Spiritual Cognitive Therapy:
Modifying Core Beliefs and Values to Maximize Positive Therapeutic Change

SAMPLE THERAPY ISSUES
How would you answer these questions? How would you help clients answer therm?
How do I find peace, meaning, and even happiness coping with:  
•death of a loved one •my death •poverty •failure *being alone •rejection *abuse •serious illness
•[your] greatest fear_____________________________________?
2. If all my life is pain, bad luck, and unhappiness, why continue to live?
3. How can I get over my anger toward someone who has abused me and ruined my life?
4. Why should I forgive someone who has hurt me (or one I love) terribly?
5. If no one loves me (or ever will), what is there in life worth living for?

AUDIENCE SURVEY
1. Has your faith/spiritual life been a primary source of values, meaning, direction, and happiness in your life?
2. Has your faith/spiritual life been a primary means of overcoming crisis, anxiety, and depression?
3 a. Have you had very negative experiences with religion or spiritual life?
b. If so, were they partially due to God being represented as a punitive, legalistic external being that didn’t really care for your personal
happiness?
4. Do you openly and frequently encourage your clients to explore their basic spiritual beliefs as either a source of problems or to help them use their faith/spiritual life to cope with life?
5. What barriers discourage you from doing 4?
6. Have you ever had a significant "conversion experience" (i.e., a sudden and radical shift in your ultimate concerns, values, or goals in life–possibly as the result of one major decision or commitment)?

WHAT IS MISSING FROM TRADITIONAL THERAPIES?
What are the limits of traditional therapies?
Are traditional therapies too superficial?

LET'S GET A CLUE (to what really changes people)
Religions
Self-help movements
Personal (non-group) "conversion experiences."

WHAT DO THESE ALL HAVE IN COMMON THAT WORKS?

WHAT IS "SPIRITUAL COGNITIVE THERAPY"?

What do the words "spirit" and "spiritual" mean?

What is "Spiritual Cognitive Therapy"?

How does the concept "ultimate concern" relate to the concept of one's "faith"?

How does the role of a psychological "spiritual cognitive therapist differ from what a preacher, prophet, or priest in helping people deal with faith/spiritual issues?

How is spiritual cognitive therapy different from regular cognitive therapy?

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SOME BASIC DEFINITIONS
Philosophy, Religion, and Spirituality
Philosophy of Life, Spiritual Center, Core Beliefs and Values-loosely defining as same for now. 

TRADITIONAL NEGLECT AND HOSTILITY TOWARD SPIRITUAL APPROACHES TO HELPING
Church-State Separation Issue
Pastoral Counseling versus Psychological ("State") Counseling (how to separate here or later-later?)
Western Worldview Conflicts With Traditional Religious Beliefs (See RBp72)
Freudian/Psychoanalytic Bias Against Spirituality 

NEEDS FOR A SPIRITUAL APPROACH TO HELPING AND THERAPY
Spiritual concerns of large numbers of helpees: (All "%"s mean percentage of all persons in the U. S.) R&Bergin, p8
U.S. 1995: 85.3% Christian; 8.7% Non-religious; 2.1% Jews; 1.9% Muslims; 0.3% Buddhist
Among Christians: Affiliated 68.6% (Catholic 21.0%, Protestant 30.6%)
Among Protestants: Evangelicals 27.5%, Black Christians 9.6%, Anglicans 2.1%, All other protestants 4.1%
Inference: 91.3% of the people who come for therapy may affiliate with some religion-85% of the all, Christian.

Changes in the beliefs of the helping community that are more favorable to overtly spiritual interventions
Growing cultural and scientific recognition of importance of spirituality and meaning for physical and psychological health

Causal effects of more specific spiritually-related issues on physical and psychological health
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David Myers (1992) summary of results

Batson, Schoenrade, and Ventis (1993)

Richards and Bergin (1998)

Wong (1998) Spirituality, Meaning, and Successful Aging WFp374ff

Pargament (1997) The Psychology of Religion and Coping
 

REVIEWS OF STUDIES RELATING PSYCHOLOGICAL PROBLEMS AND PSYCHOPATHOLOGY TO CORE BELIEFS OR MEANINGLESSNESS

Klinger (1998)

Wong (1998)

Debatts (1998)
 

POSTTRAUMATIC GROWTH

Richard Tedeschi, Crystal Park, and Lawrence Calhoun (1998). Posttraumatic Growth: Positive changes in the aftermath of crisis. Mahwah, New Jersey: Lawrence Erlbaum Associates.
 

PERSONALITY CHANGE

Heatherton, Todd F.& Weinberger, Joel L. (1994). Can Personality Change?

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PARTS OF OURSELVES AS COGNITIVE SYSTEMS

Major parts of our personality (and selves)

Simple dynamics-a melding of cognitive, humanistic, and psychodynamic therapies
 

TYPES OF ISSUES AND SYSTEMS COMMONLY RELATED TO SPIRITUALITY AND RELIGION

Metaphysical and Worldview Issues

Eg. Nature of universe and/or God, Human nature and place in universe, existence beyond what is observed, nature of death/life after death, deepest causes in the universe, is the world improving or getting worse, etc.

Epistemological/Methodological Issues (How is knowledge acquired and truth found?)

Eg. Authority (Church, Bible, State, Professional assumptions and authority), Empirical Observations and Research, Revelation?, Reason?, Enlightened and/or Shared Reason?

