In the Metropolis of the Patriarchate of Antioch – America, July 2016 - Orthodox Psychotherapy and Western Psychology

(Lectures given by Metropolitan of Nafpaktos, Hierotheos (Vlachos) at the July 18–22 Archdiocesan Clergy Symposium, convened by Metropolitan Joseph and hosted at Antiochian Village by the Antiochian House of Studies.)

In my previous paper I referred to the difference between Orthodox and Western theology. In this paper we should go on to look at this difference in a practical form, at the subject of how each of these traditions cures people.

Fr. John Romanides stressed emphatically that we can understand whether a theology is true by whether it is able to cure people. If it cannot cure them, it is not true theology. In the Orthodox Church we have a perfect therapeutic system, which is applied and expressed through the Mysteries and asceticism.

For that reason, when this method is practised correctly, people are cured.

First and foremost, therapy means passing through the three stages of the spiritual life, or at least beginning to do so. We defined these stages in the previous paper as purification, illumination and deification; or the coming of divine grace, its withdrawal and its return. This is not a psychological, sociological, ideological or ethical form of therapy. The Apostle Paul has appropriately stressed: “For all have sinned and fall short of the glory of God” (Rom. 3:23), and, “Casting down arguments and every high thing that exalts itself against the knowledge of God, and bringing every thought into captivity to the obedience of Christ” (2 Cor. 10:5).

According to Orthodox teaching, curing people does not mean propitiating God and satisfying divine justice, but man’s co-operation in order to share in the purifying, illuminating and deifying energy of God. God does not need to be cured of His wrath, which is a characteristic of fallen humanity, but human beings need to be cured. God loves everyone, righteous and unrighteous: “For He makes His sun rise on the evil and on the good, and sends rain on the just and on the unjust” (Matt. 5:45). However, people must prepare themselves appropriately so that the coming of divine grace will act for their healing and not for their condemnation, and so that God may be Paradise and not Hell. This is the basic key to the therapeutic experience of those within the Church.

I shall now speak about Orthodox psychotherapy.

1. Orthodox Psychotherapy

When we refer to Orthodox psychotherapy, we mean the therapeutic experience of the Church that comes about through the Mysteries and asceticism. Orthodox participation in the sacramental life of the Church is inconceivable without the ascetic life, but asceticism is also unthinkable without participation in the Mysteries. There is a wonderful unity between these two integrated facts of ecclesiastical life.

In the Orthodox Church there is no split between the mystery of the Cross and the mystery of glory. Some people dwell only on the mystery of the Cross and extol the pain of the crucifixion. Others insist on the experience of the resurrection, and want to be reborn without living the mystery of the Cross.

Every Mystery has both these energies of God’s grace. The stage of being a catechumen comes before Baptism, and through repentance we experience God’s illuminating grace once again. The ascetic Christian life precedes the Mystery of priesthood and continues even when someone has received the charisma of priesthood. The Mystery of the Divine Eucharist presupposes the simultaneous experience of the mystery of the Cross and the mystery of glory. No one can share in the Light of the Resurrection without previously living the mystery of Christ’s Passion and Cross. This is a basic rule in the spiritual life of the Church.

This is the context in which Orthodox psychotherapy operates. It is the tradition of the neptic, hesychastic life, which, with some modifications, can be lived by all Christians, married and unmarried, monks and laypeople, Clergy and non-Clergy.

2. Basic Principles of Orthodox Psychotherapy

The Orthodox Church is a spiritual therapeutic centre or hospital, and the Clergy work as spiritual doctors. The whole life of the Church, which brings together its sacramental and ascetical traditions, is the true method for curing human beings, who are made up of soul and body. Therapy does not refer only to the soul but to the whole human being.

All the prayers of the Church in the sacred services and the Mysteries refer to curing people. We see the same thing in the troparia that are sung during the sacred services. There is a characteristic troparion (ikos) in the service of the Great Canon composed by St Andrew, Bishop of Crete:

“Seeing Christ’s surgery opened, and health streaming forth from it to Adam, the devil suffered and was wounded; and as one in mortal danger he lamented, crying to his friends: ‘What shall I do to the Son of Mary? I am slain by the Man from Bethlehem, Who is everywhere present and fills all things.’”

