1. The Shattered Soul Life in the Balance

2. 2 Spiritual Reactions to Trauma 1. Confusion about God 2. Altered sense of meaning in/of life 3. Grief and loss issues 4. Questions of Theodicy 5. Feelings of ineffectiveness, shame, despair, hopelessness 6. Feeling permanently damaged 7. Loss of previously sustained beliefs 8. Feelings of guilt 9. Confusion about core ethical beliefs.

3. 3 Spirituality & Rebuilding a Life Spirituality is that which gives a person meaning and purpose. Spirituality is that which gives a person meaning and purpose. It is found in relationships with self, others, ideas, nature, and, possibly, a higher power. It is found in relationships with self, others, ideas, nature, and, possibly, a higher power. Spiritual distress arises when one of these relationships that provide meaning is threatened or broken… the individual becomes disconnected from their system of beliefs. Spiritual distress arises when one of these relationships that provide meaning is threatened or broken… the individual becomes disconnected from their system of beliefs. Spiritual recovery is a journey of establishing, rethinking, and redefining one’s sense of self and relationship to life. Spiritual recovery is a journey of establishing, rethinking, and redefining one’s sense of self and relationship to life..

4. 4 Spiritual Consequence of War

5. 5 Weakened Faith Research showed that a Veterans' war zone experiences (killing, losing friend, etc.) weakened their religious faith, both directly and as mediated by feelings of guilt. Weakened religious faith and guilt each contributed independently to more extensive current use of VA mental health services. Fontana, A., & Rosenheck, R. (2004). Trauma, change in strength of religious faith, and mental health service use among veterans treated for PTSD. J Nerv Ment Dis, 192 (9), 579-584.

6. 6 Veteran’s Use of Clergy Veterans may feel more comfortable approaching their pastor than they do a mental health professional. Veterans may feel more comfortable approaching their pastor than they do a mental health professional. Research shows that 4 of 10 individuals with mental health challenges seek counseling from clergy. Research shows that 4 of 10 individuals with mental health challenges seek counseling from clergy. Individuals seek counsel from ministers more than all other mental health providers combined. Individuals seek counsel from ministers more than all other mental health providers combined. Often seeing a member of the clergy is less threatening and has less stigma attached. Is viewed as engaging a known community resource. Often seeing a member of the clergy is less threatening and has less stigma attached. Is viewed as engaging a known community resource. Negative reasons... Magical thinking, avoiding truth of diagnosis, etc. Negative reasons... Magical thinking, avoiding truth of diagnosis, etc.

7. 7 Spiritual Care Approaches Providing a Safe Place ListeningGroundingAcceptingReferring

8. 8 Spiritual Leader as a Safe Haven Offer a calm, safe and non-judgmental, non- anxious presence. Offer a calm, safe and non-judgmental, non- anxious presence. Provide clear, reliable boundaries of communion and respect. Provide clear, reliable boundaries of communion and respect. Be present with veterans and families during the storms of reintegration. Be present with veterans and families during the storms of reintegration. Provide a compassionate space wide enough to encompass the awfulness of war trauma. Provide a compassionate space wide enough to encompass the awfulness of war trauma.

9. 9 Spiritual Leader as Listener Avoid advising or offering platitudes Avoid advising or offering platitudes Listen without interruption or comment Listen without interruption or comment Hearing content and emotion with respect Hearing content and emotion with respect Convey warmth and acceptance of the person, their journey and their struggles Convey warmth and acceptance of the person, their journey and their struggles Avoid asking questions Avoid asking questions Notice what is in a caring and genuine way. Notice what is in a caring and genuine way.

10. 10 Spiritual Leader Role in Grounding Provide roadmap for reintegration into church community and community at large. Provide roadmap for reintegration into church community and community at large. Provide roadmap of opportunities for appropriate outlets regarding frustration, pain, fear, guilt and trauma. Provide roadmap of opportunities for appropriate outlets regarding frustration, pain, fear, guilt and trauma. Provide avenues of dialogue for spiritual and religious growth and engagement. Provide avenues of dialogue for spiritual and religious growth and engagement. Provide honest and realistic reflection of recovery process. Provide honest and realistic reflection of recovery process. Provide spiritual, religious and community resources for veterans and their families. Provide spiritual, religious and community resources for veterans and their families.

11. 11 Spiritual Leader Role in Accepting Understand the “both/and” nature of good and evil. Then and now. Understand the “both/and” nature of good and evil. Then and now. Not trying to fix the unfixable. Not trying to fix the unfixable. To offer deep reflection on “what is goodness” and how to help others find “goodness” within themselves. To offer deep reflection on “what is goodness” and how to help others find “goodness” within themselves. Understanding and accepting the dark side of human nature. Understanding and accepting the dark side of human nature.

12. 12 Spiritual Approaches by Symptom Effect of Trauma Spiritual Care Approaches Isolation & withdrawal Build connections and a supportive healthy community Guilt Practice self-forgiveness & compassion Anger Forgiveness as movement away from hostility Foreshortened future & loss of interest Making meaningful the time that remains Hyper-vigilence & anxiety Meditation Developed by Kent D. Drescher, Ph.D