ArticlePDF Available

Religion and Psychiatry: Beyond Boundaries

November 2009

Authors:

GGZ Centraal

IntroductionThe Heresy Trial of J. Ernst DaveyProtestants and Partition Politics in IrelandFundamentalist Certainty and Political UncertaintyPsychoanalysis, Faith and ReligionFundamentalism and Holy ScriptureFundamentalism and Group PsychologyRegression and the Loss of Tempero-Spatial Functions‘Violence and the Sacred’Regression and Reconstruction of Large-Group IdentityFundamentalism, Radicalization and ViolenceReferences

Content uploaded by Peter Verhagen

Content may be subject to copyright.

Religion and Psychiatry:

Beyond Boundaries

Editors

Peter J. Verhagen

Meerkanten GGZ, Harderwijk, The Netherlands

Herman M. van Praag

University of Maastricht, Maastricht, The Netherlands

Juan J. Lo

´pez-Ibor Jr.

Complutense University, Madrid, Spain

John L. Cox

University of Gloucestershire, United Kingdom

Driss Moussaoui

Ibn Rushd University, Casablanca, Morocco

Contents

List of Contributors ix

Foreword xiii

Preface xv

General Introduction: Religion and Science 1

Peter J. Verhagen

PART 1 PROLEGOMENA (FIRST ISSUES): HISTORY,

PHILOSOPHY, SCIENCE AND CULTURE 11

Introduction 11

1.1 Evil in Historical Perspective: At the Intersection of Religion

and Psychiatry 13

Michael H. Stone

1.2 Linguistic Analysis and Values-Based Practice: One Way of

Getting Started with Some Kinds of Philosophical Problems

at the Interface Between Psychiatry and Religion 39

Bill (K.W.M.) Fulford

1.3 Science and Transcendence in Psychopathology;

Lessons from Existentialism 63

Juan J. Lo

´pez-Ibor Jr. & Marı

´aIn



es Lo

´pez-Ibor Alcocer

1.4 Psychiatry of the Whole Person – Contribution of Spirituality

in form of Mystic (Suﬁ) Thinking 73

Ahmad Mohit

PART 2 MAIN ISSUES: THE INTERFACE BETWEEN

PSYCHIATRY, MENTAL HEALTH AND MAJOR

RELIGIOUS TRADITIONS 87

Introduction 87

2.1 Judaism and Psychiatry 89

Ayala Uri, Noa Navot & Alan Apter

2.2 Christianity and Psychiatry 105

John R. Peteet

2.3 Religion and Mental Health in Islam 119

Ahmed Okasha

2.4 Psychiatry and African Religion 143

Frank G. Njenga, Anna Nguithi & Sam G. Gatere

2.5 Hinduism and Mental Health 159

R. Srinivasa Murthy

2.6 Buddhism and Psychotherapy in Japan 181

Naotaka Shinfuku & Kenji Kitanishi

2.7 Psychiatry and Theravada Buddhism 193

Pichet Udomratn

PART 3 CORE ISSUES: RELIGION AND PSYCHOPATHOLOGY 209

Introduction 209

3.1 Religious Experience and Psychopathology 211

Juan J. Lo

´pez-Ibor Jr. & Marı

´a Ine

´sLo

´pez-Ibor Alcocer

3.2 God’s Champions and Adversaries: About the Borders

between Normal and Abnormal Religiosity 235

Herman M. van Praag

3.3 Religion and Psychopathology: Psychosis and Depression 253

Andrew C. P. Sims

3.4 Obsessive Compulsive Disorder and Religion: A Reconnaissance 271

Harold J. G. M. van Megen, Dianne A. den Boer-Wolters

& Peter J. Verhagen

3.5 Religion and Psychoanalysis: Past and Present 283

Allan M. Josephson, Armand Nicholi Jr. & Allan Tasman

3.6 On the Psychology of Religious Fundamentalism 305

John, Lord Alderdice

3.7 Measurement at the Interface of Psychiatry and Religion:

Issues and Existing Measures 319

Peter C. Hill & Carissa Dwiwardani

vi CONTENTS

PART 4 RESEARCH ISSUES 341

Introduction 341

4.1 Religion and Mental Health: What Do You Mean When You Say

‘Religion’? What Do You Mean When You Say ‘Mental Health’? 343

Charles H. Hackney

4.2 A Moment of Anger, a Lifetime of Favor: Image

of God, Personality, and Orthodox Religiosity 361

Elisabeth H.M. Eurelings-Bontekoe & Hanneke Schaap-Jonker

4.3 The Relationship Between an Orthodox Protestant Upbringing

and Current Orthodox Protestant Adherence, DSM-IV

Axis II B Cluster Personality Disorders and Structural

Borderline Personality Organization 373

Elisabeth H.M. Eurelings-Bontekoe & Patrick Luyten

4.4 When Religion Goes Awry: Religious Risk Factors for Poorer

Health and Well-Being 389

Hisham Abu Raiya, Kenneth I. Pargament

& Gina Magyar-Russell

4.5 Religious Practice and Mental Health:

a Moroccan Experience 413

Driss Moussaoui & Nadia Kadri

4.6 Religious and Spiritual Considerations in Psychiatric

Diagnosis: Considerations for the DSM-V 423

David Lukoff, C. Robert Cloninger, Marc Galanter,

David M. Gellerman, Linda Glickman, Harold G. Koenig,

Francis G. Lu, William E. Narrow, John R. Peteet,

Samuel B. Thielman & C. Paul Yang

PART 5 INTERDISCIPLINARY ISSUES: PSYCHOTHERAPY,

PASTORAL CARE AND MEANING GIVING 445

Introduction 445

5.1 Gods of the Horizon: The Therapist’s and the Patient’s

Religious Representations and the Inevitability of

Countertransference 447

Moshe Halevi Spero

5.2 Assumptions About Pastoral Care, Spirituality

and Mental Health 479

Peter J. Verhagen & Adamantios G. Avgoustidis

CONTENTS vii

5.3 Coming to Terms with Loss in Schizophrenia – The Search

for Meaning 497

Hanneke (J.K.) Muthert

PART 6 CONTROVERSIAL ISSUES: RELIGION AND THE BRAIN 513

Introduction 513

6.1 The Limits of Scientiﬁc Understanding and their Relevance

for the Role of Religion in Psychiatry 515

Robert H. Belmaker

6.2 Seat of the Divine: A Biological ‘Proof of God’s Existence’? 523

Herman M. van Praag

6.3 Neuro-Theology: Demasqu

e of Religions 541

Dick F. Swaab & Wilma T.P. Verweij

PART 7 TRAINING ISSUES: RESIDENCY TRAINING

AND CONTINUOUS EDUCATION 569

Introduction 569

7.1 Religion and the Training of Psychotherapists 571

Allan M. Josephson, John R. Peteet & Allan Tasman

7.2 Multicultural Education and Training in Religion and Spirituality 587

Peter J. Verhagen & John L. Cox

Epilogue: Proposal for a World Psychiatric Association Consensus

or Position Statement on Spirituality and Religion in

Psychiatry 615

Peter J. Verhagen & Christopher C.H. Cook

Notes on Contributors 633

Index of Names 647

Index of Subjects 651

viii CONTENTS

Foreword

Religion is a major activity of human beings including those suffering from a mental

disorder. Psychiatric patients often raise for themselves the kind of questions that everybody

has considered and which religion tries to answer. Where do we come from? Is there life

after death? What is the origin of the universe? Why are we confronted with evil? Are we

free or ruled by our instincts and brain mechanisms?

Religion is an important component of life. Anthropologists have recognized that the

Neanderthals already had some sense of transcendence and of spirituality, a fact that is more

striking in the remnants of archeological excavations of Homo sapiens sapiens settlements.

The history of religions as we know them today begins in the Near East with the invention

of writing about 3000 BCE, with the written record of human religious experiences and

ideas. The middle of the ﬁrst millennium BCE has been considered by Karl Jaspers, in his

The Origin and Goal of History, as a key Axial Age of thinkers having had a profound

inﬂuence on future philosophy and religion. In this context, Rudolf Otto’s famous book, The

Idea of the Holy (1917), deﬁnes the essence of religious awareness as awe, a unique blend of

fear and fascination before the divine.

The Encyclopedia of Religion deﬁnes religion as a “push, whether ill-deﬁned or conscious,

toward some sort of ultimacy and transcendence that can provide norms and power for the rest

of life. When more or less distinct patterns of behaviour are built around this depth dimension

in a culture, this structure constitutes religion in its historically recognizable form. Religionis

the organization of life around the depth dimensions of experience, varied in form,

completeness, and clarity in accordance with the environing culture.” A religion is an

organized approach to human spirituality which usually encompasses a set of narratives,

symbols, beliefs and practices, often with a supernatural or transcendent quality, that give

meaning to the practitioner’s experiences of life through reference to a higher power or truth.

Religion includes three components: 1) a notion of the transcendent or numinous, often, but

not always, in the form of theism; 2) a cultural or behavioural aspect of ritual, liturgy and

organized worship, often involving priesthood, and societal norms; and 3) a set of myths

(sacred truths) held in reverence or believed by adherents.

Spirituality shares with religion the personal belief in ideas of religious signiﬁcance,

such as God, the Soul, or Heaven, but rejects the administrative, often bureaucratic and

hierarchical, structure and creeds of a particular organized religion.

Based on census or public opinion data, a person is considered to be of a particular religion if

they say that they are of that faith. According to David Barrett et al, editors of the World Christian

Encyclopedia: A comparative survey of churches and religions - AD 30 to 2200, there are 19 major

world religions which are subdivided into 270 large religious groups, and many smaller ones.

There are about 2.1 billion Christians (32% of the world population); 1.3 billion Muslims (19%);

0.8 billion Hindus (13%); 0.4 billion practise Chinese folk religion (6%) and 0.36 billion are

Buddhist (6%). The remaining religions are practised by the other 10% of the global population.

Another 775 million people (12%) have no religion (they consider themselves agnostics,

freethinkers, humanists, secularists, etc.) and 150 million (2%) are atheists.

Religion plays an important role in the ceremonies attached to the stages of life, such as

birth, becoming adult, marriage and death. It is also important when confronted with illness

and misfortune. The case of mental disorders is special. Severe depression uncovers what

Kurt Schneider called the primordial fears of human beings: the fear of poverty, the fear of

becoming ill and the fear of damnation, which were respectively at the origin of the delusion

of being ruined, the hypochondriacal and the guilt delusions. Delusional patients are

preoccupied with delusions on the origin of the universe, good and evil and so on and

delusions of religious content have been recognized for centuries. In spite of all of this,

psychiatrists have not paid sufﬁcient attention to the examination of religiosity in their

patients. Even fewer include religiosity and spiritualism in psychotherapy, which is strange

as both religion and psychotherapy try to bring meaning to experience. The separation

of religion and science in general parallels the separation of Church and State and this has

been sometimes taken too far. As an example, an English nurse was reprimanded by The

National Health Service for having asked an elderly lady if she would like the nurse to pray

for her.

In Western civilization, there is a division of the world into two comprehensive domains, one

sacred, the other profane. Religion is often described as a communal system for the coherence of

belief focusing on a system of thought, unseen being, person, or object, that is considered to be

supernatural, sacred, divine, or of the highest truth. Moral codes, practices, values, institutions,

traditions, rituals and scriptures are often traditionally associated with the core belief, and these

may have some overlap with concepts in secular philosophy. Religion is also often described as a

“way of life” or a life stance. The scientiﬁc method gains knowledge by testing hypotheses to

develop theories through elucidation of facts or evaluation by experiments and thus only answers

cosmological questions about the physical universe. It develops theories of theworld which best

ﬁt physically observed evidence. All scientiﬁc knowledge is subject to later reﬁnement in the

face of additional evidence. Modern science and laicism often go together.

Whether religion has a positive or a negative impact on personal growth and mental health

is a controversial issue. It is easy to quote in this respect Sigmund Freud, who wrote that

religion is a “universal obsessional neurosis of humankind”, representing an infantile stage

of mental development which prevents human beings from facing the reality of their life.

Furthermore, it is easy to argue that religion – or an aberrant way to understand religion – has

been a source of conﬂicts and mass violence in recent years, which have had an enormous

negative impact on the mental health of thousands of people.

However,there is also abundant research evidence that religion, or spirituality (deﬁned as

the individual religious experience as opposed to ritualistic religious practices), is associ-

ated with higher levels of subjective well-being and lower levels of depression, and may

promote both emotional and cognitive growth.

The issue is complex, is made even more complex by problems with deﬁnition and

assessment, but is very topical and attractive. The WPA, therefore, welcomes this comprehen-

sive and multifaceted volume, produced by one of its most active Scientiﬁc Sections, hoping that

this effort will contribute to clarify the issue and stimulate further reﬂection and research.

Mario Maj

President, World Psychiatric Association

xiv FOREWORD

Preface

CROSSING BOUNDARIES

The boundary between religious belief and the practice of psychiatry is becoming

increasingly porous. No longer can psychiatrists in a multi-faith, multi-cultural globalized

world hide behind the dismissal of religious belief as pathological, or behind a biomedical

scientism, as they are more frequently confronted by distressed patients for whom religious

belief may determine their choice of symptoms and their compliance with treatment.

There is inevitably a tension in any such boundary crossing. Religious belief, for example,

can be harmful to mental health and be a trigger for mental illness. Spirituality may not have

the safeguards and structures of established Faith Communities; and the political abuse of

religion has left an indelible scar on the world. The destructive manipulation of behaviour

and belief by cult leaders is also well known to be disastrous.

Crossing the boundary, or breaking the psychiatry and religion taboo, may therefore be

complex for an atheist psychiatrist, challenged by a patient with a religious problem, or

when the values espoused by the patient are at variance with their own values and beliefs.

Boundary violations and unrecognized counter transference when treating religious patients

from a similar faith background to the psychiatrist are other pitfalls for the unwary.

Yet, as the authors of this book illustrate, the evidence is cogent that mainstream

religiosity is an enabler of health and a protection against mental illness – through, for

example, the provision of social support, or by enabling contact with a forgiving creator

God.

The religiosity gap, we would maintain, therefore needs to be reduced; and the religious

source of the values that are instrumental to compassion, and which can unleash altruism,

needs to be more fully recognized and utilized.

The World Health Organization (WHO) has rightly regarded spiritual values as a

component of Quality of Life. After the publication of The World Health Report 2001.

Mental Health: New Understanding, New Hope by WHO, the World Council of Churches

showed its partnership and identiﬁed mental health as a key issue for the churches’ role in the

mission of the church in the twenty-ﬁrst century

[1, 2]. The World Psychiatric Association

(WPA) was also correct to establish greater links with user organisations and to explore the

provision of a more person-centred psychiatry.

The World Council of Churchesformulated its view on mental health in an ambitious Strategic Plan of the Mental

Health & Faith Communities Initiative: “Mental health is a life-long dynamic process which allows the whole

person to develop psychologically, emotionally, and spiritually within society, whilst integrating personal and

interpersonal joy and distress, leading towards the experience of well-being and harmony with oneself, others, the

environment, and God” [3].

FOUR GREAT STREAMS OF RELIGIONS

This volume is about psychiatry and the interface between psychiatry and religion. In other

words, this is not a book on religion(s). However, it is concerned, especially Part 2, with the

views religions have on psychopathology, disordered behaviour and treatment. We are just

at the beginning of exploring, understanding and comparing these views. Although we were

used to the more or less pronounced inﬂuence of Judeo-Christian traditions and doctrines in

the Western world, together with Islam, as the Semite, prophetic or Abrahamic religions, the

monotheistic religions do not have exclusive rights. They share prophetic faith, faith in a

transcendent being, consciousness of time and history, and a community based on justice

[4–6]. What do these characteristics mean for an understanding of psychopathology and

disordered behaviour in comparison with the other two main streams of religions?

The mystic religions that emerged out of India have a completely different view on human

nature and the ultimate reality of the universe [5]. It can be expected that these character-

istics mean an original take on psychiatry. The third stream, the wisdom religions, emerged

out of China. Not the prophet, not the mystic, but the sage, the wise man, is honoured as the

ideal human person in his religious context [5]. There is a fourth stream of religions, often

called tribal or indigenous religions [4]. Australian and African religion is typical of this

fourth stream.

It is inevitable that this world seems confused and confusing. But at the same time, despite

this enormous diversity, great questions are universal, such as how to cope with suffering,

serious illness and death. And despite the differences, religions of all times and places offer a

message and a way of salvation. What did and still does that mean for the understanding of

psychopathology, treatment and human welfare?

A LONG AND TENSE HISTORY

For many centuries religiosity and spirituality played a major role in speculations about the

origin of mental disorders. They were thought to be the works of demons, able to penetrate

body and mind of an individual because he had sinned. Exorcism was the treatment of

choice.

In the nineteenth century, demons lost their dominant position. The pioneers of American

moral treatment started to view mental illness as a physical illness. In many cases “moral

treatment”, a child of humanism [7, 8], seemed to be far more appropriate than the dire

treatments that had preceded it.

In the twentieth century, psychoanalysis became the dominant philosophy of psychiatry.

Though sin in a religious sense faded into the background, it returned in a different shape.

Friction between unacceptable strivings (secular “sins”) versus demands of the super ego

played an important role in psychoanalytical theorising. Religiosity proper, however, was

anathema to psychoanalysis. It was considered to be an anachronism, a remnant from an

infantile past; if anything, to be treated rather than to be cherished. The inﬂuence of those

ideas has been tremendous, including beyond the boundaries of psychiatry. They probably

have contributed substantially to secularisation of the Western world. They certainly

buttressed the inclination of many, if not most, psychiatrists of the twentieth century to

exclude religiosity from their purview. For biological and social psychiatry – focusing

xvi PREFACE

predominantly on brain functions and living circumstances – religiosity was not a factor

generally to reckon with. Transcultural psychiatry, with its roots in social anthropology, has

always taken the religious beliefs and practices of individuals and their communities more

seriously as they may relate to the understanding of mental disorder.

