Journal of Religion and Health, Vol. 38, No.

1, Spring 1999
Religion and
Public Health
Peter H. Van Ness
ABSTRACT: The paper begins by acknowledging several ways in which religious beliefs and
behavior have had a negative impact on people's physical and mental health; fanatical violence,
mortifying asceticism, and oppressive traditionalism (e.g., sexism) are mentioned. Three areas of
positive influence are explored: 1) the role of religious practices in personal health; 2) the impact
of social ministries on community health, and 3) the complementarity of religious ideas of salva-
tion with medical conceptions of health in contemporary conceptions of human well-being. That
religion mediates between the social and individual dimensions of well-being is a unifying theme
of the paper.
Orandum est ut sit mens sans in corpore sano.
Juvenal, Saturae X
I. Introduction: A postmodern inversion
Theologians and philosophers have talked much about embodiment in recent
years. Many Christian theologians have reinterpreted elements of their reli-
gion's ascetic tradition. For instance, the Apophthegmata Patrum, a collection
of aphorisms attributed to first-generation Christian ascetics, portrays Abba
Daniel as saying, "If the body is strong, the soul withers. If the body withers,
the soul is strong."
1
The soul should prevail over the body in this ancient
view; contemporary theologians have urged a more interdependent relation-
ship between body and soul. In some classic ascetic texts the human body is
personified as a demonic antagonist that must be subdued, by violence if nec-
essary. Since women and persons of color were especially feared as embodi-
ments of evilVita Antonii, for instance, records this fearfeminist and
black theologians have almost universally repudiated this part of their Chris-
tian heritage and made the affirmation of embodiment an integral part of a
morality of justice and peace.
2
Peter H. Van Ness, Ph.D., is a philosopher of religion who taught for many years at Union
Theological Seminary in New York City and most recently at Columbia University. Currently he
is pursuing studies in epidemiology and biostatistics in the Department of Epidemiology and
Public Health of the Yale Medical School.
15 C 1999 Blanton-Peale Institute
Journal of Religion and Health
The ethos of Christian asceticism owes more to Platonic and Stoic philoso-
phy than to Hebraic religion, and so it is fitting that most philosophers have
likewise rejected the depreciation of the body implied by Plato's dualism of
the intelligible and the visible and by Descartes's dichotomy of res cogitans
and res extensa. Generally philosophers have restored the integrity of mind
and body with greater consistency but less passion than theological counter-
parts, although Friedrich Nietzsche is one philosopher who cannot be faulted
for lack of passion. He vehemently criticized Western asceticism: Zarathus-
tra's mediation on "The Despisers of the Body" initiates the postmodern
theme of emphatic embodiment in an explicitly irreligious but arguably spiri-
tual way.
3
Only individuals have human bodies; to cultivate the vitality of
one's body distances oneself from society and thereby disrupts its agenda of
conformity and control. Such disruptive embodiment is an important element
of the postmodern critique of traditional religion.
Michel Foucault follows Nietzsche in this respect as in many others. In The
Birth of the Clinic he effects a clever reversal of the ancient philosophical
formula that human beings are souls burdened by corpses. (Epictetus, Juve-
nal's contemporary, is one ancient source for this metaphor.
4
) Foucault says
that medical science of the nineteenth century was the first scientific dis-
course about human beings as individuals. This occurred only when the dis-
eased bodies of individualsthe specific objects of the "medical gaze"were
disassociated from a metaphysics of evil and became proleptic embodiments
of death.
5
Thus, in a sense, only when viewed as a corpse does medical science
acknowledge individual embodiment. Human beings are characteristically
seen by medical doctors, Foucault claims, as animated corpses.
The influence of liberation theology and postmodern philosophy has con-
tributed to an atmosphere in which discussions of the relationship between
religion and embodied human well-being are undertaken with emphases that
are humanistic, individualistic, and ethical. These accents are evident in the
way that discussants challenge the institutions of science, the interests of
society, and the values of religious traditions. In this essay I shall explore
quite different emphases. In a gesture to the postmodern fondness for inver-
sions and reversals one might say that the perspective offered here inverts
the postmodern configuring of religion and embodiment. I shall seek to be
descriptive rather than prescriptive, indicating some ways in which religious
beliefs, behavior, and institutions promote health. I shall emphasize commu-
nities as well as individuals, giving attention to indices of health in popula-
tions and not just persons. Finally, I shall presuppose the scientific methodol-
ogy of contemporary practitioners in a public-health field; this involves a
considerable reliance on biostatistical inference from epidemiological data.
