Category: Scholarly

The Impact and Treatment of Religious Trauma

Scholarly

A short paper on the topic of religious trauma for a class in “Treatment in Clinical Counseling.”

Target Population

Religion and spirituality are a source of strength and meaning for many people, but for others, they are the cause of significant distress. Religious trauma (or spiritual trauma, a closely related phenomenon) can be defined as “pervasive psychological damage resulting from religious messages, beliefs, and experiences” (Stone, 2013, p. 324). Unlike trauma resulting from acute events, religious trauma tends to unfold gradually, as the product of “long-term exposure to messages that undermine mental health” (Stone, 2013, p. 325). The effects of religious trauma are varied, but include interpersonal, emotional, and cognitive difficulties (Winell, 2007), as well as enduring negative impacts on physical and spiritual well-being.

A person can experience religious trauma at the hands of religious leaders, parents, or lay members of a spiritual community. Examples of potentially traumatic adverse religious experiences include: the use of guilt and shame to control behavior (often in the context of institutions with strictly defined moral codes); the repression of critical thinking; fear-based teaching (focused, for instance, on threats of eternal punishment); the enactment of strict gender roles and definitions of sexuality (as a way to justify discrimination and unfair power dynamics); physical, emotional, sexual, or financial abuse (often as the result of religious leaders abusing their authority); and shunning or excommunication (when “disobedient” members of a religion are isolated from their community). In all of these examples, a person’s core values, sense of self, and trust in the world are severely threatened.

Unfortunately, the academic literature devoted to the discussion of religious trauma is somewhat limited, and it is hard to find empirical data documenting the exact scope of this problem. Indeed, most existing research is qualitative in nature and developed primarily through case studies and interviews. However, one recent study estimates that, among U.S. adults, approximately 27-33% have experienced religious trauma at some point in life, while approximately 10-15% are currently suffering from debilitating religious trauma symptoms (Slade et al., 2023). According to the author of the study, these estimates are conservative, so we can imagine that the consequences of adverse religious experiences are in fact even more wide-reaching.

Rationale

Just as there is a dearth of academic research on religious trauma, there is a notable deficit in clinical training. At present, most clinicians receive “little to no training on the exigencies of religious disenchantment” or other forms of religious trauma (Brooks, 2020, p. 194). This gap in competence results in a failure to serve many suffering people. And because spiritual practices are often regarded as a helpful coping strategy, unwitting clinicians may end up doing more harm than good as they try to walk their clients through the process of healing. Indeed, many popular treatment programs, such as the 12-Step recovery programs, are rooted in faith-based principles and may be triggering to spiritually traumatized clients.

How do we best serve these clients? Research suggests that, for people who struggle to make sense of a trauma, religious doubts and confusions can lead to greater distress, which in turn can lead to worsening symptoms of post-traumatic stress disorder (PTSD) (Ter Kuile & Ehring, 2014). Meanwhile, intense spiritual struggle, or “negative religious coping,” is associated with worse mental health outcomes following trauma (Kucharska, 2020). When a person experiences religious trauma, she may feel deeply lost and confused, and as if a very intimate part of her being (as well as her support system) has been stripped away. It is important that we understand this struggle so that we can facilitate the process of uncovering renewed purpose and meaning in a client’s life.

Problem Identification

Religious trauma comes with many losses: a loss of community and belonging, a loss of structure, a loss of meaning. Indeed, grief is a salient theme in the narratives of people experiencing religious trauma (Jones et al., 2022). There are also casualties to spiritual self-concept, leading to existential anxiety. Feelings of shame, abandonment, and isolation are common, too, as is a profound loss of trust, both in oneself and in the systems a person depended on to make sense of the world. In this sense, religious trauma impacts a person at the intrapersonal, interpersonal, and structural levels.

According to Johnson and VanVonderen (1991), the effects of religious trauma impair a person’s image of God, as well as impede her ability to accept grace, set healthy boundaries, and establish trusting relationships. Revictimization is also possible, since religious texts are misused to keep people in abusive situations by instilling messages of unhealthy submission and forgetting of past wrongs. Other consequences of religious trauma may include limited decision-making skills, emotional delays, low self-esteem, and a proneness to mental disorder.

