Book reviews from the Spirituality SIG

We publish book reviews for books on the topic of mental health and spirituality.

Please note, we are often asked to review books and reserve the right to choose which books are reviewed and which reviews are shown here.

As the authors of this book make clear in their introduction, belief in life after death is a feature of most of the world’s faith traditions and is widespread in the general population in most countries around the world. There is evidence that such beliefs are beneficial to mental wellbeing (Flannelly et al., 2012, Bradshaw and Ellison, 2010, Ellison et al., 2009). They may also be beneficial in terms of reducing despair during terminal illness, although this effect appears to have more to do with the underlying spirituality than with the belief in life after death per se (Mcclain-Jacobson et al., 2004). Belief in life after death is thus an important element of spirituality, and also something that psychiatrists and other health professionals should be interested in, but what is the evidence that such beliefs are well founded? Many scientists may either feel sceptical about this, or else assume that it is not a matter amenable to scientific investigation. After all, researchers cannot speak to people who have crossed over into the afterlife and returned to tell their story. Or can they? The authors of this book offer reviews of extensive empirical evidence from three lines of investigation: studies of mediumship, near death experiences (NDE), and reports of memories of a previous existence (referred to in the book as “cases of reincarnation type”, thus CORT).

Two examples of mediumship are considered in the book in some detail: Leonora Piper (1857-1950) and Chico Xavier (1910-2002). The authors offer some interesting details about each, including evidence that they were able to provide accurate information about deceased people with whom they claimed to have contact, which they could not have obtained other than through direct contact with the deceased individuals themselves. The possibility of fraud is considered and excluded. However, a quick search online reveals how controversial both of these cases were, and continue to be, especially that of Leonora Piper. More recent studies, including a meta-analysis of controlled quantitative research are considered, and other alternative explanations excluded. Arguably the more recent research provides better evidence. For me, however, the fundamental problem is that the most convincing studies provide evidence that mediums knew things that they could not have known by normal, or scientifically explicable, channels. This is not the same thing as proving that personal existence continues beyond death.

With the research on NDEs, the emphasis moves away from showing evidence of persisting memories, skills, and personality traits of a deceased person to arguing that the perception like experiences of the person having the NDE are veridical. Notably, this includes reports of out of body experiences (OBEs) in which details of procedures, or of environmental observations, are accurately recalled after the event, even though they could not have been physiologically perceived (due to lack of brain activity, or because they were not observable from the bodily location of the person concerned). Again, alternative explanations are considered and excluded. Given that these are “near” death experiences, rather than cases of confirmed death and resurrection, (and admittedly the distinction here might be subtle) it is difficult to know whether or not this evidence says anything about “life after death”, except in the very short-term post-mortem. It certainly seems to argue for the possibility of out of body experiences (OBEs), which are a slightly different, albeit related, phenomenon.

Finally, the now vast literature on CORT is summarised, admirably succinctly, in just 8 pages. As with previous sections, the possible alternative explanations are considered and excluded. I’m not sure that I can further condense the summary that the authors provide without losing something of the overall outline of the literature, but essentially there are many accounts of individuals (usually children) who claim to remember past lives. Moreover, investigation into the alleged memories reveals an historical basis for the existence of the allegedly reincarnated person, usually with evidence of veridical memories and persisting skills and personality traits that would support the contention that this is the same person, now reincarnated. In particular, rigorous research has been undertaken in the past by Ian Stevenson, himself a psychiatrist. Whilst belief in reincarnation is widespread worldwide and has had some limited support within Christianity and Islam, it is not generally believed in by Christians, Muslims or Jews. Whilst this is – potentially – the strongest evidence presented within the book the counterarguments are dismissed far too readily. (See, for example, (Edwards, 1996) for a general critique of this literature). The implications here for clinical psychiatry are especially important – for example where patients believe that they have suffered PTSD in a past life with symptoms that now impact upon present wellbeing.

The book is short and generally quite readable (although I found the philosophy sections somewhat over-condensed). I wish more had been said about comparative religious perspectives, theology, and clinical relevance, but this was clearly difficult within a book of this length. The book is very focussed on scientific evidence and the empirical scientific method is not the only way of knowing things. However, it fills an important gap in the literature and is a commendable achievement, notwithstanding these limitations of scope. It is always a good sign to get to the end of a book wanting to know more – which this reviewer certainly did!

Book review by Christopher CH Cook, Durham University

Edited by Alexander Moreira-Almeida, Marianna de Abreu Costa, Humberto Schubert Coelho. New York; Springer, 2022. 85pp. ISBN 978-3-031-06055-7

References

Bradshaw, M. & Ellison, C. G. (2010) Financial Hardship and Psychological Distress: Exploring the Buffering Effects of Religion. Social Science and Medicine, 7, 196-204.

