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Mental Health, Religion & Culture
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Mental health and religion from an
attachment viewpoint: overview with
implications for future research
Pehr Granqvista
a Department of Psychology, Stockholm University, Stockholm,
Sweden
Published online: 01 Aug 2014.
To cite this article: Pehr Granqvist (2014): Mental health and religion from an attachment
viewpoint: overview with implications for future research, Mental Health, Religion & Culture, DOI:
10.1080/13674676.2014.908513
To link to this article: http://dx.doi.org/10.1080/13674676.2014.908513
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Mental health and religion from an attachment viewpoint: overview with
implications for future research
Pehr Granqvist*
Department of Psychology, Stockholm University, Stockholm, Sweden
(Received 30 September 2013; accepted 22 March 2014)
I argue in this article that attachment theoretical considerations provide insights into why
certain moderators underlie the links observed between religion and mental health. Three
sets of moderators are discussed. First, contextual factors associated with heightened
attachment activation (e.g., stress, unavailability of one’s secular attachment figures, low
social welfare) increase the strength of the links observed between religion and mental
health. Second, aspects of mental health that are most notably affected by having a safe
haven to turn to and a secure base to depart from are particularly reliably linked to religion.
Other attachment-related aspects of mental health that religion may promote concerns
attenuation of grief and reparation of internal working models following loss of and/or
experiences of having been insensitively cared for by other attachment figures. Finally,
aspects of religion that are most consistently linked to mental health are partially those that
express attachment-components, including belief in a personal, loving God with whom one
experiences a close and secure relationship.
Keywords: attachment; religion/spirituality; mental health; internal working models
An extensive body of empirical research has shown that religion and mental health are intercon-
nected, in complex ways. The link is often positive but weak, though sometimes stronger, and
occasionally negative. These apparent inconsistencies in research findings seem to depend on a
few salient moderators (or qualifiers). First, aspects of religion matter a great deal. Second,
aspects of mental health matter a great deal. Third, the contexts within which individuals find
themselves matter a great deal. Attending to the moderators that make the difference might
help us understand why mental health and religion are interconnected. Drawing on the reli-
gion-as-attachment model (Granqvist & Kirkpatrick, 2008,2013; Kirkpatrick, 2005), I argue in
this article that attachment theoretical considerations provide insights into why those particular
moderators matter and thus contribute to understanding why mental health and religion are
connected in the first place.
The aim of this article is not first and foremost to provide a review of extant research on mental
health and religion that has been undertaken from an attachment viewpoint. Attachment-based
research on the mental health–religion connection has been scarce as well as methodologically
limited. Rather, by attending to the moderators that make a difference, the main aim of the
© 2014 Taylor & Francis
*Email: pehr.granqvist@psychology.su.se
Mental Health, Religion & Culture, 2014
http://dx.doi.org/10.1080/13674676.2014.908513
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article is to increase our understanding of why mental health and religion are connected. This
understanding may in turn be used as a heuristic device to guide future research endeavours on
this topic.
The article is divided into four main sections, the first two of which are introductory. The first
section delineates attachment theory and research, including implications of attachment for
mental health. The second section outlines the religion-as-attachment model, focusing on God
as a symbolic attachment figure and individual differences in religion-as-attachment. The third
section is the key analytical section of the presentation. In this section, the moderators noted
above are scrutinised from an attachment viewpoint. The article is concluded in the fourth and
final section, which also provides caveats and additional future directions.
Outline of attachment theory and research
Normative processes
In order to understand the attachment–religion connection and its implications for mental health,
it is useful to consider what is meant by “attachment figures”and “attachment relationships”.
Bowlby (1982/1969,1973) and his collaborator Ainsworth (1985) noted that attachment relation-
ships are strong and enduring affectional bonds characterised by the attached person –usually the
offspring –selectively maintaining proximity to his or her caregiver, using the caregiver as a safe
haven during distress and as a secure base during exploration of the environment. Used in these
ways, the attachment figure is implicitly perceived as stronger and wiser by the attached person.
Notably, although immediate physical proximity is at first an important component of attach-
ment, later on it normally becomes far less of an issue. Partly because of this developmental shift,
a psychological sense of “felt security”has been suggested as a more viable aspect of attachment
in older individuals (Sroufe & Waters, 1977).
According to Bowlby (1982/1969), the attachment behavioural system was naturally selected
over the course of evolution because it potentiated gene survival in our evolutionary environments
by protecting offspring from natural dangers. Consequently, the attachment system is activated by
natural “clues to danger”(e.g., separation from the attachment figure, physical illness, pain) and ter-
minated by “clues to safety”(e.g., physical proximity to or reassurance from the attachment figure).
Bowlby (1982/1969,1973) maintained that early interactions with the attachment figure lay
the foundation for what he termed “internal working models”(IWMs) of self and others in
relationships. IWMs are the generalising templates from early experience that guide our percep-
tion, expectations, and behaviours in future relationships.
Bowlby (1973,1980) also argued that the attachment system is active from cradle to grave, for
example in long-term adult pair-bonds, which are typically the principal attachment relationships
in adulthood. This implies that manifestations of attachment in adulthood are not to be understood
as regressive or as a sign of dependency.
In certain situations, however, the individual may turn elsewhere for attachment. On the use of
such surrogate attachment figures, Bowlby (1969/1982, p. 313) noted that:
Whenever the “natural”object of attachment behaviour is unavailable, the behaviour can become
directed towards some substitute object. Even though it is inanimate, such an object frequently
appears capable of filling the role of an important, though subsidiary, attachment “figure”. Like the
principal attachment figure, the inanimate substitute is sought especially when a child is tired, ill,
or distressed.
