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Resilience as the Relational Ability to Spiritually Integrate Moral Stress

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Abstract

Resilience is an outcome of caregiving relationships that help people spiritually integrate moral stress. Moral stress arises from lived theologies and spiritual orienting systems—patterns of values, beliefs, and ways of coping energized by shame, guilt, fear of causing harm, or self-disgust (some of the so-called negative moral emotions that cut people off from social support). Spiritual care compassionately brings to light these life-limiting lived theologies of shame and fear shaped by intersecting social systems of oppression like sexism, classism, and racism. Spiritual care helps people co-create intentional theologies that draw upon goodness, compassion, and love—moral emotions that connect them to the web of life. This interdisciplinary approach to moral stress draws upon the living stories of moral stress and resilience by feminist theologians Bonnie Miller-McLemore and Valerie Saiving.

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Notes

  1. Kinghorn (2009, 2012) makes a similar argument about moral injuries arising from war trauma.

  2. Haidt and others study the social dimensions of emotions—their potential to make people isolate from or connect with others. Moral emotions like shame, anger, fear, disgust, and anxiety are labelled negative because they tend to isolate people, whereas “positive emotions such as gratitude, interest, and love” (Fredrickson et al. 2003, p. 366) move people to reach out and connect with others. Moral psychologists explore the social and moral functions of emotions that function to either bind people together or isolate people (Haidt 2003).

  3. Moral stress can be understood as a kind of religious struggle, as recent research on religious struggles suggests. Exline and Pargament’s scale measuring religious struggles has two subscales that are useful for measuring moral stress as a dimension of religious struggles: the moral and ultimate meaning subscales. The moral subscale is self-focused rather than God- or other- focused and predicts “a greater tendency to attribute a specific r/s [religious and spiritual] struggle to the self. . . . Moral struggle also predicted slightly less anger toward God and less attribution of responsibility to God for a specific r/s struggle. These connections make sense if people are blaming themselves rather than externalizing blame to God. The other two indicators of divine struggle (religious fear and guilt, instability) focus largely on concern about one’s own misdeeds and perceptions of God’s disapproval toward the self….Our main prediction about the Ultimate Meaning subscale was that it would predict more effort in searching for life meaning. We also reasoned that a sense of ultimate meaning would offer some protection against doubt. We thus expected that higher scores on Ultimate Meaning (i.e., more struggle about meaning) would predict more religious doubt and more doubt about whether God exists. These hypotheses were supported” (Exline et al. 2014, pp. 216–217).

  4. I use the term intentional theology in a way similar to how the term lived theology is used by the Project on Lived Theology based in the Department of Religious Studies at the University of Virginia. According to the website http://livedtheology.org/ , the project’s mission is “encouraging younger theologians and scholars of religion to embrace theological life as a form of public responsibility.” The website describes lived theology as the theology one hopes to live out in one’s practices.

  5. In this issue, LaMothe (2014) describes social imaginaries of faith in ways similar to the way I describe intentional theologies co-created within spiritually integrative relationships. These social imaginaries of faith “serve as interpretive frameworks that provide meanings, values, and beliefs that justify our motivations and actions in resisting Others.” LaMothe’s use of Martin Luther King Jr.’s early years illustrate King’s moral stress of feeling hatred towards Whites as he tried to emulate the Christian social imaginary of faith emulated by his parents and their church.

References

  • Beaudoin, T. (2014). Postmodern practical theology. In K. A. Cahalan & G. S. Mikoski (Eds.), Opening the field of practical theology: An introduction (pp. 187–202). New York: Rowman & Littlefield.

    Google Scholar 

  • Bingaman, K. A. (2014). The power of neuroplasticity for pastoral and spiritual care. Lanham: Lexington Books.

    Google Scholar 

  • Brock, R. N., & Lettini, G. (2012). Soul repair: Recovering from moral injury after war. Boston: Beacon.

    Google Scholar 

  • Brown, B. (2006). Shame resilience theory: a grounded theory study on women and shame. Families in Society, 87(1), 43–52.

    Article  Google Scholar 

  • Brown, B. (2007). I thought it was just me (but it isn’t): Telling the truth about perfectionism, inadequacy, and power. New York: Gotham Books.

    Google Scholar 

  • Cohn, M. A., & Fredrickson, B. L. (2009). Positive emotions. In S. J. Lopez & C. R. Snyder (Eds.), Oxford handbook of positive psychology (2nd ed., pp. 13–24). New York: Oxford University Press.

    Google Scholar 

  • Cook, C. J. (2013). Reflections and confessions of a pedagogue. Pastoral Psychology, 62(5), 607–621. doi:10.1007/s11089-013-0520-1.

    Article  Google Scholar 

  • Cronqvist, A., & Nyström, M. (2007). A theoretical argumentation on the consequences of moral stress. Journal of Nursing Management, 15(4), 458–465. doi:10.1111/j.1365-2834.2007.00764.x.

