Shared Grace

Therapists and Clergy Working Together

Susan Bonfiglio, Harold G Koenig, Marion A Bilich, Steven D Carlson

• Publisher: Routledge
• Year: 2014
• eBook ISBN: 9781317789314
• Topic: Psychology
• Subtopic: Mental Health in Psychology
• Index: Psychology

Learn how theology and psychology can work together to provide effective therapy!Shared Grace provides a framework within which mental health professionals and clergy can work together to provide people in need with appropriate psychological services and spiritual interventions. Breaking down the walls between psychology and religion, this guide offers you proven and tried methods and models from the authors'collaborative work. Comprehensive and intelligent, this vital book will help therapists incorporate a spiritual dimension to their sessions and give patients successful and effective services.Shared Grace is also a book about the healing power of love. It is the very personal, intense account of the authors' work to help a woman who suffered from dissociative identity disorder heal from the effects of her childhood abuse. Through this poignant story, you'll find that adding a spiritual dimension into psychotherapy brings increased richness and depth to the therapeutic process. Step-by-step practical suggestions for collaboration between therapist and clergy are included. Issues brought to light in Shared Grace include:

• transforming damaged and dysfunctional images of God
• the establishment of support systems within the religious community
• the use of guided imagery
• the creation of healthy rituals and ceremoniesShared Grace will help therapists and clergy alike and enable each to obtain the support, education, and training to make interdisciplinary collaboration successful.

Chapter 1

Our Story: Beginnings

The beginnings of all things are weak and tender; we must therefore be clearsighted in beginnings.

Michel de Montaigne

Introduction

Roberta has been tormented by memories of severe sexual and physical abuse all her life. Her father had sexually abused her repeatedly throughout childhood. He would often torture her as well—tying her up, sticking objects into her body, locking her in closets. At the age of fourteen, her teacher, a trusted friend of the family, had also tried to sexually abuse her. Unable to tell anyone about her abuse, Roberta had felt frightened, confused, and guilty for years. As she grew into adulthood, she became increasingly depressed and anxious, turning to drugs and alcohol to ease the pain of her memories. She reached out in desperation to her religious community, hoping to find some relief from her pain, but she remained riddled with doubts about a God who would have allowed such horrible abuse to happen to a child. At the age of thirty-five, determined to heal from the effects of her abuse, Roberta has recently entered therapy. Roberta and her therapist work well together, but the therapist’s experience is somewhat limited and she is unable to explore Roberta’s spiritual questions and doubts in any depth.

Roberta had turned to her minister for spiritual guidance in the past.

Minister: Roberta has become so dependent on her therapist. It seems that all the therapist is doing is making her more dependent. There is no healing. They’re bringing up old issues that are so painful. Can’t they work on getting beyond that? To grow, it seems she should be able to get beyond the pain. I don’t understand why Roberta doesn’t hear what I’m saying about forgiveness. Why isn’t she open to this? She used to seek out my spiritual guidance. Now all she wants is my friendship, and she’s not interested in hearing what I have to say about God. In fact, when I did share with her that she needs to turn back to God, seeking her direction from God, she slammed the phone down on me. I’m sitting here in pain, asking God what I did wrong. How can I help this person without feeling so frustrated? Everything I say seems to make it worse!

Therapist: Roberta has been talking to a minister who has been telling her that she should not dwell on the past. Rather than encouraging her to deal with her emotions, he is just telling her to pray and to read the Bible more. I wish that she would stop talking to this person, because he’s only confusing her. He’s only making her feel worse—more guilty. I don’t understand how God enters into this anyway, because Roberta must get past the emotional pain of her childhood to go on. I don’t know what to do. All I want is to help Roberta, but as long he is pulling her in another direction, I feel as if I’m fighting a battle with one arm tied behind my back!

Both the therapist and the minister want to be helpful, yet each has experienced only frustration, pain, misunderstanding, and confusion when faced with the work of the other. Poor Roberta. She is caught in the middle between two people she admires—two people upon whom she is depending in her healing journey. Is there any way for the therapist and the minister to get past the preconceived notions they have about each other’s work? Could they call a truce? Is it even possible that in the service of helping this survivor of severe abuse they might learn to work together in a true collaboration? What if the therapist and minister are of different religions? Could they still work together?

