It’s been reported that God has a special fondness for fallen sparrows, fools, and small children which may be why he gets such a kick out of startling me. This morning, he arose in a ghostly puff of sawdust from the bottom of the woodpile and like a gleeful child, said “Boo.” “NOT FUNNY,” I […]
Here’s a little something from Rita on this Sunday afternoon. It’s more spiritual than psychological, but maybe it’s both. IMHO, it’s a short and fantastic read. To check it out, click here: Feeding birds
You know how relationships can be. Sometimes it’s easy to take the person whom you’re living with or hanging out with for granted. This morning, I was reminded (again) that Rita is a very talented writer. So I’m sharing with you a link to her blog. Warning: Rita is exploring varieties of “God” manifestations in the world. It may not be your cup of tea; on the other hand, you might like the idea of ongoing conversations with God and therefore you might love her writing. In this blog-episode, God is coming back from a short vacation. If you’re interested, check it out.
via God Comes Back
Counseling and psychotherapy theories are wildly variable and surprisingly convergent. What do I mean by this? Well, despite the fact that Sigmund Freud and Francine Shapiro and Steven Hayes and Marsha Linehan have very different ideas about what helps people change for the better, there’s also a boatload of commonality.
Based on my narrow range of experience and knowledge, nowhere is there more commonality than the theoretical outposts of Adlerian theory (i.e., Individual Psychology) and Choice Theory/Reality Therapy. Both of these approaches include a broad theoretical concept related to an individual’s personal and cultural construction of how they view themselves, others, and the world (i.e., Adlerians say “Lifestyle” while Reality Therapists say “Quality World”); both perspectives view individuals as pulled forward by internal values (and not driven by Freudian conflicts); both perspectives view behavior as purposeful, and perhaps not coincidently, they also view psychopathology as purposeful.
All this theory-speak is way for me to introduce this post as a continuation of my spirituality and counseling/psychotherapy theories series. What’s especially interesting about this post (IMHO) is that I’m writing about spirituality and Reality Therapy. I mean, how can a form of therapy that explicitly emphasizes “reality,” accommodate “spirituality?” We’ll see about that . . . maybe.
Chapter 9 of Counseling and Psychotherapy Theories in Context and Practice focuses on choice theory and reality therapy. Many people may not perfectly understand the definitions of choice theory and reality therapy. As a quick refresher, here’s an excerpt from the beginning of Chapter 9, followed by the brief spirituality section.
Reality therapy is often oversimplified and confused with confrontational therapeutic approaches. In this chapter we describe and explain the nuances and clarify the confusion.
What is Choice Theory and Reality Therapy?
Glasser developed reality therapy in the 1960s. Later, recognizing that he needed a theoretical foundation for his therapeutic approach, he began exploring cybernetics and control system theory (Powers, 1973; Wiener, 1948). Initially, Glasser used control theory to explain reality therapy. Later, he adapted the theoretical model and shifted to using choice theory (Glasser, 1998).
Choice theory is based on the idea that conscious behaviors are chosen in an effort to satisfy one of five internal basic human needs (Wubbolding & Brickel, 2017). The human mind or brain acts as a “negative input control system,” providing feedback to individuals so that they can correct behaviors and continue getting what they need and want (Wubbolding, 2012, p. 13).
Reality therapy is a present-focused, directive therapeutic approach designed to help individuals identify and satisfy their needs and wants more consistently and adaptively. As Wubbolding (2012) has written, “If choice theory is the track, reality therapy is the train that delivers the product” (p. 5).
Choice Theory, Reality Therapy, and Spirituality
In the 1989 Spring issue of the Journal of Reality Therapy, Brent Dennis, a certified reality therapist, wrote an article titled, “Faith: The fifth psychological need.” Glasser (1989) responded later that year. Glasser noted that he found the discussion interesting, but that there is “no possible way to resolve an argument about belief” (p. 29). He concluded with a statement embracing inclusiveness toward whatever anyone might place in their quality world. Consistent with this perspective, contemporary reality therapists have published book chapters on how to help interfaith and multicultural couples succeed in their partnerships and marriages (Minatrea & Duba, 2012; Olver, 2012). It’s interesting however, that Glasser described faith as residing in an individual’s quality world; he did not embrace it as a new psychological human need.
In an article on integrating reality therapy into Malaysian Islamic culture, Jusoh and Ahmad (2009) described many ways in which choice theory is consistent with Islam and can be practiced in Asian cultures. Specifically, they focused on the WDEP and SAMI2C3 systems and emphasized their compatibility with Islamic concepts. They concluded that “choice theory and reality therapy have universal attributes, and these can be interpreted in any religion or culture” (2009, p. 7). This statement seems consistent with Glasser’s (1989) inclusive statement on spirituality as a potential human need.
