Institute for Integrative Psychotherapy

Integrative Psychotherapy Articles

Psychotherapy and Spirituality

Rebecca L. Trautmann


   This article recognizes the spiritual dimension of each person as an important part of the therapeutic process, although many people experience difficulty talking about it. The process of finding words to express this dimension and exploring the meaning of that experience—with possible historical, introjected, and/or traumatic origins—are valued in the search for deeper meaning and mindfulness in life.



   “This may sound weird, but. . . .”

   With words similar to this people often bring the spiritual dimension of their lives into their therapy. I would like to share here some of my own thoughts and experiences about the place of spirituality in psychotherapy, with the goal of expanding the therapy experience of the client who may be just beginning the process or deepening the experience of the client who is already in therapy but may have limited the scope of what he or she has brought into the process.

   Much has already been written on this subject, with whole professional journals and associations specifically focused on this integration. Within transactional analysis, many wise and experienced practitioners have written books or articles in the Transactional Analysis Journal. To list just a few, Muriel James has written beautifully about the Inner Core of the self, also described as the Spiritual Self or the Universal Self (James, 1981; James & Savary, 1976, 1977). Morris (1972) and Edelman (1973) each wrote about spirituality in terms of ego states. Lawrence (1983) and Steere (1983) wrote companion articles on repentance as it compares to the transactional analysis process of redecision. In 1974 Isaacson wrote an article on religious scripts, and in 1999 Massey and Dunn wrote extensively on spirituality seen through the prism of family systems. Finally,George Kandathil and Candida Kandathil (1997) wrote eloquently about Berne’s concept of autonomy as the open door to spirituality.

   At this point some may question, “What do you mean by spirituality?” Again, many good people have written about this subject. I like what George Kandathil and Candida Kandathil 1997, p. 28) wrote, so I will quote them at length:

Spirituality is the process by which human beings transcend themselves. For those who believe in God, spirituality is their experience of this relationship with God. For a humanist, spirituality is a self-transcending experience with another person. For some it may be the experience of harmony or oneness with the universe or nature in whatever way we describe it. It takes us beyond ourselves into a realm wherein “we can experience a union with something larger than ourselves, and in that union find our greatest peace” (James, 1902/1958, p. 395). . . . For believers of religion, spiritual experience takes place commonly within the framework of their religion. For others it takes place within the framework of their ideals and aspirations. But the experience itself is inexplicable and incommunicable in its entirety, what James (1902/1958) described as “the incommunicableness of the transport” (p. 311).

   Some people may think that spirituality does not belong in psychotherapy, that therapists only deal with the emotional, behavioral, social, and cognitive aspects of our lives. While this may be true for some therapists, it certainly is not true for all. Many therapists know and value the spiritual dimension of life, but some will wait for it to emerge from the client and may not initiate the discussion directly themselves, leaving the impression that it is not part of the process. By the same token, some clients will not bring it up unless the therapist does, thus leaving the impression that it is not part of their lives. Other therapists will not deal with itat all, or will deal with it only insofar as it relates to the client’s overall psychological and social functioning. However, the therapeutic relationship works best when we can bring our whole selves to the relationship with the expectation and trust that at least here we can be known and understood, maybe even cared for, and thus know, understand, and care for ourselves, others, and the whole of creation.

   The word “psyche” means “the soul, self, also the mind” (Mish & Morse, 1997, p. 592). The Chambers Dictionary (Kirkpatrick, 1983) defines psyche as “the soul, spirit, or the mind” (p. 1039). Therapy is the process of healing, of making whole. Thus, psychotherapy can be understood as healing of the soul/self or the mind, and therefore a place where our spiritual selves belong as much as every other aspect of who we are. For people disaffected with formal religious institutions or needing to heal from experiences related to their religious backgrounds, a psychotherapist may be the only (or at least the first) person able to hear and respond to their spiritual needs.

   What often prevents people from initiating discussion of their spirituality is that it can be so difficult to talk about! Words can seem trite, inadequate, not quite right, or weird. This is why the subject may be introduced with words such as, “This may sound weird, but . . .” as I noted at the beginning of this article. Yet words are usually the primary vehicle we have to communicate our internal world or experience to another person (unless we are artists, musicians, dancers, etc). When words do not serve to communicate or bring us closer to others, we are inclined to keep that part of ourselves private and unshared—or to believe that it can only be shared in designated places or times, as in sacred meeting spaces, or only with specified people. Or we rely (gratefully!) on those people—poets especially—who have a gift for putting such experiences into words.

