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Marc Galanter has turned professional experience, clinical acumen and erudite scholarship into a fine and timely book.
Director of Alcoholism and Substance Abuse at New York University Medical Center, Professor Galanter's research interests have also included the extensive study of cultic groups. Regretting that mainstream psychiatrists have so far been reluctant to consider spirituality-oriented healing for their patients, his cautious but well-researched thesis is that, although biomedically-based psychiatry and spirituality involve two different perspectives, they might not be incompatible.
He begins with the question, `What is spirituality?' We are first told, `There is no definition. It is a way of life'. Nevertheless, the word consistently evokes deep-seated personal experiences with universal relevance and appeal. Spirituality is described as central to psychological well being, providing both energy and direction. Spiritual awareness can therefore help a person discover not only a sense of meaning and purpose in life, but also a healthy sense of belonging, orientating us when seeking to define and adhere to our values.
Another theme is that, `Spirituality can be experienced from either a secular or religious standpoint'. This shortcircuits another factor inhibiting many from engaging with the subject. Secular spirituality is no oxymoron. It is a reality for a high percentage of patients, surveys of whom reveal its central role in preventing and healing disease, also in enduring both distress and disability.
All doctors should know about this, and Galanter has done us a service in providing such a sane and sensible guide. We are treated to a critical discussion of cults, including problem areas, also of Alcoholics Anonymous and the spirituality of the 12-step method of recovery from addiction. There is thought-provoking material on Christian psychiatry, spirituality in Indian faith traditions and in Islam, on hospital chaplaincy, on alternative (complementary) medicine and on meditation. This is a rich feast, not always entirely digestible due to its transatlantic bias, but readable enough to be satisfying.
Galanter respects the intelligence of his readers. The most preachy he gets is to suggest in his final chapter that, `Mental health professionals would do well to attend to individual people as wholes over a lifetime... to see if they can be helped to an adaptation that carries meaning and value for them'. This echoes advice I received as a trainee in the eighties, and earlier as a medical student. The personcentred, holistic approach he advocates has always served me well. Psychological healing involves more than the relief of symptoms. It fosters improved emotional resilience and equanimity, thereby resulting in personal growth.
John Swinton refers to spirituality as `the forgotten dimension' of mental health care. Like him, Marc Galanter has reminded us that we must not neglect this aspect in aiming towards healthy minds: both for our patients and, arguably, for ourselves. Their books both offer us reasoned and reasonable guidance for our effort. They provide cause, at personal and collective levels, to renew our search for sanity... and to do so with hope.
Competing interests Larry Culliford is on the executive committee of the Royal College of Psychiatrists' Spirituality and Psychiatry Special Interest Group [www.rcpsych.ac.uk/spirit].
Marc Galanter Pages 288 Price £19.99 (h/b) ISBN 0-19-517669-3 Oxford: Oxford University Press