How to Help Your Therapy Clients with Their Spiritual Questions

Many of us have at some time wrestled with or just wondered about the bigger questions of life.

“Banality is like boredom: bored people are boring people, people who think that things are banal are themselves banal. Interesting people can find something interesting in all things.”

– Idries Shah, Reflections

“Where is he now! Where, Mark?” A slow sound rumbled somewhere inside him like a subterranean river, finally coming to the surface as a great gushing sob.

“I loved him! He was so real, I can’t believe he’s not here! He must be somewhere… and I know that sounds crazy to you.”

“No it doesn’t,” I said, because it didn’t.

Many of us have at some time wrestled with or just wondered about the bigger questions of life.

Sometimes, as with this client, James, the questions only come during times of crisis – in this case the death of his father.

Young children are often the greatest of philosophers, asking questions about where people go after they die, or what came before life. Adults may struggle with the fate of the soul, the ultimate meaning and true purpose of their lives, and how they should live their lives.

Research has found that many people ponder such ‘big’ questions’¹ even if they don’t share these thoughts, and that pondering these questions may be good for mental health (and, conversely, avoiding them may worsen anxiety and depression).² So letting our clients have the space to ask and explore such subjects may sometimes be vital for their wellbeing.

Mulling the big questions and mental health

One paper, published in The Lancet, examined the spiritual beliefs and needs of almost 27,000 participants in Denmark.¹ It was found that 80% of people had mulled the bigger questions of life in the four months before the study, many without ever voicing their thoughts to others.

The spiritual needs reported by the participants were classified into one of four domains:

• Religious (e.g. praying, participating in religious ceremonies)
• Existential (e.g. being forgiven and extending forgiveness to others)
• Inner peace and acceptance (e.g. dwelling at a place of quietness and peace, plunging into the beauty of nature), and
• Generativity (a sense of wanting good things for future generations or other people not physically known to or connected to the self, e.g. passing on life experience and giving something of ourselves to others).

The study found that adults reporting poor health also reported greater spiritual needs. I think this is because when the body is struggling we feel more connected to a sense of mortality. When life is no longer taken for granted we may start to look beyond life to bigger questions.

But what happens if we don’t consider the bigger questions?

Avoidance of the big questions may worsen mental health

Another study aimed to explore the relationship between experiential avoidance and mental health in American adults reporting spiritual struggles.²

The study found that experiential avoidance was consistently associated with poorer mental health, both in a general sense and specifically in relation to spiritual struggles. Correlations were found with depression, anxiety, somatic symptoms, and emotional regulation difficulties.

Of course, such adverse symptoms can occur as a result of the spiritual struggles themselves, but the research shows that these symptoms were exacerbated by higher levels of avoidance. In other words, the more people experiencing spiritual struggles try to dodge their concerns, the more likely they are to experience anxiety, depression, and difficulties regulating their emotions.

So why exactly might dodging the greater questions of life be bad for mental health?

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The search for meaning and purpose

Thought suppression – I don’t mean by tyrannical governments, but by individuals, of their own thoughts – tends to backfire.³ It causes people to feel burdened by thoughts of life and death and purpose, of where we come from and what it all means, rather than fascinated or accepting.

And just as not facing something can make it grow in warped ways, so too can feeling connected to a greater reality lend us an all-important sense of meaning.

A survey of 75,000 people found that, whether they were religious or not, those who felt a sense of oneness, including a sense of connectedness to nature, other people, and life in general, were happier and more hopeful.⁴ People live longer when they have meaning in their lives.

Other research found that having a strong sense of purpose and meaning lowered the risk of death in older adults by 15.2% compared to adults with little sense of purpose.⁵ This association held good across all races and ethnicities.

But one thing bothers me.

Are these spiritual or emotional needs?

It can certainly be argued that many of these needs – for meaning, for inner peace, and even to feel connected to a reality bigger than oneself with a sense of profound purpose and meaning – are in fact psychological and emotional needs rather than spiritual ones.

After all, the followers of the psychopathic Jim Jones, who drank the poisoned Kool-Aid, would likely have felt a sense of profound meaning, moments of inner peace, connection to something bigger than themselves, and so forth, without necessarily feeling any kind of spirituality.

Likewise, followers of nominally religious cults or atheistic political ones may feel that they complete many of these same needs in the absence of spirituality (though that can, of course, quickly fall apart as they find they have to pay back – and more – the providers of these emotional needs).

But perhaps the distinction isn’t important.

