Shouyi (guarding the One)

1. Introduction

Version followed: Ge Hong (葛洪), Baopuzi neipian 抱朴子內篇 (Inner Chapters of the Master Who Embraces Simplicity, completed c. 320 CE), chapter 18, in Fabrizio Pregadio's translation and commentary (Golden Elixir), with Pregadio's scholarly study "Early Daoist Meditation and the Origins of Inner Alchemy"; the earlier Taiping jing 太平經 (Scripture of Great Peace) account of "guarding the light of the One" as presented by Nicholson (2004). Present-day teaching of shouyi in living Daoist lineages (Quanzhen, Zhengyi) is [uncertain: not verified].

Shouyi 守一, "guarding (or keeping, holding) the One", is a family of early Daoist meditation methods, not a single fixed technique. The "One" (yi 一) is, in these texts, both the Dao as the source of all things and a presence within the practitioner's body. In Ge Hong's version the practitioner keeps the One, pictured as a deity with names, clothing and colours, present in one of three "Cinnabar Fields" (dantian 丹田) of the body, and holds attention on it without distraction [source: Golden Elixir, Baopuzi; Pregadio, Early Daoist Meditation, pp. 130–131]. In the Taiping jing the adept sits quietly with eyes closed and "guards the light of the One"; with long practice an inner light is said to arise and the body to feel lighter [source: Nicholson 2004, p. 5].

How change happens, as the tradition holds it: by keeping the One, the practitioner stays joined to the source, gains communication with the gods (tongshen 通神), protection from demons and dangers, and progress toward longevity and transcendence [source: Golden Elixir, Baopuzi; Pregadio, pp. 130–131]. These are religious claims, attributed to the texts, neither asserted nor dismissed here. No claim that shouyi treats physical disease is made in this guide; there is no clinical evidence base for shouyi as such [synthesis].

For the psychotherapist, shouyi is a contemplative practice of a living religious tradition. Its core methods involve inner deities and teachings that Ge Hong says were passed on orally under covenant. This guide therefore gives a public outline of the tradition's practice (what it is, its stated purpose, who teaches it) and then sets out, in full, the therapist's own work: assessment, client-led integration, secular adaptation, referral, trauma sensitivity and adverse effects. The therapist does not teach shouyi.

2. Framework

2a. The tradition's own progression (public outline)

Transmission first. In Ge Hong's account, the names and surnames of the One and of the inner gods were handed down orally from master to disciple, the recipient sealing the transmission by smearing the mouth with blood [source: Golden Elixir, Baopuzi]. Practice in this version therefore begins with a teacher, not a book. These names are restricted and are not given here.
Guarding the True One (shou zhenyi 守真一). The practitioner keeps the One, envisioned in human form, present in a Cinnabar Field: the lower field below the navel, the middle field below the heart (the "Golden Portal of the Crimson Palace"), or the upper field behind the point between the eyebrows (preceded there by the "Hall of Light" and "Cavern Chamber"). The text describes the One as moving among these sites. Stated aim: communication with the gods and protection [source: Golden Elixir, Baopuzi; Pregadio, pp. 130–131].
Guarding the Mysterious One (shou xuanyi 守玄一). A further method, said to let the practitioner multiply the body or become invisible to demons, and to see the spirits of heaven and summon mountain and river deities [source: Pregadio, p. 131]. Public outline only.
Taiping jing light practice. Sitting quietly with eyes closed, the adept at first sees no inner light; with prolonged practice, light is said to arise and grow brighter, and the body to feel lighter [source: Nicholson 2004, p. 5]. The text gives no colour sequence or fixed stages in that source.
Criteria for progressing are set by the teacher in the tradition. No published criteria are cited here [uncertain: not verified].

2b. The therapist's framework [synthesis]

No source gives a session count or format for psychotherapy with shouyi practitioners; none is stated here.