According to this troparion, Christ is a doctor, but also a doctor’s surgery from which health flows to Adam. The devil is smitten by this surgery, so he mourns, and wonders what he ought to do with the Son of the All-Holy Virgin. St Andrew of Crete skilfully shows that Christ’s work heals Adam, and this, of course, inflicts pain on the devil. Christ sets man free from his subjugation to the devil and cures his wounds, which were caused by sin.

We should look at the ten basic principles of the therapeutic treatment that Christ offers wounded and injured humankind through the Church. These principles underline the fact that the Church is a spiritual therapeutic centre or hospital. Anyone who lives in this spiritual hospital must know the rules by which it functions, because otherwise he will not benefit. In what follows we shall refer mainly to the teaching of St Maximus the Confessor.

a) Illness as an unnatural movement of the soul’s faculties

On account of the sin he committed, Adam lost his communion with God and distanced himself from God’s Light. His fall from divine life is characterised as spiritual sickness, which means that the powers of his soul or body do not function naturally or supranaturally, but unnaturally. If bodily illness is understood as the distortion or dysfunction of the bodily organs, spiritual illness is the dysfunction of the soul’s faculties.

All the powers of man’s soul ought to have been directed towards God. After the sin, these powers became distorted and they act in a different way. Instead of functioning naturally they fell into disorder. The will, for instance, is the appetite of nature, which ought to move towards God of its own volition. This is called the natural will. Because of the devil’s intervention and man’s free choice, however, this movement changed course, and it became a deliberative (gnomic) will by which sins are committed. This change of direction, the conversion of the natural will into a deliberative will, and the commission of sins are described as sickness.

Curing people means reinstating all the soul’s dysfunctional faculties and returning them to their normal, natural course. The deliberative will must be healed. St Maximus the Confessor speaks about the immutability of the deliberative will that came about in Christ and those who are united with Him, and says that the natural will ought to move of its own volition towards God. Referring to Adam’s sin, St Maximus the Confessor considers that ancestral sin consists, on the one hand, in the fall of free choice away from good things and towards evil, which is certainly culpable, and, on the other hand, in the transformation of human nature from incorruptibility into corruptibility, which is not blameworthy. After the fall of Adam, free choice lapsed into evil and human nature became corrupt.

Through His incarnation, Christ took human nature and deified it. This means that He made free choice immutable. He voluntarily assumed liability to corruption, suffering and death in order to conquer corruption, the natural passions, and death in His body. He Himself becomes the medicine of immortality, so in Christ human beings can attain the immutability of free choice, and they will be released in the future from corruptibility, passibility and mortality. This constitutes the healing of the whole human being, of the soul (free choice) and the body (liability to corruption, suffering and death).

b) Curing self-love so it becomes love for God and other people

The previous section specified that self-love, which is the unreasonable love of the body, is the product of the fallen life and constitutes spiritual sickness. It must be converted into love for God and other people. The more someone loves himself, the less capable he is of loving God and his fellow human beings. It is impossible for him to love God and be charitable to others.

The whole life of the Church consists in transforming selfish love into selfless love. All human beings have within them the power to love, but when they are sick they turn this power towards themselves and become selfish. They must now be cured, which means that selfish love must become selfless. When the Apostle Paul speaks about love, one of the things he writes is that love “does not seek its own” (1 Cor. 13:5).

c) Healing the rational, desiring, and incensive parts of the soul

In order for the powers of the soul to follow their normal and natural course, the soul’s rational, desiring and incensive parts must be healed. When someone departs from God’s Light and these three powers are no longer orientated towards God, they become sick. This is how the passions are created.

According to St Maximus the Confessor, the nous that is far from God becomes either like a beast, on account of the passions of the passible part of the soul (desire and anger), or like a demon, due to the passions of the rational part of the soul. The passions of the rational part of the soul are those related to love of praise. The passions of the desiring part of the soul are those linked with love of money and sensual pleasure. And the passions of the incensive part of the soul are those associated with anger and rage.

