Orthodoxy Today
Understanding Orthodoxy for Mental Health Practioners—Part 3

[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 Distinctive Ethos of Orthodox Spirituality and Psychotherapy

Some distinguishing features of Orthodox Spirituality need emphasis. In considering the Church as a hospital, the Orthodox view of sin should be noted; it is considered a disease, illness or infirmity in need of continual healing, in contrast to the West wherein sin is viewed in more of a juridical sense. In addition, a frequent image of sin in the Patristic literature is that of an archer 'missing the mark' (amartia). In regard to marriage and sexuality, as noted above, for Orthodox Christians the "theology of sex" based on Divine Love is at the highest principal, infinitely beyond empathy or ethical standards. It goes to the essence of God Himself, as the Church Fathers emphasized.

The Persons of the Holy Trinity Inter-Relate amongst Themselves

The Persons of the Holy Trinity Inter-Relate amongst Themselves

The Persons of the Holy Trinity interrelate amongst themselves in Love. Creation is an act of love. God creates in love, and out of love continues to keep the universe and mankind in being. The infinite God creates out of nothing, continues to create through His created laws of nature and has given mankind, through its two modes of male and female, a share in His creation. Sexuality is the gift from Him by which we share in His creation. Therefore sexuality is holy and should be treated as such, because it is the way we were made to share in God's creation.

God Creating the Creatures

God Creating the Creatures

In dealing with issues of sexual orientation (homosexual and heterosexual), the Orthodox position is that we are all called to a standard of sexuality in God. A heterosexual male, despite inclinations and predisposition to 'multiple females' is called by God to be bonded with one woman, blessed by Christ, through His church, and to participate in God's creation through sexual union (Morelli 2004).

Male and Female: Blessed Marital Union to Become One Flesh

Creation of Adam and Eve

In spiritual, pastoral or clinical counseling of heterosexuals, I have found it effective to point out that, yes, we have these passions or inclinations, but as Christians we are called to 'manage' them, and live a life in Christ. This may be considered as applying a disease management model (Howe, 2005) in dealing with such inclinations. Such a model involves extensive use of cognitive behavior therapies (Spiegler & Guevremont, 2010) and a social and church support system. To the homosexual I give the same answer. "Yes, you have this inclination, but your special vocation is to manage the 'passion' in a Christ-like way, etc. It is not easy, but all is in grace; ' . . .what is impossible for man is possible for God.'" (Mt 19:26)

The Orthodox Church does not endorse the position that science is inimical to religion and must not be allowed to have any bearing on it. Science, including the research referred to above, is merely a method to learn about God's creation.

The Synergy of Nature and Grace - Science and Orthodoxy

The Synergy of
Nature and Grace
- Science and

We use our intelligence - we are made in His image to do so - to understand and have dominion over the world. (Gen 1:26) We know as Christians that 'Truth is One.' There cannot be any contradictions. We are to live the Truth of Christ and use this same truth in pastoral interactions with any individuals, heterosexual or homosexual, who are trying to lead a "life in Christ."

A special issue is what is known as Spiritual Monasticism. Noted Orthodox theologian Paul Evdokimov (1998, p.137) points out that for the Orthodox there is one spirituality to be practiced by all, whether celibate monastics, ordained clerics or individuals living in the world. He tells us: "When Christ," says St. John Chrysostom, "orders us to follow the narrow path, He addresses Himself to all. The monastics and the lay person must attain the same heights."

Interiorized Spirituality

We can see, indeed, that there exists only one spirituality for all, without distinction in its demands, whether of the bishop, monk, or lay person, and this is the nature of monastic spirituality. Now this has been shaped by lay-monastics, giving the term "lay" maximal spiritual and ecclesial meaning.

Particularly distinctive and foundational to Orthodox spirituality is Repentance (Metanoia), having a sense of our unfaithfulness to God and our offense to others, contrition of heart, and a determination to amend and to have a metanoia, - a fundamental change of mind and heart - so as not to offend God and others again. St. Peter tells us in his second epistle what God has given us: "His divine power has granted to us all things that pertain to life and godliness . . .that through these you may escape from the corruption that is in the world because of passion, and become partakers of the divine nature" (2 Pt 1:3-4). The Eastern Church understands "partakers of the divine nature" not as participation or becoming God in His Being or Essence, but sharing in the warmth and light of His "Divine Energy" (Staniloae, 2003).