    Article  PubMed  Google Scholar 

  • Davidson, R. J., & Begley, S. (2012). The emotional life of your brain. New York: Hudson Street Press.

    Google Scholar 

  • DeTienne, K., Agle, B., Phillips, J., & Ingerson, M.-C. (2012). The impact of moral stress compared to other stressors on employee fatigue, job satisfaction, and turnover: An empirical investigation (Vol. 110, pp. 377–391): Springer Science & Business Media B.V.

  • Doehring, C. (2014a). Emotions and change in intercultural spiritual care. Pastoral Psychology, 63(5), 583–596. doi:10.1007/s11089-014-0607-3.

    Article  Google Scholar 

  • Doehring, C. (2014b). Intercultural spiritual care in the aftermath of trauma. In F. Kelcourse & K. B. Lyon (Eds.), Transforming wisdom: The practice of psychotherapy in theological perspective. Eugene: Wipf & Stock.

    Google Scholar 

  • Doehring, C. (2015). The practice of pastoral care: A postmodern approach (expandedth ed.). Louisville: Westminster John Knox.

    Google Scholar 

  • Drescher, K. D., Foy, D. W., Kelly, C., Leshner, A., Schutz, K., & Litz, B. (2011). An exploration of the usefulness of the construct of moral injury in war veterans. Traumatology, 17(8), 8–13.

    Article  Google Scholar 

  • Drescher, K. D., Nieuwsma, J. A., & Swales, P. J. (2013). Morality and moral injury: insights from theology and health science. Reflective Practice: Formation and Supervision in Ministry, 33, 50–61.

    Google Scholar 

  • Exline, J. J., Pargament, K., Grubbs, J. B., & Yali, A. M. (2014). The religious and spiritual struggles scale: development and initial validation. Psychology of Religion and Spirituality, 6(3), 208–222. doi:10.1037/a0036465.supp (Supplemental).

    Article  Google Scholar 

  • Forster, D. (2009). Rethinking compassion fatigue as moral stress. Journal of Ethics in Mental Health, 4(1), 1–4.

    Google Scholar 

  • Fredrickson, B. L. (2001). The role of positive emotions in positive psychology: the broaden-and-build theory of positive emotions. American Psychologist, 56(3), 218–226. doi:10.1037//0003-066X.56.3.218.

    Article  PubMed Central  PubMed  Google Scholar 

  • Fredrickson, B. L., & Cohn, M. A. (2008). Positive emotions. In M. Lewis, J. M. Haviland-Jones, & L. F. Barrett (Eds.), Handbook of emotions (3rd ed., pp. 777–796). New York: Guilford Press.

    Google Scholar 

  • Fredrickson, B. L., Tugade, M. M., Waugh, C. E., & Larkin, G. R. (2003). What good are positive emotions in crisis? A prospective study of resilience and emotions following the terrorist attacks on the United States on September 11th, 2001. Journal of Personality and Social Psychology, 84(2), 365–376.

    Article  PubMed Central  PubMed  Google Scholar 

  • Gergen, K. J. (2001). Psychological science in a postmodern context. American Psychologist, 56(10), 803–813. doi:10.1037/0003-066x.56.10.803.

    Article  PubMed  Google Scholar 

  • Gergen, K. J. (2002). Relational being: Beyond self and community. New York: Oxford University Press.

    Google Scholar 

  • Gergen, K. J. (2006). Therapeutic realities: Collaboration, oppression and relational flow. Chagin Falls: Taos Institute Publications.

    Google Scholar 

  • Graham, L. K. (1992). Care of persons, care of worlds: A psychosystems approach to pastoral care and counseling. Nashville: Abingdon.

    Google Scholar 

  • Graham, E. (1996). Transforming practice: Pastoral theology in an age of uncertainty. New York: Mowbray.

    Google Scholar 

  • Graham, L. K. (2013a). Exploring forgiveness of veteran guilt through collaborative pastoral conversation. Sacred Spaces: The E-Journal of the American Association of Pastoral Counselors, 5, 146–171.

    Google Scholar 

  • Graham, L. K. (2013b). Political dimensions of pastoral care in community disaster responses. Pastoral Psychology, 63(4), 471–488. doi:10.1007/s11089-013-0571-3.

    Article  Google Scholar 

  • Graham, J., & Haidt, J. (2010). Beyond beliefs: religions bind individuals into moral communities. Personality and Social Psychology Review, 14(1), 140–150.

    Article  PubMed  Google Scholar 

  • Graham, E., Walton, H., & Ward, F. (2005). ‘Theology-in-action’: Praxis. In E. Graham, H. Walton, & F. Ward (Eds.), Theological reflection: Methods (pp. 170–199). London: SCM Press.

