Integrating Psychotherapy and Spirituality: The Role of the Positive Emotions

By Elizabeth Dickson, LCSW




“In befriending life, we do not make things happen according to our

own design. We uncover something that is already happening in us

and around us and create conditions that enable it. Everything is

moving towards its place of wholeness. Befriending life requires that

we listen for the potential which is trying to actualize itself over time. . .”


Rachel Naomi Remen from My Grandfather’s Blessings



Harmonizing With the Three Healing Processes


For therapists who believe in the three miraculous processes for human growth and development, how do we make use of these healing processes in our work with clients? Certainly the William James definition of spirituality seems relevant here. In the same way that we can attempt to be in harmony with an unseen order of things in our lives in general, we as therapists are attempting to be in harmony with the healing forces of nature when we interact with our clients. Of course we do not always succeed, but we are seeking to participate in dynamics that go well beyond our more concrete psychotherapy tools and skills. We must be able to access and trust a kind of “knowing” that involves more than just our thinking brains.


To illustrate, in the case of the developmental thrust, if the therapist intends to work with a client’s inherent process of forward movement, we must be precisely attuned on a moment by moment basis to the client’s experience of felt meaning. We need to be sensitive enough to help the client move forward in the particular way that works for them. In the words of Rachel Naomi Remen, it requires that we “listen for the potential which is trying to actualize itself over time.”


And if we wish to create a healing relationship that can include moments of a pure type of love, we must be in harmony with the all that is happening at both the conscious and unconscious levels between the two of us at a given point in time. The same is true if we want to participate in transformational moments. We must really feel our loving compassion in those instances when a client is expressing themselves from their most vulnerable, painful, or shameful places; our reactions must be automatic and completely authentic.


Training programs can help us to be empathic and attentive, but the real ability to feel aligned with these mysterious healing processes must originate in who we are as people and will be a function of our own personal evolution. This is not about whether we believe in a personal God or whether we call ourselves religious or spiritual. It may be more about the type of relationship that we have established with the infinite aspects of life itself. If our relationship with the infinite only concerns our intellectual conclusions about the origins or purpose of life, then this type of relationship may not help us much as therapists. But if our relationship with the infinite leads us to feel more present to the fullness and possibilities that each moment holds, or to feel more alive in body, mind and spirit, then these qualities may very well assist us in our therapeutic endeavors.



Using the Positive Spiritual Emotions in Our Work


Much depends upon where we are in our lives with regard to our personal journeys. If we have reached the point where we understand the virtuous cycle of faith, where we have identified aspects of life that can restore our souls and have made an attempt to prioritize these experiences, then we are well along the way. I like to think of this as “exercising our spiritual muscles.” And if we know, even in moments, the deep sense of belonging that Brother David describes that resides at the heart of our aliveness, then maybe we will be attuned to the spiritual emotions, including awe, faith, love, compassion, gratitude, and joy—at least some of the time.


Anything that we are passionate about will naturally influence how we practice, and the positive spiritual emotions are a source of passion for many (though certainly not all) therapists. Rather than thinking of therapists as trying to make clients more spiritual, we might define spiritually-oriented therapists as those who aspire to cultivate the spiritual emotions in the psychotherapy process. The point is not whether the therapist considers themselves spiritual, but rather whether the spiritual emotions come alive in the therapy process in a way that promotes growth and healing for the client. For example, does the therapist’s love and compassion help the client feel more understood and appreciated? Is the therapist’s sense of awe developed in such a way that they can better respond to the possibilities in the moment? Can the therapist’s joy and gratitude enliven the therapy and make for a closer relationship between therapist and client?


So much of a therapist’s skill concerns how we navigate moment by moment through the psychotherapy hour–what we pick up on, our body language, when we smile or respond to what the client has said, when and how we ask questions or encourage the client to go deeper. We want to be highly sensitive to what is emerging, whether we are looking for moments of meaning or insight, a moment of opportunity in the psychotherapy relationship, or whether the focus is more on opening up feelings or possibilities for transformation, both dramatic and subtle. We have our own felt sense that helps guide us in our navigation process. Our inner navigation systems are very much influenced by our values and our passions—and for many of us, the positive spiritual emotions play a major role in guiding our behavior when we are sitting across from our clients.



Integrating the Positive Emotions with Other Skills


This does not mean, of course, that we always behaving in a loving or overtly compassionate or joyful manner, which could be extremely annoying and counter-productive. It is not enough for a therapist to be passionate about the positive spiritual emotions. If we are to “befriend life,” as Rachel Naomi Remen says, we must also “create the conditions” that enable the healing life processes, and this is far more complex than just feeling guided by the positive spiritual emotions. Developing the ability to work in harmony with the healing forces of nature is something that evolves over the course of our careers as we become more adept in all aspects of our roles.