Ethical and Psychological Issues

Eg. Nature of ultimate good(s)/evil(s), most functional or best values (truth?, love?, material?, accomplishment?, duty?, family?, nation?, all people? obedience to church or God?, daily/situational ethics, common issues such as self versus other or living for now versus future, etc.
 

WHAT IS A PERSON'S SPIRITUAL CORE?

What do expressions like "Faith," "Philosophy of Life," "Core Values and Beliefs," and "Spiritual Core" have in common?

Tillich's Concept of Ultimate Concern

Concepts of the Higher Self

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PASTORAL COUNSELING

Fundamentalistic Approaches

"Mainstream" Christian Approaches
 

TRADITIONAL PASTORAL COUNSELING SPIRITUAL TECHNIQUES

sacred books prayer and meditation worship and ritual

confession forgiveness and repentance education and self-help

community of believer meetings witnessing/role modeling service to others

counseling, educating, or converting others
 

COMMON CURRENT PRACTICES REPORTED BY PRACTICING CHRISTIAN PSYCHOLOGISTS--Richards and Potts (1995)

prayer (by therapist, client, or both) teaching spiritual concepts reference to scripture

spiritual self-disclosure spiritual confrontation spiritual assessment

religious relaxation or imagery therapist blessing or referral to priest client confession

religious journal writing, meditation religious bibliotherapy scripture memorization

encouraging forgiveness (eg. laying on hands) referral to religious authority or community

=>Note relevance of therapist role issues for choice among the above techniques-some appropriate in "state" settings or for use with "general" clients and some are not.

12-STEP PROGRAMS

Alcoholics Anonymous 12 steps: 1-admit alcoholic; 2-believe in Higher Power (HP); 3-turn our will and lives over to HP; 4-moral inventory; 5-admit to HP, to selves, and to another human wrongs; 6-entirely ready for HP to remove shortcomings; 7-ask HP to remove shortcomings; 8-list of persons harmed; 9-make amends unless hurt them; 10-continue personal inventory/admit wrong promptly; 11-prayer and mediation pray for guidance and strength; 12-practice principles and carry message to other alcoholics.
 

POPULAR SELF-HELP APPROACHES

Wayne Dyer
Bernie Siegle
James Redfield
Depok Chopra
Joan Borysenko

COGNITIVE APPROACHES

Albert Ellis
Aaron Beck
George Kelly

EXISTENTIAL/HUMANISTIC APPROACHES

Victor Frankl's Logotherapy
Paul Wong (1998)

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WHAT IS SPIRITUAL HEALTH?

What are the dimensions of spiritual health?

What are some validated ways of assessing spiritual health?

 (See appendix for list of several approaches)

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How spiritual therapy is different from traditional therapy

How the spiritual cognitive therapy is different from regular cognitive therapy

How the role of a spiritual (non-religious/state) therapist varies from the role of a priest or pastoral counselor and other ethical Issues

Richards and Bergin (1998)

(1) Ecumenical versus Denominational Approaches

(2) Checklists of ethical recommendations for spiritual therapy

Avoiding dual relationships: therapist versus religious authority (especially in "state" settings)

Collaborating (avoiding conflict) with Religious Authorities (explain overlaps, role; not demean religion or authorities)

Respecting clients' values (clarify therapist & client views, accept clients right to hold different views, pursue religious goals only when clients give permission, not proselytize, refer if differences to great.)

Respecting church-state boundaries (laws and work policies, discuss with staff; work within client value framework, not promote particular religious viewpoint, obtain written consent with controversial interventions.)

(3) When to explicitly state own values

Background and Training Issues (read psychology and sociology of religion, attend workshop, study world religions, seek supervision)

Protecting Church-State boundaries while using spiritual therapy

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Richards and Bergin (1997):

1. Metaphysical Worldview

2. Religious Affiliation

3. Religious Orthodoxy

4. Religious Problem-Solving Style

5. Spiritual Identity

6. God Image

7. Value-Lifestyle Congruence

8. Doctrinal Knowledge

9. Religious and Spiritual Health and Maturity
 

1. Client's worldview (Christian/denomination, eastern, atheistic, "postmodern"/relativistic, naturalistic/agnostic, etc)?

2. Childhood religious affiliation and experience?

3. Current religious affiliation and level of participation/devoutness?

4. Does client believe spiritual beliefs or lifestyle is contributing to presenting problems?

5. Spiritual concerns and needs of client?

6. Willingness to explore spirituality and participate in spiritual interventions?

7. Does client perceive spiritual beliefs and community as source of strength and assistance?
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CLIENT'S ULTIMATE CONCERNS (Chapter 1)

Introduction

What do great religious leaders and philosophers say our ultimate concern should be?

Religions: Hinduism-Nirvana, Buddha-happiness, Judism-10 Commandments, Jesus-2 great commandments

Philosophers: Aristotle, Kant, Bertrand Russell-happiness

Psychologists: Freud, Kohlberg, Humanism (Maslow, metavalues), Existentialism

Higher Power/God: God as concept and source of good

Spiritual, higher mental values versus externally-tied values. Desirable qualities of one's ultimate concern(s)

Poor choices for UCs lead to Growing fragmentation, repression, or conflict within parts of the personality

Common ultimate concern problems

DEVELOPING OUR NATURAL "HIGHER SELF" (HS) (Chapter 3)

A natural cognitive system that learns to unconditionally love self and others through empathy

Like Maslow's inner voice? very different from Freud's Superego

Completes with other cognitive systems-functional and dysfunctional ones. It strong HS causes personality integration.

