Spirituality Religion as a Healing Pathway for Survivors of Sexual Violence

Sannisha Dale and Jessica Henderson Daniel

INTRODUCTION

Many survivors of sexual violence face a journey of negative psychological consequences.1 However, depending on factors existing before, during, and after the trauma, many survivors experience healing. Two factors that have provided a pathway to healing for some survivors of sexual violence are spirituality and religion. This chapter discusses the role of spirituality and religion in the healing process. Definitions for spirituality and religion and distinctions between the two concepts will be provided in section one. Section two will present a review of the literature on spirituality/religiosity as coping strategies that promote healing. In section three we will acknowledge the recent emerging literature that explores the reciprocal impact of sexual abuse on spirituality as well as negative forms of spiritual coping. Additionally, we note the implications for mental health interventions, describe a case example of a survivor whose use of spirituality was central to her recovery, and summarize the major points made throughout the chapter. Finally we will conclude with a few exercises for survivors who would like to connect with their spirituality as a part of their recovery.

SPIRITUALITY VERSUS RELIGION

Spirituality and religion have been defined as similar yet separate multidimensional concepts in psychology. Spilka highlighted three conceptualizations of spirituality: (1) a form of spirituality that is God-oriented with thoughts and practices rooted in theologies; (2) a world-oriented spirituality that emphasizes the individual's relationship with ecology or nature; and (3) a humanistic spirituality highlighting human potential and achievement.2 LaPierre noted that a spiritual experience may have several components including a search for meaning and ultimate truth, sense of community, and personal transformation.3 Similarly religion assists individuals in finding meaning and community as well as addressing their ultimate concerns. However, religion is often viewed as an institution that encourages certain behaviors and practices based on doctrines, creeds, and values.4,5 A person's religious experience might be organized (e.g., attending church services) or nonorganized (e.g., praying at home).6 Although many psychologists distinguish between religiosity and spirituality, some argue that the separation might be artificial7 and insignificant since the majority of Americans maintain active religious beliefs and practices8 and consider religiosity and spirituality to be interchangeable.7 In the U.S. population estimates of the distribution of groups related to faith are 82.3% Christian, 11.2% agnostic, 1.8% Jewish, 1.6% Muslim, and 0.9% Buddhist.9

HEALING PATHWAY

Several research studies have highlighted spirituality/religiosity as a coping strategy that promotes healing in general and specifically among victims of sexual violence. As stated in prior chapters, sexual violence results in short-term and long-term consequences for many of its victims. Valentine and Feinauer interviewed twenty-two women with childhood sexual abuse histories who in adulthood were able to maintain stable relationships, successful careers, and healthy personalities.10 These women reported that spirituality/ religiosity contributed to their recovery from sexual abuse in several ways. First, through their religion and church they found a supportive network of people with whom they were able to interact. Second, it gave them faith, which helped them to find meaning and purpose. Third, they gained the understanding that they could survive the hard times and God would help to make things better. Fourth, spirituality/religiosity gave them the insight that they were of worth despite the adversity they were experiencing.

Chandy, Blum, and Resick found that among adolescent girls who were victims of childhood sexual assault, those who viewed themselves as religious/spiritual were less at risk for psychological or interpersonal problems.11 Similarly in a sample of 653 men and women it was found that victims of childhood sexual abuse who engaged in more religious practices reported fewer symptoms of depression and higher self-esteem.12 Among twenty-five men sexually abused in childhood, some men reported using spirituality to make meaning of the abuse and also entering professions to help others.13 Bryant-Davis (2005) conducted a retrospective study among seventy African American adult survivors of childhood violence (25% of whom survived childhood sexual abuse) to explore the use of various coping strategies.14 Her findings were that both males and females in the sample utilized spirituality as a coping strategy in the form of beliefs, prayer, and attending pastoral counseling. In general spirituality/religiosity has been recognized as an important coping strategy in the African American community.15

