Understanding and Treating Spiritual Abuse

Course #66703-


Self-Assessment Questions

    1 . The vast majority of general literature on the topic of spiritual abuse is
    A) rigorous and objective.
    B) qualitative and experiential.
    C) focused on Eastern religions.
    D) based on research conducted more than 50 years ago.

    FOUNDATIONS: DEFINING SPIRITUAL ABUSE

    The vast majority of general literature on the topic of spiritual abuse is qualitative and experiential in nature. Books from multiple perspectives explore spiritual abuse and its effect. These writings are too numerous to catalogue in the scope of this article. Explanatory and definitional highlights from pastoral, developmental, and clinical perspectives are covered in this section.

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    2 . All of the following are descriptive of possible cults, EXCEPT:
    A) The group is preoccupied with making money.
    B) The group is collectivistic, with no special status or mission.
    C) The group displays excessively zealous and unquestioning commitment to its leader.
    D) The group teaches or implies that its supposedly exalted ends justify whatever means it deems necessary.

    FOUNDATIONS: DEFINING SPIRITUAL ABUSE

    An authority on cultic definition is Michael Langone, founder of the International Cultic Studies Association (ICSA). The ICSA does not publish a list of groups that they label to be cultic. Rather, they encourage those evaluating cultic behavior to make judgments for themselves, using certain criteria as a guideline to determine if a group is destructive or harmful to the people involved. Based on the work of Langone, Lalich and Tobias established the following list as an evaluative guideline [10]:

    • The group displays excessively zealous and unquestioning commitment to its leader (whether alive or dead) and regards his/her belief system, ideology, and practices as the truth or law.

    • Questioning, doubt, and dissent are discouraged or even punished.

    • Mind-altering practices (such as meditation, chanting, speaking in tongues, denunciation sessions, and debilitating work routines) are used in excess and serve to suppress doubts about the group and its leader(s).

    • The leadership dictates, sometimes in great detail, how members should think, act, and feel. For example, members may be required to obtain permission to date, change jobs, or marry—or leaders may prescribe what types of clothes to wear, where to live, whether or not to have children, how to discipline children, and so forth.

    • The group is elitist, claiming a special, exalted status for itself, its leader(s), and its members. For example, the leader may be considered the Messiah, a special being, or an avatar, or the group and/or the leader may be on a special mission to save humanity.

    • The group has a polarized us-versus-them mentality, which may cause conflict with the wider society.

    • The leader is not accountable to any authorities (unlike, for example, teachers, military commanders, or ministers, priests, monks, and rabbis of mainstream religious denominations).

    • The group teaches or implies that its supposedly exalted ends justify whatever means it deems necessary. This may result in members participating in behaviors or activities they would have considered reprehensible or unethical before joining the group (e.g., lying to family or friends, collecting money for bogus charities).

    • The leadership induces feelings of shame and/or guilt in order to influence and/or control members. Often, this is done through peer pressure and subtle forms of persuasion.

    • Subservience to the leader or group requires members to cut ties with family and friends and radically alter the personal goals and activities they had before joining the group.

    • The group is preoccupied with bringing in new members.

    • The group is preoccupied with making money.

    • Members are expected to devote inordinate amounts of time to the group and group-related activities.

    • Members are encouraged or required to live and/or socialize only with other group members.

    • The most loyal members (the "true believers") feel there can be no life outside the context of the group; they believe there is no other way to be. Members often fear reprisals to themselves or others if they leave (or even consider leaving) the group.

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    3 . Spiritual abuse is a global phenomenon that transcends religious denomination or religious practice.
    A) True
    B) False

    FOUNDATIONS: DEFINING SPIRITUAL ABUSE

    As explained, it is paramount to realize that spiritual abuse is a global phenomenon that transcends religious denomination or religious practice. Throughout history, if one person has been in the position to wield power over another person and chooses to use God, enlightenment, salvation, the threat of damnation, the promise of enlightenment, or other spiritual promise/threat to exert that power, a spiritually abusive relationship can exist. This relationship can occur between a spiritual leader (e.g., pastor, priest, guru, imam, rabbi) and his or her congregation, between parents/grandparents and their children, or between mentors/gurus and their disciples.

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    4 . The term guru is from the Sanskrit meaning
    A) "to worship."
    B) "close friend."
    C) "one with knowledge."
    D) "one who casts out darkness."

