ABSTRACT Title of Dissertation: “SOMETHING TRULY GOT BROKEN”: A QUALITATIVE INVESTIGATION OF THE EXPERIENCES AND IMPACT OF SPIRITUAL ABUSE ON EAST ASIAN AMERICAN CHRISTIAN WOMEN Katie L. Rim, Doctor of Philosophy, 2025 Dissertation directed by: Professor Clara E. Hill, Department of Psychology Religion/spirituality (R/S) can promote well-being and mental health, but it can also inflict significant harm when misused by those in power. Recent research on spiritual abuse has suggested it may be prevalent in religious communities and can negatively impact one’s spiritual and mental health; however, no study has examined spiritual abuse among East Asian American Christian women, despite cultural factors that may render them particularly vulnerable to spiritual abuse. In this study, we sought to address this critical gap in the literature by qualitatively examining the experiences and consequences of spiritual abuse among East Asian American Christian women. Data was analyzed using Consensual Qualitative Research (CQR). Findings from this study include that spiritual abuse involved marginalization, pressure to participate in the church, and moral/spiritual judgment; spiritual abuse was perceived to be related to certain cultural and religious values; spiritual abuse negatively impacted participants’ mental health and had mixed impact on spiritual health; positive interpersonal experiences and the development of new perspectives on the abuse facilitated healing from abuse, while negative interpersonal experiences and isolation hindered healing from abuse; spiritual abuse resulted in long-term changes in identity; and survivors of spiritual abuse believe mental health professionals should have an understanding of spiritual abuse and recognize the importance of providing safe, client-centered spaces for survivors of spiritual abuse. Implications for practice and research are discussed. “SOMETHING TRULY GOT BROKEN”: A QUALITATIVE INVESTIGATION OF THE EXPERIENCES AND IMPACT OF SPIRITUAL ABUSE ON EAST ASIAN AMERICAN CHRISTIAN WOMEN by Katie Lee Rim Dissertation submitted to the Faculty of the Graduate School of the University of Maryland, College Park, in partial fulfillment of the requirements for the degree of Doctor of Philosophy 2025 Advisory Committee: Professor Clara E. Hill, Chair Professor Dennis M. Kivlighan, Jr. Associate Professor Richard Q. Shin Associate Professor Wonjin Sim Associate Professor Jennifer L. Wessel © Copyright by Katie L. Rim 2025 ii Dedication To the women who shared their stories with me, and to all whose stories have still to be shared. iii Acknowledgements This dissertation would not exist without the work and support of many. First and foremost, thank you to my advisor, dissertation chair, and study auditor, Dr. Clara Hill. Your dedication to your students is unmatched. Thank you for always seeing the best in me and my work, and for believing more in my abilities than I do. It is an honor to be your last advisee. Thank you to my dissertation committee, Drs. Dennis Kivlighan Jr., Richard Shin, Wonjin Sim, and Jennifer Wessel, for your feedback and guidance with this study. You challenged me to consider new questions and perspectives, and this dissertation is better off for it. Thank you to each of the women who participated in this study. Thank you for trusting me with your pain, your stories, your questions, and your faith. It is my hope that this work will serve to help others like you. Thank you to my research team: Aziz Baig, Ella Wasniewski, Jason Lu, Natalie Seah, Nusayba Abd-Elmoniem, and Ryan Lee. You gave up two hours of your evening every week for one and a half years and I am truly indebted. Thank you for treating these stories with so much respect, for tolerating the endless revisions and questions and nuances that make up qualitative research, for sharing about your lives with me, and for being the best team to leader. This dissertation could not have happened with all of you. Thank you to the friends who make up my community. I receive your love, faith, and support from near and far and it means so much to me. Thank you to my parents, whose honest questions, tenacious faith, and deep compassion have served as my model and inspiration from the beginning. You remind me that there is quiet, faithful leadership and small acts of great love being performed in countless, unseen churches everywhere. Thank you to my twin sister for iv allowing me to text you random sentences from my dissertation without context to ask for wording suggestions and for making my committee laugh when you couldn’t figure out how to leave the Zoom defense. I always know you’ll be there when I need you. And finally, to Sam - thank you for your endless love, support, grace, and confidence in me throughout this journey. It’s been quite the adventure, starting out our marriage amidst the busyness of this final graduate year. I wouldn’t want to do it with anyone else by my side. v Table of Contents Dedication ....................................................................................................................................... ii Acknowledgements ........................................................................................................................ iii Table of Contents ............................................................................................................................ v List of Tables ................................................................................................................................ vii Chapter 1: Introduction ................................................................................................................... 1 Spiritual Abuse ............................................................................................................................ 2 Definition, Prevalence, and Measurement of Spiritual Abuse ................................................ 2 Spiritual Abuse and Intimate Partner Violence ....................................................................... 4 Spiritual Abuse within Religious Communities ...................................................................... 6 Religious Trauma .................................................................................................................... 8 Rationale for Examining Spiritual Abuse among East Asian American Christian Women ....... 9 Prevalence and Context of Christianity Among Asian Americans ....................................... 10 Minority Stress and Cultural Betrayal Trauma ..................................................................... 11 Cultural Values ..................................................................................................................... 13 The Present Study ...................................................................................................................... 16 Chapter 2: Method ........................................................................................................................ 18 Participants ................................................................................................................................ 18 Research Team .......................................................................................................................... 18 Measures ................................................................................................................................... 20 Procedures ................................................................................................................................. 21 Recruiting the Sample and Data Collection .......................................................................... 21 Data Analysis ........................................................................................................................ 23 Chapter 3: Results ......................................................................................................................... 27 Type of Spiritual Abuse Experiences ........................................................................................ 27 Marginalization and “Othering” ............................................................................................ 27 Pressure to Participate in Church/Religious Organization .................................................... 29 Moral/Spiritual Evaluation .................................................................................................... 29 Interference/Control in Personal Life .................................................................................... 30 Impact of Spiritual Abuse on Health ......................................................................................... 31 Impact on Mental Health ....................................................................................................... 31 Impact on Physical Health .................................................................................................... 33 Impact on Spiritual Health .................................................................................................... 34 Factors that Impacted Coping or Healing ................................................................................. 36 Actions/Experiences that Promoted Coping or Healing ....................................................... 36 Actions/Experiences that Hindered Coping or Healing ........................................................ 40 Cultural Values Associated with the Abuse .............................................................................. 44 Respecting Hierarchy ............................................................................................................ 44 Patriarchal Values ................................................................................................................. 45 Maintaining Harmony ........................................................................................................... 46 Enduring through Suffering .................................................................................................. 47 Long-Term Changes as a Result of the Abuse Experience ....................................................... 47 Personal Growth .................................................................................................................... 47 Religious/Spiritual Changes .................................................................................................. 48 vi Loss of Health, Wholeness, and Identity ............................................................................... 49 Using Their Experiences to Help Others ............................................................................... 50 What Mental Health Professionals Should Know .................................................................... 50 Definition, Signs, and Impact of Spiritual Abuse ................................................................. 50 Importance of Providing a Safe, Client-Centered Space....................................................... 51 Chapter 4: Discussion ................................................................................................................... 52 Domain 1: Types of Spiritual Abuse Experiences .................................................................... 52 Domain 2: Impact of Spiritual Abuse on Health ....................................................................... 57 Impact on Mental Health ....................................................................................................... 57 Impact on Physical Health..................................................................................................... 59 Impact on Spiritual Health .................................................................................................... 59 Domain 3: Factors that Impacted Coping or Healing ............................................................... 