Journal of Religion and Health, Vol. 23, No. 2, Summer 1984

Psychotherapy and Religion: The Emmanuel Movement KATHERINE McCARTHY ABSTRACT: This paper reconsiders the significance of the E m m a n u e l movement, a preFreudian psychotherapeutic s y s t e m founded by Dr. Elwood Worcester as a method of churchsponsored healing. Its significance lies in three areas: (1} Historically, it was a popular effort by P r o t e s t a n t clergy to claim religious authority over psychological and psychosomatic ailments, a struggle t h a t the medical profession eventually won almost completely. {2} The E m m a n u e l movement was an effort to combat the scientific materialism and medical somaticism of its time, including the excessive use of drugs. It aimed at greater individual control over emotional wellbeing t h r o u g h a self-help m o v e m e n t t a u g h t by religious leaders using some Christian ideas. Significant parallels can be found with present-day holistic health efforts. {3} Theoretically, Worcester's conception of the " p e r s o n " is of interest as an effort to construct a nonreductionist view of the interactions of body, mind, and spirit.

This paper reconsiders the significance of the Emmanual movement, a churchsponsored form of psychotherapy developed at the beginning of this century as an effort to heal various neurotic problems and addictions by means of a combination of spiritual and psychological approaches. It was founded in 1906 by Dr. Elwood Worcester, rector of Boston's prestigious Emmanuel {Episcopal} Church, and within a few years had spread to several dozen other Protestant churches of various denominations in different parts of this country and England. It received enormous coverage in the press, particularly the women's magazines, until about 1910 when interest turned to the new ideas of Freud. Worcester's church maintained its health program for about 20 years, and he continued his work privately until his death in 1940. There are three main reasons why the Emmanuel movement is of special interest to us today. First, it was an important effort historically by Protestant clergy to extend the power and influence of. the church by claiming religious authority over psychological ailments in direct competition with the medical profession. This struggle occurred at a time when the physicians were notoriously unable to "cure" emotional problems, and their hegemony over psychotherapy through the dominance of Freudian psychiatry had not yet been established. If Worcester's idea of providing the public with free religious Katherine McCarthy, Ph.D., is an Associate Professor of Sociology at Southern Connecticut S t a t e University in New Haven, Connecticut. Reprint requests may be forwarded to her at t h a t address. 92

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psychotherapy had prevailed, the recent history of American psychiatry would be very different. Second, Worcester was a pioneer in the use of self-help techniques, which he demonstrated initially through a remarkably successful church health class for indigent victims of tuberculosis in the Boston slums. Ideas similar to Worcester's, though probably not borrowed, were used several decades later in the development of Alcoholics Anonymous and more recently in its derivative selfhelp groups for other problems. Today, we hear many people expressing the same kinds of objections to orthodox medicine that Worcester was responding to in his day: drugs and surgery are used excessively, women's problems are neglected, and techniques of prevention, such as diet, are minimized. The solutions Worcester proposed to some of these problems resemble in important ways some of the new ideas, including biofeedback, stress theories of cancer, and other types of holistic understandings. These days, however, holistic approaches and others like meditation are likely to use borrowings from Eastern, particularly Buddhist, spiritual thought rather than the specifically Christian ideas of the Emmanuel movement. In responding to the gulf between medical practice and popular demand of his time, Worcester saw an opportunity for the renewal of the power and influence of the Christian churches. Third, Worcester employed a unique conception of the interrelations of the mind, body, and spirit which he believed could equally employ the services of the minister, the physician, and the individual patient for the healing of a wide variety of human problems--a quite different conception of illness from the somaticism of physicians in his own time or in ours. Again, the recent challenges to orthodox medicine suggest that we cannot afford to overlook any sources of new ideas in this area. Of all the approaches to treatment developed since Worcester's time, only Alcoholics Anonymous has maintained consistently the idea that illness is "mental, physical and spiritual"; this may be a significant factor in its success and also help to explain why the medical profession has taken so little interest in it. The primary beneficiaries of the Emmanuel Church's free health service were women, though some men also came, particularly for alcoholism. 1 Worcester stated publicly that the clinic was open to all races and creeds, but did not mention the percentage of each race among clinic patients; probably most were white. 2 He was quite proud of the unprecedented success of the TB class with poor blacks: the magazines published photographs of racially mixed groups of successful patients. ~ Among the problems treated were "neurasthenia," fear, anxiety, extreme worry, hysterical symptoms, and addiction to various drugs. Good treatment results were reported in the literature. In a study of 178 patients seen by Worcester and McComb in 1907, Dr. Richard C. Cabot concluded that 38 percent of those of known outcome were much improved, and 23 percent slightly improved (1908). These figures compare very favorably with those of modern clinics. Yet as Cabot pointed out, the statistics describe only part of the picture.