How the several interconnections of religion and health reflect the changing
ways in which religion mediates between the social and individual dimen-
sions of human well-being will be the essay's unifying theme.
16
Peter H. Van Ness
II. On religion and public health
A dour assessment of how religion has historically influenced public health
would highlight the consequences of fanatical violence, mortifying asceticism,
and oppressive traditionalism (e.g., sexism). No doubt these are important
and negative factors in many chapters of Western religious history. They are
worthy topics for sustained reflection (and to some extent I have done as
much in other writings.)
6
Here I will consider three more positive impacts: 1)
the role of religious practices in personal health, 2) the impact of social minis-
tries on community health, and 3) the complementarity of religious ideas of
salvation with medical conceptions of health in contemporary conceptions of
human well-being. Each provides a distinctive perspective for understanding
the interactions between personal and social factors responsible for health
and disease.
1. The role of religious practices in personal health. People's religions often
influence their patterns of consumption, both in the sense of what they eat
and drink and in the sense of what they purchase and utilize. Vegetarian
diets, enjoined, for instance, by many Hindus, Jains, and Seventh Day Ad-
ventists, have been found to be associated with decreased risk of heart dis-
ease.
7
Epidemiological maps of the incidence of lung cancer and liver disease
show markedly low rates of occurrence in areas of Utah and surrounding
states where many Mormons live. Smoking tobacco and drinking alcohol are
forbidden by Mormon church discipline. On the other hand, not all religious
dietary restrictions have demonstrable health effects. Jewish dietary laws
that prohibit consumption of blood in any form or the consumption of milk
and meat together have no clear health benefits.
Personal religious behavior not strictly related to consumption also has de-
monstrable health benefits. Regimens of prayer, meditation, and worship can
have the effect of reducing levels of physiological and psychological stress and
thereby promoting health. Practices such as Hatha Yoga and T'ai Chi Ch'uan
are increasingly being embraced by Westerners in search of physical as well
as spiritual well-being. Clinical evidence is beginning to be amassed estab-
lishing a positive association between some religious beliefs and behaviors
and physical and mental health.
8
Religious beliefs and behavior also influence
the occupations that people pursuewhat they produce and provide as well
as what they consume. Violent deaths among pacifist Quakers and auto-
mobile fatalities among the mostly pedestrian Amish are relatively infrequent.
A third category of religious behavior that affects human health is the regi-
men of personal hygiene. Yogic techniques have long included the shat kriyas,
six purificatory practices that complement the eight limbs of yoga. Given the
very physical nature of yogic body postures and breath practices, a conscious
connection between the shat kriyas and physical well-being seems likely
17
Journal of Religion and Health
among even ancient practitioners. On the other hand, the Jewish practice of
washing hands before eating was observed long before the infectious role of
the microorganism was known. Thus the motivation for the practice was reli-
gious purification but the consequences included tangible health benefits.
9
Christian denominations like Christian Scientists and Jehovah's Witnesses
restrict members' use of medical services. New biomedical technologies have
made available techniques of reproduction, transplantation, and life support
about which a broader group of religious communities have expressed reser-
vation or censure. Issues of biomedical ethics will certainly take on greater
prominence and complexity as technological innovation continues.
Although identified as the activities of individuals, the personal practices
described above cannot be entirely segregated from social behavior: personal
and community health cannot be completely distinguished. For instance, sex-
ual behavior is commonly deemed a responsibility of individual self-discipline
and of communal ritual regulation. Anthropologists have well documented
how religious kinship systems and marriage rituals regulate with whom
members of a religious community may have sexual relations. Claude Levi
Strauss identifies marriage as an exchange of wives which exhibits a struc-
ture of reciprocity isomorphic to economic exchange, thereby integrating what
I have described as the personal practices of consumption and production
with the social practices of property exchange.
10
Victor Turner has persua-
sively shown how specific rituals provide occasions where certain sorts of sex-
ual feelings are expressed which in other contexts are forbidden.
11
Religion
should not be associated with a consistent sexual puritanism.
