I am writing primarily to psychodynamically oriented therapists, but as various approaches seem to be coalescing these days, I believe the fundamental issues apply mutatis mutandis to the various schools of thought. So, what does a spiritual director have to say to a psychotherapist?
Because spiritual issues are part of who the person is and is becoming, they are fair game and ought to be considered.
Spirituality is an important way of organizing the world of experience. References to God might be just that, rather than—as is sometimes assumed—veiled references to father or mother. To relegate religious issues to transference or projection, leave them unexplored, or fail to notice when the subject of God never arises is to circumvent significant elements of human life. It might suggest that the therapist should examine his or her own feelings on spiritual matters.
When involved with people of faith, be aware that a person’s relationship with God is a precious element of his/her life.
As with other aspects of patient experiences faith occupies the power, tenderness, and sacredness of the “transitional space.” Winnicott, who respects both the power and mystery of that transitional space, wrote,
It is assumed here that the task of reality-acceptance is never completed, that no human being is free from the strain of relating inner and outer reality, and that relief from this strain is provided by an intermediate area of experience (cf. Riviere, 1936) which is not challenged (arts, religion, etc.). . . . This intermediate area of experience . . . is retained in the intense experiencing that belongs to the arts and to religion and to imaginative living, and to creative scientific work.1
This paradoxical “space” is neither to be questioned in a hostile way nor to be “solved by a clever restatement.”2 The therapeutic setting can and should be a significant and safe setting for a person to explore that part of his/her life.
Religion can be looked at critically: a person‘s religious faith—just like a person’s atheism or political association—can serve many functions, not all of them salutary.
Spiritual directors are not afraid to raise questions or be skeptical—neither should a therapist. To understand how one’s spirituality functions positively or negatively is neither to endorse nor repudiate that experience.
The story of Mr. S illustrates the use of spirituality as pathological self-protection. When he first came to me at the age of 30, he reported suicidal thoughts, anxiety, unusual silence when in groups, and horrible nightmares.
Tortured as a child by his father, Mr. S found in his acting coach a man who was soft-spoken, who took him into his home and helped him get in touch with his feelings. When Mr. S complained or questioned the living arrangement, however, his coach—whom he revered as god-like—told him he was insane and a hopeless sociopath. He had to pay rent even though he acted as handyman, gardener, and record-keeper for the acting school. Nonetheless, Mr. S had found in his coach a man he felt could help him and who was on his side.
Part of their relationship was an ethereal spirituality in which the guru-like coach encouraged Mr. S to free himself from narrow-minded ideas by having sex with him. Because Mr. S found this physically painful and humiliating, he participated in his coach’s visions of spirits dancing about the acting classes and speaking to him.
Being “spiritual” was, in this case, Mr. S’s way of maintaining a precious tie to a person who he otherwise would have to admit was abusive and driving him to despair and self-destruction. This provided a rationale for behaviors that were ego-dystonic: living in a “spiritual realm” meant that Mr. S interpreted all his experiences in “a spiritual way”; thus, it was evil spirits who tormented him with anxiety while awake and violent nightmares while asleep.
One day he began to describe the previous night’s demonic attacks when he suddenly said, “I realized it wasn’t evil spirits, it was a panic attack!” After six painful months, Mr. S moved into his own apartment and broke all ties with the coach. Over time, his suicidal thinking ebbed, he had some brief, but satisfying, relationships, began paying down his debts, and felt good about being a religiously cautious but kind-hearted man.
A person’s religious convictions may in fact be beneficial.
One woman who came for spiritual direction was a mental health professional who was a committed Christian and whose religious path had been one of increasing personal freedom and peace. As trust grew between us she talked about God opening up new ways of acting in her life—as well as new ways of praying—not all in full harmony with beliefs sanctioned by her church. One session uncovered this dream: After wandering through her dimly lit, empty church, she emerged through the front doors. Looking back, she realized that it was just a façade. She walked to a nearby bus stop and sat down to wait.
The dream may have been a realization that her faith was merely an empty façade, an illusion with nothing behind it—indeed, that thought flickered through both our minds. But earlier dreams revealed her entering various churches (including her own) and visiting crypts where both dead bodies and great treasures were kept. It seemed that the dream was letting her know that it was time to leave what was familiar but no longer satisfying. She was to simply sit and wait with contemplative expectancy, since there were treasures to be found in other ways of worshipping and in places deep inside herself.
