[This is a follow up course to Orthodox Christian Spirituality and Cognitive Psychotherapy: An Online Course, that appeared in four parts over the years 2012-2013. This second course is specifically oriented to explain Orthodoxy to mental health practitioners,and serve as a useful resource for Orthodox Clergy and laity as well. Ethically, mental health practitioners should incorporate the spiritual values of their patients in the therapeutic process. The course would serve as an introduction of the Eastern Orthodox ethos and cultural traditions to these professionals.
One of the most frequently questions I am asked as Chairman of the Chaplain and Pastoral Counseling Department of the Antiochian Archdiocese is for a referral to an Orthodox mental health practitioner. Sadly Orthodoxy is not a majority spiritual tradition in North America and Orthodox practitioners are few. So careful questioning by potential patients, family and clergy of a potential practitioner regarding the practitioner's understanding and respect for the spiritual values of their patients is very important. This course is meant to aid in this inquiry.
It also should be noted that this course is an updating and reworking of a recently published chapter: Psychotherapy with members of Eastern Orthodox Churches, (Morelli, 2014).]
The Orthodox Perception of Contemporary Threats to the Church
Chief among these threats is secularism, defined as the marginalization of God and the Church, and, in place of God and His Church, a focus on "earthly things." (Phil. 3,19). This springs from the values of the contemporary Western world, including radical individualism, moral relativism, and religious and political correctness, all of which guide individual and social behavior and inform political/public policy. Secularism rejects God and His Church as the touchstone of truth and meaning. Moreover, when God is rejected, the locus of truth — the place from which truth emanates and where it is found — must necessarily rest in the created order and shifts to man himself, and as pride and an inflated sense of Godless self-sufficiency grow, ideas which find no court of accountability apart from the like-minded are implemented in this quest for a new Jerusalem. (Morelli 2009b)
Clarity in theological, and in some cases moral, matters was hard won. Church Councils were often called in the heat of conflict and, in some cases, of persecution, as, e.g., the Seventh Ecumenical Council in the times of Iconoclasm. Indeed, conflict within and without the Church is to be expected, although it may ebb and flow over time. St. Matthew (7: 15-16) quotes Christ saying, "Beware of false prophets, who come to you in sheep's clothing but inwardly are ravenous wolves. You will know them by their fruits."
In regard to moral clarity, the Orthodox would consider that the egregious societal sins, although differing in degree of "missing the mark," include: abortion, adultery, alcoholism, blasphemy, child or spousal abuse (physical, psychological, sexual or neglect), drug addiction, evil speaking (talking about someone, even if true), fornication, graft, gossip, homosexual relationships, idolatry, insider trading, kidnapping, lying, pre-emptive unjust warfare, same sex marriage, torturing and/or belittling prisoners, using others for money, power or sex, acts of vengeance (national and personal).
These indicate various underlying sinful attitudes, e.g., anger, contempt, deceit, harshness, hatred, hypocrisy, lust, negligence (such as not caring for the environment, or habits that harm one's own body, like smoking and overeating). (Morelli, 2006c) Female ordination, a seemingly neutral matter to non-Orthodox, would be considered a sin against the mind of Christ and His Church. McGuckin (2004, p. 65) quotes the understanding of St. Clement Bishop of Rome (c. 92-99 A.D.) ordained by St. Peter: "I know that you are not unaware that the Church is the Body of Christ, for scripture says: God made them male and female. Here the male is Christ, the female is the Church." Only a person of the male sex can be a proper icon of Christ.
