Issues of Spirituality and Religion in Psychotherapy Supervision

By Bienenfeld, David; Yager, Joel | The Israel Journal of Psychiatry and Related Sciences, July 1, 2007 | Go to article overview

Issues of Spirituality and Religion in Psychotherapy Supervision


Bienenfeld, David, Yager, Joel, The Israel Journal of Psychiatry and Related Sciences


Abstract: Objective: We note gaps between the basic science of psychotherapy and the spiritual dimensions of religious life; between the beliefs and practices of patients and those of therapists; and between evidence for the influence of spirituality on health and the lack of its integration into psychotherapeutic training. We attempt to provide a framework to bridge this gap in supervision. Method: We reviewed the literature on the roles of spirituality and religion in mental health and illness; on the place of religion in psychotherapy; and on the pedagogy of spirituality. Results: Issues requiring attention include definitions of terms; awareness of personal beliefs; consideration of the boundaries between religiosity and pathology; and distinction between religious structures and personal beliefs. A format for addressing these issues in supervision includes: assisting the trainee with self-awareness; providing tools for spiritual assessment of the patient; providing developmental schema for spirituality; and maintaining awareness of the intersubjectivity of the patient-therapist field and the trainee-supervisor field. Conclusions: Existing literature provides usable frameworks for integrating religion and spirituality into psychotherapy supervision. We offer suggestions on how this may be accomplished.

Introduction: Context

Contemporary psychotherapy has several problems dealing with religion and spirituality. From the outset, therapists as a group differ from their patients in the weight and significance of spiritual matters in their own lives. For example, when given the statement, "My whole approach to life is based on my religion," the percent agreeing among respective groups in the United States was elicited (1). In contrast to the general public, 72% of whom endorsed this statement, rates among mental health professionals were far more modest: Psychiatrists, 39%; Clinical psychologists, 33%; Clinical social workers, 46%; Marital and family therapists, 62%; All mental health professionals, 46%. Israeli psychotherapists differ at least as much from the general population as do their U.S. counterparts, endorsing significantly lower levels of religiosity than their potential patients (2).

Further, much of traditional psychotherapy springs from a history of antagonism toward religion. Sigmund Freud, in "The Future of an Illusion," dismissed all religion as "comparable to a childhood neurosis," and expanded:

Our knowledge of the historical worth of certain religious doctrines increases our respect for them, but does not invalidate our proposal that they should cease to be put forward as the reasons for the precepts of civilization. On the contrary! Those historical residues have helped us to view religious teachings, as it were, as neurotic relics, and we may now argue that the time has probably come, as it does in an analytic treatment, for replacing the effects of repression by the results of the rational operation of the intellect (3).

While Freud's views on this, as on many other topics, no longer carry their original weight, there remains a significant current of negative views of spiritual be liefs and religious practices among practicing psychotherapists. Fundamentally, authors and teachers of psychotherapy are invested in defining the field as scientific and the endeavor as a clinical procedure. These views bear particular relevance for psychiatrists, whose field remains under skeptical assessment from fellow physicians and the general public (4, 5).

Psychoanalyst Gerald Epstein epitomizes those who have abandoned any effort at integration because he believes that, fundamentally, spirituality and psychotherapy are irreconcilably antithetical. In his view, the basic tenets are so far apart that they cannot be mixed; the language of one field cannot be used to define the other (6).

Reasons to Make the Effort

But the majority of those who analyze the problem see a need to arrive at integration for several reasons:

1. …

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