Notably, an attachment figure may be unavailable or insufficient for many reasons. One of these,
discussed below, is poor sensitivity (attentiveness and responsiveness) to the child’s needs and
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signals. Another reason is simply that the attachment figure happens not to be physically present;
perhaps the child is at camp or in school, or the attachment figure has died. A final reason is when
a given stressor is so overwhelming (e.g., a massive natural disaster, atrocity, starvation) that one’s
“earthly”attachment figure, even when physically available and sensitive, is unable to provide
safety and security in the face of this stressor.
Individual differences in attachment
Besides providing a “deep”theory of typical (or “normative”) attachment processes, attachment
theory and research also focus on individual differences in attachment organisation. For our pur-
poses, the most important distinctions are between secure and insecure attachment (Ainsworth,
Blehar, Waters, & Wall, 1978) on the one hand and between organised and disorganised attach-
ment (Main & Solomon, 1990) on the other.
According to the theory, the core of secure attachment is a positive and coherent set of IWMs.
This condition manifests itself in a behavioural balance between attachment and exploration in
young children (Ainsworth et al., 1978); the secure child explores the surroundings using the
attachment figure as a secure base and turns to the attachment figure as a safe haven following
attachment system activation. In adults, security is manifested in linguistic coherence when dis-
cussing attachment-related memories (Main, Goldwyn, & Hesse, 2003).
In contrast, insecure (yet organised) attachment is often subdivided into avoidant (a minimis-
ing strategy) and ambivalent/resistant (a maximising strategy) attachment. We need not be con-
cerned with this distinction, except to note the assumption of a negative and incoherent set of
IWMs at the core of insecure attachment (Main, 1991). Common to all children classified as inse-
cure-organised is that they do not (perhaps cannot) explore using their attachment figure as a
secure base, and some do not turn to the attachment figure as a safe haven following attachment
activation.
Security of attachment is predicted, most notably, by the caregiver’s sensitivity to the child’s
signals (De Wolff & van IJzendoorn, 1997). Attachment figures of insecurely attached children
are less sensitive, implying that these children may have an increased motivation to find surrogate
attachment figures.
Disorganised attachment represents a break-down in attachment-related patterning during
stress (Main & Solomon, 1990) and is identified in behavioural expressions, displayed in the pres-
ence of the caregiver, such as prolonged freezing with a trancelike facial expression and simul-
taneous or sequential displays of opposing behaviours (e.g., approach–avoidance conflict
behaviours). Disorganised attachment is predicted by atypical forms of caregiving (e.g., frighten-
ing and frightened parental behaviours, a history of abuse and maltreatment) that place children in
a behavioural paradox in which their caregivers are simultaneously the source of alarm (e.g., due
to being frightening) and the only possible solution to it (i.e., because the offspring is “pre-
programmed”to turn to the attachment figure to deal with alarming events; Hesse & Main, 2006).
Attachment and mental health
Bowlby’s original chief aim in formulating attachment theory was to arrive at a theory that could
be clinically useful, both for understanding deviations in development and for treating those devi-
ations (Bowlby, 1988). Two of the volumes in his three-volume series Attachment and Loss dealt
primarily with the deleterious effects stemming from repeated separations from (Volume 2) and
loss through death of (Volume 3) attachment figures. More generally, Bowlby (1988) ascribed
much importance to the function of a secure base in providing a positive foundation for mental
health. He noted, for example, that:
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When an individual is confident that an attachment figure will be available to him whenever he desires
it, that person will be much less prone to either intense or chronic fear than will an individual who for
any reason has no such confidence. (Bowlby, 1973, p. 202)
The necessarily long side-track Bowlby (1973) took in formulating the conceptual framework of
attachment theory prevented him from realising his original clinical aim in his own life-time, but
he nevertheless clearly anticipated the importance of having a reliable secure base for mental
health, which again is the case in secure but not insecure attachment.
A large body of developmental and clinical research, on child and adult populations alike, has
now indicated that secure attachment does indeed act as a protective factor in development, which
generally facilitates the individual’s adjustment, even in the presence of other stressors or vulner-
ability factors such as poverty or a “difficult”temperament (Sroufe, Egeland, Carlson, & Collins,
2005).
In contrast, disorganised attachment has emerged as a general risk factor in development,
which is linked to behavioural problems and is overrepresented in most clinical/psychiatric popu-
lations; Bakermans-Kranenburg & van IJzendoorn, 2009; van IJzendoorn, Schuengel, & Baker-
mans-Kranenburg, 1999). When combined with other vulnerability and risk factors, disorganised
attachment may pave the way for serious adjustment problems.
Notably, unless combined with other vulnerability factors, insecure–organised individuals
typically do not develop serious adjustment problems. However, type of insecure attachment is
still informative with regard to the type of mental problems that are likely to develop if the indi-
vidual is faced with other risk or vulnerability factors (such as a “primary”disorganised attach-
ment or a “difficult”temperament). Avoidant attachment paves the way for externalising
problems (e.g., aggression, defiance, bullying) and ambivalent/resistant attachment for internalis-
ing problems (e.g., anxiety, fear, victimisation) (Bakermans-Kranenburg & van IJzendoorn, 2009;
Sroufe et al., 2005).
Religion as attachment
Like attachment research in general, the religion-as-attachment model contains both an attach-
ment-normative account and an account of how individual differences in attachment are reflected
in the religious realm. Central to the attachment-normative account is the argument that God is
used as a symbolic attachment figure by many believers.
God as a symbolic attachment figure
With an uncanny resemblance to Bowlby’s(1973) description of the significance of a secure base
for mental health (quoted above), Johnson –a psychologist of religion –noted on the psychologi-
cal function of faith, that:
The emotional quality of faith is indicated in a basic confidence and security that gives one assurance.
