University of California Press, 2011
Reviewed by Wilson Will (Rice University)
Christianity and western medicine share a curious relationship in the social science literature. Historians (e.g., Porter 2005, Numbers and Amundsen (eds.) 1997, Risse 1999), have long acknowledged the political and epistemic interactions of the two domains and in many cases see the religious and the scientific as mutually constitutive. Psychologists and psychiatrists from Jung to Horney to Hiltner wrote extensively about the relationship between mind, soul, and spirit in the early and middle parts of the 20th century, and the impact of this work was felt from the divinity school classroom to the hospital chapel.
What about anthropology? While the interface of healing and the supernatural has been a staple of the field since its founding, most book-length research has approached Christianity and western medicine either from the perspective of psychological anthropology (e.g., Csordas 1997, Luhrmann 2001, Erzen 2006) or—more recently—in geographic regions outside North America (e.g., Zimbabwe (Engelke 2007), Russia (Zigon 2010), Botswana (Klaits 2010, Werbner 2011), and Ecuador (Roberts 2012)). There are numerous historical and methodological reasons for these emphases, yet the fact remains that the anthropological analysis of Christian perspectives and influences on the body and suffering in North America has received comparatively little attention.
Spirits of Protestantism: Medicine, Healing, and Liberal Christianity by Pamela Klassen is a pivotal book for a variety of reasons, perhaps most significantly because it examines the interface of Christendom, modernity, liberalism, and affliction in the North American context from the perspective of medical anthropology. Pairing historical research with fieldwork, she considers two broad questions: given the longstanding relationship between western medicine and liberal Protestantism in the U.S. and Canada, what new insights can be gained about the concept of healing cross-culturally? Second, and more compellingly, what are the political and ideological consequences of this relationship for anthropology?
To answer the first question, Klassen begins with a useful historical overview of significant events in the relationship between Christianity and medicine since the end of the 19th century. Much of this material will be familiar to historians of religion and echoes previous work by Holifield (2005), Griffith (2004), and others, but it will be new to many anthropologists. Early parts of the book focus on how medical developments, including those in psychology and psychiatry, have shaped liberal Protestant concepts, rituals, and senses of self-identity since the Victorian era. (There is less emphasis on the reciprocal influence of Protestantism on medicine, though she does include some brief and compelling snippets on the Society for Psychical Research (118) and efforts by the Christian Medical Commission in the 1970s to promote primary health care among secular health policy organizations (54).) While some have seen in liberal-leaning post-World War II Christianity a de facto move toward secularism and a surrender to an “individualistic therapeutic culture” (xvi-xvii), Klassen takes a more nuanced view of the dialectic. Arguing that while liberal Protestants gradually “became agents of medicalization” (xi), she nonetheless rejects the views that supernaturalism “was at odds with liberalism” (129) or that secularization and medicalization stood in a one-to-one relationship in North America (xvii). Instead, she finds that these theologically progressive, even cosmopolitan, believers retained a strong, if idiosyncratic, connection to the transcendent in their outlook on individual and collective bodies. They were “lovers of science” (xviii) nonetheless critical of biomedical models that left scant space for the concept of the soul (16).
Klassen thus finds in the epistemic interaction of liberal Protestantism and western medicine not a warfare model of science and religion (Barbour 1997) but rather one of dialogue and methodological borrowing, particularly by the churches, in order to assess dogmatic claims and social interventions. For example, textual criticism was a method familiar to liberal Protestants and medical scientists alike; she argues that this common technology reflected both a “Baconian” scientific method (83) and Webb Keane’s semiotic ideology framework (2007), where both religious and scientific concepts were adjudicated in terms of their capacities “to transform, harm, and heal” (32). More generally, liberal Protestantism’s “experimentalist approach to ritual and change” (26) sought to connect “magical, rhetorical, and cultural forms of power” (97) to justify only those spiritual and psychic healing practices that could be “tested, written up, and therefore proven” (ibid.). Ultimately, much of this work resulted in the translation of concepts of “body, mind, and spirit” from the doctrinal sub-field of theological anthropology (for a sophisticated, if technical, treatise on the topic, see Kelsey 2009) and from individual life experiences of believers into “medical and psychological models of healing” (37).
If western medicine was one key dialogical partner of liberal Protestantism in this evolutionary reflection about body, soul, and spirit, another was non-western therapeutic religious practices, particularly those initially condemned by churches in their missionary work. Not quite a Kuhnian paradigm shift, not quite religious syncretism, this re-evaluation of worldviews nonetheless would require a new vision of therapeutics. It “revalue[d] those traditions once considered heathen—subaltern—not only through revising (or forgetting) their own western Christian history, but also through renovating their own ritual with the help of the very traditions—such as yoga—rendered subaltern by Christian-influenced Western colonialism” (176).
