Spirituality and Mental Health

Working with Your Client's Spirituality (and Your Own) in Psychotherapy

Russell Siler Jones

• Publisher: Templeton Press
• Year: 2019
• ISBN:
  9781599475622
• Topic: Psychology
• Subtopic: History & Theory in Psychology
• Index: Psychology

Spirituality is an important part of many clients' lives. It can be a resource for stabilization, healing, and growth. It can also be the cause of struggle and even harm. More and more therapists—those who consider themselves spiritual and those who do not—recognize the value of addressing spirituality in therapy and increasing their skill for engaging it ethically and effectively.In this immensely practical book, Russell Siler Jones helps therapists feel more competent and confident about having spiritual conversations with clients. With a refreshing, down-to-earth style, he describes how to recognize the diverse explicit and implicit ways spirituality can appear in psychotherapy, how to assess the impact spirituality is having on clients, how to make interventions to maximize its healthy impact and lessen its unhealthy impact, and how therapists can draw upon their own spirituality in ethical and skillful ways. He includes extended case studies and clinical dialogue so readers can hear how spirituality becomes part of case conceptualization and what spiritual conversation actually sounds like in psychotherapy.Jones has been a therapist for nearly 30 years and has trained therapists in the use of spirituality for over a decade. He writes about a complex topic with an elegant simplicity and provides how-to advice in a way that encourages therapists to find their own way to apply it. Spirit in Session is a pragmatic guide that therapists will turn to again and again as they engage their clients in one of the most meaningful and consequential dimensions of human experience.
 

PART ONE

Introduction

1

About This Book

I RECENTLY RAN INTO A THERAPIST FRIEND AT A CONFERENCE.

“Oh! Russell!” she said. “I was hoping you would be here. I want to talk with you about a client I’m working with.”

“Let’s hear it!”

“So, this client is in her mid-fifties, and she’s sort of depressed. A lot of her friends have died in the past few years. A few more have terminal illnesses, and all these deaths and illnesses have made her think a lot about death.

“In the first few sessions she’d drop in these little bits of information about her spirituality. She grew up Catholic, but she doesn’t go anymore. She watches a preacher online named Andy Stanley. I don’t know who that is, but anyway.”

“Anyway.”

“Anyway, I didn’t know what to say about all the spiritual stuff she’d drop in, but it didn’t seem like it was the main thing. I’d just nod my head, say ‘Uh-huh,’ and then she’d be on to something else.”

I nodded my head and said, “Uh-huh.”

“Stop it.”

“I’ll try. Can’t promise.”

“Then in the last session, I realize: she’s been dropping these spiritual hints to warm me up for what I now think is the main thing she’s coming to therapy about. She said, ‘Andy Stanley says we’re never going to be really at peace until we’re with God in heaven. But if that’s the case, why not just let go of this life and move on to the next one? What’s the reason for living now?’

“She’s not suicidal. I checked that out. She’s just not sure what the point of living is. And I didn’t know what to say to her. I mean, I know what I think about that. But I didn’t know what to say to her or even what questions to ask that wouldn’t feel like I’m doubting her assumptions and being disrespectful. So I didn’t say much of anything, really, and that didn’t feel right either. You know what I mean?”

“I do. Definitely. The ways you’d respond to most any other topic—with curiosity, respect, ‘Tell me more about that’—it’s like you couldn’t do that because the topic was religion.”

“Right! This spiritual stuff is so personal, so intimate, so . . . core. I was worried that if I asked about it at all, it would sound like I was challenging it or being suspicious of it. So I sort of froze. But I think this is the main thing she’s needing to talk about, and I need to find a way to go there with her.

“How do I do that?”

HOW DO I DO THAT?

“How do I do that?” is what the rest of this book is about.

I’ve been a therapist now for twenty-seven years, and I’ve needed answers to that question every step of the way. The people who’ve come to talk with me have always wanted more than just relief from symptoms of depression, anxiety, and the like. They want that too, but even more, they want help to live more satisfying and meaningful lives.¹ Sometimes they’re asking explicit spiritual questions, such as, “What does God want me to do?” But more often, they’re asking questions with an implicit spiritual subtext: “Who am I, really?” “What’s going to make me happy?” “Is ‘make me happy’ even the point?” Again and again, people invite me into the most haunted and hallowed spaces of their lives, and again and again, I am blown away by the magnitude and meaning of what happens when we go there. It is such a privilege—and such a responsibility. “How do I do that?”

For most of these twenty-seven years, I’ve also been in conversation with other therapists about that question—sometimes by phone, sometimes at conferences, sometimes in supervision. Since 2008 I’ve been director of the Residency in Psychotherapy and Spirituality for CareNet (a statewide counseling network of Wake Forest Baptist Medical Center, in North Carolina), where I teach and supervise associate-licensed therapists in the first two to three years of their careers. I’ve also helped write a thirty-hour continuing education psychotherapy and spirituality curriculum for therapists.

One thing these teaching and supervising roles have taught me is this: most therapists aren’t looking for lots of theory. They’re looking for practical help: “What does a spiritual conversation sound like in therapy?” “How do I talk about this stuff in a down-to-earth way?” “How do I show respect for spirituality but not make such a big deal that the client and I end up feeling too nervous to have a decent conversation?” “What do I do when a client says something spiritually that I really disagree with?” “What do I actually say? And when do I say it?”

Spirituality, of course, does not shrink and fold itself tightly into the pages of a how-to manual. Spirituality is about mystery, meaning, and transformation. It occupies a realm of connection and knowing beyond the world of facts, formula, and efficiency. We can have guides in this realm, but no guide can prepare us for everything we will encounter.

