The scale of the problem is difficult to overstate. Surveys suggest that approximately 27 to 33 percent of U.S. adults report religious trauma, a figure that implies tens of millions of people carrying psychological, spiritual, relational, and somatic injuries linked to their religious lives. Yet current diagnostic frameworks, the paper argues, do not fully capture these consequences. Survivors may present with symptoms that resemble post-traumatic stress, complicated grief, or moral injury, but the harm is threaded through their relationship with the divine, their sense of identity, and the communities that once structured their entire social world. Clinicians are actively treating this population without validated guidance, improvising from adjacent trauma literatures.

Summers grounds the framework in attachment theory, the account of human development first articulated by John Bowlby, in which infants build internal working models of relationships from the responsiveness of their caregivers. Research on the psychology of religion has extended this logic upward: many believers treat God as an attachment figure, a source of proximity, comfort, and safe haven whose perceived responsiveness shapes emotional regulation much as a parent’s does. Experimental work has supported this picture, showing that activating thoughts of God can buffer distress in ways that track a person’s internal working models. If God functions as an attachment figure, then abuse mediated by religious authority can wound the very attachment system that once provided the survivor’s deepest sense of safety.

This is why the framework treats attachment to God and the God image as primary clinical targets, distinct from general psychological symptomatology. A survivor may reduce their anxiety scores while still carrying a terrifying or humiliating internal representation of the divine, one that reactivates under stress, prayer, or even the sight of a church steeple. The framework also attends to the developmental pathways through which each survivor’s religious life was formed. Someone raised from childhood inside a high-control community has a different architecture of harm than an adult recruited into an abusive group, and the clinical entry points differ accordingly. Religious life, in this view, is not a belief system bolted onto a personality but a developmental structure interwoven with emotion regulation, identity, and relationships.

The five clinical targets around which the framework is organized come from the psychotherapy literature on trauma more broadly: they encompass the survivor’s capacity for emotional regulation, their attachment relationships, their sense of self, their narrative and meaning-making, and the somatic residues of threat that lodge in the body. Religious and spiritual abuse touches each of these. Shame, a recurrent theme in the empirical literature on religious trauma, functions as a self-directed emotion that corrodes identity rather than merely signaling bad behavior. Studies of former members of high-demand religious groups point to identity, meaning, and social support as the key mediators between spiritual abuse and psychological outcomes, which is precisely the territory these targets are designed to cover.

Against those targets, the framework positions four therapy modalities, selected on theoretical grounds rather than on outcome data, which for this population does not yet exist. Emotionally focused individual therapy, developed from Susan Johnson’s attachment-based model, works directly on emotional processing and the restructuring of attachment bonds, making it a natural fit for a survivor whose attachment to God has become a source of terror rather than comfort. The approach has a substantial process research base in couples work and a manualized individual variant, and its core claim, that adaptive adult functioning depends on accessible and responsive attachment figures, translates coherently to survivors reworking their image of the divine.

Internal family systems therapy offers a different technical angle. Richard Schwartz’s model conceptualizes the mind as a system of subpersonalities, or parts, including exiles carrying trauma burdens and protectors that manage them, led by a core Self with capacities for calm and compassion. A pilot effectiveness study of internal family systems for PTSD among survivors of multiple childhood traumas reported reductions in symptoms, and the model’s pluralistic view of the self maps well onto survivors who hold warring internal positions, the devout believer and the furious critic, the obedient child and the escaping adult. Narrative therapy, meanwhile, addresses the meaning-making target directly: abusive religious systems often supply totalizing stories that define the survivor’s worth, and narrative practice helps people externalize those stories and author alternatives, a technique with growing support in trauma-related disorders.

The fourth modality, somatic experiencing, developed by Peter Levine and grounded in part in Stephen Porges’s polyvagal account of the autonomic nervous system, targets the body. Religious abuse frequently deploys fear of eternal punishment, social exclusion, and divine wrath, threats that condition deep physiological defensive responses. Somatic experiencing works by titrating discharge of survival energy and restoring regulation of the autonomic nervous system, and it is one of the few modalities in the framework supported by a randomized controlled outcome study for PTSD, published in 2017. For survivors whose religious fear lives in their bodies as much as in their beliefs, this somatic route addresses a dimension that talk-centered therapies can miss.