The result of this strand of interactions is what Klassen describes as “medicalized supernaturalism” (xiv), a theological position that frequently supported the growing social influence of biomedicine yet left ajar the possibility of religious and spiritual intervention as legitimate forms of healing (7), whether or not they were traditionally recognized forms of Christian practice. Through this concept of medicalized supernaturalism, Klassen rejects Malcolm Bull’s argument that liberal Protestantism effectively ceded its influence to other camps—(a) supernaturalism to new (and typically fundamentalist or evangelical) healing-based Christian movements and (b) moral oversight of the body and its functions to the secular medical realm (64-65)—and provides numerous vignettes to support her claim.
What were the political consequences of these shifts for Christianity in North America? Liberal Protestants weighed the implications of an endorsement of more literal forms of “divine healing” promoted by more conservative churches and ultimately decided—strategically?—to continue a strong embrace of western science, even if this meant maintaining a smaller tent for supernaturalism. Nonetheless, believers felt that this stance would help to continue “the Church’s work” and ensure its ongoing relevance to the U.S. and Canada. How? By permitting sufficient conceptual and practical spiritual space for the healing of individual bodies through the embrace of modern medical technologies “as conduits of the spirit to the flesh” (101). Significantly, such a position could also allow liberal Protestants to continue their quest to heal “the structural pathologies of modern society” (90), something that many believed that the support of conservative forms of divine healing would inhibit. The resulting doctrines “licensed them to carve out new territory as healers—territory that encompassed the growing cultural presence of psychology, burgeoning charismatic movements, and a dawning awareness of the importance of sexuality to both self and society” (39). This rebranding was considered vital by many believers in light of such shifts as declining ranks among medical missionaries, the closure or merger of religious hospitals with secular counterparts, and the emergence of questions about the very concept of religious outreach in a “postcolonial and post-Holocaust world” (156).
This is not to say that there was a single, harmonious view among all liberal Protestants of where churches should focus their resources in the name of healing. Two camps in particular attract attention:
Whereas advocates of spiritual equilibrium often set their analyses within wider contexts of what they saw as immoral capitalist economic systems, the pathological effects of imperialism, and distortedly inhibited views of sexuality, spiritual interventionists focused largely on the recesses of sin and distress that inhered in the individual body and memory that could be healed not by better social programs but, rather, but personal repentance and the forgiveness of God. (143)
These differences in emphasis between macro- and micro-level outreach reflect in no small part developments in the 1960s and 1970s in both the geopolitical landscape and clinical psychology, both of which likewise forced a rethinking among liberal Protestants of the very concepts of health and well-being and resulted in shifting Protestant diagnoses of modernity. Social justice-oriented members of the United Church, for example, increasingly saw healing in terms of repairing past ecclesiastical misdeeds such as residential schools for First Nations youth in Canada and medical missions in Africa and elsewhere, whose interventions came to be viewed more as examples of cultural imperialism than as benevolent aid. At the individual level, meanwhile, many believers wanted to retain concepts of free will and personal accountability, albeit in a way that did not appear magical or occult (48). These approaches less “abandoned the mind to science, as transposed the concept of the soul into both psyche and spirit” (44). Likewise, they “ended up not so much establishing the equilibrium of the healthy Christian self, as revealing the precariousness of its balance” (168).
These reflexive struggles will no doubt sound familiar to many anthropologists. According to Klassen, liberal Protestants “came to see the deep ironies of how their own projects of healing were complicit with the evils they sought to exorcise” (xii). Many of them struggled to reconceputalize themselves in response to prior relationships with their interlocutors—science above and the colonized below—as part of efforts to promulgate legitimate healing for others and atonement for themselves. By questioning how biomedicine, psychology, and Christianity were all predicated upon claims “to exclusive forms of knowledge and particular modes of the modern” (xv), believers gradually changed liberal Protestant concepts of healing by questioning their “taken-for-granted assumptions and practices about what made for ethical, and healthy, human subjects” (215).
Klassen sees these processes as central to a requestioning of the very concept of liberalism in 21st century North America. She is particularly critical of anthropologists of religion and conservative Christians for propagating claims based on generalizations rather than archival or ethnographic research. For her, these researchers have promoted caricatures of liberal Protestantism as “a polyglot assembly of individualistic experimentalists cast adrift on the shifting sands of provisional truths, or alternatively, a band of romantics bound by their devotion to freedom of thought and perpetual resistance to an oppressor that is indeed themselves” (217-8).
