Most psychiatric patients want their therapist to be aware of their spiritual beliefs and needs, because human spirituality has an essential role in coping with challenges and enjoying life (16). Human consciousness is characterized by a capacity for self-awareness and free choices that are not fully determined by past experience (7). The great mystery of neuroscience is that human consciousness cannot be explained or reduced to materialistic processes (29,30).
As a result of the fact that human consciousness transcends materialistic explanations, psychiatry now finds itself at an important crossroad. The fostering of spirituality and well-being is crucial for psychiatry to achieve its meaning and purpose, but spirituality and well-being have been neglected because of a tendency toward materialistic reductionism. Psychiatry has now the opportunity to promote a broader understanding of what it means to be a human being. Humanity cannot be reduced to matter, as in behaviorism or molecular psychiatry. Humanity also cannot be reduced to the dualism of body and mind, as in cognitive- behavioral approaches.
Self-awareness requires an understanding of the physical, mental, and spiritual aspects of a human being. To foster fuller self-awareness, CBT can be augmented with an added focus on existential issues, such as finding selfacceptance and meaning in coping with life challenges. Meaning can be found by encountering someone or something that is valued, acting with kindness and purpose in the service of others, or developing attitudes such as compassion and humor that give meaning to suffering (16,31,32). Spiritually-augmented therapy is more effective than CBT in activating feelings of hope and life satisfaction (16,31,32). It is also shown in randomized controlled trials to reduce relapse rates and enhance the quality of functional recovery (16). The reduction in relapse rates suggests that fostering the search for meaning may sometimes help people develop their character to new levels in which they have reduced vulnerability to future episodes.
In order to incorporate a fuller understanding of spiritual development into general clinical practice, it is necessary to understand the way that people normally develop their sense of well-being. Fostering the development of character traits such as being self-directed, cooperative, and spiritual, automatically leads to a good quality of life. Understanding the ways to foster spiritual development allows a therapist to treat the full range of psychopathology, provided the therapist knows appropriate ways for dealing with the many obstacles that patients may encounter along the path to well-being.
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