62 Actions/Experiences that Promoted Coping or Healing ....................................................... 63 Actions/Experiences that Hindered Coping or Healing ........................................................ 66 Conclusions about What Facilitates or Hinders Healing....................................................... 68 Domain 4: Cultural Values Associated with the Abuse ............................................................ 69 Domain 5: Long-Term Changes as a Result of the Abuse Experience ..................................... 72 Domain 6: What Mental Health Professionals Should Know ................................................... 75 Fit of Findings with Original Research Questions .................................................................... 76 Limitations ................................................................................................................................ 78 Implications for Practice and Training ...................................................................................... 80 Implications for Research .......................................................................................................... 83 Table 1 .......................................................................................................................................... 85 Appendix A: Eligibility and Background Survey ......................................................................... 88 Appendix B: Interview Protocol ................................................................................................... 94 Appendix C: Personal Introduction ............................................................................................... 95 Appendix D: Recruitment and Follow-Up Messages ................................................................... 96 Appendix E: Recruitment Brochure .............................................................................................. 98 Appendix F: Mental Health and Spiritual Support Resources ...................................................... 99 Appendix G: Extended Literature Review .................................................................................. 101 References ................................................................................................................................... 128 vii List of Tables Table 1: Participant Demographics and Background Information on Spiritual Abuse Experience ..........................................................................................................86 Table 2: Categories and Subcategories within Domains for Spiritual Abuse Experiences of East Asian American Christian Women...............................................................87 1 Chapter 1: Introduction Religion/spirituality (R/S) has generally been associated with well-being (Weber & Pargament, 2014), including greater meaning in life, self-actualization, self-esteem, happiness, and optimism (Green & Elliott, 2010; Ivtzan et al., 2013; Steger & Frazier, 2005; Sternthal et al., 2010). However, recent research (see Ellis et al., 2022, for a systematic review) has also highlighted the harm that is inflicted when R/S is wielded as a weapon by those with power. Spiritual abuse (sometimes referred to as “religious abuse,” “religious/spiritual harm,” or “religious/spiritual trauma”) can be defined as a “form of emotional and psychological abuse characterised by a systematic pattern of coercive and controlling behaviour in a religious context or with a religious rationale” (Oakley et al., 2024, p. 190) and can have devastating mental and spiritual health consequences (Ellis et al., 2022). Victims of spiritual abuse often experience psychological distress, as well as disruptions in their R/S communities and R/S health (e.g., questioning their R/S beliefs) (Ellis et al., 2022). In addition, victims of spiritual abuse have also reported a secondary process of re-victimization as their experiences were delegitimized by their R/S communities (Krueger, 2018). Although studies examining R/S abuse are limited, the existing literature presents a sobering picture that warrants greater investigation. In addition, spiritual abuse has been primarily examined in predominantly White, female, Christian samples. To our knowledge, spiritual abuse has not been studied among East Asian American Christian women, even though certain cultural factors may render them particularly vulnerable to experiencing spiritual abuse. Although spiritual abuse in Asian American churches has not been examined empirically, it has been highlighted in recent national news. One recent 2 article discussed the rigidly “controlling” and “coercive” culture inside one large, predominately Asian American college church network founded in Berkeley, California (Yee, 2022). Thus, there is sobering but compelling anecdotal evidence that this neglected topic warrants further investigation. Spiritual Abuse Research on spiritual abuse has only recently begun to emerge. In the following section, I focus on the definition and prevalence of spiritual abuse, the measurement of spiritual abuse, and research on spiritual abuse within intimate partner violence and religious communities. Definition, Prevalence, and Measurement of Spiritual Abuse Johnson & VanVonderen (2005) provided one of the earliest definitions of spiritual abuse as the “mistreatment of a person who is in need of help, support or greater spiritual empowerment, with the result of weakening, undermining or decreasing that person's spiritual empowerment” (p. 20). Another commonly used definition of spiritual abuse was suggested by Oakley and Kinmond (2013), who defined it as coercion and control of one individual by another in a spiritual context. The target experiences spiritual abuse as a deeply emotional personal attack. This abuse may include: manipulation and exploitation, enforced accountability, censorship of decision making, requirements for secrecy and silence, pressure to conform, misuse of scripture or the pulpit to control behaviour, requirement of obedience to the abuser, the suggestion that the abuser has a ‘divine’ position, isolation from others, especially 3 those external to the abusive context. (p. 25) Recently, Oakley & Kimmond (2024) provided an updated definition of spiritual abuse as a “form of emotional and psychological abuse characterised by a systematic pattern of coercive and controlling behaviour in a religious context or with a religious rationale” (p.190). In addition, three core components of spiritual abuse emerged from a systematic review of the literature on spiritual abuse: misuse of power (e.g., coercion, control, or exploitation of another), psychological harm (e.g., depression, negative view of self), and negative spiritual health consequences (e.g., distance from God) (Ellis et al., 2022). Relatedly, five measures of spiritual abuse have been developed and used in the existing literature: (a) The Religious/Spiritual Abuse and Neglect of Children (RSANC; Kvarfordt & Sheridan, 2010) scale, which measures 10 types of spiritual abuse (e.g., misuse of religious teachings, use of religion to justify harsh punishment); (b) the Spiritual Abuse Questionnaire (Lawson, 2016), which was developed to help individuals reflect on whether they have experienced spiritual abuse; (c) a measure of spiritual trauma among LGBTQ+ individuals within the Church of Jesus Christ of Latter-Day Saints (Simmons, 2017), which assesses abusive experiences with leadership and abusive teachings; (d) The Spiritual Abuse Questionnaire (SAQ; Keller, 2016), which consists of two subscales: Power-based Affective Wounding (PBAF; i.e., misuse of power and resulting emotional injury) and Conditionality (i.e., the belief that one’s status with God and/or the church/religious group is dependent on behavior); and (e) the Spiritual Harm and Abuse Scale (SHAS; Koch & Edstrom, 2022) , which consists of six subscales: maintaining the system, internal distress, embracing violence, controlling leadership, harmful God-image, and gender discrimination. Although these measures provide a foundation for future research, most have not been widely used, and only 4 two (the RSANC; Kvarfordt & Sheridan, 2010 and the SHAS; Koch & Edstrom, 2022) were published in peer-reviewed journals; minimal validity has been provided for any of the five measures. Furthermore, many researchers developed their own items for assessing spiritual abuse rather than using measures with known psychometric properties (Ellis et al., 2022). Thus, measurement of spiritual abuse is in its infancy. In their systematic review, Ellis et al. (2022) found six studies that addressed the prevalence of spiritual abuse. They cited Oakley and Kinmond (2013) who found that 70% of participants in the United Kingdom endorsed feeling manipulated at their current church, 84% endorsed feeling manipulated at a prior church, and 45% endorsed that scripture was used to control behavior. In addition, spiritual abuse may be even more prevalent within some subgroups. For example, 95% of LGBTQ-identifying individuals who were current or former members of the Church of Jesus Christ of Latter Day Saints (LDS) reported at least one experience of spiritual abuse and 86% potentially met the criteria for post-traumatic stress disorder related to their experience (Simmons, 2017). In addition, high rates of spiritual abuse (ranging from 65 to 82% reported by social workers) have been reported for children within foster care systems (Kvarfordt & Herba, 2018; Kvarfordt, 2010; Kvarfordt & Sheridan, 2007) and 49.5% by Native American children within foster care (Landers et al., 2021). Spiritual Abuse and Intimate Partner Violence Spiritual abuse has been examined within the context of intimate partner violence (IPV). Bagwell-Gray et al. (2021) examined experiences of reproductive coercion and pregnancy avoidance in 660 women recruited from domestic violence shelters. They found that 21% of women reported experiencing spiritual abuse (assessed by the question, “Has your partner used religious teachings or traditions as a reason to control your daily activities?”), and that the 5 likelihood of experiencing reproductive coercion was significantly higher for women who experienced such partner-based spiritual abuse. Similarly, Hassouneh-Phillips (2003) found that while R/S was often a source of strength for Muslim women experiencing IPV, it was also sometimes a point of vulnerability. Specifically, some women believed that this life did not matter, which rendered them vulnerable to staying in abusive situations, and that perpetrators of IPV sometimes misused religious texts to exert control. Finally, spiritual abuse has also been examined as a specific dimension of “wife abuse” among Haredi (Ultraorthodox) Jewish women (Dehan & Levi, 2009). The authors argued that spiritual abuse was distinct from other forms of abuse and conceptualized it within the context of wife abuse as “any attempt to impair the woman’s spiritual life, spiritual self, or spiritual well-being” (p. 1300). Researchers have also examined the perspectives of clergy about the relationship between spiritual abuse and intimate partner violence. In their interview study of 13 Black clergy about spiritual abuse within intimate partner violence and abuse, Davis and Johnson (2021) found that clergy viewed spiritual abuse as a spiritual problem/demonic, as a misinterpretation of God’s word, and as sometimes perpetrated by religious leaders. They emphasized the importance of victims of spiritual abuse knowing the word of God as a tool for themselves and also utilized scripture to address IPV-related spiritual abuse. Furthermore, Bent-Goodley and Fowler (2006) conducted focus groups with 19 African American church members and leaders on the topic of domestic violence within faith-based communities. They found that the topic of spiritual abuse arose as participants discussed the ways that spirituality interacted