Surveying the moral landscape of the nineteenth century,
Bahá'u'lláh, prophet-founder of the Bahá'í Faith, wrote: "The
vitality of men's belief in God is dying out in every land."  The old religions,
the dominant social and cultural force for so long, were now in decline. No longer holding
sway over the thoughts and feelings of people around the world, their impotence had
prompted Friedrich Nietszche, the German philosopher and contemporary of
Bahá'u'lláh, to pronounce 'God is dead'.
Whilst the old religions have continued to lose influence during the
twentieth century, nevertheless they remain important for many people, especially the
elderly. And yet, for a phenomenon that has such a profound impact upon the individual,
the interface between religion and mental health is a remarkably under-researched area. 
In spite of this, however, the universality of religion and its
capacity to generate both good and evil prompts one to ask whether religion protects a
person against psychological problems and whether it promotes mental well-being.
This paper will focus on studies conducted on the elderly and will
attempt to answer four questions:
- What is the prevalence of religious behaviour as a way of coping with difficulties in old age?
- Is there a relationship between religiosity and psychological well-being?
- What are the limitations of research conducted in this area to date?
- What are the practical implications of such research?
Religion And The Founding Fathers Of Psychiatry
It is instructive to delve into the history of the debate concerning
the impact of religion on psychological health.
Sigmund Freud, the founder of modern psychoanalysis, was a strong
critic of religion. He thought that religious ideas had no basis in reality, that they
were mere illusions which satisfied people's childlike wish for protection from the
uncontrollable forces of nature. In fact, in Future of an Illusion, written towards
the end of his life, Freud described religion as "the universal obsessional neurosis
of humanity". Furthermore:
"...like the obsessional neurosis of children, it arose out of the
Oedipus complex out of the relation to the father...If, on the one hand, religion brings
with it obsessional restrictions, exactly as an individual obsessional neurosis does, on
the other hand it comprises a system of wishful illusions together with a disavowal of
reality, such as we find in an isolated form nowhere else but in amentia, in a state of
blissful hallucinatory confusion." 
According to Freud, this denial of reality was an immature coping
mechanism, and, like the obsessional patient who relinquishes his primitive defences with
the help of his analyst, society would grow out of its need for religion with the aid of
In contrast, Freud's one-time pupil, Carl Jung, believed that
religious faith was essential for well-being:
"Among all my patients in the second half of life - that is to
say, over thirty-five - there has not been one whose problem in the last resort was not
that of finding a religious outlook on life. It is safe to say that every one of them fell
ill because he had lost that which the living religions of every age have given to their
followers, and none of them has been really healed who did not regain his religious
For Jung, the human psyche had always been "shot through with
religious feelings and ideas", and, in a powerful broadside at his former mentor,
stated: "Whoever cannot see this aspect of the human psyche is blind, and whoever
chooses to explain it away, has no sense of reality... This father-complex (Oedipus),
fanatically defended with such stubbornness and over-sensitivity, is a cloak of
religiosity misunderstood." 
Similarly, for Erich Fromm, the humanist philosopher and psychoanalyst,
the death of God had profound and grave consequences: "In the nineteenth century the
problem was that God is dead; in the twentieth century the problem is that man is
dead."  According to Fromm, a 'sane' society needed a system of myth and
ritual to satisfy basic spiritual needs such as transcendence, orientation and belonging.
Modern industrial societies had replaced such systems with the new collective neurosis of
Having and Consumption. The consequence was a "society of notoriously unhappy,
lonely, anxious, depressed, destructive, and dependent people who are glad when we have
killed the time we are trying so hard to save." 
A Religious Perspective
"God is dead, but 50,000 social workers have risen to take his
place." (Dr J.D. McCoughey, Australian Theologian)
Whilst psychiatrists and philosophers have argued over its pros and
cons, the world's major religions have all taught the indispensability of religious
life as the foundation for well-being. The youngest of these, the Bahá'í Faith, a
religion now the second most widespread after Christianity, states that religion is the
basis of human happiness. It reorients man to his true nature and to his God, promotes the
cultivation of morals and virtues, develops discipline, and creates a pattern of order and
stability for society:
"...universal benefits derive from the grace of the Divine
Religions, for they lead their true followers to sincerity of intent, to high purpose, to
purity and spotless honour, to surpassing kindness and compassion, to the keeping of their
covenants when they have covenanted, to concern for the rights of others, to liberality,
to justice in every aspect of life, to humanity and philanthropy, to valour and to
unflagging efforts in the service of mankind...the purpose of these statements is to make
it abundantly clear that the Divine religions, the holy precepts, the heavenly teachings,
are the unassailable basis of human happiness..." 
