Running head: EMPOWERING THE HUMAN SPIRIT

Empowering the Human Spirit: A Social Work Response to Spiritual Abuse. Brenda L. Caballero Winthrop University

EMPOWERING THE HUMAN SPIRIT Abstract This paper explores the phenomenon of spiritual abuse as an issue of interest to the social work profession. The literature research reveals that spiritual abuse is often a subtle, yet insidious form of abuse, associated to the misuse or abuse of power in religious institutions, producing psychosocial and spiritual damage in the adherent, as well as long-lasting traumatic responses. The author examines the concept of spiritual abuse, the core themes and distinctive features of religious-related trauma, and its psychosocial implications, to advocate for a social work response to the experience of survivors. In the context of an empowerment perspective in direct

social work practice, trauma-focused cognitive behavioral therapy is applied to address the need of survivors of spiritual abuse, to assist in their process of recovery, restoration and spiritual empowerment. Keywords: spiritual abuse, religious trauma syndrome, spiritual empowerment, social work, direct practice, trauma-focused cognitive behavioral therapy, ethnographic interviewing

EMPOWERING THE HUMAN SPIRIT The National Association of Social Works Policy Statements (2001) and the NASW Code of Ethics (2008), assign social workers the ethical responsibility to be culturally

competent. In the United States, the definition of cultural competency transcends the boundaries of race and ethnicity to include the sociocultural experiences of people of different religious backgrounds (NASW, 2001). Part of a continual process of developing cultural competency is seeking to improve and deepen ones understanding of the role that faith and religious beliefs play in the lives of people. (NASW, 2008). Spirituality and religion are essential and integral aspects of the total configuration of human behavior: including beliefs, values, patterns of communication, and motivations for individual and social action. Assessment of religious groups fits perfectly into a person-in-environment perspective of social work in the sense that the culture of a particular religious group influences and even shapes the lives, worldviews, selfidentity, and behavior of its members. Spirituality and religion are commonly regarded as benign and beneficial. Faith and participation in religious groups are assumed to be a source of strength, emotional resiliency and social support for individuals and families. It is broadly recognized that spiritual and religious beliefs often represent a strong protective factor to help people overcome adversity. Nonetheless, this assumption that religion and spirituality are intrinsically positive and constructive, excludes and delegitimizes the experience of those who have been deeply hurt, victimized or traumatized by religion. A simple internet search of the words spiritual abuse generated about 24,100,000 results. Thousands of websites and blogs provide information for victims of abusive religious organizations and offer forums where the same impressive number of persons share experiences of trauma associated with participation in religious groups or churches. There are over thirty organizations in the United States created to denounce spiritual abuse and to offer support to

EMPOWERING THE HUMAN SPIRIT survivors (www.spiritualabuse.org/organizations). Presbyterian minister Keith Wright (as cited in Heimlich, 2011) writes: we need to give up the idea that religion is perfectthat the church of which we are part is perfect or infallible. Religion, like our parents, has the capacity to bless us and to wound us and it inevitably does both at different times.Only when we are aware of

the capacity of religion to abuse can we guard against that abuse and take steps to curb it where it exists (2013, p. 35.). Defining Spiritual Abuse Oakley & Kinmond (2013) propose a definition of spiritual abuse that is congruent within the context of the western culture in which self is central to individual experience; [and] indeed self is the starting point from which we make sense of the world (2013, p. 14). SA [Spiritual Abuse] is coercion and control of one individual by another in a spiritual context. The target experiences SA as a deeply emotional personal attack. This abuse may include: manipulation and exploitation, enforced accountability, censorship of decision making, requirements for secrecy and silence, pressure to conform, misuse of Scripture or the pulpit to control behavior, requirement of obedience to the abuser, the suggestion that the abuser has a divine position and isolation from others, especially those external to the abusive context (Oakley & Kinmond, 2013, pp. 21-22). For individuals experiencing SA, religious leadership, beliefs and religious practices become an oppressive force that limits their human potential, sense of self efficacy, and social competency. Johnson & VanVonderen (1991) define SA as a misuse of power (p. 20) to undermine a persons strengths and weaken a persons sense of worth and value. Spiritually

EMPOWERING THE HUMAN SPIRIT abusive leaders consistently violate their followers personal boundaries and their rights to selfdetermination. An empowerment based social work practice needs to acknowledge this phenomenon and recognize its impact in the personal, familial, social and spiritual struggles some clients bring to social work interventions (Caballero, 2013b, p.16). Australian social worker David Ward (2010) conducted a study using Interpretative Phenomenological Analysis (IPA), to explore the subjective experience of SA through the

participants narratives. Based on the findings of this study, Ward (2010) proposes the followin g definition of spiritual abuse: Spiritual abuse is a misuse of power in a spiritual context whereby spiritual authority is distorted to the detriment of those under its leadership. It is a multifaceted and multilayered experience that includes acts of commission and omission, aimed at producing conformity. It is both process and event, influencing ones inner and outer worlds and has the potential to affect the biological, psychological, social and spiritual domains of the individual. (p.913) Spiritual abuse is a violation of perhaps the highest form of trust. In this form of abuse the perpetrators have a deep symbolic powerperceived by the victim as representative of Godand to question them implies questioning God. The abuse is exerted by the combination of discouragement of self-directed action, the pressure to obey and the belief that the leaderships directives originate from God (Ward, 2010). The consequences are painful and far-reaching, impacting the individuals sense of worth to the core. Opportunities for spiritual bullying surface when the leadership, in the place of the highest spiritual authority, are in a position to command to the group whatever norms of behavior they consider appropriate, while the leadership themselves are subject to no accountability. In concrete terms, abusive leaders

