546 Forum 2

A Christian Approach to Dealing with Trauma-

and Stressor-Related Disorders

Donald Meichenbaum

Religion can play a significant role in helping people to cope with stress or to protect against stress. For many, if not most, when disaster or trauma strikes, it is religion, ritual and faith/spirituality that is embraced as a central means of coping (Bergin, 1983; Gartner et al., 1991; Meichenbaum, 1994).

Consider the following examples:

· A National survey conducted by Schuster et al. (2001) found that after the terrorist attacks of September 11, 2001, 90% of Americans reported that they turned to prayer, religions or some form of spiritual activity with loved ones in an effort to cope;

· Following Hurricane Katrina, 92% of those who survived and who were evacuated to shelters in Houston said that their faith played an important role in helping them get through (www.kff.org/newsmedia/7401.cfm) ;

· When a tornado struck a small southern town in Piedmont Alabama, destroying a church filled with parishioners and killing several children, including the minister’s four-year-old daughter, the survivors struggled with such questions as “Why? Why a church? Why those little children? Why? Why? Why?” The minister and parishioners commented that while:

“Their faith is shaken, it is not the same as losing it. Events like this only strengthen our faith… Our faith is an anchor in a turbulent sea… Those who die inside a church will find the gates of heaven open wide…. As long as we have faith, we are strong. No matter how dark it is, if I have faith, I have a song in the night. Our beliefs are trembled and bent, but they did not break… There is no reason. Our faith is not determined by reason. Our faith is undergirded by belief, where there is no reason.” (Meichenbaum, 1994, p545)

Many other examples could be offered of how victims who have experienced natural and man-made traumatic events have used their religious beliefs, faith and spiritual means of coping. A most poignant account is offered by Pargament (2007) who describes how prisoners in concentration camps secretly continued engaging in religious activities. Elie Wiesel (1965) in his book Night describes how God was put on trial by the prisoners of a concentration camp. They found God guilty as charged, but then the prisoners went on to pray anyway.

Another example is offered by McIntosh, Silver and Wortman (1993) who found that

religious parents coped better with infant death than nonreligious parents. McIntosh et al. proposed that such better coping was mediated through social support, cognitive

processes and the ability to find meaning.

Several major meta-analytic reviews have been conducted that demonstrate that

individuals who use religious and spiritual coping efforts demonstrate greater physical

and emotional well-being (Ano & Vasconcelles, 2005; Gall et al., 2005; Miller & Kelley,

2005; Pargament. 2007). Religious coping has been found to have a significant

association with a variety of adjustment indicators including lower levels of depression

and alcohol consumption, fewer somatic complaints, fewer interpersonal problems, lower mortality, and greater levels of life satisfaction, more use of social supports and overall improved coping ability.

There has been much discussion about what are the mechanisms and processes that

contribute to the benefits of engaging in religious and spiritual acts (Cacioppo et al.,

2005; Davis et al., 2000; Falselti et al., 2003; Gall et al., 2005; Koenig et al., 2001;

Meichenbaum, 1994; Pargament, 2007; Pennebaker, 1997; Snyder, 2002; Spilka et al.,

2003). The proposed mechanisms include the following:

1. Individuals who have been victimized often describe themselves in negative self-disdaining terms that can become self-fulfilling prophecies. As a result of experiencing this traumatic event, victims may convey that they feel:

“dirty, contaminated, desecrated, polluted, worthless, stupid, emptied, as if I fell into a bottomless pit”

“I’m dead inside. I am an emotional orphan. Feel stagnated. I am carrying too many battle scars.”

“I feel this is God’s punishment for my sins. God has abandoned me. I am all alone, a burden to others.”

Such expressions of feeling permanently scared and damaged and mentally defeated contribute to the absence of the ability to engage in mental planning and adaptive coping. Ehlers and Clark (2000) highlight that traumatized individuals who evidence persistent PTSD have an inability to develop a coherent recounting (narrative) of trauma experiences.

One outcome of engaging in spiritual coping activities is to reduce the likelihood of victimized individuals engaging in such “negative, self-disparaging, stress-engendering” story-telling to oneself and to others. One’s faith and participation in religious rituals give a person a sense of being loved and valued, exactly as one is, despite a person’s self-image as being “damaged, sinful, abused and abandoned.” As I have discussed elsewhere (Meichenbaum, 2006a, b), a major goal of interventions is to help individuals engage in non-negative thinking and develop a coherent narrative. How do spiritually-based activities help to accomplish this goal? Spiritual and religious activities can act to:

2. Normalize reactions and internal spiritual struggles.

3. Encourage emotional expression, emotional control and emotional comfort by

fostering self-disclosure and sharing. (Pennebaker, 1997 has highlighted the benefits of “opening up” and sharing accounts of trauma, instead of keeping them “secret.”)

A number of observers have discussed the relationship between emotion regulation and religion (see Corrigan et al., 2000; Emmons, 2005; Pizarro & Salovey, 2002; Nhaaat, 2001; Watts, 2007). Religious practices such as, a) prayer which is an exercise in religious reframing, b) meditation and mindfulness activities that can reduce arousal; c) acceptance and forgiveness activities that control negative emotions like anger, guilt and shame, as well as nurture empathy, have each been found to help individuals cope with trauma.