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Perhaps the most important work which they have accomplished has not been tabulated . . . . It consists in assisting a large body of sad, dispirited men and women to face the problems of life and to bear their burdens more cheerfully, in consoling the distressed, in guiding the doubtful, in counseling the despondent, and in deterring persons meditating suicide from the accomplishment of this purpose. 4 The Reverend Lyman Powell, a follower who ran his own Emmanuel Clinic at St. John's Church in Northampton, Massachusetts, claimed even better success with alcoholics, based on a small sample. 5 Worcester conceded that his method was rarely successful with morphine addicts. 6 He was most proud of his record with suicidal patients; although he dealt with hundreds of them over a period of 25 years, he never lost a single one. The church offered weekly health lectures, medical consultation, individual treatment sessions, and home visits by social workers and friendly visitors, some of whom were themselves former patients. A church-sponsored club for alcoholics provided mutual support for newly sober men; no women's names appeared in their rosters. 8 Worcester and his assistant, Dr. Samuel McComb, both of whom had Ph.D.'s in psychology, taught the other social service workers their new combination of psychological and spiritual ideas to be used in individual therapeutic sessions. After 1912 the church employed Courtenay Baylor, a former insurance agent who got sober with Worcester's help, to work with alcoholics and their families. He was probably the first paid alcoholism counselor in the country. The Emmanuel movement was born in part as a response to Christian Science and the New Thought movements, both of which claimed to heal various diseases b y Christian methods. All of these had considerable appeal among women. The Emmanuel movement and certain New Thought practitioners shared some techniques, including suggestion and the redirection of attention, but the similarities are far less impressive than the differences, as will be described. Both Worcester's work and that of his rivals of the mind-curve movement can be understood as responses to the contradictions between religion and science, which were of great concern in the late nineteenth century; yet their origins and conclusions were very different. New Thought and Christian Science began with the teachings of the midnineteenth-century mental healer from Maine, Phineas P. Quimby. His followers in both camps followed "the neo-Platonist line in Western Civilization's running battle over the duality of mind over m a t t e r . . , convinced that matter was contained in mind rather than mind subordinated to matter. ''9 Each individual participated in the Divine; and since only thought was real, a person's circumstances could be changed by altering his or her thought. As Huber has summarized it, "Since you are divine and one with God, by thinking you are one with God, you cannot be sick because God cannot be sick." 10Even poverty is merely "wrong belief." Mary Baker E d d y denied the reality of all disease, evil, and suffering, and therefore ordered her followers to stay away from the medical profession altogether. Most New Thought leaders were less rigid about medicine and the reality of disease, but preferred men-

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tal healing methods that connected mentally with "Divine Supply." Both Christian Science and New Thought were philosophies of individual perfection, often citing Emerson as their source, and showing little interest in the problems of others.l' Healing took place either by silent argument with the "wrong belief" of the patient as in Christian Science, or by teaching the individual how mentally to tap into "Divine Supply" or the "Infinite" in New Thought. The variety of opinion within New Thought defies brief summary, but several writers have pointed out that service, humility, surrender, and the recognition of suffering are uncongenial to the mind-cure view of the world. 12 Elwood Worcester was educated at Columbia University and in Anglican theology at the General Theological Seminary in New York. In 1889 he earned a doctorate in psychology at Leipzig, at the time considered the leading school in academic psychology. McComb, an Irishman, received his psychological training at Oxford and was originally ordained in the Presbyterian church; he later changed denominations in order to work with Worcester at the Emmanuel Church. At Leipzig Worcester studied with both Wilhelm Wundt, who attempted to elucidate the psychological laws of attention, and Gustav Fechner, who was renowned for his work in experimental psychology. In 1908 Worcester published a book entitled The Living Word, explicating Fechner's ideas, claiming that he was no longer able to distinguish them from his own. Worcester cited Fechner as the source of his unusual conception of the unity of mind, body, and spirit. Fechner's lifelong philosophical interest was in developing a true Geistwissenschaft--a science which would include both the material and spiritual world. He believed that the relations between these two realms could be understood through mathematical formulae which would explain both without reducing either to the terms of the other. Worcester therefore posited three realms within the person--spiritual, mental, and physical--all interdependent, yet each having its own functions which cannot be understood exclusively in the terms of the other realms. By using this model, he tried to overcome both the extreme materialist reductionism of the medical profession, which tried to explain all psychological phenomena entirely in terms of bodily states, and the opposite pole of idealism in the mind-cure movement, which explained away all bodily suffering or material deprivation by calling it mere "mental error." The mind-curists, therefore, solved the problem of religion versus science by cutting the logical Gordian knot: they merely declared that their religion was science--hence, Christian Science. Worcester, on the other hand, was using a much broader, European definition of science which comprehended mental and spiritual categories.13 This is not to suggest that Worcester's efforts to keep the three realms interdependent and distinct were always successful; he did not attempt to specify the mechanisms that caused the mental area to act upon the physical, though he gave some examples which resemble biofeedback. In later years, as his interest in both Freud and spiritualist phenomena increased, the bodily element tended to slip out of the picture. Therefore, the unique aspect of the Emmanuel movement was not in its specific techniques,

