Should the Therapist’s Couch Be an Altar?

Why the role religion plays in mental health is up to the patient, not the doctor.

A therapist’s office is no a place to be pressured into a new religion. If a person wants no part of faith, or is content with the religion she follows, new spiritual perspectives can be distracting, to say the least. But some experts maintain that if a patient is open to religion, a discussion of faith can be beneficial in course of therapy.

Carrie Cragun and Myrna Friedlander conducted research on eleven Christian patients to discover if they had a positive or negative experience with secular psychologists. They found that patients had a positive experience when their therapists were open to their beliefs and let the patients determine when they wanted to bring religion into their therapy. In contrast, patients had a negative experience when their therapists either rejected their convictions or evaded a discussion of religion altogether.

Kenneth Pargament studies the psychology of religion and spirituality. In an interview with the American Psychological Association, he said, “For many people, religion and spirituality are key resources that can facilitate their growth. For others, religion and spirituality may be sources of problems that need to be addressed in the service of their health and well-being.”

Pargament believes that an element of religion is important in therapy: “Unlike any other dimension of life, religion and spirituality have a unique focus on the domain of the sacred — transcendence, ultimate truth, finitude and deep connectedness. Any psychology that overlooks these parts of life remains incomplete.”

Yet is it unethical for religious psychologists to bring their own convictions into a conversation? Patients need the freedom to be vulnerable and honest with their therapists, but if they feel like a particular belief code is being pushed on them, they’ll be guarded concerning how much they should divulge.

According to Thomas Plante, a psychology professor at Santa Clara University, “While a clinician who might be spiritual, religious or both may want to integrate their interests and beliefs into psychotherapeutic work, it would be inappropriate and unethical to practice outside of one’s area of expertise or to promote their particular spiritual and religious beliefs on their clients.” Plante says that even though therapists may maintain their personal positive or negative views on a particular religious tradition, they must not allow that bias to color their interactions with a patient.

Clearly, therapists need to be respectful of the traditions of their patients. Disrespect or bias can cause serious detriment to the restorative process. Pargament recommends that therapists ask a question or two to determine their client’s spiritual preference in order to better treat them and understand their worldview. These questions serve to show an interest in the patient’s ideals, and, based on their response, invite them to discuss their religion or keep their religion separate from therapy. Pargament explains, “By communicating their own interest in religion and spirituality, psychologists open the door to what may become a richer, deeper conversation.”

Lacy Cooke
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  • Kurt Walker

    Regarding the article “”Should a Therapist’s Couch Be an Altar?”

    There hasn’t been an “altar” in a Protestant church in the 500 years since the Reformation. Why would we consider a therapist’s couch to be one? I regret enough of us don’t know this. There is no sacrificial altar after the crucifixion, at least according to Protestant doctrine.

    Maybe the title of the article ought to be “Should a Therapist’s Couch Be a Table?” Now THAT would be something to write about. The couch being a place where all of our brokenness is made whole in understanding that we are not alone, that we have community, that we have God’s grace, mercy, love, and forgiveness, and that at this common table of compassionate passion and communion there is no shame nor blame nor hierarchical power nor inequality. That at this table, our woundedness finds healing through empathy.