Another Step Towards Integration: Psychoanalysis and Religion

Although early psychoanalytic thinking suggested that religiosity is an illusion and a defense against the unknown, a way to repress unbearable instincts, certain psychoanalytic schools of thought, such as object psychology and self-psychology, currently advocate that it is within the context of a loving relationship that people grow (Rizzuto, 1996; Kahn, 1997). This paves the way for religious people’s needs to be viewed similarly, but which extends personal relationship to include the universe and a loving God who brought creation into being because he seeks its companionship (Strawn, 2007). Ironically, psychoanalysis’s initial dismissal of the benefit of engaging with healthy theistic accounts may have inadvertently fuelled this debate rather than eradicated it, possibly igniting a basic psychoanalytic process of the reappearance of the repressed (Hoffman, 2010).

A central active component of dynamic psychotherapy is exploring the patient– therapist relationship (transference work). Notwithstanding this, there are conflicting findings about who benefits from these interventions and under what circumstances (Hoglend, 2014). Several studies have reported that the source of therapists’ reactions can be a mix of client traits and therapist tendencies (Holmqvist, 2000; Betan, Heim, Conklin & Westen, 2005). This can influence how attuned therapists are

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to clients’ needs and how skilful they are at delivering their interventions, which may be more hostile and controlling, if they are disengaged (Henry, Schacht & Strupp, 1990) and can predict alliance and outcome (Hayes, Gelso & Hummel, 2011). This therapy transference effect can also be seen in non-dynamic therapies and, therefore, appears to have implications for therapy regardless of orientation (Høglend, 2014; Gelso & Bhatia, 2012).

In a recent quantitative study, investigating therapists’ self-reported disengaged feelings, while working specifically with the transference, Dahl, Hoglend, Ulberg, Amlo, Gabbard, Høglend, Perry & Christoph (2016) found that therapists’ disengaged feelings can negatively impact on the therapeutic process, over the long-term, even in small amounts. This was dependent on the quality of patients’ object relations, where a negative relationship increased significantly with patients who had reduced quality of object relations. The researchers randomly allocated one hundred psychotherapy patients for depression, anxiety and personality disorders, into two groups, one with transference work and one without. Patients quality of object relations was assessed before the therapy and pre-, mid- and post-treatment (at one and three years) interview and self-reports were used to measure outcomes. Key conclusions drawn by the researchers were that therapists’ internal thoughts and emotional responses to their patients (countertransference) appears to significantly affect both the psychotherapeutic treatment process and outcome. To address this, in supervision, the researchers advise that therapists need to acknowledge and understand their attitudes and emotions so that they can constructively make use of their countertransference, to learn more about the interpersonal process between themselves and their client.

Dahl et al’s analysis was based on therapists’ conscious feelings from seven therapists, which is not a representative sample and studying unconscious emotions was, also not possible. However, the researchers report strong overlapping associations between self-report, observer and clinical measures which suggests an inherent robustness to the study. Further, therapists’ disengaged feelings and the effects of this in the long-term, have not yet been examined empirically. The study’s findings that disengaged therapists who feel bored, tired or distant can point to a weak emotional connection between therapist and client and lead to a negative therapeutic process, is, therefore, important. The results convincingly reiterate therapists’ obligation to develop reflexivity in the context of their psychotherapeutic work.

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Some religions, such as Islam, may not accept psychoanalytic approaches (Banawi & Stockton, 1993), as they tend to point inward and explore intrapsychic conflicts, whereas Muslims prefer to look outward and ground their identity in religious teachings and community actualization (Hodge & Nadir, 2008). For clients from other faiths, changes to the concept of illusion, constructivism and narrative theory, may open the dialogue between the psychodynamic modality and their religious beliefs (Sorenson, 1990). For example, Winnicott saw illusion as a necessary developmental process moving the person toward reality, which could include religious experience. Many of his ideas arose out of early Christian teaching which emphasised God’s love; and have been used by psychoanalytic inter-subjectivist theorists like Benjamin (Strawn, 2007). In particular his idea that the early relationship between infant and Mother/caretaker where the Mother must withstand attacks from the infant in order for the infant to accept her agency as different to the infant’s, mirrors the therapeutic relationship and therapists’ (Christlike) forbearance of transferential attacks from their clients, and echoes Winnicott’s Christian background (Hoffman,2010). Perhaps the “attacks” on religion by many psychological practitioners could also be understood in this light, that in order for an object (in this case religion) to be valid it must first be eradicated?

Secondly, the emphasis modern psychodynamic approaches place on listening to the meaning and structure of the client’s narrative and not only the content is the same method theologians have used to understand biblical texts for many years (Watts, 2012). Further, because psychodynamic thinking has moved towards an inter- relational approach where the client’s problem is not solely located within themselves but that it is in the interaction with the therapist that their story is re-constructed, a social constructionist epistemology would say that the therapist cannot look for an objective truth with regards to the client’s problem, but can only hold their subjective perspective, which is one of many possible perspectives. This would undermine therapists’ reasons for being sceptical of people with religious beliefs. It is, therefore, important for therapists to keep in mind that just as constructivism proposes that there is no end to knowing something, there is also more to religion than can ever be known and to be careful of being reductionist with respect to religion (Watts, 2012).

Hegel, a philosopher, who also was a source of inspiration for Benjamin’s thinking, spoke about immanence and how God is divinely human and can be seen in the face of one’s neighbour, as did Martin Buber who extended this idea to the divine “Thou” only being accessible in dialogue with another person (Hoffman, 2010). Strawn

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(2007) concurs that God’s grace is constantly at work in and through His creation, and, therefore, Christianity, in particular, could be viewed as a type of “embodied spirituality” where humans are not made up of a physical body which is separate from an immortal soul but that their sense of who they are springs up from an understanding of how God views them which leads to being wholly embedded people in the world. Psychodynamic mechanisms like transference, internalization and grief are placed within humans by God and, as such, can be seen as spiritual things, as opposed to human ones, which can be usefully worked with psycho-dynamically or spiritually to bring about psychological and spiritual change.

Lovinger (1979) provides some informative insights for working with maladaptive religious resistances which can be difficult to unlock. For religious clients troubled about doubting their beliefs, for example, it is possible to point out that doubt is necessary in order to have faith and make the interpretation, “that it is more important to doubt what is false than believe what is true” (pg. 420). Study and thought are inferred rather than undiscerning belief. Thus, the therapist aims to separate the problem of belief from doubt, and reconceptualise it as reality checking, since doubt can be a necessary survival function for avoiding certain dangers in life. In this way, therapists’ interventions can be fruitfully channelled towards understanding what the religious issue means to the client and trying to provide a corrective religious perspective. The therapeutic focus is to assist the client in looking beyond their religious beliefs to the hurts, needs, angers, impulses, thoughts and feelings that have emerged from the client’s relationships with important people in their life. However, Lovinger (1979) advises that authentic religious attitudes that are not defensive in nature, should not be an issue in therapy.

The question therefore arises, can belief in God be simultaneously a social construction, as well as, an experience of God? From a Christian standpoint, Watts (2012) suggests that there is no reason why these two positions cannot be complementary because from a theological perspective there is no reason why God cannot work through psychosocial processes and, also, no reason why the human sciences should lay claim to holding the only way of interpreting religious beliefs and practices. The question remains, is it possible for psychology to embrace a theistic narrative which has survived destruction and been transformed by it?

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