Kari A. O'Grady

The Role of Spirituality in the Treatment of Trauma and Eating Disorders: Recommendations for Clinical Practice

The relationships among trauma, eating disorders, and spirituality are complex. Both trauma and eating disorders can distance women from their own spirituality, which undermines a potentially important treatment resource. In this article, we offer suggestions based on our clinical experience for helping eating disorder patients who have suffered trauma to rediscover their faith and spirituality. We describe how spirituality can be used as a resource to assist women throughout treatment and in recovery.

Earthquake in Haiti: Relationship with the Sacred in Times of Trauma

The devastating earthquake in Haiti on January 12, 2010 killed over 230,000 people and injured many more. One year later, 1.2 million people were still living in tents. Haiti is only one of many places around the globe that have been struck by community-wide disaster in recent years, including the United States own devastating tornadoes in Joplin, Missouri and Tuscaloosa, Alabama. Although several studies have demonstrated strong links between spirituality and resilience, the field is only just beginning to break ground on the role of spirituality in large-scale disaster situations (Koenig, 2006). In this article we briefly review the literature on spirituality and trauma, followed by a description of the current study within a relational framework. The study aimed to investigate the impact of the Haitian peoples relationship with the divine on their psycho-spiritual transformation following the earthquake. Results are considered from a cross-cultural perspective. Growth Following Trauma A growing body of research suggests that many traumatic life events, including natural disasters, precipitate positive psychological changes, such as a broadened view of life, an increased sense of meaning and purpose for existence, and an increase in spirituality (Sigmund, 2003). Posttraumatic growth occurs when individuals are faced with a traumatic event such as a natural disaster, and consequently positive psychological effects take place (Tedeschi & Calhoun, 1996). Although traumatic life events may produce precarious health outcomes for some individuals and devastating consequences for communities, research indicates that posttraumatic growth is possible when appropriate factors are in place (Richards, Smith, Berrett, OGrady, & Bartz, 2009; Tedeschi & Calhoun, 2004). The extent to which trauma develops into posttraumatic growth or decline is in part mediated by the meaning an individual assigns to the stressful life event (Cole, Hopkins, Tisak, Steel, & Carr, 2008; Feder et al., 2008). According to cognitive adaption theory, positive reinterpretation of a traumatic event serves an adaptive role for experiencing stress-related growth (Karanci & Erkam, 2007; Taylor, Collins, Skokan, & Aspinwall,1989). When individuals are able to create positive meaning out of tragedy, they are often able to activate critical recovery attributes such as a sense of self-efficacy and a sense of purpose in life. The study of posttraumatic growth is not only the consideration of factors that contribute to growth following trauma, but it is also the examination of the nature of growth outcomes. Previous research has, for instance, reported positive correlations between the experience of trauma and improved social relationships, positive changes in beliefs, renewed faith, cohesiveness in the community, identification of new possibilities, newfound talents and strengths, changes in self-image, and transformed comprehension of way of life (Affleck & Tennen, 1996; Linley & Joseph, 2004; Tedeschi & Calhoun, 1996, 2004). Many individuals who have felt stuck in their lives or who have been unwilling to make important life transitions feel an increased desire and strength to do so following a traumatic life event. From this understanding, community disaster may be the impetus towards a psychologically healthier and more satisfying lifestyle for some people. Trauma impacts most people, not only physically, socially, and psychologically, but also spiritually. For those who are engaged in a spiritual life, trauma that threatens this aspect of their experience can generate a great deal of internal distress. When issues of the soul may be at stake many are driven to reconsider their belief systems including their views about God or a higher power (Pargament, Murray-Swank, Magyar, & Ano, 2005, p. 247). As individuals reevaluate their beliefs and values, they are likely to undergo a form of spiritual transformation. …

A Theistic spiritual treatment for women with eating disorders

The authors describe a psychological treatment for women with eating disorders who have theistic spiritual beliefs and illustrate its application with a case report. They begin by briefly summarizing a theistic view of eating disorders. Then they illustrate how a theistic approach can complement traditional treatment by describing the processes and outcomes of their work with a 23-year-old Christian woman receiving inpatient treatment for an eating disorder not otherwise specified and a major depressive disorder (recurrent severe).