In a naturalistic study on the experiences of fourteen women healing from childhood sexual abuse, some participants described that they found support in "relationships with God, church, religion, angels and nature."16 In interviews with ten women who survived childhood sexual abuse, Bogar and Hulse-Killacky found that spirituality was a common aspect of their recovery from the abuse.17

Knapik, Martsolf, and Draucker developed a theoretical framework to explain how survivors of sexual violence utilize spirituality to respond to the abuse on their path to recovery based on interviews with twenty-seven women and twenty-three men.18 The framework consists of the core category of the Being Delivered and categories of Spiritual Connection, Spiritual Journey, and Spiritual Transformation. Being Delivered captures the participants' experience of being set free or rescued from the aftermath of the sexual violence by a spiritual power. Spiritual Connection reflects the participants' description of a connection or attempt to connect with a higher power via activities such as prayer or worship. Having a strong spiritual connection laid the foundation for some participants to begin on a Spiritual Journey on which they are strengthened and supported; develop a greater sense of awareness and insight from a divine perspective; and/or experience trials and tribulations from God that help them grow stronger. A few participants' spiritual journey led them to Spiritual Transformation as they began to view their sexual violence in a spiritually meaningful way and experienced a deep sense of divine intervention in their lives. Knapik et al. quoted one of their participants to illustrate spiritual transformation.18

It was a healing process. You know, sometimes, you don't know you're hurting. Sometimes you don't know you are a wounded person, but what is that scripture "a new being in Christ, he's a new creature, the old things have passed away and behold all things become new." And that's basically the truth, I had a new way of doing things, a new way. (p. 345)

RECIPROCAL IMPACT OF SEXUAL ABUSE ON SPIRITUALITY

Although studies described previously have found spirituality/religiosity to contribute to healing for victims of sexual violence, the negative impact of sexual abuse on spirituality/religiosity must also be acknowledged. Among a sample of 150 college students Reinert and Edwards19 found that verbal, physical, and sexual abuse during childhood correlated with views of God as controlling, distant, and unloving. Similarly in a sample of 150 Mormon women who were sexually abused during childhood, abuse was associated with lower spiritual well-being as well as viewing God as more punitive and distant.20 The severity and frequency of sexual abuse have also been associated with lower spiritual well-being.21,22

One can also imagine how damaging sexual abuse committed by members/leaders of the church might be to the spirituality of the victim. Isely et al. conducted interviews with nine men who were sexually abused by members of the Catholic clergy, and the men reported feelings of guilt, confusion, and anger.23 Studies have found individuals are more likely to disclose childhood sexual abuse when the perpetrator is a stranger and not a family member24,25 and take longer to disclose when it is a member of their family.26 The extent to which the church represents a pseudofamily to its members may further complicate the challenges to disclosure27,28 by victims of sexual violence within the church. For instance, in the Black community churches play important supportive roles such as caring for children after school.29 Recently a lawsuit was filed against a bishop of the New Birth Missionary Baptist Church, a predominantly Black congregation in Georgia, by two young men who claimed that they were sexually abused by a bishop who gave them gifts such as expensive cars and free hotel stays.30 There were also allegations that officials of the church knew of the sexual acts but concealed them. Besides having their crimes concealed, some convicted sex offenders may seek restoration in churches and be embraced and forgiven by some church mem-bers.31 These occurrences may further exacerbate the anger and confusion of victims toward the church and religion as well as place other members at risk.

Given the fact that sexual violence may negatively impact the survivors' religiosity/spirituality, reconstructing or maintaining a sense of spirituality may be significant and beneficial. For instance, Gall et al. found that victims of long-term abuse viewed God as less benevolent, but participants who reported a more positive relationship with God reported fewer symptoms of depression, anger, and anxiety.32 Elliot reported similar findings among 2,964 professional women (918 CSA).33 Among those from conservative Christian backgrounds, abuse survivors were less likely to participate in organized religion in adulthood; however fewer post-traumatic stress symptoms were reported among those who practiced organized religion as adults.

