THE FAMILY JOURN
Ullery / SPIRITU
AL: COUNSELING AND THERAPY FOR COUPLES AND F
AMILIES / January 2004
❖ Sex Therapy
Consideration of a Spiritual
Role in Sex and Sex Therapy
Elizabeth K. Ullery
Troy State University
In spite of high levels of reported spirituality in the United States,
human body), soul, and spirit. Although conservative, West-
spiritual issues are only beginning to be recognized as a therapeutic
ern Christian convention has prescribed a distinct separation
tool in sex therapy. This article provides background material for
between matter and spirit that has had tremendous implica-
theological and clinical questions as they relate to individualized
tions for attitudes regarding human sexuality, there has never
concepts of sex and sexual dysfunction. The complexity of human
been uniformity of thought on such issues (Beck, 2003;
sexuality is compounded by the intricacy of human spirituality, yet
they share common ground. An argument and corresponding guide-
Jones & Hostler, 2002). For example, exactly what consti-
lines are proposed for further exploration into incorporating
tutes “spirituality” and “soul” is not consistent in the literature
spiritual belief systems into sex therapy.
and certainly open to interpretation. In addition, much debate
has occurred over the role of the body as related to these con-
Keywords: sex therapy; spirituality; religious issues; tantra
cepts (Black, 2003; Gotz, 2001). In question is whether the
body (or any matter) can be a medium for spiritual fulfill-
troversy as spirituality and sexuality, yet these diverse
matters or can it be a means to enhance spirituality? Because
but interrelated issues remain at the forefront of human con-
this is the subject of interpretation, uncertainty arises about
sciousness. Though separate issues, many have been
the relative virtue of sex under different human conditions.
intrigued by the apparent relationship between them. Tradi-
Recognizing that definitions of spirituality can be highly
tionally, sex therapy has focused on the biospychosocial
personal, it is nonetheless important to create a point of refer-
aspects of human conduct, but in a quest for a more holistic
ence for the purpose of this article. Therefore, spirituality can
approach to treatment, some are now beginning to consider
be seen as “a core dimension of humanity that seeks to dis-
the possible meaning of spirituality in sexual behavior. Cer-
cover meaning, purpose, and connectedness with self, others,
tainly, the prevalence of spiritual adherents deserves such an
and ultimately God” (MacKnee, 2002, p. 234). In this sense,
spirituality differs from religion, which is a more organized
Results of the American Religious Identification Survey
treatment of some forms of spirituality (Bullis, 1998). Where
(City University of New York, the Graduate Center, 2001)
spirituality and sexuality converge is in their mutual striving
indicate that 81% of the U.S. population identifies with some
toward wholeness by connecting with another. Despite the
religious group. Of that number, 76.5% identify as Christians.
personalized nature of spiritual beliefs, it is on this broader,
Although these data do not identify those who subscribe to a
common ground that incorporating a spiritual dimension to
nonreligious spiritual orientation, the data do indicate that a
human sexuality can be considered.
substantial portion of Americans are generally influenced by
SEX AND SPIRITUALITY
religious principles and more specifically, by Christian atti-
tudes and mores concerning ideas of matter (including the
Clients bring a vast array of spiritual orientations to clini-
Author’s Note: Address correspondence to Elizabeth K. Ullery,
cians, but the preponderance of Christianity in Western cul-
Ph.D., Troy State University, Department of Counseling and Psy-
ture warrants particular consideration in matters of sexuality.
chology, One University Place, Phenix City, Alabama 36869; e-
Debates about the function of sexuality have occurred for
centuries and are a reflection of the elucidation and evolution
THE FAMILY JOURNAL: COUNSELING AND THERAPY FOR COUPLES AND FAMILIES, Vol. 12 No. 1, January 2004 78-81
© 2004 Sage Publications
Ullery / SPIRITUAL SEXUALITY 79
of thought over time by sundry people. As some of the earliest
102). It is thought that the body is one possible medium for
and most prominent Christian thinkers pondered the meaning
spiritual fulfillment that can produce a sense of transcendence
of key theological ideas, they often relied on and interpreted
that is beyond the physical being (Wade, 1998). The idea of
the writings of Greek philosophers who were, in turn, likely
bodily shame, common in Christian tradition, is antithetical
influenced by previous logicians and mystics. Plato, for
to this ideology (Romero & Albareda, 2001).