Develops through empathy, elaborating one's HS philosophy, choosing HS impulses over other impulses, reinforcement

A strong HS becomes inner CEO, conductor, spiritual leader, psychologist, supreme court, hero => self-actualization
 

WORLD VIEW ISSUES (SEE APPENDIX BELOW) (Chapter 4)

Deficit versus Abundance thinking

Overcoming worst fears
 

SELF-ESTEEM-RELATED ISSUES (Chapter 5)

Unconditional versus conditional self-worth

How to love yourself despite past mistakes, deficiencies, and internalized negative subparts
 

EXTERNAL VERSUS INTERNAL CONTROL ISSUES (Chapter 6)

Core issues related to dependency, codependency, assertiveness, passivity, aggressiveness, communication, etc.
 

HARMONIOUS FUNCTIONING-Creating peak learning, performance, and happiness (Chapters 7, 8)

The Harmonious Functioning Model

Six Mental Control Strategies for overcoming anger, anxiety, and depression:

CHUG-OF = Choice, Harmony, Understanding, Goals & Expectations, Optimism, and Focus
 

ISSUES RELATED TO DOMINANT THEOLOGICAL/PHILOSOPHICAL TRADITIONS

Client's beliefs related to current dominant philosophical positions

Eastern Religions, Western Religions, Classical Modernism and Philosophy of Scientific, Postmodernism, and Western Humanistic Philosophy-Psycholog.

Key dimensions of conflict between these systems (and cause of client inner conflicts)-See appendix C:
 

COMMON THERAPIST THEOLOGICAL/PHILOSOPHICAL BIASES

Richards and Bergin (1998) Responses by Mental Health Professionals to 10 Value Themes p132-See appendix B:

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THE HIGHER SELF

K These subparts consist of your "inner child", " inner professional", "inner counselor", "inner lover", "inner student", "inner parent", "higher self", etc.

K These subparts are all cognitive systems competing to be a "leader", or in the #1 position. The "leader" is your ultimate concern.

K The higher self can be a dominant leader and can become your Ultimate Concern. If weak or undeveloped it well struggle to be heard.

K The higher self (we believe) begins at an extremely early age and learns through EMPATHY to love ourselves and others unconditionally

K Based on Empathy, greater understanding, acceptance, and forgiveness of self and others.

K Values the health and happiness of self and others.

K Gives out of caring and not obligation.

K Can "Rise Above" situations or people that seem harmful, angry, or aggressive. Can treat an angry, aggressive person with deep understanding and caring.

K Chooses to be 'better' not 'bitter' from growth experiences.

K Developing our Higher Self and focusing on its' beliefs and goals is our primary way of increasing our self-esteem, personal power, and happiness. We feel "appropriate" to ourselves and how we interact with others.

K Each time we choose money, rules, status, others' acceptance, etc., over happiness and love the Higher Self grows weaker.

K The Cognitive System is biologically wired to produce Anxiety when we are uncertain about the future. Our self-esteem grows as we feel more equipped to deal with uncertainty.

K Then we take primary responsibility for our own happiness we feel more in control and less anxiety. We learn that there are choices and can reframe.

K When we don't trust our Higher Self we feel anxious and inappropriate to deal with the situation. Our Higher Self competes with other belief systems (Internalized other belief systems, i.e., dysfunctional family, rigid rules, strict religious messages, etc.).

K Can leave you feeling stuck and miserable. Small voice inside fights to be heard if HS is undeveloped. (HS grows weaker if ignored).

K If we choose higher beliefs such as self love, internal control, etc. our self-esteem grows and we move into more harmony with our selves and environment, moving more towards Maslow's Self Actualized Person.

K If strong can become a Conductor

K Helps each orchestra member become best possible musician.

K Coordinate the music so that all together it produces beautiful harmonious music.

K Is the Higher Self connected to a larger Spiritual Unity?

K In the same way the higher self integrates the parts of self to produce happiness and harmony, do the cells in the body orchestrate to produce health and harmony?

SCT GOALS

Identifying and resolving spiritual concerns relevant to their presenting problems and psychological wellbeing

Priority of growth and wellbeing in their lives

Identifying and using spiritual resources.

Helping clients resolve spiritual identity issues.

Make explicit that our primary goals are seeking values like truth, growth, health, and happiness for our clients and those whom they interact with.

At appropriate times let clients know explicitly our beliefs (and relevant evidence) about how their various spiritual beliefs/values may affect their psychological functioning.

Avoid trying to persuade/convert clients to any specific type of religious or spiritual approach.

Help clients develop skills and habits that will help the implement their highest values in daily life
 

SCT PRECONDITIONS

Unconditional acceptance/love of self and clients

Understanding, acceptance, and appreciation of the benefits of a wide variety of religious and spiritual belief systems

Psychologically healthy development and awareness of one's own spiritual beliefs and core
 

SCT ASSESSMENT

Basic Spiritual Background Factors

Religious/spiritual affiliations of family and self

Degree of involvement and knowledge of denominational beliefs and practices

Value-lifestyle congruence
 

THE SCT PROCESS FOR RESOLVING CORE ISSUES

1. Explore presenting problem

2. Find underlying highest level/core issues

3. Clarify inner conflicts--between inner subparts, values, or with external sources

4. Use appropriate cognitive techniques such as:

Reframing with Higher Self-related values

Clarifying deep issue choices.

