How Can Issues of Mood and Anxiety Benefit from Spiritual Strategies?

Use of Spiritual Strategies in Therapy

Mental health chaplains, among other things, are counselors, and their training usually includes supervised work in pastorally-oriented psychotherapy. In many ways they work as "ecumenical psychotherapists," a term coined by Richards and Bergin (1997). Effective ecumenical psychotherapists, Richards and Bergin suggest, can sensitively handle value and belief conflicts that arise during therapy in a manner that preserves the client's autonomy and self-esteem. They outline the followingunique contributions of spiritual strategies in the context ofpsychotherapy. In terms of goals, those directly relevant to a spiritual approach include: a) helping the client affirm his or her spiritual identity, b) assessing the impact of religious and spiritual beliefs in clients' lives, c) helping clients use religious and spiritual resources in their efforts to cope, change, and grow, d) helping clients resolve spiritual concerns and doubts. For Richards and Bergin, spiritual techniques are extremely important for helping clients understand and work through spiritual and religious issues and for assisting them in coping, growing, and changing. Examples of major interventions include: cognitive restructuring of irrational religious beliefs, forgiveness, meditation and prayer, Scripture study, blessings, participating in religious services, spiritual imagery, journaling about spiritual feelings, repentance, and using the client's religious support system.

The goal of all psychotherapy is insight and growth. Pargament et al. (2005) suggest that spirituality can be interwoven into virtually any psychotherapeutic tradition, since many clients are looking for spiritually-sensitive care. Moreover, he argues that the solutions prescribed by modern psychology are insufficient. U.S. psychology in particular is largely a psychology of control: "In spite of their differences, all the major paradigms ofpsychotherapy share an interest in helping people maximize the control they have in their lives" (Pargament, 2007, p. 11). Yet there is a limit to how much humans can control their lives, leading Pargament to point out that spirituality can help people come to terms with human limitations.

There are some caveats to be made when using spiritual interventions in the course of therapy. Pargament and colleagues (2005) list several. First, there is the danger of trivializing spirituality, of making it one of many tools therapists can use to ease symptoms. As Pargament et al. (2005) point out, "Sacred aspects of life are more than means to the end of normalcy, health, and mental health. For many people, the sacred is the ultimate end of living" (p. 162). A second danger discussed by Pargament and colleagues is spiritual reductionism, a tendency to interpret spiritual issues solely in terms of psychological or other phenomena. And a third is imposing values on clients, subtly or not-so-subtly. Finally, there is the danger of overstating the importance of spirituality, of making it paramount when perhaps it is not. In terms of manic depression, a religious professional who is unfamiliar with the biological etiogy of the disorder may interpret depressive episodes as dark nights of the soul - spiritual crises calling for inner transformation

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- when perhaps they are not. This is a sensitive issue, since attempts must also be made to avoid the opposite view of spiritual reductionism. A biologically-induced depressive episode, for example, may trigger a dark night of the soul. The best approach seems to be assuming that spiritual, biological, and psychological issues are intertwined and that a treatment plan should address all three.