“God Is in This Place, and I Didn’t Know!”: Psychic Vitality and Spiritual Renewal—A Relational Psychoanalytic Perspective

Abstract

In Genesis Jacob dreams of a ladder, its base rooted solidly on the ground, its top reaching toward the heavens. On it, angels ascend and descend, moving heavenward from earth, and earthward from heaven. Jacob wakes from his dream, exclaiming, “God is in this place, and I didn’t know!” The imagery of Jacob’s ladder offers a vivid illustration in spiritual terms of the capacity of the human psyche to move between different dimensions of being and levels of awareness and to be transformed by doing so. In psychological terms, it serves as a useful entry point into an examination of the transformative potential of a psychoanalytic approach to spiritual care. Drawing upon Hans Loewald’s formulation of therapeutic action, further developed by contemporary relational theorists, this essay argues that psychic transformation entails a dynamic interplay of unconscious and conscious process, in which inarticulate experience is re-animated within the structures of thought and language, contributing to renewed psychic vitality. Mediated by transference, the analytic relationship facilitates this transformation, attending to unconscious experience, ideally without imposing premature narrative closure. This essay contributes to an interdisciplinary dialogue between clinical psychoanalysis and religious studies by highlighting Loewald’s theorizing about “what makes human life human” and its potential value in the treatment and care of those suffering a crisis of the spirit.

1. Jacob’s Ladder: Dimensions of Experience

In Genesis 28:12–16, Jacob dreams of a ladder, its base rooted solidly on the ground, its top reaching toward the heavens. On it, angels ascend and descend, moving heavenward from earth, and earthward from heaven. While Jacob dreams, God stands beside him. Jacob wakes from his dream and exclaims, “God is in this place, and I didn’t know!” The Zohar, the central text of the Kabbalah, the Jewish mystical tradition, interprets Jacob’s ladder as the conduit through which the divine plenty flows, the channel of mutual influence that links the human and the divine, and which requires relationship to remain open and sustain life. Further, the Zohar identifies Jacob as the personification of this conduit. He represents the human capacity to move between different levels of awareness and dimensions of being, and to be transformed in the process. Jacob awakes from his dream with a new realization of sacred presence. Notably, in the kabbalistic framework, God is encountered not in heaven but on earth, standing beside Jacob throughout, longing to be recognized and thus revealed (Starr 2008).

This essay proposes that the spiritual imagery of Jacob’s dream offers a vivid illustration in psychological terms of the psychoanalytic understanding of the psyche’s ability to access different levels of mentation and modes of experience, and to be transformed by doing so. It serves both as a rich metaphor and useful entry point into a consideration of psychic vitality and spiritual renewal as viewed through a psychoanalytic lens. My goal in explicating these ideas from a psychoanalytic perspective is to highlight what I characterize as the spiritual dimension of psychoanalytic process. In so doing, I hope to demonstrate the relevance and value of a psychoanalytic approach to spiritual care.

Writing from my professional identity as a clinical psychologist and psychoanalyst, rather than spiritual caregiver per se, my use of the word “spiritual” is intended to encompass aspects of human experience that may include, but are not limited to, religious experience or belief. In using the word spiritual, I am referring to the ineffable dimension of creative experiencing that moves the human spirit, that stirs the soul, that contributes to our feeling more fully alive and more connected to the world around us. In the words of psychoanalyst Hans Loewald (1906–1993), whose formulations I will draw upon in this essay, it is experience that “hold[s] us spellbound,” “fill[s] us with awe,” “partake[s] of magic” (Loewald 1988, p. 80). Such experience may emerge through music, art, nature, religion, poetry, or other forms of creative engagement. As I will argue here, it may also be potentiated through the practice of psychoanalysis.

In my clinical practice, patients whom I would characterize as suffering from a crisis of the spirit report feelings of meaninglessness, apathy, or lack of connection, not only to others, but also to themselves. They describe feeling like they are “in a grind,” “going through the motions,” or “not really living.” Following the loss of a loved one, they may have difficulty reckoning with the loss and letting go of the relationship. Especially if the relationship was a complicated one, entailing ambivalence or conflict, they may feel tortured by feelings of regret or guilt. What I am describing is not only symptomatic distress, but a diminishment of psychic vitality, a constriction in the individual’s experience of aliveness, meaning, and connection.

