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Understanding Spirituality in Spiritually Integrated Psychotherapy. Kenneth I. Pargament Department of Psychology Bowling Green State University [email protected] Presented at Samaritan Annual Conference Spiritually Integrated Psychotherapy Denver, Colorado August 8, 2009. - PowerPoint PPT Presentation
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Understanding Spirituality in Spiritually Integrated
Psychotherapy
Kenneth I. PargamentDepartment of Psychology
Bowling Green State [email protected]
Presented atSamaritan Annual Conference
Spiritually Integrated PsychotherapyDenver, Colorado
August 8, 2009
Cindy Videoclips
Reductionism
Freud – religion as a means of anxiety reduction Durkheim – religion as a source of social solidarity Geertz – religion as a source of meaning Kirkpatrick – religion as an evolutionary by-
product
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)
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
A Definition of Spirituality
Spirituality is a search for the sacred.
Sacred Core
GodTranscendent
Reality
Divine
Sacred Core
Sacred Ring
GodTranscendent
Reality
Divine
Marriage
Soul
Time
Meaning
Nature
Children
Place
Sacred Qualities
Transcendence [There is an] ‘otherness’ [to religious experience. It is]
‘wholly other. . . quite beyond the sphere of the usual, the intelligible and the familiar, which therefore falls quite outside the limits of the canny” (p. 26).
Sacred Qualities Transcendence
Boundlessness “To see a World in a grain of Sand; And Heaven in a
Wild Flower; Hold Infinity in the palm of your hand; And Eternity in an Hour” (William Blake)
Sacred Qualities Transcendence Boundlessness
Ultimacy
Nature as a Sacred Resource(Ahmadi, 2006)
o “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 an use that word without connecting it to God, this is what I feel in nature and it’s like a powerful therapy” (p. 134).
Nature as a Sacred Resource(Ahmadi, 2006)
o “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 an use that word without connecting it to God, this is what I feel in nature and it’s like a powerful therapy” (p. 134).
Sacred Aspects of Life Psychological attributes (e.g., virtues, meaning)
“The things that come from God are the highest things that we look for in life; peace and joy and love and beauty and health and vitality and strength and wisdom and creativity and abundance and the whole cookie factory. . . God gives these resources to us like the sun gives light” (interviewee).
Sacred Aspects of Life
Psychological attributes (e.g., virtues, meaning) Cultural products (e.g., music, literature) “We have so much misery and suffering here.
So much difficulties and pain. But soccer is our gift from God. Our healing grace so that we Brazilians can go on” (Rev. Filiho, Washington Post)
Sacred Aspects of Life Psychological attributes (e.g., virtues, meaning) Cultural products (e.g., music, literature)
People (e.g., saints, cult leaders)
Manifestations of God in 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).
Perceptions of Sacredness: Results of a National Survey
“I see evidence of God in nature and creation” (78%)
“I see God’s presence in all of life” (75%) “I sense that my spirit is part of God’s spirit”
(68%) “I experience something more sacred in life than
simply material existence” (76%) “I see my life as a sacred journey” (55%)
The Search for the Sacred
Socio-Cultural Context
Discovery
A Direct Encounter with the Divine One night, in the middle of one of my depressions, I heard
a voice I’d never heard before, and haven’t heard since. The voice said, ‘I love you, Parker.’ This was not a psychological phenomenon, because my psyche was crushed. It was ‘the numinous.’ It was ‘mysterium tremendum.’ But it came to me in the simplest and most human way: ‘I love you, Parker.’ That rare experience taught me that the sacred is everywhere, that there is nothing that is not sacred, therefore worthy of respect. (Palmer, 1998, p. 26)
Encountering the Sacred Indirectlyo “You really want to know who raised me? It was a peppertree
with a short trunk. . . It had a great nest inside that was like a womb. . . You could sit in that womblike space and look out at the world without the world seeing you. . . I felt safe and loved and protected in that tree. It was my link with God/creation – with what was stable and real. . . that tree was a sacred presence in my life, and it taught me more about God and love than I ever learned in all the years I went to Sunday school” (Anderson & Hopkins, 1991, pp. 35, 37).
The Sacred as a Product of Internal and External Forces
“One half of ‘God’s stuffing,’ comes from the primary objects the child has ‘found’ in his life. The other half of God’s stuffing comes from the child’s capacity to ‘create’ a God according to his needs” (Rizzuto, 1979,p. 179).
