Religious and Spiritual Struggles
Handbook of the psychology of religion and spirituality / edited by Raymond F.
Paloutzian, Crystal L. Park.
Religious and Spiritual Struggles
JULIE JUOLA EXLINE
Any core dimension of human existence has the power to yield both joy and sorrow, and the spiritual side of life is no exception. Religion and spirituality provide potent sources of comfort, direction, and meaning for many people, but they can also be sources of strain and struggle. Individuals sometimes feel angry toward God, or they feel unforgiven by God. They suffer hurts from fellow believers or witness hypocrisy among their leaders. They strive to cultivate virtue in accordance with their beliefs, but sometimes these same belief systems prompt them to condemn themselves when they fall short. Some believers see themselves as victims of supernatural attack.
The idea of religious and spiritual strain is certainly not new to theologians, clergy, spiritual directors, and religious counselors, who have a long history of expertise in these areas. Although empirically oriented psychologists are relative newcomers to this interdisciplinary conversation, their interest seems to be growing. During the past decade, scholars have turned attention to topics such as religious conflict (e.g., Nielsen, 1998; Nielsen & Fultz, 1995), negative religious coping (Pargament, Ano, & Wachholtz, Chapter 26, this volume; Pargament, Koenig, & Perez, 2000; Pargament, Smith, Koenig, & Perez, 1998; Pargament, Zinnbauer, et al., 1998), spiritual struggles and concerns (e.g., Johnson & Hayes, 2003; Murray-Swank, 2003; Pargament, 2002; Pargament, Koenig, Tarakeshwar, & Hahn, 2001; Pargament, Murray-Swank, Magyar, & Ano, 2004), religious strain (Exline, 2002; Exline, Yali, & Sanderson, 2000), spiritual risk (e.g., Fitchett, 1999a, 1999b), and spiritual injury (Lawson, Drebing, Berg, Vincellette, & Penk, 1998). This chapter highlights a few specific struggles and discuss some key challenges that each one presents.
WHY STUDY RELIGIOUS AND SPIRITUAL STRUGGLE?
Within the past several decades, researchers have produced a wealth of new studies documenting potential benefits of religious involvement for health and well-being (for reviews, see George, Ellison, & Larson, 2002; Koenig, McCullough, & Larson, 2001; McCullough, Hoyt, Larson, Koenig, & Thoresen, 2000). This pioneering research has helped to bring religiosity onto the radar screen of mainstream empiricists as a viable topic for study, and it has also prompted development of interventions that are sensitive to faith issues (e.g., Miller, 1999; Richards & Bergin, 2000; Shafranske, 1996). These represent major advances for the psychology of religion.
Yet this emphasis on religion's benefits introduces a potential problem. Casual consumers of this research might embrace a simplistic view of religion or spirituality as a panacea for life's troubles. But although people typically report more comfort than strain in their religious lives, strain is common (Exline et al., 2000; Johnson & Hayes, 2003; Pargament, Smith, et al., 1998). One study of 5,472 university students (Johnson & Hayes, 2003) revealed spiritual distress in over 25% of the sample. Furthermore, spiritual distress predicted suicidal ideation and confusion about values. A 2-year longitudinal study revealed that spiritual struggles predicted higher mortality rates in medically ill elderly patients (Pargament et al., 2001). Anger toward God has been linked with poorer recovery in medical rehabilitation settings, even with other social, psychological, and physical factors controlled (Fitchett, Rybarczyk, DeMarco, & Nicholas, 1999). Spiritual crises can also lead to shaken faith, as shown in studies of religious doubt (Altemeyer & Hunsberger, 1997; Brenner, 1980; Hunsberger, Pratt, & Pancer, 2002), apostasy (Altemeyer & Hunsberger, 1997; Holmes, 2001), and anger at God (Kampani & Exline, 2002).
According to James (1902/2002), a spiritual orientation focusing only on positive themes is incomplete, as it fails to address evil and suffering (Pargament et al., 2004). We agree, and we contend that scholarly attention to spiritual struggles is timely. It will provide greater balance to the empirical literature, and it will increase understanding of everyday spirituality. Knowledge of potential struggles may even help to inoculate seekers against later disenchantment.
Another reason to study religious and spiritual struggle is an optimistic one: such struggles may, paradoxically, enhance people's lives. Growth often occurs through suffering (e.g., Tedeschi, Park, & Calhoun, 1998). As such, neglecting problems of suffering might cause us to overlook vital sources of spiritual transformation and development (Paloutzian, Chapter 18, this volume). Within positive psychology, recent research suggests that life satisfaction is poorly predicted by simple pleasures but well predicted by engagement and meaning (Seligman, 2003). Questions about meaning arise in religious contexts, but they also arise in response to suffering (Park, Chapter 16, this volume; Park & Folkman, 1997). Responses to spiritual suffering can act as turning points, places in which faith can wither or bloom afresh. In keeping with a view of struggles as potential turning points, we suggest some key challenges associated with each type of struggle, along with ways in which interventions might address them.
FOUR TYPES OF RELIGIOUS AND SPIRITUAL STRUGGLE
Our aim is to pique interest in the struggles surrounding religious and spiritual life. Because space constraints prevent an exhaustive overview, we hold the more modest aim of discussing four types of struggles: those involving suffering, virtuous striving, perception of supernatural evil, and social strain. Also, although we include references to various cultures and religious systems, we readily acknowledge that many of our ideas and references reflect a Western, Judeo-Christian bias. This bias reflects oversampling of Western populations in research to date, and it also stems in part from our personal faith commitments and experiences. Rather than trying to be all-inclusive and risking misrepresentation of other faiths, we thought it prudent to focus primarily on the Judeo-Christian traditions about which we are most knowledgeable.
Is God to Blame? : The Challenge of Suffering
All human beings face the problem of suffering. Loved ones die. Floods and tornadoes destroy homes. Accidents, crime, and serious illness shatter the illusion of invulnerability. Acts of abuse steal childhood innocence. Yet suffering is not limited to cases of trauma. People also suffer when they experience garden-variety disappointments-when their prayers seem unanswered or when life events fail to conform to their desires. The ubiquity of suffering is well reflected in traditions such as Buddhism, where it is framed as a core part of human experience.
