Atlas›Domain XIII · Contemplative & religious disciplines›Guide 207
Guide XIII-207

Centering Prayer (Keating)

William Meninger, Basil Pennington, Thomas Keating1970Spencer, Massachusetts
A 37 · L 41 · M 2216 interventions in the Trinity explorer
Client cardCompare
[source: …] where a claim comes from[uncertain] not confirmed in a primary source[synthesis] the writer's reconstruction

1. Introduction

Version followed: Centering Prayer as Thomas Keating sets it out in The Method of Centering Prayer: The Prayer of Consent (Contemplative Outreach, 2004), and as Contemplative Outreach currently publishes its four guidelines. The Welcoming Prayer is followed in the version Contemplative Outreach teaches, developed by Mary Mrozowski.

  • What it is. Centering Prayer is a Christian contemplative prayer method. It was developed in the 1970s by three Trappist monks at St. Joseph's Abbey in Spencer, Massachusetts: William Meninger, Basil Pennington and Thomas Keating. It responded to the Second Vatican Council's call to renew early Christian contemplative teaching in updated forms. [source: Contemplative Outreach, History of Centering Prayer]
  • Lineage. The tradition names its roots as Lectio Divina; the anonymous 14th-century The Cloud of Unknowing; and John Cassian, Francis de Sales, Teresa of Avila, John of the Cross, Thérèse of Lisieux and Thomas Merton. Its scriptural basis is Matthew 6:6 (praying in the "inner room"). The name refers to Merton's description of prayer "centered entirely on the presence of God". [source: Contemplative Outreach, History; Keating 2004]
  • Organisation. Contemplative Outreach grew out of the first intensive retreat in 1983, to support the network of practitioners. It teaches the method worldwide through workshops, weekly groups and retreats. [source: Contemplative Outreach, History]
  • How change happens, as the tradition holds it. The method does not aim at an empty mind, a technique or relaxation. Keating presents it as consent to "God's presence and action within": a relationship with God and a discipline that fosters it. In the tradition's understanding, contemplative prayer is a gift of God, and Centering Prayer prepares a person to receive it. Its fruits are said to show in daily life rather than during the prayer period. [source: Keating 2004]
  • Keating's psychological account. Keating describes a "false self": a homemade self-image built round childhood needs for security, affection/esteem and power/control. In deep rest, he says, "previously unconscious emotional material from early childhood" is released (the "unloading of the unconscious"). This can show up as feelings, images, bodily sensations or reactivity after prayer. The Spirit is held to direct this healing, and the practitioner's part is to consent. [source: Contemplative Outreach 2023, quoting Keating, Open Mind, Open Heart]
  • Its place in therapy. The therapist is not the client's teacher or spiritual director. The therapist supports a Christian client who chooses this practice, helps them process what arises, and adapts for safety. Instruction and spiritual formation stay with Contemplative Outreach and the client's own church. [synthesis]

2. Framework

Centering Prayer is a prayer discipline, not a phased therapy. No source gives a therapy session count. Below are the tradition's own structure and a clinical frame for working alongside it. The clinical frame is [synthesis].

A. The tradition's structure [source: Keating 2004; Contemplative Outreach guidelines and History]

  • Daily prayer periods. Keating's brochure recommends two daily periods of at least 20 minutes: one first thing in the morning and one in the afternoon or early evening. It says periods may lengthen to 30 minutes or more with practice. These are the tradition's own recommendations for its practitioners, not clinical targets; see the note below.
  • Format of a period. The four guidelines (section 4). A soundless timer is suggested. In groups, a leader may close by slowly praying the Lord's Prayer aloud.
  • Deepening, as Keating lists it.
    • regular daily practice;
    • Lectio Divina and study of Open Mind, Open Heart;
    • one or two daily-life practices from chapter 12 of that book;
    • a weekly Centering Prayer group for perseverance and support.
  • Further steps. Intensive retreats, the first held in 1983, and the Welcoming Prayer for daily life. Mrozowski's version recommends an established Centering Prayer practice before taking up the Welcoming Prayer. [source: Diocese of Newark, Welcoming Prayer]

