Religion and Coping:
The Current State of Knowledge
Kenneth I. Pargament
Department of Psychology
Bowling Green State University
Presentation to
Conference on Research in Faith and Health in Secular Society
Odense, Denmark
May 17, 2010
Coping with 9/11
 Schuster
et al. (2001)
 90% of national sample of Americans sought
solace and support from religion and spirituality
Most Frequent Method of Coping
 Conway
(1985-1986)
 Black and white elderly women with medical
problems
 Prayer was most frequent method of coping
 Prayer was more common than resting, seeking
information, prescription drugs, or going to a
physician
Reasons for the Religion Gap
 Irreligiousness
Professionals
among Health
Reasons for the Religion Gap

Irreligiousness among psychologists
 Anti-religiousness
among psychologists
Signs of Anti-Religiousness
[Religion
works by] “distorting the
picture of the real world in delusional
manner. . . By forcibly fixing
[adherents] in a state of psychical
infantilism and by drawing them into a
mass-delusion” (Freud, 1930/1961).
Signs of Change
* Prior to 1997, 200 empirical studies on religion
and coping
* After 1997, over 1000 empirical studies on
religion and coping
What Have We Learned?
 Religion
is directed to many significant ends
 Religion takes many forms in coping
 Religion adds a distinctive dimension to coping
 Religion can be helpful and harmful in coping
 Religion can be integrated into treatment
A Definition of Religion
(Pargament, 1997)
 Religion
is a search for significance in ways
related to the sacred
A Definition of Religion
(Pargament, 1997)
 Religion
is a search for significance in ways
related to the sacred
 Search
Religion as a Search
 Pathways
 Belief
“The Four Noble Truths of Buddhism”
Life means suffering
The origin of suffering is attachment
The cessation of suffering is attainable
There is a Path to the cessation of suffering
Religion as a Search
 Pathways

Belief
 Practice
The Practice of Prayer
Religion as a Search
 Pathways


Belief
Practice
 Relationships
A Convoy over the Lifespan
Religion as a Search
 Pathways



Belief
Practice
Relationships
 Experiences
Sacred Emotions:
Awe
Sacred Emotions:
Gratitude
Sacred Emotions:
Love and Compassion
A Definition of Religion
(Pargament, 1997)
 Religion
is a search for significance in ways
related to the sacred

Search
 Significance
A Definition of Religion
(Pargament, 1997)
 Religion
is a search for significance in ways
related to the sacred


Search
Significance
 Sacred
Sacred Core
God
Divine
Transcendent
Reality
Sacred Ring
Place
Meaning
Sacred Core
God
Divine
Soul
Transcendent
Reality
Children
Marriage
Nature
Time
Sacred Ring
Place
Meaning
Sacred Core
God
Divine
Soul
Transcendent
Reality
Children
Marriage
Nature
Time
Manifestations of God in People
“God has a deep raspy voice – God is a jazz singer. She is
plush, warm, and rosy – God is a grandmother. He has the
patient rock of an old man in a porch rocker; He hums and
laughs, he marvels at the sky. God coos at babies – she is
a new mother. He is the steady, gentle hand of a nurse,
the cool reassurance of a person pursuing his life’s work,
and the free spirit of a young man wandering only to live
and love life” (McCarthy, 2006).
Sacred Qualities
 Transcendence
 Boundlessness
 Ultimacy
What Makes Religion Religious?
 The
sacred can be embedded in religious pathways
 The sacred can be embedded in the most
significant goals and strivings
(1) Religion is Directed to Many
Significant Ends
 Religion
as a source of meaning
Clifford Geertz on
Religion and Meaning
“The effort is not to deny the undeniable – that there
are unexplained events, that life hurts, or that rain
falls upon the just – but to deny that there are
inexplicable events, that life is unendurable, and
that justice is a mirage” (pp. 23-24).
Park and Folkman on
Religion and Meaning
 Religion
attempts to help people reconcile
questions of meaning raised by stressful situations
with the global sense of meaning in life.
Religion and Meaning:
The Words of One Mother
 “They
say there’s reasons for God to do everything
you know. I think that’s very true because I think I
love him (second child, born after the death of the
first child) a lot more now than I would have had
our first son been here” (Gilbert, 1989, p. 10).
Murphy, Johnson, and Lohan
(2003)
 138
parents who suffered violent death of
adolescent/young adult
 Religious coping predicted finding greater
meaning in child’s death five years later
(1) Religion is Directed to Many
Significant Ends

