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Kenneth J. Doka, M.Div., Ph.D.

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The Spiritual Side of Bereavement

Posted: 07/05/11 01:00 PM ET

For years, Toni and Mark prayed for a child. Well in their 40s, their "miracle child" was born. Handsome and smart, Anthony exceeded all his developmental milestones until he reached 18 months. Then, inexplicably, he seemed to regress. Toni and Mark found he has a progressive, genetic disease. Anthony died just before his third birthday. For Toni and Mark, the illness and death provoked a deep spiritual crisis. How could God let this happen? How could He grant their prayer only to later take the child they so deeply loved?

We often think of grief as an emotional reaction, one where individuals may experience a range of reactions such as anger, guilt, sadness, loneliness and yearning, to name but a few. Yet grief is more than that. It affects us physically, sometimes even compromising the health of survivors. It influences how we think and how we behave.

Grief affects us spiritually.

These spiritual reactions to grief can occur to individuals who do not adhere to any religion or even have any theistic beliefs. Broadly defined, the essence of spirituality is how we find meaning in life. For some that involves distinctly spiritual concepts. Others may live by a more humanistic frame. Lisa did. She and her brother Jay grew up in home that eschewed religious beliefs. Yet, they were taught and internalized a deeply humanistic ethos. While the world was, they believed, a very random place, Lisa also felt that ultimately "what goes around comes around." Both Lisa and her brother fervently cared for others. Both worked in human services. When her brother Jay was killed by a distraught, crack-addicted mother as Jay tried to remove children from this neglectful, drug-infested home, Lisa's basic beliefs were shaken.

In the end, one of the most difficult issues in grief is reconstituting faith (or philosophical systems) challenged by the loss. We all have beliefs that give us some sense of security -- that make sense of the world and offer a code for life, whatever the roots. Sometimes a loss deeply challenges those notions, leading to a crisis of belief.

Naturally not every loss does that. Some losses, however much we grieve them, do not challenge our faith. My Aunt Marie died at 92 years old, healthy, alert and active until a sudden tumble down a flight of stairs placed in a terminal tailspin. We missed her terribly. She was the honored matriarch of a large Hispanic family. Yet, our beliefs were not called into question. Though her death was sudden, she had lived a good life. Even in an odd way her death was perceived as "appropriate." This was not a woman who would have done well with a long, debilitating illness.

Yet when losses do challenge our beliefs -- whatever they are -- it is important to acknowledge the normalcy of such a reaction. Sometimes we can feel frightened that we are losing our faith. Yet periods of doubt are part of the cycle of belief. Even C. S. Lewis, the great Christian writer, had moments of doubt as he struggled with the death of his wife. "Where is God when you really need Him? -- A door slammed in your face." Later Lewis could acknowledge that his own frantic need had slammed that door.

In such cycles of doubt and difficulty, it is critical to return, or not leave, our own sources of spiritual sustenance and renewal. Whether it is the counsel of similar-minded friends, the presence of our spiritual or faith community, or the resources, books, rituals and practices of our spiritual discipline, this is a time we need not to sever the connection but rather to strengthen our tie.

Kenneth J. Doka, PhD, MDiv, is a Professor of Gerontology at the Graduate School of The College of New Rochelle and Senior Consultant to the Hospice Foundation of America (HFA). A prolific author and editor, Dr. Doka serves as editor of HFA's Living with Grief® book series, its Journeys newsletter, and numerous other books and publications and is an ordained Lutheran minister.

Hospice Foundation of America is dedicated to helping the millions of Americans each year who cope with terminal illness, death and grief. In 2011, HFA focused on Spirituality and End-of-Life Care with a national education program shown at 1,000 sites across the United States and Canada, an in-depth webinar series, and companion book. HFA offers a range of publications for both professionals and the public and answers thousands of questions each year from family members trying to navigate the health care system. The Hospice Foundation website serves as a well-regarded resource for information end-of-life care and grief.

 
For years, Toni and Mark prayed for a child. Well in their 40s, their "miracle child" was born. Handsome and smart, Anthony exceeded all his developmental milestones until he reached 18 months. The...
For years, Toni and Mark prayed for a child. Well in their 40s, their "miracle child" was born. Handsome and smart, Anthony exceeded all his developmental milestones until he reached 18 months. The...
 