NEGATIVE SPIRITUAL COPING STRATEGIES

While the distinction between positive and negative spiritual/religious coping strategies is not always made by researchers, it is important. Pargament et al. explored positive and negative religious strategies among individuals coping with the Oklahoma City bombing, college students dealing with major life stressors, and patients coping with medical illnesses.34 He found that positive religious coping consisted of religious forgiveness, seeking spiritual support, collaborating with God to solve problems, spiritual connection, searching for purification through religious activities, and religiously viewing the stressor as potentially benevolent. Negative spiritual coping strategies included spiritual discontent, viewing the stressor as a punishment from God because of their sins, dissatisfaction with religious leaders and members, appraising the stressor as the devil's doing, and reappraisal of God's powers. Gall examined the role of spiritual coping in addressing current life stressors for adult survivors of child sexual abuse, and in doing so he distinguished between negative and positive spiritual coping strategies.35 Negative spiritual coping includes anger, detachment, and personal discontent in the relationship with the higher being or church community. Examples of positive forms of spiritual coping are reliance on the security and comfort of a higher being, and during stressful events seeking support from the higher being. Gall's study found that negative spiritual coping (e.g., discontent) predicted greater depressive mood while positive spiritual coping (e.g., seeking God's support) was related to lower levels of depression.35

IMPLICATIONS FOR MENTAL HEALTH PROVIDERS

Given that spirituality/religiosity may help survivors as they strive to heal from sexual violence, mental health providers may consider incorporating discussions about spirituality/religion into the therapeutic process based on the client's interest. However, in broaching the subject of religion/spirituality therapists cannot assume that spirituality/religion will be eagerly welcomed by the survivor, because as stated above, sexual trauma can be related to negative views of religion (e.g., God as distant and unloving). Likewise not all forms of spiritual coping are positive, and therefore if a client utilizes spirituality as a coping strategy, the therapist is advised to gain an understanding of how the client conceptualizes spirituality in their life. As with all values, it is critical that the therapist be aware of their own spiritual/religious or nonspiritual ideologies and be mindful not to use these beliefs to guide their decision in whether they explore spirituality as a coping strategy if the client wishes to do so.

CASE EXAMPLE

A nineteen-year-old African American female presented for therapy with complaints of nightmares, disrupted sleep, flashbacks, and hypervigilance.

She wanted to learn ways to alleviate her symptoms, but initially she was reluctant to disclose or revisit the traumatic events that caused her symptoms. After two months of increasing her trust in the therapist and the process the client shared that her virginity was stolen and she had been violently raped by a family friend as her male cousin looked on and yelled at her to stop resisting. The client reported that after the assault she was in disbelief, especially because of her relationship with the perpetrators. Prior to the rape the client was raised in a Christian home and had been a frequent churchgoer. When she disclosed the trauma to a female relative, who was a devout Christian and sibling to the brother who looked on, she was told that she should get baptized and give her life over to the Lord. The client expressed outrage at the emphasis that was placed on her doing something to heal and the lack of discourse about the perpetrators. For months the client felt isolated and alone in her struggle. She distanced herself from church members and stopped attending church because she feared that their reaction would be similar to that of her female relative who centered the conversation on the client trying to get better and dismissing the role of the perpetrators. Following her sharing of the trauma in therapy, sessions were spent addressing themes of anger, trust, and spirituality. The client questioned the idea of a "just God" because although she called on him for help during the assault and the aftermath, she felt that her prayers went unanswered. The therapist acknowledged and empathized with the client's shattered view of God and members of her religious community. The therapist also suggested an activity in which the client could choose a story of suffering and healing from her religious doctrines and share it with the therapist in the following session, in which they would discuss the themes of the story and how the person healed. Forgiveness was a significant theme in the first story, and the client was adamant that she was not ready to either forgive or forget. The therapist again validated her emotions and reassured her that healing was a process that she could take at her own pace. After a few months of sharing and discussing stories of suffering and healing in Christianity the client explained that she was still disappointed that God did not prevent the rape from occurring, but she believed He helped her to survive and make it to where she is today. She also believed that God could help her on her journey as she moved forward. The client expressed that she missed praying, listening to gospel, and attending church. The therapist helped her explore her desire to engage in those activities as well as her ambivalence. For instance the client shared that she wanted to pray, but she feared that God would sense her remaining anger toward him and she had never expressed negative emotions toward God in prayer before. Through exploration of the issues that arose around spirituality for this client she gradually returned to praying, listening to gospel, and attending church, all of which contributed to her healing.

