MD, PhD, MAE, FMedSci, FRSB, FRCP, FRCPEd.

You haven’t heard of religious/spiritual singing and movement as a treatment for mental health?

Me neither!

But it does exist. This review explored the evidence of religious/spiritual (R/S) singing and R/S movement (dynamic meditation and praise dance), in relation to mental health outcomes.

After registering with PROSPERO (CRD42020189495), a systematic search of three major databases (CINAHL, MEDLINE, and PsycINFO) was undertaken using predetermined eligibility criteria. Reference lists of identified papers and additional sources such as Google Scholar were searched. The quality of studies was assessed using the Mixed Method Appraisal Tool (MMAT). Data were extracted, tabulated, and synthesized according to the Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines.

Seven of the 259 identified articles met inclusion criteria. Three studies considered R/S singing, while four considered R/S movement. In R/S movements, three studies considered dynamic meditation while one investigated praise dance. Although moderate to poor in quality, included studies indicated a positive trend for the effectiveness of R/S singing and movement in dealing with mental health concerns.

The authors concluded that, while R/S singing and R/S movement (praise dance and dynamic meditation) may be of value as mental health strategies, findings of the review need to be considered with caution due to methodological constraints. The limited number and poor quality of included studies highlight the need for further quality research in these R/S practices in mental health.

I am glad the authors caution us not to take their findings seriously. To be honest, I was not in danger of making this mistake. Neither do I feel the need for further research in this area. Mental health is a serious issue, and personally, I think we should research it not by conducting ridiculous studies of implausible modalities.

PS

I do not doubt that the experience of singing or movement can help in certain situations. However, I have my doubts about religious/spiritual singing and movement therapy.

17 Responses to Religious/spiritual singing and movement for mental health?

  • I could well imagine that participation in any choral singing, not necessarily religious, might have some wellbeing benefits – social networking, the mental effort of learning the music, the shared experience, the physical exercise of singing (which is more physical than people sometimes realise). But while it might be a useful adjunctive therapy, I don’t believe it would of itself ever be a cure for serious, debilitating clinical depression……

    I suppose if one were to take this kind of study very seriously, there should be a comparison of different types of religious singing, and secular singing; e.g. “High Anglican” choral singing compared with more lively, body-swaying hand-clapping Southern evangelical from the USA or some African countries, compared with unaccompanied Gaelic Psalm-singing from the Hebrides (quite a primal sound), compared with an entirely secular choir……..

  • Perhaps, if people believe in it, the (very real) placebo effect, and thus the subjective benefit, is greater.

    One of the paradoxes of the placebo effect is that it works better (so one assumes – although there is some evidence to the contrary) if one believes it will work; but giving treatments that are not inherently effective is unethical.

    • Peter: but giving treatments that are not inherently effective is unethical.

      Hmmm. So any MD who knowingly gives an infective treatment (placebo) should be charged with an ethics violation?

  • Dynamic Meditation, mentioned in the report, is trademarked by the Osho organisation arising from the Rajneeshee cult founded by late Bhagwan Shree Rajneesh lated named Osho.

    The cult was extremely controversial and involved in multiple criminal activities including illegal wire-tapping, drug and weapons offences, immigration fraud, practicing medicine without a license and many other crimes. The “free love” communes / ashhrams were a magnet for sexual predators and many children raised in the ashrams were neglected and horribly abused.

    Osho was a great fan of Adolf Hitler. Members of his commune in Oregon conducted the first act of bio-terrorism in the USA when they poisoned local salad bars with salmonella that they had cultivated in their own bio-weaponry laboratory.

    The Osho movement has many offshoots including various “human potential”, “personal development” and psychotherapy organisations. Many accredited psychotherapists, counsellors and even psychiatrists are involved with the Osho movement.

    Involvement in the Rajneeshee / Osho movement is one of the reasons that so many psyhcotherapists and other mental health practitioners expose vulnerable people to dangerous quack therapies.

    The current trends embracing quack body psychotherapies to recover forgotten memories of sexual abuse arose from the neo-tantric proclivities of Rajneeshee cult members.

