by the Roman commander Flavius Silva, all the Jews committed suicide by slitting their throats in turns. Finally, when the sole survivor first looked around to see if in that slaughter there was anyone who needed him, then when he was certain all were dead, he set fire to the palace, and plunged his sword into his body and fell down heavily next to his relatives. Perhaps, this is the first mass suicide recorded vividly in history.
Guilt feelings and depression
Filled with feelings of guilt due to his sins, King David in his appeal to God for relief from a severe and painful illness had said, "There is no health in my body, my bones have no soundness because of my sin. My guilt has overwhelmed me like a burden too heavy to bear." It may not be a far-fetched conclusion if it is inferred that King David has gone through a phase of depressive disorder. After betraying Jesus Christ, his disciple Judas Iscariot felt he has sinned by betraying innocent blood. He was seized with guilt and remorse, and committed suicide by hanging. Obviously, such an act of suicide has been condemned in Judeo-Christian culture. The concepts of sin, guilt, and forgiveness for sins were emphasized in Jewish and Christian cultures.
| Alcohol-Related Mental Health Problems|| |
There are several quotes regarding alcoholism in Bible. It has been advised, "Do not join those who drink too much wine or gorge themselves on meat, for, drunkards and gluttons become poor and drowsiness clothes them in rags."
Signs of alcohol intoxication and dependence
Elsewhere, intoxication phenomenon has been vividly described as "your eyes will see strange sights and your mind will imagine confusing things. You will be like one sleeping on the high seas, lying on top of the rigging. 'They hit me,' you will say, 'but I'm not hurt! They beat me, but I don't feel it! When will I wake up so that I can find another drink?'"
Signs of alcohol dependence have been clearly indicated thus: "Woe to those who rise early in the morning to run after their drinks who stay up late at night till they are influenced with wine."
Alcoholism and antisocial personality disorder
Description of an alcoholic with antisocial personality is reflected in the verse that advocates death penalty by stoning, for a rebellious drunkard who does not obey his parents.
The Vedic scriptures have documented the use of "Somasura" (intoxicating beverages) as early as 2000-800 BC in India. Even the ancient Indian texts of Charaka and Sushruta (around 3300 AD) make distinctions between normal and excessive drinking. These texts and scriptures also identified the harmful effects of drinking.  Such ancient Indian concepts and habits on alcoholism have probably influenced the Jewish culture also.
| Relevance of Dreams to Psychiatry|| |
Even as no one from Babylon could interpret the disturbing dreams of its kings Nebuchadnezzar and Belshazzar, Daniel who was in Babylon among the exiles brought from Judha was able to interpret correctly the hidden meanings of those dreams, which interestingly, later got fulfilled.
Joseph had revealed his dreams about the future of his brothers, which were actually fulfilled. He had also rightly interpreted the dreams of Pharaoh of Egypt, which had indeed saved Egypt from being ruined by a famine.
Elsewhere it has been mentioned that dream comes when there are many cares. Fascinated by reading the descriptions and revelations of the contents of these dreams, perhaps, Sigmund Freud, who was also a Jew, could have been influenced to formulate his own theories on the interpretation of dreams.
| Concepts Related to Sexuality|| |
The guidelines and regulations laid down by Moses, as revealed to him by God regarding the sexual relationships of Jews, were probably written keeping in view the psycho-social implications of deviant sexual behaviors. These concepts might act as deterrents against such deviant behaviors.
| Toward Non-Pharmacological Therapies|| |
The Jewish advice that "it is better to go to the house of mourning than to go to a house of feasting" indicates the psychological needs of the bereaved and contributes toward crisis-intervention strategies.
Music could have been considered as a form of therapy by the Jews, for, it is reported, "Now the spirit of the Lord had departed from Saul, and an evil spirit from the Lord tormented him. But whenever the spirit from God came upon Saul, his armour-bearer David would take his harp and play. Then relief would come to Saul, he would feel better, and the evil spirit would leave him."
The teaching of Jesus for those who are dull and worried, is well explained by his words: "Therefore I tell you do not worry about your body, what you will wear. Who of you by worrying can add a single hour to his life" might be of use in formulating our psychotherapy strategies. Hostility and aggressions manifested due to various factors including delusions of persecution could be subdued by the words, "Bless those who curse you, pray for those who mistreat you. If someone strikes you on one cheek, turn to him the other also." Such teachings could be adopted in psychotherapy. In fact, the father of our nation Mahatma Gandhi adopted this principle successfully to tame the Englishmen. 
The Judeo-Christian concept of confession of sins for forgiveness by God could give relief to a troubled mind with conflicts. This aspect could be beneficial while planning for therapies such as psychoanalysis, narcoanalysis, and other psychotherapies directed to resolve the conflicts.
Ancient Indian scriptures too could be cited as tools for psychotherapy. Elsewhere, Bhagavad Gita has been declared to be masterpiece of psychotherapy, as the counseling transformed Arjuna who initially refused to fight the battle into a heroic warrior ready to take arms. 
| Conclusion|| |
Thoreau suggested "A joint Bible" of the Asiatic scriptures, Chinese, Hindus, Persians, and Hebrews, "to carry to the ends of the earth."  It has been pointed out that we need to home grow our own model of development based on our own strengths. , However, even as we develop our own spiritual model for a comprehensive treatment of the psychiatrically ill, drawing inspirations from other faiths might reflect our broad outlook and spiritual wisdom.
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