These powers of the soul, which are also connected with the powers of the body, are healed by being turned towards God. The commandment in the Old Testament, which Christ repeated, is: “You shall love the Lord your God with all your heart, with all your soul, and with all your mind” (Matt. 22:37). It is clear from this commandment that all the powers of the soul should be lovingly directed towards God. This comes about when love is linked with the incensive part; self-restraint with the desiring part; and spiritual vigilance (nepsis) and prayer with the rational part. Since the soul is inseparably linked with the body, the whole human being is cured.

St Maximus the Confessor teaches that thoughts (logismoi) are divided into complex and simple thoughts. Simple thoughts are the concept and the simple memory of gold, a human being, and so on, whereas complex thoughts are impassioned thoughts made up of the concept and the passion, in other words, the passionate acquisition of gold or the human being. Through provocation, coupling and desire, a simple thought can lead to sin and passion.

Through asceticism according to grace, one can put an end to active passions and attempt to convert complex, passionate thoughts into simple ones by separating the concept from the passion. Then one will see the surrounding world without impassioned concepts. The question of how complex thoughts can be changed into simple thoughts is the subject-matter of ascetic practice and the whole life of the Church in general, under the guidance of a spiritual father.

d) The interconnection between pleasure and pain

God did not create Adam and Eve to have bodily pleasure and pain. Their soul had the capacity for pleasure so that it would move towards theoria (vision) of God. According to St Maximus the Confessor, after they had sinned and been stripped of the Light of God, pleasure shifted from the soul to the body, and then God permitted pain to come in, so as to curb pleasure. Thus bodily pleasure, with the enjoyment of the fruit of disobedience, brought about pain, that is to say, illnesses, suffering and death itself. The Fathers refer to this as corruptibility, passibility and immortality. These are the so-called “garments of skin” that human beings put on after they had sinned and been divested of God’s grace.

The interconnection between pleasure and pain accompanies human beings all through their lives. Indulging in voluntary pleasure causes involuntary pain, and the attempt to overcome involuntary pain by means of new pleasure causes fresh pain, so a vicious circle is created. In order to be cured, man must get rid of the mutual link between pleasure and pain. Voluntarily taking up the cross of suffering through Christian asceticism, pain and fasting cures pleasure. Through life in Christ pleasure is transferred from the body to the soul, and then man moves continuously towards God through divine longing and intense divine love.

e) The nous in relation to the blameworthy and blameless passions

In fallen man – in each of us – there are blameless and blameworthy passions. Blameless passions are hunger for something to eat in order to sustain the body; thirst for a drink of water, so that our whole organism can function well; sleep to give rest to the body and soul, and so on. These blameless passions, however, can easily become blameworthy passions linked with sin. Hunger can become greed; thirst can turn into drunkenness; and sleep can become over-indulgence in sleep, laziness, and listlessness.

The method preserved in the Church changes blameworthy passions into blameless ones, so man makes use of all material good things and shares in the created world without sinning. In this endeavour the nous plays a major role. The nous is also the first to be affected, that is to say, man’s nous is darkened first, and subsequently the whole of his inner world is darkened.

When the nous is illuminated and given life by the grace of God through repentance and prayer, it can control our inner world. As a result, the blameless passions remain blameless and the blameworthy passions turn into blameless ones.

f) Christ is the spiritual doctor of humankind

Through His incarnation, Christ, Who is the second Adam, corrected the error of the first Adam, and through His Cross and Resurrection He cured wounded humankind. He conquered the devil, sin and death in His flesh, and so He became not only the doctor but also the medicine and the doctor’s surgery for curing people.

