Working Pluralistically with Religious Clients

John Wilson, Honorary Research Fellow and Director, Bereavement Service, York St John Counselling and Mental Health Clinic

I recently delivered a public lecture on loss and grief at my university. After the event a member of the audience sought me out to say that she was experiencing anticipatory grief for a parent who has a life-limiting illness. She told me that she is comforted by rituals she performs as part of her Pagan belief system.

This set me thinking of the plethora of examples over twenty years of bereavement counselling when a client has talked of the comfort which comes from a religious faith. As an atheist with Humanist leanings, how do I work, apparently effectively, with diverse beliefs I do not share? Would sharing a client’s faith make me more effective? I suspect not. So what aspect of my pluralistic practice makes working with a client’s faith a natural process free of conflict and dilemma?

My approach is based on an assumption that bereaved people go through a healthy, natural process of accommodation and assimilation, to come to terms with–and to make sense of–a changed world in which their loved-one is missing. This process is known in grief theory as ‘meaning making’ and is predicated on the teaching of Swiss psychologist Jean Piaget. Piaget recognised that a child’s understanding of her environment is constructed from ‘units of meaning’, or ‘schemas’. Accommodation is the process of altering a previous understanding to accommodate new information, and this may generate a new schema. Assimilation is a process of adapting existing schemas in the light of new information. This is as true for children making sense of their world as it is for grieving adults struggling to make sense of a world in which a lost loved-one is missing. In fact. my previous profession was teaching young children, and I noticed the parallels when working with grieving clients before I discovered that ‘constructivist’ psychotherapy is mainstream.

Humans naturally assimilate and accommodate life’s vicissitudes into a meaning framework which forms our personal narrative. It almost goes without saying that the abrupt and radical changes from bereavement can throw the assimilation/accommodation dynamic into temporary chaos. I believe, however, that clients have a capacity to heal themselves given a therapeutic relationship in which the counsellor is both sensitive to their needs and works with an attitude of mutual respect and therapeutic collaboration.

For clients who adhere to a faith, it is inevitable that the schemas they construct will have a religious dimension. I am happy to work with whatever schemas a client chooses in order for them to make sense of their loss and to draw comfort. I do not have to share the faith. My role is to facilitate the meaning-making process. The client’s schemas are her own and it is with some degree of envy that I work with clients who are totally secure in the belief that their loved one is in Heaven and that one day they will be reunited. Ritual is also important, and not just for clients with mainstream faith. Experience has taught me that humans are spiritual creatures and that, conventionally religious or not, ritual has an important part to play in grief resolution. The scattering of ashes in a special place, the planting of a tree, the lighting of a candle are all rituals which may or may not be imbued with religious faith. Then there are rituals specific to faiths, such as the saying of a Mass for the deceased.  Clients will perform rituals between counselling sessions and will use sessions to talk about how they have helped or hindered.

This is not to say that all schemas based on religious interpretation are helpful. Some deeply held beliefs can complicate grief. For example, clients who firmly believe in a Heaven, with a loved one waiting for them, sometimes ruminate on how lonely Heaven must be for them until they are joined by those that love them. Many clients find a long-held faith challenged by bereavement. This is particularly true for the deaths of those ‘taken before their time’. One client of mine believed, for a short while, that his child had died as a divine punishment: a salutary lesson from God. It later transpired that this nagging, unarticulated feeling had complicated his grief for many months.

As pluralistic practitioners, we need to be open to these religious beliefs in just the same way as we would respect any other meaning-making construals. A pluralistic approach puts the client at the heart of mutually agreed activities, the process is enabling, and the outcomes are unique to the client. The client’s schemas have the potential to act as the basis for assimilating new meaning in making sense of the loss and of life without the deceased. Our skill is to facilitate this process without judgement or criticism. We help clients, for instance, to explore their concept of Heaven with appropriate open questions: ‘Does time exist in heaven? Do you feel it is possible to be sad and lonely there?’ We support with sensitivity, those clients who find their faith shaken by loss, as they explore and come to terms with new meaning. Of the young father bereaved of a child, I gave him the space to assimilate and accommodate the veracity of this belief in a punishing god.  In the next session he reflected on what he had decided was flawed thinking, by announcing that he had been wrong, and that ‘God doesn’t kill babies’. This was the beginning of his journey of healing. Because I had listened without question to his meaning in the moment, he had both the space to clarify his dark, half-formed thoughts and the freedom to assimilate and accommodate new meaning.

The ways I advocate working with bereaved people have, as I have already stated, a pluralistic foundation. Firstly, my practice embraces and celebrates diversity and a multiplicity of solutions, with the individual at its heart. The client is supported in the uniqueness of their grief and in the journey through it. Secondly, I hold a humanistic, existentially based conviction in the ability of the client to self-heal in a therapeutic environment. Thirdly, I believe that a bereavement assessment session should include a therapeutic element, since it is the beginning of a process which recognises the client’s needs and negotiates future work. Fourthly, that this work should proceed with mutual collaboration, review, shared feedback, and attention to process, progress, and outcome. I like to think of bereavement counselling as a journey of mutual curiosity about the changes that happen in and between sessions.

In conclusion, there is no dilemma in not sharing our client’s faith. Pluralistic practice requires of us a deep respect for the client. This can, and must, include the religion and spirituality they practice. As pluralistic practitioners meeting the client where they are, we recognise what a valuable resource faith can be, even when it is not our own.

I wish to acknowledge two books which have helped clarify my thinking in writing this blog:

Bohart, A. C., & Tallman, K. (1999). How Clients Make Therapy Work: The Process of Active Self-healing. Washington DC: American Psychological Association.

Cooper, M., & McLeod, J. (2011). Pluralistic Counselling and Psychotherapy. London: Sage.