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but that it combined these with traditional Christian ideas for healing purposes in a way that tried to overcome the reductionism and oversimplification of his contemporaries--and ours. Today we see the mind-cure approach returning in efforts to cure cancer purely through visualization and positive thinking. T h e " success" wing of New Thought resurfaces in t h e " b o r n to win" philosophy, assertiveness training, and other aspects of the Human Potential movement, which also deny the reality of poverty and other real problems in the world. Part of the Emmanuel movement's enormous popular success may have been due to its recognition of the reality of the private sufferings of many women's lives. In 1908 Worcester received more than 5,000 unsolicited requests for help in response to one of his five articles in the Ladies' Home Journal; only a small portion of applicants for treatment could be handled by his staff of 10 persons. He once commented that he would rather break both thighs than endure the sufferings of some of his patients. Unlike most of his medical contemporaries, he did not claim that nervous suffering and addiction were merely "in the mind" and could therefore be dealt with by self-control alone. He placed great emphasis on the physical components of emotional distress, maintaining consistently that health could be achieved only through the cooperation of clergy and physicians, each working through his (or her} proper realm. Worcester discussed at length in his writings on the Bible the role of Christ as a healer and the importance of the healing tradition within Christianity. 14 For example, some problems might be primarily physical, such as a broken leg, but the patient's attitudes could still promote or retard healing. Many problems were more obviously related to a person's mental state. A case of deafness, for example, might be organic and should be treated first by a physician, but some cases were also of psychological origin and could be relieved by psychotherapy. He used suggestion in certain cases in which the medical profession would now use tranquilizing drugs, as in calming patients before surgery or to facilitate sleep. In one case Worcester was called by a physician to treat a twelve-year-old girl near death from convulsive vomiting and exhaustion after surgery. He told her that she would fall asleep while he related a long story about how bears become sleepier and sleepier while making their dens in winter. Within five minutes the girl did fall asleep and thereafter was able to eat and sleep normally. 15 The majority of nervous sufferers, Worcester believed, had primarily moral or habit problems--addictions, anxiety, phobias, etc.--which involved the entire person and therefore required a new way of life. Several kinds of techniques should be used simultaneously, since the realms of body, mind, and spirit interacted in a delicate balance in each person: an improvement in one area might lead to improvements in another. Severe pain from an intractable physical ailment could be relieved by changes in attitude; the physical craving for alcohol or morphine could be eliminated by a more spiritual approach to life. All nervous sufferers could be helped by redirecting their attention away from themselves to a life of service to others. Exercise, proper breathing, and

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natural sleep would ultimately promote a proper spiritual balance. Worcester and McComb's books provide suggestions to the nervous sufferers and alcoholics on how to pray. Since most patients had been spiritually depleted by their condition, a renewal of prayer would begin a new cycle of spiritual progress. Every prospective patient was required to present a notice from a physician that there was no illness present that could be treated by organic methods. A common misunderstanding by Worcester's contemporary critics was that he and McComb used only hypnosis as a basis for cure. They did employ hypnosis with a small number of alcoholics to keep them sober long enough to be amenable to other treatment, but these comprised no more than two percent of all cases. 16 In many cases they used suggestion with the patient in a state of relaxation at the beginning of treatment; the person was then taught in both individual and group sessions to practice autosuggestion on a regular basis. Worcester believed that the subconscious mind {a term he retained in later years to distinguish it from Freud's "unconscious"} was more amenable to outside influence while in this state. Worcester saw the subconscious as the repository of an essentially positive spiritual force: it was the source of enormous strength, creativity, inherited memory, and communication with the spiritual realm. It was, in short, the spirit of the soul. Consistent with his view of the unity of soul and body, the subconscious was the regulator of elementary physical processes, including heartbeat, circulation, respiration, and time keeping; thus, positive suggestions directed to it could materially affect physical health. 17 As in modern biofeedback, he believed that consciously directed relaxation could slow down these physical functions. The redirection of attention was a basic element in Worcester's suggestive therapy. Since nervous sufferers and alcoholics became morbidly preoccupied with their destructive habits and sufferings, their attention must be turned instead to higher goals--the development of a spiritual life and service to others, is Misdirected attention, produced often b y physical pain or bad habits, caused much avoidable suffering. " A large part of the sorrow, failure, sickness and discouragement of life comes from this one source, the anticipation of evil. If we could disregard all pain and misfortune but the actual, we should deliver ourselves from about eight-tenths of the sorrow of this life." 19It is interesting to note here that Alcoholics Anonymous uses some of these principles with different terminology: its repetition of simple ideas resembles autosuggestion, and the redirection of attention is employed in t h e " eleventh step," suggesting continuous effort toward spiritual growth. Avoiding the "anticipation of evil" is incorporated in the inj unction, " D o n ' t project." The theological basis of Worcester's belief in redirected attention rested upon the text, "Resist not evil," which he interpreted psychologically to mean that constructive change could be promoted more effectively by building up a person's strengths rather than by a direct attack on the problem or bad habit. The process began with individual sessions in which the patient could discuss his or her "strangulated emotions" or childhood experiences; these served the purpose of confession. 2~ Many patients were taught to pray as a means of

