Frontline: The Affirmation of a Religious (Not Merely Spiritual!) Orientation in Clinical Treatment

That word spirituality seems to be on everyone's tongue. A short time ago I observed a psychiatric resident do a “board interview” in preparation for eventually taking her oral psychiatric board examinations. As she asked the interviewee about his personal life, she inquired as to the state of his “spiritual” life. The prestigious Templeton Foundation is offering grants to design curricula on spirituality for psychiatric residents and to study “spiritual transformation.” Two problems, however, that I see with enthusiasm for spirituality, are that we are not entirely clear about what the word means and that a polarity is drawn at times between spirituality and the mundane. The mundane includes both the need for scientific knowledge and technical neutrality in psychotherapeutic work with patients and what is often referred to as “organized religion.”

Stone (2000) provided a list of themes that characterize spirituality. These include “Hopefulness, Forbearance, Humility, being Oriented toward Others, Self-Acceptance, Resignation, Serenity, Forgiveness, Compassion, Self-Transcendence, and a Feeling of Responsibility to do Something Positive for the World… [a] humanistic orientation or altruism…” (p. 228). Lawner (2001) discussed what he terms the “spiritual implications” of psychodynamic therapy, and he defines spirituality as referring to “matters that are other than corporeal or material” (p. 525). For both Stone and Lawner, spirituality flows from the best practice of psychotherapy. However, Lawner's negative definition leaves open the opportunity for a word to acquire diffuse connotations, and spirituality is often characterized as something good, something nice and warm and comforting, without a clear content being defined. That sort of vagueness leaves it unclear how, exactly, we should pursue tasks such as incorporating spirituality into our lives and into our work with patients. An example of what I am referring to is found in a recent and much distributed articl