I have no idea what spiritual therapy is. I haven’t even consulted Wikipedia. I do have some idea about physical therapy, however, and I want to approach “spiritual therapy” using that analogy.
Here’s what my experience with physical therapy has been like. Some knowledgeable person—I am going to call her a physical advisor, just to prepare the way for the use of a “spiritual advisor”—diagnoses my condition and helps me learn some exercises. The idea is that some muscle or some connection is too loose or too tight and the exercise will move it back to where it ought to be.
Some of these exercises come to make sense to me. Those are the ones I want to spend most of our time on. But there are some that do not. The exercises they gave me to deal with my vertigo did not. I did them as instructed. They may have helped. It is hard to say. One thing for sure is this: I never developed an experience of the therapy that gave me any independent control over it. It never became something I could “do” when I needed to.
I don’t want to mean too much by “experience.” If, when the fuzzy vision and the spatial disorientation occurred,  I had been instructed to look at a large letter A on the wall and to move the focus of my vision back and forth along the crossbar and if the symptoms receded as I did that—then I would be doing it still. That would be an “experience” as I am using the word. I never quite concluded that the exercises didn’t help me at all. I was never sure they did. But most of all, I never had an internal referent for the value of the “therapy” to me so I didn’t continue doing the exercises.
On the other hand, my experience with the treatment of Greater Trochanteric Bursitis Syndrome (just GTBS among us friends) was different in two important ways and it is those that I would like to use as I move to psychological/spiritual analogies. The first was that the exercises helped lessen the discomfort. Not always right away, but distinctly and relatively soon. The second is that I learned to feel just what muscle the exercise was intended to affect.
I think I see what you mean
That makes a difference that is a little hard to describe, but since it is the central point of the analogy, I’m going to tell you a story that I think clearly illustrates it. This is my wife, Bette, on our second date. We were at the mall where the theater was and I had asked if she minded if I took some pictures. She was fine with that. 
On this particular one, I tried to describe how I wanted her to be. Hands like so, elbows like so. It was hard to do and I wasn’t doing it very well. Then she said, “I think I see what you have in mind” and did this. It was exactly what I had in mind. That was a very potent experience for me for several reasons, one of which has to do with physical therapy.
Phase I: The GTBS therapy was a whole different thing, I found. I am going to break it into four phases so I can keep track of how the analogy would work. The first phase was the same. She, my “physical advisor,” says “Lie like this.  Now keep your leg straight and raise it up to here 20 times. Now bend your knee. No, no; don’t roll over backwards on your hip like that. You need to be angled forward.”
Phase II: That brings me to the second phase. When I am careful to roll forward on the hip, I can feel that it affects different muscles. At this stage, I don’t know which particular muscles, nor do I know whether doing it one way or the other will help. I can feel the difference, though.
Phase III: Then, in the third phase, I can identify which muscle exactly that exercise affects. And that means I can tell whether I have rolled forward “not enough” or “too much” or “just right.” I can tell that myself. At the clinic, she was eyeballing my posture and judging that I might not be far enough. But if I know what it is supposed to feel like when I am doing it right, I can make that judgment myself and make it much more accurately (I have better data) than she can. This is the crucial phase. It is the one I know I am going to stumble over as I try to apply it to “spiritual things.”
Phase IV: Finally, in the fourth phase, I do the exercises; I feel the stress on those muscles in particular; the bursitis (GTBS) recedes and then disappears. I am now well.
The bursitis therapy is now a skill I “have.” And I know what I am doing and why it works and what “too much” feels like. The therapist said, “Be sure not to overstretch it,” but I didn’t know at the beginning what that meant. I didn’t know what it felt like. Now that I know, I am in charge of it.
If there were a “spiritual therapy” that worked in the same ways, by analogy, as physical therapy, what would it be like? Let me point out that that long and seemingly pointless description of my physical therapy will now help us.
Here is how it will do that. First, I do not have to identify anything as “spiritual pain.” I can presume it as the basis for the analogy And that is good, because the notion of “spiritual pain,” is not really a clear concept to me.
Second, I do not have to choose among “kinds” of spiritual advisers. As a practical matter the array of therapy I would be directed toward is very broad if I call the problem I am experiencing “psychological” and even broader if I call it “spiritual.”  By means of this analogy, I am presuming that both of those issues have been dealt with and I am working on the next step.
So I get to start the analogy with “doing the things my spiritual adviser tells me to do.” This is naive obedience. It is like Phase I of the physical therapy. I have nothing to go on but my confidence in her abilities, or maybe only her reputation. I have no experience of my own and no way to assess and evaluate the experience I will have. So I do what I am told.
What might I be told to do? I might be told to meditate. I might be told to pray in a particular way. I might be told that there is really no difference between prayer and meditation. I might be told to take certain actions and not others because “spiritual therapy” is really “reflection on action.” It is a reflection on practices. I might be told that how I am feeling—exalted, depressed, fearful, gregarious—is the crucial thing to know and that each feeling is a clue to my “spiritual state” and I should pursue each feeling; I should lean into each one because that is how it will become clarified for me. The array of things my spiritual advisor might tell me by contrast to what a physical advisor might tell me is strikingly large and I have no way, other than personal preferences, of choosing among them. That is why it is confusing and why I am trying to follow the analogy.