In this sense faith is the opposite of fear, anxiety, and uncertainty. Without emotional security there is
no relaxation, but tension, distress, and instability. Assurance is the firm emotional undertone that
enables one to have steady nerves and calm poise in the face of danger or confusion. (1945, p. 191)
However, a quote is but a quote, and faith is merely one aspect of believers’relationships with
God. We clearly need more solid evidence for the idea that God functions as a symbolic attach-
ment figure to conclude that that idea is empirically substantiated. Moreover, the evidence needs
sufficient precision vis-á-vis the criteria established for attachment relationships and attachment
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figures, described above. Besides a supportive comprehensive review based on roughly 100 years
of empirical research in the psychology of religion (Kirkpatrick, 2005), recent attachment-based
studies have produced further corroborating evidence (Granqvist & Kirkpatrick, 2008,2013).
First, regarding proximity maintenance, although there are many kinds of prayers, one of the
most frequently endorsed reasons for praying is to experience a sense of closeness to God (Spilka
& Ladd, 2013). The importance of proximity maintenance is also highlighted by what it means to
be separated from God; in much Christian theology, this is, in essence, hell. In addition, across
two experimental studies, theistic (mostly Christian) believers primed with separation threats tar-
geting either God or their mothers displayed increased motivation to experience closeness to God
(Birgegard & Granqvist, 2004).
Secondly, concerning God as a safe haven, people are particularly likely to turn to God during
stress, and the more stressful a situation is, the more likely people are to do so (Pargament, 1997).
Consequently, following threatening (compared with neutral) primes, Jewish (mostly theistic)
college students demonstrated heightened psychological accessibility (i.e., lower reaction times
in lexical decision tasks) to God-related concepts (Granqvist, Mikulincer, Gewirtz, & Shaver,
2012). Also, empirical data suggest that an overwhelming majority of sudden religious conver-
sions occur during life situations of significant emotional turmoil (Ullman, 1982). Some might
conclude on the basis of findings such as these that there are, indeed, no atheists in foxholes.
However, religion needs to be schematically accessible in one’s“orienting system”(Pargament,
1997) for religious coping behaviours to occur in the face of stressors. I will return to this issue
later when discussing contextual considerations of importance for the mental health–religion
connection.
Third, with respect to the secure base component, when believers are asked to rate God’s
traits, some of the most frequently endorsed traits are loving, supportive, guiding, protective
(Kirkpatrick, 2005). These are qualities that are important for any secure base to possess in
order to promote well-being and exploration in the attached person. Consequently, in two
additional experiments with Jewish college students, priming with the word “God”heightened
their cognitive access to such secure base-related concepts, and priming with a religious
symbol (i.e., a Torah scroll) caused them to like neutral material (i.e., Chinese ideographs), as
compared with neutral priming (Granqvist et al., 2012). The idea of God as a secure base is of
course central to the proposal that religion-as-attachment is linked to mental health, so I will
return also to this issue below.
Finally, that believers perceive God as stronger and wiser really goes without saying. In fact,
at least in Christian theology, God is typically even perceived as omnipotent and omniscient, as
well as omnipresent, representing qualities that are impossible for any other attachment figure to
outdo. Thus, at least in principle, God is always available to protect and provide security, no
matter how overwhelming a stressor is, and no matter how fallible one’s earthly attachment
figures are.
Based on these considerations, it seems as though believers’perceived relationships with God
function psychologically much like other attachment relationships. However, other attachment
relationships develop as a consequence of repeated physical interaction, and other attachment
figures are perceptible (visible, audible, etc.). For these reasons, and to counteract semantic
dilution of the attachment construct, I refer to God as a symbolic attachment figure and to believ-
ers’perceived relationships with the divine as symbolic attachments.
Individual differences in religion-as-attachment
We have stated that religiosity in the case of insecure attachment develops from controlled distress
regulation strategies, where God functions as a surrogate attachment figure for the individual
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(Granqvist & Kirkpatrick, 2013). This idea has now received considerable empirical support in
relations between insecure attachment and estimates of parental insensitivity on the one hand
and several religious outcomes on the other. Perhaps most notably, insecurity and parental insen-
sitivity have been linked to fluctuations in religiousness, such as sudden religious conversions and
other notable increases in the importance of religion, which have typically also been found to
occur in stressful life circumstances (e.g., relationship problems and break-ups, crises) for
these individuals (Granqvist & Hagekull, 2003; Granqvist, Ivarsson, Broberg, & Hagekull,
2007; Granqvist & Kirkpatrick, 2004; Kirkpatrick, 1997; Kirkpatrick & Shaver, 1990).
However, fluctuations in religiousness also imply that religiousness may notably decrease for
these individuals, which has been documented especially in contexts associated with a lessened
need for surrogate attachment figures, such as following romantic relationship formation (Granq-
vist, 2002; Granqvist & Hagekull, 2003). The research literature also suggests that, at least in
parts of the Western world, insecurity and parental insensitivity are linked to religious syncretism
(e.g., a combination of high levels of New Age spirituality on the one hand and theistic, organised
religion on the other, Granqvist, Broberg, & Hagekull, 2014), possibly suggesting extreme
attempts at distress regulation using virtually any religious/spiritual mean available to the self.
It would of course be utterly mistaken to believe that the compensation hypothesis captures
the one and only pathway to religion. Such an assumption would imply that everyone who
comes to embrace religion has had a history of insecure attachments. Clearly, this is not the
case. With a second general attachment hypothesis, the correspondence hypothesis, we claim
that religion in the case of secure attachment (a) develops from generalised, positive represen-
tations of self and other (IWM aspect), and (b) partial adoption of a sensitive caregiver’s religion
(social aspect) (Granqvist & Kirkpatrick, 2008,2013). Hence, insofar as the caregivers have been
actively religious, the secure offspring is expected to become likewise, and in this case his or her
beliefs in and perceptions of the divine will mirror that of a sensitive attachment figure.