Assessment phase. Goal: understand the client's practice, lineage, teacher, intensity, meaning and any difficulties; screen for risk. Move on when you and the client share a clear picture and the client has said how, if at all, they want their practice to figure in therapy.
Agreement phase. Goal: informed consent about whether and how spiritual material enters the work, and about the limits of your role. Move on when the plan is agreed and documented.
Working phase. One or more of: client-led integration of the client's own practice; a secular attention or grounding exercise in place of the religious method; referral to or collaboration with a teacher or Daoist priest (daoshi 道士); work on difficulties linked to practice.
Monitoring throughout. Goal: catch meditation-related adverse effects early. Move back to assessment if new symptoms appear (see 4.8–4.10).
Review and ending. Goal: check the client's practice is supporting, not destabilising, them, and that their spiritual support lies outside therapy.

3. Guiding principles

The client leads on religion. Practical meaning: raise spirituality as an open question; the client decides whether shouyi enters therapy [synthesis].
Attribute, do not adjudicate. Practical meaning: speak of the One, inner gods, qi and demons as "in your tradition" or "as Ge Hong teaches"; neither confirm nor debunk [synthesis].
You are not the teacher. Practical meaning: do not teach, correct or extend the tradition's method; send technique questions to the client's teacher [synthesis].
Respect restricted transmission. Practical meaning: do not ask the client to reveal names or instructions received under covenant, and do not help them bypass a teacher [source: Golden Elixir, Baopuzi, on oral transmission; synthesis].
Use the client's own words. Practical meaning: use shouyi, dantian, the One, or the client's English terms as they use them [synthesis].
Safety above progress. Practical meaning: meditation can bring adverse effects even in people with no psychiatric history, so monitor and reduce practice when needed [source: Farias et al. 2020; Brown University 2017 on Lindahl et al.].
Spiritual experience is not automatically illness, and illness is not automatically spiritual. Practical meaning: assess function, distress and risk before interpreting visions or inner presences [synthesis].
No health claims. Practical meaning: stated benefits for longevity or protection are the tradition's; route physical health matters to the client's doctor [synthesis].
Trauma sensitivity. Practical meaning: offer choice, eyes-open options and external anchors; stop when arousal overwhelms [source: Treleaven, via Cheetah House; synthesis].
Mind the power of the teacher relationship. Practical meaning: support the client's own judgement about teachers and groups without labelling them [synthesis].

4. Intervention inventory

Items 4.1–4.4 are the tradition's own methods. They involve inner deities and teachings given under oral transmission, so each is a public outline: what it is, its purpose as the texts state it, and who teaches it. No step-by-step instructions are given for them. Items 4.5–4.15 are the psychotherapist's own work, with full steps.

4.1 Guarding the True One (shou zhenyi), tradition practice: public outline

Purpose and when used: In Ge Hong's Baopuzi, the highest form of meditation, ranked with alchemy as a route to transcendence; said to give communication with the gods and protection from demons, dangerous animals, poisons and weapons, especially in dangerous places such as mountain forests, tombs and plague-stricken lands [source: Golden Elixir, Baopuzi; Pregadio, pp. 130–131].
Outline (not instructions): The practitioner keeps the One, envisioned as a tiny deity with names and clothing, present in the Cinnabar Fields and does not let attention lapse. The text stresses guarding "without distraction" and warns that lapsing even briefly leaves one open to demons [source: Golden Elixir, Baopuzi]. A meditation poem in the same chapter evokes an inner landscape (the Hall of Light, the Crimson Palace, the Flowery Canopy, guardian dragons and tigers) [source: Golden Elixir, Baopuzi]. The names of the One were transmitted orally from master to disciple under a blood covenant; they are restricted.
Who teaches it: Historically, masters of Ge Hong's lineage. Which present-day Daoist teachers or temples transmit this specific method was not confirmed [uncertain: not verified]. Clients wanting instruction should be referred to a recognised Daoist teacher or priest (see 4.12).
Example language (illustrative): "When you guard the One in your practice, what is that like for you? You don't need to tell me anything your teacher asked you to keep private."
Watch for: Intense pressure never to let attention lapse, fear of demonic harm after lapses, compulsive checking that the One is "still there" (see 4.10); unusual perceptions that the client finds distressing (see 4.8–4.9). Signs it is going well for the client: they describe the practice as steadying, meaningful and freely chosen, and daily functioning is intact [synthesis].