Even worse, I might be told that it is the exercise of my personal preferences that is causing the pain in the first place.
Nevertheless, there has to be, in this way of making the analogy, a time when either: a) I experience some relief (Phase IV) or b) I experience directly the effect of the prescribed therapy (Phase III). Each of those leads to a kind of reflection.
If I experience the relief (Phase IV), my immediate concern is to figure out what caused it. The relief is not the end of the story for me. I need to know what I did that caused that relief. I am presuming here that the relief is part of the spiritual therapy and that what I am doing naively at my advisor’s direction, is “the right thing.”
If I experience only the immediate effect of the therapy, (Phase III) my interest will be in whether that feeling is going to make my problem go away. I now know how to do it correctly. But will it solve the problem? It’s an issue either way. It’s a coin with two sides.
I am going to introduce “prayer therapy” in a little while. I’m not proposing it or denigrating it. I just want something as much like physical therapy as I can manage.
But before we get to this hypothetical “prayer therapy,” let’s look at what happens in Phase III of the spiritual therapy. The spiritual advisor says what I should be doing (or thinking or feeling) and I try it and “feel” something distinctive that I can associate with the therapy. At this point, I am in the position Bette was in when she said, “I think I see what you are getting at.” Some part of my self is affected directly when I do what the therapist says to do. I have not yet determined that it is going to be helpful. I’ll have to do it a while before I find that out, but I do now have “control” over the nexus between the therapeutic intervention and the feeling I have. If the spiritual advisor said, “Practice doing that this week,” I would know what she meant.
Or, in Phase IV, I can feel a very good effect from something. I presume it is an effect of the spiritual exercises I have been doing. But I need to know what it was. If I don’t know that, I can’t do it again when the pain returns. And continuing to do it without that understanding is just superstition. So I am grateful for the relief, but I need to understand the mechanism.
The back door
Now, if you have any hesitation at all about this analogy, you are probably inching away from the whole project. There is, indeed, a great deal that raises concerns and that includes me. Physical pain is what it feels like, even if the source of it might not be obvious. “Spiritual pain” is another kind of thing entirely.
- Is it the pain you get as a side effect of training?
- Is it the kind that “refines you” and “burns out the impurities.”
- Is pain, as C. S. Lewis said, “God’s megaphone” making clear a message that pleasure only obscured? “Spiritual pain” is just not clear to me as a notion.
And not only that, but I am an entirely satisfactory judge of whether the trochanteric bursa is hurting me. I am not at all reliable in determining whether the values I hold are the source of the problem or my hope for solution. I don’t know and can’t know those things, yet who else will decide if the spiritual therapy is “working” or even what “working” means?
So let’s imagine that I have concluded that I am experiencing the psychological/spiritual analog of “pain” and that I have contacted a spiritual adviser, largely on the grounds that I had such good luck with my physical adviser. The spiritual adviser gives me exercises to do and I do them in naive trust. This very likely means that I am doing them poorly. Since there is no beneficial effect at all, I am sustained entirely by my faith in the advisor.
That isn’t going to last. I will decide eventually that I am not good at this or that she is not good at it. “It,” in any case, is not “working” and I will either try to adjust myself to a life with this level of spiritual pain or I keep on searching for another advisor.
The one thing that would save me from this round is the sense that I know what this exercise is supposed to do. That is the point of the analogy with physical therapy. When I directly experience the effect of the spiritual exercise, I can adjust it (more frequently, less frequently, more social contact, less social contact, etc.) so that I experience “the effect” more directly. Then, when that happens, I can take that part of the exercise—the part that I have determined to be associated with “success”—and focus on the effects it has.
Once I know what it is and why it works, I can recommend it to other people, telling them the first effects I experienced and then the first relief I got and encouraging them to adjust that account to their own lives. “It” I will say, “works” but you have to learn to adapt it to yourself, just as I did.
So…a long trip. Worth taking? I think so. I understand better now just what function is fulfilled by understanding “what worked.” And I know I have come very near to claiming whatever gift God might grant  as the result of my own work. That’s not really what I mean. That’s an artifact of the analogy with physical therapy. I do think that there is a time for naive obedience in my own spiritual life as well as a time for discernment and choice. What this metaphor does for me, I think, is to pry those two moments a little further apart than they were and I like that.
 That’s the way I experienced my vertigo; I understand it is different for other people.
 This date with Bette was the end of my “dating experience” and I had had several times asked my date for the evening if she would mind if I took some pictures. No one was happy about the prospect. It made one in particular, angry. Bette said, “Sure,” as if she could easily imagine why I would want to have a picture and/or to share it with friends.
 Physical advisors as a rule, I have concluded, say “lay” when they mean “lie.” It’s a really unfortunate verb to get wrong if you use it as much as physical advisors use it.
 I am leaving resolutely alone the question, “What is it really?”
 That would be the ultimate source of any relief I felt in my own picture of how the world works.