Psychotherapy and Spirituality: Bridging the Great Divide

Editor’s note: DeAnza Spaulding, MA, LMHCA is a trauma therapist who takes a holistic, client-centered approach to therapy. Her continuing education presentation for GoodTherapy.org, titled Ethics in Spirituality in Therapy, is scheduled for 9 a.m. PDT on November 14, 2014. This event is available at no additional cost to GoodTherapy.org members and is good for two CE credits. For details, or to register, please click here.

Right from the start, psychology taught us to be suspect of processes involving spirituality, and this led us to divide spirituality from psychological treatment. In fact, Freud once coined religion and spirituality as “obsessional neurosis.” In his 1927 book Future of an Illusion, Freud stated, “Religious views are illusions, fulfillments of the oldest, strongest, and most urgent wishes of mankind.”

As therapeutic professionals, we’ve been trained to think that spirituality has no place within the tradition of psychotherapy and that there is no intersection between these two arenas. For decades we’ve been telling people that when addressing concerns about their psychological health, such as depression or anxiety, they should seek guidance from psychotherapists and counselors, and for questions regarding their spiritual health and faith, they should consult their priests, pastors, clergy, and imams.

This dichotomy fails to address how psychological well-being impacts spiritual health and spirituality, psychological health. People have been led to believe that spirituality is an inappropriate means to address their psychological health, so they are less likely to bring their spiritual selves to the counseling setting. Perhaps they internalized the message: leave the spirituality to your spiritual leaders and the psychological care to your therapists. 

DeAnza Spaulding, MA, LMHCA

Today’s clients, however, more frequently inquire where their spiritual identities might fit in therapy. In part this has to do with how clients see themselves—many acknowledge that their spirituality is a core component of their identities. In a 2012 Pew Research Center survey, for example, 85% of Americans stated that their spirituality is an essential part of their identities.

The diverse needs and expressions of clients require therapists to reexamine the divide. Our clients are changing and assessing their personal needs, and some may be saying, “My spiritual identity is a vital part of who I am—is there any way to incorporate that in therapy?” The “leave your spirituality at the door” perspective is no longer sufficient in assessment and treatment, yet many of us find ourselves ill equipped to address the client’s spiritual needs.

Therapists fielding questions about spirituality and therapy may find themselves asking, “How do we bridge this great divide?” This question stems from concerns about how to utilize spirituality in helpful and meaningful ways in therapy. Some therapists may question their qualifications to merge these areas, as spirituality is a broad spectrum. It isn’t uncommon to think that in order to effectively utilize spirituality, one must be experienced in the various expressions. It is certainly a daunting prospect to consider learning every religion and tradition. What’s more, some therapists link spirituality to religiosity when those are two different aspects. 

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Spirituality refers to transcendence—a state where one is connected to something beyond self and imminence. The word spirit is derived from the Latin word spiritus, which means breath. Spirituality is commonly referred to as a fundamental component of a human’s sense of being and purpose—the breath that is the essence of life. Spirituality is often viewed as a connection beyond self, to nature, for example, or a Deity or higher power, as well as the ability to access that connection within self. Thus, spirituality is not about belief systems, dogma, or doctrine. This broader understanding and language allows the practitioner to explore each client’s personal meaning to spirituality.

For thousands of years people have relied on spiritual coping strategies. Spirituality aids individuals in dealing with grief, loss, transition, and change. A pilot study was conducted in 2010 on the efficacy of a multi-faith spirituality-based intervention (SBI) for generalized anxiety disorder (GAD) and found that SBI significantly reduced the baseline psychic and somatic symptoms of GAD. Similarly, a 2007 meta-analysis on the efficacy of spiritually oriented psychotherapy revealed the positive health outcomes for depression, anxiety, stress, and disordered eating. And research shows that cognitive behavioral therapy (CBT) techniques that incorporate spirituality enhance psychological outcomes for individuals in alcohol treatment (Hodge, 2011).

Therapy is a healing practice that opens pathways to hope, inspiration, and relief, and a holistic approach is a bridge to incorporating the whole person in therapy. Holistic therapies take into consideration the body-mind-spirit of the individual and honor all aspects of an individual’s identity. This approach does not require therapists have experiential knowledge in all spiritual practices. Holistic therapy allows the therapist to build on language and meaning that is derived from an individual’s experience.

References:

  1. Crook-Lynn, R.E., O’Grady, K.A., Smith, T.B., Jensen, D.R., Golightly, T. and Potkar, K.A. (2012). Addressing religious and spiritual diversity in graduate training and multicultural education for professional psychologists. Psychology of Religion and Spirituality, 4(3), 169-181.
  1. Hodge, D. R. (2011). Alcohol treatment and cognitive-behavioral therapy: Enhancing effectiveness by incorporating spirituality and religion. Social Work, 56(1), 21-31.
  1. Koszycki, D., Raab, K., Aldosary, F., & Bradwejn, J. (2010). A multifaith spiritually based intervention for generalized anxiety disorder: A pilot randomized trial. Journal of Clinical Psychology, 66(4), 430-441.
  1. Pew Research Center. (2012). Religion and the unaffiliated. Retrieved from http://www.pewforum.org/2012/10/09/nones-on-the-rise-religion/

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