That psychiatry in the twentieth century was largely a “Godless” period was not to the

advantage of the psychiatric patient. Religiosity can be considered a normal personality trait

and cannot be disregarded by psychiatrists, whatever their own ideas on religiosity might be.

The entire soul/psyche, after all, belongs to their sphere of work. This point of view is the

raison d’^

etre of the WPA’s section on Religion, Spirituality and Psychiatry, and the main

reason why this book was conceptualised under the section’s auspices. We hope that this

volume will indeed stir up curiosity and interest in the interface between psychiatry and

man’s tendency to provide life with a vertical transcendental dimension.

Peter J. Verhagen

Herman M. van Praag

Juan J. Lo

´pez-Ibor

John L. Cox

Driss Moussaoui

REFERENCES

1. World Health Organization (WHO) (2001) The World Health Report 2001. Mental Health: New

Understanding, New Hope. World Health Organization, Geneva.

2. Tharyan, P, Braganza, D, Jebaraj, P (2006) Mental health as a key issue in the future of global

health developments. International Review of Mission 95, 36–49.

3. World Council of Churches (2008) WCC Strategic Plan Mental Health & Faith Communities

Initiative. Available at: http://www.oikoumene.org/ﬁleadmin/ﬁles/wcc-main/documents/p4/

health/WCC_strategic_plan_Mental_health.pdf.

4. K€

ung, H (2002) Tracing the Way. Spiritual dimensions of the world religions. Continuum,

London.

5. Kyoung-Jae, K (2007) Christianity and Culture. A hermeneutic of mission theology in an East

Asian context. In: Chung, PS, K€

arkk€

ainen, VM and Kyoung-Jae, K (eds.) Asian Contextual

Theology for the Third Millennium. Theology of Minjung in fourth-eye formation. Pickwick

Publications, Eugene, OR, pp. 147–163.

6. Pridmore, S, Pasha, MI (2004) Psychiatry and Islam. Australasian Psychiatry 12, 380–385.

7. Taubes, T (1998) “Healthy Avenues of the Mind”: Psychological theory building and the inﬂuence

of religion during the ea of moral treatment. American Journal of Psychiatry 155, 1001–1008.

8. Van Praag, HM (2007) Psychiatry and religion: an unconsummated marriage. In: Glas, G, Spero,

MH, Verhagen, PJ and Van Praag, HM (eds.) Hearing Visions and Seeing Voices. Psychological

aspects of biblical concepts and personalities. Springer, Dordrecht, pp. 9–19.

PREFACE xvii

General Introduction: Religion

and Science

Peter J. Verhagen

Psychiatrist and Theologian, The Netherlands

I.1 PSYCHIATRY AND RELIGION

The World Psychiatric Association (WPA) Section on Religion, Spirituality and Psychiatry

(SRSP) took the initiative to start a project that would lead to the publication of a handbook

like volume that would serve several purposes. First of all the editors were convinced, and

still are, (of the fact) that the study of interface between Psychiatry and Religion offers a lot

of helpful and at the same time critical tools for psychiatric thinking and practice. Religion

and spirituality play their role in the lives of many, many people in a personal and/or socially

meaningful, be it salient way. In that sense religiosity and spirituality belong to the domains

of quality of life. In fact it is not imaginable how religion or spirituality could not be of

inﬂuence on the way of life, the well being and psychic and social functioning of people in

general, psychiatric patients in particular.

It took psychiatry a lot of time to rediscover this simple and at the same time complicated

fact. For a long time psychiatry had not been aware of the fact that a more or less silent

antipathy against religion inﬂuenced her thinking and practice fundamentally, even in her

classiﬁcatory systems like the DSM. Although Freud is frequently mentioned as the father of

this anti-religious stance, its roots go further back. Was it not psychiatry, according to the

well-known hagiography, that liberated those poor living creatures who had been captured

for so many years, chained in irons, as a triumph of human care and humanism? The real

story is slightly different. In western society God was replaced by nature and by the end of

the eighteenth century the physician who knew the order of nature, including the structure

of the body, could replace the priest who claimed his authority in the name of God. The start

of psychiatry is an illustration of that development. Religion lost its leading position, and the

physician became the new guide in life with scientiﬁc and moral authority. Since then the

relationship between psychiatry and religion has been strained to a greater or lesser extent.

The words ‘mad’ and ‘madness’ are complex terms and, as has been illustrated in several

ways, these and other terms we are used to in (descriptive) psychopathology and the

underlying way of thinking contain these tensions.

Religion and Psychiatry: Beyond Boundaries Edited by Peter J. Verhagen, Herman M. van Praag, Juan J. Lo

´pez-Ibor Jr.,

John L. Cox and Driss Moussaoui

This book is about the interface between psychiatry and religion and spirituality. It is

a book mainly written by and aimed at psychiatrists all over the world. At the same

time it is a multidisciplinary book and we welcome the contributions of many experts

in the ﬁeld of inquiry of religion, spirituality, psychiatry and mental health. The

discussion and debates are complex and span a number of disciplines: psychology,

psychology of religion, psychotherapy, psychoanalysis, cognitive sciences, neuros-

ciences, philosophy of mind, of science and of religion, history, and theology. No

single discipline can do full justice to the complexity of the issues at hand. Any

opposed claim would raise troublesome barriers; it is the intention of the editors of this

volume to get beyond such barriers.

I.2 NO APOLOGETICS

In order for progress to occur in this interdisciplinary ﬁeld of inquiry a minimum

consensus concerning the meaning of core constructs is needed. Now, here the discussion

becomes exciting, because, as one thing is very clear from the perspective of religion and

spirituality, one cannot settle any kind of consensus as intended here on purely objective

grounds. As soon as one starts to discuss such core constructs as disease, mental health,

religiousness and spirituality all kinds of background issues, assumptions and convic-

tions, mindsets come about. One of these assumptions, to name just one, is the rather

typical Western idea that illness is secular [1, p. 271]. Somatic and/or psychic, illnesses

have to do with biomedical, causal-mechanical patterns that are in no way spiritual or

religious. However, Islamic understanding of health and illness cannot be understood

otherwise than in the context of religious conceptualization. Within a totally different

discourse the anti-Semitic image of ‘the dirty Jew’ was repudiated in the nineteenth and

twentieth centuries with the Jewish model of preventive medicine based on the interpre-

tive tradition of Moses and hygiene [2].

Anyhow, it means that from a global perspective it becomes very clear that a discussion

like the one we are thinking of here has much of an interreligious and interspiritual dialogue.

Greater awareness of religious and spiritual plurality has heightened the need for such an

interreligious and interspiritual dialogue, even with regard to psychiatry, or better: from

within the profession itself. In connection with this need, there is overwhelming agreement

that training and permanent education should include instruction and guidance on how to

handle religious and spiritual issues in assessment and therapy. In the meantime such a

dialogue asks for a new kind of spirituality itself in order not to fall back into any form of

outdated exclusivism [3]. Psychiatry is not helped forwards by any form of religious

apologetics or expansionism! That is a very difﬁcult but nevertheless worthwhile task,

beyond usually very tough barriers.

I.3 OVERVIEW

Many colleagues from all around the world, among them many WPA ofﬁcials, started

working on this project which reﬂects their commitment to study the interface of

psychiatry and religion. ‘Beyond boundaries’ is felt as a challenging task and formulated

as the general theme.

2 GENERAL INTRODUCTION: RELIGION AND SCIENCE

The central part of the book, Section II, offers a description and analysis of how major

world religions look at psychiatry, its practice and psychiatric disorders. We posed several

questions to the authors. How do the religious and spiritual traditions they represent look at

mental or psychic functioning and how do they evaluate and interpret psychic disorders?

These are rather general formulations and questions. What does it mean in concreto, in daily

practice? Mahayana Buddhism is widely and profoundly immersed in the mental life of East

Asian people. Muslims attribute all events in life to God’s will and thus the concept of

mental illness is inﬂuenced by religious aspects. What do these inﬂuences mean to

psychiatric thinking and practice and to (the development of) therapy? Table I.1 shows

the top 10 organized world religions.

Necessarily, we had to conﬁne ourselves. The project will cover Christianity, Islam, and

Hinduism, Buddhism in East and South Asia, and Judaism. We are also able to include a

chapter on African Religions. Of course, this is a very ambitious program. The authors have

enough room to elaborate to the best of their knowledge/with their own expertise on

psychiatry and the religious tradition they represent. Statistics of the world’s religions are

only very rough approximations. Aside from Christianity, few religions, if any, attempt to

keep statistical records; and even Protestants and Catholics employ different methods of

counting members.

This central part, including seven chapters, is meant to be the fundamental part of this

book.

It is preceded by what could be called the prolegomena, about issues that have to be

explored ﬁrst or that cannot be missed without great detriment. When entering an

unfamiliar or unknown ﬁeld or subject one needs to know (something like) where to

begin. There are so many approaches and confusion is inevitable. Why should we (as

psychiatrists) think and write about religion, spirituality and psychiatry anyway? What

has psychiatry to do with religion or spirituality? Why care? On the one hand, it could be

said that such an idea, prolegomena I mean, is a rather typical Western post-enlightenment

idea. On the other hand, our claim could be that Western psychiatry has omitted an

important realm of human experience [1, p. 182] ‘The constraint of ontological space’). So

in this section it needs to become clear that there are plausible reasons for doing what we

Table I.1 This List Includes Only Organized Religions and Excludes More

Loosely Deﬁned Groups Such as Chinese or African Traditional Religions

Religion Members Percentage

Christianity 2.1 billion 33.0%

Islam 1.3 billion 20.1

Hinduism 851 million 13.3

Buddhism 375 million 5.9

Sikhism 25 million 0.4

Judaism 15 million 0.2%

Baha’ism 7.5 million 0.1

Confucianism 6.4 million 0.1

Jainism 4.5 million 0.1

Shintoism 2.8 million 0.0

Source: Encyclopaedia Britannica [4]

GENERAL INTRODUCTION: RELIGION AND SCIENCE 3

are going to do, and for exploring the hindrances, or for explaining why it should be

evident that we care.

In the twentieth century the encounter and interaction of religion and science took many

forms. New discoveries in science have challenged many classical religious ideas. In

response some people have defended their tradition, others have abandoned their tradition,

and still others have reformulated long-held concepts in the light of science.

This ﬁrst section contains historical, philosophical, theological and aesthetic viewpoints.

Concepts of evil are dealt with in various religious traditions throughout the ages and also

how these concepts affect(ed) psychiatric thinking from a historical point of view. The

theme will also be approached from a philosophical point of view. This is an important

aspect, because we need a tool to approach the theme. In order to ﬁnd such a tool,

philosophical ﬁeldwork needs to be done. Chapters are included on science and transcen-

dence, and on religion and spirituality as (not just as) human endeavor, in a very sensitive

and open-minded way. So, this ﬁrst section is about (world)views, assumptions, concepts

and (ontological) values, and about relevance! Is it still clear that religious believers and

spiritually minded people live by religious and spiritual stories and statements which they

interpret their (even pathological) experiences with accordingly and which enable them to

express meanings of a profound and transcendent kind? Is a human propensity for

transcendence facultative, or is there a fundamental shortfall, and does man need to learn

to cope with emptiness? Do we think exclusively in medical psychiatric categories, hiding or

masking existential layers? After this ﬁrst part follows the announced central part on

religions and psychiatry; again too ambitious, nevertheless full of starting points for future

discussion and research.

The third section is on religion, spirituality and psychopathology. In this part the core

business of psychiatry, assessment/diagnosis and psychopathology is at stake. Discussions,

explorations, research data and the like will not be restricted wherever possible to Western

thinking or Western populations only, although data from elsewhere might not be available

or insufﬁcient. Since Sigmund Freud published his ﬁrst article on religion more than a

century ago a number of developments have taken place in psychoanalysis and psychoana-

lytic psychology of religion. A review of these developments is included in this part of the

book. A chapter on the psychology of fundamentalism and religion (‘Violence of the

Sacred’) is necessarily included.

The fourth section is on empirical research, exploring the relation between spirituality/

religion and mental health. These chapters should inform the readers, if possible and

relevant, about phenomenology, epidemiology, research data, explanatory models and

theories, wherever evidence based data are available. It is important to refer to these data

whenever necessary opinion based points of view are presented, explained and discussed,

and that credulity based material should be detected. However, also attention will be paid to

a more conceptual approach. How do these psychopathological phenomena relate to

existential themes? What does that mean? Are we looking at epiphenomena or what else?

In addition, what are the effects of religious practices of fasting and circumcision?

Furthermore it is important to give an account of discussions towards the development

of new classiﬁcation and diagnostic systems, e.g. DSM-Vand WPA Program on Psychiatry

for the Person [5, 6].

Three other parts are added to the foregoing: one with regard to (psycho) therapy and

pastoral care, one concerning Religion and the Brain and a third one on religion, spirituality,

and training and permanent education.

4 GENERAL INTRODUCTION: RELIGION AND SCIENCE

How to approach the religiously committed patient? This question is thoroughly

discussed and illustrated from both a psychotherapeutic and a spiritual care-giving angle.

A chapter on the relationship between pastoral care an mental health completes the ﬁfth part.

Recent brain research has revealed changes in brain functions concomitant with religious

and spiritual experiences. This is anything but surprising. Experiences of whatever nature

are predicated upon activation of certain brain circuits. Atheists have taken the neuro-

theological data as the ultimate triumph of their viewpoint: religiosity is but a brain state,

nothing more. This is a misconception. Religious needs orginate on a psychological level,

not in the brain. The brain enables one to generate the corresponding religious feelings. As

an analogy: aesthetical feelings are made possible by the brain, they are not caused by the

brain but by external stimuli. Neuro-theological data show that man has the capacity to

conceive of a transcendental realm and communicate with it. These data do not have to mean

the death blow to the deistic idea at all. And although a ‘God spot’, or ‘God gene’ has been

discovered, no conclusions can be drawn whatsoever about the existence of God, or any

supreme being or reality. In the meantime that does not mean, despite the fact that repeated

emperical arguments can not prove the existence or non-existence of God, that the claim that

God exists is meaningless. It just means that we have to argue on anothere level of

knowledge for or against the existence of God. In connection with this type of reasoning

more can be said on brain, soul, self and freedom [7, 8].

With regard to training and education, a curriculum should offer sufﬁcient opportunity for

teaching trainees to address the existential, religious and spiritual needs of our patients, including:

Knowledge: basic knowledge of major belief systems; knowledge about the developmental,

experiential, and mental health; consequences of religious experiences.

Skills: improvement of interviewing skills; improvement of diagnostic skills with respect to

people having all kinds of religious backgrounds; therapeutic skills.

Attitudes: systematic reﬂection on the professional’s own belief system (atheism included)

and the inﬂuence of it on their functioning; analysis of transference and counter-

transference issues; empathy.

All contributors were asked to look at how (if at all) their own faith perspectives inﬂuence

the way they think about psychiatry and human nature, about the phenomena they are

writing about and the way they study and write about these phenomena. What are some of

the starting, fundamental premises of their perspective? What are some of their chief

concerns within their religious/cultural perspective that would point the reader to certain

aspects that should have priority? What aspects of religiousness or spirituality are likely to

inﬂuence directly the phenomena they are describing for better or for worse?

I.4 RELATION BETWEEN SCIENCE AND RELIGION

Ken Wilber called the relation of science and religion in today’s world ‘a deadly dance’

[9, p. 15]. He warns the reader of several stances toward this relation, that still inﬂuence and

even dominate our thinking [9, p. 15–24]:

1. Science denies any validity to religion;

2. Religion denies any validity to science;

GENERAL INTRODUCTION: RELIGION AND SCIENCE 5

3. Science is but one of several valid modes of knowledge, and thus can peacefully coexist

with spiritual modes;

4. Science can offer “plausible arguments” for the existence of Spirit;

5. Science is itself not knowledge of the world but merel y an interpretation of the world, and

therefore it has the same validity – no more, no less – a poetry and the arts.

The author argues that none of these ﬁve stances are acceptable. They are not powerful

enough in a way that both parties would ﬁnd agreeable. I take just one element from his line

of thinking that is worthwhile keeping in mind. The third statement would be properly called

‘epistemological pluralism’. However, what is meant by that? The traditional view on this

pluralism goes back to the Middle Ages: ‘every human being has the eye of ﬂesh, the eye of

mind, and the eye of contemplation’ [9, p. 18]. These three eyes are three eyes of knowledge:

empiricism, rationalism, and mysticism. It would make a great difference with regard to our

view on the relation between science and religion if the existence of this epistemological

pluralism was an accepted fact. However, that is not the case according to modernity.

Science and religion have often been seen as enemies locked in mortal combat. Some

people in both camps are even aggressively continuing the warfare, for instance on the topic of

evolution. But conﬂict can be avoided if science and religion are seen as strangers, occupying

separate domains at a safe distance from each other. Science and religion, for instance,

represent two kinds of inquiry and so they offer two complementaryperspectives on the world.

However, many people are seeking a more constructive partnership. Science raises

questions it cannot answer itself. So many participants are looking for a constructive

dialogue, because they are aware of the limitations of their own ﬁeld of inquiry, and because

both partners do not claim to have all the answers. Still other scientists and theologians even

go a step further. They seek a closer integration of science and religion.

We will use a well known inﬂuential fourfold typology, originally formulated by Ian

Barbour, who is a pre-eminent ﬁgure in the ﬁeld of science and religion [10, 11]. This

fourfold typology is in fact the standard manner to present the relationship between science

and religion and for that reason it can help us to sort out the great variety of ways in which

people have related science and religion, and neurosciences and theology in particular.

Barbour uses four key words to typify the four relationships: conﬂict, independence,

dialogue and integration; Table I.2 illustrates the way Barbour relates certain scientiﬁc

disciplines and their way of thinking, and religious assertions about human nature.

Table I.2 Genetics, Neuroscience, and Human Nature [10]

Conﬂict Independence Dialogue Integration

Reductive

materialism

Body/soul dualism Neuroscience and

the embodied self

Biological organism

and responsible

self

Sociobiology and

human morality

Body and soul:

complementary

perspectives

Anthropology and

the social self

Mind and brain:

Two aspects of one

process

Genetic

determinism and

human freedom

Sin and redemption The computer and

the brain

Process philosophy

6 GENERAL INTRODUCTION: RELIGION AND SCIENCE

I.4.1 Conﬂict?