Christ is perfect God and perfect man. He assumed mortal, corruptible and passible human nature, without sin, and deified it. According to St Maximus the Confessor, He voluntarily took upon Himself the suffering of the Cross in order to cure man’s pleasure. He also voluntarily assumed the natural, blameless passions, such as liability to suffering, corruption and death, without sin. These blameless passions, of course, did not exercise compulsion over Him, but acted according to His will, and He took them upon Himself in order to cure human beings’ blameworthy passions and enable them, too, to overcome their passibility, corruptibility and mortality in Christ. In this way, not only is sin cured, but the human body will also be set free from liability to suffering, corruption and death after the Second Coming of Christ and the resurrection of the dead. People have a foretaste of this starting from this life through the healing of free choice, the suspension of bodily functions, and the sanctification of the body (holy relics), and this will be perfected at the Second Coming of Christ.

g) Christ cures people through the Mysteries and asceticism

Christ does not heal people theoretically, emotionally and intellectually, but through their participation in His Body, the Church. This comes about through the Mysteries and the ascetic life of the Gospel.

First babies are born, and then they move and grow, but they must also eat in order to live. The same applies to human beings from a spiritual point of view. Through Baptism they are born spiritually and brought into the Body of Christ. God’s image within them is cleansed and they receive a spiritual ‘vaccination’ to counteract sin. Through Chrismation they acquire movement towards God. Through Holy Communion they are nourished with Christ’s Body and Blood in order to live.

Participation in the Mysteries, however, must inevitably be linked with keeping Christ’s commandments, which is the ascetic life. Christ said to His Disciples: “Make disciples of all the nations, baptizing them in the name of the Father and of the Son and of the Holy Spirit, teaching them to observe all things that I have commanded you” (Matt. 28:19-20). Discipleship is inescapably connected with “baptizing” (the Mysteries) and “teaching to observe” (asceticism).
God’s commandments refer to performing the Mysteries; participating in the Divine Eucharist; Holy Communion in the Body and Blood of Christ; prayer, particularly unceasing prayer of the nous in the heart; purity of thoughts and of the heart; and the struggle to direct all the powers of soul and body towards God.

h) The Church as a place of therapy

The Church, as the risen Body of Christ, is actually a place of therapy. The Church is not a social organisation, a community centre, or an ethical and charitable association. It is not a school for teaching philosophy. Rather, it is a spiritual hospital and therapeutic centre in which human beings can be cured, return to their original dignity, and rise even higher to deification.

Christ performs His therapeutic work within the Church. Christ conquered the devil, sin and death in His Body, and this is repeated in everyone in the Church. The devil is the enemy of human beings and sows evil within them. Sin is committed when thoughts develop into deeds. Death is the result of sin, but it also becomes a reason to commit sin, on account of self-love, which leads people to love glory, sensual pleasure and money. The work of Christ and the Church should be viewed from this perspective.

The Church is not something abstract but the “one, Holy, Catholic and Apostolic Church”. It is a specific spiritual organism composed of various autocephalous Churches, and each autocephalous Church has metropolises, dioceses, parishes and monasteries. Every local Church, every metropolis, every parish and every monastery is the whole Church in miniature, when it keeps its synodical and hierarchical system in operation.

A hospital that treats bodily illnesses has various clinics, and each clinic has a director and medical and nursing staff. There are also administrative staff in the hospital. We should use this image to look at the Church. The general director is the bishop; the directors of particular clinics are the priests and heads of monastic communities; the nursing staff are the deacons, monks, theologians, catechists, and so on. The work of them all is aimed at curing people and uniting them with Christ. They are all undergoing therapeutic treatment. The Church has administrative offices as well, but they cannot replace the operating theatres and therapeutic centres.

The parish should function like the sketes on the Holy Mountain. Each dwelling is home to a small community, but all the communities centre on the main ‘Sunday’ church, in which the Holy Mysteries are performed, the sacred services are held, and, above all, the Divine Eucharist is celebrated.

i) The saints are those who are being cured and who have been cured

The saints of the Church are not just people who are moral, but those who participate in the mystery of the Cross and Resurrection of Christ, who receive Christ’s healing within the Church, experience God’s purifying, illuminating and visionary energy, and are cured. Ultimately, people in the Church are not divided into those who are moral and those who are not, or those who are educated and those who are not, but into those who are spiritually sick, those who are being treated spiritually, and those who have been spiritually cured, as Fr. John Romanides would say. In accordance with what has already been stressed, therapy is understood as the transformation of selfish love into selfless love; the overcoming of pleasure and pain; the conversion of self-love into love for God and other people; and the cure of the rational and passible parts of the soul.

j) Eternal life in relation to therapy

According to the teaching of the God-seeing saints, God is Light, and whoever is deemed worthy of seeing Him sees Him as Light. However, just as light has two properties – it illumines and it burns – the same applies to the divine Light. God illumines and burns.

