Chris Cook, Andrew Powell and Andrew Sims (Editors)
Reviewed by Arthur A. Dole, Ph. D., ABPP
How do psychiatrists and other mental-health specialists justify the application of spirituality to patients in the United Kingdom? The contributors to this book maintain that spirituality is crucial to mental well-being and psychiatric care. Their evidence: international authorities, case studies, research, professional experience, official reports, and patients’ testimonies. (Incidentally, my review is based on the 300-page U.K edition, not the shorter U.S. version.)
The three editors—Chris Cook, a theologian; Andrew Powell, a psychotherapist; and Andrew Sims, a psychiatrist—state that spirituality has been defined in diverse ways. Their book, whose contributors included 17 psychiatrists, 1 social worker, and 1 psychotherapist, was supported by The Spirituality and Psychiatry Interest Group of the Royal College of Psychiatrists. Among aspects of spirituality identified in 14 chapters was, of course, religion, plus caring, empathy, mysticism, New Age practices, near-death experiences, life’s meaning, dreams, transpersonal perspectives, personal philosophy, and so on. And on. All these aspects, the contributors assert, can contribute to patient welfare within a mental-health team approach.
As an aside, Royal psychiatrists in the English National Health Service are by no means alone in expanding the meaning of spirituality, once pretty much confined to its religious aspect. Currently, Google provides 14 definitions, Wikipedia devotes to it 15 related topics, and the American Psychological Association lists 8 books and 5 videos on Spirituality and Religion in its 2010 Spring Book Catalog.
Chapter 13, Pathological Spirituality, by Nicki Crowley and Gillie Jenkinson, is of greatest relevance to readers of this journal. After a good review of the literature from Barker to Zimbardo and three case studies (“Compositions based on real clinical situations”), the authors conclude (p. 270):
I wish that Crowley and Jenkinson had included brief comments on the names of the larger harmful cults in the U.K., and on efforts there at exit consultation, rehabilitation, and treatment of cult victims.
Each team of contributors ended their chapter with a brief conclusion, followed by References. I have summarized their conclusions to illustrate the flavors of the book. (My comments, if any, about their supporting evidence are indicated in parentheses.)
Assessing Spiritual Needs, by Culliford and Eagger. Practitioners should take systematic and detailed histories to assess the patient’s spirituality. (Eleven Useful Websites, such as AA 12 steps, supplement References.)
Spirituality and Psychiatry makes a strong case for expanding the medical model by integrating religious and other related factors in the British National Health System. Some contributors used case histories skillfully and some relied on evidence from quantitative and qualitative research. They provided an impressive variety of material useful to psychiatrists and collaborating care givers, much of it relevant beyond the United Kingdom. The emphasis by many of these psychiatrists on a patient-centered approach, coupled with Beck’s cognitive therapy, is commendable. The references at the end of each chapter and the index are helpful. Most contributors cite research, official reports, and the observations of medical authorities.
As is true of many edited books, this volume slips at times into redundancy. It fails to build an integrated theme from one contribution to the next. Authors tend to over-rely on secondary rather than primary sources in presenting research. Some draw more on psychiatric elders such as Freud, Jung, and Frankl rather than on contemporary theorists.
I was surprised that hypnotism was not mentioned both as a destructive method of cult covert social influence (cf. Hassan) and as a constructive therapeutic intervention.
As mentioned previously, the meaning of “spirituality” has expanded. I, for one, as a skeptical psychologist, winced at the inclusion of mysticism, New Age practices, and transpersonal perspective, for example.
The intended primary audiences for Spirituality and Psychiatry are British NHS psychiatrists, other physicians, chaplains, and mental-health specialists. However, I recommend it in whole or in part to English-speaking mental-health specialists around the world. Theologians will also find it informative. Among members of the International Cultic Studies Association, psychiatrists, social workers, psychologists, sociologists, lawyers, exit and pastoral counselors, and other specialists will find it valuable, especially when their travel plans include Scotland, Wales, or England.
International Journal of Cultic Studies ■ Vol. 1, No. 1, 2010