Kim Mills: Many people consider religion a source of comfort and strength, something they can turn to in difficult times. But religion and spirituality can also become sources of stress and conflict in people’s lives, for example, when they wonder why God has allowed something terrible to happen or when they feel rejected by their religious community. In the past few decades, psychologists have begun to explore the role that these spiritual struggles play in people’s lives and how spirituality and spiritual struggle affect our mental health and well-being.
Today we’re going to discuss some of those questions. What is spiritual struggle? What does spiritual struggle look like for religious believers, atheists and agnostics, and the growing number of people who consider themselves spiritual but not religious? How should psychologists and other mental health professionals think about the role of spirituality and mental health and how should they address spirituality and religion with their patients? Finally, how does spirituality and belief in a supernatural power affect broader social issues such as political polarization?
Welcome to Speaking of Psychology, the flagship podcast of the American Psychological Association that examines the links between psychological science and everyday life. I’m Kim Mills.
My guest today is Dr. Julie Exline, a professor in the department of psychological sciences at Case Western Reserve University. She has been studying spirituality and religion since the late 1990s with a particular interest in two topics, religious and spiritual struggles and the causes and consequences of supernatural beliefs. Some of her recent projects include research on religious doubt and interpersonal struggles around religion and how those relate to people’s decisions about whether to disengage from organized religion.
She’s also doing research on gratitude to God, demonic attribution, and perceptions of messages from God or from people who have died. Dr. Exline is a former president of APA’s Division 36, the Society for the Psychology of Religion and Spirituality, and has won awards from that group, including the Margaret Gorman Early Career Award, the Virginia Sexton Mentoring Award, and the William James Award.
Dr. Exline, thank you for joining me today.
Julie Exline, PhD: Thank you so much, Kim. I’m delighted to be here.
Mills: Let’s start by talking about how you define spiritual struggle in your research. Broadly speaking, what are spiritual struggles and what are some of the specific types of struggles you’ve identified in your research?
Exline: So when we use the term spiritual struggle, we’re basically talking about experiences that involve some kind of tension or conflict or strain around religion and spirituality. And importantly, this is something that people can experience regardless of whether they are religious or spiritual themselves. Some of the struggles that we’ve looked at are ones that involve supernatural beliefs. So we have divine struggles focused on a person’s beliefs about God, like thinking that God is punishing you or that God has abandoned you or being angry at God. And then we have some of these demonic struggles, which of course require belief in the devil or demons or evil spirits, where you might feel like they’re attacking you or tempting you or causing bad things to happen in your life.
So those supernatural struggles clearly are ones that are going to be experienced by people who hold those specific beliefs and often by religious people. But we also have some struggles that are very common regardless of whether people are religious or spiritual or not. So we have interpersonal struggles around religion. These are things like conflicts with other people around religious or spiritual teachings or beliefs. We also have doubt related struggles where people are questioning their beliefs and we have ultimate meaning struggles where people might have questions about the ultimate meaning or purpose in their lives and moral struggles about trying to do what’s right and wrong that anybody could have.
Mills: Now, the U.S. in general is becoming a less religious country, at least in terms of affiliation with organized religion. One Pew Research Center poll found that 29% of Americans said they had no religion in 2021, up from 16% in 2007. Do you think that spiritual struggles and spiritual questions in general are playing a smaller role in people’s lives than they used to, or are they something that’s actually separate from organized religion?
Exline: That’s a great question. So some of the struggles that have to do with religious communities specifically, like feeling rejected or having conflicts with people within your religious community, those are going to be reduced if people have maybe left religion or aren’t religion. But a lot of the struggles are ones that might cause people to leave religion. So they might be having questions about their beliefs. They might feel really turned off by maybe a religious group’s opinion about some delicate social issue or something that a person feels strongly about like immigration rights or LGBTQ rights or political things.
