Religion and Mental Health: Four Decades of Evidence

David

Welcome back to Dissent from Freud. I am your host, David, and I am glad you are here with us today. In our earlier episode, Was Freud Wrong About Religion, we explored the historic debate sparked by Allen Bergin when he questioned mainstream psychology's longstanding assumption that religion is inherently harmful or neurotic. Today, we are following that question to its empirical conclusion by diving into forty years of research on religious involvement and mental health.

David

Back in the early 1980s, when Bergin debated Albert Ellis, psychology stood at a crossroads. Two very different views of the human mind were facing off, but at the time, there was only a thin body of empirical research to settle the question. The challenge was clear: would anyone actually go out and do the science?

David

That journey is captured beautifully in a Psychology Today essay by Dr. Scott Richards, titled Forty Years of Research About Religious Involvement. Richards summarizes the monumental body of evidence that has accumulated over the past four decades. And as Richards points out, no single scholar has contributed more to informing medical and mental health professionals about this research than Dr. Harold G. Koenig.

David

Dr. Koenig is a professor of psychiatry and behavioral sciences, and an associate professor of medicine, at Duke University, where he has led the Center for Spirituality, Theology, and Health since 1998. That dual appointment matters. He is not approaching this from a theological armchair. He is a physician and psychiatrist speaking directly to researchers and clinicians.

David

Over the decades, Koenig has kept the entire field informed through a landmark series of reference handbooks. In 2001, Koenig, Michael McCullough, and David Larson published the first edition of the Handbook of Religion and Health with Oxford University Press, providing the first comprehensive scholarly review of the health correlates of religious faith and practice.

David

That monumental work was updated with a second edition in 2012, followed by Koenig's 2018 volume, Religion and Mental Health: Research and Clinical Applications, and culminating in the landmark third edition of the Handbook in 2024 with Tyler VanderWeele and John Peteet. Through these handbooks and hundreds of scholarly presentations, Koenig and his colleagues transformed the conversation from personal opinion into rigorous, data driven science.

David

In March of 2020, Dr. Richards invited Koenig to deliver the keynote address at the virtual capstone conference for the Bridges Templeton Foundation grant project. Koenig presented findings from hundreds of studies examining how religious involvement correlates with mental, social, and behavioral health. And that brings us to the central question: what do the data actually show, and what do they not show?

David

Let us start with what the data show. Across hundreds of empirical investigations, religious involvement consistently predicts lower rates of depression, lower rates of suicide, and reduced anxiety and substance abuse. At the same time, it is positively associated with psychological well being, happiness, purpose, optimism, hope, forgiveness, gratitude, social support, and marital stability. It is a striking pattern that cuts directly across the old Freudian suspicion.

David

Now, what do the data not show? The data do not show that religion is a universal cure or an automatic shield against human suffering. Koenig and his colleagues are remarkably candid on this point. While some associations are strong, many of the observed relationships are moderate or weak. Furthermore, a minority of studies have observed weak or even negative relationships between religion and health.

David

Why are the quantitative relationships not stronger? The authors outline several reasons. For one, religious involvement may simply have little to no impact on certain specific health outcomes. In addition, measuring human spirituality is notoriously complex, our psychological assessment tools have limitations, and research methodology across earlier studies has varied widely in quality.

David

On page 670 of the 2024 Handbook of Religion and Health, Koenig and his coauthors offer a beautifully balanced verdict. They write that despite the complexity and study limitations, research indicates that religious beliefs and practices often have significant effects on health, usually positive and occasionally negative. That honest nuance is precisely what gives the science its credibility. Koenig and his team also expressed optimism that as measurement tools refine and funding increases, future studies will reveal even clearer patterns.

David

Based on these forty years of findings, Koenig and his colleagues propose three clear recommendations. First, healthcare and mental health professionals should routinely take a spiritual history with patients and address spiritual needs in clinical care. Second, funding agencies should support further high quality research at both individual and population levels. And third, public health leaders should openly affirm the constructive role that faith and spirituality can play in fostering community well being.

David

Forty years of rigorous inquiry have brought us a long way from the standoff between Ellis and Bergin. The empirical record does not ask clinicians to promote a creed, but it does challenge us to listen to the spiritual lives of our clients with respect, nuance, and curiosity. It also provides strong support for the idea that our clients' religious involvement and spirituality may be important resources during psychotherapy for supporting emotional healing and recovery. Thank you for listening to Dissent from Freud, and we look forward to having you join us next time.