The relationship between spirituality and/or religion and mental and physical health has increasingly come under study in recent years. It almost seems to have become conventional wisdom that spirituality is associated with better health, mental and physical. However, a recently published British study found that people who consider themselves spiritual but not religious are more likely to have a mental disorder compared to conventionally religious people and to those who are neither religious nor spiritual. Conventionally religious people and those who were neither religious nor spiritual did not differ in their mental health status, suggesting that being religious offers few advantages in terms of mental health. The reasons for this are still unclear. Studies on the psychology of spirituality offer some clues as to why spiritual but not religious people might be prone to poorer mental health although more research is needed to fully explain the relationship.
Claims that “spirituality” is beneficial for mental health (see this article for example) have been criticised on the grounds that definitions of spirituality have been broadened so much that they imply mental health by definition (Koenig, 2008). Spirituality traditionally had a narrow definition centred on belief in supernatural spirits such as God. However, mental health services have become increasingly interested in addressing the “spiritual” needs of consumers in recent times, and as a result attempts have been made to redefine the term in a way that would be maximally inclusive, so as to apply to people from diverse religious backgrounds and to those with no religion (Koenig, 2008). Many studies have broadened the term to incorporate a wide range of positive psychological concepts, such as purpose in life, hopefulness, social connectedness, peacefulness and well-being in general. This becomes problematic for research attempting to assess the relationship between “spirituality” and mental health because by most definitions good mental health implies that a person has some purpose in life, is hopeful, socially connected and has peace and well-being. Thus it becomes a meaningless tautology to say that spirituality is associated with better mental health when the term is defined this way (Lindeman & Aarnio, 2007).
A recent British study looked at the relationship between spirituality and mental health using a more traditional understanding of the term to avoid this problem of tautology (King et al., 2013). The study involved in-depth interviews with over 7000 people in England. Participants were sorted into those whose understanding of life was predominantly religious, spiritual, or neither. These terms were explained in the following way:
‘By religion, we mean the actual practice of a faith, e.g. going to a temple, mosque, church or synagogue. Some people do not follow a religion but do have spiritual beliefs or experiences. Some people make sense of their lives without any religious or spiritual belief.’
The results showed that religious participants were similar to non-religious/non-spiritual ones in regards to their mental health in most respects, although the religious were less likely to have used or been dependent on drugs in the last year. However, there were striking differences for those in the spiritual but not religious category. Compared to people who were in the neither category, spiritual but not religious people were more likely to take psychotropic medication, to use or be dependent on recreational drugs, to have a generalised anxiety disorder, phobia, or any neurotic disorder, or to have abnormal eating attitudes. These differences still held even when taking into account social support and physical health, as well as age, sex, and ethnicity. None of the groups differed in their overall happiness though.
The authors concluded that people who are spiritual but not religious in their understanding of life are more vulnerable to mental disorders than other people. The nature of the causal relationship between spirituality and mental disorder is currently unknown. An earlier British study had similar findings and the authors noted that it is possible that not having a religious framework for one’s beliefs could lead to mental disorder in people who have a need for a spiritual understanding of life (King, Weich, Nazroo, & Blizard, 2006). Alternatively, having a mental disorder might prompt a person to engage in a spiritual quest in the hope of mental healing or deeper understanding of one’s problems.
An earlier study on the personality traits associated with “spirituality” and religiosity might shed some light onto the relationship between spirituality and mental disorder (Saucier & Skrzypińska, 2006). Spirituality in this study was defined as “quest for meaning, unity, connectedness to nature, humanity, and the transcendent.” Note that this definition focuses on subjective and mystical understandings of life, in contrast to more conventional religiosity which emphasises adherence to orthodox belief systems. Although many people describe themselves in terms of both conventional religiosity and subjective spirituality, people who were more focused on subjective spirituality and less interested in religiosity tended to have distinctly different personality characteristics compared to those with a more orthodox religious orientation. People who described themselves in conventional religious terms tended to be fairly conservative in their attitudes and beliefs. Those who were more spiritual and less religious tended to be more non-conforming and even peculiar in their outlook and personal traits. For example, they were more likely than other people to describe themselves as weird and crazy. Additionally, they tended to believe in a range of “alternative” ideas (such as psychokinesis, reincarnation, astrology, witchcraft, and psychic powers), say that they “respect the power of magic,” and scored highly in measures of magical thinking, fantasy proneness, and absorption.
