The article in the October 5, 2007, issue headed "When It Comes to Religion, Psychiatrists Are Different" describes referral patterns of physicians, mostly nonpsychiatrists. The hypothetical case example of a man mourning intensely two months after his wife's death was probably not recognized by many nonpsychiatric physicians as a case of pathological grief needing psychiatric care. Since pastors are so closely connected with the processes of death, dying, funerals, and grieving, it is quite natural to refer grieving persons to them, not recognizing the severity of the case described. If the hypothetical example had been the case of a depressed man who had started hearing voices saying that he was going to hell, the referral pattern may have been quite different.

As to the perceived hostility of psychiatry to religion, it was real. Early in my career in the early 1970s I inherited a patient who stated that her former psychiatrist had told her that her religious faith was a" crutch," so she stated, "I stopped talking to him about it." Although this woman's religious faith was different from mine, I found nothing pathological about it and considered it one of her strengths.

Early in my career (1970s through much of the 1980s), I had literally scores of patients from my own religious tradition come to me for care. Many of these sought me out on their own. (At that time I was on a medical school faculty with other responsibilities and not even trying to build a practice.) All of these patients needed psychiatric care, and most would have gone without had I not been available. Many were afraid that other psychiatrists' chief goal would be to destroy their religious faith. In only two cases did I find issues that could not have been as easily handled by a culturally and spiritually sensitive psychiatrist not of my tradition. Now with the increasing acceptance of the legitimacy of spirituality in humans, people of my religious background are more comfortable seeing psychiatrists and other mental health practitioners not of our particular faith.