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acquiring the power of attention, just as some holistic healing strategies now use meditation. Worcester felt that the attitude of surrender implied in a sincere prayer was "always followed by the consciousness of peace and inner freedom. ''21 After surrender a process of conversion should follow, in which "the sinful tendency about which [the patient] was concerned is robbed of its attractive quality and the thought of it finds no entrance to his imagination. ''22 Worcester also urged sublimation through love, work, and religious devotion. 23 He felt that these, like sleep, subconscious forces, attention, and even good health itself, were spiritual matters, a point often misunderstood by his critics. 24 Various kinds of healers during this period employed suggestion and redirection of attention {what New Thought called the "law of affirmation"), but their purpose was different. They used these and other techniques to establish rigid internal discipline. 25 As Meyer described it, "The aim was to fill the subconscious so full of suggestion and lesson and science that it would have no life of its own." 24 Their effort was to control the world by controlling the mind. Worcester, on the other hand, subscribed to the typically American view of the "helpful unconscious, ''2~ and in a more traditional Christian way felt that the mind should be made open to beneficent spiritual influences from without. Worcester believed that "nervousness" was increasing in American society, especially in New England. Two chapters of the extremely popular 1908 book, Religion and Medicine, by Worcester, McComb, and Isador Coriat (a neurologist), were devoted to the hereditary and environmental causes of increasing nervousness. They cited the New York neurologist George Beard as a source for the idea that the pace and stress of industrial civilization are sources of much mental disorder. Unlike Beard, Worcester believed that the increasing use of alcohol and drugs was a major contributor to nervous disorder. The extremes of wealth and poverty played a role; " . . . we are slowly learning that it is impossible for anyone to be happy in this world so long as he is obliged to lower his eyes in the presence of the misery of his fellow men." 28The boredom and isolation of many jobs caused mental problems, as in some factory workers, mail sorters, telegraph workers, and housewives. Illness and personal misfortune were frequent causes: "Grief, pain, anger and anxiety have also their concomitants in the brain and nervous system and these are injurious or destructive in character." ~0 Aside from his opposition to alcohol and drugs, little of Worcester's work was directed toward effecting social change. Unlike his liberal contemporaries, he did not preach the social gospel. His interest was in the consequences of these social and personal problems for individual character, and the ways in which religion, as the social institution most directly responsible for issues of character, could ameliorate them. Nervous illness brought out traits of character which were antagonistic to the spiritual life. "The curse of neurasthenia and allied nervous weakness is their egotistic and antisocial character. The neurasthenic is afraid of his own shadow, worries himself to death over trifles, magnifies real troubles out of all proportion to their intrinsic significance, is self-centered, looks at everything from the point of view of its bearing upon his

