MoralStress,Resilience,Integration

Instructor: Carrie Doehring, PhD

Teaching Assistant: Jeff Zust, MDiv, MSc, MTh, MA

This advanced level course helps students continue to learn and practice competencies in interreligious, evidence-based and socially just spiritual care of religious, spiritual and moral struggles. This competency-based pedagogy helps students identify and spiritually integrate their own experiences of moral stress and injury, in order for them to experience the ways that spiritual care—especially the search for spiritual/religious practices and meanings—is different from mental health of moral stress and injury. Moral stress arises from shame/guilt/fear of causing harm involving conflicts in values. Moral injury arises from traumatic stress that is more shame than fear based and has been research extensively among military personnel and veterans. Spiritual integration of moral stress and injury uses spiritual practices and religious beliefs and values to compassionately identify life-limiting embedded shame-based values, beliefs, and ways of coping with moral stress and injury in order to compassionately understand the origins of moral stress and injury. Relational resilience is the outcome of spiritual integration based on spiritual practices fostering compassion and more complex theological/moral ways of understanding moral conflicts, stress and injury.

This course is designed to meet the needs of (1) religious leaders in the M.Div. program, (2) those preparing for the specialized vocation of pastoral and spiritual care, (3) military chaplains in Iliff’s online course provider program in military ministry available to anyone studying military ministry in an ATS school, and (4) Ph.D. students studying religion and human experience using religious, psychological, and theological studies. Students are expected to bring traveling knowledge from many of their courses to learn how to offer socially just spiritual care that fits Iliff’s “commit[ment] to social justice, inclusiveness, and religious diversity” (http://www.iliff.edu/our-president/ (Links to an external site.)).  Iliff’s longstanding history of respect for religious differences makes it a hospitable place for students of all religious and philosophical orientations, many of whom have multiple religious identities.

Requirements

1. Weekly posts and responses: class members will be expected to do the readings and reference them in weekly forums and assignments. 60% of grade
2. Mandatory Zoom Synchronous Class Sessions: Weeks 3 and 5 at 4:00-5:15 pm MST.  Students unable to attend may contact Carrie Doehring to make-up the class session.
3. Journal assignment on a personal experience of religious/spiritual/moral struggle (20% of grade). See Journal Assignment Requirements, Grading, and Outline  Revised 4-1-2021 Here is a word document of this page: Journal Assignment Requirements, Grading, and Outline 4-1-2021.docx 
4. Spiritual care competencies will be demonstrated and assessed in conversations with your partner based on the journal assignments (one in which you give spiritual care and one in which you receive spiritual care) will be video recorded in week 8. You will transcribe what you said as the spiritual caregiver and assess your responses by answering questions about how you demonstrated aspects of interreligious, socially just, and evidence-based spiritual care of your partner. (20% of grade). See outline (to be posted).

Final Grade Scale (Note: at Iliff professors determine grading scales they will use to assign final course grades) A 97-100; A- 93-96; B+ 89-92; B 85-88; B- 81-84; C+ 77-81; C: 73-76; C- 69-72; D+ 65-68; D 61-64; D- 57-60; F 0-59

Required Texts:

Graham, L. K. (2017). Moral injury: Restoring wounded souls. Abingdon Press. 

All other chapters and articles will be posted in weekly instructions.

Course Learning Goals

Learning Covenant  

Here are helpful resources:

Iliff's EAP (Employee Assistance Program for students) 

Spiritual Self-Care Resources 

Preamble

Spiritual care that does no harm must be socially just, interreligious, and evidence-based in order to fulfill ethical mandates of spiritual care professionals described in the Common Code of Ethics for Chaplains, Pastoral Counselors, Pastoral Educators and Students (hereinafter referred to as spiritual care professionals):

When Spiritual Care Professionals behave in a manner congruent with the [following] values of this code of ethics, they bring greater justice, compassion, and healing to our world. 

• affirm the dignity and value of each individual
• respect the right of each faith group to hold to its values and traditions
• advocate for professional accountability that protects the public and advances the profession
• respect the cultural, ethnic, gender, racial, sexual-orientation, and religious diversity of other professionals and those served and strive to eliminate discrimination. (2004)

Spiritual care professionals help people explore spiritual and/or religious^[i] practices fostering trust and self-compassion so that people can collaboratively search for beliefs and values that nurture compassion, healing, and justice for persons, families, and organizations. The term spiritual, with all of its limitations, is a short-hand way of describing the deep relational trust in and connection with transcendence and imminence that enliven compassion, healing, and justice in distinctive ways.

Learning spiritual care is a lifelong integrative process that weaves together knowledge, attitudes, relational abilities, and interpersonal skills. Spiritual care education and training use standards of professional spiritual care to define learning outcomes. Students introduced to these core learning outcomes from the outset of their education and clinical training—in their first role plays in academic courses and their first spiritual care interactions in clinical training—will be engaged in a collaborative process of developing personalized learning goals.

 

Core competencies in socially just, interreligious, and evidence-based spiritual care

Spiritual care courses at Iliff use a spiritually integrative pedagogy to form students seeking competency in the practice of socially just, interreligious, and evidence-based spiritual care. Socially just spiritual care pays attention to interacting social advantages and disadvantages that may harm others and reinforce prejudice, contributing to systemic social injustice.[ii] Spiritual care needs to be interreligious in order to (1) counteract colonialist ways religion has been imposed on others, and (2) establish spiritually trustworthy relationships that “demonstrate respect for the cultural and religious values of those they serve and refrain from imposing their our own values and beliefs on those served.”^[iii]  Spiritual care needs to be evidence-based by drawing upon research on aspects of religion and spirituality that help or harm persons, especially those experiencing religious, spiritual, and moral struggles. 