with domestic violence. Although participants hesitated to define spiritual abuse, (preferring to conceptualize it broadly), they recognized how R/S could be used to perpetuate abuse. They also acknowledged that clergy missed opportunities to confront IPV and were 6 sometimes complicit in perpetuating it, and that spiritual abuse could not be separated from the ways in which the church functions in regards to gender. Finally, participants agreed that it was important to understand spiritual abuse more clearly to understand its impact on survivors of IPV and the responsibility of faith communities in addressing it. Spiritual Abuse within Religious Communities A growing body of research has examined experiences of spiritual abuse within religious/spiritual communities. Bilsky (2013) used grounded theory methods to investigate abuse of religious authority (ARA) experienced by individuals from Christian faith traditions. They defined ARA as “a) the misuse of excessive authority and power (derived from a divine source) that b) exploits, harms, controls, or shames an individual with less power” (p. 137). Bilsky found that for many participants, experiences of the religious community were initially positive but became negative over time, and that the most positive factor – community and social support – became a means through with spiritual abuse was reinforced (e.g., through peer pressure). In addition, ARA impacted participants’ spirituality primarily through questioning one’s beliefs, experiencing a disruption in one’s relationship with God, and developing a sense of mistrust toward religion/religious individuals. In contrast, for some individuals, experiences of ARA positively impacted their spirituality (e.g., through spiritual growth, change in beliefs, and/or spiritual perspectives that no longer included God). Krueger (2018) used a mixed-methods approach to examine experiences of clergy nonsexual misconduct among 148 individuals. Using a phenomenological approach, Krueger (2018) found that victims of clergy misconduct experienced intense negative emotions and a changed sense of identity. In addition, many participants experienced both primary and secondary victimization as church members protected clergy after the misconduct and engaged 7 in ostracization and shaming of the victims. These experiences severely impacted victims’ spiritual (e.g., altered church involvement) and mental (e.g., social hypervigilance, chronic rumination) health. Research has also explored the relationships between spiritual abuse, mental health, and meaning-making. Johnston (2021) studied 67 people who reported experiencing a traumatic or abusive experience within a religious setting and found that spiritual abuse was positively correlated with presence of meaning in one’s life. Furthermore, religious trauma and spiritual abuse both positively correlated with depression. It is important to note that while Johnston found positive correlations between spiritual abuse and both presence of meaning and depression, predictive relationships were not significant (i.e., spiritual abuse did not significantly predict presence of meaning or depression in multiple regression analyses). In addition, Johnston assessed spiritual abuse through the Religious and Spiritual Struggles Scale (RSS; Exline et al., 2014), which was not specifically designed to measure spiritual abuse. Glasscock (2019) examined the experiences of seven former cult members who reported experiencing spiritual abuse. They found that many participants had pre-cult vulnerabilities (e.g., prior trauma history, seeking answers) that were exploited by the cult leader. In addition, cult leaders conflated the idea of following themselves with following God. Participants were also required to make extreme sacrifices in their personal lives for the sake of the group, felt extreme pressure to conform to group norms, felt threatened by use of labels (e.g., “enemy of the church) to conform, and overall experienced “totalitarian” levels of control within the cult. As a result, participants experienced a range of negative emotions toward themselves (e.g., shame, self- condemnation) and the group leader (e.g., disillusionment), experienced estrangement from social relationships because of their 8 affiliation with the cult, and suffered through painful emotional consequences from their experience (e.g., PTSD symptoms). Gomez (2005) interviewed seven individuals who had experienced interpersonal trauma that was denied by their Christian community. They found that participants experienced denial from their churches as marginalization and re-traumatization, involving feelings of betrayal and loss, and that the spiritual abuse affected participants’ experiences of communal worship and understanding of God. Finally, Kamminga (2018) found that spiritual abuse and problems with prescribed opioid use were positively correlated. In open-ended questions, some participants reported that they used opioids to cope with emotions related to their spiritual abuse. It should be noted that the sample size was too small (n = 33) to examine higher-level, predictive relationships, and that spiritual abuse was assessed through the Spiritual Abuse Questionnaire (SAQ; Lawson, 2016), which has not been examined for reliability or validity and lacks psychometric data. Religious Trauma In the popular (non-academic) literature (e.g., Hake, 2021; Taylor, n.d.; Willowcounseling, 2022), religious trauma has been distinguished from spiritual abuse, with religious trauma referring more broadly to the psychological and spiritual consequences that can result from experiences of spiritual abuse. Empirical literature has been more mixed in distinguishing between religious trauma and spiritual abuse. Psychologist Marlene Winell was the first to describe “religious trauma syndrome” based on her own experiences and clinical work. She categorized symptoms into four clusters: cognitive (e.g., identity confusion, difficulty making decisions), affective (e.g., anxiety, guilt, lack of meaning), functional (e.g., disturbed sleep, substance abuse), and social/cultural (e.g., 9 interpersonal dysfunction, employment issues). While Winell applied the concept of religious trauma primarily to individuals leaving fundamentalist Christian backgrounds, Stone (2013) offered a broader definition of religious trauma as “pervasive psychological damage resulting from religious messages, beliefs, and experiences” (p. 324). Unlike acute trauma, religious trauma can develop through long-term exposure to harmful beliefs and messages (Stone, 2013). Crocker (2021) interviewed ten sexual minority Christians on their experiences of religious trauma and spiritual resilience. They found that religious trauma was associated with mental and physical health challenges, including symptoms of depression, anxiety, and trauma and negative coping behaviors. They also found that religious trauma resulted in changes in participants’ religious beliefs and practices. Finally, Crocker (2021) found that several factors were associated with maintenance of participants’ faith despite experiencing religious trauma, including education and social support. Rationale for Examining Spiritual Abuse among East Asian American Christian Women Although (to our knowledge) spiritual abuse has not been empirically examined specifically among East Asian American Christian women, there are compelling reasons to address this gap in the research. Specifically, there may be cultural factors that render East Asian American Christian women particularly vulnerable to spiritual abuse. In this section, we begin by briefly summarizing the prevalence and sociological context of Christianity among Asian Americans before discussing specific cultural factors that may be relevant to spiritual abuse. 10 Prevalence and Context of Christianity Among Asian Americans Although often portrayed as a single, homogenous group, the racial category of Asian Americans includes individuals from more than 50 groups who speak over thirty languages (Sue, Nakamura, Chung, & Yee-Bradbury, 1994, cited in Tan & Dong, 2014). Furthermore, there is significant heterogeneity in religious traditions and affiliations within Asian Americans; one recent survey found that 42% of Asian adults identify as Christian (specifically 22% as Protestant, 19% as Catholic, 1% other), 26% identify as unaffiliated, 14% identify as Buddhist, 10% as Hindus, 4% as Muslims, 2% as other religions, and 1% as Sikh (Asian Americans, 2012). The diversity of religious affiliations within Asian Americans varies widely by ethnicity; for instance, Protestant Christians make up 61% of Korean Americans, 33% of Japanese Americans, 22% of Chinese Americans, and 4% of Vietnamese Americans (Asian Americans, 2012). In addition, it is important to note the influence of Evangelical Protestantism among Asian American Christians, particularly Korean Americans; for instance, Asian American Evangelical Protestants are among the most religious groups in the United States (Asian Americans, 2012). The strength of this cultural identity can be seen perhaps most easily through college campus parachurches, such as Campus Crusade for Christ and Intervarsity Christian Fellowship, which were formerly predominantly White in composition and which now are heavily populated by Asian Americans (Park, 2009). For instance, 80% of the more than 50 Evangelical campus organizations at UC Berkley and UCLA are Asian Americans (Kim, 2006). Some of these parachurches have formed specific chapters targeted toward Asian Americans, which provide “culturally similar community… and protection from marginalization” (Kim, 2006, cited in Hong, 2019, p. 5) 11 Scholars have argued that the prevalence of Christianity among Asian Americans may reflect two processes: first, there may be a self-selection bias among religious immigrants (Park, 2009). In other words, the individuals who choose to immigrate may be more likely to be already affiliated with the primary religion (i.e., Christianity) of the United States. This proposition is supported by statistics on both Korean Americans and Filipino Americans, which suggest that the proportion of Christians in the United States are significantly higher than in their countries of origin (Park, 2009). However, the prevalence of Asian American Christians may also reflect a new embrace of Christianity within America stemming from the hardships of immigration (Park, 2009). For instance, some scholars have referred to immigration as a “theologizing” experience (Min, 1992, cited in Kim, 2011; Smith, 1978, cited in Park, 2009); in other words, the challenges of immigration (such as navigating cultural uprootedness, language barriers, and economic difficulty) created a need for meaning that religion was able to fulfill (Park, 2009). In addition, the church also provided a critical resource for meeting immigrants’ social needs. Within ethnic churches, Asian immigrants were welcomed into a group of others who shared their language, culture, and the difficulties of adjusting to a new home country. In this way, the ethnic church has been a site of cultural expression and preservation (Park, 2009). As the Christian church was a site of cultural expression and preservation for displaced Asian immigrants, it also became a site of cultural transmission to the next generation of Asian Americans (Park, 2009). Minority Stress and Cultural Betrayal Trauma Asian Americans may be at risk for mental health challenges related to their experiences of marginalization as racial minorities. According to Minority Stress Theory 12 (MST; Meyer, 2003), individuals with stigmatized identities experience unique stressors due to structural oppression that put them at higher risk for mental health problems. Although MST was originally developed to explain the experiences of sexual minorities, it has been applied to other marginalized groups, such as racial/ethnic minorities (e.g., Arbona & Jimenez, 2014; Wei et al., 