Half a century ago, the subjects of spirituality and religion were anathema in the realm of psychoanalysis, Mortimer Ostow, M.D., a psychoanalyst from the Bronx, N.Y., said at the American Psychoanalytic Association meeting in New York City in January.

For instance, when Ostow studied at the New York Psychoanalytic Institute during the 1940s, no one was supposed to talk about spirituality and religion. And when he taught at the Jewish Theological Seminary during the 1950s, the psychoanalytic community took a dim view of that activity. "It has been the practice of analysis to ignore religious associations," he said. This is not good, he asserted.

Ostow and other analysts tackled the subjects of spirituality and religion at the meeting. It is new in the history of analysis to be talking about such things, admitted Paula Hamm, M.A., a McLean, Va., analyst.

Spirituality is a "reaching out" to a natural or religious source, Ostow said; one feels in touch with a transcendent object. Spirituality is a regression to an early phase of childhood development. It is like an infant yearning for its mother.

Spirituality and religion are not the same, Ostow continued. Spirituality exists prior to religion in a person. The spiritual experience is affect; religion is cult, ritual, myth, morality. "Spirituality has nothing to do with morality," he said.

Prayer, at least Jewish prayer, is essentially a mantra—a talking to God, Ostow explained. It is a desire to speak out and to be heard.

In fact, "speaking in tongues"—talking in languages one does not understand—is also motivated by a desire to speak out and be heard, Ostow said. It is like a babbling child reaching out to its parents and wanting them to understand, although they do not yet. Speaking in tongues, he added, brings people together via a diffusion of their ego boundaries.

But is that the only impact that speaking in tongues has on people? Tiina Allik, Ph.D., a psychoanalyst and a professor of religious studies at Loyola University in New Orleans, is not so sure. When Allik was a teen, she and her family joined a group of Estonian Baptists in Toronto for a religious service. Some of the people started praying in tongues, she said, and "the effect was startling." And then, she said, her mother fell backward, moaned, and spoke in a deep voice that she could not understand.

"I became aware of an energy that pervaded the room. . .that flowed through my body," Allik reported. This experience, she said, made her wonder whether "the electrical charge" she felt was a projection of her own feelings or something external combining with something inside of her. In any event, speaking in tongues appears to involve an altered state of consciousness not only in the speaker but also in the listener.

Mystical experiences, too, "are typically altered states of consciousness," Leon Wurmser, M.D., a Towson, Md., psychoanalyst reported. "Such trancelike states," he explained, "necessarily entail large-scale denial. . . . Although one hears and sees, the content of what is seen and heard is being treated so as if one had not heard or seen it. . . . It is thus a matter of making its emotional, affective meaning invalid. . . . "

Mystical experiences, however, are not the same as psychotic experiences, Ostow stressed. For instance, whereas the psychotic hallucination is enduring, the mystical vision is transient. And in most mystical experiences there is a revelation, whereas if psychotic hallucinations contain a revelation, which is rare, it will be a pseudo-revelation.

"Mysticism," Wurmser continued, "tries to find access to the mysteries of ‘being’ with the help of a world of images, feelings, thoughts, and wishes of inwardness. It may come as ecstatically exalted erotic love without physical sexuality, rather known from Christian and Muslim mysticism. . . . In contrast certainly to Christianity, Jewish mysticism (as Judaism in general) values sexuality in its physical form very highly. . . ."

Some analysts attending the psychoanalytic association meeting also broached the subject of whether analysts should address patients’ spiritual and religious needs.

Hamm reported that she has a number of patients who want to talk about spirituality or religion. "The way I handle it is, I ask questions," she explained. "I’m very curious about it." Another analyst reported that discussing religion with a patient helped the patient seek forgiveness.

Ostow said that he does not introduce the subjects of spirituality and religion into analytic sessions, but if patients bring them up, he discusses such subjects with them.

In fact, Ostow attested, discussing spirituality and religion with patients sometimes furthers the analytic process. For example, he once had a patient describe what appeared to be a spiritual experience. He confronted the patient about it, and then the patient started to change for the better—it was a turning point in his analysis. ▪