Overall, aside from the content briefly summarized here, little information exists on the integration of spirituality into reality therapy. However, given the growing international flavor of CT/RT, progress in this area seems inevitable.
We have a friend who is the pastor of a church in Absarokee, Montana. My impression is that she frequently talks about theories of counseling and psychotherapy . . . even though I’m sure she hasn’t planned to integrate psychological theory into her sermons. The fact that I hear psychological theories as she talks theology is just another way in which the lens of the listener frames what is heard, seen, and experienced.
Today she was preaching about feelings of inferiority. She made the case, as Adler would, that inferiority feelings are natural and normal. Then she shifted to God’s acceptance or grace. Surprisingly (to me) her focus on acceptance reminded me of Albert Ellis’s REBT and his concept of universal self-acceptance. Although my friend was speaking about God’s acceptance of all humans, regardless of our warts and behaviors, I found myself thinking of times when I’ve heard parents express deep acceptance of their children and of when clients have strived to experience greater self-acceptance.
All this brought me to a place where I started thinking about how Ellis and his REBT model might actually have a spiritual dimension. “That was pleasantly unexpected” I thought to myself . . . which prompted me to write this Sunday evening spirituality post.
The following is an excerpt (preview) from the cognitive behavior chapter of the forthcoming 3rd edition of Counseling and Psychotherapy Theories in Context and Practice. Please let me know what you think.
CBT and Spirituality
Like all therapists, cognitive behavior therapists work with religious or spiritual clients. Given that cognitively oriented therapists routinely identify and challenge (either through disputation or collaborative empiricism) client beliefs, there’s a risk that clients’ deeply held religious or spiritual beliefs might also be challenged. Additionally, practiced as a radical modernist scientific paradigm, CBT has been critiqued for overlooking transcendence, grace, and evil (Stewart-Sicking, 2015).
Looking at the situation logically (which cognitive theorists would appreciate), CBT practitioners have three options:
- Ignore client religion and spirituality.
- Freely challenge religious beliefs, whenever they cause emotional distress.
- Integrate religious/spiritual knowledge into practice in a way that supports nuanced discussions of religion and spirituality. Unhelpful or irrational thoughts might be questioned, as needed, but not central religious values (Johnson, 2013).
Historically, cognitive therapists have followed these first two options, mostly ignoring religion, or questioning its rational foundations (Andersson & Asmundson, 2006; Nielsen & Ellis, 1994). However, in the past decade or two, interest in integrating religion/spirituality into counseling and psychotherapy has increased (Stewart-Sicking, 2015).
It can help to think about client religion/spirituality as a multicultural/diversity issue. If so, the general guide is for therapists to (a) seek awareness of their own spiritual and religious attitudes and how they might affect counseling process and specific clients, (b) obtain relevant knowledge about religion/spirituality, (c) learn religion/spirituality specific skills, and (d) advocate for individuals who are oppressed on the basis of religion/spirituality as needed and as appropriate. Each of these cultural competence components can be stimulating for individual practitioners.
For practitioners interested in religion/spirituality integration with cognitive approaches, the following two areas can provide focus for further training and development.
Gain and Apply Scriptural Knowledge with Clients
Gaining knowledge regarding how to use specific religious scriptures to dispute irrational or maladaptive cognitions may seem daunting. However, from an REBT perspective, Nielsen (2001) wrote:
Since clients usually upset themselves through their awfulizing, demanding, frustration intolerance, and human rating, REBTers need only search Scriptures that decatastrophize life, suggest forbearance in the face of uncontrollable people and situations, tolerance of life’s frustrations, and that affirm basic human equality. The prominent religious writings of most major world religions emphasize such rational values. (p. 38)
Using scriptural knowledge would be most appropriate when working with clients who have similar religious beliefs. Nielsen (2001) is advocating general knowledge, but general knowledge could prove problematic. For example, if a Jewish therapist quoted the Koran to a Muslim client, the discussion might quickly shift away from being therapeutic. On the other hand, having general knowledge, if used sensitively, could represent appreciation of religious diversity and enhance the working alliance.
Use Spiritual Principles of Acceptance for Managing Disturbing Cognitions.
Contemporary CBT approaches (covered in Chapter 14) offer an alternative way of viewing and handling so-called irrational or maladaptive cognitions. These approaches include acceptance and commitment therapy (ACT), dialectical behavior therapy (DBT), and mindfulness-based cognitive therapy (MBCT). ACT, DBT, and MBCT integrate religious/spiritual philosophy (e.g., Buddhism, contemplative Christian, etc.) and generally view cognitions as disturbing, but not necessarily pathological. Acceptance of all cognitions is advocated; encouraging clients to dispute or restructure their thoughts, memories, and experiences can increase suffering (Hayes, 2016).