Orthodox Spiritual Life
For an Orthodox Christian, spiritual life is a dynamic journey into which he or she is born spiritually ill, inclined to sin, and is cleansed and made new in spirit by the reception of baptism. After baptism, while on earth, his or her life becomes a journey of continual purification and healing, eventually attaining theosis [union with God] or, as St. Peter puts it in his second Epistle, "partaking of the Divine Nature." (2Pt 1:4) Christ is the physician and psychotherapist, and the Church is the hospital in and through which the Christian receives this purification and healing. (Morelli, 2006d)
Acquiring humility is foundational in Orthodoxy. Staniloae (2003, p.182) calls humility "the highest and most inclusive of all the virtues." Recently, psychologists (e.g. Exline, Baumeister, Zell, Kraft, & Witvliet, 2008; Powers, Nam, Rowatt, & Hill, 2007) have begun to study, and have found support for, a relationship between humility and other prosocial behaviors such as forgiveness. Psychologists such as Enright, 2012, and Gassin, 2001, have developed psychotherapeutic interventions based partially on cultivating humility. The teachings of the Church Fathers, prayer, the Holy Mysteries, (in the Western Church called sacraments: Holy Confession, the Holy Eucharist, and Holy Anointing, etc.), combined with scientific psychology, are the medicine.
The Church as Hospital: The spiritual dimension of healing
Emphasis on the healing of persons is one of Christianity's great gifts to the world. It started with Christ. The Gospels record numerous instances of His healing of all manner of diseases, both spiritual and physical. St. Luke, himself a physician, recorded the most in his Gospel, and showed in his later book, The Acts of the Apostles, how this power of healing was granted to the Apostles. Thus it is unsurprising that at the end first early centuries of persecution the healing arts were developed by the Church and have flourished even to this day.
St. John Chrysostom presented the idea of the entire Church of Christ as a hospital, thereby expressing in clearer theological terms the relationship between the healing of body and soul as practiced by the early healers. He took as model the Parable of the Good Samaritan model (Lk 1:33ff), wherein the Good Samaritan exemplifies Christ who, as the Great Physician, comes to broken mankind (the man left beaten the road) in order to bring healing. The inn to which the Good Samaritan took the suffering man is the Church (Vlachos, 1993, 1994a, 1994b).
The interrelationship between body and soul is noted in almost every Orthodox liturgical prayer. Most begin with the Trisagion (Thrice-Holy) prayer that makes the relationship clear: "All-holy Trinity, have mercy on us, Lord, cleanse us from our sins. Master, pardon our iniquities. Holy God, visit and heal our infirmities for Thy name's sake" (emphasis added).
Orthodox Christianity has a rich history of healers revered as saints. Among the earliest are the physicians Ss. Cosmas and Damian, twin brothers who practiced close to the end of the Imperial persecutions (c. 305 A.D). Tilted "Unmercenary" because they refused to accept any money for their service, and "Wonderworkers" because in addition to healing the body they also cast out demons and removed other darkness from the souls of men as Christ had, they attributed their healing gifts to Christ, whom they called the "Great Physician," and regarded themselves simply as His instruments of healing, comfort, witness, and sanctification. Hronas (1999) detailed the life of other great healers: St. Luke and twenty other physicians, eighteen of them missionaries and two, priests.
In fourth century Byzantium, the Orthodox Church opened and administered various healing centers, including hospitals and homes for the poor, orphans, and aged (Demakis, 2004), many of them associated with monasteries. The monks often were often the health care workers, physicians, nurses and psychologists. St. Basil, bishop of Caesarea (370-379 A.D.), trained in medicine as well as rhetoric, was reported to have worked with the monks in this ministry.
St. John Chrysostom, as Patriarch of Constantinople (c. 390 A.D.), used the wealth of the Church to open hospitals and other philanthropic institutions. Within two centuries, the rapid growth of these centers necessitated state funding, although the Church remained active in administration and care-giving. The Emperor Justinian enhanced the reputation of these hospitals by moving the most important physicians into them. (Demakis 2004) In that era, St. Sampson, the "Innkeeper and Physician of Constantinople," was so respected for his healing power, prayer, virtue, and love of the sick and poor that the Patriarch ordained him a priest. In humility, he often hid his prayerful healing by dispensing medication. He healed Justinian who, in gratitude, donated a grand healing center to him, known as "The Hospice of Sampson."