This hypothesis has also received considerable empirical support. For example, secure attach-
ment and estimates of sensitive caregiving experiences have been linked to similarity with par-
ental religiousness (Granqvist, 1998; Granqvist, Ivarsson, et al., 2007; Kirkpatrick & Shaver,
1990), a loving and caring God image (Cassibba, Granqvist, Costantini, & Gatto, 2008; Granqvist,
Ivarsson et al., 2007; Kirkpatrick, 1998; Kirkpatrick & Shaver, 1992), and self-reports of a secure
attachment to God (Beck & McDonald, 2004; Kirkpatrick & Shaver, 1992; Rowatt & Kirkpatrick,
2002). Interestingly, secure attachment and estimates of sensitive caregiving experiences have
also been consistently linked to an implicit access to one’s relationship with God in subtly attach-
ment-activating situations (Birgegard & Granqvist, 2004; Granqvist, Ljungdahl, & Dickie, 2007;
Granqvist et al., 2012). To give a specific example, in the Israeli experiments described above,
Jewish believers with a secure adult attachment orientation had especially marked psychological
access to God-related words following subliminal threat priming and to secure-base related words
following subliminal God priming (Granqvist et al., 2012). These findings indicate that secure
individuals do not just represent themselves and God as secure at conscious levels (e.g., as
reflected in self-reports), but also use God accordingly at unconscious levels of operation,
suggesting that their positive representations of self and God are coherent or “singular”(i.e.,
internally consistent; cf. Bowlby, 1973; Main, 1991).
Mental health and religion from an attachment viewpoint
Authoritative scholars on the religion–health connection have suggested that attachment to God is
a key component of the health (including mental health)-bringing aspects of religion. For
example, in an attempt to arrive at a causal model that may account for the many atheoretical find-
ings that have thus far plagued this field and that may function heuristically to guide future
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research, Koenig, King, and Carson (2012, p. 587) put “Belief in, attachment to God”at centre
stage, as the very source of religion/spirituality that makes people engage in other, more specific
health-bringing religious behaviours (e.g., rituals, commitment, coping). Similarly, Pargament
(2002) has suggested that mental health and well-being are predicted, positively and uniquely,
by a secure relationship with God and perceived closeness to God (cf. secure attachment to
God), whereas a tenuous (cf. insecure) relationship with God would instead impact unfavourably
on mental health and well-being (Hill & Pargament, 2003). These scholars may well turn out to be
right, but –as delineated below –the empirical evidence for the vital role of attachment to God is
still far from conclusive.
A brief critique of extant research
At this point in the article, I could provide a detailed review of the few, yet steadily growing,
number of empirical studies available in the literature that have explicitly examined associations
between attachment to God and mental health (Beck & McDonald, 2004; Bradshaw, Ellison, &
Marcum, 2010; Kirkpatrick & Shaver, 1992; Miner, 2009; Rowatt & Kirkpatrick, 2002; Sim &
Loh, 2003). These cross-sectional questionnaire studies of largely religious samples of conven-
ience, drawn from largely religious, non-clinical populations, have examined concurrent
associations between self-reported attachment to God and self-reported aspects of mental
health (e.g., life satisfaction, well-being, depression, anxiety). The findings from these studies
have yielded a consistent picture suggesting that perceptions of being attached to God and
especially of having a secure attachment to God are moderately linked to mental health, and con-
versely that insecure attachment to God is linked to mental unhealth, often over and above the
effects of the conceivable covariates included in the relevant studies (e.g., romantic attachment,
attachment history with parents, God image, Big 5 personality dimensions).
Unfortunately, however, interpretation of the data collected so far is limited by at least four
notable methodological problems. First, the causal direction of cross-sectional correlations
between attachment to God and mental health remains open to question. As a simple illustration,
if God functions as both a safe haven and secure base, then trouble and suffering should tem-
porally foreshadow people’s turning to God qua safe haven. Yet, contemporaneously, using
God as a secure base should ameliorate distress and be linked to higher mental health. There is
no way to do justice to this supposedly dynamic interplay between attachment to God and
mental health in cross-sectional studies; indeed, the relation between the two could conceivably
amount to nil at a given point in time.
Second, the self-report mode of measuring attachment to God and mental health in the studies
cited makes it impossible to exclude the possibility that (any combination of) self-deception,
impression management, shared method variance, semantic overlap, lack of sufficient self-
awareness, and so on, may be, at least partly, responsible for the associations obtained. To give
an example, experiencing an attachment to God, and a secure one in particular, is typically so
strongly related to degree of general religiousness that the latter emerges as a viable third variable,
and one which has been largely overlooked in the literature (Cassibba et al., 2008; Cassibba,
Granqvist, & Costantini, 2013).
Third, the cross-cultural generalisability of positive associations between attachment to God
and mental health obtained in largely religious populations remains questionable for populations
that are less religious, and especially for populations that are largely non-religious. As a case in
point, people who turn to religion despite being covered for by generous societal support func-
tions in largely secular countries (e.g., in European “welfare states”, discussed further below)
might differ from those who turn to religion when faced with genuine poverty, uninsured
medical conditions, and so on, in other, and typically more religious, parts of the world.
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Finally, and as noted above, religion is especially important in times of true trouble. Therefore,
it may not have been advisable to study the importance of attachment to God or of religion more
generally for mental health in samples drawn from the general population. Besides insufficient
levels of stress in such samples, there might be a restriction of meaningful range in mental
(un-) health, partially attenuating the sizes of the true contributions of attachment to God and reli-
gion to mental health.
Jointly, the methodological limitations of the published research available on the topic of
attachment to God and mental health makes it difficult to draw any real conclusions. Therefore,
rather than reviewing the pertinent research in detail, our time is better spent looking into the
lessons learned in the more general literature on the religion–mental health connection, and
into how attachment-based considerations could guide future research aiming to increase our
understanding of the interplay between religion and mental health.
