International Journal of Coercion, Abuse, and Manipulation Volume 9 2026 116
Contemporary psychiatry increasingly recognises that
conditions such as autism and ADHD play a crucial
role in vulnerability and resilience. Symptoms like
hyperfocus, restricted repetitiveness, rigidity, and
impulsivity can act as push–pull factors for religiosity
and cult membership, and may also influence
progression within cult hierarchies. Substance use and
addictions, including behavioural addictions, are also
very common comorbidities in mental health patients.
Often risks in psychotic patients are associated with
comorbid alcohol and illicit drug misuse—with
prevalence well over 50% in forensic settings. Mental
health patients often self-medicate with drugs, which
can also fuel psychopathology, as well as disinhibition
and risky behaviour. In undertaking risk assessments
in complex patients, I consider a triad of psychiatric
diagnoses, neurodiversity, and substance use that can
interact and increase forensic risks and vulnerability.
The chapters on epilepsy are provocative, and such
historical interpretations are subject to bias and
controversy. Distinguishing between neurological
and psychiatric phenomena can be a challenge,
and misdiagnosis can have serious consequences.
Temporal lobe epilepsy, for example, has historically
been confused with paranoid schizophrenia, yet the
two conditions require different interventions. Epilepsy
can present with vivid multisensory hallucinations,
mood swings, and prominent fear and anxiety, which
can act as a driving force of religiosity.
Psychobiographies and Godly Visions is an important
contribution. Kent demonstrates that psychopathology,
mental illness, and neurological illness cannot be
excluded from serious study of religious experience and
cult formation. His insistence on an interdisciplinary
biopsychosocial model is the appropriate way forward.
Goffman’s Asylums (1961) was criticised for its siloed
sociological modelling, and it has had unintended
influence on defunding precious inpatient units.
Involvement of clinicians, as well as those affected by
mental health conditions—patients and their carers—
would be advised when making such broad assertions.
This excellently referenced book is important reading
for trainees in psychiatry, as well as scholars of cults
and religiosity. As a clinician, I read this book with a
view to how it can be used in prevention, safeguarding
patients. It must, however, also be read with awareness
of its potential to overgeneralise, over-pathologise,
and inadvertently further stigmatise mental illness and
the mentally ill.
Contemporary psychiatry increasingly recognises that
conditions such as autism and ADHD play a crucial
role in vulnerability and resilience. Symptoms like
hyperfocus, restricted repetitiveness, rigidity, and
impulsivity can act as push–pull factors for religiosity
and cult membership, and may also influence
progression within cult hierarchies. Substance use and
addictions, including behavioural addictions, are also
very common comorbidities in mental health patients.
Often risks in psychotic patients are associated with
comorbid alcohol and illicit drug misuse—with
prevalence well over 50% in forensic settings. Mental
health patients often self-medicate with drugs, which
can also fuel psychopathology, as well as disinhibition
and risky behaviour. In undertaking risk assessments
in complex patients, I consider a triad of psychiatric
diagnoses, neurodiversity, and substance use that can
interact and increase forensic risks and vulnerability.
The chapters on epilepsy are provocative, and such
historical interpretations are subject to bias and
controversy. Distinguishing between neurological
and psychiatric phenomena can be a challenge,
and misdiagnosis can have serious consequences.
Temporal lobe epilepsy, for example, has historically
been confused with paranoid schizophrenia, yet the
two conditions require different interventions. Epilepsy
can present with vivid multisensory hallucinations,
mood swings, and prominent fear and anxiety, which
can act as a driving force of religiosity.
Psychobiographies and Godly Visions is an important
contribution. Kent demonstrates that psychopathology,
mental illness, and neurological illness cannot be
excluded from serious study of religious experience and
cult formation. His insistence on an interdisciplinary
biopsychosocial model is the appropriate way forward.
Goffman’s Asylums (1961) was criticised for its siloed
sociological modelling, and it has had unintended
influence on defunding precious inpatient units.
Involvement of clinicians, as well as those affected by
mental health conditions—patients and their carers—
would be advised when making such broad assertions.
This excellently referenced book is important reading
for trainees in psychiatry, as well as scholars of cults
and religiosity. As a clinician, I read this book with a
view to how it can be used in prevention, safeguarding
patients. It must, however, also be read with awareness
of its potential to overgeneralise, over-pathologise,
and inadvertently further stigmatise mental illness and
the mentally ill.