The (Typikon) that details the ordering of the Pantocrator Monastery, a large healing center in Constantinople, reveals the complexity and extent of its benevolent works: a fully staffed hospital with a teaching component, an old age home, a lepers' sanitarium, and daily practical aid to the poor. (Morelli, 2006d)
Demakis (2004) notes the main characteristics of the physician-saints: they were committed to Christ, holy men before they became healers, given to personal prayer, meditation, fasting, and they actively prayed for their patients; they were outstanding physicians, often "first in their medical school class" medical science was regarded as a serious academic discipline); they had a "deep and abiding love" for mankind and strove to see "the image of Christ" in every patient, as shown by their working long hours, refusing of any payment, turning their homes into hospitals, that they ("fed and cared for their patients personally"); and they attributed their healing skills and medical successes to God.
1 Consider this explanation of the Church as Hospital by Blessed Theophylact (c. 1050 - c. 1108), Archbishop of Ochrid and Bulgaria, the great spiritual father of the Church in his commentary on the Parable of the Good Samaritan as told to us by St. Luke (10: 29-37):
All mankind shares the same nature and thus all men are your neighbors. Therefore, you too must be a neighbor to them and be near to all, not by location, but by the disposition of your heart and by your care for others. Therefore I present to you a Samaritan as an example, to show you that no matter how different or foreign he may have seemed, he was the neighbor of the one in need of mercy. You also must show yourself to be a neighbor by your compassion, and even unasked you must go to the help of others." Thus we learn from this parable to be always ready to show mercy and to make haste to be near those in need of our help. But this parable also teaches us the goodness of God towards man. It was our human nature that was going down from Jerusalem, that is, was descending from tranquillity and peace, for Jerusalem means vision of peace. Where was man descending? To Jericho, a place sunk down low and suffocating with heat, that is, to a life of passions. See that He did not say, "went down," but, was going down. For fallen human nature is always inclined downwards, not just once of old, but continuously going down towards passionate life. And man fell among thieves, that is, among demons. For if a man did not come down from that high place where the spiritual mind rules, he would not fall among demons who strip the man, depriving him of his raiment of virtue, and then inflict the wounds of sin. They strip us of every good thought and of Gods protection, and when we are thus naked, they lay on the stripes of sin. They leave human nature half dead, that is, with a mortal body and an immortal soul. And human nature was left only half dead in the further sense that man did not lie completely in despair, but hoped to find salvation in Christ. Human nature had not yet been slain outright; though death had entered the world through Adams transgression, death was soon to be abolished by the righteousness of Christ. The priest and the Levite signify the law and the prophets, who desired to make human nature righteous, but were unable to do so. For it is not possible, says Paul, that the blood of bulls and goats should take away sin. [Heb. 10:4] The law and the prophets took pity on man and sought to heal him. But they were defeated by the severity of the wounds of sin, and they passed into the past. This is what it means that they passed by. The law came and stood over the fallen man, but since it could not heal him, it turned away in revulsion and went on theother side. See that the words as it happened also have a certain spiritual meaning. For indeed the law was not given for the express purpose [of healing the wounds of sin, for Christ, not the law, was to be the healing of Adams wound]. Instead, the law was given [as a stopgap measure] on account of human weakness which could not immediately receive the mystery of Christ. This is why He says that it was as it happened, or, as we say, "by chance," and not intentionally, that the priest, signifying the law, came to heal the man. But our Lord and God, Who for our sake was made a curse [Gal. 3:13], and was called a Samaritan [Jn. 8:48], journeyed to us, that is, His journey had as its very purpose and goal our healing. He did not just catch a glimpse of us as He happened to pass by: He actually came to us and lived together with us and spoke to us. Therefore He at once bound up our wounds. He no longer permitted wickedness to operate in us freely and at will, but He bound and restrained our sinfulness and poured on oil and wine. Oil is the word of teaching which exhorts us to virtue by the promise of good things; wine is the word of teaching leading us towards virtue by the fear of