CHAPTER SUMMARY

Sexual violence is widespread and can result in short-term (e.g., fear) and long-term consequences (e.g., post-traumatic stress disorder, substance abuse) for many of its victims. Spirituality/religion is a coping mechanism that provides a pathway to healing for some survivors of sexual violence. Throughout this chapter we (a) compared the definitions for spirituality and religion; (b) reviewed research studies that support spirituality/religiosity as coping strategies that promote healing; and (c) acknowledged the recent emerging literature that explores the reciprocal impact of sexual abuse on spirituality as well as negative forms of spiritual coping. Lastly, based on the presented information, we noted a few implications for mental health providers.

Further research is needed for practitioners to have a more nuanced awareness and understanding of spirituality/religiosity. The exploration of the intersection of spirituality/religiosity with variables such as race/ethnicity, gender, sexual orientation, disability status, immigrant status, socioeconomic status, and development (emotional, cognitive, and social) may provide additional insights for both researchers and practitioners regarding spirituality/religiosity and other coping mechanisms as strategies for coping with and healing from sexual violence.

EXERCISES FOR SURVIVORS TO CONSIDER

For survivors who are interested in utilizing spiritual/religious coping strategies as they heal from sexual abuse, several activities might be beneficial. Defining what spirituality/religiosity means in their personal life is the first step. Some individuals might adhere to specific doctrines and practices as recommended by a religious denomination, but for others spirituality might entail believing in a higher power and engaging in explorations of nature and meditation. Once survivors have began to clarify the meaning of spirituality in their lives, engaging in applicable activities such as prayer, meditation, relaxation exercises, and so on, might be helpful. Other activities include reading spiritual/religious writings about healing and growth and listening to related music. Many spiritual/religious activities can be done in solitude or with groups. Private activities may help a survivor to strengthen their personal sense of spirituality, while attending groups (e.g., church ceremonies, meditation groups, and prayer groups) also offers a community of members who can be a source of support. In seeking support from members/leaders of spiritual/religious groups survivors may wish to disclose their sexual abuse history; however, survivors must be careful in seeking out members/leaders who are non-victim-blaming and nonjudg-

mental. If a survivor is engaging in therapy and desires to have their spiritual/religious thoughts and practices integrated in the treatment, survivors should broach the topic with the therapist. Some therapists are trained and comfortable addressing issues around spirituality, while others are not. Those who are not trained may be able to provide referrals to counselors who are. Healing after sexual abuse is a challenging journey, and spirituality/religion can be a source of strength along the way.

REFERENCES

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2. Spilka, B. (1993, August). Spirituality: Problems and directions in operationaliz-ing a fuzzy concept. Paper presented at the meeting of the American Psychological Association. Toronto, Ontario.

3. Lapierre, L.L. (1994). A model for describing spirituality. Journal of Religion and Health, 33, 153-161.

4. Marty, M.E., Applyby, R.S., Eds. (1991). Fundamentalisms observed. Chicago: University of Chicago Press.

5. King, D.G. (1990). Religion and health relationships: A review. Journal of Religion and Health, 29(2), 101-112.

6. Strawbridge, W.J., Shema, S.J., Cohen, R.D., Roberts, R.E., & Kaplan, G.A. (1998). Religiosity buffers effects of some stressors on depression but exacerbates others. Journal of Gerontology, 53B(3), S118-S126.

7. Hill, P.C., & Pargament, K.I. (2003). Advances in the conceptualization of and measurement of religion and spirituality: Implications for physical and mental health research. American Psychologist, 58, 64-74.

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10. Valentine, L., & Feinauer, L.L. (1993). Resilience factors associated with female survivors of childhood sexual abuse. The American Journal of Family Therapy, 21, 216-224.

