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A recent study of clinical social workers suggests that although the vast majority of clinicians (80 percent in this study) believe that discussing clients’ religious and spiritual views would be valuable to the therapeutic process, only a minority of clinicians end up doing so in practice (Oxhandler, Parrish, Torres & Achenbaum, 2015).
This is unfortunate, but not surprising. Religion and psychotherapy have had an uneasy relationship for a long time, often in competition with each other as rival means of explaining and healing the human soul.
Sigmund Freud, the father of psychotherapy, wasn’t a fan of religion. It was, he wrote, “comparable to a childhood neurosis” (Freud, 1927), “infantile” and “humiliating” (Freud, 1930).
It was also, for Freud, an unscientific means of analyzing what was going on within our minds. Religious beliefs might be worth exploring, in therapy, as fantasies and illusions, but only as a step on the way to uncovering the more scientific, deeper truths of the psyche.
Others disagreed. William James, the “father of American psychology,” felt strongly that psychological research should be inclusive of all forms of human experience. In The Varieties of Religious Experience (1902), he described a wide variety of spiritual and psychological experiences, attempting to broaden psychological and religious understanding, rather than to empirically limit the categories or narrow the analysis (James, 1902).
Closer to our own time, the humanistic psychologist Abraham Maslow argued that the science of psychology should be as inclusive as possible. In 1964, Maslow published Religions, Values, and Peak-Experiences, in which his purpose was to argue that spirituality is “well within the jurisdiction of a suitably enlarged science,” and thus fair game for psychologists (Maslow, 1964).
In a certain sense, James and Maslow have won the day. These days we believe in being inclusive, and in treating people’s core convictions and beliefs as deserving of respect on their own terms. That’s why more than 80 percent of the social workers surveyed in the study were in favor of discussing religion in therapy.
The problem arises from the fact that we haven’t done a very good job at figuring out how to put that into practice when it comes to some of our most profound, and charged, beliefs. Religion is a perfect example of this (though not the only one). Most of our guiding theories don’t incorporate religious belief. And we tend to get very little training in how to deal, specifically, with matters of faith, as opposed to issues like depression, anxiety, marital conflict, etc.
So even though, as psychotherapists, we believe that we should talk about religion and spirituality, we don’t always feel well-equipped to do it.
Scholars of religion and psychotherapy have suggested improving training and developing more expansive theoretical models to aid counselors in integrating religion into their practice (Gonsiorek, Richards, Pargament, & McMinn, 2009). Others have suggested that clients should choose therapists with similar religious beliefs. Still others, though, suggest rethinking our apporach at the most fundamental level.
Rather than immersing ourselves in knowledge about religious and spiritual perspectives, or attempting to target clients whose religious perspectives match our own, we might be better served to respectfully let these differences exist (Mayers, Leavey, Valliantaou, & Barker, 2007; Worthington & Sandage, 2001).
It would be beneficial to let go of the idea that the goal is for us to always close the distance, as much as possible, between where we are and where our clients are. We don’t need to be on the same page, or perfectly objective, or utterly nonjudgmental. We need to be honest, and open, especially in cases where our religious beliefs differ from those of our clients.
It’s inevitable that we will differ with our clients, on many issues. But this disagreement can be incredibly fruitful. It can be a source of curiosity, on both sides of the relationship, and a potential source of growth. Many therapists fear that if they’re too open about their own values, they may impose them on their clients. And that can be a serious risk (Beutler, 1979). But the much greater risk may lie in failing to acknowledge what our silence is saying.
Not talking about an issue as profoundly important to our patients as faith is itself a statement about religion. It can send a message that entire parts of a person are off limits, unwelcome, or problematic. Better to lay our cards on the table and engage in a genuine dialogue about what the people in the room can bring to each other.
References
Beutler, L. E. (1979). Values, beliefs, religion and the persuasive influence of psychotherapy. Psychotherapy: Theory, Research & Practice, Vol 16(4), 432-440. http://dx.doi.org/10.1037/h0088370
Freud, S. (1927). The Future of an Illusion, New York: W. W. Norton & Co.
Freud, S. (1930/1962). Civilization and Its Discontents. Ed. and Trans. James Strachey. New York: Norton.
Gay, P. (1989). A Godless Jew, New Haven: Yale University Press, 3-21.
Gonsiorek, J. C., Richards, P. S., Pargament, K. I., McMinn, M. R. (2009). Ethical challenges and opportunities at the edge: Incorporating spirituality and religion into psychotherapy. Professional Psychology: Research and Practice, Vol 40(4), Aug, 385-395.
James, W. (1902). The Varieties of Religious Experience, New York: Longman, Green & Co.
Maslow, A. (1964). Religions, Values, and Peak-Experiences. Columbus: Ohio State University Press, 4.
Mayers, C., Leavey, G., Valliantaou, C., & Barker, C. (2007). How clients with religious or spiritual beliefs experience psychological help‐seeking and therapy: A qualitative study. Clinical Psychology & Psychotherapy. 14(4):317 - 327. DOI: 10.1002/
Oxhandler, H. K., Parrish, E. E., Torres, L. R., & Achenbaum, W. A. (2015). The integration of clients’ religion and spirituality in social work practice: A national survey, Social Work, 60 (3): 228. DOI 10.1093/sw/swv018
Richardson, R. D. (2006). William James: In the Maelstrom of American Modernism, New York: Houghton Mifflin, 412–415.
Worthington Jr., E. L. & Sandage, S. J. (2001). Religion and spirituality.
Psychotherapy: Theory, Research, Practice, Training, Vol 38(4), 473-478. http://dx.doi.org/10.1037/0033-3204.38.4.473
