It’s not uncommon for Americans in our 21^st century to find their way to a mental health clinic. In the U.S. today, according to the DSM-5, 46% of adults are likely to develop a diagnosable mental disorder.  There are a variety of reasons for the statistics: economic stressors, environmental challenges, inadequate social resources, and often, simply a greater awareness of and the reporting of diagnoses.  For the millions of people affected by mental health disorders — depression, anxiety, personality disorders, etc. — mental health professionals provide relief and hope. Psychiatrists, counselors, marriage and family therapists are important resources, contributing greatly to the well-being of society.

Not all intrapersonal suffering can be summed up in a diagnosis, however.  The human condition is filled with moments and seasons of struggle that are not categorized neatly in a mental health textbook. Loss can lead to deep grief.  Ethical dilemmas in the workplace can open up great turmoil of conscience. We become angry at our loved ones. We can act in ways that we regret. Mid-life can bring questions of meaning. Children challenge our values. Some of us wake up in the night with questions of existence: what is my purpose? Is there life beyond this life?  For questions and moments such as these, the struggling person may turn to a spiritual director. What follows is a brief overview of spiritual direction as well as some ways that spiritual direction intersects with mental health therapy.

Spiritual Direction: A Movement Towards Soul Wholeness

Spiritual directors are those who, most typically, help individuals move towards greater soul wholeness.  While I am most familiar with spiritual direction from within the Christian mystical context, spiritual direction is an ancient practice that has roots in most of the major world religions. A spiritual tradition (be it Buddhist, Jewish, Christian, Pagan, Indigenous, etc.) is the weaving together of a worldview — questions, teaching, ritual, values, and community — all for the sake of passing along meaning and purpose to its adherents. Within these spiritual communities, throughout the centuries, spiritual directors function as healers, teachers, guides, and midwives. They often meet one-on-one with a seeker. They listen to stories of soul-sickness and struggle. They help a person to name stories of hope and to discover resources of strength within their particular spiritual tradition or within the even larger framework of braided spiritual questing.

The title “Spiritual Director” is somewhat of a misnomer.  The Spirit is the true director. The human spiritual director is simply one who is trained in knowing the questions to ask.  She herself is a seeker, and she knows the terrain of spiritual questing. A spiritual director does not have a textbook answer for the suffering person. Rather, a spiritual director spends much of her time simply being available to the spiritual companion who has come to explore. Sometimes spiritual direction is simply a ministry of presence: to laugh with those who laugh and to weep with those who weep. The spiritual director can help the companion savor the best of the human experience and to hope for a better day during the times of suffering.

The Many Forms of Spiritual Direction

The most typical form of spiritual direction is a sixty to ninety-minute session in a quiet place where conversation can flow between spiritual director and spiritual companion. In this way, spiritual direction shares commonalities with mental health therapy. It often is a verbal exercise: the externalizing of pain and suffering through the telling of stories and the speaking of words. Like an effective mental health therapist, the spiritual director knows how to actively listen, to reframe the challenges, to ask questions in ways that open up greater conversation. However, unlike mental health therapy, spiritual direction often feels less goal-oriented. The mental health therapist may help the client increase his parenting skills or de-escalate anxiety. The interventions of the mental health therapist are future-oriented and change-focused. Spiritual direction conversations are often very present-focused.  A spiritual director may help her companion to reflect upon how God typically communicates. A spiritual director may guide his companion to listen in a new way for wisdom or he may help his companion discern untapped resources of hope. Through this encounter, great intrapersonal change might happen, but such change comes as result of a spiritual experience, not as the stated goal.

Spiritual direction often is a multi-sensory experience. A Pagan spiritual director might invite her companion to walk in the woods and listen for new sounds.  A Buddhist spiritual director may focus on the act of sitting meditation.

At the Haden Institute for Spiritual Direction where I trained in Flat Rock, North Carolina, mornings would begin with yoga along the lake. Evenings would wind down with music circles. It was not uncommon to visit the art room to paint the memory of a night dream. A poem or a piece of sacred writing would often become a springboard for guided meditation. During those intensive training workshops, I invariably discovered a new way to envision the Holy and to imagine my own life path unfolding. During one particularly painful season of vocational questioning, multiple visits to the art room helped me to externalize a fear I had buried. I shared the picture with my own spiritual director, and the process helped me to experience greater courage within myself.

Some Practicalities of Spiritual Direction

Unlike the mental health professions, spiritual direction in the United States has no ties to managed health care. This means that a spiritual director may practice without a state license, because there is no such state licensing board. Depending upon one’s perspective, this freedom is an asset or a liability to spiritual direction. On the one hand, a spiritual direction practice can be unencumbered from weighty overhead and the strings of institutional bureaucracy. The spiritual director can be free to focus on the relationship and on the process of healing. On the other hand, such freedom can lead to lack of accountability. As a practicing spiritual director, I strongly advocate those who would call themselves spiritual directors to receive training from a reputable organization. Most of the major spiritual traditions have seminaries and training centers that certify practitioners to provide ethical and responsible spiritual direction. If you wish to work with a spiritual director, take some time to interview her. Ask about her training, and if she herself receives regular on-going spiritual direction.

Spiritual Directors International is the largest network of world-wide spiritual direction practices. While they do not accredit spiritual directors, SDI does serve as an international network that connects spiritual directors with each other and with resources to improve our work in the field. SDI hosts international conferences and publicizes its members’ profiles so that seekers can discover who and what is available.

Generally, a spiritual director will charge something for her services. While this sometimes has been a controversial topic, I advocate the practice for several reasons.

1. A fee will set boundaries around the time of spiritual direction, helping to maintain the sense that this is an agreed-upon relationship.
2. In our American culture, the offering of payment implies an investment in the process.
3. Spiritual directors are usually people who are never going to “get rich” from their work, but they have invested time and resources in their training and personal development. Often a fee is a practical reality, necessary for the spiritual director to maintain the best practice possible.  Each geographic area seems to have ranges of fee structures for spiritual direction. And almost every spiritual director I know offers alternatives if the fee is simply too much for the companion to offer (sliding fee or the trading of services, although this second practice comes with its own set of challenges).

An Important Alliance

The sacred texts of all world religions as well as our history books show that people throughout human history have struggled. We read of mystical visions, great longing for union, journeys of suffering, and moments of ecstasy. In response to the human condition, throughout cultures and times, many diverse people have devoted their lives to help alleviate intrapersonal suffering and to magnify wellness. While our 21^st century values the medical model of mental health therapy, there is a growing body of contemporary people who also value the effectiveness of spiritual direction.  The wise spiritual director will know when her companion is struggling with a condition best approached by a mental health therapist. But just as importantly, a mental health therapist would do well to recognize a Mystery that extends beyond clinical treatment goals. In our world of both Spirit and Matter, suffering persons need the best of both worlds — mental health therapists who understand the complexities of diagnoses and social systems, but also spiritual directors who walk with companions into the mystery of Spirit.