Psychotherapy and the Mormon Faith

Transcription

1 J Relig Health (2013) 52: DOI /s PSYCHOLOGICAL EXPLORATION Psychotherapy and the Mormon Faith Stephanie J. Lyon Published online: 22 January 2013 Ó Springer Science+Business Media New York 2013 Abstract The Church of Jesus Christ of Latter-day Saints, also known as the Mormon Church, is a Christian faith with a large presence across the globe. Although Mormon doctrine suggests that faith in Jesus allows people to overcome weakness and heal from pain, Mormon people are not immune from experiencing periods of mental and emotional suffering. The deeply held religious beliefs of Mormons can influence the nature of the psychological difficulties a Mormon individual is prone to experiencing, how and when they choose to seek treatment, as well as the types of treatment that may be most beneficial. Keywords Mormon Latter-day Saints Religion Psychotherapy Psychodynamics Beliefs of Mormon People The Church of Jesus Christ of Latter-day Saints, also known as the Mormon Church, is a Christian faith with an ever-growing worldwide presence. The church has nearly 6 million members in United States and Canada, and a total of 14 million members worldwide. The Mormon Church is the fourth largest Christian denomination in the United States, out ranked only by Catholics, Southern Baptists, and Methodists (National Council of Churches 2010). Despite the sizable ranks of Mormon Church members, many people, especially those outside the geographic center of Mormonism in the Intermountain West, know little about the spiritual beliefs and practices of the Mormon people (Koltko 1992). The Church of Jesus Christ of Latter-day Saints (LDS) was established by a young American man, Joseph Smith, who is believed by church members to be the first of the modern-day prophets. LDS people believe that in 1820 a teenaged Smith was in a quandary trying to decide which church to devote himself to. He took to the woods near his home upstate New York to pray to God for an answer to his question of faith. It is believed that during this time of prayer God came to Smith in a vision and told him to restore the Church S. J. Lyon (&) Derner Institute of Advanced Psychological Studies, Adelphi University, 92 Horatio St. Apt 3i, New York, NY 10014, USA stephanie.j.lyon@gmail.com

2 J Relig Health (2013) 52: of Jesus Christ on earth rather than join an existing congregation (The Church of Jesus Christ of Latter-day Saints 2011). Mormons believe that Smith then found and translated the Book of Mormon, an ancient text written by the descendants of Jacob who were led to America from Jerusalem. This book, along with the Bible, is a holy text of the Mormon faith (Mormon Beliefs 2011). In 1842, Joseph Smith first publicly presented the thirteen main beliefs of the Latter-day Saints The Articles of Faith. These core tenets of Mormonism include a devoted faith in God and Jesus, the belief that man is punished for his sins, faith that obedience to the gospel and atonement are the paths to salvation, belief in the power of religious visions and healing through faith, conviction that the Bible and Book of Mormon are both the word of God, belief that the kingdom of heaven will be on the American continent, commitment to honoring man s law (the laws of kings, presidents, etc.), and a belief in being honest, benevolent, and in doing good works (Mormon Beliefs 2011). Mormons share many of their core beliefs with other Christian denominations; however, members of this faith hold unique convictions including the belief in an American Zion. Also, members of the LDS church believe in Eternal or Celestial Families. It is believed that these Celestial Families, Mormon families who live by the tenets of the church, will earn the special privilege of remaining together forever in heaven. Mormons also have a strong belief that people have personal testimonies, or divine purposes, that are revealed to them if they have the sincere desire. Living life in accordance with one s testimony is among the foremost responsibilities of a Mormon person (The Church of Jesus Christ of Latter-day Saints 2011). Members of the LDS faith also believe that they are the literal children of God. They see their time on earth as merely a period of incarnation in a human body, but they believe that they existed with the Father in Heaven before their earthy lives began. Time on earth is seen as an opportunity to learn the differences between good and evil, to grow more Godlike, and achieve greater perfection. Additionally, Mormon people place a very high value on free agency, which is seen as a great gift from God. Free agency allows people to learn the consequences of their actions, which then imparts the responsibility of making wise choices upon all Mormon people. Wise choices are seen as bringing people closer to godliness, and these choices are said to come with great joy for those who act