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p e t t y fortunes. The psychasthenic is immersed in his own organic sensations, his nerve-wasting emotions, his psychical disturbances, his fears and obsessions. ''31 For these overall problems of character medical science had no remedy, as they involved the whole person rather than specific organs. What the nervous sufferer needs "is above all reconstruction of character, and if ethics and religion are powerless to reconstruct character, then the majority of thoughtful men in all ages have been laboring under a lamentable delusion." 32 For example, if the neurotic person was essentially self-centered, the Emmanuel Clinic prescribed that he or she help other patients. "Service to others is of the very essence of the Christian religion, and it is through this service that the nervous sufferer is to win his way back to health and poise and peace." 32On one occasion Worcester could not resist comparing his traditional view of service with that of his rivals. When the Emmanuel Church launched a major disaster-relief effort for the poor during the Chelsea fire, he looked around for the Christian Scientists: "I do not wish to do them an injustice and perhaps I did not look in the right place, but the only sign of their activity I perceived was a booth for the sale of their books." 34 The crucial theoretical difference between the Emmanuel view and the medical-somatic view lay in the nature and locus of feeling. To the physicians all mental phenomena were grounded in, and caused by, physiological states; mental problems, therefore, were caused ultimately by lesions of the nervous system. For Worcester and McComb, however, feeling had its origin in the mind and spiritual realms: "Men have associated desire and emotion with the body, whereas it is one of the profoundest instincts of the soul, an instinct on which the continuance of human life depends."z3 For therapeutic purposes the question of causality was unimportant: ..o it matters not one jot what theory of the relation between brain and consciousness you accept, whether that of causality or that of parallelism.., on the one hand, the spiritual life is conditioned by and dependent on the body, and on the other h a n d . . , all mental states are followed by bodily changes, whether the mental state in question be an emotion, a desire, a sensation, or an idea. Hence, it follows that in all diseases, (the so-called "functional"} this factor is of predominating significance. 36 Here again the Emmanuel philosophy differed significantly from the thinking of the physicians; Worcester and McComb felt that the c a u s e of a problem should not be the focus of therapeutic attention; instead, the same general principles of spiritual and moral reconstruction could be used to heal all types of cases. By assigning emotional states to the mental and spiritual realm, Worcester neatly justified the predominant role of the clergy rather than the physician in the direction of much therapeutic work. Ultimately, however, the individual was responsible for his or her own continuing effort at self-help in the recovery effort once the basic techniques had been taught by specialists. 37 Worcester's inclusion of alcoholics among nervous sufferers was probably unique among American therapists of the time. The idea of alcoholism as an illness had been occasionally voiced by others in the nineteenth century, but

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Worcester was the first American willing to offer an outpatient, psychological therapy for alcoholics on the same terms as other sick people. Using hypnosis for alcoholics was not new; several Europeans, including Janet, Charcot, and Tocharsky had reported excellent results. 3s The only facilities t h a t existed for alcoholics in Worcester's time were a few private sanitaria for the rich and some church-run missions for the very poor modeled on the Salvation A r m y approach. When Worcester and Courtenay Baylor retired from the Emmanuel Church in 1929, the only free clinic for alcoholics in the country came to an end. Nothing like its form of individual treatment was available again until 1944, when the Yale Center of Alcohol Studies opened two public clinics. The treatment they offered was derived from the work of Richard Peabody, a former alcoholic patient at the Emmanuel Church. 39 In spite of Worcester's recognition t h a t nervous problems included a moral aspect, he specifically rejected the mission approach of exhortation and preaching. He declared t h a t sermons were for normal people and ineffective with the sick. According to Clinebell, the Emmanuel movement differed from other religious approaches in t h a t it sought to reduce the alcoholic's guilt rather than enhance it. Emmanuel therapy apparently was frequently able to convey this experience. When guilt is reduced, the energies previously employed in the guilt and selfpunishment process are freed and made available for therapeutic ends . . . . The alcoholic's inferiority is reduced not by identifying with a powerful authority figure, but by becoming aware of his "higher and diviner self" which is his most real self." 4o Thus, Worcester was able to avoid the moralizing and punishing attitude of m a n y of his contemporaries toward both alcoholics and other nervous sufferers. He believed t h a t his own attitude was based on a Christian principle of looking at individuals in terms of their future, not their past: "There are two ways of judging men and women, to look for the best t h a t is in them, or to look for the worst; o t t o state it in other words, to regard them in the light of what they m a y become or to judge them realistically and relentlessly for what they are."41 Worcester believed t h a t the churches were becoming distant from the real needs of their communicants, and t h a t his health work would help to usher in a new era of Christian spirituality. "The mere fact t h a t the religious healing cults of this country now claim a membership of over a million and a half men and women ought to open the eyes of the blind to the fact t h a t persons suffering from mental and moral disorders desire religious help." 42 He also felt t h a t it would make the role of the minister far more useful and satisfying: We clergymen perform the regular routine of our parochial duties, conducting services, devoting much of our time to work and engagements of doubtful value to any human being . . . . But if, at the end of a year, we can look back to a certain number of persons who have gained freedom and a release from a sad and miserable existence as the result of our counsel and patient work, if we can recall

