469 - Care of Mind/Care of Spirit: Psychiatric Dimensions of Spiritual Direction

Care of Mind/Care of Spirit:
Psychiatric Dimensions of Spiritual Direction
By Gerald G. May, M.D.
San Francisco, Harper & Row, 1982. 164 pp. $11.95.

The author is a board-certified psychiatrist and has been interested in the relationship between psychology and spirituality for over a decade. He is a trained spiritual director and trains spiritual directors in conjunction with the Washington Theological Union and the Shalom Institute for Spiritual Formation in Washington, D. C.

His intention is not to present a comprehensive introduction to spiritual direction itself, but to provide a concise and practical discussion of a variety of psychiatric considerations encountered in spiritual direction. He begins by giving a history of spiritual direction, definitions of terms, and a discussion of the nature and development of spirituality. In his discussion of the mind, referring to Freud and Jung, he writes about early symbols and images of God, childhood experiences, and the development of mind sets. The unconscious, pathology, and self-image are important factors in spiritual growth with a strong positive selfimage being important. The quality of the self-image, even though the image itself is strong, may be either positive or negative.

The author's expectation is that the trained spiritual director will have some knowledge of psychology, but he does not say how much. He expects the directee to have some resistance to spiritual growth and refers to some of the defense mechanisms like repression, denial, projection, rationalization, intellectualization, and isolation as particularly operative and requiring considerable knowledge by the director. Defense mechanisms serve to preserve, protect, and promulgate selfimage and self-importance in the face of spiritual truth. However, he states that direct interpretation of such defenses is generally of as little help in spiritual direction as it is in psychotherapy. It seems to me that it is more important for the director to understand there will be resistance than to identify the defense mechanism. The discussion on depression and feelings of spiritual desolation or "dark night" experience is significant in that the director needs to be able to distinguish the difference and assess what is a true depression.

The author points out that the atmosphere in spiritual direction is one of spaciousness, peace, openness, and receptivity with the relationship between the director and directee being quite different from the relationship between the therapist and client. Spiritual direction is more relaxed and has more friendship and intimacy than psychotherapy, yet some of the hazards are similar. For example, transference is mentioned as a possible problem in direction, and he gives its classical definition. I wonder why he deals with such a complex subject when he also says that it would not develop to any great degree. The excellent discussion on sexual feelings in direction appears more appropriate than talking about

470 - Care of Mind/Care of Spirit: Psychiatric Dimensions of Spiritual Direction

transference since the level of intimacy and the degree of vulnerability required for direction is so great.

For a reasonably balanced perspective, spiritual directors should be familiar with two basic psychiatric understandings. The first of these is personality theory, and the second is the diagnostic categories themselves. He refers the reader to other writers for an understanding of personality theory and discusses the diagnostic disorders he feels are most likely to be relevant in spiritual direction. Even though he writes about disorders, he does say there should be no need for extensive labeling of any kind in spiritual direction, and that labeling is all too often a reductionist process which causes one to focus on one or a few characteristics of a soul to the exclusion of others. By including such subjects as dreamwork, transference, defense mechanisms, and diagnostic disorders, he seems to expect the spiritual director to be as knowledgeable in psychology as possible. However, he consistently cautions the director against becoming a therapist rather than a spiritual director. The better the knowledge, the better the director will be able to determine when a directee should be referred for therapy.

This book should be read by all spiritual directors and director trainees. It would also be helpful to educators of theological students, pastoral counselors, therapists, teachers of spiritual formation, and anyone interested in the development of spirituality.

E. Dean Bergen
Allentown State Hospital
Allentown, Pennsylvania