Note on duration. The 20-minute and 30-minute figures are Keating's and Contemplative Outreach's guidance for practitioners. In therapy, the client and, where relevant, their teacher or group decide how long to pray. The therapist does not set or raise durations. Where adverse effects arise, the therapist may support the client in shortening or pausing practice (section 4). [synthesis]

B. Clinical frame alongside the practice [synthesis]

  1. Assessment and consent.
    • Goal: understand the client's faith, their reasons for wanting the practice, any past contemplative experience, and their trauma, dissociation, psychosis and mood history.
    • Agree what role, if any, prayer will have in therapy.
    • Move on when the client has explicitly asked for integration, risks have been reviewed, and both of you understand the therapist's role.
  2. Connection to qualified instruction.
    • Goal: the client learns the method from Contemplative Outreach materials, a local group or a spiritual director, not from the therapist as an authority.
    • Move on when the client has a source of instruction, or makes an informed choice to practise alone using published materials.
  3. Integration.
    • Goal: debrief experiences in session, especially reactive material ("unloading") and the Welcoming Prayer in daily life.
    • Move on, or loop back, depending on stability, functioning and the client's own sense of benefit.
  4. Safety monitoring, which runs throughout.
    • Screen for challenging experiences at each review.
    • Adjust dose and add grounding if needed.
    • Coordinate with the teacher if the client wishes.
  5. Consolidation.
    • Goal: practice sits within the client's church and group life, and therapy shifts back to the presenting problems.

3. Guiding principles

  • Client-led and in the client's own tradition. Raise Centering Prayer only when a Christian client asks or consents, using their own language: God, Christ, the Spirit, consent. Meaning: never prescribe prayer, and never recast it as a secular technique without the client's agreement. [synthesis]
  • Intention, not technique. The tradition says it is not a technique, relaxation exercise or self-hypnosis. The sacred word expresses intention and consent; it is not a mantra to be repeated. Meaning: do not coach concentration or use it as a relaxation skill. Help the client hold the tradition's own frame. [source: Keating 2004]
  • No goals in the prayer period. Keating warns against expectations: an empty mind, continuous repetition of the word, peace, consolation or spiritual experience. Meaning: do not assess "success" by calm during prayer. Look at daily-life fruits and functioning. [source: Keating 2004]
  • Gentleness and minimal effort. Return to the word "ever-so-gently"; that return is the only activity the person initiates. Meaning: notice and gently challenge self-criticism or scrupulous checking about whether the client is doing it right. [source: Contemplative Outreach guidelines; Keating 2004]
  • Religious concepts attributed. Indwelling Trinity, Divine Indwelling, false self, divine healing: describe these as Keating and the tradition hold them, neither endorsing nor dismissing. Meaning: reflect the client's beliefs in their terms. Keep your own convictions out unless self-disclosure is clinically considered. [synthesis]
  • Therapist is not spiritual director. Meaning: refer questions about prayer, discernment and doctrine to Contemplative Outreach teachers, a spiritual director or clergy. Avoid the dual role of being both the client's therapist and their prayer leader. Professional ethics on boundaries and competence apply; check them against your own code. [synthesis] Spiritual and religious competencies for psychologists have been proposed (Vieten et al. 2013) [uncertain: not verified].
  • Safety over continuity. Meditation-related adverse events are not rare and can occur in people with no prior mental-health history. Meaning: screen, monitor and normalise reducing or pausing practice. [source: Farias et al. 2020, Acta Psychiatrica Scandinavica]
  • Trauma sensitivity. Treleaven's five principles concern attention, arousal, relationship, dissociation and social context. Meaning: adapt how inward attention, eye closure and silence are used for trauma survivors. [source: Treleaven 2018, publisher description]
  • No health claims. The brochure attributes pains, itches, twitches and restlessness during prayer to the release of emotional tension. Meaning: report this as the tradition's view only. Send new or persistent physical symptoms to the client's doctor. Centering Prayer is not a treatment for physical disease. [source: Keating 2004; synthesis]
  • Welcome the response, not the harm. In the Welcoming Prayer one welcomes one's own reaction to a pain, not the disease or trauma that caused it. Meaning: never use the practice to imply acceptance of ongoing abuse or danger. [source: Diocese of Newark, Welcoming Prayer]

