Sacred Matters: The Spiritual Dimension of Psychotherapy

1. Sacred Matters:The Spiritual Dimension of Psychotherapy Kenneth I. Pargament Department of Psychology Bowling Green State University Presentation to Houston Psychoanalytic Society April 26, 2014

2. Overview • We are spiritual as well as psychological, social, and physical beings • People bring their spirituality to psychotherapy • Spirituality can be a resource or a source of problems • Psychotherapists enhance their effectiveness by assessing and attending to both spiritual resources and spiritual problems in treatment

3. Theoretical Biases • Shaped by Our Genetics

4. Theoretical Biases • Products of Our Environment

5. Theoretical Biases • Personality Formed Early in Life

6. The Harvard Law of Animal Behavior • “Under controlled experimental conditions of temperature, time, lighting, feeding, and training, the organism will behave as it damned well pleases” (Pinker, 2002, p. 177).

7. A Radical Assumption • We are goal directed beings • We seek significance

8. Significant Strivings • Psychological (e.g., comfort, peace of mind, self-esteem) • Social (e.g., love, family, status) • Physical (e.g., health, fitness) • Material (e.g., money, possessions) • Spiritual (e.g., sacredness, closeness with God, ultimate meaning, transcendence)

9. The Varieties of the Sacred • People “God has a deep raspy voice – God is a jazz singer. She is plush, warm, and rosy – God is a grandmother. He has the patient rock of an old man in a porch rocker; He hums and laughs, he marvels at the sky. God coos at babies – she is a new mother. He is the steady, gentle hand of a nurse, the cool reassurance of a person pursuing his life’s work, and the free spirit of a young man wandering only to live and love life” (McCarthy, 2006).

10. The Varieties of the Sacred • People • Nature “Whatever happens in the world to me or others, nature is still there, it keeps going. That is a feeling of security when everything else is chaos. The leaves fall off, new ones appear, somewhere there is a pulse that keeps going. The silence, it has become so apparent, when you want to get away from all the noise. It is a spiritual feeling, if we can use that word without connecting it to God, this is what I feel in nature and it’s like a powerful therapy” (p. 134).

11. The Varieties of the Sacred • People • Nature • Virtues “Where is God? God is found in the incredible resiliency of the human soul, in our willingness to love though we understand how vulnerable love makes us, in our determination to go on affirming the value of life even when events in the world would seem to teach us that life is cheap.”

12. The Varieties of the Sacred • People • Nature • Virtues • Relationships • “The relationship to a human being is the proper metaphor for the relation to God – as genuine address here is accorded a genuine answer” (Martin Buber, I and Thou)

13. Ways to Think about Spirituality • Spirituality is a magnet

14. Searching for the Sacred at an Early Age “Dear God, How is it in heaven? How is it being the Big Cheese?” Young Child (Heller, 1986, p. 31)

15. Children as Spiritual Beings • The capacity for spiritual experience and knowledge • The capacity to think about God as unique rather than humanlike • The capacity to conceive of an immaterial spirit and an afterlife • The capacity to experience spiritual emotions

16. Ways to Think about Spirituality • Spirituality is a magnet • Spirituality is an organizing force

17. The Sacred as an Organizing Force “ If the foot shall say, Because I am not the hand, I am not of the body; it is therefore not of the body? If the whole body were an eye, where were the hearing? If the whole were hearing, where were the smelling? . . . But now are they many members, yet but one body. And the eye cannot say unto the hand, I have no need of thee, nor again the head to the feet, I have no need of you. Nay, much more those members of the body, which seem to be more feeble, are necessary” (I Corinthians 12: 15, 17, 20-22).

18. Ways to Think about Spirituality • Spirituality is a magnet • Spirituality is an organizing force • Spirituality is good and bad

19. Hidden Ingredients in the Recipe for Change:The Case of Alice • Prelude

20. Hidden Ingredients in the Recipe for Change:The Spiritual Resources of Alice • Prelude • Interlude

21. Mental Health Professionals are Abnormal • Percentage of Americans who state that they believe in God 95% • Percentage of clinical psychologists who state that they believe in God 25%

22. A History of Tension between Psychology and Religion Religion works “by distorting the picture of the real world in delusional manner. . . by forcibly fixing [adherents] in a state of psychical infantilism and by drawing them into a mass delusion” (Freud, 1930, pp. 31-32, Civilization and Its Discontents).

23. A History of Tension between Psychology and Religion “Obviously the sane and effective psychotherapist should not go along with the patient’s religious orientation and try to help these patients live successfully with their religions, for this is equivalent to trying to help them live successfully with their emotional illness” (Ellis, 1986, p. 15; The Case against Religion).

