Spiritual Pathology Theory of the Sound Heart Model: Socio-Cultural Factors of Spiritual Distress

Introduction: Spiritual Pathology is the study of disturbing factors in the relationship between man and God, the process of disruption in secure attachment to God, which causes spiritual distress in relation to self, people, and the world of creation . Areas covered: Balbi defines attachment as deep emotional bond with special people in life, whose interaction brings security, joy and happiness, and their presence brings peace in times of stress. Kirkpatrick generalized the style of attachment to parents to attachment to God. Expert opinion: In the Sound Heart Model, worship is natural need. The basis of religion is secure attachment to God. Secure attachment to God is belief in the presence and sufficiency of God, as a responsive safe haven. The basis of attachment to God is positive image of God and “recognizing the truth of religion” by the Prophet. The Prophet, as interpreter of Qur’an and spiritual role-model, has healthy spiritual personality. Acceptance of religion, at the time of intellectual maturity, should be done without imitation and coercion, based on knowing the truth of religion, with a free and informed choice. Spiritual pathology is the study of socio-cultural factors that cause misunderstanding of religion, negative image of God and insecure attachment to God


Introduction
Asadzandi is the theorist of the Sound Heart Model (SHM) (Asadzandi, 2023).In two decades of her professional life, she conducted interdisciplinary research on health and religion.She was able to obtain the approval of the Sound Heart Model in spiritual health in 2023.After the fourth stage of exact and strict judgments, the model was approved by the "Council of Support for Theorizing, Criticism and Scientific Debate Chairs" of the "Supreme Council of the Cultural Revolution of Iran".The content of the theory was first judged in the "Specialized Chair of Behavioral Sciences".After that the theory was judged in the "Specialized Chair of transformative Science".In the "Pre-Summit" and "Final Summit Session" in 2022 and 2023, model was subjected to strict judging by judges, critics, and observers nominated by the "Support Committee of Theorizing Chairs, Criticism and Scientific Debate".It was approved by the highest scientific authority of Iran (Asadzandi, 2023).The following content is part of the topics discussed in this theory.
According to the philosophical view of Abrahamic religions and Islamic evidences, religiosity is love and affection for God and the world created by God (Asadzandi, 2022).God has created the world with his love and affection.God has made the goal of human creation to reach divine mercy (Asadzandi et al., 2023).In religious evidences of Islam, the value of human actions depends on their intention of that action (Tabatabai, 2013).Islam emphasizes on doing things with the intention of getting closer to God who said to Abraham, peace be upon him "Say, Indeed my prayer and my worship, my life and my death are for the sake of Allah, the Lord of all the worlds" (verse 162/ Surah An'am) ( Makarem, 2018).
So the Sound Heart Model as a hermeneutic model emphasizes on the intention of doing action.In explaining the causes of spiritual health disorder and spiritual pathology, it pays attention to people's intentions (Asadzandi, 2023(Asadzandi, , 2022)).

Method
In combined study, based on the Creswell et al. model (2003) with discovery-explanatory approach (Tashakkori & Creswell, 2007;Creswell, 2003), qualitative data from:-non-systematic review and contractual content analysis of different types of spirituality, religious spirituality, spiritual training, spiritual mentoring, the theory of personality and spiritual pathology theory of Sound Heart Model,-Quantitative data from the clinical applications of model were integrated.The validity of meta-inferences of research was measured: -in the quantitative data section through internal-external validity, -in the qualitative data section with "reliability" or "capability index" (Mohammadpour et al., 2012).
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Result
In spiritual pathology theory of the Sound Heart Model, spiritual distress considers as signs of spiritual health disorder.The model considers insecure attachment to God as the cause of spiritual distress.It explains the socio-cultural factors of spiritual distress as the causes of insecure attachment to God as follows:

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Misbehavior and failure to follow religious recommendations by parents, educators, teachers, professors, religious missionaries and at the same time giving advice to others.

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Creating and strengthening a negative image of God (an unkind and distant God who does not care about his servants)

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Creating insecure attachment to God (Figure 1).