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d r u n k a r d s whom we have reclaimed, u n h a p p y and miserable homes, which we have m a d e h a p p y , would-be suicides whom we have r e s t r a i n e d from d e a t h and hell, courage which we have i m p a r t e d to d e s p a i r i n g men a n d women, 43

then not only would the minister feel that his work is worthwhile, but the public should also be more appreciative of his work. Not surprisingly, the medical profession resented this effort by the clergy to co-opt such satisfactions and successes. Worcester was frequently blasted in the press by physicians who claimed that he was practicing medicine without a license {though they themselves made no a t t e m p t to treat cases like his). 44 More moderate critics like the heurologist J a m e s Jackson Putnam, who initially approved the effort, feared that untrained clerical imitators might do harm. 45To this criticism Worcester and McComb replied that all their patients were under medical supervision, and, " I t is difficult to see what greater deference we could have shown to scientific medical authority than we have shown . . . there is no interchange of roles between the physician and the minister. Each is on his own ground. 4GThey also believed that physicians were trying to obstruct the movement to promote their own financial interests. "Psychology has also a valuable contribution to offer by teaching men, through simple acts, to help themselves. Naturally, this is not a method much favored b y professional psychiatrists, any more than any method of selfmedication, however valuable, is likely to be regarded with favor by the American Medical Association. Even in this noble profession there is what J a m e s used to call the Trades Union wing." 47 Some of the angry attacks by Worcester's fellow clergy are more difficult to explain. No one ever attacked Worcester and McComb personally, since their credentials and personal reputations seemed impeccable, and no one questioned the claim of many recoveries in the Emmanuel clinics. Still, many clergy seemed to fear that the public might expect such healing feats from all parish clergy, and the standards for their own performance would be raised too high. Some, however, imitated Worcester; by 1909 the religious commentator Ray Stannard Baker had counted 40 church clinics established on the Emmanuel model. 4sThe Episcopal Bishop of Chicago had set up his own clinic and written a book endorsing the movement. 49 Meanwhile, Worcester's detractors complained that the Emmanuel movement was too difficult, too expensive, too much like faith healing, 50or not really religious. ~1From the point of view of the ordinary parish, a clinic probably would have been an impossible strain on local resources; the Emmanuel parish was one of the most well-to-do and successful in Boston. 52 Others objected to dealing with sufferers in groups, since the medical profession did not do so: " I t does not seem possible to administer either strychnia or s y m p a t h y in wholesale fashion to a crowd of patients . . . . I have never heard of any nerve specialist who dealt with his patients in classes." 53 This last commentator saw the entire movement as somehow subversive of the social order. He felt that if the clergy generally became involved in healing, they would tend to "break down the confidence of the people in the value of expert knowledge, to raise in them false and unwarranted ex-

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pectations, to feed superstitious sentiments and to blind them to the solid, verifiable order of life." ~4 A more complex objection, voiced by several critics, was that perhaps hervous suffering should not be relieved at all. Some accused Worcester of promoting "hedonism." 55According to Charles Reynolds Brown, the question of life should be not, "What shall I eat?" or, "What shall I drink?" but, "Am I worth feeding? Is it important that I should be kept alive and well?" Further, "A certain measure of sympathy may save a nervous sufferer from despair, and a certain larger measure of sympathy unwisely expressed might induce that same sufferer to lie down and lapse into helplessness and hopeless invalidism where a hard resolute fight would have brought victory. ''~6 This argument sounds quite suspect to modern ears, hearing the male clergy claim that the sufferings characteristic of women should not be relieved. It is reminiscent of the nineteenth-century argument that anesthesia should not be used to ease the pains of childbirth. The historian Ann Douglas has suggesed that in the nineteenth century the clergy maintained their position and exerted influence largely through an alliance with middle-class women. 57 If she is correct, then the Emmanuel movement might very well represent a culmination of that alliance--one in which the popular support of women was not strong enough to overcome ultimately the quite different interests of the male medical profession in both style of practice and in language. T h e " sentimentality" that women preferred, according to Douglas, certainly was defeated by the ultimate Freudian triumph. In The Spiritual Unrest religious commentator Ray Stannard Baker described the entire controversy as a territorial war between the medical profession and the clergy; at the time they appeared to him to be neck-andneck in winning public support. 5s Not only was Worcester claiming health as the province of the parish clergy, but some physicians, mindful of his public success, were quick to adopt his methods and call them new medical techniques. Baker listed new courses in psychotherapy in the medical schools at Tufts, Wisconsin, and the University of Pennsylvania as direct responses to the Emmanuel work. 59 In 1907 the Massachusetts General Hospital established its first social service department through the efforts of Doctors James Jackson Putnam and Richard Cabot; both had worked with Worcester initially, and Cabot continued to do so for many years. Baker's chapter on the new hospital department details how suggestion and the principle of help through shared suffering were employed there in the early days, just as in the church clinic. 6~Curiously, a later history of this same department by Ida Cannon never concedes any connection to the church work. 61 From today's perspective it appears that the medical profession won the territorial struggle essentially by co-opting the ideas that the Emmanuel clergy had demonstrated to have such popular appeal. Massachusetts General and other hospitals employed social workers to deal with the "whole person"

