Religious/spiritual (R/S) abuse involves dominating another person and invoking divine authority to do so (Demasure, 2022). Religious/spiritual abuse "is the manipulation, domination and coercion of [religious person/s] ... for the purpose of fulfilling the psychological or sexual needs of the abuser" (p. 509). In turn, the victim experiences a "loss of the self," which can include a loss of identity, moral conscience, faith, theology, or psychological health-never mind the loss of virginity, money, or whatever was coerced from the person.
This type of abuse often entails a grooming process that may include an initial welcoming, then social isolation, a spiritualization of all aspects of life and complete obedience to the R/S community or abuser that punishes any contrary perspective (Demasure, 2022). The abuser (an individual or an institution), although often charismatic, is narcissistic and egocentrically working to meet a psychospiritual void (Ellis et al., 2022).
For example, an arrogant church or person (with an insecure faith) that accepts his or her religion is the only and right one may cause R/S abuse by shaming the person who rejects this belief. Thus, the victim of R/S abuse likely has had others minimize the abuse, been blamed for it, and isolated and discriminated against within the faith community (Ellis et al., 2022).
Although this is illustrated easily with stories of fundamentalist sects, it is also possible for such abuse to occur in mainstream religions. Imagine the parent who says (in effect) to a child, "I will love you if you obey the teachings of the church; if you don't, you need to leave home." Or the religious leader who tells adherents that they will not be loved by God or saved if they play rock music, marry a nonbeliever, or don't donate large sums of money to the organization. Other examples include the sexual abuse by religious leaders that occurs across denominational boundaries and the domestic abuse of spouses justified by patriarchal theologies.
Consequently, R/S abuse creates mental, physical, and spiritual health challenges. To regain health may require victims to disentangle from their religion. For patients who have such a personal history, how can a nurse provide spiritual care?
* Listen to the story if the person wants to tell it. Using therapeutic communication skills, recognize his or her pain. This pain may be expressed as doubt or anger-at the abuser, at the religious organization, or at God. Model the love of God by being present (near) to the brokenhearted (Psalm 34:18).
* Avoid coercion. The patient is a survivor of the abuse of power; do not become another abuser by telling them your R/S beliefs or practices, or even your curiosity about their story.
* Encourage the patient to seek qualified support from a professional pastoral counselor or other spiritual care expert. Remember that no matter how religious nurses are, we are not sufficiently trained to address such woundedness. Also, given that R/S abuse victims often also experience domestic abuse and mental health challenges (e.g., depression) and may use maladaptive coping strategies (e.g., substance abuse, risk taking), psychological expertise may also be beneficial.
* Remember it is God who does the saving. Presumably in self-protection, victims often distance themselves from God and their religious community. Victims also often report their experience prompts post-traumatic inner growth and a reformulated identity (e.g., more empathy, open-mindedness, and closeness to God).
Given how R/S abuse can deeply assault the human spirit and often inoculates a person against religion, the best spiritual care a Christian nurse can provide may be summarized in the admonition of 1 John 3:18: "Let us not love with words or tongue, but with actions [e.g., competent nursing care, active presence] and in truth [e.g., without deceit, manipulation, domination]."