    • yes the umbrella term includes basically all cults

      • Yes Edzard, of course. My point was not so much to point this out, as it is obvious, but to suggest that it might be important to be curious about the authors of the study.

        Professor Pamela Meredith appears to be an interesting person. I notice via her publications page on the University of Queensland website that she has published several papers incorporating “attachment theory”. https://shrs.uq.edu.au/profile/289/pamela-meredith

        Mental health academics with a liking for SCAM are not infrequently enamoured with attachment theory. It often goes hand in hand with “energy therapies” and false memory inducing therapies. It is also favoured by promoters of neuroscience woo woo, quantum woo woo and controversial body psychotherapies. A connection to new age cults and abusive / criminal yoga cults is common.

        An example of a 2009 CPD accredited attachment theory training event can be found via the below link to a conference organised by the Bowlby Centre, the leading trainer of attachment theory focussed events in the UK. The various presenters are notorious for promoting bizarre conspiracy theories and the fact that they are still working in the NHS / academia today highlights the appalling lack of professionalism and standards within academia and the NHS.
        https://web.archive.org/web/20120425055326/http://www.thebowlbycentre.org.uk/documents/Ritualpdf_000.pdf

        I also notice that Pamela Meredith’s publications include a paper that seems very similar to the one in your post, but with subtle differences and an additional contributor. here it is:
        Malviya, Shikha, Meredith, Pamela, Zupan, Barbra and Kerley, Lachlan (2022). Identifying alternative mental health interventions: a systematic review of randomized controlled trials of chanting and breathwork. Journal of Spirituality in Mental Health, 1-43. doi: 10.1080/19349637.2021.2010631

        https://espace.library.uq.edu.au/view/UQ:2d596b8

        I am curious about this. The title does not mention “dynamic mediation” but does mention “breathwork” a common term used to describe various methods of trance inducing self hypnosis and also hyperventilation practices that commonly induce powerful hallucinations similar, if not identical, to those experienced by people taking the drug DMT. “Breathwork” is a common feature of abusive cults, false memory therapies and quack psychotherapists. The controversial psychiatrist Stanislav Grof invented Holotropic Breathwork after he ran into legal problems using psychedelics in his work. Grof aimed to reproduce the effects of psychedelics via hyperventilation techniques and to use these techniques to regress patients to early, long forgotten, traumas, including birth trauma.

        Another paper caught my interest
        Can spirituality be taught to health care professionals?
        Meredith, Pamela, Murray, Judith, Wilson, Trish, Mitchell, Geoff, and Hutch, Richard (2012). Can spirituality be taught to health care professionals?. Journal of Religion and Health 51 (3) 789-889
        https://espace.library.uq.edu.au/view/UQ:252390

        I have no doubt that spirituality can be taught to professionals. Whether spirituality should be taught to professionals is a different matter entirely.

        Anyway, back to the question of whether religious/spiritual singing and movement is a suitable treatment for mental health. Just an observation but in my experience people frequently feel a natural high when singing / chanting / moving in a group. I suspect that this natural high may be intensified when spiritual / religious elements are introduced as many people find comfort religious / spiritual beliefs. It is important to understand, especially when using the kind of self-hypnosis and trance induction inherent in “breathwork”, chanting, group singing etc. that these practices induce a feeling of euphoria via the subjective perception of the dissolution of personal boundaries and an intense feeling of unity and “oneness” with the group. This subjective experience of “oneness” can leave people extremely vulnerable to undue influence.

        This is the reason why churches have choirs, armies have marching songs and cults favour chanting and singing. These activities may be helpful or harmful depending on the motivation and agenda of the persons organising the group activities. It is extremely common for recruits to abusive cults to feel wonderful, blissful and totally transformed by the experience of group chanting / dancing / breathwork. They may feel entirely different about the experience when, some years later, the euphoria wears off and they find themselves alienated from their families and exploited in various deeply unpleasant ways by a cult.

        Many things make people feel euphoric, wonderful and transformed, for example taking crack cocaine and crystal meth. This does not mean that the consumption of dangerous drugs is something to be promoted and endorsed.

