Spiritually Integrated Psychotherapy

© Rev. Barbara F. Meyers 2013. All Rights Reserved.
Mission Peak Unitarian Universalist Congregation
July 28, 2013

Some people have asked those of us working on the planned Counseling Center about how the kind of therapy we plan to offer differs from more traditional psychotherapy. Today I’m going to try and answer that question by talking about Spiritually Integrated Psychotherapy.

My story

I’ll start with an example from my own life. In 1986 I was recovering from depression and desperately unhappy. Among other things, my psychiatrist asked what I was doing for myself spiritually. I said “Nothing,” because although being brought up in a church-going Christian home, for nearly 20 years, I had nothing to do with religion or spirituality, and truth be told, sometimes made fun of people who did. Then he asked me, “Would you like to learn how to meditate?” Even though I thought it sounded like a flaky idea, I had promised myself that I would try what my psychiatrist suggested and make changes in my life to relieve my depression, so I said, “Yes.”

That was the beginning. Even though nothing dramatic happened at first, it was the start of getting in touch with who I really was, deep down. The eventual result for me was that happiness spontaneously erupted from somewhere inside. My life became more livable, and over time changed dramatically. Realizing that there was something spiritual going on, I joined a UU church; started exploring my emerging spirituality.

I didn’t know it at the time, but what I had experienced was spiritually integrated psychotherapy. Somehow, I had had been lucky enough to having a psychiatrist who had an active spiritual life himself and was able to recognize when this approach would be appropriate for a client, and he saw that in me. This was nearly 30 years ago. At the time, I had no idea how fortunate I was.

Quote about 30 years ago

30 years ago, Kenneth Pargament gave his first colloquium on religion and mental health at a university. Pargament is professor of psychology at Bowling Green State University and author of a recent book entitled Spiritually Integrated Psychotherapy (Guilford Press, 2011) which is the basis for much of what I will say today. He relates that after the talk, the department chair came up and whispered “I am a Catholic.” After a moment Pargament asked. “Why are we whispering?” Still whispering, the chair said “Religion… you know, it’s not something we talk about around here.” Not uncommon 30 years ago, but the picture has begun to change. He explains that “despite the advances that have been made in the field, there has been something missing from the ways traditional psychotherapy has tried to understand and help people who are yearning for a psychology that touches the deeper levels of what it means to be human.” This approach reflects the “growing body of research that points unequivocally to spirituality as a potent predictor of health and well-being. But the area is still far from well established.”

Spiritually integrated psychotherapy is an approach to therapy that explicitly acknowledges and addresses the spirituality of the person coming for help.

Defining Spirituality

As Pargament explains, a person’s “spirituality speaks to the deepest of beliefs, the most fundamental assumptions of life, and the most sacred of matters.” It involves a search for the sacred in one’s life. The sacred will be different for different people. Some identify God, the divine or a Higher Power as sacred. For others, nature or a transcendent reality might be sacred. I will submit that I think everyone has something that they hold sacred. I am reminded of the following words attributed to Ralph Waldo Emerson that Jeremy used in a sermon a few weeks ago. I like them and I’ll use them again:

“A person will worship something – have no doubt about that. We may think our tribute is paid in sacred in the dark recesses of our hearts – but it will out. That which dominates our imaginations and our thoughts will determine our lives and our character. Therefore it behooves us to be careful what we worship, for what we are worshipping we are becoming.”

Even though it is of supreme importance in an individual’s life, questions about spirituality and religion are routinely neglected in therapy. They are viewed as irrelevant, and even pathologized. Some social workers have told me that in their training they were told that when the client mentions something about religion, they were to write that down as a symptom. This is not anything new; Freud believed that religion was an illusion, and his bias has influenced generations of analysts and therapists. But things are changing.

It is a fact that clients often bring spiritual issues into therapy, explicitly or implicitly. Where spiritually integrated psychotherapy differs from other approaches, is that it assumes that this happens and encourages clients to give voice to these issues. It makes the implicit explicit. As Pargament says, it is “a way to identify what the client holds sacred and talk about how spirituality may be a part of the problem” or its solution.

He goes on, “Spiritually integrated psychotherapy is neither a self-contained form of therapy nor a competitor to other types of treatment. Rather it is a therapeutic approach that extends and enriches many forms of therapy by focusing more explicit attention on the spiritual dimension of people, their problems, their resources, and the process of change. It can enhance other modes of treatment by providing another perspective on psychological problems.”

Many people look to spirituality for support and guidance. It is one of the most commonly used methods of coping in dealing with a threatening or damaging situation. Here are some ways of spiritual coping:

  • Spiritual support from the sacred both transcendent and immanent in prayer
  • Support from clergy by pastoral counseling
  • Spiritual helping of others
  • Spiritual re-appraisal or re-framing of a stressor

Saints, sinners and humans

Here is a story from Pargament’s book: Mary had a successful career as a lawyer but felt that she was a failure interpersonally. She had a series of unsuccessful relationships with men that all followed a pattern: she was certain she had met the man of her dreams and fell in love, experience a few months of bliss, and then develop feelings of betrayal prompted by some inconsiderate or insensitive act on the part of her lover, and end the relationship. Her therapist said it sounded like she saw two types of people: saints and sinners. She agreed, calling them angels and devils. Her therapist suggested she was missing another group – human beings. Most of us fall into the category of human beings, with a bit of the saint and a bit of the sinner in them. Could people make mistakes and not fall into the category of devils? He suggested that there was a spiritual resource from her tradition that might help seeing people as human beings: forgiveness. Mary was able over time to see a more differentiated spiritual system for assessing people. She was able to show more compassion and forgiveness in her life to others and to herself. The next time she met a man, she was able to maintain in the relationship, work through their differences and eventually marry.