Yes. We know that such a collaboration is possible, because that is what happened to us. This book recounts our experience—a collaboration between Marion Bilich, a Jewish psychologist, and Steven Carlson, a Christian minister—as we worked together helping a woman we call “Teresa” heal from the effects of her severe abuse. Teresa was a young woman with dissociative identity disorder (commonly known as multiple personalities). Not long after her alter personalities revealed themselves in therapy, Teresa asked Marion to speak with her pastors. She wanted Marion to explain to them about some of the psychological and emotional issues involved in healing from her abuse. Her spiritual life was important to her, and she wanted her pastors to be included in some way in her psychotherapy. Marion contacted the senior pastor, Michael Hardin, unsure of what kind of input he could have in her work with Teresa. However, she remained open to the possibilities. Thus began a collaboration that profoundly affected the lives of all involved. Susan Bonfiglio, our other co-author, is a social worker. She provides a unique perspective as a member of the support group established by the senior pastor of the church to provide a support system for Teresa within her church community.

Marion: We are well aware of the controversy in the field of psychology as to whether dissociative identity disorder actually exists, and if it does, how rare it is. In addition, we are aware of the problems with recovered memories. Increasingly, therapists have been accused of planting false memories in their patients through suggestions and hypnosis. At the outset, I would like to clarify a few points. First, let us deal with the issue of recovered memories: Teresa never forgot her abuse. Though she repressed details of some of her abuse through the creation of different identities, Teresa remained aware throughout her life that she had been horribly abused during her childhood. She remembered many horrible incidents of being abused by her mother, an uncle, and a cousin, although the worst experiences of abuse were relegated to her alters.

Second, never did I suggest to her that she might be suffering from dissociative identity disorder until I had evidence. She had been in therapy with me for two years before she began revealing the details of her abusive childhood. As her story unfolded, I began to suspect she might have multiple personalities, especially when she told me about “lost years,” years of her life she could not remember having lived. I consulted with several mental health professionals experienced in the field of dissociative disorders. However, I did not make a diagnosis, nor did I discuss my suspicions with her, until one of her alter identities “came out” to talk to me. It was only then, as the alters appeared one by one that a diagnosis of dissociative identity disorder was made.

We also want to emphasize that true dissociative identity disorder may be rare, and that not all people with a history of severe and sadistic childhood abuse will have multiple identities. Although the person we describe in this book turned to alternate identities to cope with her abuse, this does not mean the book will not have relevance to therapists and clergy who work with abused women who do not have this disorder. In fact, the collaboration between therapist and clergy need not be limited to helping women who have experienced severe childhood abuse. We believe that therapists and clergy can work together collaboratively to help any individual suffering from trauma, and physical, emotional, or psychiatric illness. Our work with Teresa provides an example of how such collaborations can be undertaken, but you need not limit yourselves to work with survivors of abuse alone.

This book demonstrates how our collaboration offered Teresa a deeper, richer experience than any traditional psychotherapy alone could have accomplished. We describe how all involved—therapist, minister, survivor, and the members of Teresa’s support group— grew spiritually, emotionally, and professionally through the work together. However, this book is more than a mere recounting of our personal experiences. It provides guidelines and suggestions for others who want to undertake such an endeavor. We have interviewed many therapists and members of the clergy throughout the country and have included their experiences as well. In addition, we have developed “The Benevolence Model”—a spiritual model that we believe transcends any particular religion and provides a common framework out of which therapists and clergy of different backgrounds can work together. This book is also a deeply personal story about how four people came together and how their interactions changed their lives forever.

Collaboration between therapist and clergy is about putting aside ideological and theological differences in the service of helping survivors heal from the effects of their abuse. It endeavors to bridge the gap between psychology and religion, breaking down the walls between the two disciplines so that people can work together effectively. Collaboration can take many forms—from open communication and dialogue, to frequent consultation, or to an equal partnership designed to provide the survivor with the emotional, psychological, and spiritual support she needs to heal.

