SPIRITUALITY AND PSYCHOTHERAPY: THE HISTORICAL CONTEXT, E Kurtz

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Content: Kurtz, E. (1998). Spirituality and psychotherapy: The historical context. SPIRITUALITY AND PSYCHOTHERAPY: THE HISTORICAL CONTEXT Ernest Kurtz Some ninety years ago, at the time of the birth of modern psychotherapy in the United States as marked by Sigmund Freud's visit to Clark University, the philosopher Josiah Royce warned against "confusing theology with therapy." Royce observed that much of the American debate over psychotherapy seemed to establish the health of the individual as the criterion of philosophical (and, by implication, theological) truth. Replying to that claim, Royce pointed out that "Whoever, in his own mind, makes the whole great world center about the fact that he, just this private individual, once was ill and now is well, is still a patient." (Holifield, 1983, p. 209, quoting Royce, 1909). But "patient" is a therapeutic term. Might Royce with equal justice have observed that "Whoever, in her own mind, makes the whole world center about the fact that she, just this private individual, once sinned but is now saved, is still far from the kingdom of heaven"? With what other variations of vocabulary might we conjure in this context? Whatever the vocabulary used, any discussion of the relationship between psychotherapy and spirituality necessarily takes place within the larger context of the relationship between science and religion. That relationship has often been less than happy. Ian Barbour's Issues in Science and Religion (1966) and Philip Rieff's The Triumph of the Therapeutic (1966) remain useful summaries. Yet even this generalization will draw disagreement, for spirituality and psychotherapy are two terms shrouded in diverse denotations and confusing connotations. 1
According to usage within the American Psychological Association, the term psychotherapy refers to a young science, which claims to have some qualities of an art, that originated with Sigmund Freud and "the discovery of the unconscious" (Freedheim, 1992; Shafranske, 1996). The history of psychotherapy, then, is NOT the story of "the insane" or their treatment. That is a different history. In a pre-DSM-IV vocabulary, our concern here is the story of neurotics rather than psychotics. As understood in what follows, the goal of psychotherapy is the alleviation of mental and emotional distress that may have biological referents but the sources of which are thought to be in some way in a person's relationships, past or present, with other persons. The method of psychotherapy is a relationship with some other person or persons, which relationship in some way changes the style if not the nature of other relationships. In an age of biological psychiatry and chemical comforting, this description may seem naive. But the present age's discoveries and enthusiasms will also be integrated into some larger understanding, and psychotherapy as portrayed above will remain. The term spirituality has its own fascinating history, but is generally currently employed to denote "certain positive inward qualities and perceptions" while avoiding implications of "narrow, dogmatic beliefs and obligatory religious observances" (Wulff, 1996, p. 47). Historians of the spiritual such as Edward Kinerk (1981), Philip Sheldrake (1991) and Bernard McGinn (1991), as well as theological commentators such as Don Browning (1980) and Donald Capps (1993) would agree. The goal of spirituality is the alleviation of mental, emotional, and/or spiritual distress thought to be at least in part caused by the lack of an appropriate relationship with ultimate reality, most often signaled by and reflected in inappropriate relationships with other people and things. Spirituality is less a method than an attitude, a posture of one's very being that allows seeing not different things but everything differently (Edwards, 1755; 2
Holifield, 1983, p. 88). Just as every psychotherapy applies some psychology, some understanding of how the human mind and emotions work, any spirituality is a lived theology, a posture that positions one within total reality. Neither psychologies nor theologies need be formalized, but everyone has them, however implicitly. And just as a genuine psychology can never be the possession of any "school," theology may be mediated by but it is never the captive of any religion. As the terms psychotherapy and spirituality are most often currently used, comparisons or contrasts of them involve a category error. Spirituality is best glimpsed in such synonyms as sanity, sanctity, serenity, health, wholeness, holiness: it is, simply, that for which all persons strive. Medicine and religion, therapies and ritual, each aim to ease access to that reality. Jerome Frank (1974) has defined the components of psychotherapy as including a socially sanctioned healer, a sufferer who seeks relief, and a circumscribed series of contacts that are designed to afford the sufferer relief, certainly characteristics better fitting religion and medicine than spirituality. But all these terms -- even spirituality and therapy -- today come freighted with such baggage that we best begin by leaving aside such specifications and opening our story with the observation that every human society has had its healers, those who alleviated distress by in some way "making whole" sufferers who sought them out. And in every society, there has been the realization that this making whole takes place both within the individual sufferer and in that person's relationships with the larger world. Early societies usually combined these facets in one healer. More recent cultures are pulled by opposing tendencies to integrate and to separate them, but both modern spiritualities and modern psychotherapies opt for integration, seeing the fullness of human be-ing as comprising the physical, the mental, the emotional, and the spiritual, though 3
one or another of those facets may be ignored for a time, and there seems an enduring tendency to fold one or another of those four into one of the others. Hoping to avoid argumentative caricatures, what follows will take both psychotherapy and spirituality in their ordinary expression. All practices have aberrations. Focusing on them results in little beyond polemic pain. Remaining with the real, then, we shall concentrate on the ideal for which it always strives rather than on the deviations into which it sometimes lapses. Within this understanding, I propose that the difference between psychotherapy and spirituality relevant to this piece is that which is more commonly construed as a reflection of the different approaches of science and religion. The former, the "scientific approach," relies on the human and especially the self, agreeing with Protagoras that "man is the measure of all things." It studies that which is verifiably perceivable by the five human senses. The latter approach, that of the religious or spiritual insight, insists on the reality and significance of some power outside of the self and in some way greater than the human individual and transcendent of ordinary sense experience. What follows is less a complete narrative of the relationship between these two realities than a series of glimpses at significant moments in that history. To attempt to tell of all the interactions would require too superficial treatment of each. Instead, then, I choose to examine in some depth a series of historical moments -- less "events" than broader happenings that are significant to how we view the relationship between psychotherapy and spirituality on the threshold of the third millennium of the common era. The earliest of these moments occurred before the birth of psychotherapy and so tell directly of events in the history of spirituality that bear on later understandings of the promise and perils of the human condition. The latter part of this essay covers roughly the past century and a half and treats directly of interactions between 4