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as Worcester had suggested, but without the religious terminology. These departments under direct medical supervision kept poor patients away from the churches while relieving physicians of the burden of listening to the patients' troubles and dealing with their life problems. According to the historian Nathan Hale, contemporary observers believed that the medical profession had begun taking over certain clerical functions in the 1870s. 62 Freud's visit in September of 1909 attracted an enormous amount of attention among American physicians interested in psychotherapy. 63 The psychoanalytic philosophy eventually provided them with a set of concepts and a world view in which they could establish themselves as experts on emotional problems without the use of any spiritual language, and thus out of direct competition with the clergy. Few clergy were willing to integrate the psychoanalytic language into pastoral counseling {although Worcester himself adopted dream analysis} and therefore withdrew from competition with the new, sophisticated European ideas. On the medical side it was becoming an embarrassment for physicians to use religious language at all. Some of Worcester's medical supporters, like Isador Coriat, adopted the new psychoanalysis; others, like Cabot, were ridiculed by their colleagues into withdrawing support.84 Worcester's work did inspire the Reverend Anton Boisen, now regarded as the father of clinical pastoral education, to develop integrated religious and psychiatric concepts for the benefit of hospitalized patients. 65 His ideas, however, bear little resemblance to Worcester's. His work and that of others in pastoral counseling since his time have assumed the superiority of psychiatric authority in the understanding of emotional problems, a concession Worcester never made. He saw physicians as his assistants in dealing with the whole person, and his work began when theirs was completed. In 1908 popular support for alternatives to the psychiatric profession was very high, and the physicians did not yet have the strength to drive the Emmanuel movement and other nonmedical therapists out of business. 66Not only was Worcester's book Religion and Medicine going through multiple printings (it eventually sold 200,000 copies}, but in the same year Clifford Beers published his autobiography, A M i n d That Found Itself, 67 his story of gross mistreatment as a mental patient at the hands of the psychiatric profession. After 1910, however, the year of the Flexner Report, the physicians were able to consolidate public support sufficiently to enable them to keep potential rivals, such as social workers, working within the aegis of their medical model of emotional problems. We may see the same process repeated, as the medical profession co-opts some ideas originally proposed by its rivals. Some physicians now write about stress and meditation; others run classes for cancer patients. Perhaps the experience of the past can suggest to us better ways to guide the process in the future.

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References 1. Powell, L.P., The Emmanuel Movement in a New England Town. New York, G.P. P u t n a m ' s Sons, 1909, p. 53; Hale, N.G., Jr., Freud and the Americans: The Beginnings of Psychoanalysis in the United States, 1876-1917. New York, Oxford University Press. 2. Baker, R.S., The Spiritual Unrest. New York, Frederick Stokes Co., 1910 {first published 1909}, p. 240. 3. Worcester, E., Life's Adventure: The Story of a Varied Career. New York, Charles Scribner's Sons, 1932, p. 283. 4. Cabot, R.C., "New Phases in the Relation of the Church to Health," The Outlook, Feb. 29, 1908, 88, 9, 504-508. 5. Powell, op. cir., p. 115. 6. Worcester, E., "The Results of the E m m a n u e l Movement: Women and Alcohol," Ladies' Home Journal, Jan. 1909,26, 2, 15-16, 53. 7. Worcester, E., and McComb S., Body, Mind and Spirit. Boston, Marshall Jones Co., 1931, p. 187. 8. Yearbook of the Emmanuel Parish, Boston, "Report of the Jacoby Club," 1910. Published by the E m m a n u e l Church, p. 48. 9. Huber, R.M., The American Idea of Success. New York, McGraw-Hill Book Co., 1971, p. 130. 10. 1bid., p. 124. 11. Ibid,, p. 131. 12. Meyer, D., The Positive Thinkers: Religion as Pop Psychology from Mary Baker Eddy to Oral Roberts. New York, P a n t h e o n Books, 1980, p. 102; Braden, C.S., Christian Science Today: Power, Policy and Practice. Dallas, Southern Methodist University Press, 1958, p. 283; Huber, o19. cir., p. 143. 13. Bettelheim, B., Freud and Man's Soul. New York, Alfred A. Knopf, 1983. [The problem here may have been carried t h r o u g h to a systematic m i s u n d e r s t a n d i n g of Freud's categories in English-speaking countries, according to recent work by Bruno Bettelheim.] 14. Worcester, E., and McComb, S., The Christian Religion as a Healing Power: A Defense and Exposition of the Emmanuel Movement. New York, Moffat, Yard and Co., 1909, Chapter 23. 15. Worcester and McComb, Body, Mind and Spirit, op. cit., pp. 15-16. 16. McComb, S., "The Religio-Medical Movements: A Reply," North American Review, 1909, 189, 640,445-454,451. 17. Worcester, E., Making Life Better: A n Application of Religion and Psychology to Human Problems. New York, Charles Scribner's Sons, 1933, pp. 193-194. 18. Worcester and McComb, The Christian Religion as a Healing Power, op. cit., pp. 64-65. 19. Worcester, Making Life Better." A n Application of Religion and Psychology to Human Problems, op. cit., p. 195. 20. , "The Results of the E m m a n u e l Movement: Women and Alcohol," op. cit., p. 16. 21. Worcester and McComb, Body, Mind and Spirit, op. cir., p. 310. 22. Ibid., p. 235. 23. Ibid., pp. 68-70. 24. Ibid., p. 122. 25. Huber, op. cit., pp. 157d58, 314. 26. Meyer, op. cit., p. 93. 27. Hale, op. cir., p. 241. 28. Worcester, E.; McComb, S.; and Coriat, I., Religion and Medicine: The Moral Control of Nervous Disorders. New York, Moffat, Yard and Co., 1908, p. 176. 29. Ibid., p. 148. 30. Ibid., p. 160. 31. Worcester and McComb, The Christian Religion as a Healing Power, op. cir., pp. 64-65. 32. McComb, S., " A Reply," HibbertJournal, Oct. 1909, 8, 10-27, 18. 33. Worcester, Life's Adventure: The Story of a Varied Career, op. cir., p. 25. 34. - - , Making Life Better: A n Application of Religion and Psychology to Human Problems, op. cit., p. 204. 35. Worcester and McComb, The Christian Religion as a Healing Power, o19. cit., pp. 110-111. 36. Ibid., p. 104. 37. Powell, op. cit., p. 113.

