Reviews Book

Spirituality and the Healthy Mind: Science, Therapy, and the Need for Personal Meaning

BMJ 2006; 332 doi: (Published 02 March 2006) Cite this as: BMJ 2006;332:555
  1. Paul Foster, consultant psychiatrist (pm.foster{at},
  2. Marc Galanter
  1. Barnet psychiatric unit

    Marc Galanter, a New York based professor of psychiatry specialising in alcohol dependency and drug use, defines spirituality as the individual search for existential and transcendental meaning. Spirituality has spawned a diverse counterculture in alternative medicine, meditation, and personal growth movements. Galanter contrasts this with contemporary Western psychiatry with its emphasis on managed care. His book, which has a humane yet balanced perspective, is about how these models and approaches can be reconciled.

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    Oxford University Press Inc, £19.99/$35, pp 320 ISBN 0 19 517669 3

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    Galanter liberally peppers his book with case studies and personal accounts of mental health users and professionals, spiritual leaders and cult members. There are chapters on Eastern spirituality and one on Christian psychiatry, including a moving description of the role of hospital chaplains.

    He portrays the power of large group experiences, a power that can work therapeutically in Alcoholics Anonymous, an underestimated source of structured peer support depending on altruism and redemption in a non-denominational setting. In another context he shows how the same power of the group can cause vulnerable people to relinquish their values, as in the Jonestown cult in 1978, when 914 Americans committed mass suicide.

    Galanter describes his own unit at Bellevue Hospital, New York, with patients who have both major mental illness and a significant substance or alcohol problem. He asks these patients, “Why might you want to get better, what is really important to you?” He found that while medical students and nursing staff rated housing and benefits as most important to patient recovery, users themselves rated belief in God and inner peace highest. He began to see spirituality as a powerful motivator to overcome the stigma of severe mental illness and developed an award winning programme of inpatient care using psychopharmacology, a therapeutic community halfway house (the Greenhouse), and a day clinic. The programme leads to a sense of ownership and pride, and patients offer powerful peer support to one another.

    This book highlights the healing potential of the many spiritual pathways by which our patients find meaning in their lives. It will appeal to those involved with mental health and substance misuse services.

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