representatives of the two traditions, spirituality and psychotherapy. 1. ANCIENT GREECE The earliest forms of what may be viewed as psychotherapy came in the garb of philosophy rather than that of medicine, although holistic assumptions blurred even that distinction (Boethius, 524; Nicholson, 1995). Within the history that most shaped the culture within which we live, the distinction that interests us first emerged with some explicitness in classical Greece, wherein was recognized a differentiation between mythological and rationalist explanations. Although this division was not precisely parallel to the later distinction between psychotherapy and spirituality, it was founded in a similar vision that there existed a basic difference between seeking help from beyond, outside the self, and insistence that the only reliance is on the human and especially the self. Dodds, who comments on this dawn of rationalism and the reaction against it after 432 B.C.E., adduces as evidence for his interpretation "the increased demand for magical healing which within a generation or two transformed Asclepias from a minor hero into a major god" (Dodds, 1951). Rather than explore diverse understandings of mythology and rationalism or the mental state of the Delphic Pythia, we gain a better sense of the concerns specific to psychotherapy and spirituality by looking to the answers offered in later Greek, Hellenistic, and Roman culture to the questions: "What is `the good life'? How is it attained and how destroyed?" Though answers varied, those who contemplated such queries offered at least implicit and often explicit listings of what came to be termed by both philosophers and theologians the virtues and vices: the habits of thinking and acting that make us who and what we are, some constructively, others destructively. Zeno's philosophy of Stoicism, which is among the earliest, set the pattern. Stoicism began as a radical criticism of conventional moral attitudes, insisting that the good for humans is not to 5
be found in the identification of happiness with worldly success. Strictly speaking, Zeno argued, only virtue and vice are good and bad: virtue (a wholesome state of mind) is always beneficial, and vice (an unwholesome state of mind) is always harmful. Everything else is indifferent for happiness, since wealth or health (for instance) can be used well or badly. Zeno and the other ancients virtually all included civic responsibility, a sense of obligation for the good order of one's society, among the most desirable good habits and practices. Beyond this quality but related to it, what were later termed "the cardinal virtues" of courage, justice, prudence, and moderation were commonly encouraged, though more consistently by the philosophers than by the devotees of the religions of the place and era (Colish, 1985; Inwood, 1985). How were these qualities and this information conveyed? By the presentation of models who were to be (or not to be) imitated, as the writings of Plutarch, both his Moralia and the Lives, reflect (Plutarch, c.100; c.101). Moderns term this mentoring, a word borrowed from the name of Mentor, the trusted tutor of Telemachus, Odysseus's son, in Greek mythology. The connection with our story is even clearer if we recall how the goddess Athena took on the appearance of Mentor in order to offer Telemachus not only guidance but "good words of comfort and courage" (Hamilton, 1969). Distant as this mythic episode may seem from later understandings of "the indwelling of the Spirit," the story does foreshadow what would become one interpretration, in the Christian context, of the practice of "spiritual direction," which becomes one root of what would still later be termed "psychotherapy." 2. EARLY CHRISTIAN MONASTICISM The advent of Christianity, however momentous in other ways, brought little change but considerable specification in these practices. Mentoring shifted from the political to the spiritual life, which became in the Christian vocabulary a facet of cura animarum -- "the care of souls." 6
Religion was enlisted in explicit support of the classic virtues, and a list of capital vices was set forth. Because distances of time and place tend to make the early Christian ascetics seem weird to modern understanding, the fountainhead role of these individuals in what will become both spirituality and psychotherapy justifies pausing to make them intelligible. The "Desert Fathers" (there were also "Desert Mothers": cf. Ward, 1987) took to the desert less as a form of escape from a world they deemed corrupt and corrupting than in search of a setting that would allow them to explore the nature of the human be-ing that their faith told them had been "redeemed." The desert became their laboratory for studying what it means to be human, thus merging therapeutic philosophy into a therapeutic theology. The wastelands of Egypt and the hillsides of Palestine may seem distant from our times and concerns, but these ancient teachers shaped themes that would be analyzed and reformulated through the centuries and into our own time (Brown, 1988; McGinn, 1991; Tugwell, 1986). Three practices, each in its own way significant to later psychotherapeutic thought, characterized this early Christian pursuit of spirituality: the imitatio that sought personal change and growth in a process of identification with outstanding exemplars of the qualities one sought to develop, the asceticism that reminded of the reality of divided human nature, and the practice of spiritual direction that is docility before a chosen mentor. Understanding these practices and their relationship to modern psychotherapy requires a grasp of the monastic age's understanding of the virtues and vices, the wholesome and unwholesome states of mind, the qualities deemed desirable or dangerous for living a truly human life. The philosophers had their lists and examples, as reflected in the complementary biographies presented by Plutarch, whose Parallel Lives afford a useful bridge to understanding the early Christian emphasis on imitatio: less "imitation" than an actual putting on of the habits 7
and postures and attitudes of those, pre-eminently Jesus of Nazareth himself, who were recognized as holy, sane, healthy in the fullest sense that others wanted to "be like" them. Sanctity, sanity, spirituality, serenity, is that which, when we see it, we want it -- we want to "be like that" (Brown, 1987). The Christian tradition from its beginning urged such modeling: "Learn of me, for I am meek and humble of heart" [Mt. 11:29]. The foundation of that facet of the Christian spiritual tradition that most closely resembles the later invention of psychotherapy, "spiritual direction," was laid by Anthanasius's "Life of Anthony" (List, 1930). Because spirituality is an experience, it is best studied in the lives of those who do experience it. This does not mean that "the saints" are perfect. Classic sanctity and sanity are instead rooted in awareness and conviction of one's own imperfection. This is, after all, the reason for spiritual direction: because of the many weakness of human nature, the ease with which it can deceive itself, even someone convinced of her own direct contact with God must submit that claim to the scrutiny of some other (Tugwell, 1985). All spiritualities offer both centering practices and mirroring practices. Among the former are not only prayer and meditation and chanting, but the asceticisms of self-denial, and it was on these practices that the Desert Monks concentrated. The mirroring practices of reading and telling and hearing the stories of the saints, begun by Anthanasius, also were developed in the practice of spiritual direction, of telling some other who had the qualities one wanted of one's efforts to attain them. In such "holy conversations," we find evidence of both the didactic instruction of practical suggestions and the offering of illustrations from one's own experience, usually in service to discerning between "good spirits" and "bad spirits" in categories not too unlike many differently named modern diagnoses (McGinn, 1991; Sellner, 1983; 1990). The idea of a personal guide or "director" meant simply someone already experienced in 8
