As many of you
know, I am not an expert in spirituality.
Maybe it is because I am not an expert that I clearly see the need to
write this, because it is not facts or answers that we need but questions and
discussions. It seems that openness and
inquisitiveness may be what is called for.
I was meeting
with a group of Social Workers recently and I had an interesting experience
that stuck with me. We were processing
several difficult topics including, sexual trauma, abuse, and addictions. We discussed these topics clearly,
comfortably, and professionally. Then
something happened that I just couldn’t forget.
A Social Worker leaned forward in her chair, dropped her voice,
apologized and asked permission to discuss spirituality as it related to how
she viewed her work with clients.
This struck me,
hard. As Social Workers we have
difficult conversations all the time. We
had just finished having many of them.
The truth is, having difficult conversations is part of the job description
for a Social Worker. If we won’t have
the hard conversations then who will? I found it unsettling that the one topic
that was too hard to discuss was spirituality.
In my experience
as a Social Worker, teacher, therapist, and clinical supervisor I have found
that many Social Workers shy away from examining the role of spirituality in
their own lives and practice as well as in their dialogue with their
clients. They are not provided training
or guidance in how to do this and they are afraid that they will do it
wrong. They fear offending or alienating
a colleague or client, so they hide behind professionalism. They choose what is safe.
So following a
whispered conversation about spirituality in Social Work, I asked myself what
my role was. What example will I set for
my students? What does it mean to teach Social Work at a religious institution? How
will I prepare students to work with clients and will it involve
spirituality? Who will teach them to ask
questions about their own spiritual journey and how it intersects with their
practice? If we are unable to embrace
the conversation how will we authentically encourage our clients to share their
spiritual journey with us? Won’t they
know by our silence that this part of them doesn’t belong in the
conversation? What are we losing by
being quiet?
The reality is
that spirituality matters to many of our clients and not being able to talk to
them about something important to them limits our work with them. Research supports this. Ninety percent of the world recognizes some
type of spiritual practice (World Christian Database, 2001). A large database of research also supports
that spirituality is important to mental health (D’Souza, 2002; Konig, 1998;
Teppers, Roger, & Coleman, 2001; Russinova, Wewiorski, & Cash, 2002;
Zaza, Sellick, & Hillier, 2005).
Clients use it to cope, and identify it as something that sustains them
(Konig, 1998). Religious and spiritual
practices reduce isolation and loneliness and support a sense of mean and
purpose (Verghese, 2008).
My own work with
complex trauma, attachment, and relational disruption also supports this. When early caregivers are attentive,
nurturing and secure; children learn that people can be trusted. On the contrary when children experience
abuse, abandonment, and relational disruption they learn that people cannot be
trusted and are not stable. I have found
it impossible and inauthentic to fully restore trust in a child or adult that
has experienced this loss. When you
explain to a young adult who was abandoned by their parents that they can count
on people; you are telling them something that is fundamentally untrue. They know in their very core that if their
mother and father can leave them that anyone can. So, how do you encourage them to risk
attachment and connection despite the very real possibility that people may
disappoint them? The only way I have
seen this occur is when an individual is able to rely on something consistent
and steady. They are able to use their
spirituality to identify something larger than themselves that can be a
stabilizing force. The security of this
unwavering “being” allows them to take the risks necessary for relationships
and connection and allows them to weather the disappointments of human
relationships.
Like I said, I
am not an expert in spirituality or a religious scholar. I don’t have answers. I have questions. Maybe it is not answers we need but
questions? So I hope that you will
examine your work closely. That you will
pay attention to not only what you are saying when working with clients, but also
what you are not saying. I hope that you
will embrace a bio-psycho-social-spiritual
framework. When you are doing an
assessment I hope that you will not simply check a box on your clients’
religious identification but that you will explore what a higher power means
(and doesn’t mean) to them. That you will give them room to share a personal
narrative of spirituality, both what it is and what it isn’t to them. Remember the power of the unspoken dialogue
and remember that you are a Social Worker.
If you don’t embrace the uncomfortable conversations, who will?
D’Souza R. Do patients expect
psychiatrists to be interested in spiritual issues? Australasian Psychiatry 2002; 10:44-47
Koenig HG. Religious beliefs and practices of
hospitalized medically ill older adults. Int’l J Geriatr Psychiatry
1998; 13:213-224.
Russinova Z, Wewiorski
NJ, Cash D. Use of alternative health care practices by persons with serious
mental illness: Perceived benefits. Am J Pub Health 2002; 92:
1600-1603
Tepper L. Rogers SA.
Coleman EM, et al. The prevalence of religious coping among persons with
persistent mental illness. Psychiatric Services 2001; 52:660-665
Verghese, A. (2008). Spirituality and mental health. Indian
Journal of Psychiatry, 50(4), 233–237. doi:10.4103/0019-5545.44742
World
Christian Database.
Atheists/Nonreligious by Country. World
Christian Trends, Barrett and Johnson (William Carey Library 2001),
updated February 2007. See website:
http://worldchristiandatabase.org/wcd/ http://worldchristiandatabase.org/wcd/
Zaza C, Sellick SM,
Hillier LM. Coping with cancer: What do
patients do? J Psychosoc Oncol 2005; 23:55-73
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