    FOUNDATIONS: DEFINING SPIRITUAL ABUSE

    The term "guru" is worth exploring as well. Guru is the Sanskrit word meaning "teacher" or "master," literally translated as "one who casts out darkness." Although originating in Hinduism, many in the modern era use the term in reference to anyone whose teachings attract followers. For example, some consider the Dalai Lama to be a guru, and notable leaders in other disciplines not related to religion have even been referred to as gurus. Because of well-publicized scandals involving guru misconduct in the last several decades, especially in the areas of financial and sexual exploitation, many people in the United States attribute a negative connotation to the word "guru," similar to the negative, exploitative connotation associated with the term "cult."

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    5 . From the pastoral perspective, spiritual abuse is seen as
    A) damaging an individual's core identity.
    B) leaving victims emotionally removed from the "healing love of God."
    C) involving the mistreatment of a person who is in need of help, support, or greater spiritual empowerment.
    D) All of the above

    FOUNDATIONS: DEFINING SPIRITUAL ABUSE

    In their revolutionary work The Subtle Power of Spiritual Abuse, Jeff VanVonderen and former pastor David Johnson defined spiritual abuse as "the mistreatment of a person who is in need of help, support, or greater spiritual empowerment, with the result of weakening, undermining, or decreasing that person's spiritual empowerment" [13]. Many abuse survivors, with spiritual abuse being no exception, have a tendency to feel that they are somehow uniquely "crazy" for feeling a certain way. This doubt about the validity of experience can be an even greater factor with spiritual abuse because a great many people do not realize it is an actual form of abuse, as much as physical or sexual abuse.

    Dale and Juanita Ryan, who worked closely with Ken Blue, put it in the simplest terms: "Spiritual abuse is a kind of abuse that damages the central core of who we are. It leaves us spiritually disorganized and emotionally cut off from the healing love of God" [16].

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    6 . Primal or undifferentiated faith (birth to 2 years of age) is characterized by conformity to religious authority and the development of a personal identity.
    A) True
    B) False

    FOUNDATIONS: DEFINING SPIRITUAL ABUSE

    The fields of psychology and related helping professions have a variety of developmental models to describe the human experience. A specific psychologic model of faith development also exists, attributed to developmental psychologist James W. Fowler and based on the works of Piaget, Erickson, and Kohlberg (who introduced the stages of moral development in human being) [17]. Examine this Faith Development Model and consider where spiritually abusive experiences might have their greatest impact [17]:

    • Stage 0: Primal or undifferentiated faith (birth to 2 years of age) is characterized by an early learning of the safety of one's environment (i.e., warm, safe, and secure vs. hurt, neglect, and abuse). If consistent nurturing is experienced, one will develop a sense of trust and safety about the universe and the divine. Negative experiences will cause one to develop distrust with the universe and the divine.

    • Stage 1: Intuitive-projective faith (3 to 7 years of age) is characterized by the psyche's unprotected exposure to the Unconscious.

    • Stage 2: Mythic-literal faith (mostly school-age children) is characterized by a strong belief in the justice and reciprocity of the universe. During this stage, deities are almost always anthropomorphic (i.e., personified).

    • Stage 3: Synthetic-conventional faith (12 years of age to adulthood) is characterized by conformity to religious authority and the development of a personal identity. Any conflicts with one's beliefs are ignored at this stage due to the fear of threat from inconsistencies.

    • Stage 4: Individuative-reflective faith (usually mid-twenties to late thirties) is characterized as a stage of angst and struggle. The individual takes personal responsibility for his or her beliefs and feelings. As one is able to reflect on one's own beliefs, there is openness to a new complexity of faith, but this also increases the awareness of conflicts in one's belief.

    • Stage 5: Conjunctive faith (mid-life) is characterized by the acknowledging of paradox and transcendence relating to the reality behind the symbols of inherited systems. The individual resolves conflicts from previous stages by a complex understanding of a multidimensional, interdependent "truth" that cannot be explained by any particular statement.

    • Stage 6: Universalizing faith, or what some might call "enlightenment," is characterized by the individual treating any person with compassion as he or she views people as from a universal community and worthy of being treated with the universal principles of love and justice.

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    7 . Stage 1 of Fowler's Faith Development Model is characterized by
    A) angst and struggle.
    B) conformity to religious authority.
    C) an early learning of the safety of one's environment.
    D) the psyche's unprotected exposure to the Unconscious.