 
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brooklyncitizen
Quaerite primum regnum dei
11:35 AM on 07/09/2011
I attended a wake/funeral a couple of weeks ago and it was so beautiful. It was in an AA church for the deceased sister of my best friend . I went with another best friend to support her and left feeling that it had been I who had been supported instead.

IT was a celebration of love and of a life lived imperfectly and in suffering (she died of MS) but one that left a mark on all who knew her. The service was uplifting the music out of this world and I still get chills when I think about the energy and palpable love that filled that small church.
I later made the observation that the gathering and celebration was her last gift to us; that even in death she was giving to those she left behind for really the gathering would not have happenned otherwise.
It was a gift.
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HUFFPOST COMMUNITY MODERATOR
cinemaven
Mom, wife, social & political activist, writer...
09:37 AM on 07/09/2011
With each death that's impacted my life, the loss of faith has been faith in myself.
I don't believe in major (or minor) religion and have raised my kids to believe in themselves and take their own responsibility for faith. (I have a son who's Buddhist and one who is an atheist).

When my best friend was killed by a drunk driver when we were 10, my anger was for the driver. It happened just after I had a near death experience where I fell through ice over deep ditch and couldn't get out. I breathed water in and felt calm, happy, warm and bathed in light (and angry when I came back to some woman blowing in my mouth and hurting my ribs). I've always believed death isn't a frightening proposition. (not sure if I believe in life or anything after death but I'm not afraid of it)

When cancer took my parents, I was angry with cancer but also lost some faith in myself, wondering if I could have done more.

I have faith.. but it's a personal kind of faith. I feel a spiritual connection to people and ideals and morality but blaming or thanking a God when my life is mainly just the luck of having been born in a first world country to good parents doesn't make sense to me. Am I any more deserving than a third world family currently starving? Is there a God who likes me more? I don't think so.
11:20 PM on 07/08/2011
I can understand not being able to believe in a deity, but I can't understand the tone of callous condescension many atheists take toward those who believe their beloved has passed to "a better place." That is, after all, a universal cry of the human heart.. If you truly love someone, the thought that death has extinguished him forever is beyond ordinary endurance. That's not necessarily true when it comes to one's own mortality. There may be pros and cons to weigh when contemplating "To be or not to be." But not when faced with the death of a child, or the loss of a life partner. That's when most anyone, believer or unbeliever, would give his own life's blood to know the beloved lives on somehow, somewhere, and that they will meet again. Why pretend otherwise?
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11:45 AM on 07/06/2011
Here is what I dont get....Why are religious people sad when someone dies? It doesnt make sense, if said person is going to super happy land. They should be happy. Likewise, why do they bother trying not to die? If you really believed you were going to super happy paradise (as opposed to this sick little world), shouldnt you not care if your plane crashes? Why wear your seatbelt? Why delay super happy land?

Unless....deep down.....
12:54 PM on 07/06/2011
The reasonable response would be that everyone has feelings. We love and miss people. That's human and having a spirituality doesn't preclude being human regardless of where you think the person is going. I assume from the tone of your post that, being secular humanist, perhaps a sarcastic and coindescensing one, that you expect people should have feelings, right?
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03:17 AM on 07/07/2011
of course, but said feelings would not make sense, if you actually believed you were
a: Going to see said person again
b: Said person was going to super awesome land

I mean, do you cry for days if your friend goes on a vacation to Disney?
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HUFFPOST COMMUNITY MODERATOR
cinemaven
Mom, wife, social & political activist, writer...
09:48 AM on 07/09/2011
Such a frivolous and disrespectful question

As a non-religious person who's suffered several painful losses, I believe our sadness and pain is entirely selfish. My mom's been gone 15 years and I still sometimes reach for the phone to tell her something and it cuts like a fresh wound. It doesn't happen often any more but it still happens.

My ultra-Catholic mom believed she was going to heaven and yet she gripped onto life (despite the unbearable pain of bone cancer) with everything she had because here is where she had her children and her precious grandchildren.

My non-religious dad went happily forward after arranging with us and his doctor to have his pain ended with a dose of morphine strong enough to end his life. About an hour before he passed, he sat up (despite aforementioned dose of morphine) and began smiling and talking to his mom and brother as though they were in the room with us. He then lay back and had the first peaceful breaths he'd had in about 2 weeks.