Scientiﬁc materialism makes two assertions: matter is the fundamental reality in the

universe, and, the scientiﬁc method is the only reliable path to knowledge. Religion is not

acceptable because religion lacks public data, lacks experimental testing and so on.

Science is objective, open-minded, and universal; religion is none of these. In neurosci-

ence we can ﬁnd this same reductionistic materialism. In principle, we are told, we can

account for every mental phenomenon using the same physical laws that sufﬁce to explain

radioactivity, or nutrition, or growth. The same reductive point of view holds true for the

sociobiology: the only demonstrated function of religious beliefs and human morality is to

keep the genes intact. Another illustration of the conﬂictual relationship between the

neurosciences and theology would certainly be genetic determinism. It has sometimes

been claimed that our fate is determined by our genes. But although nature and nurture

impose severe constraints upon us, we are free selves who envision possibilities and can

decide deliberately and responsibly among alternative actions. So here the conﬂict is

between determinism and human freedom. Dean Hamer, who is a pre-eminent geneticist,

recognizes the limitations of his scientiﬁc treatise and acknowledges that his approach is

not a complete explanation of spirituality; genes exp lain only a relatively small percentage

of variance at best. Hamer shows that new discoveries in genetics and neurobiology might

indicate that humans inherit a set of predispositions that make their brains ready and eager

to embrace a higher power [12]. He calls the speciﬁc gene he identiﬁed the ‘God gene’ that

appears to inﬂuence spirituality. Elaborating on his ﬁndings he argues that spiritual belief

may offer an evolutionary advantage by providing us with a sense of meaning and purpose,

and the courage and will to overcome hardshipandloss.InfactinthatwayHamertriedto

bridge the gap between science and religion instead of stirring up the conﬂict. (For a

critical discussion of religion as ‘adaptation or evolutionary by-product’ and genetics,

see [13]).

I.4.2 Independence?

What is the meaning of independence regarding science and religion? One way to avoid

conﬂict or any problem is to keep neuroscience and religion separated in watertight

compartments (demarcation theory). One can distinguish the two according to the questions

they ask, the domains to which they refer, the claims they make, and the methods they

employ. Science asks how matters work, and about causal relations. Religion asks why and

asks for meaning and purpose. From another point of view: scientiﬁc and religious

languages have distinctive functions and so science and religion offer complementary

perspectives, for instance the complimentary perspectives of brain and mind. Body and soul

used to be two separate compartments. But nowadays it is clear from the neurosciences that

such a dualism can no longer be maintained. The dependence of mental status on

biochemical processes, for instance in moral dilemmas [14, 15] or during religious practices

as meditation or prayer, is clearly shown. So we are getting used to the concept of the

embodied self, that goes beyond the body/soul dualism, and that goes beyond this second

type of relationship between science and religion called independence. Religious concepts

like sin and redemption seem far removed from any scientiﬁc data. Even that, however, is

highly questionable from an evolutionary and ethological point of view.

GENERAL INTRODUCTION: RELIGION AND SCIENCE 7

I.4.3 Dialogue?

Contrary to the independency point of view the dialogue looks at the presuppositions and

tries to explore similarities between methods and concepts. Independence emphasizes the

differences. Many theologians today try to reclaim a religious or spiritual view of the self as

a uniﬁed activity of thinking, willing and acting. Neuroscience seems to be consistent with

theological afﬁrmations of embodiment. Embodiment is very clear when we look at our

affectivity. When I am moved by an emotion, it is clear that being emotional, for instance

being afraid, is not possible without feeling a bodily tension or beating of the heart. So here

religious thinking and the neurosciences, and also the behavioral sciences join in asserting

the embodied self with special importance of emotions.

I.4.4 Integration?

In integration scientists and theologians go even further. Exponents of dialogue may

sometimes reformulate traditional ideas. Integration is more far-reaching in articulating

theological reconstruction more extensively and systematically. For instance, reconstruc-

tion of a religious concept like original sin as a biologically based disposition from the past

that is not adaptive in the modern world. So according to this approach new knowledge from

the neurosciences will affect religious thinking!

It is up to the reader to look at his or her position, regarding one’s own religious, spiritual

and scientiﬁc background. It is one of the aims of the WPA section on Religion, Spirituality

and Psychiatry to help clear up these kinds of important discussions.

I.4.5 Neuro-theology

Neuro-theology is an example of a new emerging scientiﬁc discipline, based on neuros-

ciences, that presents strong challenges to traditional religious beliefs concerning human

nature. Neuroscience is the study of the physical structures of and causalinteractions between

neurons and neuronal assemblies [16]. It studies religious and spiritual concepts in relation to

neurological and neuropsychological ﬁndings and analyses. There is much to tell about

interesting data and recent discoveries in this particular ﬁeld regarding religion and spiritual-

ity [12, 17]. Atthe same time, ifone looks carefully, it is not difﬁcult to recognize the fourfold

typology in the way participants in neuro-theology handle and evaluate their ﬁndings.

I.5 REFINEMENTS

Barbour’s typology had been the starting point for the study of religion and science

relationships for many years. Stenmark [11] offered a new searching exploration based on

the premise that science and religion are social and dynamic practices and no static entities.

His study offers a reﬁnement of the Barbour typology. How do these relationships between

science and religion evolve? According to Stenmark we need four parameters or dimensions

to take into account in order to understand how and why science and religion relate to each

8 GENERAL INTRODUCTION: RELIGION AND SCIENCE

other as they do. His approach helps us to get a more differentiated picture of the interactions

between science and religion.

Stenmark’s approach is based on the idea that science and religion are both social

practices. He calls it the social level of science and religion, and it is about the social

interactions between practitioners of both science and religion. Such practices can be

distinguished by the aims the practitioners have in mind (teleological dimension) by the

methods that are used (epistemological dimension), and by the subject matter and content of

science and religion (theoretical dimension). The independence view would mean that these

two practices are completely different with regard to these parameters. The conﬂict view

would mean that the parameters should be the same. The dialogue and integration views

mean that there is a more or less overlap between one or more parameters.

With regard to psychiatry and religion we would have to look at these parameters and to

search for areas of overlap, or areas of total difference. What would be the overlap and the

difference between psychiatry and religion in a teleological sense? If it would be appropriate to

say that both practices aim at ‘healing’ or at helping relationships, there still would be a great

difference between mental health and welfare (salvation) as a goal. However, despite

the difference in ‘healing’ methods (e.g. medication versus prayer) the relationship between

‘the healer’ and ‘the healed’ is fundamental for employing the method. On a theoretical level the

question would be how much overlap or difference there is in theoretical output. Could both

psychiatry and religion offer us explanations of concepts like disease, illness and health, and also

of experiencing illness and health? Would these explanations be complementary or opposite?

However, if we look at the historical development of science and religion as social

practices it is clear that at different times and places human nature has been differently

experienced, behavior has been differently regarded, and claims to knowledge have been

adjudicated in different ways.

I.6 CROSSING BOUNDARIES

The boundary between religion and spirituality and the practice of psychiatry is becoming

increasingly porous, as the contributors to this book amply illustrate. No longer can

psychiatrists in a multi-faith, multi-cultural globalized world hide behind the dismissal

of religious belief as pathological, or behind biomedical scientism. During the last two or

three decades religion and spirituality have become more prominent in mainstream

psychiatry, not least because of the increased migration [18]. Globalization affects

psychiatry, as it affects religion and spirituality. According to Kale [19] globalization

exhibits ﬁve main trends in spirituality and religion:

*the use of religion and spirituality in reterritorialization;

*a worldwide quest to integrate spirituality in all aspects of day-to-day life;

*the increasing individualization of spirituality;

*the enhanced manifestation of spirituality in cyberspace;

*the syncretization of spirituality.

Religion and spirituality are on the move, so to say. This asks from psychiatrists to be more

knowledgeable. Religion, spirituality and globalization have a vital impact on wellness and

GENERAL INTRODUCTION: RELIGION AND SCIENCE 9

quality of life for a growing number of people worldwide. The World Health Organization

(WHO) has rightly regarded religious, spiritual and personal beliefs as a component of

quality of life. This growing awareness may enhance the study of religion and spirituality in

psychiatric training, research and practice. In their review Fulford and Sadler stated: ‘There is

a renewed cross-disciplinary contact (between religion and psychiatry, PJV) after nearly a

century of mutual neglect’ [20]. We really hope that this book may stimulate WPA, as a global

organization, to take an active stance in this renewed and promising contact.

REFERENCES

1. Sadler JZ (2005) Values and Psychiatric Diagnosis. Oxford University Press, Oxford.

2. Hart MB (2007) The Healthy Jew. The symbiosis of Judaism and Modern Medicine. Cambridge

University Press, Cambridge.

3. Schmidt-Leukel P (2004) A New Spirituality for a Religiously Plural World. Concilium 40,

62–68.

4. Information Please Almanac: Top Ten Organized Religions of the World. Available at http://

www.infoplease.com/ipa/A0904108.html. Accessed February 21, 2008

5. WPA Report from the London Conference on Person-centered Integrative Diagnosis and

Psychiatry for the Person. Electronic Bulletin. 2008; 59. Available at http://www.wpanet.org/

bulletin/eb59.html. Accessed February 23, 2008.

6. Cox J, Campbell AV, Fulford KWM (2007) Medicine of the person. Faith, Science and Values in

Health Care Provision. Jessica Kingsley Publishers, London.

7. Oomen PMF (2003) On brain, soul, self, and freedom: an essay in bridging neuroscience and faith.

Zygon 38, 377–392.

8. Verhagen PJ Sanctifying Personhood; beyond roles,functions, schemas and traits. Spirituality and

Psychiatry Special Interest Group Newsletter. 2007; 24. Available at http://www.rcpsych.ac.uk/

college/specialinterestgroups/spirituality/publications/newsletter24.aspx. Accessed February 23,

2008.

9. Wilber K (1998) The marriage of sense and soul. Integrating science and religion. Broadway

Books, New York.

10. Barbour IG (2000) When science meets religion. HarperSanFrancisco, New York.

11. Stenmark M (2004) How to relate science and religion. A multidimensional model. Eerdmans

Publishing Co, Grand Rapids.

12. Hamer D (2004) The God gene. How faith is hardwired into our genes. Doubleday, New York.

13. Kirkpatrick LA (2005) Attachment, evolution, and the psychology of religion. The Guilford

Press, New York.

14. Casebeer WD (2003) Moral cognition and its neural constituents. Nature Reviews Neuroscience

4, 840–847.

15. Greene J (2003) From neural ‘is’ to moral ‘ought’: what are the moral implications of

neuroscientiﬁc moral psychology? Nature Reviews Neuroscience 4, 847–850.

16. McConnell D, Pickering N (2005) Clinical Practice, Science, and the Unconscious. Editorial.

Philosophy, Psychiatry, & Psychology 12, 1–7.

17. Newberg AB, Iversen J (2002) On the “neuro” in neurotheology. In: Joseph R (ed.) NeuroTheol-

ogy. Brain, science, spirituality, religious experience. San University Press, San Jose.

18. Boehnlein JK (2006) Religion and spirituality in psychiatric care: looking back, looking ahead.

Transcultural Psychiatry 43, 634–651.

19. Kale SH (2004) Spirituality, Religion, and Globalization. Journal of Macromarketing 24,

92–107.

20. Fulford KWM, Sadler JZ (2002) Imaging the soul. Current Opinion in Psychiatry 15, 515–518.

10 GENERAL INTRODUCTION: RELIGION AND SCIENCE

CHAPTER 1.1

Evil in Historical Perspective:

At the Intersection of Religion

and Psychiatry

Michael H. Stone

Professor of Clinical Psychiatry, United States of America

1.1.1 INTRODUCTORY REMARKS

Mankind has struggled since remotest antiquity, and presumably long before recorded

history, to comprehend and to deal with – the manifold sources of challenge and threat to our

earthly existence. Precisely because the threats to our survival are so numerous, compared

with the comforting and healing actions that aid our survival, we have evolved over the

millennia with a heightened awareness of the things that can harm or kill us, lower our social

status, adversely affect our loved ones, or otherwise rob us of the necessities of life. This has

led to the broad distinctions in our language between the positive and the (altogether more

numerous) negative inﬂuences – captured under the headings Good and Bad, or in a manner

more freighted with religious overtones, Good and Evil.

Originally, the concept of Evil covered a large territory on our mental map: natural

disasters such as droughts, ﬂoods, earthquakes, plagues, and extremes of temperature;

animals that could endanger our lives; and ﬁnally – the most dangerous of all our enemies:

other humans with hostile intentions. The inescapable death of ourselves and of all living

species was often itself regarded as an evil.

Natural disasters, in particular, could be so overwhelming, wiping out great numbers of

people, even whole populations, at one stroke, that they cried out for explanation and, if

possible, for being brought under our control. But war and violent acts even in peacetime

could also reach devastating proportions. These phenomena also cried out for explanation

and control.

The religious impulse, which has sprung up spontaneously in all cultures from the

beginning of recorded time (if not from the time of our emergence as a separate species), has

acquired pride of place among the attempts our ancestors made to explain evil. Mankind has

found it both comforting and necessary to invoke the concept of the divine, whether

compartmentalized into many deities (as in the pantheons of the ancient Greeks, the Hindus,

Religion and Psychiatry: Beyond Boundaries Edited by Peter J. Verhagen, Herman M. van Praag, Juan J. Lo

´pez-Ibor Jr.,

John L. Cox and Driss Moussaoui

the early Egyptians, etc.) or, as in the Abrahamic religions of Judaism, Christianity,

and Islam, manifest in the existence of one God. Many believe that God created us in

His image; others, regarding this as an anthropomorphic conceit, assert that we created (the

concept of) God in our image. Be this as it may, religion assigns to God (whether in the

singular or the plural) supernal powers over our lives and over all Nature. Related ideas

include heavenly reward for doing well; heavenly retribution for doing evil. As we shall see,

in earlier times the natural disasters were themselves understood as punishment writ large –

for violating God’s laws about proper conduct by whole groups of people, even at times

by whole nations.

The belief in life after death, adhered to by religious persons of many faiths, brings with it

the accompanying notions that those whose lives have been (mostly) good will reap the

reward of life-everlasting in Heaven; those whose lives have been (mostly) bad, devoted

repeatedly to acts regarded as evil – will earn only a place in eternal damnation, Hell, or its

equivalent. The appeal of these beliefs is easy to grasp, given the unhappiness endured by

most well-meaning and well-behaved people, and given the outrageous success to the very

day of their death, whether in fame, power, or money, of certain undeserving people who, in

the estimation of society, were evil. One of the functions acquired by religion, in other

words, was the promise of at least belated justice via the punishment of bad people, even if it

could only be carried out in the hereafter – that the good people had been unable to effect

within the lifetime of the offenders.

Looking at the world’s timetable, it is clear that religion antedated philosophy, and that

philosophy came before psychiatry. It is not surprising, then, that in seeking an explanation

as to how the mysterious and embarrassing existence of evil arose amongst their own kind,

men turned ﬁrst to religion. The ﬁrst persons to offer explanations about evil were men of

religion: either founders of a new religion, or else men schooled in-, and strongly identiﬁed

with, an already developed religion. Many of these men were of what we would now call a

‘philosophical turn of mind’ – in the sense that they grappled with the larger issues of good

and evil, morality, how life should be lived, how death should be confronted, our place in

Nature, and our relation to Deity. The next group of men to ponder these issues and to offer

explanations, steeped as they were in both religion and philosophy – were the religious

philosophers. Only within the past three centuries have we witnessed the emergence of a few

philosophers – often raised in deeply religious families – whose approach to the subject of

evil is nevertheless more secular in construction and less tied to the tenets of this or that

religion.

Until very recently the topic of evil was felt to be the exclusive province of religion, or

perhaps of religious philosophy; explanations of evil partook of the metaphysical or the

supernatural. To that extent, only for religious adepts: priests, ministers, rabbis, imams, was

it permissible to make pronouncements about evil. Philosophers whose thoughts and

writings were imbued with religion might also address the subject. But for the vast majority

of people – to speak about evil, especially to categorize certain others as evil, was felt as an

intrusion on sacred ground, and would often enough invite adverse criticism.

In the twentieth century, however, discussion of evil underwent a sea-change. Many

important philosophers were less attached to conventional religion than heretofore. And in

the last half of the century, particularly following the Holocaust, but also in recognition of

the genocides in Armenia earlier, and in Cambodia, Rwanda, Nigeria, Yugoslavia and

elsewhere, along with the Nanking Massacre of 1937, and the mass murders of its own

citizenry in Russia and China – the topic of evil could no longer be conﬁned to the

14 PROLEGOMENA (FIRST ISSUES)

sanctuaries of religious leaders or to the university halls of the philosophers. Two signiﬁcant

developments have, in recent years, brought about a reshaping of our attitudes towards evil.

First, we have begun to pay more attention to how the word evil is used by the public and by

the media. There are certain classes of crime, for example, that predictably elicit the word,

whether from people in ordinary life or from writers and journalists. Evil is no longer ‘off-

limits’ except to men of the cloth. Second, evil has become an acceptable subject for study

by the mental health professions, including general psychiatry, forensic psychiatry, and

neuroscience. Rather than relying only on the Bible (of whatever religion) for explanations

about the nature and roots of evil, we now look where we should have been looking all along:

the human brain.

There has been an inchoate recognition for a long time that evil is a purely human

phenomenon. For an action on the part of one creature toward another creature to be

considered evil, there must be consciousness and also an awareness of death. The con-

sciousness, in this case, would involve the awareness of the suffering that one is inﬂicting

upon another. Awareness of death is a special case of consciousness, the implication being

that an aggressor realizes consciously (a) that the death of the victim may be the result of

aggressive action, and (b) that the victim would have beenvehemently opposed to this result.

