Care of Mind/Care of Spirit: A Psychiatrist Explores Spirtual Direction

by Gerald G. May

Although secular psychology addressed a great deal about how we come to be the way we are and how we might live more efficiently, it can offer nothing in terms of why we exist or how we should use our lives," writes Gerald May in this classic discussion of the nature of contemporary spiritual guidance and its relationship to counseling and psychiatry. For millions turning for answers to the world of the spirit, May shows how psychiatry and spiritual direction are alike, how they complement one another, and how they ultimately diverge.

Genres: Spirituality, Psychology, School, Counselling, Nonfiction

256 pages, Paperback

First published March 25, 2009

Reviews

[Sarah Pascual · Rating 3 out of 5]

Helpful and practical…but also dry and a bit outdated. It offered some foundational distinctions between Spiritual Direction and other helping professions, and probably would have been more helpful for me if I worked in therapeutic settings.

[Adam Shields · Rating 4 out of 5]

Summary: A psychiatrist explores spiritual direction. 

This is another assigned book from my spiritual direction class. The focus of this semester's class was spiritual direction and psychology. So assigning Care of Mind/Care of Spirit makes a lot of sense. Gerald May was a psychiatrist who became disillusioned with psychology and became a spiritual director.

My reading of Care of Mind/Care of Spirit was tainted by having his Addiction and Grace book assigned the same semester. I really did not like Addiction and Grace. My problem was mostly with his messy definition of addiction. But my frustration with May in the Addiction and Grace book did not give me a lot of charity in reading Care of Mind/Care of Spirit.

There is value here. Because he was a psychiatrist he understands that spiritual direction and psychology are not the same thing. There is a temptation for spiritual directors without much training in psychology to over psychologize the spiritual direction.

...all of life’s experiences can appear legitimately in spiritual direction, but they need to be seen in the light of spiritual concern, and at all costs they should not be allowed to eclipse that light.

He also cautions the spiritual directors to understand their role. They are a facilitator of the work of the spirit, they are not the ones doing the work.

In spiritual direction however, the true healer, nurturer, sustainer, and liberator is the Lord, and the director and directee are seen as hopeful channels, beneficiaries, or expressions of grace for each other. This is a radical difference, and one that cannot be overemphasized.

One of the points that is most helpful is his distinguishing between psychology that diagnoses a patient and spiritual direction that assists a person in discernment.

“Discernment” (or the Greek diakrisis) refers to an act of separating apart. “Diagnosis” refers to distinguishing through knowledge...Diagnosis, in Greek, refers to “through knowledge” or even “thorough knowledge,” emphasizing knowledge or even authoritarian judgment (c.f. Acts 25:21, the diagnosis of the emperor). I have previously indicated that diagnosis looks to label disorder so that it can be corrected, but discernment seeks to discriminate among inclinations so that a proper direction can be followed....Discernment, however, is generally seen as more of a gifted process than diagnosis, a graced charism that happens through the relationship.

and then a bit later

Ideally, there should be no need for extensive labeling of any kind in spiritual direction. Whether labeling assumes psychiatric or religious trappings, its overuse is likely to objectify the person and unnecessarily reduce the wonder of his or her reality. Somehow it always seems difficult to label an attribute without carrying it too far and labeling the person. Labeling is all too often a reductionistic process, causing us to focus on one or a few characteristics of a soul to the exclusion of others. Therefore, while it is very good to know something of how we come to be the way we are and the kinds of things that can go wrong with us, we must be vigilant not to let such knowledge get in the way of our wonder.

I still have frustration with the book. But there is good wisdom here. One last quote:

The temptation is to try to answer the person’s questions from your own knowledge, but how can you answer such things? We have all had times of feeling like Job or Job’s friends in the face of such questions, and no matter how much theological education you have, rational answers usually just don’t work. Personally, I think I do have some appreciation of why there is such suffering and injustice in the world—and God’s place in it—but I find I almost never try to express that when I am with an anguished person. In my own prayerfulness with the person, I usually sense an invitation to be lovingly, responsively present rather than to try to provide answers. What strikes me most clearly is that when a person in great pain is screaming Why? that person is really looking for God. She or he is really praying. These are holy moments, albeit very rough ones. I usually find myself encouraging people to express how they feel, and I hope there can be a little quiet listening on my part and theirs.

