Spiritual & Emotional Dimensions of Human Development

1. Spiritual & Emotional Dimensions of Human Development Catherine O’Connor, CSB, Ph.D. Covenant Health Systems, Lexington, MA

2. “ Grand Canyon

3. Spiritual and Emotional Dimensions of Human Development” • Participants will identify the contribution of three theorists who contributed to our understanding of spiritual and emotional development • Participants will explain three key influences of human development on spiritual development • Participants will be able to name a key spiritual and human factor in the life of three of their patients

4. Gaudium et Spes, # 62 “In pastoral care, sufficient use must be made not only of theological principles, but also the findings of the secular sciences, especially of psychology and sociology, so that the faithful may be brought to a more accurate and mature life of faith.”

5. “The person is comprised of physical, neurological, psychosocial, bio-chemical, sexual, spiritual, cognitive systems, such that if there is a perturbation in any one system, the reverbations will be felt in the other systems.”

6. DEEPLY SPIRITUAL We have in us spirit, soul and what we do with that soul is our spirituality. At a very basic level long before anything explicitly religious need be mentioned, it is true to say that if we do things which keep us energized and integrated, on fire and yet glued together, we have a healthy spirituality. Conversely, if our life’s yearning drives us into actions which harden our insides or cause us to fall apart and die then we have an unhealthy spirituality. R. Rolheilser, OMI

7. Developmental Perspectivesof the “Structure of the Self” • Sigmund and Anna Freud • Donald Winnicott • Heinz Kohut • Carl Jung • Erik Erikson • Piaget • James Fowler • Lawrence Kohlberg • Carol Gilligan • The Stone Center –

8. Influences in Spirituality • Biblical sources • Eastern, Native American Traditions • Christian Spirituality: Augustine; Benedict, Francis, Dominic, Ignatius, Teresa of Avila, Wesley, Catherine of Siena, Little Flower, Merton, Mother Teresa, Joan Chittester, Joyce Rupp, Henri Nouwen, John O’Donohue, R. Rolheiser, P. Palmer; • Et al !!!

9. Erik Erikson Human growth is a result of meeting a series of crises successfully. The ego has a particular task to develop in negotiating each “crisis”. Each ego crisis develops a corresponding ego strength Transition between stages is characterized by anxiety and crisis, a person is pulled forward by maturational forces and pulled back by the security of the familiar.

10. Crisis Opportunity

11. Phases of life: Early life Midlife Elder Years

12. Early Years

13. Freud • ID, Ego, Superego, • Role of Anxiety • Role of Unconscious • Defense Mechanisms (Anna Freud) • Separation/Attachment (Anna Freud)

14. Winnicott • We develop and grow in an interpersonal world • “When the parent smiles, it is for the child as if the sun has come out” • Transmuting Internalization & Optimal Frustration • Skin as “limiting membrane”

15. Winnicott contd… • Holes in the Psyche • Deflation of Grandiosity • Holding Environment • The transitional object – development of God Image • “Good Enough”

16. The Three “O”s • Omnipotence • Omniscience • Omnipresence J. Sperry, M.D., Human Development

17. PSYCHOLOGICAL ISSUES PSYCHIC STRUCTURE – CONTAINER OF THE PERSONALITY

18. Mental, Emotional Illnesses Psychotic Borderline Histrionic Narcissistic Neurotic Personality Types

19. Midlife Years

20. Carl Jung “Forty is a merciless age. It allows for no more self-deception”.

21. Almsgiving Carl Jung “To accept oneself as one is may sound like a simple thing, but simple things are always the most difficult things to do.… But what if I should discover that that I myself stand in need of the alms of my own kindness, that I am to myself the enemy who is to be loved – What then?

22. Heinz Kohut Mature “Self” Needs: Mirroring Idealization Alter-ego or twinship

23. MIRRORING NEEDS: - Kohut Need for external validation by others, as well as internal validation by oneself, so we can experience pride and well-being in our work.