The Sacred and its Implications
The sacred as magnetThe sacred as reservoirThe sacred as emotional generatorThe sacred as guiding light
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).
The Search for the Sacred
Socio-Cultural Context
Discovery Conservation
Spiritual Pathways
Ways of Knowing (Bible study, science) Ways of Acting (ritual, quilting)
Nontraditional Way of Acting
“By simple definition, quilting is merely sewing pieces of fabric together into a whole. But as spiritual discipline, it is a careful attention to the details of my life. Quilting as spiritual discipline is entering the sensual richness of the universe, creating order out of chaos, beauty out of the simple, wholeness from the scraps, and in the midst, being transformed” (Bushbaum, 1999, p. 236).
Spiritual Pathways
Ways of Knowing (Bible study, science) Ways of Acting (ritual, quilting) Ways of Relating (shared worship, loving
relations)
Love as a Way of Relating
“Love releases us into the realm of divine imagination, where the soul is expanded and reminded of its unearthly cravings and needs” (Thomas Moore, 1992, p. 81).
Spiritual Pathways
Ways of Knowing (Bible study, science) Ways of Acting (ritual, quilting) Ways of Relating (shared worship, loving
relations) Ways of Experiencing (prayer, meditation)
The Search for the Sacred
Socio-Cultural Context
Discovery Conservation
Conservational
SpiritualCoping
Threat,Violation,
andLoss
9/11 as a Desecration Students in Ohio and New York City coping with 9/11 About 50% agreed that attacks were “An offense against both me
and God.” About 30% agreed that “Something sacred that came from God was
dishonored.” Perceptions of desecration are linked to:
Emotional distress Anxiety Depression PTSD Poorer physical health Extremist reactions and desire for vengeance
Ways of Spiritual Coping
Benevolent Spiritual ReappraisalSeeking Spiritual SupportSeeking Support from Clergy/Congregation MembersSpiritual HelpingSpiritual Purification
Benevolent Spiritual Reframing
Child either positively reframes a situation or God’s response to a situation by imbuing religious/spiritual meaning or significance.
“God allows me to have this illness so I can be challenged more in this life. I will be more happy because I am more fulfilled. Having to cope with Cystic Fibrosis will allow me to progress further in my next life.”
Ano and Vasconcelles Meta-Analysis(2004, Journal of Clinical Psychology)
Number of Studies Cumulative Confidence
Effect Size Interval
Positive Religious
Coping with Positive 29 .33* .30 to .35
Health Outcomes
Positive Religious
Coping with Negative 38 -.12* -.14 to -.10
Health Outcomes
The Search for the Sacred
Socio-Cultural Context
Discovery Conservation
Conservational
SpiritualCoping
SpiritualStruggle
SpiritualDisengagem
ent
Threat,Violation,
andLoss
Transformational
SpiritualCoping
Dangers of Religious and Spiritual Life
Don’t let worry kill you -- let the church help
Thursday night -- Potluck supper. Prayer and medication to follow
At the evening service tonight, the sermon topic will be “What is Hell?” Come early and listen to our choir practice.
Three Types of Spiritual Struggle
Interpersonal Intrapersonal Divine
Interpersonal Spiritual Struggles Negative interactions among congregation members:
Gossiping Cliquishness Hypocrisy Disagreements with doctrine
“They get off in a corner and talk about you and you’re the one that’s there on Saturday working with their children and washing the dishes on Sunday afternoon. They don’t have the Christian spirit” (Krause et al., 2000).
Intrapersonal Spiritual Struggles
“Is Christianity a big sham, a cult? If an organization were to evolve in society, it would have to excite people emotionally, it would have to be self-perpetuation, it would need a source of income, etc. Christianity fits all of these. How do I know that I haven’t been sucked into a giant perpetual motion machine” (Kooistra, 1990, p. 95)?
Struggles with the Divine
“Many times I wonder how there can be a God – a loving God and where he is . . . I don’t understand why He lets little children in Third World countries die of starvation and diseases. . . I believe in God and I love Him, but sometimes I just don’t see the connection between a loving God and a suffering hurting world. Why doesn’t He help us -- if He truly loves us? It seems like He just doesn’t care. Does He?” (Kooistra, 1990).
