ABSTRACT
This chapter concentrates on the question of how to recognise and engage with psychological issues in spiritual direction. It looks at the nature of the spiritual direction encounter, the desirability of initial history taking, and whether and how a risk assessment may be formulated. The focus of spiritual direction is the directee's relationship with God, which may sound very different from the sort of presenting material that might be considered "normal" in therapy. Therapists have an ethical responsibility to work within their personal limits of competence and this is exactly the same for spiritual directors. A factor that is acknowledged in therapy but less so in spiritual direction is that of unconscious process, such as transference, counter-transference, projection, projective identification, and defence mechanisms. Disordered thinking and a high level of social anxiety may also alert a spiritual director to the possibility of psychosis.