EMPOWERING THE HUMAN SPIRIT commonly ignore, ridicule, control behavior with fear-based religious teachings, expose members to excessive fault-finding, and even threaten with separation from family members (Ward, 2010). A spiritually abusive system is a performance-based system where members worth is measured only in terms of how they meet the expectations of the leader and the strict behavioral standards of the doctrine. Should the individual not meet the ever-changing yardstick of the leadership, one was paraded to the group as spiritually weak (Ward, 2010). The individual needs of the members are ignored, however serious they might be. Marital problems, domestic

violence, child abuse are all considered spiritual problems and a reflection of spiritual slipping or weakness. The main concern of the leadership in such cases is the image of the group and there is an enormous pressure to keep the appearance of peace (Johnson & VanVonderen, 1991). This involves both explicit and unspoken rules against disclosing or divulging what happens inside the group to outsiders, also known as the scandal rule (Hamilton, 2009). Spiritual abuse is a life-altering process that can shatter the basic assumptions individuals have about their lives. It produces increasing tension between their inner and outer worlds (Ward, 2010). Survival inside a spiritually abusive organization depends on the ability of its members to suppress their individuality and conceal their emotional pain. However, the subdual of a persons individuality cannot be maintained indefinitely. The pressure of the religious group collides with a persons normally developmental drive to express individuality. Ward (2010) refers to this occurrence with the term double bind. On the one hand, the member wants to please God and the leadership who represent God. However, to accomplish this requires the individual to stifle normal human nuances such as asking questions, expression of individual personality and the desire for comfort when in pain (p. 910).

EMPOWERING THE HUMAN SPIRIT Raising Awareness The concept of spiritual abuse was first introduced by pastoral counselors Johnson and VanVonderen (1991). Following their publication, a great number of Christian pastoral

counselors and theologians have published articles and books on the subject, describing spiritual abuse as a problem, especially in evangelical churches, agencies and organizations that reaches pandemic proportions (Evangel, 2004, p.33). In 2006, Psychologist Marlene Winell wrote a selfhelp book for people abused by religion, and is proposing that the American Psychiatric Association recognizes Religious Trauma Syndrome to be included in the Diagnostic Manual of Mental Disorders (DSM). In 2011, Australian social worker, David Ward (2011) published a study based on the narratives of self-identified spiritually abused individuals. Wards findings suggest that spiritual abuse is a multi-faceted and multi-layered experience [] affecting the bio/psycho/social and spiritual domains of an individual (Ward, 2011). In 2011, award-winning journalist Janet Heimlich conducted an extensive research on the phenomenon of Religious Child Maltreatment, introducing a different terminology for the spiritual abuse of children that includes physical abuse, emotional abuse, sexual abuse, exploitation and medical negligence. In religious child maltreatment religious beliefs are an important factor either motivating the abuse and/or facilitating the impunity of the perpetrator. In October of 2013, Lisa Oakley published her doctoral dissertation in the United Kingdom, entitled Breaking the Silence on Spiritual Abuse, providing guidelines for social work and psychology practitioners working with individuals who have been spiritually abused. This brief overview of the literature and research on spiritual abuse (SA), indicates that in the last three decades there has been an increased awareness and interest of this phenomenon as worthy of academic and professional attention and research in the fields of pastoral counseling

EMPOWERING THE HUMAN SPIRIT and psychology. Nonetheless, SA is a topic that remains unrecognized and under researched in the field of social work. There remains little written about the phenomenon of spirituality that has turned toxic; that is, via a range of psycho-social processes, it ceases to be beneficial to the

adherent, but instead becomes a tool to inflict psycho-spiritual damage (Ward, 2011). This lack of recognition of another side to religion, leads to assumptions regarding the nature of clients experiences in religious settings that discard the possibility that religion can be a source of psychosocial dysfunction and emotional trauma. Any professionals working with clients survivors of all forms of abuse will encounter instances in which religion has been used to legitimize some form of abusive behavior. In these cases, religious beliefs are the bases of rationalizations, acting to enable the submission and compliance of the victim and the denial of responsibility by the perpetrator. In SA, religious beliefs and practices play key roles in facilitating and perpetuating the abuse. A review of the literature reveals that SA can manifest in a variety of forms. Some include, but are not limited to: (a) physical or sexual abuse in the context of a religious institution or place (e.g., sexual abuse by a pastor or priest); (b) ritualistic abuse or coerced exorcism (e.g., when a childs poor behavior is judged as the workings of an evil spirit possessing him or her) (Heimlich, 2010); (c) coercive spirituality (e.g., religious leaders abusing their position to manipulate believers into performing certain tasks that would earn them Gods favor) (Ward, 2010); (d) religious beliefs that are distorted and integrated into abusive rationalizations (e.g., in cases of domestic violence and child physical abuse, suggesting that the abusive actions are sanctioned by God ) (Simoni, Mandel & Novak, 2013, p. 31); (e) medical neglect (e.g., denying a child vital medical treatment based on beliefs of spiritual healing) (Heimlich, 2010); and (f) religious-related