4.2 Guarding the Mysterious One (shou xuanyi), tradition practice: public outline

Purpose and when used: In the Baopuzi, a further method said to let the adept multiply the body or become invisible to demons and dangerous creatures, to see the spirits of heaven and to summon mountain and river deities [source: Pregadio, p. 131].
Outline (not instructions): Only the stated aims are given in the sources used; the method belongs to teacher transmission [source: Pregadio, p. 131].
Who teaches it: As 4.1 [uncertain: not verified for today].
Example language (illustrative): "You mentioned experiences of seeing yourself in more than one place during practice. How does your tradition understand that, and how is it for you?"
Watch for: Experiences of body duplication, out-of-body states or invisibility that persist outside practice, cause fear or impair functioning: assess for depersonalisation, derealisation or psychosis without assuming them (see 4.9) [synthesis].

4.3 Guarding the light of the One (Taiping jing), tradition practice: public outline

Purpose and when used: In the Taiping jing, sitting quietly with eyes closed and guarding the light of the One; with prolonged practice a brilliant inner light is said to arise, the essence to grow brighter and the body lighter [source: Nicholson 2004, p. 5].
Outline (not instructions): Quiet sitting, eyes closed, attention held on the One as inner light; at first no light is seen, and the source describes light arising only after long practice [source: Nicholson 2004, p. 5]. No durations or stages are given here.
Who teaches it: Known chiefly from the text; living transmission not confirmed [uncertain: not verified]. Some modern popular materials present elaborate colour-sequence visualisations as "Guarding of the One" from the Taiping jing, alongside healing claims and references to prolonged fasting; how far they match the classical text is [uncertain: not verified]. Treat them as modern adaptations; health questions go to the client's doctor.
Example language (illustrative): "Some people find inner light in meditation comforting; some find it unsettling. What has it been like for you, and how has your sleep been?"
Watch for: Light sensitivity, perceptual changes, insomnia and energetic or somatic sensations are among documented meditation-related challenges [source: Brown University 2017, on Lindahl et al.]. Nicholson notes a warning about sleep loss from a different Daoist text, the Book of the Yellow Court [source: Nicholson 2004, p. 8].

4.4 Visualising and maintaining the inner gods (cun 存, cunxiang 存想), tradition context: public outline

Purpose and when used: The wider setting of shouyi: early texts teach keeping the body's gods in their places. The Taiping jing speaks of meditating on the gods of the five viscera, picturing their coming and going and speaking with them; the Laozi zhongjing (Central Scripture) places the One, the Lord of the Dao, both in the heavens and in the body; Shangqing texts describe visualising a divine person forming within the body [source: Pregadio, pp. 122–141].
Outline (not instructions): Visualisation and invocation of inner deities, in some texts on set days and hours; methods are lineage-held [source: Pregadio, pp. 128–141].
Who teaches it: Daoist lineages descended from Shangqing and related traditions [uncertain: present-day teachers not verified].
Example language (illustrative): "In your practice there are presences within the body. How do you relate to them, and do they ever feel frightening or out of your control?"
Watch for: Distinguish an experience held within a practice framework the client can start and stop from voices or presences that intrude uninvited, command, or come with loss of insight and functioning (see 4.9) [synthesis].

4.5 Spiritual and cultural assessment

Purpose and when to use: At intake, and whenever a client mentions Daoist practice. Establishes what shouyi means to the client and how intensively they practise [synthesis].
Steps: (1) Ask an open question about spiritual or religious practices. (2) If shouyi or Daoist practice comes up, ask about lineage, teacher or temple, how they learned, and how often and how long they practise in their own words; do not ask for restricted content. (3) Ask about meaning: what the One, the dantian or guarding mean to them. (4) Ask about retreats, fasting, sleep changes and other austerities linked to practice, qualitatively. (5) Ask about benefits and difficulties. (6) Ask whether and how they want their practice involved in therapy. The DSM-5-TR Cultural Formulation Interview and its supplementary module on spirituality, religion and moral traditions can structure this [uncertain: not verified; consult the manual]. [synthesis]
Example language (illustrative): "Some people draw on spiritual practice in difficult times. Is that part of your life?" "Who taught you, and what does guarding the One mean in your tradition?" "Would you like your practice to be part of what we talk about here, or kept separate?"
Watch for: Reluctance to discuss teachings received under covenant: respect it. Intensive solitary practice, recent retreat, sleep loss or fasting raise the priority of 4.8. Working when the client feels understood and can say clearly what role their practice has.