4. Intervention inventory

Interventions A–F are the tradition's openly taught practices, described in your own words from Keating and Contemplative Outreach. The therapist's role with each is to support and debrief, not to act as the authority who teaches it. Interventions G–P are the psychotherapist's work alongside the practice. Most of G–P is [synthesis] grounded in the sources cited.

A. Exploring the request and consent (spiritually integrated assessment)

  • Purpose. Establish that the practice is the client's own choice and fits their faith. Identify risk factors before any in-session discussion of prayer. Use at intake, or whenever a client raises contemplative prayer. [synthesis]
  • Steps.
    1. Ask about the client's faith community and practice, and what draws them to Centering Prayer.
    2. Ask about any previous meditation or retreat experience, including difficult experiences.
    3. Review history of trauma, dissociation, psychosis or mania, panic, depression and current medication changes. Route medication questions to the prescriber.
    4. Agree the scope: will therapy only debrief the client's practice, or will a brief silent period ever happen in session?
    5. Record consent, and name your role (not spiritual director). Offer to coordinate with their teacher or director if they wish.
  • Example language (illustrative). "You mentioned Centering Prayer matters to you. I'm not a prayer teacher, but I'd be glad to help you notice how it's going for you, alongside your group or director. Would that be useful?"
  • Watch for.
    • Pressure from others to practise.
    • Using prayer to avoid feelings that therapy needs to address.
    • Expectations that prayer will "fix" symptoms.
    • Red-flag history that calls for a more cautious start (G, K).
    • It is working when the client states their own reasons and agrees the boundaries.

B. Choosing the sacred word (Guideline 1)

  • Purpose. The tradition's first guideline. The sacred word symbolises the intention to consent to God's presence and action within. [source: Keating 2004; Contemplative Outreach guidelines]
  • Steps, as published (paraphrased).
    1. In a brief prayer, the person asks the Holy Spirit for a suitable word.
    2. They choose a short word, usually one or two syllables. Keating's examples include God, Jesus, Abba, Father, Mother, Mary, Amen, Love, Peace, Mercy, Let go, Silence, Stillness, Faith, Trust, Yes.
    3. The word is sacred because of the intention the person gives it, not because of its inherent meaning.
    4. The word is not changed during a prayer period, since that would be "starting to think again".
    5. Keating notes that some people use a simple inward glance toward the Divine Presence, or notice the breath, instead of a word. This is noticing only; no breath control is involved.
  • Therapist's role. Leave the choice to the client and their tradition. If a word carries traumatic associations, for example a parental title for someone abused by a parent, the client may prefer another. Keating's list includes alternatives such as Peace or Yes, or the inward glance. [synthesis]
  • Example language (illustrative). "Some words can bring up a lot. Does the word you're drawn to feel like a simple 'yes' for you, or does it pull you into memories?"
  • Watch for.
    • Distress cued by the word.
    • Treating the word as a mantra that must be repeated constantly; Keating says continuous repetition is not the aim.
    • Scrupulous worry about choosing "the right" word.