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38. McCarthy, K., "Early Alcoholism Treatment: The Emmanuel Movement and Richard Peabody," forthcoming, J. Studies on Alcohol. 39. CIinebell, H.J., Jr., Understanding and Counseling the Alcoholic through Religion and Psychotherapy. Nashville, Abingdon Press, 1968, pp. 114-115. 40. Worceser, E., TheAllies of Religion. Boston, Marshall Jones Co., 1929, p. 185. 41. Worcester, "The Results of the Emmanuel Movement," Part I I, Ladies' Home Journal, 1908, 25, 11,7-8. 42. Worcester and McComb, Body, Mind and Spirit, o!9. cit., p. xvi. 43. Hamilton, A.M., "The Religio-Medical Movements," North American Review, 1909, 189, 639, 225-226. 44. Baker, op. cir., p. 227. 45. Worcester and McComb, The Christian Religion as a Healing Power, op. cit., pp. 50-51. 46~ Worcester, Making Life Better, o19. cit., p. 148. 47. Baker, op. cit., p. 192. 48. Scherzer, C.J., The Church and Healing. Philadelphia, The Westminster Press, 1950, p. 181. 49. Cutten, G.B., "The Emmanuel Movement and the Church," The Independent, 1908, 65, 3130, 1228-1230, 1228. 50. Marshall, H.R., "Psycho-Therapeutics and Religion," The Hibbert Journal, Jan. 1909, 7, 2, 303-313. 51. Baker, op. cit., p. 184. 52. Brown, C.R., Faith andHealth. New York, Thomas Y. Crowell Co., 1910, p. 162. 53. Ibid., p. 150. 54. H.R.M., "Christian Science and the Emmanuel Movement," The Nation, June 25, 1908, 86, 575. ]Probably Henry Rutgers Marshall.] 55. Brown, o19. cit., pp. 162-163. 56. Douglas A., The Feminization of American Culture. New York, Avon, 1977. 57. Baker, op. cit, pp. 229-231. 58. Ibid., p. 229. 59. Ibid., pp. 237-238. 60. Cannon, I., On the Social Frontier of Medicine: Pioneering in Medical Social Service. Cambridge, Harvard University Press, 1952. 61. Hale, o19. cir., p. 139. 62. Ibid. 63. Greene, J.G., "The Emmanuel Movement, 1906-1929," The New England Quarterly, 1934, 7, 3, 494-532, 516. 64. Boisen, A.T., Tke Exploration of the Inner World: A Study of Mental Disorder and Religious Experience. New York, Harper and Brothers, 1936, p. 8. 65. Hale, N.G., Jr., "Discussion." In Gifford, G.E., Jr., ed., Psychoanalysis, Psychotherapy, and the New England Medical Scene, 1894-1944. New York, Science History Publications/USA, 1978, p. 140. 66. Beers, C.W., A Mind That Found Itself, A n Autobiography. New York, Doubleday, Doran and Co., 1908.

Psychotherapy and religion: The emmanuel movement.

This paper reconsiders the significance of the Emmanuel movement, a pre- Freudian psychotherapeutic system founded by Dr. Elwood Worcester as a method...
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