        My point is that, even if religious/spiritual singing and chanting alleviates some symptoms of mental health conditions (and it’s a big “if”) extreme caution should be advised as to who is delivering the religious/spiritual singing and chanting. In this instance the use of “breathwork” and “dynamic meditation” in the titles of the paper should serve as red flags given the networks of quacks, SCAM merchants and abusive cults involved in these practices.

  • I see no reason, why these results should not be taken seriously. The matter is known since many years and there are numerous scientifc studies that dealt with this matter.
    Here an article about it. It is not a scientific article. However, the article contains numerous links on scientific papers.

    https://theconversation.com/choir-singing-improves-health-happiness-and-is-the-perfect-icebreaker-47619

    Viewing on content like this, I see a risk of adding believe as factor to the outcomings. You may add aspets of believe to it which is fine for your personal view but bad to interpret the pure data.
    On the other hand, you may have a believe that supports an idea that things like this can’t work. You believe in material things, exclusively and may argue that there can’t be an expectation that it has a chance to work. This is on the same way bad as it would be to supprot the idea from a religious point of view.

    It’s the data that gives the answer and nothing else. And there are enough hints on scientifically understandable explainations for the findings the studies give to us.

    And as it works, I see no reason to use it for therapees under a medically controled scenario. A choir may not solve moedical problems on its own. However, it may support a therapee and help to reach healing of problems where it may speed upt the process of healing or reach a state that could hardly be reached without this method.

    • “I see no reason, why these results should not be taken seriously.”
      Not even the fact that the studies are of poor quality?

    • But that has nothing to do with the “religious” or “spiritual” (whatever that means) element mentioned in the current post.

      I struggle to understand how that component can possibly work unless one is already A True Believer.

      Personally, even the choir element would have a negative effect, serving only to remind me of the good singing voice I lost after my voice broke – cannot get close to holding a tune and haven’t for decades.

  • The conjunction fallacy informs us that:

    1. religious/spiritual singing and movement for mental health

    is probably less effective than

    2. religious/spiritual singing and movement for mental health

    both of which are probably less effective than

    3. religious/spiritual singing mental or movement for mental health.

    QUOTE
    The conjunction fallacy (also known as the Linda problem) is a formal fallacy that occurs when it is assumed that specific conditions are more probable than a single general one.
    https://en.m.wikipedia.org/wiki/Conjunction_fallacy
    END of QUOTE

    As Edzard wrote “I do not doubt that the experience of singing or movement can help in certain situations. However, I have my doubts about religious/spiritual singing and movement therapy.”

    • Oops, ran out of editing time.

      3. religious/spiritual singing and or movement for mental health.

    • Is this really an example of the conjunction fallacy though?
      As I understood that article, it’s when the specificity occurs because of a conjunction of independent events.

      So saying singing improves mental health AND rate of hair growth where these are independent is less likely just because both events have to be true for the conjunction to be true. But health and mental heath have a different and dependent relationship.

      To think of a different example consider a quack who claims that a compound is a cure for cancer. Is this more or less likely than a more specific claim, that the compound has some effect on some cancer in some population?

      • @ zebra,

        The conjunction in the conjunction fallacy may refer to:
        QUOTE
        Beyond logic, the term “conjunction” also refers to similar concepts in other fields:
        • In natural language, the denotation of expressions such as English “and”.
        • In programming languages, the short-circuit and control structure.
        In set theory, intersection [my emphasis].
        • In lattice theory, logical conjunction (greatest lower bound).
        • In predicate logic, universal quantification.
        https://en.m.wikipedia.org/wiki/Logical_conjunction
        END of QUOTE

        Using sets:
        mental health is a subset of health.
        religious/spiritual singing and movement is a small subset of singing and/or movement.

        The intersection of the above two subsets can never be greater than the intersection of the two whole sets; and it is very likely to be smaller.

        You asked the interesting question: “To think of a different example consider a quack who claims that a compound is a cure for cancer. Is this more or less likely than a more specific claim, that the compound has some effect on some cancer in some population?”

