Religious and Spiritual Aftermath of War

1. Religious and Spiritual Aftermath of War James K. Boehnlein, MD Professor of Psychiatry Oregon Health and Science University Associate Director for Education VA Northwest Network Mental Illness Research, Education and Clinical Center (MIRECC)

2. Questions After Trauma • Unpredictability of life and death • Loss • Moral Complexities

3. Religion Across Cultures • Explanation of how universe began, how life is maintained, what happens when life ceases to exist • Explanation of life’s meaning and rationale for suffering • Symbols, beliefs, values • Relationship between the self and the world

4. Spirituality • Bridges religion and science • Insightful relationship between self and others • Personal values • Meaningful purpose for life • Connectedness between self and the natural/supernatural

5. Explanatory FrameworksPain, suffering, atonement, forgiveness • Judaism – Restoration of relationship with God through atonement • Christianity – Repentance, forgiveness and rebirth • Buddhism – Acceptance of suffering; reincarnation • Islam – Death divinely ordained – impact on survivor guilt • Hinduism – Suffering a result of conflict/tension

6. Core Assumptions Altered by Trauma • Belief in personal invulnerability • Perception of an understandable world • Trust in self and others

7. Trust Security Acceptance Identity and Self-Worth Social Connectedness Grief and mourning Anger and Revenge Control Meaning Healing After Trauma: Psychotherapeutic Themes

8. Clinician Reactions • Sadness • Anger • Vulnerability • Fatigue • Intolerance of other patients • Intolerance/avoidance of violence images • Indifference vs. overinvolvement

9. Ethical Principles in Treatment • Creation of trust, predictability • Cause no harm • Respect for personal boundaries • Primacy of reducing suffering and promoting health • Respect for patient autonomy, independence, and creativity • Promotion of justice