example, saw the soul as superior to but caged by the body
Bullis (1998) described three levels of tantric sexual
during material life (Beck, 2003; Jones & Hostler, 2002).
behavior. The first level is sex as a selfish endeavor in which
Plato did not trust our senses, which he felt could deceive us
the partners seek personal satisfaction. The second level is
into wanting what may not be good for us. Therefore, desire
passionate and based on mutual desire. At the third level the
can be good only when what is sought transcends the material
partners not only revel in each other but also regard each other
world (i.e., is spiritual in nature) (Jowett, 1942). Furthermore,
as sacred. It is at this last point that sex becomes transform-
Plato argued that unlike the body, the soul is eternal (Beck,
ative, producing the highest level of consciousness, love, and
2003). Such ideas influenced St. Augustine. He later pur-
unity with the divine. The couple experiences a complete loss
ported that body, spirit, and soul are quite separate entities
of ego and duality, entering a state of bliss where “spirit was
and relegated to the body the least status and importance
joined to matter to produce enlightenment” (Gotz, 2001,
because of its ability to encompass evil (Beck, 2003).
p. 5). This condition is not attained accidentally and is pro-
Plato’s student, Aristotle, devised a different view of the
duced by deliberate plan wherein the state of mind and inten-
body and soul. Rather than being discrete, flesh and soul are
tions of the partners determine how their sexual encounter
united and the soul dies with the body, thereby constituting
the essential life-form (Loomis, 1943). St. Thomas Aquinas
One tantric missive is the KamaSutra (Danielou, 1994),
mirrored this thought, although with the divergent notion of
written by Vatsyayana in about third century India and first
the soul surviving the body (Beck, 2003). The unity of body
translated into English in the late 1800s. To the casual obser-
and soul effectively removes any real hierarchy between them
ver, the KamaSutra may appear to be merely an ancient sex
and enables the material (body) to be a sacrament (a sign of
manual (Puri, 2002). However, translators and scholars
God’s grace) in a religious context (Gotz, 2001, p. 3).
regard it more as a lesson in the art of living, including love
These ideas have great implications for human sexual con-
(Doniger, 2003). Founded in a tantric spiritualism, the
duct in Christians, who have to consider their stance on the
KamaSutra does not promote sex for the sake of pleasure but
material/spiritualrelationship from the perspective of biblical
rather describes a moral eroticism that is meant to lead to spir-
original sin, or the Fall (Jones & Hostler, 2002). Although the
itual realization (Danielou, 1994, p. 34). The author professes
Bible generally advocates sex within marriage, whether sex-
three main aims in life: love, wealth, and virtue, with the latter
ual behavior can be raised to a spiritual level is open to inter-
to include courage, frankness, self-control, charity, and the
pretation and individual moral structures. It is presumed that
search for truth (Danielou, 1994, p. 32). When a couple
many Christians must either consciously or unconsciously
brings these aims and virtues to sexual union, only then may
ask themselves whether the body is inherently corrupt or can
they aspire to higher levels of spirituality during sex. It is the
be regarded as a vehicle for spiritual experience within spe-
sentient facet of humanity that allows this kind of transcen-
cific parameters, such as marriage. For the former, the focus is
dence, consciousness, and intentionality and which separates
on the sexual act (intercourse). For the latter, the relationship
human sexuality from that of animals (Danielou, 1994, p. 35).
between two people exemplifying God’s love is paramount
Can this perspective be used effectively with Western cou-
and as such, has spiritual overtones (Stayton, 2002).
ples, especially Christians, experiencing sexual dysfunction?