Edwards, P. (1996) Reincarnation: A Critical Examination, Amherst, NY, Prometheus.

Ellison, C. G., Burdette, A. M. & Hill, T. D. (2009) Blessed Assurance: Religion, Anxiety, and Tranquility among Us Adults. Soc Sci Res, 38, 656-67.

Flannelly, K. J., Ellison, C. G., Galek, K. & Silton, N. R. (2012) Belief in Life-after-Death, Beliefs About the World, and Psychiatric Symptoms. Journal of Religion and Health, 51, 651-662.

Mcclain-Jacobson, C., Rosenfeld, B., Kosinski, A., Pessin, H., Cimino, J. E. & Breitbart, W. (2004) Belief in an Afterlife, Spiritual Well-Being and End-of-Life Despair in Patients with Advanced Cancer. Gen Hosp Psychiatry, 26 , 484-6.

Reverend Lorna Murray is an ordained minister of the Methodist Church UK who spent most of her years in ministry as a Mental Health Chaplain within the NHS. This book bears the fruits of her wealth of experience working in mental health chaplaincy, mostly in Scotland although she also brings experience of working in West Africa and India.

The author’s starting position is that human beings are relational beings and that God created us that way. We are created to be inter-dependent and so we cannot experience well-being in isolation from other people. The purpose of this book is to encourage people who identify with the Christian faith, to be more aware of how to support people going through a time of poor mental health or those with a diagnosis of a mental illness. The author’s hope is that in this way the church can be encouraged to become more involved in creating communities of well-being.  

The concept of communities of well-being is central to the book. The author envisions such communities as ones in which people care for each other and all people are accepted not just for what they do, but primarily for who they are - their 'beingness'. Such acceptance needs to be backed up by the provision of adequate resources to support all people to live a life in its fullness. Although the author’s focus is psychosocial and spiritual, there is no doubting the political implications of her message.

One of the delights of this book is the many stories which the author uses as vignettes to illustrate key issues in supporting people who are suffering psychologically. Each chapter begins with such a story followed by a reflection, which then opens up a discussion of the issue addressed in the chapter. Based on her own experience, these vignettes also offer a window into the author’s way of offering pastoral work. What comes across is a mature thoughtful approach to mental suffering that is underpinned by her Christian faith. She realises that healing is not necessarily about improving symptoms, but also about making the person feel more accepted and welcome in a community. Among the issues addressed in this way are the importance of acceptance, social inclusion, sensitivity to cultural context, guilt and shame, and suicide. 

Alongside the author’s vignettes, she includes stories from the biblical gospels. She writes thoughtfully about the care that needs to be taken in sharing these stories in pastoral work as they can be misunderstood particularly when the cultural context of the gospels is very different from the cultural context of the person being supported.

From the perspective of a chaplain, she addresses a number of issues that have been the subject of debate in the Royal College of Psychiatrists’ Spirituality Interest Group such as when it might be helpful to bring in a Christian perspective (or the perspective of another faith) into a conversation without imposing one’s own view. She also addresses the issue of prayer in a particularly moving vignette about responding to a Muslim person’s request to pray together on a mental health ward. She emphasises the importance of allowing the other to initiate this so that one is praying with, as distinct to praying for someone.

Although the book is largely aimed at people who offer or might offer pastoral care to people affected by mental health problems, it offers a useful psychosocial-spiritual perspective for psychiatrists who have an interest in Christianity and mental health. It reminds us of the importance of spirituality to many service users and the valuable role that can be played by chaplains of all faith traditions in mental health services.

Andrew Clark, 2020

Introduction by Shimon Cowen, translations by Shimon Cowen and Liesl Kosma. Melbourne; Hybrid Publishers for Institute for Judaism and Civilization, 2020. 174 pages. £15.99 paperback £4.59 Kindle. ISBN13: 978195736656

Rabbi Dr Shimon Cowen’s invitation to review his book at once triggered in me both delight and dread. I have always come away delighted in our many conversions, learnt from his erudite talks and writings, felt honoured to be invited to contribute to his first volume of the Journal of Judaism and Civilization (1998). But there was also a sense of dread as I know that his ideas require close attention,  intense concentration and sustained focus to keep up with his rapidly processing mind. To engage with Rabbi Cowen’s deep, layered understanding is an experience in self-discipline, to be sure, always worth the effort.  

This foreknowledge coupled with the title – “rediscovery of the human” - suggested a challenging journey to retrace profound, complex inner journeys from the ‘discovery’ to the ‘rediscovery’ of the human. I was taken back to big questions in life: who am I, as a person and therapist?  

I wondered if I should have accepted the invitation as soon as I read Rabbi Cowen’s first page, quoting Frankl’s remarkable final sentence in “Ten Theses concerning the ‘Person’” (one of the five translated pieces from Frankl in the second part). That sentence which threw me off my track was:

The true discovery of the human, the inventio hominis, occurs in the imitatio Dei [imitation of G-d]. 