As a psychoanalyst, I am deeply concerned with the question of what gives our lives meaning. What makes us feel inspired and enlivened, more fully ourselves, more responsive to our inner potentials? For Loewald, the answer lies in our symbolizing activity. Psychic vitality—the felt sense of aliveness and inner responsiveness—requires an interplay between unconscious and conscious, past and present. It entails a “movement between the intense density of undifferentiated, inarticulate experience and the lucidity of conscious, articulate experience.” These unconscious intensities give our current experiences their full meaning and emotional depth. The analytic relationship, in which both patient and analyst are affected by the other, facilitates this movement, thereby “rekindling” what Loewald referred to as the “symbol-forming libidinal spark in the patient” (Loewald 1978a, pp. 49–50).

2. Theoretical Framework: Loewald’s Contribution

In examining the issue of psychic vitality from a psychoanalytic perspective, I will draw primarily from the theorizing of Hans Loewald, which is particularly well suited to a dialogue between religious and psychoanalytic understandings. Loewald’s writing is infused with terms such as “sacred,” “primal unity,” “atonement,” among others, that are more often associated with religious experience than psychoanalytic formulations. While remaining faithful to a close reading of Freud’s texts, Loewald’s reformulation of development, symbolization, and therapeutic action opens a space for a more generative psychoanalytic understanding of religion and spiritual experience. As Loewald (1978a, p. 25) wrote, “Freud was not a religious man and certainly not a mystic. But one does not have to be a mystic to remain open to the mysteries of life and human individuality, to the enigmas that remain beyond all the elucidations of scientific explanation and interpretations.”

In two different senses, Loewald spoke Freud’s language. A native German speaker, Loewald was able to keenly discern and translate into English the subtle but meaningful nuances in Freud’s original German, many of which were obscured by Strachey’s English translation, comprising the Standard Edition of Freud’s collected writings. Second, Loewald adhered closely to Freud’s terminology and metapsychology when articulating his ideas in his psychoanalytic publications and presentations to his psychoanalytic colleagues. While he presented himself as an interpreter of Freud, his reading can be considered a radically relational exegesis, mystical in its implications even while cloaked in the language of psychoanalytic orthodoxy. While remaining deeply respectful of Freud, Loewald shifted the emphasis in the psychoanalytic understanding of human development from the individual mind as a closed system to the relational field within which the individual comes into consciousness (Mitchell 2000). As a result, Loewald’s theorizing occupies a unique position in the psychoanalytic canon. His ideas have been embraced both by contemporary Freudian and contemporary relational psychoanalytic theorists.

Drawing upon Loewald’s formulations of therapeutic action, I will show that, as suggested by the imagery of Jacob’s ladder, the restoration of psychic vitality requires a dynamic interplay between modes of experience and levels of awareness. It involves the movement between past and present, unconscious and conscious; between undifferentiated, inarticulate experience and rational, reflective thought. The analytic relationship, mediated by the transference, facilitates this process, allowing unconscious experience to unfold in the relational field so that it may become available for conscious reflection and articulation, ideally without imposing premature narrative closure.

The relationship between psychoanalysis and spiritual care has historically been a conflicted one, with psychoanalysts primarily emphasizing religion’s defensive function, and spiritual caregivers wary of psychoanalytic reductionism. Following Freud, who was influenced by the 19th century view of human progress, classical psychoanalytic formulations traditionally characterized religious belief as “primitive” and psychic growth as following a trajectory from “primitive” to “civilized.”1 Unconscious, primary-process, irrational thought was seen as immature and primitive, while conscious, secondary-process, rational thought was deemed mature and civilized (Aron and Starr 2013; Brickman 2018).