in such a manner (Mormon Beliefs 2011). Furthermore, the Mormon Church also believes that its members should abstain from consuming alcohol, coffee, and tea and from using tobacco or illegal drugs. Mormons also believe in dressing modestly, and the church forbids gambling, premarital sex, and masturbation. Mormon people also believe strongly in keeping the Sabbath holy and refrain from shopping, recreation, and taking part in other leisure activities on Sundays (Mormon Beliefs 2011). Rituals are also an important component to the religious practice of Mormonism. The rituals of baptism and the Mormon marriage ceremony known as sealing are two of the most essential rituals of the religion. Additionally, adult members of the Mormon Church who are deemed worthy receive an endowment which involves participating in a series of rituals within the temple that provide the individual the knowledge of how to enter the Celestial Kingdom after death. It is during the endowment ritual that Mormon people are given the sacred temple undergarments that are to be worn day and night as a way to keep the temple close to them in body and in mind (Mitchell and Mitchell 2008). Although the Mormon Church is a large and continually growing group, there exist pervasive misunderstandings about the religion, most notably the association between Mormonism and the practice of polygamy. Early in the establishment of the LDS Church

3 624 J Relig Health (2013) 52: during the nineteenth century, a belief in polygamy was a defining characteristic of the faith. However, the twentieth century found the Mormon Church seeking greater assimilation and acceptance within American culture which led to an adamant rejection of polygamy. Presently, the practice of polygamy is limited to sects of Mormon fundamentalists which the mainstream Mormon Church disapproves of and seeks distance itself from (White and White 2005). Psychological Well-Being and the Mormon Faith Although the LDS church suggests that faith in Jesus allows people to overcome weakness, heal from pain, and find peace, Mormon people, like all people, may experience periods of mental and emotional suffering. Latter-day Saints are not immune to experiencing the depression and anxiety that affects a large portion of the general population at some point during their lives. Nor are they free of phobias, psychoses, manias, or character disorders. However, because religion can have a major influence on character development, living a Mormon life may influence how psychopathology is expressed within this population. Furthermore, deeply held religious beliefs can have a heavy hand in determining the nature of the mental and emotional conflicts a Mormon individual is prone to experiencing. The LDS church places a high value on certain personality characteristics and encourages that these characteristics be cultivated by members of the church. Some of these traits include industriousness, the careful use of time, restraint of aggression, control of temper and sexual impulses, and compulsive performance of religious and personal duties. This constellation of ideal traits can encourage Mormon people to be rigid, structured, ritualistic, and overly restrained in their way of approaching the world. While these traits may make an individual a more highly valued church member, these same traits could also easily become pathological. It has been suggested that the expectation of constant activity and the weighty demands of the church can serve to legitimize obsessive compulsive behavior in Mormon people (Payne 1980). Members of the LDS community are also often encouraged to be perfectionistic and are therefore prone to the disappointment that follows when one inevitably fails to attain perfection. This proclivity for perfectionism can be seen in the Mormon belief that people are of the same race as God, but merely in a different stage of development. This belief known as the doctrine of eternal progression suggests that through faith and devotion on earth, people can attain greater perfection and grow closer to their God-like nature. While the idea that each person is God-in-embryo can provide a great sense of purpose to a Mormon person, it can also lead to a great deal of shame because any identified flaws are viewed as personal defects, compromising one s potential for godliness (Koltko 1991). Feelings of guilt and self-condemnation are also difficulties likely to impact the emotional and psychological experience of Latter-day Saints. Mormonism is a religion that imposes rigid rules of conduct, and straight and narrow ways to approval from God, [which] is bound to make guilt a major issue for Mormon people (Moench 1985). With so many behavioral prohibitions and moral imperatives, Mormons are almost certain to experience temptation to engage in acts that are seen as sinful, including premarital sex, masturbation, or consumption of alcohol. These temptations may lead to self-doubt and inner turmoil in a Mormon person taught to walk a strict and righteous path and act in a godly manner. Furthermore, because of the high worth the church places on free agency, Mormons typically feel that they are totally responsible for all their actions and

