We haven’t heard from our friend George in a while, so let’s hear what he has to say about handling psychological crises in the monastery. George was visiting a monastery when he had a conversation with an Elder. That Elder had a disciple, Fr Samuel, who was going through a crisis. George knew the disciple, who had just returned from a foreign land, and while in the monastery George had heard a few snippets of conversation from here and there, without of course falling into the fault of talking about third parties in their absence. He was curious, however, what the matter was all about. So during his conversation with the Elder, he asked him what was happening with his disciple.
The Elder briefly described how in the foreign land Fr Samuel had fallen into a crisis and could no longer function. George remarked, ‘Perhaps it is psychological?’ The Elder replied, ‘Would that it were, because then we could have a doctor give a prescription for the appropriate drugs for a few months and Fr Samuel would get over it. Unfortunately it’s spiritual.’
Here we see that the Elder, who had great gifts of spiritual discernment, recognized the value of psychiatric intervention in cases of psychological crisis. However, we also see that he could discriminate between crises that had a natural, psychological origin and those that had a spiritual origin. We also see that the ultimate treatment for crises of spiritual origin is not necessarily psychiatric.
What George tells us is that in that monastery, psychiatric intervention was invoked in all cases of crisis to stabilize the person, and then, given the discernment of the charismatically-endowed Elder, in those cases where the crisis was spiritual in nature, the appropriate spiritual treatment was given to relieve the person of his spiritual burden. This sometimes involved either or both of the Mystery of Unction (Euchelaio) and the Prayers of St Basil the Great from the priest’s Great Book of Prayers. This approach presumes that there is someone available who is charismatically endowed so as to be able to discern what the matter is all about, and who has the spiritual strength to relieve the person of his spiritual burden. Not every Elder can do these things without going to someone much greater than himself for spiritual assistance. Moreover, George tells us, in further conversation with the Elder, he learned that the success of the spiritual treatment requires as it were the agreement of God: God may wish for the sake of the soul’s salvation to leave the soul in the condition it is for a time or even until death—and without that necessarily meaning that that soul is at all lost.
Moreover, George tells us, in that monastery, the Elder had a working relationship with a pious Orthodox psychiatrist who respected the Elder and who worked together with the monastery doctor and the Elder. In cases where the case was completely psychological or, in the judgement of the psychiatrist, required continuing treatment with drugs, the Elder in no case discarded natural human treatment in favour of ‘spiritual treatment’. He recognized that these things work together and deferred to the judgement of the medically trained specialist.
This is true not only for cases of sorrow, but even for cases of psychological crisis that have another origin.