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Religious and Spiritual Aftermath of War
James K. Boehnlein, MDProfessor of Psychiatry
Oregon Health and Science UniversityAssociate Director for Education
VA Northwest Network Mental Illness Research, Education and Clinical Center (MIRECC)
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Questions After TraumaUnpredictability of life and deathLossMoral Complexities
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Religion Across CulturesExplanation of how universe began, how life
is maintained, what happens when life ceases to exist
Explanation of life’s meaning and rationale for suffering
Symbols, beliefs, valuesRelationship between the self and the world
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SpiritualityBridges religion and scienceInsightful relationship between self and
othersPersonal valuesMeaningful purpose for lifeConnectedness between self and the
natural/supernatural
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Explanatory FrameworksPain, suffering, atonement, forgiveness
Judaism – Restoration of relationship with God through atonement
Christianity – Repentance, forgiveness and rebirth
Buddhism – Acceptance of suffering; reincarnation
Islam – Death divinely ordained – impact on survivor guilt
Hinduism – Suffering a result of conflict/tension
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Core Assumptions Altered by TraumaBelief in personal invulnerabilityPerception of an understandable worldTrust in self and others
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Healing After Trauma: Psychotherapeutic ThemesTrustSecurityAcceptanceIdentity and Self-
WorthSocial
Connectedness
Grief and mourningAnger and RevengeControlMeaning
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Barriers to Treatment-Beliefs and Values
AvoidancePride in self-relianceLoss of control/autonomyTreatment is for those who are weak, “crazy”Provider will not understand or believe
traumaSocietal rejection
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Factors in Religious / Spiritual Healing
Telling the story honestlyEnding isolationMoral inventoryForgivenessHelping othersGiving and receiving love
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Clinician ReactionsSadnessAngerVulnerabilityFatigueIntolerance of other patientsIntolerance/avoidance of violence imagesIndifference vs. overinvolvement
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Ethical Principles in TreatmentCreation of trust, predictabilityCause no harmRespect for personal boundariesPrimacy of reducing suffering and promoting
healthRespect for patient autonomy, independence,
and creativityPromotion of justice
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