Throughout my years working in psychotherapy, I became increasingly interested in the questions that exist beneath the more immediate difficulties people bring to therapy.
A person may arrive struggling with anxiety, depression, loss, relationship difficulties or a profound sense of uncertainty, and these experiences can certainly be explored through psychological theory and therapeutic practice. Yet sometimes, beneath the psychological distress, there are other questions waiting to be asked.
What does this experience mean? Who am I now that my circumstances have changed? What do I believe in? What gives my life meaning? Where do I belong? How do I make sense of suffering, loss or mortality?
These questions are not necessarily psychological questions in the narrow sense, nor are they necessarily religious questions. They belong to a much wider area of human experience. It is here that I have always found the relationship between psychotherapy and spirituality particularly interesting.
The questions beneath the questions
Psychotherapy is often concerned with helping people understand their thoughts, emotions, relationships and patterns of behaviour. These are important areas of exploration, but human beings are more than their symptoms or psychological patterns.
At times, a psychological difficulty can open into a much broader examination of a person’s life.
Someone experiencing bereavement, for example, may initially need space to express grief and understand the emotional consequences of loss. But loss can also challenge a person’s understanding of who they are and what their future might look like.
A relationship ending can raise questions not only about attachment and self-esteem, but about identity, belonging and the direction of one’s life. A serious illness or awareness of mortality can bring questions about purpose and what is genuinely important.
There are occasions when the question is no longer simply, “How can I feel better?” It becomes, “How do I want to live?”
Those are different questions, although they can exist alongside one another.
This is one of the reasons I have always regarded psychotherapy as more than the application of techniques. Psychological knowledge is important, and therapeutic approaches provide valuable ways of understanding and working with distress.
But sitting alongside that knowledge is the need to understand the individual person and the meaning they attach to their experience.
What do we mean by spirituality?
I have never understood spirituality as something that can be given a single definition.
For some people it is inseparable from religious faith and a relationship with God. For others, it may be found in nature, music, art, contemplation, philosophy, creativity, compassion or a sense of connection with something larger than themselves.
Some people may describe themselves as spiritual without belonging to any particular religious tradition, while others may have no interest in spirituality at all.
In psychotherapy, I believe that distinction matters. The therapist’s role is not to introduce a particular spiritual or religious worldview, but to remain open to whatever gives meaning to the person sitting in front of them.
Carl Rogers and the whole person
My understanding of psychotherapy was strongly influenced by Carl Rogers and his person-centred approach. One of the things I found particularly significant in Rogers’ work was the emphasis on the person rather than simply on the problem.
There is something profound in that distinction.
It is possible to become so focused on symptoms, diagnoses or presenting difficulties that the complexity of the individual can disappear from view.
Rogers’ emphasis on empathy, genuineness and acceptance offered a different way of approaching the therapeutic relationship. The person is not merely a collection of problems to be solved.
They are a human being with a history, relationships, hopes, fears, values and possibilities.
That way of thinking also leaves room for questions of spirituality when those questions are important to the individual.
If a person’s beliefs, sense of purpose or understanding of existence form an important part of who they are, it would seem artificial to exclude those dimensions from a genuine exploration of their experience.
At the same time, there is an important boundary. A therapist should not use the therapeutic relationship to promote their own spiritual, philosophical or religious beliefs.
There is a considerable difference between being open to another person’s spirituality and attempting to shape it. The former can create space for exploration; the latter risks compromising the freedom and autonomy that are central to the therapeutic relationship.
Viktor Frankl and the search for meaning
My other major influence in this area has been Viktor Frankl. His work introduced an explicitly existential dimension into my understanding of psychotherapy, particularly through his emphasis on meaning.
Frankl’s central insight was that the search for meaning is a fundamental aspect of human life. His development of logotherapy placed meaning at the heart of psychological understanding and therapeutic work.
What I found particularly compelling was the recognition that people are not defined solely by their circumstances or by the difficulties they experience.
Even in situations where many aspects of life cannot be controlled, there can remain questions about how a person responds to what has happened and what meaning they may find in their continuing life.
That does not mean that suffering should be romanticised.
I would be uncomfortable with the idea that suffering is somehow automatically beneficial or that every painful experience has a predetermined meaning. Some experiences are simply devastating.
Grief, trauma, illness and loss can profoundly disrupt a person’s sense of self and their understanding of the world.
Meaning, where it emerges, is something a person discovers or develops for themselves. It cannot responsibly be imposed upon them.
This distinction seems particularly important in psychotherapy. A therapist might help someone explore what their experience means to them, but should be cautious about suggesting what it ought to mean.
Meaning is personal, and it can change over the course of a lifetime.
Spirituality without certainty
I have also come to believe that spirituality does not necessarily require certainty.
There can be a tendency to think of spirituality as involving answers: beliefs about God, existence, consciousness, death or what happens beyond this life.
For some people, those beliefs are deeply important. But spirituality can also involve questions rather than answers.