Since our own collaboration focused on work with a survivor of severe childhood abuse who was suffering from a dissociative identity disorder, we have devoted a great deal of material to describing work with survivors of abuse. However, we do not mean to suggest that all severely abused people are dissociative. Nor do we believe that collaboration between therapist and clergy should be confined to work with such individuals. It is our hope that you will consider collaboration as a means of helping many types of individuals who are suffering—those with mental illness, severe physical disorders, or physical handicaps, for example. We look forward to hearing from other therapists and clergy about how their own collaborations helped people deal with all kinds of difficult life problems.

This book is aimed at three groups:

1. Therapists and other mental health professionals. Those therapists involved in the treatment of people who were severely abused in childhood may be especially interested in this book, because we focus on work with such individuals. However, as we pointed out, therapists involved in working with individuals suffering from any major physical or emotional problem— trauma, catastrophic physical illness, severe psychiatric illness—may also be interested in the benefits of collaboration with clergy. Especially in this era of time-limited managed mental health care, therapists are looking for ways to extend the therapy of people with serious emotional and physical problems beyond the twenty-session limits. Collaboration, as we will see, can provide opportunities to do so.
2. Ministers. The book will be helpful to ministers who want to offer spiritual guidance to those in their congregations who are suffering from severe physical, mental, or emotional problems. It will be especially helpful for those ministers who work with women healing from the effects of severe abuse, since the actual collaboration described in detail in the book focuses on a woman who had been severely abused in childhood. (We use the generic term “minister” to refer to all types of clergy—rabbi, priest, pastor, nun, etc.)
3. Survivors of severe abuse who want to add a spiritual dimension to their psychotherapy. Although this book focuses on the collaboration between therapist and minister, it is also a story about how one woman was able to heal from her severe childhood abuse, through the inclusion of a spiritual dimension to her therapy. Including spiritual dimensions can enhance the healing process and profoundly alter the way one lives one’s life.

We have chosen to refer to therapists using the female pronoun, “she,” while ministers will be referred to as “he.” Similarly, survivors of abuse will be referred to as “she.” We are aware that many therapists are male, that clergy are often female, and that many survivors of severe childhood abuse are males. However, for convenience and consistency, we chose to use these pronouns to represent therapists, ministers, and survivors, as they match the genders of the authors and the subject of this book.

Undoubtedly, the process of psychotherapy for survivors of severe childhood abuse is a difficult and demanding one for both therapist and survivor alike. Robert Kluft, a psychiatrist who works with multiple personality and other dissociative disorders, has described the experience of the therapist as one of “bewilderment, exasperation, and a sense of being drained” (Kluft, 1984b, p. 51). Therapists in private practice are often isolated and alone as they struggle to help the survivor deal with memories of horrible abuse. Often the therapist has sole responsibility for the care of the survivor. Therapists and other mental health professionals might welcome collaboration—a shared responsibility, a true partnership—with a member of the clergy. This book will provide therapists with specific guidelines toward establishing such a collaboration.

Many therapists working with severely abused individuals have found traditional therapy limiting in its focus solely on the cognitive, emotional, and intrapsychic aspects of experience. Furthermore, survivors of severe abuse often pose spiritual and existential questions with which the therapist is ill prepared to deal. Moshe Torem, psychiatrist and past president of the International Society for the Study of Dissociation, has written that “listening to and being with survivors of trauma makes us confront some crucial questions about life and death and fundamental dilemmas about good and evil: Why are innocent, defenseless children abused and tortured? … Why did God allow this to happen? Why did God not rescue me when I prayed for help? Why does evil exist?” (Torem, 1993, p. 1).

Psychotherapists are generally educated as scientists in programs that emphasize interviewing techniques, listening skills, data collection, diagnosis, and treatment methods. Few have training in dealing with existential issues of life and death, good and evil. Torem points out that some therapists feel so threatened by these issues that they often avoid dealing with patients who raise such questions. “Our patients present us with fundamental issues, and if we are willing to face our helplessness, confusion and lack of knowledge, we risk exposing our imperfections, and, thus, our humanity. Science, which has become a God-like discipline for many clinicians, has not been a source of answers for such questions. The existential issues raised by our patients expose the weakness of the scientific method as a philosophy that will provide us with solutions to all problems. We have been taught by our professors that every problem can be solved by designing the ideal scientific study with data collection, double-blind testing, and statistical analysis. Not so, my friends. Science has its limits” (Torem, 1993, p. 1).