The whole idea of integrating behavior therapy with religion and spirituality might seem odd or off or impossible. But here in Theories Land, we don’t believe in the impossible. In fact, many religious folks do just fine with behavior therapy and many behavior therapists do just fine with religious folks. If you think about it, for behaviorists, the focus is purely on problematic behaviors. In some ways, this naturally leads to an acceptance of all people . . . .
Put another way, for behaviorists, there’s no room or need for discrimination based on race, sexuality, or religion. Behaviorists work with all people to help them with their problem behaviors.
Rather than digressing into the political, let’s refocus on behavior therapy and spirituality. Here’s the short section from the 3rd edition of Counseling and Psychotherapy Theories in Context and Practice. If you feel moved (by the spirit, or anything else), please let me know what you think.
Strict behaviorists don’t believe in the utility of cognition. The clients’ problems are behaviors. Behavioral treatments involve new learning to facilitate behavior change. If you stick with the perspective that cognition is irrelevant—which is the perspective we’re sticking with in this chapter—then client religious or spiritual beliefs are also not relevant.
Considering religious and spiritual beliefs as irrelevant doesn’t imply disrespect for religious and spiritual beliefs. Behaviorists are respectful of beliefs, but the focus of therapy would be on behaviors—these behaviors could include religious or spiritual behaviors. If you’re following the logic here, then you can see that behavior therapy is 100% compatible with religion and spirituality.
The focus of behavior therapy with religious and spiritual clients would be on behaviors that are related to religion and spirituality. From a behavioral model, the question is, “Are your religious/spiritual behaviors causing you distress or contributing to your well-being?” The good news about this is that behavior therapy is an evidence-based approach for modifying behavior, including the development of positive and healthy habits (and behaviors commonly thought of as representing self-control and self-discipline). The focus on enhancing self-control and self-discipline is a good fit for clients with religious or spiritual orientations (Shapiro, 1978).
Researchers have explored the relationship between behavioral activation and client values. In one study, it was found that when individuals with high intrinsic religious values engaged in a greater frequency of religious behaviors, they reported reduced depressive symptoms (Agishtein et al., 2013). Conversely, for individuals with low intrinsic religious values, increasing religious behaviors were associated with more depressive symptoms. In conclusion, despite disregard for religious/spiritual beliefs, a strict behavioral approach can be used to increase or decrease specific religious and spiritual behaviors. . . and increasing or decreasing specific religious and spiritual behaviors may be therapeutic—depending on the individual client and his/her/their situation.
An impromtu word search of the existential theory chapter for the 3rd edition of Counseling and Psychotherapy Theories in Context and Practice revealed 17 appearances of the word “spirituality.” That’s nice. Seventeen is a prime number. Seventeen is also one of my favorite spiritual numbers. Back in 2nd grade in Sunday school in a synagogue in Portland, my teacher asked us to guess a number from 1 to 20. The winner had the honor of taking a special Bible story book home for the week. My guess was a perfect 17. I got the book for the week. Obviously, the number 17 is a spiritual force in my life.
More important is the sublime integration of spirituality into existential theory. Or not. It seems to go one way or another. Either existential theorists are deeply spiritual/religious or they’re atheist/agnostic. There is no middle ground. Or maybe there is? [More on this conundrum below]
What follows are several short excerpts from the Existential Theory chapter. These excerpts culminate with the short section on Existential Spirituality.
The Danish philosopher Soren Kierkegaard (1813–1855) lived nearly his entire life in Copenhagen. Kierkegaard was devoutly religious. He was shaken when he discovered, at age 22, that his father had not only cursed God, but also seduced his mother prior to marriage. Subsequently, Kierkegaard’s writings focused primarily on religious faith and the meaning of Christianity. Eventually he concluded that religious faith was irrational and attainable only via a subjective experiential “leap of faith.” For Kierkegaard, virtuous traits such as responsibility, honesty, and commitment are subjective choices—often in response to a subjective religious conversion. Kierkegaard did not describe himself as an existentialist, but his work is a precursor to the existential philosophical movement, which formally began some 70 years following his death.
In contrast to Kierkegaard who began from a position of religious faith, the German philosopher Friedrich Nietzsche (1844–1900) had negative feelings about Christianity. It was he who, in his book Thus Spake Zarathustra, wrote, “God is dead.” Although he may have been referring to societal emptiness, he also claimed that religion used fear and resentment to pressure individuals into moral behavior. Instead of following a religion, he believed, individuals should channel their passions into creative, joyful activities. Irvin Yalom offers a fascinating view of Nietzsche’s psychological suffering in a historical fiction piece titled When Nietzsche Wept. In this novel, Yalom (1992) weaves existential principles into a fictional therapeutic encounter between Breuer, Freud, and Nietzsche.