EMPOWERING THE HUMAN SPIRIT psychological abuse (e.g., fear-based religious teachings aimed at producing obedience and conformity to religious authority) (Winell, 2007; Heimlich, 2010). Spiritual Abuse as Source of Trauma Spiritual abuse is an experience that changes people in fundamental ways. The religious system in which the abuse took place was once regarded by the individual as his or her safe haven. It was the place where they felt spiritually and emotionally nurtured and where they had clear, black-or-white answers to lifes most complex dilemmas. This familiar environment

involved close-knit relationships with the group of believers, providing a strong sense of identity, and satisfying the basic need for belonging. The betrayal of their trust by spiritual leaders shatters the individuals most basic assumptions about God, about themselves, and about the world. Clients leaving spiritually abusive systems find themselves deeply confused, isolated, grieving over the loss of certainty and congruency in their lives; the loss of spiritual status in relation to God and the church, and, possibly, the loss of many relationships. Furthermore, these individuals are dealing with the lingering effects of religious indoctrination. Even when they have started to intellectually reject some fear-based beliefs, they find themselves paralyzed with dread produced by internalized notions of the spiritual or real life consequences of leaving the fold (Winell, 2007 & Heimlich, 2011). For people who leave spiritually abusive systems, the process can potentially cause major upheaval in their lives. They are trying to come to terms with the events and circumstances of the abuse; questioning and re-evaluating their old spiritual beliefs and values, or even rejecting and abandoning core beliefs that essentially defined their entire structure of reality. Letting go of such a massive structure can leave you feeling totally adrift (Winell, 2007, p. 12). Clients sense of existential torment can be quite powerful as they fight internally

EMPOWERING THE HUMAN SPIRIT and socially to get a foothold of life. Based on her clinical work with clients traumatized by religion, Winell (2007) concludes that clients leaving fundamentalist churches and other authoritarian dogmatic groups have had enough harmful religious indoctrination to warrant

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serious attention (p. 10). Winell (2007) describes the emotions of her clients in the early stages of leaving these groups, stating that many people in this phase feel like a nave child in an adult world (p.14), since the old notions learned and internalized in their religious group are not useful to make sense of the world outside the group. Another important source of trauma in the experience of spiritual abuse is the use of shame and guilt induced by the powers of Biblical discourse (Parish-West as cited in Oakley & Kinmond, 2013). This trauma, compared to the trauma experienced by other forms of abuse such as sexual abusegives shame and guilt an unparalleled meaning and power. Peppiatt (as cited in Oakley & Kinmond, 2011) indicates that shame in the religious context makes the person feel that they somehow fall short of their own and Gods expectations such that they perceive themselves as a failure (p. 105). The dread of failure, shame and ridicule can be so pervasive that people are willing to risk serious physical harm or even death to evade it (Gilbert cited in Oakley & Kinmond, 2013). SA threatens a persons sense of ontological security. It causes interpersonal and intrapersonal trauma via complex dynamics of alternating, intermittent reward and punishment (Oakley & Kinmond, 2013, p.91). This component of trauma is critical in understanding the emotional and behavioral responses of those who have experienced spiritual abuse, in recognizing risks of suicidality and in developing sensible, client-centered interventions.

EMPOWERING THE HUMAN SPIRIT Prevalence of Spiritual Abuse in the United States Spiritual abuse is a problem that transcends religious denominational demarcations. However, the potential for SA to occur has been strongly associated to religious authoritarian cultures. Journalist Janet Heimlich (2011) numbers a series of characteristics of potentially abusive religious organizations: They tend to be ultraconservative, so members are apt to seize onto literalistic and

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legalistic interpretations of scriptures and doctrine; they are narcissistic, often convinced that they possess the one true faith and all other worshipers are wrong, misguided, or evil; they are collectivist, so the needs of the overall culture take precedence over the needs of the individual; obedience to authority is paramount, and, as in the case of the Inca, such a society maintains a strict social hierarchy; they have many rules, and those who break them can be subject to stiff punishment; and finally, fear is a big component, as members believe that spiritual or real-life consequences await those who do not meet the expectations of the culture (2011, p. 49). Spiritual abuse is not a phenomenon that is exclusive of particular religious groups. Religious abuse is not selective and as such may be channeled regardless of religious orientation; nonetheless, it is more frequently detected in religions that are more fundamentally grounded (Simoni & Novsak, 2013). Christian fundamentalism is an umbrella term that comprises a diversity of conservative sects, namely: evangelical, charismatics, and Pentecostals (ECP) churches. Fundamentalist doctrine appears to emphasize submission to authority and their teaching concentrate on those biblical passages that refer to submission to church leadership. Followers are more easily positioned to feel compelled to obey the rules and regulations of their religious culture since their good behavior will earn favor with God (Enroth,

EMPOWERING THE HUMAN SPIRIT 1992). Simoni & Novsak (2013) identify the elements of Christian fundamentalism that are