From the vantage point of the late twentieth century, though, with its ex-
perience of the AIDS epidemic and other socially transmitted diseases, it is
evident that some disadvantages occur when sexual behavior becomes ex-
empt from religious strictures without becoming subject to other agencies of
social discipline. A prominent example of such a nonreligious agency of social
discipline is the Twelve Step methodology of Alcoholics Anonymous (AA) and
related programs. Bill Wilson, the founder of AA, mandated that the program
be spiritual, for instance, that it include an acknowledgment of God and a
confession of wrongs; yet he also insisted that it be nonreligious in the sense
of having no tie of doctrine or community to an institutional religion. AA
shows how some of these elements of religious life can be abstracted from
their institutional origins and be put to effective therapeutic purposes. Twelve
Step programs are not religious but they are eminently social in their spiritu-
ality.
12
This combination of spirituality and sociality may be a factor in their
effectiveness. The significance of this fact will be more fully explored in the
essay's conclusion.
2. The impact of social ministries on community health. Social ministries
are self-conscious attempts by religious communities to assuage the suffering
and promote the flourishing of human beings beyond their borders. Often
18
Peter H. Van Ness
they are undertaken with a missionary motivation, but not always. The fact
that so many soup kitchens, clothes pantries, and homeless shelters are affili-
ated with religious organizations bears testimony to this association. In what
many view as a cynical or, at least, insensitive remark, President Reagan
claimed that the delivery of such relief services was more the task of churches
and private charities than government. Some commentators have argued
that there is evidence that these religiously based social programs are more
effective with certain populations than are comparable government pro-
grams. Joe Klein's article in the June 1997 New Yorker gives a sympathetic
airing of this point of view." To illustrate this aspect of the relation between
religion and public health, I offer two more detailed accounts of how the reli-
gious impulse has been expressed in socially significant ministries.
Attending to the needs of the suffering has often been understood as a
religious obligation. Many Christians have interpreted Jesus's commandment
that "you love one another as I have loved you" (Jn. 15:12) to include nursing
of the sick. In his recent book The Rise of Christianity, Rodney Stark has
argued that the adoption of this view by early Christians played a significant
role in the transformation of Christianity from a Jewish sect of some 1000
persons shortly after the crucifixion of Jesus to a religion of 35 million people
in the decades after the conversion of Constantine.
14
A devastating epidemic occurred in the Roman Empire from 160 to 180
C.E. In some places as much as one-third of the population died. Included
among the casualties was the Emperor Marcus Aurelius, who died in 180 in
Vienna. A second equally severe epidemic began in 251 C.E. Testimony to its
severity can be found in the writings of Cyprian, the bishop of Carthage, and
Dionysius, the bishop of Alexandria. Stark argues that Jews and Christians
nursed the sick of their communities to a greater extent than did pagans.
Galen, for instance, the foremost Greek physician of the second century, fled
Rome for a country estate during the first epidemic. This practice of nursing
the sickproviding them with water and food, and clean and warm clothing
led to a greater survival rate among Jews and Christians, even though it
sometimes led to the death of the caregivers. Stark says that Christians were
especially known in antiquity for providing this sort of care and they did so to
both Christians and pagans. Emperor Julian (known as "the Apostate" to
Christians) chided his pagan priests to emulate the charity of Christians and
thereby oppose the advance of Christianity. (Religious law prevented Jews
from close contact with the food and bodily fluids of Gentiles.) Some Chris-
tians regarded dying in these circumstances as a sort of martyrdom. The
higher survival rates of Christians, their reputation for service to others, and
a theological ability to explain the epidemics contributed to higher conversion
rates than in other time periods. Survival and conversion during periods of
epidemic, says Stark, contributed to the rapid numerical expansion of the
Christian community. Individual acts of nursing the ill formed the first link
in this causal chain of events that transformed the Roman Empire.
19
Journal of Religion and Health
The negative effects of environmental pollution on public health is a matter
of increasing concern. Representatives of Biblical religion, with its historical
ethos of the human dominion over the natural world, have not always been
sensitive to the moral and physical dangers of the abuse of nature. This situa-
tion is changing. The leadership of the current Eastern Orthodox Archbishop
of Constantinople in mobilizing ecological efforts in Eastern Europe and
Russia is an especially significant development. Clergy frequently play a cru-
cial role when communities are forced to deal with a social crisis; critical
health problems caused by pollution of the environment are no exceptions to
this rule. An account of one such incident is provided by Jonathan Harr in his
recent book, A Civil Action.