Furthermore, Shoghi Effendi, the Guardian of the Bahá'í Faith
from 1921 to 1957, wrote compellingly of the consequences of irreligion both for the
individual and for society:
"Human character is debased, confidence is shaken, the nerves of
discipline are relaxed, the voice of human conscience is stilled, the sense of decency and
shame is obscured, conceptions of duty, of solidarity, of reciprocity and loyalty are
distorted, and the very feeling of peacefulness, of joy and of hope is gradually
Thus, 'peacefulness', 'joy', and 'hope',
are replaced by agitation, despair and hopelessness, which form the basis of psychological
problems from depression and suicide to drug addiction and violence.
There is, however, a note of caution insofar as religion can be
manipulated and abused by leaders intent on power. Thus, religion can be either functional
or dysfunctional, and the criterion by which this is measured is the degree to which
religion promotes unity:
"...religion must be the cause of unity, harmony and agreement
among mankind. If it be the cause of discord and hostility, if it leads to separation and
creates conflict, the absence of religion would be preferable in the world." 
Religion: Psychological Benefits vs Harm
Schumaker  summarises the arguments proposed by various writers of the
potential benefits and harms of religion to mental health. Some of the benefits suggested
- That religion reduces anxiety by offering an explanatory model of personal and world events.
- That it offers a sense of hope, meaning and purpose, resulting in emotional well-being.
- That it provides a reassuring fatalism enabling one to better withstand pain and suffering. Such beliefs are echoed in the following words: "My calamity is My providence, outwardly it is fire and vengeance, but inwardly it is light and mercy." 
- That religion provides solutions to situational and emotional conflicts.
- That it resolves the problem of death through belief in an after-life.
- That it provides a sense of power and control through association with an omnipotent force.
- Religion encourages service to self and to others, as well as suppressing self-destructive practices.
- That it promotes social cohesion.
- That it offers a sense of identity, satisfies the need for belonging, and unites people around shared understandings.
- That it provides a foundation for cathartic collectively enacted ritual.
Some of the proposed harms of religion include:
- That it generates unhealthy levels of guilt.
- Promotes low self-esteem by way of beliefs that devalue our fundamental nature.
- Provides the foundation for the unhealthy repression of anger.
- That religion creates fear and anxiety through threats of fear and punishment.
- That it discourages a sense of internal control, rather placing excessive reliance on external sources of control, and thus
fostering dependency, conformity and suggestibility.
- It inhibits sexual expression.
- That religion is divisive and promotes intolerance of 'sinners'.
- That it instils paranoia of malevolent forces threatening one's moral integrity.
- That it interferes with rational and critical thought. 
Given the plausible nature of many of these arguments, it is useful to
view religion as a phenomenon with the potential to exert either positive or negative
effects. The concept of 'functional' and 'dysfunctional' religions,
briefly mentioned previously, is a useful classification, developed by Spilka11.
Functional religion contains meanings that promote a person's freedom and potential
for development, whilst dysfunctional religion involves meanings "that lead to
dogmatism, restrict thought and limit freedom and opportunity, distort reality, separate
people, and arouse fear and anxiety." 
In "Psychoanalysis and Religion,"  Fromm describes religion
as "...a system of ideas, norms, and rites that satisfy a need that is rooted in
human existence, the need for a system of orientation and an object of devotion."
Whilst Fromm's definition is useful in a general sense, research
in the area of religion is hampered by the difficulties associated in attempting to define
such a multidimensional phenomenon. There are endless modes of religious expression and
many studies deal with only one or a few dimensions of religiosity.
Glock  offers a five part definition: (i) ideological (the
person's belief system); (ii) intellectual (knowledge about scriptures); (iii)
ritualistic (overt institutional actions); (iv) experiential (direct knowledge of ultimate
reality through religious experiences); (v) consequential (the secular effects of the
Allport and Ross  pass beyond external behaviours into the realm of
experience and motivation. They describe those who are 'extrinsically' motivated
as opposed to those 'intrinsically' motivated. The extrinsically religious
"uses" his religion for personal gain and holds his beliefs lightly and
selectively. The intrinsically motivated, in contrast, "lives" his religion and
integrates his beliefs into daily life. Hoge  has developed a ten-item scale of intrinsic
religiosity that is both validated and practical for clinical application.
