Research on spiritual struggles: A brief snapshot focusing on new horizons

Research on spiritual struggles: A brief snapshot focusing on new horizons

In response to suffering and stress, many people find strength by turning to religion and spirituality for coping strategies (Pargament 1997). Yet sometimes these sources of sacred direction, comfort, and support also include sources of stress: disturbing doctrines, frightening beliefs about God or the devil, disapproval or rejection from religious communities, or unsatisfying answers about the nature of ultimate reality, for example. In our own work, we have used the term spiritual struggles (or religious/spiritual struggles or negative religious coping) to refer to these experiences of tension, strain, or conflict around religion and spirituality (Exline et al. 2014; Pargament & Exline 2022). Many people report experiencing these spiritual struggles (Abu-Raiya et al. 2015, which show important connections with mental health). Not only have spiritual struggles been linked with increases in emotional distress over time (Bockrath et al. 2021), but they even predict higher mortality rates (Pargament et al. 2001) and suicidality (Currier et al. 2018).

Over the past several decades, hundreds of studies on spiritual struggles have been published, as summarized elsewhere (Exline 2013; Pargament & Exline 2021; Pargament & Exline 2022). In this article, we hope to build on those earlier reviews by offering ideas about new horizons: What fruitful directions might spiritual struggle research take in the future? We organize our discussion around four main themes related to spiritual struggle: 1) conceptualization, measurement, and methods, 2) connections with distress, 3) connections with growth, and 4) clinical interventions. Although this article is not intended to be a literature review, we will give some brief background to help orient readers to some relevant research efforts and topics related to spiritual struggles. We will focus largely on our own research efforts to date, including their limitations, as we reflect on areas where we hope to see more studies in the future.

Conceptualization, assessment, and methods

The spiritual struggle concept grew directly from our earlier work, which used the terms negative religious coping (encompassing spiritual discontent, punishing God reappraisals, interpersonal religious content, demonic reappraisal, and reappraisal of God’s powers; Pargament et al. 1998; Pargament et al. 2000) and religious strain (encompassing alienation from God, religious fear and guilt, and interpersonal rifts around religion; Exline et al. 2000). Although initial measures showed promise, there was a need for further innovation. The full RCOPE (Pargament et al. 2000), despite the benefit of thoroughness, was not used often because of its length. The Brief RCOPE (Pargament et al. 1998) and Religious Comfort and Strain Scale (Exline et al. 2000) only tapped a few types of struggles.

About a decade ago, we created a new measure to assess six types of spiritual struggles: divine (e. g., feeling angry at God or punished by God), demonic (e. g., feeling tempted or attacked by the devil or evil spirits), ultimate meaning (e. g., questioning whether life has a deeper meaning or purpose), doubt (e. g., doubts or confusion about beliefs), moral (e. g., struggling to follow moral principles; concern about moral failures), and interpersonal religious struggles (e. g., conflicts or hurts involving religious people or religious issues; anger at organized religion). To tap these six domains, we developed two forms of the Religious and Spiritual Struggles (RSS) Scale: the original, 26-item RSS (Exline et al. 2014) and the shorter RSS-14 (Exline et al. 2022). Both have shown good preliminary evidence of reliability (subscale αs ranging from .85 to .93 for RSS, 75 to .88 for RSS-14) and validity (expected associations with other indicators of religiousness, emotional distress, and struggle) among U.S. adults (Exline et al. 2014; Exline et al. 2021). Researchers have begun cross-cultural testing and adaptation (e. g., Abu-Raiya et al. 2015; Abu-Raiya et al. 2016; Currier et al. 2019; Ebrahimi-Jamarani et al. 2021; Esperandio et al. 2022; Janů et al. 2018; Zarzycka et al. 2018). One project also used the RSS to examine spiritual struggles among atheists (Sedlar et al. 2018). Open-ended and qualitative measures have also been developed, with good preliminary evidence of reliability and validity (Wilt et al. 2020; Wilt et al. 2021; Wilt et al. 2022). What might be some useful next steps in the areas of conceptualization, assessment and methodology?

