Faith and therapy: can I talk to my therapist about God?

“I don’t know whether this even belongs here. Since my mother died I haven’t been able to pray. Every evening I try, and every evening I end up sitting in front of nothing. But that’s probably not a subject for therapy, is it?”

And another person, in another room, with almost the opposite worry: “Before we start, I’d like to clear something up. I’m not religious, and I wouldn’t want anyone telling me at the end that what I’m missing is spirituality.”

The two sentences sound as though they come from opposite banks, yet they carry the same fear. The first person is afraid that their faith will be surplus to requirements in the therapy room, perhaps even something to be explained away. The second is afraid that their lack of faith will be. What both really fear is the same thing: that the therapist will have a plan of their own about God, and that they will not fit into it.

This post is an answer to both. I would like to explain why faith and non-belief both belong in therapy, what the research says about faith as a support and as a burden, what a therapist does with it and what they must not do, and where therapy is not the right address.

The short answer: yes, you can

You can talk to a therapist about God. You can equally talk about not believing, about no longer believing, or about not knowing. Everything that shapes your life belongs in therapy, and for many people their relationship to faith is one of its load-bearing walls: it determines how they understand suffering, guilt, forgiveness, death and what a good life is. For such a person, a conversation about distress that went round that wall would be a conversation about half the house.

The reverse holds too. If faith plays no part in your life, there is no need to go looking for it in the conversation. Therapy without a word about spirituality is not incomplete therapy. What spirituality in therapy is, and how broadly the profession understands it, is described briefly in the knowledge base; here I am mainly interested in what it means for you, sitting in the chair and weighing up whether to raise the subject at all.

Where the awkwardness comes from

The awkwardness has a history. Psychotherapy and religion long regarded each other with suspicion. In 1927, in The Future of an Illusion, Sigmund Freud described religion as an illusion springing from a childlike need for protection, and that view marked the profession for decades. On the other side, religious communities often saw psychology as a rival that renames sin as a symptom. Someone who grew up between those two messages has good reason to hesitate at the door of the therapy room.

Research shows, however, that people want this conversation more often than therapists assume. In 2001 Elizabeth Rose and two colleagues asked clients of counselling services whether they would like to discuss religious and spiritual matters in their sessions. The majority said yes. The wish is there, then; what is often missing is a sign that the subject is welcome.

The sheer volume of research also shows that this is not a marginal topic. When Gene Ano and Erin Vasconcelles prepared a meta-analysis in 2005 on how religious coping with stress is related to psychological wellbeing, they were able to include 49 studies. Their result is also the shortest summary of the whole field: faith can help people in distress, and it can deepen their distress. It depends on the role it plays.

Faith as a resource

The American psychologist Kenneth Pargament spent several decades studying what people do with their faith when things are hard. He was not interested in whether someone believes, but in how they lean on that belief. He described a range of ways he called positive religious coping: seeking support from God, the sense that you are not alone in what is hard, understanding an event within a wider frame, the support of a community, forgiveness.

In Ano and Vasconcelles’s meta-analysis, these ways of coping were associated with better psychological adjustment to stress, for example with more personal growth following a hard experience. The reasons are not mysterious. Faith can give meaning to an event that has none in itself. Rituals give grief a shape and a time, which shows especially around a death. Community means people who come without having to be called. And for many, prayer is the only moment in the day when nothing has to be proved to anyone.

If faith is that kind of resource for you, a therapist will not go round it. They will ask what helps you, and the answer “prayer” or “Sunday Mass” is just as valid as “running” or “talking to my sister”. A resource that holds is part of the solution, not an obstacle on the way to it.

Faith as a burden

The other half of Pargament’s work is less well known and perhaps more important for therapy. He also described negative religious coping, which today is more often called religious or spiritual struggle: the conviction that God is punishing you, the feeling that he has abandoned you, anger at him, conflict with your community, doubt you are not allowed to voice. In the meta-analysis mentioned above, these were associated with more anxiety and depression. In a 2001 study of elderly patients, Pargament and colleagues even found that those who, in their illness, felt that God had abandoned or was punishing them were at greater risk of death over the following two years.