You can see all of my highlights here.

[Spencer · Rating 3 out of 5]

The fellas a true believer

Notes:

Spiritual guidance is when someone helps someone see and respond to a spiritual truth. Its not therapy, or counseling, or conversation. Its attending to the numinous, in the moment.

The intimate heart journey became the domain of psychiatry and psychology - the new priesthood

The church offered moral guidance, but no longer emotional guidance

An appreciation of the mystery may have more value than figuring anything out

Soul- the essence of your existence
Spirit- the energy of your being (can be good or bad and you need discernment)

Lay people are called and gifted to offer spiritual guidance.

A director points in a direction, they dont give orders

Meditation- reflecting on a topic
Contemplation- open awareness without focus
Prayer- interchange with God
Kataphatic- seeking god through sensory and thought experience
Apophatic- God is behind senses and thoughts

You cant offer apophatic guidance if you are kataphatic

Psychotherapy is abt efficient living
Spiritual direction is abt loosening attachments and surrendering to God

Tend to the soul and dont be railroaded by a partial part of a person

4 forces
Our spiritual longing
Gods longing for us
Our fears and resistance
Evil (when something other than God is our ultimate concern)

Reality is an experience mediated by the brain

Unitive experience- self is suspended, awareness remains. The experience cant be recognized while its happening or there would be an “I”. Its nothing that can personally be achieved. Effort is self defining. One can only be open to a truth that is already there but unrealized.

Non unitive spiritual experience- sensory

Possession occurs rarely and is often proceeded by obsession

Dream analysis can create ego absorption

Has your spirituality in any way made you less of an asshole?

Conscious desires may be blocked because of unconscious resistances

Spiritual directors must not allow desire for problem solving to cloud perception of what god may be calling for

We seek to narcotize our longing for union with furtive passing intensities.

We dont know the difference between a spiritual strength and weakness

We and God are endlessly mysterious, our self images are expedient symbols of who we really are

Self importance / attachment to self image, is the biggest obstacle to spiritual growth.

Desire to hold onto unitive experience is a way to destroy the experience and assert self

Thinking abt god is a way to bypass the experience of god

Dont use spirituality as an excuse to be lazy, or prayer as a tranquilizer

Dont use spirituality to fuel your narcissism.

Don’t substitute consolation for desolation. Its God if its not depression. Be in the emptiness. Be angry at god but dont alienate from god.

Not all depression is a dark night of the soul. The dark night is a period of unknowing. May include a loss of god and of self image.

Depression may be a reaction to the dark night, but it is not the dark night.

Dark night experiences dont make one less functional, or loose their sense of humor, or compassion. There is no self absorption. It feels right. One doesnt feel annoyed with someone in the dark night like they do with someone depressed.

Maybe the presumed dark night is the work of evil - one must discern…

Being in spiritual direction is like being in prayer- together.

The director is efficacious insomuch as they have surrendered to god

In vulnerable intimate relationships, “condensation” of erotic feelings can coalesce with feelings of affection and trust

Sexual feelings pursued may be a substitute for hunger for the lord (and it requires fulfillment, not sacrifice of the ego). Its worshiping the creation, not god

Diagnosis of pathology seeks to destroy mystery. Discernment seeks to appreciate it.

Spiritual direction is not a profession. They cant be trained. They need to be called and gifted. There is no way to certify a spiritual director. The real director is God.

[Tamara Murphy · Rating 3 out of 5]

In the realm of learning discernment as I encounter various spiritual experiences among those I direct, I was grateful to Gerald May’s description of “unitive experiences” in chapter 3, and later about “excessive preoccupation with psyche and evil”.