2005), religious minorities (e.g., Bassioni & Langrehr, 2021; Every & Perry, 2014), and individuals with disabilities (e.g., Lund, 2021). MST has been especially used to examine the experiences of individuals with multiple minority identities, such as LGBTQ people of color (e.g., Cyrus, 2017; Ramirez & Paz Galupo, 2019). Although their experiences of racism are often denied through underreporting and stereotypes of the “Model Minority” myth, Asian Americans have a long history of experiencing oppression and xenophobia in the United States (Lee, 2021; Lei et al., 2022; Litam, 2020). In addition, the surge of reported hate crimes against Asian Americans in the wake of Covid-19 has brought greater recognition of anti-Asian racism (Jin, 2021; Lee, 2021). Recent research (e.g., Lei et al., 2022; Wei et al., 2011) has applied MST to explain how race- related stress contributes to negative mental health outcomes for Asian Americans. In the face of racism and discrimination, Asian Americans may find safety and support in Asian American spaces. According to cultural betrayal trauma theory (CBTT; Gomez, 2017a), societal oppression, such as racism and discrimination, leaves marginalized groups feeling unsafe; as a result, some group members turn to each other for support and safety, developing “intracultural trust” (i.e., “attachment, dependence, loyalty, and responsibility with other ingroup members;” Gómez, 2017b, p. 432). In this context, within-group interpersonal trauma is experienced by members as “a violation of this (intra)cultural trust and is conceptualized as cultural betrayal” (Gómez, 2017b, p. 432). This echoes aspects of Janoff- 13 Bulman’s (1992, 2010) “shattered assumptions” theory of trauma, which suggests that traumatic experiences “shatter” our core, fundamental (sometimes unconscious) assumptions of other people and the world (e.g., “The world is a good place”), leaving trauma victims upended in a dangerous, meaningless world. CBTT extends the “shattered assumptions” theory of trauma by highlighting the unique distress minority group members may experience when core assumptions of intracultural trust are violated. This may also pose implications for help-seeking, as it may be harder for marginalized individuals who experienced trauma by someone within their cultural group to disclose their trauma, given their knowledge that the perpetrator also experiences oppression within the majority culture (Delker et al., 2019). Cultural betrayal has been associated with psychological distress, such as internalized prejudice and anxiety. Gómez (2017b) found that among Asian American and Pacific Islander (AAPI) college students, cultural betrayal predicted disassociation, hallucinations, posttraumatic stress symptoms, and hypervigilance. These findings suggest that Asian Americans who experience spiritual abuse by other Asian Americans (e.g., at an Asian American church) may experience a sense of cultural betrayal and may be at heightened risk for mental health problems. Cultural Values In addition to risk factors associated with belonging to a marginalized group, certain cultural values might also render East Asian American Christian women vulnerable to spiritual abuse. Although it is important to acknowledge inter-ethnic cultural differences (Kim et al., 2001), East Asian Americans generally share certain cultural values stemming from the strong influence of Confucianism in East Asia (Chuang, 2012; Ozaki & Otis, 2017). These cultural values provide relevant context for the importance of examining spiritual 14 abuse among East Asian American Christian women. Patriarchalism. East Asian cultures are generally considered patriarchal, referring to a societal structure that places men in positions of privilege and domination over women (Gao et al., 2012; Ozaki & Otis, 2017). Within patriarchal cultures, men are generally seen as dominant both in the family and workplace while women are expected to occupy positions of obedience (Ma et al., 2021; Ozaki & Otis, 2017). These patriarchal values are embedded into the cultural socialization process of Asian Americans (Koo et al., 2012), and research has found that greater adherence to Asian values was associated with higher endorsement of patriarchal beliefs among Asian American young adults (Yoon et al., 2019). The influence of patriarchalism can be seen within many Asian American churches, in which women are often excluded from serving as pastors or elders (Park, 2009; Tan & Dong, 2014). Cha et al. (2006) noted that the “authoritarian” leadership culture within many Asian American churches, particularly the Korean American church, is a result of the “intersection between Confucianism and church life” (Cha et al., 2006, p. 61). In churches with this leadership style, the spiritual authority of church leaders is rarely questioned (Oh, 2003, cited in Cha et al., 2006) and church members may not feel free to voice differing opinions. These patriarchal norms may serve to augment the power held by male leaders within Asian American churches, furthering the power differential between church leaders and the congregation. Cha et al. (2006) noted that male pastors in particular can be elevated to an “unhealthy role of father figure” (Cha et al., p. 62). These gender dynamics may serve to augment the inherent power differential between church members and leaders, potentially rendering Asian American women particularly vulnerable to abuse. Collectivism. Although portrayals of Asian cultures as uniformly collectivistic are 15 oversimplified (Cohen et al., 2016; Wang & Chen, 2010), it would be remiss not to consider the influence of collectivism on Asian cultural norms. Within collectivistic cultures, individuals are viewed as interdependent, and the needs of others tend to take priority over the needs on the individual (Cohen et al., 2016). Specific collectivistic values within East Asian cultures include respect for hierarchy and authority, familism (e.g., importance of the family) and filial piety (i.e., honoring one’s family and elders), and avoidance of direct confrontation (Chang, 2015; Tan & Dong, 2014; Zhang et al., 2005). Collectivistic cultural norms may have important implications regarding social support seeking, including mental health utilization; Chang (2015) found that despite believing that familial support was generally available, Asian American undergraduates reported concerns that self-disclosing one’s problems to others would result in criticism and that this presented a barrier to seeking social support. Additionally, findings from the broader trauma literature have similarly suggested that for those who upheld Asian values of interdependence, individuals who were relationally very close to perpetrators of emotional and sexual abuse were less likely to disclose the abuse compared to individuals who were not close to perpetuators (Foynes et al., 2014). These findings can be interpreted in relation to concerns about “face loss,” or the loss of one’s social image due to one’s performance in interpersonal contexts (Liu et al., 2017). Previous research has found that Asians reported greater face loss concerns compared to White individuals, and that face loss concerns are associated with greater psychopathology and less help-seeking behaviors (Liu et al., 2017). The saliency of face loss in Asian cultures has led some to characterize Asian cultures as “shame-based” (Zane & Ku, 2014). In addition, Asian American undergraduates reported learning the importance of 16 forbearance from their parents, which refers to one’s ability to endure difficulties with emotional restraint (Chang, 2015). As Chang discussed, forbearance and self-reliance may be adaptive for Asian Americans when facing minor challenges, but may become hurtful when dealing with significant stressors. In comparison to Latino students, who similarly reported cultural barriers to seeking social support, Asian students reported greater concerns over other peoples’ opinions and fear of disgrace, perhaps because Asian cultures are generally considered “tight” (i.e., there is strict adherence to social norms) (Chang, 2015). These findings potentially explain why Asian Americans are the least-likely to utilize mental health treatment among all racial/ethnic minority groups (Lee et al., 2021). The Present Study The original purpose of this study was to examine the experiences and impact of spiritual abuse on East Asian American Christians. We focused specifically on East Asian Americans, given the particularly strong influence of Confucianism on East Asian cultures (Ozaki & Otis, 2017) that may be relevant to spiritual abuse. Our specific research questions were as follows: 1. What kinds of spiritual abuse do East Asian American Christians experience? 2. How does spiritual abuse impact their mental and spiritual health? 3. How do cultural factors influence the experiences and consequences of spiritual abuse for East Asian American Christians? 4. What factors facilitate healing from spiritual abuse? After initial recruitment efforts, we decided to further narrow our sample to East Asian American Christian women, due to the high proportion of respondents who identified as female and cultural values regarding patriarchalism that might render East Asian American 17 women particularly vulnerable to spiritual abuse. Given the dearth of psychological research on this topic and the exploratory nature of this study, we decided to use Consensual Qualitative Research (CQR; Hill & Knox, 2021), a rigorous and established qualitative method, to investigate this topic. CQR is rooted in postpositivist and constructivist perspectives, which emphasize truth as a constructed reality and the subjectivity of researcher interpretation. 18 Chapter 2: Method Participants Our sample was composed of nine East Asian American Christian women. They were between the ages of 19 and 41 years old (M = 30.3, SD = 5.6). Six identified as Korean/Korean American and three identified as Chinese/Chinese American. Seven identified as heterosexual/straight and two did not identify their sexual orientation. On the Spiritual Abuse Questionnaire (SAQ; Keller, 2016), participants’ total scores ranged from 37 to 66 (M = 49.9, SD = 9.6), with a possible range of 17-68. See Table 1 for participant demographics and background information on the spiritual abuse. Research Team The first author of this study conducted all interviews and led the research team. She is a doctoral student in counseling psychology with previous experience using CQR methodology. She identifies as a Korean American, heterosexual, cisgender, Protestant Christian woman in her late twenties. Her parents immigrated to the United States from South Korea as children. She grew up attending predominately Korean American Protestant churches and her father was a pastor within Korean American churches throughout much of her life. She has heard (directly and indirectly) stories of spiritual abuse within predominately Asian American churches from friends and acquaintances. She has not experienced spiritual abuse herself. The first author recruited research assistants to form her CQR team through an online post in her university’s psychology department e-news blog and through reaching out to peers in her graduate program. The team originally consisted of 8 members. One Korean American, 19 31- year-old, heterosexual, cisgender female graduate student withdrew from the team due to scheduling conflict before the analysis began. Another 21-year-old, bi-racial Asian/White, bisexual, cisgender female undergraduate student withdrew from the team after the domaining and coring stages of CQR (around halfway through the analysis) due to scheduling conflicts. Six remaining team members, excluding the first author, completed the entire CQR analysis: a 21- year old, Asian, Muslim, heterosexual, cisgender male in his first year of a masters in professional psychology program; a 22-year old, White European/Pakistani American, agnostic, bisexual, cisgender