In 2014 Julie Exline and colleagues sorted such struggles into six areas: struggle with God, struggle with evil, conflicts with people and community, moral struggles, doubt and the question of meaning. The list is useful because it shows that a “crisis of faith” is not one thing. One person does not doubt God but can no longer walk into the church where someone humiliated them. Another has no difficulty with the community but is eaten away by the feeling of never being good enough.

Guilt has a place of its own. Faith can give guilt a way forward: acknowledgement, repair, forgiveness. But it can also lock it into a loop in which no confession brings peace. I described the difference between guilt that mends something and guilt that only corrodes in Healthy guilt and toxic guilt: how to tell them apart.

It is important to add that religious struggle is not a sign of weak faith, nor a sign that faith is harmful. Pargament stressed that such struggles can also be a crossroads from which a person leaves with a more mature relationship to faith, or without faith but more at peace. It is harder when someone is alone with the struggle and may not speak of it either in the community or at home. When doubt ends in leaving, the loss of people and rituals comes with it; that is the subject of Losing your faith, or the community that used to hold you.

What a therapist does with this, and what they do not

A therapist is not a priest, and not an opponent of priests. It is not their job to judge whether God exists, which reading of a sacred text is correct, or whether you should stay in your community. Their job is to understand what faith or non-belief means in your life: what it gives you, what it takes from you, who you got it from and what has happened to it.

From this follows a rule that applies in both directions. A therapist does not convert you. Not towards faith if you have none, and not away from it if you have. They do not hint that prayer would help you, and they do not hint that your faith is a defence you ought to outgrow. Imposing one’s own world view is among the things described in What a therapist must not do: boundaries, ethics and when to end the relationship at once.

A short exchange shows how this sounds in practice (composed, not a real person):

“Before I start: are you religious?”
“I can answer that. But first I’m curious what my answer would tell you.”
“If you are, I’m afraid you’ll try to persuade me to go back. If you aren’t, I’m afraid the whole thing will seem childish to you.”
“So you’re afraid that either way I’ll have a plan for you. I haven’t. I’m interested in what happened to your faith and how you are living with that.”

Asking whether your therapist is religious is entirely fair. Therapists answer it differently: some say, others prefer first to explore what the question means. Either can be fine. What is not fine is coming away from the answer with the feeling that you have to defend what you believe. How to recognise a therapist with whom you do not have to is covered in How to choose a therapist who is right for you.

Research does not suggest that therapy for religious people has to be a different kind of therapy. In a 2018 meta-analysis, Laura Captari and colleagues compared standard therapies with ones adapted to the client’s religion or spirituality. The adapted ones were at least as effective for psychological difficulties and somewhat better for spiritual wellbeing. The message is simple: taking account of what a person believes does therapy no harm, and may do it good.

If you are not religious

Everything above applies in mirror image. Non-belief is not an emptiness to be filled, and it is not a symptom. A person without faith also has answers to the questions of what a good life is, what they owe others and how to live with impermanence; they have simply assembled them from other sources. A therapist who saw a deficiency in that would be making the same mistake as one who sees faith as a crutch.

Non-religious people, too, sometimes have unfinished business with religion. Many grew up in a religious home and left the faith behind, but not the sense of guilt, the image of a stern gaze from above, or the tension with parents asking when the christening will be. These are not religious questions in the narrow sense, but they are questions in which religion is part of the story. They belong in therapy wherever you stand today.

And questions of meaning, death and freedom are the property of neither side. How they appear when they overwhelm a person is described in Existential crisis: when you ask yourself what it is all for.

Faith in the family story

A relationship to faith rarely arises in one person alone. It is inherited, often along with everything that came with it: the grandmother who prayed every evening and with whom it was safe; the father who used God as a threat; the grandfather who stopped going to church after the war and never spoke of it; the mixed marriage because of which two branches of the family did not sit at the same table for twenty years. Your faith or non-belief is often also an answer to one of these people.

In 2000, in the Journal of Marital and Family Therapy, Marsha Wiggins Frame described the spiritual genogram: a family tree in which, alongside births and marriages, you draw in denominations, conversions, departures, quarrels over religion, and the people who were the bearers of faith in the family or of rebellion against it. The aim is not to establish who was right, but to see what was put into your hands before you were able to choose.

In work with the family story, such traces often surface by themselves. I described what otherwise happens in a longer genogram session in A Look into the Past: what happens in a 90-minute genogram session.

