David H. Rosmarin is an assistant professor in the department of psychiatry at Harvard Medical School and the founder and director of the Center for Anxiety in New York. He is a board-certified psychologist, clinical innovator and prolific researcher who has authored over 50 peer-reviewed articles, focused on spirituality and mental health. He is also the author of Spirituality, Religion, and Cognitive-Behavioral Therapy: A Guide for Clinicians.
Rosmarin recently published a research study on sexual abuse in the Jewish community in the journal Child Abuse and Neglect. He spoke with The CJN about his findings.
What prompted your interest in a study on religiosity and sexual abuse?
I have been doing research for the last 10 to 15 years on spirituality and mental health. That’s my area of study. Sexual abuse has been a subject that I’ve avoided, as it’s very political and charged. It hasn’t been a subject I wanted to get involved in, because I really saw it as not relevant to my program of research, until I realized that in certain groups, it can have relevance to both spirituality and mental health. Most of all, I had several patients who had experiences with sexual abuse and I found that spirituality played an important role.
How did you go about the study?
Sexuality is a very sensitive subject, especially among more religious Jews, so we had to be very careful how we did the study. The main purpose of the study was not to focus on sexual abuse. Back in 2013, we launched the Harvard Medical School Study on Judaism and Mental Health, to assess for various facets of Jewish spiritual/religious life and emotional wellbeing/distress over a three-year period with nearly 500 Jewish individuals from the United States and Canada. We recruited participants with the help of pretty much every major organization in the Jewish world – from both ultra and centrist Orthodoxy, to the United Synagogue of Conservative Judaism, to the Union of Reform Judaism and specialty organizations which help individuals who convert to and from Orthodoxy. Then, we only asked participants about sexual abuse after they were in the study for two full years. As such, we had the trust of these people who gave us their information, and they weren’t recruited for the particular subject of sexual abuse. So, we think our findings are valuable.
Does religious association or observance get affected by sexual abuse incidents?
We found childhood sexual abuse to occur across the spectrum of Jewish religious affiliation, yet there was three times as much prevalence among formerly Orthodox individuals. That suggests that those who went through a childhood sexual abuse experience while Orthodox find it harder to relate to religion later in life. Interestingly, we also found that across the board – for Orthodox and non-Orthodox Jews, irrespective of how they were raised – individuals with a history of childhood sexual abuse had lower levels of religious belief, practice and value. In other words, our findings suggest that going through childhood sexual abuse may make it harder for someone to relate to religion.
Yet, your study seems to indicate that religion does act as a buffer against the effects of sexual abuse?
Correct. Despite lower prevalence of religion among abuse victims, we still found that religious engagement – higher levels of belief and practice – were negatively correlated with emotional distress and lower odds of having a psychiatric diagnosis.
Does that seem to be a paradox in terms of religion and sexual abuse?
Not really. The two main findings of the study are that: 1) history of childhood sexual abuse was associated with greater risk for psychiatric distress and less religious involvement, however; 2) spiritual/religious engagement and belief seem to act as a buffer and facilitate resilience in the context of abuse. What this suggests is that sexual abuse may alienate victims from spiritual tools that could help them to heal. It’s more of a tragedy than a paradox.
Is spirituality and religion being integrated into sexual abuse treatment?
Slowly, this is becoming the norm, but there is an old guard within the field of psychotherapy that views spirituality as pathological and irrelevant to mental health. Quite frankly, that camp is wrong and such an approach can cause damage to patients. If our findings tell us one thing, it’s that clinicians need to be able to address both the positive and negative aspects of spirituality with their patients. If we ignore it, or pathologize it, we are doing many people a disservice.
What are the take aways from the study?
We found that 16.1 per cent of males and 25.4 per cent of females had at least one incident of inappropriate genital contact as a child. Those are staggering numbers that are on par with what research has found in the general population. And to clarify, the prevalence of sexual abuse in our study was the same among individuals who were raised Orthodox and remain Orthodox, individuals who were raised non-Orthodox and are now Orthodox and individuals who have never been Orthodox. However, those who were raised Orthodox and no longer affiliate with Orthodoxy had much higher levels of abuse. Further, as we’ve discussed, it seems that spirituality can be negatively impacted by the experience of sexual abuse, yet it remains an important resource for a lot of people who have abuse history. So, I guess the most important take away is that sexual abuse is unfortunately quite common and can have a lot of negative effects, so it our duty to address this issue.
This interview has been edited and condensed for style and clarity.