4 J Relig Health (2013) 52: feelings an attitude which when taken to extremes can results in despair, depression, and inaction bordering on paralysis (Koltko 1991). There are also certain pressures and responsibilities thrust upon Mormon people, including the pressure to enter into a heterosexual marriage with a fellow Mormon and produce offspring. It is a central belief of Mormon people that only a marriage celebrated in the temple qualifies as a celestial marriage and that only these marriages will last both in this life and throughout eternity (Koltko 1991). The only marriages that can take place in the temple, and thus become everlasting according to LDS beliefs, are marriages between two faithful Mormon people, one a man and one a woman. Because of the importance placed on celestial marriage, a Mormon person may feel extreme pressure to deny any romantic or sexual feelings for members of the same sex and even feelings directed toward those of the opposite sex who are outside the Mormon faith. Rejection and denial of these feelings could be a major source of conflict for Mormon people. Furthermore, the desire to preserve the celestial family may lead Mormon individuals to feel a great pressure to stay in unfulfilling or even abusive marriage. Pressures related to marriage and family can be particularly trying for single Mormon women over the age of thirty. Marrying and having children is part of the plan laid out for the majority of Mormon women when they are very young, yet fulfilling this plan becomes more unlikely for a single Mormon woman with every passing year. Largely because single adult males tend to withdraw from the Mormon faith, for every 100 actively church-going Mormon females over the age of thirty there are only 19 active Mormon males (Goodman and Heaton 1986). Therefore, it is not unusual for single Mormon women over thirty to experience feelings of hopelessness about their romantic futures. These women may also be likely to experience high levels of anxiety, sadness, or shame in regard to not fulfilling their expected role as a Mormon woman. The prospect of exploring romantic relationships with a non-mormon man can be very difficult for a Mormon woman taught that a temple marriage is a higher form of union than any alternative. In addition to the restrictions placed on marriage, the Mormon Church also dictates what types of sexual behaviors are appropriate for people to engage in. Unlike some other conservative Christian faiths, LDS people do not believe that sex is inherently sinful or reserved only for the purpose of procreation. In fact, Mormons believe that sexuality has an aspect of divinity to it and is therefore part of the progression to godliness (Koltko 1991). Despite this, there are still many aspects of sexual life that Mormon people are taught to abstain from. Auto-erotic activity and homosexuality are strictly prohibited, as is sex outside of marriage. Within marital sex, Mormons are taught that some sexual positions and activities are appropriate and others are impure. This long list of sexual prohibitions, coupled with the fact that Mormons are discouraged from talking openly about sexual matters, can likely manifest in feelings of guilt, shame, and confusion around issues of sexual desire and expression. As is true of members of any religious faith, Mormon individuals may at times question their religious convictions and doubt their beliefs. Questions of faith have the potential to be a major source of anxiety for a Mormon person because a fear about the stability of your testimony is a fear about the stability of something as central as the way you deal with reality (Koltko 1992). Just as the values encouraged by religious faith can impact the particular difficulties people face, religion can similarly influence the use of defenses against psychological conflicts (Apolito 1970). One defense encouraged by the Mormon values system is a manic type of denial or avoidance. This can be seen in the constant flurry of goal-driven activity inherent in the Mormon lifestyle. If a person can fill every moment with some activity, he

