Is Something Missing in Your Therapy? |
When therapy overlooks meaning, something essential may be missing.
Inner beliefs shape mental health more than we realize.
Healing is harder when parts of you stay unspoken.
“The Tao that can be told is not the eternal Tao,” wrote Lao Tzu in Tao Te Ching more than 2,500 years ago, capturing a paradox that still resonates today. Our deepest experiences of meaning, awe, and transcendence often resist language. Yet the fact that spiritual and existential concerns are difficult to articulate does not make them any less psychologically real and important. Questions of purpose, belief, connection, and mystery quietly shape many people's emotional lives—even when they are not spoken aloud.
It is ironic that psychotherapy, a field devoted to exploring what is hidden or unconscious, has often been wary of engaging directly with spirituality. Sigmund Freud’s influential view of religion as an illusion rooted in dependency and neurosis cast a long shadow over psychoanalysis. Although Freud wrote extensively about religion and religious identity, his skepticism led generations of clinicians to treat spiritual material with caution—or to avoid it altogether.
Meaning, Spirituality, and Mental Health in Psychotherapy
Today, avoidance of religious and spiritual matters in psychotherapy feels increasingly out of step with reality. We no longer live in a society where spirituality is confined to organized religion. People draw meaning from many sources, including nature, meditation, music, social justice, or personal beliefs that defy easy labels.
As a patient in therapy, do you feel that something essential but difficult to describe is missing? Are you talking with your therapist about your job and relationships but not addressing something deeper that has to do with questions about purpose, values, belief, spirituality, or what gives your life coherence during times of struggle?
As therapists, we may excel at addressing thoughts, emotions, and behavior but we often sidestep spiritual concerns that quietly shape how people heal, endure loss, make sense of their lives, and connect to something larger than themselves.
How Spiritual Concerns Show Up in Therapy
Even if you’ve never used the word spiritual, this dimension may already be present in your therapy. It can show up in many ways. You might talk about family rituals, cultural traditions, or objects that feel sacred because of their emotional significance. You may describe prayer, meditation, or moments of quiet reflection, even if you’re unsure what you believe. You might feel deeply guided by values like compassion, forgiveness, service, or justice.
You may also have experiences that are harder to explain: moments of awe in nature or music, a sudden sense of gratitude, feelings of oneness or timelessness, or waves of existential anxiety that seem to come out of nowhere—sometimes late at night, when the usual distractions fall away. These experiences are not unusual, and they are not signs that something is “wrong.” They are often signals that you are grappling with life’s biggest questions.
As therapists, being attuned to these signals does not require us to endorse any belief system. It merely asks that we recognize spirituality and meaning as legitimate areas of psychological inquiry.
A Broader View of Human Meaning
While Freud emphasized the dangers of religious illusion, many later thinkers took a more expansive view. William James famously argued that religious experiences were among humanity’s most valuable psychological resources. Erik Erikson wrote that ritual, imagination, and belief emerge naturally across the lifespan, shaped by early attachment, culture, and social bonds. Humanistic psychologists, like Abraham Maslow, emphasized peak experiences—moments of insight, connection, or transcendence that reorganize a person’s sense of self and values. These experiences, often described as deeply meaningful or even sacred, can arise in love, creativity, therapy, or moments of profound clarity and may represent growth toward greater integration and authenticity.
Object relations theorists added another important insight: representations of "the divine" function psychologically much like other internalized relationships. For some, these representations provide comfort and resilience; for others, they may be harsh, punitive, or fear-laden, echoing earlier relational trauma. From this perspective, spiritual beliefs are neither inherently healthy nor pathological—their impact depends on how they are structured and experienced.
Spiritually integrated therapies expand the bio-psycho-social model to include spiritual concerns and may incorporate mindfulness practices, ethical reflection, journaling, or conversations about belief and doubt. The goal is to help people align their emotional lives with their deepest values and sources of meaning.
When Spiritual Questions Are Central
If you are in therapy, chances are you are trying to make sense of your life. If spiritual concerns—the "big" questions—are on your mind, don't hesitate to bring them up during sessions. You might be struggling with a crisis of faith, feeling disconnected from values that once guided you, or questioning long-held beliefs after loss or trauma. A thoughtful therapist can help you reflect on what you hold sacred, how your beliefs have helped or hindered you, and where you feel spiritually engaged, stuck, or conflicted. This doesn’t mean your therapist becomes a spiritual teacher. It means they recognize that emotional health and meaning are intertwined.
Exploring our place in the world is part of gaining a deeper understanding of ourselves and can lead to healing and transformation. You may already have had glimpses of this in therapy: a moment when you felt deeply understood, when something “clicked,” or when a painful experience suddenly made sense in a new way. These moments can feel quietly transformative. They often mark turning points, even if neither you nor your therapist labels them as spiritual. Talking about meaning can help you integrate these experiences rather than letting them pass unnoticed. It can also help you examine how your beliefs—or doubts—affect your relationships, self-image, and choices. At the same time, therapy can help distinguish between spiritual beliefs that support growth and those that reinforce guilt, fear, or rigidity. Exploring these patterns can be freeing, especially if you were taught that certain questions were forbidden or dangerous.
Is Your Therapy Addressing What Gives Your Life Meaning?
If you’re wondering whether your therapy is meeting your spiritual needs, it may help to ask yourself:
Do I feel able to talk about what gives my life meaning?
Can I bring up questions about purpose, belief, or doubt without feeling dismissed?
Does therapy help me feel more connected to myself, to others, or to life itself?
Are my deepest values reflected in the work we’re doing?
If the answer to some of these is “no,” that doesn’t mean your therapy has failed. It may simply mean that an important dimension of your experience hasn’t yet been named. You can choose to raise these topics and see how your therapist responds. A receptive response can open new and meaningful territory. When spirituality and meaning are welcomed as part of that whole, something essential may no longer feel missing.
To find a therapist, please visit the Psychology Today Therapy Directory.
"Five Approaches to Religion and Spirituality" by Samuel L. Pauker, M.D. https://guilfordjournals.com/doi/pdf/10.1521/prev.2025.112.4.403