Why does anyone bother trying not to die. For an atheist who believes there is nothing, what's the big deal? There's nothing frightening about nothingness but this life is precious enough for the religious and non-religious to want to hold on to.
09:15 AM on 07/06/2011
I'm a hospital chaplain intern. Spirituality is a very personal experience, regardless if someone is traditionally spiritual, is more open or even if they don't have any. Everyone has a soul.

I've lost a loved one and I've been with many people as they struggled with their own impending death or the death of a loved one. We grieve for life. And no discussion of God's "plan" or any other imposed thoughts can take away that pain.I hated God and still do sometimes. But so what? No one should tell anyone what to feel or think at such a horrible time. Death redefined my spirituality and from my experience, that is the norm, not the exception.

Also, as much as I understand people have had bad experiences with traditional religion, I think discounting it completely is wrong. All my chaplain peers were great care givers who believed in the dignity of the human being first and never preached. Having been with many traditionally religious people( I am open, but traditional)at the time of death I can tell you that there is more to it than the cliches and that a traditional religious experience provides a "way" to care for others and reach out to God( however you define God) and grieve when the chaos of death is overwhelming. It's not the only way, but it's a good way.
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10:21 AM on 07/06/2011
Allen2Saint

"I hated God and still do sometimes"

Whats to hate? The poor craftsmanship during the creation of humans? Not helping the needy? The power? Allowing war? What?

"Death redefined my spirituali­ty"

You are now spiritual because you heard about death? You had a spiritually before knowing about death? Someone important to you died? Whats a short version of death defined spirituality?
12:19 PM on 07/06/2011
By all the things you've said I can't tell if you're being sarcastic or serious, so I'll just respond honestly.

I hated God after a family member died. A death that could have been prevented and was pretty rough. And my experience of living through the grief and becoming a chaplain redefined my spirituality.
12:44 PM on 07/06/2011
I lost a loved one. The circumstances were rough. The ordeal was pretty horrible and it was preventable. The process of dealing with the grief, becoming a chaplain to work with other spiritual people who shared an interest in hospital work, and serving the patients, all of whom taught me something, helped me define my spirituality.
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notdarkyet
End the Drug War.
11:27 PM on 07/05/2011
One thing I have learned in my experience with grief is that it can be one of the hardest things we deal with as humans. It can take a terrible physical toll as well as spiritual. I have always said my husband was my soul mate and I had Christians attack me saying atheists don't believe in the soul. They seem to think they have all the answers. There are many spiritual paths and ways to grow. Christianity is a baby step on the journey. Some people never get past that.
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conscioushope
"There is no darkness but ignorance." Shakespeare
08:21 AM on 07/06/2011
Beautiful, notdarkyet. Your soul is beautiful and light-giving as well. faved since a fan
09:49 AM on 07/06/2011
notdark,
I'm sorry anyone who called themselves Christian spoke to you that way or attacked you, especially when you were talking about your husband. It's wrong. I dont feel my spirituality is a baby step, but I think many Christians need training wheels! Me included some days.
10:45 PM on 07/05/2011
My elderly mother died a horrible death due to her hospice care. Her "non-profit" church-affiliated hospice has an internship program for ministers. I don't where they were or what they were doing while she was suffering. I am glad that I don't belong to any of the denominations they belong to. If I did, I could be suffering a terrible spiritual crisis in addition to the horrific memories of my mother's final days.

Hospice uses a simplistic one-size-fits all protocol that can elicit severe adverse reactions while refusing basic medical treatments that can ease discomfort (my mother was not in severe or serious pain) because they are considered "curative" rather than palliative (and Medicare probably won't pay for them). The staff at my mother's hospice were the most manipulative, dishonest, bullying and ruthless medical professionals I have ever experienced. The following is a link to a powerful and moving article describing the serious problems with hospice care of the elderly. It serves as a good guide for what to watch out for. If I had read the article a year ago, before my mother was placed in hospice "care," she could still be alive and enjoying life today.