This has to do with man’s spiritual state. If he has a pure nous and a spiritual eye, he will see God as Light at the Second Coming of Christ. If, however, his nous is darkened, he will experience the burning property of the Light. Both the light and the fire are uncreated, so Paradise and Hell depend on the state of the human being. Paradise is the experience of the illuminating energy of God, and Hell is the experience of the burning energy of God.

This is clearly shown in the icon of the Second Coming of Christ. The Light that illuminates the righteous issues from God’s throne, but the river of fire which engulfs sinners also flows from God’s throne. Spiritual therapy is therefore necessary. The nous, which is the eye of the soul, must be purified so that, when Christ appears at His Second Coming, it can see Him as Light and not as fire, and can share in God’s illuminating energy, not His burning energy. It follows that the pastoral ministry of the Church is first and foremost therapeutic. We should view the work of the Church from this perspective.

Eternal life is related to the way in which we live in the present life. These are the ten basic principles on which the spiritual hospital of the Church operates, and one must respect them in order to begin to be cured, and for this to have eternal consequences.

3. Psychology and Neuroscience

This way of looking at the Church as a spiritual hospital or therapeutic centre, although it is very old and is recorded in the writings of the Fathers and the entire tradition of the Church, is nevertheless also very up to date, because contemporary science refers to curing people of various unpleasant conditions. In the Western world more than two hundred systems of psychotherapy have developed, each with a different content and purpose, because the Orthodox neptic tradition was unknown.

We know from various studies that up until the nineteenth century psychology went along with philosophy and expressed its various philosophical trends. Subsequently, however, psychology became independent of both philosophy and biology. Later many trends developed within psychology, such as behaviourism, cognitive psychology and existential psychology. Nowadays cognitive psychology is linked with neurology, and cognitive neuroscience is cultivated, as scientists study the interaction between psychological and neurological states in people.

A few definitions need to be given to clarify the subject of therapy from the point of view of contemporary science, and after that the value of Orthodox psychotherapy will be specified. Behaviourism is the view “that was originally expressed by John B. Watson and developed into a basic approach of psychology. It is concerned with the scientific study of behaviour that is obvious, objectively observable, and directly measurable, and excludes the study of processes such as thought, the emotions and motives. Behaviourism formulated principles and laws for the behaviour of organisms.”

Cognitive psychology is “a branch of psychology concerned, on the one hand, with analysing human intellectual processes (attention, perception, memory, thought, reasoning), and, on the other, with studying the way in which information is processed by the individual.”

Cognitive neuropsychology is “a branch of cognitive psychology that studies the effects of cerebral damage or injury on different cognitive functions, such as language, memory, attention, perception, and so on.” Neuropsychology is “a branch of psychology and neurology that concentrates on the study and understanding of behaviour and intellectual functions as a result of disturbances in the activity of the brain and the nervous system in general.”

Existential psychology is “based on existentialist philosophy. It emphasises self-awareness, the individual’s conscious experiences, and his freedom to choose his way of life and means of self-fulfilment.” (Anastasia Chountoumadi, Lena Pateraki)

It is clear from this that contemporary science with its various branches attempts to investigate the behaviour, intellectual processes and existential problems of human beings. The sciences try to combine with one another in order to help people, given that human beings are complex and collaboration between many factors is required in order to help them.

This is considered necessary because, unfortunately, today’s way of life creates various splits and problematic states. People live an inhuman, competitive society in which the law and the right of the strongest prevails. It is amoral, anti-social and disruptive. Thus human beings feel inwardly disorganised. They cannot control their mental world, their thoughts and emotions. They do not have healthy role-models to imitate and there are no healthy traditions to develop their behaviour. They do not find healthy principles to which they can attune their existential world so as to give life meaning. What is more, in contemporary society there is a split between reason, emotion and external behaviour, so people cannot develop in a balanced way or deal in an integrated manner with the problems that trouble them.