At the heart of this book Rabbi Cowen’s scholarly thoroughness is offered in five introductory chapters, which illuminates Frankl’s complex inner journey with ‘Spiritual Clarification’. This is a double journey, on many levels. As the inventor of ‘logotherapy’, Frankl initially rejected, only to subsequently reclaim, Freud’s psychoanalysis. In passing, it should be noted that Rabbi Cowen’s focus on Frankl and Freud’s original therapies, is the substance of the book; and these are offered to contrast with other, less well known Jewish psychotherapists. 

To illustrate, one example, Rabbi Cowen quotes from Rabbi A. Amsel (later Amsell, p. 65), ‘there is no difference in kind between the dynamics of normal and abnormal behaviour, the difference being of degree only… Judaism views mental illness as a moral rather than a medical problem. It is only where the communication with the patient is impossible that Judaism would assign the cure to the medical profession.’ (p. 64). That throws me into one camp: I am a medical practitioner. I am also Jewish. Where do I stand on mental illness?

A second example, Rabbi Chaim Lipsitz offered: “I tend towards careful use of psychological technique and not the philosophy behind them”. (p. 65) Off track two: I do follow some of the psychological techniques and the philosophy and I am Jewish. While the third approach, Moshe Halevi Spero’s ‘unfied halachic view’, according to Cowen ‘seeks to determine the foundations in religious law itself for specific clinical treatments.’ (p. 65). [I confess not knowing enough about Jewish law. Where does that leave me? Am I competent therapist then? Am I a competent Jew?

Back to the main theme, Rabbi Cowen explains in chapter one that his idea to write on Frankl arose from Rabbi Menachem Mendel Schneerson’s (the Lubavitcher Rebbe) letter wondering why Frankl’s teaching failed to gain wider acceptance in therapeutic practice. Rabbi Cowen’s study addresses and elaborates the Rebbe’s partial response, that it had to do with a lack of therapists ‘displaying “the living example” required for the practice of “logotherapy” (p.3) . That took me off the hook: I was not a “living example”; but that was a partial excuse. The other was that I was a child psychiatrist, not using logotherapy. Babies don’t have logos – at least not yet.

Rabbi Cowen’s analysis seems to me to be a search for that spiritual spark -  the Divine - in logotherapy. His text follows intimate details in texts, quoting from his own earlier publications, ever searching for clues, deeper and deeper connections between Frankl’s philosophical, religious and psychological ideas as they correspond with ideals within theological and mystical frameworks. 

In this intense quest, Rabbi Cowen’s itinerary takes on Frankl’s structure of personality, as he distinguishes “bodily” (“somatic”), “mental”, and “noetic” (or meaning [making and] supplying) faculties. In turn, Rabbi Cowen’s spiritual illumination [of Frankl’s work], in turn, [is] sparked by the Maharal of Prague’s “physical” (gufni), vital (chiyuni) and “intellectual soul” (nefesh hasichlis) dimensions (p.20) of human personality.

Now there are a number of very powerful tables which Shimon/Rabbi Cowen integrates into his book and one table would be worth a seminar series I would say. These are usefully captured in figures that translate ‘the orientation of spirit/the treatment of nature’ (p. 25), while a later figure similarly organised Freud’s ‘id- as libido’, ego- as intellectual faculty’ and ‘superego-as unitive faculty’ again imagined in a figure to correspondences with the soul powers of Chesed/Nezach, Tiferes/ Yesod and G’vurah/Hod respectively, embraced by Malchus (p. 57).

For me the most dramatic section of the book involved the famous encounter between ‘Freud and the Grand Rabbi’ (p. 57). 

In the winter of 1902-03 the meeting in Vienna between Freud and Rabbi Sholom DovBer Schneerson (the Grand “Rebbe”) was documented by his son, Rabbi Josef Yitzchok Schneerson. 

In response to Freud’s curiosity wanting to know what kind scholarly discipline Chassidus was, 

‘My father replied: The discipline of Chassidus [Chassidic mystical theology] requires that the head explain the heart what the person should want, and the heart implement in the person’s life that which the head understands.’

The conversation continued …and another account has Freud’s explanation for the Rebbe’s apparent suffering from low spirits as, 

‘The Professor stated that his [the Rebbe’s] suffering was a deep inward [one], which is [found] only in profound, committed thinkers. The heart desires more than the head can grasp, and the head understands more than the heart can come to.’ (p. 59) 

I have found these few words offer many interpretations to meditate on, over many occasions over the years. Each time I read it I find another level of meaning. 

