The U.S. is an exceptionally religious country, where the vast majority of individuals believe in a personal God. Those who experience a personal relationship with God are likely to form an attachment, the essence of which is relying on a caregiver for a feeling of comfort and security in times of distress.
Research has shown that relationships with God have all the hallmarks of attachment: Believers interact with God (e.g., in prayer); seek proximity with God in times of distress (e.g., trauma or loss); feel a loss when separated from God; and derive a feeling of self-worth and self-confidence from the relationship.
Of course, God is an exalted attachment figure in being seen as stronger and wiser than our prototypical attachment figures, that is, parents: God is viewed as omniscient and omnipotent. Little wonder that attachment needs are directed toward God.
Not surprisingly, research also has shown parallels between attachments formed with parents and those formed with God. A pattern of correspondence is common: Individuals who are securely attached to parents are likely to form a secure attachment with God, whereas those who are insecurely attached are likely to be insecure with God.
Securely attached persons feel confident in God’s benevolent support; those who are insecurely attached might experience God as emotionally distant, abandoning in times of need, or punitively judgmental.
Alternatively, a secure attachment with God can compensate for insecure attachment with persons, insofar as God is considered more trustworthy and loving. Yet the underlying insecurity can render the compensatory attachment with God somewhat precarious, for example, leaving the individual feeling disillusioned or betrayed when suffering is not alleviated.
The pervasiveness and potential emotional significance of attachment relationships with God have major health implications. Extensive research demonstrates the physical and mental health benefits of religious faith. Equally important, however, is more recent research on what Kenneth Pargament calls spiritual struggles.
These struggles take three broad forms:
- Interpersonal struggles revolve around religious conflicts with family members, religious leaders and congregations;
- Intrapersonal struggles emerge in relation to doubts about beliefs; and
- Divine struggles spring from conflicts in the relationship with God. These struggles can lead to positive transformations (e.g., renewed or strengthened faith), but they also can be detrimental to physical and mental health.
Psychotherapy is a potential resource for individuals who are immersed in distress associated with spiritual struggles. Yet there is a significant professional problem that we need to address forthrightly, best researched in relation to us psychologists.
Although there are wide individual differences among psychologists, as a group we tend to be (1) less religious than our patients; (2) less inclined than our patients to address spiritual matters in psychotherapy; and (3) poorly educated and trained in the area of religion and spirituality, notwithstanding the extensive literature that is now available.
There are exceptions and specialized psychotherapies integrating spirituality are being developed and researched. Of course, pastoral counseling is a viable option to psychotherapy, and pastoral counseling also is often employed alongside psychotherapy, as we do frequently here at The Menninger Clinic.
I have two main points to make about the significant professional problem that patients’ spiritual concerns are likely to be insufficiently addressed in psychotherapy.
First, for us professionals: Although specialized education would be ideal, more important is a genuine interest in our patients’ spirituality, respect for diversity, willingness to enter into unknown territory and eagerness to learn.
Second, for patients: Don’t hesitate to bring up your spiritual concerns with your psychotherapist, given their potential significance for your mental health – and consider pastoral counseling in any event.
Allen, J.G. (2013). Restoring mentalizing in attachment relationships: Treating trauma with plain old therapy. Washington, DC: American Psychiatric Publishing.
Kilpatrick, L.A. (2005). Attachment, evolution and the psychology of religion. New York: Guilford.
Pargament, K. I. (2007). Spiritually integrated psychotherapy: Understanding and addressing the sacred. New York: Guilford.
Pargament, K. I. (2013). APA handbook of psychology, religion and spirituality, Volumes 1 and 2. Washington, DC: American Psychological Association.