Practicing a spiritually integrative learning process

Spiritual integration is a collaborative and relational process of using spiritual practices for coping with stress compassionately, finding purpose through values, and understanding stress and suffering in a variety of ways, unique to persons, families, and communities.  Life-giving practices become a tether to the inherent goodness of one’s body, trustworthy others, lament for social injustice, and transcendent interconnections. The process of integration is what grounds students in their own religious and/or spiritual heritage, identity, and communities, in ways that enhance spiritual differentiation, empathy, and reflexivity—three core abilities for socially just and interreligious spiritual care. 

Learning outcomes for developing and demonstrating spiritual integration

Spiritual care courses at Iliff prepare students to become community faith leaders and chaplains engaged in an ongoing collaborative process of spiritual integration who

1. Experiment with a calming practice of deep slow breathing, and intrinsically meaningful calming and settling practices
2. Identify when an aspect of their coursework triggers a stress response in them
3. Identify differences between their bodies’ stress response and the calming effects of their spiritual practices
4. Describe what self-compassion feels like during calming practices, for example, through the warmth of touch during slow deep breathing
5. Use self-compassion to identify their stress emotions (e.g., anger, helplessness, fear…),
6. Use a calming practice while listening to/reading responses from others in order to experience the mystery of the other

In weekly forum discussions and assignments, students report on how they are

• Experimenting with using breathing and or body-centered calming practices that help them become more aware of their physiological, emotional, and spiritual responses to stress
• Exploring ways to make their breath or body-centered practices connect them relationally with a sense of transcendence and increase a ‘felt’ sense of trust (e.g., in the goodness of their bodies and/or relational webs which may include a transcendent quality of connection with nature, humanity, and God, Allah, Jesus, Buddha or other divine beings)
• Deepening their awareness of the particular ways that stress is experienced in their bodies, how spiritual practices help them be self-compassionately aware of their body’s stress responses
• Using course forums to experience relationships of compassionate accountability for sharing and reflecting upon spiritual practices in this course and with trusted others in their relational webs (e.g., communities of faith; contextual learning opportunities for practicing spiritual care)
• Using momentary spiritual practices in flexible ways during spiritual care and learning interactions to experience a felt sense of trust in the process of spiritual care.

Practicing spiritual self-differentiation

When community faith leaders and chaplains are attuned to how stress triggers bodily memories, they can use calming spiritual practices to hold these memories in self-compassion. They may then be able to care for self by separating past memories from present circumstances in a process of spiritual self-differentiation. Self-differentiation helps students manage relational boundaries in the emotional intensity of intimate, family, work, and learning community relationships.

Self-differentiation in intimate/high investment relationships is both an interpersonal process of managing relational boundaries and a psychological process of managing emotions, thoughts, and behaviors. Those in professional helping relationships learn how to psychologically self-differentiate in order to maintain healthy boundaries. Chaplains and community faith leaders draw upon their knowledge of faith traditions in order to be spiritually self-differentiated. They are able to separate their beliefs and values about suffering from another’s beliefs and values, in order practice spiritual empathy—an interpersonal capacity to imagine how another experiences stress and stress-related emotions that generate their orientations to suffering.

The added dimension of spiritual self-differentiation is what makes chaplains and community faith leaders competent in interreligious spiritual care. We use the term interreligious to describe a specialized kind of intercultural competency that integrates:

• Knowledge of the socially constructed nature of religious beliefs, values, and rituals^[iv]
• Attitudes of cultural humility toward cultural, religious, moral and spiritual differences, and the ineffable mystery of the other
• Competency in spiritual differentiation, enabling chaplains to differentiate among and particular religious, spiritual, and moral orientations of others.
• Skills in spiritual self-care for coping with the anxieties/losses of letting go of absolute meaning/value systems that avoid, polarize, or minimize religious and spiritual differences.

The term interreligious competence highlights this integration of graduate studies, especially comparative studies of religion, with formation and clinical training enhancing spiritual self-differentiation in religiously diverse contexts. We recognize the limitations of the term interreligious for describing spiritual care to those with humanist, agnostic, or atheist orientations, as well as those who reject the term spiritual in describing their traditions and communities (for example, Buddhist, Confucian, Hindu, or American Indian persons).

Learning outcomes for developing and demonstrating spiritual self-differentiation

Spiritual care courses at Iliff prepare students to become community faith leaders and chaplains who practice spiritual self-differentiation by

1. Developing a solid flexible spiritual self—sometimes called spiritual or pastoral authority—that truly respects religious differences by not enacting a caste system of religious/spiritual traditions and practices, with some more superior or truthful than others. Students are able to use their agential power grounded in their specialized knowledge of and training in spiritual care, and in their organizational role.
2. Using calming spiritual practices helps students recognize when stress makes them cope with jarring experiences of religious differences by wanting to fuse with/disengage from others in ways that minimize, polarize, or use inclusion as a way of ‘re-centering’ themselves in familiar or habitual orientations that blur differences, which are shaped by childhood and culture.
3. Making grounded responses in a listening/following style of using receptive power that echoes the language the other uses to describe their suffering and sources of hope and comfort
4. Venturing out of their cognitive/theological ‘comfort zone’, tolerating discomfort for spiritual growth.

