When am I talking about Faith?

An old supervisor of mine had a coffee mug that always made me chuckle. Depicted was a cartoonish Sigmund Freud, coffee mug in hand, next to the words "Freudian Slip: When you say one thing but mean your mother." Of course, the joke here touches an age-old truth about psychotherapy.

Sessions are not always as they seem. We talk about things when we don't talk about them. There's a list of subjects, encapsulated in a half-serious mythology about psychotherapy, detected below the surface of a conversation. Your mother. Your father. Sex. Trauma. Therapists of all stripes do well to attend to the ways these matters seep through the subtext.

But another subject joins the list. Researcher (and past OLOGY guest) Dr. Kenneth Pargament has defined spirituality thus: A Search for the Sacred. The simple turn of phrase captures something large: Ultimacy. It is common for humans to understand themselves in the reflection of something transcending, be it a religious faith, a philosophy, or some theory of everything.

More and more, cognitive scientists conclude spirituality, thus defined, is innate to humans. Of course, matters of faith, spirituality, and religion prove slippery when social scientists try and measure them. But, together, they form an important piece of multiculturalism. So, clinicians should be attentive to another adage. Faith in therapy is one of those things we talk about even when we do not talk about it. How do we attend to it? As clinicians, how do we know when we are talking about faith in a session? I advise clinicians to do the following:

• Listen for Oughts: Conversations betray moral commitments all the time. I ought to do this. I feel this way but I shouldn't. I ought not to live this way anymore. Often, these reflect one's spiritual and religious makeup.
• Listen for Ologies: This one is a bit more convoluted, and it perhaps requires a little training in theology. Several different subfields, particularly within Judeo-Christian theologies, illuminate the relationship between people, God, and all things spiritual. Here's a few of them.
  • Ecclesiology - Study applied to the structure of a religious community.What significance does community, tradition, or religious gathering play in my client's life?
  • Soteriology - Study applied to doctrines of salvation.What does my client believe will deliver him or her from harm, ruin, loss, or sin?
  • Anthropology - Study applied to human characteristics. What does my client believe about the nature of humanity?What is its purpose?
  • Eschatology - Study applied to concerns about human ultimacy and destiny. What does my client believe about the afterlife or humanity's ultimate destiny? How does that inform the way he or she lives life?
• Listen for Awe: Moments of transcendence pepper life. Ineffable longings, sensed connections with things bigger, or out-of-body experiences are just examples. Any time these come up in therapy, faith and spirituality are not far behind.

Therapy touches on these all the time in my practice. This, too, is regardless of a client's professed faith or areligious attitudes. With a developed ear, an effective clinician can detect when such concerns are at play and thus respond to them therapeutically. We're talking about faith even when we aren't talking about it.