Integrated Perspectives: Spirituality and Psychotherapy: An Important Combination

By La Torre, Mary Anne | Perspectives in Psychiatric Care, July-September 2002 | Go to article overview

Integrated Perspectives: Spirituality and Psychotherapy: An Important Combination


La Torre, Mary Anne, Perspectives in Psychiatric Care


This column discusses the concepts of an integrated psychotherapeutic approach to patient care and explores some of the underlying principles that make it beneficial.

Using the terms spirituality and psychotherapy in the same sentence may seem strange because there has been a long history of mutual skepticism, if not antagonism, between the two. In the past, mental health professionals and ministers have seen science and religion as separate, and attempts to connect them have been dismissed as disruptive and unhealthy (Fallot, 2001). We only need to go back to Freud (1927/1964) to see how this attitude of separateness and disconnection has been perpetuated. He characterized religion as an illusion, and connected it with pathology such as obsessive compulsive behavior. This attitude fostered the view that spirituality was irrelevant at best and indicative of pathological thinking at worst, encouraging many therapists to avoid the topic altogether. In sessions, then, any discussion of religious experiences was often viewed as regressive and dysfunctional (Fallot).

Over the years, however, there have been attempts by noted therapists such as Jung and others to integrate these two aspects of spirituality and psychotherapy. In the last 20 years, a growing number of voices have joined in the discussion (Fallot, 2001). Many therapists now are beginning to consider the healing opportunities available when incorporating a more holistic view of mind, body, and spirit. Even the American Psychiatric Association (APA) has begun to consider the role of religion and spirituality in psychiatry. For example, the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) (APA, 1994) includes a category, "religious and spiritual problems," which, while it focuses on problems, separates spiritual issues from psychological problems for the first time. In addition, a model curriculum is being presented to the APA to help train psychiatric residents in religious issues (Fallot). These moves signal a shift in thinking by the psychiatric community away from separation toward integration, as therapists begin to speak of the "major role" spirituality and religion can play in our modern world (Lukoff, 2000).

Such a dramatic shift in thinking is easy to understand when looking at the growing sense of isolation and alienation present in the patient population, which the psychiatric community can no longer ignore. With families eroding and communities no longer available to provide support, there is a growing sense of confusion and conflict about values, standards, and priorities (Aponte, 1996). People who come into therapy today are looking for something more. As Nicholas (1994) states, "Patients not only are coming into therapy with confusion about their own individual morality but are seeking to compensate for the lack of reliable and humane guideposts that are available in society as a whole" (p. 5). In this atmosphere, therapists are looked to for support as clients struggle with a loss of meaning and a sense of emptiness. A therapist who focuses on traditional therapies can provide only transitory relief for the emptiness and is limited because the process speaks primarily to individual pathology rather than the wider aspect of humankind (Karasu, 1999).

Practicing psychotherapy with a wider inclusion of spiritual issues involves a willingness to explore one's own attitudes and beliefs. This may be a difficult task for therapists who may feel unprepared both educationally and experientially. Studies have shown that mental health professionals tend not to be involved in religious practices and beliefs, seeing them as a small part of their life (Lukoff, Lu, & Turner, 1992; Shafranske, 1996). They may see themselves as spiritual but not religious (Fallot, 2001). This difference in self-image may make it difficult for therapists to explore religious traditions with their clients or to see the value of doing so. …

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