So a lot of times these struggles are part of what drive people out of religion, and a lot of times after people have left, my colleague Daryl Van Tongeren has done some really cool research on what’s called the religious residue effect, where when people have left religion, a lot of times a lot of their values and beliefs, there’s a ghost of what was there when they’re coming out of their religious lives. So a lot of the struggles that a person might have had around religion might not be completely resolved by leaving religion, and people who were never religious to start with or who have left might still have spiritual struggles, but a lot of times they’re going to be more about anger at organized religion or questioning whether there’s that ultimate meaning or purpose in your life because a lot of times religion helps to meet those needs for meaning and purpose for people.
So when people have more freedom in their beliefs, that’s great in some ways and it can free you up from struggles around things like doctrine or high-demand religious communities, but it can also have you feeling adrift and might have a sense of a lack of community that you might be yearning for and might leave you with a sense that, “I’m not quite clear what my life is about anymore if it’s not aligning with these religious beliefs and identities that I used to hold dear.”
Mills: So overall, how common is it to experience spiritual struggles? What have you found in the surveys that you’ve done?
Exline: So we’ve done some surveys looking at large groups of people in the US, say around 20,000 people. Around 60% to 70% are saying that they’ve had spiritual struggles recently, and on a lifetime item, again, around 70% are saying that they’ve had spiritual struggles at some point in their lives. So when we define struggles in these broader ways, it’s really clear that a lot of people are experiencing struggles around religion and spirituality.
Mills: Can religion actually be the cause of spiritual struggles? And if that’s the case, how can people work through their angst without leaving the faith that caused them the problem?
Exline: A lot of times people’s struggles do come specifically from the teachings of a religion, say, trying to follow a religious text or authority that’s saying, “This is the way it is, or this is straight from the mouth of God,” and you might disagree with those things or you might just find them really difficult to live with. So for example, I was raised in a fundamentalist Christian tradition where we believed that everyone was going to hell unless they held specific beliefs or went through a specific conversion experience. And I can tell you that that was a major source of spiritual struggles for me and probably a big part of why I’m doing this work today.
So it’s very challenging sometimes when the struggles come from the beliefs themselves and the teachings themselves. A lot of times people have to have the openness and to feel safe enough to question the beliefs, which often is difficult to do in a very authority based tradition. And then a lot of times there needs to be a sifting of what do I really believe? What makes sense to me and which beliefs are even going to work for me psychologically? So for me, that belief that pretty much everyone was going to hell except a select few was really psychologically damaging. So that’s something that I had to reassess, but in the type of church that I was raised in, it would not have been seen as acceptable to question that authority. It would’ve been like, “Yeah, it’s upsetting, but it’s just the way that it is.”
So it can be very hard for people to navigate when you’re trying to respect sources of religious authority and maybe believing that this is really the way it is, and some of the beliefs are really frightening or difficult or might cause you to judge certain groups of people negatively when it’s coming straight out of the religious text. This causes a lot of stress for people if they want to be nice to people and not judge them.
Mills: Do atheists experience spiritual struggles? Is this something that’s relevant to non-believers or maybe they do, but they call them something else?
Exline: When we first started studying anger at God about 20 years ago, we were initially going to leave atheists and agnostics out of that study completely because we thought, “Well, they don’t believe in God. It’s not going to be relevant for them.” But we allowed everybody to take the survey just to see what happened and what we found was that a lot of atheists and agnostics actually did say that they felt some anger toward God. So that got us really looking at these things more closely.
What we find is that atheists and agnostics often experience spiritual struggles around things like ultimate meaning, anger at organized religion, these interpersonal conflicts around religion. They’re going to have some of these questions maybe about whether their beliefs are correct, they’re going to have moral struggles. They’re not usually going to have struggles about the devil, but sometimes there are still some struggles about God because people, especially if they are people who have left religion, they might still have these bad memories about, “I prayed for my grandma to be healed and she died.” Or they’ll remember how they felt let down by God or punished by God. So some might not want to believe in God, but there’s still this residue that’s left where there might still be some energy for a person.
