Wednesday, July 8, 2015

Is Spirituality and Religion Important to Trauma Survivors?


Trauma stories continually make headlines.

African Americans were shot to death at a midweek service in Charleston, SC.

An ISIS (Islamic State of Iraq and Syria) terrorist murdered and maimed Britons on Holiday in Tunisia.

Boko Haram slaughtered 150 Nigerian Muslims whilst praying during Ramadan.

Two days ago, July 7, Londoners mourned the deaths of 52 bomb victims. Representatives from Christian , Hindu, Jewish, Muslim and other faith groups joined to show their support. The memorial service was held in a Christian church. The victims and their families were linked to many faith traditions.

Many trauma survivors and their families draw on their religious or spiritual faith for support. People pray, consult clergy, and seek help from psychotherapists. In addition to basic survival needs following a tragic event, many survivors are plunged into a spiritual struggle as they wonder why God did not intervene to protect them or their loved ones.

Spiritually Oriented Psychotherapy for Trauma
    is the title of a book I recently read. My academic review has been accepted for publication in an upcoming issue of the Journal of Psychology and Christianity. But I thought some readers of this post might appreciate a few thoughts on the book–in case you are looking for ways to help trauma survivors and their families. Here’s a few things you’ll find.

Clergy and health care providers often encounter victims of trauma–some more than others. I often attended workshops and seminars as part of professional development. But, as the editors of the book point out–spirituality is often missing from assessing the effects of trauma and presentations of effective interventions. This book provides a great start on providing the missing component.

Four authors (chapter 4) collaborated to provide readers with an overview of religious and spiritual assessment. They include a review of specific measures that clinicians will find helpful. I’ve reviewed thousands of clinicians records over the years and I often don’t find much more than a brief reference to a patient's identified religion. And sometimes there’s no clue about their faith--despite the fact that almost everyone on the planet is affiliated with a specific religion or reports spiritual beliefs. Here's a link to a review of a related book by Tom Plante.

Spiritual struggle.
How do you find meaning when your world is turned upside down? Most us us know that trauma effects can be numerous. Survivors of severe trauma often experience long-term negative general health, mental health, social, and economic effects. But few have looked at the damage done to a survivor’s faith or the faith of their loved ones.  Faith is important to making sense of the world–trauma destroys meaning–at least until new meaning can be found. Faith communities often rally around victims and their families–but some do not. Survivors and their families sometimes struggle alone and wonder why they were abandoned. You get the point, many trauma survivors experience spiritual struggle- sometimes its about beliefs and sometimes it centers on the lack of care by members of their faith community.

Specific Applications.
A few chapters focus attention on responding to specific types of trauma. Here are some examples:
Chapter 8 focuses on survivors of sexual abuse.
Chapter 9 provides guidance in helping people following a disaster. You will find a planning guide in this chapter.
Chapter 10 discusses the role of religion in Intimate Partner Violence.
Chapter 11 guides readers in treating members of the military and their families.

Additional Thoughts

This book makes a significant contribution to filling an important need for clinicians who help trauma survivors. I recommend the book to care workers.

Researchers will find many areas that need to be addressed including better assessment strategies and documentation of effective practices.

Additional work is needed to understand assessment and intervention strategies with people of different faiths and cultures--especially those where faith is woven into the fabric of a culture. An accurate assessment and the choice of effective interventions requires cultural competency and that may include spiritual competency. I imagine a multivolume work will be needed in the years to come.

We must not forget the mental health needs of those providing direct care following a traumatic event and those involved in the horrific post-disaster response teams. For example, I have a friend who has performed morgue duty following several disasters. That work is often grueling and takes a physical and mental toll. Trauma team members vary in experience and coping skills. Some may need support services onsite as they try to meet the demand of so many in dire need. And some may need help much later.

I think therapy can be overdone in some cases. Wisdom is needed. Trauma tourists can just get in the way when rescue efforts are primary and survivors are not ready to deal with the psychological aspects of trauma. I visited a Kenyan refugee camp following a massacre. Their primary focus was on burying their dead, medical needs, shelter, and food. I am also influenced by Seeley's book about therapy after the 9/11 attacks on the U.S.

I wonder if the many books and workshops aimed at improving trauma services assume that spirituality does not matter or that most people are atheists. In some ways, many clinicians have been prepared for trauma work with atheists and agnostics if spirituality and religion were omitted from the learning experiences. But I also wonder if a different approach might be needed for those who do not identify as religious or spiritual. In other words, most people have a need for purpose and meaning in life; trauma can change one’s purpose and limit or interfere with the pursuit of meaningful life activities.


SPIRITUALLY ORIENTED PSYCHOTHERAPY FOR TRAUMA edited by Donald F. Walker, Christine A. Courtois, and Jamie D. Aten. Washington DC: American Psychological Association, 2015, pp. 292. ISBN: 978-1-4338-1816-5; $59.95

Other related references

McLeland, K. C., Sutton, G. W., & Schumm, W. (2008). Marital Satisfaction before and after deployments associated with the global war on terror. Psychological Reports, 103, 836-844. Academia Link
Sutton, G. W. (2009). Finding God amidst the Greensburg Tornadoscape: Resurrection and restoration, The Journal of Pastoral Care & Counseling, 63, Accepted May 24, 2008.  Academia Link
Sutton, G. W. (2012). Refugee center: Kenya. Recorder. 55, 36. (Link to the Recorder Link

Sutton, G. W. (2010). [Review of the book Left to tell: Discovering God amidst the Rwandan holocaust, by I. Ilibagiza.] Encounter, issues/2010summer.html   Academia Link

Sutton, G. W. (2007). [Review of the book One nation under therapy: How the helping culture is eroding self-reliance by C. H. Sommers & S. Satel]. Journal of Psychology and Christianity, 26, 276-277.   Academia Link

Sutton, G. W. (2010). Spirituality and health: Considering spirituality and religion when planning strategies for psychological assessment and treatment. Journal of Psychology and Theology, 38, 132-133. Academia Link

Trent, S. K. & Sutton, G.W. (2009). [Review of the book Therapy after terror: 9/11, psychotherapists, and mental health by K. Seeley.] Journal of Psychology and Christianity, 28, 187-188.  Academia Link


I receive no payment related to writing about the book. I know one of the editors, Jamie Aten, because I have seen him at professional meetings. My copy of the book came from the Journal editor and not from the publisher or any of the editors or authors. As far as I know, none of my writings were cited in the book.

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