Spiritual Belief, Psychotherapy, and Clinical Practice

Introduction

There is a growing trend in psychological counseling to incorporate some form of “spirituality” into clinical practice, a practice usually reserved for strictly “scientific” approaches to psychology and methods of healing. In fact, to a traditional psychological counselor, the two concepts of “spirituality” and “psychology” or “counseling” seem to be oxymoronic. Typical Western science stands for everything that “spirituality” is not; and “spirituality” is, supposedly, everything science is not. Whereas scientific psychology is supposed to be strictly supported by empirical evidence and grounded in scientific fact, things “spiritual” are supposedly based on faith and grounded in ethereal essences. In other words, the two concepts could seemingly not be more opposite from one another. Nevertheless, there is a growing trend in professional counseling circles to incorporate various doctrines, principles, and practices associated with religion and spirituality into their clinical practices. And they have typically found great success in doing so. In this context, success is measured by how healed and “whole again” the clients and patients of psychological counseling have felt.

A Brief Review

There has not been any more severe critic of religion and spiritually, and them incompatibly with the science of psychology and the practice of psychotherapy, than Sigmund Freud, the father of modern psychology. Freud was a confirmed and outspoken atheist in both his thinking and in his practice. He portrayed religious practitioners as caught in a universal obsessional neurosis and characterized religious beliefs as a system of wishful illusions, a rejection or denial of reality, and a state of hallucinatory confusion. For Freud, religious rapture and mystical experiences projected nothing more than an infantile helplessness and a regression to primary narcissism. A selection of choice quotes from Freud’s writings illustrates well his attitude toward religion. In one of his more well-known books, New Introductory Lectures on Psychoanalysis (1933) Freud wrote that "Religion is an illusion and it derives its strength from the fact that it falls in with our instinctual desires." In the Future of an Illusion (1927) Freud wrote that "Religion is comparable to a childhood neurosis." The modern bias towards any hint of religion or spirituality in psychology and counseling stems from the Freudian critique and builds on Freud’s attempts to turn psychoanalysis and psychodynamic theory into an exact science, alongside physics, chemistry, and biology.

Following Freud, two very influential doctrines upon which modern psychology derives its scientific core are “positivism” and “empiricism.” Empiricism is the doctrine that any and all knowledge can only be derived from the five senses. Because empirical knowledge is derived from human sensation it is capable of being verified and validated. Empiricism holds to the belief that whatever cannot be verified by the five senses cannot be considered knowledge. Positivism is the doctrine that natural science and the “scientific method” are capable of discovering the changeless laws of nature. According to positivism, only science can provide the true and real knowledge of the world and of reality. Neither religion nor spirituality deals directly with the empirical world of natural science. It is because religion is so non-scientific that empiricists and positivists totally reject it as a form of valid knowledge and deny that it can have any interesting role in the development of a science such as psychology. Only empirical knowledge can be formally objective and value-free. Everything else, religion and spirituality included, are considered subjective and value-laden and not fit to be called knowledge of any sort. One major assumption of early modern psychological counseling is that mental health problems are like diseases which primarily require accurate diagnosis and treatment. They have an empirical foundation, just as bacteria and viruses do, and hence the only treatment and cure must come from some sort of chemical or pharmacological intervention.

Modern Psychological Counseling and Spirituality

The entire culture of Western Civilization has been influenced by empiricism, positivism, science and technology and hence one can detect a general skepticism towards religion in many people, especially when it comes to purported “sciences” such as psychological counseling. However, this does not mean that people are less religious or spiritual. Spiritual values are part and parcel of human lived experience and it is in the 21st Century that “spirituality” has replaced institutionalized religion as a source of inspiration and personal power.

Spirituality is a more general term that includes religion but that also encompasses the general human impulse to reach out towards the greater whole of which we all are a part. According to Swinton (2001, p. 36), “What seems to have happened is that the spiritual beliefs and desires that were once located primarily within institutionalized religions have migrated across to other forms of spirituality. The spiritual quest continues, but in very different and much more diverse forms than those traditionally assumed to be normal”. Religion can be defined as a human invention that centers on specific rituals and a set of stories that outline a basic moral code and belief system. Religious people are generally spiritual people as well, but spiritual people do not necessarily have to be religious. They may work to attain a heightened spirituality through alternative methods. What many psychotherapists and counselors have been seeing lately is that many of their clients’ inflictions can be interpreted as resulting from psychic imbalances between body-soul-mind. Many individuals seeking psychological counseling or therapy have a strong desire to be “whole” and in close touch with spiritual energies greater than themselves, and not left feeling fragmented, alone, and helpless. The sense of incompleteness and the conscious need for transcendence, for contact with some deep spiritual reality, are widespread in us in industrialized, high-technology society. We, therefore, see, more practicing psychotherapists and counselors beginning to incorporate issues of spirituality and humanism into their day to day practices. This is only made possible when spirituality "...rather than being viewed as a specifically religious concept…has broadened in meaning into a more diffuse human need that can be met quite apart from institutionalized religious structures. This changing meaning of spirituality is reflected in the variety and diversity of definitions and understandings that are found in the literature on spirituality and mental health” (Swinton, 2001, p. 48).