As would be predicted based on attachment theoretical considerations, the general literature
on religion and mental health suggests that the association between the two are full of moderators
or qualifiers. What aspects of religion we look at matters a great deal. Similarly, what aspects of
mental health we look at matters a great deal. And more than anything, the contexts within which
individuals find themselves matter a great deal. Each of these set of qualifiers is discussed below,
in reversed order, and in relation to attachment theoretical considerations.
Under which conditions?
The research literature has pointed to several contexts which appear to facilitate religious beliefs
and behaviours. Conceivably, when faced with such contexts, God and religion might also
become increasingly important for mental health. I will discuss four sets of contexts that
appear to be especially important, without any implication that they represent an exhaustive
list. First, as repeatedly noted above, stress and emotional turmoil are well-known facilitators
of religious experiences. Moreover, the general literature on religion and health seems to show,
again and again, that not only are people more inclined to turn to religion during stress but
also that religion has its most salubrious effects during times of true trouble. For example, the
positive effects of religion variables, such as those of “positive”religious coping and “intrinsic”
religiousness, on mental health outcomes are typically moderated by levels of stress, such that
religion confers its most beneficial effects in times of real trouble. This has often been found
in coping research (Pargament, 1997,2002) and has been confirmed also in a meta-analysis on
religion and depression, which showed that some aspects of religion were negatively linked to
depression especially under conditions of high stress, whereas the main effect of religion on
depression was relatively modest (Smith, McCullough, & Poll, 2003).
Research on religious conversions offers converging evidence. Not only are intense and
sudden conversion experiences likely to occur during stress, but such experiences are associated
with marked attenuation of distress and increases in well-being, at least in the short term (Hood,
Hill, & Spilka, 2009; Pargament, 1997). In attachment terms, stress and emotional turmoil are rel-
evant because they should be associated with heightened attachment activation, and the use of
God and religion as a safe haven to deal with the situation.
Secondly, the broader societal and cultural context is important to bear in mind. In particular,
at least among the Organisation for Economic Co-operation and Development countries, demo-
graphic data show that one specific variable explains a surprisingly large amount of statistical var-
iance (roughly 50%) in population estimates of religiosity, namely the proportion of the gross
national product that governments spend on social welfare (schools, health care, health insurances
et alia; see Gill & Lundsgaarde, 2004; Scheve & Stasavage, 2006). People are simply much less
religious in welfare states, with parts of Europe (especially Sweden and Denmark) as the very best
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cases in point. In these countries, state agencies and other functions of the welfare system appear
to have replaced many of the functions historically cared for by religion. Notably, the high
welfare–low religiosity link is not restricted to Church attendance or religious beliefs but is
equally applicable to the seeking of solace and comfort from God and religion (i.e., to the safe
haven function of religion) (Gill & Lundsgaarde, 2004; Scheve & Stasavage, 2006).
As a corollary, religion is especially likely to be conducive of health in nations/cultures
marked by lower social welfare, that is, in contexts where religion is both “needed”and culturally
normative. Not surprisingly, then, the religion–health associations obtained in US samples (low
on social welfare, religion as normative) often seem to have somewhat limited relevance for
some European populations (cf. la Cour, Avlund, & Schultz-Larsen, 2006; Zwingmann, Wirtz,
Muller, Körber, & Murken, 2006), in which a broader range of meaning–making systems and
support functions than the strictly religious no doubt needs to be taken into consideration
(Ahmadi, 2006; la Cour & Hvidt, 2010).
From an attachment viewpoint, it may be that the successful implementation of welfare poli-
tics normally helps to keep people relatively safe and secure from alarm; they need not be shaken
to their bones as there is, for most part, a safety net to fall back on. In addition, over time and
generations, secular support functions conceivably take a toll on the role of religion in people’s
life because religious terms and frames of reference become decreasingly available and ultimately
schematically inaccessible in people’s minds (or “orienting systems”; Pargament, 1997). In con-
trast, religion continues to be important as a source of support in societies that lack a well-func-
tioning secular back-up plan.
Thirdly, and supporting the idea of surrogate attachments and the compensation hypothesis,
research suggests that religion may be especially helpful when other attachment figures are una-
vailable or insufficient as security providers. For example, in an early study by Kirkpatrick and
Shaver (1992), the “effects”of attachment to God on psychological outcomes were moderated
by perceived attachment history with mother. Respondents who remembered their mothers as
relatively insensitive but still had perceptions of a secure attachment to God appeared to
benefit the most from their perceived relationship with God. However, these findings failed to
conceptually replicate in a more recent study (Miner, 2009), which showed that perceptions of
an insecure attachment history with parents overshadowed the possibly positive effects of a
secure attachment to God. Yet, further corroborating evidence comes from a prospective longi-
tudinal study using a population-based sample of elders (Brown, Nesse, House, & Utz, 2004).
Brown and colleagues not only found a prospective increase in the importance of religious
beliefs for elders who were to become widowed (i.e., who were to lose their principal adult attach-
ment figure; Bowlby, 1980; Mikulincer & Shaver, 2007) during the course of the study compared
to the non-widowed (cf. Cicirelli, 2004), but also that grief over the loss decreased specifically as
a function of the increased significance of the widowed individual’s religious beliefs, and particu-
larly for those who were judged as relatively insecure.
An additional set of contexts in which religion, and particularly a secure attachment to God,
might act protectively is when risk factors for mental unhealth (e.g., anxiety, depression, eating
disorder) are present. This idea was supported in a short-term longitudinal study showing that
distal risk factors for eating disorders (e.g., pressure to be thin, thin–ideal internalisation) prospec-
tively predicted more proximal risk factors for eating disorders (i.e., bodily dissatisfaction,
dieting) exclusively among study participants who experienced an insecure attachment to God
(Homan & Boyatzis, 2010). In other words, women who perceived a secure attachment to God
(i.e., who felt loved and accepted by God) were buffered from the effects of the distal risk factor.