It is the same with psychotherapy that engages spirituality. All therapists must find their own way, with each client, to work with spirituality. No book and no instructor can spare you the necessity of being present, open, and attuned in each moment.

That said, it is easier to be present, open, and attuned when we have some basic level of confidence that we know what we’re doing. In spiritually integrated psychotherapy, as in most things, there is no way to prepare ahead for every possible contingency. But there is a framework that is helpful to know, and this framework can be taught.

That is my chief intention in this book: to teach you a framework. Not to tell you everything you’ll ever need to know about engaging spirituality in psychotherapy, nor to minimize how important it is to allow your own gifts, sensitivities, and perspectives to affect the way you practice. But to give you the basics, the skeleton, the scaffolding, so that you can do it your own way—the way only you could do it—with confidence that you’re working in a trustworthy manner.

WHERE THIS BOOK CAME FROM

This book began in the woods.

I live in the mountains of North Carolina, just outside Asheville, and I spend as much time as possible outside. It’s one of my lifelines, to be in the presence of “wild things.”² I love the deer, the bears, the foxes, and the snakes. I love the peaks, the creeks, and the quiet. I love the birds, their joy, their vulnerability, and the way they fuss when they’re annoyed. I love the trees, which are like elders to me. Trees live lives of dignity and service; they’ve seen it all and survived it; and when it’s their time to go, they lie down and begin nourishing the next generation.

I was among the trees, running a favorite trail. It was fall, a sunny afternoon in gold and red late October. It was also a season of grief, four months after a major loss,³ and as is the way of grief, my outer and inner worlds were being roughly and tenderly rearranged.

I came to a gate that separates the woods from a pasture. I opened it, passed through from the huddle of trees to the open blue sky, and there it was.

Write a book about psychotherapy and spirituality. Write in the same plain, down-to-earth language you use when you talk with clients and friends. Make it practical, not theoretical—you’re a therapist, not an academic—and pack it with as much clinical dialogue as you can, so people can hear what this work sounds like and feel less intimidated to try it themselves. Make it adaptable for use with almost any psychotherapy model. And write from your heart. Let it be a book that feels spiritual, so the tone of the book might be a match for the topic.

I write an occasional blog, and I’ve published a few short pieces in religious and literary journals. But I’ve never felt the tug to write anything “professional.” This is partly because the other things I do professionally are plenty satisfying, but mainly because there are already so many wonderful books about psychotherapy and spirituality. Here’s my personal starting five:

•Spiritually Integrated Psychotherapy, by Ken Pargament

•Encountering the Sacred in Psychotherapy, by James Griffith and Melissa Elliott Griffith

•Spiritual and Religious Competencies in Clinical Practice, by Cassandra Vieten and Shelley Scammell

•Grace Unfolding, by Greg Johanson and Ron Kurtz

•Understanding Pastoral Counseling, edited by Elizabeth Maynard and Jill Snodgrass

And it’s a deep roster. There are many, many other terrific books on this topic.

But none of them is the book I was being prompted to write, a book that says,

•Here’s what spiritual conversation actually sounds like in psychotherapy.

•Here are spiritual themes and spiritual issues you’ll commonly encounter.

•Here’s the essential clinical architecture.

•Here’s the sequence and flow of how it happens.

•And oh, by the way, since your own spirituality is part of the therapy process too—the same way your gender, race, social location, and personality style are—here’s how to draw upon that aspect of yourself in ethical and skillful ways.

That book, I decided, was worth writing. And here it is.

HOW THIS BOOK IS ORGANIZED

This book is organized into three parts:

1.An introductory section. This section includes the present chapter, a couple of chapters about what I mean by “spirituality,” and a chapter about the word “God.” Think of this first part as an orientation and warm-up for the rest of the book.

2.A section focused on working with your clients’ spirituality. This section covers what spiritual conversations sound like and how they start, how to assess your clients spiritually, how to make spiritually oriented interventions, and how to work with spiritual struggles and unhealthy spirituality. Think of this as the nuts-and-bolts how-to section that includes lots of illustrations from my clinical practice. You’ll read what I said, when I said it, and why. You’ll have to adapt what you say and when you say it to fit your own therapeutic style, but you’ll at least have something concrete and specific to work from.

3.A section focused on you, your spirituality, how you stay aware of it, and how you make use of it. Lots of therapists tell me they detach themselves as much as they can from their own spirituality, so that they don’t inadvertently force their spirituality on their clients. It’s impossible to do this completely, of course, but even trying to do this robs these therapists of a rich source of understanding and power. In part 3 I talk about drawing upon your own spiritual history and spiritual beliefs in ethically responsible ways, including working with your spiritual countertransference.

A WORD TO THE WARY

I believe something spiritual is happening every moment in psychotherapy. It’s not always explicit, as when a client speaks a clear-cut spiritual word like “God” or “prayer.” But if there is a spiritual dimension to human experience—and I believe there is—then it is always present, always affecting our clients’ mental health and overall well-being (for better or worse), and always a resource that can be drawn upon to help people stabilize, heal, and change.

If you’re reading this book, there’s a chance you believe this too. That the spiritual does...

Table of contents

• Cover
• Title
• Copyright
• Contents
• Part One: Introduction
• Part Two: Working with Your Client’s Spirituality
• Part Three: Working with Your Own Spirituality
• Acknowledgments
• Notes
• Bibliography
• Index