June 9, 2014

By Melissa Schaaf

“Spiritual care that works with psychology is a distinctive form of client healthcare.”

Carrie DoehringThat is the stance that licensed psychologist and ordained minister Rev. Dr. Carrie Doehring takes when it comes to mental health and religion. Doehring, an associate professor of pastoral care at the Iliff School of Theology, spoke at the University of Denver’s Osher Lifelong Learning Institute (OLLI) lecture series on the topic of psychology and religion and whether or not they mix. OLLI is an adult learning membership program designed for persons age 50 and over.

She explained that providing pastoral care with psychological or psychiatric care can help an individual with their spirituality and wellness in a welcoming, nonjudgmental environment. The first step, however, is to understand the definition of spirituality for each individual person.

“It’s important to listen to how spirituality is operating in someone’s story when they come for health care,” she said.

In her lecture, Doehring defined spirituality as:

A search for:

  • Meaning and purpose in life
  • Ways of coping and connecting with a sense of transcendence or the sacred

That is embodied and experienced through:

  • One’s emotions
  • And relationship with others

Understanding spirituality can lead a caregiver to delve deeper into the emotions, core values, ultimate beliefs, and practices of a care seeker. Doehring explained that emotions “are the energy of our spiritual orienting systems;” core values are intrinsically meaningful principles, qualities or aspects of life; ultimate beliefs are convictions or worldviews about life and death, one’s purpose, the meaning of suffering, and whether there is a God or a transcendent dimension of life; and practices are ways of coping and connecting with the sacred.

She noted that an individual’s theology can affect the way they feel about a particular situation they are in or action they have taken.

“A lot of emotions and fears correlate with theology,” she added. “This can elicit different coping practices, such as fight or flight, avoidance, and self-reliance.”

Different values, theological or not, can surface as a result of facing a particular situation. Personal values, familial values, and cultural values can clash, creating tension for clients in what they believe to be true versus what they are taught to believe is true.

“I’m interested not in what they say they believe – what religious traditions say they ought to believe – but in what is driving them at this moment,” Doehring said. “I’m interested in the lived religion of people.”

She explained that this is known as espoused beliefs and values versus lived beliefs and values. Espoused is what we say we believe and value, what we are supposed to believe and value, and what our families, communities and religious traditions tell us to believe and value. Lived beliefs and values are what the individual personally relates to and puts into practice in their daily lives.

In order to successfully help clients seeking spiritually-oriented psychological or psychiatric care, the care giver must understand the truths of each person and only then can they create spiritually-integrated change. Doehring described the components to providing successful spiritually-integrated care, beginning with radical respect, providing compassion, and exercising theological reflexivity.

Radical respect is the relational foundation of caregiving. There is respect and compassion for each person’s narrative of truth, acknowledging the similarities and differences in each story and spiritual orientation. The focus is on lived practices, values and beliefs, and the dialogue is conducted with full awareness of biases and intractable otherness.

“There needs to be respect of what’s different between each tradition without searching for one god,” she added. “There is a long tradition of Christian bias where Christians tend to see the traditions of other religions through the lens of their own religion. Intractable differences are then reduced to a common Christian world view.”

The second component is compassion. Compassion often acts as an antidote to fear; it is not judgmental and therefore can foster accountability. The caregiver’s word choices, body language, and voice level can all evoke compassion.

“When compassion is at the emotional center of care giving and when we can move a care seeker from fear and anger to a sense of self-compassion, then a lot is going to start coming together for them,” she said. “This makes them more flexible and integrated. Compassion has to be expressed in the care giving relationship.”

Theological reflexivity is the process in which caregivers and care seekers collaboratively identify the emotions that trigger and energize the care seeker’s spiritual orienting system. They can begin to explore the emotional and narrative logic that dynamically connects particular beliefs and values with habitual ways of coping. Theological reflexivity is used to assess what is life-giving versus life-limiting about different lived theologies or spiritual orienting systems.

All of these components—radical respect, compassion, and theological reflexivity—can assist a care giver to determine the issues or struggles that care seekers are experiencing that may not line up with their true beliefs and values.

“It’s very helpful to recognize, and to help care seekers explore and discover their ambivalence,” she commented. “It’s important to exaggerate that ambivalence and then initiate a talk about reasons to change and how they would change.”

Doehring explained that integrating spirituality with psychological and psychiatric care can help heal a person in a different manner other than mainstream mental health care methods. It focuses more on how the person sees him/herself and how they relate to their surroundings and find meaning.

“That’s the beauty of the system,” she added. “We’re not looking at particular religious beliefs, but looking at how people are oriented to the world based on their core values.”