An exercise: my relationship to faith on one page

Before you talk about this with anyone, it helps to know where you stand yourself. The exercise is the same for believers and non-believers. It takes twenty minutes.

1. Write down what you were given at home. Three to five sentences about how faith was talked about in your family. Who believed, who did not, what was passed over in silence.
2. Write down where you are today. No labels. Not “religious” or “non-religious”, but in your own words: what you believe, what you doubt, what you do not know.
3. Make two columns: what this gives me and what this costs me. It applies to non-belief too. Perhaps it gives you freedom and costs you peace at Sunday lunch. Perhaps faith gives you support and costs you the feeling that you are never enough.
4. Find the sentence you tell nobody. “I am angry with God.” “I miss Mass, even though I don’t believe.” “I’m afraid my mother is right.” Write it down. You need not show it to anyone.
5. Decide whom you could tell one part of this. A friend, a priest, a therapist. Not all of it; one sentence.

The fourth step is usually the hardest and the most useful. A sentence you are not allowed to say takes up more room than a sentence that has been written down once.

Where therapy is not the right address

So far I have argued that faith belongs in therapy. It is only fair to say where that does not hold.

A therapist does not answer theological questions. Whether something is a sin, what your tradition teaches about divorce, how to pray when you cannot: these are questions for a priest, a spiritual director or another person you trust within your community. A therapist can help you understand why the question grips you so tightly, but does not have the answer and must not act as though they do.

Therapy does not replace community and ritual. A believer will not find in therapy what worship and fellowship give them. That is not its task. Many people have both, a therapist and a spiritual director, and one does not exclude the other.

Some distress with religious content is a health matter first. Intrusive blasphemous thoughts that torment you, and that you try to cancel out with rituals or repeated prayers, can be a form of obsessive-compulsive disorder known as scrupulosity. Voices, a sense of special mission alongside sleeplessness, deep depression with the conviction that you are damned: in these cases the first step is your GP or a psychiatrist. I do not make diagnoses or prescribe medication, but I can help you recognise when it is time for that step. If you are having thoughts of suicide, in Slovenia call the Samarijan confidential helpline on 116 123 (24 hours), the Klic v duševni stiski helpline on 01 520 99 00 (7 pm to 7 am), or 112.

Sometimes faith is a way of avoiding something. In the 1980s the psychologist John Welwood coined the term spiritual bypassing for this: using spirituality so as not to have to feel anger, grief or hurt. “It is all God’s will” can be deep trust, but it can also be a lid. The same holds the other way: “all this is just psychology” can also be a lid over questions a person does not want to open. A good conversation notices both.

How to raise it

The simplest way is to say it at the start, in one sentence. “My faith matters to me and I’d like you to know that.” “I’m not religious and I wouldn’t want that treated as a problem.” “I have a complicated relationship with faith and I don’t yet know whether I want to talk about it.” Any of these is enough. The therapist’s response will tell you a great deal: whether they ask more with interest, close the subject quickly, or start explaining their own views. What else happens at the beginning is described in What a first session with a psychotherapist is like — no mysteries.

Since the question is an obvious one to put to me, I will answer it here. I am a marriage and family therapist in training under supervision, and I am training at the Franciscan Family Institute in Ljubljana. The name of the institute does not mean a session is a catechism class. We talk about faith if you bring it, and as much as you wish. If you are a believer, I will not treat that as something that needs explaining. If you are not, I will not steer you anywhere. In both cases I am interested in the same thing: how you are. Sessions are held in person in Ljubljana, and I also work with English-speaking clients.

What to remember

• You can talk to a therapist about God, doubt and non-belief; everything that shapes your life belongs in therapy.
• Research shows two sides: faith can be a strong source of support, while religious struggles (feeling punished or abandoned, unspoken doubt) are linked with more distress.
• A therapist does not convert you in either direction and does not rule on theological questions; they are interested in what faith or non-belief means for you.
• Non-belief is not a deficit. A non-religious person may still have unfinished business with the religion of their childhood, and that belongs in the conversation.
• For questions of doctrine the right address is a spiritual director; for intrusive thoughts, voices or severe depression, a doctor. The doors do not exclude one another.