4.6 Client-led integration within spiritually integrated psychotherapy

Purpose and when to use: When a client who already practises shouyi wants it to support therapy goals (e.g. steadiness, meaning, a sense of being held by the Dao) [synthesis].
Steps: (1) Obtain and document explicit consent to bring practice into therapy. (2) Ask the client to describe, in their own words, how the practice helps them; do not add instructions. (3) Link therapy goals to resources the client names (e.g. "returning to the One" as a way to settle after distress). (4) Agree with the client when they will use their practice between sessions, at the level their teacher has given them. (5) Review effect each session; if practice becomes distressing, move to 4.8. (6) Send any question about correct technique back to their teacher. [synthesis]
Example language (illustrative): "You said guarding the One helps you feel centred when anger rises. Would it help to plan when you might turn to it this week, in the way your teacher has shown you?"
Watch for: The therapist sliding into the teacher role; practice used to avoid feelings or decisions (spiritual bypass); escalating practice intensity. Working when the client reports the practice helps them meet goals and they remain the author of it.

4.7 Secular attention-and-grounding exercise in place of the religious method

Purpose and when to use: For clients who want a non-religious centring exercise, or who are interested in shouyi but have no teacher. This is not shouyi: it removes the deity, the covenant and the religious aims. Cross-refer to Domain II (MBSR, MBCT, MSC, CFT) for established secular protocols. [synthesis]
Steps: (1) Explain it is a secular attention exercise, not Daoist practice. (2) Invite a comfortable seated posture with eyes open or lowered. (3) Invite the client to rest a hand on the belly and notice its ordinary movement with natural breathing, without changing the breath. (4) When attention wanders, note it and return, without self-criticism. (5) Keep it brief and stop on request. (6) Debrief: what did they notice? [synthesis]
Example language (illustrative): "This isn't a religious practice, just a way of gathering attention. You can keep your eyes open. Let your hand rest on your belly and simply notice it moving. Whenever your mind wanders, gently come back. We can stop at any time."
Watch for: Rising anxiety, dissociation or trauma memories (shift to 4.11); clients wanting you to teach the religious method (refer, 4.12). Working when the client can settle attention and reports feeling calmer or more present.

4.8 Screening for and monitoring meditation-related adverse effects

Purpose and when to use: Before a client begins or intensifies practice, before retreats, and at every review. A systematic review of 83 studies (6,703 participants) found adverse events in about 8.3% overall (3.7% in experimental, 33.2% in observational studies); the most common were anxiety, depression and cognitive anomalies, and they occurred in people with no prior mental health history [source: Farias et al. 2020]. Lindahl et al. (2017) documented 59 kinds of challenging experience in seven domains (cognitive, perceptual, affective, somatic, conative, sense of self, social), some lasting months or years; contributing factors included psychiatric or trauma history, practice intensity, quality of supervision, the instructor relationship, and diet, sleep and exercise [source: Brown University 2017, on Lindahl et al. 2017, PLOS ONE].
Steps: (1) Before intensive practice or retreat, ask about past psychosis, mania, dissociation, trauma, current depression or anxiety, sleep, and substance use. (2) Ask about planned intensity, solitude, fasting or sleep restriction, and access to the teacher. (3) Agree warning signs that mean reducing practice and contacting you or the teacher. (4) At reviews, ask across the seven domains: perception (light, sound), emotion (fear, panic, flatness), body (insomnia, involuntary movements, energy sensations), thinking, motivation, sense of self, relationships. (5) If difficulties appear: reduce dose (shorter, less frequent, eyes open, more movement and ordinary activity), add grounding, restore sleep and regular meals, and involve the teacher if the client wishes. (6) Point clients to specialist support such as Cheetah House (consultations, support groups, symptom list) [source: Cheetah House]. Steps 1–5 [synthesis] informed by the sources above.
Example language (illustrative): "Meditation helps many people, and some have hard experiences with it too. Have you noticed anything unusual in your sleep, perception, emotions or sense of yourself since practising more?" "Would it make sense to scale back for a while, and talk to your teacher about it?"
Watch for: Insomnia, hypersensitivity, panic, loss of emotion, depersonalisation, persisting "positive" states that interfere with work [source: Brown University 2017]. Working when symptoms settle with dose reduction and the client can practise without destabilisation.