And also:

“Excessive preoccupation with psyche and evil - either from supportive or antagonistic standpoints - fosters a degree of self-consciousness and self-importance that is very likely to eclipse the ever-present mystery of God's truth. Discernments are essential, but it is not at all necessary or helpful to become attached to making them. If possible, it is best to see psychological phenomena such as dreams, fantasies, images, and thoughts as manifestations of God's potential in the same way that nature, art, relationships, and all other phenomena are. Gazing into an empty, blue sky, kneeling in prayer in a cathedral, and recalling memories associated with a dream can all be worthwhile spiritual explorations. They can also all be distractions from spiritual exploration. The beauty of the sky or the cathedral can create an absorption with sensate experience, just as dream analysis can create ego-absorption.”

My personal experience growing up around a variety of church denominations with various understandings of the role of the Holy Spirit through a variety of natural and supernatural pathways has left me a bit skeptical of the experiences that fall on the more supernatural end of the spectrum. At the same time, I’ve experienced some of those hard-to-articulate connections with God and I long for a better understanding of what it means to discern those kinds of encounters. I found Dr. May’s encouragement to “test the fruits” enlivening and confidence-boosting:

“The importance of experiences lies not so much in their precise nature as in one's response to them. In part this represents a harkening back to an old principle of discernment...of evaluating an experience in relation to its fruits. More deeply, however, we are speaking of remaining attentive to the mystery and reality of God behind all phenomena, refusing to allow superficial appearances to distract us from this central concern. We do a disservice to ourselves and others when we allow our interest in the nature of a phenomenon to obscure the mysterious wonder of the very existence of that phenomenon.”

And also:

“In spiritual direction, however, there has to be an ongoing awareness that anything can happen; that the Holy Spirit is already affecting the person; and that one must participate in this work through careful discernment and support. here again, it is necessary to walk the fierce path of free will and dependence. We must always claim the freedom we have been given; to do otherwise would devalue our humanity. But at the same time, we will increasingly recognize the extreme inadequacy of personal will and knowledge in figuring out what life is or how we should live it. As we grow in wisdom, we also grow in the realization of our utter dependence upon the Lord in all things. it seems to me, then, that in its purest human form spiritual direction is a journey towards more freely and deeply choosing to surrender to God.”

[Steve Watson · Rating 4 out of 5]

I quite liked Gerald May’s book. Parts were more engaging for me than others, but I appreciated the professionalism and insight with which he wrote. For my own notes, I’ll simply highlight a few sections I found particularly helpful, with brief comments,

Four forces in human spirituality: (23-25)
spiritual longing
God’s longing for us
Internal fears of and resistance to spiritual realization (opposed growth toward freedom)
Evil forms and sources

Very helpful summary. I resonate with May’s attention to desire and longing.

“Legitimate spiritual guidance involves a full acceptance of the physical and psychological nature of human beings and an informed, caring response to the manifestations of that nature.” (31)

I appreciate May’s insinuation that there is spiritual guidance that is illegitimate: anything that is uninformed, uncaring, or fails to accept human nature as worthy and dignified has no place in ministry.

“The very heart of our longing for God often remains unconscious until the time is right for it to emerge…. All one’s basic needs may be met and all one’s relationships going well, yet there may be a deep inner nagging, a longing for something more or something different that might make life complete…. In the absence of clearly identifiable disorder, it is terribly destructive to encourage the dulling or denial of this deepest existential discomfort, for this is one pain we are not meant to anesthetize ourselves to; one hunger we are not meant to deny; one ‘problem’’ we are not meant to fix with our own hands.” (60)

How much spiritual poverty in the developed world comes from anesthetizing our longings, discomforts, and deepest desires!

“An internal monastery is very difficult to establish in a culture that is constantly subverting surrender.” (67)

This is evocative of Teresa of Avila’s beautiful language about the interior castle.