For those who favour the “long-short” way, many pages of this book offer insights to treasure, to read, re-read, and re-read once more, to finally savour [what the meaning is]. For those wishing the “short-long” way Rabbi Cowen offers a final ambitious and integrative figure as a three column summary [I’ll just read the column headings]:
 
First the teachings of the religious tradition [- column one]; second, the primary perspective on faculties of personality, and third, the r relationship to the Noahide laws. (p. 76).  Now, if you can’t even find the links – welcome. I’m still struggling. Yet, Shimon has already integrated them. So between the lines and the spaces is a measure of the depth and profundity of the thought that has gone into this book [1] .
 
From the opening to the final chapter of his long introduction, half the length of the book itself, Rabbi Cowen’s profile of Frankl’s complex life, as philosopher and controversial therapist, whose unique therapy, ‘logotherapy’ arose partly as protest against the ‘reductionist’ views from which he initially detached himself - Freud’s psychoanalysis and Adler’s ‘individual psychology’ – which were the two dominant Viennese schools at that time, in the 1920s and ‘30s. In contrast, Frankl imbued his approach with spirituality, the essence of man’s quest for meaning. 

Rabbi Cowen highlights in forensic detail the ontological distinctions, still on-going tensions and divisions between the teachings and traditions within the major streams of psychotherapies - as relevant in 2022 as then -  and between them and theology. Frankl expressed variously a ‘search’ for, a ‘will’ to meaning, or a ‘belief’ in meaning. These are powerful human motivations. 

Millions of readers shared his ‘search for meaning’. But, as often stated, his logotherapy never entered mainstream schools. Yet, as Rabbi Cowen’s last translation from Frankl, “The Science of the Soul” – almost an oxymoron in many psychological schools today - concludes, we have much wisdom to encounter as we contemplate our world-view to ask ourselves and to attune ourselves to transcend experiences both in our patients and in ourselves.

I would respond to the science of the soul with a slight alteration to Frankl’s words. His words were ‘G-d or my innermost self’? To which I would respond with the minor emendation, “G-d as my innermost self”.  

Dr George Halasz, Adjunct Senior Lecture in Psychological Medicine, Monash University.

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[1] A brief explanatory note added by Shimon Cowen. This table shows how, in the light of a great Renaissance Jewish theologian, the Maharal of Prague, both a physical and spiritual ancestor of Frankl, whom Frankl claimed as the forerunner of his own “dimensional ontology” of personality, Frankl and Freud’s diverse theories can be related to one another and to the fundamental code of universal values, known as the Noahide laws (in and through which, according to religious tradition, the imitation of the Divine consists). Frankl who believed in moral absolutes, developed a layered model of personality, in which these layers with their sub-departments are correlated with harmonizing universal values. Freud’s own pantheon of instincts paradoxically also connects – as illuminated also in the work of the Maharal of Prague – with these universal values as their negative or inverse expressions. In other words, the Freudian instincts, the raw “bad” self, once tamed and transformed, “reinvert” into the same set of universal values, embodied in the Noahide laws. Understanding this requires some close study, but the five chapters of the Introduction provide it: they explain the connection between Frankl’s model of human personality as the imitation of the Divine and connect the same with a transformed and reclaimed Freudian theory.


Edited by Sarajane Aris (SMN), Hilary Garraway and Hannah Gilbert. Shoreham-by-Sea; Pavilion 2021. 344 pages £35 paperback. ISBN: 978-1-914010-62-0

This handbook is essential reading for health and social care professionals, service users and carers, as indicated in its subtitle. It is a revised and extended edition, following up on Spirituality and Mental Health edited by Peter Gilbert in 2011 and incorporating a new emphasis on mental health and wellbeing. Spirituality is increasingly recognised, as the foreword notes, ‘as an integral part of wellbeing and psychological health.’ The pandemic along with the effects of social media have exacerbated mental health issues across the life cycle, but especially among young people. The introduction asks where we are now, giving an overview of the current context and including chapters on integrating spirituality into mental-health services, African psychology and finding meaning and purpose. The editors propose that spirituality may well become 'The heart of and foundation for our mental health and well-being.’ I found the article on African psychology of special interest, in the light of colonisation as a global system of white supremacy, resulting in an evacuation of an all-pervasive spirit entailing interconnectedness and communal group connection, which we urgently need to rediscover.

The 28 chapters are arranged in four parts, including spirituality across the life-cycle, therapeutic practice and 14 themes and journeys covering a huge range of topics embracing spiritual crises, faith, psychotherapy, research, spiritual competencies, visions, compassionate leadership, caring, spiritual training, burnout, spiritual care, eco-spirituality, new spiritualities and the transpersonal. Many well-known authors are featured, and the book will surely put spirituality and spiritual care firmly on the agenda. Some authors propose spiritual reflections, and there are comprehensive references at the end of each article. In the final chapter, the editors summarise key themes and threads such as connectedness and the collective, the language of spirituality, diversity and inclusion, compassion and the whole person. They call for a process of reclaiming our inner knowing, transcending separateness and celebrating our shared humanity. They also highlight a few areas not covered in detail, such as bodywork and multiple faith perspectives. They conclude with some questions and reflections to explore on an individual and collective level, including expanding our awareness into more subtle realms so as to become part of the necessary spiritual transformation. As a whole, the book represents the depth dimension of life and healing, and deserves the widest possible readership.