There is also the matter of attitude. Acts that we regard as evil are often preceded by

powerful emotions of hatred (whether in the form of contempt, envy, jealousy, outrage over

being humiliated, and the like). Born of such hatred are such acts as murder, rape, grievous

assault, public humiliation, the depletion or ruin of another’s possessions, etc. All these

manifestations are unique to our human species (with perhaps a few analogous acts among

some of the higher apes). The cat bears no malice toward the mouse, nor the walrus to the ﬁsh

it devours for its sustenance. For all intents and purposes we are the only members of the

animal kingdom of whom it is meaningful to apply the word evil.

In reviewing how the concept of evil has evolvedover the centuries, we turn our attention

ﬁrst to the men of religion in ancient times, some of whom also became the founders of new

religions. We then see how the concept was reworked and understood by men who were at

once professional philosophers and deeply religious persons. In the more recent centuries

the main commentators on evil were philosophers, often with a strongly religious back-

ground and upbringing, but who were not also clergymen. Still more recently, we confront

professors of philosophy of a more secular orientation. Finally, commentary on evil is

divided between philosophers who are less strongly identiﬁed with a particular religion –

and persons in the disciplines of psychology and psychiatry.

1.1.2 EVIL AS VIEWED BY MEN OF RELIGION IN ANTIQUITY

One of the earliest ideas about evil is to be found in the writings of Yajnavalkya, a Hindu

religious adept and ascetic of the eighth century BCE. He spoke of an ‘inner person’ who

existed in two states: one of this world, one in the Other. When we are born and acquire a

body, we are joined with evils; when we die, we abandon evils. In the intermediate situation

of the dream state we see both the evils of this world and the joys of the Other world – an idea

that is incorporated in a religious text: the Brhadaranyaka Upanishad [1]. As for ‘evils,’

Indian and Buddhist countries believe in the notion of karma, according to which all our

deeds, whether good or evil, are rewarded or punished; our ultimate fate is determined by the

accumulation of our deeds, extending over our lifetime ([1], p. 40).

1.1 EVIL IN HISTORICAL PERSPECTIVE 15

A near-contemporary of Yajnavalkya, the Old Testament prophet Isaiah spoke in the

tradition of Jewish monotheism, referring to the fallen angel Lucifer (lit.: the bearer of light)

as one who had claimed that he would ascend into Heaven and exalt his throne above the

stars of God...I will be like the Most High [Isaiah 14:12–15]. The prophet asserts that no,

Lucifer (called also Satan: Hebr. for ‘adversary’) will be brought down to Hell. Lucifer’s

sins were those of pride and covetousness – akin to our modern concept of narcissism. But

there is a hint in Isaiah’s remarks that the good and evil observed among men is related in

some way to the supernatural, celestial battle waged between God and His adversary –

Lucifer/Satan.

Prince Gautama Siddharta (623–543 BCE) as he neared 30 gave up a life of riches,

wandering in northern India as a poor man, and developing a philosophy that emphasized the

renunciation of earthly desires and the state of non-attachment. Having achieved enlight-

enment, he became known as the Buddha (from the Sanskrit verb to awaken). Though he

never claimed divine status, rather that of a teacher and guide, he has now become the object

of veneration by those who claim Buddhism (and its offshoots) as their religion. Buddha

taught that to escape suffering one needed to eliminate desire and to follow the noble Eightfold

Path (right view, right speech, right thought, etc). To be avoided were the chief sins – all

related to lust or desire; namely, anger, greed, and foolishness. These constitute the same

triad of sins embodied in Japanese Zen-Buddhism: ikari (anger), musabori (greed) and

orokasa (foolishness).

The religious teacher and prophet of ancient Persia, Zoroaster, was probably a contem-

porary of the Buddha, though some have suggested he may have lived much earlier, even

before 1000 BCE [2]. The religion he founded – Zoroastrianism – postulated the twin

brother-Gods, Ahura-Mazda (the God of Light and Good), and Ahriman (the God of

Darkness and Evil). There is a close parallel here to the Old Testament story of the

twin brothers, the virtuous Abel and the murderous Cain. Ahriman is said to have chosen of

his free will to behave in an evil way, creating in the process the phenomena of sin, death,

and evil.

The Jewish prophet of the Old Testament, Ezekiel (622–570 BCE), a contemporary of

the Buddha, wrote of Lucifer in this way: ‘Thou wast perfect in thy ways from the day

that thou wast created, till iniquity was found in thee.... Thou hast sinned: therefore... I

will destroy thee, o coveting cherub... and never shalt thou be anymore’ [28:12–19].

Centuries later, Christian theology could not accept that God created Lucifer/Satan as a

wicked creature, since this would amount to God creating an evil. Instead, St.

Augustine’s idea (built upon Ezekiel’s understanding) found preference, according to

which God had not created Lucifer as evil. Rather: Lucifer, now as Ha-Satan [the

adversary] via an exercise of his own free will – chose an evil path, and was cast out of

Heaven (cf. [3]).

1.1.3 EARLY PHILOSOPHERS

Kong Fu-zi [Kong, the Master], whom we know as Confucius [551–479 BCE], albeit a

religious man, rarely discussed supernatural phenomena, emphasizing instead a humanistic

approach – one that recognized the free will of all people [4].

Confucius taught that the superior man is one who has learned to overcome his innately

evil nature, through the practice of jen [acknowledgment, knowledge]. He also advocated

16 PROLEGOMENA (FIRST ISSUES)

moderation as a transcendent virtue, akin to the emphasis on the ‘middle way’ in the

philosophy of Aristotle. Evil, for Confucius, was not seen as a supernatural force implanted

in us, and against which we must constantly struggle, but as an inborn human tendency –

against which we must constantly struggle.

Mencius [372–289 BCE], who may have been taught by Confucius’ grandson, Zi Si, was

an idealist after the manner of Plato, in agreement with the latter that he believed in man’s

innate moral goodness, in contradistinction to Confucius’ belief in man’s originally evil

nature.

The comments of Plato [427-347 BCE] on evil have a resonance with those ofConfucius.

For Plato, God was not the cause of evil; instead, God guarantees the inevitable decree of

Fate; namely, that the man who will make the wrong or immoral decision will pay for it,

becoming tormented, perverted, and unhappy. God is without blame (an

aitio&). The ‘evil

soul,’ meanwhile, is that part of the soul where evil naturally resides; that is, the irrational

part of the soul which is receptive to evil and to ‘unmeasuredness’ – i.e., excess and defect,

the sources of unrestrained wickedness and cowardice. One effect of this irrational soul is to

make the soul think that whatever it avoids or shuns is ‘evil,’ and whatever it seeks is ‘good’

([5], Phaedrus 256B 2–3).

Plato’s pupil, Aristotle (384–322 BCE), expressed similar views concerning evil: evil was

a form of the ‘unlimited’; good, of the limited. Excess and deﬁciency are failings; virtue lies

in the (golden) mean. As Aristotle mentioned: Men are bad in countless ways; good, only in

one ([6], II vi). The mark of virtue was to have the right feelings at the right times on the right

grounds toward the right people for the right motive and in the right way. In this regard,

Aristotle’s ideas harmonize with those of the Buddha’s Eightfold Path.

Epicurus, a Greek philosopher [341–270 BCE] from the generation after Aristotle, held

that the purpose of philosophy was to attain a happy, tranquil life, adding that pleasure is

the measure of what is good; pain, of what is bad. He held that the gods neither reward

nor punish people, but also counseled against hedonism – remarking that restraint and

temperance were prime virtues, much as was emphasized by Plato and Aristotle ([3],

1:20). The philosophical school he founded (Epicureanism) was one of the three then

dominant schools of thought, alongside Stoicism and Skepticism. Epicurus is noted for

his effort to explain the world without recourse to myth or religion, but through reference

to material principles – testable in what we would call a scientiﬁc way via direct

observation. Moral reasoning for Epicurus involved a cost/beneﬁt analysis of pleasure

versus pain (the latter included both physical and mental suffering). Mirrored in his

philosophy is the Jeffersonian credo, embedded in the American Declaration of Inde-

pendence, asserting that human beings have the inalienable rights to life, liberty, and the

pursuit of happiness. In one of his writings, preserved by the early Christian rhetorician,

Lactantius [240-ca. 320 CE], Epicurus casts doubt on God’s responsibility for evil via a

method of careful reasoning that we will confront only much later in the works of Pierre

Bayle. As Epicurus phrased it: God either wishes to take away evils, and is unable, or He

is able and unwilling, or He is neither willing nor able – or He is both willing and able. If

He is willing but unable, He is feeble, but this is not in accord with the character of God.

If He is able and unwilling, He is envious, which is equally at variance with God. If He is

neither willing nor able, He is both envious and feeble – and therefore not God. If He is

both willing and able (which alone is suitable of God), where then does evil arise? And

why does God not remove evils? It will be many centuries before this dilemma is resolved

satisfactorily.

1.1 EVIL IN HISTORICAL PERSPECTIVE 17

1.1.4 COMMENTARY ON EVIL IN THE 1ST MILLENIUM

OF THE COMMON ERA

The word evil, once the New Testament was organized in its ﬁnal form by Bishop Irenaeus in

the late second century CE, occurs some 106 times (as against 446 times in the Old

Testament). The Greek word kako

´nis used much as was the Hebrew [ra] of the OT– in a

variety of ways: wickedness, hurt, mischief, bad, afﬂiction, adversity, harm, wrong, etc: that

is, both to designate the deed and also its consequence. There is not so much comment on the

primal source of evil (as in Zoroaster’s Ahriman), as there is an implicit recognition that men

are strongly inclined to commit acts which others deﬁne as evil – particularly if there is a

weakness in their link to God. In this sense, God plays a role more in the center stage of

human conﬂict than is apparent in the philosophy of Plato, where God (or the ‘gods’) are at a

greater remove from human affairs, operating more as observer or ﬁnal judge. Thus the New

Testament speaks of the ungodly man: one whose life-course is an injury to himself and to

everyone around him; he is morally evil and hurtful. Saul of Tarsus [? to ca. 67 CE], who

became St. Paul, famously wrote in the ﬁrst epistle to Timothy: ‘the love of money

[jilargura] is the root of all evil’ – referring especially to ‘...they that will be rich fallinto

temptation and a snare, and into many foolish [lit. ano

´hto&’mindless’] and hurtful lusts,

which drown men in destruction and perdition’ [1 Tim. 6:9 & 10]. Paul here inveighs against

the same evils of greed and foolishness that the Buddha underscored. Elsewhere, Paul gives

us a brief catalog of evils: adultery, fornication, uncleanness, lasciviousness, idolatry [lit.:

heresy], witchcraft, hatred, strife, envy, drunkenness, revellings, and such like’ [Paul’s

Epistle to the Galatians 5: 16–24]. Oddly, the King James version also mentions ‘murder’

[Gal. 5:21] – which would be jo

´no&/phonos, whereas the original Greek of the Septuagint

only reads jqo

´no&/phthonos – which signiﬁes envy or malice. Paul does not present these

evils in a hierarchical manner; certain ones nevertheless appear to us more malign (such as

ecqra: hatred, enmity) than others (such as drunkenness).

Plotinus [205–270 CE] is believed to have been a Hellenized Egyptian, the developer of

neo-Platonic philosophy. He himself was not Christian nor did he refer to Christianity in his

works. Plotinus’ cosmology inﬂuenced subsequent philosophers from many backgrounds,

including Jewish, Christian, and Muslim. One aspect of his cosmology centers around his

belief that the soul is composed of a higher and a lower part: the higher part – divine, and

imparting life to the lower part, which in turn is the seat of the personality with its passions

and vices. Evil is linked with matter, in contrast to the Intellect, which is always pure – and

which turns away from matter. For Plotinus evil was not irremediable, since it came about

through privation: through the soul becoming disconnected from the higher part because of

forgetfulness. In this latter state, the soul loses its ability to rule over its inferior part and

comes under the inﬂuence of matter. The remedy for the soul, by which it can free itself from

evil – is through the experience of love.

In contrast to the mind-set of Plato or Mencius, the early Christian philosophers tended

toward a pessimistic view of humanity, picturing man as sinful, evil as inescapable,

salvation as difﬁcult to achieve. This gloomy view was not universal among them, but

was characteristic of the most inﬂuential thinkers. Consider, for example, the ideas of St.

Augustine as contrasted with those of Pelagius. Both were born in the same year [354 CE]:

Pelagius in Britain; St. Augustine, in North Africa. St. Augustine, before his conversion to

Christianity at age 31, struggled with sexual feelings that overwhelmed him and which he

strove to ‘conquer’ after coming under the inﬂuence of St. Ambrose in Milan. In his effort to

18 PROLEGOMENA (FIRST ISSUES)

understand evil, St. Augustine argued that God was good and the things He made were good.

Evil, not being attributable to God, came from the sin committed by Adam and Eve in

violating God’s prohibition against eating the forbidden fruit (which conferred knowledge,

including, by the way, knowledge about sex and procreation). Because of this hubris, we

became corrupted by our own free will – the Original Sin of these ﬁrst two humans being

passed down the generations. For St. Augustine this vitium (ﬂaw) lay in our passions and

desires of the ﬂesh, summed up under the heading of concupiscentia (which includes all

desires – for wealth, admiration, power, not just for sex), the root being Pride (the craving for

self-exaltation). In one of his more dour comments, he wrote Sub Deo justo, nemo miser nisi

mereatur: Under a just God, no one is miserable who has not deserved misery. Yet St.

Augustine disagreed with Plotinus, claiming instead that whatever exists on earth (including

matter) is good, because it came from God. The one curative that could free our will from its

inherited and otherwise irremediable predisposition to sin – was the elusive (and for St.

Augustine, not very liberally dispensed) force of God’s grace [7].

Pelagius’ views were diametrically opposed to those of St. Augustine, rejecting the

latter’s fatalistic and rigid conceptions. Opposing the doctrine of Original Sin, Pelagius

proposed instead that Adam was created susceptible of death – whether or not he had sinned;

his sin was his alone and not that of all mankind; infants are in the same state as Adam before

the Fall; and even before Christ there were some men who were sinless. Each person,

furthermore, was free to choose between good and evil. Though Pelagius regarded his

contemporary as nearly Manichaean (and thus heretical) in his picture of Good and Evil as

akin to two separate forces, it was St. Augustine who won the day and set the tone for much

of Christian philosophy in the years to come. Pelagius emerged, despite his (as we would see

it) humanistic philosophy, as the ‘heretic.’ In fairness to his rival, St. Augustine did

recognize (in a manner at variance with Manichaeism) that ’... I once thought that it is

not we who sin but some other nature that sins within us (mihi videbatur non esse nos qui

peccamus, sed nescio quam aliam in nobis peccare naturam)... The truth, of course, was

that it was all within my own self, and that my own impiety had divided me against myself’

([8], V, 10).

1.1.5 ARABIC PHILOSOPHERS IN THE TIME

OF THE FIRST MILLENNIUM

A number of important Arabic philosophers bookended the ﬁrst millennium, having

ﬂourished in the century-and-a-half just before, or just after 1000 CE.

The ﬁrst philosopher of major signiﬁcance during this era was Ab



usuf al-Kind

ı(ca.

801–873), who was born into an aristocratic family in Kufa (in what is now Iraq). A

polymath learned in many academic subjects, Al-Kind



ıis credited with having introduced

Indian numerals (that we now refer to as Arabic numerals) into the Islamic and Christian

worlds. In the ﬁeld of psychology he wrote a treatise on sleep and dream interpretation. As

to his philosophic thought, he was inﬂuenced by Aristotle and by such neo-Platonic writers

as Plotinus and Proclus. In his treatise The Eradication of Sorrow, Al-Kind



ıtouches on the

broad topic of good and evil, insofar as he speaks of grief as related either to the loss of

loved ones or to the loss of personal possessions. Yet one cannot live without sustaining the

loss of loved ones nor can one acquire all he may desire. As Butterworth [9] mentions, ‘the

only way to escape sorrow is to be free from these attachments’ (p. 269). In this sense

1.1 EVIL IN HISTORICAL PERSPECTIVE 19

Al-Kind



ıargues for the kind of asceticism urged by the Buddha long before him, and by

the neo-Platonic philosophers as well – who equated evil with the material world – and

with the inordinate quest for material wealth; good – with philosophic contemplation and

the pursuit of virtue. Implicit in his recommendation for the virtuous life is something akin

to life according to an Aristotelian Golden Mean – where, regarding possessions, one

strives to get along with the low side of average; to be satisﬁed, that is, with ‘just enough.’

This would be the optimal antidote to greed (recall the Buddha’s triune conception of

evil: anger, greed, and foolishness) – that was still compatible with a tolerable human

existence.

The philosopher/polymath whom we know as Rhazes was born in Persia, in the city of

Rayy (whence his name: ‘from the city of Rayy’) in about 854. He became physician in

charge of the Royal Hospital in Rayy, eventually moving to a similar post in Baghdad.

Among his medical accomplishments were the discovery of sulfuric acid and the medical

use of alcohol. Though a proliﬁc writer (one year he is said to have written 20,000 pages, or

55 a day), little has come down to us of his original works. A freethinker whose philosophic

ideas were more in keeping with Platonic than with Aristotelian thought, Rhazes did not see

creation as a gift or an act of grace bestowed on us by a benevolent deity. Rather, he felt

that ‘... in this life, evils outweigh goods,’ in sympathy with the Epicurean view, and

also with his physicianly observation that there was a ‘prevalence of pain and suffering

over peace and pleasure in all sensate beings’ [10]. Akin to the Judaeo-Christian notion of

expulsion from the Garden of Eden because of sin, Rhazes pictured our bodily existence

as representing a fall from the life-giving principle of the Soul – a fall that can be broken by

the gift of intelligence. The fall was not so much imposed on us by God as permitted by a

tolerant and all-seeing Wisdom [10]. There is a hint here of man having free will,

despite the omnipotence of an all-knowing God – leaving us free to pursue good or to

descend into evil.

In a manner analogous to Pelagius’ departure from orthodox Christian belief, the Persian-

born Islamic philosopher, Ab

u Nas¸r al-F

ar

abi [870–950], the founder of Islamic Neo-

Platonism, questioned the authority of the Qur’an and rejected the notion of predestination.