Theistic Psychotherapy and the God Image

SUMMARY Assessing and working with issues of God image in therapy are often an essential part of successful treatment. God image development is a complex process that may include influences from family, peers, culture, gender, age, religious theology and tradition. From a the-istic perspective, individuals actual relationship with God can have the greatest impact on God image development. According to this perspective, it is important that therapists help clients explore their image of God and the ways it impacts their spirituality and presenting concerns. Encouraging clients to engage in spiritual practices such as prayer, meditation, scripture study, and spiritual reflection can help them create a more genuine relationship with God, and promotes a healthier, more mature God image.

The Role of Inspiration in Scientific Scholarship and Discovery: Views of Theistic Scientists

This qualitative research study examined the ways those who identify themselves as theistic scientists and scholars experience inspiration, as defined as divine guidance or influence, in their scientific scholarship and discovery. It also explored participants beliefs about how scientists and scholars can seek and prepare to receive inspiration in their work. Open-ended surveys of 450 participants from the behavioral and natural sciences and from a variety of religious backgrounds were analyzed for content themes in the areas of experiences with inspiration, preparing to receive inspiration, and further thoughts on inspiration in science. The themes extracted indicated that these scientists and scholars have experienced inspiration throughout all stages of the research process. They also believe that certain practices and virtues, such as openness to inspiration and nurturing a relationship with God, can help scientists and scholars be more prepared to receive inspiration in their work.

A Way Forward for Spirituality, Resilience, and International Social Science

This special issue on spirituality in resilience processes across international contexts helps clarify a three-pronged research agenda for the future study of trauma and disasters by psychologists of religion and spirituality. First, the special issue demonstrates the value of expanding from U.S.-based theories, data, models, and practices to incorporate a wider repertoire of international research (e.g., Western Africa, Romania, Haiti, China, and diverse additional contexts). Second, the special issue suggests that the topic of resilience defies the constraints of traditional variance-based research methodologies and requires the adoption of newer process-based research methodologies in order to study longitudinal phenomena, such as cosmology episodes, post-traumatic growth, and forgiveness processes. Third, the special issue emphasizes the need for psychologists of religion and spirituality to collaborate more frequently with allied social scientists (e.g., sociologists of religion and scholars of management, spirituality and religion) in order to comprehend the systemic, multilevel complexities of large-scale trauma.

Religious coping, dispositional forgiveness, and posttraumatic outcomes in adult survivors of the Liberian Civil War.

This cross-sectional study examined religious coping, dispositional forgiveness, and posttraumatic outcomes (posttraumatic stress and growth) among adult survivors of the Liberian Civil War (1989-2003). This study contributes to the literature on religion/spirituality, forgiveness, and trauma in post-conflict African contexts. Participants were 407 adult survivors recruited in 2011 from a faith community in Liberia and a Liberian refugee camp in Ghana. Participants completed the Brief RCOPE, Heartland Forgiveness Scale, Impact of Event Scale–Revised, and Posttraumatic Growth Inventory. Relative to men, women reported lower levels of positive religious coping, dispositional forgiveness, and perceived posttraumatic growth; however, there were no sex differences in negative religious coping or posttraumatic stress. Directly exposed survivors (who experienced or witnessed the war as a combatant or noncombatant) reported higher levels of posttraumatic stress and lower levels of dispositional forgiveness and perceived posttraumatic growth, relative to indirectly exposed survivors (whose family members or close associates experienced or witnessed the war). Regression-based analyses indicated that dispositional forgiveness partially mediated (explained) the relationship between positive religious coping and perceived posttraumatic growth. These findings suggest that, in post-conflict African contexts, there may be differences in religious and posttraumatic outcomes based on sex and on war exposure. Moreover, survivors may engage in positive religious coping because it can help promote forgiveness toward others (and possibly themselves) and may help to restore a personal (and possibly communal) sense of meaning and purpose, enabling them to experience perceived posttraumatic growth.