    Google Scholar 

  • Graham, J., Nosek, B. A., Haidt, J., Iyer, R., Koleva, S., & Ditto, P. H. (2011). Mapping the moral domain. Journal of Personality and Social Psychology, 101(2), 366–385. doi:10.1037/a0021847.

    Article  PubMed Central  PubMed  Google Scholar 

  • Haidt, J. (2003). The moral emotions. In R. J. Davidson, K. R. Scherer, & H. H. Goldsmith (Eds.), Handbook of affective sciences (pp. 852–870). New York: Oxford University Press.

    Google Scholar 

  • Haidt, J. (2008). The emotional dog and its rational tail: a social intuitionist approach to moral judgment. In J. E. Adler & L. J. Rips (Eds.), Reasoning: Studies of human inference and its foundations (pp. 1024–1052). New York: Cambridge University Press.

    Chapter  Google Scholar 

  • Haidt, J. (2013). Moral psychology for the 20-first century. Journal of Moral Education, 42(3), 281–297.

    Article  Google Scholar 

  • Haidt, J., & Bjorklund, F. (2008). Social intuitionists answer six questions about moral psychology. In W. Sinnott-Armstrong (Ed.), Moral psychology (The cognitive science of morality: Intuition and diversity, Vol. 2, pp. 181–217). Cambridge: MIT Press.

    Google Scholar 

  • Kinghorn, W. (2009). Religious communities and the moral context of combat-related post-traumatic stress disorder among American military veterans. Paper presented at the AAR Annual Meeting, Montreal, QC, Canada.

  • Kinghorn, W. (2012). Combat trauma and moral fragmentation: a theological account of moral injury. Journal of the Society of Christian Ethics, 32(2), 57–74.

    Article  Google Scholar 

  • Kusner, K. G., & Pargament, K. (2012). Shaken to the core: understanding and addressing the spiritual dimension of trauma. In R. A. McMackin, E. Newman, J. M. Fogler, & T. M. Keane (Eds.), Trauma therapy in context: The science and craft of evidence-based practice (pp. 211–230). Washington, DC: American Psychological Association.

    Chapter  Google Scholar 

  • LaMothe, R. (2014). American political life: The intersection of nationalistic and Christian social imaginaries of faith as sources of resistance and resilience. Pastoral Psychology.

  • Litz, B., Stein, N., Delaney, E., Lebowitz, L., Nash, W. P., Silva, C., et al. (2009). Moral injury and moral repair in war veterans: a preliminary model and intervention strategy. Clinical Psychological Review, 29(8), 695–706. doi:10.1016/j.cpr.2009.07.003.

    Article  Google Scholar 

  • Lützén, K., Blom, T., Ewalds-Kvist, B., & Winch, S. (2010). Moral stress, moral climate and moral sensitivity among psychiatric professionals. Nursing Ethics, 17(2), 213–224. doi:10.1177/0969733009351951.

    Article  PubMed  Google Scholar 

  • Maynard, J. F., Hummel, L. M., & Moschella, M. C. (2010). Pastoral bearings: Lived religion and pastoral theology. Lanham: Rowman & Littlefield.

    Google Scholar 

  • McGuire, M. B. (2008). Lived religion: Faith and practice in everyday life. New York: Oxford University Press.

    Book  Google Scholar 

  • Miller-McLemore, B. J. (1992). Epistemology or bust: where are we really headed? Journal of Pastoral Theology, 2, 61–85.

    Google Scholar 

  • Miller-McLemore, B. J. (1994). Also a mother: Work and family as theological dilemma. Nashville: Abingdon.

    Google Scholar 

  • Miller-McLemore, B. J. (1996). “Also a mother”: beyond family values. Journal of Feminist Studies in Religion, 12(1), 133–150.

    Google Scholar 

  • Miller-McLemore, B. J. (2013). Embodied knowing, embodied theology: what happened to the body? Pastoral Psychology, 62(5), 743–758. doi:10.1007/s11089-013-0510-3.

    Article  Google Scholar 

  • Miller-McLemore, B. J. (2014a). Coming to our senses: feeling and knowledge in theology and ministry. Pastoral Psychology, 63(5), 689–704. doi:10.1007/s11089-014-0617-1.

    Article  Google Scholar 

  • Miller-McLemore, B. J. (2014). [Comments on “Resilience as the ability to spiritually integrate moral stress”].

  • Moon, Z. (2015). Coming home: Military service, reintegration, and the role of the church. St. Louis: Chalice Press.

    Google Scholar 

  • Moschella, M. C. (2008a). Ethnography as a pastoral practice: An introduction. Cleveland: Pilgrim Press.

    Google Scholar 

  • Moschella, M. C. (2008b). Living devotions: Reflections on immigration, identity, and religious imagination. Eugene: Pickwick Publications.

