Beyond Belief: Human Spiritual Development, Assessment and Treatment

1. Beyond Belief: Human Spiritual Development, Assessment and Treatment Dr. Bradford H. Price, PC, LICDC Clinical Director The Woods at Parkside, Gahanna, Ohio

2. Where we stand  determines what we see -Robert McAfee Brown, 1980

3. Beyond Belief: Outline Develop a Working Understanding of the Spiritual Dimension of Humanness Describe the Developmental Stages of Human Spirituality Describe the Effect of Addiction on the Spiritual Dimension/Experience Identify and Define the Categories Involved in an Assessment of Spirituality

4. Outline (cont.) 5. Review the Structure and Process of an Spiritual Assessment Interview 6. Identify Common Issues and Strategies Involved with Attending to the Spiritual Dimension Effectively in the Treatment Process

5. Spirituality� Is Not an �It� not something a person has not something a person gets not a possession not something to be grasped

6. Spirituality� Is a dimension of our humanity along with the physical, cognitive, volitional, social and affective among others�.. It is the dimension of our experience that �holds� the rest of life together. The glue, the string, the wire�. It is the dimension that makes sense of the others. The dimension of life that creates meaning-makers.

7. 1. Spirituality is the collection of relationships we have with whatever or whomever is most important to us or what is of ultimate concern. Each of us experiences some alienation and some belonging in our spiritual lives, the balance between them shifting through time.

8. 2. To determine what is most important and of ultimate concern, we ask two questions: * What provides my life with power? * What provides my life with meaning?

15. When we have completed these lists and identified what is the source of power and meaning for our lives, we then know what is at our spiritual core or center. The Spiritual Dimension is at the center of human experience and the other dimensions adjust themselves to accommodate the spiritual.

16. 3. We have at least one common purpose for living� �. to make more power and meaning 4. We are also engaged in a common quest - for spiritual fulfillment - for freedom from self-preoccupation - for that which is beyond the lone human being

17. When the spiritual dimension is exhibited and then observed by others, it does so in Ethics, Morals, Values, Traditions When we experience spiritual distress, generally this indicates a lack of congruence between what is at our spiritual core and our behavior. Frequently this distress is experienced as guilt and/or shame.

18. Because of this, it is far more important to attend to the process of spirituality rather than the content. How someone lives out their spirituality is of primary concern as opposed to what is believed/thought as part of a theology or belief system.

19. STAGES OF SPIRITUAL DEVELOPMENT -Mythic-Literal -Synthetic-Conventional -Individuative-Reflective -Conjunctive

20. MYTHIC-LITERAL (7-12) Individuals appropriate the stories, beliefs and observances related to community membership. Self-Generated Stories Fully Anthropomorphic God-Images Reciprocity and Fairness are Major Concerns

21. MYTHIC-LITERAL (cont.) Can be Affected Deeply and Powerfully by Symbolic/Dramatic Material Limitations Literalness and rigidity in regard to �fairness� results in overcontrol and perfectionism. 2. Internalizing shame because of abuse, neglect or perceived disfavor of significant others.

22. MYTHIC-LITERAL (cont.) Transition to Synthetic-Conventional Conflict/contradiction in stories leads to reflection on meanings. Emergence of Mutual Interpersonal Perspective

23. SYNTHETIC-CONVENTIONAL(13-Late Adolescence) Individual develops a coherent, meaningful synthesis of the collection of active commitments and concerns. Largely Interpersonal Conformist (modelling and culture) Values/Beliefs Are Deeply Felt

24. SYNTHETIC-CONVENTIONAL (cont.) Differences/Distinctions with Others Locus of Authority Emerging Issues Identity Incorporate Past and Future Create Image of Ideal Based on Own Personality/Relationships

25. SYNTHETIC-CONVENTIONAL (cont.) Limitations Expectations of and Evaluations by Others Become �Sacred� Fundamental Betrayal of Trust