Characteristics such as magical thinking and so on have been linked to a set of traits known as schizotypy, or proneness to mildly psychotic thinking. Schizotypy refers to a cluster of cognitive, emotional, and behavioural traits that are similar to but generally milder than those exhibited in schizophrenia. It is associated with unusual beliefs about reality (e.g. that it is possible to harm other by thinking bad thoughts about them) and the tendency to have odd perceptual experiences (such as feeling that strangers are reading one’s mind). Other research has found that adherents of New Age beliefs and practices (such as yoga, Reiki, astrology, and Tarot) tend to be high in schizotypy and this is reflected in a loose 'holistic' thinking style (Farias, Claridge, & Lalljee, 2005). Schizotypy tends to be associated with high levels of anxiety and depression (Lewandowski et al., 2006). It could be the case that people with schizotypal tendencies and associated proneness to anxiety and depression may find unconventional spiritual ideas to be particularly appealing. It is also possible (and I admit this is speculation) that adherence to such ideas exacerbates their existing mental imbalances. (It should be noted though that many people with schizotypal tendencies are otherwise well-adjusted. Schizotypy has also been linked to artistic creativity.)
Whether unconventional spiritual pursuits are harmful to mental health is not yet known. In some respects, the association between spirituality and mental disorder seems contrary to the benefits that many spiritual traditions claim to offer. Spiritual fulfilment is supposed to lead to inner peace, even bliss. In fact certain mystics have gone so far as to claim that spiritual “work” can lead to an inner transformation that will result in “True wisdom and perfect happiness”! The very idea of “perfect happiness” seems like an impossible mirage, although a more charitable interpretation is that the term is intended as a poetic metaphor rather than a literal reality. So why are so many spiritual people so troubled? It may be that some people are simply not that successful in pursuing whatever spiritual fulfilment they are seeking. King et al. (2013) found that those who were spiritual but not religious rated the strength of their belief and the importance of the practice of their faith somewhat lower than the religious participants in their study. This might indicate a lack of dedication or self-discipline on the part of those who claim to be spiritual but not religious. More detailed studies are needed to determine if this is the case.
Another limitation of the study by King et al. was that it did not examine the specific content of the beliefs and practices of the spiritual but not religious. The content of one’s spiritual beliefs could well affect one’s mental health. For example, belief in the interconnectedness of things might be relatively beneficial, whereas more “superstitious” beliefs such as in the “evil eye” could be harmful to one’s mental health. Research could examine whether certain particular spiritual practices are more associated with mental disorder than others. For example, yoga and meditation are generally thought to be beneficial to one’s well-being, but more bizarre practices (such as “regression” to before one’s birth) might encourage a person to hold peculiar ideas that may not serve them well in real life.
An additional puzzle is why the three groups in the King et al. study did not differ in their overall happiness even though one group was more prone to mental disorder. Happiness was assessed with a single question, whereas mental health status was assessed with a clinical interview, so a more detailed assessment of well-being might provide a more nuanced picture.
Considering the increasing prominence in modern society of people who consider themselves spiritual but not religious, more in-depth research is needed to understand fully why this group seems to be particularly vulnerable to mental illness.
© Scott McGreal. Please do not reproduce without permission. Brief excerpts may be quoted as long as a link to the original article is provided.
 I discuss absorption and its relationship to mystical experiences occasioned by psychedelic drugs in a previous post.
Other posts discussing spiritual beliefs
Farias, M., Claridge, G., & Lalljee, M. (2005). Personality and cognitive predictors of New Age practices and beliefs. Personality and Individual Differences, 39(5), 979-989. doi: 10.1016/j.paid.2005.04.003
King, M., Marston, L., McManus, S., Brugha, T., Meltzer, H., & Bebbington, P. (2013). Religion, spirituality and mental health: results from a national study of English households. The British Journal of Psychiatry, 202(1), 68-73. doi: 10.1192/bjp.bp.112.112003
King, M., Weich, S., Nazroo, J., & Blizard, B. (2006). Religion, mental health and ethnicity. EMPIRIC – A national survey of England. Journal of Mental Health, 15(2), 153-162. doi: doi:10.1080/09638230600608891
Koenig, H. G. (2008). Concerns About Measuring "Spirituality" in Research. The Journal of Nervous and Mental Disease, 196(5), 349-355 310.1097/NMD.1090b1013e31816ff31796.
Lewandowski, K. E., Barrantes-Vidal, N., Nelson-Gray, R. O., Clancy, C., Kepley, H. O., & Kwapil, T. R. (2006). Anxiety and depression symptoms in psychometrically identified schizotypy. Schizophrenia Research, 83(2–3), 225-235. doi: http://dx.doi.org/10.1016/j.schres.2005.11.024
Lindeman, M., & Aarnio, K. (2007). Superstitious, magical, and paranormal beliefs: An integrative model. Journal of Research in Personality, 41(4), 731-744. doi: 10.1016/j.jrp.2006.06.009
Saucier, G., & Skrzypińska, K. (2006). Spiritual But Not Religious? Evidence for Two Independent Dispositions. Journal of Personality, 74(5), 1257-1292. doi: 10.1111/j.1467-6494.2006.00409.x