female senior psychology major; a 19-year old, Chinese, agnostic, heterosexual, cisgender male sophomore biology major; a 19-year old, Malaysian Chinese, Christian, heterosexual, cisgender female sophomore public health major; an 18-year old, Middle Eastern, Muslim, heterosexual, cisgender female senior psychology major; and a 20-year old, Taiwanese American, heterosexual, Agnostic male junior public health major. Before beginning data analysis, the research team wrote about their biases and expectations on religion/spirituality and spiritual abuse. Six members of the team described having positive views of religion, two described feeling ambivalent or neutral toward religion, and one described having a negative view of religion. Initial associations around the concept of “spiritual abuse” included manipulation, using guilt to control others, misuse of scripture, abuse of power, and sexual abuse in the Catholic church. Two team members reported having experienced or possibly experienced spiritual abuse; five reported knowing someone personally who they believe experienced spiritual abuse. Expected themes or findings from the study included spiritual abuse harming individuals’ mental health, spiritual abuse having a lasting effect, victims of spiritual abuse having pre-existing vulnerabilities, shame/guilt, 20 gender norms, and individuals’ religious faith either buffering against the effect of the abuse or becoming stronger through the abuse. All team members were encouraged to set aside their biases and expectations as much as possible during the data analysis process. A licensed counseling psychologist who is also the first author’s graduate advisor served as the auditor for the study. She identifies as a White, heterosexual, cisgender woman in her 70’s with extensive clinical, research and teaching experience. Although no longer spiritual and never having experienced spiritual abuse, she grew up in a religious home and church, and her father was trained as a minister. Measures Eligibility and Background Survey Interested participants were asked to complete a Qualtrics survey containing eligibility screening items, an online consent form, demographic questions, the Spiritual Abuse Questionnaire (SAQ; Keller, 2016), and a request for a brief summary of the spiritual abuse experience (See Appendix A). Spiritual Abuse Questionnaire. The Spiritual Abuse Questionnaire (SAQ; Keller, 2016) consists of 17 items that assess two dimensions of spiritual abuse, using a 4-point scale ranging from 1 (strongly disagree) to 4 (strongly agree). The first subscale, Power-based Affective Wounding (PBAF), captures misuse of power and resulting emotional injury (e.g., “I now feel cynical about church/religious groups”). The second subscale, Conditionality, reflects the belief that one’s status with God and/or the church/religious group is dependent on behavior (e.g., “I believed God would punish me if I didn’t do what my church/group encouraged me to do”). A total score was calculated by summing all item responses; higher scores reflect higher levels of spiritual abuse. Keller (2016) demonstrated that the SAQ had 21 convergent validity through positive associations with measures of religious and spiritual struggle, PTSD symptoms, and institutional betrayal, and good internal consistency (ɑ = .98). Interview Protocol Interviews were semi-structured, such that the interviewer asked standardized questions while also using additional probes (e.g., “Tell me more about that”). The protocol was developed by the first author, reviewed by her advisor, and revised after completing one pilot interview with a personal acquaintance of the first author who identified as experiencing spiritual abuse. The protocol included questions about participants’ religious/spiritual and ethnic backgrounds, their experiences of spiritual abuse, its impact on their mental, physical, and spiritual health, what factors contributed to and hindered efforts to cope and heal from the abuse, and their perspectives on spiritual abuse (see Appendix B). Personal Introduction At the start of each interview, the first author read a personal introduction in order to situate the interviewer’s positionality to the study topic and to help establish rapport with participants. The introduction briefly described the first author’s identities, cultural and religious background, and interest in the topic of spiritual abuse (see Appendix C). Procedures Recruiting the Sample and Data Collection Approval was obtained from the university Institutional Review Board on July 13th, 2023 [2048608-1]. Participants were recruited via email listservs, social media posts, and personal contacts. Recruitment materials (see Appendices D and E) included a definition of spiritual abuse, a description of the study procedure, eligibility requirements, a copy of the 22 interview protocol, and a link to the eligibility and background survey. The original eligibility requirements for the study were that participants must be a) 18 years or older, b) identify as East Asian American, and c) have previously experienced spiritual abuse within a predominantly Asian American, Protestant Christian church or ministry in the United States at 18 years or older. Exclusion criteria for the study were if (a) the spiritual abuse was still ongoing and/or (b) the spiritual abuse was accompanied by physical or sexual abuse. After initial recruitment efforts, we decided to limit participation in the study to only women. This was due to the fact that initial respondents to the survey were predominantly women, and we speculated that experiences of spiritual abuse among Asian Americans might differ based on gender. Given that we aimed for a relatively small sample of 10-15 individuals and might not have enough participants to create sub-groups based off gender, we felt that limiting the sample to only women would allow us to reduce heterogeneity in responses and better analyze the experiences of this particular group. In total, 96 individuals completed the Eligibility and Background Qualtrics survey, including individuals who partially completed the survey. Eighteen of those individuals were contacted by the first author to schedule a 60-90 minute Zoom interview, with the first author striving to choose individuals who met the eligibility requirements for the study and who we felt, based off the brief summary of their experiences that participants provided in the survey, would be able to discuss their experience of spiritual abuse in detail and depth. Twelve of the 18 individuals who were contacted ended up completing the interview, including one individual whose interview was only partially completed due to ineligibility concerns. After completion of the interview, participants were provided with a list of emotional and spiritual 23 support resources (see Appendix F) and a $25 Amazon gift card. Three participants ended up being excluded from the final analysis: one participant who had partially completed the interview due to eligibility concerns, one participant who requested after the interview to withdraw from the study before data analysis had begun, and one participant who requested her data be withdrawn from the study after data analysis had been completed. Interviews were transcribed verbatim by research team members; all identifying information was removed and code numbers were used. Transcripts were sent to participants to review for accuracy and confidentiality; all were approved with a few minor changes to protect participant confidentiality. Data Analysis Data analysis was conducted through weekly Zoom meetings. Before data analysis began, research team members all read Hill et al. (2005) as an introduction to Consensual Qualitative Research and discussed biases and expectations regarding the study topic. The team also acknowledged existing power dynamics within the team (e.g., first author vs. team members, graduate students vs. undergraduate students), discussed ways to reduce power differentials to create a non-hierarchical team culture, and discussed the importance of and strategies for self-care throughout the project. The first step in CQR involved creating a list of domains, or discrete topics that emerged from the data. The team created an initial domain list after reading one transcript and continued to modify the domain list after reading two more transcripts. The domain list was then sent to the study auditor and revised based on her feedback. Next, team members coded two transcripts, assigning all data chunks to one or more domains. Throughout the coding, the team continued to make revisions to the domain list based on the transcripts and feedback 24 from the auditor until it was “stable”. Next, the whole team constructed core ideas, or summaries of the data, for one transcript. After all team members understood the domaining and coring process, they were divided into subgroups to code and create core ideas for the rest of the transcripts. A consensus version (table that contains all of the raw data from the transcript with corresponding domains and core ideas) was created for each case. Each consensus version was reviewed by the first author and auditor, who provided feedback. Revisions were made by each subgroup through consensus and additional discussion with the first author as needed. Throughout this process, the domain list continued to be modified as needed based off the transcripts and auditor feedback. Once all transcripts were coded, the final domain list was numbered and a final table, which consisted of all of the consensus versions merged and ordered by domain, was created. Finally, the team conducted the cross-analysis. Team members read Chapter 9 (“Cross- Analysis”) of Hill (2012) and discussed the steps for conducting the cross-analysis. The first author then independently identified possible themes for one relatively simple domain, which were then modified based on the team discussion until initial categories and subcategories were developed. The team then together coded each core idea within that domain into one or more categories and subcategories. The team then together created a list of categories and subcategories for the rest of the domains, following the same process. Once team members understood the process, they were divided into subgroups to then code core ideas into categories within each domain. When discrepancies arose, the team returned to the raw data to stay as close to the data as possible. Each cross-analysis was reviewed by the first author and team auditor, who provided feedback. All edits were made through consensus by 25 the subgroup responsible for the coding and with additional consultation with the first author and auditor as needed. The first author and auditor then worked together to make final revisions to the cross-analysis. After data analysis had been completed and a draft of the manuscript had been written, all participants were invited to review the manuscript to ensure that confidentiality was maintained and to solicit feedback regarding the study findings. Three participants responded with positive feedback and one participant responded with a request to be withdrawn from the study. The first author and auditor worked together to make revisions to the cross-analysis and manuscript to reflect the removed participant. Throughout the data analysis process, the first author worked to ensure that all team members’ voices were heard and given equal weight. She saw her role as one of facilitator and consultant on the content area and methodology. The first author strove to reduce inherent power dynamics by continually asking how people felt, inviting differing opinions, and making all decisions by consensus. All feedback was provided as suggestions and decisions regarding revisions were made by the subgroup responsible for that portion of the analysis, often in consultation with the first author. The team dynamics were collaborative and positive, and no problems were mentioned by any team members. Throughout the data analysis process, which was completed over 1.5 years, the team met for three in-person social gatherings to facilitate team rapport and celebrate progress on the project. At the end of the data analysis process, the team reflected on initial expectations and reactions to the findings. Some team members reported that their views on religion and/or Christianity changed, with some sharing that their perspectives became more positive based on participants’ reliance on faith for healing, and many sharing that they developed a more nuanced 26 and mixed attitude toward religion and/or Christianity through seeing both the positive and negative aspects of faith and religious institutions. Team members also shared that their understanding of spiritual abuse became broader and less rigid. Team members reported being surprised by the severity of spiritual abuse and its impact on participants, as well as how much spiritual abuse some participants endured before leaving their church. Finally, team members shared that they enjoyed the team meetings, found the analysis process sometimes “tedious,” and developed better understandings of qualitative research. 