Kierkegaard and Nietzsche represent an interesting paradox or dialectic in existential thinking. A dialectic is a process where learning is stimulated from the integration of opposites. On the one hand, some existentialists embrace deep religious faith, whereas others are staunchly atheistic. Still others claim an agnostic middle ground. These differences in fundamental beliefs represent a wide sweep of human intellectual diversity and provide for fascinating philosophical exploration. You will glimpse existential dialectics intermittently in this chapter.
Four Existential Ways of Being
There are four primary existential ways of being-in-the-world. They include:
- Umwelt: Being-with-nature or the physical world.
- Mitwelt: Being-with-others or the social world.
- Eigenwelt: Being-with-oneself or the world of the self.
- Uberwelt: Being-with-the-spiritual or over world.
Boss (1963), Binswanger (1963), and May et al. (1958) described the first three of these existential ways of being. van Deurzen (1988) added the fourth.
These dimensions of existence are ubiquitous and simultaneous. Some people focus more on one dimension than others or shift from one to another depending on particular intentions or situations. For example, while on a hike up the Stillwater gorge in Montana, it’s easy to experience being-with-nature as water powerfully cascades around you. However, depending on other factors, this experience can take people inward toward eigenwelt, toward an uberwelt spiritual experience, or stimulate a deep mitwelt (albeit a nonverbal one). In most cases, the direction your being-ness moves within a given situation is likely a combination of several factors, such as: awareness, anxiety, previous experiences, intention, and/or your spiritual predisposition.
According to Rollo May, “The daimonic is any natural function which has the power to take over the whole person” (1969, p. 123). Historically, Daimon possession was used to explain psychotic episodes and is popularly referred to as demonic possession. However, May repeatedly emphasized that daimonic and demonic are not the same concept: “I never use the word demonic, except to say that this is not what I mean” (May, 1982, p. 11).
The daimonic is an elemental force, energy, or urge residing within all persons that functions as the source of constructive and destructive impulses. May wrote, “The daimonic is the urge in every being to affirm itself, assert itself, perpetuate and increase itself .… [The reverse side] of the same affirmation is what empowers our creativity” (May, 1969, p. 123).
Similar to C. G. Jung, May considered harnessing and integrating the daimonic as a central psychotherapy task. He viewed psychotherapy as an activity that plumbs the depths of an individual’s most basic impulses … the purpose of which is to acknowledge, embrace, and integrate every bit of being and energy into the whole person. May commented specifically about the danger of leaving the daimonic unintegrated:
If the daimonic urge is integrated into the personality (which is, to my mind, the purpose of psychotherapy) it results in creativity, that is, it is constructive. If the daimonic is not integrated, it can take over the total personality, as it does in violent rage or collective paranoia in time of war or compulsive sex or oppressive behavior. Destructive activity is then the result. (May, 1982, p. 11)
The goal is to integrate natural daimonic urges and energies in ways that maximize constructive and creative behavior.
A spiritual-oriented client was engaging in guided imagery with an existential therapist. The client “discovered” a locked door in the basement of his “self.”
“What’s behind the door?” the therapist asked.
“It’s darkness,” he said. With shivers of fear, he added, “There’s dread. It’s the dread of being unacceptable. . . of being unacceptable to God. Even worse, it’s my dread of being unforgiveable.”
“Shall we go in?” asked the therapist.
The therapist noticed his client’s reluctance and said, “Let’s wait a moment and breathe. I’m wondering if you can even get in the door. I’m wondering if you want to get in. There’s no rush. We know where the door is. We can wait. Or we can create a key and try to get in. Or we can leave the door shut. But first let’s wait here and breathe before deciding anything.”
For two minutes, client and therapist sat breathing together. The paralyzing fear diminished and the client said, “I have a key. Let’s look inside.”
“Yes. Let’s look inside.”
The key opened the lock. The door creaked open. In the dreaded darkness, there was light. A dialogue with the dread and unforgiveable ensued and the client found a broad sense of love and acceptance. There were tears of relief. His spiritual load was lightened. His basement demons were exorcised.
In this chapter we’ve discussed the deep and profound quality of existential psychotherapy. Schneider (2010) called it the “Rediscovery of Awe.” Frankl and Wong referred to it as the pursuit of meaning. In existential therapy, meaning and awe are individualized, as is spirituality. There’s great potential in combining the existential and the spiritual in psychotherapy, but clients should be forewarned and informed: combining the spiritual and existential isn’t about formulaic or surface explanations; it requires a commitment to go deep and explore doubts, uncertainties, and core vulnerabilities.
Here’s a link to the new Theories 3rd edition cover: https://www.amazon.com/Counseling-Psychotherapy-Theories-Context-Practice/dp/1119279127/ref=dp_ob_title_bk