Spiritual & Emotional Dimensions of

Human Development

Catherine O’Connor, CSB, Ph.D.Covenant Health Systems,

Lexington, MA

Grand Canyon“

Spiritual and Emotional Dimensions of Human Development”

• Participants will identify the contribution of three theorists who contributed to our understanding of spiritual and emotional development

• Participants will explain three key influences of human development on spiritual development

• Participants will be able to name a key spiritual and human factor in the life of three of their patients

Gaudium et Spes, # 62

“In pastoral care, sufficient use must be made not only of theological principles, but also the findings of the secular sciences, especially of psychology and sociology, so that the faithful may be brought to a more accurate and mature life of faith.”

“The person is comprised of physical, neurological, psychosocial, bio-chemical, sexual, spiritual, cognitive systems, such that if there is a perturbation in any one system, the reverbations will be felt in the other systems.”

DEEPLY SPIRITUAL

We have in us spirit, soul and what we do with that soul is our spirituality. At a very basic level long before anything explicitly religious need be mentioned, it is true to say that if we do things which keep us energized and integrated, on fire and yet glued together, we have a healthy spirituality. Conversely, if our life’s yearning drives us into actions which harden our insides or cause us to fall apart and die then we have an unhealthy spirituality.

R. Rolheilser, OMI

Developmental Perspectivesof the “Structure of the Self”

• Sigmund and Anna Freud• Donald Winnicott• Heinz Kohut• Carl Jung• Erik Erikson• Piaget• James Fowler• Lawrence Kohlberg• Carol Gilligan• The Stone Center –

Influences in Spirituality• Biblical sources• Eastern, Native American Traditions• Christian Spirituality: Augustine; Benedict, Francis, Dominic, Ignatius, Teresa of Avila, Wesley, Catherine of Siena, Little Flower, Merton, Mother Teresa, Joan Chittester, Joyce Rupp, Henri Nouwen, John O’Donohue, R. Rolheiser, P. Palmer; • Et al !!!

Erik Erikson

Human growth is a result of meeting a series of crises successfully. The ego has a particular task to develop in negotiating each “crisis”. Each ego crisis develops a corresponding ego strength

Transition between stages is characterized by anxiety and crisis, a person is pulled forward by maturational forces and pulled back by the security of the familiar.

Crisis

Opportunity

Phases of life:

Early life

Midlife

Elder Years

Early Years

Freud

• ID, Ego, Superego,

• Role of Anxiety

• Role of Unconscious

• Defense Mechanisms (Anna Freud)

• Separation/Attachment (Anna Freud)

Winnicott

• We develop and grow in an interpersonal world

• “When the parent smiles, it is for the child as if the sun has come out”

• Transmuting Internalization & Optimal Frustration

• Skin as “limiting membrane”

Winnicott contd…

• Holes in the Psyche

• Deflation of Grandiosity

• Holding Environment

• The transitional object – development of God Image

• “Good Enough”

The Three “O”s

• Omnipotence

• Omniscience

• Omnipresence

J. Sperry, M.D., Human Development

PSYCHOLOGICAL ISSUES

PSYCHIC STRUCTURE –

CONTAINER OF THE PERSONALITY

Mental, Emotional Illnesses

Psychotic Borderline

HistrionicNarcissisticNeuroticPersonality Types

Midlife Years

Carl Jung

“Forty is a merciless age.

It allows for no more self-deception”.

Almsgiving Carl Jung

“To accept oneself as one is may sound like a simple thing, but simple things are always the most difficult things to do.…

But what if I should discover thatthat I myself stand in need of the alms of my own kindness, that I am to myself the enemy who is to be loved – What then?

Heinz Kohut

Mature “Self” Needs: Mirroring

IdealizationAlter-ego or twinship

MIRRORING NEEDS: - Kohut

Need for external validation by others,as well as internal validation by oneself, so we can experience pride and well-being in our work.

IDEALIZATION NEEDS: Kohut

To feel part of, or connected with,persons whose lives, ideals, and values are a source of inspiration, and who contribute to our inner sense of peace and calmness.

Alterego or Twinship Needs

Kindred spirits who affirm our uniqueness and humanity, and who provide a sense of togetherness and belonging

Movements of the Spiritual Life

Loneliness - Solitude

Hostility - Hospitality

Illusion - Prayer.

SPIRITUAL ISSUES

Covenant – “I am”

Do we find God in our center?

or

Do we find ourselves in the center of God?

Task of Adult Life

To grieve whatnever was

and never will be.

Judith Viorst – Necessary Losses

“I have been trying

to make the

best of grief

and am just beginning to learn to allow it

to make the best of me.”Barbara Lazean Ascher

W. Brueggeman

“That which is

remembered in grief

is redeemed,

made whole and

renewed.”