    FOUNDATIONS: DEFINING SPIRITUAL ABUSE

    The fields of psychology and related helping professions have a variety of developmental models to describe the human experience. A specific psychologic model of faith development also exists, attributed to developmental psychologist James W. Fowler and based on the works of Piaget, Erickson, and Kohlberg (who introduced the stages of moral development in human being) [17]. Examine this Faith Development Model and consider where spiritually abusive experiences might have their greatest impact [17]:

    • Stage 0: Primal or undifferentiated faith (birth to 2 years of age) is characterized by an early learning of the safety of one's environment (i.e., warm, safe, and secure vs. hurt, neglect, and abuse). If consistent nurturing is experienced, one will develop a sense of trust and safety about the universe and the divine. Negative experiences will cause one to develop distrust with the universe and the divine.

    • Stage 1: Intuitive-projective faith (3 to 7 years of age) is characterized by the psyche's unprotected exposure to the Unconscious.

    • Stage 2: Mythic-literal faith (mostly school-age children) is characterized by a strong belief in the justice and reciprocity of the universe. During this stage, deities are almost always anthropomorphic (i.e., personified).

    • Stage 3: Synthetic-conventional faith (12 years of age to adulthood) is characterized by conformity to religious authority and the development of a personal identity. Any conflicts with one's beliefs are ignored at this stage due to the fear of threat from inconsistencies.

    • Stage 4: Individuative-reflective faith (usually mid-twenties to late thirties) is characterized as a stage of angst and struggle. The individual takes personal responsibility for his or her beliefs and feelings. As one is able to reflect on one's own beliefs, there is openness to a new complexity of faith, but this also increases the awareness of conflicts in one's belief.

    • Stage 5: Conjunctive faith (mid-life) is characterized by the acknowledging of paradox and transcendence relating to the reality behind the symbols of inherited systems. The individual resolves conflicts from previous stages by a complex understanding of a multidimensional, interdependent "truth" that cannot be explained by any particular statement.

    • Stage 6: Universalizing faith, or what some might call "enlightenment," is characterized by the individual treating any person with compassion as he or she views people as from a universal community and worthy of being treated with the universal principles of love and justice.

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    8 . According to Fowler's Faith Development Model, conjunctive faith, or an acknowledging of paradox and transcendence relating to the reality behind the symbols of inherited systems, usually occurs
    A) at 3 to 7 years of age.
    B) in school-age children.
    C) at midlife.
    D) in old age.

    FOUNDATIONS: DEFINING SPIRITUAL ABUSE

    The fields of psychology and related helping professions have a variety of developmental models to describe the human experience. A specific psychologic model of faith development also exists, attributed to developmental psychologist James W. Fowler and based on the works of Piaget, Erickson, and Kohlberg (who introduced the stages of moral development in human being) [17]. Examine this Faith Development Model and consider where spiritually abusive experiences might have their greatest impact [17]:

    • Stage 0: Primal or undifferentiated faith (birth to 2 years of age) is characterized by an early learning of the safety of one's environment (i.e., warm, safe, and secure vs. hurt, neglect, and abuse). If consistent nurturing is experienced, one will develop a sense of trust and safety about the universe and the divine. Negative experiences will cause one to develop distrust with the universe and the divine.

    • Stage 1: Intuitive-projective faith (3 to 7 years of age) is characterized by the psyche's unprotected exposure to the Unconscious.

    • Stage 2: Mythic-literal faith (mostly school-age children) is characterized by a strong belief in the justice and reciprocity of the universe. During this stage, deities are almost always anthropomorphic (i.e., personified).

    • Stage 3: Synthetic-conventional faith (12 years of age to adulthood) is characterized by conformity to religious authority and the development of a personal identity. Any conflicts with one's beliefs are ignored at this stage due to the fear of threat from inconsistencies.

    • Stage 4: Individuative-reflective faith (usually mid-twenties to late thirties) is characterized as a stage of angst and struggle. The individual takes personal responsibility for his or her beliefs and feelings. As one is able to reflect on one's own beliefs, there is openness to a new complexity of faith, but this also increases the awareness of conflicts in one's belief.

    • Stage 5: Conjunctive faith (mid-life) is characterized by the acknowledging of paradox and transcendence relating to the reality behind the symbols of inherited systems. The individual resolves conflicts from previous stages by a complex understanding of a multidimensional, interdependent "truth" that cannot be explained by any particular statement.