   Each person’s experience of the Divine, of Spirit, is absolutely unique. It is easy to believe that no one else could possibly understand what that experience or “knowing” is like, especially if that experience is one of nothingness (no-thingness) or emptiness. For some it is a deeply personal relationship, and there may be somefear or hesitancy in sharing it with another person, almost as if in the sharing something will be lost, changed, or diminished. Some may even fear being shamed. Taking the risk of speaking about it with a trusted therapist can be very gratifying or releasing—sometimes even transformative. Here we can begin to find words—our own words—to feel more normal, more part of a whole, in these very private, personal, idiosyncratic experiences: these experiences of Spirit.

   It is also important not to underestimate how potentially gratifying, releasing, even transformative your sharing might be for your therapist, too, in a reciprocal way. More than once I have had the experience of sudden clarity about my own spiritual quest through a client’s struggle. In that moment I also feel profound gratitude for the gift of my client’s sharing and for being able to do this work together.

   For people who are aware of their soul’s stirrings, it is essential to find a therapist who is open and understanding and who perhaps shares a similar awareness. When I went in search of a psychotherapist for myself, many years ago, I specifically needed to know about the nature of our therapeutic relationship and whether the therapist would be available for “soul work.” Psychotherapy and the therapeutic relationship were so vitally important in my process of healing that I had to know that I could bring all aspects of myself to the relationship and that my soul yearnings would not only be accepted, but would be valued and care-fully explored.

   There are therapists who specifically define themselves by their religious affiliation, such as “Christian counselors,” and thus let you know the context in which the therapy process will be understood. Other people have spiritual work as their particular focus in therapy. However, in the main, therapists do not specify this dimension in themselves or as a focus of their work. Therefore, it will be up to you as the client to inquire about it if it is important to you. You will also get a sense of your therapist’s orientation or availability if he or she asks about your spiritual life as part of getting to know you or from the way your questions are answered.


   In the process of meditating or finding the stillness of Spirit, many of us who live busy, crowded, overstimulated lives encounter obstacles that can be talked about and worked through in therapy. We may find ourselves distracted by unresolved encounters with others (e.g., an argument that was dropped but never resolved); regrets (e.g., “I wish I had taken the time to explore my child’s fears instead of just reassuring”); guilt (e.g., “How can I open myself to the experience of God when all I can think about is the terrible thing I said to my friend?”); fantasies (e.g., that trip to a faraway place that I would love to take); inner voices (e.g., “You should be cleaning the house, writing that article, or returning phone calls instead of just sitting here”); or feelings (e.g., anxiety, doubt, anger, even excitement). When we can note these distractions and honor them by bringing them into therapy, our meditations, prayers, worship, or even our constant mindfulness/awareness in each moment can be enormously enhanced. Working on unresolved guilt or finding new ways to resolve conflict, for example, can help free us from that thought-clutter in order to be more fully and wholly in the moment, whether we are meditating or going about our daily activities.

   The other day I was with a client who said something in an offhanded way about “quickly praying” for certain people before falling asleep at night. I asked her why she prayed quickly. Her response was, “Because God used to be an important part of my life, but after [several losses] I don’t know where He is anymore, so I only pray out of habit.” After talking a little more she said, “Holding my mother while she died was the most terrifying and the most spiritual experience of my life. I have been haunted by the experience ever since and don’t know how to talk about it.” This led us into long, often emotional discussions about her relationship with her mother, her experience of God, and death—a huge part of her life that she had shoved into a closet and fearfully held shut (or open!) with her “quick prayers.”

   In attempting to know God, some people discover that they have made God into their own image: God may be felt as a harsh,judgmental, frightening, remote figure who is actually a projection of their Parent ego state. Or God may be a nurturing, compassionate, creating mother figure. We try to learn who that figure represents, whether it is someone from their history or someone of their own creation, like some children create a frightening “bogeyman” to keep themselves from misbehaving. Others may be holding a secret that they believe to be unforgivable and expect God to be as unforgiving as they are of themselves. By directly encountering that figure or memory, working with it, and resolving these past relationships or experiences, real transformation can occur. Then they can be open to experiencing the Divine manifested and expressed in a multitude of different ways and with greater dimension than before. At the same time, they are able to be more loving, accepting, and expressive with themselves.

   Some people find that they relate to God primarily from a Child ego state, looking to God as someone who will give them what they want or need, or deprive or punish them. Sometimes the concept of karma can be used in a similarly reductionistic way, seeing rewards for “being good” and negative experiences as the result of “being bad,” without realizing that this may be the Child’s view of parents or authority figures. When examined carefully and with sensitivity to what their relationship with parental figures was like, even the idea of karma can take on a much broader meaning and significance, one that allows people to be responsible for their lives and how they live in a much fuller, more authentic way. By addressing needs from the past and how they learned to get needs met, people not only resolve those experiences from the past, but also find themselves relating to others—including God—differently.

   One man spent numerous therapy sessions in conversation with God—sometimes angrily, sometimes tearfully, but always with deep engagement—as he dealt with the experiences he had to cope with in his life. Ultimately, he began to face his own guilt for having betrayed his “bargain” with God, made at a time in his youth when he believed he was so bad (and deserving of his abuse) that he needed to devote his life to selfless service in order to “be good.”

