Edited by Alexander Moreira-Almeida, Bruno Paz Mosqueiro and Dinesh Bhugra


Review by Gunnel Minett

Spirituality and religion play an important role in mental health. They are often central to people’s efforts to cope with suffering, as well as they struggles to create purpose and meaning in life. However, as this book points out, both spirituality and religions can be described as ‘the elephant in the room‘ when it comes to addressing personal believes in a psychotherapeutic setting. One reason is that therapists, who tend to be less religious, may find it difficult to question their clients about their beliefs in order not to upset or offend them. Or they prefer to focus on a more scientific approach to mental health.  

Traditionally there’s been a difference between a faith-based outlook on life and a scientific approach, the letter often equated with materialistic and atheistic beliefs about life. To address this, the book argues, there needs to be a ‘scientific’ approach to the discussion of how to deal with religion and spirituality in the mental health field. The book thoroughly  examines all aspects of this topic. It is divided into three sections; a theory section that sets the scene for the current situation, a section that presents the general principles of religions and their relationship with mental health and a final section that describes clinical practice as it looks today. 

The book’s overall conclusion is that religion and spirituality are good for us. The book lists many studies showing a correlation between faith and wellbeing. People who belong to a religious group, it suggests, are less likely to suffer from mental problems. At least when the religious group to which they belong is positive and tolerant in its approach. This is regardless of religion or faith system or where in the world the study was conducted. Religious groups which exercise stricter control of their congregations, however, do not show the same positive outcome. And the worst group seems to be atheists and non-believers who suffer from the highest level of mental health problems. 

There is however a major problem with this ‘scientific’ approach to studying the correlations between faith and mental wellbeing. To be scientific usually means to be without personal involvement and consequently to be detached from the outcome in order to avoid bias when the data is evaluated. But just as when trying to understand our own consciousness, we can’t take an outsider-view and observe our worldview outside our own perception of it. The same applies to evaluating religious beliefs. Faith is something we are usually introduced to early in life, which means that it tends to ‘set the scene’ as to how we see the world around us later in life. Not to mention the fact that in many countries there’s still a firm assumption that religion is necessary for establishing moral values. In particular this coupling with moral values makes it difficult for many to see the world from a non-religious viewpoint. This means that religion confronts many scientists with the dilemma of having to deal with incredible and inexplicable ‘facts’.  And of course, from the opposite point of view, a scientist with a firm belief in some form of higher order in the universe will tend to view non-believers differently from a non-believer when interpreting the same data.

This issue is addressed to some extent in the book. But it would have added value to the various articles if the writers had ‘come clean’ about their own beliefs. That would have helped the reader to evaluate the various studies referred to. Were there, for instance, studies conducted by muslim scientists of Christianity or Judaism. Or were the studies conducted by American scientists outside of USA taking into account the different approach to religion in America and Europe. They may have looked at Christianity in both cases but not taken into account the difference in level of faith in the more secular countries of Europe.  

For instance, a Swede may call himself a Christian, simply because that used to be the default denomination ‘allocated’ to him at birth by the state. In America professing  Christianity usually indicates a firmer belief and a conscious and active choice. In Sweden, which is one of the most secular societies, religion also has a very different role in society than it does in America. In America it would be out of the question to elect an atheist or non-believing president – much more important, for instance, than to require some psychological test to establish the mental stability of the future leader. In Sweden, where faith is a private matter and not as clearly linked with morality, the opposite would apply. Such a different approach to religion surely must influence the questionnaire responses and their interpretation. 

Another question which could have been covered in more detail is why people turn to religion. Here again, a secular country such as Sweden could have been comprehensively compared with the strong role of religion in America. There seems to be a direct correlation between welfare and social support systems and religion. In countries with strong social support from the state there seems to be less interest in religion. One obvious reason would be that people don’t ‘need’ to turn to religion for their mental wellbeing since the state will provide the basic sense of being looked after and belonging which many in America seek for in religion.

These are some missed opportunities for discussions around faith and mental wellbeing, but, as they are keen to point out in the book, this is hopefully just the beginning of an investigation into the real role of religion and spirituality in the psychotherapeutic  environment. And not just in that context. Throughout human history, in addition to promoting mental wellbeing, religions have also been responsible for many extremely negative disagreements and conflicts. Consequently, it’s really high time that we grasp the nettle and try to understand religions in a systematic and even scientific manner. To allow faith to remain the elephant in the room simply because we don’t know how to handle it is no longer an option. As the book concludes, we need to be able to deal with all forms of faith and the important roles it plays in human existence. If we’re prepared to do this (and this book is a good contribution) we may be able develop religion into another useful tool in psychology’s toolbox. 

Published by Oxford University Press, 2021, ISBN 978-0198846833