C. Settling and introducing the word (Guideline 2)

  • Purpose. Begin the prayer period. [source: Keating 2004; Contemplative Outreach guidelines]
  • Steps, as published (paraphrased).
    1. Sit relatively comfortably, back straight, not so comfortable as to invite sleep.
    2. Close the eyes, which symbolises letting go of what is happening around and within.
    3. Settle briefly, then silently introduce the sacred word, as gently as "a feather on absorbent cotton".
    4. If you fall asleep, continue the prayer on waking.
    5. Use a soundless timer.
  • Trauma-sensitive options [synthesis drawing on Treleaven 2018]. Eyes may stay softly open with a lowered gaze. Choose a seat facing the door. Keep feet on the floor. Agree an opening and closing signal in advance. Check whether the client wants these; the eye-closure symbol is the tradition's, so offer adaptations as options, not corrections.
  • Example language (illustrative). "If closing your eyes feels unsafe today, you can keep them open and resting on the floor. The intention is what matters in this prayer, as you've described it."
  • Watch for.
    • Rising arousal (rapid breathing, startle, freezing).
    • Dissociation (blank stare, losing time).
    • Falling asleep repeatedly, which may point to sleep problems worth assessing.

D. Returning ever-so-gently when engaged with thoughts (Guideline 3)

  • Purpose. The core of the method. [source: Keating 2004; Contemplative Outreach guidelines]
  • Steps, as published (paraphrased).
    1. "Thoughts" covers everything that arises: sensations, feelings, images, memories, plans, reflections, commentary and spiritual experiences.
    2. Thoughts are inevitable and normal.
    3. When you notice you are engaged with a thought, return "ever-so-gently" to the sacred word, with minimal effort.
    4. The word may become vague or disappear.
    5. Keating lists kinds of thought to meet in the same way: ordinary wandering, thoughts with attraction or aversion, insights and psychological breakthroughs, self-reflection ("How am I doing?"), and material from the unconscious.
    6. Do not analyse experiences during the prayer.
  • Therapist's role. Normalise wandering. Explore any harsh self-talk about "failing". Note that the tradition itself says to let go even of psychological breakthroughs during prayer; these can be brought to therapy afterwards. [synthesis]
  • Example language (illustrative). "It sounds as if every time your mind wandered, you scolded yourself. The guideline you follow asks for the gentlest possible return. What would that kind of gentleness look like?"
  • Watch for.
    • Perfectionism and scrupulosity.
    • Intrusive trauma memories that keep returning however gently the client comes back to the word. Treat this as a sign to adapt (K, L), not to persist.
    • It is working when the client describes less struggle with wandering and kinder self-talk.

E. Ending in silence (Guideline 4)

  • Purpose. Carry the silence into daily life. [source: Keating 2004; Contemplative Outreach guidelines]
  • Steps, as published (paraphrased).
    1. At the end of the period, remain in silence with eyes closed for a couple of minutes.
    2. In a group, the leader may slowly pray the Lord's Prayer aloud while others listen.
  • Clinical addition [synthesis]. For clients who come out of silence disoriented, add an orienting step before standing: open the eyes, name objects in the room, feel the feet.
  • Example language (illustrative). "Before we go on, let your eyes take in the room. What do you notice?"
  • Watch for.
    • Lingering derealisation or depersonalisation.
    • Low mood or agitation after practice.
    • Note when these happen and how long they last.

F. Welcoming Prayer (Mrozowski; Contemplative Outreach)

  • Purpose. A companion practice for consenting to God's presence in physical and emotional reactions during daily life. It is linked to Keating's teaching on dismantling the emotional programs of the false self. Mrozowski's version recommends an established Centering Prayer practice first. [source: Diocese of Newark, Welcoming Prayer; Contemplative Outreach 2023]
  • Steps, as published (paraphrased).
    1. Focus, feel and sink in. Notice the reaction as it is felt in the body.
    2. Welcome. Name it (for example, welcoming anger) as an opportunity to consent to the Divine Indwelling.
    3. Let go. Release the desires for security, affection and control, or more simply the desire to change the feeling. Keating describes letting go as "passing through the experience, not around it".
    4. Start with small irritations, such as a traffic jam, before serious upsets.
    5. It takes seconds and can be used anywhere.
  • Key caution. One welcomes one's own response to a pain, not the disease or trauma that caused it. [source: Diocese of Newark, Welcoming Prayer]
  • Therapist's role. Debrief daily uses. Help distinguish letting go of an inner reaction from tolerating ongoing harm. Agree to postpone use of the practice with high-intensity trauma material. [synthesis]
  • Example language (illustrative). "When you welcomed the anger, you were welcoming your own reaction, not saying what he did was acceptable. Does that distinction fit how you understand it?"
  • Watch for.
    • Spiritual bypassing, where "letting go" replaces protective action or grief.
    • Body focus that floods a trauma survivor.
    • It is working when reactivity drops and the client still sets boundaries.