The human spirit is the essential life-force that undergirds, motivates and vitalizes human existence, and spirituality constitutes the manner in which individuals and communities respond to the existence of the human spirit. The initial interpretation of these concepts is derived etymologically from the meaning of the Latin word spiritus, initially meaning “breath.” From metaphorically linking the Latin root to the modern interpretation of “spirit” and “spiritual” we can see how modern therapists interpret “spirit” and “spiritual” as a powerful force that energizes human existence and fills it with meaning and purpose. Ellison describes the essence of the spirit thus:

“It is the spirit of human beings which enables and motivates us to search for meaning and purpose in life, to seek the supernatural or some meaning which transcends us, to wonder about our origins and our identities, to require mortality and equity. It is the spirit that synthesizes the total personality and provides some sense of energizing direction and order. The spiritual dimensions do not exist in isolation from the psyche and the soma but provides an integrative force. It affects and is affected by our physical state, feelings, thoughts and relationships. If we are spiritually healthy we will feel generally alive, purposeful and fulfilled, but only to the extent that we are psychologically healthy as well. The relationship is bi-directional because of the intricate intertwining of these two parts of the person.” (Ellison, 1983, pp.705–6)

Counseling, the Healing Process, and Human Spirituality

Within neurobiology and psychology, the connection between the mind and the brain is becoming more and more apparent. Similarly, within psychiatry, the lines between the biological, psychological and sociological etiology and treatment of mental health problems are no longer as clear as they once appeared to be. More and more it is being recognized that human beings are whole persons whose physical, emotional, social and spiritual needs are inextricably interlinked. Mental health problems are not entities that simply affect one dimension of the person: the mind. They are whole-person experiences that affect a person in every dimension of their existence. What goes on in the psychological and spiritual realms can have a profound influence on what goes on in the physical realms, and vice versa.

Take for example a case of depression, a common psychological ailment inflicting many individuals. The typical way to treat depression clinically is to prescribe medicine. According to modern science, depression stems from an imbalance of certain chemicals in the brain and therefore the best (or only) way to treat it is by a contemporary psychological treatment such as Prozac. Treated from a perspective of human spirituality, however the therapist would probably determine that the person’sspirit has been inhibited, crushed or flattened by biological, social or psychological events. Depressed patients often complain that they feel as if they are simply going through the motions. Their actions and experiences appear to have no meaning beyond themselves. The psychological counselor implementing spiritual principles into his or her practice will interpret the situation as a conflict between “reflexive” versus “meaningful” responses to reality. Reflexes are physical actions that are devoid of meaning or purpose beyond their immediate function. They are nothing more than automatic responses to bioelectric stimuli. They do not have any personal meaning or independent sense of purpose beyond their specific function to the producer of the reflex. On the other hand, if we focus on a person’s spirit, we can see that it is spirituality that makes the difference between reflexive human existence in which human actions and experiences are viewed as a stream of meaningless causes, and meaningful human existence, as expressed in a simple smile or wave of the hand, for example, in which actions and experiences are understood as containing meaning, hope, purpose, direction and possibilities beyond themselves. Hence, we can say that the depressed person is living reflexively, rather than meaningfully. Within such a situation, the task of the spiritual therapist is not simply to locate the locus of pathology, but also to locate the locus of meaning within the person’s life and in so doing begin to explore ways in which the person’s spirit can be revitalized and the movement from reflexive existence to meaningful living can be initiated and followed through.

In order to genuinely grasp the importance and meaning of the spiritual experience of people with mental health problems, we need to develop an approach that will enable therapists in a real sense to enter into the life-worlds of people with mental health problems, and to seek to understand their experiences rather than simply explain their conditions. The integration of a “spiritual” approach to modern psychological counseling begins by taking a hermeneutic approach to understanding mental health problems. Hermeneutics is simply a word designating the science of interpretation in the social sciences. The hermeneutic approach differs in emphasis from the biomedical approach in that its primary focus is not on pathology, but rather on the interpretation and significance of meaning, and the semantics of illness and disease. While accepting the reality of pathology and the significance of medical and psychiatric interventions, the hermeneutical model takes seriously the fact that mental health problems are never merely biological or psychological. Mental health problems are human experiences that occur within the lives of unique, spiritual, meaning-seeking individuals. Rather than beginning by asking ‘what is wrong with this person’, therapists should begin their questioning from hermeneutic or spiritual approach and ask: ‘What gives this person’s life meaning?’ ‘What is it that keeps them going, even in the midst of their psychological pain and turmoil?’ ‘Where is this person’s primary source of value?’ ‘What can be done to enhance their well-being?’ In asking such questions, the person’s situation is reframed in a way that reveals hidden dimensions closer to the hermeneutical model.

Conclusion

If human beings are whole persons and if mental health problems affect every aspect of the person, then spiritual care on its own will not be enough. Nor will pharmacological or psychotherapeutic intervention be sufficient to meet the needs of the whole person. What will be required is a multidisciplinary approach that seeks, through constructive dialogue

between the disciplines, to develop ways of caring that acknowledge and reach out to the whole person, including those more mysterious and less tangible aspects that emerge from reflection on the human spirit. One of the aims of this essay was to provide a foothold from which such a multidisciplinary approach might begin to be understood.

References

Ellison, C.G. and Levin, J.S. (1998) The religion–health connection: evidence, theory, and futuredirections. Health Education and Behaviour 25, 6, 700–720.

Swinton, John (2001). Spirituality and mental health care: Discovering a forgotten dimension. London, England: Jessica Kingsley Publishers, pp. 1-219.