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congruent with religious systems that tend to be authoritarian and where spiritual abuse is more prevalent: (1) they hold an interpretation of scriptures that is erroneous, warped and literal without consideration of the historical and cultural context of the original texts; (2) they promote the image of a God who is vindictive and unloving and, therefore punishes bad behavior and non-conformity in believers; (3) their culture enforces the denial of individuals emotions; they have a tendency toward marked perfectionism by the standards and demands of rigid religious dogmas. Heimlich (2011) explains that the potential of a religious organization to be abusive of its members is directly associated with three main characteristics that together form a perfect storm: (a) the culture adheres to a strict, authoritarian social structure; (b) the culture is fearful; (c) the culture is separatist. These elements are found in the central teachings of ECP churches, in which the doctrine of original sin guides the rest of their belief system. Christian fundamentalists believe that God and Satan, along with angels and demons are actual, objective powers combatting for human souls. They consider the second coming of Christ as imminent, and as a result, they expect the final judgment of all humankind when the faithful will be sent to heaven and the rest will go to hell for eternity. One dominant characteristic of ECP churches is a mood of militant opposition to secular culture, liberal theology, higher criticism, and scientific views that challenge the Bible. Consequently, fundamentalists tend to form tightly knit groups with a distinct separatist subculture and a moral code (Winell, 2007). Altemeyer (as cited in Heimlich, 2011) explains that faced with the choice between authority and humane insight, the fundamentalist chooses authority every time (p.54).

EMPOWERING THE HUMAN SPIRIT Facing the Ethical Challenge It is pertinent to clarify that religious beliefs and teachings do not work in isolation to cause psychosocial damage; there are multiple influences at work, including individual

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temperaments, family dysfunctions, social pressures, external events, and other challenges. The point here is to look at religion as one possible source of difficulty (Heimlich, 2011). The challenge presented is not that of where to assign the blame. Social workers have the professional commitment to be respectful of peoples spiritual and religious beliefs, and to avoid judgmental and ethnocentric assumptions. In response to this ethical dilemma, Lewandowski & Canda (1995) developed a typological model for the assessment of religious groups. The model is designed to assess the psychosocial impact on clients that results from their involvement in a diversity of religious organizations. Rather than evaluating beliefs, the model develops a typology of religious groups based on specific organizational characteristics related to leadership and recruitment styles (Lewandowski & Canda, 1995, p.17). Lewandowski & Candas (1995) model has the purpose of promoting a therapeutic dialogue with clients, in a way that empowers them in making their own well-informed decisions regarding their involvement in religious groups. This model identifies characteristics of totalitarian groups that are helpful to evaluate the prospect for spiritually abusive beliefs and practices. It clarifies likely benefits and dangers of various types, which can be useful in the spiritual discernment of both clients and practitioners (Lewandowski, 1995). While remaining respectful of a clients beliefs and spiritual backgrounds, clients can be assisted to differentiate between beneficial and harmful practices, which would eventually help them establish a foundation for a more personally congruent spirituality and the reconstruction of a more functional system of meaning in their lives.

EMPOWERING THE HUMAN SPIRIT Spiritual Abuse in the Context of Social Work Practice

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A deeper understanding of the effect of some forms of destructive religious indoctrination brings to the forefront the need to advocate for the inclusion of the spiritual dimension in conducting assessments across a variety of practice settings and across populations. Administering a spiritual assessmentas part of a larger bio-psycho-social-spiritual assessmentprovides a more holistic understanding of clients realities, which in turn provides the basis for subsequent practice decisions (Hodge, 2013, p. 223). Self-awareness and a critical look at ones own cultural biases, allow social workers to remain open to the possibility that religion or spirituality might be playing a predominant role in some clients presenting problems, even though the initial reasons for a clients seeking professional help does not point to religious beliefs as a salient dimension. A more comprehensive, holistic social work assessment would not disregard a clients religion or spirituality as a significant variable impacting a clients perceptions, cognitions, personal boundaries, and norms for social and cultural behavior. Roberts-Lewis (2011) recognizes that in spite of the increasing interest among social workers to incorporate spirituality into clinical practice, important barriers still prevail that deter social workers from addressing spiritual issuessuch as spiritual abusewith their clients, including: 1) lack of knowledge of particular religions and traditions; 2) personal countertransference issues; 3) sense of privacy of religious beliefs; and 4) fear of over-stepping client autonomy (p. 139). In response to these acknowledged obstacles, the author proposes the use of Ethnographic Interviewing, a technique first developed to increase cultural competency of social welfare workers. This technique applied to spirituality assists the social worker in understanding the clients worldview, including the aspect of spirituality from the viewpoint of an individual, family, or community system that is different from oneself (p. 141). This

EMPOWERING THE HUMAN SPIRIT assessment is conducted with the practitioners assuming the role of learner of the clients religious experience, using the client as a cultural guide (Robert-Lewis, 2011, p. 141) to deepen ones understanding of the clients beliefs and determine the extent to which spiritual issues intersect the clients current personal, familial or social situation. Spiritual Abuse and Spiritual Empowerment