G. Debriefing "unloading of the unconscious"

  • Purpose. Help the client process emotional material that surfaces during or after prayer. Keating describes it as the spontaneous release of early emotional material, showing as feelings, images, bodily sensations or reactivity, for example snapping at a colleague after prayer. Use it when the client reports new or intensified feelings linked to practice. [source: Contemplative Outreach 2023; synthesis]
  • Steps [synthesis]:
    1. Invite a description of what arose, when, how intense it was and how long it lasted.
    2. Respect the client's own interpretation in Keating's terms ("unloading", false-self programs) and explore it with ordinary therapeutic methods: links to history, current triggers, needs.
    3. Rate distress and functioning. If either is rising, go to K and M.
    4. Agree what stays in prayer (letting go, as the tradition teaches) and what comes to therapy (understanding, working through).
  • Example language (illustrative). "You've said this felt like old material coming up, the way Keating describes it. Can we look at it together here, at a pace that feels manageable?"
  • Watch for.
    • Framing every symptom as "unloading" and so delaying needed care.
    • Re-experiencing trauma, which Lindahl et al. (2017, PLOS ONE) record among meditation-related challenges.
    • It is working when material becomes more understandable and less disruptive over time.

H. Lectio Divina and weekly group (the tradition's deepening practices)

  • Purpose. Keating lists Lectio Divina (listening to Scripture as if in conversation with Christ) and a weekly Centering Prayer group as ways to deepen practice. He describes the group as encouraging perseverance and giving mutual support. Use these when the client wants community and structure. [source: Keating 2004]
  • Steps.
    1. Explore whether the client has, or wants, a local group or Lectio practice.
    2. Help them find Contemplative Outreach groups or their parish.
    3. Leave instruction in Lectio to the tradition; this guide gives only its outline. [synthesis]
  • Example language (illustrative). "Would it help to practise alongside others? Your group could be the place for questions about the prayer itself, and here we can look at how it's affecting the rest of your life."
  • Watch for.
    • Isolation.
    • Excessive solo practice.
    • Group pressure or a teacher relationship that feels coercive (see section 5).
    • Group support is working when the client reports encouragement without obligation.

I. Referral to and coordination with teachers, spiritual directors and clergy

  • Purpose. Keep spiritual formation with qualified people in the client's tradition. Coordinate care when the client wishes. [synthesis]
  • Steps.
    1. Map who guides the client's practice.
    2. Obtain written consent before any contact.
    3. Share only what is agreed: for example, that the client is shortening sessions, or which adverse experiences have occurred.
    4. Agree who handles what: the director handles prayer and discernment; you handle mental health.
    5. Refer to Contemplative Outreach materials (the guidelines, Open Mind, Open Heart) for instruction rather than teaching it yourself.
  • Example language (illustrative). "Would you like me to talk with your spiritual director, so we're not pulling in different directions? You decide what I share."
  • Watch for.
    • Conflicting advice.
    • A director who discourages mental-health care, or a therapist who discourages faith.
    • Dual relationships, for example a therapist who attends or leads the client's prayer group.

