Intersections: religion, culture, gender

Religion and spirituality are hugely important to most of humanity. About 85% of the world's population claim adherence to a religious group: Christian (2.2 billion); Hindu (1 billion); Islam (1.6 billion); secular, including agnostic and atheist (1.1 billion), and other religions including Buddhism, Judaism, Sikhism, and traditional ethnic religions (1.1 billion). Although the psychology of religion as a specific field has developed well over recent decades, we still fail to attend to religious issues in studying development, social, occupational and other areas.

It is important to define and differentiate religion, spirituality and culture. Religion involves acceptance of spirituality, a moral system and a sense of purpose. Spirituality has been defined as the search for and experience of the sacred (Pargament, 2007). Religiosity and spirituality usually co-occur. Culture comprises the ideas, customs, and social behaviour of a particular people or society (see Loewenthal, 2007). Each of these exerts a strong influence on people's ideas, feelings and behaviour, and it is instructive to help students disentangle the roles of each where possible.

Instructional Frameworks

It is also important to establish ground rules for discussions of beliefs, whether a student’s own or others’. The content can be highly personal, and individuals may have difficulty viewing topics from outside their own religion or culture. Nonjudgmental, respectful treatment of each other is essential, and the instructor must be prepared to step in to dispel myths or inappropriate comments.

Class discussions can start with a simple exercise, asking such questions as: What are the largest religions in the world? How many of the 7 billion people in the world adhere to each of them? In what countries/regions of the world is each religion most likely to be found? They can also locate statistics on different religions within their own country. Students often cannot name or locate several of these, and are surprised at the diversity.

If students are comfortable doing so, they can discuss how important religious beliefs are to their own lives and their friends. They can describe (anonymously) people they have met from different religious groups, and the similarities and differences between their experiences. Be prepared to step in to dispel myths and help students distinguish the roles of religion and culture. Often students’ only awareness of systems other than their own comes from media and stereotypes, and they have not differentiated the impacts of religion and culture. For example, within a repressive society, is religion directing the repression or is it being used as a political tool to maintain power over members?

Another important distinction is between religion and spirituality. Students can describe the kinds of impacts each has in their own or friends’ lives. They can be asked to provide examples of people who are spiritual but not religious, to help them explore these concepts more deeply, including roles and identity, cultural and religious contexts, and the impact upon mental health.

Gender, race, and other differences may mistakenly seen as universal when they are culturally and religiously specific. This chapter adopts an intersectional and identity process approach, looking at ways in which the effects of gender, culture, and religion interact in different contexts, and regarding identity as complex and fluid.

Conceptual Frameworks

Intersectionality focuses on interactions between different social categories/features of identity, contributing to profound forms of disadvantage and injustice. Crenshaw (1991) has studied and highlighted ways in which battering and rape are features of systematic domination of women of colour. If either gender or ethnicity were considered in isolation, it would not enable the detection of the horrendous experiences resulting from their intersection. Consider Aisha, Edith and Jonathan:

Aisha worked hard in a poorly paid boring job, and looked after her husband, children and in-laws. Her husband complained a lot about her cooking and housekeeping. She couldn't pray, feeling that Allah was not with her, and she became very depressed and felt she was not a good Muslim. A neighbour advised seeing a doctor but her mother-in-law said this would bring shame on the family (Loewenthal, 2015; acknowledgements to Cinnirella & Loewenthal, 1999, and Gilbert et al, 2004).

Edith had been forcibly separated from her American Indian family and brought up with a white family. In this family she was made to believe that she was dirty and inferior, that all American Indians were alcoholics, drunks who would never amount to anything. As an adolescent she returned to her people and began to hear stories of the trauma suffered by her family and her people. She believes that her shame and disappointment at being told she was inferior, and her sharing the suffering of her people were factors leading to her alcoholism. She joined a culture-specific sobriety program and, like others, felt that learning about [American Indian] spirituality and culture were important in helping to lose her shame of herself, stay sober, and develop an identity in which she could take pride and pleasure (based on Myhra, 2011).