Partly, this depends on the source of their problems. First, cli-
nicians must assess and address any medical etiologies before
Perhaps contrary to some impressions, many Eastern reli-
embarking on a path of spiritual sexual enlightenment with
gions have also imposed constraints on sexual behavior. Like
couples (Millner & Ullery, 2002; Ullery, Millner, & Willing-
Christians, traditional Hindu, Buddhist, and Jainist adherents
ham, 2002). Once this is accomplished, if a couple expresses
encounter a duality between sexuality and spirituality (Wade,
openness to spiritual approaches to sex therapy then clini-
1998; White, 1998). However, a tantric tradition arose among
cians have some ideological bases from which to draw.
some Hindus, Buddhists, and Taoists in the East wherein
human sexuality and spirituality are intertwined and interde-
pendent (MacKnee, 2002; Urban, 2000). Tantra refers to a
INTO SEX THERAPY
philosophy pertaining to the “liberation or expansion of con-
sciousness” that employs a holistic integration of mind, body,
and spirit that can be attained through bodily activity such as
Given the large proportion of Christians in the United
eating, breathing, and sexual behavior and is founded on the
States and diversity of Christian attitudes toward human sex-
belief that everything in nature is divine (Bullis, 1998, p.
uality, it is important to note that a number of clerics, writers,
80 THE FAMILY JOURNAL: COUNSELING AND THERAPY FOR COUPLES AND FAMILIES / January 2004
and researchers have espoused acknowledging a spiritual
therapy and spirituality. Here, Beck discussed Freud’s role in
dimension to sexual behavior. So, too, for Jewish Kabbalists
pathologizing religion and spirituality but noted Jung’s posi-
has there been a history of integrating the sacred with sex
tive spiritual bent and argued that there is a need to inject more
(Gotz, 2001). The common thread among these writers
soul into psychological work. Griffith & Griggs (2001)
appears to be an interpretation and acceptance of sexual
described a model of religious identity formation based on
expression as congruent with religious and/or spiritual teach-
Marcia’s (1966) expansion of Erikson’s stage of “identity
ings. For example, Stayton (2002) noted that many choose to
versus identity diffusion.” From this perspective, an individ-
interpret the Bible literally on some issues (e.g., masturbation
ual can go through four, possibly nonlinear, stages of reli-
and homosexuality) but not on others (e.g., menstruation and
gious identity formation. The stages are explained as diffu-
slavery), as suits their worldview. Inescapably, humans are
sion, foreclosure, moratorium, and achievement, during
sexual beings, and for that writer, the ultimate message of the
which an individual may advance toward or retreat from reli-
Bible is one of “the loving relationships of people” (Stayton,
gious allegiance as influenced by life events (Griffith &
2002, p. 28). According to this view, and similar to tantric
Griggs, 2001). In a preliminary study, Cashwell (2001) found
wisdom, motives and intentions, not specific acts, are the
participants who report higher levels of spirituality viewed
determinants of sexual virtue and spirituality.
counselors as possessing more expertness and trustworthi-
A pastoral counselor, Thorne (2001), has come to the con-
ness. Finally, Wolf and Stevens (2001) outlined expected cli-
clusion that sexuality is an intrinsic feature of a spiritual jour-
ent benefits with a spiritual inclusion in therapy. Possible
ney. By drawing on centuries of mystic literature that repeat-
among these are increased family cohesion, enhanced physi-
edly uses erotic language to describe peak experiences,
cal and mental health, increased community support, and
including Hebrew and Christian scriptures, Thorne believes
improved ethical considerations (i.e., apropos a crucial com-
that the merging of spirituality with sexuality is a response to
ponent of an individual’s or family’s life). Although all these
God. Analyzing tantric practices and the Bible, Bullis (1998)
ideas require more investigation, they do show a clear interest
found a number of shared symbols, concepts, and themes.
Chiefly, ideas of sharing and preserving energy, the concept
among researchers and practitioners to incorporate spiritual-
of the body as a sacred expression of the universe, and sexual
ity into therapy.
mystery run through both tantric script and the Bible. In addi-
To date, such writers tend to be making blanket references
tion, Bullis pointed out that when sex is approached as a ritual
to psychotherapy and very little mention is made about spe-
and with intentionality, sex can be an expression of prayer and
cifically implementing spiritual sex therapy. Although only a
Sabbath. To accomplish this, couples must be present in the
modicum of ground has been broken in this realm, it seems to
moment, make ritual acts fun and congruent with individual
make sense to pursue this route, albeit with prudence. The
tastes (e.g., lighting candles, drawing baths, etc.), and the
historical, intellectual, ideological, and functional connec-
goal must be mutually valuable (Bullis, 1998, p. 114).