Spirituality in Resilience Processes in International Contexts: An Introduction

This special issue was prompted by several converging social and scholarly trends: a perceived rise in the frequency and severity of disasters, a call for more studies of the role of spirituality in disasters, a commitment to research on non-U.S. populations, and a recognition of the need for more sophisticated understandings of resilience processes. First, there has been a sharp increase of community-level disasters in the past decade with three of the most economically devastating natural disasters occurring in the past 8 years and approximately 5,000 terrorist attacks per year occurring over the past 10 years (Aten & Boan, 2016). The recent surge in refugee populations fleeing from war-inflicted disasters has garnered daily public attention on social media and traditional news sources. The overwhelming demands of these disasters necessitate multi-level theory and interventions to mitigate, manage, and recover from their complex effects. Second, research in the psychology of spirituality and religion has boomed in the last few decades; simultaneously, studies of spirituality and trauma are on the rise. However, scholarship on resilience during disasters within the psychology of spirituality and religion lags behind other fields of research. This seems like a misstep as coping during disaster has been viewed by many as intertwined with spirituality due to its inherent meaning-making nature (Orton & OGrady, in press; Park, 2010). Four years ago, Walker and Aten (2012) co-edited a special issue in the Journal of Psychology & Theology on trauma and spirituality. In it, they called for future research addressing disasters and spirituality: Overall, we need more collaborative research, or researchers, that are capable of bringing together the best of disaster mental health and psychology of religion researchers if we are going to more fully capture the complexity of psychology of religion and disaster phenomena. (p. 351) The current special issue is an attempt to respond to the call for more sophisticated considerations of spirituality in resilience processes during disasters. Third, although the Journal of Psychology and Theology is a U.S.-based journal, the cosmologies of those with whom its readers work is increasingly more diverse. It is no longer uncommon for practitioners to work with first- and second-generation immigrants whose nations of origin differ dramatically from that of the practitioner. Consistent with this trend is the growing recognition of the untenable assumption that Western-based theory and research is universally applicable (Arnett, 2008; Henrich, Heine, & Norenzayan, 2010). Finally, the special issue explicitly refers to resilience in terms of processes rather than variance. Early research on resilience focused on resilience as a trait (i.e., hardiness) to be investigated as an outcome variable. In general, the field of psychology defaults to variance-based research; however, notable scholars have pointed out that variance-based studies are seldom replicable (Maxwell, Lau, & Howard, 2015) and often fail to capture the lived experience of participants and clients (Gergen, Josselson, & Freeman, 2015). Understanding and fostering multi-level resilience across complex contexts requires exploration of processes. In response to these four needs, the 2015 call for papers for a special issue on spirituality in resilience processes across international contexts was intended to attract cross-disciplinary and multi-level investigations of resilience processes during adverse life events, or cosmology episodes, across diverse contexts. Specifically, the call was for empirical or theoretical articles that addressed spirituality and religion in resilience processes at the individual, team, organizational, community, and/or national level with preference for manuscripts that focused on international populations. …

Resilience Processes during Cosmology Episodes: Lessons Learned from the Haiti Earthquake

The Haiti earthquake of January 2010 serves as an anchor for a new field of research on the role of spirituality in international large-scale catastrophes. Using the case study of one Haitian grandmother affected by the earthquake as a microcosmic representation of the Haitian people, we build an interdisciplinary theory of spirituality in extreme contexts. First, we identify 2 management theory concepts that we found useful: “cosmology episodes” and “sensemaking processes.” Second, through a comparative case study—juxtaposing our findings from the Haiti earthquake of 2010 with Weicks (1993) findings from the Mann Gulch forest fire of 1949—we elaborate on 5 resilience processes that collectively constitute the anatomy of a cosmology episode: anticipating, sense-losing, improvising, sense-remaking, and renewing (or declining). Third, we initiate a more advanced conversation by reinterpreting literature from the psychology of religion and spirituality related to cosmology episodes, by focusing attention on the dynamics of spirituality-imbued transformative pivots within cosmology episodes, and by exploring the role of divine inspiration in cosmology episodes such as the Haiti earthquake. Finally, we call for more interdisciplinary collaboration (e.g., psychology, anthropology, sociology, management, political science, and theology) on the complex topic of the role of spirituality in resilience processes during international cosmology episodes.