Jonathan is an orthodox Jewish businessman. His business faltered, his wife had to go out to work and became tired and irritable, and he feels isolated. No one asks him for charitable help any more, he can’t seem to talk peaceably with his family, he sleeps and eats poorly, is irritable and morose. He tries to conceal his consumption of spirits and he has no Jewish drinking companions, since social drinking is not normative among orthodox Jews (based on Loewenthal, 2007).

Identity is complex, fluid, and constantly developing, comprising "elements" that constantly interact. Breakwell’s (2010) Identity Process Theory proposes that identity is not a static, neatly-labelled entity, but a complex dynamic process, involving elements varying in salience and value as the individual adapts to circumstances, as in Steve’s case.

Steve is a hardworking, ambitious husband and father. He worked long hours and was getting promotions in his managerial position. Suddenly he was made redundant. He searched for a new job, but he was not successful. His highly valued professional identity lost its salience and value, as did his identity as the provider for the family. He began to feel worthless and useless sleeping badly and eating poorly. He began to spend more time with his children, and even going with his family to church – which he had previously been very scornful about. His father identity gained in salience and values and his religious identity, previously feeble, gained a little salience and value as it hitch-hiked on the changes in his husband and father identities (based on Coyle, 2011).

Berry’s (1997) acculturation theory describes four conceptions of identity which enable a more elaborate view of the processes involved in intersectionality: (1) integration, in which ones own culture and host culture are both valued and salient; (2) assimilation, devaluing ones own culture and valuing the host culture; (3) separation/segregation, valuing of ones own culture and a rejection of the host culture; and (4) marginalisation, low valuing of both own and the host culture. Are students familiar with minority group members in any of these four positions? Which might be the more comfortable? Berry, Kim, Power, Young, and Bujaki (1989) reported that among adults in multicultural societies, integration is associated with the highest levels of well-being while marginalisation is associated with the lowest levels.

Impacts of Religion and Spirituality

Mental Health

Although prolific, research on mental health and religion/spirituality, until recently it was largely restricted to U. S. students of Christian and occasionally Jewish background (see Koenig, King & Carson, 2012; Loewenthal, 2007, 2015; and Pargament et al., 2013). Conclusions to date include: 1) weak but positive relationships between measures of religiosity/religious activity and measures of mental health (Koenig et al, 2012; Loewenthal, 2007). Specific effects may vary in different religious-cultural groups; for example among Jews, the more religiously-active do very limited social drinking. This is associated with low levels of alcohol abuse but may lead to raised prevalence of depression among men, since social drinking is not used as a means of coping among men as it is in other religious-cultural groups (Loewenthal et al, 1995; Loewenthal et al, 2003a; 2003b). Among American Indians, the co-variations of levels of alcohol use, gender, prevalence of depression, and the revival of spirituality may follow similar patterns, but remain to be fully explored (Beals et al., 2005). (2) negative effects of particular religious beliefs or practices, such as spiritual abuse, or a view of G-d as punitive or indifferent - and these may be under-researched and under-reported (Koenig et al, 2012; Loewenthal, 2007). (3) justifying and sanctifying psychologically damaging rules and practices as religious, when there is no such sanction, such as female genital mutilation (FGM) discussed later in this chapter. (4) barriers to seeking professional help related to religious-cultural factors, often involving shame and stigma. Some religions explicitly shun professional treatment options, focusing on explanations such as sin and referring the individual to seek guidance or “education” within their religion (Leavey et al, 2007); (5) misdiagnosis of religious behaviour as psychotic. Describing a Black American lawyer who believed that a candle dripping wax on a bible while he prayed was sending heavenly messages, Fulford (1999) observed that many trainee psychiatrists suspected psychosis. Yossifova and Loewenthal (1999) found individuals described as religiously active were more likely to be judged psychologically disturbed, compared to individuals with identical case vignettes not said to be religiously active. And (6) for the significant minority defining themselves as "spiritual but not religious," spirituality may be negatively related to mental health. King et al. (2013) suggested "People who have a spiritual understanding of life in the absence of a religious framework are vulnerable to mental disorder" (p. 68), including anxiety disorders, abnormal eating attitudes and drug dependency.

Marriage

Most women have the biological capacity to give birth and nurse infants, while men are freer to provide material support for their families and to play important roles in caring for and socialising older children. In some cultures this general pattern has been overlaid by culturally and religious sanctions, even when there are no such religious justifications. Sanctification - even though baseless - adds power to a tradition.

