Psychological Disorders and Fasting

Beginning in the 1970s, researchers recorded success treating some psychiatric conditions with therapeutic fasting, most notably schizophrenia (Cott, 1974).

In the field of psychiatry, Yuri Nikoliav of the Moscow Psychiatric Institute, fasted ten thousand patients diagnosed with chronic refractory schizophrenia, a recurring condition characterized by gross distortions of reality, which is resistant to treatment. The patients, who had been treated with more conventional types of psychiatry and had not responded, were placed on water fasts lasting from twenty-five to thirty days. Nikoliav's fasting regimen was successful in more than 70% of all cases. The results were so impressive that the large majority of the schizophrenic patients at the 3,000-bed research center requested admission to the unit.

New York Psychiatrist Alan Cott spent two weeks observing Nikoliav's fasting treatments. Cott then undertook an experimental controlled fasting program as part of a research project at the Gracie Square Hospital in New York. The patients in Cott’s study had been previously diagnosed as schizophrenic for at least five years and had failed to improve under previous forms of treatment. After treating 28 schizophrenics, Cott reported that over 60% of those who completed the fast remained well, providing they stayed on a special low-fat diet.

In his book What Really Causes Schizophrenia?, Harold Foster calls the therapeutic fasting of schizophrenics as one of the "five most effective unconventional approaches to the treatment of schizophrenia." Foster subscribes to a branch of medicine called "orthomolecular medicine." Orthomolecular psychiatry is a type of orthomolecular medicine whose proponents argue that dietary supplements and other treatments can be effective in treating mental illness. Linus Pauling, winner of two Nobel prizes, coined the term "orthomolecular psychiatry" in 1968 to refer to the treatment of psychiatric illnesses with substances (such as vitamins, minerals, enzymes, trace elements, co-enzymes) that are normally present in the body. In orthomolecular psychiatry, high amounts of vitamins are sometimes used, not to correct a deficiency per se, but to create a more optimal biochemical environment. Fasting is another method used in orthomolecular psychiatry.

Juli Shapiro, a doctor at the hematology unit at Moscow Psychiatric Institute who was present during Nikoliav’s therapeutic fasting of schizophrenic patients, discovered the biological mechanism at work in fasting schizophrenics. Shapiro determined that fasting had a major impact on histamine levels. This was due to the fact that, during a fast, a large amount of heparin formed in the tissue surrounding blood vessels, lowering histamine levels. Shapiro also revealed that catecholamines, a water soluble chemical compound that circulates in the bloodstream and is depressed in schizophrenics, normalize during the fast.

In 1970, Abram Hoffer, using an orthomolecular dietary approach, fasted his schizophrenic patients for 4 days and began reintroducing foods he suspected they were allergic to. According to Hoffer, 60% of the 200 schizophrenic patients he fasted, were allergic to specific foods. When the foods were eliminated, they improved or became normal. Hoffer said he believed, "Cerebral allergy plays a major role in the etiology of the schizophrenic syndrome."

Other researchers have found that fasting can attenuate symptoms of anxiety and depression (Tovt-Korshyns'ka et al., 2002, Yamamoto et al., 1979). According to Fuhrman, (1998), there is evidence that fasting can alleviate the symptoms of depression (p. 19). In a Japanese study of 382 patients with a variety of psychosomatic problems and various mental diseases, researchers claimed that fasting therapy had an efficacy rate of 90% in 69 cases of depression, dropping to 87% at long term follow up (Yamamoto et al., 1979).

Research suggests that fasting helps attenuate depression due to its profound effect on the brain (Suzuki et al., 1976, Yamamoto et al., 1979, Yashiro, 1986). One study looked at changes in the brain waves from 262 fasting patients and noted a slowing and synchronization of alpha waves, together with an increased incidence of theta waves (Suzuki et al. 1976). This translates into a more relaxed and an introspective state of awareness that is less neurotically preoccupied with the superficial and transitory patterns of thought. Similar brain wave patterns have been observed in Zen meditators (Kasamatsu & Hirai, 1986) and in subjects practicing yoga (Banquet, 1979). This correlation suggests that fasting and meditation have similar psycho-physiological effects on the brain and nervous system. In a study in Japan, fasting was shown to alleviate depression, neuroses, and anxiety, as well as improve the ability to adapt to frustration and external stress (Yashiro, 1986).