In contrast to this view, Loewald held that religious feelings, rather than being a sign of immaturity, can develop throughout the maturation process, just as scientific thinking can. In his seminal paper, “On the Therapeutic Action of Psychoanalysis” (Loewald 1960, pp. 19–20), he wrote, “I believe it to be necessary and timely to question the assumption handed down to us from the nineteenth century that the scientific approach for the world and the self represents a higher and more mature evolutionary stage of man than the religious way of life.” In Loewald’s formulation of therapeutic action, as well as his understanding of the process of individual growth throughout the lifespan, earlier modes of being, rather than given up or overwritten, must be reworked and re-integrated into mature life.

To situate Loewald contextually, I begin with a brief biographical sketch. I then examine his careful reading of Freud’s metapsychology, followed by his conception of therapeutic action and psychic vitality. I offer a brief clinical vignette to illustrate these ideas. Finally, I explore the implications of a psychoanalytic understanding of psychic change for spiritual care, emphasizing the importance of attending to unconscious processes in the creation of conscious narrative meanings.

3. Biographical Context

Loewald was born in 1906 to Jewish parents in the Alsace region of Germany. His father, a physician, died shortly after his birth. As a young man, Loewald was deeply drawn to philosophy, and moved to Marburg and Freiberg to study with Martin Heidegger, whose thinking was steeped in his engagement with Christian theology. Heidegger’s philosophy of Being left a profound and lasting imprint on Loewald’s theorizing, which resonates throughout his writing. However, as the Nazis rose to power, Heidegger proclaimed himself a Nazi and publicly aligned himself with the Nazi regime. Loewald experienced this as a profound betrayal (Downey 2025). Soon after, he left Germany to study medicine and psychiatry in Italy, where he practiced until 1939, when the fascist government barred Jews from medical practice and ordered foreign-born Jews to leave the country. Loewald emigrated to the United States, at first to Baltimore, then joining the faculty at Yale, where he remained until his death in 1993 (Carlson 2025).

While in Baltimore, Loewald delivered a public lecture on psychoanalysis and Christianity, later published in the Journal of Pastoral Care (Loewald 1953)2. The lecture was delivered to a church group as part of Loewald’s community outreach for the child guidance clinic he was directing at the time (David Carlson, email message to author, 23 February 2026). The paper is an extremely clear explanation to a lay audience of the psychoanalytic understanding of individual development and of psychoanalytic process. It is also a far more explicit articulation of Loewald’s engagement with and valuation of religious experience than his analytic writings would openly reveal. Notably, the publication does not appear in any of his bibliographies, perhaps due to the religious skepticism held by many, if not most, psychoanalysts at the time.

As Carlson (2025) has noted, the paper presents in more accessible and direct form the argument Loewald (1951) developed in his psychoanalytic publication, “Ego and Reality”—namely that, rather than being a sign of immaturity, religious feelings can develop throughout the maturation process. Expressing the view that psychoanalysis’ treatment of religion had been one-sided, Loewald (1953, p. 9) wrote, “[Psychoanalysis] takes into account only one aspect of the child’s experience of himself in the universe: namely, the helplessness he experiences in his environment when he is not taken care of. But it does not take into account the feeling of oneness, of trust, and of belonging which also enters into religious feeling … [Religion], in its mature form, is no more primitive than love is.”

That Loewald was a German Jewish intellectual steeped in Christian theology through his study with Heidegger makes his intellectual trajectory all the more remarkable. Despite the catastrophic betrayal of his revered mentor, Loewald did not turn away from the philosophical and theological questions that animated his thinking. Instead, he carried them forward, transformed, into his psychoanalytic theorizing. It is within this context that Loewald’s re-reading of Freud’s metapsychology takes on particular significance. To appreciate how he reimagined the psychoanalytic understanding of religious experience and psychic vitality, we must next turn to his close reading of Freud’s deeply ambivalent formulations of reality and religion.

