Harold Koenig was a family practitioner before he became a psychiatrist. He observed that his patients who were active in their religions not only lived healthier and happier lives than did his nonreligious patients but that his religious patients sometimes experienced what he considered to be "miracles" in terms of their health. He turned to the scientific literature and found abundant, but often overlooked, objective evidence that people who are in tune with their religions have healthier lifestyles and fewer mental and physical disorders. He became Director of the Duke University Center for the Study of Religion/Spirituality and Health and Associate Professor of Psychiatry and Behavioral Sciences as well as Assistant Professor of Medicine at Duke.

This inspiring book explores religion and health not from the perspective of a particular religion but from the perspective of all religions. Dr. Koenig does not write about a narrow segment of the society in terms of culture, education, income, or race. This is an inclusive book, not an exclusive book. Dr. Koenig maintains his scientific and medical perspective throughout the book even as he digs deeply into issues that are often dismissed by nonreligious physicians as outside of the reach of medicine.

My own background in addiction psychiatry prepared me for the fact that the first case history in this book deals with alcoholism and the role of religion in recovery. Lee, "a typical ‘terminal’ alcoholic," was brought into the emergency room on Halloween night in 1981 where Dr. Koenig was a third-year medical student on an internal medicine rotation. At he age of 50, Lee had been through many addiction treatments and tried Alcoholics Anonymous (AA) without lasting success. In the hospital, Lee told Dr. Koenig, the medical student with time to talk with his patient, that "God has a purpose for my life." Against the ingrained skepticism Lee found in the hospital, he kept to this view. Lee married a woman he met in the detoxification program. He and his wife built a new life together, and 2 years later they told Dr. Koenig, "We could not have done it without God’s help."

Dr. Koenig frequently returns to the issues of alcohol and other drug problems for his examples. I recall my puzzlement over the role of spirituality in the 12-step programs. Early in my work with my own patients over long periods of time I realized that the 12-step programs were the difference between life and death for most of my addicted patients. Not until much later did I did begin to grasp the vital role of spirituality—and for many, but by no means all, of the members of these miraculous fellowships the role of religion—in the process of recovery and the prevention of relapse. Bill Wilson in the "Big Book" of AA +(1) made it clear that the most fundamental problems faced by alcoholics are selfishness and self-centeredness. The strongest antidote to these potentially lethal character defects (defects that are by no means limited to alcoholics and addicts) is first the recognition "that our lives had become unmanageable," and second a belief "that a Power greater than ourselves could restore us to sanity." My addicted patients taught me about the lifesaving role of faith "in a Power greater than ourselves" +(2), just as Dr. Koenig’s patients taught him.

Dr. Koenig began his research on faith and health with the observation that although fear of death was a major stress factor in the lives of many older people, his patients who were religious seemed to have less fear of death even when seriously ill. He found that elderly people who were "very likely" to rely on religious faith and prayer when they were under stress were less likely to report a strong fear of death. This humble but clinically important initial study led Dr. Koenig to his life’s work on the role of faith in health and disease.

Dr. Koenig sees religion as having direct preventive health effects in two ways. "First, research shows that religious people with a strong social support network often have their diseases diagnosed earlier, become actively involved in their treatments, and follow their care givers’ instructions more closely than do less religious people." "The second health-enhancing direct effect of religious faith is the avoidance of unhealthy habits. For example, healthier lifestyles among the religiously involved lead to lower rates of pulmonary disease such as emphysema and lung cancer (consequences of smoking), lower levels of liver disease such as cirrhosis (stemming from alcohol abuse), and significantly lower levels of other substance abuse than exist among the general population." Dr. Koenig extends this picture of the benefits of an active religious life to include reductions in the rates of divorce, crime, suicide, and many other common problems. Dr. Koenig is clear that he is not advocating faith instead of modern scientific medicine, but he does conclude that actively practiced religious faith enhances the benefits of medicine in both prevention and treatment.

Dr. Koenig not only tells highly motivating stories that are easy to relate to as a patient and as a physician but also offers practical recommendations for physicians so they can do a better job helping both their religious and their nonreligious patients. He suggests a patient-centered approach that includes taking a religious history and being open to addressing spiritual as well as medical concerns. Of particular value are the physician’s efforts to help patients integrate modern science with deep personal faith and to see how faith and medicine work together to help the patient not only get and stay well but also cope constructively with the diseases that inevitably develop, even in the most devoutly religious. For those patients who are already religious, Dr. Koenig suggests ways to make more time for prayer and to become more involved in their own spiritual communities. For the patients who are nonbelievers, Dr. Koenig urges attending a church or synagogue as a visitor and reading the secular writings of people of deep faith such as C.S. Lewis, Albert Schweitzer, and Martin Luther King, Jr.

This is a gentle, wise book about a subject to which both doctors and patients need to be more open. This is true for health care in general and for psychiatry in particular. Dr. Koenig shows with understatement that doctors do not need to be religious zealots to work with their patients within the patients’ own spiritual traditions to help them and their families feel more secure and lead healthier lives.