Studies have found that fasting has a profound effect on the brain, improving memory (Choi & Kim, 2000, Witte et al., 2009), slowing cognitive decline, and reducing the incidence of dementia (Mattson, 2000a, Mattson, 2000b).

References
(To view, roll mouse over the "References" heading; to hide, click on the heading)

Al-Ghazzali, & Faris, N. A. (Trans.). (1995). The mysteries of fasting. Chicago: Kazi.

Anderson, R. (1998). Introduction. In W. Braud & R. Anderson (Eds.), Transpersonal research methods: Honoring human experience (pp. xix-xxxi). Thousand Oaks, CA: Sage.

Armstrong, K. (1994). History of God: The 4,000-year quest of Judaism, Christianity and Islam. New York: Ballantine.

Assagioli, R. (2007). Transpersonal development: The dimension beyond psychosynthesis. Findhorn, Scotland: Smiling Wisdom.

Bayman, H. (2001). The station of no station. Berkeley, CA: North Atlantic Books.

BBC. (2003, October). Santhara - fasting to death. British Broadcast Corporation. Retrieved May 2, 2009, from http://www.bbc.co.uk/religion/
religions/jainism/customs/ fasting_2.shtml

Bell, R. M. (1985). Holy anorexia. Chicago: University of Chicago Press.

Berenbaum, H., Kerns, J., & Raghavan, C. (2000). Anomalous experience: Examining the scientific evidence. In E. Cardena, S. J. Lynn, & S. C. Krippner (Eds.), Varieties of anomalous experience: Examining the scientific evidence (pp. 25-46). Washington, DC: American Psychological Association.

Blake, W., & Keynes, G. (Ed.). (1966). Blake: Complete writings. Oxford: Oxford University Press.

Boulding, K. E. (1979). Ecodynamics: A new theory of societal evolution. Thousand Oaks, CA: Sage.

Braud, W. (2009, January). Exceptional human experiences (EHEs): Their relevance to transpersonal psychology. Paper presented at the ITP Global Seminar, Los Gatos, CA.

Brumberg, J. J. (1988). Fasting girls: The history of anorexia nervosa. Cambridge, MA: Harvard University Press.

Buhner, S. H. (2003). The fasting path: For spiritual, emotional, and physical healing and renewal. New York: Avery Publishing Group.

Butcher, T. (2007). Yoga consciousness in ancient mystery religions: Cinderella sutras. London: Janus Publishing Company.

Bynum, C. W. (1987). Holy feast and holy fast. Berkeley, CA: University of California Press.

Campbell, J. (1991). The masks of God, vol. 1: Primitive mythology. New York: Penguin.

Chapple, C. K. (2007). Purgation and virtue in Jainism: Toward an ecological ethic. In P. Bilimora, J. Prabhu, & R. Sharma (Eds.), Indian ethics: Classical traditions and contemporary challenges (Vol. 1, pp. 217-227). Burlington, VT: Ashgate.

Chellappa, P., & Ramaraj, R. (2009). Depression, homocysteine concentration, and cardiovascular events. Journal of the American Medical Association, 15,1541-1542.

Clark, R. (2000). The sacred tradition in ancient Egypt: The esoteric wisdom revealed. St. Paul, MN: Llewellyn Publications.

Cohen, H., & Bruckstein, A. S. (Trans.). (2003). Ethics of Maimonides. Madison: University of Wisconsin Press.

Colbin, A. (1986). Food and healing. New York: Ballantine.

Cortright, B. (1997). Psychotherapy and spirit: Theory and practice in transpersonal psychotherapy. Albany, NY: State University of New York Press.

Cott, A. (1974). Controlled fasting treatment for schizophrenia. Journal of Orthomolecular Psychiatry, 3, 301-311.

Daniels, M. (2005). Shadow, self, spirit. Charlottesville, VA: Imprint Academic.

Deegalle, M. (2000). Asceticism: Buddhist perspectives. In W. M. Johnston (Ed.), Encyclopedia of Monasticism (Vol. 1, pp. 89-91). Chicago: Fitzroy Dearborn.

Denton, L. T. (2004). Female ascetics in Hinduism. Albany, NY: State University of New York Press.

Drury, N. (2006). The dictionary of the esoteric: Over 3,000 entries on the mystical & occult traditions. London: Watkins.