The Church is not simply a religion but God’s communion with human beings that aims to cure them and deify them. Christians live in a society with the characteristics described above, but at the same time they also grow within the atmosphere of the blessed spiritual community of the Church. As a result, they mature spiritually and avoid any sort of split, unless there is a physical problem due to hereditary or other illnesses and disabilities, which requires the intervention of medical science.

Within the Church people know, by means of Orthodox hesychasm, how to regulate their thoughts and ideas. They are helped in their behaviour by the Church’s worship and communication with the saints, and they acquire good role-models. Their life has meaning, and they solve all the existential problems connected with life, illnesses and death.

Consequently, within an organised ecclesiastical community or an Orthodox monastery, people live in practice the content of behaviouristic, cognitive and existentialist psychology and psychotherapy in an integrated way. Of course, when there are issues of physical health or neurological problems, the relevant authoritative scientists must give their opinion.

Over and above this, within the Church there is an abundance of God’s grace. Human beings are united with Christ, and through Him with the Triune God. They receive a complete therapy, which cannot be replaced by any other social, philosophical or scientific system. In other words, they reach deification. No social or scientific organisation is a substitute for the Church and what it can offer wounded humankind.

Since my childhood, I have travelled a long distance in the life and tradition of the Church. I am grateful to God for counting me worthy to belong to the Orthodox Church through Baptism and Chrismation, and to partake of the Body and Blood of Christ. I am grateful to my parents for bringing me into the world of the Church from my early childhood, and I am also grateful to my spiritual fathers for teaching me in practice what is meant by the therapeutic method. I also owe a great debt of gratitude to God for counting me worthy to meet many ascetics and great theologians, including contemporary Fathers of the Holy Mountain (Fr. Paisios, Fr. Ephraim of Katounakia, Fr. Ephraim of Philotheou, Fr. Porphyrios of Kavsokalyvia, Fr. Theoklitos of Dionysiou, Fr. Gabriel of Dionysiou, and Fr. George, the Abbot of Grigoriou), Fr. Sophrony Sakharov, but also Fr. John Romanides. They revealed to me the great treasure of the Orthodox ascetic and hesychastic tradition of the Orthodox Church.

On this journey of mine I was helped a lot by Holy Scripture (Old and New Testaments), which I studied as a therapeutic book, but also by the philokalic books of the Fathers of our Church, which showed me this vast spiritual wealth of our Church.

I should mention the Fathers of the fourth century, including St Basil the Great, St Gregory the Theologian, St John Climacus, the author of The Ladder, St Maximus the Confessor, St Symeon the New Theologian, St Gregory Palamas, St Nicodemus of the Holy Mountain, especially his book A Handbook of Spiritual Counsel: The Guarding of the Five Senses and the Imagination of the Nous and Heart, and what are the Natural Delights of the Nous, The Philokalia of the Neptic Saints, and others.

Through all these I became acquainted with the hesychastic tradition of the Orthodox Church, which offers us fullness. The lack of this hesychastic tradition in the West and the dominance of rationalistic scholasticism and humanistic Protestant moralism created major difficulties. All the contemporary systems of psychotherapy developed as a result.

We should glorify God that we live in the Orthodox Church, and we must strive to find its great treasure, which remains secretly within it, to learn its mysterious way of working, and to acquire fullness of life, in order that, when we see God at His Second Coming, He will be light and eternal life.
The conclusion is that all these currents of contemporary psychology operate inside the Orthodox Church, but the Church has other elements at its disposal that none of the other psychological trends have.

Everything taught by our holy Fathers has been tested over the centuries. It has been put into practice and produced billions of saints. While living on earth they knew the goal of Christians and the meaning of life. Most importantly, however, they lived in a wonderful tradition that Christ revealed to humankind. And now that they have fallen asleep, they rest in peace.



Since 1982 the nuns of the Birth of the Theotokos Monastery have been publishing the books of Metropolitan Hierotheos, the founder and spiritual father of the community, and distributing them throughout the world.


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