Connections with kindred concepts

In our own work, we have used the term spiritual struggle, and the findings we review here focus mainly on this concept. However, there are many kindred ideas in the literature, and we would like to learn more about how these concepts and measures relate to each other and to important outcomes, such as emotional distress, physical symptoms, religious disengagement, and spiritual growth. Researchers could examine points of overlap and distinctions between spiritual struggle and closely related, clinically important concepts such as spiritual pain (Delgado-Guay et al. 2011), religious crisis (Piedmont 2012), spiritual decline (Cole et al. 2008), spiritual dryness (Büssing et al. 2013), spiritual grief (Burke et al. 2014), spiritual suffering (Bartel 2004), religious/spiritual distress (King et al. 2017; Monod et al. 2010), spiritual needs (Büssing 2021), meaning crises (Schnell 2009) and moral injury (Jinkerson 2016). (This is just a brief sample. There are many other relevant concepts and measures not listed here.)

Enhancements in assessment

Elsewhere, books on spiritually integrative therapy (Pargament 2011; Richards et al. 2023), spiritual/pastoral care and chaplaincy (Cadge & Rambo 2022; Fletcher 2019; Roberts 2011), spiritual diversity (Sandage & Strawn 2022) and spiritual competencies (Vieten & Scammell 2015) provide many helpful suggestions for assessing spiritual beliefs in therapy. Our emphasis here is mainly on empirical techniques. When designing the RSS and RSS-14, we aimed for moderate-length measures with reliable but brief subscales. Yet in some contexts, these measures may still be too long – for example, in large surveys and some clinical settings. Our research team is also working to develop shorter screeners, including a six-item version (one item per struggle) and a single-item measure of spiritual struggles. A variety of other relevant screeners exist as well (see King et al. 2017, for a review; and also see the many kindred concepts mentioned in the prior section).

On the other hand, the two-to-five-item subscales of the RSS and RSS-14 may be too short or general for some purposes. Researchers could create more in-depth measures (e. g., 12 to 15 items) of specific struggles, perhaps with multiple subscales, to tap nuances of the constructs. For example, moral struggles could involve problems discerning the right course of action (especially when moral values clash with each other), trouble staying on track, or challenges in responding to moral failures. Divine struggles could include not only the emotional struggles covered in the RSS, but also cognitive ones: questions about God’s role in one’s life (Wilt et al. 2020), difficulty discerning divine guidance, or confusion about conflicting views of God, for instance. Also, how do struggles relate to kindred concepts that do not directly imply struggle? In the case of divine struggle, one might consider negative God representations or views of God’s role in suffering (Wilt et al. 2016; Wilt et al. 2017). The struggle categories from our open-ended measure (Wilt et al. 2020) may provide some good starting points here.

When developing the RSS, we faced many questions about scope. We knew that we could not cover every type of struggle, and we wanted to keep the measure relatively brief. We settled on six domains: divine, demonic, interpersonal, moral, ultimate meaning, and doubt. But there are many important domains that we could not include, given space constraints. To give just a few examples, the RSS does not assess worries about the afterlife, compassion-based pain about suffering, challenges of interpreting and integrating intense spiritual experiences, problems around religious discernment, or challenges of trying to follow religious/spiritual practices (e. g., making time for services, prayer, or reading religious texts). We hope to explore some of these topics in future work, although we would probably create separate measures rather than adding more subscales to the RSS. We hope that researchers in other settings will also develop new measures for struggles not tapped in the RSS.

Although the RSS assesses the presence of doubt struggles and interpersonal religious struggles, it does not assess the specific sources of these problems: What specific teachings, beliefs, or behaviors lead people to struggle? As captured in Altemeyer and Hunsberger’s (1997) measure, people may have doubts about religion for many reasons, including concerns that religious people are hypocritical, money-focused, intolerant, or prejudiced toward specific groups of people (e. g., women, those from other religions, those identifying as LGBTQ+). The tangling of religion and politics is also likely to be a concern for many. Whether by adding or adapting an existing measure (e. g., Altemeyer & Hunsberger 1997) or developing new measures, we hope that researchers will continue to identify specific reasons why people struggle with religious doubts. As a starting point, the paper on open-ended struggle measurement (Wilt et al. 2020) revealed some specific sources of doubt struggle: doubts about God’s existence, wondering about the nature of God, doubts regarding religious truth, and questions about the nature of fate, free will, destiny, or predestination. Future qualitative work could help to identify more sources of struggle, which might vary greatly across religions and cultures. Qualitative studies could also help to clarify connections between spiritual struggle and the many kindred concepts mentioned above. For example, not every spiritual difficulty involves a sense of struggle or conflict. Other challenges might involve a sense of pain (Delgado-Guay et al. 2011), suffering (Bartel 2004), or crisis (Piedmont 2012), to give just a few examples.

The RSS, along with most other measures of spiritual struggle, is a self-report measure. It would be helpful to have an array of implicit and behavioral measures available as well, especially for struggles that people might be reluctant to admit, such as anger toward God (Exline et al. 2012; Exline & Grubbs 2011) or doubt about central teachings of one’s faith. Psychophysiological measures, observer ratings of body language or facial expressions, or implicit association techniques are just a few methods that might be useful. To assess divine struggles, one qualitative technique that shows promise involves asking people to imagine themselves in conversation with God, writing about what they would like to say to God and how they imagine God might respond (Wilt et al. 2021; Wilt et al. 2022). Initial validation data using this measure have yielded good results (Wilt et al. 2022).

Cross-cultural adaptations

The RSS and RSS-14 were developed in the United States, and the Divine and Demonic subscales use language about God and the devil that is common in monotheistic traditions. Several translations and cross-cultural adaptations have been done, including versions that have undergone initial validation in Israel (Muslim: Abu-Raiya et al. 2015; Jewish: Abu-Raiya et al. 2016), Poland (Zarzycka et al. 2018), Brazil (Esperandio et al. 2022), Iran (Ebrahimi-Jamarani et al. 2021), Colombia (Currier et al. 2019), and the Czech Republic (Janů et al. 2018), and more are underway. Tailoring of RSS items may be important within specific cultures or religions. For example, the Divine subscale could be framed in polytheistic terms with a focus on gods, or the term “God” might be replaced with another term (e. g., Allah; Yahweh; the Universe; the Great Spirit). The Demonic subscale uses terminology focusing on the devil and evil spirits. In some cultures, it might be useful to supplement these items with others that are common in the culture (e. g., witchcraft, black magic, curses, or the “evil eye”; demons; ghosts or ancestral spirits). In other contexts, it might be more helpful to focus on “an evil force” or simply “evil” instead of focusing on personified entities (e. g., the devil, demons). Other cultural adaptations may be needed to accurately capture key concepts.

Connections with distress: mental health, physical health, self-regulation problems

Because the concept of spiritual struggle conveys a sense of tension, strain or conflict, it makes sense that these struggles would relate positively to indicators of emotional distress. To date, hundreds of studies have documented links between spiritual struggle (or negative religious coping) and distress, such as symptoms of depression or anxiety (for reviews, see Pargament & Exline 2021; Pargament & Exline 2022.) A smaller but noteworthy set of studies has also shown links between spiritual struggles and other outcomes, including physical symptoms (Sherman et al. 2005), length of hospitalization (Park et al. 2011), immune status (Ai et al. 2009), and aggressiveness (Schaal et al. 2014), and difficulty regulating behaviors such as alcohol use (Stauner et al. 2019), gambling (Gutierrez et al. 2020), and pornography use (Grubbs et al. 2020). Some of the most impressive work has used data from national samples (e. g., Abu-Raiya et al. 2015; Ellison & Lee 2010; McConnell et al. 2006) or sophisticated bifactor modeling techniques (Stauner et al. 2016; Stauner et al. 2021).

Although most studies linking struggles with distress have been cross-sectional, a recent meta-analysis of 32 studies (Bockrath et al. 2021) showed strong evidence for what Pargament and Lomax (2013) have termed a primary struggles model, in which spiritual struggles predict increases in distress or other problems over time. A few studies also support a secondary struggles model, in which emotional distress predicts increases in struggle. For example, Reynolds and colleagues (2014) examined two samples of adolescents – those with diabetes and those with cystic fibrosis – and found that depression predicted increased spiritual struggle over two years in both samples. More recently, Cowden and colleagues (2022) sampled adults with chronic health conditions using a cross-lagged panel design. They found good support for a complex struggles model–one in which struggles predicted distress over time and vice versa.

At this stage, then, there is a solid foundation of research showing links between spiritual struggles and distress. What might be some fruitful directions for future work in this area?

Longitudinal and experimental work

Longitudinal studies continue to play a key role in untangling connections between struggles and distress, but they might also be fruitfully expanded to focus more on predicting the development of struggles over time, along with struggle resolution and/or growth from struggle. (See, e. g., Wilt et al. 2019; Wilt et al. 2021.) Experimental work would also be valuable, both to evaluate possible interventions and, perhaps, the types of conditions that might promote spiritual struggle. Of course, it will be important here not to induce struggles through experimental manipulations; natural experiments might add to knowledge without generating new struggles for participants. Another option might be to manipulate conditions salient to struggles among those who report struggles and those who do not. For example, consider a study that would simply ask people to describe their views of God: Would this exercise generate more struggle among people who were experiencing divine struggles when they came into the study, compared to those who were not having such struggles?

Consider other indicators of well-being and problems

At this stage, it would be useful to seek opportunities to include other indicators of well-being or problems, other than simply focusing on connections with distress. Researchers could assess indicators of physical health (e. g., illness, immunological indicators, pain, mobility issues, mortality), especially in medical settings where such data would be readily available. It would also be valuable to have more data on how struggles relate to social problems (e. g., aggression; prejudice; crime; pollution; political polarization), workplace performance, and conflict in close relationships. In general, we would encourage researchers to take a broader look at how struggles may relate to indicators of well-being, suffering, and social problems.

Adapt assessment techniques to specific clinical contexts

Given their brevity, measures such as the Brief RCOPE, RSS and RSS-14 might be best seen as screening measures. In clinical practice, there could be benefits in following these measures with deeper assessment of specific struggles. For example, if clients endorse certain struggles on a screener, open-ended questions might help to provide more clarification about clients’ subjective experiences of these struggles, factors that led to them, coping strategies, and effects of the struggle on a person’s life. This information could be a key part of a spiritual assessment (cf. Pargament 2011) that could set the stage to thoughtfully address spiritual struggles as part of the therapeutic process (see Pargament & Exline 2022). Spiritual care professionals and other clinicians could also develop new struggle-related concepts or measures that are specific to the groups with whom they work (e. g., children, veterans, college students, older adults, clergy).

How do mental health concerns relate to specific struggles?

Some research contexts might lend themselves to in-depth assessments of specific spiritual struggles. For example, research on religious disengagement or religious nonbelief could provide a natural place for a closer examination of a variety of struggles, including doubt, interpersonal, and ultimate meaning struggles. Research on substance abuse, moral injury, or forgiveness might provide a natural place to focus on moral struggles. There would seem to be an endless array of possibilities here, given the many problems that can prompt spiritual struggles. This type of research might help to identify the types of struggles that are most closely linked with general distress and specific types of distress (e. g., anxiety, depression, guilt, anger).

Studies of specific struggles could also help to identify more predictors and outcomes of struggle. For example, our research group has an interest in supernatural attributions, including attributions to divine and demonic sources as well as human spirits, fate/destiny, karma, and luck. (See Exline & Wilt 2022, for a recent review.) Much of our work has focused on how specific divine attributions predict anger toward God (Exline et al,2011; Wilt et al. 2016; Wilt et al. 2017). In a more recent study of responses to COVID-19 (Exline, Pait et al., 2022), we found that demonic attributions around COVID-19 vaccines were linked with more struggle and also with more conspiracy thinking, fundamentalism, religious nationalism, seeing political opponents as enemies and as evil, and apocalyptic beliefs focused on hell and metaphors of cosmic battle. An important caveat here is that demonic attributions may serve useful psychological functions in some cases. For example, some research suggests that robust belief in Satan is associated with lower tendencies to blame God for evil and suffering in the world (Beck & Taylor 2008).

Connections with social problems

As reflected in the COVID-19 study (Exline, Pait, et al. 2022), as well as other projects on spiritual struggles around political elections (Wong et al. 2019) and military service (e. g., Breuninger et al. 2019), we see great value in moving beyond purely personal stressors to those focused on controversial social issues. Here again, there seems to be an almost endless set of societal problems that could prompt spiritual struggle: war, immigration, political problems, climate change, racism and other forms of oppression, LGBTQ+ issues, reproductive rights, and gun control, to name just a few. Another advantage of working on topics such as these is that it can help to move the study of spiritual struggle beyond purely clinical contexts to those involving interfaces with fields such as social psychology, political science, sociology, and more. We are just beginning to explore some of these broader social issues in our own work and hope that other researchers will join us.

Struggles and growth

Although there has been controversy over the idea that people can grow through trauma and suffering (e. g., Jayawickreme & Blackie 2014), it is appealing to consider the possibility that spiritual struggles could lead to growth. Spiritual struggles could conceivably lead people to grow stronger, experience powerful personal breakthroughs, or connect in deep ways with others, nature, or God. For example, divine struggles might lead people to revise their views of God, perhaps seeing God as more loving and less punitive. Ultimate meaning struggles might lead to a career change or to new relationships. Doubt struggles might help people clarify what they truly believe vs. what they have been taught. Yet, despite the intuitive appeal of the idea that struggles lead to growth, evidence for this idea is mixed. Some studies suggest positive links between struggles and perceived growth, whereas others show null or negative associations (Pargament et al. 2006; Pargament & Exline 2022). What might be going on here, and how might new studies untangle this confusing web of findings?

Identify key predictors of growth, including moderators

The mixed findings in this area may suggest that spiritual struggles lead to growth only under certain conditions. Some work has been done to identify factors that shape the trajectory of spiritual struggles toward growth, including accepting rather than suppressing struggles (Dworsky et al. 2016), finding a sense of meaning in struggles (Wilt et al. 2016), benevolent spiritual reframing of struggles (Saritoprak et al. 2018), and experiencing sacred moments (Wilt et al. 2019). More study is needed to learn more about those pivotal factors that may shape the direction of spiritual struggles toward growth. This knowledge could be especially valuable as a guide in practical efforts to help people through times of struggle.

Long-term studies

Many struggle studies are cross-sectional or focused on short timeframes. People who are currently struggling may not see benefits from the struggle at the time. Some sources of growth may take time to emerge, and the pain of an ongoing struggle may overshadow thoughts about growth. Here, longer-term longitudinal studies could give people more time to not only resolve struggles but to integrate them into their life stories in meaningful ways. To better understand these processes, it would be valuable to assess growth via life stories or narratives rather than relying only on self-report scales. In a therapy context, it would also be useful to assess relative costs and benefits of long-term vs. short-term therapy in treating different types of struggles (or in individuals with different types of clinical presentations).

Control religious/spiritual variables

Another issue when exploring spiritual struggles and growth is that people who are more religious or spiritual might have more energy (positive and negative) around spiritual topics and would thus tend to answer religious/spiritual questions affirmatively. For example, compared to those who do not believe in a personal, relational God, those who strongly hold such beliefs might report more God-focused emotions (positive and negative). Correlational analyses might pick up on this God-belief dimension and find that all of the God-focused variables (whether oriented toward struggle or growth) correlate highly. These types of studies might overestimate the link between spiritual struggle and growth simply because both outcomes reflect spiritual engagement. Controlling for a person’s overall level of religiousness or spirituality may provide a clearer picture of links between struggle and growth.

Moving beyond retrospective reports of growth

Another challenge lies in the assessment of posttraumatic or spiritual growth, especially in self-report contexts (Jayawickreme & Blackie 2014): How can we tell, especially via retrospective self-reports, whether people have actually grown in meaningful ways? Some people might report growth as a way of finding meaning from painful events (“God must have some purpose”) – or even to help justify or compensate for suffering. On the brighter side, there is evidence that self-reports of growth can be corroborated by reports by other people (e. g., Park et al. 1996) and have been tied to actual increases in positive mental health variables (Park & Fenster 2004). Also, self-reported spiritual growth has been shown to align with changes in spirituality over time (Haugen 2011). Although these results suggest that retrospective self-reports of growth have some validity, we hope that future work will continue to build on the modest base of longitudinal studies.

Address subjectivity around judgments of growth

What exactly is spiritual growth? For example, if someone decides to leave a religious community after experiencing interpersonal and doubt struggles, should this be considered a sign of spiritual growth or decline (cf. Cole et al. 2008) – or perhaps both? If someone decides that they want to deepen their engagement with religious beliefs or organizations that others might see as dangerous or even toxic, could this still be a growth experience for the person making the decision? These thorny issues highlight the roles of subjective value judgments around which spiritual outcomes are seen as desirable (framed as growth) or undesirable (framed as decline). Here we could see benefits in using open-ended, qualitative questions to assess self-perceptions of spiritual growth and decline. Short ratings could also help, such as simply asking people to rate the extent to which they believe that they have grown spiritually – and perhaps also the extent of spiritual struggle, loss, or decline.

Does growth always come from a person’s own actions?

Another interesting question involves whether people see themselves as being the sole or primary agents of growth vs. seeing others (people or supernatural entities) as playing a role in their spiritual growth. For example, in one study of Christian undergraduates (Exline et al. 2017), we found that perceived growth from struggle was based not only on one’s own actions (via positive religious coping) but also on a belief that God was intervening to help. It is interesting to consider how people might experience support from other living people or from those who are deceased, such as ancestors, saints, or loved ones who have died. (For a recent review, see Plante & Schwartz 2022.) Some people might also see impersonal spiritual forces, such as karma (White et al. 2019) or fate (Au & Savani 2019), as sources of growth. (See Exline & Wilt 2022, for a review.)

Clinical interventions

This article has focused mainly on research on spiritual struggles. For clinically-oriented examples and suggestions, readers might seek out recent work on spiritual competencies (Pearce et al. 2020; Vieten & Scammell 2015), chaplaincy and spiritual care (Cadge & Rambo 2022; Fletcher 2019), pastoral care (Roberts 2011), spiritually integrated therapies (Pargament 2011; Richards & Allen 2023), spiritual diversity (Sandage & Strawn 2022), and spiritual struggles (Pargament & Exline 2022). We have also written about three different conceptual “lenses” that professionals might use to interpret client reports of supernatural activity, including after-death communications (Exline 2021) and demonic struggles (Exline et al. 2021). Clinicians could frame such reports as signs of psychopathology, normal psychological processes, or authentic supernatural experiences–each of which could have very different implications for treatment.

Research on spiritual struggles has important practical implications not only for psychotherapy but also for the work of pastoral, chaplains, and health care providers. Our hope is that assessment tools, research findings, and intervention ideas from work on spiritual struggles and kindred concepts will be of help to clergy as they serve the spiritual needs of their congregations. Given the well-established link between struggles and emotional distress, there are sometimes major clinical questions about where to focus: Should a therapist focus primarily on the emotional issue at hand (e. g., depression; obsessive-compulsive disorder) in hopes that the struggle will improve, or should the struggle be a major treatment focus? Or perhaps a blend of these two techniques will be in order. Of course, every person will have different needs. Assessing whether spiritual struggles are primary, secondary, or complex can help guide the direction of clinical practice. For cases in which some clinical attention focuses on spiritual struggles, we offer a few suggestions.

In many cases, simply offering social and/or spiritual support may be a key part of helping people cope with spiritual struggles. Rather than pressuring themselves to come up with foolproof remedies or theologically-based answers for clients, we would suggest that providers can do a great deal of good simply by providing a safe, supportive, affirming environment in which clients can feel free to bring up spiritual struggles. (For more on implicit and explicit assessment techniques for spiritual struggles, see Pargament 2011; Pargament & Exline 2022).

Many people might see certain struggles, such as anger toward God, as morally wrong (Exline et al. 2012). And if they do share their struggles, the listener’s response can be important: One study focused on situations in which undergraduates disclosed to someone else that they were angry at God (Exline & Grubbs 2011). Although supportive responses predominated (e. g., “I’ve felt that way myself,”), about half of participants also reported some level of negative response (e. g., feeling judged). To the extent that they received supportive responses, participants were more likely to report strengthened faith and drawing closer to God in the wake of the struggle. In contrast, negative responses to disclosure were linked with reports of more ongoing struggle, attempts to suppress anger, exit behaviors (e. g., rebellion; pulling away from God), and substance use. These findings suggest that simply providing a safe, accepting environment can help provide space for clients to explore their struggles without pressuring them (or the therapist) to find quick answers or solutions.

There is now a major need for research on techniques to help people navigate spiritual struggles. These approaches could look different depending on whether the strategy focuses on a specific struggle (e. g., anger at God; religious doubt) vs. struggle more broadly. The setting could also make a big difference: Interventions designed for faith-based settings would likely draw on sacred texts and tradition-specific teachings and practices, whereas those in secular settings would need to be broader. Here are a few examples of interventions in secular settings: Harris and colleagues (2011) have developed a trauma-focused intervention focusing on spirituality, including struggles. Dworsky et al. (2013) developed a program entitled Winding Road for college students experiencing spiritual struggles. This nine-session group program, which focuses on helping participants to articulate and normalize their struggles and develop related coping resources, was successful in helping students normalize rather than pathologize struggles, find social and spiritual support, accept (rather than suppress) these tensions, broaden and deepen their spirituality, and improve their affect. The program has also proven helpful for adults with mental illness (Reist Gibbel et al. 2019).

Following Dworsky and colleagues’ (2013) approach of framing struggle as a journey, we have sometimes thought of spiritual struggle as presenting a “fork in the road” that could lead people toward either spiritual growth or decline. Although this may be true in some cases, we have begun to shift from an either/or perspective to a both/and perspective: Struggles, especially very painful, life-changing ones, often lead to growth in some areas even though they lead to decline in other areas. For example, a study of South African adults (Jung et al. in press) showed that in response to interpersonal transgressions, spiritual struggles were associated with small increases in both depression and perceived posttraumatic growth six months later. Successful coping with spiritual struggles might involve opportunities to seek wholeness and integration in the wake of these challenges: How can people bring together the “light and shadow” parts of their spiritual stories as part of a meaningful and life-giving narrative?

We have been particularly drawn to the metaphor of Japanese kintgusi art (Pargament & Exline 2022), in which pottery is broken and then restored using gold filigree: The piece has been restored, and beautifully so; but rather than detracting from the piece, the scars actually add to its beauty. We have used many other metaphors in our own work and writing as well, such as heroic journeys, seasons of life, and silver being refined. Clinically, one might explore metaphors that are meaningful to clients in revealing or illuminating core elements of their struggles or growth experiences. And along these lines, it would also be fascinating to do a research study to see which types of metaphors people find useful in framing their spiritual struggles.

There are important practical implications of spiritual struggle research that go beyond clinical interventions. Consider, for example, how we might anticipate and address spiritual struggles before they arise or become deeply entrenched. Spiritual struggles could also become a topic that is discussed more openly within religious institutions. Imagine spiritual struggles as a regular topic in religious education programming or as an issue openly addressed in religious services, for example. In this vein, Lutheran pastor George Zornow (2014) has developed a program called “Crying Out to God,” in which he encourages church members to lament – sharing any and all feelings with God, including struggles. Zornow himself models this openness by talking about his own spiritual struggles in congregations. Spiritual struggles could also become a part of family conversations. Such dialogue might be of special value to adolescents at a time when they are more likely to be experiencing struggles and feeling confused by them.

Conclusion: Spiritual struggles research as an expansive horizon

Religion and spirituality are such significant topics – touching on issues at the very core of what it means to be human, and reflecting tremendous diversity in terms of beliefs, practices, and challenges. Our aim here was to suggest some possible future directions in research on spiritual struggles. Despite several decades of research attention (see Pargament & Exline 2021; Pargament & Exline 2022, for recent reviews), empirical work on these compelling topics remains in its infancy. There is a great need for work in all areas: conceptualization, assessment, methods, clinical approaches, and basic and applied research. We also need the help of people who can share research findings with others – through educational materials or the media, for example. There is plenty of room for anyone interested in spiritual struggles to make a distinctive and valuable contribution. We hope that you will join us.