Toward effective service to individuals, and divorcing families and stepfamilies

About Spiritual Assessment and Interventions
p. 2 of 3

Tap Your and Your Clients' Spiritual Resources!

By Peter K. Gerlach, MSW

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The Web address of this article is http://sfhelp.org/etx/basics/spirituality2.htm

        This Web page continues exploring spirituality (vs. religion) as a clinical resource and/or client stressor. The first page proposes...

  • some key semantic definitions;

  • a self-assessment inventory about your spirituality and your workplace;

  • a reason to include spirituality in clinical work with divorcing families and stepfamilies;

  • basic perspective on, and premises about spirituality and clinical spirituality interventions; and...

  • potential benefits of including spirituality in the work with receptive clients. 

        This page ...

  • describes psychologically-toxic spirituality,

  • outlines ideas on assessing client spirituality, and ...

  • offers ideas on how to use the clinician's and client's spirituality with client-families whose spirituality seems non-toxic. 

        The final page offers intervention-options for clients with toxic spiritual or religious beliefs and practices.


 About Toxic Spirituality ...

        This site promotes high-nurturance (wholistically healthy) family relationships. "Toxic" means anything that significantly blocks or degrades that, in someone's informed view. Because spirituality is one of  four core ingredients of personal and family wholistic health, I propose that some spiritual and religious values, beliefs, and practices can be unquestionable toxic. Some people believe that accepting our spiritual "One-ness" is the core human health issue.

        Let's define toxic spirituality or religion as beliefs that promote excessive shame, guilt fear(e.g. of Satan, demons, Hell, Purgatory, and/or "eternal damnation"), hatred, scorn, pretense, intolerance, distrust , righteous superiority , black/white and fuzzy thinking, aggression ("you must believe the one true Word!"), dependence on a Holy Book for rote values ands answers instead of self-aware personal judgment and instinct; and reality distortions (e.g. the Salem witchcraft persecutions). When present, these attributes usually indicate false-self dominance , unawareness , and denials .

        This model proposes that spiritual neglect, abuse, and aggression are major toxic stressors. They each (1) indicate _ a low-nurturance setting and _ major adult wounds ; and (2) significantly degrade personal and family-system balance and health. Premises:

  • spiritual neglect occurs in a family when co-parents don't value or intentionally try to help kids' _ understand and _ experience a nurturing Higher Power, _ honestly answer kids' questions about their own spirituality (or lack of it), and _ respect every person's right to form their own spiritual and religious beliefs and practices over time.

  • spiritual abuse occurs when one person (like a co-parent) forces toxic spiritual beliefs and/or religious practices on a dependent person who cannot defend themselves or withdraw. A common example is the innocent traditional child's prayer "Now I lay me down to sleep," which implies the adult calmly believes each night that the child may "die before (s/he) wakes." 

  • spiritual aggression occurs when one person insists that another person must accept some (undesired or repugnant) spiritual beliefs or religious practices without regard for that person's opinions or needs. The distinction between abuse and aggression can be vague an subjective. It may be relevant only if "abuse," "abused," and "abuser" are highly-provocative terms to one or more participants.

        Righteous belief in the concept of evil (purposeful, malevolent intentions and actions) can be toxic, depending on how that belief affects actions and relationships. Judging a person or a personality subself to be evil (vs. wounded and unaware) makes the judger "1-up" (superior). This prevents mutually-respectful communication and relationships, and fosters resentment, defensiveness, and retaliation or withdrawal. I suspect that people who need to label others as evil and themselves as good are unaware of being chronically ruled by excessively-shamed subselves. 

        Nurturing spirituality is faith in a benign, accessible Higher Power which promotes genuine acceptance, love, and respect of self and others; serenity (vs. inner pain); healthy bonding and grieving; wholistic healing and growth; forgiveness and compassion; selective trusts; realistic optimism (vs. rigid idealism or cynicism) and hope; and self awareness and actualization.

        Implication: some beliefs and actions based rigidly on the Hebrew/Christian Old Testament are psychologically toxic. That book's demand of absolute obedience to a "wrathful, vengeful God" promotes fear, guilt, and shame just for being born human - specially when amplified by a stern, judgmental church community. The belief that rejecting Jesus the Christ as a personal Savior dooms a person to "burn forever in Hell" is psychologically toxic beyond dispute - specially to a vulnerable child. Notice your reaction: indignation, defensiveness, pity, and scorn are sure signs of false-self dominance.