15
In the summer of 1966 residents of a neighborhood in Woburn, Massa-
chusetts began to experience an unusual number of cases of leukemia, espe-
cially among children. The Reverend Bruce Young of the Trinity Episcopal
Church was the pastor to several families who had members suffering from
the disease. In this capacity he consoled them, in part by listening to the
family members reflect about the possible origins of the illness. One mother
of a child with leukemia, Anne Anderson, became convinced that the several
cases of leukemia in her small neighborhood probably had a common cause.
She speculated about the presence of a virus; she also questioned the quality
of the town's drinking water which had been a long-standing cause for com-
munity concern.
Advised by town engineers that the drinking water was safe and informed
by family physicians that random clustering of illness could account for the
several cases, most community members, including the Reverend Young, ini-
tially dismissed Anne Anderson's speculations. However, when a pool of arse-
nic was discovered in North Woburn and reported in the local paper, the
young priest decided to take Anne's concerns more seriously. He decided to
act. He put an announcement in the same paper asking representatives from
families with a member suffering from leukemia to attend a meeting at the
church. A total of twelve cases was discovered.
During subsequent months the Reverend Young continued to serve as pas-
tor to the suffering families and likewise continued to act publicly to mobilize
interest and action on behalf of the Woburn community. He preached from his
church pulpit on the possible link between environmental pollution and leu-
kemia in Woburn; he persuaded a local physician to contact the Center for
Disease Control; he pressed newspapers to cover the issue and gave nu-
merous interviews himself; he testified in Washington before the Senate
Committee on Public Works and the Environment; and finally, he arranged
for parents of leukemia sufferers to meet with lawyers at his church.
After lawyers become involved, Hair's story turns almost exclusively to
chronicling the legal case and the fortunes of individual lawyers. The Rever-
end Young and the afflicted families recede to the status of background fig-
ures. Eventually the leukemia victims in Woburn received small financial
20
Peter H. Van Ness
settlements from two corporations responsible for polluting the ground water
of East Woburn and the city became one of the Superfund sites which the
Environmental Protection Agency has scheduled for remediation. However,
the corporations were never legally judged responsible, nor did they ever pub-
licly acknowledge guilt. The Reverend Young and Anne Anderson regarded
this as a failure of both their own lead lawyer and the American legal system.
Not surprisingly the jacket cover declares this same "young, flamboyant
Porsche-driving lawyer" to be a hero and Harr's chronicle to be "the story of
how one man can ultimately make a difference."
In focusing on the activities of the Reverend Young I am not proposing him
as an alternate hero. (Finding heroes in tragic human dramas is ineluctably
simplistic and in this case Anne Anderson is the person who was most persis-
tent in assuring that this outbreak of leukemia was not being treated as
merely a statistical oddity.) His example is instructive, though, in the way in
which his pastoral and social activities overlapped to enable him to recognize
the depth of human suffering and elicit practical social responses by medical,
legal, and journalistic professionals. Individuals can be catalysts for social
process of public-health discovery and remediation.
3. The complementarity of religious ideas of salvation and medical concep-
tions of health. The final intersection of religion and public health I shall
discuss concerns their respective involvements with healing. In one impor-
tant way there has been a convergence in religious and medical thinking
about healing. Some religious persons are reinterpreting their traditions of
"faith healing" in a way that de-emphasizes supernatural divine action and
appreciates human mediation of divine healing powers. From the other direc-
tion, some medical practitioners are giving a more positive interpretation to
the "placebo effect" in which the genuine healing is acknowledged to occur in
the absence of identifiable causal agents. An account and advocacy of this
convergence is effectively provided by Herbert Benson in his latest book, enti-
tled Timeless Healing: The Power and Biology of Belief.
16
The Latin word "placebo" means "I shall please or be pleasing." It was
coined to describe the phenomenon whereby patients report improvement in
a medical condition after having received only nominal treatmentfor in-
stance, one involving no effective pharmacological or surgical intervention. It
was thought that the patients reported improvement disingenuously, in order
to be pleasing to their physician. It now commonly denotes a different effect.