4. Freud’s Views on Reality and Religion

In “Ego and Reality,” Loewald (1951) demonstrated that Freud held two conflicting concepts of reality that never came to terms with one another. The first and most predominant one was that reality was an intrinsically hostile outside force, represented by the paternal figure, that the ego had to defend against. In “The Future of an Illusion,” Freud (1927) located the origins of religion in the ego’s defensive attempt to cope with the fear of threatening reality—the conflict with the father—and the need and longing for the father’s protection.

Freud’s (1930) second view, elaborated in “Civilization and its Discontents,” held that originally, reality is comprised within the ego—the ego contains everything. Later the ego carves itself out from the external world (significantly, Loewald translated the German as it carves out from itself an external world), but this original feeling-state survives alongside the more developed ego. Loewald (1951, p. 11) wrote, “Our adult ego feeling, Freud says, is only a shrunken vestige of an all-embracing feeling of intimate connection, or we might say, unity with the environment.”

Responding to Romain Rolland’s critique that he had failed to address the fundamental element of religious experience—the oceanic feeling, a sensation of limitlessness and eternity, Freud (1930, p. 66) likened this experience to the state of being in love, in which the boundary between ego and object “threaten to melt away.” He linked it to primary narcissism and the infant–maternal bond. Freud acknowledged that this early ego-feeling could persist alongside the more sharply demarcated ego of maturity. He wrote, “If we may assume that there are many people in whose mental life this primary ego-feeling has persisted to a greater or less extent… the ideational contents appropriate to it would be precisely those of limitlessness and of a bond with the universe” (Freud 1930, p. 68). Yet Freud confessed the phenomenon caused him “no small difficulty” (Freud 1930, p. 65) and ultimately declared it too obscure and too intangible to pursue further.

As Loewald (1951, p. 10) observed, “The idea that religious feelings may contain elements having to do with the primary narcissistic position in which reality is comprised in the primary ego, and therefore with the mother—this idea is, if not rejected, declared to be obscure, at best of secondary importance, and objectionable.” It is precisely at this point, where Freud becomes uneasy and turns away, that Loewald picks up the thread. While Freud was inclined to dismiss the oceanic feeling as another form of regressive defense, Loewald saw its potential to enrich and enliven the ego. It is here that Loewald makes his distinctive theoretical contributions regarding religion and spirituality, offering a non-reductive psychoanalytic understanding of religious experience embedded in a spiritually inflected psychoanalytic formulation of human development (see especially (Loewald 1979)).

5. “Conscire” and the Experience of the Sacred

Loewald rooted the experience of the sacred in the being of the maternal–the infant matrix. He viewed the developing ego as emerging from an original primal, dense unity that, over time, differentiates into distinct parts, creating boundaries between self and other. Throughout the lifespan, the ego’s task is to synthesize and integrate earlier forms of experience into increasingly more complex levels of differentiation and organization. Ego development is an ongoing, dynamic process. As the psyche develops and individuates, at the same time, it internalizes and integrates. Integration involves a reconciliation, a re-linking or at-one-ment with the original unity, which is kept alive throughout the individual’s life, but in increasingly more mature, differentiated forms (Loewald 1979).

Loewald (1978b, p. 497) translated Freud’s (1933, p. 80) “Wo Es war, soll Ich warden,” as “where id was, there shall ego come into being,” holding that psychic transformation is a matter of the ego’s renewal by the dynamic unconscious. The interplay between the dynamic unconscious and the ego, a reciprocal shaping of different levels of mentation, is what makes human life human. Irrational forces have the potential to enrich and transform the rational. These unconscious intensities give our current experiences their full meaning and emotional depth. Loewald (1978a) used the term “conscire,” knowing together, to describe the intersection of unconscious with conscious knowing, explicitly connecting this form of knowing with mysticism. Deeply felt religious experience, because it arises from the id, has the potential to enrich and transform a civilization that has grown too rigidly rationalistic.

Inherent to the knowing of the unconscious is a sense of unity and timelessness, rooted in the infant–maternal relationship that exists before the development of ego boundaries, and before the capacity to make distinctions develops. Echoing Heidegger, Loewald termed this state “being.” From this unitary state, mental processes differentiate, enabling a complex, mutual relationship between different levels of mentation, and potentiating “conscire,” the knowing together.