In weekly forum discussions and assignments, students report on how they are

• Experiencing confidence in or anxiety about their solid flexible spiritual self, especially in using agential power as spiritual rather than psychological care providers.
• Describing jarring moments in course conversations/discussions, when use of spiritual practices helps them be aware of embedded values and beliefs arising from stress that makes them fuse with/disengage from the other.
• Make interreligiously respectful responses using receptive power
• Use challenging/uncomfortable moments to finetune learning goals specific to their own learning process

 

Practicing spiritual and social empathy

Spiritual and social empathy is builds upon spiritual self-differentiation by spiritual and social perspective-taking involves standing in the other’s shoes to the extent that one can, and imagining the world from the other’s spiritual perspective, especially the macro systems of intersecting social privileges or disadvantages within their cultural and political contexts. Perspective-taking helps students differentiate spiritually and emotionally while considering differences in social advantages and disadvantages, especially racial differences. Blurring one’s own and another’s perspective will lower empathic attunement and could contribute to spiritual neglect, coercion, and microaggressions.

 

Learning outcomes for developing and demonstrating spiritual and social empathy

The following are examples of learning outcomes for how students integrate key concepts in spiritual and social empathy with an interpersonal capacity for ‘seeing the other’ using these key concepts, and then using communication styles and skills appropriately in particular learning and spiritual care interactions:

1. Using specialized knowledge from their theological and religious studies to consider the macro systems of intersecting social privileges or disadvantages within a care seeker’s current context contexts
2. Using an overarching orientation of post/decolonialism^[v] to name the ways that colonialism exercises power over all aspects of ecological, transnational, political, and economic life
3. Bringing post and decolonial orientations to understanding the impossibility of ‘doing no harm’ in a world organized by colonialism and the need for spiritual practices that hold lament

In weekly forum discussions and assignments, students report on how they are

• Using key concepts from across Iliff courses to articulate intersectional and postcolonial descriptions of how social privileges and disadvantages ameliorate and/or exacerbate suffering for oneself and another.
• Demonstrating social empathy for how these intersecting advantages and disadvantages shape their own and the other’s stress-based values and beliefs about suffering and hope.
• Describing practices of lament in their own process of spiritual integration, while listening for the ways lament could be part of spiritual care conversations.

Practicing Spiritual Self-Reflexivity

Spiritual reflexivity goes beyond theological reflection to understand how a chaplain’s/community faith leader’s and care seeker’s social, religious/spiritual identities interact in the process of exploring contextual intentional values and beliefs about suffering cocreated within relationships of trust in spiritual care and learning circles. Reflexivity begins with identifying how one’s stress-oriented and intentional beliefs and values are shaped by one’s own intersecting social privileges and disadvantages. The next step is to use spiritual and social empathy to imagine the other’s stress-generated values and beliefs and how these are shaped by their social location. Calming practices help one identify core contextual values and beliefs about particular experiences of suffering and hope. Spiritual reflexivity includes understanding possible interactions among (1) your beliefs and values about the care receiver’s experience, your role as their chaplain or community faith leader, and your social location, (2) the care receiver’s beliefs and values about her experience, her role as a patient/ community faith member, and her social location. Students use agential and receptive power in fine-tuning their communication styles/skills in listening to and guiding a search for meanings.

 

Learning outcomes for practicing spiritual self-reflexivity

The following are examples of learning outcomes for how students integrate key concepts in spiritual self-reflexivity using communication styles and skills appropriately in particular learning and spiritual care interaction

1. Focus on key concepts from readings to understand develop contextual intentional values and beliefs about suffering/hope intrinsically and contextually meaningful given interacting social locations
2. Focus on key concepts in readings to listen for how another’s social location and narratives might generate their stress-related embedded beliefs and values about particular kinds of suffering/hope
3. Describe the process of co-creating contextual meanings and values through the process of spiritual care conversations. enhance self-differentiation in specific spiritual care and learning interactions

In weekly forum discussions and assignments, students report on how they are

• Using momentary spiritual practices to regulate emotions in order to draw upon key concepts from readings to develop contextual intentional values and beliefs about suffering/hope in this week’s topic
• Use key concepts in readings to listen for how their group members’ social location and narratives might generate their stress-related embedded beliefs and values about particular kinds of suffering/hope
• In forum responses and assignments demonstrate the process of co-creating contextual meanings and values through the process of spiritual care conversations. enhance self-differentiation in specific spiritual care and learning interactions

 

Practicing evidence-based spiritual care

Students in this course begin to develop research literacy by

• paying attention to when and how readings use research, in order to understand the relevance of research on when/how aspects of spirituality and religion help or harm others.
• using access to databases to search for relevant research on suffering and common religious, spiritual, and moral struggles arising from common experiences of suffering
• citing research to support their approach to spiritual care in course discussions and practice.

References

Doehring, C., & Kestenbaum, A. (In press). Introduction to interpersonal competencies. In S. Rambo & W. Cadge (Eds.), Introduction to chaplaincy and spiritual care. University of North Carolina Press.

Doehring, C., & Kestenbaum, A. (In press). Practicing socially just, interreligious, and evidence-based spiritual care In S. Rambo & W. Cadge (Eds.), Introduction to chaplaincy and spiritual care. University of North Carolina Press.

Lizardy-Hajbi, K. (2020). Frameworks toward post/decolonial pastoral leaderships. Journal of Religious Leadership. 19(2), 98-128.

 

[i] Humanist, pagan, and first nations communities are examples of traditions/cultures that do not use terms like spiritual or religious to describe themselves. Use of these terms may be less relevant for them.

