ABSTRACT
This chapter focuses on the spiritual dimension in the dialogue between patient and therapist in the situation of the patient becoming, or having been, seriously physically ill. The "spiritual" embraces questions of meaning, purpose, existence, and mortality, for the patient and also for the psychotherapist. The chapter focuses on some of the issues that can arise in the course of clinical work that seeks to allow for the spirituality of the patient to be expressed. It considers what spirituality means in our Western culture and discusses how the spiritual enters into and affects both the dialogue and the relationship between patient and therapist. The "spiritual" can seem to be embarrassing, frightening, or too personal to be enquired into, and it can also be felt to be important, interesting, or fascinating. The spirituality of the person can find expression through formal religious or non-religious ceremony, within the context of a group or community, or through solitary prayer, meditation, or reflection.