4.9 Distinguishing spiritual experience from psychiatric illness

Purpose and when to use: When a client reports inner light, inner deities, body duplication, contact with spirits or demons, or other unusual experiences linked to practice [synthesis].
Steps: (1) Listen first, in the client's terms; do not interpret. (2) Ask whether the experience fits their tradition's teaching and their teacher's expectations. (3) Assess control (can they start and stop it?), insight, distress, functioning, sleep, and risk to self or others. (4) Screen for psychosis, mania, depression and dissociation with your usual tools. (5) If the experience is framework-consistent, controllable and not impairing, treat it as a spiritual matter and support meaning-making; the DSM-5-TR includes a code for a religious or spiritual problem as a focus of clinical attention (Z65.8). (6) If there are signs of illness, arrange psychiatric assessment promptly, while respecting the client's religious frame. (7) Do both when unsure: stabilise and assess, and do not tell the client their tradition is wrong. [synthesis]
Example language (illustrative): "In your tradition, is seeing light like this expected? Can you let it go when you finish practising?" "I'd like to make sure your sleep and health are looked after too, alongside what this means to you spiritually."
Watch for: Pathologising a normal religious experience; equally, missing emerging psychosis or mania because it carries religious content. Working when the client feels heard and risk is managed.

4.10 Fear of lapse, demons and scrupulosity

Purpose and when to use: Ge Hong teaches guarding the One without distraction and says lapsing even briefly lets demons harm one [source: Golden Elixir, Baopuzi]. For a vulnerable client this can become an obsessional loop: constant checking that the One is guarded, fear of harm after a lapse, repeated restarting. This guidance is [synthesis]; for ERP adapted to scrupulosity, see clinical materials such as the IOCDF's [uncertain: not verified].
Steps: (1) Distinguish devotion from compulsion: ask about time consumed, distress, rituals to undo lapses, and reassurance seeking. (2) Formulate obsessive-compulsive patterns if present, in the client's language. (3) With consent, and with the client's teacher or a Daoist priest if they wish, clarify what the tradition actually expects (many religious authorities do not require perfect, anxious vigilance; ask rather than assume). (4) If OCD is present, offer ERP adapted to the tradition: gradual exposure to ordinary lapses of attention without neutralising rituals, built with the client and, where they want, approved by their religious authority. (5) Never prescribe a breach of the client's religious commitments. (6) Monitor distress and refer for specialist OCD treatment if needed. [synthesis]
Example language (illustrative): "When your attention drifts from the One, what happens inside? How much of your day goes into checking it?" "Would it help to ask your teacher how they see a wandering mind?"
Watch for: ERP inflaming religious guilt; clients feeling their faith is under attack. Working when checking and fear decrease while the client's practice and faith remain intact.

4.11 Trauma-sensitive adaptation

Purpose and when to use: For clients with trauma histories who practise or want centring exercises. Trauma-sensitive mindfulness (Treleaven) is a published adaptation offered for teachers and clinicians; Cheetah House lists trauma basics and mindfulness-and-trauma resources [source: Cheetah House]. The steps below are [synthesis].
Steps: (1) Offer choice at every point: eyes open, posture, length, stopping. (2) Prefer external anchors (sounds, feet on the floor) if attention inside the body triggers distress; inward focus on the lower abdomen or other dantian sites may not suit everyone. (3) Keep practice short and within the client's window of tolerance. (4) Teach a stop-and-ground routine (orienting to the room, naming objects, movement). (5) Debrief and adjust. (6) Suggest the client discuss adaptations of their religious practice with their teacher.
Example language (illustrative): "You're in charge here. Eyes open is fine. If you notice your attention going somewhere painful, we can stop and look around the room together."
Watch for: Flashbacks, numbing, dissociation, shallow fast breathing. Working when the client can stay present and ends calmer.

