Spirituality Expands a Therapist's Horizons
Arthur J. Deikman, M.D.
The goal of psychotherapy is the relief of psychological suffering and the removal of obstacles to functioning in the world. Normally, this means focusing on such experiences as anxiety, depression, self-defeating behaviour, destructiveness, and interferences with work and love. The spiritual disciplines are concerned with knowing - by experience - the answer to the questions, Who am I? What am I? Why am I? Although it is expected that many symptoms with which psychotherapy is concerned will resolve in the process of spiritual development, such improvement is regarded as a secondary by-product, not the primary aim or effect.
Nevertheless, unless individuals can satisfy their needs for work, intimacy, and social acceptance, they are likely to have a hard time progressing on the spiritual path, for they will be unconsciously seeking to meet those needs through activities that have another goal. Here, psychotherapy can be considered complementary to spirituality because, by resolving psychodynamic conflicts that interfere with everyday functioning, it can decrease the pressure to use spiritual pursuits in the wrong way.
Another question that arises frequently is whether techniques from the domain of spiritual practice should be introduced into the psychotherapy situation. My own view is that they should not - unless the psychotherapist is also qualified as a spiritual teacher. Although a variety of procedures such as meditation, chanting, and visualization can be used to provide calmness and relaxation, the mystical literature indicates that such benefits are secondary. The sages who invented these techniques emphasized that they should be used as part of an integrated, individualized teaching system requiring the supervision of a teacher whose own perceptual capacity has been developed and who thus knows how to prescribe them according to the specific spiritual needs of the student. To use such techniques for lesser purposes may decrease their effectiveness for spiritual development. Since locating a competent therapist can take some searching, and locating a competent spiritual teacher can take even more, locating someone who is adequately skilled in both is a difficult undertaking indeed. I do not regard myself as such a person, nor do I know of anyone else who is.
Thus, if patients wish to practice meditation, I help them explore their
motivation: what they hope to obtain, what problems they hope to solve, how
realistic their expectations are. Sometimes the idea is dropped because their
need calls for a different remedy than meditation. Sometimes the idea is pursued,
in which case I refer them to a source of meditation teaching. But I do not
myself give instruction in meditation or any other spiritual technique
I believe the primary value of spiritual practice in psychotherapy is its effects on the therapist, the maturation it fosters, the wider and deeper perspective it can provide. It is this larger perspective that constitutes the best way of combining the two fields. For example, suppose I am treating someone for depression and a major complaint is the feeling that his or her life is empty. It makes a significant therapeutic difference whether such a person devotes any time and resources to caring for others or whether his or her life has been devoted solely to accumulating money, power, or fame. In the latter case, the question must be addressed. How much fulfilment can be derived from acquisition? In the former, the questions need to be raised. What is the person's motivation for doing things for others? Is there a secret contract or assumption involved that has been disappointed?
In some cases, where self-denial and self-sacrifice have been a prominent part of a person's life, that person may believe that by exerting willpower he or she can ignore the need for being cared for, for pleasure, for recognition. This can be a form of disguised omnipotence, the wish to be invulnerable. In other cases, service has been performed in the expectation of reward: when payment is not forthcoming, resentment and depression result.
Such fantasies, conflicts, and strategies can be dealt with effectively by traditional psychotherapy. However, the possibility of fulfilling the need for meaning will likely be missed or ignored if the therapist holds to the perspective of modern science and believes that there is no intrinsic meaning to human life, that we impose meaning rather than discover it. After all, whether the Big Bang theory is correct or not, science tells us that life originated by chance in a random universe.
From the spiritual perspective, it is quite a different matter. At the very least, the question remains open, for the nature of "I" eludes science, and the mystic's insistence on another way of knowing resonates with our sense that "something is there." If the therapist engages another human being in an extended therapeutic process, the problem of meaning will eventually arise. Then, the spiritual has much to offer the psychotherapeutic. And what the therapist understands of both will play an important part in the outcome.