Orthodox Outlet for Dogmatic Enquiries Psychotherapy


What is "psychotherapy" in the context of Orthodox Christianity?

By: Alexander Lapin

World Cultural Psychiatry Research Review
April-july 2007 edition p.80-86 / © 2007 WACP ISSN: 1932- 6270




To answer the question posed in the title of this article, one have to ask first about what is the Orthodox Christianity? Thus, approximately one half of the earth population belongs to the monotheistic, so called Abrahamite faiths, which are Judaism, Christianity and Islam. The largest of them is Christianity by roughly one third of the worldwide population. Approximately one half of Christians belongs to Roman Catholic Church, while somewhat more than one third of them can be ascribed to the Protestantism in a wider sense: with Lutherans, Reformed and Anglicans as the most important historical lines. While Catholics are in doctrinal and juridical sense united around Pope of Rome, Protestants are spread into several hundred different confessions and denominations. Nevertheless, these two Christian families together are usually considered as the Christianity of Western cultural heritage.

But this is not the whole picture! About one sixth of today's worldwide Christians (roughly 280 millions) belong to the East whatever this term means for first. According to the geographic distribution of different religions in the world, the Orthodox Christianity (which corresponds to 90% of worldwide Eastern Christianity) prevails today in several countries of former Soviet block. Among others, this means that by downfall of the communist regime, which, by self-understanding was disapproving any religion, one can expect a growing importance of the Orthodox Christianity not only concerning migrants and ethnic minorities, but also in context of global politics. This justifies the necessity to get to know better the "mentality" as well as "basics" of this religion and culture and this in turn, is also one of the aims of this article.

Correspondence to: Dr. Lapin Alexander, Univ. Doz. Mag. D. Sozialmedizinisches Zentrum Sophienspital Apollogasse 19, A-1070 Wien, Austria

Received July 29, 2006. Accepted April 16, 2007.




It is not the communist regime, as rather the early Christian history and its geo-political situation of that time, which is until now determinative for Eastern Christianity (Ware, 1997). Thus, four ancients and the most respectable Orthodox Patriarchates, such as of Constantinople, Alexandria, Antioch and Jerusalem, exist since the Eastern-Roman Empire, which is designed today as Byzantium. In this sense, Patriarch of Constantinople is the first among all Orthodox Christians, although his primacy is done by honour and is of far less power as that of Pope of Rome. His flock consists of a small Greek community of Istanbul, as well as of inhabitants on some Greek Islands (mainly Crete). By his title of Ecumenical Patriarch, is he also the Head of Christian Diaspora, which however today, is referred mainly to Greeks in United States and in other countries of the world (about 6 millions in total). Other "old" Patriarchates are rather of local importance and their believers today, are mostly Christian Arabs. Except the Patriarchate of Alexandria, which includes some eparchies (dioceses) in countries of central Africa, such as Cameroon, Kenya or Uganda or Madagascar. Important, not at least because of the number of faithful, are Patriarchates, which have been constituted in course of the medieval history. Here, the most important is the Patriarchate of Moscow (with about 150 millions of faithful), whose history goes back to the 16th century and to the Russian Empire, when the city of Moscow got the title of "Third Rome" (Ware, 1997). Today, faithful of Moscow Patriarchate are citizens of successor countries of the Soviet Union: Not only of Russian Federation, but also of Ukraine, Belarus, Baltic States, Moldova or Kazakhstan. Additionally, there is a large Russian Diaspora around the world. Other Patriarchates, such as Romanian, Serbian, Bulgarian and Georgian (of 23, 15, 10 and 5 millions of faithful respectively) are often mentioned in context of daily news from Balkan and Caucasus, but in the same time, many of their faithful are living now as foreign workers in different Western countries and their communities here are growing rapidly. Smaller local Churches usually don't have the formal status of Patriarchate, but they are also "autocephalous", which means they are self-governed and nationally independent. Most of them were established in course of 20th century, either in result of a specific mission (Japan), or on the base of an appropriated ethno-religious minority (Poland) or have been formed by émigrés or refugees. The best example of the later is The Orthodox Church of America (one million), but also the Orthodox Church of Poland reveals a considerable number of faithful (750 thousand). The status of an "autocephalous" Church has also the Church of Greece (of the Greek mainland; 9 millions) and of historical importance is the Church of Cyprus (about half million), which obtained its "autocephaly" already in 5th century (Ware, 1997). Finally, a certain curiosity represents the Church of Sinai with just few Hundred of faithful, which are merely related to the famous monastery of Saint Catherine. Other "local" Churches such as of Albania, Finland, Czech lands & Slovakia, each gathering not more than one hundred thousand of faithful, are rather of missionary and "diasporic" character.