When faced with suffering, a natural response is to conduct anattributional search (Wong & Weiner, 1981), an attempt to pinpoint the source of suffering and the reasons behind it. Sometimes people attribute responsibility to God, in which they believe that God either caused or allowed the suffering. They may hold God partly responsible for suffering even when a human perpetrator exists, as in cases of parental divorce or abandonment, abuse, and romantic infidelity (Exline & Martin, in press). It seems likely that such attributions to God would occur primarily in faith traditions involving a personal, relational God who actively engages with individuals. It would seem more difficult (though not impossible) to attribute suffering to God if God is viewed as an impersonal energy force or an abstract figure far removed from human affairs.
Anger toward God
Attributions to God can provide consolation, particularly if people see the suffering as part of a good plan by God. But people sometimes believe that God deliberately harmed them, failed to heed their requests, or passively allowed their undeserved suffering. In such cases, people can develop intense anger and mistrust toward God (Exline & Martin, in press; Exline, Yali, & Lobel, 1999; Fitchett et al., 1999; Murray-Swank, 2003; Novotni & Petersen, 2001; Pargament, Smith, et al., 1998; Pargament, Zinnbauer, et al., 1998).
Anger toward God seems to be common, at least in the Western world. In the 1988 General Social Survey, 63% of Americans sampled reported that they sometimes felt anger toward God. When undergraduates in a recent study recalled negative events in which they believed God played a role, 50% reported that the event prompted negative feelings toward God (Exline & Bushman, 2004). Confusion and mistrust arose frequently among the students, often accompanying a conviction that God's actions were illogical or unfair (Exline & Martin, in press). These preliminary data come exclusively from U.S. samples, where Judeo-Christian beliefs continue to predominate. We are not aware of any data on the frequency of anger toward God (or gods) in samples focusing on other cultural groups or faith traditions.
Although occasional, transient anger toward God seems common, more prolonged or frequent anger has been linked with global indices of distress and poor adjustment. For example, frequent or unresolved anger toward God has been linked with low selfReligious and Spiritual Struggles 317 esteem (Pargament, Zinnbauer, et al., 1998), depression (Exline et al., 1999), anxiety (Pargament, Zinnbauer, et al., 1998), trait anger (Exline et al., 1999), poor problemsolving skills (Pargament, Zinnbauer, et al., 1998), and insecure attachment (Exline & Martin, in press; see also Hall & Edwards, 2002). Also, people are more likely to feeloffended by God if they have an inflated, narcissistic sense of personal entitlement-that is, if they see themselves as better than others and believe that their superiority entitles them to special treatment (Exline & Bushman, 2004).
Some evidence suggests that religiosity and perceived closeness to God may protect against anger toward God (Exline & Bushman, 2004). However, this same study also suggested that religiosity is associated with greater belief that anger toward God is morally wrong. This raises the question of whether individuals-perhaps especially devout believers-might be afraid to report feelings of religious doubt or anger toward God. Clinical accounts suggest that not only might people balk at admitting to others that they feel anger toward God; they might be wary about admitting such feelings to God or even to themselves (Novotni & Petersen, 2001).
Holding God responsible for negative events might not only lead to anger and distress; in some cases, such attributions may shake basic beliefs about God's existence. Problems of evil and suffering constitute a major source of religious doubt (Altemeyer & Hunsberger, 1997). In a recent study of college students, 21% of those who previously believed in God reported that their belief in God's existence decreased in the wake of a major negative life event attributed to God (Kampani & Exline, 2002). Such responses were often transient, but not always. Nine percent of students in this sample indicated that they resolved their anger by deciding that God did not exist (Exline & Martin, in press). Further analyses identified a group of conflicted unbelievers; individuals who reported strong negative emotions toward God but were not certain whether to believe in God (Kampani & Exline, 2002). These data corroborate clinical accounts ofemotional atheism (Novotni & Petersen, 2001), in which people who feel wounded by God decide that God does not exist. Even those who maintain belief may experience spiritual dryness or distress. They may see God as hidden from them (e.g., Cooke, 1998; Howard-Snyder & Moser, 2001; Yancey, 1988), leading to what Saint John of the Cross termed a "dark night of the soul" (Coe, 2000).
The ability to recover from an episode of disappointment with God has been framed as an index of healthy spiritual development (Hall & Edwards, 2002). Although empirical research on this topic is sparse, anecdotal accounts suggest that people may benefit from first acknowledging-and perhaps communicating-their negative feelings toward God (Novotni & Petersen, 2001). This might be accomplished through techniques such as prayer, writing a letter to God (Exline, 2003), or an empty chair technique (Smith, 1997). To facilitate this process of "crying out to God," those from Judeo-Christian traditions might also find it useful to meditate on holy writings written by fellow sufferers such as the Hebrew Psalmists (see Zornow, 2001, for an intervention). Before attempting such steps, however, individuals will need to decide whether they find it morally appropriate to express negative feelings toward God.
For those seeking a close relationship with God, steps may be needed to resolve negative feelings and to rebuild trust (see Murray-Swank, 2003, for an application to sexual abuse survivors). To facilitate closeness, individuals may need to reattribute events so that they are not seen as the actions of a malevolent, condemning deity (Exline & Martin, in press; Kushner, 1981). This may be a difficult task, particularly for those who have longstanding negative images of God. Tools to rebuild trust and intimacy might include prayer, imagery, and meditation on texts emphasizing positive attributes of God. Other tools may be social. Therapeutic bonds or expressions of encouragement, love, or blessing from others could help to heal spiritual wounds (Smalley & Trent, 1993). Also, to the extent that God images reflect parental images (Rizzuto, 1979), forgiving one's parents could facilitate resolution of anger toward God (Bliss, 2003).
What if the problem is not negative feelings per se, but rather a sense of God as distant, hidden, or silent? Although such perceptions might not trouble individuals who see God as an abstract force, they could greatly disturb those who desire an intimate, personal relationship with God. The sense of distance could prove distressing in itself, and it might also spread to other problems such as spiritual dryness and difficulty discerning God's will about specific situations.
When people experience distress around a sense that God is distant or hidden, they face a challenge about how to resolve or manage this sense of disconnection (see Coe, 2000). Some might benefit from experiential techniques designed to facilitate a sense of interaction with God. For example, one Christian intervention focuses on prayer as a two-way conversation, one in which individuals train themselves not only to speak to God, but also to use imagery, journaling, or reading of holy texts to "listen" to what God might say in response (Virkler & Virkler, 1986). Within Judaism, Nachman of Breslov began a practice known ashitbodedut, which encourages supplicants to speak to God as though God were one's closest friend (Shulman, 1993). Some might also choose to deepen relationships with others in their spiritual communities, with the notion that strengthening these bonds might help to facilitate a sense of connection with God as well. Another option might be to consider periods of dryness ordistance as normal seasons of spiritual life, times in which people can grow in faith, character, and wisdom even when they do not feel the presence of God (Cooke, 1998). Where possible, normalizing periods of hiddenness might comfort those experiencing spiritual dryness, especially if the alternative is to believe that God has turned away from them.