This is in a study that we did a few years ago that Aaron Sedlar was the first author on this paper. We found that just like with religious people, religious and spiritual struggles were quite common among atheists, and they had the same kinds of correlates with mental health. So for atheists too, spiritual struggles are correlated with more anxiety, depression, stress, lower levels of life meaning and things like that.
Mills: So you mentioned anger at God a moment ago, which is I understand a very common spiritual struggle, and in some ways it’s analogous to being angry at another person. How does spiritual struggle mirror and differ from other kinds of interpersonal conflicts?
Exline: For many people, there’s a perceived relationship with God that in some important ways is really parallel to human relationships. So people are more likely to be angry at God for the same reasons they would get angry at another person if they think that God is being unfair or arbitrary, if they think that God has an intention to harm, if they think that God clearly caused something that was negative, and maybe if the person felt entitled to have something go their way. These are the same reasons that people get angry at other people.
And then there are all these other dynamics that happen for people that are more positive, like feeling grateful to God or having a sense of attachment to God. But there are some really important differences in the relationships clearly because most people don’t report being able to see God or hear God or experience God with their senses. So they might be going based on inferences from their own life experiences, but a lot of it is going to come out of teachings and social input that they’re getting from other people about what God is like coming down through some kind of authority source.
So there’s all this mystery around what God is like, and then there’s that huge issue of authority and power. There’s just a little bit of a power differential between people and God, and that’s going to make a big difference in terms of how people are going to relate to God versus others. So in a sense, it can be like this virtual relationship that people might not be sure if it’s real or not, and if it is real, well, this is a pretty significant relationship if God has as much power and control and wisdom as people tend to think that God does if they believe in God.
Mills: Now, you recently co-authored a book on working with spiritual struggles in psychotherapy. Why do you think this is important for mental health professionals to consider, and how prepared are most of them to have these conversations with their patients?
Exline: So one thing that we’ve found very, very consistently is that spiritual struggles are not only correlated with things like depression and anxiety and stress, but there’s evidence through longitudinal studies that spiritual struggles are sometimes primary, meaning that the anger at God at time one is predicting increases in depression between time one and time two. So if you’re angry at God, you might get more depressed later. There’s lots of evidence for those kinds of relationships.
So a lot of therapists tend to be less religious than the general population. This is definitely true for psychologists, much less religious on average than the general population. So a lot of times there might be some kind of a hesitation where even if a therapist might see spiritual struggles as being important, they might be reluctant going into this area and delving into these types of questions. They might be concerned that they’ll be expected to come up with religious answers for things. They might have an anti-religious bias in some case, and they’re afraid that it will show through or that it will lead to a rift with the client. And this is where some of the recent training that’s been happening and the great books being written on things like Spiritually Integrated Therapy, my colleague Ken Pargament wrote a great book on that, and a really nice line of work on spiritual competencies that’s evolving. Some really nice funded projects are happening in this area.
These are things that are going to be resources for clinicians so that they’ll be more comfortable talking with people about spiritual issues and treatment, but the connections with mental health are very clear and consistent. And again, there is that evidence. This is from a meta-analysis that Margaret Bockrath was the first author on. There’s good evidence that yes, spiritual struggles can actually lead to mental health problems.
Mills: There’s an idea that religious people are generally happier or more content than people who aren’t religious. Is that borne out in the research?
Exline: There is some research suggesting that people who are more religious live longer, they have better health behaviors in some areas, they have better self-control, but a general relationship with happiness is something that’s more elusive. There are these connections with things like better physical health, for example, and some indicators of greater well-being. A lot of it seems to have to do with the meaning-making function that religion provides, and also with the sense of community or social support that people get from religion. But a lot of the benefits that are more psychological, the meaning-making functions, people will turn to other types of ideologies, belief systems or spiritual beliefs that are more personally tailored, where they don’t have to always go to organized religion to find those answers. And for an increasing number of people, they’re wanting that flexibility of, “Yes, I do believe in something transcendent. I believe in the divine. I believe that we’re all interconnected. I maybe believe specifically in God or afterlife, but I don’t want to have to go along with the teachings of a specific religion that I might not agree with.”