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An empowerment approach to social work practice that includes the spiritual dimension, would recognize that human beings are also spiritual beings. This notion is evidenced by the presence of those needs related to finding deeper meaning, transcendence, inspiration, the pursuit of truth, oneness with the Divine or the universe, and enlightenment (Richards, Bartz & OGrady, 2009, p. 67). These spiritual basic desires are exploited by spiritually abusive leaders who offer to fulfill those needs in exchange for their followers unquestioning submission to their authority. Through spiritually sensitive, empowerment-based therapeutic interventions, individuals are encouraged to rediscover their spiritual identity, their spiritual power and their innate ability to access the Divine or their own inner source of strength, resilience and illumination. This infuses their spirituality with freedom to either choose or reject certain beliefs, church leadership styles and religious practices. The social work practitioners role is to support the clients growth, assist the client in learning to recognize the social and institutional dimension of their spiritual struggles, encourage critical thinking, and safeguard the clients right to self-determination. Working with individuals survivors of spiritual abuse, from an empowerment perspective, is about supporting them to change; to move from a position of powerlessness, into a place where they can begin to feel empowered and comfortable within their self. Because spiritually abusive teachings often regard spiritual growth as opposed to self-growth, clients

EMPOWERING THE HUMAN SPIRIT understanding of spirituality may rely heavily on notions of radical self-denigration, selfrejection and self-denial. The ultimate goal in working with these clients would be to support them in integrating and harmonizing their spirituality with other aspects of the self, so that spiritual growth occurs in a context of wholeness. Spiritual empowerment results from

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embracing spirituality while making it congruent with a persons humanness; caring and giving attention to not just one dimension of a persons life, but equally nurturing a persons spirit, creativity, physical health, intellect, sexuality, finances, social interactions, and interpersonal relationships. The Bible scriptures address this notion of wholeness in the following verse:

Beloved, I pray that you may prosper in every way and [that your body] may keep well, even as

[I know] your soul keeps well and prospers (3 John 1:2, Amplified Bible). Spiritual Abuse and Trauma Focused Cognitive Theory Oakley & Kinmond (2013) propose the use of cognitive behavioral therapy (CBT) to work with clients who have been spiritually abused. Furthermore, in the literature review, trauma focused cognitive behavioral therapy is the approach most recommended for the clinical work with clients presenting stories of abuse related to religion (Walker, Reese, Hughes, & Troskie, 2010, p. 174; Rosmarin, 2011). TF-CBT is not only appropriate to work with the traumatic responses of different types of abuse, but also suitable to address spirituality issues. From the perspective of cognitive theory, the domain of spirituality is conceptualized as the core beliefs, and the values derived from those beliefs that give meaning to a persons view of reality, to their life experiences, and to what motivates their actions (Walsh, 2010, p. 163). Cognitive behavior interventions are appropriate to support the client to reframe their abusive experiences; to challenge and re-evaluate the cognitive distortions and misattributions of blame constructed by the abuser(s) and absorbed by the

EMPOWERING THE HUMAN SPIRIT client during the abusive experience (Oakley & Kinmond, 2013, p. 90). The goal of TFCBT with clients who experienced SA is to support them in rebuilding a new healthy sense of self and to facilitate their reconstruction of old perceptions and beliefs. Even when some of their values will remain the same, challenging cognitive distortions assists the client in the process of sorting out through what they have been taught and allows them to keep only what they esteem beneficial and valuable at the end of the process (Winell, 2007, p. 16). In the context of TF-CBT, the practitioners role is not to question the validity of a persons religious beliefs, but to guide individuals in analyzing how their religious belief system and related values contribute to their conception of worth and their personal boundaries for behavior (Edwards, 2006). Walker, Reese, Hughes, & Troskie (2010) suggest that respect for clients religion and spirituality could be demonstrated by initially maintaining an open but supportive neutral stance toward the clients personal religiousness and spirituality (p. 175). In the early stages of TF-CBT, this acceptance of the clients religious background, helps establish the basis to create a therapeutic space of warmth, genuineness, unconditional positive regard, empathy and congruence to support the client to develop trust and grow (Oakley & Kinmond, 2013, p.90). Normalizing Spiritual Struggles Psychoeducation is typically the first element of TF-CBT. This component applied to the work with individuals who experience SA involves information on the nature of SA, the definition and dynamics of religious-related trauma, as well as the common emotional and behavioral responses after experiencing this form of trauma. This information is conveyed with the purpose of normalizing spiritual struggles. Pargament (as cited in Walker, et al., 2010) suggests that:

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EMPOWERING THE HUMAN SPIRIT Spiritual struggles may take several forms including intrapsychic (such as religious doubts about the nature of God), interpersonal (for example, conflicts with others at ones church), or with the Divine (as in questioning why God allow events such as trauma to occur) (p. 176). These spiritual struggles have their source in the cognitive dissonance generated by the spiritually abusive experience. The new information that challenges the clients original beliefs which will be useful in further stages of TF-CBTis contained within the clients own experience of SA. As a result of this inner process, the client might spontaneously enter in an active personal process of questioning and re-assessing spiritual beliefs and practices in light of the abuse suffered. During this process, a clients faith may undergo adjustments and changes as the trauma itself is sorted out. This process can be rather painful and distressing, but can be extremely productive for the client as the clinician incorporate those struggles as part of cognitive coping and processing. Self-Talk and Mindfulness Spiritually toxic teachings generate in adherents tendencies to distorted cognitive patterns such as overgeneralization, catastrophizing, and dichotomous (polarized or blackor-white) thinking. Dichotomous thinking tendencies, for instance, are reflected in the clients use of strongly worded statements (Edwards, 2006) that contains words and phrases such as ought, should have, and must in describing their experiences. Statements such as unpardonable sin, bad decisions are made by bad people, doubting means you are spiritually weak and a backslider are also examples of cognitive distortions. Self-Talk coaching, part of the behavioral component of TF-CBT, assists clients in reflecting on their words and their subjective interpretations of those messages. When clients are able

