“And [Jesus] said to them,‘The Sabbath was made for man,
not man for the Sabbath.”1
Conversations with students at Hope College about Sabbath often share a couple themes. First, students wonder about what Sabbath means for Christians in a theological sense. Second, they ponder how to practice Sabbath in terms of the timeframe and activities. After reflecting on Sabbath, students tend to positively embrace the idea of Sabbath but find implementing Sabbath into college life difficult. Keeping Sabbath as a portion of a Sunday and including others in Sabbath activities have been helpful practices for my friends and me. Rather than expand on the beautiful theological meaning of Sabbath or recommendations for practice, I aim to explore how Sabbath is related to health in empirical psychological literature.
At Hope College, I have enjoyed the opportunity to conduct psychology research at the intersection of health and religion. Broadly, religiousness is associated with better health.2 This association is partly explained by social, behavioral, and psychological mediators. For example, religious people often experience social support from their religious communities. Religion supports salubrious health behaviors through two directions. First, religions often encourage positive health behaviors like good nutrition and exercise. Second, many religions provide prohibitions against harmful health behaviors, such as alcohol use and smoking. Psychological mediators of religion and health include having a coherent worldview, hopefulness, and utilizing effective coping mechanisms for anxiety through prayer, meditation, or other spiritual practices.
Much research explores broad links between health and religious affiliation or religious service attendance, but there is not much work on the specific ritual of Sabbath-keeping. I attempt to outline the current knowledge of how Sabbath is related to health and well-being. I chose to explore how Sabbath-keeping related to health because it is connected to social, behavioral, and psychological practices that could effectively cause better health. People who keep Sabbath might spend their day attending religious services and enjoying quality time with family and friends. Additionally, they may take time for rest and restoration by getting sleep and mentally disengaging from their daily stressors. Finally, they may spend time praying and reflecting on their ultimate values. Altogether, I expected Sabbath practice to be robustly linked to physical and mental health.
Throughout this review, I will explore many groups of Sabbath-keepers, including Jews in various countries, Christians of various Sabbath-keeping and non-Sabbathkeeping denominations, and even those who identify as nonreligious/secular. I will describe three theoretical models of Sabbath and psychological well-being, the association between Sabbath and mortality, the practice and experience of Sabbath-keeping, the mediators of Sabbath and health, the role of technology use, the expansion of health to include spiritual health, and the clinical implications of this research.
Models of Sabbath and Psychological Well-Being
One psychological theory of how Sabbath-keeping may be related to better psychological well-being was created by Margaret Diddams and colleagues.3 Their theory divided Sabbath keeping into three progressive stages: the Life Segmentation model, Prescribed Meaning model, and Integrated Sabbath model. Within the Life Segmentation model, boundaries are intentionally and regularly created to separate Sabbath from work so that people can be involved in leisure and family time. Many people who apply this broad Sabbath model to their lives do not call it “Sabbath” or engage in religious practice. Instead, it might be described as work-life balance for the purpose of avoiding burnout. Psychological literature suggests that Life Segmentation is an effective coping strategy for stress management and can promote greater resiliency.4
Next, the Prescribed Meaning model adds a positive meaning to the time that has been effectively segmented in the first model. Religious people often add worship, celebration, prayer, and study to their Sabbath time. This model moves beyond using Sabbath as a tool to become more productive on the other six days because people understand the meaning of Sabbath-keeping to be more than avoiding burnout.5
Finally, the model of Integrated Sabbath is built on a preexisting psychological framework called Self-Determination Theory. Self-Determination Theory describes three themes that drive people’s internal motivation: autonomy, competence, and relatedness. When behaviors are internally motivated, people will experience greater wellbeing and better performance of those behaviors. Within the context of Sabbath-keeping, the three themes are identified as rest, reflection, and relationships.6 Rest is an autonomous choice that, like psychological research on autonomy demonstrates, leads to well-being. Likewise, competence in maintaining a time of Sabbath reflection will improve self-efficacy and hope. Even if people cannot improve their situation through their own actions of self-efficacy, their Sabbath reflections of divine efficacy yield “transcendent hope.”7 Finally, relatedness and relationships fulfill the need to belong. Sabbath-keeping becomes internalized when rest, reflection, and relationships shape a person’s whole life. According to Self-Determination Theory, an integrated Sabbath leads to personal growth and well-being.
