Reframing Diagnoses: The Role of Spiritually Informed Care in Medical and Psychological Treatment through the Lens of Gurmat Therapy

This article explores the intersections between medical and psychological diagnostic frameworks and spiritually informed care, arguing for the epistemological necessity and therapeutic promise of integrating spirituality, specifically Gurmat Therapy, into clinical practice. Drawing on the Sikh spiritual tradition and contemporary critiques of biomedical and psychological paradigms, this article evaluates how Gurmat Therapy destabilises Western dualisms of mind and body, offers a non-pathologising ontology of the self, and foregrounds existential meaning in healing. The discussion critically compares dominant biomedical and psychotherapeutic models with Gurmat-informed approaches, advocating for a post-diagnostic, spiritually grounded epistemology of care.

Introduction

In recent decades, mental health paradigms have shifted toward integrative and holistic approaches, yet dominant models remain deeply rooted in Cartesian dualism and diagnostic reductionism. As psychiatric diagnoses such as depression, anxiety, and psychosis continue to rise globally (World Health Organization, 2021), there is growing concern that biomedical and psychological categories often reify suffering while neglecting the metaphysical, moral, and existential dimensions of human experience (Bracken et al., 2012). This article offers a critical engagement with medical and psychological diagnoses and introduces Gurmat Therapy, a spiritually informed, Sikh-derived therapeutic modality, as a framework capable of addressing the ontological ruptures and epistemic blind spots of current diagnostic systems.

Diagnosing Suffering: The Limits of Biomedical and Psychological Paradigms

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and the International Classification of Diseases (ICD-11) remain the primary tools for diagnosing mental disorders. However, their symptom-based, categorical approach has been widely critiqued for lacking cultural sensitivity, contextual understanding, and conceptual coherence (Frances, 2013; Summerfield, 2001). Mental illness, under these systems, is often medicalised as dysfunction in the neurochemical machinery of the brain, thus externalising and depersonalising the sufferer.

Similarly, psychotherapeutic frameworks, especially within cognitive-behavioral traditions, prioritise functional adjustment and behavioral normalcy, often pathologising spiritual crises, existential grief, or moral conflict as irrational or maladaptive (Kirmayer, 2007). The emphasis on diagnosis obscures the deeper questions of human purpose, spiritual yearning, and metaphysical estrangement.

Gurmat Therapy: An Epistemological Intervention

Gurmat Therapy, grounded in the Sikh scriptural canon (Guru Granth Sahib) consciousness-based psychology and metaphysical insights from Gurmat philosophy, intervenes at the epistemological level. It posits that suffering (dukh) is not merely a biomedical anomaly or psychological dysfunction but arises from spiritual disconnection, haumai (ego-centeredness), and karmic entanglement (Singh, 2021).

The remedy, therefore, is not symptomatic management but ontological realignment—reconnecting with the inner self (atma) and the Divine (Naam). This approach challenges the diagnostic gaze by shifting the question from "What is wrong with you?" to "What is disconnected within you?" It reframes distress not as illness but as an invitation to inner inquiry and spiritual growth.

Comparative Epistemologies: Gurmat vs. DSM

Dimension	DSM/ICD Paradigm	Gurmat Therapy Paradigm
Ontology	Human as a biological machine	Human as spiritual consciousness (atma)
Diagnosis	Disorder/dysfunction in brain	Disconnection from Naam and inner self
Healing	Symptom reduction, medication	Spiritual attunement, ego dissolution
Role of clinician	Objective diagnostician	Co-journeyer in spiritual realisation
Aim	Functional normalcy	Self-realisation and spiritual sovereignty

Gurmat Therapy offers a spiritual anthropology that transcends the medicalised self. It speaks to the human condition in its entirety - body, mind, soul (atma), and cosmos.

Case Example: Depression Revisited

In a typical psychiatric setting, depression may be diagnosed based on symptoms such as anhedonia, fatigue, hopelessness, and disturbed sleep. The treatment protocol may involve SSRIs and cognitive therapy. However, within Gurmat Therapy, such a presentation might be interpreted as man da rog (the affliction of the mind) - a condition stemming from spiritual alienation and excessive ego-identification. Healing, therefore, involves contemplative self-inquiry (vichaar), devotional engagement with Naam Simran (mantra-based remembrance), and cultivation of sehaj(equanimity). The goal is not merely to feel better, but to become whole.

The Promise and Perils of Integration

While there is increasing interest in integrating spirituality into mental health care (Koenig, 2012), such efforts often instrumentalise spiritual practices to enhance clinical outcomes rather than engage with the metaphysical commitments of spiritual traditions. Gurmat Therapy resists this by offering not just techniques but a coherent worldview—one that calls into question the very foundations of pathologising frameworks.

Conclusion: Toward Spiritually Sovereign Care

The future of mental health care lies not merely in expanding diagnostic categories or inventing new therapeutic techniques, but in rethinking the very nature of suffering, healing, and the self. Gurmat Therapy offers a radical re-envisioning; where diagnosis is not the end but the beginning of an inner journey, and where care is not confined to pathology, but oriented toward spiritual sovereignty. In an era of rising mental health crises, perhaps what we need is not more diagnoses, but deeper awakenings.

References

Bracken, P., Thomas, P., Timimi, S., et al. (2012). Psychiatry beyond the current paradigm. British Journal of Psychiatry, 201(6), 430–434.

Fernando, S. (2010). Mental health, race and culture. Palgrave Macmillan.

Frances, A. (2013). Saving Normal: An Insider's Revolt Against Out-of-Control Psychiatric Diagnosis. HarperCollins.

Kirmayer, L. J. (2007). Psychotherapy and the cultural concept of the person. Transcultural Psychiatry, 44(2), 232–257.

Koenig, H. G. (2012). Religion, spirituality, and health: The research and clinical implications. ISRN Psychiatry, 2012, 1–33.

Singh, S. (2021). Gurmat Therapy and the Path of Self-Sovereignty. Sikh Formations, 17(2), 145–165.

Summerfield, D. (2001). The invention of post-traumatic stress disorder and the social usefulness of a psychiatric category. BMJ, 322(7278), 95–98.

World Health Organization. (2021). Mental health atlas 2020. WHO.

Author: Sonya Sanghera, 2024