Indeed, religious trauma is linked to depression and anxiety (Cashwell & Swindle, 2018). Scrupulosity, a morality-focused presentation of obsessive-compulsive disorder, is especially common. Of course, the associations with PTSD and complex (c-)PTSD are evident. It is also possible for religious trauma to masquerade as other disorders, such as bipolar disorder and borderline personality disorder, or to co-occur with eating disorders and substance use problems (Winell, 2011). Clinicians must be educated on the etiology and expression of religious trauma so that they are equipped to differentiate it from other, seemingly similar conditions. Treating a client’s presenting concerns while ignoring the presence of trauma hinders the provision of effective services.

Community Intervention System

Unfortunately, the number of clinicians specializing in religious trauma is small, and it can be hard to come by counselors who are familiar with the nuances of this problem. Below, I have listed a reference to a religious trauma-informed therapist directory, which could be useful in securing distance counseling services with virtual providers around the country. Professional resources, including trainings on treatment considerations and interventions, are also provided. In the event that a client cannot connect with a specialist in religious trauma, practitioners offering broad “trauma-informed care” are recommended.

  • Reclamation Collective
    https://www.reclamationcollective.com
    Community advocacy organization offering a wide variety of support groups, workshops, and help for people navigating religious trauma. Hosts an online directory of religious trauma-informed therapists across the country.
  • Center for Trauma Resolution and Recovery
    https://www.traumaresolutionandrecovery.com/
    A group of trauma-informed practitioners from across the U.S. who use online coaching and support groups to provide access to trauma resolution and recovery to clients around the world. Specializes in addressing trauma resulting from religious abuse, cults, purity culture, and harmful theology.
  • Religious Trauma Institute
    https://www.religioustraumainstitute.com
    Religious trauma trainings, support, and community for therapists, researchers, advocates, and survivors. Featuring a series of clinical trainings, consultation groups, assessment tools, and treatment resources for mental health professionals, as well as workshops (like “Religious Trauma and Politics”) for the general public.

Treatment Interventions

When undertaking the treatment of religious trauma, clinicians should be mindful of a few guiding principles: evaluate the extent of the trauma; honor the losses it caused; address the impact of religion as a tool for social injustice; and assemble a list of religious and spiritual resources for clients (Morrow, 2003). Throughout, clinicians must remember the primacy of client self-determination vis-Ă -vis religious belief and avoid imposing personal values.

Specific approaches to treatment vary and depend on clinician orientation as well as client preference. In general, identifying adverse religious experiences from a trauma-informed lens is recommended. Winell’s (2007) phases of recovery may also guide the treatment process, helping clinicians to situate their interventions in the context of distinct phases (separation, confusion, avoidance, feeling, and rebuilding) that characterize the healing journey.

One approach to consider is trauma-focused cognitive-behavioral therapy (TF-CBT), which has been adapted to address religious trauma in children and adolescents (Walker et al., 2010). This modality involves psychoeducation (on, for instance, how a person’s religious beliefs may change because of the abuse she has experienced); parenting skills (focused on the role of praise and selective attention rather than harsh discipline); relaxation exercises; cognitive coping and processing (with an emphasis on deconstructing religious threats and exploring cognitive distortions); constructing a trauma narrative (allowing the client to process her trauma and find meaning in her experiences, while borrowing, if appropriate, from the wisdom of spiritual frameworks); safety planning; and in vivo exposure (to prevent generalization of anxiety symptoms). Other tools consistent with this approach include creating a spiritual timeline (in which clients map out the history of their trauma) (Super & Jacobson, 2011) and utilizing a blend of thought-stopping techniques, positive imagery, and positive self-talk (Walker et al., 2010). If a client wishes to retain her religious affiliation, the counselor may help her to locate Scriptural texts or other religious evidence which affirms, rather than condemns, these healing attitudes.