http://open.salon.com/blog/whatsonemore/2011/04/26/dad_i_really_didnt_mean_to_kill_you
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Cindbird
11:51 PM on 07/05/2011
It really depends on the Hospice. As a paramedic, I had the chance to work with different hospices. Some was super, others I wouldn't send a dying dog to. The best was a hospice which was run by a hospital. Their workers really cared about the patients and cared for them as well. Pain control was a top priority as well as emotional support, both for the patient and the family as well. Others were as bad as your experience was. No real care given to physical discomfort, no care or emotional support. I apologize for what you and your mom went through. As a member of the medical profession, I can tell you, it never should have been that way. You have to search and ask for family references. Most good hospices will give you a list to speak to or access to web sites which rate hospice care. If they don't then I'd say find another hospice. When my mother-in-law was dying, we had a super hospice that made sure she was comfortable and made sure that the rest of the family was involved in her care. They asked how each of us was doing, made sure we knew what they did and why and had a 24 hour phone line if we had questions or even just needed to talk. Hospice should be a place with people who make the process of dying easier. It should be an experience of openness and healing.
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11:45 AM on 07/08/2011
My partner had Seasons Hospice care before he died. They were marvelous. And I know people at Vitas. They, too, are wonderful.
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HUFFPOST COMMUNITY MODERATOR
cinemaven
Mom, wife, social & political activist, writer...
09:17 AM on 07/09/2011
I'm so sorry for your loss and experience.

The hospice care my mom and dad had during their battles with terminal cancer was so amazing. Both had care which came to the home in concert with family care. My dad had non-religious care and the women who came were amazing.

My mom's care was half health care workers and half catholic church volunteers - mom's priest, 2 nuns and 2 ladies auxiliary volunteers(also in concert with family) and they were also amazing. We couldn't have done it without the help provided.

I have other friends who've been in full care hospice with very much the same results I've had.

I read the article and I'm sorry to say I don't see it as serious problems. It reads to me more like the broken heart of a child losing a parent and looking to blame someone. The article outlines so many problems her father had and by her own account (though clearly not to her) he was at the very end of his life. The extended time it took to feed him is something family should be taking on as there isn't enough nursing care to provide that kind of care. She didn't want a feeding tube despite her father constantly aspirating. She chose to ignore the pleas and wisdom of the staff who spent every day with him and poured milkshakes down his throat.

Despite excellent care, neither of my parents died calm sleepy deaths... sadly, most people don't.
02:05 AM on 07/12/2011
If you read the article and the follow-up responses, you would have seen that the author’s father had had a previous adverse reaction to morphine. It is not alright to give a medication to a patient to which he has had a previous adverse reaction. (I think that’s pretty well-known in the medical profession, as well as being just basic common sense.) It is particularly not alright when the patient is already in a weakened and delicate state.

It is not alright for hospice workers to have told the daughter that her father was not having an adverse reaction to morphine. She had seen his previous adverse reaction. The hospice workers had not. Rather than listening to her, they only stopped giving him morphine when she finally told them that she had called in a relative who was a doctor. Only then did her father have some moments of real rest before he died.
02:06 AM on 07/12/2011
Lying to and misleading family members is not acceptable.

In regard to the author’s refusing feeding tubes, that was concerning his care before entering hospice. I don’t believe hospice generally allows feeding tubes. (They did not use them in my mother’s hospice.) We also don’t really know what someone is truly experiencing when they are not allowed to have nutrition or fluids for days at a time, even when they are heavily medicated. That would be considered starvation and torture under any other circumstances. I’m glad the author poured the milkshakes her father loved down his throat and gave his dehydrated body some relief. I only wish I had given the same kind of relief and comfort to my mother.

As the author points out, it’s also very questionable why hospice would use the very limited number of exact same of medications for treating people with such vastly different diseases and with such vastly different kinds and different levels of pain and discomfort.
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Down in FL
It's all about the density of states
10:15 PM on 07/05/2011
I find the phrase "challenging one's faith" (or any variant thereof) to be a bit disingenuous. It has not been my experience that people who claim to have "had a crisis of faith" actually challenged the very rational behind their faith. Instead, it seems, what people really mean by such a phrase is challenging the apologetics (the rhetoric that reconciles the tenets of the religion with reality). As far as I can tell, they never ask themselves "why should having faith be a good thing?" or "what good reason do I have to believe what I believe?"