It means the phenomenon in which patients do actually, measurably make
progress in overcoming some physiological illness after they have received
nominal treatment. For instance, in double-blind studies patients can be di-
vided into two groups wherein one group is given a proven effective medica-
tion for a certain illness and the second group is given a placeboa sugar
pill. Neither the patients nor the doctors know what sort of pill goes to which
group. In this circumstance the patients sometimes improve more than a con-
21
Journal of Religion and Health
trol group that has received no treatment whatsoever but less than the group
taking a known effective medication.
The placebo effect is now regarded by many physicians as real in some
respects.
17
It is thought to be a result of the beliefs and expectations of both
the patients and doctors that the treatment will prove effective. Physicians
like Herbert Benson believe that the placebo effect is one and the same phe-
nomenon whether the relationship exists between a patient and physician or
between a "believer" and a "faith healer." What is crucial is the caring rela-
tionship and the shared confidence in the treatment. Just as in the seventies
Benson looked to religious practices of meditation as resources from which to
distill a nonreligious means for eliciting "the relaxation response," so too in
his more recent writings does he look to the religious phenomenon of faith
healing as guidance to physicians who seek to harness "the power of belief in
nonreligious ways. The biomedical research which is being undertaken to test
the validity of secular varieties of meditation and faith healing is of interest,
among other reasons, because it concerns the question of whether therapeutic
religious practices can remain effective when abstracted from their social,
historical, and institutional contexts of origin. There is an element of paradox
in Benson's project. In order to make the health benefits of religious medita-
tion and faith healing available to persons outside specific religious commu-
nitiesin this sense to make its benefits more publiche seeks to make the
relevant practices less religious. From a certain conception of religion this
means making them less social and so less a matter of the health of commu-
nities than of individuals. In the concluding section of this essay I will sug-
gest why this note of paradox has a more general application than simply to
Benson's research agenda.
///. Conclusion: Descartes' last laugh
Emile Durkheim influentially argued that religion is "an eminently social
thing."
18
The voice of God articulates the interests of society. Human catego-
ries of knowledge are social constructs and, to some extent, the products of
religionone of the most archaic of human social institutions. More recently
sociologists like Talcott Parsons have remarked that while religion may have
once provided the broad social and conceptual structures for society it is now
more frequently the case that religious beliefs, behavior, and institutions oc-
cur as differentiated parts within a predominantly secular social and concep-
tual structure. In this context all religions take on some degree of sectarian
character.
19
In recent years scholars like Diana Eck have stressed how differentiated
these religious communities are from one another, how pluralistic is the con-
temporary religious landscape. This empirical pluralism and its ideological
affirmation contribute to a phenomenon that I shall call the diffusion of reli-
22
Peter H. Van Ness
gion into spirituality. This is a process in which traditional religious behavior
migrates from specific institutional contexts and loses prescriptive devotional
regularity.
20
Churches and temples become less privileged as places for en-
countering God, and holy days or sabbaths are less exclusively times for devo-
tional activities. Religious practices like prayer and meditation are no longer
associated with set times and places. Diffusion in this sense occurs in physi-
cal space and time.
A recent Newsweek poll reports that only 60% of Americans "think a person
needs to believe in God in order to experience the sacred."
21
This finding sig-
nals a loss of salvific urgency in some people's spiritual views and a decline in
adherence to supernatural authority. Diffusion occurs here in the world of
knowledgein epistemic space, so to speak. This means that religious beliefs
become subject to the same contingencies as other cultural constructs. Where,
when, and to whom one is born are acknowledged to have a lot to do with
one's choice of religion. The people that one encounters at times of crisis and
curiosity are accorded a key role in religious behavior. Even matters of taste
are judged to influence strongly, and not unduly, one's spiritual preferences.
Authors of the Religion in America survey summarize this trend with the
heading "Much depends on life cycle."
22
As a good Augustinian Rene Descartes made God and the soul central fea-
tures of his philosophy. He also pledged fidelity to the Roman Catholic Church
and presented his philosophy as compatible with his religion. Many people
today who have inherited Descartes' philosophical legacy of methodological
rationalism in their public and professional lives have rejected these several
features of his worldview. They have qualified their allegiance to institutional
religion in favor of more personal and eclectic forms of spirituality; they have
reconceived his traditional idea of God in the direction of a pervasive notion
of sacredness; finally, they have rejected his dichotomy of mind and body in
favor of a nonmaterialistic integration of spirit and body.