Like Freud (1930, p. 72), Loewald (1978a, p. 42) called this state narcissism, but this type of narcissism “does not refer primarily to love of self in contrast to love of others, but to that primordial love-mentation which does not structure or divide reality into poles of inner and outer, subject and object, self and other.” The timelessness of the unconscious transcends the boundaries of temporal knowing. It is “structured or centered differently, that beginning, and ending, temporal succession and simultaneity, are not a part” of it (Loewald 1978a, p. 68). Although these primary-process states originate from the beginning of the infant’s life, this does not mean that they must be discarded. To the contrary, their presence throughout adulthood is vital to being fully alive.

Loewald’s vision of a rich human life, and by extension, a successful analytic outcome, is a sense of aliveness and openness to experience without which the human condition would be desolate. He wrote,

It would seem that the more alive people are…the broader their range of ego-reality levels is. Perhaps the so-called fully developed, mature ego is not one that has become fixated at the presumably highest or latest stage of development, having left the others behind it, but is an ego that integrates its reality in such a way that the earlier and deeper levels of ego-reality integration remain alive as dynamic sources of higher organization.

(Loewald 1988, p. 20)

Building on and explicating Loewald, Mitchell (2000), a founder and leading theorist of the relational psychoanalytic paradigm, proposed that fantasy and reality, rather than being in opposition to one another, are mutually interpenetrating. “There is a sense of enchantment in early experience, and an inevitable disenchantment accompanies the child’s growing adaptation to the consensual world of objective reality” (Mitchell 2000, p. 23). For Loewald, and following him, for Mitchell, the objective world of consensual reality is not the only true reality. “Adult reality that has been wholly separated from infantile fantasy is a desiccated, meaningless, passionless world” (Mitchell 2000, p. 24).

Mitchell (2000) highlighted the significance of Loewald’s theoretical contributions in radically transforming the basic values that guide the psychoanalytic undertaking. Rather than the triumph of the rational over the irrational, the goal of the analytic endeavor becomes the ability to move fluidly from one realm of experience to the other. Central to this paradigm shift in psychoanalysis is an increasing concern with how meaning is created in the context of human relatedness. Drawing upon Loewald’s vision of mind as embedded from the beginning in an interactive field with other minds, and further developing from these interactions, Mitchell proposed a system of mutual influence between the individual and the larger relational matrix, in which each, the microcosm and the macrocosm, the intrapsychic and the interpersonal, shape and transform one another.

In the relational framework, mind comprises a mutual relationship between different levels of mentation. Although primal unity is the original state from which consciousness emerges, it does not disappear, but continues to exist alongside higher modes of organization, serving as a source of renewal and vitality. In both the relational and kabbalistic paradigms, cultivating open channels between foreground and background, union and separateness, imagination and reality, makes the creation of new meaning possible, and potentiates the experience of the sacred (Starr 2008).

6. Therapeutic Action and Psychic Vitality

Rather than viewing the psyche as a closed and self-contained system, Loewald understood the ego, the organizing center of individual experience, as dynamically constituted in interaction with its relational surround. In other words, the individual comes into being within the matrix of human relatedness. The child begins to recognize himself as a separate center of self by internalizing aspects of the parent, including the parents’ image of the child as mediated through the numerous ways in which the parent repeatedly recognizes the child, cares for him physically and emotionally, and metabolizes, organizes, and reflects his inchoate experience. As Loewald (1960, p. 20) wrote, “The child begins to experience himself as a centered unit by being centered upon.” Over time, the child develops a sense of himself as a person who is separate from, but also with, others.

When the relational environment is sufficiently responsive to the individual’s needs and emerging potentials, while also supporting separation and individuation, the ego can more freely carry forward its inherent movement toward increasing differentiation, complexity, and integration. However, when the relational field is inconsistent, intrusive, or unresponsive, development becomes compromised. In the service of psychic survival, or of preserving connection with important others, elements of experience may be repressed, dissociated, or foreclosed. Affective experience that was not recognized or metabolized remains unintegrated. It does not disappear, but rather persists in distorted or symptomatic form, separated from the ego’s reflective capacities, and often manifesting as anxiety or feelings of deadness, disconnection, or spiritual desolation.

