Care vs. Cure

Caring for the Soul in Counselling:
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Care vs. Cure

“The great malady of the twentieth century, implicated in all of our troubles and affecting us individually and socially, is 'loss of soul.’”
- Thomas Moore

Background of the Psychology Field: Cure Orientation
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Much of the landscape of the Western mental health care system is generally aligned with the Western medical system (Ottens and Klein, 2005). Psychotherapy, in its attempts to be “taken seriously,” generally aligns itself with the scientific worldview that dominates the medical model (Kochunas, 1997). Many writers on the subject feel that the psychotherapy field has lost its soul due to this—in particular, due to an emphasis on the randomized control trials, audit culture, empirical research, and pharmacology that dominate the Western medical model (eg. Elkins, 1995; House, 2012; Ottens & Klein, 2005). Much of the psychology world, like the medical world, operates from a ‘diagnosis’ or ‘disease’ framework, and employs control, cure, and rationality as treatment (Ottens and Klein, 2005).

The emphasis of the scientific worldview on the psychotherapy field has contributed to our sense of the compartmentalization and fragmentation of the human experience, and the mechanization and technologization of our systems of psychotherapeutic care (eg. Carson, 2020; Colman, 2009; Duran, 2019; Roseman-Halsband et al, 2019). Efficiency is favoured over authenticity (House, 2012)—systemization is favoured over exploration. Insurance providers only offer enough coverage for brief forms of therapy, and pharmaceuticals are often prescribed as the first step of response. The quick fix is prioritized—what some writers call the ‘fast food’ of the therapy world (Henderson, 2009). In other words, cure is centered over care.

This is not to say that there is no value in any of this—quite the opposite is true. Medication is often life-saving. Evidence-based practices keep clients safe from the individual whims of therapists. And often, we really do just want to feel better as soon as possible.

Rather, the argument among many writers interested in soul care is that, while it is absolutely wise to integrate medical and mechanistic models into a comprehensive theory of psychotherapy, if these models serve as the foundation of this profession, they produce a psychology that is barren of soul (eg. Elkins, 1995). Some believe this is problematic—after all, psyche etymologically means soul.

Some writers on the subject go so far as to say that a soulless model of psychology actually supports the soullessness of our culture (Ottens & Klein, 2005). Such a model “unintentionally participate[s] in the further desacralization of our society, and in the desouling of individual lives. Soulless therapies produce soulless results” (Elkins, 1995, p. 82).

A Shift in Emphasis: Care Over Cure

A psychotherapy that includes the soul orients itself from a place of care, rather than cure. First and foremost, care over cure means that we believe in the inherent worth of the client, whether or not any change occurs. Soul care requires a commitment to the basic lovability of the client (Clarkson, 2021). It means the therapists’ most essential tool is love, rather than logic (Ottens & Klein, 2005).

Care over cure is non-pathologizing. The medical response (as well as the everyday cultural response) to experiences like yearning and meaninglessness is to seek a pathological label for them, like anxiety or depression, and then to remove them, much like one would a disease, rather than learn how to hold and care for them (Brizzi, 2020). But from a soul care perspective, we don’t come to therapy because there is something wrong with us, we come to therapy to care for ourselves (Roseman-Halsband, 2018).

We can all have the tendency, especially when coming to counselling, to treat ourselves as a list of malfunctions and maladies. We treat ourselves as something in need of fixing. But the soul is associated with depth, and therapy that nurtures the soul does not center fixing or adjusting or making someone “healthy” as its goal—focusing on “fixing” a symptom can mean that the underlying problem, the depth the soul craves, is never explored (Moore, 2021; Ottens & Klein, 2005).

An additional problem in reducing therapy to fixing or problem solving is that it makes the therapists’ expertise the critical factor—which goes against the collaborative, relational, process-oriented nature of soul care (Ottens & Klein, 2005).

Instead of ‘fixing,’ we are caring. This means staying with, holding attuning, accompanying, regulating, experiencing, making meaning, getting to know pain, being human, and learning self-compassion (Clarkson, 2021). This can be a challenge if the therapist has a deep need to make it better (Clarkson, 2021). And it can be a challenge for the client, who often just wants to feel better as soon as possible. But it also offers a freedom to client and counsellor, because it removes expectations of behavioural change or cure (Clarkson, 2021). Together we then get to learn to care for how things are instead of aiming to change things into how we think they should be.

For both client and therapist, to do this kind of work, rather than jumping for quick fixes, we have to be willing to sit with and in the symptoms, to more deeply attune to them as potential cries of the soul (Moore, 1994). It is in this very turning from cure, and towards care, that we get to create and learn what care individually looks like. We have to navigate “the myriad failures that come with being a human creature” in order to “make together a place for safety and love” (Quillman, 2020, p. 26).

In doing this, we are beginning to move past a psychotherapeutic practice that overvalues rationality, and return to re-valuing the sensations, emotions, and feelings that are “to the soul what colours are to our eyes” (Ammann, 2022, p. 963).

References

Ammann, R. (2022). Sandplay: traces in the sand - traces in the brain. Journal of Analytical Psychology, 67(4), 962–978.

Brizzi, M. (2021). The Soul of Existential Therapy: Dialogues with Professors Todd DuBose and Miles Groth. Existential Analysis: Journal of the Society for Existential Analysis, 32(1), 159–163.

Carson, C. (2020). The workplace as sacred space. Alternative & Complementary Therapies, 26(1), 23–27

Clarkson, B. (2021). Is it God who cures? A transpersonal perspective on script formation, the role of physis, and the “soul work” of the therapeutic process. Transactional Analysis Journal, 51(3), 317–330.

Colman, W. (2009). Response to Umberto Galimberti. Journal of Analytical Psychology, 54(1), 19–23.

Duran, E. (2019). Healing the soul wound: Trauma-informed counseling for indigenous communities. Teachers College Press.
 
Elkins, D. (1995). Psychotherapy and spirituality: Toward a theory of the soul. Journal of Humanistic Psychology 35(2), 78-98.
 
Hendersen, R. S. (2009). Depth healing: An “enterview” with Murray Stein. Jung Journal: Culture & Psyche, 3(4), 153–161.

House, R. (2012). General practice counselling amidst the ‘audit culture’: History, dynamics and subversion of/in the hypermodern National Health Service. Psychodynamic Practice, 18(1), 51–70.

Kochunas, B. W. (1997). Preserving soul: Rescuing diversity in the managed care era. Counseling & Values, 42(1), 12.

Moore, T. (1992). Care of the soul. HarperCollins.
 
Moore, T. (2021). Soul therapy. HarperCollins.

Ottens, A. J., & Klein, J. F. (2005). Common factors: Where the soul of counseling and psychotherapy resides. Journal of Humanistic Counseling, Education & Development, 44(1), 32–45.

Quillman, T. (2020). Neuroscience and the therapist’s love for the patient: Intersubjective space, the embodied imagination, and transformation. Journal of Spirituality in Mental Health, 22(1), 1–29.