23
Yet when these views are placed in the context of remarks here on the
relation between religion and public health a phenomenon is revealed which
might be called "Descartes' last laugh." When religion no longer serves as the
comprehensive framework of a community and its ethos but becomes differen-
tiated as multifarious parts of a more encompassing social structure, then
religion offers less promise of experiential wholeness because it no longer
communicates the experience of the wholeness of society. Durkheim's path to
wholeness via religion becomes ineffectual when religion no longer represents
society as a whole.
This circumstance leads many people to search for a sense of psychological
and cosmic wholeness relatively unmediated by society; they postulate a more
direct correlation between some sort of cosmic or metaphysical wholeness and
the wholeness of body and spirit. The analytic psychology of Carl Gustav
Jung when embraced as a sort of secular spirituality is an example of a very
individualistic path toward wholeness.
24
In some cases even the therapist is
23
Journal of Religion and Health
circumvented as Jungian books, tapes, and personal practices are deemed
sufficient for the sought-for transformation. It is historically noteworthy that
early members of AA claimed medical figures such as Jung and William
James as "quasi-founders" of their movement.
25
As diversely influential as
these two psychologists have been in recent decades, they never inspired any
social institutions as enduring and influential as AA. Their influence has
been as highly individualistic as were their conceptions of religion.
The loss of the social dimension of religion can lead to a preoccupation with
personal health and an equation of health and spiritual well-being. It can
lead to a spirituality that assigns to the well-being of the body a measure of
what Paul Tillich called "ultimate concern." Juvenal's prayer presupposes a
Roman conception of God as a communal benefactor; this presupposition is
increasingly less apt to contemporary Americans. When embodied well-being
becomes a spiritual preoccupation it implicitly promotes a sort of mind-body
dichotomy. Anxious thought attaches to individuated objects. Extreme vege-
tarianism sometimes evinces an anxious care for the body that merges with
an ascetic suppression of bodily vitality; the dietary practices of Mohandas
Gandhi show elements of this sort of preoccupation, though, of course, his
devotion to social justice prevented it from becoming the dominant theme of
his spirituality.
26
Thomas Moore's widely popular book The Care of the Soul combines Jun-
gian psychology and self-help individualism with traditional Roman Catholic
"soul" language and a contemporary appreciation of individual embodiment.
27
While explicitly rejecting Cartesian metaphysics and methodology and effec-
tively ignoring communal theological norms, Moore's book engenders a sort of
reflection that is both soul-oriented and self-interested, mildly other-worldly
and yet health-conscious. Being neither scientifically naturalistic in the sense
of brooking no distinction between mind and body nor theologically Biblical in
the sense of seeing salvation as a communal undertaking, Moore's project
does not fully challenge the Western spiritual legacy of Neoplatonism. Care of
the soul does not preclude care of the body but the separation of both con-
cerns from the social forces that Durkheim believed constitutive of religion
inhibits the reunion of body and soul in the more extensive context of commu-
nal well-being.
Descartes has the last laugh in the sense that people who reject his ortho-
dox theism and his methodological rationalism end up implicitly embracing a
major element of his modernist sensibilityhuman destiny is the story of
individual souls and bodies uneasily conjoined. This is a potentially problem-
atic aspect of the changing relationship between religion and public health.
As spiritual identities and experiences take less traditionally religious forms
they may also acquire a less prominently social character and so people may
construe health as a phenomenon of embodied individual personalities rather
than of an inclusive social community of diverse peoples.
24
Peter H. Van Ness
References
1. Owen Chadwick, ed. and trans., Western Asceticism, Library of Christian Classics XII. Phila-
delphia: Westminster, 1958, p. 109.
2. Athanasius: The Life of Antony and The Letter to Marcellinus, trans. Robert C. Gregg. Clas-
sics of Western Spirituality (New York: Paulist Press, 1980, pp. 35-36 (#5-6).
3. Friedrich Nietzsche, Thus Spoke Zarathustra, trans. R.J. Hollingdale. Baltimore: Penguin,
1969, pp. 61-63.
4. Epictetus: The Discourses as Reported by Arrian, The Manual, and Fragments, trans. W.A.
Oldfather. Loeb Classical Library, 2 vols. (Cambridge, MA: Harvard University Press, 1928,
2:47 (fragment 26)).
5. Michel Foucault, The Birth of the Clinic: An Archaeology of Medical Perception, trans. A. M.
Sheridan Smith. New York: Vintage, 1994, pp. 196-197.
