I have been hesitant to write a post on religion because it is a highly charged topic in virtually every setting, but it comes up very often in DID treatment. While religious faith can have a great positive impact in therapy, it can just as easily have a great negative impact on a patient should have been connected with the underlying trauma. As a psychiatrist, whether religion was brought up by my patients in a positive or negative light, I dealt with it based on that particular patient’s preferences only. I avoided making generalizations of any kind because each patient is an individual, and therapy must be geared to that individual’s experience.

I will restrict my comments to the impact of religion on the therapeutic approach one takes with patients. Appreciating its impact on each individual patient that brings it up is critical for establishing and maintaining the therapeutic alliance.

The therapist must not push back against a patient’s view of religion, regardless of the therapist’s own view. Otherwise, there is a serious risk of diverting therapy away from its primary obligation, which is helping the patient deal with trauma. Why is there such a risk? Remember that being told not to believe their own experience, their own perceptions, and the consequent feelings of being invalidated, are all common experiences of early childhood abuse survivors.

Should the therapist try to impose his/her own ideas about religion onto the patient, it can trigger distrust and retraumatization. It can become yet another replay of some terrible memory. To have any chance of a real therapeutic alliance, therapy cannot involve any demand by the therapist – direct or indirect – for the patient to have the same view of God or religion as the therapist.

In my work with DID patients that had specific views of religion, rule No. 1 was to respect the patient’s perception or idea of God, including the idea that God does not exist. The therapist’s own belief system does not apply here. I would never argue or disagree with whatever my patients’ religious belief might be. The only time to question a patient’s belief would have been if the belief was encouraging them to harm themselves or harm others.

For the DID patients I worked with, it was clear that harming themselves or others was tied to how they were dealing with the trauma and its aftermath, not to any religious view or lack thereof.

For patients that disparage and are frightened of religion, all that therapists who believe their own religious tradition need to consider in order to set aside their own belief system is the truth that throughout history people have performed sadistic horrors in the name of religion. They can remember that wars have been and continue to be fought in the name of religion. Critically important for those with early childhood trauma, abusers often hide behind the facade of religious piety. The fact is that people have hidden their commission of evil deeds behind many names and facades, religious and otherwise.

For patients that do have religious faith, therapists that disparage religion need to consider that faith, throughout history, has been a powerful source of strength that has sustained people as survivors. Faith can sustain people by nourishing their hope of survival and healing from their trauma.

It is important to maintain that open view so as to be able to consider both the negative and the positive experience of religion in patients. Why? Just as I have seen religion used to perpetuate early childhood abuse, I have also observed in some of my patients that faith can play an important role in helping heal those who have been severely traumatized. I have seen many patients whose therapists considered them “too damaged” to benefit from therapy. Nevertheless, they derived strength to fight successfully for recovery because of their religious faith. It was clear that their faith sustained them with hope, that most important element in the process of healing past trauma.

Confidence that it is possible to heal, that it is possible to be freed from the bonds of retraumatizing memories, is the key to healing. For some, abusers have twisted religious imagery and practice. These patients may find healing only in a life that is completely extricated from religion. For patients like that, a therapist might gingerly feel out whether it is safe for the patient to hear the view that one can have a spiritual view without any trappings of religion.

For others, even those whose abusers twisted religious imagery and practice as part of the abuse context, maintaining or even finding faith beyond those evil twists gave them the confidence needed for healing. Because that key of confidence is so important, it is inappropriate to judge another person’s religious faith as right or wrong or superstitious. Instead, support them with the view that what gives them confidence in their healing journey is of benefit.