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EMPOWERING THE HUMAN SPIRIT to recognize harmful thoughts and words in their own internal dialogue, they can start working to create a different script that reflects a less rigid view of themselves, of others and of the Divine. The practices of meditation and mindfulness used in TF-CBT are congruent with most religious traditions. However, rigidly conservative clients, with a religious fundamentalist background, might be uncomfortable or alarmed with any reference to foreign spiritual traditions. Religious fundamentalism traditionally rejects any spiritual practice centered in the self, as opposed to prayers centered in God as a presence outside of the self. A culturally sensitive clinician should be able to modify these techniques to the particular form of spirituality that is more familiar to the client. The therapeutic components of meditation and mindfulness can be adapted to integrate a clients own spiritual practices and beliefs. For instance, the client can be asked to repeat mentally and concentrate on the words of selected Bible verses or the Jesus Prayer. Similar passages from the Torah or the Quran could be identified in collaboration with clients of Jewish or Islamic traditions (Caballero, 2013, p. 15). The use of Sacred texts that are positive, constructive and inspirational, will further be used by the client to replace fear-based, self-loathing, condemning Self-Talk. The Use of Scriptures Spiritually abusive systems promote a distorted view of the Divine as portrayed in Biblical scripture. Those maladaptive interpretations can be treated in cognitive therapy as testable hypotheses (Caballero, 2013, p.12). The original sacred texts are then used by the practitioner to examine alternative interpretations and to generate contradictory evidence that support alternative beliefs which may allow for therapeutic change (Edwards, 2006).

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EMPOWERING THE HUMAN SPIRIT The most fundamentalist branches of Christianity, with emphasis on doctrines of original sin, obedience to authority and divine judgment, instill in their believers an image of a vengeful god, whose forgiveness and mercy are expected to expire at the end of times. It is not an unconditionally loving god, but punitive and vindictive. Nonetheless, the same Biblical scripture, contains all the contradicting evidence necessary to challenge those literal interpretations. As an alternative to having to completely abandon their religious roots, clients can learn to reframe the meaning of the spiritual messages contained in the sacred scriptures, thus preserving the essence of their own religious tradition. However, the clinician must not make the assumption that working with scripture is an appropriate approach with each and every client who present issues of SA. Some clients who experience SA, opt to reject all the beliefs and practices of the abusive system and may even develop a strong aversion to religion and spirituality (Oakley & Kinmond, 2013, p. 118). Other clients might start considering alternative religious systems; some might be exploring spiritual beliefs outside of institutionalized religion, while others may be trying to adopt a more secular or scientific approach to life (Winell, 2007, p. 10). In every instance, an empowerment approach is always the best practice; a supportive and genuine stance, attuned to the specific needs and concerns the person brings to the intervention process, and in which the clients are encouraged to formulate their own goals for their therapeutic work. The clinician must also be aware of the limits of their own expertise, and use actual scripture as leverage to help dispel faulty beliefsbut only if they are secure in their Biblical knowledge and only if the client leads in this direction (Oakley & Kinmond, 2013).

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EMPOWERING THE HUMAN SPIRIT A Narrative Component to Trauma Focused Cognitive Behavioral Therapy Building on the teaching of Self-Talk, clinicians assist their clients on the first stage of cognitive processing and coping. Clients are guided to visualize the connection between their thoughtsmirrored in their Self-Talk, behaviors and feelings (Cohen et al. as cited in Walker et al., 2010). Afterward, clients learn to consistently substitute maladaptive thoughts with alternative thoughts that could result in more positive feelings and more desirable behavioral outcomes. At this point the clinician incorporates components of narrative therapy to prepare the client to discuss the trauma itself, a process that is usually intense for most clients with stories of SA. Oakley & Kinmond (2013) explain that working with these clients can often feel like a balancing act as their spirituality remains core to their personhood and sense of self, and they need to work that in therapy, but any linkage made to religion or even Biblical discourse is likely to be very unwelcomed and may provoke a traumatic response (p.94). Working with spiritually abused individuals requires the awareness that clients who have experienced SA come from cultures that enforce silence and secrecy. This demand means that members within their groups are prevented from sharing their experiences with others, especially those outside the group. Consequently, the person experiencing SA might have never had someone to either validate or refute the distorted ideas they are being given. As part of the narrative component in TF-CBT, the client may be presented with stories of other survivors of spiritual abuse and their journeys to recovery, as well as stories of spiritual struggle taken from sacred texts. These stories contain powerful messages of hope and overcoming adversity by trust and reliance upon a faithful, responsive and merciful God. The images from these narratives facilitate clients process of reframing their own

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EMPOWERING THE HUMAN SPIRIT experiences. One of the important tasks of therapy is to support the abused person to piece together a coherent personal story of abuse (Oakley & Kinmond, 2013, p. 105), to help clients recover their voices and make their stories audible. Once the client feels safe and empowered, writing and telling their stories helps them work toward reclaiming the control and autonomy denied by their abusive experiences.