punishment. For example, when you hear the Lord say, Come unto Me and I will give you rest [Mt. 11:28], this is the oil of gladness and rest. And it is the same when He says, Come ye and inherit the kingdom prepared for you [Mt. 25:34]. But when He says, "Depart into darkness [Mt. 25:30], this is the wine of sharp teaching which stings as it cleanses our wounds. You may also understand it this way: oil represents Christs human actions and wine represents His divine actions, for I may say that the Lord acted at times as a man and at times as God. When He ate and drank and relaxed, not displaying the austerity and asceticism of John the Forerunner, this is the oil. But His extraordinary fasting, His walking on the water, and all His mighty deeds of divine power, these are the wine. We can compare Christs divinity to wine, which no one could tolerate if it were poured onto a wound, unless it were tempered with oil, that is, accompanied by His humanity. Therefore, since Christ has saved us both by His divinity and by His humanity, this is why it is said that oil and wine were poured out. And at every baptism those who are baptized are delivered from wounds of the soul when they are chrismated with the oil of myrrh and then immediately commune of the divine Blood. The Lord lifted up our wounded nature upon His own beast of burden, namely, upon His own Body. For He made us members of Himself and communicants of His own Body; and when we were lying down, wounded, He raised us up to His own dignity, making us one Body with Himself. The inn is the Church, which receives all. [Pandocheion, "inn," has the literal meaning "that which receives all."] But the law did not receive all. For the law says, the Ammanite and the Moabite shall not enter into the Church of God [Dt. 23:3] But now, from every tribe and people, God accepts those who fear Him and who desire to believe and to become a member of Christs Body, the Church. God receives all, even sinners and publicans. See the preciseness of His expression, how He says that the Samaritan brought him to an inn, and took care of him. Before he brought him to the inn, he had only bound his wounds. What then am I saying? That when the Church had been established, becoming the inn which receives all, and was increased by the faith of nearly all peoples, then there were the gifts of the Holy Spirit, and the grace of God was spread far and wide. You may learn this from the Acts of the Apostles. The innkeeper is a type and symbol of every apostle, teacher, and archpastor, to whom the Lord gave two pence, representing the two Testaments, Old and New. Just as both coins bear the image of the one king, so do both Testaments bear the words of the same God. When the Lord ascended into the heavens He left these two coins in the hands of the Apostles, and in the hands of the bishops and teachers of every generation. And He said to them, And whatsoever thou spendest more of thine own, I will repay thee. Indeed the Apostles spent much more of their own: ”with great labors they sowed the word of teaching everywhere. And those teachers in each generation who have explained the Old and the New Testaments have also spent much of their own, for which they will be rewarded when the Lord returns at the second coming. Then may each of them say to him, "Lord, Thou gayest me two pence; behold, another two pence have I spent of mine own." And to him the Lord will answer, "Well done, thou good servant."
(These references are for the entire course, only a portion are for Part II)
Abramson, L. Y., Seligman, M. E. P., & Teasdale, J. (1978). Learned helplessness in humans: Critique and reformulation. Journal of Abnormal Psychology, 87, 49-74.
Alfeyev, Bishop Hilarion, (2002). The Mystery of Faith. London, England: Darton, Longman and Todd.
Alfeyev, Archbishop Hilarion. (2009). Christ the Conqueror of Hell: The descent into Hades from an Orthodox perspective. Crestwood, NY: St. Vladimir's Seminary Press.
Athanasius, St. (1975). On the Incarnation of Our Lord. Crestwood, NY: St. Vladimir's Seminary Press.
Bandura, A. (1986). Social Foundations of Thought and Action: A Social Cognitive Theory. Englewood Cliffs, NJ: Prentice Hall.
Beck, A.T., Rush, A.J., Shaw, B.F., & Emery, G. (1979). Cognitive Therapy of Depression. NY: Guilford Press.
Beck, A.T. (1988). Love is Never Enough: how couples can overcome misunderstandings, resolve conflicts and solve relationship problems through cognitive therapy. NY: Harper-Collins
Beck, A.T. (1999). Prisoners of Hate: The cognitive basis of anger, hostility and violence. New York: HarperCollins.
Beck, J.S. (1995). Cognitive Therapy: Basics and Beyond. NY: The Guilford Press.
Beck, J.S. (2011). Cognitive Therapy: Basics and Beyond. (2nd ed.). NY: The Guilford Press.
Breck, J. (2001). Scripture in Tradition: The bible and its interpretation in the Orthodox Church. Crestwood, NY: St. Vladimir's Seminary Press
Burns, D. (1980). Feeling Good. New York: William Morrow.