The spontaneity and creative relatedness that mark early development may give way to forms of accommodation. What served adaptation at one stage of development may, over time, increasingly restrain vitality, limiting the ego’s capacity to tolerate and sustain tension, ambivalence, and affective intensity. Loewald (1953, p. 7) wrote,

Psychoanalysis found, in treating patients, that the odd and disturbing symptoms, the troubling emotional and mental conditions are expressions—often in very distorted ways—of the misdirected and misunderstood needs and drives which were pushed underground; that it is they which play havoc with the patient’s life and higher development. In many patients so much that seems adult, noble, and high-minded is a façade kept up with a tremendous waste of energy, at the cost of often unbearable anxiety, hostility, and guilt feeling, inhibiting true feeling and creativity.

The individual’s developmental potentials are not lost so much as sequestered. In Loewald’s (1960) formulation of therapeutic action, the psychoanalytic task is to bring earlier levels of psychic organization into renewed and living contact within the immediacy of the analytic relationship, so that arrested developmental trends may be transformed and psychic vitality restored.

For Loewald, as for contemporary relational theorists, the analytic relationship, mediated by the transference, is the central vehicle of psychic transformation. Inevitably, the patient brings to the psychoanalytic encounter patterns of expectation, anxiety, longing, and defense that have been shaped in earlier relational contexts. In the context of the here-and-now of the analytic relationship, these earlier modes of relating are brought to life in the present. By maintaining a reflective, reliable, and developmentally more integrated stance, the analyst offers a new relational experience that rekindles the symbolizing spark in the patient, enabling them to make new meaning (Loewald 1978a). The analytic relationship becomes a space in which disorganization of the ego may safely occur, so that earlier levels of organization can be re-experienced, symbolized, and re-integrated on a higher, more differentiated level that is truer to the patient’s emerging potentials. Energy that had been expended in the maintenance of repression—what Loewald (1953, p. 7) referred to as “pushing” developmental needs “underground”—is now restored, and newly available to the patient in the service of creative living.

In the analytic encounter, via the transference, the affective intensity of the past is brought alive in the present, into living relation with an empathically attuned, recognizing other. The analyst comes to recognize the emerging potentials of the patient, reflecting this recognition in her interpretations, “always from the viewpoint of potential growth” (Loewald 1960, p. 20). Over time, the patient internalizes this new relational experience, gaining an expanded capacity for reflection and articulation of heretofore unconscious experience. In Loewald’s formulation, structural change occurs as the dynamic interplay between unconscious and conscious life is restored and re-integrated on a more mature level of organization. In contemporary relational language, transformation unfolds within the intersubjective relational field, as the past becomes alive in the present, and new forms of subjectivity emerge. In the following clinical vignette, which describes a seminal segment of a much longer analysis, my hope is to bring these ideas alive for the reader.

7. Clinical Vignette3

Trevor entered treatment presenting with a pervasive sense of loneliness and alienation. A graduate student, he spent his days alone in the library, writing and re-writing the same few paragraphs of his dissertation, only to unravel them again the next morning. His difficulties spread to the classroom, where he became increasingly anxious and self-conscious as he found himself losing hold of his students’ attention and his own capacity to think.

In the analysis, I experienced Trevor as gentle, softspoken, and clearly intelligent. Yet he was relentlessly self-critical, unconsciously attacking himself using the same cruel characterizations his mother repeatedly hurled at his father, who had failed in the very field Trevor had chosen. When he was younger, his mother had repeatedly referred to him as “my little genius,” opposing him to his father, whom she castigated as a “loser.” While he was growing up, his parents fought constantly. Although Trevor tried to intervene, he was helpless to stop it. Now, in the present, Trevor found himself unconsciously caught up in the bind of his parents’ conflict: If he were to be successful in his field, he would be allying himself with his mother, gratifying her narcissistic identification with him and justifying her attacks against his father. If he were unsuccessful, he would be allying himself with his father against his mother’s cruelty, but that would make him a failure, just like his father. Unraveling his own words was his unconscious solution to an impossible problem.

