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Dealing With Spiritual Struggles

Interview with Dr. Meryl Reist Gibbel on spiritual struggles and mental health.

Meryl Reist Gibbel, used with permission
Source: Meryl Reist Gibbel, used with permission

At certain times of our lives, the spiritual aspect of our humanity can become strained. Spiritual struggles happen all the time, regardless of religion. The questions and confusion can often impact our mental wellbeing. But, there are ways to navigate these struggles.

Meryl Reist Gibbel, Ph.D. is a clinical psychologist at WellSpan Philhaven, a comprehensive behavioral health organization in central Pennsylvania. Her area of specialization is the Psychology of Religion and Spirituality, with particular clinical and research interests in the areas of spiritually integrated psychotherapy and spiritual struggle. Dr. Reist Gibbel co-directs WellSpan Philhaven’s Center for Spiritually Integrated Care, a virtual center whose mission is to build competence in the provision of spiritually integrated mental healthcare.

JA: How did you first get interested in this topic?

MRG: During a difficult time in my young adult years, I encountered my own “dark night of the soul” that gave birth to questions that were inherently religious and spiritual in nature: Where is God in this painful and confusing time? Why isn’t God taking away my pain? Could God have prevented all of this from happening? These questions were accompanied by fear, anxiety, and shame.

Out of my own spiritual struggle and in talking with others who were asking some of the same questions, I developed a passion for understanding the intersection of spirituality and health, particularly mental health. I longed to bear witness to the spiritual struggles of others and offer acceptance and thoughtful questions in place of cheap platitudes or sure answers. Upon becoming a psychologist, I continued wanting to offer a safe place for individuals to engage with their spiritual struggles and how their struggles interface with their mental health, explore spiritual questions without judgment, and broaden and deepen their understandings of the divine.

JA: What was the focus of your study?

MRG: Psychological literature is clear that people with mental illness often make sense of their illness in religious or spiritual terms. Additionally, we know that people with mental illness can be particularly vulnerable to the negative effects of spiritual struggle, particularly when such struggles are not appropriately addressed in an effective and time-sensitive manner.

Broadly defined, spiritual struggle refers to distress of a religious or spiritual nature (i.e., feeling punished or abandoned by God, having doubt about religious or spiritual beliefs, or experiencing conflict with other people that is centered on religious matters). There was a gap in the literature exploring how spiritual struggles in people with mental illness are addressed in the context of psychological treatment.

My study was the first attempt to evaluate a systematic approach to addressing spiritual struggles among people with mental illness by using an intervention entitled Winding Road. A group of colleagues and I developed Winding Road, a 9-session, spiritually integrated intervention designed to address spiritual struggles in a religiously diverse group of adults with mental illness.

Winding Road’s goals are to encourage acceptance of spiritual conflicts, enhance willingness to explore spiritual struggles, decrease stigma associated with spiritual struggle, broaden and deepen understandings of the divine, and facilitate greater integration of spirituality into daily life. Participants were patients in a partial hospitalization program at a private psychiatric hospital in central Pennsylvania. Volunteers for the study were randomly assigned to receive Winding Road or treatment-as-usual.

JA: What did you discover in your study?

MRG: Winding Road impacted both the spiritual and psychological well-being of the participants. In terms of spiritual well-being, participants who received Winding Road reported feeling less abandoned or punished by God (the concept of “divine spiritual struggle”) as compared to participants in the treatment-as-usual condition. Illustrative of this change, one Winding Road participant shared that, “God became more personal to me. Before He was just, you know, up there and not very accessible but…the struggles are easier now.” In the words of another participant, “I feel that I became closer to God [as a result of Winding Road] because I was able to talk to Him instead of worrying about Him being mad and not listening to me.” In addition to less spiritual struggles, participants also reported greater forgiveness—of self, others, and perceived forgiveness from God.

Related to psychological well-being, data revealed that, as compared to participants in the treatment-as-usual group, Winding Road participants reported significantly less stigma related to their spiritual struggle, increased positive affect and more effective emotion regulation as related to their spiritual struggles, and a decrease in various addictive behaviors.

Photo by DJ Johnson on Unsplash
Source: Photo by DJ Johnson on Unsplash

JA: How might readers apply what you found to their lives?

MRG: Spiritual struggles are a normal and natural part of one’s spiritual development. They aren’t reserved for those with weak character or wavering faith. In fact, many of our religious and spiritual “heroes”—Mother Theresa, the Buddha, Jesus—experienced periods of religious doubt and spiritual anguish. It is important we make room for spiritual struggles rather than resisting them because we’re too afraid. When we make space for struggles and their accompanying emotions, we can engage our questions and open ourselves to tremendous growth we might otherwise miss out on. We offer ourselves the chance to cross new spiritual thresholds that can lead to deeper wisdom, peace, and compassion for ourselves and others.

JA: How can readers use what you found to help others?

MRG: Related to my response above, I think people are starving to know they aren’t alone in their experience of spiritual struggle. They long to be reminded that, in light of their searching, doubting, or despair, they don’t have weak faith they ought to be ashamed of.

Spiritual struggles are normal and occur for most people at some point in their lives. In my experience as a psychologist, helping people tolerate spiritual “imperfection” is fruitful; when they’re able to accept their struggle, they are better equipped to tolerate the fear and shame that so often accompanies and even exacerbates their struggle and any mental health issues.

Asking thoughtful questions about their ideas of the divine can help lead a person along on their spiritual journey toward a deeper, broadened, and more integrated God-image. I can’t help mentioning ethics here, however: It’s always important to recognize the boundaries of our competence. Spiritually integrated therapy is not about teaching our clients to interpret sacred texts in any particular way; referrals to clergy should be reserved for this.

JA: What are you currently working on that you might like to share about?

MRG: As previously mentioned, Winding Road participants reported a decrease in addictive behaviors as compared to participants in the treatment-as-usual condition. Several colleagues of mine (Faigin, Pargament, & Abu-Raiya, 2014) found spiritual struggles to be a risk factor for various addictive behaviors. They theorized that spiritual struggles may create a spiritual void of sorts that people attempt to fill with means (i.e., alcohol, drugs) that aren’t up to the task.

In my next research project, I’d like to explore whether and how addressing spiritual struggles (with an intervention like Winding Road or something similar) in people with a recent history of alcohol or drug dependence/abuse could promote lengthened sobriety, increase impulse control, and contribute to improved overall spiritual and psychological well-being.


Reist Gibbel, M., Regueiro, V., & Pargament, K.I. (2019). A spiritually integrated intervention for spiritual struggles among adults with mental illness: Results of an initial evaluation. Spirituality in Clinical Practice, 6, 240-255.

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