    • Stage 6: Universalizing faith, or what some might call "enlightenment," is characterized by the individual treating any person with compassion as he or she views people as from a universal community and worthy of being treated with the universal principles of love and justice.

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    9 . Purcell defines spiritual abuse among people as existing on a continuum from zero to terrorism.
    A) True
    B) False

    FOUNDATIONS: DEFINING SPIRITUAL ABUSE

    Purcell's succinct definition of spiritual abuse is "any unhealthy, mind-altering relationship with the God of a person's conception that has life-harmful consequences" [19]. He defines spiritual abuse among people as existing on a continuum from zero to terrorism.

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    10 . As it applies to spirituality, legalism is defined as
    A) receiving two contrasting viewpoints about God or spirituality.
    B) the extent to which a religion or spiritual group is accepted as valid.
    C) a religious belief that people can please God or any chosen deity by obeying specific rules.
    D) the belief that the Bible or other sacred texts must be interpreted literally to be properly understood.

    FOUNDATIONS: DEFINING SPIRITUAL ABUSE

    Purcell has identified three causes of spiritually abusive dynamics. Although he writes primarily from a Christian perspective, these causes clearly apply to abuse dynamics within other belief systems as well [19]:

    • Legalism: A religious belief that people can please God or any chosen deity, even earning their way into heaven or an afterlife, by obeying specific rules. This is commensurate with a reward and punishment mentality, the lowest stage in Kohlberg's stages of moral development.

    • Literalism: The belief that the Bible or other sacred texts must be interpreted literally, not symbolically, to be properly understood.

    • Mixed messages: Receiving two contrasting viewpoints about God or spirituality (e.g., "God loves you unconditionally," vs. "But God will only love and accept you if you follow all of the rules").

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    11 . A desire for or a need to control is a common trait in those who spiritually abuse, typically because they are lacking an internal sense of security and stability.
    A) True
    B) False

    COMMON THEMES IN SPIRITUAL ABUSE

    A desire for or a need to control is a common trait in those who abuse, typically because they are lacking an internal sense of security and stability. Those who work with trauma survivors typically assume that those who abuse others have been abused or mistreated themselves on some level. A trauma-sensitive perspective informs that if the original wound is not resolved, a person may act out in a maladaptive attempt to heal. The likelihood of a maladaptive, or unhealthy, response increases if the person is never shown healthier ways to resolve his or her wounding. This section will explore the traits of those who are likely to spiritually abuse—traits that are common regardless of the religious denomination or spiritual practice in question. In addition, some of the traits of those vulnerable to spiritual abuse will be discussed. Finally, the section will end with a discussion of the similarities and differences between those abuses that occur in religious or spiritual settings (e.g., churches, temples, ashrams) and those that occur within the home or family.

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    12 . Which of the following is NOT one of the major traits of those who spiritually abuse others?
    A) An intent to harm
    B) Narcissistic traits/tendencies
    C) A genuine belief in one's righteousness
    D) Skill in the language of love, emotions, trust, and intimacy

    COMMON THEMES IN SPIRITUAL ABUSE

    There are three major traits of those who spiritually abuse others:

    • Narcissistic traits/tendencies, resulting from deep insecurity

    • Usually a genuine belief that one is doing "the right thing" (rarely an intent to harm)

    • Skilled in the language of love, emotions, trust, and intimacy

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    13 . Victims of spiritual abuse often
    A) have a relatively stable life.
    B) have a genuine intent to pursue truth.
    C) hold the belief that love is given, not earned.
    D) are described as emotionally detached or unavailable.

    COMMON THEMES IN SPIRITUAL ABUSE

    People who are spiritually abused genuinely desire love, acceptance, intimacy, and the positive attributes of spiritual experiences. Many have been hurt in other areas of life and are seeking a spiritual connection. Abusers tend to sense this and take advantage of or exploit it. Commonly observed traits in people who are prone to being spiritually abused include:

    • Deep insecurity and emotional sensitivity

    • A genuine intent to pursue truth

    • Deep longing for love, emotions, trust, and intimacy

    • A belief that love is earned

    • Periods of crisis or major life change

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    14 . Those who are prone to being spiritually abused typically have extreme sensitivity.
    A) True
    B) False

    COMMON THEMES IN SPIRITUAL ABUSE

    As discussed, those who spiritually abuse are often insecure. Those who are prone to being abused typically have the added dynamic of extreme sensitivity. Such sensitivity is like a fire in a fireplace. If it rages out of control, it can burn the house down, but if the fire dies (i.e., sensitive tendencies are numbed), the house will be freezing. The key is to keep a balance. Many sensitive people have the purest of intentions, as the traits suggest, to do the right thing and to live in truth, love, trust, and deep intimacy. Yet if this is not managed, it can make them vulnerable to a host of negative responses (e.g., addictive responses) or to being exploited emotionally, sexually, financially, physically, and spiritually.