Revd. David Lorimer, Programme Director, Editor, Paradigm Explorer.

This book comes from the Christian faith community, written by leading experts, with a foreword by the Archbishop of Canterbury. The volume is arranged in three segments, considering the underlying theology, specific case studies from the bible and then the practical application of this learning.  

The first chapters give us an overview of the Christian story and our individual need for meaning-making, and then we turn to an overview of the Hebrew bible view of wholeness, “Wholeness in Old Testament perspective is not perfection…it inhabits the space between reality and the hoped-for perfection of all things.” P31

In a provocative chapter Joanna Colicutt points out the times in the New Testament narrative when Jesus' family come to intervene since he was thought to be ‘beside himself’. She asks: was Jesus divinely mad, or simply clinically insane? If you, like me, react instinctively against the idea that Jesus could possibly have ever had a psychotic episode, what does that say about how we value those living with psychosis and their spiritual experiences?  

There follow two chapters on St Paul, highlighting the Hebrew worldview which Paul and Jesus would have shared, that an individual is an indivisible whole, not separable parts of body, mind and spirit. It is impossible to directly correlate our modern views of mind with any single term in Paul’s writings.  

The second section of the book looks at various biblical resources and considers what we can learn from them in our responses to mental ill-health. From Job we broaden our pastoral responses to suffering. In the book of psalms, we find a rich and deep resource for faithfully expressing anxiety distress and lament. Jeremiah’s sufferings help us better understand sustained suffering. Jesus sermon on the mount gives us an image of healthy living, and Jesus healing of the Gerasene demoniac, “is a story about finding new life through the power of Jesus to set people free from spiritual, mental and social forces that enslave, exclude and condemn.” p153

In the third section, practicalities are addressed. John Swinton summarises his approach to mental health care and the bible, (for more details see his book, reviewed below). He sees health as being not the absence of difficulty but the presence of Jesus Christ with us in the storms of life. He lays out how the bible can be helpful to those struggling with e.g. depression, and how a hermeneutic of suicide can make bible study risky in severe depression. The Church as a promoter of recovery for those living with mental illness is the focus of the end of Swinton’s piece and the next chapter. We are then invited to look at the bible through the lens of trauma and resilience. We discover that the bible books are robust, that we are not alone in suffering, that the bible gives us a language for lament, and promotes our resilience. 

Scholarly and yet accessible, this excellent book speaks with a diversity of voices about mental health and illness, the lifelong challenge of finding our stories in God's big story, and the centrality of Scripture in this process. It will be a useful resource for those involved in Christian pastoral work, as well as those seeking to integrate their faith with their life experiences as someone living with, or alongside those with, mental illness.

Revd. Dr Alison J Gray, FRCPsych

Committee Member, RCPsych Spirituality and Psychiatry SIG

Book: London; SCM Press, 2020. 232 pages £25 paperback £20 Kindle [2020 prices]. ISBN13: 978-0334059776 

This is a timely book written by Jan Alcoe and Sarah Eagger and published by the Janki Foundation. The Janki Foundation is a UK charity promoting the integration of spirituality into healthcare. Jan and Sarah have both been involved with this organisation for many years – Jan as a publishing and training adviser and Sarah as the current chair. She is also past chair of the Spirituality Special Interest Group and continues to be involved with this. 

The book is timely because it is published at a time when we are in the midst of two deep global crises - a pandemic and a climate crisis. Together these crises have contributed to a growing fear and uncertainty amongst many people. The book is a self-help guide which, as the authors explain, “is for all who wish to live a fulfilling and contented life in an uncertain world. The tools it offers help us to weather the storms around us by digging inner foundations of calm. In this way, however strongly the weather rages, we can stand firm and act resourcefully, staying true to ourselves, rather than being blown around in a maelstrom of fear”.   

As a self-help guide, the book is aimed at anyone who recognises a need for calming the mind and is interested in a spiritual approach, including those who experience mild anxiety and worry. The authors make clear that this is not a substitute for appropriate professional help for more serious psychological problems, although the tools may be used as an adjunct to professional treatment.

One of the features of the book is that it blends together sound science with practical spirituality and presents this in a highly accessible way.  An example of this is the easy-to-understand introductory guide to the three different systems of the brain – the primitive threat/defence system which produces the adrenalin-mediated fight or flight response, the motivational drive system mediated by dopamine pathways, and the soothing system with a response mediated by endorphins and oxytocin.