This is distressing to me because challenging the apologetics often only serves to manufacture a new set. It ends up strengthening some contrived framework that keeps the individual fastened to a religion.
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Down in FL
It's all about the density of states
10:19 PM on 07/05/2011
rationale*
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french queen13
my beloved is mine and I am his
11:00 PM on 07/05/2011
And if that faith has given them strength? If abandoning it would achieve nothing but more grief?
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Down in FL
It's all about the density of states
11:16 PM on 07/05/2011
The best way to deal with reality is to accept it and attempt to understand it. Not to pretend, not to lie to yourself, not to hide it away. To what extent are you willing to deceive yourself or others to protect against the ills of the world?

And further, your question is dishonest in the sense that it presupposes that a person's mental state after abandoning faith can be known before said abandonment.
06:43 PM on 07/05/2011
I have experienced an intense spiritual crisis and soul pain, following the death of my young son, and now after more than 30 years of professional experience helping others through grief and trauma, I find the spiritual crisis to be an immense opportunity for spiritual growth. What often happens, is that people begin to challenge long held beliefs that no longer seem to be true for them and in so doing sometimes have to let go of religious beliefs that no longer serve, yet in the process often unwittingly become very spiritual. This journey within is well recognized and often referred to as the Dark Night of the Soul. It is often difficult for many professionals to understand this inner change, because many do not recognize the differences between religion and spirituality and so when the person they are helping starts to step out of their belief system it is not seen as a step backward, not as growth. I believe it is time for professionals to expand their definitions of spirituality beyond those of religion. While there may be overlap between the two, people can be very spiritual and have little or no religious affiliation.
References
1) Simington, J. (1999). Listening to Soul Pain (Audiovisual).Souleado Productions. Edmonton, AB: Taking Flight Books.
07:13 PM on 07/05/2011
What you said is true Jane. One can practice a faith for a long time, perhaps not knowing that it doesn't have all the anwers for them UNTIL a spritual crisis occurs. Part of the grieving can be a search for a new faith or set of beliefs that fits better and offers more consolation.
12:13 AM on 07/06/2011
Yes indeed, and sometimes that new set of beliefs is way beyond what they would have ever imagined before the crisis. This is why growth is oftern referred to as coming out of the box! It reminds me of a butterfly saying I once heard. "Why do you stay in the box." Because the box is safe." "Why do you fly out of the box?" " Becasue now that I know I can, I never want to remain in the box.
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conscioushope
"There is no darkness but ignorance." Shakespeare
09:14 PM on 07/05/2011
Thank you for your post, Jane. Beautiful....fanned
03:31 PM on 07/05/2011
thank you for including the idea that if one is not religious they can still experience spirituality and have complicated reactions to death. it was nice to have a broader definition that can include everyone.
02:49 PM on 07/05/2011
I find that most of us today doubt our own beliefs too easily. Why must God always make everything good happen? The world is a random place and blaming God for any bad experience is simply foolish. Such thoughts come as the human race develops further, in the past humans did not consider each action to be God's will. You have faith in God, this faith does not mean that God will not bring hardships your way, God does not ask to be worshiped. He's done you more than enough favours already.
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conscioushope
"There is no darkness but ignorance." Shakespeare
09:15 PM on 07/05/2011
God is not a person.
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french queen13
my beloved is mine and I am his
11:01 PM on 07/05/2011
Exactly.
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conscioushope
"There is no darkness but ignorance." Shakespeare
09:26 PM on 07/05/2011
"Blaming God" can also be a human reaction to intense grief. Your answers are shallow and flat for anyone who has suffered a significant loss. You must be young.
02:30 AM on 07/06/2011
Yes I'm young. I've suffered significant losses. But the point is such a reaction in my view is illogical and in the end harms oneself. If you've already suffered a significant loss why blame God and make yourself feel worse? Instead one should try to come to terms with one's loss.
02:44 PM on 07/05/2011
I agree with OPEN2facts. My faith was seriously shaken after my mother died from cancer. I don't want to hear it is "God's way" or "She is in a better place" or "It is for the best". Really? Having her grandchildren grow up without never knowing her is "God's way"? Shattering our entire family was the way God wanted things? I seriously doubt it. I am not ready to write off the idea that God exists but I am convinced that no one here on Earth really knows why things happen or what God really wants until we die. Then and only then will we really find out if there is something more and what God really thinks. In the meantime, I am not wasting a minute on organized religion telling me what THEY think God wants me to do.
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conscioushope
"There is no darkness but ignorance." Shakespeare
09:16 PM on 07/05/2011
Thank you for you powerful post born of great grief. That is spirituality. fanned
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french queen13
my beloved is mine and I am his
11:05 PM on 07/05/2011
"God's way" does sound terribly anthropomorphic, and like this human-type God made a conscious choice, doesn't it? I believe in God, but not in that sort of way, and with diseases and the like ... it happens. It just happens, it's life, it's nature, call it what you will, it's something we grieve over. I do believe the part about being in a better place, because that's where I see us all going, but there the resemblance ends.
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nlightenup
Retired psychologist, responds to open minds.
02:19 PM on 07/05/2011
Thank you for including the point about grief affecting us physically. The physical effects can be profound and extremely varied, and sometimes very different from what one might expect would be produced by stress alone. Adults who lose a beloved parent, for example, might, for several months following the death, experience physically things they went through while growing up--a re-experiencing of things like physical growing pains, if you will, that recall times when the parent was present and actively caring. It's especially important for people who are deeply grieving to take extra care physically, to avoid injuries that might occur from being distracted. It helps to practice mindfulness when doing physical work, or even just when walking.
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notdarkyet
End the Drug War.
11:19 PM on 07/05/2011
Many spouses die soon after their partners and even a few years later because of the physical toll of grief. It can have a profound impact on one's health.
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KrautMan
Carpe jugulum
02:17 PM on 07/05/2011
It always puzzles me, when otherwise obviously intelligent people color the loss of 'faith' and 'belief' (as used in the context of this article) as something negative. From where I stand, these persons have much in common with people who are at the receiving end of an abusive relationship, which they nevertheless desperately try to sustain.
03:15 PM on 07/05/2011
Found you again KrautMan spreading your hatred. Your view of God must really be skewed. Sorry about that. Praying your eyes are opened soon to His unending love for you!
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KrautMan
Carpe jugulum
03:57 PM on 07/05/2011
Pay attention. How would I hate a non-existing entity? I'm sharing an observation, where did you find 'hatred' in this comment?
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Andres64
Religion is a sectually transmitted disease.
04:09 PM on 07/05/2011
--Praying your eyes are opened soon

