Spirit in Session: Working with Your Client's Spirituality (and Your Own) in Psychotherapy289
Spirit in Session: Working with Your Client's Spirituality (and Your Own) in Psychotherapy289
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.
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About the Author
Read an Excerpt
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, 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 'Uhhuh,' and then she'd be on to something else."
I nodded my head and said, "Uh-huh."
"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. 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." 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, 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 doesn't segregate itself from the rest of human experience in some roped-off spirituality section. That it is integrated and interwoven with all the other dimensions of human experience: mind, body, relationships, and more. And that there are ways of giving attention to the spiritual and working with it that can help people survive the absolute worst life throws at them and change their most intractable habits of thought, feeling, and behavior.
Or maybe you don't believe this. Maybe spirituality never made any sense to you. Maybe it makes you uncomfortable because it's not part of your background. Or maybe it makes you uncomfortable because it is part of your background, and you're still trying to get over it. You'd still like to know what to do when clients introduce spiritual material into their work with you, but you're approaching this book with a bit of wariness.
You might even be wary of the term "spirituality" itself, because in the religious world you're from, "spirituality" is the vague, anything-goes approach of people who aren't really serious about faith, who want to choose the parts they like and ignore the parts they don't. You might be wondering if this book is going to be spiritual enough for you.
However you've come to this book — all aboard and enthusiastic, or uneasy and looking for the first good exit — I'm glad you're here. And if you're among the wary, I'm especially glad. I deeply respect that you're willing to stretch yourself in service of your clients, and I have tried to write this book with respect for you in mind.
By "respect," I do not mean that I have tried to protect you from your uneasiness. I mean more the opposite, that I've tried to give you opportunity here, in this book, to be in the presence of your uneasiness — not to torture you, but to give you strategies for remaining in a conversation that helps another person, even when there's something about that conversation that makes you uneasy, and opportunities to practice those strategies for yourself as you make your way through this book.
Ready? Here we go.CHAPTER 2
A Word about a Word
IT'S IMPOSSIBLE TO WRITE A BOOK ABOUT PSYCHOTHERAPY AND spirituality without using the word "God." And if it were possible to do so, it would be foolish, given how central that word is in so many people's spiritual experience. (The last major survey of religious belief in the United States at the publication time of this book, for example, the Pew Research Center's Religious Landscape Study of 2014, showed that 89 percent of U.S. adults believe in "God or a universal spirit," 63 percent believe in God with "absolute certainty," and 71 percent are Christian.)
But the word "God" is a complicated word. It means different things to different people, and it sparks a wide range of associations. So before we go any further, let's talk about God.
THE WORD "GOD" IS A POETIC WORD
There's this beautiful phrase in Buddhism: "the finger pointing at the moon." It comes from a passage in which the Buddha instructs his students to spend more time meditating, observing their actual minds, than listening to his teachings. Your mind, he tells them, is like the luminous moon. My teachings are just a finger pointing to the moon.
All the many names for God are like this. Yahweh, Allah, the Tao, Jesus, Spirit, Brahman, Baha, Higher Power, the Life Force, the Beloved, and more: they are fingers pointing at the moon.
They all convey something true about the Spiritual Ground of Reality, and none of them expresses the Full Truth. They are inspired, soulful stabs at Whatever It Is That'll make a carpenter spend forty days in the wilderness without food; or a prince sit down beneath a bodhi tree and not move until enlightenment strikes; or a criminal who's fled the country return to the scene of his crime, request an audience with the king, and say, "Let my people go"; or a black seamstress not give up her seat on a bus to a white man; or a man step gently but unhesitatingly into the path of a tank in Tiananmen Square; or the adult survivor of childhood abuse ask, "Tell me, what is it you plan to do with your one wild and precious life?" Whatever That is, the That that throws and sows and grows all this grace and grit, That's what we're pointing to when we say the word "God."
Or take all the best words you know: nouns like love, truth, beauty, and grace; verbs like touch, breathe, laugh, cry, and sing; adjectives like tender, fierce, extravagant, hilarious, and holy. That's also what we're pointing to when we say "God."
There are people in all religions, of course, who believe that their particular word for God or understanding of God is "right," or "more right," than others'. And who's to say? But as therapists, our job is not to parse out who's right about God and who's not. Our job is to hear what our clients' experiences with God and beliefs about God mean to them, how they are a resource in their lives, or how our clients might be struggling with this God in some way.
So try this. Try listening to your clients' words about God as poetry, not science, and let those words lead you into deeper connection with the poet in your office.
ATTACHMENT TO GOD, RESISTANCE TO GOD
Some of you reading this may feel quite at home with the word "God." Others of you believe in some sort of Divine Reality, but you are not of the Judeo-Christian-Islamic tradition, and the word "God" is not your word. Or you are of that tradition, but you find the word "God" worn out from overuse or tainted by misuse, and you prefer a different term. Still others of you do not resonate at all with the notion of a theistic universe, and there aren't any words for God that make sense to you.
We can't prove or disprove God, of course, not the way we can prove that "Topeka is in Kansas" or disprove that "the earth is flat." But the God we believe in but can't prove, or don't believe in but can't disprove, always comes with a backstory. Ana-Maria Rizzuto's Birth of the Living God, for instance, shows how early-life attachment relationships become blueprints for our adult understandings of God. And later-in-life experiences, too, where God is connected to some cause of kindness or of meanness, also color our relationship with God. Whatever you feel and think about God, there are plenty of good reasons for it. And the same holds for your clients.(Continues…)
Excerpted from "Spirit in Session"
Copyright © 2019 Russell Siler Jones.
Excerpted by permission of Templeton Press.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.
Table of Contents
Part One: Introduction
1 About This Book / 3
2 God: A Word about a Word / 11
3 Spirituality, Spiritually / 17
4 Spirituality, Conceptually / 29
Part Two: Working with Your Client’s Spirituality
5 How Spiritual Conversation Begins / 47
6 Spiritual Assessment: What We Need to Know and How We Come to Know It / 65
7 Working with Spiritual Resources: Spiritual Interventions, Part 1 / 77
8 Working with Spiritual Struggles: Spiritual Interventions, Part 2 / 107
9 Working with Harmful Spirituality: Spiritual Interventions, Part 3 / 137
Part Three: Working with Your Own Spirituality
10 Spirituality and Your Overall Approach to Psychotherapy / 171
11 Spirituality and Specific Moments in Psychotherapy / 183
12 Spiritual Countertransference / 205
13 Conclusion / 225
Acknowledgments / 231
Notes / 233
Bibliography / 249
Index / 257