The seven tools described are all ways of stimulating the soothing system of our mind and body. A chapter is devoted to each of the tools which are:

  1. Creating inner safety
  2. Being present
  3. Loving myself
  4. Stepping back and accepting
  5. Empowering myself
  6. Connecting
  7. Discovering inner peace and wholeness

Each chapter has a similar format. It begins with the rationale for the tool and introduces key relevant concepts. The main aspects of the tool are then described. Practical encouragement and tips are offered to help the reader experience the tool in practice. A major feature of the book is the reference to a library of audiotapes on the Janki Foundation’s website.

These are high quality guided practice recordings that can be used to help develop the reader’s use of the tools. Each chapter also includes a few so-called “rescue remedies” to be used as quick ways to recover calm in difficult situations. There are helpful quotes from people who have used the tools - many of them referring to how the practices have helped them during the pandemic. Each chapter ends with appropriate positive affirmations.

The final chapter encourages us to continue to use these tools beyond the duration of a particular storm. Not only does this better prepare us for facing future difficulties, but the practices also encourage the growth of something more profound within us – our deep sense of interconnectedness with all life.

The spirituality that underpins the book is inclusive and practical and, as such, the guide will be of help to people from different faith backgrounds, as well as those who do not feel a connection with any particular faith tradition.

Overall, the book is full of warmth. It is presented with clarity and heart. It has a beautiful simplicity which is a hallmark of deep wisdom. 

Andrew Clark 

Book review editor for the Spirituality and Psychiatry Special Interest Group at the Royal College of Psychiatrists.

This book digs a little deeper into the specific theological and pastoral issues which are raised by three major mental illnesses categories, Major Depressive Disorder, Psychosis and Schizophrenia, and Bipolar disorder. It is based on repeated interviews with Christian service users over 2 years, and the authors experience as mental health nurse, chaplain and now researcher.

Professor Swinton begins by drawing out the difference between a thin, fast and superficial description of someone’s condition such as is found in the DSM and ICD manuals, and a deeper richer more complete ‘thick description’ which encompasses more of the persons' specificity and individuality and captures more of the complexity.

Spiritual reductionism and Biological reductionism are equally wrong; It is equally false to view all Major Depressive Disorder (MDD) as being caused by the individual spiritual disorder, such as lack of faith and obedience, as to view MDD as being entirely and utterly biological. 

The author highlights the need for Christians to be honest about the challenges and the dark side of life, to avoid the risk of depressed Christians living inauthentically, pretending to be happy rather than seeking to live honestly and joyfully. Joy is “being able to celebrate the goodness of Jesus even during horrendous struggles…” p80.  Medication taking can be a spiritual practice, when it relieves psychological pain such that one is able to engage fully with oneself, other people and God once again.

ProfessorSwinton highlights the ‘hermeneutical injustice’ of not accepting and valuing the lived experiences of those with severe mental illness, recognising that there can be a complex interplay between illness and healthy spirituality. He argues convincingly that demon possession has a completely different presentation to mental illness including, what is for me the key point, that mental illnesses fit into recognisable categories and respond to medication, which demons don’t.  

“If we find ourself thinking that people hear voices because they are demon-possessed rather than because they have been treated terribly in the past, we need to expand our intellectual and spiritual knowledge and become more aware of the significance of our hearts”. P 212

In the final section we are shown different aspects of healing, where health is defined as the presence of God, not the absence of difficulties. The healing support offered by the church community at its best, enables people to recover and live well with their ongoing challenges, even when they are not cured of their mental illness. Most helpfully Professor Swinton introduces the concept of ‘retrospective spiritual discernment’, seeing where Jesus was with the individual as they went through the storm of major mental illness, and how this can help them face the future. 

This accessible book will be of particular interest to chaplains, Christian ministers and psychiatrists, and to all who wish to learn more about a distinctively Christian, bible-based and professionally informed, approach to severe mental illness.

Revd. Dr Alison J Gray, FRCPsych

Committee Member, RCPsych Spirituality and Psychiatry SIG

Book Details: London; SCM Press.  2020. 320 pages £17.18 in 2020. Paperback. ISBN-13: 978-0334059745

Horatio Clare is a lecturer, journalist and travel writer, he here provides us with a vivid description of his journey through manic breakdown into recovery, both from the inside and through the observations of friends and family. The first part begins as an adventure story; on a family holiday in Italy he realises that he is part of a great conspiracy, everywhere he looks he sees hidden communications and secret signs. Aliens have landed, humans will have to work together, he has an important role to play. Back home he frightens his family and alienates his friends. His psychotherapist says he needs a psychiatrist. Clare hears noises and interprets these as spies using hidden access tunnels to complete their secret missions. He is reviewed by mental health services and manages to talk his way out of going to hospital. He begins to literally tear down the walls and ceiling of the flat. Eventually he is sectioned.

