Secular Bias in Psychotherapy

Article from "Frontiers in Mental Health"

By Nina Silander, Psy.D., OTI Faculty

The following article appears in the first issue of “Frontiers in Mental Health,” journal of the Open Therapy Institute. Download the full issue here.

The United States is a religiously diverse nation. Yet, compared to the average American, mental health professionals are much less religious than most patients (Shafranske & Cummings, 2013). So unsurprisingly, many therapists are uneasy about discussing matters of faith in therapy, and often they’re ill-equipped to manage issues at the intersection of psychology and spirituality. Fortunately, some scholars have made valuable efforts to address these gaps (e.g., Cook, 2020; Vieten et al., 2013). What follows is a preliminary review of secular bias specifically in mental health professions, a discussion of how religion benefits well-being, and some suggested solutions.

Secular Bias

Historically, professional psychology has been antagonistic towards religion. This is in part due to secular, materialist roots of the field and its aspirations to be an exclusively scientific discipline. In the provision of clinical service, the field also shifted what was once the domain of the clergy—nurturing spiritual and interpersonal health—into a nonreligious context. Most famously, Freud viewed religion as an “infantile neurosis,” likened to wishful thinking and in need of a cure. The behaviorist, Skinner, meanwhile, rejected notions of the “soul” and religion as “pre-scientific.” Many therapists continue to regard religion as primitive and superstitious. And despite regarding religiosity as a facet of currently esteemed multiculturalism, religious practices and experiences are easily viewed as pathological.

Unfortunately, the antagonism towards religion means that psychology, like other domains of academia, often:

• treats all religions as if they’re the same;

• overlooks the extent to which many renowned scientists throughout history held deep religious convictions (e.g., Blaise Pascal, Isaac Newton, and John Dalton);

• negates the limits of science (i.e., is unable to make claims about morality and meaning); and

• leaves little room for the ways in which science and religion may actually complement one another.

These problems are subsequently compounded by the opposition in academia against Christianity in particular, on the basis that it is a white supremacist, patriarchal, and oppressive religion. Ironically, Christianity (and other Abrahamic religions) is not originally Western or Anglo, and Western Christians are dramatically outnumbered by Christians in other parts of the world. Nonetheless, this antagonism towards Christianity further limits any opportunity for discussion about religion’s centrality to the cultural identity of many therapy clients and its associated health benefits.

The Benefits of Faith

Intrapersonal Benefits

Religious and spiritual beliefs and practices typically provide a foundation for personal growth and development. An orientation towards transcendental ideals and divinely informed worldviews allows many to live beyond material preoccupations and hedonistic impulses. Themes related to self-sacrifice and perseverance promote resilience in the face of adversity, and the hope for eternal life can serve as a powerful bulwark against nihilism and its destructive logical consequences. Horatio Spafford, upon losing his four daughters during an ocean voyage in 1873, demonstrated this by authoring the profound hymn, “It Is Well With My Soul.”

Research confirms much of what we intuitively know about the individual-level effects of religion/spirituality. Religiously affiliated and practicing people experience lower rates of psychiatric illness, substance use, and chronic illness, as well as improved marital satisfaction and increased longevity (Chida et al., 2009; Ofstedal et al., 2019). Additionally, the more active one is within a religious community, the clearer these individual-level health benefits appear to be (Nicholson et al., 2010). The precise relationship between religiosity and these outcomes is complex, given interacting social, physiological, and psychological factors (Oman & Thoresen, 2002).

Interpersonal and Communal Benefits

Participation in a religious community offers the support of a social network (a “spiritual family”), often transcending immediate geographic communities and even having international reach (e.g., the Jewish diaspora). The religious community also strengthens the building blocks of society more broadly in supporting marriages and families by bolstering committed relationships. In turn, this fosters healthy homelives for children’s development and nurturing quality relationships, fortifying them against stressors that strain familial bonds (Dollahite & Thatcher, 2005).

Religion also offers communities social cohesion (i.e., shared values, aspirations, and lifestyles) and reciprocal investment. Religious communities have long provided support for the widowed, orphaned, financially destitute, and infirm, influencing the development of modern-day health and social services. The role of religion at the communal level can also promote a balanced civic-mindedness, in which overarching, transcendental ideals may limit the effects of chronic stress (Ford et al., 2023), as well as the susceptibility of democracy to become tyrannical.

Religion in Therapy

As with difficulties in navigating socio-political values in therapy, clients may also be reluctant to discuss religious beliefs, particularly when they perceive their therapists as having unsupportive beliefs or lacking cultural humility (Judd, 2019). Sadly, these concerns are often reasonable, as many therapists are uncomfortable discussing religion in therapy and may pathologize certain religious beliefs and practices (Vieten et al., 2013). This can unfortunately result in missed opportunities to truly understand a client, leverage protective factors for their well-being, and promote the development of meaningful and long-lasting relationships within a client’s community. Practically, it can undermine the therapeutic relationship and lead to the premature termination of treatment.

Aside from practicing with a religious framework, therapists may also feel very limited in terms of being able to address matters of morality, which are inextricably linked to psychological well-being and inherent features of religious belief and practice. Therapists are thus caught in the strictures of affirmation and unconditional positive regard and unable to address needs related to character and moral development. As a result, some therapists could risk superficializing therapy and perpetuate a loss of meaning and responsibility amongst clients (i.e., “Do whatever makes you happy.”). People typically benefit from prioritizing (long-term) purpose ahead of (short-term) gratification.

To remedy these concerns, Vieten et al. (2013) have developed pertinent clinical competency guidelines for spiritual/religious diversity. Attending to these, as well as models of cultural humility and learning religiously-based interventions, can promote therapists’ ability to effectively respond to and engage with clients’ religiosity. Some have advanced certain evidence-based therapy approaches effectively adapted for the religious/spiritual (e.g., Koenig et al., 2015), and therapeutic interventions have been developed specifically for faith-based individuals, such as the use of the “God image” in therapy (Olson et al., 2016). Ultimately, the recognition of religiosity/spirituality as a fundamental component of cultural competency can significantly improve the practice of psychotherapy.

Conclusion

While religious/spiritual topics clearly aren’t always present in professional psychotherapy, they’re more relevant than many therapists assume. With professional humility, intellectual curiosity, self-study, and consultation, therapists can explore ways of leveraging the advantages of religiosity to the benefit of their patients—in conjunction with other therapeutic interventions. This will be to the benefit of religious clients, increase trust in the profession, and improve therapeutic outcomes.

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References

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