Spirituality, like culture or ethnicity, involves streams of experience that flow through all aspects of life from family heritage to personal belief systems, practices, and faith communities. They influence ways of dealing with adversity, the experience of pain and suffering, and the meaning of symptoms, their causes, and future course. They also influence how people communicate about their pain, their attitudes toward helpers (e.g., clergy, physicians, therapists, faith healers), and their preferred pathways in coping and recovery. Some seek help for particular spiritual concerns; others suffer a spiritual void. Many who have physical, emotional, or interpersonal problems are also in spiritual distress. Mental health and health care providers are increasingly including the spiritual dimension in clinical assessment and treatment.
Increasingly, a family systems approach with individuals, couples, and families in distress addresses the interaction of biological, psychological, social, and spiritual influences. Family therapists attend to the spiritual dimension, both as a source of understanding suffering and as a potential resource for healing and resilience.
Religion and Spirituality
Most Americans find spiritual meaning and connection through religion—a particular faith tradition with organized, institutionalized beliefs, practices, and rituals. Involvement in a faith community offers pastoral guidance and congregational support in times of need. In all religions, the family is central in rites marking birth, entry into the adult community, marriage, and death. Spirituality can be experienced within and/or outside formal religious structures. It involves an active investment in internal values yielding a deep sense of meaning, wholeness, harmony, and connectedness within oneself and with others. Often people who do not consider themselves to be religious are deeply spiritual, leading ethical lives. Many find spiritual nourishment through nature, the arts, and service to others. For many, humanitarian values inspire dedication to help those in need or to alleviate injustice.
A value system provides a moral compass to guide actions and ethical relationships. It transcends the limits of one’s experience, enabling people to view their own painful situation from a broader perspective that fosters meaning, purpose, and hope. Without this larger view, individuals are more vulnerable to suffering and despair.
Most Americans (85%) say religion or spirituality is important in their lives. One third view it as the most important part of their lives: It fosters closeness with their families, fulfillment in their jobs, and hopefulness about the future. African Americans are the most religious and involved in congregational life. Many immigrants also turn to traditional healing practices. With increasing religious diversity and interfaith marriage, couples and families commonly knit together spiritual beliefs and practices that fit their lives.
Spiritual Sources of Distress
Much suffering seen in mental health settings—for example, depression, addictions, or violence—also involves spiritual issues. An inability to invest life with meaning can block coping and well-being. Harsh, narrow, or judgmental religious convictions may contribute to guilt, shame, or worthlessness and wound the spirit. Patriarchy, sexism, and heterosexism—cultural patterns embedded in most religious traditions— contribute to interpersonal violence. Some misuse religious teachings to sanction subordination and violence toward women and girls. A husband’s abusive, demeaning treatment may be rationalized by fundamentalist beliefs that a wife must be submissive. Marriage and family therapists have an ethical responsibility not to condone any abusive behavior that harms a spouse, child, or other family member whether based in family, ethnic, or religious traditions. If violence is ongoing, the priority is to ensure the protection and safety of vulnerable members. Above all, every religion upholds the core values of respect for others and the dignity and worth of all human beings.
Spiritual Resources for Healing and Resilience
Family therapists are increasingly integrating the spiritual dimension of experience in practice, exploring the meaning and significance of spiritual beliefs and practices, spiritual concerns, and potential spiritual wellsprings for healing and resilience. When spiritual issues are beyond the role or expertise of the clinician, consultation with pastoral counselors and community clergy is valued.
Life crises, trauma, loss, or cumulative stresses can contribute to emotional symptoms, substance abuse, and interpersonal conflict. They can impact family functioning, with ripple effects for all members and their relationships. Resilience is the ability to rebound from crises and overcome prolonged adversity. Belying the American cultural myth of the “rugged individual,” resilience is relational: nurtured by family, community, cultural, and spiritual connections. Resilience-oriented family therapy identifies and strengthens resources that enable families to rally, to buffer stress, reduce the risk of long-term dysfunction, and support positive adaptation.