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    15 . The Primary Care PTSD Screen
    A) is a diagnostic tool.
    B) consists of four items that can be modified for spiritual abuse.
    C) is a psychometric test designed to measure the severity of one's PTSD.
    D) is not recommended for providers who are inexperienced in assessing for PTSD.

    ASSESSING FOR SPIRITUAL ABUSE

    Providers who are not experienced in assessing for PTSD or trauma should start with a semi-standardized interview tool such as the Primary Care PTSD Screen (Table 1) [22]. The Primary Care PTSD Screen is not meant to be a diagnostic tool, but it is an effective screening tool, indicating whether or not further assessment is necessary. If a client answers "yes" to any of these questions, the results of the screening should be considered positive. A list of other screening tools or psychometric measures and instructions on their use in clinical settings is available at https://www.ptsd.va.gov/professional/provider-type/doctors/screening-and-referral.asp. Any trauma-related tool can be used to assess for the presence of spiritual abuse as long as it is appropriately modified.

    PRIMARY CARE PTSD SCREEN

    In your life, have you ever had any experience that was so frightening, horrible, or upsetting that in the past month you:

    1. Have had nightmares about it or thought about it when you didn't want to?

    2. Tried hard not to think about it or went out of your way to avoid situations that remind you of it?

    3. Were constantly on guard, watchful, or easily startled?

    4. Felt numb or detached from others, activities, or your surroundings?

    If you want to specifically tailor the tool to assess for spiritual abuse, you can modify the opening statement: In your life, have you ever had any spiritual or religious experiences that were so frightening, horrible, or upsetting?

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    16 . The idea of observing and reacting to issues that come up during the treatment process is an important part of assessing for spiritual abuse.
    A) True
    B) False

    ASSESSING FOR SPIRITUAL ABUSE

    The idea of observing and reacting to issues that come up during the treatment process is an important part of assessing for spiritual abuse. Many forms of trauma are not evident in the first session. Even if they are, it is generally not prudent to ask clients detailed questions about the trauma until sufficient rapport has been established and the client has sufficient stabilization, or coping, skills to deal with the distress that may manifest in his or her disclosures. Few clients will identify spiritual abuse as being a trauma or a form of abuse, even if asked during an initial assessment, because many people continue to be unaware of the possibility of this type of abuse. One potential avenue in the initial assessment is to ask a question about religious and/or cultural upbringing. Clients may respond with, "I grew up in a very devout (insert denomination or religion) home, so I was given a lot of negative messages about sex." Such responses provide an opportunity to follow-up or even educate clients on spiritual abuse.

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    17 . Which of the following statements regarding 12-step programs and spirituality is TRUE?
    A) The steps demand devotion to a specific God or religion.
    B) All patients initially resist the spiritual aspects of 12-step programs.
    C) Part of the 12-step philosophy is to begin exploring a relationship with a Higher Power.
    D) Working to develop spiritual resources is not a standard part of the 12-step treatment process.

    ASSESSING FOR SPIRITUAL ABUSE

    Issues of spiritual abuse may also reveal themselves when working with a client to develop spiritual resources. This is a standard part of the treatment process in traditional substance use disorder treatment, especially those following a 12-step model. Founded in 1935, the 12 steps of Alcoholics Anonymous (AA) have been developed by many treatment centers as a philosophical approach. Part of 12-step philosophy is, after a person admits powerlessness over drugs or alcohol, to begin exploring a relationship with a Higher Power or power greater than oneself and to turn one's will and life over to the care of this power. The steps are not intended to demand devotion to a specific God or religion, but rather to allow addicts to develop their own conceptualization of God. Although many people find 12-step spirituality to be user-friendly and easily accessible to those who desire spirituality and not religion, others resist the 12-step model as being too "God-oriented." Others are able to express their belief in God, but find the idea of trusting a God of their understanding or turning their life over to a Higher Power scary. These resistances may be a natural part of addiction recovery, or they may be a sign that spiritual abuse occurred and is unresolved.