[ii] Spiritual care professionals are ethically mandated to “promote justice in relationships with others, in their institutions and in society” Common Code of Ethics for Chaplains, Pastoral Counselors,  Pastoral Educators and Students (Council on Collaboration, 2004), 4.1.

[iii] Collaboration. Short Common Code of Ethics for Chaplains, Pastoral Counselors,  Pastoral Educators and Students 1.3.

[iv] When academic degree programs do not include courses in comparative studies of religion supporting interreligious practices, students and religious leaders may perpetuate spiritual harm through interreligious naivete. For an introduction to how comparative studies shape interreligious dialogue, see Paul Hedges, Controversies in Interreligious Dialogue and the Theology of Religions (London: SCM Press, 2010).

[v] Lizardy-Hajbi uses the term “’post/decolonial’ in order to acknowledge both the separate contextual and theoretical streams from which challenges to coloniality have arisen in the literature, as well as to highlight their common foundational aims as critiques to colonial being-thinking-acting” Kristina Lizardy-Hajbi, "Frameworks toward Post/Decolonial Pastoral Leaderships," Journal of Religious Leadership 19 no. 2 (2020): 98-128.

Learning Covenant in Spiritual Care Courses

Confidentiality: Personal disclosures are not to be discussed outside of class without agreement and permission. Students can talk about their stress/emotional reactions with trusted others, as long as the focus is on them and not the content of what other students share. In case study assignments that are not fictional, students need to disguise the identity of care seekers. Students must be aware of and abide by the mandatory reporting laws of the state in which they provide professional caregiving. If they are designated spiritual caregivers within their religious tradition, they need to also be aware of what their religious organization requires. If students have reason to suspect or have first-hand knowledge of recent, current or ongoing child abuse or neglect perpetrated on a child currently under the age of 18 years, elder abuse, sexual and domestic violence, or threats of homicide or suicide in any of the pastoral situations they use for fulfilling the requirements of this course they need to seek immediate consultation with supervisors, denominational leaders, and the professor of this course so that proper reporting procedures can be ascertained. Current information on (1) "clergy as mandated reporters" and (2) links to state laws can be found at the Children's Bureau of the US Department of  Health and Human Services. Faculty will abide by the bounds of professional and Title IX reporting laws rather than absolute confidentiality. Under Iliff’s Mandatory Reporting Policy, all employees, with the exception of the Dean of the Chapel and Spiritual Formation,[i] are mandatory reporters. The primary purpose for sharing this information with the Title IX Coordinator is to ensure the impacted party receives information about rights and resources, and that Iliff is able to respond appropriately to such incidents.

Self-Differentiation: In preparing forum posts and responses, assignments, and spiritual care conversations, students are responsible for (1) tracking how they experience stress in their bodies and stress-related emotions, and (2) using practices that foster self-compassion and empathy, such that their emotional/stress reactions are resources for learning, not liabilities.

Levels of self-disclosure: The purpose of self-disclosure is to develop competencies in spiritual care, especially a commitment to one’s own process of spiritual integration that enhances self-differentiation and a capacity for empathy. The purpose of self-disclosure in this learning context is not for personal healing. In deciding how to use/disclose personal experiences in discussions and assignments, students need to track their levels of stress before they share in class discussions, and in assignments/forum postings, and to not disclose experiences that overwhelm their capacities for self-differentiation, spiritual integration, and critical thinking skills. Students need to use their support systems when they become overwhelmed and in making decisions about what kinds of personal experiences to share in weekly posts and journal/case study assignments.

Respect for differences: Students are responsible for using social and theological empathy to imaginatively step into and respect the worlds of those who are different from them in terms of beliefs, values, practices, and social location.

Group and team learning depend upon timely posts and assignments: Every effort must be made to post on time. If posts will be late, faculty, students must notify faculty, forum discussion groups, and/or learning partners. If assignments are consistently late and if late assignments jeopardize their learning partner’s deadlines, students may be required to withdraw from the course. Normally incompletes are not granted because all learning in the course is collaborative.

Availability of faculty: Faculty in spiritual care courses will normally respond within 24 hours to emails (Contact Carrie Doehring by email). Messages sent within Canvas are sometimes hard to track amidst other Canvas notifications. Spiritual care faculty offer support but not spiritual care or counseling and are available to help students with referrals for spiritual care, spiritual direction, and counseling. 

Self-care: If this course makes you aware of sources of stress you'd like to work on with professional support, please see details about these professional services available for Iliff students: https://iliff.bloomfire.com/posts/3807145-eap-assistance-program https://iliff.bloomfire.com/posts/3807145-eap-assistance-program

 Standards: All students are expected to abide by Iliff’s statements on Academic Integrity, as published in the Masters Student Handbook.  Students should demonstrate academic and professional communication skills that include coherent expression of ideas, use of good grammar, and appropriate citation of sources referenced in responses and assignments. In this course, we use APA format for citations and references.  Iliff's writing lab has a link to suggested sites for writing resources and style guides. Use this link to find the Purdue Online Writing Lab, and their guide to APA 7 formatting.  All course participants should use inclusive language and language that respects the diversity of sexuality, gender, and sexual orientation.

Discussion posts and responses are also expected to meet these academic standards (vs. more casual standards that apply to other online conversations/emails). Please proofread assignments and discussion posts before you submit them. Seek support from the Iliff Writing Lab (Links to an external site.) as needed.

LINKED PAGE: https://iliff.bloomfire.com/posts/3807145-eap-assistance-program

If you feel like you need professional support, please know that you are eligible to receive free services from EAP (Employee Assistance Program).  All of Iliff students are enrolled in the EAP. This is a comprehensive support service that provides counseling, coaching, and thousands of other resources. Regardless of where you live, you have access to this service!  Usually, an EAP service is provided for staff and faculty in higher education, but we have extended it to Iliff students! 