Mills: Now, in addition to the research that you’ve done around spiritual struggles, you have also done a lot of work in supernatural attributions or people’s beliefs that events have supernatural causes. What are the kinds of things that people tend to attribute to supernatural causes, and why do they do this?
Exline: People often see the supernatural as being very involved in their day-to-day lives depending on their belief system. So if someone thinks that God or the devil or spirits not only exist but are powerful and are active in the world and are actively trying to do things here and communicate with people, it’s not much of a stretch to think that a certain event that happens in your day might be a message from God, or it might be kind of a wink from a deceased loved one. Or if something bad happens, there might be not much of a stretch to say, “Oh, I think that the devil is causing this, or the evil spirits are responsible for this.”
A lot of it has to do with these specific beliefs about these entities having these abilities. We call these, they’re supernatural operating rules. So if you think that God or the devil or spirits are out there operating in the world and doing all these things, then it’s not at all a stretch to think that, “Oh, they’re affecting things in the world and causing things to happen in a person’s life.”
One important thing here is that you might think, well, a person would only assume that God was involved if something really dramatic happened that seemed to violate natural laws, something like the type of miracle that got reported in the Bible, Moses parting the Red Sea with God’s help, that sort of thing. But because people often see supernatural forces working indirectly through natural events, behind the scenes doing these subtle things, something doesn’t have to violate natural laws or even seem to in order for somebody to see God or the devil or the spirits being involved with it.
So there could be something like seeing a rainbow, seeing a certain animal, having something that happens in a day repeatedly like a word that keeps coming up, where people are often searching for meaning behind these events. And especially if you’ve been socialized through religious or spiritual beliefs or other people around you to think, “Oh, our loved ones give us messages after they go.” It’s going to be reasonable to think that if someone that you trust has said, “Oh, that’s how I interpret these animal sightings, or these different things that come up, or these songs that come on the radio randomly.”
If somebody that you trust seems to make these types of attribution or explanations, it’s going to seem like something that’s more plausible to believe. And there’s also, for many people, a strong desire to want to believe that our loved ones still live and exist on the other side or to believe in a God who loves us and comforts us, and that desire is another big driver. So in order to see a supernatural explanation for something, it has to seem at least somewhat plausible logically. So it’s not like we just check our brains at the door. It has to seem like based on how I think supernatural entities work, I think this could happen and people are going to be more likely to make the attribution if there’s that desire. I really would like to believe this. That kind of adds fuel to it. It makes it more likely that the person is going to lean toward a supernatural explanation as opposed to wanting to dismiss it.
One other thing I should say, just really briefly, is that there are some cases where mental health conditions can feed in as well. So clearly some people who are having dissociative disorders or a psychotic disorder are going to see things, hear things, have experiences that are unusual that might set the stage for more supernatural attributions to. But one really important thing that we’re trying to clarify in our work is that having an experience that you see as supernatural is not necessarily a sign of a psychological disorder.
Mills: But where is that threshold? So how would a psychologist or a mental health provider be able to tell that someone has gone beyond just that need for comfort like, “I saw a cardinal and that was my mother speaking to me,” as opposed to somebody who has really had a break psychologically?
Exline: This is where good assessment skills come in, just general clinical assessment skills. You have to look at how this belief seems to be fitting in with the person’s other thoughts. Do their other thoughts seem like they’re reasonably organized, orderly? Do they seem like they’re having paranoid or grandiose thoughts? Do they seem like they’re having a lot of unusual experiences? Then if you see these other indicators of maybe unusual thinking or extreme distress around these thoughts, you might go a little more deep into your assessment with a more in-depth assessment of psychological symptoms, and in some cases, perhaps a medical assessment. There could be something like epilepsy or a tumor or something that’s causing these things.