Altogether, this theory suggests that all three Sabbath models support positive psychological well-being. Further, the Integrated Sabbath model includes a mindset that will extend into all of life, so it may be the most salient.8
Sabbath and Mortality
The earliest study of Sabbath and health that I identified took an epidemiological approach by investigating the ultimate health outcome — mortality — within the country of Israel. Jon Anson and Ofra Anson studied how Sabbath days were associated with lower mortality levels for Jews in Israel.9 Researchers utilized a correlational study based on 261,813 recorded deaths in Israel from 1983 to 1992; the deaths of Jewish adults demonstrated a significant pattern of decreasing on the Sabbath day compared to the other days of the week.10 This decline in mortality was not found for Jewish children or non-Jewish people living in Israel. Additionally, the decline in mortality was found for both external and internal causes of death.11 External causes of death included occupational and traffic accidents, while internal causes of death included cerebrovascular, cardiovascular, and malignant diseases.12 The decline in mortality from external causes may be explained by Sabbath rules, such as not driving, but the decline of internal causes of death on Sabbath reveals the influence of Sabbath as a social and religious phenomenon.
In an expansion of their previous work, Anson and Anson controlled for long-term and seasonal trends in mortality, but interestingly, they did not find a similar decrease in deaths during other holy days.13 Researchers suggest that there may be a specific Sabbath effect, rather than a general holy day effect. The health-promoting effects of Sabbath may have to do with the frequency and consistency of observing the Sabbath.
The Sabbath Experience
The next set of studies I reviewed are qualitative interviews taken from different religious populations.
Simon Dein and Kate Miriam Loewenthal conducted semi-structured interviews of thirteen orthodox Jews in the UK and US.14 The purpose of this study was to investigate how orthodox Jews in the UK and US perceived the benefits of observing the Sabbath. After the interviews, researchers conducted a thematic analysis and found that the Sabbath was perceived as different from other days. More specifically, Sabbath provided a time to reflect on ultimate values and strengthen relationships.15 Additionally, participants reported that they had a better mood and dealt with less stress on the Sabbath. Even so, some Sabbath observers identified that they felt increased worry on the Sabbath due to the lack of distraction and inability to take action. Overall, the majority reported that Sabbath improved their well-being.16
Barbara Baker Speedling conducted semi-structured interviews of ten women who were not part of Sabbath-keeping communities, with the goal of observing how Sabbath-keeping might benefit people who do not have strong community support for Sabbath observance.17 The ten women were not part of Sabbath-keeping communities but had practiced Sabbath for at least six months. Speedling identified six overarching themes: “Sabbath-keeping enhanced self-awareness, improved self-care, enriched relationships, developed spirituality, positively affected the rest of a Sabbath-keeper’s week, and Sabbath-keeping practices and philosophies also evolved over time.”18 Based on these findings, the researcher recommended that healthcare professionals promote Sabbath-keeping, and for people who do not wish to keep Sabbath in a religious way, Speedling suggested that a secular Sabbath include slow living, simplicity, taking a technology break, and avoiding economic behavior.19 Although this study was subjective, it provided support for how Sabbath may improve self-awareness, selfcare, relationships, and spirituality.
Another qualitative study conducted by Erik C. Carter used a phenomenological approach to open-ended, semistructured interviews of Seventh-day Adventist pastors to gather descriptions of Sabbath-keeping.20 Sabbath-keeping was strictly limited to the seventh day per the beliefs of Seventh-day Adventists, which can be the busiest day of the week for pastors. Carter selected five participants from the Kentucky-Tennessee Conference of Seventh-day Adventists based on the participants’ different life stages, education levels, and church district organizations. Results indicated that the pastors found the Sabbath to be both restful and stressful.21 The pastors only reported stress in the morning when they were busy managing church service details and anxious about preaching.22 Paradoxically, these same experiences of greeting people and preaching were viewed as joyful and energizing.23 All the pastors spent about thirty minutes in prayer before leading a church service, and the afternoon was spent in spiritual rest, enjoying nature, and, especially for pastors with children, connecting with family.24 Carter concluded that there was a range of practices and experiences in Sabbath-keeping among Seventh-day Adventist clergy, but there was a shared difficulty in creating boundaries to prevent overcommitment.25 Although this study’s sample is narrow, it provided a helpful understanding of the lived experience of stress and joy that can be present in Sabbath practice.
