Dr. Carrie Doehring

How did you become interested the relationship between caring for self and caring for the world?

I became interested in the role of compassion in caring for self and caring for the world after interviewing Vietnam veterans using Buddhist practices to cope with military posttraumatic stress. Meditation helped them experience self-compassion, which was the turning point in integrating their traumatic experiences. Their stories reminded me of how spiritual practices that foster self-compassion can open up new ways of experiencing God or a sense of goodness in oneself and the world. Self-compassion makes people more resilient. Whereas empathic distress makes people more likely to withdraw when they encounter people who suffer, compassion activates concern and makes people reach out to others. I realized that helping people care for themselves by using spiritual practices that foster compassion is not only important for self-care; it is important in helping them care for the world.

Say more about “moral anxiety.” It is an intriguing phrase.

Moral anxiety arises when our core values are in conflict. For example, parents might experience moral anxiety when their values about being good parents conflict with values of achievement related to work. Sorting out the conflicting values is complicated because sometimes the values we put into practice were formed in childhood and are no longer values we espouse as a high priority. Yet these embedded childhood values continue to exert an influence. We can clarify sources of moral anxiety by identifying which values are indeed high priorities, and which can be acknowledged as still influential but no longer meaningful. Addressing and resolving moral stress in whatever ways we can is important for self-care.

Why is it important for psychotherapists and religious leaders to be aware of these issues?

Our religious values and beliefs along with spiritual practices form a spiritual orienting system or, as I call it, a lived theology that can be life-limiting or life-giving. Psychologist of religion Ken Pargament has pioneered ways to measure when religions and spirituality is helpful or harmful for people coping with stress. I am interested in how certain emotions like fear or anxiety can bring together childhood values, beliefs, and coping practices that are beneficial or harmful. I’ve been using research and case studies to explore what this might look like.

How have participants responded to your talks on this topic before?

Religious leaders who take my online self-care course choose practices they want to establish that pulls together core values and beliefs they want to put into practice. They keep journals where they track the cues that will prompt them to use the new coping and/or spiritual practice, and they pay attention to how rewarding their new practice is. They read each other’s journals and offer compassionate encouragement. The changes that can happen over 3 or 4 weeks are really inspiring (Doehring, 2013).

How do you think the current climate of health care changes contributes to the “moral anxiety?”

I understand that health care professionals often work in cultures of scarcity, and are pressured to hurry appointments and see a quota of patients. This can make it harder to invite patients to tell their stories in their own way and be in charge of their treatment. A helpful approach to helping people that counteracts this top-down scarcity model is motivational interviewing, which I incorporate into teaching communication skills (Doehring, In preparation; Miller & Rollnick, 2012; Rollnick, Miller, & Butler, 2008).

What type of self-care practices have been mentioned in your previous seminars?

My interviews with Vietnam veterans explore the use of Buddhist meditation. In the self-care courses I teach, I encourage people to find whatever practice helps them live out core values. So, for example, one person made a habit of silence in the morning by turning off the radio and television. Another wanted to use her bicycle more because she was committed to ecology. She made biking into a spiritual practice. Many students use exercise and walking as a form of spiritual practice. For others, listening to music is spiritually meaningful. I enjoy seeing how creative people are in choosing these practices.

References

• Doehring, C. (2013). New directions for clergy experiencing stress: Connecting spirit and body. Pastoral Psychology 62(5), 623-638. doi: 10.1007/s11089-013-0512-1
• Doehring, C. (In preparation). The practice of pastoral care: A postmodern approach (Revised and expanded ed.). Louisville, KY: Westminster John Knox.
• Miller, W. R., & Rollnick, S. (2012). Motivational interviewing: Helping people change (3rd ed.). New York, NY: Guilford Press.
• Rollnick, S., Miller, W. R., & Butler, C. C. (2008). Motivational interviewing in health care: Helping patients change behavior. New York, NY: Guilford Press.