        Your “more specific claim, that…” does not contain any actual specifics, whereas the title of the article on which we are commenting contains several actual specifics, which I attempted to indicate using typographical strikethroughs in my amended post.

        Perhaps, instead, you meant by “a more specific claim” something along the lines of: compound R (remedy) has a clinically significant positive effect E on cancer type C in demographic D. The probability of this being true cannot possibly be greater than the probability of the broad/general claim being true. Because, R is a (one element) subset of compounds; E is a subset of possible effects of R; C is a subset of all cancers; D is a subset of all people.

        I hope the above helps to clarify, if not then by all means ask.

        My particular interest in the topic of the article is that I’ve noticed churches, and a few other organisations, increasingly making a song and dance about mental health issues in order to attract funding and prestige.

        • You are correct in identifying conjunction as being modeled by intersection in set theory. However this is not the same as a subset relationship.

          If mental health is a subset of health, we can think of health as being a series of unions – ie disjunctions, not conjunctions –
          health = mental health OR heart health OR back health OR …..
          And that is why (and you are correct in your conclusion) that general heath is more likely, because it only requires one of the specifics to be true.
          But this is not the conjunction fallacy, since conjunctions are not involved.

          If heath was defined in terms of conjunction we would have
          health = mental heath AND heart health AND back heath AND …
          in this case general health would be less likely since it requires all of the specifics to be true, and not realizing this would be the conjunction fallacy.

          • Hi zebra,

            Thanks for your reply. I’m not sure why you wrote “If heath was defined in terms of conjunction we would have
            health = mental heath AND heart health AND back heath AND …”
            because that is not what I claimed.

            • The cardinality of mental health is much lower than the cardinality of health.

            • The cardinality of religious/spiritual singing and religious/spiritual movement is much lower than the cardinality of singing and/or movement.

            Therefore, the cardinality of the intersection of the specific claims is much lower than the cardinality of the general claims, in the case we’re discussing. Thus the probability of the specific claim being true is much lower than the probability of the general claim being true.

            As a side note, the usage of the language conjunction word “and” is inconsistent, often ambiguous. E.g., its usage in the descriptor “friends and family” is, I would suggest, one’s friends union one’s family; rather than, one’s friends intersection one’s family.

          • Pete Attkins,

            I think I may be understanding where the difference is arising. You wrote that (apologies that I don’t know how do wiki formatting):
            “Therefore, the cardinality of the intersection of the specific claims is much lower than the cardinality of the general claims, in the case we’re discussing.
            Thus the probability of the specific claim being true is much lower than the probability of the general claim being true.”

            I agree that the probability of the specific claim being true is much lower than the general claim.
            However, this is not because of the intersection of specific claims.

            We are trying to decide which of the following claims is more likely:

            (C1) singing improves mental health (a more specific claim)
            (C2) singing improves heath (a more general claim)

            We can consider the general claim to be composed of a series of more specific claims,
            and of course, as you point out, different people might want to interpret there composition differently, so previously I was demonstrating this with both OR/union/disjunction and AND/intersection/conjunction.
            But lets go with OR for now because we both seem to feel this is more reasonable.

            We can then rewrite this as
            (C1) singing improves mental health
            (C2) singing improves mental health OR non-mental health

            I think we both agree that C2 is the more likely – and this is because of the of the way disjunction works, it only requires one of its terms to be true for the compound term to be true. (In terms of cardinality its the sum of the cardinality of its terms).

            But if you want to involve intersection then we need to change that OR to AND, and then as you also correctly point out this reduces the chance of it being true, which would mean the probability of the general case is being reduced, which neither of us would agree with.

            Thus the composition of the general claim involves disjunction and not conjunction, and the conjunction fallacy doesn’t apply.

          • zebra, I visualise problems and solutions differently from the vast majority of people. I also try to abide by the red banner.

            It’s far easier for me, and for the readers, if I agree with you and simply state that my initial comment on Saturday 19 March 2022 at 14:33 was a load of old tosh.

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