Integrating spirituality into psychotherapy

Spirituality and psychology have had a tumultuous relationship throughout the history of their respective fields (Knox, Caitlin, Casper & Schlosser, 2005).  Sigmund Freud believed that religion was a neurosis of the mind (Myers & Williard, 2003).  Carl Jung, on the other hand, embraced the spiritual dimension of his clients (Karasu, 1999).  Today, some counselors seek to distant themselves from spirituality, while others believe it can enhance their practice and help improve their clients’ lives (Elkins, 1995). 

Furthermore, many clients from a wide range of backgrounds, religious beliefs and spiritualities will go to a counselor with the hopes that they may can discuss their spiritual concerns (Knox et al., 2005).  A counselor can be more effective if they are equipped to respond to various spiritual issues in a manner that is knowledgeable, sensitive and respectful of all cultures and belief systems (Zinnebauer et al., 1997).  This paper examines the potential challenges, benefits and techniques for integrating spirituality into psychotherapy from a multicultural perspective.

One of the difficulties of integrating spirituality into psychotherapy is that there is no agreed upon definition of spirituality amongst researchers, counselors and clients (Sage, 2006).  For example, some people use the word spirituality and religion interchangeably with no significant difference in meaning, while others see spirituality as distinct from religion (Sage, 2006).  This is evident when people categorize themselves as spiritual but not religious, religious, or religious and spiritual (Zinnebauer et al., 1997).  Further, people’s definition of what it means to be spiritual may vary from person to person.  For example, a person may describe himself or herself as spiritual because they are interested in crystals, go to a psychic or believe in angels (Zinnebauer et al., 1997).  


In general, though, most people understand spirituality to refer to a subjective and personal experience with God, transcendent Being or Ultimate reality and a search for meaning in life (Knox et al., 2005).  Whereas, religion often refers to following a shared set of rules, beliefs, practices within a community of similar people (Fallot, 2001). There is sometimes, but not necessarily, a commonality between a person who considers him or her religious and a person who considers him or her to be spiritual (Frazer & Hansen, 2009).  For example, both spirituality and religion can involve a person developing a relationship with the Sacred, Higher Power, God, Transcendent Reality or Ultimate purpose (Fallot, 2001).  Moreover, a therapist should not view religion or spirituality as better or worse than one or another, good or bad, or one being superior to the other (Zinnebauer et. al, 1997).  It can, however, be helpful to understand the common distinctions and meanings of spirituality and religion so that a counselor can have a more nuanced understanding, knowledge and awareness of how to work with and speak to a client who describes him or herself as spiritual.  

Common errors in integrating spirituality into counseling

Additionally, part of being a multicultural counselor is effectively working with individuals who have different beliefs systems, including clients who identify themselves as spiritual, without imposing their own values, religion or spiritual beliefs onto the client.  (Walker, Gorsuch, & Tan, 2004).  Thus, one potential pitfall of attempting to integrate spirituality into psychotherapy is when a therapist may force his or her own values onto a client or impose his or her own spiritualities during therapy in a manner that is not sensitive to the client’s belief system (Knox et al., 2005).  Disrespecting or dismissing a client’s spirituality may decrease the likelihood of success in therapy or termination of therapy because the client feels judged, dismissed, or disregarded.  For example, one client felt judged when her therapist said that she was ‘too Catholic.’ (Knox et. al, 2005, p. 15).  Similarly, another client felt disrespected when the counselor told the client to lie on the floor so the therapist could fix the client’s aura.  Thus, a counselor should be always be respectful of the client’s unique spirituality and avoid imposing their own spiritual beliefs onto the client (Knox et. al., 2005). 

Further, a counselor should avoid engaging in spiritual interventions that they are not qualified for (Hodge, 2011).  For example, it would be unethical for a counselor to perform religious sacraments, forgive a client’s sins, or make a theological interpretation of a religious teaching during a counseling session (Hage, 2006).  Many counselors believe these highly specialized acts should be referred to someone who has the proper training and appropriate credentials to administer them such as a priest, Rabbi or minister (Knox et. al, 2005).  Thus, if a client requests these services, the most ethical course of action for a counselor would likely be to refer the client to the member of the clergy or a spiritual leader who is qualified to meet these requests (Hodge, 2011).

Another potential pitfall of attempting to integrate spirituality into psychotherapy is spiritual bypassing (Miovic, 2004).  Spiritual bypassing occurs when a person engages in a spiritual practice to escape or avoid dealing with a painful emotion, unhelpful thought pattern or the presenting problem (Boorstein, 2000).  For example, a person may choose to spend their time meditating or praying to avoid dealing with their anger.  A counselor should not solely rely upon a spiritual intervention in cases when what a client really needs is to work on an underlying psychological issue or presenting problem such as changing their behavior, restructuring their thoughts or dealing with unpleasant emotions (Boorstein, 2000).