In the U.S., religion has been associated with better marital functioning and lower divorce rates. However, most studies employed only single-item or global indices of religion, such as affiliation, importance of religion, or frequency of attendance; more in-depth measures are needed to indicate how these effects are achieved. (Mahoney et al, 2008) Marriage is desired, religiously-sanctioned and encouraged in most societies, and generally entails obligations that would normally have positive effects on well-being, such as love, respect and support. Yet sometimes marriage entails negative practices which are regarded as religious in origin, although there is no such religious authority. Examples of exploitation and oppression of women can be instructive; e.g., before the 1880s British women suffered the loss of all property on marriage as property was automatically transferred to the husband (Combs, 2005; Griffin, 2003). Even today, in many countries, women's property rights are non-existent or very limited (Agarwal,1994); it is often customary in South Asia to regard married women as the property of their husband and his family and contact with a woman's family of origin may cease altogether (see Aisha’s vignette, earlier).

There are enormous variations in rulings across cultures and religions, making it difficult to generalise about women's rights. Economic activity by women has long been shown to protect against depression (e.g., Brown & Harris, 1989). Yet economic dependency on husbands and fathers continues in many countries, with some occupations closed to married women or even to all women. Kate Davidson (2015) reported that globally, 90% of countries have laws that discriminate against women in employment; in 18 nations, women cannot get a job without their husband's permission; Russia bans 456 occupations to women; and in France, women cannot take any jobs where they must lift more than 25 kilos, even though women often carry children of that weight on a daily basis. Mirza and Jenkins’s (2004) review of studies in Pakistan found that economic difficulties and poor education, being a housewife, relationship problems with in-laws, and absence of confiding supportive relationships were associated with depression.

Similarly, the agonising, life-threatening and potentially permanently disabling practice of female genital mutilation (FGM) is claimed by practitioners to be important in facilitating a girl's future role as a good wife. FGM is particularly likely in Muslim and adjacent countries, though it probably predates Islam. Although popularly regarded as religiously authorised, there is no religious authority for it and is not required in Islam (UNICEF, 2013). There are serious health and obstetric consequences and likely psychological dangers, including Posttraumatic Stress Disorder (FGM National Group, 2015).

There are some explicit religious justifications for practices that may be detrimental to well-being: for example, in Islam and some forms of Mormonism, polygamy is permitted, although not universally practised. Polygamy (compared to monogamy) has been reported to be associated with higher level of domestic violence against women and women's psychiatric disturbance, including depression, somatisation and psychoticism (Al-Krenawi, 2013; Karamagi, Tumwine, Tylleskar, & Heggenhougen, 2006).

These issues are particularly relevant when teaching about family relationships and the psychology of women. Students can examine these issues with an eye to distinguishing religious from cultural factors and recognizing the power of using religious sanctity as a persuader. Questions can be raised about class members' hopes for marriage, and their views on how religious beliefs and non-belief and culture affect these hopes and experiences.

Domestic Violence

Violence within intimate relationships is likely present in all societies. Severe violence by men is more frequent and results in more serious injuries, although regardless of gender, experiencing domestic violence (DV) is associated with raised risk of a range of outcomes, including depressive disorders, substance abuse and chronic mental and physical illness (Coker et al., 2002). This brief video offers an idea of how DV and its aftermath are experienced: . Widely regarded as a method of asserting masculine superiority (e.g. Crenshaw, 1991), DV also has a cultural-religious intersection. Hayati, Emmelin, and Eriksson (2014) identified three groups of men's attitudes in rural Indonesia: traditionalists accepted violence as a means of upholding the superior position of men within marriage; pragmatists saw violence as undesirable, but sometimes necessary to improve women's behaviour; while egalitarians saw no reason for violence. This video offers examples of changing attitudes in India: .