In the analysis, as in his writing, Trevor’s thoughts often trailed off mid-sentence, as if it were useless even to try to articulate them. As we explored his childhood history and family dynamics, the unconscious sources of Trevor’s difficulty in expressing himself became clearer. Over time, he revealed to me that the only time his pain lifted was when he drank late at night at the neighborhood bar. Only then did he feel a fleeting sense of euphoria and belonging, the closest he ever came to having a spiritual experience. But in the morning, shame and self-reproach inevitably returned with a vengeance, fueling his cycle of self-attack.

I learned that Trevor had been drinking steadily since adolescence. Yet no one in his life—not his parents, or siblings, or friends, or the previous therapists he had seen, had ever confronted him about his drinking and the damage it was causing him. In fact, their silence only corroborated his feeling of hopelessness, that there was “nothing to be done,” a phrase his father often used when Trevor tried to tell him of his struggles. I imagined Trevor as a young adolescent struggling to individuate from his parents’ toxic dynamics by becoming intoxicated himself. In my mind’s eye, I began to envision a different future, one in which Trevor had the possibility of living up to his considerable potential. I was struck with the realization that this future would not come to be if he continued to drink.

I shared with Trevor that his pattern of drinking and the associated shame he experienced was unraveling whatever progress we made in analysis. Unless he detoxed, neither of us could know who he was or who he might become. Shaken and stunned, but also grateful that I cared enough about him to intervene so directly, Trevor entered detox and became sober. He began attending Alcoholics Anonymous meetings but was put off by its religious language. Although he desperately wanted “spiritual change,” he did not believe in God. “I can’t even do AA right!” he cried in frustration, resuming his attack on himself. I wondered with him whether the idea of a “higher power” might be understood in a way that referred not to a divine being, but to a feeling of connection to something beyond his isolated, self-condemning stance.

Trevor’s thoughts turned to an earlier period in his life when he had been deeply engaged in social activism. He began to recognize that his research had little to do with what had originally drawn him to the field. What interested him was the teaching. I invited Trevor to teach me about the ideas that mattered to him. In doing so, I encountered a different version of him: thoughtful, articulate, and engaged. At the same time, something in the room shifted. No longer speaking from within a closed circuit of self-condemnation, Trevor’s thoughts unfolded in complete sentences that could be received, understood, and responded to. In the presence of an interested and responsive other, aspects of Trevor that had previously been inaccessible gradually began to come into being. When approached analytically, the religious language of AA that had originally been an obstacle became a portal into the experience of spiritual vitality and connection Trevor had been longing for.

Trevor experimented with bringing this renewed sense of engagement into his teaching. For the first time, he described feeling a little more hopeful. He attributed this shift not to doing something different, but rather to experiencing himself differently while doing it—as someone who had something meaningful to offer, and who was capable of having a positive impact on others.

I offer this abridged clinical example to illustrate that Trevor’s renewed sense of vitality and connection was potentiated both by identifying the unconscious sources of his present self-constriction and by the experience of being recognized and understood within a responsive relational field. Within the context of the analytic relationship, unconscious aspects of Trevor’s experience—his identification with his unsuccessful father; his internalization of his mother’s relentless criticism; his aborted longings to make a positive impact in the world—were brought into living contact with the present and into the symbolic register of language and conscious thought, enabling their integration on a higher level of organization, leading to a new experience of psychic vitality.