He felt reason was superior to revelation – a heretical idea for a Muslim [11]. Al-F

ar

abi may

have been inﬂuenced in this direction by his (heretical) teacher ‘

Isa al-Warr

aq (died 909

CE). Dividing the cosmos into three worlds: the First (independent of matter; the realm of

intelligible forms and higher spirits); the Second (the heavenly spheres); and the Third

(material entities), F

ar

abi posited that evil was excluded from the ﬁrst two, and could exist

only in the third realm. Even there, in the domain of willful action, good and evil can be

found, and depend on either the proper use, or else the misuse, of material means. Voluntary

evil is associated with wrong choice, as when, for example, the rational faculty is oblivious

to the supreme good and is directed instead toward an inferior good such as pleasure or proﬁt

([11], p. 97). There is no simple correspondence, in other words, between Pleasure and

Good versus Pain and Evil, since certain pleasures are obviously associated with vice and

with harm to others. Rhazes before him had cautioned that pleasure is to be pursued only in a

manner that brings on no greater pain or harm ([9], p 271). As with Pelagius, and in opposition

to St. Augustine, God and the supernatural are no longer primary elements in Al F

ar

abi’s

conceptualization of evil and its origins. Even though he invokes God as the ‘Lord of the

Worlds,’ God, in Al F

ar

abi’s view, does not act directly on the sublunary world (Rhazes

would agree with this postulate), and is thus more remote than the God of St. Augustine.

20 PROLEGOMENA (FIRST ISSUES)

Ab

u ’Ali al-Husayn ibn Sina, whom we know as Avicenna, was born near Bukhara (in

Central Asia) in 980. He died in 1037 CE. A polymath like the previously mentioned Islamic

philosophers, Avicenna is better known today for his voluminous medical writings than for

his essays on other topics. In his philosophical work, he was interested primarily in creating

a coherent system that dealt with man’s place in the world in a way harmonious with Islamic

religious doctrine. His earliest works were inﬂuenced by Al-F

ar

abi, and include his Maqala

ﬁ’l Nafs (Compendium on the Soul) in which he argues for the incorporeality of the soul,

though without adopting the Neo-Platonic notion of its pre-existence [12]. As with medieval

philosophers in general, Avicenna used the philosophical mind-set in the service of religion,

positing that God, as one pure Good could produce only a cosmos that was orderly and good.

But this raises the vexatious question: if God is pure Good, whence Evil? Avicenna’s answer

was that there was no Pure Evil (like the Zoroastrian Ahriman) on the other side of the

balance. Rather: in our world there are particular evils, best understood as ‘accidental

consequences of good’ ([12], section 5). Still to be explained: moral evils among human

beings, as opposed to natural evils such as earthquakes and ﬂoods. Here Avicenna posited

that God knows the things that exist, but not individuals. This drew ﬁre from a later Islamic

philosopher, Al Ghazali (1058–1111 CE), for whom Avicenna’s denial that God had

knowledge of particulars, as well, was heretical. In the area of psychology Avicenna’s

religion-inspired views existed side by side with his practical medical knowledge. In a

prelibation of Descartes’ seventeenth-century theory, he believed that the soul is indepen-

dent of the body, even going so far as to enunciate an argument, similar to Descartes’ cogito

ergo sum, that a blind man, were he suspended in the air, would be unaware of his body, yet

still possessed of self-awareness – because he could still think ([12], section 7). But in his

great compendium, the Canons of Medicine, Avicenna described various ‘down-to-earth’

psychological (we would say psychiatric) conditions, such as melancholy and mania – along

with recommendations for their treatment. Avicenna’s views on the temperaments (San-

guineous, Phlegmatic, Bilious, Melancholic or ‘Atrabilious’), and their connections to the

four elements: air, water, ﬁre, and earth, respectively, derive from ancient Greek sources

(particularly, Galen). We still use the corresponding temperament terms manic, phlegmatic,

melancholic//depressive, and irritable even today, as did Kraepelin in the early 1900s. But

Avicenna hardly conﬁned himself to psychological issues, and though he touched on

psychiatric conditions, he cannot in any meaningful sense be called a psychiatrist.

The most prominent successor to Avicenna, Ab

u’l Wal

ıd ibn Rushd (our Averrho€

es), born

in Islam’s western-most area, in Cordoba (1126–1198), is famous for his commentaries on

Aristotle. Ibn Rushd was in touch with Christian and Jewish philosophers in Islamic Spain,

including Maimonides (also from Cordoba), who greatly admired him. As with many

philosophers, from the Greeks to the time of ibn Rushd, the attainment of intellectual

excellence was considered a ’prerogative of the privileged few’ ([13], p. 301). The masses,

in contrast, could aspire at best to a level of moral excellence through leading a life of virtue

(according to the wisdom and recommendations of the philosophers). Moral uprightness

was a potential for them, even though a comprehension of the essential truth lay beyond their

grasp. A philosophical posture vis-

a-vis good and evil is implicit in this view, though ibn

Rushd focuses less on the topic of evil than did some of his Islamic predecessors. Dante

knew of both Avicenna and ibn Rushd, whom he situated in the limbo of Inferno – where lay

the unbaptized and the virtuous pagans (whereas another prominent Aristotelian, St.

Thomas Aquinas, was in Paradiso). Toward the end of Canto IV (ll. 142–144) of the

1.1 EVIL IN HISTORICAL PERSPECTIVE 21

Inferno, Dante wrote:

Euclide geom

etra e Tolomeo, Euclid the geometer and Ptolemy,

Ipocr

ate, Avicenna e Gali€

eno, Avicenna and Galen,

Averoı

`s che ’l gran comento feo. Averro€

es who made the great Commentary. [14]

1.1.6 RELIGIOUS PHILOSOPHERS OF THE MEDIEVAL PERIOD

The humanist Jewish philosopher Maimonides [1135–1204] transmitted Aristotelian

rationalism, which had been kept alive through the Arabic sources of the previous four

centuries, to later Christian theologians like Albertus Magnus and St. Thomas Aquinas.

Maimonides accepted the Platonic view that earthly matter was the source of evil and saw

the Imitatio Dei of St. Augustine as a way of freeing oneself from the ties of matter [15].

He also saw the imagination as tied to material things, one manifestation of which was the

anthropomorphism and belief in a corporeal, as opposed to an abstract, God [16]. He

advocated, in a manner akin to asceticism, minimizing one’s attention to bodily functions

and impulses (food, drink, sex...), recognizing how they underlay the ‘evil impulse’

[yetzer ha-ra]. Yet his realism was such that he understood that the evil impulse

was not irredeemably evil: later rabbis would argue, in fact, that without a measure of the

impulse, one would not marry, have children, build a house, or engage in business. What was

crucial in Maimonides’ argument was that the impulses that govern sex and the desire for

mastery can gooverboard (beyond, in effect, the Aristotelian mean) and end up as evil actions.

For St. Thomas Aquinas [1225–1274?] the main theological struggle was that of

theodicy: how to explain the existence of evil, given an omnipotent God who was thoroughly

benign and good – an echo here of the earlier lament of Bo€

ethius: ‘If there be a God, from

whence so many evils?’ ([17], xix). The resolutionlay for him in the concept of free will. Only

God had a free will that was at the same time incapable of sin. But St. Thomas considered it

impossible for God to create human beings having both a rational nature and free will – who

would always choosewhat was right and never commit a fault or a sin. As towhy it should be

that God could not have gone the extra distance and engineered our freewill in such a way that

we too could not commit sins – St. Thomas does not hazard an explanation. He does conclude,

however, that the root of all vices lay in the inordinate love of self [Question VIII, art. 2, reply

19] – a comment in linewith our modern conception of narcissism (Aquinas St. Thomas [71].

For further explication of the views of St. Augustine and St. Thomas, the reader should

consult the excellent summary of Carlos Steel [72].

Count Giovanni Pico della Mirandola [1463–94] hoped to put to rest, as had Pelagius

before him, the belief still held by some – that evil was born of two distinct sources, one

representing the Good; the other, Evil, as posited by Zoroaster and the similar-minded third-

century prophet, Mani – from whose name the Manichaean heresy derives.

Writing in the early Renaissance period, St. Ignatius Loyola [1491–1556], the founder of

the Jesuit order, expressed a mixture of views: some that pay homage to traditional Christian

theology; others that have a more modern ring. He mentions (in the traditional vein) that the

Devil, studying the nature and traits of each man, suggests splendor to the ambitious, gain to

the covetous, delight to the sensuous, etc. But he avoids the trap of theodicy in stating that

one cannot deﬁne Good and Evil in absolute terms, and that evil is an emergent property that

grows out of a particular context, dependent also on the mind-state of the person(s) in

question [18]. Stressing the important role played by our free will – by which we may choose

to turn away from God’s loving desire (and thus commit evil acts), Loyola lays less emphasis

22 PROLEGOMENA (FIRST ISSUES)

on God as omnipotent and all-good, which so bedeviled, or rather confounded, those who

grappled with theodicy. Similar views were expressed by Loyola’s contemporary, Juan Luis

Vives [19]. As a Jew who converted to Catholicism under the impact of the Spanish

Inquisition, Vives was perhaps more ready to think along less conventional paths, con-

tending that the Will is essentially spontaneous (and not always subject to Reason), and is at

liberty to choose to do evil things as well as good things, God notwithstanding.

1.1.7 THEOLOGIANS AND PHILOSOPHERS OF THE

RENAISSANCE AND ENLIGHTENMENT

Among the prominent theologians and philosophers of the sixteenth through the nineteenth

centuries, the subject of evil is treated more and more as a human affair, with God or the

Devil playing less active roles from the standpoint of causation. There is an increasing

tendency to picture God in a more abstract, less anthropomorphic, manner. Most of the

philosophers are believers; many come from families where the father was a clergyman. But

the dominant explanation concerning the origin of evil relies on concept of free will, albeit a

free will that was granted us by the deity.

The German Protestant religious mystic, Jacob Boehme [1575–1624] argued, in a

way that would have been considered quite heretical earlier, that God was ‘underneath’

rather than ‘above.’ In what amounts to a prelibation of Spinoza’s philosophy, Boehme

stated that Nature rises out of God, and that we ‘sink into him’ [20]. He also posited two

triads of forces, one of which was composed of the elements: Soul, Body & Spirit –

corresponding to which are Good, Evil, and Free Will. In his later writings Boehme

envisioned evil as the direct outcome of the wrathful side of God, adding that the object

of the world’s life and history was to exhibit the eternal victory of Good over Evil; Love

over Wrath.

For Thomas Hobbes [1588–1679], the son of a Protestant vicar, God was one Substance,

of which there could be more than one Persons (or Representatives), such as Moses, or later,

His own Son, Christ ([21], p. 520). But Hobbes’ comments on Good and Evil reﬂect his

sociological/political understanding of these attributes. Portraying human life as involving a

universal desire for self-preservation, Hobbes argued that because Man is in the state of

nature anarchic and greedy, a social or civil order soon evolves – as a means of avoiding a

war of all against all. In his famous comment about our life as ‘solitary, poore, nasty, brutish

and short’ ([21], p. 186), Hobbes states that the remedy for this is the appointment of a

sovereign, who saw to it that men exchanged a degree of personal freedom in return for

personal safety. Good, Evil, and Justice had no meaning, in Hobbes’ schema, until men

curbed their desires and entered into a social pact ([21], Ch. XIII).

The comments on evil of Descartes [1596–1650] resemble those of Vives: in his De

Passionibus he asserted that ‘All good and evil in this life depend on the Passions alone’

[CCXII] . For Descartes the passions (we would call them the emotions) are the products of

Nature; their use is to contribute to actions that preserve or improve the body. Yet the Will

must at times oppose the Passions with ‘...ﬁrm and determined judgments touching the

knowledge of Good and Evil, according to which the Soul has resolved to conduct its

actions’ [CXXXVII]. What Descartes does not make clear is how we know what is Good and

what is Evil to begin with.

Sometimes called the last of the medievalists, Baruch Spinoza [1632–77] had a

conception of evil as identiﬁed, in neo-Platonic language, with privation or ‘absences

1.1 EVIL IN HISTORICAL PERSPECTIVE 23

which express no essence.’ He also thought of God in a way reminiscent of Boehme: God is

‘immanent in the world’ and individual things are themselves modes or modiﬁcations of

God. The one reality is ‘God or Nature’ [23, 24]. This equation of God with Nature earned

for Spinoza an excommunication from his Jewish coreligionists, but also later even from the

Calvinists – both groups regarding such an unexalted view of God as heretical. Spinoza

argued, in regard to evil, that there is no evil in the nature of things: the same object may be

good in one set of circumstances and evil in another. Whatever advances man toward a more

perfect nature is a true good; evil could be seen as a criticism of God’s goodness. A

`propos

free will, we may know a thing to be (good or) bad, yet not ﬁnd in ourselves thepower either

to do the good or to abstain from the bad.

In the same way that Spinoza’s family ﬂed to Holland to avoid religious persecution,

Pierre Bayle [1647–1706], the son of an impoverished Calvinist minister in southern

France, ﬂed to Holland – because of his unconventional ideas that ran counter to the

Catholicism of Louis XIV. Picking up where Epicurus left off two millennia before, Bayle

contended that it cannot be the case that Evil exists and that God is both omnipotent and

benevolent [25], for if God were both willing and able to remove Evil, then where does

Evil come from? To strengthen his point (meanwhile alienating the religious orthodoxy of

his day), Bayle challenged the accepted wisdom that belief in divine reward promotes

morality – given that many religious believers are not deterred from evil acts, including

cruel and destructive behaviors, whereas many atheists are not immoral, even though they

standinnofearofdivineretributionfortheir non-belief. Instead, as Bayle emphasized,

people’s conduct is determined primarily by secular sanction and by character structure:

those who are cruel will act cruelly, whether or not they believe in God or the Hereafter.

People who are kind will distance themselves from cruelty, even if they do not believe in

divine punishment [26].

Bayle’s contemporary, the Baron Gottfried von Leibniz [1646–1716] is known more for his

co-invention of the calculus than for his theodicy [27]. Bayle, the incurable pessimist, viewed a

God who could have made a world where therewere fewer crimes and sufferings – yet chose not

to do so – as something of a criminal on a grand scale. Leibniz, the incurable optimist, argued

that, au contraire, this was the best world that could have been created; any alternative world

would have been worse – a view savaged by Voltaire in his famous parody, Candide. Leibniz

did deﬁne three categories of Evil; namely, the metaphysical, the physical, and the moral. The

‘metaphysical’ related to the degeneration inherent in the substance of which the world was

made (since only God is perfect). The ‘physical’ concerned the pain and suffering we experience

in the world, whilst ‘moral’ evil amounts to the crime – for which physical (or ‘natural’) evil is

the punishment. It was this latter notion that came in for Voltaire’s ridicule: how, for example,

were the 60,000 victims in Lisbon on that fateful day in November, 1755 – any more ‘deserving’

of the earthquake than were the citizens of some other city? The Lisbon earthquake was in fact a

turning point, much as the Holocaust or 9/11 in our day, that forced men to rethink the concept of

evil, and to rid themselves of the idea that natural disasters were somehow or another ’God’s

punishment’ for our sins. As Voltaire wrote, with timeless eloquence:

What crime, what sin, had those young hearts conceived

That lie, bleeding and torn, on mother’s breast?

Did fallen Lisbon deeper drink of vice

Than London, Paris, or sunlit Madrid?

—(from Poem on the Lisbon Disaster [28])

24 PROLEGOMENA (FIRST ISSUES)

In Bayle and Leibniz we have the paradox of two men, both Protestant, both born within a

year of each other: one still wedded (though not exclusively) to the metaphysical view of

evil; the other, rejecting the metaphysical in favor of a more down-to-earth (and down to the

individual person) conception. Perhaps the answer lay in the fact that Bayle was poor and

was exiled; Leibniz was rich and honored in his own country.

The empiricist Scottish philosopher, David Hume [1711–76], though raised in a Calvinist

background, removed God from the equation concerning good and evil, claiming that what

ought, and what ought not, to be the case cannot legitimately be derived from the ideas of a

deity. He argued against the notion that Reason alone enables us to make moral distinctions.

Rather: morality is concerned with such non-ideational entities as Passions, Volitions, and

Actions. It is only when we are able to attend to our own feelings that we are able to

distinguish Virtue and Vice; between moral good and evil [29].

In the same way that Bayle and Leibniz emerge at the conceptual antipodes regarding the

origins of evil, the postulates of Jean-Jacques Rousseau [1712–88] are diametrically

opposite, regarding the original state of man, to those of Thomas Hobbes. In his Second

Discourse (1762) Rousseau claimed that the human condition derives from society, whereas

in the ‘state of Nature’ Man was free and independent, healthy, happy, and innocent. Once a

social condition develops, there was, Rousseau supposed, a fall from Nature, and with it a

corruption of the once ‘noble savage.’ Here Rousseau was mistaken, for there is not a shred

of anthropological evidence to support his claim. But there was certain grandeur to his error:

scientiﬁcally mistaken, but politically correct – for his time. It was not hard to see evils

(social evils, in this case) in Rousseau’s France, on the cusp of the up-coming revolution – if

one contrasted the lot of the common man with that of the aristocracy. Hobbes may have

been right about society in general, but Rousseau was right about the society in particular

with which he was familiar. At all events, Rousseau deserved great credit, as Susan Neiman

pointed out ([30], p. 41), for being the ﬁrst to treat the problem of evil as a philosophical (one

might even say, sociological), as opposed to a theological problem. Rousseau took the

problem out of God’s hands and ‘put it squarely in ours’ ([30], p. 43). Evil did not require

reference to supernatural forces, which meant in effect that evil is not a metaphysical

problem; it is a human problem.

