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How Often Is Spirituality a Part of Psychotherapy?

It all depends on how you look at it.

Q: Some of my clients want to talk about spiritual issues in psychotherapy, but most don’t. So I’m curious. With what percentage of your clients are you doing spiritually integrated psychotherapy?

A: Here are two answers, both of them true.

1. 60 percent. I just did a quick count, and well over half my current clients are talking explicitly about spiritual issues in their therapy sessions. I’d guess that number is higher for me than it is for most therapists. I’ve been in practice in the same community for almost 30 years, plus I’m an ordained minister, so I’m sure I draw more than my share of people who want to talk about spiritual matters.

But the important point here is: Not every client talks explicitly about spirituality or religion. If they want to talk about it, great. If they don’t, also great. It’s up to them, not me.

Among those who are talking about it, some came to see me with that express intention: to get support around a particular spiritual struggle. They’re gay, but their religion teaches them that’s not OK. They used to believe in God, but a rash of tragedies has broken their heart and demolished their ability to believe. Their marriage is killing them, but they consider their vows a sacred promise. A minister sexually molested them when they were young, and there’s a giant “Never, never, never” between themselves and the relationship they wish they could have with any sense of transcendence.

Others, though, came without any upfront spiritual agenda. They came because they were depressed or anxious or grieving or struggling in a relationship. But explicit spiritual resources have ended up playing a big part in the way they’re finding their way forward.

One woman thought it might help her feel less depressed if she did something for others, so she joined a group at her church that does a meal for homeless people once a week. Another is humming an old hymn in her head when she gets anxious. Several clients are using meditation apps to help them start their day. And one man is praying for God to help him control his temper.

Spiritual and religious issues aren’t the only thing these clients talk about in their sessions, mind you. It’s one of the things, but for the most part, they’re talking about the everyday experiences of their lives, the pains and strains, the desires and delights, the people they love and the people they despise, and all the many details of their journey to survive and thrive. And that’s a segue way to my other answer.

2. 100 percent. When people are living the everyday experiences of their lives, whether they think of those experiences as spiritual or not, whether they think of themselves as spiritual or not, they are doing so, in my opinion, as spiritual beings. I think all people are spiritual, at all moments, whether they identify that way or not—the same way I think all people are physical, emotional, and social, no matter how connected or disconnected they are from those dimensions of their experience. The spiritual dimension doesn’t need to be called spiritual to be spiritual. So, I’m doing spiritually integrated psychotherapy with 100 percent of my clients, whether we’re talking explicitly about spirituality or not.

Simon Clayton/Pexels
Source: Simon Clayton/Pexels

I have a broad understanding of spirituality: It’s the way we relate to everything that’s sacred. “Everything that’s sacred” includes beings, places, and experiences that are widely understood as sacred: gods, rituals, shrines, prayers, and other practices. But it also includes everything that’s made sacred by its connection to those sacred beings, places, and experiences.

And in my mind, there’s nothing that’s not connected to the sacred: apples, baseball, children, dogs, electromagnetism, friends, grief, honeysuckle—you see where I’m heading. “The way we relate to everything that’s sacred” is “the way we relate to everything.”

Some of the most profound spiritual experiences people have, for instance, are things they may not think of as spiritual. Saying goodbye to a loved one. Wrestling with themselves to do the right thing. Letting go of a grievance. Saying yes to an opportunity that requires courage. Pausing, in the midst of some urgency, to take a deep breath and feel the sun on their face. Hearing a line from a song that makes them cry and changes the direction of their entire life.

Some people think things like that are spiritual, but, of course, many do not. And be assured, I do not try to convince my clients—and I’m not trying to convince you—that this is the case. (Wouldn’t that be hilarious: “Do you realize that what we’re talking about right now is spiritual?” “No, it’s not.” “Yes it is.”)

But in my eyes, every moment of every client’s life is a spiritual moment. And in my ears, every interaction I share with a client is an occasion for them (and me) to utilize and deepen their named-as-such-or-not spiritual capacity, the capacity that gives rise to gratitude, mindfulness, forgiveness, kindness, courage, wisdom, acceptance, and lo the host of other attributes that guide humans from harried to happier.

So, with what percentage of my clients am I doing spiritually integrated work? One hundred. Or 60.

How about you?