Nason-Clark (2004) highlights several ways in which religions affect the likelihood of DV and responses to it; e.g., reported rates of DV among Christian families in the U.S. is similar to rates reported nationally, suggesting that a religious family is not a guaranteed safe place in spite of affirmative marriage vows. Nason-Clark suggests that religious images of domestic contentment may make the discovery and reporting of DV difficult. At the same time, professionals and volunteers in women’s refuges may see religion as causing and/or supporting abuse, and work to persuade abused women to abandon not only their husbands but their religion (Whipple, 1987), prolonging and exacerbating distress for victims. Interventions must be culturally sensitive; members of one Jewish community told me their only local shelter did not provide kosher diet or meet other requirements, so strictly orthodox women were reluctant to seek refuge (Loewenthal & Rogers, 2004).

Cultural norms regarding married women as the property of their husbands and husband's families may also license the use of violence against wives, and have been cited as at least partially responsible for the high suicide rate among young Asian Muslim women immigrants (Ineichen, 2012).

Fatima, a Muslim woman with three children aged 5, 10 and 11, has been married for 13 years and lives in the heart of the (South Asian immigrant) community. Over the last 10 years she has suffered physical and emotional abuse from her husband and his family, especially her mother-in-law. She feels trapped and unable to get away. It would mean leaving her children, and bring shame on the family (based on Gilbert, et al., 2004).

Gilbert et al.'s work illustrates a powerful sense of entrapment suffered by many wives, bolstered by the importance of maintaining family honour (izzat). This leads to a strong conflict with Western values, since women and their families may feel strongly that an abused wife must endure her suffering for the sake of preserving izzat. Some participants endorsed suicide as a possible response to DV, since izzat is not compromised. Here again, culturally-supported practices are asserted as embodying sacred values, without justification (Loewenthal, 2013).

Some religions and cultures, such Guatemala and Ecuador, are more collectivist than others, creating a reluctance to seek help for suffering and psychological distress (Hofstede, 1980). Because psychotherapy is concerned with promoting individual welfare, it may not be valued or sought in these cultures; in fact, even speaking out about DV may be futile or even punished. Seeking therapy may also be seen as a betrayal of religion (Weatherhead & Daiches, 2006). For example, Muslim immigrant women may report services to be culturally and religiously inappropriate, preferring religious and family and social support unless the issue is really serious.

Students can discuss the range of religiously-related effects which lead to underreporting of DV and reluctance to seek help, and as a group suggest ways to improve sensitivity and provide needed help within such intersections of religion, gender and culture.

Depression

It has often been suggested that women are more vulnerable to depressive illness than are men (e.g. Nolen-Hoeksema, 2001). For example, unipolar depression is often a response to adversity but may be tempered by coping, temperament and genetic factors, not being sensitised by early adversity, and social support (Brown & Harris, 1989; Kendler et al, 2010; Mirza & Jenkins, 2004). Each of these factors can be affected by culture and religion, and alcohol use can further add to this complexity. This video is one of many offering a view of the experiences and feelings that go along with alcohol use and abuse:

In general, those with higher scores on measures of religious activity and belief tend to suffer from lower levels of depression. However, this relationship may be moderated by the number of adverse life events, which may vary by gender and by religiosity (Loewenthal et al, 1997; Loewenthal et al., 2000; Smith et al, 2003). Among (religious) Jews, men and women are equally likely to suffer from depressive disorder (Levav et al, 1993; Loewenthal et al, 1995; Pirutinsky et al, 2011), although overall prevalence of depression in Jewish communities is similar to that in the US (about 10%). One possible factor is that moderate alcohol use lowers the prevalence of depression (Loewenthal, 2009), and Jewish culture does not support recreational drinking and drunkenness.

Although there is cultural variation, and though alcohol consumption among women is rising (ICAP, 1995-2015), women generally consume less alcohol than do men. There are cultural-religious attitudes specific to women's alcohol consumption (ICAP, 1995-2015); Loewenthal et al. (2003a and b) found that religious Jews and Protestants expressed concern about the loss of control associated with excessive alcohol intake and women considered it less appropriate to drink and get drunk than did men, and reported less drinking. Quotes from the interviews can be discussed in relation to students’ own personal, cultural and religious beliefs:

Because of our history (as Jews) we are permanently on guard in a way…there’s a feeling that drinking will put you off guard and who knows what might happen…there is a need to be kind of ‘in control’ (Jewish man, p. 208).