Another approach which has been proposed as a treatment for religious trauma is Internal Family Systems (IFS). IFS is evidence-based and supported in the treatment of PTSD (Hodgdon et al., 2022) and depression (Haddock et al., 2017). Interestingly, the concept of “Self” in IFS bears a resemblance to the concept of the Divine in various spiritual traditions (Schwartz, 2001), perhaps making it well suited to clients grappling with spiritual themes. Although promising, IFS would benefit from greater empirical support for its application to religious trauma. Other trauma-informed approaches, like eye movement desensitization and reprocessing (EMDR), are likely also good choices for this population, as is a combination of individual and group therapy with a focus on the role of secure attachment (Stone, 2013).

Regardless of the approach chosen, clinicians should be aware of unique obstacles which may arise. Some people who have experienced religious trauma have been taught to ignore or distrust their emotions or bodily cues (Stone, 2013). Since trauma is often stored in the body, the introduction of somatic interventions may be helpful, but should be done slowly and with care. In addition, mindfulness techniques may be uncomfortable for some clients, and should be implemented gently. For clients wishing to retain a spiritual connection, elements of meditative prayer may be incorporated into these exercises. In all things, the client should retain the right to make her own decisions as she regains a sense of personal agency and navigates the process of her healing.

References

Brooks, E. M. (2020). The disenchanted self: Anthropological notes on existential distress and ontological insecurity among ex-Mormons in Utah. Culture, Medicine, and Psychiatry, 44(2), 193-213.

Cashwell, C. S. & Swindle, P. J. (2018). When religion hurts: Supervising cases of religious abuse. The Clinical Supervisor, 37(1), 182-203. https://doi.org/10.1080/07325223.2018.1443305

Haddock, S. A., Weiler, L. M., Trump, L. J., & Henry, K. L. (2017). The efficacy of internal family systems therapy in the treatment of depression among female college students: A pilot study. Journal of marital and family therapy, 43(1), 131-144.

Hodgdon, H. B., Anderson, F. G., Southwell, E., Hrubec, W., & Schwartz, R. (2022). Internal family systems (IFS) therapy for posttraumatic stress disorder (PTSD) among survivors of multiple childhood trauma: A pilot effectiveness study. Journal of Aggression, Maltreatment & Trauma, 31(1), 22-43.

Johnson, D. & VanVonderen, J. (2005). The subtle power of spiritual abuse. Baker Publishing Group.

Jones, T. W., Power, J., & Jones, T. M. (2022). Religious trauma and moral injury from LGBTQA+ conversion practices. Social Science & Medicine, 305. https://doi.org/10.1016/j.socscimed.2022.115040

Kucharska, J. (2020). Religiosity and the psychological outcomes of trauma: A systematic review of quantitative studies. Journal of Clinical Psychology, 76(1), 40-58. https://doi.org/10.1002/jclp.22867

Morrow, D. (2003). Cast into the wilderness: The impact of institutionalized religion on lesbians. Journal of Lesbian Studies, 7(4), 109-123. https://doi.org/10.1300/J155v07n04_07 

Schwartz, Richard C. (2001). Introduction to the internal family systems model (5th reprinting). Oak Park Il: Trailheads Publications.

Slade, D. M., Smell, A., Wilson, E., & Drumsta, R. (2023). Percentage of U.S. adults suffering from religious trauma: A sociological study. Socio-Historical Examination of Religion and Ministry 5(1), 1-28. https://doi.org/10.33929/sherm.2023.vol5.no1.01 

Stone, A.M. (2013). Thou shalt not: Treating religious trauma and spiritual harm with combined therapy. Group 37(4), 323-337. https://doi.org/10.13186/group.37.4.0323

Super, J. T. & Jacobson, L. (2011). Religious abuse: Implications for counseling lesbian, gay, bisexual, and transgender individuals. Journal of LGBT Issues in Counseling, 5(3-4). https://doi.org/10.1080/15538605.2011.632739

Ter Kuile, H., & Ehring, T. (2014). Predictors of changes in religiosity after trauma: Trauma, religiosity, and posttraumatic stress disorder. Psychological Trauma: Theory, Research, Practice, and Policy, 6(4), 353.