4. Convey a sense of “control” and “mastery” that helps people feel that they are not mere victims of arbitrary events in which “bad thing happen to good people” or that “good things happen to bad people.” A belief in a “higher power” who is perceived as being in control implies less arbitrariness in what happens.

5. Foster social connectedness with fellow congregants, clergy and with a higher power or deity. Participation in a faith community can help a victim find ways to create blessings from his/her tragedy. This is not to minimize the tragedy or make it seem salutary or beneficial. Rather, through such activities as sharing one’s story with others and/or ministering to others who face a similar situation, one has the opportunity to see that blessings can come from hardship and adversities.

(Cacioppo et al., 2005 have reviewed the research literature that sociality, spirituality and meaning-making are central features of human beings, and that relational and collective connectedness combat feelings of isolation and loneliness and that they are critical to the healing process. Socially connected individuals are more likely to meet the demands of everyday stressors by means of active coping and by recruiting help from others.)

6. Promote group cohesiveness, connection and a sense of communion, both with the past and the present.

As Cacioppo et al., 2005 also observe, “socially connected individuals are more likely to behave in a selfless fashion reinforcing their connections to others and enhancing their self-esteem. Socially isolated individuals are more likely to act in a socially protective and self-deflating manner. Social isolation and accompanying loneliness can have negative physiological consequences (increasing sympathetic activation and contribute to sleep disturbances that can exacerbate stressful reactions).”

To underscore Cacioppo et al.’s point, Ano & Vasconelles (2005) and Pargament (2007) have reviewed the literature on the significant health benefits and mental and spiritual well-being associated with the use of spiritual coping efforts. They report that such spiritual coping is particularly helpful for people with poorer and less available personal and social resources who live in trying situations and who are more likely to be members of minority groups, the elderly, less educated and of lower socioeconomic status and who feel insecure and isolated. The importance of religiosity, as reflected by church attendance, has been found to act as a buffer or protective factor against the development of adolescent juvenile delinquency developing, even when such youth live in a highly disordered neighborhood. Such a commitment to religious beliefs and practices has been found to reduce the likelihood of antisocial behaviors (Johnson et al., 2001).

7. Provide opportunities for public expressions of shared grief and mutual support and reassurances that victims’ sacrifices and lives will be remembered, honored and commemorated. As Elie Weisel (1960) observed:

“I belong to a people whose suffering is the most ancient in the world. I belong to a people whose memory keeps the suffering alive. Just as all days were created for one day alone, the Sabbath, all other words were created and given for one word alone. Remember!”

Traumatic memories are not obstacles to be obliterated, removed, escaped from (for these efforts will fail), but these memories are a bridge from the past to the present and the future. Memories are not to be forgotten, but to be contained and sanctified. Jeffrey Jay (1994), in a thoughtful article, “Walls for wailing,” highlights the need for traumatized individuals to “move toward memory,” rather than “move beyond memory.” Thou shalt remember, thou shalt seek an

accounting! Jay also advises:

“One must have the courage of memory because through it, one can seek God.”

Discussed below are additional metaphors offered by Jay and others on how psychotherapists can incorporate spirituality into their practice.

8. Offer a degree of closure on a painful period and encourage transition behaviors to engage in new adaptive activities and nurture hope. As Snyder (2002) observes:

there is a need to nurture hope and optimism that leads to engaging in goal-directed behaviors and embracing positive strivings and visions. Encourage access to inner strengths, empowerment, control and acceptance.

One’s faith conveys hope and sense of mastery. The people can have some control over their lives, hope that they can find a way to give their experience some meaning, and hope that in spite of tragic events, life is not over and can improve.

9. Nurture meaning-making in the face of misfortune. As Gall et al. (2005, pp 95–96)observe:

“If a higher power is perceived to be at work in a stressful event, then the event may be viewed as an opportunity to learn something that this higher power is trying to teach. The event may also serve as a ‘wake-up call’ to take stock of life and rearrange priorities.”

Such efforts at meaning-making can provide a sense of relief, comfort, security and belonging. Placing one’s faith and trust in a “just and loving God” can provide traumatized individuals with a “supportive partner” and a “personal confidant.” It can help preserve a belief in a just world.

10. Provide guidance in the form of coping models. The Bible, the Torah, the Koran and other holy scriptures can be viewed as “inspirational self-help books,” providing a framework to cope with stress. The use of these spiritual forms of coping may prove most helpful for handling those aspects of stressful situations that cannot be personally controlled, nor changed, and that are not amenable to direct-action problem-solving coping efforts. A good example of these mechanisms is offered by Rabbi Harold S. Kushner in his 1981 book, When Bad Things Happen to Good People.

Meichenbaum, D. (n.d.).Trauma, spirituality, and recovery: Toward a spiritually-

integrated psychotherapy. Miami, FL: The Melissa Institute.

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