Appropriate Conversations About Spirituality in Counseling

A man prays at sunsetA client of mine who is currently “taking a break” for financial and other reasons wrote me an email letting me know that part of the reason for his decision was that he did not feel that our discussions about spirituality were a productive use of his time. Coincidentally, we were at the point where he would have had to pay his deductible (meaning he would have out-of-pocket costs for his sessions rather than a small copay). He said he did not think he wanted to spend his time on “…that type of conversation” and that it was not really what he came for (even though he did say he wanted to develop his spiritual self once we got past some very major issues). It was also ironic that he really had no one else in his life to talk about spirituality but me and that as an Ordained Yoruba Priest I was also uniquely qualified.

His rather snarky comments (you had to read the whole email) initially irritated me but then got me thinking. What is appropriate for counseling, regardless of what a client may express an interest in? How do I respond if a client wishes to explore his/her issues from a spiritual as well as psychological perspective? I was wondering if in some ways I had overstepped by bounds by discussing spirituality. I questioned whether my excitement about exploring spirituality drove the conversation.

In thinking about it, I came to the conclusion that even though he had requested my help in that area, the form in which it was forthcoming was uncomfortable to him (lots of probing questions from my side). I realized that he may have also felt inadequate and perhaps somewhat competitive with me in this area. I believe there was a great deal of “transference” on his part because he knew almost nothing about my own struggles with spirituality and my journey.

I would venture to say that most therapists have been trained to let the client lead the therapy. In social work school we are taught to meet the client where he/she is. In my advanced psychoanalytic and object relations training, we let feelings and information emerge when the client is ready. How that shows up in the room can be difficult at times for the therapist, who must subtly guide a client into areas which may be difficult to talk about. We know that frequently it is what a client doesn’t talk about that is more significant than what he/she brings into the treatment. Hence, one of my former supervisors reported that he asked a client “…tell me something you don’t want to tell me…”

We also have to be careful about our own agendas. Thus, in encouraging my client to talk about his spiritual beliefs in the hope of getting him to open up about this topic, I may have touched upon something he didn’t want to tell me. I suspect that what he was hiding was his confusion. That was what he might not have wanted to expose, especially to me who seems to be not at all confused (he should only know!).

My conclusion about the appropriateness of the topic of someone’s spirituality is that it is perfectly fine to discuss by invitation only (that is if the client invites me to explore it). However, it is important for me as a therapist to first explore the client’s reasons for wanting to discuss the topic. If in the course of the discussion I am met with resistance, the more appropriate way to approach it is by discussing why it is hard to talk about. Often that opens up a wellspring of experiences with spirituality, religion, allegedly spiritual people, etc. from the past. It may even reveal a wish to understand and get closer to me.  Disclosure of this kind can only strengthen the bond between client and myself as therapist/spiritual counselor. It also lets the client feel that he/she has the room to bring anything on his/her mind into the room, or not.

© Copyright 2011 by Kalila Borghini, LCSW, therapist in New York City, New York. All Rights Reserved. Permission to publish granted to GoodTherapy.org.

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • Hannah

    Hannah

    February 15th, 2011 at 11:49 PM

    Sometimes a person may decline help if he sees that he is unable to respond to the help adequately. Add to that the fact of paying up in this case, the patient ‘opting out’ is not very surprising.

  • DD

    DD

    February 16th, 2011 at 5:05 AM

    People are different…Although you may say things in good faith and although the same thing has helped a lot of people in the past,some individuals may not like the same…This does not imply that you are wrong but just that the person has trouble seeing things from your view-point…

  • Shelly

    Shelly

    February 16th, 2011 at 5:33 AM

    Counseling can be all about exploring issues that may be uncomfortable for the patient, but that does not necessarily mean that they need to be ignored either. If this is something that the therapist thinks would be benficial for the patient than it is certainly worth giving it a try. The patient could be hesitant at forst because this could be new territory for him or her. But once the topic gets rolling it may have a stronger impact on him than he would have thought.

  • Zane

    Zane

    February 17th, 2011 at 5:51 AM

    In my opinion counseling is not the time to be pushing your own thoughts and opinions on a client. This is the time for him to unload and unburden, not you. You may have some suggestions about how to get him to open up and maybe for even how to deal with the issues in his life that need to be addressed, but if he feels like it is church and he does not wnat that then what good are you possibly doing for him? he is going to shut down completely and get nothing from the sessions and will eventually stop going altogether.

  • micheal

    micheal

    February 20th, 2011 at 3:56 PM

    “I was wondering if in some ways I had overstepped by bounds by discussing spirituality. I questioned whether my excitement about exploring spirituality drove the conversation.” Yes you did. You let your own interest take precedence there. I agree with Zane. It’s not the time to be pushing your own thoughts and opinions on a client. Obviously it was discussed at length when he felt the need to bring it up.

    “Coincidently, we were at the point where he would have had to pay his deductible (meaning he would have out-of-pocket costs for his sessions rather than a small copay).”

    You already said he’d quit for financial and other reasons. Why mention that? I think it’s pretty snarky of you to bring that up. And you call him snarky? People in glass houses shouldn’t throw stones.

  • wendy

    wendy

    February 20th, 2011 at 5:20 PM

    Since he said he wanted to explore that, he opened the door apparently. Perhaps you opened it too wide too fast when all he wanted to do was dip his toes in the water.

  • Cameron

    Cameron

    February 20th, 2011 at 6:51 PM

    It’s best to not discuss religion altogether unless you’ve experienced or learned about several of them and accepted there’s good and bad in them all. Even the most saintly people will have something to say about other beliefs and it’s not always a nice thing. He may simply have not been comfortable with your path and couldn’t work up the nerve to say so face-to-face.

  • Jeremy

    Jeremy

    February 23rd, 2011 at 9:58 AM

    If you can connect on a spiritual level with a devout person, I feel it makes it much easier to steer them the way you want to. That’s how AA works for people, but it will backfire harshly when it comes to clients that aren’t very spiritual or don’t like to discuss it. It’s a gamble you need to be very careful about taking and not suited for all clients IMHO.

  • Bernard

    Bernard

    February 23rd, 2011 at 12:22 PM

    I think therapists should be neutral like Switzerland and not make their own affiliations with churches or religions known to the client, never mind include their belief systems in the therapy.

  • Kalila Borghini

    Kalila Borghini

    February 25th, 2011 at 9:50 AM

    Yikes! I had just typed a long response to all of your responses and for technical reasons it was deleted. Guess it wasn’t supposed to see the light of day. Anyway, thanks to all of you for your feedback. I agree and disagree with it. I can appreciate the feedback about sounding snarky myself. I admit I was offended that the patient felt that a discussion of spirituality wasn’t worth paying for. On another point, I always try to work where the patient is in terms of his/her beliefs and explore and question what those are. My lessons here are to investigate further what the patient is really looking for and maybe even ask how he/she feels that I am a Priest in a particular faith before any exploration gets underway. Topics like spirituality and religion are potential landmines and I have learned to be more sensitive to that. In terms of my role being to let a client unload and unburden, I see my role as more than that. I am also an advisor, a person who challenges a patient, someone who helps the patient connect and express his/her feelings. Some patients are not comfortable with my style but others welcome the change from a more passive, traditional approach. In terms of bring my beliefs into the room, patients who come to me know who I am in terms of my spiritual path/religion before they come so it’s present whether I like it or not. That does have an impact which I will be more diligent in the future about exploring.

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