(b) Mental Health
Concepts of mental health or well-being can be defined in a negative
sense, as in the absence of illnesses such as depression or anxiety disorders.
Alternatively, well-being can be measured by looking at positive characteristics of
health. Maslow's studies of 'self actualised' people are useful in defining
some of these characteristics: e.g. joy, wisdom, creativity, humour, peak or mystical
experiences.  However, such concepts can be value laden and therefore bias the results of
religion's perceived influence on mental health. For example, Humanist
Psychologists' emphasis on autonomy, self-determination and emancipation from
external sources of control as indicators of psychological health conflict with
monotheistic religious concepts such as submission to the will and laws of God.
Religiosity and Mental Health in Old Age
As mentioned previously, research in the area of religion and mental
health is rare. Nevertheless, there are pockets of activity around the world. This paper
will focus on work done amongst geriatric populations, especially that of Koenig and
others at the Centre for the Study of Aging and Human Development, Duke University, North
A number of studies suggest that religious behaviour is a common way of
coping with difficulties in old age. Koenig and others  studied 100 adults aged 55-80,
looking at their coping responses during three unpleasant and stressful life events.
Unlike earlier studies which tended to look at poor, African-American women, the
researchers chose a stratified, random sample of 50 men and 50 women, all white and all of
middle or upper class. Respondents were asked how they had coped, and what they did or
thought that stopped them from giving up. 45% reported that religion had helped them
during one or more of the three stressful events. Women (58%) were more likely to do so
than men (32%). The three most common forms of religious coping behaviours, accounting for
74% of those reported, were (1) Trust and Faith in God, (2) Prayer, and (3) Help and Strength
from God. Thus, cognitions played a more important role than organised activities. The
main limitation of this study, as with others conducted in North Carolina, was its
representativeness. North Carolina is part of the American "Bible-Belt", where
religious practice is common, and so there is doubt about the extent to which the results
of this study are representative of other parts of the country.
In a study of 200 randomly selected low income women aged over 65,
Conway  gave participants lists of possible coping mechanisms to stressful events in the
past year. Of the 80 participants (46 African-American, 34 white), Prayer was the most
commonly listed 'action oriented' coping response (91% of participants),
followed by Consulting a Health Professional. Of the cognitive coping responses, the two
commonest thoughts used by participants were: "I'm better off than a lot of
people" and "thinking of God or your religious beliefs" (86%). This was in
contrast to the thought, "I think that a professional will get me through the
situation", reported by only 25%. When asked, "Who assisted You?", God was
the most common response (85%), followed by a Professional (78%). The sample being studied
was biased towards African-Americans (greater than 50%, compared to less than 20% in the
general population) and the results may reflect to some extent the fact that
African-Americans have had less access to medical services in the past and so relied more
on religion to help them through difficult situations.
(ii) Association between religion and mental health
Studies conducted on the relationship between religion and mental
health have tended towards a small positive correlation between the two. Mental health
indicators used have been scales of well-being, life satisfaction, morale and the like, as
well as psychiatric concepts of depression and anxiety. Dimensions of religion measured
are religious attitudes and beliefs (intrinsic) and external religious activities
Koenig and colleagues,  in a study of 836 elderly adults from
Illinois and the mid-West, tested the hypothesis that religious activities and attitudes
correlate with morale. The adults came from five community groups: an outpatients clinic,
a Senior's lunch programme, members of Conservative Protestant Churches, a Jewish
Seniors' lunch programme, and a group of retired Dominican and Franciscan nuns.
Participants were given questionnaires with measures of morale, subjective coping,
organisational religious activities (ORA) such as prayer groups and Bible classes,
non-organisational religious activity (NORA) such as private prayer and devotional
reading, and intrinsic religiosity (IR). Subjects were also assessed on known confounding
variables of degree of social support, health, and financial status.
Results showed significant and moderately strong correlations between
NORA, ORA, IR, and morale, subjective coping. Specifically:
ORA and Morale (r= 0.26), subjective coping (r=0.14)
NORA and Morale (r= 0.16), subjective coping(r=0.12)
IR and Morale (r= 0.24), subjective coping (r=0.12).
