Religion, Culture and Mental Health Are religious practices involving seeing visions and speaking in tongues beneficial or detrimental to mental health? Do some cul- tures express distress in bodily form because they lack the linguis- tic categories to express distress psychologically? Do some religions encourage clinical levels of obsessional behaviour? And are religious people happier than others? By merging the growing information on religion and mental health with that on culture and mental health, Kate Loewenthal enables fresh perspectives on these questions. This book deals with different psychiatric conditions such as schizophre- nia, manic disorders, depression, anxiety, somatisation and dissocia- tion as well as positive states of mind, and analyses the religious and cultural influences on each.   is Professor of Psychology at Royal Holloway, University of London. She has published numerous articles and spo- ken at international conferences on her research areas of the impact of religious and cultural factors on mental health, and of family size in relation to well-being. Her research has also earned her funding from the Economic and Social Research Council, the Wellcome Trust, the Leverhulme Trust and the Nuffield Foundation. She serves on the editorial board of several journals concerned with the psychological aspects of religion, and is an editor of Mental Health, Religion and Culture. Religion, Culture and Mental Health Kate Loewenthal Royal Holloway University of London CAMBRIDGE UNIVERSITY PRESS Cambridge, New York, Melbourne, Madrid, Cape Town, Singapore, São Paulo Cambridge University Press The Edinburgh Building, Cambridge CB2 8RU, UK First published in print format ISBN-13 978-0-521-85023-0 ISBN-13 978-0-511-26118-3 © Kate Loewenthal 2006 2006 Information on this title: www.cambridge.org/9780521850230 This publication is in copyright. Subject to statutory exception and to the provision of relevant collective licensing agreements, no reproduction of any part may take place without the written p ermission of Cambrid g e University Press. ISBN-10 0-511-26118-7 ISBN-10 0-521-85023-1 Cambridge University Press has no responsibility for the persistence or accuracy of urls for external or third-party internet websites referred to in this publication, and does not g uarantee that any content on such websites is, or will remain, accurate or a pp ro p riate. Published in the United States of America by Cambridge University Press, New York www.cambridge.org hardback eBook (NetLibrary) eBook (NetLibrary) hardback Contents List of figures page vii List of tables viii Acknowledgements ix Note about ‘G-d’ x 1 Introduction 1 Some questions 1 Definitions of culture, religion and mental health 4 How does culture affect the relations between religion and mental health? 9 2 Schizophrenia 11 Definitions and symptoms, and an overview of causes and relations with religion 11 Visions, voices, delusions and schizophrenia 15 Spirit possession, demons 24 Afro-Caribbean schizophrenia? 34 Diagnostic issues 39 3 Manic disorder 49 Definitions and causes of manic disorder 49 Religious factors and manic disorders 50 4 Depression 55 Definitions, symptoms, causes and relations with religion 55 Religious coping beliefs 60 Some gender issues: women, religion and depression 67 5 Anxiety 74 Definitions, symptoms and causes 74 The overall anxiety-lowering and anxiety-heightening effects of religion 76 Obsessive-compulsive disorder and religion 81 Are religious people seen as more anxious? 85 v vi Contents 6 Somatisation 87 Definitions, symptoms and causes 87 Between-group variations in somatic and psychological symptoms 88 Explanations of these variations 96 7 Dissociation 105 Definitions and causes of dissociation and dissociative personality disorder 105 Religious factors in relation to dissociative states and tendencies 107 Religious factors in relation to dissociative personality disorder 110 Religious possession and trance states: are they dissociative? 118 8Positive states 125 Religion and positive mood: definitions and associations 125 Purpose in life, and hope 127 Forgiveness 132 Authentic happiness 136 9 Conclusion 140 References 142 Index 164 Figures 4.1 Distress stimulates religious coping beliefs, which can then affect levels of distress page 64 4.2 Some relations between stress, religious coping beliefs and mood 66 4.3 The alcohol-depression hypothesis 71 5.1 Common themes of obsessions in different cultures 82 5.2 Clinical judgements made about people high and low in religious activity 86 8.1 Purpose in life in relation to religious belief and time since conversion 129 vii Tables 2.1 Changes in religious activity among first-onset schizophrenia patients page 21 6.1 A treatment plan 100 7.1 Similarities and differences between demon (dybbuk) possession and dissociative personality disorders 120 viii Acknowledgements Thanks to my family: my dear parents, my husband Tali Loewenthal and our children – Esther Cadaner, Leah Namdar, Yitzchok Loewenthal, Chana-Soroh Danow, Moshe Loewenthal, Rivka Lent, Brocha Werner, Freida Brackman, Sholi Loewenthal, Mendy Loewenthal, Zalmy Loewenthal – who were always interested – and to their husbands, wives and children. Gratitude is due to leaders of the Jewish community, especially the Lubavitcher Rebbe, Rav J. Dunner, Rabbi S. Lew, Dayan A. D. Dunner and Rebbetzen Hadassah Dunner, Lady Amelie