Model of Repentance: The Prodigal Son

Model of Repentance: The Prodigal Son

The quintessential model of repentance/confession is found in the parable of the Prodigal Son (Lk 15:11-32). The key phrase is: "when he came to himself." In one moment he grasped the reality of his separation from his father's house, and had the insight that he had brought this on himself by focusing on the material goods to which he had thought he had a right, rather than valuing being in his father's embrace. He had penthos, or a sense of loss or mourning, at not being with his Father. This sense led to a change of mind and heart, referred to in Eastern Christian spiritual literature as metanoia. He acted on his penthos: "I will arise and go to my father, and I will say to him, 'Father, I have sinned against heaven and before you; I am no longer worthy to be called your son; treat me as one of your hired servants."

In Orthodox Spirituality, penthos and metanoia impel action and point to a transfiguration from sinfulness to godliness in thought word and deed, in both the present and the future.i In the Holy Mystery (Sacrament) of Confession, the priest is considered as a spiritual father and physician of the soul. Seminary courses do not directly teach priests how to 'hear confession.' My practice in teaching graduate pastoral theology and continuing education classes, and also my personal practice as a priest, is to emphasize the 'spirit' of the sin ("missing the mark") over the letter. I see this as attempting to heal the underlying cause of the sin. For example, if a penitent confesses having sexual intercourse outside of marriage, I might ask: "Were you in a blessed committed self-giving marriage with this person?" Their answer would be obviously, "No." My goal is to have the penitent discover that sexual intercourse has to be in a blessed committed relationship to be Godly, that is to say, be "hitting the mark," and not a spiritual illness.


St. Mary of Egypt

St. Mary of Egypt

A good model of penthos and metanoia is St. Mary of Egypt (522 AD). In the Orthodox Church her feast day is celebrated on the 5th Sunday of Great Lent and on 01 April. The life of this 6th century Egyptian Saint has become a model of repentance for all Christians as it witnesses that even though having been mired in the the Church.

Beginning at the age of 12 she went to Alexandria, Egypt and began a life of unrestrained and insatiable sexual sin for the next 17 years. She did not do it for money, but for the sheer lustful sensual pleasure which she considered the pinnacle of the meaning of life. She joined up with a group of men going to Jerusalem before the Feast of the Exaltation of the Holy Cross. she did this not out of holiness, but that she would have more individuals to join in her depraved lifestyle. She even approached the church which contained the Life-giving wood (The Cross) on the day of the Feast but was inexplicably denied entry. In the numerous lives of the saints the denial was attributed to a force from God.

While remaining outside in the church portico she saw an icon of the Mother of God (Theotokos). She immediately had a sense of her profligate life and like the Prodigal Son, had a change of mind and heart, now to direct herself away of sin but to Godliness. She uttered this prayer:

O Lady Virgin, having given birth in the flesh to God the Word! I know, that I am unworthy to look upon Thine icon. It would be mete for me, an hateful prodigal, to be cast off from Thine purity and be for Thee an abomination, but I know also this, it was for this also that God became Man, in order to call sinners to repentance. Help me, O All-Pure One, that it be permitted me to enter into the church. Forbid me not to behold the Wood, upon which in the flesh the Lord wast crucified, shedding His innocent Blood also for me a sinner, to deliver me from sin. Do Thou command, O Lady, that the doors of the Holy Veneration of the Cross be opened to me. Be Thou for me the ardent Guide to He born of Thee. I promise Thee from this moment no more yet to defile myself with any sort of fleshly defilement, but just as soon as I but see the Wood of the Cross of Thy Son, I shalt immediately cut myself off from the world, and go whither Thou as Guide shalt guide me.

The Mother of God interceded to God for her and the now penitent and future Saint Mary was able to enter the church. Later she heard a voice telling her to emulate St. John the Baptist. She should go beyond the Jordan River, into the desert for the rest of her life. During this time she lived a life of extreme asceticism for nearly 50 years, the early part of which she underwent psychologically and spiritually tortuous temptations related to her early life of sexual sin. At the very end of her life she was miraculously visited by a holy monk and saint himself, Zosimus, who gave her the Holy Mystery of the Body and Blood of Christ, since she had not received since her conversion those many years ago.

Her life is a beautiful example of interiorized spirituality, The possibility of theosis, that all can "partake of the divine nature," (2Pt 1:4) exceeds the grace and ranks of ecclesiastical office and monastic life. This grace can be attained by anyone.


(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

Fr. George Morelli

V. Rev. Fr. George Morelli Ph.D. is a licensed Clinical Psychologist and Marriage and Family Therapist.

Be sure to visit Fr. Morelli's new site Orthodox Healing  for the latest essays and information.

Published: October 1, 2014

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