Survivors of severe abuse have also decried the limits of a scientific psychotherapy that excludes spiritual dimensions. A plea from a woman with multiple personalities illustrates this point:

I wish therapists could feel more comfortable with discussions about religion and God. After all, many MPD victims are linked to ritual abuse. Yet therapists are often afraid to say the “G” word in therapy. I have a really skewed idea of God and need to come to terms with my religious beliefs in order to get well. I want my therapist to be with me in my struggle. (Grace, cited in Cohen, Giller, and Lynn W., 1991, p. 110)

Based on a survey of clinical psychologists, Shafranske and Malony (1990) concluded that 60 percent of clients often express themselves in religious language. Mental health professionals can no longer afford to ignore their clients’ religious and spiritual lives. Yet while many therapists long to add a spiritual dimension to their work, they often lack the knowledge or training necessary to deal with such issues effectively in psychotherapy. A survey of over 400 clinical psychologists found that only 5 percent had religious or spiritual issues covered in their training programs (Shafranske and Malony, 1990). Collaboration with members of the clergy, as described in this book, can provide therapists with the guidance and training they lack.

Recently, several prominent mental health professionals have begun urging collaboration between therapists and clergy. Psychologist Andrew J. Weaver and psychiatrist Harold G. Koenig have noted the large body of research supporting the relationship between religious commitment and mental health (Koenig, 1995; Weaver, Koenig, and Ochberg, 1996). In the treatment of women who have been severely abused, inclusion of clergy in the therapeutic process is finally being recognized as valuable. Psychiatrist Elizabeth Bowman and pastoral counselor William E. Amos have concluded that by including clergy in the treatment of individuals with dissociative disorders, therapists can be assured that their patients’ spiritual needs are met, that therapeutic neutrality is maintained, and that “therapeutic tasks are dealt with more rapidly and competently than either therapist or clergy could accomplish alone” (Bowman and Amos, 1993, p. 52). Psychologist Christopher Rosik (1992) also suggests ways for therapists and clergy to work together within a religious setting to help individuals with DID. It appears that collaboration between the mental health profession and members of the clergy is an idea whose time has come. This book will help therapists take steps to establish a working relationship with members of the clergy. In addition, the book examines some of the spiritual questions and issues that may surface in psychotherapy with survivors of severe abuse, and we have also provided guidelines to help the therapist when confronted with such existential issues as good and evil.

Ministers, too, will benefit from such collaborative efforts. Although they have the training and knowledge to deal with spiritual questions, clergy have often had little preparation for dealing with the special needs of members of their congregation who were severely abused as children or who suffer from mental illness. Yet, people in distress often turn first to clergy. A survey by the National Institutes of Mental Health reported that clergy are more likely than psychologists and psychiatrists to have a person with a psychiatric diagnosis seek t...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Table of Contents
• Acknowledgments
• Chapter 1. Our Story: Beginnings
• Chapter 2. Healing the Effects of Severe Childhood Abuse
• Chapter 3. The Benevolence Model
• Chapter 4. Implementation of The Benevolence Model I: Transforming Images and Experience
• Chapter 5. Implementation of The Benevolence Model II: Healing Through Relationship
• Chapter 6. Working Together: Guidelines for Therapist/Clergy Collaboration
• Chapter 7. Establishment of Support Groups
• Chapter 8. Healing Interventions
• Chapter 9. Therapists and Clergy Growing Together
• Appendix A: Teresa’s Personality Structure
• Appendix B: Resources for Therapists
• Appendix C: Resources for Clergy
• Appendix D: Resources for Support Group Members
• Appendix E: Resources for Survivors
• Appendix F: Resources for Guided Imagery
• References
• Index