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    18 . The greatest predictor of facilitating meaningful change in clients with complex PTSD is
    A) the severity of symptoms.
    B) available coping resources.
    C) the type of traumatizing event.
    D) the quality of the therapeutic alliance.

    TREATING SPIRITUAL ABUSE

    As is the case when treating all forms of trauma, forging a solid therapeutic alliance is absolutely imperative when working with victims of spiritual abuse [19]. The importance of a solid therapeutic alliance is well-established by research in the field, and its implication in treating trauma is even more significant [25,26]. The literature addressing general traumatic stress indicates that the quality of the therapeutic alliance, as rated by clients, is the greatest predictor of facilitating meaningful change in clients with complex PTSD [27,28,29]. The Anaïs Nin quote,"Shame is the lie that someone told you about yourself" is often used to illustrate the effects of abuse on young children. Helping professionals are in a position of power, and this power may be used to continue reinforcing negative self-talk or to help a person start to see a new truth about himself or herself, which can hopefully assist that person in developing a healthier relationship with spirituality. The modeling process is the very essence of setting a crucible for change through the therapeutic alliance.

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    19 . Which of the following is NOT one of the three stages of treatment of PTSD and other trauma?
    A) Recounting
    B) Stabilization
    C) Reprocessing
    D) Reintegration

    TREATING SPIRITUAL ABUSE

    There is a general consensus in the traumatic stress literature that addressing trauma should occur in three stages [30,31,32,33]:

    • Stabilization

    • Working through of the trauma (reprocessing)

    • Reintegration/reconnection with society

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    20 . Which of the following methods is the most effective for reprocessing trauma?
    A) Exposure therapy
    B) Somatic experiencing
    C) Trauma-focused cognitive-behavioral therapy
    D) No one specific therapy is considered the most effective.

    TREATING SPIRITUAL ABUSE

    No one specific therapy is considered the most effective for reprocessing trauma [34,35]. The decision of which approach to use is based on a combination of factors, including the needs and strengths of the client, the experience and strengths of the therapist, the therapeutic alliance, and the choice of a method that engages and inspires the participants [25]. A wide variety of methods and approaches can help a person resolve trauma, including, but not limited to, psychoanalysis, experiential therapy, EMDR, trauma-focused cognitive-behavioral therapy, exposure therapy, stress inoculation therapy, somatic experiencing, narrative therapy, Gestalt therapy, and more innovative approaches like art therapy, music therapy, yoga therapy, dance therapy, and animal- or equine-assisted therapy. A combination of modalities is often necessary to help a client optimally heal, especially when issues connected to core identity are involved.

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    21 . When working in an outpatient setting, reintegration is
    A) of limited usefulness.
    B) incorporated throughout treatment.
    C) only attempted after all other work is complete.
    D) left up to the individual client and his/her friends and family.

    TREATING SPIRITUAL ABUSE

    There will be a great deal of overlap between stage 3 and stages 1 and 2, especially when trauma work is being done with a client in an outpatient setting. In fact, when working outpatient, reintegration is incorporated throughout treatment. The three-stage model is not meant to be a stepwise approach. If a client is working on trauma in stage two and finds him- or herself overwhelmed to the point of regressing dangerously, it is likely that he or she will need to step back to stage one work for a while. Whole sessions may be spent working on stage two material, but it can be good practice to close each session with stabilization strategies.

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    22 . In cult recovery, allowing and encouraging the client to grieve losses is part of the re-evaluation stage.
    A) True
    B) False

    TREATING SPIRITUAL ABUSE

    Interestingly, the literature on cult recovery offers a similar three-tiered model. Langone proposed the following three stages of recovery, with associated tasks for each stage [36]:

    • Re-evaluation (focus on the past)

      • Re-evaluate cult affiliation.

      • Learn how one was under the influence of mind control.

      • Help client to understand trauma and how to deal with "floating" or flashback episodes.

      • Begin re-evaluating beliefs and value system before, during, and after the cult involvement.

    • Reconciliation (focus on the present)

      • Allow and encourage client to grieve losses.

      • Expect emotional volatility, normalize, and offer support.

      • Let the past re-emerge.