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In presenting and discussing these texts, the clinician must avoid attempting to offer explanations as to why God might have allowed the abuse to happen. The role of the social worker is to bear witness to the clients spiritual struggles related to meaning, purpose of the trauma, and suffering (Walker et al, 2010, p.178). When existential questions arise, the clinician encourages the client to process their feelings by writing down their thoughts about what they think God might respond to their questions. These exercises help pave the way to the latter stage of cognitive coping and processing, when the client and the clinician collaboratively identify, explore, and correct trauma-related cognitive errors, including spiritual cognitions related to the abuse.

Cognitive Coping and Processing

The experience of spiritual abuse fosters in the person highly distorted views of reality, of self and others. Those maladaptive cognitions can be operationalized as the rejection of doctrines with emphasis on renewal, repentance, restoration, redemption, forgiveness, grace and mercy, but strongly embraces ideas that promote guilt, shame, unworthiness, personal destruction, and self-condemnation (Edwards, 2006). Johnson & VanVonderen (1991) indicate that people who leave authoritarian-spiritual abusive systemswhere spirituality is used to inflict psycho-spiritual damagestruggle in the following areas: (a) the development of a

EMPOWERING THE HUMAN SPIRIT distorted image of God; (b) tendency toward extremes of perfectionism, self-righteousness or

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shame, (c) development of a distorted self-identity, (d) a tendency to the extremes of compliance or defiance in relation to authority, (e) problem in the area of personal boundaries, (f) difficulty with personal responsibility, (g) lack of living skills, (h) hard time admitting the abusethe person have lost track of what normal is, it feels like they are being disloyal to family, to church, even to God, and (i) difficulty with trust: hard time trusting a spiritual system again (p.44).

During this phase of the therapeutic work, cognitive distortions are challenged in light of contradicting evidence. By the time the clinician has reached this stage with the client, he or she will have received and started processing new perspectives and information, as well as new coping skills and cognitive tools, to critically evaluate the content of religious messages and ideas. This can be a highly empowering experience for the client, since the use of critical thinking is discouraged inside spiritually abusive systems. Through psychoeducation and critical discussion about SA, the client is helped to externalize the experience of this form of abuse, to view SA not just as a personal problem, but as an institutional and social issue. The person who survived the experience of SA, may start recognizing that he or she has the desire to meet other people who suffered this form of abuse or be part of a support group. Support groups for survivors of SA are being instrumental in raising awareness and in helping influence social policy enforcing more accountability for religious leaders. Clients involvement in these groups can further empower them not only to effect changes in their lives, but to advocate for themselves and others, and use their life experiences to promote changes in society.

EMPOWERING THE HUMAN SPIRIT The Rebuilding Phase

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Recovery from SA is only the result of consistent and persistent efforts of dismantling and letting go of a massive inner structure of toxic and insidious beliefs. In the most severe cases, the residual effects of the religious indoctrination will be dealt with for decades. To heal from religious-related trauma can be a lifelong process that survivors will have to continue on their own, hopefully, making use of the therapeutic tools learned and integrated in the clinical work. With professional help, clients recover from the most disruptive responses to their traumas: flashbacks, nightmares, self-destructive tendencies, panic, withdrawal, avoidance, isolation, hostility and aggression (Oakley & Kinmond, 2013). Nevertheless, most of them will continue working in rebuilding their liveslearning to live on their own termsfor a long time after the final session of counseling. Every aspect of their lives has to be reconsidered, restored and redesigned. Winell (2007) suggests that the process of recovery from spiritual abuse can be long and cumbersome, because your religion took care of so much, defining and dictating reality in so many ways, you are now faced with largely reconstructing your life (p. 15). This rebuilding phase for survivors of SA involves working towards rediscovering their self-worth; learning to appreciate their own body and feel comfortable with their sexuality; reconnecting to the Divine or their Higher-Self in a new healthy way, learning to look inside themselves for security satisfaction; and ultimately, rejoining life on a more fulfilling basis.

Implications

The impact of these proposed interventions can be far reaching, as individuals start restoring the actual bases upon which they have built their interpersonal relationships. As a consequence of recovering from spiritual abuse, some clients start to reformulate their

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approaches to marital relations and parenting. This enables them to break generational chains of religious-related child maltreatment and religious-related domestic violence. Moreover, as part of the behavioral component of TF-CBT, clients are encourage to take steps to end their social isolation and rejoin society, outside of secluded religious groups. Upon gaining awareness of the nature and prevalence of SA, survivors may start to become interested in sharing their stories and experiences with other survivors; discovering the commonality of their stories and finding peer support to deal with the aftermath of the abuse. Oakley and Kinmond (2013) state that victims of SA leave their churches quietly, too afraid or ashamed to share their experiences or denounce the abuse suffered. The phenomenon of SA then becomes a revolving door, through which people exit while, at the same time, more and more people, unknowingly, continue entering spiritually abusive churches. Support groups of former members of abusive religious groups have the potential to become the ground to form alliances for advocacy and social action, to raise awareness of SA and prevent SA from occurring to others.