After controlling for health, social support, financial status, sex and
age, correlations were reduced but remained moderately strong and highly significant. For
persons 75 years and older, religious variables contributed more to the variance in
well-being than any other variable, except for health.
Although correlations ranged only between 0.10 - 0.30, the authors
commented that other variables such as social support and financial status rarely
correlate with well-being at strengths above 0.30. The main limitation of this study was
its cross-sectional nature, which excludes any conclusions about causality. It remains
unclear whether religion generates morale or whether those with high morale are attracted
In an offshoot of the above study,  decreased intrinsic religiousness
in elderly women correlated with chronic anxiety (p<0.05).
In the First Duke Longitudinal Study of Aging, 272 volunteers were
followed for 18 years and degree of religious attitudes and activities were correlated
with longevity, happiness, usefulness and personal adjustment, with controls for age, sex
and occupation. Results showed that religion was not related to a longer life, that
religious attitudes (eg. "Religion is the most important thing to me",
"Religion is a great comfort") were not significantly related to happiness, but
significantly related to feelings of usefulness (r= 0.16) especially in those engaged in
manual occupations (r= 0.24), and to adjustment in those from non-manual occupations (r=
0.24). Religious activities (eg. church attendance, reading Bible) were significantly
related to happiness (r= 0.16), especially men (r= 0.26), those over 70 (r= 0.25), and
significantly related to usefulness (r= 0.25), especially manual occupations (r= 0.34),
and those over 70 (r= 0.32). They also were significantly related to adjustment (r= 0.16),
especially manual occupations (r= 0.33) and males (r= 0.28). Correlations increased over
the 18 years of observation and the authors concluded that, not only does religion play a
significant role in personal adjustment for many older persons, but as people age,
religion becomes increasingly important.
Furthermore, Beckman and Houser  demonstrated positive correlations
between religiosity and well-being in widowed women, both with children (r=0.22,
p<0.05) and without children (r= 0.27, p<0.05).
Some studies have shown no or insignificant relationships. In a
longitudinal study over 8 years of mostly Mexican-American Catholics,  there were small,
insignificant correlations between church attendance and life satisfaction, and little
change over 8 years. Tellis-Nayak  found weak to negligible relationship between
religiosity and (i) well-being, and (ii) anxiety about death.
Conclusion and Discussion
Studies conducted to date in the area of religion and mental health
suggest that religious behaviours, both public and private, are commonly used by the
elderly in the face of difficult life events. The extent, however, to which these studies
are representative is questionable given that the samples have been recruited from
populations or subgroups in which religion traditionally has been well represented.
Furthermore, whilst there have been studies showing no correlation
between religiosity and well-being in later life, the general consensus is that of a
positive, albeit weak, correlation. In addition, there are no studies showing a
significant negative association.  However, one must consider the possibility of a bias in
the literature where studies are excluded because of a lack of positive findings.
There are a number of possible explanations for the weak correlations. 
A 'dilutional' effect may be occurring because of inaccurate measurement of
religious attitudes and behaviours. For example, crude measures of religiosity, such as
denomination, might allow the majority of less committed members of a denomination to
dilute the effect of a committed religious faith on mental health. Another possible reason
is that people may turn to religion at times of mental distress and so this would also
dilute the positive effects of religion on those who have been devoted believers for many
years. Longitudinal studies are needed to control for this effect. Furthermore, religion
tends to be more prevalent in the lower classes, where, for other reasons, there is a
higher incidence of anxiety and depression. Religion, therefore, may be acting as a buffer
against social and financial deprivations and more studies are needed controlling for
these confounding variables. Finally, 'dysfunctional' religions may contribute
to mental disturbance and thus cancel the positive effects of 'functional'
Clinically, the research described in this paper highlights the need
for health professionals to be aware of the importance of religion as a coping strategy in
the elderly. Counselling and psychotherapy can take advantage of these strategies. For
example, patients can be supported in their beliefs, encouraged as far as possible to
participate in religious activities, and referrals made to religious professionals.