So this is where it’s important to just really get to know the person that you’re talking with and to have those good assessment skills where when you hear about a supernatural experience, just try to really find out as much as you can about it, about what led up to it, about the quality of the person’s thoughts about other things. Are they seeming like they’re thinking clearly about other things?
And then you can follow up if needed with more detail to try to find out, because you certainly don’t want to go into a situation and miss some type of serious condition like schizophrenia because you’re saying, “Oh, all of the supernatural stuff is fine.” But at the same time, a tendency that many clinicians have psychologists and psychiatrists in particular is going to be to automatically dismiss things like these beliefs that a loved one is talking to a person to dismiss them as hallucinations, and this is what a lot of people are worried about. They’re afraid to tell therapists or doctors because, “They’re going to think I’m crazy.”
So this is part of what we’re trying to help clinicians be more nuanced about. Yes, there might be something going on that would indicate a psychological problem that might need treatment, but in many cases there is not. And in a lot of situations, a belief of having received a message from God or a deceased loved one or a belief that something is karma can be really helpful and healing and motivating for people. So it’s important to not dismiss these things out of hand.
Mills: Now, we’re talking about supernatural attributions that are more positive, but there are some people who also believe in demonic attribution, and I’m wondering is that perhaps a more concerning sign if people begin to ascribe all kinds of behaviors to the fact that the devil is making something happen or the devil is making me do something?
Exline: This whole question about people seeing the devil or evil spirits behind things is one that hasn’t been studied nearly as much as beliefs about God, and it’s something that we’re just starting to look at more. Clearly, for a lot of people, believing that the devil is tempting or attacking them or causing negative events in the world is just part of their religious belief system. So it might just be part of this is how the world works, and it might not be especially distressing to make these attributions to the devil, but in some cases, if a person feels really victimized by the devil like, “I’m afraid that maybe I’m going over to the dark side myself, or I’m afraid that the devil is stronger than me and the devil is going to take me away from God,” that could really lead to a sense of terror that you’re going to end up in hell or end up doing terrible things because you’re following the devil.
And I think this is where a lot of my interest is, not so much distant people’s personal beliefs that the devil might be influencing them, but in the judgements that people make of other people when they say that they’re following the devil. Now, this is something where there have been studies done looking at political issues, divorce. If you think that somebody who you’re disagreeing with is following the devil, you can see how that really adds a lot of oomph to your opinions that they are in the wrong and could even lead down a dangerous direction of the-
Mills: Yeah, it gives you justification. Sure.
Exline: Yes, it could even make it seem like this other person is evil and given the tendencies that humans already have to depersonalize others, and to be aggressive, what could better justify aggression toward another person or group than accusing them of following the devil and being evil? You could see at its extremes that this is the kind of mindset that could lead people toward very aggressive behavior, maybe even wanting to annihilate others because after all, you’re in a fight against evil. So we want to do more work on this, but there is some good evidence for links between these demonic attributions about other people and aggressive behaviors that I think is really, really important psychologically.
Mills: You’ve written about your fascination with near death and shared death experiences, psychedelic journeys and perceptions of after-death communication, the types of things that many people see as doorways to other dimensions. Can you tell our listeners a little bit about how you’re studying these concepts and what you’re finding?
Exline: I’m really fascinated with people’s experiences that they interpret as suggesting some type of world beyond this one. So for some people, these are these near death experiences where somebody might have a heart attack, say, and have an amazing experience, maybe hovering above their body, seeing what’s going on in the room, being met by loved ones or spirit guides going down a tunnel, going to another place. There are thousands of accounts of these. The International Association for Near Death Studies is a great resource here for people who’ve had these experiences. They’ve become more common now that we know how to bring people back from cardiac arrest. So more people are in the situation where they can come back, and of course, there’s a lot of controversy around whether these are actually suggesting another metaphysical reality or whether it’s just something that the body is doing.
