Understanding Autism: From Basic Neuroscience to Treatment

Kate Loewenthal, Professor of Psychology at Royal Holloway, University of London, is the author of numerous articles dealing with religion and mental health. In the present work, she brings credibility, balance, and clarity to the subject, anchored in genuine scholarship. The book’s brevity (141 pages of text) belies the richness of the source material, much of it recent, that she taps for her discussion. The emphasis is on mental health—specifically, the standard psychiatric syndromes and the influence of religious beliefs on them. She does not address the historical evolution of religious practices, nor the role religion plays in social movements, politics, and international affairs. There is no consideration of fundamentalism, extremism, terror, or persecution (in fact, none of these appears in the index). After an introduction that defines culture, religion, and mental health, 6 chapters, 1 each, are devoted to schizophrenia, manic disorder, depression, anxiety, somatization, and dissociation. The eighth chapter deals with positive states, and the ninth is the conclusion. In a curious “Note about G-d,” the author explains her use of this spelling. She is an orthodox Jew “who wishes to follow the prescription of Jewish law not to write out any name of G-d in full. ” The frequent reference to God in a book about religion means that the peculiar spelling occurs often, and when it does, it calls attention to itself. But it also serves to remind us of the author’s religious viewpoint. That notwithstanding, Loewenthal, to her credit, presents a balanced view of religion and mental health based on her work and extensive search of recent literature. In discussing schizophrenia, she states that “religious beliefs may be two-edged weapons—while offering comfort, they may be a factor in suggesting or condoning bizarre or dangerous behavior” (p. 22). This, the longest chapter, includes a discussion of Afro-Caribbean schizophrenia as seen in the United Kingdom and the United States and the V-code category in DSM-IV of “Religious or Spiritual Problem,” such as “the loss or questioning of faith or problems associated with conversion. ” This leads to a thoughtful discussion (p. 45) of boundary issues arising from the clinician’s religious beliefs and their influence on his or her practice. She also quotes Butler and Pargament (2003) when they “make the important point that there are no methods of religious coping that in themselves are invariably associated with positive mental health outcomes” (p. 45). The chapter on mania contains the one surprise in suggesting “that the neurobiological changes associated with meditative practices may contribute to a pathway which leads to the onset of mania. ” Two authorities are cited for this, Wilson (1997) and Yorston (2001), who describe the case of a young woman whose “manic episodes were preceded by days spent in Zen meditative retreat” (p. 50). In the chapter on depression, she cites Pargament (1997) on particular styles of religious coping “associated with better or worse psychiatric outcomes . higher well-being is associated with . a secure relationship to G-d, lower well-being is associated with imposed religion . and a tenuous relationship with G-d and the world” (p. 59). In considering obsessive-compulsive disorder (OCD), she shares the view “that religion is one more arena in which OCD expresses itself, but is not a determinant of OCD” (pp. 83–84). In her discussion of dissociation, the author finds that trance and possession states have dissociative features. In considering positive states, she gives special emphasis to forgiveness, generally encouraged by most religions. In her conclusion, she addresses and rebuts notions of religion leading to guilt, encouraging paranormal experiences, and making abuse legitimate. She finally concludes that on balance religious traditions “may have good effects on mental health. ” There is always the question of cause and effect: Does good mental health lead to positive religious experiences or is it the other way around? Dr. Loewenthal does not specifically answer this, but she does provide rich material and a balanced picture for anyone interested in the topic.