Mediators of Sabbath and Health
In addition to the qualitative interview studies, some researchers have taken a quantitative approach utilizing surveys. These studies often look at various social, behavioral, and psychological mediators that connect Sabbath practice to health.
Recently, Rae Jean Preschoeld-Bell and colleagues conducted a study involving a Sabbath-promoting workshop intervention for United Methodist clergy in order to compare mental and spiritual health at baseline, three months after the workshop, and nine months after the workshop.26 This longitudinal study design was unique compared to the other cross-sectional Sabbath studies because it could associate changes in Sabbath-keeping with changes in mental health over time. The final sample consisted of 129 United Methodist clergy in North Carolina who completed all three surveys. The workshop was led by the non-governmental organization Blessed Earth, varied in length from three to fifteen hours, and involved Bible passages, prayer, anecdotes, reasons, and a vision for Sabbath-keeping.27 Additionally, discussion time, question time, and post-workshop resources were included. Overall, participants increased in their Sabbath-keeping behavior throughout time, but there was no control group for comparison. Increasing Sabbath observance was associated with greater feelings of personal accomplishment at work.28 Also, participants who began observing Sabbath after nonobservance at baseline decreased their emotional exhaustion. Decreasing Sabbath observance was associated with worsened spiritual and mental health. Researchers concluded that there was a small, beneficial relationship between Sabbath-keeping and mental health. They also allowed participants to self-define Sabbath practice and suggested that future research utilize a stricter definition of Sabbath.29
Devon J. Superville and colleagues quantitatively tested religious support and religious coping as potential mediators of Sabbath and health.30 The purpose of this study was to investigate how Sabbath-keeping was related to health and whether this relationship was mediated by religious coping, religious support, diet, or exercise. This study used a correlational method based on data from the Biopsychosocial Religion and Health Study. Of the 5,411 participants, 97% were Seventh-Day Adventists. Altogether, researchers found that there was a significant correlation between Sabbath-keeping and improved mental health. Researchers did not find a significant association between Sabbath-keeping and physical health.31 The association between Sabbath-keeping and improved mental health was partially mediated by religious coping, religious support, diet, and exercise. Further, the effects of religious coping and religious support were more salient compared to diet and exercise.32 Researchers could not rule out the possibility of reverse causality that increased mental health led to increased Sabbath-keeping.
Drawing on the Sabbath and psychological well-being theory developed by Diddams and colleagues,33 Karl G. D. Bailey and Arian C. D. Timoti investigated how people who had higher levels of Sabbath-keeping internalization displayed greater subjective well-being.34 This study was based in Self-Determination Theory, which posits that human needs for competence, autonomy, and relatedness drive the process of internalizing motivation. Using a survey, researchers gathered data on 362 students from a Sabbath-keeping university community. A vast majority of the sample identified as Seventh-day Adventist Christians. Participants with higher levels of Sabbath-keeping internalization displayed greater subjective well-being.35 This study provided support for the theory that the Integrated Sabbath model would yield the greatest well-being as described by Diddams and colleagues.36
Sabbath and Technology Use
One unique study focused on electronic media use within the relationship between Sabbath practice and psychological well-being. Eliyakim Herkshop and colleagues explored whether Sabbath-keeping Jews’ experience of electronic media abstinence depended on whether it took place on a weekday or the Sabbath.37 Researchers were interested in technology addiction as a poor mental health outcome that includes distress, irritability, and anxiety. Previous research found that Jewish smokers experienced less cravings and fewer withdrawal symptoms when abstaining on the Sabbath compared to a non-Sabbath day. Thus, researchers hypothesized that Jews would experience a better mood and less adverse psychological reactions when abstaining from electronic media on a Sabbath day compared to a non-Sabbath day.38