The Elder Years

Task of the Elder Years:

“To Possess your Soul”

Thomas Kroon

“By your endurance you will

gain your souls”

NRSV Luke 21:19

To Possess Your Soul

“In your patience,

possess ye

your souls” Luke 21:19

PSYCHOLOGICAL ISSUES

Developmental Process:

Age-ing

to

Sage-ing

SPIRITUAL ISSUES

UNHELPFUL SPIRITUAL ISSUES

e.g. - Belief that anger is sinful- Scrupulosity- Negative God image - Understanding of suffering

Guide to Old Age

“ To continue to weed the garden of my life,

remove yesterday’s flowers anddead branches,

so that I may continue to foster growth.”

J.B. Birnen

W. Cone. Ph.D

“Old people do not

automatically get grumpy, but

grumpy people do get old!”

Story Telling

Telling the story

Maintains our identity

and

Gives us energy for the future

Memories

“Memories, good and bad,

are important to a healthy life. Memories tell us we come from somewhere,

we have traveled through timeand are now a part of the present.”

Paul White

Spiritual Wellbeing

Spiritual well being is the affirmation of lifein a relationship with God, self, community,and environment that nurtures andcelebrates wholeness.

National Interfaith Coalition on Aging 1975

“You put such a stress on passion whenyou’re young. You learn about the valueof tenderness when you grow old. You also learn in late life not to hold, to givewithout hanging on; to love freely, in thesense of wanting nothing in return”

Joan Erickson

Ten Hopes of Palliative Care Patients

Newly admitted Patient 8 Physical 2 Emotional

5 Days later 5 Physical 5 Emotional/Social

10 Days LaterMostly emotional/social/spiritual

Ira Byock, MD

Ten Developmental Landmarks and Tasks for the end of life

1) Completion of worldly affairs2) Completion of community relationships3) Life review and the telling of “one’s

stories”4) Self-acknowledgement and self-

forgiveness5) Acceptance of worthiness6) Completion of relationships with family

and friends

Ten Developmental Landmarks and Tasks for the End of Life (cont’d)

7) Sense of personhood8) Sense of meaning about life in

general9) Surrendering to the transcendent10)Acceptance of finality of life

Ira Byock, MD

Five Tasks to complete Living:How to say:

1) Forgive me

2) I forgive you

3) Thank you

4) I love you

5) Good-bye (God be with you)

Erik Erikson

“Dying is a part of the continuum of living. When older people do not fear dying, younger people need not fear living”.

Etty Hillesum

“It sounds paradoxical:by excluding death fromour life we cannot live a

full life, and byadmitting death into our

life we enlarge andenrich it.”

Persons suffering with Alzheimer’s/Dementia

…We hold onto the stuff of our souls, for oneanother. We are collectively to possess thesouls of those who cannot do it forthemselves. As we hold on to one another,we hold in our hands our communalsalvation.

She may have lost possession of her soul to a disease, but her soul is not lost. It is possessed by those who love her and care forher, as if by God, into whose book her name is written.”

Thomas Kroon

DIMINISHMENT or…?

Physical

Psychological

Mental

Spiritual

The Completed Life CycleConflict & Resolution

1. Infancy – Trust Vs Mistrust: hope

2. Early Childhood – Autonomy vs.

Shame & Doubt: will

3. Play Age –Initiative vs. Guilt: purpose

4 School Age – Industry vs. Inferiority:

competence

Culmination in old age

- Appreciation of interdependence and relatedness

- Acceptance of the cycle of life; from integration to disintegration

- Humor; empathy, resilience

- Humility; acceptance of the course of one’s life and unfulfilled hopes

Ego Crisis & Ego Strength Erik & Joan Erikson, New York Times, June 14, 1988

Conflict & resolution

5 Adolescence – Identity vs. Role Confusion:

Fidelity

6 Young Adulthood-Intimacy vs. Isolation: Love

7 Mature Adulthood – Generativity vs. Stagnation:

Care

8 Old Age – Ego Integrity vs. Despair:

Wisdom

Culmination in old age

- Sense of complexity of life; merger of sensory, logical and aesthetic perception

- Sense of the complexity of relationships; value of tenderness and loving freely

- Caritas, caring for others, and agape, empathy and concern

- Existential identity; a sense of identity strong enough to withstand physical disintegration

John 21:18

“Amen, amen, I say to you, when you were younger, you used to dress yourself and go where you wanted; but when you grow old, you will stretch out your hands, and someone else will dress you and lead you where you do not want to go.”

E. Kubler Ross

“ I say to people who care for people who are dying, if you really want to love that person and want to help them, be with them when their end comes close. Sit with them – you don’t even have to talk. You don’t have to do anything but really be there with them.”

George Bernard Shaw

“Life is no brief candle to me. It is a sort of splendid torch;

which I have got hold of only for the moment, and I want to make it burn as

brightlyas possible before handing it on to future

generations.”

ALTEREGO OR TWINSHIP NEEDS: Kohut

Kindred spirits who affirm our uniqueness and humanity, and who provide a sense of togetherness and belonging.