“Free to be me” – the spiritual dimension to mental health

Cover image of book and portrait photo of Dr Hilary Garraway

Integrating body, mind and spirit in CBT: Dr Hilary Garraway

In this guest blog, Dr Hilary Garraway, a graduate of the CMS Pioneer hub at St Cedd’s Centre in Romford, describes her pioneering journey towards giving space to the spiritual in mental health services.

Psychology literally means ‘the science of the soul’ and yet clinical psychology is a predominantly secular profession. Mental health services don’t routinely encourage conversations about spirituality and this area is often left to the chaplains, if at all. Despite this secular setting, I have found that many clients have rich spiritual lives that they wanted to explore within therapy and that for some their mental health difficulties were actually a doorway to the Divine.

Psychologists use certain therapeutic models and often this is Cognitive Behavioural Therapy (CBT). Over the years I have broadened my way of using CBT in three main areas. Firstly, to include people’s strengths and potential as well as their problems. Secondly, focusing more on contextual issues such as the impact of socio-economic issues and the importance of connecting with nature. Thirdly, recognising that each person has a human spirit and we each have a personal spirituality. This could be just momentary ‘glimpses of God’ or a deeply ongoing awareness of the Divine in the everyday. A significant quote that has shaped my thinking is from the Christian writer and mystic Evelyn Underhill: “A spiritual life is simply a life in which all that we do comes from the centre, where we are anchored in God.” This central point, for me, is the place of our human spirit.

So what has emerged is ‘Holistic CBT’ which adds the human spirit to the standard CBT model, explores context more and people’s strengths. This approach guides clients to explore their unhelpful patterns of thinking and behaving, which limit their potential, and encourages helpful patterns to be who they truly are. It uses art, writing and other creativity to help clients engage in different ways. Holistic CBT provides therapists with a way to talk about spirituality with clients within a framework that is familiar to them. The model uses generic spiritual language so that it is inclusive to all faiths and spiritualities and clients are encouraged to use language that feels authentic to them. Coming from a traditional missionary context into the NHS, I needed to learn a new language myself and I also needed to recognise God at work in different guises. As a result my spiritual life has deepened and my view of God has expanded.

From this Holistic CBT model, I developed a personal development course called Free To Be Me which I’ve used in the NHS with people chronically unwell, with various mental health diagnoses, as well as using it in a church context with people who have never needed mental health services. This highlights that we’re all on a journey towards wholeness and the course is more about developing the person than solving a problem. It also provides a way of taking therapy out of the clinical room and into the community and I’m hoping the Free To Be Me course can be run in a variety of places by people that are not necessarily mental health professionals. We have found that the course reduces anxiety and depression and improves well-being but this is almost as a side effect of people focusing on who they are, valuing their uniqueness and potential, facing their fears and exploring their dreams.

One of my personal life-long dreams has been to have a book published and I am now onto my third book with more in the pipeline. The Holistic CBT book was one of my projects during the CMS pioneering training I did at St Cedd Centre for Pioneer Mission, Romford. This training helped me to persevere with writing it along with the Free To Be Me course manual. A third book due out in October is a collaboration with others creating the Mental Health, Spirituality and Wellbeing Handbook. Having these published now enables these ideas to spread and I hope in time that Holistic CBT is used to give space to the spiritual in mental health services and beyond.

For those wishing to know more or wishing to contact me, please visit my website – www.hcbt.co.uk

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