 

Here is a summary of their services, and you can find all of their available services and how to access them by clicking https://iliff.bloomfire.com/posts/3807145-eap-assistance-program

 

• Individual, couples, and family tele-counseling
• Peak performance coaching
• Legal services
• Debt counseling
• Child and elder care
• Caregiver benefits
• Self-help resources
• Wellness Center
• Lifestyle benefits
• Stress assessment and services
• and more! 

[i] College and university chaplains are included in the category of Confidential Resources, which usually includes those working in the Counseling Center, Health Center, and the University Chaplain. Faculty/staff members who happen to be similarly licensed in their field (e.g., who may be accredited as professional chaplains or licensed mental health professionals). are not exempt from reporting. Student chaplains are usually mandated reporters.

Students may wish to add readings and chapters they find helpful in exploring values and beliefs. If possible, annotate your reading and the attached file with a description of how this reading was helpful. (click on "edit", add your reading and notes and then click on "save").

Requirements

1. Weekly posts and responses: class members will be expected to do the readings and reference them in weekly forums and assignments. 60% of grade
2. Mandatory Zoom Synchronous Class Sessions: Weeks 3 and 5 at 4:00-5:15 pm MT.  Note: the week 8 session has been eliminated since you'll be doing your zoom conversations then.
3. Journal assignment on a personal experience of religious/spiritual/moral struggle (20% of grade) . Due Thursday, May 6 See

   Journal Assignment Requirements, Grading, and Outline  Revised 4-1-2021

   Due Thursday, May 6  (20% of grade)  Here is a word document of this page: Journal Assignment Requirements, Grading, and Outline 4-1-2021.docx  

   Here is a sample journal assignment: Doehring_Carrie_Journal_Assignment.docx  Note: this sample journal assignment is updated from a previous version titled "Doehring Journal Assignment about Moral Stress."

   Your journal assignment and its accompanying spiritual care conversation offer learning opportunities for spiritually integrating an experience of stress that has generated religious/spiritual/moral struggles.^[i]  Using spiritual practices while you remember, reflect, write, and then later talk about your experience will be an opportunity to see whether you are able to trust the process of spiritual integration. The use of calming spiritual practices, our course readings, forum discussions, and zoom meeting, as well as the structure of this assignment, are designed to help you trust this process.

   Exploring and writing about your experience of moral stress in a structured way provides an opportunity to become more spiritually differentiated---(1) able to separate your past experiences from the present, as well as (2) able to separate your story from another’s. You will be using an intersectional perspective to understand how social advantages and disadvantages alleviated or exacerbated your moral stress. Such reflections will deepen your capacity for spiritual and social empathy of others whose experiences are similar to or different from you. Understanding how moral stress generates emotions, values, and beliefs that may be life-giving or life-limiting provides an opportunity to be spiritually reflexive.  Drawing upon your literature search and course readings will likely enhance your search for life-giving beliefs and values that help you share your experience with others in meaningful ways.  For example, when moral stress involves core aspects of who you are, especially your vocation as spiritual caregivers, this journal assignment helps you experiment with how to talk about your process of spiritual integration with a CPE educator, peers, or those endorsing your vocation.

   Your literature search for relevant research and scholarship on moral stress

   While you draft the sections of your journal assignment, you can begin your literature search for religious, theological, psychological, and cultural studies on the kind of stress/suffering you are describing (e.g., moral, religious, and/or spiritual struggles arising from COVID, racial violence, our climate crisis, complex grief, religiously based prejudice, sexual discrimination and violence, reproductive choices and loss, parental and relational struggles, etc.). Here is a guide to how to do a literature search prepared by a former Iliff librarian: How to do a literature search  This page and videos will help you identify which subject headings and key terms are most relevant for finding scholarship and research on your experience of stress/suffering. For example, if you are writing about a pandemic experience of moral stress and injury, likely key terms are moral injury, COVID, and pandemic. 

   You are required to find and quote from at least four references from a literature search in both the ATLA database and psychological databases. At least one of these four references needs to be from psychological studies. The journal Pastoral Psychology is often a helpful resource that is included in the ATLA database. Some of the articles from the journal Religions draw upon social scientific research. Keep an eye out for references to Ken Pargament’s research in reference lists of the psychological articles, chapters, and books you find in your literature search. Other references from your literature search can be used to help you explore your beliefs and values about suffering and moral stress, especially within your own religious and spiritual traditions (e.g., Christian, Jewish, Buddhist, or humanist beliefs specific to your traditions and practices).

   You will also need to quote from all relevant course readings, in order to demonstrate how you are drawing upon specialized knowledge on religious, spiritual, and moral struggles in spiritually integrating your experience.

   While APA formatting for citations and references is preferred, you may use another formatting style as long as you use it correctly and consistently. Iliff's writing lab has a link to suggested sites for writing resources and style guides. Use this link to find the Purdue OnlineWriting Lab, and their guide to APA 7 formatting.  

   The final assignment should be single-spaced and not exceed 4000 words including references. Word lengths are suggested in the sections below. Some sections may be shorter or longer, but the entire assignment should not exceed 4000 words. Please submit your assignment as a word document, so that your course faculty can download it and add comments to your word file. This enables you to save the file with their comments. Title your word file as follows: Last name_First name_Journal_Assignment: (e.g., Doehring_Carrie_Journal_Assignment)

   Please use the subheadings of the outline provided below but do not copy any of the accompanying descriptions of these sections. In listing your values, beliefs, practices, and intersecting aspects of your social identity, you may use bullet points if you wish, followed by sentences that fully describe these.