There is something valuable about being able to say, “I don’t know.”
Questions about existence, consciousness, mortality and meaning are among the oldest questions human beings have asked.
Psychology, philosophy, religion and spirituality have approached them in different ways, but none has provided answers that satisfy everyone.
Perhaps part of being human is learning to live thoughtfully alongside uncertainty.
For some people, this uncertainty can be frightening. For others, it can create a sense of openness and wonder.
The important point, from a therapeutic perspective, is that the person’s experience of it matters.
Suffering, loss and meaning
One of the most difficult areas where psychotherapy and spirituality can meet is in our understanding of suffering.
When someone has experienced significant loss, it can be tempting for others to search for a positive explanation.
We sometimes hear that everything happens for a reason, that adversity makes us stronger, or that suffering is part of a larger plan. Although such beliefs may be meaningful to some people, they can also be unhelpful when imposed upon someone who is grieving or struggling.
There are experiences for which no simple explanation is adequate.
Yet people can sometimes create meaning from what has happened to them.
A person who has experienced bereavement may eventually find that the relationship they lost continues to influence the way they live.
Someone who has experienced adversity may develop a deeper compassion for others. Another person may discover a renewed appreciation of life, relationships or values that previously went unnoticed.
These possibilities should not be confused with saying that the suffering itself was necessary or good.
The meaning may lie not in the suffering but in the person’s response to it and in the life that follows.
This distinction has stayed with me because it respects both the reality of suffering and the human capacity to respond to it.
The therapeutic relationship as a place for exploration
Perhaps one of the most important connections between psychotherapy and spirituality is the opportunity to explore difficult questions in the presence of another person without immediately needing to resolve them.
There are times in life when people need answers. There are also times when what they need most is someone who can remain alongside them while they ask the questions.
The therapeutic relationship can provide a space in which a person can explore questions about identity, meaning, mortality, responsibility, relationships, hope and belief without being judged or directed towards a particular conclusion.
Sometimes simply giving these questions a place in the conversation can be valuable.
This returns me to one of the things I learned from Carl Rogers: the importance of listening.
Genuine listening is not simply waiting for an opportunity to respond. It involves attempting to understand another person’s world as they experience it.
When the subject matter is deeply personal or existential, that kind of listening becomes particularly important.
A person may not need their therapist to tell them what life means. They may need the freedom to discover what it means to them.
Psychology, philosophy and spirituality
I have always found the boundaries between psychology, philosophy and spirituality interesting.
They are distinct areas of thought, with different traditions and purposes, but they often meet around some of the same fundamental questions.
Psychology asks questions about human thought, emotion and behaviour. Philosophy asks questions about knowledge, existence, ethics, consciousness and meaning.
Spiritual traditions often explore questions of transcendence, connection, purpose and the nature of existence.
None of these disciplines needs to replace the others.
In fact, I think there can be value in allowing them to remain distinct while recognising the areas where they overlap.
A psychological understanding of depression, for example, does not necessarily answer a person’s existential question about whether their life has meaning.
Equally, a spiritual belief may provide comfort and purpose without removing the need for psychological understanding or professional support when someone is experiencing significant distress.
For me, the most interesting conversations occur in that space between disciplines, where we can acknowledge the complexity of human beings rather than trying to reduce every question to a single explanation.
Looking back
Having now retired from clinical psychotherapy, I have the opportunity to look back on these questions from a different position.
I am no longer approaching them primarily as a practitioner working with individual clients. Instead, I can reflect upon them as subjects of continuing personal and intellectual interest.
My wider professional life has also shaped the way I think about them.
Alongside psychotherapy, I have spent many years involved in education, mental health, community work and teaching. These experiences have repeatedly brought me into contact with people from very different backgrounds and circumstances.
They have reinforced for me the importance of seeing individuals within the wider context of their lives.
Perhaps this is why I continue to return to questions of meaning, identity, spirituality and human development.
They are not questions that belong exclusively to psychotherapy. They belong to being human.
An ongoing conversation
I do not see psychotherapy and spirituality as interchangeable, nor do I believe that psychotherapy should attempt to provide spiritual answers.
Spirituality is not a substitute for psychological care, just as psychological theory cannot necessarily answer every existential question a person may have.
What interests me is the space in which the two can meet respectfully.
People sometimes want to understand why they feel as they do. At other times, they want to understand what their experience means, where they belong, what they believe, what they value, or how they might live differently.
These questions can emerge during periods of difficulty, but they are not limited to times of psychological distress. They are part of the broader human search for understanding.
After 24 years in psychotherapy, I remain struck by the complexity of that search.
Human beings are psychological, social, relational and, for many people, spiritual beings as well. We are shaped by our histories and circumstances, yet we continue to ask questions about who we are and who we might become.
Perhaps there is no final answer to many of these questions.
Perhaps the value lies partly in continuing to ask them.
For me, that conversation between psychology, spirituality, philosophy and the human experience remains as interesting now as it was when I first began exploring psychotherapy.
James Theard