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. https://doi.org/10.1037/a0017782

Winell, M. (2007). Leaving the fold: A guide for former Fundamentalists and others leaving their religion. Apocryphile Press.

Winell, M. (2011). Religious trauma syndrome. Cognitive Behavioural Therapy Today, 39(4), 19-21.

More than Tired: An Advocacy Paper (ME/CFS)

Scholarly

An excerpt from an advocacy paper I wrote, in which I tried to articulate some of the challenges of living with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) from a mental health perspective.

Target Population

The target population includes persons with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and their community of family, friends, and caregivers, as well as mental health professionals unfamiliar with the nuances of this invisible chronic illness.

Rationale

ME/CFS is a poorly understood invisible chronic illness, and persons living with it often encounter a host of unique challenges, including loneliness, medical skepticism, inadequate funding and social supports, limited treatment options, uncertain health outcomes, drastically altered personal relationships, and the grief of missing out on normal life activities and goals.

Some research suggests that persons with ME/CFS have a lower health-related quality of life score than even persons with cancer, diabetes, lupus, or heart disease (Hvidberg et al., 2015). And yet, despite its biological underpinnings, ME/CFS has often been portrayed – in medical circles and in the general public – as a psychological disorder that’s “all in the mind” (Froehlich et al., 2022).

Mental health providers should be aware that ME/CFS is a complex biological disease often triggered by infection, and be able to distinguish it from psychological disorders like depression and anxiety (while also recognizing that depression and anxiety often arise secondary to the pain of living with ME/CFS) (Daniels et al., 2017). They should also be aware of the implications to daily living of a mild, moderate, or severe ME/CFS diagnosis, so that they can sensitively support clients suffering with this invisible disability.

Many “long-haul COVID” patients are now experiencing the symptoms of ME/CFS (Komaroff & Lipkin, 2023), so the need for advocacy is especially great. As a personal aside, I myself have been struggling with post-viral symptoms for the last few years and can attest that the obstacles they pose to daily functioning are considerable. Raising awareness of ME/CFS, and validating the severity of its impact, can go a long way toward relieving the burden of individuals who feel stuck wondering whether they might be exaggerating their symptoms or “making it all up inside their heads.”

Problem Identification

A very simple and basic problem emerges in the discussion of ME/CFS – namely, that many people don’t even know it exists. Or, if they do, they have a mistaken idea of what it entails. The name of the disorder – “chronic fatigue syndrome” – does the community of sufferers no favors, as it tends to reduce perceptions of the illness to “simply feeling a little more tired than usual.” So the first issue to address is the issue of insufficient awareness regarding the reality of a ME/CFS diagnosis.

A second issue involves the disentanglement of ME/CFS from mental health conditions with overlapping symptoms. Although living with ME/CFS can have psychological impacts, it is not primarily considered a mental health disorder. It is important for counseling professionals to accurately distinguish between the symptomology of an ME/CFS “crash” and the clinical presentation of, for example, a depressive episode. At the same time, counselors should be alert to how and when ME/CFS co-exists with mental health disorders, and should understand how this chronic physical illness might change the presentation of existing psychological conditions (like the manic phases of bipolar disorder).

A third issue centers on client education and empowerment. Too many persons with ME/CFS have been convinced that their symptoms aren’t “real,” or that they should just be “powered through.” Counselors have an important role to play in giving clients the tools they need to articulate their struggle to both family members and medical professionals and to advocate for themselves in an informed and compassionate way.