what wished to attain, as the terms "venerable" or "elder" or "old one" convey. "Abba," in Greek geron, also implies a need for insight and discernment in the practice of "disclosure of thoughts" (Louf, 1982; Ware, 1986). The point here is twofold: first, the long-standing suspicion of self-instruction in the area of spirituality (or, later, psychotherapy, Freud's self-analysis being the only accepted exception); second, an awareness that one can learn from another's experience as well as one's own. Basic to all civilization is the realization that each one need not learn everything for himself: each generation builds on what those who went before discovered. Equally misunderstood by moderns is the practice of asceticism. Not only in Christianity but in all spiritualities of which we have records, asceticism is not world-rejecting but is seen within the metaphor of the discipline of training for participation in competitive sport and as a practice exercise of the kind of "detachment" better captured by the German Gelassenheit, which carries the connotation of letting go AND letting be. Over time, these practices produced more. As finally codified by Evagrius Ponticus near the end of the 4th century, the early Christian anchorites developed a catalog of logismos. Though often confused with "the capital sins" and indeed the basis for that later listing, the term logismos is better translated as "bad attitudes." These were the ways of thinking, the patterns of organizing experience, the postures of being, that experience taught these men and women were the key impediments to attaining the sanctity, the wholeness, that they sought (Tugwell, 1985). Any spirituality has, likely more explicitly than any psychotherapy, a catalog not so much of "do's and don't's" as of the ways of thinking that get one in trouble. A later popular vocabulary would label them "toxic." Rational-emotive therapists name them "irrational beliefs" and cognitive therapists term them "cognitive distortions." But however designated within the disciplines that would help us find wholeness, all these endeavors suggest that there are virtues 9
and vices, habits helpful to and practices harmful to one's deepest well-being. Among the "vices" listed by Evagrius were the later-named "capital sins," but it is important to note their meaning here, in the setting of their original monastic tradition. Reading Evagrius empathetically, the reader senses the presence of a wise, experienced, compassionate cognitivebehavioral therapist who happens to be also familiar with the depth psychologies. The problem, Evagrius took care to point out, lay not in "bad thoughts" but in a process of bad thinking that is really wrong vision -- seeing things from the perspective of our fears and fantasies (unrealities) rather than seeing things truly. Logismos involve choosing to see the bad - bad in the sense of "unreal," not fitting reality. Logismos are the arch-enemies of the soul, the demons from within that destroy proper perspective on the world and thus prevent us from concentrating on the actual reality of our life, leading us further and further from our actual condition, making us try to solve problems that have not yet arisen and need never arise. Of the eight logismos charted by Evagrius, four merit brief attention in our context. Avarice did not signify "materialism" as moderns think of it, but futile planning for an unreal future. He defines avarice not as pure material greed but as "the principle of thinking about what does not yet exist," a preoccupation with hopes and fears, with imaginary or future things . . . in more modern terms, with abstract numbers rather than with actually present persons and things. Envy stands at an opposite extreme from avarice: It involves obsession not with the future but with the past, a haunting remembrance of "the old days" as those "happy days" now gone and never to return. Evagrius expanded the Greek term lype, which signified distress over deprivation, to include a kind of depression, a cultivated sorrow. Much of the pain of spiritual suffering, he suggested, comes from wallowing in fantasies of things being other than how they are. 10
Anger came next, and by anger -- not ira but iracundia --Evagrius meant not the emotion but a clinging to its fervor, the resentment that refuses forgiveness. As an example, he offered the experience of obsession with someone who has wronged us, the situation of being "unable to think of anything else." Such fixations can ruin our health, even -- Evagrius warns -- give us nightmares. As always, the trouble comes from failing to see the real issue. Anger, which is inevitable, is not to be squandered by focusing attention on the wrongs of others; rather, it should be directed at our own faults, and especially at how we have wronged others, thus moving us to make amends, to right the scales of justice and so bring peace to the world of our relationships. After anger came the classic trap, the "noonday devil," acedia -- a kind of listlessness or boredom in which nothing engages interest or appeals. The translation of acedia truest to Evagrius' thought is self-pity, a far more accurate term than "laziness" or "sloth," for it conveys both the utter melancholy of this condition and the self-centeredness on which it is founded. Spirituality's understanding of "sin," then, began far from that reality's modern caricatures. In fact, it much more resembles the kinds of thinking-traps that many clients bring to the psychotherapist's office. And the ancient spiritual guide, like the modern psychotherapist, while not ignoring actions, saw them as far less significant than orientation -- the dispositions and postures, the patterns of thinking that bring harm. 3. FROM THE FALL OF ROME TO THE DAWN OF THE ENLIGHTENMENT Much of medieval life remains veiled by ignorance and stereotypes (Cantor, 1991). Such high points as the rediscovery of Greek medicine from Islamic sources and the spread of accurate anatomical knowledge in the universities, the Renaissance and the Reformation, the voyages to the Americas and trade with Asia and Africa, are less important to our story of the relationship 11
between psychotherapy and spirituality than are echoes of the themes already seen, echoes that bridge these insights into the modern age. From the early medieval period well into the nineteenth century, diverse kinds of individuals acted as local healers. The practices of medicine, spirituality, and psychology were intertwined by the naive holism of people who enjoyed firsthand familiarity with wild and domestic animals, with crops and seasons and all the vagaries of a nature they were certain was ordered despite all the chaos that confronted them. Images for the spiritual life, for human life, became standardized: the journey, warfare, a ladder (Miles, 1988). Some trends that took shape in earlier Christianity were reinforced by Islamic importations: the 14th century "letters of spiritual guidance" by Ibn `Abbad were popular, and the Sufi maqam offered a modernizing catalog of virtues on the way to becoming "stages" (Ibn `Abbad, 1332; Renard, 1996). The late 11th and early 12th centuries saw the appearance in Spain of Jewish contributors to the ongoing story of the healing of the mind and spirit. Bahya ben Joseph ibn Pakuda (c.1080) produced one of the most popular books of Jewish spiritual literature, Guidance to the Duties of the Heart, which combines a traditional theology with a moderate mysticism inspired by the teachings of the Muslim Sufi mystics. This work compares the commandments of the heart -- those relating to thoughts and sentiments -- with the commandments of the limbs, the Mosaic commandments enjoining or prohibiting certain actions, another evidence of the perdurance in variations of the holistic understanding of human being. For well over a thousand years, then, cura animarum -- the care of souls -- embraced the emotional, the mental, and the spiritual life of people, for rather than being differentiated, these were seen as aspects of one unified human life. But the practitioners of the cura animarum were not only, and in some locations were not mainly, authorities constituted by the Church. "Local 12