The paper is careful about the limits of what it can claim. The four modalities are presented as promising, not proven, for this specific population, and the theoretical fit of each to the harm dimensions of religious abuse is an argument, not a demonstration. Measurement itself remains immature: spiritual abuse questionnaires and scales such as the Spiritual Harm and Abuse Scale have only recently been developed, and definitional debates continue across the literatures on spiritual abuse, religious trauma, and adverse religious experiences. A systematic review of empirical work on religious and spiritual abuse and trauma confirmed a growing but still thin evidence base, concentrated in descriptive studies rather than treatment research.

That gap is the paper’s closing argument. With roughly a third of American adults reporting religious trauma and no intervention outcome studies of any design available, the field’s most urgent priority, Summers writes, is rigorous testing of treatments for survivors of adverse religious and spiritual experiences. Until those trials exist, clinicians must work from theory, and the value of this framework lies in making that improvisation systematic: matching specific dimensions of harm to specific therapeutic mechanisms, honoring the attachment relationship with God as a clinical target in its own right, and giving researchers a structured map of where the evidence must go next. For a population that has often been told its pain is not real, the recognition that it demands serious science is itself a clinical intervention.

Subject of Research: Attachment-informed clinical framework for treating religious and spiritual abuse as trauma

Article Title: Religious and Spiritual Abuse: Trauma, Attachment, and an Integrative Framework for Clinical Response

Article References: Summers, H. (2026). Religious and Spiritual Abuse: Trauma, Attachment, and an Integrative Framework for Clinical Response. Pastoral Psychology. https://doi.org/10.1007/s11089-026-01375-y

Image Credits: AI Generated

DOI: 10.1007/s11089-026-01375-y

Keywords: religious trauma, spiritual abuse, attachment theory, attachment to God, trauma-informed care, emotionally focused therapy, internal family systems, narrative therapy, somatic experiencing, clinical framework, Pastoral Psychology, psychotherapy

Religious trauma syndrome was first articulated by psychologist Marlene Winell in 2011, who described a cluster of symptoms, including anxiety, depression, guilt, shame, and difficulty making decisions, that can emerge when individuals leave or are harmed by high-control religious environments. The new review draws on trauma psychology frameworks, including Judith Herman’s influential work on trauma and recovery and Bessel van der Kolk’s account of how traumatic experience is encoded in the body and mind, to explain how these symptoms develop. In authoritarian religious settings, the review argues, coercive leadership practices can suppress autonomy, shape identity, and normalize shame-based control. Techniques long associated with thought reform, from Robert Lifton’s classic studies of psychological totalism to Margaret Singer’s analyses of cultic groups, find parallels in religious environments where questioning is punished, doubt is framed as moral failure, and belonging is made conditional on obedience.

A central concept in the review is institutional betrayal, a framework developed by psychologist Jennifer Freyd to describe the harm that occurs when institutions on which individuals depend fail to protect them or actively violate their trust. In religious contexts, the review suggests, betrayal can be particularly corrosive because faith communities often occupy a uniquely central role in a believer’s social and psychological world. When the institution that promises unconditional love and spiritual safety instead enforces control, conceals abuse, or silences dissent, the resulting injury compounds the original harm. The review connects this dynamic to research on abusive supervision in organizational settings, including studies showing that hierarchical abuses of power in workplaces produce silence, fear, and psychological distress among those subject to them. Religious organizations, the review argues, are not exempt from these dynamics; they may amplify them by sacralizing authority and framing obedience as devotion.

Developmental vulnerability emerges as another key factor. Drawing on James Marcia’s classic work on ego-identity status, the review notes that adolescents and young adults are in the midst of forming their identities, making them especially susceptible to environments that dictate beliefs, regulate relationships, and define self-worth in theological terms. Recent dissertation and thesis research cited in the review, including a 2025 mixed-methods study of evangelicals exposed to high-control religiosity during their formative years and a phenomenological study of religious trauma among transgender and gender diverse people, illustrates how experiences during these developmental windows can produce lasting trauma outcomes. When authoritarian leadership coincides with psychologically vulnerable developmental stages, the review concludes, the potential for harm is greatest, because the individual’s emerging sense of self is built within, and often around, the controlling institution.

The review does not treat religion itself as the problem. It emphasizes that organized religion has historically provided meaning, resilience, moral guidance, and social cohesion for millions of people, and it considers the positive psychological and social functions that faith communities can offer when ethical leadership is present. Citing research on community health partnerships, such as the Triad Pastors Network’s work building health ministries within African American communities, the review points to examples of religious institutions serving as engines of public good. The distinction it draws is not between religious and secular organizations, but between governance models that concentrate power and those that distribute accountability. The same communal structures that can shelter and sustain can, under authoritarian leadership, isolate and control.