Notably, although these contextual considerations may reek of a “deficiency approach”to reli-
gion (Noller, 1992), religion may of course also aid secure people in secure contexts to flourish
further, by providing them with an additional secure base for exploration and growth. However,
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I am volitionally cutting the case in this article to the basic requirements for avoiding serious suf-
fering, or for achieving relative tranquillity even in the presence of serious stressors.
Which aspects of “mental health”?
From an attachment viewpoint, the benefits of religion for mental health would naturally be ana-
lysed in terms of having God or some other religious entity as a safe haven and a secure base, from
which one can gain felt security. Such a secure attachment to God might also, as noted above,
protect the individual against the adverse effects of other attachment-related difficulties, such
as the loss of a “secular”attachment figure. In addition, like a secure relationship with a psy-
chotherapist or other attachment figure, it may help one to repair maladaptive IWMs (stemming
from loss or parental insensitivity). Thus, the individual would (re-) gain the sense of self as being
worthy of care and a representation of others as potentially available in times of need, along with
an open, non-defensive way of processing attachment-related information.
More specifically, the psychological desideratum of having a safe haven is the sense of having
someone perceived as a protective stronger and wiser other to turn to when alarmed and dis-
tressed. Naturally, this should be accompanied by attenuated worry and fear. The psychological
desideratum of having a secure base is that it promotes a sense of personal competence and
control, which would enable calm and confident exploration. Not coincidentally, in their
review of research on associations between various aspects of mental health and religious orien-
tations, Batson, Schoenrade, and Ventis (1993) concluded that the most consistent positive links
had been obtained between freedom from worry and fear as well as personal competence and
control on the one hand and intrinsic religiousness (religion as a master-motive in life, a perceived
end unto itself) on the other. These conclusions, based on correlational findings, were later echoed
by the conclusions that were drawn in the Israeli subliminal experiments, described above (Granq-
vist et al., 2012).
Regarding attenuation of grief, and as referenced above, Brown et al.s’(2004) study produced
supportive findings for a positive role of the importance of one’s religious beliefs. Conceivably,
the positive role of religious beliefs in relation to attenuation of grief may be partially intertwined
with reparation of maladaptive IWMs. Bowlby (1980) noted that to proceed favourably in terms
of promoting adaptation to a life without the loved one’s physical accessibility, the mourning
process requires that bereaved individuals eventually accommodate information regarding the
permanence of the person’s death into their representational world. Otherwise, the individual is
at risk of remaining unresolved or disorganised with respect to the loss, for example, he/she
may display continued searching for the lost person (Main et al., 2003). Available evidence indi-
cates that the proportion of unresolved/disorganised loss may be somewhat lower in religious
samples (3–17%; Cassibba et al., 2008,2013; Granqvist, Ivarsson et al., 2007) than in the
non-clinical meta-analytic sample (16%; Bakermans-Kranenburg & van IJzendoorn, 2009). As
noted by Cassibba et al. (2008), religion may promote mental resolution of loss via offering a pro-
spect of reunion with deceased loved ones in the hereafter. In addition, the bereaved individual’s
attachment to God may serve as a surrogate bond, giving the individual a sense of a dialogical
partner that assists in “grief work”in lieu of the inaccessibility of a lost attachment figure.
Needless to say, however, “reparation of IWMs”is a difficult conjecture to empirically secure,
in part because it requires careful prospective designs, and in part because IWMs, like other mind
constructs, are inferred but not directly observed. Nevertheless, there is additional suggestive evi-
dence in the literature. First, self-reported insecure attachment history and romantic attachment (in
the latter case, particularly a negative self-model) have been linked to increasing religiousness and
spirituality over time, and yet secure attachment has been linked to higher religiousness and spiri-
tuality at a given time (Kirkpatrick, 2005). One interpretation of this pattern is that increasing
10 P. Granqvist
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religiousness somehow helps the individual to gain attachment security. Second, Adult Attach-
ment Interview-based estimates of parental insensitivity in the past have predicted a history of
using religion as compensation for inadequate attachments, but current insecurity (incoherent
attachment discourse) has been unrelated to religion as compensation (Cassibba et al., 2008,
2013; Granqvist, Ivarsson, et al., 2007). Thus, similarly, religion-as-compensation may increase
attachment security (i.e., lead to a certain degree of “earned security”; Main et al., 2003). This
would be comparable to the idea of reparative effects from other relationship experiences, such
as with a good therapist or a secure romantic partner (Bowlby, 1988; Main et al., 2003).
Repair of a negative self-model (i.e., from being unworthy to being worthy of care) might be
one avenue through which earned security via religion/spirituality plays itself out.
Which aspects of religion?
Religion is clearly multifaceted. That sentence should be read as a serious understatement. In fact,
as far as concepts are concerned, “religion”is as thorny to capture and simultaneously demarcate
as is any other concept of widely agreed-upon notoriety (e.g., “culture”). Regrettably, however,
many of the psychologists and health professionals who conducted the early research on the reli-
gion–health connection seem to have been largely unaware of or at least put a blind eye to reli-
gion’s truly multifaceted nature. In this field, more than in any other, religion has often been
treated as a unitary construct, yielding a simple operational definition/variable (e.g., Church
attendance). This has in turn often led to inconsistent and atheoretical findings that ultimately
beg for post hoc interpretations. Fortunately, progress has been made as of late to disentangle
the aspects of religion that seem to bode well, and less well, for dimensions relevant to mental
health (Pargament, 2002,2013). Some of those aspects (elaborated below) converge with what
would be expected based on attachment theoretical considerations, which might be one reason
for Koenig et al. (2012) to suggest that attachment to God is part of the source that motivates reli-
gious behaviours and thus contributes to driving religion–health associations.