4.12 Referral to and collaboration with a teacher or Daoist priest

Purpose and when to use: When a client wants instruction in shouyi, has questions of doctrine or technique, or is struggling with practice. Ge Hong's account places the method within master-disciple transmission [source: Golden Elixir, Baopuzi]. [synthesis]
Steps: (1) Ask whether the client has a teacher, temple or Daoist association. (2) If not, discuss how they might find a recognised teacher through established temples or associations, and how to assess one (see 4.13). (3) With written consent, offer to liaise with the teacher about pacing, adverse effects or adaptations. (4) Share only agreed information. (5) Keep roles distinct: the teacher guides practice; you guide therapy. [synthesis]
Example language (illustrative): "That's a question for your teacher rather than me. Would it help if, with your permission, I spoke with them about slowing things down for now?"
Watch for: Clients seeking you as a substitute teacher; teachers dismissing distress. Working when practice and therapy are coordinated.

4.13 The teacher relationship and coercive control

Purpose and when to use: When a client's teacher or group has strong influence over them. The instructor relationship is one of the factors linked to meditation-related challenges [source: Brown University 2017]. Independent findings of misconduct specific to shouyi teachers: none found in the sources consulted; no one is named here. [synthesis]
Steps: (1) Explore the relationship: what they receive, what is expected, how disagreement is handled. (2) Note signs of coercive control: isolation from family, demands for money or secrecy beyond normal religious discretion, punishment for questions, sexual approaches, fear of leaving. (3) Reflect concerns without labelling the group. (4) Support the client's own decisions; plan for safety if leaving. (5) Work with religious trauma if it emerges. [synthesis]
Example language (illustrative): "How does your teacher respond when you have doubts or need to rest from practice?"
Watch for: Secrecy around restricted teachings is normal in many lineages and is not itself a red flag; secrecy about harm is. Working when the client can weigh the relationship freely.

4.14 Health claims and physical health

Purpose and when to use: When the client hopes shouyi will protect them, extend life or heal illness, or practises alongside fasting or sleep restriction. Ge Hong's protective and longevity claims are religious teachings [source: Golden Elixir, Baopuzi]; evidence status: no clinical evidence that shouyi treats physical disease [synthesis]. Some modern presentations link it to prolonged fasting [source: "6.3 Guarding of the One Meditation" PDF]; no fasting guidance is given here.
Steps: (1) Ask respectfully about health hopes. (2) Affirm the client's right to religious meaning while asking that medical care continues. (3) Route questions about fasting, sleep, exertion and medication to the client's doctor; do not advise on medicines. (4) Coordinate with the doctor with consent. [synthesis]
Example language (illustrative): "Your practice clearly matters to you. Alongside it, would you be willing to keep seeing your doctor about this, and check with them before any fasting?"
Watch for: Delayed medical care; weight loss, exhaustion. Working when the client keeps both religious and medical care.

4.15 Role boundaries and the therapist's own commitments

Purpose and when to use: Throughout. The therapist is not a Daoist teacher, priest or spiritual director in therapy. Spiritual and religious competencies for psychologists have been published (Vieten et al. 2013) [uncertain: not verified]. Professional ethics on competence, multiple relationships and respect for religion apply [synthesis].
Steps: (1) Note your own beliefs and any reactions to Daoist cosmology, inner deities or demons. (2) Self-disclose only if it serves the client. (3) Do not attend the client's practice group or receive teachings from the client. (4) Seek supervision or consultation with someone knowledgeable about Daoism when unsure. (5) Refer when the work exceeds your competence. [synthesis]
Example language (illustrative): "I'm not a Daoist teacher, so I won't guide your practice, but I'm glad to help you think about how it fits with what you're working on."
Watch for: Dual relationships; quietly steering clients toward or away from religion. Working when the client feels respected and roles are clear.