Sin, Sacrifice, and Self-Forgiveness: The Challenge of Cultivating Virtue
Virtually all religious systems denote certain rules to obey, sins to avoid, and virtues to cultivate. In some cases religious rules and rituals become an end unto themselves, blocking the personal or experiential aspects of spiritual life. In fact, many people associate the term "religion" with empty, mindless, or compulsive motivated adherence to rules and rituals that have been externally imposed by religious institutions (Hill et al., 2000; Zinnbauer, Pargament, & Scott, 1999). One reaction to this negative view of religion would be to fashion a more personal form of spirituality or ethics, a practice that is common today. Personalized forms of spirituality allow people to use their own values and preferences as a guide. They may generate their own private belief systems and ethical codes, or they might draw from established religious traditions while keeping only selected parts (Exline, 2002). Another option would be to identify with a single faith but to focus on a personal relationship with God as opposed to rules and rituals. Any of these approaches could provide some freedom from externally imposed religious laws. Yet even the most personal systems of ethics or spirituality are likely to involve moral guidelines of some sort. As such, we contend that most forms of committed religiosity or spirituality entail self-discipline as people strive to follow their guiding principles.
Attempts to cultivate virtue can translate into hard self-regulatory work as people strive to perform virtuous acts while avoiding indulgence in forbidden (but tempting) passions (Baumeister & Exline, 1999). Within theistic systems, one central struggle involves surrender or willingness to submit to God's authority (see Wallace, 2002, for a transpersonal perspective). Because surrender works directly against basic human desires for personal control, self-reliance, and freedom of choice, some will view it as a sign of weakness. Yet researchers have begun to discuss surrender as a potentially adaptive coping style (Cole & Pargament, 1999; Speer & Reinert, 1998; Wong-McDonald & Gorsuch, 2000). The challenges of surrender are well documented in the literature on 12-step groups (e.g., Hart & Huggett, 2003; Kurtz & Ketcham, 1992; Speer & Reinert, 1998). Because of its emphasis on dependence, self-sacrifice, and limited personal control, surrender is likely to be an ongoing source of struggle within theistic belief systems. Even after initial acts of surrender, committed followers may encounter continued challenges to self-interest as they continue to grow in their faith and to cultivate virtue.
Facing One's Sins
In any belief system that entails virtuous striving, people have to deal with times when they fall short. An initial challenge is simply being willing to acknowledge one's shortfalls and sins. Doing so would seem to require a sense of humility, which involves a nondefensive willingness to see the self accurately (for reviews, see Exline et al., 2004; Tangney, 2000). Religious involvement could arguably work for or against humility. On the one hand, success at cultivating virtue or adhering to the surface rules of one's religion could lead to a self-righteous pride that is the very opposite of humility (Rowatt, Ottenbreit, Nesselroade, & Cunningham, 2002). On the other hand, most major world religions denounce individualistic pride while promoting humility as a virtue (Tangney, 2000). Regardless of whether they explicitly promote humility, religious and spiritual systems often include experiences of transcendence and awe that help people to see themselves as part of a larger picture-thus fostering a sense of humility (Exline et al., 2004). Yet even with spiritual help, cultivation of humility is likely to be a struggle. Scholars list pride as one of the most deadly and insidious sins (e.g., Schimmel, 1997), one ready to rear its head whenever people are doing well in other areas.
Individuals seeking deeper spiritual commitment may also experience conflict between different parts of the self, in which a part seen as redeemed or divine wrestles against another part seen as sinful or merely human. For devout persons who strive to align their behavior with God's will, with deeply held principles, or with transcendent aspects of the self (e.g., the redeemed soul; the divine inner man), knowledge that one has sinned could yield intense pain and guilt (Kook, as referenced in Bokser, 1978). Such suffering might be heightened if people do not see any hope of doing better in the future-if they have a low sense of what we might termspiritual self-efficacy. To the extent that depression, shame, or low self-esteem could intensify such hopelessness, treatment focused on these problems could prove helpful. Another suggestion appears within Christian teaching: once people have experienced the saving grace of God through Christ, those who feel overwhelmed by their dark sides might find hope by focusing on God's power to transform them-as opposed to relying totally on themselves to perform all of the work.
For most people, simply coming to terms with their ongoing potential for sin will be difficult. But how should people respond in the wake of specific sins? On the one hand, from a moral or religious perspective, it seems crucial to accept responsibility where appropriate. Indeed, accepting responsibility is framed as one of the traditional steps to repentance within Judaism and other traditions (e.g., Schimmel, 2002). Taking responsibility for misdeeds is likely to entail feelings of sorrow, regret, and guilt, and these feelings may facilitate acts of repentance to repair damage (e.g., Baumeister, Stillwell, & Heatherton, 1994; Tangney & Dearing, 2002). If people simply shrug off their misdeeds without suffering distress or making amends, one might conclude that they are not taking their offenses seriously (e.g., Fisher & Exline, 2003; Holmgren, 1998). Yet the other extreme might pose problems as well. Even if they have made sincere attempts at making amends, some people engage in prolonged self-flagellation and rumination about their sins (Bassett et al., 1990). Those who are unable or unwilling to resolve punitive feelings toward themselves often suffer from low self-esteem, anxiety, and depression (e.g., Mauger et al., 1992). Such individuals might benefit from interventions to facilitate self-forgiveness.
For those committed to maintaining a personal relationship with God, a central goal in dealing with one's own sin might be to receive God's love and forgiveness-a process that has been empirically linked with self-forgiveness (Cafaro & Exline, 2003) and with unconditional forgiveness of others (Krause & Ellison, 2003). People might encounter a number of barriers when seeking God's forgiveness. Some barriers are purely psychological, such as perfectionism or negative self-views. Others might be more specific to religion. For example, some individuals might be unable to seek God's forgiveness-or to experientially receive it-because they believe that they have committed an unforgivable sin (Virkler, 1999). Others may see God as punitive and harsh (e.g., Benson & Spilka, 1973), which would make them reluctant to expect forgiveness from God. Seeing God as severe might lead to terror about breaking religious rules, which could lead to joyless, inhibited faith or obsessive-compulsive patterns of scrupulosity (Abramowitz, Huppert, Cohen, Tolin, & Cahill, 2002; Ciarrocchi, 1995; Greenberg, Witztum, & Pisante, 1987).
What interventions might help people receive God's forgiveness? Possible tools might include written or spoken confession (Martin & Exline, 2004; Murray-Swank & Pargament, 2001, 2003), reading holy texts about God's forgiveness, or the use of imagery or other means to listen for God's voice (Martin & Exline, 2004; Virkler & Virkler, 1986). Traditional rituals of repentance and atonement might also be helpful. For example, Roman Catholics might choose to fast, confess their sins to a priest, or recite the rosary. Jewish penitents might express repentance through the rites of Yom Kippur, the symbolic casting of sins into the river on Rosh Hashanah, or the traditionalmikvahritual involving immersion in fresh water. Penitent individuals might also make amends to those they have harmed, as in 12-step programs. However, one prior study suggests that if people believe that they have offended God, confession and making amends to others may actually not predict belief that God has forgiven the self (Cafaro & Exline, 2003). Although this finding awaits replication, it raises the possibility that atonement alone might not be sufficient. To be most effective, interventions may need to include some means by which people can find assurance of God's forgiveness.
It seems likely that desires to make peace with God will be especially relevant forthose considering their own mortality. Mortality primes lead people to seek reassurance and affirmation of their value, as suggested by terror management studies (e.g., Greenberg, Solomon, & Pyszczynski, 1997). If a happy afterlife is believed to depend on God's forgiveness, desires for peace with God should become urgent when the prospect of death is made salient.
Perceived Attacks from the Spiritual Realm: The Challenge of Supernatural Evil
For most people, the termspiritual experienceis likely to prompt images of sacred encounters: ecstatic visions, miracles, or moments when people feel united with God or the universe. Granted, most self-reports of spiritual experience are positive (Hardy, 1979). However, this is not always the case. Many believe that people can suffer attack, oppression, or even possession by evil forces such as Satan, demons, or evil spirits. Stark (1965) used the termdiabolical causationto refer to these attributions in his taxonomy of religious experience. Since that time, psychologists have paid scant attention to this particular dark alley of spiritual life.
A review of the literature reveals many case studies discussing the possibility of possession by evil spirits, often using a cross-cultural, ethnographic framework (e.g., AlSubaie & Alhamad, 2000; Brockman, 2000; Chiu, 2000). Professionals from diverse fields (e.g., medicine, anthropology, pastoral care, and mental health care) have documented strange, frightening behaviors sometimes interpreted as demonic possession. Common symptoms include a dramatic personality shift that includes bodily contortions and marked changes in behavior, facial expression, voice tone, and speech content (MacNutt, 1995). Speech might refer to the self as a specific demon or spirit, and it might include self-references using the plural term "we" instead of the singular "I." People in this state often show sacrilegious or sexual behavior that is grossly out of character. These syndromes are not entirely bound by culture, nor are they limited to persons with psychological disorders or impaired reality testing-although they do occur in psychiatric populations (see Wilson, 1998). Anecdotal accounts suggest that possession-like states may even occur in sacred settings, such as prayer sessions and religious retreats (MacNutt, 1995).
Regardless of whether they believe in demonic possession, many people do believe that supernatural forces of evil are active in the modern world. Some people attribute human suffering and sin to these forces. Although diabolical attributions are common among psychotic persons (Wilson, 1998) and those with other psychological disorders (Pfeifer, 1999), they are by no means limited to the mentally ill. One recent study revealed that although attributions to Satan were rare, they did sometimes occur for life-altering events with negative consequences (Lupfer, Tolliver, & Jackson, 1996). Other studies provide complementary results, suggesting that demonic and satanic appraisals correlate reliably with other indices of spiritual distress in nonclinical samples (e.g., Exline et al., 2000; Pargament, Smith, et al., 1998).
Controversy about Intervention
When people believe that evil forces are attacking them, the obvious challenge is to somehow find freedom from the torment. However, there is little agreement about how to accomplish this aim. First of all, individuals disagree sharply about whether supernatural evil forces exist. Sixty-five percent of Americans in the 1999 General Social Survey reported belief in the Devil (cited in Spilka, Hood, Hunsberger, & Gorsuch, 2003, p. 152). Even among those who do believe in the Devil, specific beliefs diverge considerably. Some view the Devil as an abstract evil force or a symbolic representation of human nature's dark side, while others see the Devil as a literal, active being who is deliberately wreaking havoc in the modern world (e.g., Wilson & Huff, 2001). Even those who share a belief in a literal Devil may disagree in their beliefs about the existence or power of lesser evil spirits.
Some individuals view demonic attributions or possession-like states as the result of physical processes or psychological phenomena such as somatization (Houran, Kumar, Thalbourne, & Lavertue, 2002), internalization of a bad paternal object (Ivey, 1993), or attempts to disavow responsibility (Spanos, 1989). If people believe that possession-like states can be explained through psychological or physical causes, their preferred treatments will focus on those routes. For example, if diabolical causation beliefs are seen as delusional or otherwise misguided, a likely aim would be to pinpoint social or psychological functions served by such beliefs.
On the other hand, some clinicians view demonic oppression or attack as an authentic source of emotional distress, and they argue for the importance of being able to distinguish demonically caused symptoms from more general psychological symptoms (e.g., Bufford, 1989; Friesen, 1992; Isaacs, 1987). Those who view demonic possession or attribution as authentic are likely to favor approaches focused on the spiritual realm itself. For example, people in some cultures attempt to appease evil or ancestral spirits through rituals involving sacrifice, dance, or trance states (e.g., Somer & Saadon, 2000). If they see themselves as victims of curses, they might try to mobilize supernatural forces in their favor, perhaps using magical spells or curses in the service of self-defense or counterattack. Some may even choose to side with evil forces in order to secure power for themselves, as reported in cases of Satan worship (Ivey, 1993).
In sharp contrast to the above perspectives, another approach involves viewing demons as mortal foes that must be cast out or "bound" (i.e., silenced or weakened by being subjected to God's authority). Casting out demons is the central focus of exorcism or deliverance rituals. Such rituals currently take place in many world religions, including some segments of Christianity (e.g., Rosik, 1997), Islam (e.g., Al-Subaie & Alhamad, 2000), and Judaism (e.g., Goodwin, Hill, & Attias, 1990). Although literature remains sparse, dramatic positive effects of exorcism appear in single-case accounts (Barlow, Abel, & Blanchard, 1977; MacNutt, 1995) and some empirical work on dissociative disorders (e.g., Bull, Ellason, & Ross, 1998). Yet these procedures do carry risks. For example, exorcisms are often used to treat mental illness in the Arab world, sometimes with dangerous effects (e.g., Younis, 2000). Negative outcomes have also been reported with use of exorcism in multiple personality disorder patients (Bowman, 1993; Fraser, 1993).
Even within circles that believe in supernatural evil, controversy surrounds the issueof whether deliverance ministries are an appropriate response (e.g., Rosik, 2003). Within Christianity, there is more agreement about other tools ofspiritual warfare, such as using the "armor of God" to defend against Satan (Ephesians 6:11-18). This spiritual armor includes elements such as faith, righteousness, peace, and truth, with the Bible being the primary offensive weapon. To date, we are not aware of any empirical studies focusing on these techniques.
From the Supernatural to the All-Too-Natural: Challenges of
Clearly, religious struggle does not always center on people's relationships with God or their battles against supernatural evil. In everyday life, religious problems often take more mundane forms, centering on the difficulties of interacting with other people.
Strife and Sin within Religious Communities
Individuals hurt and offend one another within religious communities just as they do in other domains of life. Some examples are dramatic, such as publicized cases of sexual abuse or financial corruption by religious authorities. Overt displays of hypocrisy, prejudice, violence, and abuse of power are likely to lead to distaste and reluctance to identify oneself with such a contaminated system. Such blatant offenses might even lead some followers to doubt the value of religion more generally (Altemeyer & Hunsberger, 1997).
In the shadows of these sensational crimes lurk ordinary ones that nonetheless do serious damage. As shown in recent studies (e.g., Krause, Chatters, Meltzer, & Morgan, 2000; Krause, Ellison, & Wulff, 1998), religious communities are not immune from the usual human tendencies toward gossip, greed, petty jealousies, turf battles, and the like. Members often disagree on central doctrines and on fine points about worship style anddress code. People may feel judged or scrutinized and can even become targets of hostility or prejudice from religious peers or leaders-a problem often reported by gays and lesbians (Schuck & Liddle, 2001).
Given the many potential areas for conflict, people in religious communities are likely to face the same challenges of "getting along" that they face in their other close relationships. They need to learn how to forgive and repent, when to trust others and when to protect themselves, and how to curb their own selfish or aggressive impulses. Furthermore, they may feel a strong need to maintain harmonious relationships with others in their religious communities because of their shared belief system. These prospects can be daunting, and the associated disagreements have been documented as a major source of religious struggle (e.g., Exline et al., 2000; Nielsen, 1998; Nielsen & Fultz, 1995; Pargament, Smith, et al., 1998; Pargament, Zinnbauer, et al., 1998).
The issues just raised areingroup problems-problems within communities. But what about cases involving outgroups, in which people do not see themselves as members of the same community? Disagreement may continue in spite of efforts on both sides, a problem that often occurs in interfaith marriages (Lehrer & Chiswick, 1993) or families in which children diverge from the faith of their upbringing (Altemeyer & Hunsberger, 1997).
Although religions vary in their degree of exclusivity, greater identification with a religious system often highlights differences between one's own group and other outgroups. Social-psychological studies suggest that these ingroup/outgroup distinctions often lead to biases favoring the ingroup (e.g., Tajfel, 1982) that may, in turn, lead to acts of discrimination or even violence. Also, to the extent that they see their group as correct, members of religious groups risk social conflict by trying to convert others (Langone, 1985).
Social-psychological research suggests that to avoid such problems, groups should focus on transcendent, common aims or beliefs in order to foster cooperation (e.g., Sherif, 1966). Yet a focus on shared beliefs might seem difficult or even misguided if one's religious system holds central tenets that oppose those of the other group. Religious affiliates might not want to compromise the purity of their faith by joining with outsiders. Also, if they believe that their fate in the afterlife is tied to ingroup membership, they may believe that they would ultimately harm outsiders by focusing on common ground rather than conversion.
Finally, people may suffer persecution if they hold unpopular religious beliefs. Persecution can take dramatic forms such as imprisonment or torture. But persecution also occurs in daily life, as when teens suffer teasing or ostracism from peers because of their religious beliefs or practices. Rejection is a powerful social force, as shown in recent research (e.g., Twenge, Catanese, & Baumeister, 2002). Some may manage threats of rejection by conforming with a majority group, while others reaffirm a sense of self-worth or belonging in other ways-perhaps by focusing on their strengths or by drawing closer to God or to like-minded others.
In their discussion of amazing apostates, Altemeyer and Hunsberger (1997) suggest that some people from religious homes turn away from their faith because, having been raised to value truth, they find their religious systems lacking in the very quality they were raised to value. Perhaps for some of these youth, disenchantment results from seeing dissonance between rosy, idealized images of religious life and the personal struggles they face. In actuality, suffering is an integral part of all major world religions. Yet in the search for converts, it may be tempting to sugarcoat the religious experience in an effort to avoid alienating potential followers. Ironically, a willingness to discuss spiritual struggles might actually help to increase commitment, as people see their spiritual concerns acknowledged and addressed in a forthright manner.
The notion that suffering may expose hidden wellsprings of strength is expressed inthe writings of Samson Raphael Hirsch, an Orthodox Jewish rabbi who writes of the roleof suffering in personal development: "Suffering forces a man back upon himself and into himself, and because he is deprived of all external help, every spark of strength which slumbers in him is called forth, all those latent resources of his nature are awakened" (Hirsch, 1837/1962, p. 38). In a world without suffering, humans have no barriers against which to press, and they risk becoming weak through their complacency. Perhaps, then, the opportunity for struggle is actually one of the greatest gifts that religion and spirituality have to offer.
- Abramowitz, J. S., Huppert, J. D., Cohen, A. B., Tolin, D. F., & Cahill, S. P. (2002). Religious obsessions and compulsions in a non-clinical sample: The Penn Inventory of Scrupulosity (PIOS).Behaviour Research and Therapy,40, 824-838.
- Al-Subaie, A., & Alhamad, A. (2000). Psychiatry in Saudi Arabia. In I. Al-Issa (Ed.),Al-Junun: Religious and Spiritual Struggles 325
- Mental illness in the Islamic world(pp. 205-233). Madison, CT: International Universities Press.
- Altemeyer, B., & Hunsberger, B. (1997).Amazing conversions: Why some turn to faith and others abandon religion.Amherst, NY: Prometheus.
- Barlow, D. H., Abel, G. G., & Blanchard, E. B. (1977). Gender identity change in a transsexual: An exorcism.Archives of Sexual Behavior,6, 387-395.
- Bassett, R. L., Hill, P. C., Pogel, M. C., Lee, M., Hughes, R., & Masci, J. (1990). Comparing psychological guilt and Godly sorrow: Do Christians recognize the difference?Journal of Psychology and Theology,18, 244-254.
- Baumeister, R. F., & Exline, J. J. (1999). Virtue, personality, and social relations: Self-control as the moral muscle.Journal of Personality,67, 1165-1194.
- Baumeister, R. F., Stillwell, A. M., & Heatherton, T. F. (1994). Guilt: An interpersonal approach.Psychological Bulletin,115, 243-267.
- Benson, P. L., & Spilka, B. (1973). God image as a function of self-esteem and locus of control.Journal for the Scientific Study of Religion,13, 297-310.
- Bliss, P. (2003).Debt-canceling: Form on forgiveness.Unpublished workshop materials, The City Mission, Cleveland, OH.
- Bokser, B. Z. (1978).Abraham Isaac Kook: The lights of penitence, the moral principles, lights of holiness, essay, letters, and poems.Mahwah, NJ: Paulist Press.
- Bowman, E. S. (1993). Clinical and spiritual effects of exorcism in fifteen patients with multiple personality disorder.Dissociation: Progress in the Dissociative Disorders,6, 222-238.
- Brenner, R. R. (1980).The faith and doubt of Holocaust survivors.New York: Free Press.
- Brockman, R. (2000). Possession and medicine in south central India.Journal of Applied Psychoanalytic Studies,2, 299-312.
- Bufford, R. K. (1989). Demonic influence and mental disorders.Journal of Psychology and Christianity,8, 35-48.
- Bull, D. L., Ellason, J. W., & Ross, C. A. (1998). Exorcism revisited: Positive outcomes with dissociative identity disorder.Journal of Psychology and Theology,26, 188-196.
- Cafaro, A. M., & Exline, J. J. (2003, March).Correlates of self-forgiveness after offending God. Poster presented at the Mid-Winter Conference on Religion and Spirituality, Timonium, MD.
- Chiu, S. N. (2000). Historical, religious and medical perspectives of possession phenomenon.HongKong Journal of Psychiatry,10, 14-18.
- Ciarrocchi, J. W. (1995).The doubting disease: Help for scrupulosity and religious compulsions. Mahwah, NJ: Paulist Press.
- Coe, J. H. (2000). Musings on the dark night of the soul: Insights from St. John of the Cross on a developmental spirituality.Journal of Psychology and Theology,28, 293-307.
- Cole, B. S., & Pargament, K. I. (1999). Spiritual surrender: A paradoxical path to control. In W. R. Miller (Ed.),Integrating spirituality into treatment: Resources for practitioners(pp. 179-198). Washington, DC: American Psychological Association.
- Cooke, G. (1998, August). Flowing with the anointing.Spread the Fire Magazine,4(4). Available online at www.tacf.org/stf/archive/4-4/feature1.html.
- Exline, J. J. (2002). Stumbling blocks on the religious road: Fractured relationships, nagging vices, and the inner struggle to believe.Psychological Inquiry,13, 182-189.
- Exline, J. J. (2003). [Letter writing: A tool to reduce anger toward God?]. Unpublished raw data.
- Exline, J. J., & Bushman, B. J. (2004).Anger toward others versus God: A comparison of predictors, consequences, and means of resolution.Manuscript in preparation.
- Exline, J. J., Campbell, W. K., Baumeister, R. F., Joiner, T., Krueger, J., & Kachorek, L. V. (2004). Humility and modesty. In C. Peterson & M. E. P. Seligman (Eds.),Character strengths and virtues: A handbook and classification(pp. 461-475). New York: Oxford University Press.
- Exline, J. J., & Martin, A. (in press). Anger toward God: A new frontier in forgiveness research. In E. L. Worthington, Jr. (Ed.),Handbook of forgiveness research. New York: Guilford Press.
- Exline, J. J., Yali, A. M., & Lobel, M. (1999). When God disappoints: Difficulty forgiving God and its role in negative emotion.Journal of Health Psychology,4, 365-379.
- Exline, J. J., Yali, A. M., & Sanderson, W. C. (2000). Guilt, discord, and alienation: The role of religious strain in depression and suicidality.Journal of Clinical Psychology,56, 1481-1496.
- Fisher, M., & Exline, J. J. (2003).Self-forgiveness: Virtue or vice?Manuscript in preparation.
- Fitchett, G. (1999a). Screening for spiritual risk.Chaplaincy Today,15(1), 2-12.
- Fitchett, G. (1999b). Selected resources for screening for spiritual risk.Chaplaincy Today,15(1), 13-26.
- Fitchett, G., Rybarczyk, B. D., DeMarco, G. A., & Nicholas, J. J. (1999). The role of religion in medical rehabilitation outcomes: A longitudinal study.Rehabilitation Psychology,44, 1-22.
- Fraser, G. A. (1993). Exorcism rituals: Effects on multiple personality disorder patients.Dissociation: Progress in the Dissociative Disorders,6, 239-244.
- Friesen, J. G. (1992). Ego-dystonic or ego-alien: Alternate personality or evil spirit?Journal of Psychology and Theology,20, 197-200.
- George, L. K., Ellison, C. G., & Larson, D. B. (2002). Explaining the relationships between religious involvement and health.Psychological Inquiry,13, 190-200.
- Goodwin, J., Hill, S., & Attias, R. (1990). Historical and folk techniques of exorcism: Applications to the treatment of dissociative disorders.Dissociation: Progress in the Dissociative Disorders,3, 94-101.
- Greenberg, D., Witztum, E., & Pisante, J. (1987). Scrupulosity: Religious attitudes and clinical presentations.British Journal of Medical Psychology,60, 29-37.
- Greenberg, J., Solomon, S., & Pyszczynski, T. (1997). Terror management theory of self-esteem and cultural worldviews: Empirical assessments and conceptual refinements.Advances in Experimental Social Psychology,29, 61-139.
- Hall, T. W., & Edwards, K. J. (2002). The Spiritual Assessment Inventory: A theistic model and measurefor assessing spiritual development.Journal for the Scientific Study of Religion,41, 341-357.
- Hardy, A. (1979).The spiritual nature of man: A study of contemporary religious experience.Oxford, UK: Clarendon Press.
- Hart, K. E., & Huggett, C. (2003).Lack of humility as a barrier to surrendering to the spiritual aspect of Alcoholics Anonymous.Manuscript submitted for publication.
- Hill, P. C., Pargament, K. I., Hood, R. W., Jr., McCullough, M. E., Swyers, J. P., Larson, D. B., &
- Zinnbauer, B. J. (2000). Conceptualizing religion and spirituality: Points of commonality, points of departure.Journal for the Theory of Social Behaviour,30, 51-77.
- Hirsch, S. R. (1962).Horeb: A philosophy of Jewish laws and observance(I. G. Dayan, Trans.). London: Sencino Press. (Original work published 1837)
- Holmes, E. R. (2001). A therapeutic model for amazing apostasy.Dissertation Abstracts International: Section B: The Sciences and Engineering,62(3-B), 1579.
- Holmgren, M. R. (1998). Self-forgiveness and responsible moral agency.Journal of Value Inquiry,32, 75-91.
- Houran, J., Kumar, V. K., Thalbourne, M. A., & Lavertue, N. E. (2002). Haunted by somatic tendencies: Spirit infestation as psychogenic illness.Mental Health, Religion and Culture,5, 119-133.
- Howard-Snyder, D., & Moser, P. (Eds.). (2001).Divine hiddenness: New essays.Cambridge, UK: Cambridge University Press.
- Hunsberger, B., Pratt, M., & Pancer, S. M. (2002). A longitudinal study of religious doubts in high school and beyond: Relationships, stability, and searching for answers.Journal for the Scientific Study of Religion,41, 255-266.
- Isaacs, T. C. (1987). The possessive states disorder: The diagnosis of demon possession.Pastoral Psychology,35, 263-273.
- Ivey, G. (1993). Psychodynamic aspects of demonic possession and Satan worship. South African Journal of Psychology,23, 186-194.
- James, W. (2002).The varieties of religious experience.Amherst, NY: Prometheus Books. (Original work published 1902)
- p. 327
- Johnson, C. V., & Hayes, J. A. (2003). Troubled spirits: Prevalence and predictors of religious and spiritual concerns among university students and counseling center clients.Journal of Counseling Psychology,50, 409-419.
- Kampani, S., & Exline, J. J. (2002, August).Can unbelievers be angry at God?Presentation at the annual meeting of the American Psychological Association, Chicago, IL.
- Koenig, H. G., McCullough, M. E., & Larson, D. B. (2001).Handbook of religion and health.New York: Oxford University Press.
- Krause, N., Chatters, L. M., Meltzer, T., & Morgan, D. L. (2000). Negative interaction in the church: Insights from focus groups with older adults.Review of Religious Research,41, 510-533.
- Krause, N., & Ellison, C. G. (2003). Forgiveness by God, forgiveness of others, and psychological well-being in late life.Journal for the Scientific Study of Religion,42, 77-93.
- Krause, N., Ellison, C. G., & Wulff, K. M. (1998). Church-based support, negative interaction, and psychological well-being: Findings from a national sample of Presbyterians.Journal for the Scientific Study of Religion,37, 725-741.
- Kurtz, E., & Ketcham, K. (1992).The spirituality of imperfection: Storytelling and the search for meaning.New York: Bantam Books.
- Kushner, H. S. (1981).When bad things happen to good people. New York: Avon Books.
- Langone, M. D. (1985). Cults, evangelicals, and the ethics of social influence.Cultic Studies Journal, 2, 371-388.
- Lawson, R., Drebing, C., Berg, G., Vincellette, A., & Penk, W. (1998). The long term impact of child abuse on religious behavior and spirituality in men.Child Abuse and Neglect, 22, 369-380.
- Lehrer, E. L., & Chiswick, C. U. (1993). Religion as a determinant of marital stability.Demography, 30, 385-403.
- Lupfer, M. B., Tolliver, D., & Jackson, M. (1996). Explaining life-altering occurrences: A test of the"God-of-the-gaps" hypothesis.Journal for the Scientific Study of Religion,35, 379-391.
- MacNutt, F. (1995).Deliverance from evil spirits: A practical manual.Grand Rapids, MI: Chosen Books.
- Martin, A. M., & Exline, J. J. (2004).Facilitating self-forgiveness through religiously oriented interventions.Manuscript in preparation.
- Mauger, P. A., Perry, J. E., Freeman, T., Grove, D. C., McBride, A. G., & McKinney, K. E. (1992). The measurement of forgiveness: Preliminary research.Journal of Psychology and Christianity,11, 170-180.
- McCullough, M. E., Hoyt, W. T., Larson, D. B., Koenig, H. G., & Thoresen, C. (2000). Religious involvement and mortality: A meta-analytic review.Health Psychology,19, 211-222.
- Miller, W. R. (Ed.). (1999).Integrating spirituality into treatment: Resources for practitioners. Washington, DC: American Psychological Association.
- Murray-Swank, A., & Pargament, K. I. (2001, October).Spiritual confession: An integrative review of the psychological literature and spiritual perspectives.Paper presented at the annual meeting of the Society for the Scientific Study of Religion, Columbus, OH.
- Murray-Swank, A., & Pargament, K. I. (2003). [An experimental study of spiritual confession]. Unpublished raw data.
- Murray-Swank, N. A. (2003).Solace for the soul: An evaluation of a psycho-spiritual intervention for female survivors of sexual abuse.Unpublished doctoral dissertation, Bowling Green State University, Bowling Green, OH.
- Nielsen, M. E. (1998). An assessment of religious conflicts and their resolutions.Journal for the Scientific Study of Religion,37, 181-190.
- Nielsen, M. E., & Fultz, J. (1995). Further examination of the relationships of religious orientation to religious conflict.Review of Religious Research,36, 369-381.
- Novotni, M., & Petersen, R. (2001).Angry with God. Colorado Springs, CO: Pion.
- Pargament, K. I. (2002). The bitter and the sweet: An evaluation of the costs and benefits of religiousness.Psychological Inquiry,13, 168-181.
- Pargament, K. I., Koenig, H. G., & Perez, L. M. (2000). The many methods of religious coping: Devel-opment and initial validation of the RCOPE.Journal of Clinical Psychology,56, 519-543.
- Pargament, K. I., Koenig, H. G., Tarakeshwar, N., & Hahn, J. (2001). Religious struggle as a predictor of mortality among medically ill elderly patients: A two-year longitudinal study.Archives of Internal Medicine,161, 1881-1885.
- Pargament, K. I., Murray-Swank, N., Magyar, G. M., & Ano, G. G. (2004). Spiritual struggle: A phenomenon of interest to psychology and religion. In W. R. Miller & H. Delaney (Eds.),JudeoChristian perspectives in psychology: Human nature, motivation, and change(pp. 245-268). Washington, DC: APA Books.
- Pargament, K. I., Smith, B. W., Koenig, H. G., & Perez, L. (1998). Patterns of positive and negative religious coping with major life stressors.Journal for the Scientific Study of Religion, 37, 710-724.
- Pargament, K. I., Zinnbauer, B. J., Scott, A. B., Butter, E. M., Zerowin, J., & Stanik, P. (1998). Red flags and religious coping: Identifying some religious warning signs among people in crisis.Journal of Clinical Psychology,54, 77-89.
- Park, C. L., & Folkman, S. (1997). Meaning in the context of stress and coping.Review of General Psychology,1, 115-144.
- Pfeifer, S. (1999). Demonic attributions in nondelusional disorders.Psychopathology,32, 252-259.
- Richards, P. S., & Bergin, A. E. (Eds.). (2000).Handbook of psychotherapy and religious diversity. Washington, DC: American Psychological Association.
- Rizzuto, A. M. (1979).The birth of the living god: A psychoanalytic study. Chicago: University of Chicago Press.
- Rosik, C. H. (2003). Critical issues in the dissociative disorders field: Six perspectives from religiously sensitive practitioners.Journal of Psychology and Theology,31, 113-128.
- Rowatt, W. C., Ottenbreit, A., Nesselroade, K. P., & Cunningham, P. A. (2002). On being holier-thanthou or humbler-than-thee: A social-psychological perspective on religiousness and humility. Journal for the Scientific Study of Religion,41, 227-237.
- Schimmel, S. (1997).Seven deadly sins: Jewish, Christian, and classical reflections on human nature. New York: Oxford University Press.
- Schimmel, S. (2002).Wounds not healed by time: The power of repentance and forgiveness.New York: Oxford University Press.
- Schuck, K. D., & Liddle, B. J. (2001). Religious conflicts experienced by lesbian, gay, and bisexual individuals.Journal of Gay and Lesbian Psychotherapy,5, 63-82.
- Seligman, M. E. P. (2003, October).Positive psychology. Keynote address at the conference Scientific Findings about Forgiveness, Atlanta, GA.
- Shafranske, E. P. (Ed.). (1996).Religion and the clinical practice of psychology. Washington, DC: American Psychological Association.
- Sherif, M. (1966).In common predicament: Social psychology of intergroup conflict and cooperation.Boston: Houghton Mifflin.
- Shulman, Y. D. (1993).The chambers of the palace: Teachings of Rabbi Nachman of Bratslav. Northvale, NJ: Aronson.
- Smalley, G., & Trent, J. (1993).The gift of the blessing. Nashville, TN: Nelson.
- Smith, R. F., Jr. (1998).Sit down, God . . . I'm angry. Valley Forge, PA: Judson Press.
- Somer, E., & Saadon, M. (2000). Stambali: Dissociative possession and trance in a Tunisian healing dance.Transcultural Psychiatry,37, 580-600.
- Spanos, N. P. (1989). Hypnosis, demonic possession, and multiple personality: Strategic enactments and disavowals of responsibility for actions. In C. A. Ward (Ed.),Altered states of consciousness and mental health: A cross-cultural perspective(pp. 96-124). Thousand Oaks, CA: Sage.
- Speer, R. P., & Reinert, D. F. (1998). Surrender and recovery.Alcoholism Treatment Quarterly, 16, 21-29.
- Spilka, B., Hood, R. W., Jr., Hunsberger, B., & Gorsuch, R. (2003).The psychology of religion: An empirical approach(3rd ed.). New York: Guilford Press.
- p. 329
- Stark, R. A. (1965). A taxonomy of religious experience.Journal for the Scientific Study of Religion, 5, 97-116.
- Tajfel, H. (1982). Social psychology of intergroup relations.Annual Review of Psychology,33, 1-39.
- Tangney, J. (2000). Humility: Theoretical perspectives, empirical findings and directions for future research.Journal of Social and Clinical Psychology,19, 70-82.
- Tangney, J. P., & Dearing, R. L. (2002).Shame and guilt. New York: Guilford Press.
- Tedeschi, R.G., Park, C. L., & Calhoun, R. G. (Eds.). (1998).Posttraumatic growth: Positive changes in the aftermath of crisis. Mahwah, NJ: Erlbaum.
- Twenge, J. M., Catanese, K. R., & Baumeister, R. F. (2002). Social exclusion causes self-defeating behavior.Journal of Personality and Social Psychology,83, 606-615.
- Virkler, H. A. (1999). Allaying fears about the unpardonable sin.Journal of Psychology and Christianity,18, 254-269.
- Virkler, M., & Virkler, P. (1986).Dialogue with God.Gainesville, FL: Bridge-Logos.
- Wallace, G. C. M. (2002). Dying to be born: A meditation on transformative surrender within spiritual and depth psychological experiences.Dissertation Abstracts International: Section B: The Sciences and Engineering,63(2-B), 1054.
- Wilson, K. M., & Huff, J. L. (2001). Scaling Satan.Journal of Psychology,135, 292-300.
- Wilson, W. P. (1998). Religion and psychoses. In H. G. Koenig (Ed.),Handbook of religion and mental health(pp. 161-173). San Diego, CA: Academic Press.
- Wong, P. T., & Weiner, B. (1981). When people ask "why" questions, and the heuristics of attributional search.Journal of Personality and Social Psychology,40, 650-663.
- Wong-McDonald, A., & Gorsuch, R. L. (2000). Surrender to God: An additional coping style?Journal of Psychology and Theology,28, 149-161.
- Yancey, P. (1988).Disappointment with God: Three questions no one asks aloud.New York: Harper Collins.
- Younis, Y. O. (2000). Possession and exorcism: An illustrative case.Arab Journal of Psychiatry,11, 56-59.
- Zinnbauer, B. J., Pargament, K. I., & Scott, A. B. (1999). The emerging meanings of religiousness and spirituality: Problems and prospects.Journal of Personality,67, 889-919.
- Zornow, G. B. (2001).Crying out to God: Prayer in the midst of suffering.Unpublished manuscript, Evangelical Lutheran Church in America
©2005 The Guilford Press
A Division of Guilford Publications, Inc.
72 Spring Street, New York, NY 10012
All rights reserved