Spiritual Therapy

In 1920 an American minister named Anton Boisen had a psychotic break and spent fifteen months in a state hospital. When he came out he did not treat it as something to get past. In 1924 the superintendent of Worcester State Hospital invited Boisen to be its chaplain, and in 1925 he began bringing theology students onto the wards to sit with patients and write up what they heard. His argument, set out in his book Exploration of the Inner World in 1936, was that some breakdowns are an attempt to solve a religious problem rather than only a disease to be managed.

Boisen also held that mental illness came from a failure to grow into loyalty to God, and that religion could heal it. That conviction could be turned around and handed to a patient as a verdict on their soul.

In 1926 an American businessman named Rowland Hazard went to Zurich to see Carl Jung about his drinking, and stayed some months. Jung told him medicine and psychiatry had nothing further to offer, and that his remaining hope was a genuine spiritual experience, which was rare.

Hazard joined the Oxford Group, a Christian movement that held four absolutes: honesty, purity, unselfishness and love. He stayed sober, and in 1934 he brought the group’s teaching to an old drinking friend named Ebby Thacher, who brought it to his friend Bill Wilson and said Wilson should choose his own conception of God. In 1935 Wilson and Bob Smith founded Alcoholics Anonymous. AA put a spiritual experience at the center of recovery and made a higher power part of the program.

In 1984 a psychologist and Buddhist teacher named John Welwood named something he had watched happen inside his own meditation community. He called it spiritual bypassing, the use of spiritual ideas and practices to step around unresolved pain and unfinished growing up.

In December 1991 three clinicians, David Lukoff, Francis Lu and Robert Turner, put a proposal to the group writing the fourth edition of the psychiatric diagnostic manual. It was accepted in January 1993 and appeared in 1994 as Religious or Spiritual Problem. It covered losing or questioning a faith, converting to a new one and questioning spiritual values, and it said these could be a focus of clinical attention without being a disorder. It was a short entry doing one specific job, which was to tell clinicians that a spiritual crisis is not automatically a symptom.

The approach got a name in 2007, when the psychologist Kenneth Pargament published Spiritually Integrated Psychotherapy. He had spent twenty years studying what people actually do with a faith when life is hard. Some hand the problem to God and wait. Some set faith aside and handle it themselves. Some work on it alongside God, and he saw that third group tended to do better.

But faith has also been used to harm.

In Canada the churches ran the residential schools with government funding, about seventy percent of them Roman Catholic and the rest Anglican, United, Methodist and Presbyterian. Roughly 150,000 First Nations, Métis and Inuit children were taken into them. The last school closed in 1996, and in 2015 the Truth and Reconciliation Commission called what had been done cultural genocide.

Harm inside a faith also happens one person at a time. Religious trauma is the emotional, psychological and spiritual harm caused by abusive, controlling or rigid religious environments, beliefs or people in power. Some people are harmed by coercion, manipulation and shaming teachings over time. Some are harmed in the process of leaving a faith and losing a community, a worldview and often a family at the same time. Marlene Winell named the pattern religious trauma syndrome in 2011. It is not a diagnosis in the psychiatric manual, but some therapists work with it as a form of trauma. 

Some help carries its own version of the problem. Alcoholics Anonymous has reached millions of people, but it asks for a higher power, which leaves anyone whose harm came from religion choosing between the help and the history.

Trauma-sensitive spiritual therapy works inside those gaps. It is honest about how the therapist’s own beliefs affect the care. It holds space for spiritual help and spiritual harm. It works with religious trauma caused by institutions or by people. It does not use spiritual practice to bypass harm, and it says plainly where its scope begins and ends.

Trauma-sensitive spiritual therapy starts with what you believe.