Despite their "autocephaly", local Orthodox Churches stand together in full Eucharistic and doctrinal unity. They consider themselves as a part of Holy Orthodox Catholic[1] and Apostolic Church, which has been founded by Jesus Christ in course of the Pentecost and which, since than, exists in unbroken succession until our days (Efthimiou, online). The differences between the local Orthodox Churches are considered by them self as of rather subordinate significance and concern especially the liturgical language (sometimes identical with the national language), different particular features of the rite, as well as some special national traditions.

The teaching of the Orthodox Church is based on Holy Scripture, but Orthodox Christians plead also for, what they name the "Church Tradition". It comprises dogmatic decisions of seven Ecumenical Councils (between the years 325 and 787), as well as "patristic heritage", which results from the huge work of "Holy Fathers of the Church", famous ascetics, martyrs, apologetics and theologians especially from the early period of Christian history. Although partly forgotten in the West, their spiritual and ascetic experience survives now in a rich tradition of the Eastern Church: in its liturgical poetry, chants and hymns, different liturgical texts, symbols and customs (Ware, 1997). "The Fathers" are still considered as the highest spiritual authority between the Orthodox. This, despite the fact, that in their works expressed always their own experience and views, which were not in all points necessarily in accordance with the opinion of the "official" Church and the Establishment of that time. But the "Church Tradition", it is also the veneration of icons, Church architecture, divine services[2] and sacraments. All this together forms that, what can be designed as the "liturgical life", which is an important and in the same time very intimate part of life of every Orthodox Christian. Thus, especially from the perspective of the rationally oriented West, the "liturgical life" of Orthodox Christians is conspicuous by its mysticism. Indeed "mystical", but in the same time very concretely consented is the presence of Holy Spirit[3], either in divine services or in sacraments, which, in Orthodox Church are designed as "mysteries". For Orthodox Christians it is no question to approve the existence of God, because the Human rationality is too vain in order to be able to comprehend God by His substance. But in the same time, the Human is very well able to recognize the concrete presence of God, even by action of His energies (Ware, 1997; Belejkanic, 1996). Moreover, for Orthodox the word "Church" means less an "Institution", as rather the "mystical body of Christ" or theandric (e.g. "divine-human") organism. In the same time, it is also the community of God with His people (Belejkanic, 1996). Thus, the term "Church" is meaning less an ecclesiastical hierarchy (as often understood in the West), but rather a "building" or "place", where all faithful - alive or passed, laics or clergy, saints or sinners - are in communion with God. Therefore, there is no "Vicar of Jesus Christ on the Earth" like the person of Pope in the Rome in Roman Catholic Church. There are just bishops, which all together (including patriarchs) are successors of Apostles, brotherly and equal among one and to other, but in the same time, fallible as every Human can be. In this sense it is understandable, that Orthodox parish priests are usually married, while bishops, monks and nuns remains celibately. In the same time, Orthodox monasteries are sometimes of very strong contemplative character. Until the "Great Schism" in 1054 the Eastern and Western Christians were in the same "universal" Church, but since this date, especially due to the geo-political development, the gap between the two parts of Christianity becomes more and more deeper. While the focal point of Christianity moved to the West, the significance of the Christian East declined successively. Very often Eastern Christians felt under foreign, sometimes very hostile rule. Ottoman Turks and Islamic Arabs in Middle East, Tatars in Russia and, in the modern time, the communist regime in the Eastern Europe, all this put Eastern Christians a priori in another historical context, as the Christianity of the West. Important aspects of Western history, especially the dominant role of Church in Middle Age with historical phenomena like Inquisition, Reformation religious wars, as well as different confrontations of (Western) Christianity during the period of Enlightenment and Industrial Revolution - all this was of only marginal importance for the Christian East. Moreover, Eastern Christianity becomes now an insignificant and forgotten aspect of that, what the West designs now as the "Orient".

