In recent years a plethora of books have appeared on religion/spirituality and health. Mental health has not been underrepresented. This upsurge in single-authored and edited works on a subject that virtually disappeared from mainstream psychology and psychiatry during the 1960s through the 1980s is in some contrast to the writings of mental health professionals such as Freud, Jung, Pfister, Fromm, and May which emerged during the early and mid-twentieth century. The volume under review is perhaps a hybrid of current and previous focus in writing about religion and mental health.

Kate Loewenthal, an Orthodox Jew and Professor of Psychology at the University of London, has worked for many years exploring the impact of religious and cultural factors on mental health. This theme is in concert certainly with the writings of Freud, who very much explored (not always objectively according to some) both the origins of religious sentiments secondary to psychological factors (often maladaptive factors in his view) as well as the impact of these factors on the mental health of individuals as well as their culture. Yet Loewenthal takes a step into modern psychology and psychiatry by disaggregating psychiatric morbidity into its diagnostic categories, specifically: schizophrenia, manic disorder, depression, anxiety, somatization, dissociation, and even positive states (a tip of the hat to Seligman). She explores each separately and asks of each the following questions: ‘Does religion cause, exacerbate or relieve these disorders?’, ‘What role is played by cultural factors in the relations between mental health and religion?’, and ‘Are religion's roles in mental health similar in every culture?’

These are broad and perhaps pedestrian questions, yet she cuts to some much more provocative questions across these chapters such as, ‘Do visions, voices and delusions always mean that the person reporting them is mad?’ and ‘Can we distinguish between religious trances and states of spirit possession, and dissociative states?’ I believe that Loewenthal is right on target when she considers religion as a context from which psychiatric disorders in their vicissitudes emerge. Though her definition of culture is crisp, she recognizes that religion is a fuzzy construct and, though she suggests a number of ways the reader (and investigator) may explore the interface between religion and mental health, she does not help us nail down this elusive construct. But as long as we accept that though we cannot define it, we for the most part know religion when we see it, then the discussions in the more focused chapters are both clear and useful.

A typical chapter, let us consider the chapter on depression, begins with case histories (four on depression) of a patient/client with depressed mood and religious questions/conflicts intermixed throughout the syndrome. After the obligatory review of DSM-IV symptoms, she discusses the causes and begins to interweave the cultural and religious causes into the description. Next she reviews how religious beliefs can both promote and undermine coping with life's challenges. Finally, she considers gender issues, addressing the intriguing and as yet unanswered question, ‘Why do women experience depression more than men in some culture-religious groups but not all?’ Tying together in a short space factors that might contribute to this discrepancy is not easy, such as cultural-religious differences in the acceptance of drunkenness, social support, religious shame, the greater activity in general of women in religious groups, and the proscription against suicide which is strongly prevalent in cultures such as Islam but more equivocal in Hinduism. She comes down on cultural-religious variability in views toward alcohol use and suicide as perhaps the most important explanations.

In summary, this book is not a comprehensive review of the psychology of religion (that cannot be done in just over 150 pages), yet the author provides a useful though at times uneven journey for the reader into a topic that no doubt will be expounded upon by many writers in the near future given the center stage religion, especially fundamentalist religion, has taken in world events.