Religion as a source of meaning
 Religion
as a source of identity and community
Durkheim on
Religion and Community
“The idea of society is the soul of religion” (1915,
p. 433).
Religion and Community:
The Words of a Bereaved Priest

Anxiety-Reduction
Meaning

Community

"The funeral was astounding. . . The whole church, everybody
was there. Many, many friends were there. Students from
here, and the liturgy was a real experience of the resurrection.
It was terrific. My blind niece played the piano. . . And my
best friend David gave the homily. . . So there were so many
powerful spiritual expressions and family expressions. It is
hard to separate one from the other."
Wink, Dillon and Larsen (2005)
 1920’s
longitudinal study of San Francisco Bay
sample
 Greater involvement in religious institutional life
buffered effects of poor physical health on
depression
 Religious involvement provides church-based
support and sense of personal identity
(1) Religion is Directed to Many
Significant Ends


Religion as a source of meaning
Religion as a source of identity and community
 Religion
as a source of emotional comfort
Young (1926)
 Content
analysis of 3000 Protestant hymns
 One third dealt with theme of comfort by a loving,
protecting God
Religion and Comfort:
A Mother at the Bedside of her Ill Child
“It was almost like someone had thrown a soft
blanket over me. . . I felt a tremendous sense of
peace. . . I tell people I have felt the peace of
Christ.”
(1) Religion is Directed to Many
Significant Ends



Religion as a source of meaning
Religion as a source of identity and community
Religion as a source of emotional comfort
 Religion
as a source of impulse control
 Religion as a source of efficacy
 Religion as a source of personal transformation
(1) Religion is Directed to Many
Significant Ends






Religion as a source of meaning
Religion as a source of identity and community
Religion as a source of emotional comfort
Religion as a source of impulse control
Religion as a source of efficacy
Religion as a source of personal transformation
 Religion
as a source of spirituality
Religion and
the Search for the Sacred
“It is the ultimate Thou whom the religious person
seeks most of all” (Paul Johnson, 1959, p. 70).
Religion and the Search for the Sacred
9 year old boy:
“I’d like to find God! But He wouldn’t just be there,
waiting for some spaceship to land! He’s not a
person, you know! He’s a spirit. He’s like the fog
and the mist. . . I should remember that God is
God, and we’re us. I guess I’m trying to get from
me, from us, to Him with my ideas when I’m
looking up at the sky!” (Coles, 1990)
(2) Religious Coping
Takes Many Forms
Who (self, couple, family, friends, co-workers, clergy,
congregation, God)
 What (prayer, meditation, bible, ritual, media, music,
relationships)
 When (acute stressor, chronic stress, daily hassles)
 Where (private, public, nature)
 Why (meaning, community, comfort, spiritual)
 How (specific methods of religious coping)

Active Religious Surrender:
A 60-Year Old Woman with Schizophrenia
“I have no motivation to do anything, so I pray; I
offer my suffering to Jesus. This gives me strength
and comfort to do things” (Mohr, 2006).
Divine Struggles
 “I’m
suffering, really suffering. My illness is
tearing me down, and I’m angry at God for not
rescuing me, I mean really setting me free from my
mental bondage. I have been dealing with these
issues for ten years now and I am only 24 years
old. I don’t understand why he keeps lifting me
up, just to let me come crashing down again”
(undergraduate dealing with bipolar illness).
Factor Analysis of Religious Coping Styles
Item
Deferring
Self-Directing
Collaborative
I do not think about solutions to my problems because
God provides them for me
.78
-.05
.06
When a situation makes me anxious, I wait for God to take
those feelings away
.69
.09
.00
When I feel nervous or anxious, I calm myself without
God’s help
.01
.70
-.03
When faced with a decision, I make the best choice I can
without God’s involvement
.05
.70
-.19
Together, God and I put my plans into action
.00
.04
.80
In solving problems, I work hard at them knowing
God is working right along with me
.06
-.06
.70
Nature as a Sacred Resource
(Ahmadi, 2006)
o
“Whatever happens in the world to me or others, nature
is still there, it keeps going. That is a feeling of security
when everything else is chaos. The leaves fall off, new
ones appear, somewhere there is a pulse that keeps
going. The silence, it has become so apparent, when
you want to get away from all the noise. It is a spiritual
feeling, if we an use that word without connecting it to
God, this is what I feel in nature and it’s like a powerful
therapy” (p. 134).
Who Says We’re Not a Science?
C.R.C.
Y2
C.P.S
Y1
.87