On the other hand, it was even the "Church Tradition", which for Eastern Christians get an indispensable condition for keeping the own identity in circumstances of the foreign neighbourhood. It becomes a living bridge to the heritage of the spiritual richness of the original

Christianity, which arose in that time and from the region of Eastern Mediterranean, which in the same time was a fruitful crossing point of different ancient cultures...



Before to speak about psychotherapy, one has first to point out, that today, modern Orthodox Christians are fully accepting the contemporary psychiatry and psychotherapy as a part of the valid medical treatment. However the term "Ψυχοθεραπεία" (psychotherapeia) can be understood also as a term of the Orthodox theology. All the more, since its language, in contrast to the Western theology, uses rather medical than juridical terms. According to the recently published book entitled "Orthodox Psychotherapy" of the contemporary Greek theologian, Metropolitan Hierotheos Vlachos (Hierotheos, 1994): "...the Christian Orthodox faith can be considered neither as a "philosophy" or "ideology", nor as a "natural religion" or "cult", but as a "healing". Healing from the loss of the sense of life, healing of the distress, which is due to the spiritual disorientation...". Thereafter Church is an "inn", a "hospital", as in parable of the Good Samaritan [Luke 10,25]. Holy Fathers are "expert physicians", monasteries are "medical schools" and finally - the psychotherapy gains its own significance: it is the healing of the Souls. But what should be the aim of such a therapy? What is mean in this context by terms like "normal", "healthy" or "natural"? And finally, how can be answered the basic anthropological question what - or who is "Human"?

According to the Orthodox theology, Human is the supreme creation of God and, in the same time, he is the Image of God. Human is of Body and Soul, but also of divine Spirit [Genesis 1,27] and, even due to the later peculiarity, the Human is not just an "Individual" (as "one" isolated from "many"), but moreover a "Person" (προσωπόν, prosopon), which is unrepeatable and unique and which has his past and his future and which is able to grow but also to fall. To be a "Person", it means that the Human is able to undergo relations. Moreover, he is literally determined by his relations^. (Jezek, 2005). These can be intrinsic - as relations between Body and Soul (e.g. Human is conscious of his physical, psychical, as well as his spiritual state), as well as extrinsic, which means that Human can be conscious of God's transcendent existence, the existence of his next (especially in sense of love, care and responsibility) and finally of the nature, by which he is surrounded (in sense of the ecological responsibility) [Genesis 1,28]. In the same time, the divine potential of the Human enables him to be a "creative being": he is able to create things and to realise his own intentions - according to his own though, ideas, and even the Spirit (Scouteris, 2003). In the same time, it is the "divine potential" of the Human, which enables him to make morally based decisions and to distinguish between the Good and the Bad according to his own "heart", as would be said in the language of old religions. As Soul, Body and Spirit being in together in "symphony", enables to Human to realize himself in a widest thinkable measure of his liberty. This is an ideal state, state at the moment of the creation of Human, a state when the Human was in the closest vicinity of God, The Creator and Παντοκράτορ - "Pantokrator" ("Everything-Keeper"). It was the state before the Fall (primary sin), at the moment of creation of Human and from theological point of view "before the expulsion from the Garden of God" [Genesis 3]. This is also the state, which Orthodox theology considers as the most "natural", "healthy" and "normal" (Belejkanic, 1995). After the "Fall" this state has changed considerably. The communion between God and the Human was broken, the Human felt into a state of πάθος pathos, which means pain, passion, illness and which in consequence, is the reason for death as the final separation of Soul from the Body [Rom 5,12]. But, according to the Orthodox theological doctrine, this state is not entirely hopeless one. It is grace to the "divine potential", by which the Human is called to return back to God: To make first step on the way of his salvation from the negative consequences of the "Fall". According to the "Fathers", which, as mentioned in the Orthodox Church are considered as a high theological authority, the "salvation" is a positive state. But in contrast to the Western theology, Holy Fathers are less interested in the question of the "guilt", as in the "therapy" of the consequences of the "Fall". Putting on Christ, the Human has to fulfil this effort in synergy with God, but in the same time in free will and by fully conscious decision. And even this, as the principle of synergy between Human and God, is the basic and substantial category of the Orthodox anthropology (Scouteris, 2003).