“It is our only hope for salvation, I feel, that our search for God is seeded, borne, supported, and accompanied by God’s search for us.” (69)
“...to attend to the Holy Spirit in their interchanges, to be aware of seeking grace, and to recall as often as possible that the true healing, growing effects of spiritual direction come of God’s work through the relationship… (113-114)

I find it freeing to conceive of spiritual direction, and in fact much of the relational life of a pastor as well, as paying attention to God’s search for us. There is so much less fixing and striving in this.

“Have you ever had any other imagery or strong feelings in prayer? Any strong emotions of love, body sensations, or sexul images? What are the times you’ve felt closest to God? What about nature, usic, sex, worship, or times of crisis?” (140)

In talking about sexuality and spirituality, May encourages probing questions early in the relationship. I appreciate these questions and the encouragement to ask more probing questions in general.

“Curing refers to restoring efficient functioning. Healing refers, in the largest sense, to increasing love.” (209-210)

My hope for all that can be cured gets lower as I age and as I know more people. My hope for increasing healing, though, grows. And I love this simple definition of that word.

“Not advising directees in areas outside the director’s competence.” (216)

Preachers and pastors and other Christians can be so dang opinionated. I appreciate that May lists, as an obvious ethical consideration in ministry, as obvious as not having sex with those you serve, that one doesn’t advise outside one’s area of competence and training.

[Dennis Podryadchikov · Rating 5 out of 5]

What happens when a psychiatrist writes a book on spiritual formation? Even though the primary audience is other psychiatrists, anyone interested in spiritual direction will gain a number of valuable insights, including how to address visions and how to work with possible disorders. What is strange is that May does not cover the influence of the world when talking about sources of influence on one's life such as the self and the spiritual enemies. Other than that, the book is an excellent source for spiritual companions, who may think of themselves as spiritual surgeons, as per May's suggestion. Some books are worthy to be read more than once; this book is one of them.

[Carlos · Rating 5 out of 5]

This book is a bit dated in the resources it points to (ie: it makes reference to the DSM III instead of the DSM V), and one wishes that the author had had the chance to update it. That being said, I think that this book provides a valuable resource in exploring the practice of spiritual direction and how it may interplay with the practice of psychological counseling. As with many of May's books, I found this book to be an enjoyable read with many valuable insights.

[Josiah Stern · Rating 4 out of 5]

Fascinating exploration of Spiritual Direction, it’s importance in modern society, and ways in which we can practice it better. May leans heavily on psychological language throughout this book and utilizes it well to explain the compelling aspects of spiritual direction and how it differs from psychotherapy. Anybody interested in spiritual direction and the way we approach caring for an individuals spiritual health should give this book a read.

[Matthew A. Stead · Rating 4 out of 5]

Great for defining spiritual direction

A bit heady at first, but down to earth after the intro work. I have a better understanding now of what's expected.

[Noel Walker · Rating 3 out of 5]

Care of Mind, Care of Spirit is a practical primer for the psychiatric dimensions of spiritual direction intended for ministry professionals and spiritual directors. Author Gerald May offers a practical discussion of a variety of psychiatric considerations encountered in spiritual direction. He summarizes mental and neurological disorders that ministry professionals might encounter in providing spiritual guidance while at the same time providing a warning against ministry professionals working beyond their depth. Providing spiritual guidance straddles the two domains (psychiatry and theology) and one needs to give attention to both in order to serve people well.

[Bob · Rating 4 out of 5]

Excellent introduction into the combination/relationship of psychology and spirituality. Gerald May was a leader in this field and is deeply missed.

[Kathy · Rating 3 out of 5]

Good book for those studying spiritual direction. Not too heady.

[Christopher Pokorny · Rating 3 out of 5]

I can see this book being used as an introductory handbook for navigating the worlds of spiritual direction and psychology.

[Jonas Stephan Johnson · Rating 5 out of 5]

Good day all is well please this is i faith a corking volume through we do not need a corking mind through worth health care in it thanks so much god bless proper have it good.