Notwithstanding the high bets placed on attachment theory for understanding the religion–
mental health connection, as a “mid-level”psychological theory, attachment theory is not and
cannot be a comprehensive psychological theory of religion, let alone of associations between
religion and mental health. The scope of the theory is much too narrow for that. It is a theory
about the evolutionary foundation, formation, nature, and psychological effects of a particular
form of close relationships, about generalising mental representations of self and other stemming
from such relationships, and about how people gain felt security in the face of various sources of
distress (i.e., attachment activation).
If we seek to identify attachment-related aspects of religion and of how religion and mental
health might be intertwined, then it is on those same ballparks we have to look. How does the
individual view his or her relationship with God? Perhaps as a relationship one can rely on (cf.
secure attachment to God), as one to avoid (cf. avoidant/dismissing attachment), as one to get
caught in (cf. resistant/preoccupied attachment), or be afraid of (cf. disorganised/fearful attach-
ment). How does the person represent God? Perhaps as a loving and accepting, or distant,
judging, or frightening figure. What does the person do to gain closeness to and guidance from
God? He/she might pray (e.g., contemplative/meditative or petitionary prayer). What does the
person do when faced with stressors (i.e., attachment activation)? He/she might engage in reli-
gious coping behaviours (e.g. experience spiritual connection, seek spiritual support).
In other words, what we find is that we enter into some of the most frequently used constructs
in the contemporary psychology of religion, and in the literature on the religion–mental health
connection in particular. I hasten to add that one reason for scholars to make such a fuss about
these constructs is that they are demonstrably important for people’s mental health and well-
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being (Pargament, 2002,2013). Thus, as applied to religion, attachment theory is useful for under-
standing people’s perceived relationships with the divine, their representations of deities, and
certain religious analogues to attachment behaviours, such as some forms of prayer, conversions,
and religious coping behaviours. However, the theory is not necessarily useful for understanding a
whole lot of other important things regarded as religious/spiritual, such as fundamentalism, reli-
gious codes of ethics and conduct, religious group cohesion (Kirkpatrick, 2012).
Notably, I make no claim that attachment theory or research would rightfully “own”any of
the observations that are usually attributed to other theories (e.g., coping theory, theories of prayer
or religious orientations). Yet, no theory owns any observation; observations are always out there
for anyone to grab and try to make sense of as best as they can. My argument is rather that based
on attachment theoretical considerations, one would predict the importance of some of the very
same constructs in the psychology of religion that in fact appear to be reliably related to mental
health. Relatedly, it might be tempting for anyone who is armed with a strong conceptual frame-
work, like attachment theory, to suggest new and potentially “hotter”constructs to replace some
of the highly similar constructs that are already in use. In such a way, one might successfully steal
the research community’s attention from the old constructs. Such devious scholarly behaviour
could well be initiated by future researchers who might, for example, take the content from
what is now referred to as a religious coping dimension and re-label it “religious attachment
behaviour”, or from petitionary prayer and call it “attachment prayer”, or from loving and
caring God imagery and call it “God as sensitive attachment figure”. Readers are advised to
be on guard.
Conclusions and future directions
Drawing on the religion-as-attachment model, I have argued in this article that attachment
theoretical considerations provide insights into why contextual factors as well as particular
aspects of mental health and religion matter a great deal for which links that can be expected,
and in many cases indeed already have been observed, between religion and mental health. We
have seen that contextual factors associated with heightened attachment activation (such as
stress and other risk factors, unavailability of one’s secular attachment figures, and possibly
low social welfare) typically increase the strength of the links observed between religion and
mental health. Also, aspects of mental health that are most notably affected by having a safe
haven to turn to, such as freedom from worry and fear, as well as a secure base to depart from,
such as a sense of personal competence and control, are particularly reliably linked to religion.
Other attachment-related aspects of mental health that religion may promote concerns attenuation
of grief and reparation of IWMs following loss of and/or experiences of having been insensitively
cared for by secular attachment figures. Finally, we have seen that the very aspects of religion that
are most consistently linked to mental health are partially those that express attachment-
components, including belief in a personal, loving God with whom one experiences a close
and secure relationship.
Thus, attachment theory seems promising as a conceptual framework that may capture impor-
tant moderators underlying the religion–mental health links and that thus may facilitate a fuller
understanding of those links. However, the promise of attachment theory for the literature on reli-
gion and mental health runs even deeper. This is because the evolutionary and developmental
foundations of the theory, unlike most other theories in the field, encourage us to ask the big
“Why”-questions that thus far have remained unanswered. For example, individual differences
in those aspects of religion that make a difference for mental health (one’s perceived relationship
with God, one’s representation of God, one’s security with God, positive versus negative religious
coping, and so on) are not just sitting there; they have naturally had developmental trajectories
12 P. Granqvist
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preceding them, which should be of interest to scholars in this field. Those developmental trajec-
tories presumably lead to different ways of being religious, as well as to different dispositions for
what we call mental health, in the first place. From a developmental point of view, understanding
of the religion–mental health connection will be incomplete until we understand how and why
individual differences in ways of being religious are there in the first place. As an analogy,
what good is a regression model which includes only the mediator/moderator and outcome vari-
ables, but without any real predictor variable?
The compensation and correspondence paths underlying the attachment–religion connections,
described above, are particularly worthwhile to consider in this regard, and should be explored
further in research on religion and mental health. As adults, secure individuals who have been
cared for by sensitive and religious caregivers, typically have a representation of and relationship
with God that reeks of “secure”generalising working models, which are serviceable also at
implicit levels of operation (i.e., the correspondence path; Granqvist & Kirkpatrick, 2008,
2013). These individuals naturally have a disposition for favourable mental health and are pre-
sumably “protected”from elevated levels of suffering also in the context of stress and other
risk factors (cf. Granqvist et al., 2014; Miner, 2009).
