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Understanding Religion and Spirituality in Clinical Practice

Author(s) : Margaret Clark

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John Sargant on 07/08/2012 17:26:10

(5 out of 5)

When the work between a therapist and a patient enters the subjects of spirituality or religion, it may quickly go beyond the training that most therapists at present receive. Life in its physical, emotional and intellectual aspects may be thoroughly explored, but the spiritual may in contrast be avoided as an irrelevant hobby, or dismissed as a dangerous delusion.

This is one of a series of monographs produced primarily for trainees on psychotherapy and psychodynamic counselling courses. So it has many insights to offer in other counselling too. The author begins with a clear definition of spirituality and religion, and her reasons for using a capital G for God. In less than 100 pages, she writes to help therapists to deal with their patients' and their own experiences in these fields, rather than ignoring or avoiding them.

Whatever the bewildering range of religions, sects, cults and unbelief in society, the central theme is the image which each person has of God. Ch 3 explores the internal and external factors forming this image, which may be accepted or rejected, can change as life proceeds, and will be different from almost everyone else's image of God.

Chs 1, 2 and 4 relate this to the classical theorists, Freud and Jung, and to Winnicott of the later 20th century. Then chs 5, 6, 7 and 8 concentrate on evaluating spiritual and mystical experiences, again rooting these categories which are often used vaguely or misunderstood, in a wide range of other published approaches to the subject in ch 5, from Bion's "unknowable O" to Archbishop Williams on relating "the soul (whatever exactly that is)" to external realities of life.

The author writes with variety, too. From the pithy in talking about God ("same word, different meaning") to the expanding of abstract concepts like nature into vivid images "(blossom in spring-time, hills patchworked with cloud shadows, sea breakers roaring)".

In each short chapter, the author's aim of enabling us to understand is hugely helped by two or three "clinical vignettes". Each of these tells a story of the work done by a different therapist and patient, in two or three pages, in a wide range of situations. These scenes from real life, told anonymously, involve the reader in personal, emotional and yes, often spiritual experiences. Each vignette would repay study in a group. These chapters don't depend on expert knowledge of psychodynamic counselling, nor of world religions, but are packed with wise hints to help us increase our understanding. Any reader can then be more helpful "at the drop of a crisis", or in the longer term.

The last four chapters are each concerned with different aspects of spiritual experiences, from inspiration to addiction, seeing visions and hearing voices, being convinced that God demands a particular response, and encountering the Devil, or being possessed, with awareness of the borderline with psychosis and the need for other treatments. A variety of religious communities appear in the vignettes, and the interplay of family influences with the patient's image of God. For the therapist, and their supervisor, understanding the patient's concerns and experiences may also interact with what the therapist "believes or practises or despises or regrets or is tempted by or is awed by or dallies with in these spheres".

John Sargant, a friend of the author and retired parish priest.
A page to encourage other people to read the book, March 2012.