J. Screening before intensive retreats

  • Purpose. Intensive and extended retreats are part of the tradition; the first was held in 1983. Longer, more intensive practice is a plausible dose factor for adverse experiences. Lindahl et al. (2017, PLOS ONE) identify practice-level, practitioner-level, relationship and health-behaviour factors that influence challenges. [source: Contemplative Outreach History; Lindahl et al. 2017, PLOS ONE; synthesis]
  • Steps [synthesis]:
    1. Before a retreat, review current mood, sleep, psychosis or mania history, dissociation, recent trauma or loss, and substance use.
    2. Ask whether the retreat has staff the client can approach, and whether silence can be broken for help.
    3. Make a plan: warning signs, who to contact, and permission to leave or reduce sitting.
    4. With consent, inform the retreat leader of relevant needs.
    5. Book a session after the retreat.
  • Example language (illustrative). "Before the retreat, let's agree what would tell you to step back, and who you'd tell."
  • Watch for.
    • Recent decompensation.
    • Severe insomnia.
    • Active trauma symptoms.
    • The client minimising risk because they fear being stopped.

K. Dose reduction and grounding

  • Purpose. Lower intensity when practice is destabilising. Farias et al. (2020, Acta Psychiatrica Scandinavica) found adverse events in meditation are not rare and can occur without prior mental-health history. [source: Farias et al. 2020, Acta Psychiatrica Scandinavica; synthesis]
  • Steps [synthesis]:
    1. Normalise reducing or pausing practice as care, not failure. Keating himself warns against goals in prayer.
    2. With the client, shorten or space out prayer periods, keep eyes open, or pray in company.
    3. Swap to more active forms where the tradition offers them: spoken prayer, Scripture reading, walking, service. Discuss this with the client's director.
    4. Teach grounding: orienting to the room, feeling the feet and the chair, naming objects, gentle movement.
    5. Address sleep and routine.
    6. Reassess weekly. Resume gradually only if the client wishes and is stable.
  • Example language (illustrative). "Stepping back for a while isn't abandoning your prayer. Many traditions make room for seasons of different prayer. What would a gentler form look like for you this month?"
  • Watch for.
    • Guilt or scrupulosity about reducing practice.
    • Symptoms that persist after reduction, which call for fuller assessment (M, N).

L. Trauma-sensitive adaptation

  • Purpose. Inward attention and silence can worsen traumatic stress. Treleaven warns of "flashbacks, dissociation, and even retraumatization". His five principles concern attention, arousal, relationship, dissociation and social context, and the book offers 36 modifications. [source: Treleaven 2018, publisher description; applied here as synthesis]
  • Steps [synthesis]:
    • Attention. Allow eyes open, an external anchor, or the inward glance rather than closely watching inner states.
    • Arousal. Agree stop signals, and keep the client within a tolerable range.
    • Relationship. Make every adaptation optional and collaborative.
    • Dissociation. Shorten the time, use orienting endings and check presence.
    • Social context. Consider religious trauma, gendered or abusive images of God, and church-related harm. Let the client choose language and images.
  • Example language (illustrative). "You're in charge of this. You can open your eyes, move or stop at any time, and that's part of doing it well."
  • Watch for.
    • Freezing or going blank.
    • Compliance without real consent.
    • Images of God tied to abusers.

M. Recognising challenging and adverse experiences

  • Purpose. Detect difficulties early, using published research. [source: Lindahl et al. 2017, PLOS ONE; Farias et al. 2020, Acta Psychiatrica Scandinavica; Cheetah House]
  • Steps.
    1. Ask routinely about each of the seven domains of meditation-related experience in Lindahl et al. (2017, PLOS ONE): cognitive, perceptual, affective, somatic, conative (motivation and will), sense of self, and social.
    2. Note that their effects ranged from positive to severe and enduring distress and impairment.
    3. In Farias et al.'s (2020) review, the most common adverse events were anxiety, depression and cognitive anomalies.
    4. Rate severity and duration, and act on functional impairment.
    5. Cheetah House (Britton and colleagues) offers consultations and support groups for practitioners, and trainings for teachers and clinicians. Consider these for specialist consultation.
  • Example language (illustrative). "Sometimes prayer and meditation stir up hard things: fear, unreality, sleep trouble, feeling unlike yourself. Has anything like that happened?"
  • Watch for.
    • Panic, depersonalisation, derealisation and perceptual changes.
    • Insomnia, involuntary movements and social withdrawal.
    • Suicidal thoughts: follow standard risk assessment.