In contrast, insecure individuals who have been cared for by insensitive caregivers typically
have a representation of and relationship with God that vacillates over time and situations and
across explicit and implicit levels of operation (i.e., the compensation path; Granqvist & Kirkpa-
trick, 2008,2013). This profile is naturally challenging to capture as it contains apparent incon-
sistencies both between and within individuals. For example, concerning inconsistencies between
individuals, this profile is likely to contain the very individuals for whom religion is most service-
able as a source of felt security. As a case in point, although the “religious syncretists”studied in
Granqvist et al. (2014) were typically insecure and had been cared for by insensitive caregivers,
they did not report elevated levels of distress, presumably at least in part due to their experiences
of a personal, compensatory relationship with the divine. Over time, and at least in some cases,
that relationship might potentially aid in bringing about reparation of maladaptive working
models and some degree of earned attachment security. In contrast, the compensation profile
also contains individuals who have tenuous relationships with and shy away from God, who –
presumably due to generalising working models –might be represented as distant, inconsistent
or perhaps frightening. This latter group of individuals is typically not protected from suffering;
indeed their representations of and feelings in relation to God and religion may be yet another risk
factor for mental unhealth.
The picture is complicated further by apparent inconsistencies within individuals and across
situations for people on the compensation track. Most notably, these individuals have been found
to turn to God and religion as surrogates when faced with major stressors (such as following
romantic relationship break-ups; e.g., Granqvist & Hagekull, 2003). On the other hand, they typi-
cally mentally shy away from God when faced with more subtle or implicit attachment-activating
stimulation (e.g., subliminal threat primes), presumably due to automatically activated generalis-
ing working models (Birgegard & Granqvist, 2004; Granqvist et al., 2012). It may be that insecure
individuals’habitual, yet notoriously fragile, strategies for dealing with stress (Ainsworth et al.,
1978; Main, 1991; Mikulincer & Shaver, 2007) crumble during more intense levels of stress, and
that this is a prerequisite for their seeking of God as a compensatory attachment figure. Put dif-
ferently, it may not be until they “hit rock bottom”that they try out what is known as the
“primary”attachment strategy of seeking safety and security, albeit in this case from a surrogate
source, rather than just continue to display their characteristic conditional strategy of defensively
minimising or maximising attention to their secular attachment figures (cf. Main, 1991). If this
speculation is correct, the successful identification of such “rock bottom”situations has the poten-
tial to be of much clinical, proselytising, and pastoral use alike.
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In this article, I have mostly discussed the goods of religion, those that may facilitate mental
health. As true as there are helpful religious behaviours and experiences, there are also ills of reli-
gion, which contribute to or in some cases perhaps directly express mental unhealth, such as
depression, anxiety, and other modes of suffering. A brief list of the most notable ingredients
might include insecure attachment to God, a view of God as frightening, “negative”religious
coping, and spiritual struggles. Notably, these examples often represent the flip side of the
salubrious religious parameters discussed in the bulk of this article. From an attachment perspec-
tive, it seems plausible to assume that experiences of particularly insensitive and perhaps even
aberrant and abusive caregiving might, through generalising working models, ultimately lead
to such problematic ways of representing and experiencing God. Further, it may be conjectured
that the more adverse one’s past attachment-related experiences have been (e.g., seriously abusive
versus somewhat inconsistent or rejecting), the more difficult it will be to find in God a functional
surrogate attachment figure, and more generally to derive salubrious effects from one’s religion.
Extrapolating from past research findings in support of the notion of social correspondence
(Granqvist & Kirkpatrick, 2008,2013), this is hypothesised to be especially difficult for individ-
uals whose childhood caregivers were not just inadequate as attachment figures but who were also
actively religious themselves. For example, if they preached about a loving God, that God would
be difficult to have faith in. If they preached about a wrathful God, there would be every reason to
believe in that God.
As a methodological direction for future research on different ways of representing one’s
attachment to God, it is imperative to construct less explicit methods of evaluation to avoid
falling prey to the self-report biases that threaten the validity of extant attachment to God ques-
tionnaires. We currently address this issue by using an interview about believers’representations
of God in relation to the self (Granqvist & Main, 2003) which was adapted from the Adult Attach-
ment Interview protocol. This interview method may ultimately prove to be useful also for shed-
ding light on the attachment foundation of the religion–mental health connection, and particularly
on the important question of whether earned security is sometimes derived from one’s attachment
to God.
In closing, I have noted that attachment theory is not a comprehensive theory for understand-
ing links between religion and mental health. It is highly likely that there are other therapeutic
components of religion than those identified through attachment theory, for example, a provision
of meaning in life, social and existential support through affiliative relationships within one’s reli-
gious community, a sense of belonging in a relatively cohesive group of like-minded individuals,
and an ethical code for how to behave and for how to identify the goods and ills in life. At the end
of the day, however, rather than being reducible to the sum of these and other separate com-
ponents, perhaps the main benefit of religion is the sense of integration (or unity) brought to
the self through the many different psychological, social, and cultural functions brought together
by one’s religion, and centring around one’s perceived relationship with God (cf. James, 1902). In
comparison with religion, the rest of our contemporary, hyper pluralistic societies often work in
the very opposite direction. We divide our minds and selves among the many jurisdictions and
pieces surrounding us –work, science, fiction, therapy, medicine, self-help projects, survivor
groups, social welfare functions, and so on; they all serve to make life temporarily manageable
while side-stepping its foundational questions and ignoring the self’s ultimate call for a source
of unity, be it illusory or not.
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