healers," people who were recognized as able to heal, to make whole, flourished. Some were mountebanks and some were quacks, but far more were sincere individuals who in one way or another had learned how to tap the natural healing powers of herbs and suggestions, various forms of exercise and persuasion (Frank, 1974). Most often, in the culture of the time, these people chose to operate within religious imagery if not under church auspices. In time, both the Reformation and the witchcraft craze, and even more the economic changes connected with both, undercut such practices, and the Renaissance gave way to the Age of Enlightenment. But it merits note, before leaving this 1200-year era, that near its end Robert Burton's Anatomy of Melancholy reproduced and reinforced Galen's distinction between "true afflictions of conscience and a melancholy that occurred when gross elements in the blood" malfunctioned, with recommendations for the treatment of both, separate, conditions (Burton, 1621). 4. THE ENLIGHTENMENT Studies of art and anatomy as well as of the Islamic preservation of and additions to Aristotle's science led to the Renaissance rediscovery of the differentiation among the unity of the physical, mental, emotional, and spiritual. This plus the rediscovery of classical alternatives to the Christian vision led eventually to the Reformation in religion and to the modern mode of thinking that arose in the Enlightenment era, which for our purposes we will date at roughly equivalent to the 18th century, more specifically from Bayle's Dictionary (1697) to Kant's Foundations (1797) or, in the American context, from the denouement of the Salem witch trials in 1692 to the dawning of the Second Great Awakening at Cane Ridge, Kentucky, in 1801 (May, 1976). Enlightenment insight expected an Age of Reason to replace the Age of Faith, but that 13
process proved slow and difficult, and many -- from mid-nineteenth century Romantics to latetwentieth century postmodernists -- questioned the expectation's validity (Berman, 1981). In an ironic twist, though its science displaced planet Earth from the center of the physical universe, Enlightenment psychology revived the Protagorean vision that placed human beings at the center of the moral universe. If this freed from faith, it did not liberate from gullibility. The twin development of science and secularization instead saw the emergence of "a company of scientific magicians who purveyed to the credulity of the eighteenth-century public" (Bromberg, 1975, p. 162). Anton Mesmer, who was in all innocence one of those "scientific magicians," was also the grandparent of modern psychotherapy. The Age of the Enlightenment was also the age of magnetism and electricity, and the concept of "force" began what becomes a regular appearance in discussions of psychotherapy, witness to a tacit assumption that some kind of superior force is required to overcome mental symptoms. Mesmer's "animal magnetism" fit well into the aspirations of the era (Fuller, 1982). Solving a spiritual problem through science was "quintessentially Victorian," and Mesmerism, especially as imported to the United States after his death, became "simply the first in a long line of attempts to heal the psychological problems, spiritual hunger, and moral confusion of the American unchurched" (Bromberg, 1975, pp. 163-164). The Romantic reaction against Enlightenment assumptions offered few real alternatives in the area of mental healing. In the United States, Emersonian Transcendentalism, the Fox sisters' spiritualism, the Oneida and other perfectionists, each demonstrated anew the quick path from mysticism to obscurantism, from a dollop of scientific insight to a flood of quack exploitation. Within professional medicine, George Miller Beard's neurasthenia and S. Weir Mitchell's rest cure reflected the gender assumptions of a population recently riven by a Civil War that had slain 14
or maimed so many of its young men just as a modern economy unfolded under the pressures of immigration, industrialization, and urbanization. Psychotherapy as we know it came to being in a world of confusing tumult -- a world convinced, with more validity than are some other ages, that it was undergoing change at an unprecedented rate (Douglas, 1977; Meyer, 1965). 5. THE UNITED STATES IN THE NINETEENTH CENTURY: Mesmerism was brought to the United States by Charles Poyen in 1836. Its major underlying tenet, the same as that of all the embryonic psychotherapies of the time, "was a belief in the accessibility and availability of the realm of the spirit in a nontraditional and experiential setting." Though left undefined, "spirit" tended to feature "a secular universalism and a valorization of self-expression that was rooted in the larger Romantic and CounterEnlightenment movements in Europe" (Cushman, 1992; Fuller, 1982). But there were differences in the American context, as subsequent history makes clear. Though pristine Puritanism soon deceased, the Evangelical impulse of the two Great Awakenings of the 1740s and the 1800s pulsed through American society throughout the nineteenth century and beyond (McLoughlin, 1978). In the United States more than in the northern Europe from which newly professionalizing Americans drew their modern identity, "the care and cure of souls" was a pastoral function, in colleges as well as in churches and congregations. Yet already, before the advent of psychotherapy, a process of change was underway (Bledstein, 1976). As summarized by Holifield (1983), what unfolded was a "story of changing attitudes toward the 'self' [that] proceeds from an ideal of self-denial to one of self-love, from self-love to selfculture, for self-culture to self-mastery, for self-mastery to self-realization within a trustworthy culture, and finally to a later form of self-realization counterposed against cultural mores and social institutions." The story emerged in stages, and any understanding of the healing of "self " 15
that is personality change and how this process came to be understood in American culture must begin here in the early 19th century, with Charles Grandison Finney and Horace Bushnell. Although carried on in theological terms, their differing visions encapsulate much later dialogue between psychotherapy and spirituality. "The outstanding revivalist in America for almost half a century," Finney propounded "New Measures" in his classic Revivals of Religion, especially his lecture on "How to Promote a Revival" (Finney, 1835; McLoughlin, 1968). Underlying Finney's vision was the Jacksonian Age's go-getting answer to the classic theological quandary over the relationship between divine sovereignty and human free will. The Great Awakening of the 1740s had shown that revivals, though the work of God, could be "called down." But those revivals, though sparked into flame by a traveling evangelist such as George Whitfield, were likely to catch fire only in tinder long prepared by the regular exertions of a believing parish minister and his flock (Heimert, 1966). Finney's conversions were "called down" differently. The gathering of strangers into groups far larger than any parish, the preparatory admonitions, the recital of vivid testimonies, the anxious bench for those wavering, the reaction to those first "struck down" by the Spirit: assuming that a person wanted to change, no more effective means of convincing them that they have been changed has yet been devised. Finney's ideas did not arise out of vacuum. Early nineteenth-century theology, which was for all purposes a practical psychology, followed the science of the time in abounding in "schemes of classification" and particularly in efforts to "classify the stages in the order of salvation" (Holifield, 1983, p. 127; Rosenberg, 1976). But there are different kinds of "stages." Horace Bushnell, pastor of the well-to-do North Congregational Church of Hartford, Connecticut, from 1833 to 1876, believed "Growth, not Conquest, the True Method of Christian Progress," as he titled an 1844 essay. Two years later he 16