5. Handling problems

The classical sources address practice problems only in religious terms (lapses let demons in; transmission requires a master) [source: Golden Elixir, Baopuzi]. Everything below except where cited is [synthesis].

Overwhelm during or after practice (panic, intense light, somatic surges, insomnia). Pause practice; ground with eyes open, orienting and movement; restore sleep and regular meals; reduce dose when resuming; involve the teacher with consent; refer to Cheetah House or psychiatric care if symptoms persist or escalate [source: Brown University 2017; Cheetah House; synthesis].
Client fears demonic harm after lapses. Explore the fear in their own terms; ask the teacher's view with consent; assess for OCD and use adapted ERP if present (4.10). Do not argue cosmology.
Client wants you to teach shouyi or reveal the One's names. Decline kindly; explain that the method is transmitted by teachers and that you are not one; refer (4.12). Do not use published fragments to construct a practice for them.
Client is practising from books, videos or modern popular versions without a teacher. Explore what they do and how it affects them; screen for adverse effects (4.8); encourage connection with a recognised teacher; offer the secular exercise (4.7) if they want a non-religious alternative.
Stuck client using practice to avoid feeling (spiritual bypass). Name the pattern gently; link the practice's stated aim of wholeness with facing what is avoided; set therapy goals that include difficult emotion.
Resistance to discussing spirituality, or feeling judged. Return control: confirm that religion is in therapy only if they want it; acknowledge cultural distance if you do not share their tradition; ask what would make it feel safe.
Non-adherence to agreed reductions in practice. Explore meaning (fear of losing progress, teacher's expectations, identity); negotiate a smaller change; involve the teacher if the client agrees.
Rupture over religious meaning (e.g. client hears your screening questions as calling their experience madness). Acknowledge, repair, explain why you ask about health alongside meaning, and invite them to correct your understanding.
Religious or unusual content with signs of psychosis or mania. Prioritise safety and prompt psychiatric assessment; keep respecting the client's religious frame (4.9).
Practice combined with prolonged fasting or sleep restriction. Do not advise on amounts; ask the client to involve their doctor; monitor for weight loss, exhaustion and mood change (4.14).
Teacher pressure, coercion or abuse. Assess safety and coercive control; support the client's choices; follow safeguarding and reporting duties where they apply (4.13).
Therapist's own discomfort with inner deities or demonology. Use supervision; keep attributing beliefs to the tradition; refer if bias affects the work (4.15).

Sources

Online sources:

Ge Hong (Baopu zi) – Golden Elixir (texts and translation by Fabrizio Pregadio)
Pregadio, F. "Early Daoist Meditation and the Origins of Inner Alchemy", pp. 121–154 (PDF, author's site) [uncertain: journal and year not verified]
Nicholson, P. T. (2004). Restoring the One: Meditation and Light Visions in Early Daoist Texts. Paper, 6th Conference of the International Society for Shamanistic Research, Changchun
"6.3 Guarding of the One Meditation" (PDF chapter; author not named; modern popular adaptation).
Brown University News (2017). Study documents range of challenging meditation experiences (on Lindahl et al., PLOS ONE)
Farias, M., et al . (2020). Adverse events in meditation practices and meditation-based therapies: A systematic review. Acta Psychiatrica Scandinavica, 142(5), 374–393
Cheetah House – Trainings for Teachers & Clinicians

Books and other works cited:

Ge Hong. Baopuzi neipian 抱朴子內篇, chapter 18 (c. 320 CE), as translated on Golden Elixir.
Taiping jing 太平經, as presented by Nicholson (2004) and Pregadio.
Treleaven, D. A. (2018). Trauma-Sensitive Mindfulness: Practices for Safe and Transformative Healing [uncertain: not verified].
Vieten, C., et al. (2013), spiritual and religious competencies for psychologists [uncertain: not verified].
American Psychiatric Association, DSM-5-TR, Cultural Formulation Interview and the religious or spiritual problem code (Z65.8).
ICD-10-CM Z65.8, Other specified problems related to psychosocial circumstances (includes 'Religious or spiritual problem')
Lindahl, J. R., et al. (2017). The varieties of contemplative experience. PLOS ONE [details from the Brown University report].

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