It can lead to abuse or to violence…it can cause husbands hitting wives…destroying furniture, things like this…attacking wives and children (Jewish woman, p. 209)

I find it demeaning and and undignified (for a woman to be drunk and) out of control (Jewish woman, p.209).

Alcohol consumption is higher among California Jews pursuing an assimilationist acculturation style, in which Jewish identity is less valued and less salient, than less assimilated East coast Jews, especially among men (Levav et al,1997). Moderate recreational use of alcohol in coping with stress may be effective in reducing rates of depression among men (e.g. Lipton, 1995), though there are risks (see, e.g., ).

What about Muslims? Islam bans the use of alcohol, Prevalence of depression is generally high, and the rates for women are approximately double those among men (Loewenthal, 2009; Mirza & Jenkins, 2004). This effect may result from the social, economic and political disempowerment of women in Muslim society, rendering women relatively more vulnerable to adversity and further raising their prevalence of depression.

Historically, many North American Indian (NAI) tribes, with strong family interconnections, led a somewhat-mobile life with agriculture and hunting for food. European settlers displaced the native Indians from their territories and often confined them to reservations. Conditions remain adverse on many reservations (see Trimble and Morse, this volume). While there is division of labour by gender, NAI women are generally treated with respect by men (Beverly Hungry Wolf, 1982; Mary Crow Dog, 1990), and prior to the nineteenth century, religious leadership was undertaken by both men and women. However, once confined to reservations, men were unable to hunt and unemployment was high; children were often forcibly sent for adoption by white families to ensure assimilation of Western values; and poverty and starvation were widespread. Cheap "Injun liquor" was used by the invading whites to subdue unrest, and alcoholism and DV became widespread. Mary Crow Dog describes this intersection with gender: as men were deprived of the opportunity of providing for their families by hunting, they began to abuse alcohol and other substances, to drive recklessly, and to physically abuse women. While forms of adversity differed for men and for women, the damage to well-being may have been equally great, involving alienation and enforced assimilated to dominant cultural-religious values, imposed by governmental authority.

Each tribe has their own spiritual and cultural traditions, which makes generalisations in this area difficult, although the late 20^th century revival of NAI spirituality often incorporates practices shared by different tribes (Mary Crow Dog, 1990). Programmes and individual efforts to reduce alcoholism among NAIs have been intrinsically meshed with the revival of tribal spirituality. This revival often meant protest and, more often for men, incarceration, leaving women unsupported in the care of their children, again a form of adversity differed by gender. Yet, many also report that the rise in the salience and value of NAI identity and spirituality is a key feature in raising self-esteem, eliminating dependence on alcohol and other substances, and the adoption and pursuit of worthwhile life goals. Quotes from participants in Donovan et al. (2015) reflect the impact of using NAI spiritual healing rituals to combat alcohol abuse:

I think ...having Healing of the Canoe as a class in high school definitely helped me and also made changes in some of the other kids’ lives.

It was a good learning opportunity and a great experience. Good way to learn

knowledge about drugs and alcohol. The people that I got a chance to learn with we

strengthened our bond over the three workshops (p. 62).

This material can help students understand that there is no simple, single cause of depression; instead we see a range of interactions between identity, religion, acculturation and gender. Furthermore, the frequent claim of women's proneness to depression is by no means universal; for example, culturally and religiously governed patterns of alcohol use affect the depression gender disparity.

Conclusions

Our psychology textbooks still offer little information about religion-related factors and their effects. These influences need to be integrated across the curriculum, not confined to a rarely-taught "psychology of religion" course. Interesections, particularly with gender, are tremendously important. For instance, students may have varying views on the ways in which religion might disempower or support women, questions they can be encouraged to pursue.

Religious beliefs and practices can be a source of both good and bad feelings and behaviours, and further research should uncover the conditions under which these effects occur. Clearly, there are powerful effects of gender, varying in different religious and cultural contexts and often tragically related to the relative powerlessness of women. There is also a need for additional research examining effects on mental health, including the mental health effects of living secular and religious lifestyles. Finally, more research is needed on the powerful "sanctification effect" and understanding how customs and habits can acquire religious sanctity even when there are no religious sources to justify them..