Prayer in Therapy (Even If You’re Not Spiritual)

Prayer has been a topic of much debate across a variety of health care professions. Some studies demonstrate its efficacy and others, reveal nothing at all (https://bit.ly/3mdhibR). From my perspective, much of this has to do with a set of assumptions that move away from measuring where prayer can be most effective and understanding that prayer is both a highly individual and qualitative experience. The questions we want to answer connect not so much to whether prayer can accelerate healing or whether the benefits of prayer can be generalized to a larger population. The questions are more individual (“does this person benefit from prayer”) and less mystical ( using prayer to tolerate a situation v. changing a situation). Like much of what is taught in treatment, prayer is a distress tolerance skill — one that has been used for centuries before psychology was even a consideration in human thinking. It has helped humanity throughout the ages in sustaining hope and creating meaning from pain.

As healthcare professionals, our job is not to advance religion; speaking for myself, I am probably the worst spokesperson for matters of faith. Our job is to identify what works for people. Sometimes prayer works for people, and sometimes it doesn’t.

Prayer can be something a client tries a few times and concludes, “this just doesn’t work for me” or something that a client learns and uses in everyday life. It isn’t a lot of work or time on our part — it’s a matter of planting a seed and letting a client decide on whether or not it’s something they want to continue. How we introduce prayer is essential.

We ought to keep in mind that we (meaning the country) are becoming less religious and less spiritual. We were never really that spiritual to begin with — I would argue that in our society, religion was more about trying to make sense out of things and keep order than it was about any real, meaningful connection. With that in mind, we want to come to a flexible understanding of prayer. God(s) is certainly on the list, so is nature, the universe, your wisdom, family members (dead or alive whose counsel you value). Prayer can be to something greater than yourself; that’s how DBT would frame it and where I feel the most significant value resides. Prayer can also be with something or someone you view laterally that possesses a quality or virtue you hold in high regard.

Secondly, we want to communicate a reasonable, pragmatic purpose to prayer. A purpose that most people (religious, spiritual, or neither) can buy into and expand upon on their own if they choose. I typically explain prayer through a CBT/DBT perspective across four purposes:

(1) Prayer to tolerate, to hold strength through a painful situation.
(2) Prayer to unburden yourself, temporarily, of a painful situation.
(3) Prayer to seek meaning from a painful situation.
(4) Prayer to feel connected and grateful.

Nowhere on that list or in how I practice prayer with clients will you find “Prayer to change a painful situation.” That is not to say that clients should not pray for that. It’s perfectly acceptable for anyone to do so. Still, we cross the line from skill to theology by involving ourselves, which is not something therapists or healthcare providers really ought to get into — unless connected to their role or identified in their practice (pastoral counseling as an example).

Lastly, prayer (within a skills framework) is about mindfulness. Mindfully connecting to the resource identified as a higher power, something greater than you or someone you love and respect. It sometimes involves words, and other times it involves imagery. For some people, it involves Jesus, Allah; for others Nature, or the Universe. Sometimes prayer can involve the objects around you — the things you can touch and feel.

We can move away from the question “Does prayer work for people?” to “Can prayer work for this person and how?” The final decision-maker on that, of course, is the client. So we come down to what I would like for us to consider — that prayer is something that has been used across the ages to deal with some very dark times, and its potential should not be abandoned. It is like any other skill people have used. Sometimes it works, sometimes it doesn’t. Our job as therapists, I think, is to present it to a client in a way that is flexible and pragmatic. Below is a link to a video where I walk through one example of prayer that is less connected to the mystical.