        Christian and similar concepts of "original sin" can be toxic to persons and families. If over-emphasized and taken literally, this idea promotes (a) chronic guilt, shame, anxiety, self doubt, and (b) rote reliance on reported beliefs of people dead for millennia, vs. personal judgment and inner spiritual wisdom. Yes, the concept of personal or mortal sin can promote morally-right actions, but (I fear) at the risk of significant psychological wounding, stunted personal development, and chronic shame and anxiety.

        Taken literally, modern manifestations of the ancient Persian (pre-Christian) concept of "Hell" and "the Devil" can also be psychologically toxic, because they promote spiritual aggression and abuse, and terror. These encourage false-self dominance and related wounds - specially in young children. Earnest proponents warn that Satan constantly schemes to snare unwary persons' souls, depriving them of (Christian) salvation and Heavenly peace. This promotes choosing Christian beliefs and affiliations because of fear and distrust.

        As a grateful believer in an unconditionally-loving God, I am not Bible-bashing here. I am proposing there's a toxic price tag to not seeing Holy books as offering useful symbolic and metaphoric guidance, inspiration, and moral encouragements, vs. Divine instruction and "law." Zealots' mindless beliefs that God or Allah - via  the Bible or Koran - demand that they kill "infidels" and "unbelievers" to be "righteous" and "attain Paradise or Heaven" is one of the bloodiest tragedies in the human saga. Incidentally, can you recall reading or hearing of militant Buddhist, Quaker, or Hindu "fanatics"? 

        You probably know adults who make major life decisions based on rigid religious credos (and needs for social inclusion and approval), rather than on their own inner spiritual/rational wisdom. After 70 years on Earth and over a decade of experience with inner-family therapy , I propose that people who don't know they're controlled by a false self risk stunted, distorted, or toxic spirituality. This seems specially likely in low-nurturance human environments. Unaware, wounded co-parents risk uncritical reliance on charismatic, fervent religious leaders for life-guidance, rather than on their inner Spirit and true Self. Whose beliefs are shaping your life?

        I invite you to reflect now on what you believe about _ nurturing and toxic spirituality, and _ how your beliefs and related moral (right/wrong) values affect the professional service you provide. Notice your self talk now...

        We've briefly reviewed ideas on _ why include spirituality in clinical work with these clients, and _  toxic and nurturing spirituality. Let's use these ideas now to explore options for...


 Assessing Client Spirituality

        Have you evolved an effective conscious way to learn about your clients' spirituality now? If you belief spirituality is a valid aspect of clinical work, four relevant questions are: assess for _ what, _ when, and _ how?

Assess What?

        Typical questions to research are...

  • Does spirituality or religion significantly shape this family's nurturance level ? The clinician may judge "significantly" differently than the family's leader/s.

  • If not, is this a symptom of the family's leaders bearing significant false-self wounds? To answer, the clinician must first assess _ "Who comprises this family system now?," and _ "Who leads it recently?"  

  • If so, where do the impacts of each of these two factors fall on a line between "highly toxic" and "highly nurturing"?

    • If "significantly nurturing," how can I best use this to promote effective clinical service with this family?"

    • If "significantly toxic": is there credible evidence of spiritual _ neglect, _ abuse, or _ aggression affecting members of this family? If so, _ how do these relate to the client's presenting problems, and _ what are my clinical options?

  • If this client-family's spiritual beliefs and/or religious practices differ significantly from mine, does that hinder my respect for, and objectivity with them? If so, what is my best option?

  • If any client adult judges my spiritual and religious beliefs, does this help or hinder our work? What are my options?

  • Do this family's spirituality or religious preferences and practices significantly bias _ an ex mate and/or relatives, _ my supervisor, _ any consultant/s working with the family, or _ anyone else who affects this family's nurturance level? And...

  • How receptive are these client adults to discussing and using spirituality openly to enhance our work together?

        Reflect on current or recent divorcing or stepfamily clients - have you assessed any of these questions with them? If so, has this helped or hindered your service to them, so far? If you need to discuss this with anyone, _ who and _ why?

Is There a Best Time to Assess Client Spirituality?