Problem Background Information

Barriers to advocacy exist at multiple levels. At the level of science, we encounter the problem of scarcity; much remains unknown about ME/CFS and it is hard to locate the exact causes and mechanisms of illness. As a result, treatment options remain limited, and many doctors are poorly equipped to help patients who present to their offices with the complicated mix of symptoms that accompany this diagnosis. The lack of treatment options can diminish hope and pose an extra challenge for counselors as they walk their clients through the process of confronting and accepting a long-term diagnosis with mixed chances of recovery. Fortunately, scientific research continues to uncover new strands of understanding, and a fuller, more nuanced picture of ME/CFS, as a sort of neuro-immuno-endocrinological dysfunction (Rivera et al., 2019), is beginning to emerge. Increased research efforts in the wake of the COVID pandemic are yielding more and better insights into this complex condition, and it would be wise for medical professionals, including counselors, to keep abreast of such developments.

At the level of culture, we experience the problem of stigma. As mentioned earlier, many people don’t know enough about ME/CFS to respond to it effectively. Too often, individuals with this chronic illness are told that they are depressed, or that everyone is tired, and they need to stop being lazy and push through their fatigue. In fact, a hallmark of ME/CFS is a phenomenon called post-exertional malaise, and symptoms are exacerbated, rather than helped, by “pushing through.” Even well-intentioned suggestions, like increasing physical exercise, can backfire and lead to progression of the disease state. Counselors, in particular, should be mindful of this complexity, and revise their inventory of recommended coping skills accordingly.

At the level of systemic care, we encounter the problem of medical skepticism. Although ME/CFS is gaining recognition in the medical community, many doctors still treat the diagnosis with indifference or disapproval. The Social Security Administration, meanwhile, does not include ME/CFS among its list of pre-approved impairments, and many patients experience significant barriers in trying to obtain disability benefits. Because ME/CFS can severely limit a person’s ability to work, financial stress is common. Unfortunately, current structures make access to governmental support more difficult than it ought to be.

Finally, at the level of diversity, we must consider the impact of socioeconomic variables. For those living in poverty, or with reduced economic means, the burden of chronic illness often feels heavier. In particular, individuals in financial hardship may have less possibility of lightening their work schedules, or of sharing the responsibility for generating family income, and as a result, have less opportunity for the extended rest that is so critical to ME/CFS recovery. Reduced social supports (and hence access to caregiving) can also increase the challenge of living with ME/CFS, since the illness, especially in its more advanced stages, can make independent self-care difficult (Jason et al., 2010).

Advocacy Goals

Broadly, my goal is to educate counseling professionals on the signs and symptoms of ME/CFS, and to help them find ways of better serving clients with this condition. Part and parcel of this goal is training counselors in best practices: how to offer appropriate self-care strategies, how to differentiate ME/CFS from apparently similar psychological conditions, how to approach the unique consequences of living with a chronic and poorly understood illness, and how to accompany clients in their search for a meaningful life, even as their health problems may make their lives feel frustratingly small. Counselors should deepen their understanding of the role of therapy, including its limits, as an adjunct treatment for ME/CFS.

Another part of this goal is high-level advocacy. This may involve working in interdisciplinary teams to promote more effective care. Giving counselors the tools to educate other health professionals on the mental, emotional, and social impacts of ME/CFS will promote empathy, weaken skepticism, and improve outcomes for clients. It may also be important to work alongside social agencies to increase visibility of the ME/CFS diagnosis and to campaign for better access to governmental aid and/or other accommodations, as well as greater funding for relevant research projects.

Advocacy Allies

Several agencies and organizations come to mind when considering possible allies in our advocacy efforts. A few are listed here.

Ohio Counseling Association (OCA): “The premier professional organization serving and representing all current and future counselors.” OCA often offers a variety of educational experiences for both students and licensed professionals. This association could be a useful partner if we wish to expand our efforts state-wide, especially since our goal is increased training and education.

Social Security Administration (SSA): The SSA may not be a close ally in our advocacy efforts, per se, but they are an important resource when it comes to understanding disability services and benefits. Working with their office, as well as with the offices of local disability attorneys, may yield helpful insights for patients who are wishing to navigate the process of applying for governmental support as they cope with ME/CFS.