26. SYNTHETIC-CONVENTIONAL (cont.) Transition to Individuative-Reflective Contradiction Between Valued Sources of Authority Significant Changes by Valued Sources in �Sacred� Rules, Policies, Procedures Encountering Other Experiences and Perspectives Leaving Home

27. INDIVIDUATIVE-REFLECTIVE(late adolescence-middle adulthood) Continues synthesis of concerns and commitments by focusing on personal responsibility for beliefs, lifestyle and attitudes Polar Tensions Individuality � Belonging to Community Subjectivity � Objectivity Self-Fulfillment � Service to Others

28. INDIVIDUATIVE-REFLECTIVE(cont.) Experience Dual Development: Self/Outlook New Identity and Outlook are Differentiated and Acknowledged Strength Seen in New Capacity for Critical Reflection: Identity & Ideology

29. INDIVIDUATIVE-REFLECTIVE(cont.) Sense of Coherence in Universe Expressed as Explicit System of Meaning Symbols are Usually Reduced to Propositions, Definitions or Conceptualization

30. INDIVIDUATIVE-REFLECTIVE(cont.) Limitations Excess Confidence in the Conscious Mind and Critical Thought Narcissistic Tendency to Overassimilate Perceived Reality and Perspectives into Own World View

31. INDIVIDUATIVE-REFLECTIVE(cont.) Transition to Conjunctive Awareness of �Recalcitrant Residue� Heightened Experience of Past/Future 3. Greater Openness to Ambiguity

32. CONJUNCTIVE(middle adulthood and beyond) Individual integrates much that was suppressed or unrecognized in the interest of supporting prior self-certainty and assimilation. Symbolic Power is Reunited with Conceptual Meaning Reclaim and Rework Personal History Boundaries and Outlook are Open and Permeable

33. CONJUNCTIVE (cont) Vulnerable to the Truths of the �Other� Open to Embracing What is Different and Threatening to Self and Outlook Supports the Possibility of Other�s Generating Identity and Meaning

34. CONJUNCTIVE (cont) Increased Awareness of Defeat and the Reality of Irrevocable Commitments and Acts Appreciates Symbols, Myths and Rituals, Own and Others Always Divided

35. Now that we have developed a working definition of spirituality we can consider how chemical dependency affects it. Then we will consider how it can be assessed and addressed effectively in treatment.

36. Chemical Dependency is the pathological love relationship that exists between an individual and the reward produced by MACs (Mood-Altering Chemicals)

37. This relationship transcends all other needs and relationships It is multidimensional Initiated by a biochemical moment The individual makes meaning of this and commits to its nurture and preservation

38. It is the commitment to this meaning-filled relationship that establishes the foundation of addiction and provides the motivation to do whatever is necessary to sustain the relationship.

39. This relationship becomes the most fundamental and significant focal point for the person�s spiritual reality and functioning

40. Addicts then, are persons whose primary spiritual relationship is grounded in their commitment to the pathological love relationship with the reward produced by MACs. Their behavior supports and protects this relationship causing them great emotional pain unless they modify, compromise or violate their ethics, morals and values.

41. As a result, addicts will hear others say, You aren�t the person I once knew. This isn�t like you. What happened to you?

42. The awareness that the behavior violates personal ethical standards results in GUILT Other pain follows�sadness, loneliness, disappointment, shame, fear�.

43. Therefore, the second dimension of the person�s humanity violated by addiction is the affective The other dimensions suffer in turn as they attempt to accommodate the addiction that consumes the individual�s core.

44. Spirituality and Assessment The spiritual dimension of human experience can be assessed as other dimensions are assessed. The overall development of this aspect of a person�s humanity can be evaluated and the professional�s perception of what is healthy and unhealthy can be described. Of particular concern is the effect addiction has had and what aspects of the person�s spirituality require special attention.

45. Now we will turn to the process of assessment. Categories Structured Interview Integration of results of spiritual assessment with other dimensions