Why? Is your "loving" god going to torture him otherwise?

-- to His unending love for you!

Doesn't sound very unending to me.
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brokerallen
The Middle Class Needs To Take Back America
04:51 PM on 07/05/2011
Your position could make sense intellectually. But God loves us all. My prayers are with you that you would realize how very much he loves you.
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KrautMan
Carpe jugulum
05:13 PM on 07/05/2011
Hey, whatever floats his boat in your imagination.
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dschiff
Always learning
02:13 PM on 07/05/2011
The article doesn't address the issue... it notes that people have crises of faith when people die... and then just says to turn back to your faith for comfort. This is no solution, but the classic 'problem of evil'. Why doesn't god help protect innocents?
1) God can't interfere (is therefore not omnipotent, not worth praying to, perhaps just made the world and left)
2) God can interfere but chose not to (is thus not omnibenevolent, letting innocents die)
note: you can try to justify this one with some strange 'God has a greater plan' which involves letting infants die. This is pretty serious intellectual gymnastics.
3) God doesn't exist, and people die of natural causes. (this one happens to be true)
03:17 PM on 07/05/2011
or maybe you just dont understand the ways of God and therefore label it "intellectual gymnastics". I personally am ok with not understanding everything about God. God hates the evil in this world and sometimes we see miracles and sometimes we dont. Who are we to judge God? Who are we to decide when He should intervene?
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buggeroffyou666
Hierophant of the Crawling Chaos
09:29 PM on 07/05/2011
And nothing you have posted about your imaginary friend in any way addresses or refutes post. At all. Who are we to judge Santa and the Tooth fairy? Well they are made up so it's not even a viable question.
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Down in FL
It's all about the density of states
10:05 PM on 07/05/2011
If your God's plans involve letting little kids starve then s/he isn't really all that great. Thankfully, there is no good reason to believe in your God, or any other for that matter.
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buggeroffyou666
Hierophant of the Crawling Chaos
09:24 PM on 07/05/2011
F/F