On the other hand, this "therapy" comprises the whole "Person" of the concrete Human, his Soul but also his Body, which in contrast to some Western theological opinions, is not opposed to the Soul, but is (should be) with him "in symphony". Thereafter, "salvation" is a dynamic process, which has to be begun and fulfilled in a holistic way, by the whole human person - by the Soul but also by the Body (Hierotheos, 1994). Thus, the "purification" of the Soul should be done first, by "ignition of love" of God and than, by the "entrance in communion" with Him. Such process is achieved via "νούς" nous - a term which can be translated as the "reason" of the Human, or, as mentioned in different works of Holy fathers, as the "eye" of the Soul, the "eye" of the Heart, or as the "eye" of the Body.

A great theologian Gregory Palamas (1268-1310) gives concrete suggestions how to overcome the "passions". It should be done by quiet prayer - not as the Stoics do, by mortification and repression, nor by Gnostic retreat from the material world but to overcome the passions by transformation. And for this way, Gregory Palamas propose three steps of the personal way of "return" to God. It should start by prayer and fasting (e.g. by "psychosomatic effort"), in ησυχία, hesycheia, which means a harmonic stillness and appeasement of the Soul", in order to attain θέωσις, theosis, which means "deification", to be as like as God( Ware, 1997; Belejkanic, 1995). It is highly indicative for the divergent development of the Christianity, that the last serious theological conflict between West and East concerned the matter of "hesychasm". It took place in 14th century, originally as a disputation between two ethnic Greeks: the already mentioned Gregory Palamas and Barlaam of Calabria (+1350). It was Barlaam who criticised the "technique" of prayer of Monks on Mount Athos, which was brought by them from Eastern Mediterranean from the early times of the Christian monasticism. The Athonite monks pretended to see the "divine uncreated light", after their long time repeated ascetic - what they called "Jesus prayer" and which was performed in stillness and fasting. Barlaam disapproved this practice commenting it by following words "...holiness and perfection cannot be found without division, reasoning and analysis, ...anyone desiring to possess perfection and holiness must be taught "methods of distinction, reasoning and analysing". But Gregory Palamas replied this view as heresy of the Stoics and Pythagoreans: "...we Christians do not regard as true knowledge that which is found in words and reasoning, but that demonstrated by deeds and life, which is not only true but also sure and irrefutable..." and he goes on to say that "no one can know himself through distinctions, reasoning and analyses unless his "nous" has been made free of conceit and evil by severe penitence and intensive ascetism..." (Hierotheos, 1995)