Even more starkly, she charges that anthropology today suffers from an “amnesia” regarding its Christian theological roots, which has contributed “to the misrecognition of the continued legacy of Christian theological categories and modes of argument for anthropological theories of embodiment, ritual, healing, and even medicine” (xiii). Hence, the book’s aim to “open up new avenues for theorizing liberal subjects and liberal modernities” (xix) through a description of a branch of Protestantism that embodies “a disposition of critical openness to change and science, optimism about religious interrelations, and commitment to social, political, and economic justice rooted in biblical texts” (13) is both timely and needed. This project of spiritual epidemiology serves as a thinly veiled plea for anthropologies of medicine, psychology, history, and particularly religion to reflect upon their epistemic relationships to Christianity over the past hundred or so years, particularly regarding the ways in which they as social scientists have paralleled epistemic projects of liberal Protestants.
A book of such scope invites questions. What did the formerly colonized think of these shifts by liberal Protestants? For example, we learn about processes of reconciliation in the residential schools affair in Canada, but most of the voices come from individuals within the church, not members of First Nations groups themselves. Likewise, what has western medicine thought of this liberal self-scrutiny and ultimate embrace of much of secular science? Here too additional voices from the other side of the dialectic would be helpful. Finally, those lured by the book’s cover image of a primitive surgical ward and expecting a treatment of liberal Christianity within the clinical context will find relatively little ethnographic detail about religion in the hospital setting; instead, they will have to wait for Wendy Cadge’s Paging God: Religion in the Halls of Medicine, under contract with Chicago.
That these quibbles are in effect requests for more information, rather than objections to the central arguments of the text, bespeaks Spirits of Protestantism’s success as an analytical project. Klassen has taken the first of what will hopefully be several medical anthropological forays into the complex relationship between Christianity and western medicine in North America. In so doing, she has offered a courageous and balanced treatise that is not a plea for the reënchantment of anthropology (or medicine) but a nuanced call for the careful analysis of the seemingly familiar.
Barbour, Ian G. 1997. Religion and Science: Historical and Contemporary Issues. Rev. and Exp. ed. San Francisco: HarperSanFrancisco.
Csordas, Thomas J. 1997. The Sacred Self: A Cultural Phenomenology of Charismatic Healing. Berkeley: University of California Press.
Engelke, Matthew. 2007. A Problem of Presence: Beyond Scripture in an African Church. Berkeley: University of California Press.
Erzen, Tanya. 2006. Straight to Jesus: Sexual and Christian Conversions in the Ex-Gay Movement. Berkeley: University of California Press.
Griffith, R. Marie. 2004. Born Again Bodies: Flesh and Spirit in American Christianity. Berkeley: University of California Press.
Holifield, E. Brooks. 2005. A History of Pastoral Care in America: From Salvation to Self-Realization. Eugene, OR: Wipf & Stock Publishers.
Keane, Webb. 2007. Christian Moderns: Freedom and Fetish in the Mission Encounter. Berkeley: University of California Press.
Kelsey, David H. 2009. Eccentric Existence: A Theological Anthropology. Louisville, KY: Westminster John Knox Press.
Klaits, Frederick. 2010. Death in a Church of Life: Moral Passion during Botswana’s Time of AIDS. Berkeley: University of California Press.
Luhrmann, T. M. 2001. Of Two Minds: An Anthropologist Looks at American Psychiatry. New York: Vintage.
Numbers, Ronald L., and Darrel W. Amundsen, eds. 1997. Caring and Curing: Health and Medicine in the Western Religious Traditions. Baltimore: Johns Hopkins University Press.
Porter, Roy. 2005. Flesh in the Age of Reason: The Modern Foundations of Body and Soul. New York: Norton.
Risse, Guenter B. 1999. Mending Bodies, Saving Souls: A History of Hospitals. New York: Oxford University Press.
Roberts, Elizabeth F.S. 2012. God’s Laboratory: Assisted Reproduction in the Andes. Berkeley: University of California Press.
Werbner, Richard. 2011. Holy Hustlers, Schism, and Prophecy: Apostolic Reformation in Botswana. Pap/DVD ed. Berkeley: University of California Press.
Zigon, Jarrett. 2010. “HIV Is God’s Blessing”: Rehabilitating Morality in Neoliberal Russia. Berkeley: University of California Press.
Wilson Will is completing his tenure as the Medical Humanities Postdoctoral Fellow at Rice University. He completed his PhD in Anthropology and Social Studies of Medicine at McGill University, with a dissertation entitled “Making Hospital Chaplains in an Age of Biomedicine.” Current research focuses on the biomedicalization of American religion and on the relationship between theology, risk, and statistics.