6. Align self with benefit to client and client's Higher Self-related values (avoid role of preacher/priest)

7. Help client apply higher values to daily thoughts and actions
 

KEY SCT TECHNIQUES

Reframing

Clarifying deep issue choices

Conceptualizing the problem

Attributional probing

Relating spiritual issues/themes to history of client and current situations: defining alternatives

What if (possibility thinking)

Visualization techniques related to spiritual issues

(Inner conflict) role-playing

Training and rehearsal of effective interpersonal and self-related skills
 

BRIEF TRAINING IN REFRAMING AND VISUALIZATION TECHNIQUES

Mazon

DEALING WITH SPIRITUALLY-RELATED ETHICAL ISSUES

Types of situations and sample solutions

1. Non-value-related presenting problem

2. Non-religious, value-related

3. Implicitly religion-related

4. Explicitly religion-related
 

SUMMARY, REFERENCES, AND QUESTIONS
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David Myers (1992)

Gallup poll, series of questions, "highly spiritual' who agree with statements like, "God loves me even though I might no always please him," "My religious faith is the most important thing in my life" twice as likely to say they are "very happy." p183

In US, church attenders less likely to become delinquent, abuse drugs/alcohol, divorce or be unhappily married, or commit suicide. They tend to be physically healthier and live longer.
 

Pergament (1997) Reviews of research related to following issues:

1. Proportion of people who involve religion in coping (with stress, serious life events, etc.)

31 studies; 60-100%, 13 studies; 30-59%, 9 studies, 0-29%, 7 studies. (Others didn't use percentages.)

Conclusions p142, Summary, appendix A, p409

2. Predictors of religious coping: Appendix B, p411

a. Personal predictors of religious coping: less educated, Baptists, religiously active, personal religiousness, belief in divine influence, women, older, less hostile, more humble, more submissive, neuroticism, intrinsicness, orthodoxy, loving God image, salience of religious cognition, etc.

b. Situational predictors of religious coping: threat of loss, personal danger, bereavement, physical suffering, unlikely events, mysticism related to lower anticipatory threat, catastrophic events, illness and death, greater number of stressors, negative events, more important events.

c. Contextual predictors of religious coping: organizational religiousness, frequent church attendance.
 

3. Surveys of people from stressful situation who found religion helpful in coping. (Eg. 7,000 WWII vets from 57-83% found religion helped them a lot "when the going was tough." In other studies reviewed by Pergament ranged from about 50-85% found religious coping helpful in dealing with stressful situations. In open-ended question studies, 18-69% spontaneously listed religious coping methods as helpful. Pp277-278.
 

4. Religious orientation(s) and outcomes of negative events (on physical and psychological health and solving immediate problem)-46 studies. Appendix C, p423ff, Summary table, p282

5. Religious coping methods and outcomes of negative events (on physical and psychological health and solving immediate problem)-40 studies. Appendix D, p439ff, Summary table, p285

Summary of helpful and harmful religious coping methods p288-300

Is religion more helpful to some people than others? p307

Pergament's Stress Moderator, Deterrent, and Combined Moderator-Deterrent Models p304

Studies; Appendix E, p458ff.
 

[QUOTES to use p307-308. Comparison of religious coping to other forms of coping, p308-311, summary table, p311.

QUOTES to use p310 Overall conclusions of effects of religious coping, p312-314, QUOTES to use p312]
 

A Tally of the Results of Research on the Statistical Relationship between Measures of Religious Coping and Outcomes of Negative Events. Pergament (1997) p285.

Batson, Schoenrade, and Ventis (1993)

Mental health criteria p235-239

Effects of religion on mental health studies p241-286;

Summary of extrinsic, intrinsic, and quest dimensions on mental health p286-291

Studies of prejudice and religious involvement p297-302 Summary p302.

Studies of prejudice and extrinsic and intrinsic dimensions p305-310 Summary p310

Studies of prejudice and extrinsic vs. intrinsic vs. quest p318-321; Overall Summary p329

Studies of religion and concern for others and helping behavior p336-362; Overall Summary p362
 

Richards and Bergin (1998)

Relation of intrinsic and extrinsic dimensions to various personality scales p81

Physical health p86

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CLASSIFICATION SYSTEMS OF SPIRITUAL HEALTH and MATURITY

Kohlberg's Stages of Moral Development

Gordon Allport's Dimensions of religious maturity (especially extrinsic versus intrinsic) WFp160

Batson, Schoenrade, Ventis (1993) Conceptions of Mental Health BSVp235-238

Fowler (1996) Stages of Faith and Selfhood RBp184

Paloutzian and Ellison (1979) Two-Dimensional Model of Spiritual Well-Being RBp185

Clinebell (1965) Tests for Mentally Healthy Religion RBp188

Malony (1985), Eight-Dimensional Model of Christian Maturity RBp186

Bergin (1998) Religious-Spiritual Values, Lifestyles, and Mental Health RBp189

Richards and Bergin (1998) Psychospiritual themes in a spiritually integrative personality theory (inspired by Erikson,

1963 stages of development

Wong et al's Eight Factors o f Personal Meaning WFp123-126

102 Characteristics of an Ideally Meaningful Life WFp134-137

From his series of empirical studies of people's conceptions of a meaningful life
 

ASSESSMENT INSTRUMENTS

Allport and Ross (1967) Religious Orientation Scale (Extrinsic and Intrinsic scales) BSVp162

