Psychotherapy and Religion — A Paradox?

Over the last five years in both my private analytic practice and my work on an adolescent psychiatric outpatient service, I have seen an increasing number of patients who belong to fundamentalist religious groups. Working psychodynamically with patients who are deeply religious has presented many challenges, roadblocks and detours, especially in the areas of transference and countertransference.

In the past, the worlds of religion and psychoanalysis remained separate. Whereas religion has been associated with faith, psychoanalysis stood for reason. Both offer ways to give meaning to human existence, human nature, moral stature and destiny. These two opposing systems are often seen as competing with each other for the ultimate truth. Because religion is antilogical and represents a style of reasoning that is antithetical to psychoanalysis, most patients who were religious did not come for analysis.

It could be said, however, that spirituality has always been a part of the analytic experience and has bridged the gap between the two worlds. Spirituality is free standing. It often remains outside of institutionalized religion. It is an open system where searching and individualizing meaning lends itself to self-reflection and therefore psychoanalysis. Unlike organized religion, it is a personal search. Spirituality can be seen as the feelings, thoughts, experiences and behaviors that arise from the search for meaning or the sacred.

Religion, on the other hand, is an organized, structured set of spiritual beliefs and practices with specific symbols or ideas about God, particularly composed of sacraments and ritual activities that are shared by a community. Fundamentalist belief is organized religion with rigid, dogmatic, literal doctrines that are not open to interpretation. Right and wrong are clearly defined and individual behavior is viewed as good or evil. Although there is a fine line between spirituality, religion and fundamentalist belief, as psychoanalysts it is co