Healing Wounded Images of Self and God By Tom Medlar, LMHC on 3/29/22 - 12:06 PM

Carl Jung famously reflected that many of his older patients suffered due to disconnection from religion and sought to find or re-establish a spiritual outlook in later life.

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Grace was 103 years old and living in a rest home. She was referred to me for psychotherapy for possible depression. “You know what it’s like to be 103,” Grace said.

“You’ll have to tell me what it’s like,” I responded.

“I don’t know if I’m depressed or not, I just can no longer do all the things I love. I love to read but my eyes are bad, and my fingers can’t hold a book or turn the page,” she said and held up her fingers gnarled by arthritis. “I always did needlework, knitting and crocheting, but look, I can’t do that anymore.” Using her walker to get to the bathroom was a slow and painful excursion for Grace because of her arthritis.

“I do have something I want to tell you, but I don’t want you to think I’m crazy,” Grace said. “I have a vision, it’s the same thing over and over, and it’s not a dream—it happens when I’m awake, like this, sitting up in bed. There is an old man standing in my door, and he slowly shuffles to the foot of the bed, and in a deep voice that sounds like it’s coming from under the earth, he says, ‘We have to get together in the midst of this pain and work it out.’ Well, this same thing keeps happening again and again,” Grace explained.

Grace had earlier referred to her history of religious faith and her current questions. I inquired further about her beliefs and doubts. She had always been a person of faith, yet now she felt inadequate and unlovable because she could no longer be the active and productive person she had previously been. We explored what the visionary experience might mean for her if she considered it in light of that cluster of feelings and thoughts. Perhaps she might come to consider that God was mirroring her current pain and asking to be close to her in its midst, and to allow that, rather than judging and dismissing her worth. This might be the solution to her troubles. With that understanding she suggested, “I think I’ll be okay now, Tom, I don’t have to think I’m no good just because I’m not like I used to be.”

Larry was 74-year-old who had spent the last three years in a nursing home. He was nearing the end of his life and was dreading it. He was born with a deformed hand. He said his father had been alcoholic and abusive. Larry both loved and hated his father. During nearly every psychotherapy session, he made comments about hating God. If his earthly father had been so cruel, how could he trust a heavenly father? Psychologically, he could partly hold onto the affectionate side of his father-conflict by projecting the hurtful side upward.

“But I did see the light one time, Tom,” he said. Larry had been scuba diving, doing restoration work beneath a large ship—and he became stuck, ran out of oxygen, and knew he was about to die. “Suddenly there was a beautiful light all around, and I had never felt better in all my life, and I was loose, and I came to the top.”

“Did that change any of your thoughts about God,” I wondered?

“Aw, no, I still hated God; but I did see the light two more times.” Larry went on to describe two additional near-death experiences, with bright light and peaceful feelings—but he was not able to consciously draw comfort from those experiences as he neared the end of life.

Chris was a 64-year-old resident in a nursing facility, and in one therapy session shared an essay he’d written about mental illness and religious faith. “In our struggle with schizophrenia, we have much to contend with. The many highs and lows, confusions and crises in the life of a schizophrenic. We try medication, psychiatrists, and the like. These work to a degree, but are not something that sustains you or makes you stable. God is good for the mentally ill. The only concern is we have to be careful not to confuse spirituality with our mental illness. Mental illness makes it difficult to believe in God. We are so confused and not sure what to believe anyway with hallucinations and such. God is aware of this and He knows the plight of the mentally ill.”

Ah, but there’s the rub—how to distinguish mental illness from spirituality? Certainly, some persons with a mental illness do confuse the two. So what might be characteristics of a wholesome religious outlook versus psychopathological distortions? The unhelpful and pathological elements may be characterized by fear, anxiety, avoidance, grandiosity, aggression, subjective idiosyncrasy, irrationality, and hatred. Whereas productive and encouraging spiritual viewpoints might include humility, patience, peace, insight, fortitude, and may be conventional, doctrinal, rational, and foster love.


I have worked with many thousands of clients over my 40-year career, the great number of whom have passed away. For many of these clients, facing death was always more distressing for those lacking a religious outlook. Many of them, as well as my current clients of all adult ages, have also struggled to endure disability, and/or chronic pain, or past trauma, and sometimes profound loneliness. When asked how they survive, and where they find encouragement, the common response has been—“God.” It has been quite rare for someone to disavow all questions of religious faith; more commonly, these individuals struggle with unexamined doubts and spiritual conflicts associated with past relationship issues. We often hear the phrase “the fog of war,” referring to the challenge of sustaining clarity during moments of danger and chaos. Many of my clients encounter a fog of faith as they grapple with spiritual doubts made worse by illness and isolation.

The unanswered questions and doubts are invariably present and may be withheld if I don’t notice or respond to their indirect emergence. I find that I can aid the conflicted client in their quest for new perspective, for a renewed outlook that might offer them meaning and hope. Faith was regained for Grace when she humbly allowed God’s comfort to overtake her fears of being unlovable due to infirmity. Dozens of my clients have reported near-death experiences, and all of them described spiritual comfort and a dissolution of their fears of dying; all, that is, except for Larry, who had been wounded too deeply and too early in life. Chris had a major mental illness, but also a vibrant religious faith and the wisdom to understand the need to keep each as distinct as possible.

In psychotherapy with these clients, I have followed the lead of the spiritual symptoms, signals, questions, and comments, and helped them to sort through possible distortions in order to create space for a life-affirming and personality-broadening outlook on our shared existential challenges regarding illness, aging, and death.

File under: The Art of Psychotherapy, Musings and Reflections