Collaborative
Religious
Coping
.83*
 x11
.93
2
.12*
2
P sy chosocia l
Competence
21

.48*
21
y32
D.P .S.
Y3
* p < .05
.27*
- .57
 32
Def err ing
Religious
Coping

3

5
.77

BAPC
Y6
.40*

6
.40*
.72*

.74*
y53
y63
.85
** p < .10
.51*
 31
.94*
 x21
S- E
Y5
.64**
 11
I ntrinsic
Religiousness
Feagin
X
y21
.32*
1

.22*
Hoge
X
.61*
y11
1
.14*
2
.62**
1
.25*
.60*

y42
D.R.C.
Y4
.65*

4
.86*

y73
Trust
Y7
.84*

7
The RCOPE:
Positive Religious Coping Methods
 Seeking
spiritual support
 Benevolent religious reappraisals
 Active religious surrender
 Seeking help from clergy or members
 Religious forgiveness
 Giving spiritual support to others
 Collaborative religious coping
The RCOPE:
Religious Struggles
Anger at God
 Feeling punished by God
 Demonic reappraisals
 Anger at congregation or clergy
 Religious conflict with others
 Internal spiritual questions and doubts
 Conflicts between higher and lower self

(3) Religion Adds A Distinctive
Dimension to Coping
Spiritual Meditation among Patients
with Vascular Headaches
(Wachholtz & Pargament, 2005)


83 college students with vascular headaches according to criteria of
the International Headache Society (1988)
Random assignment to four groups






Spiritual Meditation (e.g., “God is peace,” “God is joy” )
Internally Focused Secular Meditation (“I am content,” “I am joyful”)
Externally Focused Secular Meditation (“Grass is green,” “Sand is soft”)
Progressive Muscle Relaxation
Practice technique 20 minutes per day for four weeks
Assess changes in headache frequency, pain tolerance, affect,
headache control efficacy
Headache Occurrence Prior to and during the
Intervention
15
14
Headaches
13
12
GROUP
11
Spiritual Meditation
10
Internal Secular
9
Exter nal Meditation
8
Relax ation
1
2
Time
Diary Analyses of Headache Occurrence by Group and Time
2.2
2.0
Headaches
1.8
1.6
GROUP
1.4
1.2
Spiritual Meditation
1.0
Internal Secular
ay
ay
ay
ay
0
-3
26
5
-2
21
0
-2
16
5
-1
11
5
1-
10
6-
ay
ay
D
D
T ime Period
D
Relaxation
D
.6
D
External Meditation
D
.8
Pain Tolerance by Group and Time
120
110
100
90
80
GROUP
70
60
Spiritual Meditation
50
Internal Secular
40
External Meditation
30
Relaxation
1
2
TIME
Migraine Specific Quality of Life by Group and Time
83
82
81
MSQL
80
79
GROUP
78
Spiritual Meditation
77
Internal Secular
76
External Meditation
75
Relaxation
1
2
T ime
Headache Management Self-Efficacy by Group and
Time
130
HMSE
120
110
GROUP
Spiritual Meditation
100
Internal Secular
External Meditation
90
Relaxation
1
2
T ime
Ellison et al. (2001)
 Probability
sample of adults in Detroit
 Religious variables tied to distress and well-being
 Effects not mediated by self-esteem, mastery,
social support, or other psychosocial variables
 “The salutary effects of religious involvement
cannot be explained away in terms of social or
psychological resources, at least insofar as these
constructs are conventionally conceptualized and
measured” (p. 243).
The Distinctive Role of Religion
“Try as we might to maximize significance through our own insights and
experiences or through those of others, we remain human, finite, and limited. At
any time we may be pushed beyond our own immediate resources, exposing our
basic vulnerability to ourselves and the world. To this most basic of existential
crises, religion holds out solutions. The solutions may come in the form of
spiritual support when other forms of social support are lacking, explanations
when no other explanations seem convincing, a sense of ultimate control through
the sacred when life seems out of control, or new objects of significance when old
ones are no longer compelling. In any case, religion complement nonreligious
coping, with its emphasis on personal control, by offering responses to the limits
of personal powers” (Pargament, 1997, p. 310).
(4) Religion can be
Helpful and Harmful
Growth
Integration
Discovery
Conservation
Conservational
Spiritual
Coping
Threat,
Violation,
and
Loss
Spiritual
Struggle
Transformational
Spiritual
Coping
Spiritual
Disengagement
Socio-Cultural Context
Disintegration
Decline
Ano and Vasconcelles Meta-Analysis
(2004, Journal of Clinical Psychology)
Number of Studies
Cumulative
Effect Size
Confidence
Interval
Positive Religious
Coping with Positive
Health Outcomes
29
.33*
.30 to .35
Positive Religious
Coping with Negative
Health Outcomes
38
-.12*
-.14 to -.10
Ano and Vasconcelles Meta-Analysis
(2004, Journal of Clinical Psychology)
Number of Studies
Religious Struggles
with Negative Health
Outcomes
22
Cumulative
Effect Size
.22*
Confidence
Interval
.19 to .24
Consequences of Religious Struggles
Two-year longitudinal study of medically ill elderly
patients (Pargament, Koenig, Tarakeshwar, & Hahn,
2004)
 Struggles with the divine predicted increases in depressed
mood, declines in physical functional status, declines in
quality of life after controls
 Struggles with the divine predicted 22-33% greater risk of
mortality after controls
 Struggles also predicted stress-related growth