began his "Discourse on Christian Nurture," in which he suggested that rather than expecting some dramatic conversion experience, a child of Christian parents should grow up not knowing himself as other than Christian. Education, not conversion, according to Bushnell, was the normal way of attaining change and wholeness (Bushnell, 1861; McLoughlin, 1968; Smith, 1965). We are still some way from today's "psychotherapy" and "spirituality." Yet if what has been characterized as the mid-nineteenth-century "spiritual emptiness, moral confusion, and a yearning for intense experience" issued in "a new type of religious or spiritual practice," then that "institution of popular, unchurched religious psychology" remains with us (Cushman, 1990; Fuller, 1989). Some may think its expressions confined to television preachers or the "self-help" sections of bookstores, but elements of this approach may also be found in many therapeutic and more traditional religious settings. Unsurprisingly, those who ignore this possibility seem to become the most inextricably entangled in it (MacIntyre, 1981; Mercadante, 1996; Meyer, 1965). This presents a difficulty for any effort to be judicious. The story of the relationship between psychotherapy and spirituality may easily be viewed as either tragedy or comedy, and it cannot be told without seeming the one or the other. For rarely in American history have psychotherapy and spirituality, in their interaction, been represented by the best in either's tradition or expression. No doubt due in part to the democratic style of American society, a kind of cultural Gresham's Law dictates that popularizations override careful analyses, with the result that both psychotherapy and spirituality know each other mainly by caricature. Although we are interested in neither tent-revival jerkings nor phrenology's racism, neither the panentheism of imported gurus nor the victimology encouraged by mail-order Doctors of Psychology, it is within the echoes of these excesses that we find the real story of psychotherapy and spirituality in the 17
United States, and so I ask readers of both camps to be patient with the elements of caricature that necessarily intrude into what follows. For "the institution of popular, unchurched religious psychology" did not stop with spiritualism and mesmerism. The line of faith healers and mind-cures that runs from hypnotism and spiritualistic seances through New Thought, the Theosophy of Madame Blavatsky and the Unity School of Lee's Summit, Missouri, reached a temporary culmination in Mary Baker Eddy and Christian Science (Braden, 1963). The mind-cure approach at that point diverged into two streams: those that clung to spirituality as their chief therapeutic tool (New Thought etc.) and those that sought to bond with the newly emerging medical science that was studying personality dissociation as a phenomenon indicative of the subconscious mind (Emmanuel Movement). Those engaged in these endeavors contested "whether faith cures and moral therapeutics of neurotics were the same or to be distinguished, but meanwhile both disciplines taught methods for attaining serenity and peace of mind; both charged themselves with the task of resolving basic concepts of psychotherapy with correlative ones from Christian and Jewish doctrine" (Bromberg, 1975; Meyer, 1965). But the story is even more complex, for the Emmanuel Movement, one grandparent of the self-help mutual-aid movement pioneered by Alcoholics Anonymous, had solid ties with the medical establishment of Boston and Harvard. Emmanuel has been styled "the first serious effort to transform the cure of souls in light of the new psychology," the core expression of "theology becomes therapy," but its form was uniquely shaped by the medical context of the turn-of-the-century northeastern United States (Holifield, 1983, p. 201). In late nineteenth-century Europe, Kraft-Ebbing, Nordau, and Lombroso were setting forth ominous visions of human nature -- of a dangerous self, sexual and aggressive. While 18
Americans still relied on George Miller Beard and S. Weir Mitchell, whose moral exhortation became the backbone of the first generation of explicitly medical and psychological rather than religious advice manuals, Sigmund Freud began by the end of the century to dominate the European scene (Cushman, 1992; Hale, 1976). From the perspective of the history of understandings of the meaning of "human," Freud less offered a new departure than he reflected a classical reaction against Romantic, nineteenth-century optimism. Despite his animus against all forms of religious belief, Freud's recognition and embrace of "human doubleness" fit well with classic spiritual insight, and "the discovery of the unconscious," if stripped of the hermeneutics of suspicion, cohered well albeit in different imagery with the logismos of the fourth-century desert monks as well as with traditional understandings of "demons" and even "original sin" (Balint, 1968; Dodds, 1951; Rieff, 1966). Carl Jung, enamored of a still more different imagery, would achieve that stripping, but his apparent identification of the unconscious with the divine presented a different pile of problems that, ironically, opened the door of the modern imagination to even greater Romanticisms (Greenwood, 1990; Noll, 1995; Rieff, 1966; Satinover, 1994). 6. THE UNITED STATES IN THE TWENTIETH CENTURY: In the United States, however, and especially in the neighborhood of Boston, the advent and popularity of Christian Science challenged and even frightened the medical profession, which found itself -- in this pre-Flexner era -- losing patients to a methodology that some found as effective while less painful and costly. This context lay behind the extension of the work with groups begun by Joseph Hershey Pratt for tuberculosis patients in 1905 to other homebound chronic sufferers, a project furthered by Richard Cabot and others of almost-as-awesome name at Massachusetts General Hospital. In the same year, two ministers at Boston's Emmanuel Church, 19
Samuel McComb and Ellwood Worcester, who had been trained in the Leipzig laboratories of Gustav Fechner, began a clinic in which they sought to blend pastoral counseling with the latest medical and psychological knowledge and techniques. Soon, not only Pratt and Cabot but psychiatrists Isador H. Coriat and James Jackson Putnam were cooperating with the Emmanuel Mission (Hale, 1971; Holifield, 1983; McCarthy, 1984). That cooperation began to sour in 1908 and was terminated in 1909, the year Sigmund Freud visited the United States to speak at Clark University. Freud's ideas were embraced with enthusiasm by a psychiatric profession uncertain of its identity at the dawn of its own professionalization. The acceptance of Freud, as the writings of Putnam make clear, was aided in no small degree by the threat posed by Christian Science and the frustration of the Bostonians' experience with the Emmanuel Mission (Hale, 1971; 1976). There was yet another ingredient in this early twentieth-century mix out of which psychotherapy as we know it develops. The Mental Hygiene Movement -- "the watershed of mental healing" -- took life from Clifford Beers's 1908 autobiography, The Mind that Found Itself, a book that led noted psychiatrist Adolf Meyer to comment: "It looks at last as if we have what we need . . . a man for a cause" (Beers, 1908; Bromberg, 1975; Dain, 1980). Preparing the way for all this and at times assisting it along was the psychology of William James, a Harvard professor who deeply respected the experience of "ordinary people," as his classic Talks to Teachers (1899) brilliantly attest. Philosopher as well as psychologist, James blended laboratory findings with common sense. His reliance on introspection and his respect for diverse and at times questionable manifestations of "the spiritual" rendered William James for many decades an unlikely avatar of "psychologist." James's clear identification with "the sick soul" and lightly veiled autobiographical references may indeed make him seem a forerunner of 20