National Alliance on Mental Illness (NAMI): “The nation’s largest grassroots mental health organization dedicated to building better lives for the millions of Americans affected by mental illness.” NAMI is a great resource for advocacy, education, and awareness across a number of mental health conditions. While ME/CFS is not classified as a mental illness, it often has profound effects on mental wellbeing, and co-occurring mental health disorders are not uncommon. NAMI, especially its Ohio chapter, could be an excellent partner, and may be helpful to us if we wish to organize a “walk” or some other community/fundraising event.

Solve M.E.: The Solve ME/CFS Initiative is “a non-profit organization that serves as a catalyst for critical research into diagnostics, treatments, and cures for … ME/CFS, long COVID, and other post-infection diseases.” This initiative works closely with scientific communities, governmental agencies, and patient groups to improve the lives of affected individuals. Its mission is closely aligned with ours, and its substantial pool of resources (including a team of knowledgeable professionals) could greatly aid our research and outreach projects.

Trans-NIH ME/CFS Research Working Group: This working group, operated through the National Institutes of Health, is designed to pursue high-quality research on the cause, diagnosis, underlying mechanisms, and treatment of ME/CFS. Their website offers helpful information on the process of submitting grant applications, and they would be a powerful ally in our efforts to increase awareness and supports at more systemic levels.

Patient Advocacy Groups: Patient advocacy groups, like the Massachusetts ME Association and the Long COVID Alliance, as well as other groups throughout the world, connect patients struggling with similar experiences and give voice to their concerns, wishes, questions, and needs.

Bateman Horne Center: A non-profit organization trying to improve access “to informed health care for individuals with ME/CFS, long COVID, and fibromyalgia by translating [their] clinical expertise into medical education and research initiatives.” The Bateman Horne Center offers extensive resources for patient and provider education (including videos, research initiatives, a support group, an ME/CFS crash survival guidebook, and crisis resources), and they would be a valuable point of contact for us, both as we prepare our own training materials and as we connect with professionals whom we would like to consult and invite to workshops and events.

References

Daniels, J., Brigden, A., & Kacorova, A. (2017). Anxiety and depression in chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME): Examining the incidence of health anxiety in CFS/ME. Psychology and psychotherapy, 90(3), 502–509. https://doi.org/10.1111/papt.12118

Froehlich, L., Hattesohl, D. B., Cotler, J., Jason, L. A., Scheibenbogen, C., & Behrends, U. (2022). Causal attributions and perceived stigma for myalgic encephalomyelitis/chronic fatigue syndrome. Journal of health psychology, 27(10), 2291–2304. https://doi.org/10.1177/13591053211027631

Hvidberg, M. F., Brinth, L. S., Olesen, A. V., Petersen, K. D., & Ehlers, L. (2015). The health-related quality of life for patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). PloS one, 10(7). https://doi.org/10.1371/journal.pone.0132421

Jason, L. A., Roesner, N., Porter, N., Parenti, B., Mortensen, J., & Till, L. (2010). Provision of social support to individuals with chronic fatigue syndrome. Journal of clinical psychology, 66(3), 249–258. https://doi.org/10.1002/jclp.20648

Komaroff, A. L., & Lipkin, W. I. (2023). ME/CFS and Long COVID share similar symptoms and biological abnormalities: Road map to the literature. Frontiers in medicine, 10, 1187163. https://doi.org/10.3389/fmed.2023.1187163

Rivera, M. C., Mastronardi, C., Silva-Aldana, C. T., Arcos-Burgos, M., & Lidbury, B. A. (2019). Myalgic encephalomyelitis/chronic fatigue syndrome: A comprehensive review. Diagnostics (Basel, Switzerland), 9(3), 91. https://doi.org/10.3390/diagnostics9030091

 

A Developmental Approach to Understanding High Sensitivity

Scholarly

I haven’t been doing too much in the way of creative writing lately. But I have had to write some papers for school, so I figured I might as well share one of them with you here. The prompt was to address a developmental issue from the perspective of its relevance to the counseling profession.