27 Chapter 3: Results Table 2 presents the frequencies of the categories and subcategories within six domains. Categories that included core ideas from all or all but one of the participants (8 or 9) were considered general, those that emerged for more than half up to the cutoff for general (5 to 7) were typical, those that emerged for two up to half of the sample (2 to 4) were variant. Results are presented below in descending order of frequency. We provide quotations from cases to illustrate the data, removing filler words (e.g., “uh,” “you know”) and deleting sections of quotations as indicated by ellipses ( . . . ) to enhance readability. At times, we paraphrased the actual quotes for sake of clarity and brevity. We used pseudonyms for all participants. Type of Spiritual Abuse Experiences In this domain, participants described their experiences of spiritual abuse. Four categories emerged from the data: marginalization and “othering,” pressure to participate in the church/religious organization, moral/spiritual evaluation, and interference/control in personal life. Marginalization and “Othering” Typically, participants described experiences of being excluded, “othered,” and treated as second-class citizens at their church, often due to their gender. Jane described being dismissed as a “raging feminist” and excluded by the male leaders at her church when she worked there as an intern. The male leaders would ignore her when they passed her in the hallway and excluded her from email communications about events she was supposed to be helping with. Jane said: 28 I was set aside as a separate tier, sort of a “You’re not really one of us” kind of thing. And actually, it's even funny, because for the longest time, they didn't want to use the word “intern” with me because that made them feel uncomfortable because they believe that authority should be given away to the men pastors . . . So they were trying to think of new titles for me. One of them was “woman's coach,” but functionally, I was doing everything. It was really confusing. Stacey described being excluded by the other members of her Christian campus organization: I got this language from some of the peers from that group as if like, “This is not what you're supposed to do. This is not the image that you want to portray in our group. You're not doing your responsibilities” . . . I don't speak Cantonese, so I only speak Mandarin. A lot of them are Cantonese . . . they would say, “This is not what you should be doing reflecting the values of this group.” Mina said that she was often treated like a “servant” by her pastor and his wife due to her status as a female seminarian. For instance, she was asked to cook for the church and carry heavy furniture for the pastor. Mina recalled one example: [The pastor’s wife] had a huge bag of bagels and she was giving that to all the lay people in the church. And I was also passing by and I thought she was giving that to me. And I kind of automatically said, “Oh, thank you Samonim [pastor’s wife], and then she's like, “No, no, no. This is not for you . . . You're not a lay person. This is not for you. You shouldn't eat this.” And I was like, “Oh, okay.” And she was like, “Yeah. But can you deliver this to my son who lives near your home?” . . . I felt like I was treated as like a servant in the church. 29 Pressure to Participate in Church/Religious Organization Typically, participants described being pressured or coerced into participating in their church. Stacey described feeling pressured by her Christian campus organization to participate in their activities, even when she needed to focus on her schoolwork and job: I prioritized myself for the things that I have to do . . . I just had to skip some of the activities in order to do what I had to do in order to graduate, or to support myself . . . Sometimes I just said, “Oh, this semester, I really can't do this xyz activity. Going to this church activity, I can't do that.” And then they just couldn't accept that. When she declined participating in certain activities, Stacey recalled being asked, “Why would you only think about yourself?” Jenny recalled studying a bible passage with her mentor within a Christian campus organization and the mentor interpreting the passage by telling her that she shouldn’t care so much about her academics and should be more involved in the organization. She was repeatedly pressured to attend the organization’s retreat and recalled their response when she declined: So [church mentor] says “Okay, well . . . Imagine you are juggling and so your life is like juggling and as you grow more skilled in juggling as you grow older, you can juggle more balls . . . Imagine your life, your relationship with Christ and you coming to this retreat is the glass ball. So you’re juggling a bunch of balls, but this one’s a glass one. If you drop that, then you know, if you drop the other balls, you can always pick them up. But this is glass, so if you drop it...” and then they would raise their eyebrows at me and it would just be silent. Moral/Spiritual Evaluation Typically, participants described feeling morally or spiritually judged by leaders in 30 their church. When Grace told her pastor that a conflict with her friend was due to miscommunication, he insisted, “It’s not a miscommunication. It's a heart issue. It's a pride issue.” She also recalled that in her first mandated “counseling session” with the pastor, [The pastor] used Paul's epistles against me. Like the verse about “Do nothing out of selfish ambition.” He said that I was pursuing my Ph.D. selfishly and people who pursue a Ph.D. usually don't get into heaven. Grace was told her personal therapy was “clearly not working” and she needed “soul surgery.” Christine recalled being berated by her church leader for going on a “personal retreat” to work through her jealousy over not getting a lead role in her church’s skit and being “corrected” for her lifestyle: She started yelling at me and she's like, “How dare you run away and just fall into your own self-pity party and worry all of us,” and like, “You are having jealous thoughts, you're such a sinner, you’re so sinful that you have these kinds of jealous thoughts” . . . getting these corrections more about my character, like that I was being lazy if I didn’t wake up on time for DTs, that I wasn’t being thoughtful if I didn’t bring soup over to my roommate or something, if she was sick. That I wasn’t being spiritually passionate if I wasn’t getting that many students in my ministry. Interference/Control in Personal Life Variantly, participants discussed experiences in which they felt church leaders exerted control and regulation of their personal lives. In one example, Grace’s pastor interfered in her relationship with her fiancé after finding out about a conflict between Grace and one of her friends, who also attended the same church. Grace recalled: The pastor went to . . . girls that I had supposedly hurt while at that church. And then 31 he had them all write up letters on how I hurt them. And then the pastor presented all those letters to my husband, at the time fiancé, and he said, “[Participant] has a sin of pride. The wedding needs to be postponed. You guys can't get married in this state.” The pastor also mandated that Grace attend “counseling sessions” with the church leaders, in which Grace recalled them “gaslighting me the entire time with scripture” and asking for pictures of her personal journal. During that time, Grace and her fiancé were told they were not allowed to talk to each other for four weeks. If Grace didn’t “show progress,” she was told that she and her fiancé would need to cancel their wedding. In another example, Anna’s church enforced strict rules around church members’ choices in relationships, entertainment, and general lifestyle, such as limiting interactions between men and women, restricting social media use, and forbidding members to watch Korean dramas. Church members were told to “confess” their “sins” to leaders and were punished through “corrections” when they broke church rules. For instance, Anna was told to write a 20-page “reflection” because of her views on opposite-gender relationships and her choices in her dating relationship. She was also told by her church leader to stop seeing her therapist because she was trusting her therapist more than her church leaders. Impact of Spiritual Abuse on Health Participants described how the spiritual abuse impacted their mental, spiritual, and physical health during the time they were experiencing the abuse. Impact on Mental Health In this subdomain, three categories emerged from the data: psychological symptomology/negative affect, interpersonal challenges, and academic/career disruptions. 32 Psychological Symptomology/Negative Affect Generally, participants reported experiencing psychological distress and negative emotions in response to the spiritual abuse. Grace said, “Because of the gaslighting, it was so severe. I wanted it to stop. I seriously contemplated suicide because it was just so much.” Mina said, At one time, I felt so insecure and I still remember, I woke up in the middle of the night because of a panic attack I had at 3 AM in the morning. And I didn't know it was a panic attack. I thought I just had a nightmare, and then that continued for one month. And I could see myself changing. And I felt anger, disappointment, also despair. Anna described experiencing depression as a result of the spiritual abuse: I just want[ed] to not live because I [felt] like, “If I die, well, at least I'll be in heaven. And heaven is where all things broken will be made right. So maybe I'll work right in heaven” . . . It's kind of weird, because it's not like I was like suicidal . . . It was more like, “Oh, I just kind of want to be in heaven because it's rough down here.” Interpersonal Challenges Generally, participants reported that the spiritual abuse resulted in interpersonal challenges. Jane reflected: A lot of my anger went towards men at the time. I had a severe distrust of men . . . I guess a lot of people would have said that I was very hostile at the time . . . I realize now that was actually me functioning out of a lot of anxiety, of feeling like, “I need to take control of my situation because no one else will protect anybody here.” Grace described feeling anxious and alone, “I was afraid someone would reach out to me that I didn't want to talk to . . . And I didn't know who was actually there for my best interest or 33 who wanted to control me.” Stacey noted that the abuse she experienced in her campus organization made her wonder, “Why can’t I bond with other people in the group?” Disruption in Academics/Career Variantly, participants noted that their professional and academic lives