    Google Scholar 

  • Nelson, S. L. (2003). Facing evil: Evil’s many faces: five paradigms for understanding evil. Interpretation, 57(4), 399–413. doi:10.1177/002096430005700405.

    Google Scholar 

  • Nilsson, S., Sjöberg, M., Kallenberg, K., & Larsson, G. (2011). Moral stress in international humanitarian aid and rescue operations: a grounded theory study. Ethics & Behavior, 21(1), 49–68. doi:10.1080/10508422.2011.537570.

    Article  Google Scholar 

  • Pargament, K., & Cummings, J. (2010). Anchored by faith: religion as a resilience factor. In J. W. Reich, A. J. Zautra, & J. S. Hall (Eds.), Handbook of adult resilience (pp. 193–210). New York: Guilford Press.

    Google Scholar 

  • Pargament, K., Desai, K. M., & McConnell, K. M. (2006). Spirituality: a pathway to posttraumatic growth or decline? In L. G. Calhoun & R. G. Tedeschi (Eds.), Handbook of posttraumatic growth: Research and practice (pp. 121–135). Mahwah: Erlbaum.

    Google Scholar 

  • Pargament, K., Mahoney, A., Exline, J., Jones, J., Jr., & Shafranske, E. (2013). Envisioning an integrative paradigm for the psychology of religion and spirituality: an introduction to the APA handbook of psychology, religion and spirituality. In K. Pargament, A. Mahoney, J. Exline, J. Jones Jr., & E. Shafranske (Eds.), APA handbook of psychology, religion and spirituality (1st ed., pp. 3–19). Washington, DC: American Psychological Association.

    Chapter  Google Scholar 

  • Peterson, C. (2006). A primer in positive psychology. New York: Oxford University Press.

    Google Scholar 

  • Ramsay, N. J. (2013). Intersectionality: a model for addressing the complexity of oppression and privilege. Pastoral Psychology, 63(4), 453–469. doi:10.1007/s11089-013-0570-4.

    Article  Google Scholar 

  • Reynolds, S. J., Owens, B. P., & Rubenstein, A. L. (2012). Moral stress: considering the nature and effects of managerial moral uncertainty. Journal of Business Ethics, 106(4), 491–502. doi:10.1007/s10551-011-1013-8.

    Article  Google Scholar 

  • Saiving, V. C. (1960). The human situation: a feminine view. Journal of Religion, 40(2), 100–112.

    Article  Google Scholar 

  • Saiving, V. C. (1988). A conversation with Valerie Saiving. Journal of Feminist Studies in Religion, 4(2), 99–115.

    Google Scholar 

  • Scheib, K. (2014). All shall be well: flourishing and well-being in positive psychology and feminist narrative pastoral theology. Journal of Pastoral Theology, 40(2), 100–112.

    Google Scholar 

  • Stallinga, B. A. (2013). What spills blood wounds spirit: chaplains, spiritual care, and operational stress injury. Reflective Practice: Formation and Supervision in Ministry, 33, 13–30.

    Google Scholar 

  • Stolorow, R. D., Atwood, G. E., & Orange, D. M. (2002). Worlds of experience: Interweaving philosophical and clinical dimensions in psychoanalysis. New York: Basic Books.

    Google Scholar 

  • Tugade, M. M., Devlin, H. C., & Fredrickson, B. L. (2014). Infusing positive emotions into life: the broaden-and-build theory and a dual-process model of resilience. In M. M. Tugade, M. N. Shiota, & L. D. Kirby (Eds.), Handbook of positive emotions (pp. 28–43). New York: Guilford Press.

    Google Scholar 

  • Ungar, M. (2012). The social ecology of resilience: A handbook of theory and practice. New York: Springer Science + Business Media.

    Book  Google Scholar 

  • Vargas, A. F., Hanson, T., Kraus, D., Drescher, K., & Foy, D. (2013). Moral injury themes in combat veterans’ narrative responses from the National Vietnam Veterans’ readjustment study. Traumatology, 19(3), 243–250. doi:10.1177/1534765613476099.

    Article  Google Scholar 

  • Weber, L. (2010). Understanding race, class, gender, and sexuality: A conceptual framework (2nd ed.). New York: Oxford University Press.

    Google Scholar 

  • Werdel, M. B., Dy-Liacco, G. S., Ciarrocchi, J. W., Wicks, R. J., & Breslford, G. M. (2014). The unique role of spirituality in the process of growth following stress and trauma. Pastoral Psychology, 63(1), 57–71. doi:10.1007/s11089-013-0538-4.

    Article  Google Scholar 

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Doehring, C. Resilience as the Relational Ability to Spiritually Integrate Moral Stress. Pastoral Psychol 64, 635–649 (2015). https://doi.org/10.1007/s11089-015-0643-7

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