Implicit Spirituality

Perhaps you are wondering about whether every conversation with the therapist will be explicitly religious, or you are wondering about whether it has any value for people who are humanists, agnostics or atheists. The answer is that it doesn’t require theism. Many of the things that people will talk about have an implicit spirituality.

The example from my life, was a case of implicit spirituality. My psychiatrist could see someone in pain and in looking at the whole person, saw an important missing piece – spiritual grounding. He gently suggested a possible way to fill this void.

I am reminded of the words of Carl Jung, whose approach was very different from that of Freud with regard to religion. At my ordination the following reading from Jung was read:

“Among all my patients in the second half of life – that is to say, over 35 – there has not been one whose problem in the last resort was not that of finding a religious outlook on life. It is safe to say that every one of them fell ill because he had lost what the living religions of every age have given to their followers, and none of them has really been healed who did not regain his religious outlook.” – C.G. Jung, Modern Man in Search of a Soul

When addressing implicit spirituality, there are other ways to talk to the client. Here are some of Pargament’s suggestions:

  • One can talk about resources and pathways: What is your source of strength and courage; Where do you find peace; Who truly understands you; How do you find comfort when you are in need; For what are you deeply grateful; What sustains you in the midst of your troubles
  • One can talk of destinations: What are you striving for; Why is your presence in the world important; What legacy would you like to leave behind; How would you like people to remember you when you are gone; To what are you most devoted; Who is your true self; What do you put your faith and hope in; to whom do you express love; when have you felt most fully alive?
  • Or, one can talk about struggles and transformations: Deepest questions; what causes you despair; how has this experience changed you; what have you discovered about yourself that you find most disturbing; how has it shaken your faith; what are your deepest regrets; when have you experienced forgiveness?

Embedded in the psycho-spiritual questions are words that contain sacred qualities such as: peace, courage, solace, sustenance, devotion, faith, hope, love, letting go, forgiveness, regrets, despair and suffering.

Loss of sacred

Pargament explains, “People find their way into therapy presenting problems attributable in one way or another to that lost sense of the sacred, such as the depression that grows out of spiritual emptiness [he’s talking about me here], the anxiety that accompanies the feeling of life being lived inauthentically, and the pursuit of false god such as consumerism, workaholism, narcissism, nihilism, hedonism, and alcoholism – those destructive ‘isms’ of our times. Other false gods are: drugs, sex, anger, anxiety, possessions, money, people, fame, power, relationships. They are problematic because they are incapable of holding the sacred. And they confuse symbols of the divine with the divine itself. The result is a life dedicated to gods that diminish rather than enrich human experience.”

Creation of things of beauty

In another story from Pargament’s book: Agnes had given up her love for the cello, which was a spiritual pursuit for her, to devote her life to the worship of her husband Peter. As charming as he was, Peter could not bear the weight of the sacred. He was painfully human, unable to care for Agnes financially, emotionally, or spiritually. For years she had sacrificed her own dreams to advance those of her husband, and became unable to nourish herself spiritually. She became more and more aware of her poor choice in gods, and the high price she had paid in her own life. She was frightened that she had thoughts of wanting to kill Peter, the idol who had accepted her sacrifices and failed to care for her in return. And she came uncomfortably close to killing herself, in part for her foolishness, and in part to put an end to the emptiness she felt inside. Clearly, spirituality was an important part of Agnes’s problem, and there were hints that it might be part of the solution, too. Perhaps she hadn’t lost her soul, but had simply lost touch with it. The therapist saw that this was a period of spiritual transformation, moving from a false God to a more authentic sense of her own spirituality and from self-derogation to more fulfilling ways to nurture her soul. Her transformation toward a more fully integrated and effective spirituality became a central part of therapy. God to her was about creation and beauty – the things that are truly immortal. When she moved towards those things by reconnecting with music, her problems subsided.

How to

I suggest the following exercise for those of you who want to try out some of these ideas on yourself. Set aside a quiet time during the week to think deeply and carefully about 10-15 of your most important personal strivings, those goals that direct and determine what you do every day. Which of these do you hold sacred? How much time and effort are you putting into these most important strivings? Are some externally imposed? Try and distinguish between true and false strivings. Do your answers to these questions lead you to affirm some parts of your life? To question parts of your life? What you do with your new-found self-knowledge could change your life for the better.

What we’re trying to do with the center

What we will be doing at the counseling center is to try and live up to this ideal of practice in the therapists we engage, the educational classes we teach, and the programs that we begin. The unique thing we have to give is to explicitly say that this vision will guide our work and it will be a place where people can come to explore what is most deeply meaningful to them as human beings. Explore with them where they find peace, courage, solace, sustenance, devotion, faith, hope, love, letting go, forgiveness, regrets, despair and suffering. And walk with them in their unique path.

Some of you may worry that we will be imposing a spiritual path or particular theism or religion on the people who visit. The most basic of truths that we will live by is that it is the right of clients to define truths as they see them. Anything else would be ineffective and potentially harmful. And grounds for dismissal from our center.

In summary, I’ll ask: Why give spirituality a greater voice in therapy?

My answer is:

  1. First, Spirituality is a natural and normal part of life.
  2. Second, Spirituality contributes to a more complete accounting of human strengths and weaknesses.
  3. Third, Spirituality is a therapeutic fact of life.
  4. And fourth, we are now in a position to move from theory to practice.

We are grateful for the vision and the trust we have been given by this congregation to pursue this important ministry.