For more than a century, religious thinkers and mental health professionals have eyed each other with suspicion. "Religion is an illusion," said Sigmund Freud, the founding father of psychology, and he and his followers largely dismissed it. For their part, believers, especially conservative Christians, saw the rise of Freud's approach as a new threat from the realm of science. "To go to a worldly psychiatrist," said one mid-20th century Christian text, "is a defeat."

But in the past 30 years, a warming trend has set in. Psychologists, social workers, and other kinds of therapists have been working to strengthen their understanding of spirituality as a factor in their clients' wellness. The Association for Transpersonal Psychology, the Association of Humanistic Psychology, Common Boundary, and the Society for Social Work and Spirituality have all sponsored conferences and helped publish literature on how to support spiritual journeys in therapy. These groups have been more apt to focus on "spirituality," an inner search for meaning and wholeness that may or may not involve institutional religion.

Over this same period, therapists began to share their ideas with the general public, resulting in a bumper crop of books combining psychology and spirituality, including best-sellers like M. Scott Peck's "The Road Less Traveled," first published in 1978, and "Care of the Soul," the 1992 bestseller by psychotherapist and former Catholic monk Thomas Moore.

Meanwhile, believers have been incorporating clinical therapy into their pastoral practice, and graduate-degree programs in psychology have sprung up at evangelical Christian schools. The clinical psychology program at Christian Evangelical Fuller Theological Seminary in Pasadena, Calif, founded in 1972, was the first American Psychological Association-accredited program outside of a university. The program at Baylor University, in Texas, was founded four years ago, after Southern Baptist Theological Seminary in Louisville, Kentucky, closed its the graduate social work program.

With so much interest, we might expect psychotherapy and religion to have dropped their mutual suspicion. Quite the contrary. Even as they reach out, their courtship is a tense one, with hostility on both sides.

In a recent journal article, social work doctoral fellow David K. Hodge castigated his social workers, by far the majority of practicing psychotherapists, for discriminating against evangelicals. Hodge cited studies that showed that the majority of Americans (25 percent of whom call themselves evangelical Christians) believe in a personal God, while social workers, on the whole, do not. The majority of social workers professed liberal political values while evangelicals hold conservative ones. In Hodge's eyes, these and other differences fuel a bias among social workers against evangelicals that is played out in the therapy room as well as in the halls of academia.

What's ironic in this discrimination is that social workers are taught to be sensitive to diversity as a basic skill, and inclusivity is invoked with mantra-like frequency. This regard for other cultural viewpoints seems to crumple, however, when it runs up against a view that they regard as intolerant. "Evangelicals see Jesus as the only way," says Hendricke Vande Kemp, a psychologist in private practice in Virginia who taught in the Fuller program for many years. "There's a subtle inference," she says, "that 'Ours is the right religion.'"

Frederick Brewster, a Ph.D. in public and community health and licensed clinical social worker in Silver Spring, Md., admits he's bothered by what he perceives as evangelical Christians' condescension and judgmentalism. Counting "a fair number" of born-again Christians among his friends, he says that they "are good people" but admits that he has "trouble with their punitive and exclusionary" attitude.

"One friend won't go into a Unitarian Church because it's not based in Jesus Christ," says Brewster. "Once this person said, referring to a group of Muslims who happened to be nearby, 'I don't want to be sitting here. They are ungodly people.'" In contrast, Brewster says, the liberal social workers he knows "seem to know themselves well enough to be respectful of persons."

Belleruth Naparstek, an author and social worker who leads guided imagery training seminars, says she often sees the mutual bias in action. Naparstek is acutely aware that conservative Christian fiercely resist the therapeutic and educational benefits of guided imagery, used to manage stress and enhance learning. They brand it as "the work of the devil--Satanic and terrible," she says.

But when discussing evangelicals' resistance to introducing guided imagery in public schools, Naparstek's workshops break into a nasty buzz. Participants snicker about "ignorant, anti-intellectual, narrow and rigid" religionists, says Naperstek. The same professionals, who would bend over backward to accommodate cultural differences among "people of color" don't extend the same courtesy to "people of faith."

Mark Baker, Director of La Vie [Christian] Counseling Center in Santa Monica and Pasadena, Calif., has experienced what he calls a "clash of cultures" up close. Early in his career, Baker, a Ph.D. in clinical psychology and a M.Div. in theology, had his application to a psychoanalytic institute for training rejected. A colleague later told him that the institute rejected his application partly out of fear that he would "substitute one form of fundamentalism for another."

On the other hand, Baker recounts a conversation he once had with a church member, who dismissed mental health as something "that might be great for Tuesday afternoons in the library [but] doesn't belong in the House of God."

The differences are more than philosophical. As Hodge points out in his journal article, cultural differences can lead to misunderstandings in marital therapy, where liberal therapists' preference for "egalitarian marriage"--in which the partners share the power and decision-making often runs headlong into the conservatives' support for "complementary marriage"--in which the partner's roles are different but are understood to have equal worth. Evangelicals end up feeling threaten by the therapist instead of helped.

For their part, many conservative Christians view marital therapy as a "marriage breaker"--a process intent on breaking up the household. What evangelical couples don't understand, says Vande Kemp, is breaking up a marriage is not considered a therapeutic task. She points out that the couple's relationship is usually a mess by the time they ask for help, and they sometimes have little more connection between them than a belief in the sanctity of marriage.

An irony of the religious-secular clash is that social work has deep roots in religion. Radical Catholic Dorothy Day, founder of "houses of hospitality" and the Jewish Educational Alliance, or "Edgies," were involved in charitable work and social services in the late 19th and early 20th centuries.

The integration of religious work and social work, however, was not without its abuses. The Orphan Train Movement, begun after the Civil War and lasting up until the 1920s transferred more than 30,000 immigrant children--many of them Catholic--to seemingly more wholesome Protestant families in the Midwest. Later, the Indian nations saw their children taken from reservations and placed in schools where they were not allowed to speak their native language or practice their religion. More recently, Bible study classes have been made mandatory in some shelters for the homeless, and a Mormon girl living in a home for juvenile delinquents was forced to go to Mass.

But social workers coming out of religious schools like Baylor are learning not to apologize for their religious orientation. Diana Garland, professor and chair of the School of Social Work at Baylor University admits that "All of us have biases. At Baylor we have a bias--that religion and spirituality are resources and strengths in people's lives." The danger, she says, only comes in a lack of respect for the worldview of clients.

In fact, many therapists seem to think it is fine to integrate religious beliefs into therapy as long as the therapist if up front about it. Joseph Walsh, Dean of the School of Social Work at Loyola University, a Catholic school, says "blending the two" is fine so long as the therapist says so quite clearly "on their letterhead and over their door."

Vande Kemp agrees. She stresses the importance of having "the option to choose a therapist who shares your values." More and more therapists are declaring themselves to have Christian, Buddhist, conservative Catholic, Methodist, Jewish, or transpersonal orientations. Faith groups, meanwhile, are inviting therapists to help them go places nobody might have imagined half a century ago. Not long ago, Vande Kemp was asked to speak at a meeting of the Sufi Psychological Association.

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