        At intake: The answer depends on your and/or your organization's policy on this: "If I or we ask about client spirituality and religion as part of the intake process, how may that affect the work? In religiously homogenous communities ("Chattanooga is largely Baptist"), this may be clear. Insecure (wounded) client adults may be uncomfortable with or resent such questions, feeling "It's none of your business!," or "That has no bearing on our (presenting) problems!" Conversely, "religious" clients may find the question appropriate and reassuring. An intake-questionnaire item asking clients to define "Family religious preference, if any: ______" may be an acceptable compromise for average clients.

          After intake: If the clinician or agency doesn't ask at intake, clients may reveal their spiritual or religious identities and beliefs spontaneously as sessions unfold. When and how they do, in the context of the work, will suggest whether to ask for more information or not. If the clinician notices no such spontaneous information, s/he has more strategic options earlier if s/he asks some general question/s during initial conversations: "Do you feel someone's spirituality is affecting your (presenting) problem in any significant way?" First asking "Do your family members see spirituality and religion as the same, or different?" is a stylistic choice. Be prepared for something like: "We've never talked about that." 

         Special situations: as client members reveal themselves, some key situations make spirituality and religious assessment specially relevant and useful - e.g.

  • "Addicted" families: if one or more family members appear to have any of the four addictions ,  describing and/or referring clients to a 12-step program should include telling them to expect it to invite them to turning unmanageable life situations over to a personal Higher Power. This may prevent atheist and agnostic (wounded) clients from following such referral.

  • Individual recovery (inner-family) work: many children and adults ruled by false selves are significantly stressed by subselves excessively guilty, shamed , and scared by toxic religious beliefs. At some point in the work, it can be productive to focus respectfully on these subselves. Assessment options include exploring _ what they believe about God, Satan, Heaven, Hell, sin, evil, etc., _ where they got their beliefs, _ who they fear would disapprove of their shifting beliefs, and _ how other subselves react to these beliefs. There are many variations.

  • Families majorly conflicted over religious prejudice - the three or more extended biofamilies comprising stepfamilies are specially vulnerable to significant values conflicts over spirituality and religion. Some divorced bioparents develop serious conflicts over their children's religious training. Most client co-parents haven't developed a unified, effective strategy to resolve values conflicts in general. Doing so is part of safeguard Project 2  here.

  • Families significantly stressed by blocked grief . A major resource in healthy grieving is (a) accepting that we can't control many aspects of our relationships and environment, and (b) "turning them over" to a caring Higher Power. People with clear spiritual faith may temporarily lose it when reacting to some incomprehensible loss ("If there's a loving God, how could He allow this?"). They need to progress on the spiritual level of mourning, which (a) finds some answer to that question (e.g. "I accept that I can't know why God does what He does."), and (b) eventually restores a stable spiritual faith.

  • Families stressed by a media or social source of toxic religious beliefs or practices - e.g. a church, cult, or "movement." Can you think of any in media headlines recently?  

  • Families unintentionally neglecting the spiritual development of dependent children.

Some options apply to all five client types . In what follows, "God" can be any title, label, or Prophet you feel is most relevant:

  • Include one or several questions on any intake forms or checklists - e.g. "On a scale of 1 to 10 (10 = "extremely"), how important would you say spirituality (vs. religion) is to your immediate family recently?"
     

  • When appropriate, ask generic questions like ...

    "What does 'spirituality' mean to you?"

    "Do you believe in a Higher Power now? 'No' is perfectly OK with me."

    "Do you feel that God can help you with this problem?"

    "How are you most comfortable accessing God?"

    "Do you feel God is present in and with us right now?"

    "How comfortable would you be in our asking for God's help as we work together?"

    "Have you ever had an experience where you felt God's presence or intervention?"

    "What did each of your childhood caregivers teach you about spirituality?"

    "If God spoke to you now about your problem, what do you feel you'd hear?"

    "Do you have a spiritual mentor now?", or "Have you ever had a spiritual mentor or teacher?"

    "How would others in your family feel about our using our spirituality to help us in our work?"

        The way attending clients answer questions like these (mindlessly, timidly, anxiously, vaguely, confidently,...) reveals as much as their answers. My experience is that responses to questions like these usually suggest follow-on assessment questions which help develop a "sense" of individuals' and the family's client's spiritual and religious beliefs, rules (boundaries), morals, and priorities.