I’d suggest that if it is possible for human beings to develop a spiritual dimension, then being able to regulate our emotions and feel calm and connected might be a prerequisite to greater spiritual knowledge and capacity – as long as before that happens those needs aren’t hijacked and warped by manipulative systems of rigid dogmas, which become the opposite of open questioning.

Being emotionally calm and grounded might be a starting point for participating in the greater truths of reality.

Anyway, if, as it seems, addressing our clients’ existential or spiritual concerns may help them and avoiding these issues may harm them, how might we as practitioners aid our clients in addressing these ‘big’ questions?

Idea one: Listen and help explore

Our job as practitioners is not to indoctrinate clients into a particular belief system or to keep steering them back towards these bigger life themes if they show no interest in them. But we can give them room to air their thoughts and feelings on such issues.

James was keen to talk about where his father had gone after he’d died. And it does seem counterintuitive that someone with a voice, and expressions, and unique characteristics of humour and character can suddenly just be nowhere. It’s hard to get your head around.

But I certainly didn’t tell James his father wasn’t anywhere and had become nothing, nor that he’d floated loftily up to heaven and was sitting on a cloud as we spoke! The truth is, I didn’t know the answer to this question. But I did explore the ideas with him and gave him space to think about it.

I talked in terms of “maybe this” and “maybe that”, of “some people believe…”, and even a bit of quantum physics (which is most definitely not my speciality!) – that (apparently!) no energy is ever truly lost to the Universe.

James seemed to find this discussion comforting, as he hadn’t felt able to discuss such things with other people in his life.

Idea two: Use Socratic questions

James wanted reassurance perhaps that on some level his father still existed.

“But,” he told me imploringly, “I’m a scientist! And there’s no evidence of a human soul that can transcend physical boundaries!”

I asked him Socratically whether everything was available to scientific confirmation. He thought for a while and suggested that deep and lasting love was real but couldn’t really be proved beyond a doubt scientifically.

I asked him whether he felt the concept of faith was necessary to take one further sometimes than narrow scientific confirmations. I told him I didn’t know the answers to these questions but was just wondering aloud. Socratic questioning is about our clients being given free rein to ponder questions that might expand their sense of possibility rather than coming up with the ‘right’ answer.

The above two ideas also helped with the third consideration.

Idea three: Help destigmatize mulling on the bigger questions

The large Danish study I cited above found that many people had mulled the bigger questions of life but felt it was taboo to do so. James and other clients who have wanted to explore large existential themes have told me they felt “stupid” or “weird” for even thinking about such things.

I reassured James it is natural and human, even ‘normal’, to sometimes reflect on what it is all about – ‘it’ being life, the Universe, and everything – and that he could talk about that with me for as long as he liked. Indeed, the greatest minds had always wrestled with these issues.

I also suggested that none of us could always be expected to conjecture on such vast themes, as we have day-to-day life and concerns to address. He laughed when I suggested that even Plato would have been aware of local gossip, problems of bureaucracy, concerns about what to make for dinner, and so forth.

“We have to get on with day-to-day living,” I suggested, and this too seemed to comfort him.

James, of course, was grieving, which is a natural time to think about the nature of our most fundamental of experiences.

But many of us do consider how we all relate to one another and how, fundamentally, we might partake of some vast human destiny much wider than the incidentals and preoccupations of our societies and politics, media and basic psychologies.

Where are you going?

Where did we come from, where are we going, and what is behind it all?

To prematurely assume we know or don’t know, or that there is nothing to know, closes the mind as fast and surely as a trap door. After that door has snapped tight, all thoughts or perceptions merely go towards backing up the pre-established belief.

It takes a real act of faith to dogmatically assume that all of reality is merely physical, arbitrary, and essentially meaningless.

But the truly questioning mind may find that through the art of calmly looking it finds not mere belief but genuine understanding.

The Heart of Psychotherapy

At the heart of psychotherapy, no matter what your chosen approach, is the change of meaning. Loosening up – or radically changing – how a client sees themselves, an aspect of their experience or their future prospects, is often the catalyst that really gets them moving. The ability to reframe conversationally, with no fanfare or announcement, allows your reframes to slip through the ‘defences’ that are locking self-defeating thoughts in place. Refine your reframing skills with Mark’s online course Conversational Reframing.

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About Mark Tyrrell

Psychology is my passion. I've been a psychotherapist trainer since 1998, specializing in brief, solution focused approaches. I now teach practitioners all over the world via our online courses.

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