Dundas, P. (2002). The Jains. New York: Routledge.

Dunn, M. (2003). Emergence of monasticism: From the desert fathers to the early middle ages. Oxford: Wiley-Blackwell.

Ellmann, M. (1993). The hunger artists: Starving, writing, and imprisonment. Cambridge, MA: Harvard University Press.

Epstein, G. (1995). Standing on Sinai. In E. Hoffman (Ed.), Opening the inner gates: New paths in Kabbalah and psychology (pp. 249-265). Boston: Shambhala.

Ezra, D. S. B. (2002). The impact of Yom Kippur on early Christianity. Tübingen, Germany: Mohr Siebeck.

Fallon, B. A., & Horwath, E. (1993). Asceticism: Creative spiritual practice or pathological pursuit? Psychiatry, 56(3), 310-316.

Firman, J., & Gila, A. (2002). Psychosynthesis: A psychology of the spirit. Albany, NY: State University of New York Press.

Firman, J., & Vargiu, J. G. (1996). Religiousness and spirituality. In S. Boorstien (Eds.), Transpersonal psychotherapy (pp. 117-142). Albany, NY: State University of New York Press.

Flinders, C. L. (1993). Enduring grace: Living portraits of seven women mystics. San Francisco: HarperCollins.

Flinders, C. L. (1999). At the root of this longing: Reconciling a spiritual hunger with a feminist thirst. San Francisco: HarperCollins.

Foster, S., & Little, M. (1980). The book of the vision quest: Personal transformation in the wilderness. Covelo, CA: Island Press.

Foster, P. (2006, October). Woman starves herself to death in ancient ritual. Telegraph Media Group. Retrieved May 2. 2007, from http://www.telegraph.co.uk/news/1530366/
Woman-starves-herself-to-death-in-ancient-ritual.html

Fowler, J. (2002). Perspectives of reality: An introduction to the philosophy of Hinduism. Portland, OR: Sussex Academic Press.

Frager, R., & Fadiman, J. (2005). Personality and personal growth (6th ed.). New York: Pearson Prentice Hall.

Gandhi, M. K. (2001). Non-violent resistance (satyagraha). Mineola, NY: Dover.

Gethin, R. (1998). The foundations of Buddhism. Oxford: Oxford University Press.

Ghosh, L., & Merchant, R. (1999, October 18). New age addiction. India Today, 46-47.

Goldberg, B., Anderson, J., & Trivieri, L. (1994). Alternative medicine: The definitive guide. Berkeley, CA: Ten Speed Press.

Goldhamer, A. C. (2002). Initial cost of care results in medically supervised water-only fasting for treating high blood pressure and diabetes. The Journal of Alternative and Complementary Medicine, 6, 696-697.

Goldhamer, A. C., Lisle, D. J., Sultana, P., Anderson, S. V., Parpia, B., Hughes, B., & Campbell, T. C. (2002). Medically supervised water-only fasting in the treatment of borderline hypertension. The Journal of Alternative and Complementary Medicine, 5, 643-650.

Goscienski, P. J. (2005). Health secrets of the stone age. Concord, Ontario: Better Life.

Grof, S. (1998). The adventure of self-discovery: Dimensions of consciousness and new perspectives in psychotherapy and inner exploration. Albany, NY: State University of New York Press.

Grof, S., & Grof, C. (1989). Spiritual emergency: When personal transformation becomes a crisis. New York: Jeremy P. Tarcher.

Hagelin, J. S., Rainforth, M. V., Cavanaugh, K. L. C., Alexander, C. N., Shatkin, S. F., Davies, J. L., Hughes, A. O., Ross, E., & Orme-Johnson, D. W. (1999). Effects of group practice of the transcendental meditation program on preventing violent crime in Washington, D.C.: Results of the national demonstration project, Social Indicators Research, 47, 153-201.

Harner, M. (1980). The way of the shaman. New York: Harper Row.

Hoffman, E. (1996). An Introduction to Kabbalistic Psychotherapy. In S. Boorstein (Eds.), Transpersonal psychotherapy (pp. 165-180). Albany, NY: State University of New York Press.

Hoffman, V. (1995). Eating and fasting for God in Sufi tradition. Journal of the Academy of Religion, LXIII(3), 465-484.

Homer. (2007). The iliad and the odyssey. Radford, VA: Wilder Publications.