Demakis J. (2004). Historical precedents for synergia: Combining Medicine, diakonia and sacrament in byzantine times. In S. Muse (Ed.), Raising Lazarus: Integral healing in Orthodox Christianity. Brookline, MA: Holy Cross Orthodox Press.
Ellis, A. (1962). Reason and Emotion in Psychotherapy. Secaucus NJ: Lyle Stuart.
Ellis, A. & Harper, R. (1975). A Guide to Rational Living. NY: Wilshire
Enright, R.D. (2012). The Forgiving Life: A Pathway to Overcoming Resentment and Creating a legacy of love. Washington, DC: American Psychological Association
Erwin, E. (1980). Psychoanalysis: How firm is the evidence? Nous, 14, 443-456
Exline, J.J., Baumeister, R.F. Zell, A.L., Kraft, A.J., & Witvliet, C.V.O., (2008) Not so innocent: Does seeing one's own capability for wrongdoing predict forgiveness. Journal of Personality and Social Psychology, 94, 495-515.
French, R. A. (1991)(trans). The Way of a Pilgrim; and The Pilgrim Continues His Way. San Francisco, CA: Harper
Galanter, E. (1962). Contemporary psychophysics. In Brown, R. (Ed.), New Directions in Psychology. NY: Holt, Rinehart & Winston.
Gassin, E.A. (2001). Interpersonal forgiveness from an Eastern Orthodox perspective. Journal of Psychology and Theology, 29, 187-200.
Hausherr, I. (1990). Spiritual Direction in the Early Christian East. Kalamazoo, MI: Cistercian Publications.
Howe, R. (2005) The Disease Manager's Handbook. Sudbury MA: Jones and Bartlett Publishers.
Hronas, G. (1999). The Holy Unmercenary Doctors: The Saints Anargyroi, physicians and healers of the Orthodox Church. Minneapolis, MN: Light and Life.
Izard, C. (1993). Four systems for emotion activation: cognitive and noncognitive processes. American Psychologist. 100, 1, 68-90.
Izard, C. E. (2001). Emotional intelligence or adaptive emotions? Emotion, 1, 249-257.
Izard, C.E. (2002). Translating emotion theory and research into preventative interventions. Psychological Bulletin, 128, 796-824.
Kadloubovsky, E., & Palmer, G.E.H. (1954). Early Fathers from the Philokalia. London: Faber and Faber.
Kahneman, D. (1973). Attention and Effort. Englewood Cliffs, NJ: Prentice Hall.
Krindatch, A. (2011),(Ed.). Atlas of American Orthodox Christian Churches. Brookline, MA: Holy Cross Press
Langes, M. (Ed.) (1977). The Evergetinos. Athens, Greece: Monastery of the Transfiguration.
Lazarus, R.S. (1991) Emotion and Adaptation. NY: Oxford University Press
Loftus, E. F. (1980). Memory, Surprising New Insights Into How We Remember and Why We Forget. Reading, MA: Addison-Wesley
Marmor, J. (1962). Psychoanalytic Therapy as an Educational Process: Common Denominators in the Therapeutic Approaches of Different Psychoanalytic Schools. In Masserman, J.H. (Ed.). Science and psychoanalysis. (Vol. 5). Psychoanalytic education. Pp. 286-299. New York: Grune & Stratton.
McGoldrick, M., Giordano, J. & Garcia-Preto, N. (Eds.). (2005). Ethnicity & Family Therapy. (3rd ed.). NY: Guilford Press.
McGuckin, J. A. (2004). The Westminster Handbook to Patristic Theology. Louisville, KT: Westminster John Knox Press.
Morelli, G. (2004) Sex is Holy: The responsibility of Christian parenting. The Word. 48. 6, 7-8.
Morelli, G. (2006a, March 6). Asceticism and Psychology in the Modern World. http://www.orthodoxytoday....
Morelli, G. (2006b, May 08). Orthodoxy and the Science of Psychology. Available: http://www.orthodoxytoday....
Morelli, G. (2006c, July 29). Dealing with Brokenness in the World. Available: www.orthodoxytoday.org/OT....).