C. Daniel Batson (1993) Religious Life Inventory (External, Internal, Quest scale) BSVp170

(Christian) Doctrinal Orthodoxy scale BSVp171

Battista and Almond (1973) Life Regard Index (LRI-R WFp250-see results above)

Richards and Bergin (1998) Religious-Spiritual Client Intake Assessment Questions (Levels 1 and 2) RBp191-193

Gorsuch and McPherson (1989) Intrinsic-Extrinsic Relgious Style RBp196

Paloutzian and Ellison (1991) Spiritual Well-Being Scale RBp197

Pergament, Ensing, et al. (1990) Religious Coping Items and Scales (for Christians) Pp184

Scales:

1.Purposes of religion in coping (spiritual, self-development, resolve problems, sharing/closeness with people,

restraint of emotions and actions);

2. Religious appraisals;

3. Religious coping activities (spiritually based, good deeds, discontent with religion/God, social support, pleading

with God, religious avoidance of problem).

Pergament (1997) RCOPE scales-Positive religious coping and Negative religious coping scales

(used w/ survivors of OC bombing) Pp299
 

Wong (1998) Personal Meaning Profile (PMP) WFp138-139
 

Assessment Instruments (PMP, LRI, Role-Reptest, Narratives, etc.))

Some other Meaning and Goal assessment instruments (FWp30 and (better)238ff):

Purpose in Life (PIL) test, Crumbaugh and Maholick, 1969

Seeking of Noetic Goals Test (SONG), Crumbaugh, 1977

Meaning in Life Depth (MILD), DeVogler-Ebersole and Ebersole, 1985

Life Attitude Profile (LAP), Reker, Peacock, and Wong, 1987

Motivational Structure Questionnaire, Cox and Klinger, 1988

Work Concerns Inventory, Roberson, 1989

Interview Questionnaire (to assess current goals), Klinger
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DIMENSIONS of SOC

1. Meaningfulness (most important factor)

2. Comprehensibility

3. Manageability
 

RESEARCH on SOC

Positive correlations with scales of locus of control, hardiness, self-esteem, mastery, life regard, optimism, potency

general well-being ,r=.63 to .70; trait anxiety, r=--.77; neuroticism, r=-.81; global stress, r=-.67; morale, .66 to .70

Some negative results relating manageability to daily hassles, etc.

In David Korotkov (1998)

Kobasa: Involvement, Control, Optimism related research on hardiness and health.
 

1. Purpose: Objective goals and subjective fulfillments

2. Efficacy and control

3. Value and justification

4. Self-worth
 

SCALES

1. Achievement Striving (32% variance)

2. Religion (8.8% variance)

3. Relationship (4.6% variance)

4. Fulfillment (4.3% variance)**

5. Fairness-Respect (3.5% variance)

6. Self-confidence (2.7% variance)*

7. Self-integration (2.5% variance)*

8. Self-transcendence (2.5% variance)

9. Self-acceptance (2.3% variance)*

___________________

*Scales related to self-related attitudes.

**Dropped for studies related to depression/happiness SAMPLE CORRELATIONS

"All PMP factors were positively correlated with psychological well-being, suggesting that meaning, regardless of its source, is an important mediator of psychological well-being. This finding confirms that happinesss is an inevitable by-product of meaningful living."

IMPORTANT NOTE: Correlation of minus .70 between total PMP and Beck Depression Inventory.
 

Theme                                                                                                        % agree                    % agree to guide all/many clients

Theme 1: Competent perception and expression of feelings                           97                         87

Theme 2: Freedom, autonomy, and responsibility                                            96                         85

Theme 3: Integration, coping, and work                                                             95                           81

Theme 4: Self-awareness and growth                                                                  92                           77

Theme 5: Human relatedness and interpersonal and family commitment      91                          73

Theme 6: Self-maintenance and physical fitness                                                  91                           71

Theme 7: Mature values (sense of purpose, principles, etc)                              84                           68

Theme 8: Forgiveness                                                                                             85                           62

Theme 9: Regulated sexual fulfillment                                                                  63                           49

Theme 10: Spirituality and religiosity                                                                    49                            29
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DESIRABLE QUALITIES OF ONE'S ULTIMATE CONCERN(S):

Ultimate. Highest value/goal in one's life. Will be chosen above all other (secondary) values. Tillich

Unconditional. Is primary under any condition.Tillich

Simple and elegant. Ideally, it would be a relatively simple statement-easily understood by many-that is at the same time so powerful that it can explain or encompass all life events.

Comprehensive. Is at least tangentially relevant to any situation in life.

Unifying. Is able to successfully resolve differences in conflicts between two or more competing lower values. Tillich.

Truthful-Valid. Represents the true state of affairs in the universe-(not usually evaluated by therapist?) Tillich

It should no conflict with any other type of valid knowledge or truth (eg. Scientific knowledge, historical knowledge, personal knowledge, etc). This is a murky area for therapists.

High unconditional value of oneself and others. All people's health, happiness, and general welfare are highly valued.

Identify with all people-not just a subgroup.

High unconditional value for the environment and to some degree the entire universe.

Universality. Kant's cat imperative "act as if the maxim of your action were to become through your will a universal law of nature."

Adaptable. Through it's nature is able to adequately deal with all possible changing conditions and conditions of life in ways that meet the other criteria.