Houston, J. (1998). The passion of Isis and Osiris: A gateway to transcendent love. New York: Ballantine.

Jaini, P. (1979). The Jaina path of purification. Berkeley, CA: University of California Press.

James, W. (2007). The varieties of religious experience. Stilwell, KS: Digireads.

Jestice, P. G. (2004). Holy people of the world: A cross-cultural encyclopedia. Mount Kisco, Oxford: ABC-CLIO.

Jonas, B.S., & Lando, J. F. (2000). Negative affect as a prospective risk factor for hypertension. Psychosomatic Medicine, 2, 188-196.

Kaelber, W. O. (2005). Asceticism. In L. Jones (Ed.), Encyclopedia of religion (Vol.1, pp. 526- 530). New York: Thompson Gale.

Kanazawaa, M., Hongob, M., & Fukudo, S. (2006). Fasting therapy for functional gastrointestinal disorders. International Congress Series, 1287, 309-312.

Keown, D. (2003). Dictionary of Buddhism. Oxford: Oxford University Press.

Kinnard, J. N. (2006). The emergence of Buddhism. Westport, CT: Greenwood Press.

Kornfield, J. (2001). After the ecstasy, the laundry: How the heart grows wise on the spiritual path. New York: Bantam.

Krippner, S., & Achterberg, J. (2000). Anomalous healing experiences. In E. Cardena, S. J. Lynn, & S. C. Krippner (Eds.), Varieties of anomalous experience: Examining the scientific evidence (pp. 353-396). Washington, DC: American Psychological Association.

Krippner, S., Bogzaran, F., & De Carvalho, A. P. (2002). Extraordinary dreams and how to work with them. Albany, NY: State University of New York Press.

Krippner, S., & McIntyre, T. M. (2003). The psychological impact of war trauma on civilians: An international perspective. Westport, CT: Praeger.

Kroeber, A. L. (2006). Handbook of the Indians of California, vol 1. Whitefish, MT: Kessinger.

Kroll, J. (2005). The mystic mind: The psychology of medieval mystics and ascetics. New York: Routledge.

Laidlaw, J. (2005). A life worth leaving: Fasting to death as telos of a Jain religious life. Economy and Society, 34(2), 178-199.

Lansford, T. (2004). Asceticism. In F. A. Salamone (Ed.), Encyclopedia of religious rites, rituals, and festivals (pp. 35-38). New York: Routledge.

Larsen, S. (2001). Forward. In E. Tick, The practice of dream healing: Bringing ancient Greek mysteries into modern medicine (pp. ix-xviii). Wheaton, IL: Quest Books

Lelwica, M. M. (2002). Starving for salvation: The spiritual dimensions of eating problems among American girls and women. Oxford: Oxford University Press.

Ling, T. O. (1972). A dictionary of Buddhism. New York: Charles Scribner’s Sons.

Lochtefeld, J. (2002). The illustrated encyclopedia of Hinduism. New York: Rosen.

Lyon, W. S. (1998). Encyclopedia of native American shamanism: Sacred ceremonies of north America. Santa Barbara, CA: ABC-CLIO.

MacGregor, G. (1989). Dictionary of religion and philosophy. New York: Paragon House.

Maslow, A. H. (1962). Lessons from peak experiences. Journal of Humanistic Psychology, 2, 9- 18.

Maslow, A. H. (1971). The farther reaches of human nature. New York: Viking Compass.

May, G. G. (2005). The dark night of the soul: A psychiatrist explores the connection between darkness and spiritual growth. New York: HarperOne.

McAuliffe, J. D. (Ed.). (2002). Encyclopedia of the Quran. Boston: Brill, Leiden.

Metzner, R. (1986). The unfolding self: Varieties of the transformative experience. Novato, CA: Origin Press.

Metzner, R. (2001). Well of remembrance: Rediscovering the earth wisdom myths of Northern Europe. Boston: Shambhala.

Muhlestein, J. B., Anderson, J. L., Horne, B. D., Lavasani, F., Maycock, C. A., Bair, T. L., Pearson, R. R., & Carlquist, J. F. (2003). Intermountain Heart Collaborative Study Group. Effect of fasting glucose levels on mortality rate in patients with and without diabetes mellitus and coronary artery disease undergoing percutaneous coronary intervention. American Heart Journal, 2, 351–358.