   Here is a rubric that will be used for grading this assignment:

   Demonstrates these learning outcomes:

   • Spiritual integration: demonstrates how calming practices increased your awareness of stress-based emotions, values, and beliefs during the completion of the assignment.
   • Spiritual self-differentiation: demonstrates a capacity to separate your past memories from present circumstances in a process of spiritual self-differentiation (e.g., by detailing the differences between (1) your stress-generated coping, values, and beliefs that accompanied moral stress or re-experiencing of moral stress and (2) your values and beliefs that emerge when calming practices are used.
   • Social empathy: demonstrates social perspective-taking in describing how intersecting social advantages and disadvantages shaped your experience of suffering and moral stress, and how these aspects of your social identity relate to the family/cultural values and beliefs about suffering and hope you have described in part 3 (the coping, values and beliefs generated by stress).
   • Spiritual reflexivity: uses key concepts from course readings and your literature review to develop contextual intentional values that anchor your vocation and beliefs about suffering/hope complex enough to bear the weight of your suffering.

   Fulfills these assignment requirements:

   • Includes quotations from at least four references from a literature search in the ATLA and psychological databases available through Iliff’s library.
   • At least one of the four references is from psychological studies, preferably involving research (e.g., Pargament’s research of spiritual struggles).
   • All quotations cite key concepts/findings (not tangential concepts or findings).
   • Uses consistent formatting (APA formatting preferred)
   • Word count does not exceed 4000 words

   Submission requirements:

   • Submitted as a word document
   • Word file titled: Last name_First name_Journal_Assignment

   JOURNAL OUTLINE

   Part 1. Spiritual practices (150-250 words): Describe the intrinsically meaningful body-aware calming and/or settling[ii] practices you used in working on this assignment that:

   1. Increased self-awareness of your stress-based reactions/emotions that give rise to life-limiting, socially oppressive beliefs, values, and consumer ways of coping.
   2. Increased self-compassion and spiritual trust in the process of searching for meanings about one’s stress responses and life experiences.

   Part 2. Describe a life-changing experience of moral stress that involved core values and beliefs (150 - 300 words)

   Describe a life-changing experience that was stressful and/or transformative because it involved core beliefs and values.[iii] Keep in mind that you will continue to draw upon narrative details of this experience in other sections of the journal assignment when you describe your values and beliefs.

   Part 3: Elaborate the stress/emotion-based beliefs and values, and ways of coping that arose in the immediate aftermath of this experience by answering the following questions (1000-1500 words)

   Stress-based Emotions: describe what emotions (like shame, guilt, anxiety, fear of causing harm or being judged, anger, loneliness, sadness, relief, guilt, or joy) shaped your immediate response.

   Values:

   1. Moral Foundations: Using the six moral foundations identified in moral foundations theory,[iv] identify any of these foundations that were meaningful in this experience of moral stress. Add a narrative description of whether/how each value might come from your family’s ethnic/religious/cultural identity. Assess whether/how each value was helpful in giving you a sense of purpose, or whether/how it intensified moral stress.
   2. Describe three to four relevant particular values that did or could have generated spiritual struggles/moral stress (see the shortened list of values if you have difficulty identifying what values were at stake^[v]). Add a narrative description of whether/how each value might come from your family’s ethnic/religious/cultural identity. If you are describing a recent experience, use this section to identify immediate values and beliefs and whether these came from childhood/family or from your current relationships and communities. Assess whether/how each value was helpful in giving you a sense of purpose, or whether/how it intensified moral stress.

   BELIEFS: what beliefs, particularly about suffering and hope, did you initially have about this experience? Use key readings from our course as well as from your literature search to use readings on how religious and theological perspectives have been used to understanding stress/suffering related to this aspect of sexuality. Nelson (2003) provides a helpful orientation to traditional and contemporary ways of understanding suffering and evil in theistic traditions. Assess whether/how these perspectives are relevant and meaningful or harmful.

   COPING: How did you cope? If you are describing a more recent experience, see if you can separate out ways of coping that were automatic habits from the past/childhood/our consumer culture that are often default ways of coping. Add a narrative description of whether/how such coping might be shaped by your family’s ethnic/religious/cultural identity.  Assess the pros and cons of the ways you coped.

   Part 4: How was your experience of moral stress shaped by intersecting social systems, like religious sexism, heterosexism, racism, classism, ableism….?  (200 to 300 words).

   Describe aspects of your social identity that shaped your experience by giving you social disadvantages or social advantages. See if you can identify layers from childhood: like social advantages or disadvantages that shaped your parents’ religious/spiritual existential identities in ways that helped or harmed their coping with life-changing events; and the extent to which you internalized and still experience these dynamics inter-generationally.

   Part 5. Describe the intentional beliefs and values that are energized by positive emotions like compassion, joy, gratitude, hope, or sadness experienced in spiritual practices. Your spiritual practices and these intentional values and beliefs help you integrate this experience in ways that resist/protest embedded family, cultural/religious values/beliefs/coping that perpetuates sexism, racism, classism, heterosexism, ableism, and other forms of social oppression. These intentional beliefs and values may be what you want to experience, and/or may have evolved for you over a long-term process of using spiritual practices and searching for meanings that helped you integrate this life-changing experience into your life. (1000 – 2000 words).