Counseling implications

Nevertheless, one practical reason a counselor should be prepared to discuss spirituality during a session is that some clients will want to discuss the spiritual dimension of their life during psychotherapy (Sage, 2006). For example, a client may ask a therapist to help him or her deal with his or her anger at God (Knox et. al, 2005).  Other clients may want a therapist to help them find sacred meanings or purposes for events in their life so they can learn and grow from those events (Mayer, 2000).  In such cases is important for a multicultural counselor to be knowledgeable, aware, and culturally sensitive to the clients’ unique understanding of God and spirituality (Walker, Gorsuch & Tan, 2001). One reason it is important for a counselor to gain an understanding and awareness of what God spirituality means to each particular client is so that a counselor can offer interpretation and use interventions that are consistent with the client’s conception of God, reality or transcendence (Hodge, 2011).  

Likewise, it can also be helpful to determine how a client’s spiritual beliefs are affecting their overall functioning in life (Fallot, 2001).  Psychotherapists who are unaware of their client’s spiritual beliefs may not be able to know how those beliefs or experiences are affecting their mental health or other areas of life (Sage, 2006). For example, during one counseling session a woman questioned whether she could love another person even though she still felt a connection with her recently deceased husband (Knox et. al, 2005).  Another client could potentially talk about communicating with a spirit (Fallot, 2001).  These examples would not be considered a pathology unless they were causing an impairment in the person’s life.  Thus, creating a respectful atmosphere where a client feels safe to discuss the spiritual dimension of their life will help a counselor determine how such beliefs and experiences are affecting other areas of their life (Fallot, 2001). 

Alternatively, some clients may not wish to discuss spiritual matters during counseling sessions.  In these cases, a counselor can still integrate spirituality into psychotherapy in a way that does not infringe upon the client’s beliefs or values (Walker, Gorsuch, & Tan, 2004).  For example, one method of integrating spirituality into psychotherapy that would not be an issue for a client, who would rather not discuss spiritual concerns during therapy, is for the counselor to silently pray during the counseling session without the client’s knowledge (Walker, Gorsuch, & Tan, 2004). Similarly, simply conceptualizing a client as an aspect of Divinity, or part of the Divine, without telling the client, is another spiritual practice a counselor can engage in that would not disrespect the client’s beliefs, but still integrate spirituality into psychotherapy (Boorstein, 2000).  These practices are consistent with multicultural counseling because they would still respect the client’s unique beliefs and values (Knox et. al, 2005).

Finally, if a client is open to or requesting that the counselor actually use spiritual interventions as part of their therapy, then transpersonal psychology is one field of psychology that can be helpful (Miovic, 2004).  There is no agreement on the exact nature of transpersonal psychology and it overlaps with other fields of psychology (Boorstein, 2000).  However, one salient feature of transpersonal psychology is helping a person to view their life from the perspective of one’s soul (Myers & Williard, 2003).  Another similar approach to transpersonal psychology is to help a client develop an awareness of the part of one’s consciousness that resides outside of one’s body (Boorstein, 2000).  Developing an awareness for this invisible part of a person is similar to the developing an appreciation for the existence of love in that this aspect of one’s consciousness, like love, cannot be known intellectually, but can be known experientially (Boorstein, 2000). 

Some specific interventions for helping a client develop an awareness of their soul or whole consciousness during psychotherapy include meditation, past-life regression hypnosis, or asking a client how they are honoring the Divinity within them (Boorstein, 2000). Additionally, contemplating the role of Jungian synchronicity and archetypes in one’s life is another common practice of transpersonal therapy (Miovic, 2004).  These type of transpersonal and spiritual interventions can be difficult to use because they deal with experiences beyond the body and are outside science’s current three-dimensional understanding of reality (Boorstein, 2000).  However, they can help clients develop an expanded awareness of one’s self (Boorstein, 2000).

Some psychologists want to avoid using such interventions and studying the nature of the soul because they favor the traditional scientific model (Elkins, 1995).  However, many clients do want to discuss the spiritual dimension with their counselor as part of their therapy (Knox et. al, 2005).  Spiritual challenges are similar to many life challenges such as moving (, elderly foot care, or other difficult transitions in life. Thus, it will be important for multicultural counselors to know how to respectfully and effectively integrate spirituality into psychotherapy in a manner that is consistent and culturally sensitive to their client’s unique understanding of reality, spirituality and God (Hodge, 2011). This may take the precision of a marksman using crossbows who are trying to hit various target.



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