Ten Jewish participants in their twenties agreed to participate in the study. Retrospective reporting was utilized at two separate time points following the Sabbath because writing was prohibited on the Sabbath. Researchers compared the reported adverse psychological reactions between weekday abstention and Sabbath abstention for the two different time points and found that participants experienced less adverse psychological reactions on the Sabbath, including less anxiety, thoughts and plans of using devices, restlessness, and overall difficulty to abstain.39 Researchers suggested that their small sample size and a selection bias of recruiting people confident in their ability to abstain on weekdays may have influenced the results.40 One potential explanation for these results is that Jewish society does not expect Jews to be accessible via electronic media on the Sabbath, which may ameliorate psychological pressure. Future research is still needed to provide empirical support for Speedling’s suggestion of incorporating a technology break into a secular Sabbath for people who do not belong to a Sabbath-keeping community.41
Inclusion of Spiritual Health
Holly Hough and colleagues investigated how Sabbath-keeping was associated with mental, physical, and spiritual well-being among United Methodist clergy. Broadening this area of research to a biopsychosociospiritual model of health may provide valuable insights.42 This correlational study surveyed 1,316 United Methodist clergy. Sabbath-keeping was associated with better mental health, but this relationship was not significant after adjusting for sociodemographic, rest, and social support variables. Sabbath-keeping was not associated with better physical health. Nevertheless, Sabbath-keeping was significantly associated with better spiritual well-being, better quality of life, and increased satisfaction with relationships.43 This finding is in-line with the Sabbath improvement in spirituality noted by Speedling44 and Proeschold-Bell and colleagues.45
The Student Experience of Sabbath
Jama L. White and colleagues described how Sabbath might be beneficial for graduate students in mental health fields and with Judeo-Christian backgrounds.46 The purpose of this study was to investigate how Sabbath might be beneficial for mental health professionals using quantitative and qualitative methods. Participants were 296 graduate students in mental health fields who had a Judeo-Christian background. From quantitative analyses, researchers found that Sabbath-keepers had greater satisfaction with the amount of rest compared to non-Sabbath keepers. From qualitative analyses, researchers identified that barriers to rest were lack of sleep, obligations to school or family, and inner turmoil of anxiety, guilt, and stress.47
Overall, Sabbath-keeping was beneficially related to mortality, well-being, mental health, spiritual health, technology addiction, and relationship satisfaction. Researchers interested in the links between religiousness and health should continue exploring this nascent area of research because of its promising implications for health promotion. Specifically, researchers should develop well operationalized and controlled experimental studies, preferably longitudinal, to explore the causal relationship between Sabbath practice and health in a broad population. Additionally, researchers should work to identify the strongest mediators so that the most effective Sabbath practices can be encouraged.
While the study of Sabbath and health is yielding exciting insights in its incipient stage, the underdevelopment of shared research methods creates limitations. For example, the small sample sizes of narrowly-defined populations results in a consistent problem of low generalizability. Additionally, the lack of experimental studies that include a control group prevent us from drawing causal inferences between Sabbath practice and health. Reverse causality that decreased health caused decreased Sabbath-keeping is a viable possibility. Also, a third cause, such as life stress, could lead to decreased Sabbath-keeping and worsened mental health. Finally, researchers failed to use a consistent definition of Sabbath. When research develops in the future, multiple definitions of Sabbath may need to be developed to account for different practices of different religious traditions. Regardless, stricter and more well-defined Sabbath definitions are much needed.
Although the limitations of previous research make it currently tenuous to prescribe Sabbath-keeping as an evidence-based health intervention, pastors and psychologists should be encouraged that a variety of benefits have been found for a variety of populations. People who adhere to Sabbath-keeping generally find benefits. The beneficial possibilities of Sabbath outweigh the difficulties of creating Sabbath boundaries. As future research substantiates the link between Sabbath-keeping and health, healthcare professionals may advise a Sabbath for both religious and secular people to enjoy rest, reflection, and relationships. Altogether, it is valuable to consider how the practice of Sabbath might improve physical, mental, and spiritual health.
Amy Osterbaan ’22 is majoring in Psychology and Exercise Science and minoring in Religion. She is from Ada, MI. We thank Dr. Alyssa Cheadle (Psychology) for her involvement with Amy’s piece.
1 Mark 2:27
2 Harold G. Koenig, Dana E. King, and Verna Benner Carson, Handbook of Religion and Health, 2nd ed., (Oxford University Press, 2012).