Immanuel Kant [1724–1804] also rejected the notion of Original Sin –as an affront to our

moral freedom [31], but retained a place for religion, given that religion underlines our duty

to uphold moral values as divine commands. Christianity focuses on pride as the primary sin,

which Kant regarded as ineradicable by human means. Kant distinguishes between self-

conceit (Eigendunkel) and Self-Love (Eigenliebe), as the latter can be good insofar as it is

controlled by ‘practical reason.’ He understood the evil that arises in the human heart as

stemming from the subordination of what he called the Objective Law of Duty to (mere)

happiness. Evil becomes one of the choices open to us via our free will. Man has a propensity

[Hang] to evil (akin to Maimonides’ yetzer ha-ra), which must be combated through our

becoming our own ‘moral sentries.’ Kant made a distinction between B€

ose [evil] and U

¨bel

[bad, though it is the cognate for the English word evil]: evil actions are those which aim at

the violation of the humanity of another person (such as murder, rape, torture). Whereas bad

actions are those that might be harmful or disagreeable to one’s general well-being (e.g.,

delayed payment of a debt or failure to honor some other type of promise). While neither

Kant nor other philosophers give detailed descriptions of individual case-histories em-

bodying evil actions, he was aware that terrible crimes occurred, and remarked that ’great

crimes are paroxysms, the sight of which makes one whose soul is healthy to shudder’ [32].

1.1 EVIL IN HISTORICAL PERSPECTIVE 25

Here is a comment that presages our contemporary, more emotional, use of the word evil,as

pertaining to acts that are (to those who witness or experience them) breathtakingly

inhuman.

Georg Hegel [1770–1831] became famous for his dialectic triad of thesis, antithesis, and

synthesis – inspired in part by the French Revolution. Hegel felt the latter movement could

be understood as a burst into freedom for the masses (thesis), that then ushered in a reign of

terror (antithesis) that led ﬁnally to a better post-revolutionary form of government based on

freedom and equality (synthesis). As for his comments on evil, these are mostly to be found

in his Philosophie des Rechts [33] – the German word conveying the meanings both of

‘right’ and ‘law.’ Hegel sought to establish a groundwork for morality centered on each

person’s free will and humanity – within the context of our life as members, inevitably, of a

social entity. The social entity, in turn, needed to be regulated by a superordinate morality,

which for Kant (more so than for Hegel) necessitated the acceptance of God as the

embodiment of that higher morality. What makes a person evil in Hegel’s view is the

choosing of natural desires in opposition to the good ([33], section 40). Though Hegel does

not give ‘case histories’ of evil, he does assert that there is an important distinction between

crimes that attack the entire manifestation of one’s Will (i.e., of another person’s freedom

and humanity), as in the instance of murder, slavery, or religious compulsion – in contrast to

lesser crimes that invade less of the life-space of another person [34]. As for the matter of

‘free will,’ it is noteworthy that Hegel felt that the success of America (along with England

and France) in the nineteenth century related in large part to the large numbers of Protestant

dissenters who ‘created a tradition for a people who aspired to create libertarian societies’

([35], p. 172). The point here is that the dissenters exercised greater freedom to think for

themselves and to stress their individuality – in contrast to those who adhered to monolithic

systems of thought and belief, like the Catholics and Muslims.

For Arthur Schopenhauer [1788–1860], irritable, embittered, pessimistic, this was, in his

180turn from Leibniz, the worst of all possible worlds – where pleasure was the exception

in human life; pain, the rule. As he concluded in his most important work, Die Welt als Wille

und Vorstellung ([36] The World as Will and Representation), the Will isequated with effort

and desire, which is ultimately painful and ‘evil.’ Pain arises from the desire to have – and

then not having. After a brief satisfaction with one’s desire there is momentary pleasure –

and then the emergence of new desire and new pain. Selﬁshness or egoism (narcissism, in

our language) was for Schopenhauer, universal: the egoist seeks his own advantage and is

ready to strike down those who oppose him. His Weltanschauung resonates in this way with

Hobbes’ ‘war of all against all.’ Schopenhauer recognized that the attachment to life that

characterizes all living forms makes understandable our horror in reaction to murder – as the

maximal violation of our inherent will-to-live. Toward the end of life Schopenhauer

embraced Buddhism, by virtue of its preaching deliverance from Self – unlike the egoist:

the malicious man who thinks only of himself.

The year before Schopenhauer’s death coincided with the publication of Darwin’s Origin

of Species. Darwin, though of course not a philosopher, gave new meaning to the kind of

existential struggle for survival alluded to by Hobbes and Schopenhauer. Putting this

struggle on a scientiﬁc footing for the ﬁrst time, Darwin drew attention to natural selection.

Herbert Spencer ﬁve years later used the term ‘survival of the ﬁttest.’ Some took this to mean

that brute force triumphed over weakness, applying the idea to our species as well as to the

other animals. But Darwin was not arguing that evil won out over the good, particularly as he

held that the ethical life (among men) is different from the life in (the rest of) Nature. It is the

26 PROLEGOMENA (FIRST ISSUES)

ethical life that brings us out of the state of all-against-all warfare and leads us to peace. In

our own generation it has become clear through the work of evolutionary psychiatry – that as

a group species we also harbor genes that promote compassion and altruistic behavior. As

James Wilson has put forward [37], we would not have survived as a species if we did not

possess, alongside our aggressive tendencies, other innate, gene-driven tendencies that

promote moral sentiments: sympathy, fairness, self-control, and (here, James cited Kant)

duty. Viewed in this light, evil can be seen as an exaggeration of our aggressive tendencies;

good – as a manifestation of our adherence to the moral sentiments outlined by Wilson. In

this schema religion no longer has any explanatory value vis-

a-vis evil, though it retains its

value as a promulgator and advocate of the moral sentiments by which our lives should be

guided.

Darwin’s new theory did not sweep away all at once the religion-based explanation for

evil. Søren Kierkegaard [1813–55], for example, though born after Darwin, died before the

Origin was published. Still ensconced within traditional Christianity, he understood sin as

rooted in Willing. Sin (and hence evil) occur when a person refrains from doing what is right

even though he understands what is right [38].

For Friedrich Nietzsche [1844–1900] God played no role in the causation of evil, which,

he argued, was to be understood in purely human terms. ‘Being evil’ was ‘being not moral,’

practicing immorality, resisting tradition – however reasonable or stupid tradition might be.

Nietzsche recognized that ‘harming the neighbor,’ however, was felt to be preeminently

harmful in all the moral laws of different ages ([39], #96). Though Nietzsche endorsed the

idea of the will to power as the basis of human nature (a view in sympathy with that of

Schopenhauer), he also spoke of ‘resentment’ as a key emotion in those whose quest for

power was denied them. This resentment, Nietzsche saw as resulting from the ‘corruption of

human nature’ that was encouraged by religion in general, speciﬁcally by Christianity ([40],

p. 262) – a pretty radical departure from beliefs of Nietzsche’s Lutheran father, grand-

fathers, and great-grandfather. His much-misunderstood concept of the U

¨bermensch

[‘Superman,’ or ‘Overman’) was totally unrelated to the notion, as hijacked by the Nazis,

of a superior race. Nietzsche’s U

¨bermensch was the creative artist who lives ‘beyond good

and evil’ (as popularly conceived): the powerful man, that is, who has mastered his passions

and risen above the mediocrity of everyday existence [41]. At all events, Nietzsche took the

concept of evil far away from the religion-based explanations (the theodicies of Leibniz and

others), adopting a much more relativistic notion of what constituted evil. Apart from

harming one’s neighbor, that is, certain acts or tendencies might be regarded as evil in one

culture or one context, but not so in another culture or context.

1.1.8 MODERN CONCEPTIONS OF EVIL. THE INFLUENCE

OF PSYCHIATRY & NEUROSCIENCE

During the last century the ways of deﬁning and understanding evil have been left less in the

hands of theologians and philosophers; much more, in the hands of experts in psychology

and psychiatry, including those in the ﬁeld of neuroscience. There has been increasing

recognition that evil is a purely human phenomenon, and that the place to look for its site and

origins is not in the heavens but in the human brain. Even the question ‘what is evil?’ is

recognized as an erroneous question, since it presupposes there is some ineffable substance

that corresponds to the substantive [i.e., the noun] ‘evil,’ or that there is some one-size-ﬁts-

1.1 EVIL IN HISTORICAL PERSPECTIVE 27

all deﬁnition that is universally acceptable. Instead, a more meaningful approach is to adopt

the standard proposed by the Austrian philosopher Wittgenstein [1889–1951], who took the

position that the meaning of a word is its usage [42]. Viewed in this light, we look to the

way in which people in ordinary life, as well as the ways in which journalists and others in

the media, employ this term. It turns out that we reserve the word ‘evil’ in everyday life

for actions that evoke the emotion of horror: acts that are breathtakingly horrible because

of the intense suffering to which the victims are subjected, the outrageousness of the

acts, their heinousness or depravity – especially if the acts were prompted by scheming

(malice aforethought) of a ‘diabolical’ nature (implying the intention to hurt in a particularly

cruel and sadistic manner). Thus, a man who kidnaps a child, whom he then violates

sexually, and afterwards strangles and dismembers – is readily identiﬁed as having

committed an evil act. And if he has committed a string of such acts over time, with every

intention of repeating such behavior if given the opportunity – people will often apply the

word evil to the man himself: he is an evil person. Perhaps the only philosopher to draw

attention to this way of thinking about evil: as that which is breathtakingly awful – is Susan

Neiman [30].

Persons who are apprehended by the authorities for having committed acts of these kinds

will usually be incarcerated in prisons or, if mental illness had been a key factor in the

commission of the act, will be mandated to a forensic hospital for observation and treatment.

In either situation, a forensic psychiatrist may be summoned to evaluate the offender – as to

whether he or she is mentally ill, or is instead in the grips of a personality disorder, such as

antisocial or psychopathic personality. It is uncommon for people to use the word evil in

reference to crimes (such as ﬁnancial swindles) that do not involve violence or intense

psychological harm (as by extreme humiliation, subjugation, or unlawful imprisonment).

Furthermore, one seldom refers to a person as evil (in contrast to particular acts of violence),

unless the person has engaged habitually and for an extended period of time in acts of

unusual cruelty. Many men committing serial sexual homicide, and some repeat-rapists, fall

into this category, especially where there is an element of torture of the victim(s).

Descriptions of such persons can be found in numerous books and articles by forensic

psychiatrists and psychologists [43–46]. Buss, writing from the perspective of evolutionary

psychiatry, focuses on those brain mechanisms that subserve aggression and defense against

threats to one’s survival: mechanisms that under certain circumstances can operate in a

grossly exaggerated manner – leading to extreme acts of violence of the sort to which the

public will apply the label ‘evil.’ Egger, Stone, and Ward et al. enumerate the background

factors in men committing serial sexual homicide, some of whom subject their victims to

prolonged periods of torture, earning thereby the label of ‘evil person.’ The background

factors conducing to violence in general: genetic predisposition to psychopathy, parental

neglect or cruelty, hormonal factors, head injury with unconsciousness, drug abuse, etc. –

have been discussed in detail by Debra Niehoff [47]. In an outstanding book written by a

survivor of an attempted murder by an axe-wielding psychopath, Terri Jentz [48] deﬁned as

an act of evil: ‘when an act ruptures all categories of comprehension’ (p. 516), elsewhere

describing her ‘belief in the existence of utter evil as a modern revision of Manicheanism,’

based on her study of gratuitous cruelty in the twentieth century (p. 512). Even more

poignantly is her comment about her would-be assassin, whose sadism was in no way

conﬁned just to her and her friend (who was blinded by this axe wielder): ‘I was astonished at

the many searing memories this one man had ignited in so many people...Was this evil’s

strategy, to perform breathtakingly brutal acts that so shocked the nervous system and

28 PROLEGOMENA (FIRST ISSUES)

overwhelmed the brain that these traumatic events were not integrated into consciousness,

but left disturbing, damaged mosaics of unassimilated memories?’ (p. 509).

The inadvertent spokesman for the general public and its use of the word, Jentz has left us

with as accurate a depiction of evil as we are likely to ﬁnd in the lay literature. In the

psychiatric literature the term evil occurs very seldom. Freud, when writing of his celebrated

case, the Wolf Man [49], mentions the patient’s dissatisfaction with God, leading to his own

strange theodicy, according to which: ’If He were almighty, then it was His fault that men

were evil, wicked and [that they] tormented others... He ought to have made them good;

He was responsible for all the wickedness’ (p. 62). In his Introductory Lectures [50] Freud

speaks of our dream-life – in which the Ego, freed from all ethical bonds, ﬁnds itself at one

with all the demands of sexual desire, even those which have been condemned by our ethical

upbringing; lusts we think of as remote from human nature show themselves.... These

censored wishes appear to rise up out of a positive Hell’ (p. 142).

`propos Freud, the interconnections between religious thought and the development of

his psychoanalytic theories are discernible, albeit subtle and complex. Among his ancestors

were rabbis and Hasids, but his father, Jakob, broke away from the stricter practices and

traditions of his forebears, while retaining great pride in his Jewish heritage and his

familiarity with Yiddish and Hebrew. Sigmund grew up still less familiar with Jewish

observance, though retaining throughout his life a ‘Judaism without religion’ ([51], p. 6).

Toward the end of his life, Freud wrote his controversial Moses and Monotheism – which

angered both observant Jews and Christians (as Spinoza had managed to do, years before,

with his equation of God with Nature). Freud likened Moses to the ﬁrst Messiah, and saw

Christ as reborn as a resurrected Moses – transﬁgured as the Son in the place of his Father

([52], p. 114). Freud’s biographer, Peter Gay, tells us that Freud spoke with his friend, Lou

Andreas Salom

e in 1935, mentioning that ‘The ﬁgure of Moses ...had haunted him all his

life,’ adding that Freud had compared Jung to Joshua – ‘who would take possession of the

promised land of psychiatry while he, Freud, the Moses, was destined to glimpse it only

from afar’ ([52], p. 605). So far we have commented on Freud’s complex relationship to his

Jewish origins. But the impact of his religious background upon his practice of psychiatry is

less readily detectable. There is some fairly compelling evidence for a more direct inﬂuence,

however, in two related areas. Two of the ’pillars’ of psychoanalysis are free association and

dream analysis, both crystallizing in Freud’s mind in the 1890s. David Bakan [53] makes

the case that Freud’s exposure to the Hasidic and Kabbalistic background of his grand-

parents’ generation set the stage for his discovering the value of ‘free association’ as a

method of gaining access to deeper layers of reality. Freud may well have been aware, for

example, of his thirteenth-century coreligionist – the Spanish-Jewish mystic philosopher

from Saragossa: Abraham Abulaﬁa. As part of his method of achieving a trance-like state in

which he felt in closer touch with God, by unsealing the soul and untying the knots which

bind it (Bakan, p. 76) was through the practice of k’ﬁtsah [] – which meant jumping or

skipping from one thought to another, till he was able to escape the quotidian, and reach ever

more lofty and spiritual levels. Abulaﬁa induced this state in himself in the quest of a

religious goal. Freud appears to have transformed this method in the quest of a psychiatric

goal; namely, that of gaining access to hidden layers in the psyche of his patients, with the

ultimate goal of liberating them from their neurotic conﬂicts. The second pillar – dream

analysis – represents an interest of long-standing in Jewish tradition, as noted in the Old

Testament story of Joseph (Genesis 41: 1–37), and in the Moreh Nevuchim (Guide to the

Perplexed) of Maimonides. But dream-interpretation before Freud tended, with a few

1.1 EVIL IN HISTORICAL PERSPECTIVE 29

exceptions, to stereotyped and sterile; the results, unconvincing. Dream dictionaries were

popular, in which common dream elements were said to have certain speciﬁc meanings.

Aside from the genius of the poet, Pushkin, who gave his heroine, Tatyana, a dream which

had the effect of warning her against marrying the ‘gloomy and dangerous crank,’ Evgeny

Onegin (a full 60 years before Freud’s Traumdeutung/The Interpretation of Dreams) – there

was almost nothing in the earlier dream literature that hit upon the psychological meaning of

the dream, unique to each dreamer. It was Freud’s genius that paved the way to unlock these

highly individual meanings – via his patients’ own free associations to their dreams. Granted

there are culturally determined, rather common symbols: bottles are often female genitals;

snakes are often penises – but not always. In the dreams of one of my analytic patients from

many years ago snakes kept cropping up. From her associations it became clear the snakes

did not represent her boyfriend’s organ; instead, they led her to think about his sister – an

intrusive and highly critical woman who kept trying to interfere in their relationship. None

of the old dream-dictionaries would have led one to this conclusion.

The relationship of Carl Gustav Jung (1875–1961) to religion was quite different from

that of his erstwhile mentor, Freud. Jung’s father was a Swiss pastor; Jung himself

throughout his life was preoccupied with mystical themes, astrology, and spiritism (the

latter prompted by the spiritistic trances he witnessed in his 15-year-old maternal cousin,

Helene, when he was a young man). During his youth, Jung once saw an eighteenth-century

carriage, and imagined that he had a memory of it in a previous life ([54], p. 664). During the

period of the Great War, Jung became intrigued with Gnosticism, not only for its emphasis

on knowing, but on its interest in the problem of evil ([54], p. 719). Equally interested in

dreams as Freud was, Jung, once he became a psychiatrist, developed a different technique.

He took to writing his dreams down, then telling himself stories stimulated by the dream

images, and encouraging fantasies to arise in his mind, as an outgrowth of these mental

pictures. Next, Jung would draw the resulting images on paper. He began this practice in

1913. It was out of these exercises that his theory of archetypes emerged. He believed that

there existed a set of universal, primordial images – the archetypes – embedded in the

unconscious of every person. Various coincidences convinced Jung of this proposition, such

as the similarity of a hallucination (of a phallus suspended from the sun, that produced the

wind) mentioned to him by a schizophrenic patient – to an early Greek text that spoke of a

tube hanging from the sun that set the winds in motion ([54], p. 705). These impressions led

Jung to speak of a ’collective unconscious.’ He later used the terms collective subconscious

and then the objective psyche, by which he referred to what he believed was a reservoir of the

experiences of human beings as a species – by virtue of its being common to everyone.

