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What caretakers can do for patients struggling with their faith
When patients are open about their fear that God has abandoned them or that he's punishing them, what should caretakers do? - photo by Kelsey Dallas
Patients who hold negative spiritual beliefs, such as asserting that God is punishing them or that he's abandoned them, experience more physical pain and diminished mental health compared to their spiritually optimistic counterparts, according to a study in the Journal of Spirituality in Mental Health.

Researchers behind the study, published this past summer, concluded that caretakers should try to intervene to help patients gain a more positive spiritual outlook to guard them against harmful physical and mental health consequences. However, experts who have studied how people cope with negative spiritual beliefs said shifting someone's spirituality is a difficult process, which can't be undertaken lightly.

"If someone believes God is judging them and you talk about a benevolent God, you're spitting in the wind, because they're looking for an answer to why God is judging them and you're telling them they're supported," said Jim Ellor, a professor of social work at Baylor University who has been active in chaplaincy ministry for more than 35 years.

"You have to put yourself into a patient's head and try to help them find what will heal them, rather than reacting with your own sense of what will help," he added.

Ellor and others said chaplains, a patient's friends and family members and health care providers all have a role to play when it comes to responding to someone's spiritual concerns, but changing spiritual outlook for the better requires more patience and open-mindedness than most people assume.

Addressing negative spirituality

Negative spiritual outlooks come in two varieties, which demand different approaches from caretakers, Ellor said.

Many people who feel as if God has abandoned them or that they're being punished are reacting to a specific upsetting event, like the death of a child or an argument with fellow church members, he noted. In this case, faith leaders, chaplains, loved ones and even doctors or nurses could help ease a patient's spiritual unrest by talking through the hurtful situation.

"We can address these events by reframing them and helping (the patient) put them in perspective," Ellor said.

However, sometimes negative spirituality is rooted in someone's personal philosophy, which means it will be nearly impossible to address without extensive therapeutic work, he added, noting that a key part of chaplaincy work is letting a patient's unique perception of God drive conversations.

Similarly, Julie Exline, a professor of psychological sciences at Case Western Reserve University, said spiritual growth, such as repairing a damaged relationship with God, starts with the individual who's struggling with negative beliefs. Friends, family members and religious figures have to follow a patient's lead.

Exline's research has shown that receiving a supportive, rather than combative, response to a confession of negative spiritual beliefs allows people to emerge from a tough situation with deeper faith or, at the very least, an improved relationship with God.

"Any time people can have their anger with God normalized, they'll feel less fear and shame," she said.

However, it's hard not to want to intervene aggressively when you see how negative beliefs affect mental well-being, said Brick Johnstone, a professor of health psychology at the University of Missouri and co-author of the new study.

"Somebody needs to identify people with negative beliefs and address them," he said. "It's not an easy thing to do, but it's important."

Johnstone and his fellow researchers drew this conclusion after analyzing the health outcomes of nearly 200 patients with conditions like traumatic brain injuries, cancer and stroke. They investigated negative spirituality by asking study participants if they've felt abandoned or punished by God.

"If you believe God's working against you," it's going to be hard to get better, Johnstone said.

The stakes

Although the urge to confront and correct someone's negative feelings toward God is noble, it can further damage mental well-being, Ellor said. As he learned when he went through a non-medical crisis, responding poorly to someone's spiritual pain leads to more hurt feelings and anger.

Several years ago, when Ellor lived in Illinois, his basement filled with water during a flood. He bailed out water throughout the night, and, early the next morning, his family was visited by a group from a nearby church, who offered to pray to get rid of the evil spirits they said were causing the damage to his home.

"I was fairly rude to them. Unfortunately, some groups see other people's tragedies as a moment for conversion," he said.

This experience, as well as his many years as a chaplain, helped Ellor realize that the most helpful way to address a patient's negative spiritual beliefs is to listen to concerns with the goal of offering comfort, not inspiring immediate change.

Caretakers must acknowledge what's at stake when they overreact to someone's loss of faith or sense that God is punishing them, Exline said.

"It's risky to come in (to a hospital room) and try to correct a patient's beliefs or change their theology," she said, noting that this strategy might lead them to reject religion for good.

"When people are in a real crisis, you're not going to want to go into their heads and challenge those beliefs," she added. "Instead, be present with them in their suffering."

Spiritual literacy in health care

Although it's chaplains, loved ones and fellow church members who most need to hear this message of how to address someone's negative spiritual beliefs, health care providers like doctors and nurses should also be attuned to a patient's spiritual needs, according to both Exline and Ellor.

"I've given talks at hospitals and tried to encourage people to give patients a safe environment to talk about spiritual concerns," Exline said, noting that this effort involves asking questions like, "Very often people find health issues are hard on their relationship with God. Has there been anything like that for you?"

Health care providers should be careful not to let their own spiritual baggage influence these conversations, Ellor noted, offering an example of this type of misstep from his own chaplaincy career.

"I once worked with a Roman Catholic physician who insisted I come baptize a 4-day-old baby who was about to die due to birth defects. But the family was Baptist, and they don't believe in baptizing babies," he said.

"He was claiming their child was going to hell, while they struggled to accept that their baby was dying. That doesn't help," Ellor added.

However, when health care professionals are aware of the kind of spiritual concerns patients bring to their hospital room and respond meaningfully, "they can do a lot of good" and pave the way, along with chaplains, for people to find spiritual healing, he noted.

With an empathetic, patient-centered approach, caretakers "can help people (address their negative spiritual beliefs) and see something different, albeit not over night," Ellor said.
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