Holistic Cognitive Behaviour Therapy

Posted on July 19th, 2021

A spiritual life is simply a life in which all that we do comes from the centre, where we are anchored in God: a life soaked through and through by a sense of His reality and claim, and self-given to the great movement of his will.” Evelyn Underhill

Training in spiritual direction within the Chelmsford diocese gave me the opportunity for regular trips to the Chelmsford Diocesan House of Retreat in the lovely little Essex village of Pleshey. As well as being home to the Spiritual direction training for the area, it also has a special link with Evelyn Underhill. She gave her first retreat there in the 1920’s and was a regular retreat facilitator as well as a writer, theologian and one of the first female lecturers in theology. The above quote from her writing has become a significant benchmark and prayer in my own life and is one of the key threads in the work I have been doing to integrate faith and psychology.

This journey of integration began for me in the 1980’s as a young Christian entering the world of Christian counselling and working with Youth with a Mission before working in NHS mental health services as a clinical psychologist. During my time in the NHS I have had an ongoing journey of exploring how to integrate my faith with my work; to find a way of offering therapy within a secular environment which allowed space for clients to explore spirituality and faith. A key turning point was when I was reading Margaret Silf’s book, Landmarks, and I realised that every time a client makes progress in therapy they are moving closer to being in line with what God intended for them to be; each step is a step closer to reaching their God given purpose and potential.

Looking back I can see that my own understanding of God had to broaden and my spiritual journey deepen from those early YWAM days to a more contemplative and inclusive path. Over the years authors such as Margaret Silf, Richard Rohr and many others have been instrumental in shaping my expanding awareness of God.

During my years of working in adult mental health as a CBT (cognitive behaviour) therapist and psychologist I have been developing my own CBT practice to include more of people’s contexts including their social and cultural experiences and acknowledging socio-economic and environmental influences more. I also included people’s spiritual beliefs about God, the demonic and, when working with Muslim clients, beliefs about jinn.

Over the years the formulations I developed with clients became more holistic and also focused more on people’s strengths and potentials as well as their problems. It’s very rewarding to help someone to be less depressed or less anxious but nothing compares to those rich conversations about spirituality and helping someone connect with their true potential and God given identity. Training in spiritual direction and becoming part of Contemplative Fire, a new monastic community, helped shape my thinking further in bringing both spiritual growth as well as psychological well-being into my work. So over time, I was gradually integrating what I was learning spiritually within my NHS therapy work, particularly being influenced by aspects of Ignatian spirituality and introducing things like the Examen into the therapy I was offering clients.

So this broader CBT approach which has emerged from my journey of integration is about developing a person and not just solving a problem. By doing so, people find ways to overcome their problems indirectly because they deepen their connection with their God-given strengths and passions.

I started talking about this approach to CBT as ‘Holistic CBT’ (HCBT) and began teaching and writing about it. This approach guides clients to explore their helpful patterns that facilitate the potential within them and also to use CBT ideas to change the unhelpful patterns that hinder who they truly are. Thinking back to the quote at the beginning, this process encourages us to live more from the centre, from our spirit. If we don’t live from that place, we can allow ourselves to spiral into unhelpful patterns that limit who we truly are (see Figure 1).

Having worked with this approach with individuals, I then developed a group programme based on the HCBT model called ‘Free to be Me.’ This is a 16 week personal development course. I have now run this a few times in my church as well as running it at work.

Holistic CBT uses generic spiritual language so that it is inclusive to all faiths and spiritualties, while still being a model rooted in Christian tradition. Clients are encouraged to use language that feels authentic to them and so some clients use terms such as identity or consciousness instead of spirit. This feels a really important aspect of therapy particularly when it is used with people of different faiths and with varied relationships with God. Having worked outside of Christian circles I have found so many people with genuine experiences of God and also people that have been very hurt by the church. Some feel a real sense of loss and spiritual abandonment that they do not feel able to connect with God through church because of these past hurts. So inclusive and welcoming language is an important principle of the Holistic CBT model.

Holistic CBT uses different modalities such as art and reflective writing to explore ideas and it recognises the importance of peer support, connecting with creation and connecting with the Creator. Holistic CBT has come out of my own spiritual journey, learning about Christian contemplative traditions and the therapy encourages people to connect with our still centre (referred to in the quote at the beginning). Holistic CBT also draws from various CBT approaches and ideas from psychosynthesis, Jungian psychology and various other sources. So really it isn’t unique but it perhaps brings together different strands in a unique way.

I’ve been so grateful to Pavilion publishers who agreed to publish two books on HCBT - one is about the theory and the other is the Free to be Me manual that can be used to run the course as well as being a resource for offering individual therapy. For those wishing to know more or wishing to contact me, please visit my website – [url=http://www.hcbt.co.uk]http://www.hcbt.co.uk[/url]

The books are being launched on 22 July 2021. Information about the online book launch is here - [url=https://learn.pavpub.com/courses/free-to-be-me/]https://learn.pavpub.com/courses/free-to-be-me/[/url]

References: Underhill, E (1937) The Spiritual Life. Four Broadcast Talks. London: Hodder & Stoughton.

About the author: Dr Hilary Garraway is a consultant clinical psychologist working in the NHS as Adult Psychology Lead for Enfield. She is trained in spiritual direction, ecotherapy and art therapy and lectures on spirituality in therapy and related topics.

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