5 626 J Relig Health (2013) 52: will not feel anxious, depressed, or empty. But the temporary nature of the solution is apparent during a lull when [negative] feelings come flooding back (Payne 1980). The obsessional traits commonly employed by Mormons can serve a similar purpose, because meticulous concern for minor detail, for the trivia of life, allows one to avoid life s major issues and thus remain free from the negative emotions associated with confronting such issues (Moench 1985). In addition to manic and obsessional denial, the hyper-religiosity exhibited by many LDS church members can be seen as a type of intellectualized defense. Mormons feel that their religion has comprehensive explanatory powers, [therefore] some Mormons describe their problems in religious terms rather than acknowledge their emotions (Koltko 1991). Additionally, it is likely that any anxiety rooted in questions about one s religious conviction would be strongly defended against through the use of denial and an ever deepen commitment to the church through reaction formation. All of the major defensive patterns employed by Latter-day Saints serve to distance the Mormon person from his or her emotions through a discouragement of introspection. Challenges in the Treatment of Mormon People There is a very substantial bridge that must be crossed before psychotherapy with a Mormon patient can begin, because there are many barriers that may prevent a Mormon from seeking treatment even when he or she may be in great need of assistance. Latterday Saints consider their gospel to be a comprehensive guide to happiness in this life and the next (Koltko 1991). Therefore, by acknowledging sadness or dissatisfaction with life, a Mormon person may feel as if he or she is not living faithfully enough. Furthermore, patients who have been promised in blessings that they will recover from illness, if they exercise faith, worry that to turn then to [outside sources] for treatment would be a denial of faith in the efficacy of the blessing or the Lord s power to heal (Moench 1985). When seeking treatment from a professional is pitted against religious devotion, as it often is for Mormons, it may take a great deal of suffering before a Mormon person makes the difficult choice to seek therapy. If a Mormon person is able to acknowledge that he or she is in need of counseling or support, it is unlikely that the first step would be to reach out to a psychologist, psychiatrist, or psychoanalyst. Many Mormons believe that their counseling needs can be adequately met by members of the Mormon priesthood authority. Mormons believe that these men are entitled to receive revelation from God on behalf of the members under their stewardship and are therefore appropriate sources of guidance (Koltko 1992). Even when Mormons do feel that they could benefit from psychotherapy, devotion to the church may let them be persuaded otherwise. Mormon obedience to church authority can mean that patients delay needed psychiatric treatment because their personal physician or bishop recommends against it (Moench 1985). The Church of Jesus Christ of Latter-day Saints has a long history of suspicion and disapproval of the field of psychology. Psychotherapy was long seen as a tool used to lead people away from the church that, along with the study of philosophy, was identified as the Church of the Devil. This negative appraisal continued for a many years, exemplified by the fact that and there were nearly no Mormons trained to be psychotherapists until the late 1950s. Brigham Young University, the academic seat of the Mormon faith, began grating Doctoral degrees in Psychology in 1958 in an effort to train LDS therapists to work within

6 J Relig Health (2013) 52: the LDS community (Swedin 2000). Since that time, the field of psychology has become gradually more accepted by the Mormon community. In the event that a member of the LDS church does decide to begin therapy, there are many unique challenges that both the therapist and the patient may face, particularly in regard to transference and counter-transference. Personal beliefs and values are likely to influence both parties assessment of the other, and feelings of skepticism and superiority are likely to arise. For example, due the patriarchal nature of Mormon culture, the therapist patient gender dynamic may be particularly salient when working with Mormon clients (Koltko 1991). The specific transferential issues this could bring up would vary depending on the therapist and patient s respective genders. Overall, however, it is likely that Mormons of both genders would be more resistant to working with a female therapist and may be overly deferential and obedient to a male therapist. Another particular challenge of treatment with a Mormon patient is the issue of the therapist s own religious convictions, or lack there of. A good deal of the Mormon bias against psychotherapy has roots in the fact that the field has long been seen as an atheistic tradition beginning with Freud, who publicly declared himself an atheist (Apolito 1970). Because of this, many Mormon s see psychoanalytic treatment in particular as based on an amoral values system that is fundamentally out of alignment with their own (Swedin 2000). If, in the course of the therapeutic relationship, the therapist chooses not to disclose his or her own religious views, it may be particularly difficult to build a