In context of "psychotherapy" it means, that the role of Christian faith can be reduced neither to a rite, nor to an intellectual discussion. The Christian "psychotherapy" should be fulfilled by effort in order to find stillness of the Soul and self-reflection and to recognize his own Person as the Image of God. As has been mentioned, only a part of the "patristic heritage" is known at the present. Lot of them has been forgotten, destroyed, lost or simply not read because of lacking knowledge of the language of that time. An important, from the point of view of the Orthodox, is the work Philokalia, which means "The Love of Good Things". It is a collection of texts, compiled by monks of Mount Athos in the 18thcentury, e.g. during the period of a deep cultural depression of Hellenic, and especially Orthodox-Christian culture in Turkish-Ottoman Empire, but in a certain sense also in Russia. Philokalia is an anthology of wisdom of famous ascetics of Egypt, Mesopotamia, Asia Minor as well as from other countries, which lived between 4th and 14th century. Its first edition in Greek is related to the name of Nikodim the Athonite (1748-1809) and appeared 1782 in Venice of more than 1200 pages. Shortly after then, it was translated into the Church-Slavonic language by Paissy-Velichkovsky (1722-1799) and just recently, it was published in English (trans. by Palmer et al., 1998). As one example for many, one have to cite Maxim the Confessor (580-662 A.D.):

"...Misuse of intellect powers is ignorance and stupidity, misuse of incentive and desiring powers is hatred and licentiousness". "...The proper use of these powers produces spiritual knowledge, moral judgment, love and self- things but avarice, not to begotten of child but unchastity, not esteem but self-esteem.



The term "psychotherapy" as used in today's psychiatry is an approach to cure mental disorders and pathological behaviours. All in sense of the materialized approach of the objective medical science, its experience is substantiated by biological models, which are based for example on biochemistry of neurotransmitters or on molecular psychopharmacology. Usually, results of such approaches are demonstrated by evidence-based studies, which in turn, are preformed on collectives of individuals and evaluated by statistical methods. By contrast the "Orthodox" psychotherapy pretend to be the therapy of sense of life, not only of its behaviour (Vlachos). Its importance independent of the kind or stage of the (somatic) disease. Moreover the Orthodox "psychotherapy" is addressed not only to patient but also to physicians as well to anybody. In other words, "Orthodox psychotherapy" is the therapy of Soul in the original sense. It should help to find him-self in sense of self-knowledge, in order to overcome the spiritual disorientation by return to God and to origin of the Human in his proper nature and goodness. This way is proposed by purification of the soul, by effort of the body by finding the base of his self. Thus, by encouraging the own spiritual grow of the own "Personality". Finally, "Ψυχοθεραπεία" is an important task of the Orthodox theology. It is also an important aspect, which forms "mentality" of people, which is historically related to the culture of the Christian East. And finally, it can be an interesting suggestion in matter of Human spirituality.



  • Belejkanic I. Pravoslavne dogmaticke bohoslovie I. & II. (Orthodox Dogmatic Theology I & II), Orthodox Theological Faculty, University of Presov, Slovakia, 1996

  • Efthimiou M. How old is the Orthodox Church?. Available online at http://www.orthodoxphotos.com/history.shtml

  • Hierotheos V. (Transl. by Esther ECW). Orthodox Psychotherapy. The Science of The Fathers. Levadia, Greece, Birth of the Theotokos Monastery, 1994

  • Jezek V. Od individualismu k obecenstvi. Uvod do byzantske teologicke atropologie [From The Individualism to The Community. Introduction in Byzantine Theological Anthropology]. Orthodox Theological Faculty, University of Presov, Slovakia, 2005

  • Scouteris C. Bioethics in the Light of Orthodox Anthropology. Proceedings of the Conference: Christian Anthropology & Biotechnological Progress, Chania, Greece, 75-89, 2003

  • Palmer GEH, Sherrard P, Ware K (Trans). The Philokalia. The Complete Text compiled by St. Nikodimos of the Holy Mountain & St. Makarios of Corinth, Vol. I-IV. London UK, Faber & Faber, 1998

  • Ware T. The Orthodox Church (4th Reprint). London UK, Penguin, 1997


[1] ...in sense of "geographically universal" but also "integral" concerning the faith

[2]...for example the liturgy of Saint John Chrysostom

[3]...see the historical and theological disputation around filioque, which was the final reason for the Great Schism in 1054

Article published in English on: 3-7-2012.

Last update: 3-7-2012.