Source of Security. Trusting in this principle, being, whatever provides ultimate security for person.

Clear, Prescriptive. It should include extremely general, implied guidelines for evaluating or recommending almost any behavior. Like one's personal supreme court.

Growth and integrity-oriented. Grows more elaborate and integrated. Causes integrity of personality.

Promotes psychological and physical health. It should become increasingly complex and integrated within itself and with the rest of the personality over time from interacting with many particular life events. Each new event should become integrated with the core. Eg. Maslow, Self-actualization, see other models of spiritual/psychological health.
 

COMMON ULTIMATE CONCERN PROBLEMS

1. Poorly developed Higher Self and Philosophy of Life. Causes lack meaning to life, depression, narcissism, addictions, dependency/external control.

2. Fragmented Ultimate Concerns. Cause inner conflict, anxiety, indecisiveness.

3. Sample of common poor choices of UC: (Also see Kohlberg's stages, but he lacks top stage of love/empathy).

According to Tillich, anything we pick as an UC that does not fully deserve to be UC will cause serious life problems. One of my more recent hypotheses, is that I believe they are at the heart of many psychological disorders.

Self-pleasure, now: childlike selfishness, lack empathy, narcissim, sociopathic/anit-social "gimme", addictions.

Another person, family, or everyone (love, parent, acceptance) as god. Dependency/ external control, codependency, addictive relationships, self-deprivation.To be loved and accepted by all.

Achievement/success or over-identify with a role: Workaholic, feels worthless without success, may lead to depression, anxiety. May be aggressive, lack empathy, manipulative. Physical health problems. Unhappy.

Power, status, recognition, respect, pride. "I am important" Manipulative, ruthless, conceited, self-serving decisions, status symbols. Fears:being weak, rejected, looked down on by others,

Nation, Church or other group or institution: Must go to church and obey all rules or go to hell. Us vs Them.

Blind obedience to God or a Set of Rules==> "Rule bound" leads to OCD-like behavior.

Health. Hypochondriac.

4. Ultimate Concern as source of greatest anxiety and fear. Greatest fear is flip-side of ultimate concern.

5. Fanaticism, extreme views, and repressing doubt.

6. People with inflexible UC s fear change. May underly some sensitivity to criticism. If value growth/progress, welcome it.

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 WHO or WHAT IS IN CONTROL (God, Nature, Chaos, Other People, Me, etc)? [U Don't believe in Higher Power]

==> You can often substitute World, God, Others, Nature below--depending upon this belief.
 

WORLD VIEW ISSUES PERSONAL ISSUES

 WORLD FRIENDLY OR NOT TO PEOPLE Am I loved and cared for?
 

 PROGRESS versus REGRESSION Are things to get better or worse?
 

 STRUCTURE/PLAN/ORDER versus CHAOS       Is God (or anyone/anything) in control?

Can I understand it? Can my life be in control?
 

 UNCONDITIONAL CARING versus CONDITIONAL Does God/Nature/People unconditionally care about

(authoritarian) "SHOULDS" me, my health, and my happiness? OR

Ok fail, poor, alone, sinful, sick,? Does he just want me to obey rules and reward me only

if I obey and punish me if I don't?
 

 ZERO EXPECTATIONS/ABUNDANCE versus Do I view what I have as a gift or right?

ENTITLEMENT/DEFICIT Elaborate. How fair is life? [U-High Exp]

*ex about receive * I am entitled to a good job, etc
 

 THE REWARD STRUCTURE (Positive versus Do I focus on getting rewards or avoiding punishments?

Punitive, Immediate versus Delayed, Certainty?) Do I focus on immediate gratification or long-term goals?

Is there a heaven? Hell?

How much consistency or fairness is there?
 

 FREE-CHOICE versus NO-CHOICE How much potential control do I have of important

Versus Determinism or Fate events in my life (my own decisions? goals? actions? emotions? thoughts?)

INTERNAL versus EXTERNAL CONTROL

Versus "Sacrifice for others"

 COMPLEX, MULTIPLE-CAUSATION versus Are events multi-caused or is one person to blame?

SIMPLISTIC, SINGLE CAUSATION If one person, is it me (INTROJECTION) or someone else (PROJECTION)?
 

Eastern religions versus Western religions RBp72
 

Philosophical conflicts between modernistic science and religious traditions: RBp30-31

Naturalism and atheism versus Theism

Determinism versus Free will

Universalism (of natural laws) versus conceptuality

Reductionism and atomism versus Holism

Materialism and mechanism versus Transcendent spirit and soul

Ethical relativism versus Universals and absolutes

Ethical hedonism versus Altruism

Classical realism and positivism versus Theistic realism

(Universe is only reality and science only valid source o f knowledge versus God ultimate creative force)

Empiricism versus epistemological pluralism
 

Influence of Postmodernism Philosophy RBp37 + Cobb

No metaphysical absolutes

No fundamental or abstract laws or truths

Anti-reductionism, anti-determinism, anti-positivism

Human values and behavior meaningful only within its contexts (of relationships, culture, etc)-no absolute values

truth is only relative to cultural context and language-not absolute

observations and perceptions biased by values and context

uncertainty and chaos are more basic than order and certainty

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Submit to God's will and all will go according to his plan (eg. Muslin women who wouldn't have mastectomy because they thought cancer was God's will)

Preoccupation with negative events-self-contempt, dread, horrors of world. They lack grace, redemption, forgiveness, love, happiness aspects.