Practitioners in contemporary psychoanalysis and psychiatry, apart from those who are

adherents to Jung’s psychology, do not accept the notion of a collective unconscious. There

is another concept that Jung developed that relates to the subject of evil. The set of personal

characteristics that a person wishes to conceal from others, even from himself, Jung called

the ‘shadow.’ Jung further postulated that the more someone tried to keep this shadow

hidden, the more the shadow becomes active, predisposing to evil actions. Further, Jung

imagined that the shadow could, especially under the inﬂuence of alcohol or other mind-

altering agents, become the predominant force in the individual, leading to hitherto

unsuspected levels of evil. Robert Louis Stevenson’s 1886 classic, Dr. Jekyll and Mr.

Hyde, may be understood as a parallel in novel-form to Jung’s shadow. Consistent with

Jung’s beliefs in archetypes, collective unconscious, shadows, and the like – is his religious

faith. Toward the end of his life, in a 1955 interview with a journalist, Jung stated that ‘God is

30 PROLEGOMENA (FIRST ISSUES)

the voice of conscience speaking within us,’ adding that he had an ‘unshakable conviction of

the existence of God...I do not take His existence on belief – I know that He exists’ ([54], p.

726). It is easy to see why Freud and Jung eventually parted ways, given that the religion-

based views of Jung, expressed rather in poetic than in scientiﬁc language, were quite alien

to Freud, who retained his biological foundation and his antipathy to organized religion to

the end, even while pursuing similar psychoanalytic pathways as did his younger counter-

part. Jung’s psychology, in this respect, offers analogies to whatever it is in us that leads to

evil action, but does not have the kind of explanatory value that would give it purchase in the

ﬁeld of science, including in the domain of forensic psychiatry.

What contemporary psychiatry can now provide by way of explaining the phenomenon of

evil, as deﬁned in popular usage – is the following: (a) commonalities can be discovered

when one looks at a large number of detailed case histories of persons whose acts have been

described as ‘evil,’ (b) study of the brain, via functional magnetic resonance imaging and

other techniques, can reveal differences in the brains of such persons, when compared with

the brains of ordinary persons. I refer here only to evil acts committed in peacetime, since it

is well known that in wartime many ordinary men suddenly ﬁnd themselves capable of

cruelties which would be most foreign to their lives before and after their participation in

warfare.

As for the commonalities among persons with a penchant for committing evil acts, there

are two in particular that stand out. One group consists of serial killers intent upon torturing

their victims. From a diagnostic standpoint these persons (the vast majority of whom will be

men) exemplify the conﬂuence of psychopathy and sadistic personality. The main person-

ality traits of the psychopath, as deﬁned by Robert Hare and his colleagues [55] are glib

speech (insincerity), grandiosity, lying, manipulativeness, callousness, lack of empathy and

remorse, and inability to take responsibility for one’s actions. The main traits of sadistic

personality as outlined in DSM-III-R [56] consist in the enjoyment of another’s suffering,

humiliation, and subjugation of others [57]. Another group consists of persons, outside the

domain of serial homicide, who scheme (‘with malice aforethought’) to subject another to

extreme pain and/or death – as witnessed in the cases of certain men who stage the death of

their wives in order to make their deaths appear accidental, or who make plans to hide their

bodies in hopes of rendering their death an uncertainty (as in the case of Scott Peterson, who

killed his pregnant wife and threw her body into the ocean [58]).

Neuroscientists do not use the word evil in their reports, but considerable research has

recently been carried out on brain activity in persons whose violent crimes have inspired the

word evil in everyday discourse. Much of this research has been summarized in the book

about psychopathy of James Blair and his colleagues [59]. One common underlying factor

concerns brain-differences in psychopaths that diminish their capacity for empathy;

speciﬁcally, for feeling compassion for the suffering of others. Absent this capacity, the

possibility of inﬂicting torturous suffering on others becomes greatly enhanced. This is

reﬂected in the commission of acts that the public experiences as ‘evil.’ Speciﬁc regions of

the brain that communicate with one another in determining what behaviors emerge in

response to particular urges or stresses have been outlined by Kalivas and Volkow [60] in

their paper on pathways relevant to addiction. Their model is pertinent as well to other

maladaptive behaviors, including those related to violent crime. The key regions in this

schema involve a memory system, subserved by the amygdala, in touch with prior

experiences (including those of harm done to the individual by early caretakers). This

region communicates with another – the dopamine-dependent nucleus accumbens – that

1.1 EVIL IN HISTORICAL PERSPECTIVE 31

weighs the salience (degree of desirability) of various behavioral options. Both these

regions are important parts of what is often called the ‘bottom-up’ brain mechanisms, and

concern our basic drives [61]. Final decisions regarding action (that is, what we actually end

up doing in any given situation) are the function of the ‘top-down’ mechanisms. A control-

mechanism mediated by the anterior cingulate gyrus exerts either a weak or a strong control

upon the various options being considered. Finally the orbitofrontal cortex, integrating all

this information, either allows the most favored option to go forward into actual behavior –

or decides against it, thwarting the behavior. A man struggling with the temptation to kid-

nap and rape a child (which would end up as an evil act, if consummated) may think of

how that child might feel, or might think about the consequences of getting caught and

arrested – and then decide against this ‘desired’ behavior. Or his desire may be so strong as

to override the ’braking’ mechanisms; his impulse-control may be so weak as to fail to

inhibit the behavior. In these scenarios, the crime (the ‘evil’ act) will occur.

As I mentioned at the beginning of the chapter, judgments about which acts are

considered evil are made more easily in peacetime – by individuals and by the public –

than is the case in situations of group conﬂict (as in riots or between gangs) or of full-scale

war. The witness of inter-group strife, so characteristic of our species, reminds us of our

origins as members of small tribes numbering perhaps 100 or 150 persons. Our brains have

evolved over the approximately four million years since we split off from bonobos and

chimpanzees to become hominids, gradually emerging as what Carl Zimmer has cleverly

called (because we can talk and read) the gossiping ape [62]. To meet the multitudinous

threats to survival in our early days, our brains became ‘wired’ for group afﬁliation and for

aggressive defense against those who would harm us—whether the predators were saber-

tooth tigers or (more commonly) other people. Religion sprung up in every human society,

presumably answering to vital needs and impulses peculiar to a distinctly social species such

as our own. We cannot do without each other, and (all too often) we cannot get along with

one another – especially when goods necessary to survival are scarce and when the

conditions that make life secure and comfortable are seriously compromised. During times

of adversity religion can play contrary roles: religion uniﬁes and strengthens the bonds

among members of a religious group, offering hope, and emboldening group action that

fosters survival. But therein lay the rub. For at such times, religion may be used by one group

to rally forces against a competing group, fomenting a war that is justiﬁed (in the eyes of the

adherents of the warring group) against those who do not believe in the ‘true God’ of the

group that has taken up arms. This conceit – that God stands behind only our group – helps

explain the paradoxical situation in which the monotheistic Abrahamic religions, quickly

separate into tribes (albeit large ones) in times of trouble. The followers of Jehovah, Christ,

and Allah are suddenly at each other’s throats. This phenomenon becomes particularly acute

during times of drastic change or drastic shortage. If the crisis is local, we see the emergence

of religious cults, some of which are led by fanatics of remarkable cruelty. The Reverend Jim

Jones in Guyana, David Koresh in Waco, Texas, and Jeff Lundgren, the breakaway Mormon

leader in Kirtland, Ohio are examples. If the crisis involves whole nations or religious

memberships, we see the emergence of religious armies, with a charismatic leader at the

helm, poised to conquer another group or nation. If the army is strong, there will be war; if it

is too weak to conquer outright, there will be terrorism. The red thread running through all

these religion-inspired actions is fundamentalism. Two chief characteristics of such

fundamentalism, as mentioned by Vamik Volkan in a recent address on psychoanalysis

and religion [63], are a list of unchangeable doctrines adhered to by the believers, and their

32 PROLEGOMENA (FIRST ISSUES)

opposition to non-believers or to ‘lukewarm’ believers. By no means is fundamentalism

regularly associated with violence. But under particular circumstances a group of believers

may be energized by a charismatic and hate-ﬁlled leader, such that religious fundamental-

ism becomes the force by which violence is unleashed. Kernberg [64] made the point, in the

immediate aftermath of 9/11, that the internal tensions of the jihadists (bemoaning the

decline of Islam since the defeat in 1683 at the gates of Vienna, and the relative

impoverishment in Dar al-Islam (the countries where Islam is the dominant religion)

compared with the Western industrialist countries – are now displaced toward the outside,

toward, that is, the ‘inﬁdel’ West. Volkan has striven to create a bridge between the

psychology of the individual, as emphasized in traditional psychoanalysis, and the

psychology of the group – stressing how children are raised as ﬂedgling members of a

social group – with which they strongly identify, at the same time they develop, during the

same formative years, a sense of personal identity. The admonitions and information

imparted to children in their ﬁrst half dozen years, creating both the individual and the group

identities, become ‘hard-wired’ into brain circuitry, fostering automatic, unconscious

responses. In certain groups, these responses may include such convictions as we the

faithful of religion X are better than you people of religion Y and we are thus, through God’s

favor, more deserving of the good things of the world than you...Like all thought-habits of

long standing, these automatic responses are not easily overturned. The topic of religious

fundamentalism and its psychology has been previously explored by Ren

e Girard [65] and

summarized recently in the admirable article by Lord Alderdice of Northern Ireland [66].

Alderdice makes the point that the jihadist terrorists that ﬁgure so prominently in the current

geopolitical scene are heavily indoctrinated, but are not mentally ill. The fundamentalist

environment in which they were enveloped was one that predisposed to violent solutions.

Many were educated in madrassas, memorizing the Qur’an, with its many references to the

inﬁdel and to the dire fate that awaited them (as in the long passage in Sura 5: 35–66).

Saturated in a Good/Believer versus Evil/Inﬁdel atmosphere, the step toward violence,

when under the inﬂuence of a paranoid leader during socially disruptive times – is not a long

one. One may note in contrast that in the Old Testament ‘inﬁdel’ does not occur; the word is

used in the New Testament just twice (2 Corinthians 6:15, and 1 Timothy 5:8). In neither

reference is the (Christian) believer abjured to harm or to kill the inﬁdel; merely to avoid

association with the inﬁdel.

Psychiatry, as it turns out, has much of value in helping us to understand the mind-set of

fundamentalists, as well as of those who become terrorists. But psychiatrists at the

vanguard in this arena, such as Jerrold Post [67], Vamik Volkan, Otto Kernberg, John

Alderdice, and also the historian-philosopher, Ren

e Girard, convey their excellent points

to like-minded audiences; in effect, they preach to the converted. The fundamentalists, and

the terrorists among them, do not listen. The most militant and disaffected among them

continue to regard those who disagree with them as inﬁdels and evil-doers. We are then apt

to see a perversion of religion: religious leaders sanction actions that, ironically, the rest of

the world regard as evil. Examples are legion: the Protestants and Catholics in Northern

Ireland bombing each other’s houses, the Sunnis and the Shiites in Iraq bombing each

other’s mosques, Hindus and Moslems in India destroying each other’s holy places, the

jihadists bombing the Twin Towers and cafes in Tel-Aviv, or slitting the throat of journalist

Daniel Pearl in Karachi (February 1st, 2002) – because he was a Jew. The date is of interest

to me: I was in Karachi 20 years earlier to the day, living as a Jewish psychiatrist in the

home of Moslem psychiatrist colleagues, lecturing on my topic of ’borderline personality,’

1.1 EVIL IN HISTORICAL PERSPECTIVE 33

and attending many Moslem weddings. It was a different time. When religion is hijacked

and made into a pretext for war and atrocities, we may, as psychiatrists, correctly diagnose

that calamity as a sign that a large group of people has come to feel humiliated,

disenfranchised, dealt out of the chance to have the good things of life: dignity, adequate

food, satisfactory work, the pursuit of happiness. Military action may be necessary as an

unfortunate ﬁrst step. Ultimately the excesses of fundamentalism, and the terrorism it may

spawn, can be corrected only politically: by helping in whatever way possible to improve

the lives of the group whose cause was spearheaded (literally) in the ﬁrst place by the

fundamentalists and their terrorist cohorts. In this great task, psychiatry can play only an

advisory role, helping to educate political leaders as to what the social ‘disease’ had been,

and what might be its most likely cure. Equally important as an antidote to religious

fundamentalism, when it has gotten out of hand, is the voice of the ‘lukewarm’ believers,

the moderates, who show, instead of paranoid hatred and fanaticism, tolerance and the

warm acceptance of others. More such voices are beginning to be heard. An outstanding

example is that of the Moslem writer, Irshad Manji. She has shown the courage to criticize

the jihadists within Islam in her widely read The Trouble with Islam Today [68]. And

Salman Rushdie has outlived the fatwa leveled against him by Ayatollah Khomeini. I was

privileged to hear Rushdie address a large audience two years ago, where he could speak

freely, and where it was not even necessary for the public to pass through metal detectors.

There is hope.

In summary, religion and philosophy no longer have a meaningful role in explaining the

causes of evil, though they of course retain an important role in setting forth theguidelines for

appropriate moral values and acceptable behaviors. For clues concerning causation, we must

turn instead to psychiatry, psychology, and neuroscience. Age-old conundrums as to whether

humans are inherently good or inherently evil fall by the wayside, as we become aware that our

genetic givens and our brains are equipped with the mechanisms for both altruistic/

cooperative interactions – and for narcissistic or aggressive interactions. This position was

already championed long ago by the Moslem empiricist historian of culture – ibn Khaldun

[1332–1406]. Unhappy with the abstract and metaphysical arguments of theologians and

philosophers, ibn Khaldun relied on what he could actually observe in societies. He

recognized that ‘evil qualities’ existed in man – such as injustice and aggression, which

were ’natural’ to human beings, yet compassion and affection were also part of our human

nature – in such measure that we were more inclined to the good than to the bad [69, 70].

Which behaviors are favored, as we now realize, are dependent upon a host of factors:

heredity, constitution, gender, early rearing, culture, brain damage, involvement with drugs

that lower impulse-control, etc. When aggressive actions pass a certain socially-acknowl-

edged boundary-line and pass into the grotesque and the heinous, we have entered the realm of

evil. As one of their functions, religion and philosophy deplore such actions. To understand

evil actions – is the domain of sciences that explore the workings of the human brain.

REFERENCES

1. Scharfstein B-A (1998) A Comparative History of World Philosophy. Albany, NY: State

University of New York Press.

2. Boyce M (1984). Textual Sources for the Study of Zoroastrianism. Chicago: Chicago University

Press.

34 PROLEGOMENA (FIRST ISSUES)

3. Forsyth N (2002). The Origin of Evil. Perspectives on Evil 1: 17–52.

4. Williams JN (1988) Confucius, Mencius, and the notion of the true succession. Philosophy East &

West 38, 157.

5. Plato (1973) Phædrus & Letters VII and VIII. Walter Hamilton, tr. London: Penguin Books.

6. Aristotle (1955) Nicomachean Ethics. JAK Thomson, tr. London: Penguin Books.

7. Mendelson M (2000) St. Augustine. The Stanford Encyclopedia of Philosophy.

8. Augustine St Aurelius (2007) Confessions. AC Outler & M Vessey, trs. New York: Barnes &

Noble Classics.

9. Butterworth CE (2007) Ethical and political philosophy. In The Cambridge Companion to Arabic

Philosophy. PAdamson & RC Taylor (editors), 4th edit. New York: Cambridge University Press,

pp. 266–286.

10. Goodman LE www.muslimphilosophy.com/ei2/razi.htm.

11. Fakhry M (2002) Al-F

ar

abi: Founders of Islamic Neoplatonism. Oxford: One World.

12. Rizvi SH (2006) Avicenna/IbnSina. www.iep.utm.edu/a/avicenna.htm.

13. Fakhry M (2004) A History of Islamic Philosophy. 3rd edn. New York: Columbia University

Press.

14. Durling RM Translator & Editor (1996): The Divine Comedy of Dante Alighieri: vol. I:

The Inferno. New York: Oxford University Press.

15. Seeskin K (2000) Searching for a Distant God: The Legacy of Maimonides. New York: Oxford

University Press.

16. Maimonides (1956) A Guide for the Perplexed. M Friedlander, tr. New York: Dover Press.

17. Oesterle JA & JT (1995) On Evil: St. Thomas Aquinas. Notre Dame, Indiana: Univ of Notre Dame

Press.

18. Loyola St. Ignatius (1997) Personal Writings. JA Munitiz, ed. & tr. New York: Penguin Books.

19. Vives JL (1538/1553) De Anima et Vita. Basel: Johann Oporinus.

20. Boehme J (1648) Concerning the Three Principles of the Divine Essence. J Sparrow, tr. London:

H. Blunden [reprinted: KessingerPublishing].

21. Hobbes T (1651/1968) Leviathan. CB Macpherson, editor. London: Penguin Books.

22. Descartes R (1650) De Passionibus. Amsterdam: Elsevier.

23. Spinoza B (1989) Tractatus Theologico-Politicus. S Shirley, tr. Leiden: Brill.

24. Spinoza B (2000) Ethics. G. H. R. Parkinson, ed. & tr. New York: Oxford University Press.

25. Bayle P (1697/1991) Historical and Critical Dictionary. RH Popkin, tr. Indianapolis, Indiana:

Hackett Publishing Company.

26. Edwards P (2003) Pierre Bayle: 1647-1706. Free Inquiry 23 (summer issue): 55ff.

27. Leibniz GW (1988). Theodicy. AM Farrar, ed.; EM Huggard, tr. Chicago, Illinois: Open Court

Publishing.

28. Voltaire FMA (1756/1994) Poem on the Lisbon Disaster. In– A Treatise on Toleration and Other

Essays. Amherst, New York: Prometheus Press.

29. Hume D (1740/2000) A Treatise on Human Nature. DF & MJ Norton, eds. Oxford, UK: Oxford

University Press.