working alliance with a Mormon patient. In these cases, the patient may expend a great deal of psychic energy speculating about the therapist s beliefs or wondering what the therapist thinks and feels about LDS beliefs. When a Mormon patient is working with a non-mormon therapist, there may indeed be problematic counter-transferential feelings. An atheistic or merely non-lds therapist may have difficulty accepting a Mormon patient s religious and moral convictions as valid, and similarly, the patient may feel judged and misunderstood by a therapist who does not share his or her deeply held values. These questions may be more emotionally charged than other transferential issues, but they can be viewed as similar to other types of curiosity that the patient has about therapist, and can be handled as such. Another difficulty a therapist may face in working with devout Mormons is how to distinguish extreme religious beliefs from psychotic symptoms, because the line between religious thought or behavior and mental disorder is sometimes thin (Moench 1985). Specifically, Mormon people hold a strong belief in the power of personal revelations. These revelations may seem like hallucinations or delusions to those who do not hold the same religious convictions. Therefore, many Mormons are reluctant to discuss these occurrences with the typical therapist because Mormons (like others) do not wish a sacred part of their lives to be considered a sign of mental illness (Koltko 1991). This provides a challenge to non-mormon therapists working with Mormon clientele. A therapist must respect the religious convictions of their clients and validate religious experiences, yet be careful not to excuse a behavior that may be indicative of psychosis as religious experience. Therapeutic Approaches in Working with Mormon Clients Although many Mormon people may be resistant to psychotherapy as a whole, some approaches to therapy are more well received than others when working with this population. Among the LDS community, there seems to be a bias in favor of cognitivebehavioral treatments over both psychodynamic and psychopharmacological approaches to

7 628 J Relig Health (2013) 52: treatment. One reason for this preference is resistance many LDS people feel toward looking inward and seeking to deeply know the self. Furthermore, Mormons have a relatively low tolerance for ambiguity and paradox; they seem leery of the existence of conflicting unconscious motives and drives (Koltko 1991). This belief is in direct conflict with the foundations of psychodynamic modalities of treatment. Another reason that, for many Mormon patients, action-oriented therapy may be more comfortable than an insight-oriented approach is that Mormons are comfortable with the notion that one must do something to make progress and see change. Mormons prefer therapeutic modalities which seem to emphasize the exercise of agency by focusing on conscious thought and overt behavior (Koltko 1991). This importance placed on action and agency is a reason why Mormons also have difficulty acknowledging any potential benefits that may be obtained through psychopharmacology. Additional evidence for this preference can be found in the fact that most Mormon therapists identify themselves as using a cognitive-behavioral approach (Richards and Potts 1995). Although cognitive-behavioral approaches to therapy may seem more appealing to most potential LDS clients, psychodynamic and psychoanalytic treatments are not without value for this population. The psychodynamic technique of working surface-to-depth could be used to slowly ease a Mormon client into a deeper exploration of the self, just as it could with a non-mormon client. There are also several practices familiar to Mormons and even advocated by the church that can help therapy patients become more inwardly oriented. These practices include writing in journals and practicing meditation (Koltko 1991). A good therapeutic alliance and psychoeducation may be among the most important aspects in treating a Mormon patient in psychodynamic therapy. It is essential that a therapist not only be aware of his or her own religious biases but also open to understanding the beliefs central to the Mormon client s religious convictions in order to build a strong working alliance (Koltko 1990). Furthermore, a therapist working with this population would be wise to explain the potential benefits to be obtained by looking inward, including that greater insight can help a person learn from his or her mistakes, as this ability is highly valued by most Mormon people. Additionally, emphasizing that seeking to understand the self through psychotherapy is a type of work, or a way of exercising one s of free agency, may be particularly well received by members of the LDS community. Critique of the Existing Literature Mormonism is an evangelical Christian religion that has been defending itself