3 Margaret Diddams, Lisa Klein Surdyk, and Denise Daniels,“Rediscovering Models of Sabbath Keeping: Implications for Psychological Well-Being,” Journal of Psychology and Theology 32, no.1 (2004): 3–11. https://doi. org/10.1177/009164710403200101
4 Diddams, Surdyk, and Daniels, “Rediscovering Models,” 4–5.
5 Diddams, Surdyk, and Daniels, “Rediscovering Models,” 5–6.
6 Diddams, Surdyk, and Daniels, “Rediscovering Models,” 6–7.
7 Diddams, Surdyk, and Daniels, “Rediscovering Models,” 7.
8 Diddams, Surdyk, and Daniels, “Rediscovering Models,” 7–9.
9 Jon Anson and Ofra Anson, “Thank God it’s Friday: The Weekly Cycle of Mortality in Israel,” Population Research and Policy Review 19, no. 2 (2000): 143–154. https://doi.org/10.1023/A:1006483623664
10 Anson and Anson, “Thank God it’s Friday,” 147–149.
11 Anson and Anson, “Thank God it’s Friday,” 146–153.
12 Anson and Anson, “Thank God it’s Friday,” 147–149.
13 Anson and Anson, “Thank God it’s Friday.”
14 Simeon Dein and Kate Miriam Loewenthal, “The Mental Health Benefits and Costs of Sabbath Observance Among Orthodox Jews,” Journal of Religion and Health 52, no. 4 (2013): 1382–1390. https://doi.org/10.1007/s10943- 013-9757-3
15 Dein and Loewenthal, “Mental Health Benefits,” 1386.
16 Dein and Loewenthal, “Mental Health Benefits,” 1382–1390.
17 Barbara Baker Speedling, “Celebrating Sabbath as a Holistic Health Practice: The Transformative Power of a Sanctuary in Time,” Journal of Religion and Health 58, no. 4 (2019): 1382–1400. https://doi.org/10.1007/s10943-019- 00799-6.
18 Speedling, “Celebrating Sabbath,” 1388.
19 Speedling, “Celebrating Sabbath,” 1395–1396.
20 Erik C. Carter, “The Practice and Experience of the Sabbath Among Seventh-Day Adventist Pastors,” Pastoral Psychology 62, no.1 (2013): 13–26. https://doi.org/10.1007/s11089-012-0482-8.
21 Carter, “Practice and Experience,” 16–18.
26 Rae Jean Proeschold-Bell et al., “Changes in Sabbath-Keeping and Mental Health Over time: Evaluation Findings From the Sabbath Living Study,” Journal of Psychology and Theology, (2021). https://doi. org/10.1177/00916471211046227.
27 Proeschold-Bell et al., “Changes in Sabbath-Keeping.”
30 Devon J. Superville, Kenneth I. Pargament, and Jerry W. Lee, “Sabbath Keeping and Its Relationships to Health and Well-Being: A Mediational Analysis,” The International Journal for the Psychology of Religion 24, no. 3 (2014): 241–256. https://doi.org/10.1080/10508619.2013.837655.
31 Superville, Pargament, and Lee, “Sabbath Keeping,” 241–256.
33 Diddams, Surdyk, and Daniels, “Rediscovering Models.”
34 Karl G.D. Bailey and Arian C.B. Timoti,“Delight or Distraction: An Exploratory Analysis of Sabbath-Keeping Internalization,” Journal of Psychology and Theology 43, no.3 (2015): 192–203. https://doi. org/10.1177/009164711504300304
35 Bailey and Timoti, “Delight or Distraction,” 195.
36 Diddams, Surdyk, and Daniels, “Rediscovering Models.”
37 Eliyakim Hershkop et al., “Electronic Media Abstinence in Sabbath Observant Jews: A Comparison Between the Weekday and Sabbath,” The Israel Medical Association Journal 22, no. 9 (2020): 587–593.
38 Hershkop et al, “Electronic Media Abstinence,” 587–593.
39 Hershkop et al, “Electronic Media Abstinence,” 587–593.
41 Speedling, “Celebrating Sabbath.”
42 Holly Hough et al., “Relationships Between Sabbath Observance and Mental, Physical, and Spiritual Health in Clergy,” Pastoral Psychology 68, no. 2 (2019): 171–193. https://doi.org/10.1007/s11089-018-0838- 9.
44 Speedling, “Celebrating Sabbath.”
45 Proeschold-Bell et al., “Changes in Sabbath-Keeping.”
46 Jama L. White, Amanda M. Blackburn, and Mary K. Plisco, “Rest as a Virtue: Theological Foundations and Application to Personal and Professional Life,” Journal of Psychology and Theology 43, no. 2 (2015): 98–120. https:// doi.org/10.1177/009164711504300203
47 White, Blackburn, and Plisco, “Rest as a Virtue,” 98–120.