When Assessment Timing

        Is there a best time in the work to assess a client's spiritual resources and limits? Because assessment is an organic, phased process, and spirituality or religion can be highly-charged topics, clinical flexibility helps, here. Experience suggests that building a solid therapeutic alliance and gaining a sense of the clients' traits and situation first, is a good guide for if and when to ask assessment questions like those above. In part, the timing will depend on _ the clinician's style and comfort level with this topic, _ cues provided by the attending clients, and _ the presenting problems. 

        Some clients will bring up spiritual or religious issues spontaneously, creating an opportunity to assess. With those who don't, the clinician's Self will guide them to wait until a "lull" or an impasse occurs in the flow of the work. Clinical impasses are "windows of opportunity" that can open new intervention possibilities. Example: the clinician asks ...

"I confess, I feel stuck right now. I'd like us to be quiet for a few moments, and see if (God, Higher Power, Inner Voice, ...) will give you or me a direction that we're not seeing yet. Would you feel OK doing that?" 

        Such a question is both an assessment and a teaching intervention. My experience since 1981 is that most clients with prior clinical experience have never _ had a professional admit to being "stuck," and/or _ heard a question like that. What's your experience?


 


 


The Right Conditions

        What "conditions" promote successful clinical spirituality interventions with typical divorcing and stepfamily clients?

  • The clinician's inner family (personality)  is clearly under the guidance of their true Self (vs. false self) and a meaningful Higher Power. Otherwise spirituality interventions may be contrived, insincere, ambivalent, or covertly manipulative or shaming.

  • The client and clinician mutually respect each other's theology, even if they clearly disagree on some elements.

  • Both agree that the clinician (other than an invited spiritual counselor) is not  trying to instruct the client on what or how to believe, or how to worship. Nor is s/he  judging the "rightness" of what the client believes - unless their beliefs seem toxic to the client and/or others. "Toxic" means significantly degrading the client's or dependent kid's wholistic health by promoting excessive fear, guilt, shame, distrust, bigotry, and/or confusion. In this site, "client" means the attending person/s' nuclear family

        Other "right circumstances" include ...
  • The clinician's choices about spirituality interventions are  self-motivated and authentic, and  are acceptable to co-workers, supervisor, and clinical or program director, if any. If not, overt or unspoken values' conflicts with colleagues may promote inner conflict ("ambivalence") in session, which can confuse and hinder the client's trust in the clinician.

  • The attending client/s are receptive enough (per their judgment) to the clinician's respectfully exploring spirituality issues and resources - among others - in assessing and filling the client's unfilled needs; and ...

  • The clinician is able to flex to adapt to the client's spiritual concepts and language, rather than requiring or implying that the client should use the clinician's concepts and terminology. A corollary is that the clinician needs to avoid imposing their own spiritual biases about if or how a Supreme Being may or may not help in the work; And ...

  • any other conditions you feel are necessary before making valid spirituality interventions.

 Options for Using (Clinician + Client) Spirituality Effectively

        If the right conditions are met and the timing is right, how can a clinician or other professional use their own and the client's spiritual resources to help reach their human- service goals? Because clinician personality and paradigm, clients, and situations are unique, specific answers must be unique also. Options are that the clinician perceives the client-family's spirituality is...

  • irrelevant to presenting problems, and clinical goals and interventions, or...

  • a potential resource to them and the work; or...

  • the client's faith and religious practices and/or environment (e.g. church community) seem to _ reduce client-family's nurturance level, _ promote significant false-self wounds, and _ contribute to the client's presenting problems.

These scenarios raise different procedural and boundary questions, and invite different interventions. Let's look at each, briefly ...

1) Client Spirituality Seems Benign (Non-toxic)

        Spirituality-intervention options vary with the client type, their problems, and the (non-marital > marital >personal) phase of the work.

Options With Courting-stepfamily Clients

        These clients typically don't know what they don't know about psychological wounds and stepfamily realities and implications . Typically, they're muting, intellectualizing, or avoiding any significant conflicts about spirituality or religion (and other things). Exceptions are client couples from different conservative religious denominations (e.g. fundamental Christian and Orthodox Jewish, or Muslim and Baptist) whose extended-family or social environment promotes mutual judgment (prejudice) and rejection. Stepfamily research suggests that cross-denominational unions are significantly more likely in American re/marriages than first marriages.

        With this in mind, assessment and intervention options with these clients include ...