   Emotions (emotions that arise from life-giving coping and spiritual practices identified below):

   Spiritual practices:

   Values:

   Beliefs:

   Coping:

   References (100-200 words): Reference at least four references from your search. At least one of the four references needs to be from psychological studies. Other references from your literature search can be used to help you explore your beliefs and values about suffering and moral stress. Include also relevant course readings which you have cited.

   References for this journal outline

   Abu-Raiya, H., Pargament, K. I., Weissberger, A., & Exline, J. (2016). An empirical examination of religious/spiritual struggle among Israeli Jews. International Journal for the Psychology of Religion, 26(1), 61-79. doi:10.1080/10508619.2014.1003519

   Bradley, D. F., Uzdavines, A., Pargament, K. I., & Exline, J. (2016). Counseling atheists who experience religious and spiritual struggles. In A. Schmidt, M. Chow, P. Berendsen, & T. O’Connor (Eds.), Thriving on the edge:  Integrating spiritual practice, theory, and research.

   Haidt, J. (2012). The righteous mind: Why good people are divided by politics and religion. Pantheon Books.

   Iyer, R., Koleva, S., Graham, J., Ditto, P., & Haidt, J. (2012). Understanding Libertarian Morality: The Psychological Dispositions of Self-Identified Libertarians. PLOS ONE, 7(8), e42366. https://doi.org/10.1371/journal.pone.0042366

   Menakem, R. (2017). My grandmother's hands: Racialized trauma and the pathway to mending our hearts and bodies. Central Recovery Press.

   Nelson, S. L. (2003). Facing evil: Evil's many faces: Five paradigms for understanding evil. Interpretation, 57(4), 399-413. doi:10.1177/002096430005700405

   Pargament, K., Wong, S., & Exline, J. (2016). Wholeness and holiness: The spiritual dimension of eudaimonics. In J. Vittersø (Ed.), The handbook of eudaimonic wellbeing (pp. 379-394): Springer.

    

   [i] Religious and spiritual struggles are widespread across a range of faith orientations; for example, among atheists (Bradley, Uzdavines, Pargament, & Exline, 2016), Muslims, Jews (Abu-Raiya, Pargament, Weissberger, & Exline, 2016), as well as the general population. Pargament et al. (Pargament, Wong, & Exline, 2016) note that spiritual struggles are common and can have either life-giving or life-limiting outcomes: [note: the next three paragraphs are an excerpt from Pargament et al., 2016, pp. 387-388]

   "Spiritual struggles have to do with the most fundamental issues of life – questions of ultimate meaning, good and evil, religious doubts, intimacy, the divine, and one’s relationship with a higher power (Exline et al., 2014). These struggles are fundamentally dis-orienting; they shake people to their very core.  A number of studies have linked struggles in the spiritual domain to psychological, social, and physical signs of distress (Exline, 2013).  But distress and dis-orientation are not the end of the story. 

   As people struggle, they try to re-orient themselves to the challenges posed by internal transitions and external events.  Although popular culture has sentimentalized the value of difficult life experiences, as we hear in statements such as “no pain, no gain” and “suffering builds character,” it must be stressed that efforts to re-orient following difficult life experiences are not necessarily successful. Some people experience only pain, suffering, and brokenness through their struggles.  In this regard, higher levels of spiritual struggles have been associated with decline in immune functioning (Trevino, Pargament, Cotton, Leonard, Hahn, Caprini-Faigin, & Tsevat, 2010), increases in depression (e.g., Pirutinsky, Rosmarin, Pargament, & Midlarsky, 2011), and even greater risk of dying (Pargament, Koenig, Tarakeshwar, & Hahn, 2001).

   It is true, however, that spiritual struggles can be a source of growth and greater wholeness… Empirical studies have shown some ties between spiritual struggles and reports of growth following trauma and major life events (e.g., Gall et al., 2011; Magyar-Russell et al., 2013; Trevino et al., 2012).  We suspect this growth is manifested by shifts in orienting systems that become more whole; that is, more deeply purposive, broader and deeper, more flexible, more coherent and discerning, and more benevolent and life-affirming.  In support of this notion, Desai and Pargament (2015) compared college students following a period of spiritual struggle who experienced growth or decline.  Those who reported greater growth were able to find greater meaning from their struggle, were able to draw on more positive religious coping resources, had a more secure relationship with God, and had integrated religion more fully into their lives." (Pargament et al., 2016, pp. 387-388)

   There are three types of spiritual or religious struggles (Exline, Pargament, Grubbs, & Yali, 2014):

   • Struggles with God (e.g., questioning God’s love, feeling angry at God, feeling like God has abandoned or is punishing us because of some aspect of our sexual lives)
   • Intrapsychic struggles within us: conflicting values, ultimate meanings, and doubts about aspects of our sexuality
   • Interpersonal struggles between us and our significant others over aspects of our sexuality.

   These three kinds of religious and spiritual struggles are interconnected. For example, spiritual doubt can lead to interpersonal struggles. Interpersonal struggles lead to guilt and shame. Guilt and shame lead to fear of being punished by God and/or religious authorities/others. Fear of punishment and hell can lead to anger at God and organized religion.

   [ii] Black therapist Resmaa Menakem describes settling practices that increase awareness of body memories of systemic oppression. He draws on research in trauma to describe how memories of systemic racism are stored in our bodies.  He describes the skill of “settling one’s body” as essential for the work of socially just care. Menakem describes a simple settling practice of slowly looking over each shoulder and surveying your surroundings while paying attention to your breathing and how you experience stress in your body. This practice helps community faith leaders become aware of their own bodily memories of overwhelming stress and deepens their awareness of life threats arising from systemic oppressions. Those who have experienced sexual harassment, abuse, or assault may find that settling practices raise awareness of how body memories may be re-awakened to create a sense of pervasive threat and danger.