N. Distinguishing spiritual difficulty from mental disorder

  • Purpose. Neither pathologise a spiritual crisis nor miss illness. The tradition includes John of the Cross, whose "dark night" is a recognised category of spiritual desolation within Christian contemplative writing. Whether Keating's own writings use this frame here is [uncertain: not verified]. [synthesis]
  • Steps.
    1. Assess for psychosis, mania, major depression, dissociative disorder and OCD by standard criteria.
    2. Check functioning, sleep, insight and safety.
    3. Where distress is religious or spiritual and does not meet criteria for a disorder, DSM-5 provides the code V62.89 (Z65.8), "Religious or Spiritual Problem" (Barrett 2020).
    4. Consult the client's director on the spiritual side, with consent.
    5. Refer to psychiatry if disorder criteria are met.
  • Example language (illustrative). "Your tradition has words for seasons of dryness and darkness in prayer. I also want to make sure we're not missing a depression that could be treated. Can we look at both?"
  • Watch for.
    • Reduced need for sleep, grandiosity, or hearing commands, which point to mania or psychosis.
    • Pervasive hopelessness, which points to depression.
    • Rigid ritual checking, which points to scrupulosity (section 5).

O. Secular and clinical adaptations; cross-referral

  • Purpose. Some clients want a non-religious practice, or an evidence-based protocol. [synthesis]
  • Steps.
    1. Do not secularise Centering Prayer itself; the tradition states it is not a technique.
    2. For secular contemplative training, cross-refer to Domain II: MBSR, MBCT, Mindful Self-Compassion and CFT.
    3. For contemplative and spiritually integrated psychotherapy, cross-refer to Domain VII.
    4. For trauma-sensitive body-based practice, cross-refer to Domain IV.
    5. Published outcome studies of Centering Prayer exist, including a pilot outcome study by Fox and colleagues [uncertain: not verified]. Do not present the practice as treatment for any condition.
  • Example language (illustrative). "If you'd like a version without a religious frame, there are mindfulness programmes designed for that. Or we can keep your prayer as yours and work on other skills here."
  • Watch for.
    • Imposing a secular frame on a believer.
    • Imposing religious practice on a secular client.

P. The therapist's own commitments and self-disclosure

  • Purpose. Manage boundaries when the therapist shares, or differs from, the client's faith. [synthesis]
  • Steps.
    1. Reflect on your own views of prayer and contemplative practice.
    2. Disclose only if it serves the client.
    3. Never pray with or lead a client in prayer as a substitute for their community.
    4. Seek supervision.
    5. Check your profession's ethics code on competence, boundaries and multiple relationships (the APA Ethics Code for psychologists) [synthesis].
  • Example language (illustrative). "My own beliefs matter less here than yours. What would be most helpful for you to know about how I'll approach your faith?"
  • Watch for.
    • Over-identification with the client.
    • Subtle evangelising or subtle dismissal.

5. Handling problems

The tradition's sources address goal-seeking, sleepiness, bodily sensations and arising thoughts. Everything else below is [synthesis] unless a source is cited.

