According to the National Institute of Mental Health, psychotherapy refers to a variety of treatments that aim to help a person identify and change troubling emotions, thoughts, and behaviors. From the early beginnings of talk therapy (think Sigmund Freud and couches) to the present day, there has been an enormous evolution of what therapy “is” and an abundance of ways we can work to change, “emotions, thoughts and behaviors.”

Spirituality, in its simplest terms, is defined by an individual's search for ultimate or sacred meaning, and purpose in life. I will use the term, “spirituality,” as an all-encompassing term which can include the full spectrum of spiritual and religious beliefs. 

The beliefs we hold about ourselves, others, and the world around us play an integral role in our emotions, thoughts, and behaviors. Much of our belief system, as children, stems from our parents, the environment we grew up in and our own unique genetic highway. As we enter late adolescents and early adulthood we begin to question, update and reprogram our belief system – synthesizing our own experiences into what we have already been told. And, we don’t stop doing this, thanks to neuroplasticity, which is where our brains continue to adapt to new ways of thinking and new experiences throughout our lifetime.

Common therapy goals that are often presented by clients, which might indicate a need to explore belief systems, might sound like - “I don’t want to be so negative,” “I want to know what my purpose is,” “I just want to be happy,” “I wish I weren’t so judgmental,” “I feel so negative about the state of the world, there’s no hope.” As a therapist explores deeper roots of belief systems (which lead to thoughts, emotions, and behaviors), the question may come up as to what role does spirituality play?  

In an article about integrating spirituality in counseling practice, Corey and Bleuer explain that counselors ask every imaginable question about a client’s life, yet often do not inquire about the influence, meaning, or trauma from spirituality and/or religion in an individual’s life. They further emphasize that if a counselor does not raise the issue of how spirituality influences a client, then clients might assume that such matters are not relevant for counseling. If a client is not interested in exploring the topic of spirituality, then that preference is best respected. In this case, to ensure clarity, it is recommended for a therapist to inquire about what a client means by “spirituality.” If a client is interested in spiritual concepts or integrating spirituality into therapy, then it is usually best practice to follow the client’s preferences. Yalom, a renowned psychotherapist and author of The Gift of Therapy, elucidates that all humans contemplate existential questions that are inherently spiritual concepts, and germane to the therapeutic experience. He mentions concepts like gratitude, forgiveness, loving-kindness, acceptance, letting-go, and defining meaning and purpose. 

Even with this knowledge, most counselors do not receive extensive training regarding the integration of spiritual and religious concepts and the relationship they serve to one’s well-being. In this way, many counselors may feel unprepared, at best, or inept in managing this component of a client’s mental health. For some therapists, talking about religion and/or spirituality is a slippery slope. For example, the therapist may not hold similar beliefs, or worse, they may not hold sufficient knowledge about a client’s particular belief system to be of service in helping them explore how their beliefs have affected them. Therapists might also, (appropriately) worry that they could influence a client’s spiritual beliefs just by sharing their own. All these potential issues are valid. However, appropriately exploring cultural diversity and spiritual/religious differences should be provided throughout a therapist’s schooling and licensing process.

Therapists are taught that avoiding a topic in therapy simply because they don’t know enough about that topic, is unethical. Rather, it is recommended they address the elephant in the room regarding the unequal knowledge around the topic, and then seek more information to learn what is needed. If they are not versed in a specific issue that is central to a client’s therapy, then they may need to refer the client to someone with the appropriate expertise. This approach extends to spiritual and religious differences.

Therapists and clients are continuously influencing each other during the reciprocal therapy process, but a skilled therapist holds boundaries over the extent of the influence and the reason for the influence. If a therapist does disclose personal belief systems, then it is imperative that the therapist filter their response through a lens of asking, “Is what I am about to disclose going to help move this client towards their therapy goals or does this disclosure move therapy in the direction this client wants to go?” For example, a therapist might share a morning meditation routine as a potentially helpful intervention for improving mood and assisting with a challenging start to the day; however, the therapist may be cautious in sharing this recommendation with a client who is struggling with their faith or spirituality. 

Ethically speaking, therapists are continuously aware of the reciprocal nature of the therapeutic relationship and hold appropriate boundaries as to what they share with their clients, prioritizing individual client goals above all else. Sharing personal beliefs about spirituality holds true to this line of ethics. Therapists tread carefully and use disclosure only if they deem it as an appropriate addition that will aid in growth towards the client’s individual goals. 

According to Corey and Bleuer, “Spirituality seems most authentic and valuable when it enables us to become as fully human as possible.” How, then, can we use spirituality to be more fully human? In most religious and spiritual systems there is a call to action and within that action is where evolution and growth of “self” can often be found. Whether it be living closer to the principles laid out by a particular religion, meditation, practices and traditions that increase connection with others, service work, more time in nature, prayer, practices of increasing compassion, etc.  The nature of being human is a continuous flux between growth and stagnation, growth and stagnation. Many people seek therapy when they feel stagnant. How prudent it might be to explore ways to increase action, in the realm of spirituality, if someone is seeking therapy for stagnation.

Additionally, throughout the therapy process, spirituality and/or religion may take a uniquely valuable role when it is referenced across specific developmental stages. For example, 

• Adolescents naturally seek independence, separation from parents and identity formation. Questioning, curiosity and/or expansion around family and individual spiritual belief systems is often (naturally) part of this process. Being able to explore this in a safe, non-influencing, open environment could be significantly beneficial. 
• In adulthood, where one experiences an increased sense of responsibility and maturity, seeking balance is a common theme. Adults may find a pull towards strengthening spirituality or a new search for something that “fits” into their changing lives. 
• The elderly often present in therapy with some level of anxiety around aging and death. This stage of life can be an opportunity to strengthen beliefs around their spiritual perspectives or find new truths for which they feel most aligned. 

Finally, what role does spirituality hold in the therapeutic relationship? The answer is that it is not only relevant, but it is also recommended to explore the role of spirituality (or the lack of it) in a client’s life. In fact, questions regarding one’s beliefs should be asked by every therapist in one of the first few sessions. It is especially valuable if the client desires to incorporate it into their overall well-being. Even more, it may be a vital missing piece for the client’s overall well-being. 

The awareness of the therapeutic process providing sacred space to explore these core aspects of oneself, is a welcomed perspective. For me, this is what it means to be a counselor who incorporates mind, body, and spirit into the consideration of one’s wellness. If you would like to explore more about your spirituality in an inclusive, accepting, professional therapeutic relationship, I invite you to join me in the sacred journey of self-discovery. 

 

 

References: 

Corey, G., & Bleuer, J. (n.d). Integrating Spirituality in Counseling Practice. ACA Knowledge Center, Counseling.org/knowledge-center/vistas.

Yalom, I. (2009). The gift of therapy. HarperCollins.

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Written by:

Clinical Director, Qualified Supervisor, Psychotherapist

Caren Phillippi, LMHC, QS