11. Chandy, J.M., Blum, R.W., & Resnick, M.D. 1996. Female adolescents with a history of sexual abuse. Risk outcome and protective factors. Journal of Interpersonal Violence, 11, 503-518.

12. Doxey, C., Jensen, L., & Jensen, J. (1997). The influence of religion on victims of childhood sexual abuse. International Journal for the Psychology of Religion, 7, 179-186.

13. Etherington, K. (1995). Adult male survivors of childhood sexual abuse. Counseling Psychology Quarterly, 8, 233-242.

14. Bryant-Davis, T. (2005). Coping strategies of African American adult survivors of childhood violence. Professional Psychology: Research and Practice, 36, 409-414.

15. Joseph, M. (1998). The effect of strong religious beliefs on coping with stress. Stress Medicine, 14, 219-224.

16. Glaister, J.A., & E. Abel. 2001. Experiences of women healing from childhood sexual abuse. Archives of Psychiatric Nursing, 15(4), 188-94.

17. Bogar, C.B., & Hulse-Killacky, D. (2006). Resiliency determinants and resiliency processes among female adult survivors of childhood sexual abuse. Journal of Counseling and Development, 84, 318-327.

18. Knapik, G.P., Martsolf, D.S., & Draucker, C.B. (2008). Being delivered: Spirituality in survivors of sexual violence. Issues in Mental Health Nursing, 29(4), 335-350.

19. Reinert, D.F., & Edwards, C.E. (2009). Attachment theory, childhood maltreatment, and religiosity. Psychology of Religion and Spirituality, 1, 25-34.

20. Pritt, A.F. (1998). Spiritual correlates of reported sexual abuse among Mormon women. Journal for the Scientific Study of Religion, 37, 273-285.

21. Feinauer, L., Middleton, K.C., & Hilton, G.H. (2003). Existential well-being as a factor in the adjustment of adults sexually abused as children. The American Journal of Family Therapy, 31, 201-213.

22. Weber, L.J., & Cummings, A.L. (2003). Relationships among spirituality, social support, and childhood maltreatment in university students. Counseling and Values, 47, 82-95.

23. Isely, P.J., Isely, P., Freiburger, J., & McMackin, R. (2008). In their own voices: A qualitative study of men abused as children by Catholic clergy. Journal of Child Sexual Abuse, 17, 201-215.

24. Hanson, R.F., Resnick, H.S., Saunders, B.E., Kilpatrick, D.G., & Best, C. (1999). Factors related to the reporting of childhood rape. Child Abuse & Neglect, 23, 559-569.

25. Smith, D., Letourneau, E.J., Saunders, B.E., Kilpatrick, D.G., Resnick, H.S., & Best, C.L. (2000). Delay in disclosure of childhood rape: Results from a national survey.Child Abuse & Neglect, 24, 273-287.

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28. Sorsoli, L., Kia-Keating, M., & Grossman, F.K. (2008). "I keep that hush-hush": Male survivors of sexual abuse and the challenges of disclosure. Journal of Counseling Psychology, 55(3), 333-345.

29. McAdoo, H., & Crawford, V. (1991). The Black church and family support programs. Prevention in Human Services, 9(1), 193-203.

30. Brown, R. (2010, September 21). Lawsuits accuse megachurch leader of sexual misconduct. The New York Times. Retrieved from http://www.nytimes .com/2010/09/22/us/22church.html

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33. Elliott, D.M., Mok, D.S., & Briere, J. (2004). Adult sexual assault: prevalence, symptomatology, and sex differences in the general population. Journal of Traumatic Stress, 17(3), 203-211.

34. Pargament, K.I., Smith, B.W., Koenig, H.G., & Perez, L. (1998). Patterns of positive and negative religious coping with major life stressors. Journal for the Scientific Study of Religion, 37(4), 710-724.

35. Gall, T.L. (2006). Spirituality and coping with life stress among adult survivors of childhood sexual abuse. Child Abuse and Neglect, 30, 826-844.

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