  • "Nothing happens" / dryness / feeling stuck.
    • Keating says the principal fruits are found in daily life, not in the prayer period. He also warns against aiming for peace, consolation or spiritual experience. [source: Keating 2004]
    • Response: shift review to daily-life changes, such as reactivity and relationships. If dryness comes with anhedonia, sleep change or hopelessness, screen for depression (N).
    • Example (illustrative): "Your tradition says not to judge the prayer by the period itself. What, if anything, has shifted in your days?"
  • Scrupulosity about "doing it right".
    • Signs: repeated checking of whether the word was said correctly, guilt over wandering, compulsive extra sessions.
    • Response: assess for religious OCD. Where it is present, use ERP adapted with the client's religious authority. IOCDF guidance on scrupulosity [uncertain: not verified]; for the IOCDF's Catholic ERP material, see guide 202 (sacraments of reconciliation and anointing).
    • Point out that Keating's guideline is minimal effort and the gentlest return. Reassurance-seeking about technique should not be reinforced. [synthesis; source for the guideline: Keating 2004]
  • Overwhelm, flashbacks or dissociation during or after prayer.
    • Stop or shorten practice and ground (K).
    • Apply trauma-sensitive options (L).
    • Assess severity and duration (M).
    • Coordinate with the director if the client wishes (I).
    • Do not encourage pushing through on the basis that it is "unloading". Keating's teaching that material may surface does not imply that severe or lasting distress should be endured untreated. [synthesis]
  • Bodily sensations.
    • Keating's brochure attributes pains, itches, twitches and restlessness to the release of emotional tension, and heaviness or lightness to spiritual attentiveness. It advises not attending to them during prayer. [source: Keating 2004]
    • Clinically: involuntary movements and somatic changes are also recorded as meditation-related challenges (Lindahl et al. 2017, PLOS ONE).
    • New, severe or persistent physical symptoms go to the client's doctor. Do not interpret them spiritually on the client's behalf. [synthesis]
  • Falling asleep.
    • The tradition says to continue on waking. [source: Keating 2004]
    • If it is frequent, assess sleep, mood and medication effects, routing medication questions to the prescriber. [synthesis]
  • Non-adherence and guilt.
    • The client may feel they "should" pray at the frequency Keating recommends.
    • Response: frame those recommendations as the tradition's invitation, not therapy homework. Explore barriers and ambivalence. Leave decisions about practice to the client and their director. [synthesis]
  • Spiritual bypassing.
    • Using "let go" (Welcoming Prayer) or prayer time to avoid conflict, grief or necessary action.
    • Response: return to the published caution that one welcomes one's reaction, not the cause of harm. Explore needed action alongside the prayer. [source: Diocese of Newark; synthesis]
  • Ruptures over faith.
    • The client fears the therapist will pathologise their prayer, or feels pushed toward or away from it.
    • Response: name the rupture, restate respect for their tradition and your role limits, and invite feedback.
    • Example (illustrative): "I may have sounded as if I was questioning your prayer. That wasn't my intent. Can you tell me how it landed?"
  • Client asks the therapist to teach or lead the prayer.
    • Explain role limits and refer to Contemplative Outreach groups, materials or a spiritual director (I).
    • Brief in-session silence, if ever used, needs explicit consent, the client's own framing and safety planning. [synthesis]
  • Teacher, group or community concerns.
    • Misconduct by Contemplative Outreach teachers: none found in the sources consulted.
    • General guidance: the teacher relationship carries power. Watch for coercive control in any group: isolation from outside relationships, discouraging medical or psychological care, demands for secrecy, punishment for leaving.
    • Support clients who are leaving a community, and work with religious trauma. Cheetah House lists religious-trauma resources. [source: Cheetah House; synthesis]
  • Emerging psychosis, mania or suicidality.
    • Pause intensive practice.
    • Carry out urgent assessment and follow standard risk-assessment practice.
    • Involve psychiatry.
    • With consent, inform the retreat leader or director (J, N). [synthesis]
  • Secular client drawn to the method without faith.
    • Explain that the tradition frames it as Christian prayer of consent to God, not a technique.
    • Offer secular alternatives in Domain II, or let the client explore the tradition with its own teachers. [source: Keating 2004; synthesis]

Sources

Web sources:

Books cited:

  • Keating, T. Open Mind, Open Heart (as cited by Contemplative Outreach 2023).
  • Vieten, C., et al. (2013), spiritual and religious competencies for psychologists. [uncertain: not verified]
  • Fox et al. Centering prayer's effects on psycho-spiritual outcomes: a pilot outcome study [uncertain: not verified].
  • American Psychological Association, Ethical Principles of Psychologists and Code of Conduct (referred to generally) [synthesis].
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