It is important to define what we mean by spirituality and define it in relation to therapy. However, before I do that, I wish to make clear that spirituality is what people say it is, that I have no desire to control or direct our discussions about it. Also, for me spirituality is essentially about experiences – some of which are truly beyond words – so to get caught in arcane arguments about what spirituality is, or is not, seems especially unhelpful. The pragmatic philosopher Rortyurges us to avoid those questions which cannot be answered.

A better discussion could be had about healthy and unhealthy spirituality, though Allman et alfound that prejudice occurred even among therapists. In their research they presented a vignette or brief case study of full-time practitioners who were members of the American Psychological Association. The case study included material showing that the client had had a mystical experience but also demonstrated some signs of psychological disturbance. Respondents were asked how they would work with such a client. A number of their respondents who favoured mystical experiences ignored the psychological disturbance shown in the vignette, while those less accepting of mysticism focused only on the psychological disturbance. In other words, the practitioner’s own view of mysticism was biasing their responses to the client. Practitioners who had themselves had a mystical experience, who valued their own spirituality and who were of a humanistic orientation, were more likely to view such experiences as healthy.

With these caveats, I wish to offer the following definition of what spirituality is in a therapeutic context. This view draws a lot on the work of Elkins et al3, whose research emphasised spirituality as something people experience; John Swinton4, who affirmed the sense of connectedness that is part of spirituality, including belonging to a faith community; and John Rowan5, who clarified the relationship between spirituality and our various levels of the self:

  • It is rooted in human experiencing rather than abstract theology. 
  • It is embodied. 
  • It involves linking with other people and the universe at large. 
  • It involves non-ordinary consciousness. 
  • That active engagement with spirituality tends to make people more altruistic, less materialistic and more environmentally aware. 
  • It deals with the meaning that people make of their lives. 
  • It faces suffering and its causes. 
  • It relates to god/goddesses/ultimate reality. 
  • It often uses the word ‘soul’ or ‘higher self’. 
  • Techniques such as prayer, meditation, contemplation, mindfulness, yoga and t’ai chi are often used as spiritual practices.

There are three aspects of considering spirituality and therapy: the role of spirituality in the life of the client; the role of spirituality in the life of the therapist; and spirituality within the therapy session itself, including spiritual experiences.

There remains a lack of acceptance – indeed, understanding – of spiritual experiences within supervision. This is where I believe there is both a training issue and an issue for the professional bodies. Without committing ourselves to a spiritual or even religious agenda, can we not accept that there are experiences that happen inside and outside of counselling that will often be labelled ‘spiritual’ and that in most cases are beneficial or even life changing? If this is the case, then let us consider how to integrate such experiences into our theories, training, supervision and practice. Let us remember that we live in a world in which the vast majority of people do believe in God, do have spiritual experiences6. It is high time that our therapy theories and practices were more respectful, more accepting of the healthy part that spirituality plays in many people’s lives. Yes, there are problems, and spirituality can be entwined with some very real mental health issues, but so can sexuality and that does not lead most people to lives of celibacy!

I can hear a small voice say to me, ‘OK, suppose you are right. But are these experiences that are best left to the experts in these matters, namely the religious leaders, the priests, imams, rabbis, gurus and so on?’ If only this were true, for as one participant commented: ‘I found it hard to describe my experience in a Christian setting too and to find clarification of what, I felt, had been a moment of Grace.’

There are three further problems related to leaving these matters to religious leaders. First, should we be hiving off this aspect of human experience as being not a fit matter for therapeutic practice? Secondly, even if religious leaders were well equipped to do such work (and Terry Biddington’s Chapter 3 in this book discusses this very issue), many people would probably not visit them even though many people remain interested in, and awake to, their spirituality. Thirdly, I suspect your average therapist would run a hundred miles rather than involve a religious leader in the therapeutic process for a client. (Such work does happen from time to time in the US, according to Richards and Bergin7.)

I find it hard to accept that many therapists are still so arrogant in their attitudes to spirituality and religion. For all the rhetoric on training courses about stepping into the client frame of reference and the use of empathy, many secularly minded therapists struggle with having a positive view towards any religious faith, however liberally minded their client’s faith might be. In truth, some of the more fundamentalist believers make such prejudices easier to hold and maintain. Nonetheless, I have met some healthy, lovable people of strong religious convictions, many of whom wrestle with their more rigidly minded fellow believers.

So clearly the problem is not sorted, the tensions remain. But merely to focus on the tensions would itself be to do a disservice to the many therapists who are working with a due regard for the part that healthy spirituality can play in the lives of their clients. 

William West is a reader in counselling studies at Manchester University.

William West, Exploring Therapy, Spirituality and Healing, published 2011. Palgrave Macmillan. Reproduced with permission of Palgrave Macmillan.


1 Rorty R. Objectivity, relativism and truth. Cambridge: Cambridge University Press; 1991.
2 Allman L, de la Rocha O, Elkin D, Weathurs R. Psychotherapists’ attitudes towards clients reporting mystical experiences. Psychotherapy. 1992; 29:564-569.
3 Elkins DN, Hedstrom LJ, Hughes LL, Leaf JA, Saunders C. Toward a humanistic-phenomenological spirituality. Journal of Humanistic Psychology. 1988; 28(4):5-18.
4 John Swinton J. Spirituality and mental health care. London: Jessica Kingsley Publishers; 2001.
5 Rowan J. The transpersonal, psychotherapy and counselling. London: Routledge; 1993.
6 Hay D, Hunt K. Understanding the spirituality of people who don’t go to church. Nottingham: Centre for the study of human relations, Nottingham University; 2000.
7 Richards PS, Bergin AE. A spiritual strategy for counselling and psychotherapy. 2nd edition. Washington DC: APA; 2005