Morelli, G. (2006d, December 21). The Ethos of Orthodox Christian Healing. Available: http://www.orthodoxytoday....
Morelli, G. (2009, September 26). Secularism and the Mind of Christ and the Church: Some Psycho-Spiritual Reflections. Available: http://www.orthodoxytoday....
Morelli, G. (2014). Psychotherapy with members of Eastern Orthodox Churches. In P. Scott Richards & Allen E. Bergin (Eds.) Handbook of Psychotherapy and Religious Diversity (2nd ed. pp. 77-102). Washington DC: American Psychological Association.
Novaco, R.W. (1975). Anger Control: The Development of an Experimental Treatment. Lexington, KY: Lexington.
Novaco, R.W. (1977). Stress inoculation: A cognitive therapy for anger. Journal of Consulting and Clinical Psychology, 45. 600-608.
Palmer, G.E.H.; Sherrard, P.; and Ware, K. (Trans.) (1971, 1981, 1988, 1990). Philokalia, I IV. London: Faber and Faber.
Posner, M.I., & Snyder, C.R.R. (1975). Attention and Cognitive Control. In Solso, R.L. (Ed.), Information Processing and Cognition: The Loyola Symposium. Hillsdale, NJ: Erlbaum.
Powers C., Nam, R.K., Rowatt, W.C. & Hill, P.C. (2007). Association between humility, spiritual transcendence, and forgiveness. Research in the Social Scientific Study of Religion, 18, 75-94.
Rathus, S. A. (1973). A 30-item schedule for assessing assertive behavior. Behavior Therapy, 4, 398-406
Sakharov, Archimandrite Sophrony, (1999). St Silouan the Athonite. Crestwood, New York: St. Vladimir's Seminary Press.
Shiffren, R.H. (1988). Attention. In Atkinson, R.C., Herrnstein, R.J., Lindzey, G., & Luce, R.D. (Eds.), Stevens' Handbook of Experimental Psychology. (Vol.2). NY: Wiley.
Spiegler, M.D. & Guevremont, D.C. (2010). Contemporary Behavior Therapy. Belmont, CA: Wadsworth.
Staniloae, D. (2003). Orthodox Spirituality: A Practical Guide for the Faithful and a Definitive Manual for the Scholar. South Canaan, PA: St. Tikhon's Seminary Press.
Tavris, C. (1984), Anger: The misunderstood emotion. NY: Simon & Schuster
Vlachos, Archimandrite Hierotheos (1993). The Illness and Cure of the Soul in the Orthodox Tradition. (Translated by Effie Mavromichali). Levadia, Greece: Birth of the Theotokos Monastery.
Vlachos, Archimandrite Hierotheos (1994a). Orthodox Psychotherapy: The Science of the Fathers. (Translated by Esther Williams) Levadia, Greece: Birth of the Theotokos Monastery.
Vlachos, Archimandrite Hierotheos (1994b). Orthodox Spirituality: A Brief Introduction. (Translated by Effie Mavromichali). Levadia, Greece: Birth of the Theotokos Monastery.
Ware, Bishop Kallistos (1979). The Orthodox Way. Crestwood, NY: St. Vladimir's Seminary Press.
Ware, Bishop Kallistos (1963). The Orthodox Church. London: Penguin Books.
Weiner, B. (Ed.). (1974). Achievement Motivation and Attribution Theory. Morristown: General Learning Press.
Wheeler, E. P. (ed., trans.) (1977). Dorotheos of Gaza: Discourses and Sayings. Kalamazoo, MI: Cistercian Publications
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V. Rev. Fr. George Morelli Ph.D. is a licensed Clinical Psychologist and Marriage and Family Therapist.
He is the Coordinator of the Chaplaincy and Pastoral Counseling Ministry of the Antiochian Orthodox Christian Archdiocese and Religion Coordinator (and Antiochian Archdiocesan Liaison) of the Orthodox Christian Association of Medicine, Psychology and Religion.
Fr. Morelli is also Assistant Pastor of St. George's Antiochian Orthodox Church, San Diego, California.
Fr. Morelli is the author of: