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The American Psychological Association (APA) recently adopted new multicultural guidelines for psychologists (Clauss-Ehlers et al., 2019). Within these guidelines, psychologists are charged with delivering culturally adaptive and strengths-based approaches to interventions. However, possibly a byproduct of the field’s reliance on Cartesianism, spirituality is often overlooked as an important area of cultural competence and ingredient in the therapeutic process. Many clinicians also receive little training in spiritual competency (Bartoli, 2007), which may decrease the likelihood a clinician will include it in the therapeutic process and possibly even lead to undervaluing this domain. Yet spirituality is consistently identified as an important resilience factor in the face of mental health challenges (e.g., see reviews Bockrath et al., 2021; Haney et al., 2020), is important to people’s lives (Vieten et al., 2013), and many clients report wanting to address it in treatment (Rose et al., 2001).

Although many definitions of spirituality exist, one most relevant to this discussion is “an aspect of a person or group dealing with a search for meaning, moral frameworks, and relationships with others, including ultimate reality” (Canda & Fuman, 1999, p. 44). Many have characterized trauma as a spiritual or soul wound (e.g., Comas-Diaz et al., 2019; Park et al., 2017; Shay, 2014), perhaps in acknowledgment of what makes trauma traumatic—the violation of trust a person can experience about right and wrong, basic goodness, safety and justice. Although certainly complex and multifaceted, perhaps one of the most critical processes of healing trauma involves meaning-making (e.g., Fischer et al., 2020; Park, 2013). Across all forms of trauma, ranging from life-threatening illness, war, sexual abuse and natural disasters, individuals must confront: How do we make sense of tragedy, harm, betrayal and loss? What does it mean that humans cause deep suffering to each other? These are inherently spiritual questions (Kusner & Pargament, 2012), regardless of whether a client practices Hinduism or nihilism.

In large part due to the recent proliferation of both moral injury and psychedelic-assisted therapies in psychology, spirituality in the therapeutic context has re-emerged as an important ingredient and approach for trauma-related healing (e.g., Griffiths et al., 2018; Coady, Hawkins, Chartoff et al., 2021; Smother & Koenig, 2018). More treatments have been developed (e.g., Harris et al., 2018; Pearce et al., 2018), competencies have been proposed (Vieten et al., 2013), and interdisciplinary treatment models pairing spiritual-psychological services have been developed (Cenkner et al., 2020). In several studies using various psychedelic-assisted therapies, participants reporting the most significant gains in reductions of posttraumatic stress disorder (PTSD), depression and anxiety were those who also reported having greater spiritual significance and personal meaning of their experiences (Cox et al., 2018; Davis et al., 2020; Griffiths et al., 2006, 2008; Williams et al., 2021). These collective findings highlight the clear link between spirituality and healing. Spirituality is too important to the psyche, the Greek root of which means soul, to continue to be left out.

About the Author

Dr. Amanda Khan is a licensed clinical psychologist and researcher specializing in the assessment and treatment of trauma sequelae. Dr. Khan is a staff psychologist at Sage Integrative Health, a Bay Area holistic psychedelic clinic. She is Co-Chair of the Moral Injury SIG for ISTSS.


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