Upon leaving their religious groups, individuals who experience spiritual abuse need to have access to social work practitioners that are knowledgeable of this phenomenon and are, at the same time, comfortable discussing and addressing dysfunctional or toxic aspects related to religion and spirituality. These professionals in turn, have the challenge to find effective supervision or consultative support when exposed to their clients spiritually traumatic stories. Issues of counter transference and visceral traumatization are as common when working with spiritual abuse, as with other forms of abuse and trauma (Gubi & Jacobs, 2009). The encounter with clients accounts of spiritually abusive experiences has the potential to awaken strong emotional reactions in therapists such as: powerlessness, helplessness, anger, the desire to vindicate God, and the urge to try to defend and justify their own religious or spiritual beliefs

EMPOWERING THE HUMAN SPIRIT (Gubi & Jacobs, 2009, p. 197). Adequate training on SA for social workers and social work supervisors would increase professionals competency to address different forms of abuse connected to religion or spirituality.

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Maintaining a non-judgmental position in relation to a clients religious beliefs, does not imply suppressing critical judgment about the detrimental effects of oppressive and abusive forms of religious indoctrination, even when we are challenged to examine our own cultural biases. It is imperative that social workers, as part of their professional mandate to protect vulnerable populations, have a clear understanding of how policy protecting religious freedom may sometimes come at the cost of individuals physical, psychosocial and spiritual safety and well-being. In the case of religious child-maltreatment, victims lack the ability to choose their religious or spiritual upbringing, and are unable to advocate for themselves when religious beliefs and practices result in their physical or psychospiritual damage. Social workers have the opportunity to join the dialog on spiritual abuse that is gaining momentum worldwide and prepare to take a clear stance about this insidious and potentially destructive form of abuse, advocating for more transparency and accountability for religious leaders and institutions.

EMPOWERING THE HUMAN SPIRIT References

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Caballero, B. (2013) Direct Social Work Practice who Experience Spiritual Abuse (Unpublished Paper). Winthrop University. Rock Hill, SC. Edwards, A. (2006). Cognitive and cognitive-behavioral therapy with religiously-oriented clients: two case studies. Social Work & Christianity, 33(1), 36-57. Enroth, R. (1993) Churches that Abuse. Grand Rapids, MI: Zondervan. Gubi, M.G. & Jacobs, R. (2008). Exploring the impact on counselors of working with spiritually abused clients. Mental Health, Religion & Culture, 12(2), 191-204. Hamilton, M. A. (2009). The Rules against Scandal and What they mean for the First Amendment's Religion Clauses. Maryland Law Review, 69(1), 115-131. Heimlich, J. (2011) Breaking their Will: Shedding Light on Religious Child Maltreatment. Amherst, NY: Prometheus Books. Hodge, D. R. (2013). Implicit Spiritual Assessment: An Alternative Approach for Assessing Client Spirituality. Social Work, 58(3), 223-230. Johnson, D. & VanVonderen, J. (1991) The Subtle Power of Spiritual Abuse. Minneapolis, MN: Bethany House Publishers. Lewandowski, C. A., & Canda, E. R. (1995). A Typological Model for the Assessment of Religious Groups. Social Thought, 18(1), 17-38. National Association of Social Workers (2001). NASW Standards for Cultural Competence in Social Work Practice. Washington, DC: NASW Press. National Association of Social Workers (2008). Code of Ethics of the National Association of Social Workers. Washington, DC: NASW Press.

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Oakley, L & Kinmond, K (2013) Breaking the Silence on Spiritual Abuse. London, UK: Palgrave Macmillan. Richards, P., Bartz, J. D., & O'Grady, K. A. (2009). Assessing religion and spirituality in counseling: Some reflections and recommendations. Counseling and Values, 54(1), 6579. The Terrible Legacy of Spiritual Abuse. (2004). Evangel, 22(2), 33-34. Roberts-Lewis, A. C. (2011). Response to Mark Chaves: Practical Interventions to Assist Social Work Students in Addressing Religious and Spiritual Diversity. Social Work & Christianity, 38(2), 139-145. Rosmarin, D. J. (2011). Incorporating spiritual beliefs into a cognitive model of worry. Journal of Clinical Psychology, 67(7), 691-700. Simoni, B., Mandelj, T., & NOVAK, R. (2013). Religious-Related Abuse in the Family. Journal of Family Violence, 28(4), 339-349. Walker, D. F., Reese, J. B., Hughes, J. P., & Troskie, M. J. (2010) Addressing religious and spiritual issues in trauma-focused cognitive behavior therapy for children and adolescents. Professional Psychology: Research and Practice, 41(2), 174-180. Walsh, J. (2010). Theories for direct social work practice (2nd Ed.) Belmont, CA: Thomson Brookes/Cole. Ward, D. (2011). The lived experience of spiritual abuse. Mental Health, Religion & Culture, 14(9), 899-915. Winell, M. (2007) Leaving the Fold: A Guide for Former Fundamentalists and Others Leaving their Religion. Oakland, CA: New Harbinger Publications.

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