late twentieth-century popular psychologies, as Donald Meyer accuses, or even the protoprogenitor of what has been termed "recovery porn" (Kurtz, 1996; Meyer, 1965). But there was more to the William James whose courage Freud admired and confessed to envying. James was a philosopher of the spirit attempting to revivify the classic virtues, not a panderer of therapies attempting to lure the masses into buying his books (Browning, 1980; Barzun, 1983; Zaleski, 1993-1994). The rediscovery by Platt and Worcester and others of the power of groups as settings wherein individuals may in some way be "made whole" fit well with the insights of the Progressive era of the first nineteen years of the American twentieth century. But it also reflected the religiospiritual focus on "gathered community" that has found so many expressions throughout history, from "chosen people," to ecclesia, to the development of cenobitic monasteries out of the desert anchorite experience, to the construction of the "city on a hill" that John Winthrop understood the Puritan adventure of colonizing New England to be, to the utopian communities and later communes that continually pop up on the American scene, although not in the decade of the 1920s. For both spirituality and psychotherapy followed the larger culture in losing sight of that communitarian vision in the decade that followed the blunting of Progressive insight in the aftermath of "The Great War." 7. THE TWENTIES TO THE FIFTIES In the 1920s, according to the familiar stereotype, the inhabitants of the United States passed through a prolonged adolescence, testing newly found freedoms in a context of mood-swings that ranged from carefree exuberance to disillusioned cynicism, but virtually always styled with selfconscious posturing (Leuchtenburg, 1958). Although a victorious power that had made the world "safe for democracy," America became isolationist, as signaled by the halt of immigration 21
by the Johnson Acts of 1921 and 1924. A buoyant consumer economy was maintained, for a time, by the continuing move from farms to cities and the new availability of consumer credit with which to purchase new "consumer durables" such as automobiles, refrigerators, radios and more that poured off factory assembly lines untroubled by a labor movement effectively squelched in the post-war Red Scare (Bernstein, 1966). As false for most Americans as were the stereotypes of Jazz Age flappers and wide stock ownership, that broader population also changed during this decade, largely as a result of the relentless drumbeat of new advertising techniques pioneered by Edward Bernays, who rarely let clients forget that he was a nephew of Sigmund Freud. If the elite embraced Freudian psychoanalysis or their understanding of it, which emphasized the evil of repression and the power of sex, the greater part of the population became laboratory specimens for the behaviorist manipulations of followers of John Broadus Watson (Baritz, 1960; Lears, 1994; Susman, 1984). To critics such as T.S. Eliot, what united both apparently contradictory psychologies -- psychoanalysis and behaviorism -- was their demeaning of human freedom and thus of human beings (Eliot, 1943). In a decade when eugenic thought was chic as well as prevalent and the concept of "lesser races" undergirded immigration "reform," few noticed that demeaning, except for the Blacks and Catholics and Jews thrust into that category, all of whom also just happened to adhere to religious visions that rejected such ideologies (Frazier, 1964; Cone, 1984; Broderick, 1963; Rosenberg, 1976). The self-conscious adulthood of 1920's adolescence also embraced disillusionment, often without much analysis of whether what was rejected was really illusion. Under the impact of the birth of Fundamentalist religion with the publication of The Fundamentals between 1905 and 1910, the Protestant churches, the usual vehicles of spirituality in the United States up to that 22
time, became mired in the politics of "The Fundamentalist Controversy" and increasingly irrelevant for a significant part of the American people (Furniss, 1954). The works of psychologist James Henry Leuba and others, meanwhile, more and more seemed less to explain religion than to explain religion away (Wulff, 1991, pp. 47ff). More significantly for the relationship between psychotherapy and spirituality, the 1920s gave a twist to the Progressive Age's faith in experts, who seemed to many progressively to become more dictators than helpers (Bledstein, 1976; Lubove, 1965). As cultural historian Christopher Lasch has detailed, the extension of psychology's focus from child guidance to child rearing devalued immigrant religious traditions and shifted the prestige of expert authority from the extended family to professionals, a doctrine assiduously spread through the public school system (Lasch, 1977). The Mental Hygiene movement, in summary, "applied the bourgeois values of quantification, objectification, and cleanliness to the realm of emotional and psychological complaints" (Cushman, 1995). The popular psychologies of the decade were hardly better. Followers of Dubois and Couй pursued their goals, convinced of the power of implanted ideas over the will (Couй, 1922). A decade supposedly ruled over by the contradictory insights of Watson's behaviorism and Freud's psychoanalysis actually found most citizens completing a change begun in the 1890s: from a valuing of character, the focus shifted to personality and eventually to the enthronement of celebrity personalities whose ability to sell products made them more and more a dominant force in American society (Lears, 1994; Susman, 1984). And what of spirituality? In the seminaries, the influence of John Dewey, especially his Democracy and Education (1916), shaped the nascent pastoral care movement. In the same period, clergyman Anton Boisen, supported by the enduring noblesse oblige of the Harvard 23
hospitals' Richard Cabot, began training seminary students at Worcester State Hospital, a program that would evolve into clinical-pastoral training (Boisen, 1936; Holifield, 1983, pp. 222229). This impetus to the merging of psychotherapy and spirituality was blunted if not broken by the Great Economic Depression that followed upon October 1929, bringing to America the vision of human finitude that had dawned on Europe in August 1914 (Barrett, 1958). The Depression of the 1930s dampened the ardor of most clergy and "applied psychologists," but the more extreme religio-philosophical movement rolled on. Divine Science, Universal Science, Life Science, Jewish Science, and later Scientology, served thousands (Braden, 1963; Bromberg, 1975, p. 179). But more was going on. In 1932, the same year his brother Reinhold published Moral Man and Immoral Society, Yale's Helmut Richard Niebuhr translated Paul Tillich's The Religious Situation, which argued that genuine religion was antithetical to the illusion that cultural values, even those of human health and well-being, were the values of God (Niebuhr, 1932; Tillich, 1932). Some psychotherapists took to heart the insights of these "crisis theologians." Rollo May's 1939 The Art of Counseling presented human beings as "finite, imperfect, and limited," their consequent insecurity driving them to prideful self-will. May expressed wariness of optimism about "growth" and its attendant assumptions that more enlightenment, education, and ethics could transform the personality. Reflecting the formulations of neo-orthodox thinkers, he suggested that human life was marked by an unending conflict between freedom and determination (May, 1939). But soon the twin victories over the Depression and the Axis powers restored confidence in experts and heightened reliance upon professionals. Still, there were doubters, and psychological and theological thinkers alike wrestled with the realities of the roles taken by Europe's most 24