Specific Spiritual Struggle
Predictors of Mortality
 “Wondered
whether God had abandoned me”
(RR = 1.28)
 “Questioned God’s love for me” (R = 1.22)
 “Decided the devil made this happen” (R = 1.19)
It Gets More Complicated
Moderators of the Helpfulness of Religious Coping
* Characteristics of the person (e.g., race, age,
religiousness)
*Characteristics of the situation (e.g.,
controllability)
*Match between religious coping methods and
demands of the situation
What Do We Mean by
Helpful and Harmful?
 Psychological
 Social
criteria
criteria
 Physical criteria
 Spiritual criteria
The Key
(and very unsexy) Question
“How helpful or harmful are particular religious
(and spiritual) expressions for particular people
dealing with particular situations in particular social
contexts according to particular criteria of
helpfulness and harmfulness” (Pargament, 2007).
(5) Religion can be
Integrated into Treatment
Winding Road: Goals
 Articulate
and normalize religious struggles
 Facilitate development of personal spiritual
identity
 Broaden and deepen understanding of sacred
 Broaden coping resources
 Facilitate acceptance of struggles
 Facilitate forgiveness
Winding Road: Illustrative Activities
 Write
and share spiritual autobiography
 Share religious struggles
 Create religious genogram
 Visualize ideal older spiritual self
 Share a sacred object with the group
 Surrender ritual
 Write a group-lament to God
Winding Road: Quantitative Results
Decline in Religious Struggles
Decline in Negative Affect
Decline in Psychological Distress
Decrease in Stigmatization
Increase in Positive Affect
Increase in Behavioral Control
Increase in Emotional Control
Increase in Religious Value-Behavior
Congruence
Increase in Acceptance from God
< p. 01
< p. 05
< p. 01
< p. 05
< p. 05
< p. 05
< p. 05
< p. 05
< p. 05
Winding Road: Qualitative Findings

Growth and Transformation
“I had a lot of rash emotions coming into this experience. It’s
definitely calmed me down a little bit. I look at my struggles as
more of a positive. It is a learning and growing experience. I’ve
matured in my view of the struggle – that it doesn’t have to be
resolved right now. But I got a lot of new ideas, that I can come
back to in the future if I need to. I’ve been able to get a lot of my
struggle sorted out and get a clearer idea of what’s going on.
Now it’s not always pestering me. I was able to detangle it a
little bit… Now it’s not so much of a struggle as an evolution.”
Future Direction for Research on
Religion and Coping

What are the implications of religious coping for nonChristians?
Correlates of Religious Struggles
among Muslims
(Abu-Raiya and Pargament, 2006)
 Depression
 Purpose
in Life
 Angry Feelings
 Positive Relationships
 Alcohol Use
 Poorer Physical Health
r= .35
r = -.41
r = .32
r = -.44
r = .62
r= .35
Correlates of Religious Struggles
among Hindus
(Tarakeshwar et al., 2003)
 Depression
 Life
Satisfaction
 Marital Satisfaction
r = .40
r = -.40
r = -.27
Correlates of Religious Struggles
among Jews
(Rosmarin, 2008)
 Depression
 Anxiety
 Worry
r = .34
r = .27
r = .15
Future Direction for Research on
Religion and Coping
What are the implications of religious coping for nonChristians?
 What are the implications of religious coping for other
groups and contexts?
 What forms does religious coping take interpersonally?
 How does religious coping unfold over time?
 How efficacious are religiously integrated interventions?

Take Home Message
Any effort to understand the ways
people cope with life’s greatest
challenges that overlooks the religious
dimension of life will remain
incomplete.