Sensitivity – sometimes also found in the literature as “environmental sensitivity” or “sensory processing sensitivity” – is a normal, innate trait that exists as a continuum of human responsiveness. A minority of the population (15-30%, by different estimates; Lionetti et al., 2018) exhibits high sensitivity, a trait which confers increased perception of sensory inputs (like sights, sounds, and smells) as well as increased cognitive processing of that input. Elaine Aron, an expert in the field, uses the acronym “D.O.E.S.” to describe the main features of high sensitivity (Aron, 2016): depth of processing (taking in many levels of information from a given input), overstimulation (being easily overwhelmed by chaotic environments), emotional responsivity or empathy (feeling deeply and possessing a well-developed intuition about people and relationships), and sensitivity to subtleties (noticing details and small cues that others might miss). High sensitivity is not to be confused with shyness, introversion, or neuroticism, although it may coexist with these qualities in some individuals (Aron & Aron, 1997).

In general, highly sensitive persons (HSPs) are more sensitive to – or more strongly impacted by – the everyday events of life. They are more negatively affected by adverse experiences than less sensitive persons, but they are also more likely to benefit from positive experiences (Belsky & Pluess, 2009). Because HSPs navigate the world with a unique set of sensory and emotional sensitivities, they are best served by professionals who understand the vulnerabilities and strengths that their trait bestows. Counselors, in particular, are apt to encounter many highly sensitive clients in the course of their work, and should take care to understand the nuances of working with this population.

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Montessori and Counseling Theories

Scholarly

A short reflection on the compatibility of the teachings of Maria Montessori with basic counseling theories. 

In the last few years, I have grown extremely interested in the Montessori Method. This framework, which is less a “method” than a holistic approach to learning, was developed by Maria Montessori, an Italian physician, almost a century ago. Ms. Montessori spent a great deal of time observing children in an experimental classroom setting. From her observations she realized that children optimize their learning potential when their education unfolds in a carefully sequenced, developmentally appropriate way. Montessorian ideas are implemented in schools around the world, and have been widely supported by recent research in educational psychology.

There are many elements associated with the Montessori approach to education. Chief among them are the ideas of independence (allowing children to do things by themselves), “following the child” (recognizing that children are wisely guided by their own inner roadmaps), the prepared environment (equipping children with appropriate materials and giving them a well-ordered space for them to work), and the “absorbent mind” (acknowledging that children experience sensitive periods of development in which certain kinds of knowledge acquisition come easily, almost effortlessly, if the environment is well-prepared). Montessori education is also known for its multi-age classrooms (in which older children mentor younger children), sensorial materials, and view of play as the child’s natural form of “work.” Angeline Stoll Lillard, in her book Montessori: The Science Behind the Genius, summarizes the Montessori Method by describing eight of its key principles and highlighting the plentiful research literature that support them (Lillard, 2017).

While not a counseling theory per se, the Montessori philosophy offers useful insights to the creative counselor. For example, Montessori asserts that movement and cognition are closely related – an observation that dovetails neatly with the advice of my Counseling Children professor, who recommends getting children to move their bodies whenever possible in the counseling room. (Emotions are often stored in the body, after all.) Montessori also endorses collaboration, and believes that children learn best when adults provide plentiful freedom within a few clear limits. In a similar way, counselors must help their clients to feel secure and purposeful by providing thoughtful boundaries, while also giving them lots of freedom to express themselves uninhibitedly and spontaneously. Finally, Montessori prioritizes “contextual learning,” which it views as more meaningful than abstract, compartmentalized learning. Counselors likewise see the importance of learning in context, and often role-play scenarios with clients, or challenge them to “test out” their new skills in real-life settings between sessions. There are many other examples of the parallels between Montessori education and good counseling practice, but even just the few examples mentioned here should illustrate the compatibility of the two domains.

Although Montessori is most often associated with the early years of development (preschool and elementary school), the philosophy actually provides a template for learning across the lifespan. Montessori principles can be implemented from infancy (prescribing such things as freedom of movement and the use of beautiful natural materials in the baby’s bedroom), and they can also be applied effectively in old age (promoting dignity and purposeful engagement, especially among adults with dementia). And because Montessori is child- (or person-) centered and inherently flexible, it can be used successfully with many different populations, including those with learning differences. Part of the beauty of the Montessori approach is that it allows each person to creatively develop her own unique gifts and strengths, independent of some generic, one-size-fits-all mold.