"civilized" peoples in the extermination camps of the Holocaust (Lifton, 1986). 8. THE POST-WORLD WAR II SCENE Chastened by the Holocaust and the realities of nuclear power in an era of Cold War, a variant of existentialist insight emerged in the psychotherapeutic thought of the post-war period, a variant that blended psychotherapeutic and spiritual insight in ways not seen before. Set forth most explicitly by concentration camp survivors such as Viktor Frankl, this understanding of the human condition and its emotional disturbances cohered well with the neo-orthodox theology that had emerged in the 1930s, and it gained slow adherence into the 1950s when it was overtaken by the "Peace of Mind, Heart, and Soul" of popularizers Norman Vincent Peale, Fulton J. Sheen, and Joshua Loth Liebman, in what became the customary Herbergian Protestant, Catholic, Jew formulation (Frankl, 1955; 1959; Herberg, 1955; Liebman, 1946; Peale, 1948; 1952; Sheen, 1949). In some ways the Eisenhower decade of the 1950s marked both the high point and low point of American religious spirituality, as evidenced less in the addition of "under God" to the Pledge of Allegiance or of "In God We Trust" (with large unconscious irony) to American coinage, than by President Dwight David's Eisenhower heartfelt affirmation that "Our government makes no sense unless it is founded in a deeply felt religious faith -- and I don't care what it is." (Quoted, and emphasis added by, Herberg, 1955, p, 84, citing the New York Times of December 23, 1952.) At various times in this era, a "third psychiatric revolution" was proclaimed. The term signified for some the revolt of psychologists against the medical model, the new emphasis on "a full life" issuing in new schools of psychotherapy that had a somewhat sociological flavor (Bromberg, 1975, p. 276). Others used the phrase to denote a restoration of religious insight to psychotherapy (Stern, 1954) or the growth of a spiritually-based group therapy (Mowrer, 1964a, 25
b). But perhaps most significant in the late 1950s was theologian Wayne Oates's critique of the positive thinkers for treating personality as a reflex mechanism subject to prudential ethics and wishful voluntarism. Such an approach, Oates observed, ignored the self's internal contradictions, overlooked the necessity for people to accept their limitations, and presented religion merely as a crutch to be used for narrowly personal benefits (Oates, 1955, 1957). The decade of the 1960s, with its assassinations, flower children and anti-Vietnam war agitation, marked the beginning of a kind of confluence between psychotherapy and spirituality. In the wake of such as Peale and Blanton and the "Peace Movement" of Liebman and Sheen, an American psychotherapy derived from Karen Horney and Harry Stack Sullivan and an "ego psychology" largely imported from Britain seemed to open new possibilities (Guntrip, 1973; Horney, 1950; Sullivan, 1947). Finding both classic spirituality and classic Freudian insight "too dark and gloomy," sufferers and therapists and spiritual guides united in rediscovering the "goodness" of the self. Classic thought, whether Freudian, Christian, or Jewish, had a deep awareness of the human potential for evil, a reality increasingly ignored by 1960s and later psychotherapeutic thought, both popular and academic. Both Freud and the classic psychologies as well as the classic spiritualities, that is to say, remained profoundly aware of human duality, a vision lost or obscured by emergent expressions of psychotherapy and spirituality less rooted in history than in the day's tie-dyed T-shirt, inspirational poster, and smiley-button markets (Wulff, 1996, pp. 55ff offers a useful summary from the viewpoint of psychology). Meanwhile, from the National Training Laboratory for Group Development emerged the "encounter" and "growth" movements, "T-groups," "Sensitivity Training" and a humanistic psychology that, although in some ways "spiritual," soon became virtually indistinguishable from the utopianisms that had flourished with similar brevity in earlier ages. The "human 26
potential movement" offered a therapeutic ethic that insisted on the distinction between the conventional public self and the true inner self. Such a distinction found expression in a persistent tendency to exalt the values of "honest" self-expression and a communal intimacy that furthered the ongoing repeal of reticence. The decade saw a by-now familiar litany of honorific words became part of the popular vocabulary of what might still be loosely called "virtue": openness, honesty, tolerance, sensitivity, and self-realization (Bromberg, 1975; Gurstein, 1996; Holifield, 1983, p. 310). The psychoanalysis of Carl Jung, meanwhile, emphasized the "process of individuation" and recognized that religious ideas had a place in psychotherapy. Many spiritually-inclined individuals found help in Jungian insight; many others find Jungian quasi-theism less mystical than obscurantist. Similar difficulties confronted those who turned to Asian spiritualities. In contrast to the rational psychotherapy of the Western world, which seeks causes and attempts adjustment to the social environment, and in contrast to the traditional spiritualities of the Western world, which glory in the goodness of creation, Eastern philosophies are therapeutic in that insight into the essential emptiness of the universe leads to freedom from desire, misery, and anxiety (Bromberg, 1975, pp. 334ff). Such approaches have always appealed to some; they rarely are embraced by many. For those concerned about spirituality, the emphasis on self-realization and its synonyms soon lay bare the problems of the flirtation of the spirituality of the pastoral theology movement with psychotherapy. Following the lead of the neo-Freudians, many theologians adopted an ethic of self-realization that defined "growth" as the primary ethical good, a vision directly contrary to much spiritual insight. Then the oil-price shocks of the later 1970s and increasing concern about ecology began to call into question such assumptions (Page, 1996; Schumacher, 27
1973). A memorable scene captures the divide that existed between spirituality and psychotherapy in this era. Theologian Paul Tillich's final public appearance was a dialogue with psychologist Carl Rogers. The two disagreed about the ambiguity of human nature. Rogers believed that "estrangement" was imposed by cultural institutions. Tillich held that it was a tragic and inevitable component in any process of maturation. Rogers argued that for the modern world, God was dead, and he wondered why Tillich continued to use a religious vocabulary. Tillich insisted that scientific language is always limited in scope and that only the language of religious symbol and myth could point beyond itself to the unconditioned Ground of all existence (Holifield, 1983). But more was going on even at the time. The late 1950s saw the beginnings of a psychotherapeutic revolt against the medical model (Bromberg, 1975, p. 276). Also, although O. Hobart Mowrer's denunciation of "acceptance" as "cheap grace" was not much heeded, the later 1960s saw a movement by the explicitly spiritually-rooted away from what came increasingly to be regarded as a psychological approach criticized as "a sterile and introverted Narcissism of I for Me by Myself" (Lasch 1978). Without abandoning the ideal of acceptance, some pastoral writers began to talk about the importance of "confronting" people with the need to face and change their destructive patterns of living. Two decades later, this approach encountered its own limits when the over-extension of the Twelve-Step program pioneered by Alcoholics Anonymous became ensnared with an ever-broadening concept of "addiction" (Bregman, 1996; Kurtz, 1996; May, 1988; Mercadante, 1996). 9. THE CURRENT SCENE ON THE EVE OF THE MILLENNIUM Other essays in this volume detail the current scene. I hope to tie together the broad story 28