Murray, S. A., Huber, R. V., & Mechem, E. (Eds.). (2008). Hammond atlas of world religions: A visual history of our great faiths. Duncan, SC: Hammond World Atlas.

Murray, M., & Pizzorno, J. (1997). Encyclopedia of natural medicine. New York: Three Rivers Press.

Narby, J., & Huxley, F. (2001). Shamans through time: 500 years on the path to knowledge. New York: J.P. Tarcher.

Nash, R. J. (2001). Religious pluralism in the academy: Opening the dialogue. New York: Peter Lang.

Nicholas, J. (2000). A thin body carries the most definition(s): Reconceptualizing voluntary self- starvation as an act of resistance. Unpublished master’s thesis, Queen’s University, Kingston, Ontario.

Olson, C. (2005). The different paths of Buddhism: A narrative-historical introduction. London: Rutgers University Press.

Owens, C. M. (1975). Zen Buddhism. In C. T. Tart (Ed.), Transpersonal Psychologies (pp. 155- 201). New York: Harper & Row.

Parrinder, G. (1973). Dictionary of non-Christian religions. Philadelphia: Westminster Press.

Peters, L. G. (1975). The contributions of anthropology to transpersonal psychiatry. In C. T. Tart (Ed.), Transpersonal psychologies (pp. 207-227). New York: Harper & Row.

Pizzorno, J., & Murray, M. (1999). Textbook of natural medicine. New York: Churchill Livingstone.

Rader, R. (2005). Fasting. In L. Jones (Ed.), Encyclopedia of religion (Vol. 5, pp. 2995-2998). New York: Thompson Gale.

Renard, J. (2005). Historical dictionary of Sufism. London: The Scarecrow Press, Inc.

Roberts, J. (2003). Setting the frame: Definition, functions, and typology of rituals. In E. Imber- Black, J. Robert, & R. A. Whiting (Eds.), Rituals in families and family therapy, revised edition (pp. 3-48). New York: W.W. Norton & Co.

Rogers, C.R. (1961). On becoming a person. Boston: Houghton Mifflin.

Rothberg, D. (2000). Spiritual inquiry. In T. Hart, P. Nelson, & K. Puhakka (Eds.), Transpersonal knowing: Exploring the horizon of consciousness (pp. 161-184). Albany, NY: State University of New York Press.

Schnall, D. J. (1981). Yom Kippur. In K. Crim, R. A. Bullard, & L. D. Shinn (Eds.), Abingdon dictionary of living religions (pp. 817). Nashville: Abingdon.

Shukla, A. (2009). 4,000 Jains end year-long fast. Diligent Media. Retrieved May 2, 2009, from http://www.dnaindia.com/report.asp?newsid=1251050

Smith, H. (1995). The illustrated world religions: A guide to our wisdom traditions. New York: HarperOne.

Smith, H., & Cousineau, P. (2005). The way things are: Conversations with Huston Smith on the spiritual life. Berkeley, CA: University of California Press.

Sperry, L. (2001). Spirituality in clinical practice: Incorporating the spiritual dimension in psychotherapy and counseling. New York: Routledge.

Sperry, L., Hoffman, L., Cox, R. H., & Cox, B. E. (2007). Spirituality in achieving physical and psychological health and well-being: Theory, research and low cost interventions. In L. L'Abate (Ed.), Low-cost approaches to promote physical and mental health: Theory, research, and practice (pp. 435-452). New York: Springer.

Spilka, B. (2005). Religious practice, ritual, and prayer. In R. F. Paloutzian & C. L. Park (Eds.), Handbook of the psychology of religion and spirituality (pp. 365-377). New York: The Guildford Press.

St. Pierre, M. (2002). Walking in the sacred manner: Healers, dreamers, and pipe carriers – medicine women of the plains. New York: Touchstone.

Stone, J. D. (1997). Hidden mysteries: ETs, ancient mystery schools and ascension. Sedona, AZ: Light Technology.

Suvarna, M. S., & Nirgun, M. (Eds.) (1974). The book of secrets: Keys to love and meditation. New York: Macmillan.

Tart, C. T. (1997). Body mind spirit: Exploring the parapsychology of spirituality. Charlottesville, VA: Hampton Road.

Thomas, L. E., & Eisenhandler, S. A. (1999). Religion, belief, and spirituality in late life. New York: Springer.

