Spiritual Resources in Coping with Pregnancy Stress: Spiritual harmony with God, self & others

Overview on Spiritual Struggles in Coping 

• In 1997, Pargament published The Psychology of Religion and Coping: Theory, Research, and Practice which documented the power and prevalence of religious and spiritual involvement in the coping process. Since then, considerable psychological research has been conducted on a variety of spiritual problems. One spiritual problem that has received considerable attention is spiritual struggles.  
• Major life stressors affect people not only psychologically, socially, and physically, but spiritually as well.  Natural disasters, accidents, illnesses, and other stressful events can threaten or harm people spiritually, triggering spiritual struggles.
• Spiritual struggles in coping represent efforts to protect or transform peoples’ relationships with whatever they hold sacred, including their connection to God/Higher Power, their spiritual identity, and their connections to a religious community.
• Terminology. Much of the research on spiritual struggle is referring to as “negative religious coping” but we and other researchers have begun to use the term “spiritual/religious struggles.”  Why
  • Spiritual struggles may be pivotal points in the time or “forks in the road” in human development.  Some studies suggest that people who are able to resolve spiritual struggles over time benefit and grow from those struggles.  Others may choose to disengage from spirituality or religion involvement temporarily or permanently.  Still others who remain stuck in their struggles decline emotionally and physically.
  • Even atheists & people who are not engaged in organized religion may experience spiritual struggles, such as feeling distant, unhappy, angry, cut off from, or abandoned by God

How do we define & measure Spiritual Struggles in Coping?

• Spiritual struggles refer to conflicts over spiritual matters with God/Higher Power, within oneself, and with other people. These conflicts generate distressing emotions and questions about one's spiritual journey.
• This definition points to three types of spiritual struggles:
  • Divine struggles with God/Higher Power - conflict with God/Higher power   
  • Internal/Intrapsychic struggles-  inner conflict about spirituality & religion
  • Interpersonal/Communal struggles - conflict with other  family members, friends, clergy, community members, or the larger culture about spirituality & religion
• Spiritual struggles are most commonly measured by the 7-item Negative Religious Coping subscale from the Brief RCOPE (Pargament, Feuille, & Burdzy, 2011). 
• See Defining Religion & Spirituality for more on our approach to defining these two overlapping concepts.

What systematic empirical research has been done on Spiritual Struggles in Coping with Pregnancy Stress? 

• Despite extensive research on spiritual struggles on other topics, almost no systematic research has focused directly on spiritual struggles with pregnancy stressors. Nevertheless, the Relational Spirituality Framework highlights that a stressful pregnancy may trigger spiritual struggles, with God, within the self, or with a religious community. A stressful pregnancy includes pregnancies that with a high risk of miscarriage, unintended or unwanted pregnancies, or those that involve life-threatening medical problems for the mother or baby.  
• Prior studies on spirituality and stressful pregnancies has relied on indirect measures, such as frequency of religious attendance or overall importance of religion in daily life, to gauge whether low income or unmarried women (mostly teens) experience spiritual struggles over their pregnancies. To encourage more in-depth research on spiritual struggles with pregnancy stressors across diverse families, we draw on prior research on spiritual struggles on non-pregnancy stressors (e.g., natural disasters, illness).  
• Practically speaking, our research program on spiritual struggles over pregnancy has focused on Divine Spiritual Struggles rather than Internal or Interpersonal Spiritual Struggles.

How do we define Divine Spiritual Struggles in Coping with Pregnancy Stressors? 

• We define Divine Spiritual Struggles in coping with pregnancy stressors as having conflict with God when interpreting and reacting to a stressful pregnancy. To unpack this definition, it is useful to define conflict. We define conflict as an individual experiencing disagreement within the self or with others about his or her goals in life and/or pathways to reach those goals. Much like people can be in conflict internally or with other people, individuals can be in conflict with God when problems arise. A stressful pregnancy can threaten cherished goals in life. An individual may experience conflict with God over why the pregnancy stressors occurred and what should be done to resolve the pregnancy problems. These struggles with God can create distressing emotions and thoughts about one’s relationship with God.

How do we measure Divine Spiritual Struggles in Coping with Pregnancy Stressors for psychological research?

• In our transition to parenthood study, we used the following three sub-scales (three items each) from Pargament’s R-COPE to assess divine spiritual struggles with pregnancy. These nine items were mixed in with items from other sub-scales from the R-COPE. 
• 3 Subscales from the RCOPE on Divine Spiritual Struggles
• Instructions: The following statements describe specific ways that people might cope with stressors associated with pregnancy. As you think of the stressors you have faced in your pregnancy, how much do you use each of the following things to cope? To cope with this pregnancy, I have…
• Spiritual discontent subscale
  • Wonder whether God had abandoned me.
  • Voice anger that God didn’t answer my prayers.
  • Question God’s love for me.
• Punishing God subscale
  • Wonder what I did for God to punish me.
  • Decide that God was punishing me for my sins.
  • Feel punished by God for my lack of devotion.
• Reappraisal of God’s power’s subscale
  • Question the power of God.
  • Think that some things are beyond God’s control.
  • Realize that God cannot answer all of my prayers.

How do Divine Spiritual Struggles in Coping with Pregnancy Stressors during Infancy help or harm?  

• To our knowledge, our transition to parenthood study represents an initial effort to examine how much married, first-time parents experience spiritual struggles in coping with parenting stressors, and if spiritual struggles increase the problems in parenting, and parent or infant adjustment.  
• In an initial study headed by Steve Lucero, we found that spiritual struggles with pregnancy predicts greater depression, anxiety, and less marital commitment for both fathers and mothers.
• We are still conducting analyses and will post additional findings when available.

How do Spiritual Struggles in Coping with Parenting Stressors during Childhood or Adolescence help or harm?  

• See Mahoney 2013 for summary of available data.

Additional Readings

• Lucero, S. (2010, April). Religious coping with the stressors of a first time pregnancy as a predictor of adjustment among husbands and wives.  Master’s thesis. Bowling Green State University, Bowling Green Ohio.
• Mahoney, A. (2013). The spirituality of us: Relational spirituality in the context of family relationships. K. I., Pargament, J. J. Exline & J. W. Jones, (Eds.) APA handbook of psychology, religion, and spirituality: Vol I. (pp. 365-389). Washington, DC: American Psychological Association. DOI: 10.1037/14045-020.
• Mahoney, A. (2010). Religion in families 1999-2009: A relational spirituality framework. Journal of Marriage and Family, 72, 805 – 827.
• Mahoney, A., LeRoy, M., Kusner, K., Padgett, E., & Grimes, L. (2013). Addressing parental spirituality as part of the problem and solution in family psychotherapy. D. F. Walker & W. Hathaway (Ed.) Spiritually oriented interventions in child and adolescent psychotherapy.pp. 65-88. American Psychological  Association.
• Pargament, K. I. (1997). The psychology of religion and coping: Theory, research, practice.  New York: Guilford Press.
• Pargament, K. I., (2007).  Spiritually integrated psychotherapy:  Understanding and addressing the sacred.  New York: Guilford Press.
• Pargament, K. I. (2011).  Religion and coping: The current state of knowledge.  S. Folkman (Ed.), Oxford Handbook of stress, health, and coping (pp. 269-288) New York:  Oxford University Press.