Gods Lost, Found, and Reconsidered:
Discovering and Managing Spiritual and
Religious Coping in Clinical Care
James W. Lomax, M.D.Karl Menninger Chair for Psychiatric Educationand Brown Foundation Chair in Psychoanalysis
Presentation Objectives
• Why learn about religion and spiritual matters?
• Illustrative clinical stories, interpretation and
framework
• Discussion of your experiences
Disclosure of Interests
• Personal developments
• Institute for Spirituality and Health (ISH)
Disclosure of Interests (Cont.)
• Center for Psychoanalytic Studies
• Center for Professionalism
Spiritual Coping
• Frequent response to stress
• Positive and negative implications
• Relationship to “anomalous” experiences
• Religious Ordering, Spiritual Seeking,
Behavioral Activity
Spiritual Struggles
• Dark side to “Seeking the Sacred”
• Intrapsychic, Interpersonal, Supernatural
• Insecurity, Ambivalence, Conflictual
• Predisposing to Mood, Anxiety, Substance
Abuse Disorders
First Clinical Situation: Fred, Spiritual
Coping After Sacred Losses
• Traumatic End of Career and calling
• Compensation in Professional and Personal
Relationships
• Ongoing tensions
Treatment of a Very Complicated Grief
• Things mostly improved
• A major gap
• Building an alliance allows revelation
Psychotherapy as “Practice Field”
• Translating therapy into life
• Mutual relief
• “Displaced” recovery of shared love
Sylvia, Spiritual Struggle
• Surprising irritability and unprofessionalism
• Angrily anticipating my intervention
• Major Depression and Pharmacotherapy
• Getting and using a developmental history
• Spiritual struggles and her psychopathology
Seeking Spiritual Community
• Something missing
• Seeking community
Seeking Spiritual Community (Cont.)
• My boundary crossing
• Utility of community partnership
• Finding new community
Connecting Stories to Framework
• Two “Sacred Moments”
• Fred: Using an anomalous/sacred coping
• Sylvia: Struggles coping with “betrayals”
• Therapeutic “practice field”
• Translating therapeutic learning into repaired
(Fred) or new “community” (Sylvia)
Your Experiences Using Patient
Religious, Spiritual Resources
• What is helpful?
• What is “challenging?”
• Use of community partners
Thank you
