For the past 30 years, psychologists, social workers, and other kinds of therapists have been working to strengthen their understanding of spirituality as a factor in their clients' lives and wellness. The effort represents an "up" trend in the see-sawing, century long relationship between religion and the mental health profession, which got off to a rocky start due to the deep suspicions about faith harbored by psychiatry's founder, Sigmund Freud.

The most public expression of the warming trend has been on the bestseller list. Since the 1970s, a bumper crop of spiritually oriented psychology books, led by 1978's "The Road Less Traveled," by Presbyterian minister and psychiatrist M. Scott Peck, have led the bestseller lists. The most recent smash hit was psychotherapist and former Catholic monk Thomas Moore, with his 1992 book "Care of the Soul."

Less celebrated but as important are contacts that have been made in the past three decades by organizations such as the Association for Transpersonal Psychology, Association of Humanistic Psychology, Common Boundary, and the Society for Social Work and Spirituality--all of which have sponsored conferences and helped publish literature on ways that therapy could support clients' spiritual journeys. 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.

Meanwhile, some faith-based educational institutions, where therapy has traditionally been considered suspect, have established graduate degree programs in psychology over the same span. The clinical psychology program at Christian Evangelical Fuller Theological Seminary in Pasadena, Calif, founded in 1972, was the first American Psychological Association-accredited School outside of a university. The four-year-old program at Baylor University, in Texas was founded after Southern Baptist Theological Seminary in Louisville, Kentucky, closed its the graduate social work program.

With so much mutual interest, we might expect psychotherapy and religion to have developed into cozy, if not intimate, bedfellows. Quite the contrary. Even as they reach out, their courtship is a tense one, with hostility and suspicion on both sides.

In a recent journal article, social work doctoral fellow David K. Hodge castigated his social workers, who make up by far the majority of practicing psychotherapists, for discriminating against evangelicals. The discrimination, he wrote, stems from vastly different views about God and politics. Hodge cited studies that showed that the majority of Americans (of which evangelicals make up a full 25 percent) believe in a personal God, while social workers, on the whole, do not. The majority of social workers professed liberal values while evangelicals hold conservative political beliefs. In Hodge's eyes, these and other differences fuel a bias among social workers against evangelicals that is played out in both the therapy room as well as in the halls of academia.

What's remarkable about this discrimination is that psychotherapists are taught that a sensitivity toward diversity is a basic skill. In academic social work circles, inclusivity is invoked with a mantra-like frequency. This regard for other cultural viewpoints seems to crumple, however, when it runs up against evangelicals' exclusively Jesus-oriented view. Hendricke Vande Kemp, a psychologist in private practice in Virginia, who taught in the Fuller program for many years, says evangelicals see Jesus as the only way." There's a subtle inference that "Ours is the right religion."

Frederick Brewster, a Ph.D. in public and community health and licensed clinical social worker in Silver Spring, Maryland, admits he's bothered by what he perceives as conservative 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, has also seen the bias in action. Participants in her workshops have described how they tried to introduce guided imagery into public schools, only to be met with fierce opposition from fundamentalist Christians. A snickering and nasty buzz about "ignorant, anti-intellectual, narrow and rigid" religionists often erupts in the room, she says. Apparently, people who bend over backwards to refer to African-Americans as "people of color" don't extend the same courtesy to "people of faith."

Yet Naparstek is acutely aware of fundamentalists' resistance to seeing the therapeutic and educational benefits of guided imagery, which has been used to manage stress and enhance learning. They brand it as "the work of the devil--Satanic and terrible," she says.

Freud, the father of psychology and a self-avowed "godless Jew," set the tone when he wrote that religion is an "illusion," constructed to deal with our strong feelings of powerlessness in the world. From this viewpoint, the goal of therapy is to nurture a belief and trust in the self alone.

Freud's contemporaries, most notably William James and Carl G. Jung, strongly disagreed with Freud's assessment. James, author of "The Varieties of Religious Experience," wrote that "we and God have business with each other." But their influence began to gather strong support only in the 1960s, when the pendulum began to swing away from the rational, scientific, objective approach that had been steering the mental health professions. It's still not unheard of for a therapist to tell a religious person: "when you're in therapy you won't need to talk about God anymore."

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 often 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.

Despite occasional abuses, social workers 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. Not long ago, she was asked to speak at a meeting of the Sufi Psychological Association.

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