To explain this contrast, the review turns to organizational leadership scholarship. It invokes James MacGregor Burns’s foundational distinction between transactional and transforming leadership, and Robert Greenleaf’s concept of servant leadership, in which legitimate power is exercised for the benefit of those led rather than over them. It also draws on Amy Edmondson’s research on psychological safety, the shared belief that a group is safe for interpersonal risk-taking, as a protective factor against the silence and fear that authoritarian environments cultivate. Studies of abusive supervision, including research on how bad bosses suppress employee voice through damaged leader-member relationships, are used to map organizational dynamics onto congregational life. The implication is that the tools developed to diagnose and reform dysfunctional workplaces may be equally applicable to religious institutions, where the stakes include not only professional well-being but spiritual identity and community belonging.

Accountability is the linchpin of the review’s governance argument. Drawing on Grant and Keohane’s framework for understanding accountability and abuses of power in world politics, the review outlines how weak oversight allows leaders to act without consequence, and how multiple forms of accountability, including hierarchical, legal, and social mechanisms, can constrain abuse. In many religious organizations, the review observes, accountability structures are either absent or captured by the very leaders they are meant to check. Charismatic authority, theological claims of divine mandate, and insular communities can combine to create environments where complaints are dismissed, whistleblowers are ostracized, and harm is rationalized as discipline or divine will. The review suggests that governance reform, rather than individual therapy alone, is therefore essential to mitigating religious trauma at scale.

The constructive core of the review is its proposal of trauma-informed governance models as potential mechanisms for reducing institutional harm. Such models would emphasize transparency in decision-making, psychological safety for members and staff, and servant leadership that prioritizes the flourishing of the community over the power of its leaders. Trauma-informed governance, as the review frames it, means designing institutions with an explicit awareness of how power can wound: creating channels for reporting concerns without retaliation, involving members in governance decisions, training leaders in the psychology of trauma and coercive control, and building accountability structures that operate independently of charismatic authority. The goal, the review stresses, is not to dismantle faith communities but to preserve their beneficial communal functions while removing the structural conditions under which harm flourishes.

The review also situates religious trauma within a broader landscape of institutional harm, citing research on survivors of institutional childhood abuse and their experiences of posttraumatic growth, as well as clinical work on treating former cult members with therapies such as eye-movement desensitization and reprocessing. These literatures, the review argues, demonstrate both the severity of institutional trauma and the possibility of recovery, particularly when survivors find communities that validate their experiences. Measurement tools from trauma psychology, including the Impact of Event Scale and instruments for assessing depression, provide clinicians with means of evaluating distress, while spiritually integrated psychotherapy offers approaches that address religious injury without dismissing the sacred. The review’s synthesis suggests that recovery is aided when the institutional sources of harm are named and understood, not merely internalized as personal failure.

Ultimately, the review makes a case that is likely to resonate far beyond pastoral psychology: that the prevention of religious trauma is a leadership problem with identifiable structural solutions. By reframing religious trauma syndrome as a governance concern, the work invites boards, denominations, congregations, and scholars to apply the same rigor to religious organizations that organizational scientists apply to corporations and governments. Where transparency, psychological safety, and servant leadership take root, the review concludes, faith communities can retain the meaning, resilience, and social cohesion that have made them enduring fixtures of human life, while the authoritarian dynamics that turn devotion into damage are systematically designed out. In an era when institutional trust is under scrutiny across society, the argument that how organizations are led determines whether they heal or harm may prove to be the review’s most consequential contribution.

Subject of Research: How authoritarian religious leadership and weak governance contribute to religious trauma syndrome and how trauma-informed governance may mitigate it.

Article Title: Governance and the Mitigation of Religious Trauma: An Organizational Leadership Literature Review

Article References: Atterbury, A. (2026). Governance and the Mitigation of Religious Trauma: An Organizational Leadership Literature Review. Pastoral Psychology. https://doi.org/10.1007/s11089-026-01374-z

Image Credits: AI Generated

DOI: 10.1007/s11089-026-01374-z

Keywords: religious trauma syndrome, organizational leadership, institutional betrayal, trauma-informed governance, psychological safety, servant leadership, pastoral psychology, authoritarian leadership, identity formation, accountability, trauma psychology, faith communities