It is also worth speculating on the long term mental health
consequences of irreligion on an aging population. Whilst there are problems with
definition, there is evidence that irreligion has been increasing in most societies of the
world for at least the past one hundred years.  Although one cannot draw any conclusions
on causality in the studies mentioned in this paper, nevertheless if religion does indeed
provide protection against depression and anxiety, will there be a dramatic rise in the
incidence of mental illness in the near future? And if the traditional religions are no
longer able to satisfy people's spiritual yearnings, will this allow
'dysfunctional' religions to exert greater influence on the naive and the
Finally, an important area for further research is to investigate the
mental health and sense of well-being amongst other religious groups. The research
presented in this paper has concentrated on followers of the Judaeo-Christian tradition.
It would be worthwhile to extend these investigations to members of other religions, in
particular the Hindu, the Buddhist, the Muslim and the Bahá'í faiths. If religion
is to be judged by its fruits, then it would be of interest to know whether the models of
personal and community life offered by such religions contribute to psychological
1. Bahá'u'lláh. Gleanings from the writings of Bahá'u'lláh. Wilmette, Illinois: Bahá'í Publishing Trust, 1971.
2. Koenig HG. "Religion and Mental Health in Later Life." In:
Schumaker JF. Ed. Religion and Mental Health. New York: Oxford University Press,
3. Freud S. The Future of an Illusion. London: Hogarth Press,
4. Jung CJ. Modern Man in Search of a Soul. New York: Harcourt,
Brace and World, 1933.
5. Fromm E. To Have or To Be. London: Abacus, 1982.
6. 'Abdu'l-Bahá. The Secret of Divine Civilisation.
Wilmette, Illinois: Bahá'í Publishing Trust, 1957.
7. Shoghi Effendi. The World Order of Bahá'u'lláh.
Wilmette, Illinois: Bahá'í Publishing Trust, 1974.
8. 'Abdu'l-Bahá. In: Bahá'í World Faith - Selected
Writings of Bahá'u'lláh and 'Abdu'l-Bahá. Wilmette, Illinois:
Bahá'í Publishing Trust, 1966.
9. Schumaker JF. "Introduction." In: Schumaker JF. Ed. Religion
and Mental Health. New York: Oxford University Press, 1992.
10. Bahá'u'lláh. The Hidden Words. London:
Nightingale Books, 1992.
11. Spilka B. "Functional and Dysfunctional Roles of Religion: An
Attributional Approach." Journal of Psychology and Christianity, 1989; 8:5-15.
12. Fromm E. Psychoanalysis and Religion. London: Yale
University Press, 1980.
13. Glock CY. "On the study of religious commitment".
Religious Education Research Supplement 1962; 57:98-110.
14. Allport GW, Ross JM. "Personal Religious Orientation and
Prejudice." Journal of Personality and Social Psychology 1967; 5:432-443.
15. Hoge DR. "A validated intrinsic religious motivation
scale". Journal for the Scientific Study of Religion 1972; 11:369-376.
16. Hjelle LA, Zeigler DJ. Personality Theories, Basic Assumptions,
Research and Applications. Singapore: McGraw-Hill, 1992.
17. Koenig HG, George LK, Siegler IC. "The Use of Religion and
Other Emotion-Regulating Coping Strategies Among Older Adults." The Gerontologist
18. Conway K. "Coping with the Stress of Medical Problems Among
Black and White Elderly." International Journal of Aging and Human Development
19. O'Brien ME. "Religious Faith and Adjustment to Long-Term
Haemodialysis." Journal of Religion and Health 1982; 21:68-80.
20. Koenig AG, Kvale JN, Ferrel C." Religion and Well-Being in
Later Life." The Gerontologist 1988; 28:1.
21. Koenig HG, Moberg DO, Kvale JN. "Religious Activities and
Attitudes of Older Adults in a Geriatric Assessment Clinic." Journal of the
American Geriatrics Society 1988; 36:4.
22. Goldberg EL, Van Natta P, Conistock GW." Depressive Symptoms,
social networks, and social support of elderly women." American Journal of
Epidemiology 1985; 121:448.
23. Beckman LJ, Houser BB. "The consequences of childlessness on
the social-psychological well-being of older women." Journal of Gerontology
24. Markides KS, Levin JS, Ray LA. "Religion, Aging, and Life
Satisfaction: an eight-year, three wave longitudinal study." The Gerontologist
25. Tellis-Nayak V. "The transcendent standard: the religious
ethos of the rural elderly." The Gerontologist 1982; 22:359-363.
26. Schumaker JF. "Mental Health Consequences of Irreligion."
In: Schumaker JF Ed. Religion and Mental Health. New York: Oxford University Press,