were disrupted as a result of the spiritual abuse. Grace remembered, “I took two incompletes on that semester because I was in two classes. And I didn't turn on my computer those entire four weeks. I could barely function.” Jane said, “I barely got through college because of what had happened. It was really hard for me academically because I was just so depressed. I just had such a hard time focusing and had a hard time really doing anything.” Christine said, “I would take the day off from work because I was feeling just overall like malaise and sick and just not wanting to do anything, because I feel like my leader doesn't like me or is displeased with me.” Impact on Physical Health In this subdomain, two categories emerged: somatic symptoms related to mental health and physical health problems not related to mental health. Somatic Symptoms Related to Mental Health Typically, participants discussed physical health problems related to their psychological distress. Grace said she “wasn’t eating” due to her depression and anxiety. Tiffany remembered, “I cried a lot, didn't eat a lot. I had a really hard time sleeping.” Christine described “stomach aches or digestive issues or headaches . . . I would get sick pretty frequently.” Physical Health Problems Not Related to Mental Health Variantly, participants discussed physical health problems not specifically related to 34 mental health concerns that were direct results of the spiritual abuse. Mina was injured as a result of being asked by her pastor to help carry furniture, “That actually made me to have [a] hernia . . . So I had to go back to Korea and get a surgery.” Anna recalled being in physical pain when she was required to wash dishes for four hours, “my back was dying. I had my period that day and I get the worst cramps. I had cramps and I was not looking happy.” Impact on Spiritual Health In this subdomain, four categories emerged: disengagement from God or church, greater closeness/dependency on God, questioning God, and negative beliefs about God and/or self. Disengagement from God or Church Variantly, participants reported that they experienced greater distance and disengagement from God or church during the time of their spiritual abuse. Jane remembered: There was like maybe a solid 6 month to a year period where I was truly angry, and I was angry at God. I just did all the stereotypical college things like went partying and was just really rebellious and did not care about church and did not go. Erin stopped going to her church to avoid abusive pastors. She said the experience also caused her to feel guarded and not want to participate at her next church: I remember getting very tense whenever someone asked me to serve at the third [new] church. It was like, “Can I say no?” . . . I was like, “Okay, I don't think I want to go to a Korean church ever again.” Greater Closeness/Dependency on God Variantly, participants reported that while they were experiencing spiritual abuse, they became more dependent on God and experienced greater relational closeness to God. Tiffany 35 said, “In that particular time, I did feel really close to God, because I had no one else really to rely on.” Mina described how her relationship with God became a place of healing for her during the abuse: I was more depending on God, asking for His help. And because my church community and my school Christian community was not safe for me, I was really focused on studying and my relationship with God. So, for me, the only healing space I could have was in class, where I could study about God, and my personal practice time with God, like praying or praising. So it even strengthened my relationship with God. Questioning God Variantly, participants reported that the spiritual abuse they experienced caused them to question and/or doubt God. Tiffany said, After that whole incident with the male leader shutting me down, I went home and I just opened my Bible just cried to God, cause I was like, “Is this really what this Word means? Is this really what this verse is talking about?” . . . I think I was really struggling with “God, is this the kind of leader that You are? . . . Why would you allow this to happen?” Anna stated, It's hard for me to think that, “Oh, God still loves [the abusers] though.” For me, it's like “God, they're wrong, though. But yet You stand behind them . . . You're also for those people. You're for me. But you're also for them. So are You on my side or not?” Negative Beliefs about God and/or Self Variantly, participants reported struggling with negative religious beliefs about God and/or themselves due to the spiritual abuse. Christine remembered how she felt after being punished by her religious leader for crossing “physical boundaries” in her relationship: 36 That ended up being the start of my soul just literally dying because I felt like that sin was too shameful to ever recover from. I was never going to be good enough to do college ministry or to be a lead for [Church] because I've just sinned so bad, like I've fallen so bad that I'm going to be a useless person in [Church]. Anna described the impact of the spiritual abuse on her beliefs about herself: “Oh, my gosh! God must be so upset with me.” And “Wow, I’m such a horrible person” and “Wow, God is barely putting up with me”. That was my constant understanding of God. So basically, how I've viewed my leaders ended up being how I view God. Factors that Impacted Coping or Healing In this domain, participants identified the actions and experiences that helped or hindered them on their journey of coping and healing from the abuse. Actions/Experiences that Promoted Coping or Healing In this subdomain, six categories emerged: positive interpersonal experiences, developing new perspectives on the abuse, focusing on meaningful activities, engaging with religion/spirituality, gaining distance/space from the abuse, and mental health treatment. Positive Interpersonal Experiences Generally, participants reported that having experiences of being supported and validated by others helped them recover from the abuse. Erin described how important it was for her to be around other Christians who accepted her: And if it wasn't for [pastor] and having this other church I could go to, I could very much see myself just sinking into despair, being like, “Oh, I'm going to hell, this whole church 37 rejected me.” But since I was able to go to a different church, I was like, “Oh, okay, these are other Christians who accept me.” Anna stated, Just having people who understand . . . There are a lot of [former church members] who experienced the spiritual abuse. So just talking to them about my experience, and kind of breaking it down, and seeing them get angry for me. I think that's really helpful, because initially, I was like “I’m not angry. I was in the wrong” kind of mentality, and I was defending [the church] too when I talked to other people . . . I think that helped. Developing New Perspectives on the Abuse Typically participants reported that developing new understandings of their spiritual abuse experience helped them move on from the abuse. Mina said, I found that from the Bible, Jesus did not judge anyone. And he really showed love and he was not demanding. He was embracing. And just from that, I realized what my pastor was doing was wrong. He wasn't showing any love. He wasn't showing any respect. He was just abusing his authority. So, I think I also realized that he was wrong and the Church was wrong. Christine said, When I started to learn about spiritual abuse, at first I was like, “No, I can't even research that term” because “abuse” is such a strong word . . . I'm like, “No, this couldn’t be it.” And then but as I kept learning more about it and reading other books and listening to podcasts and reading articles, I was like, “Oh, my gosh, this really was.” And all these things started to like click together in my mind . . . because of that knowledge, I feel like my eyes were open to properly process my experience. 38 Tiffany became able to see multiple sides to her experience and have more compassion on herself and others: At the time, it was really easy for me to be like, “These men are oppressive, they are silencing me.” . . [Now], I also recognize that there are different sides. There are different perspectives . . . And so, in that way, when I'm thinking about more of the different pieces of the story at the time, I think I found that I've been able to have a lot more compassion and grace for myself, in terms of how I handle[d] the situation. Focusing on Meaningful Activities Typically, participants described how investing in meaningful activities and goals helped them move on from the abuse. Stacey said that “keeping busy” and focusing on her academics helped lessen the impact of the abuse. Tiffany found healing in her job as a teacher to immigrant students: I feel like [the students] were very healing for me . . . These were students from different countries around the world and their only connecting point was learning English so it was really lovely in the classroom, hearing these students . . . try their best to connect with each other with the one language that could get them to communicate . . . I was like “This is what community feels like” and I think that felt really redemptive for me. Engaging with Religion/Spirituality Variantly, participants reported that engaging with their faith helped them cope and heal from the abuse. Christine said, A huge part of it was reading through Scripture without the [Church] lens. [There were] so many things we had to unlearn about what church was. . . We read through 39 Paul's letters, and were like, “You know, he isn't yelling at them, he isn't making them feel bad and he isn't correcting them about these little character type of things, about whether you smiled or how you dressed or if you're losing weight, he wasn't correcting them about that . . . so we had to correct our beliefs and our theology. Erin said, I did think [about] how Jesus said up on the cross, “God, please forgive them, for they do not know what they do.” And so, I was like, “Okay, if I am to be like Jesus, or strive to be like Jesus, that means people are just really flawed, and they're going to hurt me. But that doesn't mean God isn't good.” And so I think in that regard, and having that mindset, I was able to not hate God and turn away from Christianity. Gaining Distance/Space from the Abuse Variantly, participants reported that simply having time and distance from the abuse helped them move on and heal. Jane said, “It was the physical moving away [that helped]. Getting married and moving away to different church that really helped me.” Jenny said, Time - definitely time. I think if I jumped out and jumped into the second semester immediately and joined another Christian group that wouldn't have been necessarily good for me, I think, just kind of the same for like processing a loss or a [big event] even. It's just you just need time to think about things. Mental Health Treatment Variantly, participants identified therapy as helpful in their journey of coping and healing from the abuse. Tiffany stated: She [therapist] helped me process through a lot of what I was feeling. So, even though I still chose to silence myself in the church, that I was able to have that space to talk 40 about it with my therapist, and I think she was able to connect a lot of my tendencies and my behaviors to early childhood dynamics, things like that. And that was very helpful for me to understand why I react the way that I do. Jane said, “I was going through therapy . . . to sort of unpack a lot of the things I went through. So I think, because of that, my mental health was in a better place.” Actions/Experiences that Hindered Coping or Healing In this subdomain, four categories emerged: harmful interpersonal experiences, feeling isolated/alone, experiencing self-doubt/blame, and experiencing reminders/triggers of the abuse. Harmful Interpersonal