A growing body of research finds that health, healing, and resilience are strengthened by a deep faith that is lived out in daily life, interpersonal relationships, and service to others in need. Medical studies find that faith, prayer, and spiritual rituals can strengthen health and healing by triggering emotions that influence immune and cardiovascular systems. Every spiritual orientation values some form of prayer, meditation, and rituals such as lighting candles or incense. For most, prayer originates in the family and is centered in the home. Prayer may serve varied functions: to connect with God, to express praise and gratitude, to gain perspective, to sustain strength and courage through an ordeal, to find solace and comfort in the face of tragedy, to request help or guidance, or to appeal for a miracle.
Meditation promotes clarity and tranquility, easing tension, pain, and suffering. A contemplative state can facilitate more deliberate action. Shared meditative experiences foster genuine, empathic communication; reduce defensive reactivity; and deepen couple and family bonds. Family therapy draws on meditative practices in integrative healing approaches.
Rituals and ceremonies in every faith tradition connect individuals and families with their communities and guide them in life passage through rites such as communion, baptism, bar/bat mitzvahs, weddings, and funerals. They facilitate difficult transitions, script actions, and comfort the dying and the bereaved. Rituals also transcend a particular struggle, suffering, or tragedy, connecting it with the human condition. Rituals are encouraged in family therapy to mark important milestones, reconnect with a family’s heritage, create new patterns, and foster healing from trauma and loss.
Many studies have found that personal faith and involvement in a religious community promote resilience. Those who are deeply spiritual cope better with stress, have fewer alcohol or drug problems, less depression, and lower rates of suicide. What matters most is drawing on the power of faith to find meaning, hope, solace, and comfort.
Resilience involves both active “mastery of the possible” and acceptance of what cannot be changed, akin to the Serenity Prayer in 12-step recovery programs, which can be a valuable adjunct to couple or family therapy. The steps promote a spiritual awakening that prepares family members to practice principles for abstinence, integrity, and greater well-being. Prayer, meditation, and connection with a Higher Power all facilitate reflection, sustain efforts through troubled times, and spark life-altering transformations.
Emerging research in the trauma field finds that spirituality is a significant influence in resilience and posttraumatic growth. Suffering, and often its injustice or senselessness, are spiritual issues. Beyond coping or surviving trauma, loss, or hardship, resilience involves the potential for positive growth that can be forged out of adversity. By tapping spiritual resources for resilience, those who have been struggling can emerge stronger and more resourceful in meeting future challenges. Studies reveal that despite a traumatic childhood and troubled adolescence many are able to turn their lives around in adulthood, drawing on affirming relationships and religious involvement for strength.
A serious crisis can be an epiphany, opening lives to an untapped spiritual dimension, heightening attention to important matters, and sparking reappraisal of life priorities. Many seek help in times of crisis; resilience-oriented family therapy draws on spiritual resources to support positive change and both personal and relational growth. In the wake of trauma, harm, or injustice, major faith traditions encourage forgiveness instead of holding onto grievances, being bound up in feelings of rage, or preoccupied by thoughts of revenge. Family therapy facilitates the repair of relational wounds and can guide those who seek reconciliation and a journey of forgiveness, drawing on spiritual resources.
Some face adversity beyond their control, such as an irreversible illness. It is crucial not to attribute lack of recovery to insufficient spirituality. Family therapists’ conviction of the potential for human resilience is joined with compassion toward all who suffer, believing in the dignity and worth of every human being and supporting all people’s search for greater meaning, connection, and fulfillment in their lives.
Bibliography:
- Koenig, H., McCullough, M. E., & Larson, D. (Eds.). (2001). Handbook of religion and health. New York: Oxford University Press.
- Walsh, F. (2003). Spiritual resources in family therapy. New York: Guilford Press.
- Walsh, F. (2006). Strengthening family resilience (2nd ed.). New York: Guilford Press.
- Walsh, F., & McGoldrick, M. (2004). Living beyond loss: Death and the family (2nd ed.). New York: W. W. Norton.
- Werner, E. E., & Smith, R. S. (2001). Journeys from childhood to midlife: Risk, resilience, and recovery. Ithaca, NY: Cornell University Press.
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