Working with a patient claiming a direct relationship with god: encountering otherness

Although we expect to encounter otherness in the consulting room, some types of otherness are more difficult to encounter than others. Differing ethnicities, religions, lifestyles, or other aspects of worldview can bring us into uneasy alliance with the other, as we also encounter disowned or unclaimed aspects of self in this process. I will discuss some of my difficulties working with a man who was born into my own religion-thus offering some common heritage of world view-but subsequently adopted another religion with such intensity that his faith seemed to have psychotic aspects. I struggled to keep my bearings with a man who could at times be cogent, at other times seem quite crazy, and also struggled to keep in mind how prejudices in my own culture might skew my perspective such that intense faith and devoted adherence to scripture seems suspect rather than worthy of respect.