limned above by concluding with a few observations suggested by study of the history of the relationship between psychotherapy and spirituality. From Hans Selye on stress in the 1950s, through 1960s' Transcendental Meditation and "The Relaxation Response" as presented by Herbert Benson in the 1970s and after, through the efforts to harness ecstasy by Richard Bucke, Edgar Cayce, Carlos Casteneda, Alan Watts and Timothy Leary, to the popularizations of Larry Dossey, Depak Chopra, Joan Boryshenko, and Caroline Myss as well as renewed interest in American Indian spiritual healing practices, the continuing assumption of an interface connecting physical medicine as well as psychotherapy with spirituality leads some to see dawning a new and promising rapprochement among them (Siegmund, 1965). This vision is furthered financially by Sir John Templeton, whose munificence in awarding prizes and sponsoring publications and conferences on the topic helps the willingness of students to immerse themselves in this still academically unpromising area. A federal Office of alternative medicine meanwhile scandalizes some even as it brings hope to others. Modern scientific medicine -- and psychotherapy claims to be scientific even if not strictly medical -- was born out of the rejection of what Ahlstrom (1975) termed "harmonial piety," a view of the world "in which spiritual composure, physical health, and even economic well-being are understood to flow from a person's rapport with the cosmos." Is such harmonial piety a necessary sequella of holistic vision? Some day, perhaps, efforts to prove the existence of God will have a DSM diagnostic category -- which will likely suit the age's saints just fine: Mystical and spiritual experience exists in a different category than "proof." Still, some will always be intrigued by attempts to demonstrate the material effects of some spiritual cause. Given that most individuals intuit in themselves some unity of the physical, mental, emotional, and spiritual, there is always hope that we can know more about those aspects and their 29
relationship, especially in ourselves. Others will no doubt continue to resist such trends, seeing them as just another in the long parade of the spiritually deprived attempting to fashion in their own image a "God of the gaps." More impressed by the mystical tradition than by rational psychologies, these rejoice in an ecumenism that makes it possible for those rooted in varying religious traditions to draw on the spirituality of each other. In part inspired by Jungian insight and its Campbellian popularization, others incorporate insights from East Asian religions into current mental healing techniques (Bromberg, 1975, pp. 334 ff.; Campbell, 1988). At least since the 1960s also, "New Religions" have converged on the idea of altering human consciousness. "Altering human consciousness" can of course be attempted with or without chemical assistance (Bromberg, 1975, p. 336; Clark, 1969; James, 1902). But as Martin Marty observed: "Wheresoever two or three yoga or Zen students gathered, conversation almost never had to do with intellectual constructs but with liberation from them" (Marty, 1989, p. 142). For those who primarily observe, thus falling under harsh strictures from many representatives of both psychotherapy and spirituality, the main question today is "Which psychology, Which spirituality?" Large differences remain unresolved in understandings of the relationships between asceticism and repression, a problem hardly solved by the careless calling of medieval saints "anorexic" or the irresponsible labeling of monasticisms as vehicles for escape (Wulff, 1991). Another area of divergence between at least some forms of psychotherapy and spirituality involves discretion, reticence, and privacy. The psychotherapeutic mind-set, rejecting "repression," tends to favor the free expression of thoughts and feelings (Bromberg, 1975, pp. 270 ff.). At first, this applied only or mainly in the therapeutic setting, but popularization of these 30
ideas has extended the practice variously named "letting it all hang out" and "honest sharing" to all areas of life and experience. Spirituality, because its concern is a different kind of human vulnerability, in general retains a mistrust of sheer spontaneity not because it is "evil" or to be "repressed" but out of a hesitancy to intrude upon others, a concern lest the destruction of privacy and the devaluing of the sense of shame issue in the progressive loss of those traits and characteristics that are precisely the most human as well as the most humane (Gurstein, 1996). Related to this divergence is a different emphasis on the relationship of "rights" to "responsibilities" and the ways of thinking about the wrongs done to one. Influenced by contemporary legalism, psychotherapy tends to present its insights in terms of "rights" and "empowerment." Spirituality has always been more aware of responsibilities. Not unrelatedly, the psychotherapeutic approach, especially in its more popular manifestations, attends to how one has been wronged. While the term victim may be eschewed, discovering experiences of victimization seems to be what much contemporary psychotherapy is all about. The classic tradition of spirituality, while it does not advise ignoring injuries received, suggests that these be viewed in the context of the injuries one has inflicted on others. "Self-esteem" seems the highest goal of many psychotherapies; spiritualities usually present "self-centeredness" as the bane of spiritual existence. Those two visions are compatible, but often those promoting one or the other seem to ignore that reality (Adelson, 1996; Glendon, 1991). And so we conclude with more questions than answers. Can the classic virtues and vices retain any meaning in a culture that worships "the market" as God, a system that defines greed and envy as economic necessities? Spirituality in all its forms has always begun by urging renunciation. Can psychotherapy, which is essentially the tool of any culture it serves, share that vision? (Cushman, 1992, 1995). Both psychotherapy and spirituality have to do with the 31
acceptance of realistic limits. But what of the unbridled valuing of human control, a lynchpin of psychotherapy, as opposed to spirituality's concern to preserve the sense of awe in the presence of mystery and an awareness of the strengths tapped by an admission of powerlessness? The first prayer, like the first call to a therapist, is a cry for help. But what comes next, if these two view helplessness differently? (Tiebout, 1949). The critiques of psychotherapy offered by such as Rieff, Laing, Szasz, and Cushman stand irritatingly unanswered. The critiques of spirituality offered by serious thinkers who have the misfortune to wander into the "self-help and psychology" section of any large bookstore grow increasingly strident. Where do we go from here? I have not the foggiest idea: historians are not prophets. But I offer this essay in the hope that the frame it provides may assist the other essays in this book to further meaningful movement in something approximating a direction that will contribute to the sanity of humankind. 32
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