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SPIRITUAL CARE OF THE INSANE
that he will intrude even inadvertently upon the province of
medicine. Moreover, the possibility of physician and minister
being able to work in co-operation is immensely increased
when the counsellor can offer evidence of his competence, and
with it the assurance that he recognises his limitations.
Counsellor and Patient
Mentally diseased people are not inferior to others. Their
intellectual level may be very high and their character excellent.
’The diseases that assail them may leave many of their faculties
unimpaired. Their personalities must always be respected and
their human worth must never be affronted or disparaged.
Should patients be told the truth about their condition? One
should invariably be honest with sick people although at times
the temptation may be strong to put them off with lies or
halftruths about their condition. One writer insists that it is better
for a patient to take him to hospital by force than to induce him
to go there by guile. Even if the patient’s anger or enmity is thus
incurred less damage is done. One may put oneself out of favour
with a patient by telling him the truth, but greater harm will be
done by false reassurances. Say no to a patient, if necessary,
but never make a promise that cannot be kept.
Within one field especially the counsellor’s tact and
discernment are of immediate importance. This is when he is dealing
with patients suffering from delusions or obsessions. It is not
enough to ignore these symptoms or to treat them as amiable
eccentricities, as the ill-informed are apt to do. There are
many cases where the negativism of the patient is increased by
any behaviour that reveals incredulity, or by confident
assurances that his morbid ideas are groundless. It is always unhelpful
to dismiss obsessions as imaginary, to be ironical about the
patient’s queer ideas or to treat anything he says superficially or
with nonchalance. Every patient must be taken seriously; then in
favourable cases encouragement and gentle guidance can
produce an appreciable abatement of obsessional ideas and
misconceptions. As a rule no attempt should be made to argue
about such symptoms. The origin of morbid ideas is such that
their unreality cannot be brought home to the patient by rational
discussion of a kind that would convince a normal person. The
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