Clare spends a month in hospital, describing the characters there, all of whom seem to have been triggered into illness by cannabis. He finds visits to the local art gallery to be healing. After this he is then discharged to his flat in town and ongoing therapy.

Gradually he repairs his relationship with his family. Then he decides to stop taking his medication, but without telling his wife. She has made it clear that stopping his meds would mean the end of their relationship. He remains stable, and after a year it becomes apparent that he is off the meds, and his wife accepts this, the gamble seems to have paid off.

In the second part of the book Clare considers the impact of big pharma on psychiatric decision making, and looks at alternatives to the current system; I felt there was a tinge of grandiosity in his writing style here. He speaks to friends and revisits some of the people with whom he interacted whilst he was unwell, one of the ward support workers, the social worker who sectioned him. He begins to understand their point of view better.

Horatio Clare argues that sectioning people is often the right thing to do, that families should not hesitate to go this route when necessary, and that it should be easier to get people the care they most desperately need. At the same time he is highlighting the damage done by cannabis, and questioning the prevailing view of long term medication being appropriate in bipolar disorder. He learns about describing, and Open Dialogue and advocates for these approaches.

This book should become a classic, it is very readable, well written and contains clear descriptions of the way Clare’s mind was working and how he was able to interpret every experience as further evidence for his delusions. He does not shy away from describing the ensuing damage to his relationships, and his flat.

Mental Health professionals can learn from his story how an educated, articulate person can be completely caught up in a delusionary system and behaving in a very disturbed manner, and yet argue their way out of mental health detention. The author crashed his car into a dam, stripped naked and was found wandering by police, and yet still avoided being sectioned.

Alison J Gray, FRCPsych.

Andrew Powell was the founding chair of the Spirituality in Psychiatry Special Interest Group of the Royal College of Psychiatrists, which is celebrating the 20th anniversary of its founding this year. Over those years it has provided a deeply valued forum for those psychiatrists with an interest in spirituality. This book is a collection of 17 papers and talks given by Andrew between 2006 and 2017, several of them given at conferences organised by the Spirituality in Psychiatry group. It is a welcome sequel to “Ways of the Soul” which included papers from the previous decade. Both collections draw richly on Andrew’s experience of working clinically as a psychiatrist and psychotherapist, as well as his understanding of psychoanalytic and Jungian psychology, quantum physics, anthropology and comparative religion.

Each paper is complete in itself and although many of them were originally addressed to clinical audiences, they are refreshingly jargon-free and so are accessible to anyone interested in the subject matter.

The overall focus of the book is the question of what it means to be human and the challenges we all face both on a personal and collective level. Indeed one of the chapters is the transcript of a dialogue addressing this very question. Andrew brings a broad bio-psycho-social-spiritual perspective to his reflections on being human. He sees our bodies as providing a vehicle and opportunity for an evolving partnership between the ego and the soul. The ego helps individuals to grow and survive in the physical world. The soul co-habits with the ego for the purpose of gaining experience and so must share in the ego’s experience of pain. The soul is seen as the particular manifestation of the all-encompassing Spirit (which may be called “God” or “Supreme Consciousness”) in an individual form. Both ego and soul need each other and when working in partnership can become the perfect instrument for creating heaven on earth. However, the ego’s innate tendency to separate and divide and see the world through its own lens, means that it is often unaware of and disconnected from the soul.

At an individual level, Andrew sees the disconnection between ego and soul as a key factor in mental health problems. At a collective level this disconnection has led to a profound sense of alienation and has led to untold destruction of our fellow human beings and Nature. Helping individuals and groups to re-establish a healthy connection between ego and soul has been Andrew’s life work.

The more clinically orientated chapters describe ways of helping others listen to and converse with their soul. With the help of remarkable anecdotes and case stories, Andrew provides glimpses both of his own journey and those of the patients he has supported. He offers examples of ways in which a clinician can invite the patient to go deeper, such as using a question like: “What would your heart say if it could speak?” He also devotes significant passages to the importance of forgiveness, which is ultimately seen as a quality of the soul which balances the ego’s tendency to retaliation. From this perspective, forgiveness does not need to be forced or pushed. Helping someone connect with their soul brings forth the quality of forgiveness naturally.

The chapters examining our collective human situation give a particular emphasis on how, over the last 300 years, especially in so-called Western culture, humanity has become increasingly enthralled by scientism. This is an ideology which particularly appeals to the ego with its explanatory and technological power. Whilst science has brought extraordinary benefits to humanity, scientism has led to a narrow materialistic worldview with little room or respect for spiritual perspectives. Consequently, many in today’s world have a deep prejudice towards matters of the soul. Inevitably, modern mental health care has been shaped by a similar prejudice. Andrew draws on some of the findings of quantum physics and transpersonal psychology to address this narrow worldview and to show that it is no longer in step with modern scientific and psychological research. Fittingly, the final chapter of the book is entitled: “Prejudice – can we live without it?” The chapter and book ends with Andrew’s answer to his own question which is “yes, we must, if there is to be a future for humanity.”

