Thoughts on A Spirituality of Psychotherapy

 by Colm O’Doherty

Have you ever prayed for any of your clients, or wondered about praying, or maybe decided not to pray, for them?

Might there be a quiet nod in God’s direction, for instance, for the woman who left the session today, broken and hopeless, after recalling memories from more than twelve years of awful sexual abuse?

Or for the man who spoke about the sudden death of his young son three months after he had buried his wife?

What about a prayer for oneself, the psychotherapist, when feeling completely at a loss and edging towards a sense of hopelessness about the worth of the work with a particular client?

Have you ever felt like not praying, or that you shouldn’t pray? After all this work isn’t about divine intervention, and prayer could feel like a kind of escapism or clutching at straws.

Have you ever had moments of silent wonder at the courage, or forgiveness, or sheer survival of some of your clients?

Or a silent scream of “Oh my God!” when your client falls down into an abyss of pain, and keeps falling?

I find it more relevant and more engaging to start with these questions rather than with the more objective question: “What is the relationship, if any, between psychotherapy and spirituality?”. From the reading I have done in this field, often the first requirement is to define the word ‘spirituality’ and to come up with a number of core elements. That done, the next step is to consider whether or not any of these elements can be found in the practice of psychotherapy, and thereby identify the overlap. For the moment – and maybe for much longer! – I will leave aside the definitions and choose a starting point of a more personal nature.

Of the different spiritual traditions that have emerged in the course of history I have been formed primarily by the Western Christian tradition, and it is from this particular well that I will draw in considering spirituality. Many other perspectives on spirituality could be derived from other rich sources – hence the “A” in the title. Central to this tradition is the person of Jesus, his life, his death, his resurrection. Not only his words, but all that is entailed in his life, death and resurrection, provide us with a very particular context within which to explore the nature and meaning of our lives and of all that happens to us. We have, as it were, a horizon, and those who choose this horizon use what is central to it to interpret their lives in a particular way in an effort to find meaning.

Choosing such a horizon as a frame of reference for life’s meaning brings us into the realm of personal belief, personal faith, which is the territory of any living spirituality.

So maybe the question is not: “Is there a spirituality of psychotherapy?” but rather, “Can I bring a faith perspective to that part of my life that I spend working as a psychotherapist with clients?”.

It is, of course, essential that the first frame of reference for meaning in the psychotherapy setting is sourced from the fields of psychotherapy, psychology and psychiatry. These disciplines provide the bedrock for the psychotherapeutic engagement, for our understanding and our efforts to make meaning of the clients’ experiences and for what might bring about a greater sense of well- being for our clients. There are a number of other frames of reference that can add depth and texture to the work, for instance, all that we are coming to know about the workings of the brain from neuroscience, and the insights we have from anthropology and how human beings have developed over the ages. So it is for the purpose of better understanding what it is to be human that we engage with these various disciplines.

In the same way there is a wisdom about human nature that comes to us through the variety of spiritual traditions that could serve us well in our work.

It is important that we do not see our referencing these spiritual traditions as a way of trying to spiritualise the raw, tangible reality of emotional pain and distress in our clients. Furthermore, any spiritual perspective is not there to undermine the years of psychological training and the richness of insight and learning that we acquire from the study of psychotherapy. Any spirituality of psychotherapy must respect and welcome the discipline and delicacy of the psychotherapeutic exploration engaged in by both psychotherapist and client, as well as the myriad of psychological constructs that facilitate our understanding of human behaviour and relationship.

To be sure, the psychological/psychotherapeutic/psychiatric frame can stand alone, but the addition of other frames can enhance our understanding of the human person and hence of human wellbeing. I think that Christopher Bollas (1987) breaks through into horizons other than the psychological when he uses the language of “mysteries” and “mysterious” when writing about “the kernel of our true self”. He has no hesitation in drawing from other frames of reference, such as the world of literature or from classical music, in his efforts to deepen his appreciation of what it means to be human. Winnicott (1965) can write very movingly about the psychological implications of being alone. This is a core theme in so much of literature, the arts and indeed the sciences. The poet, Dermot Bolger (2012) can take us further into the emotional isolation of this experience when he writes in his most recent volume of poetry about the unknowability of those we most intimately know. Teilhard de Chardin, the palaeontologist, considers unknowability to be intrinsic to each of us since he sees each human person as being a spark of the divine (1964). These diverse perspectives can add deep colour and rich texture to our thinking about aloneness, thus going some way to doing justice to our quest for an ever fuller understanding of human nature.

So back to our work with clients; what has the perspective of spirituality to offer to our work? As I have indicated, the particular spirituality I am considering here has Jesus at its centre. Jesus’ raison-d’etre, so to speak, was com-passion; he came to identify with suffering. He lived and worked with those on the edge of society: the leper, the prostitute, the mad, the bereaved, the disturbed and the distressed. His own suffering entailed him being nailed and speared and put on public display, and his life climaxed in the agonizing roar: “My God, My God, why have you forsaken me?”. Though indeed resurrected, he carries the forever marks of those nails and spear, as well as the forever story of such utter aloneness. Room aplenty here for the stuff of human suffering that we meet in our work; room for the darkest of abysses and the deepest of chasms that have been gouged into the bodies, hearts and minds of so many of our clients. Room here also for belief in the possibility of a way through, not a life ‘after’ but a life ‘through’ – not without scars – what can be experienced as death, even though this future is inconceivable in the midst of the suffering.

This is the nature of the horizon that can be available to the psychotherapist who is informed with the faith perspective. I would call it a horizon of ultimacy, a final horizon. (We all have such a horizon, our own horizon of ultimacy. Though it is not often explicit, it is present and active as part of our assumptive world, and comes into view in our more important judgements and decisions.) Within this horizon and in centre stage are all the psychological constructs appropriate to any particular psychotherapeutic orientation; they can never be put aside, even though we can, and indeed are encouraged by Bollas (1987) to glance to the right or left of them in our musings and “distractions”. Just as the work of psychotherapy is not about the psychotherapist instructing the client about the various psychological constructs that are enlightening the process of the therapy, so neither are the spiritual constructs discussed with clients. They ‘belong’ to the psychotherapist and can be part of what informs one’s disposition in relation to the engagement with the client, and with oneself on behalf of the client.

The psychological frame of meaning and the spiritual frame can co-exist in a dynamic way. A constant conversation goes on within each of these frames, thinking, wondering, imagining, remembering, musing on the possibility of various understandings and insights. Furthermore, a constant dialogue can take place between the two frames. Sometimes this can be comfortable, where each frame finds easy accommodation with the other, e.g. when growth and wellbeing are in process. At other times it can be decidedly uncomfortable, as when nothing that is being said seems to be reaching the client, and no way forward looks possible. But even at such times uncomfortable dialogue is preferable to the absence of dialogue.

As the title indicates, these are thoughts about A spirituality of psychotherapy. Might they give rise to dialogue, comfortable or uncomfortable?

Colm O’Doherty M.Phil is an accredited psychotherapist and supervisor with IAHIP and IACP. He is currently working in Dublin and in Ballina, Co. Tipperary.


Bolger, D. (2012) The Venice Suite. Dublin: New Island.
Bollas, C. (1987) The Shadow of the Object. London: Free Association Books.
De Chardin, T. (1960) Le Milieu Divin. London: Collins.
Winnicott, D. (1965) The Maturational Process and the Facilitating Environment. London: Hogarth.