2. Fragmented Religion

Fragmented religion: "religion a la carte," Bibby (1987) research on Canadian attitudes:

Egs: 20% knew and practiced some of most Christian common beliefs, 75% read horoscope vs 45% Bible.

Fragmentation between religion and other aspects of life: compartmentalized

Fragmentation between religious belief and practice:

3. Religious Rigidity

4. Insecure religious attachment: God as parental figure (loving, comforting, protective, forgiving, supportive versus punative, avenging, hard, severe, wrathful)

Three styles of Attachment to God: Secure, Avoidant, Anxious/ambivalent
 

Problems of ends: Wrong Direction

I have decided turn away from God and live life for myself alone.

I have lost interest in God, other people, myself, and everything else.

I have decided to stop taking care of myself (or the world) and focus only on what God wants for me

Problems of means: Wrong road

I believe that God is punishing me for my sins.

I know God will make the situation better if I just wait long enough.

I pray that God will punish the real sinners.

Problem of fit: Against the wind

My family or friends speak to me about religion in a way I do not agree with.

I disagree with the church's view about why this event happened to me.

I feel that God is not being fair to me.
 

1. Eternal identity versus mortal overlay

2. Free agency versus inefficacy

3. Inspired integrity versus deception

4. Faithful intimacy versus infidelity

family kinship versus alienation and isolation

5. Benevolent power versus authoritarianism

communal structure versus social integration

6. Health and human welfare values versus relativism and uncertainty

growth and change versus stagnation

good versus evil
 
 

SEEKING INSIGHT INTO THE FOLLOWING SEVEN GLOBAL ASSESSMENT QUESTIONS WILL HELP THERAPISTS MAKE SUCH A DETERMINATION:
 

1.What is the client's metaphysical worldview (e.g., Western (theistic), Eastern, naturalistic-atheistic, naturalistic-agnostic)? 2. What was the client's childhood religious affiliation and experiences?

3. What is the client's current religious affiliation and level of devoutness?

4. Does the client believe his or her spiritual beliefs and lifestyle are contributing to his or her presenting problems and concerns in any way?

5. Does the client have any religious and spiritual concerns and needs?

6. Is the client willing to explore his or her religious and spiritual issues and to participate in spiritual interventions?

7. Does the client perceive that his or her religious and spiritual beliefs and community are a potential source of strength and assistance?

Does a particular form of religious thought and practice

1. Build bridges or barriers between people?

2. Strengthen or weaken a basic sense of trust and relatedness to the universe?

3. Stimulate or hamper the growth of inner freedom and personal responsibility?

4. Provide effective or faulty means of helping people move from a sense of guilt to forgiveness? Does it provide well-defined significant ethical guidelines, or does it emphasize ethical trivia? Is its primary concern for surface behavior or for the underlying health of the personality?

5. Increase or lessen the enjoyment of life? Does it encourage a person to appreciate or depreciate the feeling dimension of life?

6. Handle the vital energies of sex and aggressiveness in constructive or repressive ways?

7. Encourage the acceptance or denial of reality? Does it foster magical or mature religious beliefs? Does it encourage intellectual honesty with respect to doubts? Does it oversimplify the human situation or face its tangled complexity?

8. Emphasize love (and growth) or fear?

9. Give its adherents a frame of orientation and object of devotion that is adequate in handling existential anxiety constructively?

10. Encourage the individual to relate to his or her unconscious through living symbols?

11. Accommodate itself to the neurotic patterns of the society or endeavor to change them?

12. Strengthen or weaken self-esteem?

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FEELING NEGATIVE EMOTIONS

"It's terrible to feel negative emotions like anxiety or depression."
 

"Negative emotions are feedback that something is wrong, and provide motivation to grow." (Ch-2)
 

FEAR OF LOOKING INSIDE

"If I look at myself too closely, I'm afraid that I'll find out that I'm sick."
 

"If you look inside closely, you'll find your Higher Self and the causes of your unhappiness. By understanding yourself, you will empower your Higher Self and can be happier and more productive." (Ch-2)
 

OBEDIENCE/PLEASING OTHERS

"I must obey (my church, parents, the law, etc.) or I am not a good Christian."
 

"Jesus said that the two great commandments are love God and love your neighbor as you love yourself. If any command or rule conflicts with the rule of love, then it is wrong. The protestant movement is based upon Luther's belief that each person must interpret what is right or wrong for him/herself."
 

GENERAL PESSIMISM AND NEGATIVE WORLD VIEW

"The future is bleak, the world is going to be polluted, overcrowded, and worse. The country is in decline. Life is miserable, then you die."

"There is too much suffering and injustice to believe that good forces or God control the world."
 

"There are creative forces inherent in all nature and that created humans from the primordial soup, that has created our technological wonders, that caused Nazism and Communism to fail. We have moved from physical evolution, to biological evolution, to spiritual evolution. Those creative forces and a Higher Self are inside every human being." (Ch-4)
 

RESENTMENT, VICTIM OR DEFICIT THINKING

"I resent the fact that I've worked so hard and been so good and received so little, while others have been evil and have received so much."
 

"Life is not fair-that is a fact. If you expect it to be, you are doomed to unhappiness. If you want to choose to be happy (as ultimate concern), then you must have zero expectations and be grateful for all that you receive." (Ch-4)
 

GUILT, RESENTMENT, LACK OF FORGIVENESS, LOW SELF-ACCEPTANCE & SELF-ESTEEM

"I can never forgive myself for wasting all those years (failing, doing drugs, etc.)." OR

"I can't forgive another for the harm he/she did to me."
 