      • Deal with arrests in the maturation process.

      • Help the client regain purpose.

    • Reintegration (focus on the future)

      • Help plan and focus on the future.

        -Encourage recovery of the whole self.

      • Help clients integrate cult experience into their permanent identities.

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    23 . Because spiritual abuse can affect multiple dimensions of a person's life, including physical, psychologic, emotional, relational, educational, vocational, sexual, financial, and spiritual realms, it is critical to assess which areas have been affected and address them accordingly.
    A) True
    B) False

    TREATING SPIRITUAL ABUSE

    Therapists who are accustomed to treating the whole person will be in a good position when it comes to treating spiritual abuse. Because spiritual abuse can affect multiple dimensions of a person's life, including physical, psychologic, emotional, relational, educational, vocational, sexual, financial, and spiritual realms, it is critical to assess which areas have been affected and address them accordingly within the three-stage consensus model [11,41]. First, clinicians should practice within a spiritually sensitive, reflective framework and not dismiss spiritual issues in the counseling process [42]. Second, especially in working with women, clinicians should help survivors connect with the full range of their emotional experience, which may be difficult because many traditional, orthodox religious groups promote emotional repression [43]. In the cases of spiritual abuse that happened as a result of oppression (e.g., in indigenous cultures), it can be critically important to bring in the respective culture's healing rituals, if the client is willing [2]. Narrative counseling, or affording oppressed survivors the chance to share their stories, is also a helpful tool [44].

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    24 . Which of the following steps has been found necessary in order for survivors to heal from spiritual abuse?
    A) Sufficient time to grieve
    B) Confrontation of one's abuser
    C) Avoidance of faith communities
    D) Preventing talk about God or a Higher Power

    TREATING SPIRITUAL ABUSE

    One qualitative study specifically addressed the question of effective treatment for spiritual abuse recovery [20]. In this study, 100 spiritual abuse survivors in the Christian tradition from English-speaking countries throughout the world participated. The researcher concluded that four main steps were necessary in order for these survivors to heal from spiritual abuse:

    • Sufficient time to grieve

    • Forgiveness and release of the situation to God

    • A suitable faith community

    • Moving forward in Christ with the help of the Holy Spirit

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    25 . All of the following are considered traits of healthy spirituality, EXCEPT:
    A) Questioning, doubt, and dissent are discouraged or punished
    B) Compassion, forgiveness, respect, and unconditional love as its foundation
    C) The belief that spirituality arises from a personal relationship with God/the Universe
    D) Acknowledgement that each person alone contains everything needed for a fulfilling spiritual existence

    TREATING SPIRITUAL ABUSE

    Spiritually and culturally inclusive counselors may appreciate the following list of traits of healthy spirituality and/or religion:

    • Realization that spirituality is simply the search for meaning in everyday life

    • Compassion, forgiveness, respect, and unconditional love as its foundation

    • Individuals encouraged to look within to find the source of wisdom and knowledge

    • Each person's path is accepted as right for them, and paths that are different from their own are not devalued

    • Acknowledgement that each person alone contains everything needed for a fulfilling and successful spiritual existence

    • The belief that spirituality arises from a personal relationship with God/the Universe and not from a relationship with any religious institution

    • The spiritual/intuitive gifts of all individuals are recognized as divinely empowered

    • Releasing judgment and acceptance of the connectedness and unity of all

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    26 . A client specifically seeks care from a Christian counselor for treatment of spiritual abuse perpetrated by a member of a Christian church. Which of the following approaches is the most appropriate?
    A) Focusing on non-Christian spiritual alternatives
    B) Referring the client to a nondenominational counselor
    C) Tailoring or modifying treatment to include Christian tenets
    D) Avoiding the subject of spirituality and focusing more on other forms of abuse

    TREATING SPIRITUAL ABUSE

    Clinicians who are devout in the beliefs of one specific faith should feel free to tailor or modify the approaches discussed in this section, as long as it is clear that they are healthy for the client. It is only healthy for a clinician to be specific with her or his religion or faith if the client is seeking that specific care (e.g., Christian counseling). If a client is seeking a counselor of a specific faith, this is a way of indicating a desire to continue in that faith, so counselors should incorporate the healthiest elements of that faith. However, if a practitioner is working in a secular setting, it is her or his responsibility to refrain from pushing a specific faith and keep an open mind to the client's spiritual needs.

