Twenty years after my psychology internship in Pittsburgh, a friend and I rented kayaks a mile or so upstream from where the Allegheny and Monongahela Rivers flow together into the Ohio. Floating past downtown Pittsburgh, we were too busy taking in skyscrapers and the secular temples where the Pirates and Steelers draw hordes of their faithful to notice the confluence of waterways. Turning to head back upstream at twilight, a full moon, yellow and huge, was rising above the cityscape, and everything looked different. Paddling up to Point State Park, we needed to leave the Ohio and choose right (Monongahela) or left (Allegheny). On which river had we started this adventure? We only saw the choice looking back.
Looking back at my own career as a psychotherapist, I realize that I began my training in the river of empirical psychology. This approach to human suffering requires conducting scientifically sound research, crunching data, and analyzing thousands of studies in meta-analyses to determine what works to achieve “clinically significant outcomes.” All of this has contributed greatly to our understanding of how to help people. But in that empirical stream, the soul —the original meaning of “psyche,” the Greek word at the root of “psychology”— felt like flotsam to be avoided. And the whole field had moved more toward “empirically-validated treatments,” in large part because insurance companies demanded it.
Shortly after that kayaking trip, however, I heard an interview with Buddhist monk and clinical psychologist Jack Kornfield that, in retrospect, put me on a much bigger river. The interviewer asked how he drew a clear line between doing therapy and providing spiritual counsel. Kornfield’s answer: “I don’t.”
Following Kornfield’s lead did not require me to inject spiritual matters into the therapy process. It involved recognizing that my patients had always shown up with both specific mental health concerns and existential human struggles that do not fit neatly into diagnostic categories. They have never been just the Allegheny or the Monongahela—they were always the Ohio. I needed a three-rivers approach to therapy that allowed my scientific training to flow together with my full humanity, including my spiritual nature. This originally felt like some sort of heresy, but researched-based books, such as Ken Pargament’s Spiritually-Integrated Psychotherapy: Understanding and Addressing the Sacred, have helped me feel less afraid of ex-communication.
There’s an acute awareness in these not-quite-post-pandemic days of the burgeoning need for mental health services. If you seek professional help, you can get information about a therapist’s professional training by knowing their degree, specialties, license, and years of experience. But how can you get a sense of whether a therapist will be a soulful, healing presence in your life? There is no perfect therapist, but here are six things to be attuned to in the first several sessions:
Do you like your therapist?
In the first hour people spend with me, I know that the biggest determiner of whether I see them a second time will be their initial gut feelings about whether I will be a positive, likable, hopeful presence in their life. Thousands of studies show that the relationship between therapist and patient is the number one active ingredient in positive outcomes. As the renowned therapist Irvin Yalom wrote in Existential Psychotherapy, “It is the relationship that heals.”
Is the therapist a compassionate human being?
If so, this means you’re meeting with someone well-acquainted with human suffering, not just in patients, but in their own life. The therapist’s willingness to share their familiarity with life’s difficulties—in limited doses and focused on furthering their work with you—can go a long way to helping you feel less “messed up” or alone in your challenges. A compassionate therapist will help you let go of shame, see your problems as part of being human, and learn to practice self-compassion.
Is the therapy process creative?
While there’s a place for well-researched, manualized programs that focus on techniques, a soulful approach to therapy may include stories, metaphors, poetry, dream interpretation, humor, music, or enactments, in which you try out skills in the session instead of just talking about them.
Is your therapist wise?
Psychologist Marsha Linehan emphasizes the need to integrate emotionally reactive mind and logical mind into “wise mind.” Beyond their professional training, do you sense your therapist has actively cultivated wise mind? You might hear helpful references to insights from spiritual teachers, poets, or novelists. Or you might just find yourself receiving new perspectives that dramatically shift how you look at your life situation.
Does your therapist walk the walk?
I wouldn’t want golf lessons from someone who’s only read about golf. And I’d prefer to learn mindfulness meditation and other practices from someone deeply familiar with how practicing them can be transformative.
Does the therapist engage your spirituality or is it treated as if it doesn’t belong in therapy?
A three-rivers therapist may invite you to go deeper on your spiritual path or support you in finding a new one. They might also challenge you on ways your spirituality has become part of what is keeping you stuck.
There’s still a significant stigma around going to a mental health professional. Thinking of therapy only in terms of disorders and treatments perpetuates this stigma. So if you go for help, bring your specific syndromes and your whole humanity too! Find a three-rivers therapist well-versed in diagnosis and techniques who is also a soul healer. It truly is the relationship that heals.