The Phenomenon of God’s Abandonment in Clinical Psychiatry

Abstract

   Background: God’s abandonment in religious literature is defined as the loss of divine grace, the feeling of distance from God, abandonment by God, God’s departure from man, which is manifested in the weakening of divine support, often perceived as a period of spiritual crisis and accompanied by despair and heartache. At present, there are lack of a psychopathological andclinical studies in the scientiашc literature concerning the phenomenon of God’s abandonment. This phenomenon is complex and little studied neither in the spiritual life nor in the context of clinical psychiatry. The phenomenon of God’s abandonment requires further research for proper diagnosis, choice of the correct treatment, psychotherapeutic support, and adequate tacticsof pastoral care.   Objectives: identification of clinical and psychopathological features and structure of the phenomenon of God’s abandonment in order to determine the syndromal and nosological affiliation, prognosis issues and right choice of therapeutic tactics.   Patients and methods: 35 patients (16 male and 19 female) aged 18–55 years (mean 39.8 ± 11.6), who had a sense of God’s abandonment in the clinical picture of endogenous depression and depression-delusional disorders, were examined. Clinical-psychopathologic, psychometric (HDRS, CRS, SAG) and statistical methods were used. As a control group, 5 male individuals who were monastic residents and were not in the psychiatrist’s ашeld of vision and not demonstrated obvious signs of psychiatricdisorders were examined. For this group, a retrospective analysis of the peculiarities of the phenomenon of God’s abandonment was carried out on the basis of the assessment of subjective and objective data.   Results: the conducted research has revealed that the phenomenon of God’s abandonment is a special psychopathological symptom complex specific for the studied group of patients, regardless the syndromal or nosological affiliation. The main manifestation of this phenomenon is the religiousanesthesia (as the religious equivalent of anaesthesia psychica dolorosa) with the leading manifestations of the absence of sensations of religious feeling with the key experience of abandonment by God in close link with the other psychopathological disorders. Three types of conditions with the phenomenon of God’s abandonment have been identiашed: type 1 — depressions with the phenomenon of God’s abandonment and manifestations of affective delusion (22 patients, 62 %; 12 men, 10 women; mean age 43.4 ± 11.2 years) in the structure of affective psychosis; type 2 — acute psychotic states with the phenomenon of God’s abandonment and noncongruent delusional disorders (13 patients, 37 %; 4 men, 9 women; mean age 31.7 ± 8.2 years) in the structure of schizoaffective disorder or schizophrenia spectrum; type 3 — crisis of faith (5 men from the control group; mean age 40 ± 11.8 years) which is the psychological crisis with experience of God’s abandonment within the framework of personal development.   Conclusion: the phenomenon of God’s abandonment can represent a range of psychological and psychopathological conditions: starting from spiritual psychological crisis up to wide range of psychiatric disorders: overvalued ideas, anesthetic and depersonalizing non-psychotic depressions, and delusional depressions or acute psychosis. The identiаfied types of states with the phenomenon of God’s abandonment had different diagnostic value.