Later came another dream: It was a sunny day and she was in a car with another person. As she drove along an open road she saw huge, bright balloons over the steeple of a white church where a bell was ringing in the steeple. She felt drawn inside to what was clearly a Christian church—all the usual symbols were in the usual places—but there was also an orthodox Jew davening (reciting Jewish liturgical prayers), a Muslim Sufi Dervish whirling (a sacred dance in which the dervish rotates in a precise rhythm), and symbols of other religions. She was delighted to see that the God of whose family she was a part approved of her appreciation. She took this as confirmation that God smiled on her openness. This smiling, benevolent God has been a great comfort to her in subsequent struggles.
What goes on between sessions can be fodder for the consulting room, as well as a living part of the process.
Life between sessions is used by the spiritual directee to address assignments given, prayerfully and thoughtfully, by the spiritual director. For the religious therapy patient, likewise, spiritual practices—and even God—can become part of the therapeutic process, just as the patient’s analytic experiences and insights become part of spiritual direction. If a goal of therapy is to help patients be “their own therapists” after formal treatment has ended, why not encourage that process between sessions, when the therapist is not around?
Mr. J was raised in a moderately religious Jewish home and had begun to wonder if renewing an old relationship with God might help him overcome depression. He wondered what God thought or might have to say. Since we had time constraints, and I knew he was a disciplined journal-keeper, I eliminated the middle-man (me) and encouraged him to write directly to God in his journal, then spend time listening for a response. We even discussed “letting God write back”—in other words, write with a view of exploring the subjectivity of God, since that was whom he was wondering about. This bore much fruit. God’s response was warm (God was glad to hear from him), a little painful (God was disappointed that Mr. J hadn’t asked for help sooner), and encouraging (God was willing to help). It revealed a lot to Mr. J about how he felt about his life: he was alone, victimized, wanting help.
Transcend your own worldview in the service of your patient.
Don’t give up what you believe or take on what you cannot, but take seriously the religious experience of the person you are counseling—knowing that the mystery is infused with meaning. Just as we ought to be careful to keep our own morality from overwhelming the patient, so we ought not impose our worldview on vulnerable patients. So, too, with a relationship with God. As Belgian spiritual director Herwig Arts puts it, “It may not be the end of the real, but the beginning of the invisible.”3 Can the therapist accept religious experiences that the patient considers factual, actual, and real without secretly or openly relegating them to the unreal, distorted, or wrong? Find within yourself those aspects of your core that will allow you to make room for your patient’s entire world, even if it requires something as hard to believe in as a God quite different than yours.
If you feel like you are in over your head, call a clergyperson.
When baffled by a patient’s struggles, consider referring to the clergy. Enlightened clergy refer to therapists often, but rarely have I heard of a therapist doing likewise. Just as a clergyperson or spiritual director may not be equipped to treat certain psychological phenomena, so an analyst might not be equipped to handle certain spiritual phenomena. Consider clergy among your resources, to consult or to refer. In the end, it is a matter of the relationship in your office, but it might be helpful for the therapist to have an idea of what it means to belong to a particular religious group.
The religious person’s spirituality is a way of organizing reality. This is one of the primary functions of faith: to discover, embrace, and express one’s ultimate concern. For the theist, this involves a relationship with God often explored or fostered by spiritual direction. Psychotherapy is a way to exploring another dimension of the person’s world. The moment a therapist tries to prescribe or proscribe a worldview, tries to give or take away a god, it is no longer therapy, but spiritual advising.
Psychotherapy can be inordinately helpful to a religious person as they explore the contours of every relationship—within and without—including both the immanent and the transcendent. Psychotherapy can be inordinately unhelpful, however, when it ends up being covertly evangelistic, that is, when it claims metaphysical or religious authority, thereby establishing itself as a religion without giving the patient the right to decide whether or not to sign up—not just for that particular school of treatment, but for a hidden religious agenda as well.
To explore the gods (or God) who shape the human soul is sacred in any setting. To ignore them is to neglect a significant aspect of those who come to us for help. Spiritual directors and psychoanalysts can be friends and allies. Religion and psychotherapy, while certainly not the same thing, are not mutually exclusive. It is my hope that these suggestions will be helpful to therapists and their patients, and also foster a dialogue between two disciplines that both hope for the well-being of their guests.
1. Donald Winnicott, Playing and Reality (London and New York: Tavistock/Routledge, 1971), 13–14.
2. Donald Winnicott, The Maturational Processes and the Facilitating Environment (Madison, CT: International Universities Press, 1965), 181.
3. Herwig Arts, With Your Whole Soul (New York: Paulist Press, 1983), 134.
This article was published in Theology, News & Notes, Winter 2006, “Psychology and Spirituality.”