6. Peter H. Van Ness, Spirituality, Diversion, and Decadence: The Contemporary Predicament.
Albany, N.Y.: State University of New York Press, 1994. Most recently, "Philosophy and
Suffering: A Case for the Comparative Philosophy of Religion," Union Seminary Quarterly
Review 50: pp. 107-115.
7. For the relationships between a vegetarian diet and heart disease, see Dean Ornish, Dr.
Dean Ornish's Program for Reversing Heart Disease. New York: Random House, 1990.
8. Scientific Research on Spirituality and Health: A Consensus Report, ed. David B. Larson,
James P. Swyers, and Michael E. McCullough. Rockville, Md.: National Institute for Health-
care Research, 1998.
9. Roy Porter, The Greatest Benefit to Mankind: A Medical History of Humanity. New York:
Norton, 1997, p. 85.
10. Claude LeVi-Strauss, The Elementary Structures of Kinship, trans. James Harle Bell et al.
Boston: Beacon Press, 1969.
11. Victor Turner's account of ritual experiences of communitas is relevant here. See The Ritual
Process: Structure and Anti Structure. Ithaca, N.Y.: Cornell University Press, 1975.
12. For a portrayal of AA and its progeny as forms of "secular spirituality," see Ernest Kurtz's
chapter entitled Twelve Step Programs" in Spirituality and the Secular Quest, vol. 22 of
World Spirituality: An Encyclopedic History of the Religious Quest, ed. Peter H. Van Ness.
New York: Crossroad, 1996, pp. 277-304.
13. Joe Klein, "In God They Trust," New Yorker, June 16, 1997, pp. 40-48. Klein refers to the
research of John Dilulio and describes it as devoted to testing the hypothesis that "faith-
based programs are the most effective ways to deliver social services."
14. Rodney Stark, The Rise of Christianity: A Sociologist Reconsiders History. Princeton: Prince-
ton University Press, 1996, pp. 73-94.
15. Jonathan Harr, A Civil Action. New York: Vintage, 1996.
16. Herbert Benson (with Marg Stark), Timeless Healing: The Power and Biology of Belief. New
York: Simon & Schuster, 1996.
17. For a brief historical review of the place of placebos in the history of medicine, see Arthur K.
Shapiro and Elaine Shapiro, "The Placebo: Is It Much Ado about Nothing?" in The Placebo
Effect: An Interdisciplinary Approach, ed. Anne Harrington. Cambridge, MA: Harvard Uni-
versity Press, 1997, pp. 12-36.
18. Emile Durkheim, The Elementary Forms of Religious Life, trans. Karen E. Fields. New York:
Free Press, 1995, p. 9.
19. Talcott Parsons, Structure and Process in Modern Societies. New York: Free Press, 1961.
20. The phenomenon described here may reflect a broader change in American social life, that is,
the increasing disinclination of Americans to join social groups and participate in civic insti-
tutions. David D. Putnam has made this case provocatively in his essay "Bowling Alone:
America's Declining Social Capital," in the Journal of Democracy. Putnam's thesis may not
entirely apply to religious groups because pollsters have found that religious membership
and attendance have remained fairly constant over the last twenty years; Putnam responds
that people often exaggerate their religious participation.
21. "The Search for the Sacred: America's Quest for Spiritual Meaning." Newsweek, 28 Novem-
ber 1994, p. 56.
25
26 Journal of Religion and Health
22. Religion in America, p. 12.
23. Wade Clark Roof, A Generation of Seekers: The Spiritual Journeys of the Baby Boom Genera-
tion. San Francisco: Harper & Row, 1993.
24. For Jung as a progenitor of a variety of secular spirituality see Lucy Bregman's article "Psy-
chotherapies" in Spirituality and the Secular Quest, pp. 251-276.
25. Kurtz, "Twelve Step Programs," p. 284.
26. Erik Erikson gives a psychoanalytic interpretation of Gandhi's vegetarianism that in a differ-
ent manner explains how his ethical and spiritual ideals of service constrained his neurotic
preoccupation with diet; see Erik H. Erikson, Gandhi's Truth: On the Origins of Militant
Nonviolence. New York: Norton, 1993, pp. 141-175.
27. Thomas Moore, Care of the Soul: A Guide for Cultivating Depth and Sacredness in Everyday
Life. New York: HarperCollins, 1992.
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