30. Neiman S (2002) Evil in Modern Thought. Princeton, New Jersey: University of Princeton Press.

31. Lilla M (1998). Kant’s theological-political revolution. Review of Metaphysics 52: 397ff.

32. Garcis EV (2002). A Kantian theory of evil. The Monist 85: 194ff.

33. Hegel GWF (1821/1952) The Philosophy of Right. TM Knox, tr. New York: Oxford University

Press.

34. Rayburn HA (1921) The Ethical Theory of Hegel: A Study of the Philosophy of Right. Oxford,

UK: Clarendon Press.

35. Harris L (2007) The Suicide of Reason: Radical Islam’s Threat to the West. New York: Basic

Books.

36. Schopenhauer A (1819–1859/1966) The World as Will and Representation. 2 vols. EFJ Payne, tr.

New York: Dover Publications.

1.1 EVIL IN HISTORICAL PERSPECTIVE 35

37. Wilson JQ (1993) The Moral Sense. New York: The Free Press/Macmillan.

38. Kierkegaard S (1849/1980) Sygdommen til Døden (Sickness unto Death). A Hanny, tr. London:

Penguin Books.

39. Nietzsche FW (1878) Human, All Too Human. RJ Hollingdale, tr. Cambridge: Cambridge

University Press.

40. Blackburn S (1994) The Oxford Dictionary of Philosophy. New York: Oxford University Press.

41. Nietzsche FW (1887/1966) Jenseits von Gut und B€

ose (Beyond Good and Evil). W Kaufman, tr.

New York: Randon House/Vintage Books.

42. Wittgenstein L (1953) Philosophical Investigations. GEM Anscombe, tr. Oxford, UK: Basil

Blackwell.

43. Buss D (2005) The Murderer Next Door: Why the Mind is Designed to Kill. New York: Penguin

Books.

44. Egger SA (2002) The Killers Among Us: An Examination of Serial Murder and its Investigation.

Upper Saddle River, New Jersey: Prentice Hall.

45. Stone MH (2001) Serial sexual homicide: Biological, psychological and sociological aspects.

Journal of Personality Disorders 15, 1–18.

46. Ward T, Polaschek DLL, & Beech AR (2006) Theories of Sexual Offending. Chichester, UK: John

Wiley & Sons.

47. Niehoff D (1998) The Biology of Violence. New York: The Free Press.

48. Jentz T (2006) Strange Piece of Paradise. New York: Farrar, Straus & Giroux.

49. Freud S (1918). From the History of an Infantile Neurosis. S. E. XVII, pp. 3–122. London:

The Hogarth Press.

50. Freud S (1916). Introductory Lectures on Psychoanalysis. S. E. XV. London: Hogarth Press.

51. Gay P (1988) Freud: A Life for Our Time. New York: W.W. Norton.

52. Freud S (1938) Moses and Monotheism. S. E. XXIII, pp. 3–137.

53. Bakan, D. (1990) Sigmund Freud and the Jewish Mystical Tradition. London: Free Association

Books.

54. Ellenberger HF (1970) The Discovery of the Unconscious: The History and Evolution of Dynamic

Psychiatry. New York: Basic Books.

55. Hare RD, Harpur TJ, Hakstian AR, Forth AE & Hart SD (1990). The Revised Psychopathy

Checklist: Reliability and factor structure. Psychol. Assessment 2: 338–341.

56. Diagnostic & Statistical Manual of Psychiatric Disorders, 3rd edn., revised [DSM-III-R] (1987).

Washington, DC: American Psychiatric Press.

57. Stone MH, Butler J & Young K (2009) Sadistic Personality. In: Blaney PH & Millon T (eds.)

Oxford Textbook of Psychopathology, 2nd edn. Oxford University Press, New York,

pp. 651–670.

58. Linedecker C (2003) The Murder of Laci Peterson. DesMoines, Iowa: America Media Inc.

59. Blair J, Mitchell D & Blair K (2006). The Psychopath: Emotion and the Brain. Malden,

Massachusetts: Blackwell Publishing.

60. Kalivas PW & Volkow ND (2005). The neural basis of addiction: A pathology of motivation and

choice. Amer J Psychiatry 162: 1403–1413.

61. Siever LJ (2008) Neurobiology of aggression and violence. American Journal of Psychiatry 165,

429–442.

62. Zimmer C (2001) Evolution: The Triumph of an Idea. New York: Harper Collins.

63. Volkan V Psychoanalysis and Religion. (Power-Point presentation: www.acopsa.org/acopsa_

assets/ReligiousFundamentalismandViolenceDD.pdf).

64. Kernberg OF (2001) The psychology of religious fundamentalist ideologies. Presented at the

New York Academy of Medicine, October 30th.

65. Girard R (1972). Violence and the Sacred. Baltimore: The Johns Hopkins Press.

66. Alderdice John Lord (2008) On the psychology of religious fundamentalism. www.

medicalnewstoday.com/articles/113876.php.

36 PROLEGOMENA (FIRST ISSUES)

67. Post JM (2007) The Mind of a Terrorist: The Psychology of Terrorism from the IRA to al-Qaeda.

New York: Palgrave Macmillan.

68. Manji I (2005) The Trouble with Islam Today. New York: St. Martin’s Press.

69. Ibn Khaldun (1967) The Muqaddimah: An Introduction to History. F Rosenthal, tr.; NJ Dawood,

ed. Princeton, New Jersey: Bollinger Series/Princeton University Press.

70. Baali F (1988) Society, State, and Urbanism: Ibn Khaldun’s Sociological Thought. Albany,

New York: State University of New York Press.

71. Aquinas St. Thomas (2002) Summa Theloogica [shorter version]. C Vollert, tr. Manchester,

New Hampshire: Sophia Institute Press.

72. Steel C (1994) Does evil have a cause? Augustine’s perplexity and Thomas’s answer. The Review

of Metaphysics 48, 251–273.

1.1 EVIL IN HISTORICAL PERSPECTIVE 37

Christianity and Schizophrenia Redux: An Empirical Study

Article

Full-text available

Feb 2020
J RELIG HEALTH

This paper explores the relationship among schizophrenia, spirituality, and Christian religiosity. We interviewed 120 patients with schizophrenia and 120 control individuals (74.2 % of individuals with self-reported Christian religions). Patients with schizophrenia showed increases in positive spirituality and decreases in positive congregational support, as measured by the Brief Multidimensional Measure of Religiousness/Spirituality. There was no significant difference in Christian religiosity. Higher positive spirituality was predicted by more severe self-disorder, perceptual disorder, and positive clinical symptoms. Schizophrenia patients with religious delusions did not exhibit enhanced Christian beliefs and rituals. These results do not confirm the hypothesis of general hyper-religiosity in schizophrenia.

Tlazolteotl, the Aztec goddess of epilepsy

Article

Feb 2016
EPILEPSY BEHAV

Exploring Depression: Community Perceptions and Social Influences in Southeast, Nigeria

Article

Aug 2024

ABSTRACT Despite increasing global awareness of mental health issues, understanding the perception and influences of depression remains limited within specific cultural contexts such as Southeast Nigeria. This study investigates how residents define and perceive depression, exploring socio-cultural, demographic, and religious factors that shape these perceptions. In-depth interviews were conducted with twenty participants (10 males and 10 females) from Anaocha and Idemili South Local Government Areas in Anambra State. Thematic analysis revealed that depression is perceived as a profound emotional and psychological burden, characterized by sadness, hopelessness, and isolation. Influential socio-cultural factors included beliefs in supernatural forces, traditional healing practices, gender norms, educational levels, and religious/spiritual practices. Stigma emerged as a significant barrier to help-seeking, with cultural expectations of resilience and reliance on religious coping mechanisms complicating the mental health landscape. The study proposes resilience-based interventions to enhance help-seeking behavior and support individuals with internalized stigma. These interventions by professional service providers such as social workers will increase mental health literacy, reduce stigma, and promote community resilience. Future research could also prioritize comparative studies across different regions to examine regional variations in depression perceptions and inform tailored interventions in social service delivery that effectively address local socio-cultural contexts, thereby advancing social research.

Religion and mental health: a critical reflection in consequence of four reviews (1969-2013)

Article

Full-text available

Oct 2017

Peter Verhagen

The effect of religious and spiritual beliefs on the quality of life among university students in Jordan measured by the modified version of (WHOQOL-SRPB) instrument

Article

Full-text available

Jan 2012

Ahmed Al-Naaimi

Psychiatry

Chapter

Jan 2014

Kelley Raab Mayo

CLIENT PERCEPTIONS ON THERAPEUTIC QUALITY OF CARE WHEN DISCLOSING SPIRITUAL AND RELIGIOUS BELIEFS OR EXPERIENCES: A MIXED METHODS STUDY

Thesis

Full-text available

Aug 2015

Maia Nikitovich

A project based upon an independent investigation. http://hdl.handle.net/11020/24685 The spiritual and religious life of clients is an important clinical factor in therapy; it holds significant meaning and may support therapeutic outcome. This study explored client perceptions of the quality of care they received in therapy when disclosing their spiritual/religious life to their therapists as well as the factors that might contribute to their perceptions of care and disclosure. A total of 75 respondents participated in an online survey tool composed of quantitative and qualitative questions. Qualitative responses were coded and data was analyzed using descriptive statistics. Findings showed that most clients (73%) shared some or all of their beliefs; in contrast only 40% shared their spiritual or religious experiences. Almost all clients (80-90%) have had a significant spiritual/religious experience, most often describing a feeling of interconnection and well-being, a loss, gain, or change of faith, high intuition, and/or a sensory experience (auditory, visual, or tactile.) Fifty percent of clients who shared their beliefs with their therapists were satisfied or very satisfied with the care they received; 23% were somewhat satisfied or unsatisfied. Of clients who shared their experiences 38% were satisfied and less than 10% were somewhat satisfied or unsatisfied. A poor working alliance, misattuned responses, lack of engagement, and the therapist’s lack of knowledge on the subject were reasons for low levels of satisfaction. The study concludes with suggestions on how to improve the therapeutic quality of care for spiritual or religious clients.

Family therapy and fundamentalism: One family therapists exploration of ethics and collaboration with religious fundamentalist families

Article

Full-text available

Dec 2015

Hannah Sherbersky

What are the therapeutic limitations of systemic psychotherapy when working with families who hold religious fundamentalist beliefs? At a time of debate about religious fundamentalism, terrorism and radicalisation, where do family therapists position themselves when confronted by extreme beliefs in the therapy room? Research suggests that the increase in modernity within our society equates not just with an increase in secularisation, but rather an increase in pluralism. Contemporary models of family therapy pay explicit attention to issues of gender, culture, ethnicity, discrimination and societal contexts. The author, therefore, proposes that family therapists need to examine their position regarding religious fundamentalism in relation to the social constructionist relativist continuum and engage with uncomfortable questions about whether they believe that fundamentalism has essentially pathological roots. This article will explore whether the dualist position within some religious movements set against a more secular psychotherapeutic and psychiatric cultural milieu can invite a fundamentalised response from clinicians. The author draws on her own work with families who hold religious fundamentalist beliefs and enquires about ethics, transparency and collaboration within family therapy practice. This article invites complex ongoing challenging questions and debate.

Naturalistic study of crisis referrals to an Irish community adult mental health service

Article

Full-text available

Aug 2011

There is no agreed definition of a mental health crisis; however, a useful one is ‘a situation where mental health has deteriorated to an extent that the user is likely to be at risk of harm to self or others and is in need of urgent intensive specialist support and treatment’ (Minghella et al , 1998). Community-based care is the primary model of specialist mental healthcare in Ireland (Government of Ireland, 2006 a ). When clinically indicated, a patient with mental health crisis is referred to the community mental health team (CMHT) for an urgent assessment.

Serum Ferritin Is Negatively Correlated With Inattention in a Sample of Egyptian Children with Attention Deficit Hyperactivity Disorder

Conference Paper

Full-text available

May 2015

OBJECTIVE: Iron deficiency was suggested to play a role in the pathophysiology of attention deficit hyperactivity disorder (ADHD) due to the role of iron in the production of dopamine and noradrenaline. The aim of this study was to assess iron status in a sample of Egyptian children with ADHD. METHODs: Thirty children with ADHD (6-12 years old) and 15 age and sex matched controls were recruited. Subjects were evaluated using the Mini International Neuropsychiatric Interview for kids (mini-kid) and Conner's Parent Rating Scale - Revised (CPRS-R). Laboratory measures were also carried out to investigate iron status in all subjects including: complete blood count, serum iron, total iron binding capacity, and serum ferritin. RESULTS: Children with ADHD showed significantly lower levels of hemoglobin and serum ferritin as compared to control groups. A strong negative correlation was found between serum ferritin and ADHD total score and cognitive subscore but not with hyperactivity subscore. No significant differences were found between the two groups as regards other hematological data. CONCLUSIONS: Iron deficiency, with or without anemia, might play a role in pathogenesis of ADHD. Further work is needed to confirm the clinical utility of iron supplementation in the treatment of ADHD, especially in developing countries.

On the psychology of religious fundamentalism

Chapter

Nov 2020

John T Alderdice

Searching for a Distant God: The Legacy of Maimonides

Book

Oct 2023

Kenneth Seeskin

Monotheism is usually considered Judaism's greatest contribution to world culture, but it is far from clear what monotheism is. This work examines the notion that monotheism is not so much a claim about the number of God as a claim about the nature of God. Seeskin argues that the idea of a God who is separate from his creation and unique is not just an abstraction but a suitable basis for worship. He examines this conclusion in the contexts of prayer, creation, sabbath observance, repentance, religious freedom, and love of God. Maimonides plays a central role in the argument both because of his importance to Jewish self-understanding and because he deals with the question of how philosophic ideas are embodied in religious ritual.

The discovery of the unconscious. the history and evolution of dynamic psychiatry

Article

Oct 1971
Transcult Psychiatr

A review of H. F. ELLENBERGER's book, The Discovery of the Unconscious, opens up this section. In this monumental work the author shows how the main schools of dynamic psychiatry over the past two centuries had their roots in the broad cultural movements of their time. A wide perspective of psychotherapeutic approaches ranging from faith healing to psychoanalysis is presented. J. ZUBIN highlights cultural factors regarding etiological models of schizophrenia and regarding the diagnosis of this illness. He comprehensively discusses emerging trends in descriptive psychopathology and cross-cultural studies. E. F. TORREY has provided us with a preview of his book, The Mind Game: Witchdoctors and Psychiatrists. Based on his experiences in several cultures he has identified com monalities in the activities of psychotherapists all over the world. He offers models based on his experiences with different ethnic groups for future mental health services for these groups and others. The last paper in this section concerns itself with the application of verbal psychological tests in translation for cross-cultural psychological or psychiatric purposes. K. GLATT compared differences in the responses to the MMPI in French, Spanish, and German translations (see also R. Prince and W. Mombour, Transcultural Psychiatric Research.

How to Relate Science and Religion: A Multidimensional Model

Article

Jan 2006

James C. McGlothlin

Sigmund Freud and the Jewish Mystical Tradition

Article

Mar 1960

Hearing Visions and Seeing Voices: Psychological Aspects of Biblical Concepts and Personalities

Book

Jan 2007

This book’s aim is to enrich and deepen our psychological understanding of biblical concepts and personalities. Such understanding is relevant for theology as well as for psychology and psychiatry. It may help theologians to contextualize their discipline by bringing it into contact with contemporary psychological and existential issues and tensions, both at an individual and a societal level. It also encourages psychologists and psychiatrists to develop and refine their vocabularies when they try to comprehend the existential meaning of what is transmitted to them by their clients. The book highlights the concepts of prophecy, martyrdom, and messianism from Christian and Judaic perspectives. Each concept offers one biblical figure as representative: Jeremiah, Paul, and Jesus, respectively. The sections on these three subjects and personalities are sandwiched between a section on historical and conceptual issues, and a section devoted to select interdisciplinary issues. Biblical images of pain, anguish, suffering, hope, resentment, and awe are part of our cultural background and shape the way we understand our lives and sufferings. Biblical perspectives on human existence, on the other hand, differ in some important respects from modernist conceptions that prevail in psychotherapy and psychiatry. The book investigates the possibility of a theological criticism on common frameworks of psychological and psychiatric understanding of the inner world of the client. It also offers new ways to understand the ‘transformative’ power of religion.

The Spiritual Brain: Science and Religious Experience

Chapter

Dec 2017

Andrew Newberg

Until the late eighteenth century, religions, particularly in the West, were defined by their sacred texts and dogmatic formulations. Friedrich Schleiermacher, in the late eighteenth century, was one of the first scholars that attempted to define “religion” by switching from a doctrinal emphasis to a more cognitive, visceral, or intuitive one. Schleiermacher defined religion as a “feeling of absolute dependence.” Since his day most attempts at a general definition of religion have relied heavily on emphasizing the intuitive, emotional, or visceral elements rather than the doctrinal ones. This shift has important implications for bringing a neuroscientific approach to the study of religion. However, this also results in a neuroscientific approach to both religious and non-religious spirituality and spiritual experiences. In fact, as the definitions have evolved, the distinction between spirituality and religiousness has become much more complicated.

Social Psychology and Religious Fundamentalism

Chapter

Jan 1983

Ralph W Hood Jr

Religion is obviously shaped by the social context within which it exists. Hence, one might expect some legitimacy to the concept of rural religion. Furthermore, if there is even partial truth to the claims that, relative to more cosmopolitan cultures, rural cultures are less heterogeneous, less tolerant of divergencies in belief and action, and less abstract in their conceptualizations, then these claims should hold true to the same extent for rural religion as they do for rural culture in general. In this sense, religious fundamentalism is not unanticipated in rural areas. Yet, as we shall see, it is more than just a curiosity that the persistence of the faith of the rural Roman (the paganus) became an English word for unbeliever (pagan) and the religious conservatism of the English heath dwellers became another word for unbeliever, heathen (Smith & Zopf, 1970). Yet these terms conceal a bias that also characterizes the scientific study of religion in general and of religious fundamentalism in particular. The problem of bias, noted through many chapters of this text, is even more apparent when investigators confront not only a rural culture unlikely to be their own, but also a religious fundamentalism dominant in that culture and to which they are unlikely to subscribe.

Values and psychiatric diagnosis

Chapter