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Book Forum: Religion and Psychiatry   |    
Perspectives on Spiritual Well-Being and Aging
FRANCES R. FRANKENBURG, M.D.
Am J Psychiatry 2001;158:1348-1349. doi:10.1176/appi.ajp.158.8.1348
View Author and Article Information
Bedford, Mass.

Edited by James A. Thorson. Springfield, Ill., Charles C. Thomas, 2000, 230 pp., $45.95; $31.95 (paper).

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In psychiatry we search for psychopathology. When we see an old person, we ask about symptoms and signs of depression and paranoia. We review our patient’s medical condition, because we know that chronic pain and illness may have malignant effects on coping mechanisms. We scrutinize our patient’s multiple medications, inquire about side effects, and think about drug interactions. We consider the possibility of dementia and administer quizzes. We worry about isolation and loneliness and wonder if end-of-life issues need to be addressed. As a contrast to this gloomy approach to aging, there is another outlook: that old people are wise, that ripeness is all, that the best is yet to come. This book is an edited collection of articles (some of which have appeared elsewhere) to do with spirituality and old age that may be of some compensatory cheer to mental health professionals, in that it emphasizes the latter view.

Chapters by Ai, Blazer, Koenig, and Wotherspoon summarize research indicating that old people who have a spiritual life (as defined by adherence to Jewish or Christian beliefs) seem to be less depressed, have better physical health, and recover more fully from medical illnesses than do others. The reasons for this are not clear, in part because there is such a variety of ways in which a person can "be spiritual." Which is best for your health: attending religious services on a weekly basis, praying by yourself to a higher power, or doing good works? How important is the actual spiritual component? Would regular attendance at a secular activity or membership in a nonreligious community confer health benefits?

Some of the chapters in the book are less clearly to do with spirituality and well-being. In one chapter the author seems to imply that old people would be healthier if only they would appreciate sunsets when told to do so. In another chapter there is an odd discussion of which circumstances, according to Jewish writings, would allow you to leave your mentally ill or demented parents. An unpleasant chapter describes old people who use their illnesses to "manipulate" their families. These three chapters do not fit in well with the rest of the book.

Although some of the authors are scrupulous in mentioning non-Judeo-Christian systems of belief, these references are rare. Clinicians working with older patients who have beliefs not consonant with Christianity or Judaism will not find this book helpful.

The message of this book: people who participate in a spiritual life may have an easier time coping with the inevitable losses and indignities that accompany old age.

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