Jakobovits and the Chief Rabbi, Sir Jonathan Sacks. My dear friends and advisers Naomi Futerfas, Kerry Bak, Joyce Paley, Feigy Rabin, Shoshana Segelman, Evadne Stern and Yael Kestecher are among many who shared experiences, wisdom, practical support and many laughs. Almost last, but certainly not least, thanks to many academic colleagues and collaborators: Professor Michael Eysenck, Professor Andy MacLeod, Dr Marco Cinnirella, Vivienne Goldblatt, Esther Spitzer, Professor Stephen Frosh, Dr Caroline Lindsey, Micky Herzog, Diane Heywood, Jeffery Blumenfeld OBE, Guy Lubitsh, Dr Simon Dein, Dr Chris Lewis, Professor Ken Pargament, Tirril Harris, Dr Joseph and Shree Berke, Professor Robert Kohn, Professor Ely Witztum, Professor David Greenberg – and many oth- ers, each of whom has had an influence which would need a much longer book than this one to describe. Special thanks to Sarah Caro and her colleagues at Cambridge University Press, for inspiring and nursing this book along. ix [...]... beliefs and practices about illnesses and cures may be invoked Do these help, or hinder, or have no effect? And are somatic complaints and/ or attributing them spiritual causes more common in some cultures than in others? r Can we distinguish between religious trances and states of spirit possession, and dissociative disorders? 4 Religion, Culture and Mental Health Lou had seemed morose and miserable and. .. health Does religion cause, exacerbate or relieve mental disorder? And what role is played by cultural factors in the relations between mental health and religion? Are religion’s roles in mental health similar in every culture? An underlying task for this book and its readers is to examine several prevalent ideas and questions about religion and mental health Are these ideas misconceptions, or distortions... material based on clinical experience and research interviewing Before this, we need to look at some definitions of culture, religion and mental health Definitions of culture, religion and mental health Culture The Victorian anthropologist Tylor (1871) defined culture as ‘that complex whole which includes knowledge, belief, art, morals, law, custom, and any other capabilities and habits acquired by man as a... factors, often measured psychometrically, and their associations studied statistically, with culture and religion interacting or moderating each other’s effects on mental health and other psychological factors For (social and cultural) psychiatrists, religion is firmly embedded in culture, and the method of studying the relations between culture and mental health often use descriptive case material,... written about culture and mental health Important themes include: r Attention to the question whether there are variations between cultures in the prevalence and incidence of different psychiatric disorders, and if so why r The description of psychiatric conditions which may be culturespecific r The understanding of the interpretive framework used in different cultures for the understanding of mental illness... including Buddhist, Christian, 8 Religion, Culture and Mental Health Hindu, Jewish and Muslim, and including non-practising and non-affiliated r The Royal Free interview for religious and spiritual beliefs (King, Speck & Thomas, 1995) This measure is said to be appropriate for people who profess no religious affiliation, and/ or who prefer to use the term spirituality rather than religion, as well as people... there, ordering her to travel to Rome and speak to the pope and emperor ‘words that I shall say to you’ While in Rome, Birgitta became heavily involved in politics, inspired by her visions, and founded an order of nuns (described in Kalian & Witztum, 2002) 18 Religion, Culture and Mental Health Birgitta and others were seen as ‘heroic and extraordinary historical figures’, and there is often little evidence... understanding of mental illness 10 Religion, Culture and Mental Health In addressing these and other questions, cultural and social psychiatrists and medical anthropologists very seldom consider religious factors separately from cultural factors The focus is typically on the expression of psychiatric disorder in a particular cultural context, and religious aspects are part and parcel of that cultural context... spiritual well-being (e.g Ellison, 1983) and specific virtues and other positive states (Seligman, 2002) Chapter 8 examines positive states Introduction 9 Throughout this book the aspect of religion and mental health assessed or under discussion in any particular study will be described How does culture affect the relations between religion and mental health? Books and articles on the psychology of religion... identities and beliefs Many other examples could be given, but these examples should be more than enough to underline the point that when ‘religion’ is under discussion and measurement, one or more of many possible aspects will have been targeted Mental health As with religion, social scientific and psychiatric research can target one or more of many possible aspects of mental health Mental health be . the psychological aspects of religion, and is an editor of Mental Health, Religion and Culture. Religion, Culture and Mental Health Kate Loewenthal Royal. Religion, Culture and Mental Health Are religious practices involving seeing visions and speaking in tongues beneficial or detrimental to mental health?