An Illustration of Spiritual Struggle
“I am told God lives in me – and yet the reality of darkness and coldness and emptiness is so great that nothing touches my soul.”
Spirituality and Health Study Participants
1629 participantsAge: Mean = 49.1 years, SD = 17.7675.3% Christian56.2% Attend religious services “almost every day” or
“every day”55.3% Engage in private prayer “almost every day” or
“every day”59.9% “Very religious” or “fairly religious”
Spirituality and Health Study Measures
Mental Health: Symptom Assessment-45 Questionnaire (Davison, Bershadsky, Bieber, Silversmith, Maruish, & Kane, 1997)
AnxietyDepressionHostilityInterpersonal Sensitivity
Religious Struggle: Negative Religious Coping Subscale of Brief RCOPE (Pargament, Koenig, & Perez, 2000)
Social Support: Six items adapted from previous research (Zimet, Dahlem, Zimet, & Farley, 1988)
Obsessive-CompulsiveParanoid IdeationPhobic AnxietySomatization
Spirituality and Health Study Procedure
Sample recruited from sampling frame maintained by Survey Sampling International
Sampling frame reflects demographics of 2000 U.S. census
Contacted 8,500 individuals1,895 completed the survey (22% response rate)266 surveys excluded due to missing data
Spirituality and Health Study
Statistical AnalysesRegression
Criterion measures: SA-45 subscalesModel 1: Age, gender, education, ethnicity, income, marital
status, frequency of prayer, frequency of church attendance, social support, occurrence of personal illness/injury
Model 2: Religious struggleModel 3: Interaction of religious struggle and personal
illness/injury
Spirituality and Health Study
SummaryReligious struggle positively associated with
various forms of psychopathologyRelationship between religious struggle and
psychopathology stronger for individuals with recent illness or injury
Measures (Pargament, Koenig et al. 2004)
Number of Active Diagnoses Subjective Health Severity of Illness Scale (ASA) Activities of Daily Living (ADL) Mini-Mental State Exam (MSE) Depressed Mood Quality of Life Positive Religious Coping and Religious Struggle Global Religious Measures (Church Attendance, Private
Religiousness, Religious Importance) Demographics
Consequences of Religious Struggles Study of medically ill elderly patients over two years
(Pargament, Koenig, Tarakeshwar, & Hahn, 2004) Struggles with the divine predicted increases in depressed
mood, declines in physical functional status, declines in quality of life after controls
Struggles with the divine predicted 22-33% greater risk of mortality after controls
Struggles also predict stress-related growth
Specific Religious Struggle Predictors of Mortality
“Wondered whether God had abandoned me” (RR = 1.28)
“Questioned God’s love for me” (R = 1.22) “Decided the devil made this happen” (R =
1.19)
The Transformation of the Sacred
Rites of passageRevisioning the sacredConversion
*Admitting the limitations of the self:*Incorporating the sacred into the life of the self
Prelude to Conversion “I’m sitting there on the table, and they were
taking pictures of all the marks and bruises, and I was waiting to hear whether or not my skull was fractured. They had just told me that my eardrum was broken. . . I felt like I was going to faint, and I knew, sitting there on that table, that there had to be something different, there had to be a better way, there had to be more than this” (Pargament, 1997, p. 246).
Centering the Sacred My motivations and my whole sense of direction have
changed. My values changed. What I thought was important changed. I just completely shifted gears. It’s given me a sense of purpose and direction I never had before, and I’ve been searching different avenues but never found exactly what I was supposed to be doing. I’ve tried a lot of different things, a lot of different jobs, traveled a lot, had lots of experiences in my life. Yet always there was that kind of restless searching, searching. Now I feel like I know exactly what I’m supposed to do. (Miller & C’de Baca, p. 130)
Spiritual Disengagement
“How could you in all your greatness have abandoned me, a little girl, to the merciless hands of my father? How could you let this happen to me? I demand to know why this happened? Why didn’t you protect me? I have been faithful, and for what, to be raped and abused by my own father? I hate and despise you. I regret the first time I ever laid eyes on you; your name is like salt on my tongue. I vomit it from my being. I wish death upon you. You are no more. You are dead” (Flaherty, 1992, p. 101).
