1988) and orienting, motivating forces (Gorsuch & Venable, 1983; Ryan,
Rigby, & King, 1993). Three of these scales (Gorsuch & Venable, 1983;
Pargament et al., 1988; Ryan et al., 1993) were designed for Christian subjects,
while that of Hall and Edwards (1996) was designed ‘‘from a Judeo-Christian
perspective’’ (p. 233). The scales of Maton (1989) and Kass et al. (1991) are not
specifically Christian or Judeo-Christian, but still have a profoundly theistic
outlook. Future investigators need to flag non-theistic, non-religious items in
the latter two scales such as a question about ‘‘an experience of profound inner
peace’’ (Kass et al., 1991, p. 211). They would also do well to consider
including items in such as ‘‘do you now feel closer to something greater than
yourself?’’
Inner Wisdom
Wayne Muller is a therapist and minister who has spent more than three
decades helping individuals who grew up in troubled families. He noted that
their lives were blighted by their early experience, but at the same time he
observed that
adults who were hurt as children inevitably exhibit a particular strength, a
profound inner wisdom, and a remarkable creativity and insight. Deep
within them—just beneath the wound—lies a profound spiritual vitality, a
quiet knowing, a way of perceiving what is right, beautiful, and true.
(Muller, 1992, p. xiii)
In some cases, survivors of childhood abuse eventually abuse their own
children, abuse drugs or alcohol, or engage in self-injurious or criminal
activity. Do these survivors experience any posttraumatic growth at all? Kira et
al. (2013) used the PTGI (Tedeschi & Calhoun, 1996) to conclude that
survivors of ongoing traumas (such as childhood abuse) do not experience
posttraumatic growth. However, this finding does not mean that Muller (1992)
is wrong. None of the items on the PTGI, the CiOQ (Joseph et al., 1993) or the
PWB-PTCQ (Joseph et al., 2012) seem to capture Muller’s quality of inner
wisdom. It may be that survivors have suffered the worst, and now appreciate
what life can offer, even if they are unable to direct their own actions to fully
experience it. Perhaps the only way to measure inner wisdom is through the
observations of an experienced therapist like Muller.
Increased Compassion
The PTGI (Tedeschi & Calhoun, 1996), the PWB-PTCQ (Joseph et al., 2012),
and the HGRC (Hogan et al., 2001) include a self-evaluation of compassion as
an important factor. The ‘‘changes that come from efforts to recover’’
questionnaire (Burt & Katz, 1987) includes compassion in a negative way with
the item ‘‘I’m unsympathetic to other people’s problems’’ (p. 70), although the
authors did not indicate the number of respondents disagreeing with this
statement. The CiOQ (Joseph et al., 1993) contains the item: ‘‘I’m a more
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understanding and tolerant person now’’ (p. 275) with which 71% of the Jupiter
respondents agreed. Chodron (2001) suggested that such compassion arises
naturally out of a heart-breaking experience:
Sometimes this broken heart gives birth to anxiety and panic, sometimes to
anger, resentment, and blame. But under the hardness of that armor there is
the tenderness of genuine sadness. This is our link with all those who have
ever loved. This genuine heart of sadness can teach us great compassion. It
can humble us when we’re arrogant and soften us when we are unkind. It
awakens us when we prefer to sleep and pierces through our indifference.
This continual ache of the heart is a blessing that when accepted fully can be
shared with all. (p. 4)
Berliner (1999b) also noted that the genuine heart of sadness can create a
heightened vulnerability and a longing to help others.
I
MPLICATIONS FOR
T
HERAPY
The Severance Phase
At the end of every synagogue service, mourners rise for the recitation of
kaddish (the mourner’s prayer) in a powerful acknowledgment of their
separate status. In general, however, bereaved persons often find others have
‘‘an intolerance of their grief ’’ (Cacciatore & Flint, 2012, p. 167). Deceased
persons have ‘‘departed’’ or ‘‘passed on,’’ and bereaved clients themselves are
often reluctant to use words like death to describe their experience. To come
to terms with the reality of loss, Cacciatore and Flint (2012) suggested the use
of rituals in which metaphor and symbol, stories, and ceremonies all play a
role. A ritual ‘‘provides a forum where the death is acknowledged and
accepted as real’’ (Reeves, 2011, p. 417). It is a reminder to the bereaved
person that they are forever separated from the life they once had with the
deceased. However, the motivation for the ritual must come from clients
themselves (Reeves, 2011).
How should the therapist deal with rituals with an overtly spiritual or religious
content? Saunders, Miller, and Bright (2010) described four possible approaches
in dealing with such matters, two of which the therapist should avoid. Spiritually
avoidant care neglects the importance of spiritual matters to a client and so
amounts to malpractice, and spiritually directive care is only appropriate for
persons acting in a religious capacity. Spiritually conscious care implies an
awareness of spiritual matters and a willingness to refer if necessary, and it
should be considered a minimum standard. In spiritually integrated care, a
therapist helps the client identify spiritual needs and suggests spiritual and
religious activities. My experience as an interfaith hospital chaplain helps me to
be spiritually integrated, but I encourage even those without a religious
background to consider helping a client in this way. A spirit of openness,
inquiry, and some knowledge of religious customs is more important than
formal religious training.
Nadir Experience
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