Thompson, J. M. (2005). Buddhism. In W. L. Bailey & E. Taitz (Eds.), Introduction to the world's major religions: Vol. 3. Abingdon: Greenwood Press.

Thorner, A., Raj, M. K., Krishnaraj, M., & Trust, S. (2000). Ideals, images and real lives: Women in literature and history. New Delhi: Orient Longman.

Toker, S., Shirom, A., & Melamed, S. (2008). Depression and the metabolic syndrome: Gender- dependent associations. Depression and Anxiety, 8, 661-669.

Vaage, L. E., & Wimbush, V. L. (1999). Asceticism and the new testament. New York: Routledge.

Valantasis, R. (2008). The making of the self: Ancient and modern asceticism. Eugene, OR: Cascade Books.

Vandereycken, W. (1994). From fasting saints to anorexic girls: The history of self-starvation. Washington Square, NY: New York University Press.

Vaughan, F. (1993). Healing and wholeness: Transpersonal psychotherapy. In R. Walsh & F. Vaughan (Eds.), Paths beyond ego: The transpersonal vision (pp. 160-165). Los Angeles: J.T. Tarcher.

Vaughan, F. (2005). Shadows of the sacred: Seeing through spiritual illusions. Lincoln, NE: iUniverse.

Villoldo, A., & Krippner, S. (1987). Healing states: A journey into the world of spiritual healing and shamanism. New York: Fireside.

von Braun, C. (2007). Fasting. In K. von Stuckrad (Ed.), The Brill dictionary of religion (Vol. 2, pp. 719-720). Boston: Leiden.

Wallis, A. (1981). The Radical Christian. Fort Washington, PA: London: Power Books.

Wallis, A. (1968). God's chosen fast. Fort Washington, PA: Christian Literature Crusade.

Walsh, R. (2000). Essential spirituality: The 7 central practices to awaken heart and mind. New York: Wiley.

Walsh, R. (2004). Shamanism. In H. Palmer (Ed.), Inner knowing: Consciousness, creativity, insight, and intuition (pp. 60-67). New York: Jeremy P. Tarcher/Putnam.

Walsh, R., & Vaughan, F. (1993). Introduction. In R. Walsh & F. Vaughan (Eds.), Paths beyond ego: The transpersonal vision (pp. 1-10). Los Angeles: J. T. Tarcher.

Washburn, M. (1994). Transpersonal psychology in psychoanalytic perspective. Albany, NY: State University of New York Press.

Webster, H. (1973). Fasting. In S. Mathews & G. B. Smith (Eds.), A dictionary of religion and ethics (pp. 164). London: Gale Research Company.

Werblowsky, R. J. Z., & Wigoder, G. (Eds.). (1997). The Oxford dictionary of the Jewish religion. Oxford: Oxford University Press.

Wheatley, L. A. (2007). The story of the imitatio Christi. Whitefish, MT: Kessinger.

White, R. A. (1994). Working classifications of EHE's. Exceptional Human Experience: Background Papers, 149-150.

White, S. E. (1940). The unobstructed universe. Boston: E. P. Dutton.

Wigoder, G., Skolnick, F., & Himelstein, S. (Eds.). (2002). The new encyclopedia of Judaism. Washington Square, NY: New York University Press.

Wiley, K. L. (2004). Historical dictionary of Jainism. Blue Ridge Summit, PA: The Scarecrow Press.

Williams, P. A. (2001). Doing without Adam and Eve: Sociobiology and original sin. Minneapolis: Augsburg Fortress.

Wilson, L. (2004). Ascetic practices. In R. E. Buswell (Ed.), Encyclopedia of Buddhism (pp. 32-34). New York: Thompson Gale.

Wulff, D. M. (2000). Mystical experience. In E. Cardena, S. J. Lynn, & S. C. Krippner (Eds.), Varieties of anomalous experience: Examining the scientific evidence (pp. 397-440). Washington, DC: American Psychological Association.

Young, B. H. (2007). Meet the Rabbis: Rabbinic thought and the teachings of Jesus. Peabody, MA: Hendrickson.

Zinnbauer, B. J., & Pargament, K. I. (2005). Religiousness and spirituality. In R. F. Paloutzian & C. L. Park (Eds.), Handbook of the psychology of religion and spirituality (pp. 21-42). New York: The Guildford Press.