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    27 . Clients who have been spiritually abused are severely scarred by spiritually abusive experiences, so avoiding discussion of spiritual practices is optimal.
    A) True
    B) False

    TREATING SPIRITUAL ABUSE

    Some clients may be so scarred by spiritually abusive experiences that they want nothing to do with reconnection to a spiritual source. If this viewpoint is voiced, it should be respected. However, many who are spiritually abused have an innate drive to be spiritual. Thus, avoiding that part of the person is usually not optimal, and inquiry, curiosity, and experimentation should be encouraged, as appropriate. It can be healing for the client to find what works and is healthy and to make a connection that only spirituality will likely fulfill. A major part of recovery for any kind of abuse, but especially spiritual abuse, is negotiating what is healthy and authentic.

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    28 . Which of the following is a Gestalt therapy technique that may be useful for addressing spiritual abuse and its manifestations?
    A) Yoga
    B) Music therapy
    C) Guided imagery
    D) The empty chair technique

    TREATING SPIRITUAL ABUSE

    There are several techniques from the Gestalt approach that are useful for addressing spiritual abuse and its manifestations [47]. As long as a qualified professional who is comfortable dealing with trauma and intense affect uses these techniques with clients who are properly stabilized, they are generally safe. It is rarely productive for a survivor of abuse to confront the abuser (the only exceptions being when the abuser is in some form of active recovery and has an awareness of how they victimized others, or if the survivor is well-prepared to simply say what he/she has to say without engaging in extended attempts at reasoning). However, the empty chair technique can help survivors to release the feelings they have been holding in a dynamic, experiential way by imagining the abuser in an empty chair across from them.

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    29 . Giving clients permission to vent their anger at the churches, groups, or entities that abused them is an important part of reprocessing the trauma of spiritual abuse.
    A) True
    B) False

    TREATING SPIRITUAL ABUSE

    Giving clients permission to vent their anger at the churches, groups, or entities that abused them is an important part of reprocessing the trauma of spiritual abuse. Anger toward God or the divine is an issue in treating all types of trauma (e.g., "How could God let this happen?"). Clearly, that anger can have an even more pervasive impact for survivors of spiritual abuse, as their trauma was perpetrated "in the name of God." Allowing clients to work through their anger with the abuser, Higher Power, or spiritual organization in a supportive manner is an effective component of stage two reprocessing. This spirit of non-judgment, even if the client seems stuck in her or his anger and resentment for quite a while, is critical when working with survivors of spiritual abuse.

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    30 . Counselors should engage in which of the following professional development approaches in order to improve their work with victims of spiritual abuse?
    A) Having a referral network
    B) Assessing one's own spirituality
    C) Raising awareness about the reality of spiritual abuse
    D) All of the above

    PROFESSIONAL DEVELOPMENT ISSUES

    This is why it is important for clinicians to assess their own spirituality. Some do not identify as a spiritual person or understand why anyone would be drawn to spirituality, and knowing this is a first step. These counselors should determine if this state of being inhibits them from being effective with clients who deeply desire to be spiritual. If a clinician dismisses spiritual abuse as related to church corruption or religious superstition, clinical relationships can be damaged.

    Many counselors who work with spiritual abuse or trauma have had negative personal experiences with spirituality. If unresolved, this state tends to manifest as not wanting to explore spirituality with clients. If addressed, it can make counselors more effective in working with survivors. Not only can this effectiveness be used to help clients, but it can help to raise awareness about the realities of spiritual abuse. As discussed, many people are unaware that spiritual abuse exists, including colleagues, and education is important. Helping professionals may also be hesitant to address spiritual abuse because they are unsure of what to do with the issues that may come up in sessions. Thus, education about the experiences of people who go through spiritual abuse and trauma is a valuable part of enhancing treatment. This education should be more than just technical; it should include information about what people experience and how to build the understanding, empathetic relationships that can facilitate people growing into their authentic selves.

    Part of being an effective helper is recognizing when one is beyond his or her area of competence or comfort. Having a referral network is vital. An Internet search of spiritual abuse counselors by geographical area may not retrieve a great deal of results. Instead, a pastor or religious leader who is known for her or his tolerance may be a good source. Working through one of the many books on the topic of spiritual abuse and personally reflecting upon the content may also provide guidance. For many clients, acknowledging that spiritual abuse is real can be a powerful validation.

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