Much of the therapist’s skill requires the integration of the use of the spiritual emotions with all of the other functions that we take on. When it comes to felt meaning, for example, we are not just in a state of limitless awe “listening for the potential that is trying to actualize itself over time.” Even if we were extremely talented at doing this, I doubt that many clients would want to hire a therapist solely for this purpose. Our clients also expect us to be professionals with an extensive knowledge base of theory, skills and techniques. No one wants the therapy to just refer back to the client and how they are feeling from one moment to the next.


Therapists need to think in terms of plans and goals. Most of us come in to every session with our own theories, agendas and ways of conceptualizing a client’s problems. Our challenge as spiritually-oriented therapists is to balance our rational agendas with a commitment to remain open and to prioritize what might emerge unexpectedly in a session. If we are successful in integrating these seemingly competing approaches, we will behave very differently than if we become caught up in our own preconceived ideas and close off the aliveness of the process. If we remember to value the intricacy that is at the depth of our client’s being, then we are more likely to be truly interested in finding out more about the client’s actual experience and less likely to be overly wedded to our own agendas. We can always ask ourselves if we are following the dictates of Jon Kabat-Zinn and “appreciating the fullness and vitality of each moment” in our interactions with our clients.


When it comes to the psychotherapy relationship, we also need to integrate a mix of different skills beyond just our love and compassion. Much of the power of the relationship comes from its aliveness, the ability of the client and therapist to respond genuinely and spontaneously in the moment, to be able to be expressive and laugh together as well as entertaining deep feelings. The therapist needs to be flexible enough to be fully present with the client as they experience joy, pain, humor, sadness and excitement. Yet to do this effectively the therapist must also be able to set appropriate boundaries as necessary, and stay grounded and constructive in the face of fear, anger, anxiety, despair, and other difficult emotions that a client may experience. Ideally, we make room for feelings like anger and hopelessness while maintaining the ability to tap into feelings of love, compassion, awe, faith, joy and gratitude when the time is right.



Positive Experiences in Psychotherapy Reinforce Our Faith


Fortunately we as therapists do not have to place all of our faith in ourselves, our unique personalities and our specific accumulated psychological wisdom. Instead, we can place much of our faith in our ability to harmonize with the healing forces of nature. Faith for the psychotherapist might be summed up as faith in the possibilities of what can emerge in the psychotherapy process when we are able to establish the right (or at least “good enough”) conditions. Faith is something that most of us have to develop over time as we witness what works and what doesn’t work, and as we become more skilled at integrating the complex mix of all that we do.


With experience we are rewarded with a multitude of examples of the healing processes in action, and our faith can deepen as a result. We witness the many times when, working together, we are able to help our clients find meaning and experience a sense of forward movement in what seem like stuck places. And we see repeatedly how clients who take the risk of sharing unexplored parts of themselves can open up feelings of love and compassion that make it absolutely clear that the risk was worthwhile.


Over time, we as therapists also gain solid evidence that we as imperfect individuals are nonetheless capable and worthy of taking on the role of healer and guide. We find that, when we have good intentions, hold our boundaries, stay constructive with the darker times, and remain accepting (at least somewhat) of our imperfections, that we can develop powerfully healing relationships with our clients. We find that we can experience many moments of a pure type of love with our clients, and that these loving feelings can co-exist along with all of the other feelings that humans would expect to encounter.



Conclusions: Integrating Psychotherapy and Spirituality


I propose two ways of conceptualizing how spirituality and psychotherapy are integrated. First, the fact that therapists are attempting to coordinate with the healing forces of nature is, in itself, a type of spiritual act. If we define spirituality as “the attempt to harmonize with an unseen order of things,” then psychotherapy could qualify as a spiritual practice. The unseen order that we deal with involves the mysteries of human growth and development rather than the mysteries of the origins of the universe, but that does not make it less wondrous. If we consider human beings and human healing processes as complex enough to qualify as “infinite,” then our work as therapists is an act of faith, since every working day we are “grasped by and turned to the infinite,” as Tillich says.


The second way that we as psychotherapists integrate spirituality in our work is that the qualities which we associate with spirituality are also the qualities we need as therapists. The ability to be present in the moment, to capture the fullness and vitality of the “now,” is central to both spirituality and psychotherapy. And if we as therapists have been successful in developing our own positive spiritual emotions (including awe, faith, love, compassion, joy and gratitude), then it is likely that we can bring these positive emotions alive at appropriate times in our interactions with our clients. The therapy process itself serves as a ritual that can connect us with our own and with our client’s spiritual emotions and can deepen our spirituality. This can feel like a virtuous cycle of faith.


The 23rd Psalm tells us that we can lie down in green pastures and find still waters. We can discover our “path of righteousness,” not in the negative sense of righteousness, but in a positive sense of trusting that we are held and protected by the power of something that embodies goodness. I believe that most therapists count on this affinity or partnership with goodness to help give us the strength that we need, even if we are not directly conscious of it. Knowing that we have positive intentions is an excellent start, but we count on something else as well. We count on the experience of actually feeling aligned with these positive forces, which is more than just an intellectual recognition of our intentions. When we feel aligned with the natural healing forces and can sense and be guided by a kind of visceral knowing, then this becomes the ultimate experience of faith.