   [iii] As our learning covenant notes in referencing levels of self-disclosure: The purpose of self-disclosure is to develop competencies in spiritual care, especially a commitment to one’s own process of spiritual integration that enhances self-differentiation and a capacity for empathy. In deciding how to use/disclose personal experiences in assignments, students need to track their levels of stress as they work on assignments, and to not use/disclose experiences that overwhelm their capacities for self-differentiation, spiritual integration, and critical thinking skills. Students need to use their support systems when they become overwhelmed and in making decisions about what personal experiences to share in journal assignments.

   [iv] Moral Foundations Theory is described on the moral foundations website. On this page, you will also find a link to Chapter 7 in Jonathan Haidt’s (2012) The Righteous Mind.

   From https://moralfoundations.org/: “Moral Foundations Theory was created by a group of social and cultural psychologists to understand why morality varies so much across cultures yet still shows so many similarities and recurrent themes. In brief, the theory proposes that several innate and universally available psychological systems are the foundations of “intuitive ethics.” Each culture then constructs virtues, narratives, and institutions on top of these foundations, thereby creating the unique moralities we see around the world and conflicting within nations too.”

   Moral foundations theory and research can be used to help religious leaders and chaplains spiritually differentiate between their moral foundations and another’s. This research demonstrates six moral foundations that shape foundational/core values. The first three moral foundations are described as individualizing and often form the moral foundations of those who identify politically as Democrats as well as Libertarians

   Care: protect and care for the vulnerable. “Everyone—left, right, and center— cares about Care/harm, but liberals care more [and are] more disturbed by signs of violence and suffering, compared to conservatives and especially libertarians” (Haidt, 2012, p. 182). Related virtues: kindness, gentleness, and nurturance. Related emotion: compassion, anger.

   Fairness: “there are two major kinds. On the left, fairness often implies equality, but on the right it means proportionality—people should be rewarded in proportion to what they contribute, even if that guarantees unequal outcomes” (Haidt, 2012). Related virtues: justice, trustworthiness. Related emotions: Gratitude, guilt, anger.

   Liberty/oppression: “Resentment people feel toward those who dominate them and restrict their liberty. Its intuitions are often in tension with those of the authority foundation. The hatred of bullies and dominators motivates people to come together, in solidarity, to oppose or take down the oppressor” (moralfoundationstheory.org).

   Libertarian moral intuitions endorse “individual liberty as their foremost guiding principle, and weaker endorsement of all other moral principles [emphasizing] lower interdependence and social relatedness” (Iyer et al., 2012, p. 1).

   Conservative moral intuitions “sacralize the word liberty, not the word equality” (Haidt, 2012, p. 176)

   Those who identify politically as Republicans tend to give equal weight to six moral foundations: the three above and these three binding foundations with “the basic social unit [as] the family rather than the individual, and in which order, hierarchy, and tradition are highly valued” (Haidt, 2012, pp. 184-185. Liberals have ambivalence about these three moral foundations.

   Loyalty: is related to “our history as tribal creatures able to form shifting coalitions. Related virtues: patriotism and self-sacrifice for the group. It is active anytime people feel that it’s ‘one for all and all for one.’” Related emotions: group pride; betrayal

   Authority: “underlies virtues of leadership and followership, including deference to legitimate authority and respect for traditions.” Related virtues: obedience. Related emotions: respect; fear.

   Sanctity: is “shaped by the psychology of disgust and contamination. It underlies religious notions of striving to live in an elevated, less carnal, more noble way. It underlies the widespread idea that the body is a temple which can be desecrated by immoral activities and contaminants (an idea not unique to religious traditions).” Related virtues: cleanliness, chastity, temperance, piety. Related emotion: disgust; reverence/awe

   [v]

   Here are examples of values. This is a shortened list taken from Zuckoff, A., & Gorscak, B. (2015). Finding your way to change: How the power of motivational interviewing can reveal what you want and help you get there. New York, NY: Guilford Press.

   Achievement: to have important accomplishments

   Adventure: to have new and exciting experiences

   Authenticity: to be true to who I am

   Autonomy: to determine my own actions

   Belonging: to feel like a part of something

   Challenge: to take on difficult tasks and problems

   Contribution: to add something to the world

   Creativity: to have original ideas and create new things

   Dependability: to be reliable and trustworthy

   Duty: to carry out my duties and obligations

   Family: to have a happy, loving family

   Generosity: to give what I have to others

   God’s will: to seek and obey the will of god

   Growth: to keep changing and growing

   Justice: to promote fair and equal treatment for all

   Knowledge: to learn and add to valuable knowledge

   Passion: to feel strongly and live with intensity

   Purpose: to have meaning and direction in my life

   Responsibility: to make and carry out responsible decisions

   Risk: to take risks and chances

   Spirituality: to live and grow spiritually

   Tradition: to follow respected patterns of the past

   Work: to work hard and well at my life tasks

    

    

    

   Here is a word document of this page: Journal Assignment Requirements, Grading, and Outline 4-1-2021.docx
4. Spiritual care competencies will be demonstrated and assessed in conversations with your partner based on the journal assignments (one in which you give spiritual care and one in which you receive spiritual care) will be video recorded in week 8. You will follow an outline to describe what you learned about spiritual care of moral stress from developing and using a conversation guide with your partner. (5% conversation guide + 15% reflection = 20% of grade).