Abstract

Revealing a tension between the medical model of depression and the very different language of theology, this book explores how religious people and communities understand severe sadness, their coping mechanisms and their help-seeking behaviours.

Drawing from her study of practicing Catholics, contemplative monks and nuns, priests and laypeople studying theology, the author describes how symptoms that might otherwise be described as pathological and meet diagnostic criteria for a depressive disorder are considered by some religious individuals to be normal and valued experiences. She explains how sadness fits into the 'Dark Night of the Soul' narrative - an active transformation of emotional distress into an essential ingredient for self-reflection and spiritual growth - and how sadness with a recognised cause is seen to 'make sense', whereas sadness without a cause may be seen to warrant psychiatric consultation. The author also discusses the role of the clergy in cases of sadness and depression and their collaboration with medical professionals.

This is an insightful read for anyone with an interest in theology or mental health, including clergy, psychiatrists and psychologists.

A balanced account of one of the most unbalanced topics in cultural psychiatry, psychiatric anthropology, and religious studies. An important study for inclusion in courses on religion and medicine, and an empirical provocation to psychiatry, anthropology and religious studies to reconsider what it means to struggle, endure, succumb, and overcome a ubiquitous form of human misery.
Professor Arthur Kleinman, Department of Social Medicine, Harvard University, author of 'Rethinking Psychiatry: From Cultural Category to Personal Experience'
In her preface, the author writes "I would like you to think of it [the book] as a sort of diary of my travels, a witness to my experiences and to the lessons I learned along the way." This is indeed how I experienced reading the book - I had a sense of journeying alongside the author in her study.
Andrew Clark
Royal College of Psychiatrists' Spirituality and Psychiatry Special Interest Group

In The Lost Art of Healing: Practicing Compassion in Medicine (1999), Dr. Bernard Lown, a Nobel laureate and physician, writes about the fundamental need for human relationships between doctor and patient, pointing out how true healers make use of sympathetic listening and a trusting relationship, which affects outcomes from cardiac illness to depression. If medical care values meaning and context, with a strong alliance between
provider and patient being crucial to outcome, they are even more critical in psychiatry, psychology, and religion, three fields in which emotion is at the forefront of care (Greenberg, 2016). Cure, in Latin, means to care! Durà-Vilà's work goes a long way toward this good end.

PsycCRITIQUES
American Psychological Association
Durà-Vilà's rich ethnography of spiritual sadness is as haunting as it is beautiful. By giving us intimate glimpses into participants' spiritual lives, this work illuminates how, for some, sadness can become a source of deep reflection, and even grace, as well as what is potentially lost when medicalization strips sadness of its resonant meanings. Deftly and sympathetically weaving together spiritual and biomedical perspectives, this is a "must-read" book for anyone interested in depression, spirituality, and how institutions like religion and psychiatry shape our inner worlds.
Professor Rebecca Lester, Department of Anthropology, Washington University, author of ‘Jesus in Our Wombs: Embodying Modernity in a Mexican Convent’
This scholarly presentation of a well-researched study deserves to be read widely. I hope that it will help to change attitudes in a wide range of contexts.
Revd Anne Holmes
Church Times
We need a much better understanding of, and antidote to, the all-pervasive but often pointless medicalisation of human sadness and anxiety. This book engages with this problem from a fresh vantage point - that of men and women living a secluded religious life who not only make sense of psychological torment but face it head on, accommodating and transforming it as a kind of spiritual alchemy. Based on rich ethnographic research, Glòria Durà-Vilà explores the spiritual conceptualisation of human angst and loneliness with insightful compassion. In doing so, she permits us a unique and revealing account of dwindling religious communities that will stimulate anyone interested in the human condition.
Professor Gerard Leavey, Director of the Bamford Centre for Mental Health and Wellbeing, Ulster University
This is a truly ground breaking publication. By bringing together insights from psychiatry and spirituality Dr Glòria Durà-Vilà has provided an exceptionally helpful guidebook for all involved in helping people in situations of personal distress, sadness and trauma.
Professor Bernadette Flanagan, author of 'Embracing Solitude'
Glòria Durà-Vilà is a consultant child and adolescent psychiatrist working in the Surrey and Borders NHS Trust. She was brought up as a Roman Catholic and has an interest in both religion and psychiatry. She is Honorary Lecturer in the Department of Mental Health Sciences at University College London and author of My Autism Book, also published by Jessica Kingsley Publishers. She is based in London, UK.
In this substantial study, Glòria Durà-Vilà has stepped boldly into the conflict between sacred and secular understandings of sadness, and revealed it to be a remarkably interesting, important and fertile area of study. The book presents detailed and careful research which not only shines light into contemporary and traditional experiences of darkness and depression, but also into the often murky ways that religious and medical professionals think about each other. The work is certainly illuminating; it deserves to be influential.
Dr Stephen Cherry, Dean of King’s College, Cambridge, author of ‘Barefoot Disciple’, ‘Beyond Busyness: Time Wisdom for Ministry’ and ‘Healing Agony’
Lucid scholarship and sensitive ethnography situated in the ecclesiastical landscape of Spain provide grist for Durà-Vilà's cultural critique of a psychiatric check-list approach to diagnosing depression devoid of context. Clearly written and engaging, the study explains strengths and limitations of medicalising and spiritualising normal sadness and pathological depression. As a timely study of challenging issues, it demonstrates the value of a cultural formulation of religious faith. The book is an important contribution to cultural psychiatry, psychological anthropology and religious thought.
Professor Mitchell Weiss, Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, University of Basel
This book deepens our understanding of the complex distinction between normal sadness and depressive disorder. Through a penetrating study of Catholic help-seekers in Spain the author clearly illuminates the ways that individuals interpret their distress and take various kinds of actions to relieve it. This book makes an important contribution to knowledge not just about depression but also about the process of medicalization more generally.
Professor Allan Horwitz, Department of Sociology, Rutgers University, author of 'The Loss of Sadness: How Psychiatry Transformed Normal Sorrow into Depressive Disorder'
A novel book that tackles in a creative and original way, as well as being empirical, documented and rigorous, one of the great topics of today: the relationship between spirituality, religion and mental health in a globalised world in a state of deep transformation. This brilliant analysis highlights the differences among sadness, the Dark Night of the Soul and depressive disorders in a social framework with a strong tendency to medicalise human suffering.
Professor Joseba Achotegui Loizate, Department of Psychiatry, University of Barcelona, Secretary of the World Psychiatric Association - Transcultural Psychiatry Section