tions between human sexuality and spirituality are compel-
To further indicate that Christians can, indeed, experience
ling and create an impetus for scholars and clinicians to fully
ecstatic and God-present sexual encounters, MacKnee
explore how they interact for therapeutic purposes. Nonethe-
(2002) studied 10 Christian individuals who described such
less, the present lack of a solid empirical foundation in
events. Though not informed by Eastern philosophy, these
spiritual sex therapy impels a cautious approach.
persons nonetheless articulated sensations strikingly similar
The feasibility of spiritual sex therapy rests on a number of
to practicing tantrics. Themes derived from these descrip-
factors. A critical feature of every account of spiritual sex
tions include a sense of wonder and amazement, emotional
stated herein is that it does not occur casually and cannot be
cleansing, euphoria, holistic involvement (nonduality), tran-
recreated cavalierly. That is, the blend of body and spirit is
scendence, and the evidence of God. Participants in this study
done successfully only when there is purpose, meaning, and
also describe postsexual aftereffects such as healing, empow-
value attached to it (Helminiak, 1998). Clinicians contem-
erment, and connection, perhaps indicating a potential thera-
plating a spiritual approach to sex therapy should, then, care-
peutic application to some types of sexual dysfunction, par-
fully consider the following points:
ticularly those with psychosocial roots such as relational
1. Counselors must know their own spirituality and how it may
problems and body image concerns.
affect that of their clients.
2. Counselors must ascertain whether both partners share a sim-
ilar level of commitment to the therapeutic and spiritual
Can spirituality fit in with psychotherapy? The psycho-
therapeutic literature is beginning to reflect an overall rise in
3. Counselors must ask to what degree religion interfaces with
spiritual concerns as more and more individuals recognize a
each partner’s sense of spirituality.
need to address clients holistically. For instance, claiming
4. Following on issues of religiosity, counselors have to estab-
that psychotherapy has been a “secular profession,” Beck
lish whether Christian clients’ beliefs lie more toward an
(2003) explored the historical relationship between psycho-
Augustinian (duality) view of body and spirit or Aquinian
Ullery / SPIRITUAL SEXUALITY 81
(unity of body and spirit) viewpoint. An individual who
Bullis, R. K. (1998). Biblical tantra: Lessons in sacred sexuality. Theology
equates his or her body with shame and derogation may be an
and Sexuality, 9, 101-116.
inappropriate candidate for spiritual sex therapy, depending
Cashwell, C. S. (2001). The inclusion of spiritual process in counseling and
on the willingness to explore other points of view.
perceivedcounseloreffectiveness. Counseling&Values, 45(2),145-154.
5. Counselors must practice within their competencies and be
familiar with the accomplishments noted in the extant litera-
City University of New York, the Graduate Center. (2001). American Reli-
ture. A good example is sexual script theory (Jones & Hos-
gious Identification Survey. Retrieved June 29, 2003, from http://www.
tler, 2002). Sexual script theory views sexual behavior as the
manifestation of idiosyncratic scripts that are created from
Danielou, A. (1994). The Complete KamaSutra. Rochester, VT: Park Street
unique cultural, interpersonal, and intrapsychic experiences.
Utilizing therapeutic tools such as a sexual genogram, the
Doniger, W. (2003). The Kamasutra: It isn’t all about sex. Kenyon Review,
counselor can aid clients with broadening or changing their
sexual scripts (Jones & Hostler, 2002). In addition, counsel-
Gotz, I. L. (2001). Spirituality and the body. Religious Education, 96(1), 2-
ors must educate themselves about pertinent spiritual orien-
tations, acquire specialized training, and network with others
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in the field.
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Elizabeth K. Ullery, Ph.D., is an assistant professor in the Depart-
Black, P. (2003). The broken wings of Eros: Christian ethics and the denial of
ment of Counseling and Psychology at Troy State University, Phenix
desire. Theological Studies, 64(1), 106-127.