So that’s not the area that I’ve focused on as much. That’s not my wheelhouse, but I am very interested in how people who have had these near death experiences or a shared death experience, meaning you might be at the deathbed of somebody and witness their spirit leaving their body or maybe even accompanying them to this other world briefly and coming back. There are some really cool stories about those types of experiences, and even people having meditation experiences or psychedelic experiences can have these profound encounters that again, they perceive as being with divine beings, deceased loved ones, sometimes demonic forces, or having this profound sense of a world beyond or the interconnectedness of all things that can be really life changing.
Part of the reason I’m so interested in these things is because for a lot of people, these types of experiences might help to give spiritual meaning for people who are not part of an organized religious tradition. And I even wonder if they might help to resolve spiritual struggles in some cases by giving people hope of some loving interconnected ultimate reality that we can all share in, and that could really help. So for example, as I’ve entertained ideas like this in the last decade or so in my own life, it’s really helped me to have a sense of, okay, if there’s an afterlife, it doesn’t just have to be this heaven or hell thing. There are all these other possibilities, and a lot of this I find much more comforting, and I think the evidence for it is really interesting to consider.
Mills: So just to wrap up, what questions are you working on now? What are the next big issues you would like to have answered?
Exline: A few things we’re looking at now are whether people can forgive religious communities that have hurt them. Let’s say that you decided to leave or you decided to stay. Can you set boundaries about what you believe and what you don’t? And even allow yourself to have some anger, but be able to let go of that anger at an appropriate time where it’s not holding you back? Because a lot of times when people have left religion, they’re very angry, understandably, but people can get stuck in the anger. I have a long research history with the topic of forgiveness, which we didn’t talk about today, so we’re interested in applying that.
I’m also really interested in people’s experiences of after-death communication. Kathleen Pait, a grad student who works with me did her master’s on that. We plan to do more work in that area. We’re looking with Will Schutt, who’s working with me, we are looking at the question of whether psychedelics might trigger spiritual struggles or help to resolve spiritual struggles in some people, and we’re also really interested in these questions about political polarization and how supernatural beliefs and attributions could either make people more or less polarized depending on their content.
So I like to think about supernatural beliefs as being an accelerant. They make your love or hatred of another person stronger by providing this connection to an authority beyond this world. So I think that depending on whether your belief is that other people you disagree with are to be met with love and respect, or if you think they’re to be met with hostility and a sense that God is on our side. In either case, having a divine endorsement for whatever you think about these other people could really push things in the direction of more love, forgiveness, and connection or more hatred and polarization and aggression.
Mills: That all sounds remarkably interesting. I wish you all good luck in doing this research. I want to thank you for joining me today, Dr. Exline.
Exline: Thank you so much, Kim. This was really fun and I appreciate having this opportunity to talk with you today.
Mills: Thanks again. You can find previous episodes of Speaking of Psychology on our website at www.speakingofpsychology.org or on Apple, Stitcher, YouTube, or wherever you get your favorite podcasts. If you have comments or ideas for future podcasts, you can email us at speakingofpsychology@apa.org. Speaking of Psychology is produced by Lea Winerman. Our sound editor is Chris Condayan.
Thank you for listening. For the American Psychological Association, I’m Kim Mills.
Julie Exline, PhD, is a professor in the department of psychological sciences at Case Western Reserve University in Cleveland, Ohio. She is a licensed clinical psychologist in Ohio and has been certified as a spiritual director through the Ignatian Spirituality Institute at John Carroll University. She is a past president of the Division 36 (Society for the Psychology of Religion and Spirituality - SPRS) and was chosen to receive the Margaret Gorman Early Career Award, Virginia Sexton Mentoring Award, and William James Award from the SPRS. Her current research focuses on a wide array of themes around spiritual struggles and supernatural attributions.