  • Assess for nurturing (vs. toxic), shared couple spirituality (vs. religious compatibility), and overtly include those among the couple's current strengths. Doing so helps offset scary warnings of major stepfamily conflict and re/divorce risk;

  • If one or both partners are divorced, assess for significant inner or intra-family values conflicts over that (like "divorce is a sin"), and how each divorced partner is coping with any related shame, guilts, anxieties , and confusion. Also ask the couple's opinion about how co-parenting ex mates are doing with the same questions. Seed the vision of healing each of these intra-personal stressors, and how that will benefit any kids involved, long-term;

  • If one partner identifies as "spiritual" or "religious," and the other doesn't, assess whether the couple has meaningfully considered how that values difference will affect their co-parenting decisions and child-visitation harmony. If "no," are they motivated to do so? Serious open or muted conflicts here can lead into assessing and teaching the couple about their inevitable stepfamily values and loyalty conflicts. Intervention option: explain and facilitate Projects 2 and 9 .

  • Assess whether _ you and _ the client-couple think that spirituality or religion is a strength or stressor in the past and current relationship between ex mates, and/or their extended families. If the latter, facilitate the couple's resolving that, vs. ignoring, minimizing, or enduring.

  • If one or both partners or a co-parenting ex mate appears to be significantly ruled by a false self, assess for possible worship or religious addiction . If you suspect it, indicated interventions are the same as with any other symptom of false-self dominance.

  • Alert receptive couples to the PREPARE (MC) and REFOCCUS pre-re/marriage assessment services. These may inspire the couple to do the more detailed safeguard projects 1-7 proposed here. Both computer-"scored" assessments are usually facilitated by trained clergypersons in various church denominations. 

Options for Spirituality Interventions with the Other Four Client Types

Representative Spirituality Interventions with "Non-toxic"

Divorcing Biofamilies and Divorcing Stepfamilies

Clinical Focus and Phase

Marital
problems
Inner-family
(individual) work
      1) If attending clients are ambivalent about divorce (ruled by a false self), and their surface reasons for divorce include serious spiritual or religious conflicts, see if the clients are open to _ learning about using effective problem-solving skills _ to reduce such values conflicts to "tolerable." If not, seed awareness of those. yes yes - focus: inner-family conflicts
      2) If co-parents seem distracted from using existing inner and outer spiritual and religious resources (e.g. pastoral counseling, prayer, and/or church-community support) effectively, _ identify that respectfully, and _ encourage them to proactively overcome the distractions. If they're psychologically wounded, they probably won't, and seeding the idea may still help. yes True recovery naturally invites proactive use of spiritual resources
      3) If one or both co-parents seem enmeshed with or codependent on extended family or church community members over religious beliefs, respectfully confront the couple with their letting other people's beliefs, and underlying guilt and fear of disapproval and rejection break up their marriage. Option: give such couples copies of this, and encourage them to apply it. yes yes
      4) Pray with and for consenting clients for guidance, resilience, and hope with receptive clients yes
      5) Use inner-family systems therapy or equivalent to facilitate _ internal recognition and _ balanced participation of the client's Spiritual subself seed with 
receptive clients
yes
      6) In session, acknowledge impasses and invite all present to get mentally and physically quiet and listen to their "still small (spiritual) voice" for inspiration and direction. If a positive experience, encourage clients to do that outside clinical meetings. with receptive clients yes
      7) Strategically use the clinician's own spirituality to illustrate, inspire, and guide attending clients. yes yes
      8) Encourage clients to meditate, pray, and journal, as their process unfolds yes yes
      9) Teach attending clients the three levels of healthy grief,  help them identify their divorce-related losses, and explore the spiritual level of their grieving. If clients aren't open to this now, seed this healing task. Alert them to their children's and key relatives' primary need for the same three-level healing.  with receptive clients yes, and with other (prior) losses
      10) Refer co-parents as indicated to - or network with - a competent spiritual "coach" or pastoral counselor, and/or a spiritually- compatible "marriage-saver" program, book, or divorce-support group. Ideally, counselors and facilitators will know stepfamily basics. yes yes

        These are illustrative suggestions, not comprehensive. Every case will merit or invite uniquely appropriate spirituality interventions like these. Recall this site's premise that effective clinical work has long-term effects on client families. Therefore, if full interventions like these aren't feasible or timely now, seeding client spiritual awareness and nurturance can still be potentially helpful, long-term.

Continue this clinical series on spirituality assessments and interventions with options for non-divorcing stepfamily clients, and client-families with toxic spirituality issues.

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Updated December 25, 2008