As you can tell, I am very admiring of the Montessori Method, and believe that its ideas are useful and sound. It is incredible that, despite getting its start almost 100 years ago, Montessori aligns quite precisely with modern research into the science of learning. I believe that this philosophy provides a refreshing alternative to traditional American classrooms, and I suspect that it may also translate beautifully into the work we do as counselors.

Reference

Lillard, A. S. (2017). Montessori: The science behind the genius (3rd ed.). Oxford University Press.  

Toward a Continuum of Mental Health and Disorder

Scholarly

A short paper I wrote for a class on clinical psychopathology. 

Mental health has long been considered as a separate entity from mental illness. Indeed, in many ways the field of psychopathology seems built on the assumption that “normal” behaviors are discontinuous with “abnormal” ones – and that the line dividing them acts as a strict and impenetrable barrier. But failures to capture the nuances of mental disorder in clinical practice have awakened resistance to this assumption. We have instead begun to wonder, as developmental psychopathologist Dante Cicchetti (1993) proposed, whether “the mechanisms responsible for abnormal behavior may be only quantitatively, not qualitatively, different from those that cause normal variability.”

So far, we have conducted little systematic research testing the hypothesis that abnormality represents the extreme of a continuum of normal variability in behavior (Rutter & Sroufe, 2000). But our attempts to respond to this idea probe deeply into philosophical questions about the very nature of mental health. And our conclusions will shape decisions about nosology, diagnosis, and treatment, while shedding light on such persistent problems as the “medicalization of normality” (Craighead, Miklowitz, & Craighead, 2017). The implications – for society, research, and clinical care – cannot be overstated.

In this paper, we will briefly review the history of dichotomous, discontinuous thinking about psychopathology and then describe its gradual evolution to a more continuous, dimensional approach. We will also contemplate the structural and subjective implications of this change as our field moves forward.

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Don’t Analyze Literature from the Psychiatrist’s Chair

Scholarly

Prompt: “The critic’s task is analogous to the psychiatrist’s. Agree or disagree?”

Salvador DalĂ­ said, “The only difference between me and a madman is that I’m not mad.” Now we are being asked to make a distinction very like this one: Are the artist and his work of art a species of madness, and ought we to diagnose them as such? Read More“Don’t Analyze Literature from the Psychiatrist’s Chair”

Gender Differences in Religiosity: Why Are Males Less Religious?

Scholarly

A literature review I wrote a few years ago for a class called “Boys’ Psychosocial Development,” taught by Professor Judy Chu.

Women are more religious than men. The phenomenon is so universally acknowledged that it has become an assumption in many sociological studies. It is not, however, the assumption itself that complicates current research, but rather the mechanism that underlies it. What accounts for gender differences in religious attitudes and behaviors? What makes men less religious than women? Several theories have tried to offer a cohesive explanation. By way of analysis, I will look at four of the most influential theories – including gender role socialization, structural location, gender orientation, and risk aversion – in order of their entrée into the academic literature. These theories alternately prioritize social, contextual, personal, and biological processes as a means of interpreting the gender-religion link. After considering the advantages and limitations of each, I will concede that no theory has proven robust enough to give a comprehensive view. Understanding the origin of gender differences in religion thus remains a difficult problem. But it is also a crucial one, with implications for the broader context of male development. Religiosity – which I will define here as how religious a person is, with respect to activity and belief – can be negatively correlated with criminality and violence and positively tied to health and healing. More generally, religion is one of the major resources used to generate meaning in life, explaining the world through positive beliefs, rituals, symbols, traditions, and support (Fletcher, 2004). Therefore understanding why men are less religious may produce insights in service of a larger goal, namely, helping men to lead full and healthy lives.

Read More“Gender Differences in Religiosity: Why Are Males Less Religious?”

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