24. IDEALIZATION NEEDS:Kohut To feel part of, or connected with, persons whose lives, ideals, and values are a source of inspiration, and who contribute to our inner sense of peace and calmness.

25. Alterego or Twinship Needs Kindred spirits who affirm our uniqueness and humanity, and who provide a sense of togetherness and belonging

26. Movements of the Spiritual Life Loneliness - Solitude Hostility - Hospitality Illusion - Prayer.

27. SPIRITUAL ISSUES Covenant – “I am” Do we find God in our center? or Do we find ourselves in the center of God?

28. Task of Adult Life To grieve what never was and never will be. Judith Viorst – Necessary Losses

29. “I have been trying to make the best of grief and am just beginning to learn to allow it to make the best of me.” Barbara Lazean Ascher

30. W. Brueggeman “That which is remembered in grief is redeemed, made whole and renewed.”

31. The Elder Years

32. Task of the Elder Years: “To Possess your Soul” Thomas Kroon

33. “By your endurance you will gain your souls” NRSV Luke 21:19

34. To Possess Your Soul “In your patience, possess ye your souls” Luke 21:19

35. PSYCHOLOGICAL ISSUES Developmental Process: Age-ing to Sage-ing

36. SPIRITUAL ISSUES UNHELPFUL SPIRITUAL ISSUES e.g. - Belief that anger is sinful - Scrupulosity - Negative God image - Understanding of suffering

37. Guide to Old Age “ To continue to weed the garden of my life, remove yesterday’s flowers and dead branches, so that I may continue to foster growth.” J.B. Birnen

38. W. Cone. Ph.D “Old people do not automatically get grumpy, but grumpy people do get old!”

39. Story Telling Telling the story Maintains our identity and Gives us energy for the future

40. Memories “Memories, good and bad, are important to a healthy life. Memories tell us we come from somewhere, we have traveled through time and are now a part of the present.” Paul White

41. Spiritual Wellbeing Spiritual well being is the affirmation of life in a relationship with God, self, community, and environment that nurtures and celebrates wholeness. National Interfaith Coalition on Aging 1975

42. “You put such a stress on passion when you’re young. You learn about the value of tenderness when you grow old. You also learn in late life not to hold, to give without hanging on; to love freely, in the sense of wanting nothing in return” Joan Erickson

43. Ten Hopes of Palliative Care Patients Newly admitted Patient 8 Physical 2 Emotional 5 Days later 5 Physical 5 Emotional/Social 10 Days Later Mostly emotional/social/spiritual Ira Byock, MD

44. Ten Developmental Landmarks and Tasks for the end of life • Completion of worldly affairs • Completion of community relationships • Life review and the telling of “one’s stories” • Self-acknowledgement and self-forgiveness • Acceptance of worthiness • Completion of relationships with family and friends

45. Ten Developmental Landmarks and Tasks for the End of Life (cont’d) • Sense of personhood • Sense of meaning about life in general • Surrendering to the transcendent • Acceptance of finality of life Ira Byock, MD

46. Five Tasks to complete Living: How to say: • Forgive me • I forgive you • Thank you • I love you • Good-bye (God be with you)

47. Erik Erikson “Dying is a part of the continuum of living. When older people do not fear dying, younger people need not fear living”.

48. Etty Hillesum “It sounds paradoxical: by excluding death from our life we cannot live a full life, and by admitting death into our life we enlarge and enrich it.”

49. Persons suffering with Alzheimer’s/Dementia …We hold onto the stuff of our souls, for one another. We are collectively to possess the souls of those who cannot do it for themselves. As we hold on to one another, we hold in our hands our communal salvation. She may have lost possession of her soul to a disease, but her soul is not lost. It is possessed by those who love her and care for her, as if by God, into whose book her name is written.” Thomas Kroon

50. DIMINISHMENT or…? Physical Psychological Mental Spiritual