against the loud voices of critics since its inception. Mormon people are often very involved in their religion and seek to educate and convert non-believers through their devotion to missionary work. It is important to note that the literature on the relationship between the Mormon faith and psychology has been written almost exclusively by Mormon psychotherapists and published in Mormon journals (Journal of the Association of Mormon Counselors and Psychotherapists and Dialogue: A Journal of Mormon Thought). This fact has undoubtedly contributed to a bias in the literature that affirms the existing negative views of atheistic psychotherapy and bolsters the positive views of more faith-based approaches to mental health. For example, a review of papers published in the Journal of the Association of Mormon Counselors and Psychotherapists shows that Mormon psychotherapists are overwhelmingly interested in avoiding personal dissonance or compartmentalization between what

8 J Relig Health (2013) 52: they do in therapy and the religion they practice (De Hoyos and De Hoyos 1982). By espousing this belief, Mormon psychotherapists may be overlooking potentially beneficial secular treatments for their patients. When religion and psychotherapy are as enmeshed as they are in the Mormon community, it is difficult to look objectively at how faith and psychotherapeutic treatment mutually influence each other. Just as the literature written by practicing Mormon psychotherapists is likely to be biased, the few papers written on the topic by non-mormons are equally likely be skewed, but in the opposite direction. Some psychotherapists look upon atheism as an earmark of scientific superiority, and upon religious worship as an atavism left over from primitive magic or animism (Zilboorg 1958). Some professionals may feel inclined to try to convince religious people of the inadequacy of the faith-based therapy options and may regard religious convictions as nothing more than delusional thinking. When it comes to psychotherapeutic treatment of deeply religious people, including members of the Mormon Church, there is a delicate balance to be struck between a blind acceptance and complete rejection of faith. Just as knowledge about a patient s childhood experiences, biological predispositions, and close relationships contribute to the therapist s understanding of the whole person, religious faith has a profound impact on who a Mormon person is in the world. An understanding of the values of the LDS church, the common difficulties Mormon people may face, and the depth of the individual s religious convictions are essential components in the successful psychotherapeutic treatment of a Mormon client. References Apolito, A. (1970). Psychoanalysis and religion. American Journal Psychoanalysis, 30, 115. Catholics, Mormons, and Assemblies of God growing; Mainline churches report a continuing decline. (2010). News from the National Council of Churches. Retrieved December 4, 2011, from De Hoyos, G., & De Hoyos, A. (1982). The Mormon psychotherapist: A synthesis. Journal of the Association of Mormon Counselors and Psychotherapists, 8(3), Goodman, K. L., & Heaton, T. B. (1986). LDS Church members in the US and Canada: A demographic profile. Journal of the Association of Mormon Counselors and Psychotherapists, 5(1), Koltko, M. E. (1990). How religious beliefs affect psychotherapy: The example of Mormonism. Psychotherapy, 27(1), Koltko, M. E. (1991). The psychological foundations of the Mormon client in counseling and psychotherapy. Journal of the Association of Mormon Counselors and Psychotherapists, 17(1), Koltko, M. E. (1992). Latter-day myths about counseling and psychotherapy. Dialogue: A Journal of Mormon Thought, 25(4), Mitchell, J. P., & Mitchell, H. J. (2008). For belief: Embodiment and immanence in Catholicism and Mormonism. Social Analysis, 52(1), Moench, L. A. (1985). Mormon forms of psychopathology. Issues in Religion and Psychotherapy, 11(1), Mormon Beliefs. (2011). Mormon Beliefs. What Mormons believe about Jesus Christ, Bible, Book of Mormon, and more. Retrieved December 4, 2011, from Payne, M. (1980). The obsessive-compulsive Mormon. Dialogue: A Journal of Mormon Thought, 13(2), Richards, P. S., & Potts, R. W. (1995). Using spiritual interventions in psychotherapy: Practices, successes, failures, and ethical concerns of Mormon psychotherapists. Professional Psychology: Research and Practice, 26(2), Swedin, E. G. (2000). Psychotherapy in the LDS community. Journal of the Association of Mormon Counselors and Psychotherapists, 25(1),

9 630 J Relig Health (2013) 52: Testimonies. (2011). The Church of Jesus Christ of Latter Day Saints. Retrieved December 9, 2011, from White, O. K, Jr, & White, D. (2005). Polygamy and Mormon identity. The Journal of American Culture, 28(2), Zilboorg, G. (1958). Freud and religion. A restatement of an old controversy. London: Geoffrey Chapman.