This brief and challenging book insightfully addresses the features, meaning and implications of spiritual voices and visions. It investigates the experiences of three key medieval religious women who have had an enormous impact throughout centuries – Julian of Norwich, Margery Kempe and Joan of Arc – and it is welcome for several reasons. The relevance of religious and spiritual beliefs and practices for the mental health field has been well established based on robust scientific evidence. However, a key source of spirituality (i.e. spiritual experiences) has been largely neglected in research and clinical practice. This book examines this previously neglected area. In addition, previous psychopathographies of religious figures have often been based on secondary sources and biased by a narrow perspective and lack of proper religious and psychiatric knowledge on the part of most authors. The divergent conclusions reached usually reflected the authors’ mindsets more than the analysed religious figures. This book helps address these limitations by focusing on primary sources and using an interdisciplinary secondary bibliography. The author has very considerable background knowledge in religion and psychiatry, as well as in the relationship between these two.

At the core of each book are three chapters dedicated to the mystics in three sections: description and analysis of their spiritual visionary and auditory experiences (focusing on their self-reports), discussion of their possible medical diagnosis and their spirituality. The fourth and final chapter discusses the main implications for psychiatry today: voices/visions may be spiritually meaningful, help in spiritual coping and be both positive and negative experiences. The author also concludes that the focus should be on exploring the meaning of these experiences and on distinguishing genuine spiritual experiences from mental disorders (with which I partially disagree).

Despite being a short book, two other themes could have been briefly discussed. The first is the critical spiritual insights those extraordinary women had based on their experiences that have consistently challenged and inspired humanity for many centuries. The second and perhaps more important omission is the lack of discussion of the transcendental (also called ‘paranormal’ or ‘anomalous’) knowledge allegedly conveyed through these experiences. These were (and still are) cited as one of the (if not main) reasons why these women and others believed the experiences were actual spiritual experiences and not just illusions, fantasy, trickery or madness. For example, Margery and Joan are reported to have had many precognitive experiences that came true. Joan was also allegedly able to locate a long-lost sword and tell the Dauphin's secret thoughts. In addition, despite being an illiterate poor peasant, she showed the advanced skills needed to command an army with victorious battle strategies. The wisdom of her answers (dictated by her voices) to many highly complex theological questions posed at her trial by professors from the University of Paris is also striking. This sort of evidence was essential for the spiritual meaning attributed to their experiences.

In summary, this is a much needed and very welcome book that opens the door to improving psychiatric research, theory and practice.