24. Lack of Training • Less than 20% of clinical and counseling psychology programs provide graduate students with any training in psychology of religion and spirituality

25. How Practitioners Cope with the Religion of their Clients • Change the subject

26. Religion as a Predictor of Mortality • Hummer et al. (2000) • National sample of adults • Frequent church attendance is tied to 7 year increase in life expectancy • Frequent church attendance is tied to 14 year increase in life expectancy among African-Americans

27. Most Frequent Method of Coping • Conway (1985-1986) • Black and white elderly women with medical problems • Prayer was most frequent method of coping • Prayer was more common than resting, seeking information, prescription drugs, or going to a physician

28. Positive Spiritual Coping:Benevolent Spiritual Appraisals “I was told by the swamis early in my study of Vedanta that disability was present in my life so that I could grow in new ways and progress along the path to God consciousness. . . This life is riddled with physical frustrations but wealthy with opportunities for spiritual growth” (Nosek, 1995, Hindu woman disabled with neuromuscular disorder)

29. Positive Spiritual Coping:Spiritual Support

30. Positive Spiritual Coping:Spiritual Support “I’m speaking to my higher power, my God. And I give thanks to that power. It has been a source of strength. You know, it’s like tapping in to some sort of power source that I can recharge my batteries” (Siegel & Scrimshaw, 2002).

31. Positive Spiritual Coping:Active Spiritual Surrender “I pray a lot. I gave it to God because I couldn’t deal with it, it was too stressful for me. It was like a load had been lifted off of me. I didn’t have to worry about that because I knew it was in God’s hands. . . Before I thought I was running everything, but I realized that it’s God that’s in charge of everything about me (Siegel & Scrimshaw, 2002).

32. Positive Spiritual Coping:Seeking Support from Religion “The pastor there, he doesn’t look down on a person because of HIV. . . And when the congregation prays, they pray for all different kinds of thinigs without saying anyone in particular and they also pray for people what are HIV positive and who have AIDS. So that’s my support group really, is my church” (55- year old Puerto Rican Baptist woman, Siegel & Scrimshaw, 2002).

33. Positive Spiritual Coping:Spiritual Purification “In the beginning when I was first diagnosed and everything, I was angry at myself. . . Through the spiritual part of my life, I’ve gotten to be understanding that I have to forgive myself and I have to forgive him (the man that infected me), and God forgives both of us” (Siegel & Scrimshaw, 2002).

34. Positive Spiritual Coping:Quantum Change in Men • Wealth • Adventure • Achievement • Pleasure • Respect • Spirituality • Personal peace • Family • God’s will • Honesty

35. Rise in Reports of Mystical Experiences (Gallup, 2010) • 22% of Americans report mystical experience (sudden religious insight or awakening) in 1962 • 49% of Americans report mystical experiences in 2009

36. How Practitioners Cope with the Religion of their Clients • Change the subject • Reduce religion to something presumably more basic • A form of anxiety-reduction • A method of impulse control • A way to achieve social connectedness • A means to find meaning in life • A source of evolutionary advantage

37. Ellison et al. (2001) • Probability sample of adults in Detroit • Religious variables tied to distress and well-being • Effects not mediated by self-esteem, mastery, social support, or other psychosocial variables • “The salutary effects of religious involvement cannot be explained away in terms of social or psychological resources, at least insofar as these constructs are conventionally conceptualized and measured” (p. 243).

38. Hidden Ingredients in the Recipe for Change:The Spiritual Resources of Alice • Prelude • Interlude • Finale

39. “Fireflies” by Alice Remember when you were a child in the summertime at night. There were tiny little yellow lights going off and on continuously. I always thought they were flies carrying little lanterns so they could see their way in the darkness. Sometimes the fireflies blend in with the stars. Remember when you feel in the darkness. Look around, there’s always a flicker of light to give you a glimmer of hope. Think back when you were a child and remember the fly carried his lantern. He found his way. You will too.”

40. The Darker Side of Spirituality:The Spiritual Struggles of Bob • Prelude

41. The Darker Side of Spirituality:The Spiritual Struggles of Bob • Prelude • Interlude

42. Impact of Trauma • Psychological • Social • Physical • Spiritual

43. Three Types of Spiritual Struggle • Intrapersonal • Interpersonal • Divine

44. Divine Struggles • “I’m suffering, really suffering. My illness is tearing me down, and I’m angry at God for not rescuing me, I mean really setting me free from my mental bondage. I have been dealing with these issues for ten years now and I am only 24 years old. I don’t understand why he keeps lifting me up, just to let me come crashing down again” (undergraduate dealing with bipolar illness).

45. Divine Struggle Items(Exline, Pargament, Grubbs, & Yali, in press)

46. Demonic Items

47. Interpersonal Struggle Items

48. Moral Struggle Items

49. Ultimate Meaning Struggle Items

50. R/S Doubt Items