My overall response to this book is one of warmth and hope. Having worked in the same field, I was struck by the courage in Andrew’s professional work which comes through in these papers. He was exploring ways to help people connect with their soul which would have been frowned upon by some colleagues. He was exploring a pathway to healing that not many psychiatrists had trodden. It is worth remembering that the origin of the word “courage” is from the French word for heart “coeur” and this book does indeed have plenty of heart. This heart-centredness is blended with clarity of thought which many readers will value, whether or not they are clinicians.

The book is also a timely exposition of the centrality of love and its importance in any situation in which one is in a position to help another human being. Andrew reminds us that in the face of inevitable suffering we always have at our disposal “the best medicine known to humankind – the healing power of love”.

Luminous LifeThe title of this book derives from an ancient Indian philosophical concept: “Atmadeepo Bhava” which literally means “Be your own Light”. It is the culmination of the author’s many years of working in mental health services in India and UK.

It describes a model of humanistic psychotherapy based on the author’s clinical experience of trying to help people with a wide range of mental health problems. It is described as a “Self-therapy” which, although particularly influenced by the work of Victor Frankl, Abraham Maslow, Narayana Surya and Carl Rogers, is also personal and distinctive.

The therapeutic model is presented in a self-help format and is clearly addressed to those wanting help, rather than to professionals. The language is relatively jargon-free, practical and refers to theory lightly.

The focus is on what each individual (and those close to them) can do in the here and now to help ameliorate the individual’s psychological suffering. To this end, a range of practical exercises are suggested, not in a prescriptive manner, but rather as tools for each individual to try out for themselves. The approach is underpinned by a deeply spiritual worldview drawing on the author’s own spiritual practice and ancient Indian sacred texts.

Seven major modules

The book describes seven major modules, which the reader is encouraged to work through in whatever order suits them. These modules cover Health, Forgiveness, Self, Connections, Will-power, Relationships and Living with Family. Four additional short modules are presented exploring Time, Negotiation, Creativity and Connecting with the “Common Person”.

A quarter of the text is devoted to the module on Health. The author likens health to a cube or room with six sides: physical, mental, cultural, social, material and spiritual. Interestingly, he also adds a section on philosophical health which he likens to the atmosphere within the room. He addresses each of these areas, with a particular emphasis on personal responsibility.

The module on forgiveness considers both forgiveness of self and other. It offers practical advice on how to deal with painful memories and persistent feelings of anger and guilt.

The module on Self considers the distinction between Self and Other and the importance of balancing the needs of both. It emphasises the intimate relationship between loving self and loving other. There is an interesting section on the pro-self and anti-self tendencies in all of us, which are part of the human experience.

Neither group of tendencies can be completely eliminated. The author notes that the anti-self tendencies have been alluded to in various cultural and religious texts. He refers to the idea of the “Six Enemies” described in ancient Indian texts as obstacles faced by any person on the spiritual path. These are lust, anger, greed, attachment, pride and envy. In the author’s view, the root problem underlying each of these is greed and practical suggestions are offered to control greed.

The module on will-power identifies this quality as the real power behind all our projects, large and small. The practical suggestions advocated to strengthen will-power include self-generated “deprivation exercises”, which may raise eyebrows amongst some readers.

The remaining three major modules focus on nurturing connections with fellow human beings (especially those close to us), to Nature and also to things that serve us well in our homes and workplaces.

In the final section of the book, the author widens his already broad lens and considers how we may all contribute to creating a healthier civilisation characterised by respect for Nature, a true balance of masculine and feminine roles, multiculturalism, a more spiritual and less materialistic approach to life and care for each other.

Conclusion

In summing up, the author again draws on ancient Indian sacred texts in which the three major manifestations of the Supreme Being are described: Satyam – Truth, Shivam – Welfare (sometimes translated as Goodness) and Sundaram – Beauty. Our task as human beings is to strive to manifest these qualities in our lives. For the author, it is striving for welfare of self and other, through service, which is the key for us. “You, I and other fellow beings will therefore achieve our respective places under the Sun if we continue to walk the path of ‘Love Self and Love Others.’”

The book could be a useful tool in working with patients who are looking for a self-help guide and perhaps particularly with those who have an interest in spirituality. It reflects the warmth, humanity and care of the author. I was left feeling that those patients, past and present, who worked with the author were fortunate to work with him.

Dr Partha Choudhury is happy to share his contact details in case any one wish to contact him: choudhp@yahoo.com  & telephone +44 (0) 7435425926

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