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Psychotherapy needs to be receptive to a patient's ultimate concerns like beauty, spirituality, and mortality.

The patient's symptoms sometimes stem from conflicts regarding their ultimate concerns.

The reality of evil is another often-unacknowledged ultimate concern in therapy.

Existential theologian and philosopher Paul Tillich (1952) spoke of our "ultimate concerns," those things that most truly and passionately matter to and motivate us, providing our lives with a profound sense of commitment, meaning, and purpose. Ultimate concerns influence our values, choices, and actions, though we sometimes refuse to admit to or deny having them, even to ourselves. Ultimate concerns, when consciously acknowledged and courageously confirmed, can imbue existence with a newfound sense of meaning, purpose, significance, and direction. This is why exploring and clarifying our ultimate concerns is not only appropriate but an essential task in psychotherapy.

However, most modern psychotherapy is relatively brief, symptom-focused, pragmatic, goal-oriented, technique-driven, manualized, and exclusively concerned with specifically addressing the patient's presenting problems, symptoms, or complaints and nothing else. Once these presenting signs and symptoms—which are considered by both the clinician and patient as being their primary concern—have been reduced or eliminated, typically today with the help of some psychopharmacological intervention, the patient is sent packing (see my previous post). But what happens when the patient spontaneously and, to some therapists, superfluously starts speaking in session not of their difficulties at work, nor of their distressing anxiety or depression symptoms, but rather of more esoteric subjects like loneliness, beauty, God, death, or the problem of evil? Is this still psychotherapy?

Should Spiritual and Existential Questions Be Included in Therapy?

Some today might say such soulful subjects are inappropriate and irrelevant to........

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