8. Implications for Spiritual Care

The foregoing discussion of therapeutic action offers a way of thinking about spiritual care that incorporates a consideration of the unconscious in the restoration of psychic vitality. While the psychoanalytic formulation of psychic change overlaps in meaningful ways with narrative approaches often used in spiritual caregiving, it rests upon a different understanding of how change occurs. From a relational psychoanalytic perspective, transformation involves bringing consciousness into contact with the unconscious dimension of experience. Affective experience that had been repressed, and thus remained outside awareness, is made newly available for conscious, reflective thought and expression through language. Rather than a focus on making meaning through consciously constructing a new narrative, the psychoanalytic emphasis is on restoring the psyche’s developmental potentials through a lived relational encounter. The analyst’s organized presence functions explicitly as a maturational “other,” whose reliability, recognition, and interpretive activity contribute to the patient’s inner reorganization. The patient internalizes a new relational experience and thus a new experience of themselves.

In the psychoanalytic framework, what constrains psychic vitality is not only the painful or limiting story one tells oneself (which, nevertheless, is also significant), but also unconscious patterns of relating that may, in fact, be contributing to the negative valence of the narrative. Therapeutic action requires attention to layers of psychic life that are not yet symbolized and thus are not fully knowable to the person. It is here that explicit consideration of the unconscious becomes necessary, and in the psychoanalytic view, indispensable.

Spiritual caregivers are often exquisitely attuned to dimensions of meaning and to the narratives through which these are expressed. Yet many of the forces organizing these experiences operate unconsciously. A person may sincerely embrace a new existential, theological, or spiritual understanding and yet still find themselves experiencing the same spiritual emptiness or repeating the same relational impasses or cycles of self-accusation. A relational psychoanalytic perspective suggests that these repetitions are not simply failures of narrative coherence, but are manifestations of earlier, unintegrated emotional configurations that seek recognition and transformation. When space is made for unconscious processes, including transference, defensive patterns, and unspoken expectations that are inevitably carried into the caregiving relationship, the relationship itself becomes a site of reorganization. In this way, attention to the unconscious deepens and enriches the conscious articulation of narrative meaning making.

Further, it is essential to underscore the ethical and clinical importance of the caregiver’s restraint with respect to too readily applying their own worldview to the patient’s situation. This is also true for the psychoanalyst. However well-formed, compassionate, theoretically or theologically grounded the caregiver’s convictions may be, the imposition of a preexisting interpretive frame risks prematurely organizing the person’s experience according to meanings that are not yet the person’s own. Such imposition risks “making the patient in the caregiver’s image.” In psychoanalytic terms, it risks foreclosing the patient’s emergent subjectivity by substituting the analyst’s framework of meaning for the patient’s still-forming one. Restraint, rather than being a matter of withholding, is an active, skilled practice. It involves bearing witness, staying in the room with unformulated experience, and—returning to the imagery of Jacob’s dream—keeping the channels between levels of awareness open, trusting the patient’s capacity to arrive at their own meaning. As illustrated in Trevor’s case, the analyst’s willingness to hold the question of a “higher power” open, rather than resolving it, created the conditions in which Trevor could discover his own form of spiritual connection.

It is human nature to feel anxious about the inherent limits of one’s ability to help another person who is suffering, and thus to attempt to resolve ambiguity, assuage anxiety, or impose coherence too quickly. But the analyst’s task is to sustain a stance of reflective openness in which the person’s experience can unfold without being enlisted into a narrative frame. This stance can be difficult to maintain, requiring a tolerance for anxiety, uncertainty, and the experience of not-knowing, as well as an attunement to layers of meaning that remain unarticulated. Within such a space, previously unformulated experience can find symbolic representation in the person’s own idiom, rather than being prematurely organized around the caregiver’s meanings.

9. Conclusions

From a relational psychoanalytic perspective, the biblical narrative of Jacob’s awakening and concomitant realization of sacred presence, “God is in this place, and I didn’t know!”, can be understood as the psychological rediscovery and recognition of a dimension of experience that had always been present but had heretofore remained unformulated, outside of conscious awareness. Psychic vitality emerges through the restoration of channels of communication between differentiated and undifferentiated levels of mentation. When unconscious, unformulated experience is brought into connection with conscious reflective thought in the context of a responsive analytic field, it can be symbolized, integrated, and transformed, resulting in a renewed feeling of aliveness and expanded capacity for relatedness.