"If you are a Christian, you believe that God loves everyone unconditionally and will forgive anyone for whatever mistakes you have made."

"If you love yourself (and all humans) unconditionally, then that means your happiness (and others happiness) is valuable no matter what mistakes you have made. "

"You don't earn happiness, you choose that which makes you happy."

"If you cannot forgive, then it will undermine your happiness. Every moment of anger is one less moment of happiness."
 

MUTUAL MISERY--MARTYRDOM

"If others are in pain and misery, then I should suffer too if I care about them."
 

"If you care, it's natural to feel empathy. But if you "rise above" your suffering, then it can help them feel happier too. Your top goal is for both to feel happy-not for both to feel miserable."
 

CODEPENDENCY

"I should take care of those I love when they need me, no matter what I have to sacrifice myself."
 

"Your happiness is as important as theirs! To follow the second commandment (and avoid codependency), balance caring for your happiness with caring for theirs. Also remember that you can never make another person happy and you are therefore not responsible for their happiness. You can only make yourself happy."
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Theology/Philosophy

Best: Paul Tillich (1957), Dynamics of Faith. New York: Harper.

John B. Cobb, Can Christ Become Good News Again? St. Louis: Chalice Press.
 

Psychology (of Religion, etc.):

Best:

Wong, Paul & Fry, Prem (1998). The Human Quest for Meaning. L. Erlbaum: New Jersey.

Richards, P. Scott & Bergen, Allen (1997). A Spiritual Strategy for Counseling and Psychotherapy. Washington D. C.: American Psychological Association.

Closely Related:

Pargament, Kenneth I. (1997). The Psychology of Religion and Coping: Theory, research, practice. New York: Guiliford Press.

Bateson, C. Daniel; Schoenrade, Patricia; & Ventis, W. Larry (1993). Religion and the Individual. New York: Oxford Press.

Teeschi, R. G.; Park, L. C.; & Callhoun, L. G. (1997). Posttraumatic Growth: Positive Changes in the Aftermath of Crises. New York: L. Erlbaum.

Beit-Hallahmi, Benjamin & Argyle, Michael (1997). Relgious Behaviour, Belief, and Experience. London: Routledge.

Additional References:

Ader, Robert and Cohen, Nicholas (1993). Psychoneuroimmunology: Conditioning and stress. Annual Review of Psychology, 44, 53-85.

Adler, Nancy and Matthews, Karen (1994). Health psychology: Why do some people

get sick and some stay well? Annual Review of Psychology, 45,229-59.

Brewin, Chris R. (1996). Theoretical foundations of cognitive-behavior therapy for anxiety and depression. Annual Review of Psychology, 47, 33-57.

Burns, David (1980). Feeling Good: The New Mood Therapy. New York: Signet.

Burtt, E. A. (1982). The Teachings of the Compassionate Buddha. New York: Penguin Books.

Carkhuff, Robert A. (1969). Helping and Human Relations. New York: Holt, Rinehart, and Winston.

Cohen, Sheldon and Herbert, Tracy (1996). Health psychology: psychological factors and physical disease from the perspective of psychoneuroimmunology. Annual Review of Psychology, 47, 113-142.

Cox, Harvey (1995). Fire From Heaven: The Rise of Pentecostal Spirituality and the Reshaping of Religion in the Twenty-first Century..

Dyer, Wayne (1992). Real Magic. New York: Harper Collins.

Dyer, Wayne (1976). Your Erroneous Zones. New York: Avon Books.

Frankl, Victor (1969). Man's Search For Meaning. New York: Washington Sq. Press.

Heatherton, Todd F.& Weinberger, Joel L. (1994). Can Personality Change? Washington D. C.: American Psychological Association.

James, William (1958). Varieties of Religious Experience. New York: Mentor.

Kelly, George (1955). The Psychology of Personal Constructs. New York: Norton

Maslow, Abraham H. (1971). A. H. Maslow: The Further Reaches of Human Nature. New York: Penguin.

Maslow, Abraham H. (1962). Toward a Psychology of Being. New York: Van Nostrand.

Myers, David G. (1992). The Pursuit of Happiness. New York: Avon Books.

Rogers, Carl (1961). On Becoming A Person. New York: Houghton Miffin.

Rogers, Carl (1951). Client-Centered Therapy. Boston: Houghton-Mifflin.

Russell, Bertrand (1958). The Conquest of Happiness. New York: Bantam.

Sternberg, Robert J. (1990). Wisdom: Its Nature, Origins, and Development. Cambridge: Cambridge University Press.

Stevens, Tom G. (1998). You Can Choose To Be Happy: "Rise Above" Anxiety, Anger, and Depression. Seal Beach, CA: Wheeler-Sutton.

Richard Tedeschi, Crystal Park, and Lawrence Calhoun (1998). Posttraumatic Growth: Positive changes in the aftermath of crisis. Mahwah, New

Jersey: Lawrence Erlbaum Associates.

Tillich, Paul (1963). Systematic Theology (Vols I-III). New York: Harper & Row. 

Tillich, Paul, The Dynamics of Faith.

Tillich, Paul, The Courage To Be.

You may take the Success and Happiness Attributes Questionnaire (SHAQ) free at: http://www.csulb.edu/~tstevens/success

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