Decline
Growth
Socio-Cultural Context
Discovery ConservationConservational
SpiritualCoping
SpiritualStruggle
SpiritualDisengagement
Threat,Violation,
andLoss
TransformationalSpiritualCoping
Integration
Disintegration
Dis-integration in Sacred Destinations
Problems of small gods
Small Gods
The Grand Old Man The God of Absolute Perfection The Heavenly Bosom The Resident Policeman The Distant Star The God in Retirement
Dis-integration in Sacred Destinations
Problems of small gods False gods
Spiritual Struggle as a Predictor of Addiction
(Caprini, 2007) 90 freshmen complete measures of addiction and spiritual
struggles at three points in time over first year of college After controlling for neuroticism, social support, and
global religiousness, spiritual struggles predict greater likelihood of developing 11 of 15 types of addictive behaviors, including Gambling Food starving Prescription and recreational drugs Sex
Alcohol as a False God “As my alcoholism progressed, my thirst for God
increasingly became transmuted into a thirst for the seemingly godlike experiences that alcohol induced. Alcohol gave me a sense of well-being and connectedness – and wasn’t that an experience of God? Alcohol released me from the nagging sense that I was never good or competent enough – and wasn’t that God’s grace? Alcohol dissolved my worries about the future, allowing me to live in the present – and wasn’t that a divine gift? At my core there was a thirst, a thirst for whatever would fill the emptiness” (Nelson, 2004, p. 31).
Dis-integration in Sacred Destinations
Problems of small gods False gods Internal sacred clashes
Ambivalence toward the sacredSelf-degradationDemonization of self and others
Dis-Integration in Sacred Pathways
Problems of Breadth and Depth
Miles Wide and Inches Deep
“Spirituality in the United States may be three thousand miles wide, but it remains only three inches deep” (George Gallup, 1999, p. 45).
“ Even though nine out of ten adults have a copy of the Bible in their homes, only 35% of this largely Christian population knows who delivered the Sermon on the Mount and only 40% know what the Trinity is. “
Dis-Integration in Sacred Pathways
Problems of Breadth and Depth Problems of Fit
Spiritual Extremism Problems of Fit between Spiritual Pathways and
Situations Problems of Fit between the Individual and Social
Context
Spiritual Extremism“Several years ago, I came across a disturbing account of a man who had murdered his wife, three children, and mother for ostensibly religious reasons. With [my daughter] being so determined to get into acting I was also fearful as to what that might do to her continuing to be a Christian. . .Also, with [my wife] not going to church I knew that this would harm the children eventually . . . At least I’m certain that all have gone to heaven now. If things had gone on who knows if this would be the case. . . It may seem cowardly to have always shot them from behind, but I didn’t want any of them to know even at the last second that I had to do this. . .I’m only concerned with making my peace with God and of this I am assured because of Christ dying even for me (“Memorandum . . .” 1990, p. 25).
Dis-Integration in Sacred Pathways
Problems of Breadth and Depth Problems of Fit
Spiritual Extremism Problems of Fit between Spiritual Pathways and
Situations Problems of Fit between the Individual and Social
Context
Dis-Integration in Sacred Pathways
Problems of Breadth and Depth Problems of Fit
Spiritual Extremism Lack of Fit between Spiritual Pathways and
Situations Lack of Fit between Individual and Social Context
Problems of Continuity and Change
Spiritual Struggle at Two Times
CHRONIC (High Struggle at Baseline and High Struggle at Follow Up)
ACUTE (Low Struggle at Baseline and High Struggle at Follow Up)
ACUTE (High Struggle at Baseline and Low Struggle at Follow Up)
NONE (Low Struggle at Baseline and Low Struggle at Follow Up)
Integrated vs. Dis-Integrated SpiritualityThe effectiveness of the search for the sacred lies not in a specific belief, practice, emotion, or relationship, but in the degree to which the individual’s spiritual pathways and destinations are well-integrated, working together in synchrony with each other. At its best, spirituality is defined by pathways that are broad and deep, responsive to life’s situations, nurtured by the larger social context, capable of flexibility and continuity, and oriented toward a sacred destination that is large enough to encompass the full range of human potential and luminous enough to provide the individual with a powerful guiding vision. At its worst, spirituality is defined by pathways that lack scope and depth, fail to meet the challenges and demands of life events, clash and collide with the surrounding social system, change and shift too easily or not at all, and misdirect the individual in the pursuit of spiritual value (Pargament, in press).