Experiences Typically, participants discussed experiences of being invalidated or dismissed when they shared about the abuse. Tiffany shared, However, when I shared it with another one of my friends that I thought was really close, she was like, “I understand that you're really stressed about this instance, but you sharing this with me, it's actually not helping me see [church leader] in a good light, and I want to make sure that I maintain good feelings about this person. So I would appreciate if you don't talk about this anymore” . . . And she made it a point to say, “He’s your small group leader. He's the spiritual leader. So maybe it is worth thinking about what he said.” . . . I think in some ways that was probably more hurtful for me because I felt like “Am I crazy?” Jane recalled, And so there were a lot of times when I would openly share with other leaders within 41 the church where I would want to voice my concerns and the general instinct would be, “Ugh, pastors go through so much and so we need to honor them.” Christine shared about the response of church leaders after she sent an email to many members of the church speaking up about her experiences: One of my former leaders was calling up some people that I had cc’ed on that email saying, “Oh it didn’t happen the way [Participant] said it. And you can’t really believe what she’s saying right now.” . . . So it’s been kind of a retraumatizing time. Feeling Isolated/Alone Typically, participants reported that feeling isolated and not having close community hindered their ability to cope or heal. Erin said: I still feel stuck in some ways. And maybe it's because I don't necessarily feel like I have a community that emulates the kind of community and closeness I had with people in the second church . . . I miss that kind of community and intimacy and I haven't found a good substitute for it. Tiffany said, It also didn't help that I was living by myself. So I think that really encouraged me to just kind of silo myself off from people. I didn't really connect with my college friends from [College]. I was like, “I have no energy to talk to you, because I'm tired all the time from student teaching, from dealing with church stuff whatever.” So, I think that prevented me from reaching out and getting support. Christine recalled her loneliness after leaving the abusive church: Because we were really discouraged from having close relationships outside of the 42 church, when I left, I realized how little I had any sort of relationship with anybody else. I barely knew any of my co-workers because [it was] kind of looked down upon to hang out with your coworkers after hours and stuff . . . I wasn't close to my parents too much . . . I had constantly said no to any of their offers to go on a family trip because of [Church] that I didn't have any rhythms with them and I didn't have any other friends in any other sphere of life . . . So when I left I felt like I had nothing . . . I was pretty depressed and really doubting that “Oh, maybe I didn't make the right decision. Maybe I should go back, because this is so hard.” Experiencing Self-Doubt/Blame Variantly, participants discussed how doubting, questioning, or blaming themselves for some aspect of their experience hindered their ability to move on or heal from the experience. For Jane, self-doubt hindered her from reaching out: It’s just confusing mostly, like was my experience really as bad as I feel like it was? Even like thirty minutes before coming onto this call, I was thinking, “Was this really spiritual abuse? I don’t know.” I still feel kind of confused. Tiffany said, As an Asian woman, I’m very aware of certain stereotypes that we have . . . and it just always felt like I didn't fit the mold of what a woman should look like, what Asian women should look like. And then, in that experience with that church kind of like, “Oh, but fit the mold of a Christian woman,” and I think because of that, it really led me down this path of questioning myself. Who am I supposed to be? And how am I supposed to act within my role as aa Christian woman, as an Asian Christian woman? I think those are still questions that I wrestle with today. 43 Experiencing Reminders/Triggers of the Abuse Variantly, participants reported that being reminded of the spiritual abuse hindered their ability to move on from the experience. For Grace, her choice to “stalk” her church’s social media page kept her from moving on: I would go on [the church] Instagram or Facebook and stalk them and see what they've been up to, and finding more proof that it was good that I left . . . I kept looking back for validation and proof that I was right to leave and that I wasn't crazy. Christine said she and her husband felt “pressured” to join a new church right away so that other people didn’t think they “became non-Christians.” She remembered struggling with how different the churches were from her former church and feeling triggered: At one point I really broke down at a prayer meeting . . . I was just crying. And looking back at that point, I was like wow, I was really shell-shocked by these different churches, and how different their culture was, and how insulated and kind of in-our- own-world we were in. I didn't know how to just operate in these other church settings . . . all of a sudden there were too many things at Sunday services that were starting to trigger me. Anna had a negative experience in counseling that reminded her of her abusive church: I found something that's called “biblical counseling.” I just thought it was Christian counseling. But it's actually not . . . How it works is you'll list out your problems, you’ll go to the Word of God, and you figure out in what ways you're not living the Word out correctly, that is causing those issues. You basically have to confess it and work through them with the therapists that you have. And for some people that works out great. But then, for people like me, I don't think that worked well because it felt 44 exactly like what [Church] did. So I felt really triggered. Cultural Values Associated with the Abuse In this domain, participants discussed cultural values they perceived to be related to their experience of spiritual abuse. Although most values were related to Asian culture, some were related to Christianity. Four categories emerged: respecting hierarchy, patriarchal values, maintaining harmony, and enduring through suffering. We note that participants’ experiences of spiritual abuse were embedded within their specific cultural context, and thus it is artificial to “separate out” the impact of culture from other domains. However, we found that creating a specific domain for relevant cultural values allowed us to highlight these results more clearly. Respecting Hierarchy Typically, cultural values around hierarchy and the importance of respecting authority figures impacted participants’ experience of spiritual abuse. Jenny said, It's just like an Asian value to respect. So respect your elders and so it kind of implies [that] you should respect the people and listen to the people who are leading you, even if it doesn't make sense. Christine discussed how her Korean ethnicity related to her experience of abuse: I did feel like the way I've experienced spiritual abuse was tied to the fact that I was Korean, and a lot of the leaders were Korean. Because there is so much of Korean culture, and some Asian cultures at large, where there's this kind of unstated given that you respect your elders, you submit to them. And anyone who's older has every right to speak into your life and give you their unsolicited advice . . . [The church] knew that they could rely on that cultural trait of people speaking into your life . . . They use that 45 and spiritualize it and call that “discipline,” because then you can't push back, like I can't say “no” to that, it's not just their unsolicited advice, it's my leader discipling me and so when she does say something . . . I need to obey my leader in this, because she's trying to disciple me. Patriarchal Values Typically, participants discussed patriarchal values within their culture impacted their experience of abuse. Mina said, I felt like because I was a single woman and I was young - I was in twenties - I think they were able to treat me like that because I was a single woman seminarian. If I were married and if I had a husband who can be with me, I think that it might have been a little different . . . I didn't have anyone. So, that's why they knew they could treat me like that . . . They were judging me based on my status as a single woman seminarian. They just wanted to abuse their authority to show that I am below them. I'm the lowest status. Grace said, They were definitely misogynistic. When I said that marriage was a partnership and they were like, “Oh, that's not biblical,” I knew instantly like, “Oh, it's because I'm not the typical wife.” Actually, my mom pointed it out, because she asked me for the age of the girls that I had hurt and whether they were married or not. And I said, “Yeah, actually all of them are married minus [church member].” And my mom was like, “That's it. They're all married. Of course, you're not fulfilling the married wife standard.” Like I had no intention of changing my last name. I still don't. And I know that was a big contentious issue in the church. It was definitely a gender thing. It was 46 more of a patriarchy thing and I wasn't matching the picture of a “biblical woman” for them. Maintaining Harmony Variantly, participants discussed cultural values around maintaining harmony, even at personal cost. Jane described how speaking up at her church caused her to feel ashamed: Also the shame I feel of just questioning, “What’s wrong with me, going against the flow and disrupting harmony in what seems peaceful otherwise? Everyone else seems okay with this, so why can't I be okay with this?” I feel ashamed. I think that’s very deeply cultural too. Messages Tiffany received as a child about restraining her emotions to avoid making others uncomfortable caused her to silence herself about the abuse: I didn't want people to see that I was angry. I didn't want people to see that I was upset or scared . . . I chose to keep it to myself, because again, it's the value that my mom had instilled in me of like, “You don't want to make people uncomfortable” . . . I felt like it was important for me to essentially sacrifice myself, sacrifice my own needs and my own desires to be seen and heard. To be like, “I don't want to cause any problems in this community. I don't want to be the one that's creating division.” I think that's more Christian. But similarly, a collectivistic kind of value of “Let me hold back . . . So that I can protect the harmony of this community” . . . It's such a convenient blending of the two, the convenient blending of the need to prioritize community and harmony blending with the Christian need of “We are one body, don't create division, be peacemakers.” 47 Enduring through Suffering Variantly, participants described how values around perseverance, forbearance, and endurance through suffering shaped their response to the abuse. Tiffany said: I don't know how much of this is stuff that I've learned from my culture, from my family, but it's like, if I'm committed, I'm committed. If I'm committed, if I say I'm committed to a community, [then I] should stick with it, even though they're so painful to be around . . . I felt like “I'm sticking with it because that's what community is about, you can't just dip out, you can't just ‘shop for churches.’” People talk about that all the time. Mina said, I think this belief I had in my mind, I thought it was a spiritual trial, like shown in Bible that I had to win over or go through. But actually, it was not. It was something that I had to run away from. But I think that value, that thought, really hindered me to move on quickly after I realized that it wasn't a good place for me to be. Long-Term Changes as