   This leads us to another area of exploration: the concept of “script.” As in the example just mentioned, people often decide on a life plan, usually based on decisions they made about themselves or others during difficult situations in childhood and often suggested or reinforced by family dynamics. This man so believed that his abusing mother was right and that he was an “evil, bad boy,” that the only way to stop being abused was to be “very good.” So he tried to be good in all the ways a little boy could, although he still believed (with his mother’s constant reminders) that God knew how truly bad he was. To be good for God, he committed himself to a career of service, for which he received a good deal of recognition and strokes. Underneath, however, he never embraced this reality because his firmly entrenched script belief was that he was bad and no amount of good works or self-punishment could change that. It was only when he came to therapy for help with his depression that he began to understand the basis for his conclusions about himself. When he talked to God in therapy he realized that it was this same script belief that formed not only his concept of God, but also his spiritual life.

   Another client was talking about undergoing a surgical procedure and feeling quite distressed. I asked if she ever prayed. She burst into tears and said, “To whom?” This opened up the issue, yet unaddressed, of her having converted from one religious faith to another at the time of her marriage and her feelings of confusion, guilt, resentment, and, especially in this situation, separation from God.

   Other kinds of experiences that might be brought to therapy include “unexplainable,” mystical experiences, like feelings of oneness; “peak experiences,” as described by Maslow (1964/1970); numinous experiences; or visions, to mention a few. Some people have profound yet disturbing experiences in the course of observing religious rituals or visiting sacred sites. These experiences are so often not talked about because of the failure of language to describe them adequately or the fear of not being understood or even thought of as crazy.

   People—particularly, in my experience, children who have been traumatized—sometimesexperienced a presence, which they might refer to as “an angel,” during the trauma. One therapist who used art to work with a child finally inquired about the yellow spot in the corner of each picture depicting the accident. The child said, “That was the angel who was there with me the whole time.” A significant part of one client’s survival and healing was the awareness of these “presences” from an early age. They conveyed to her the existence of a loving energy, even though the environment in which she lived was anything but loving. Knowing this loving energy existed gave her the hope she needed to keep going and to believe that a loving relationship could be hers, somewhere, sometime. When people talk about an experience like this, they are sometimes condescendingly smiled at, which conveys the impression, “This is just your imagination” or “Isn’t that sweet?” (like in a fairy tale) or “We won’t give this any validity so you don’t get carried away with such fantasies.” What people really need is someone able and willing to talk open-mindedly about it and to find a way to understand the experience. What they do not need is the feeling that there is something wrong with them or that they cannot talk about it but must keep it to themselves.


   As we become more comfortable talking about our spiritual selves or spiritual life, we begin to realize that there is no distinction between “my life” and “my spiritual life:” to be alive is to be spiritually alive. As with any other dimension of our being, we can be more or less aware, as we are more or less aware at any given moment of what we are feeling, or how fast our heart is beating, or the memory that is lingering on the edge of our consciousness. For both client and therapist, then, the goal is increasing awareness or mindfulness and integrating what may have been a split-off sense of a “spiritual self” with the whole of our being.

   Nearing the end of several years of therapy, a client was reflecting on how he experiences a sense of quiet joy in his life. He recognized that he had actualized his dream of living simply, close to nature, and in the warmth of his family.“It feels almost spiritual,” he said after a moment of silence. And so it is. Transcending self through resolving script, being in full contact with ourselves and all of creation, living authentically and with integrity, and embracing the mystery of “beyond self” is what therapy can be about, whatever words we might use to describe it or however we might approach it.

   Rebecca Trautmann, R.N., M.S.W., has a private psychotherapy practice in New York City. Please send reprint requests to her at or at 349 E. 82nd Street, #5R, New York, New York 10028, U.S.A.


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Kandathil, G., & Kandathil, C. (1997). Autonomy: Open door to spirituality. Transactional Analysis Journal, 27, 24-29.

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Mish, F. C., & Morse, J. M. (Eds.). (1997). The Merriam-Webster dictionary. Springfield, MA: Merriam-Webster.

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Steere, D. (1983). Response to repentance article by Constance Lawrence. Transactional Analysis Journal, 13, 163.

This article was originally published in the Transactional Analysis Journal (Vol. 33, No. 1, pp. 32-36, January 2003). It is republished here with the permission of the author and the International Transactional Analysis Association.

The Institute for Integrative Psychotherapy is approved by the American Psychological Association to sponsor continuing education for psychologists, by the National Board of Certified Counselors for counselors and by the American Board of Examiners in Pastoral Counseling for pastoral counselors. The Institute for Integrative Psychotherapy maintains responsibility for this program and its content.