Wounded Images of Self and God
“Among all my patients in the second half of life – there has not been one whose problem in the last resort was not finding a religious outlook on life. It is safe to say that every one of them fell ill because he had lost what the living religions of every age have given to their followers, and
none of them have been healed who did not regain his religious outlook.This of course has nothing to do with a particular creed or membership in a church.”
Carl Jung, “Psychotherapists or the Clergy” (1932)
Psychotherapy can assist persons who wrestle with questions of faith, with wounded images of self and God. Psychotherapy with clients in nursing homes is not the same as pastoral counseling, and must make room for individual religious differences, or a lack of religion.
But in my experience as a psychotherapist, even persons who verbalize an atheist viewpoint still grapple with faith questions as they near death. A person who professes no beliefs might say to me that they still hope to see their loved ones after they die.
A lady in her 90’s asked, “Tom, how will I know if I’m dead?” She thought that if there is nothing, then nothing knows nothing. But if she knew she was dead, then she must have a soul that was knowing.
Another lady, Grace, was 103 years old and living in a Rest Home. She was referred to me for psychotherapy with a question of possible depression.
“Well, I don’t know if I’m depressed or not, I just can no longer do all the things I love. I love to read but my eyes are bad, and my fingers can’t hold a book or turn the page,” she said and held up her fingers, gnarled by arthritis.”I always did needlework; knitting and crocheting, but look, I can’t do that anymore.”
Using her walker to get to the bathroom was a slow and painful excursion for Grace because of her arthritis.
“I do have something I want to tell you, but I don’t want you to think I’m crazy,” Grace said. “I have a vision, it’s the same thing over and over, and it’s not a dream – it happens when I’m awake, like this, sitting up in bed.
There is an old man standing in my door, and he is twisted like a tree that has long been out in the wind. He slowly shuffles to the foot of the bed, and in a deep voice that sounds like it’s coming from under the earth, he says, “We have to get together in the midst of this pain and work it out.”

Well, this same thing keeps happening again and again,” Grace explained.
Grace had earlier referred to her history of religious faith, and her current spiritual questions. I inquired further about her beliefs and doubts. She had always been a person of faith, yet now she felt inadequate and unlovable because she could no longer be the active and productive person she was.
We explored what the visionary experience might mean for her if she considered it in light of that cluster of feelings and thoughts. Perhaps, she came to consider, God was mirroring her current pain and asking to be close to her in its midst, and if she might allow that, rather than judging and dismissing her worth, it might be the solution to her troubles. With that understanding she suggested, “I think I’ll be okay now, Tom. I don’t have to think I’m no good just because I’m not like I used to be.”
Larry was 74 years old and had spent the last three years in a nursing home. He was nearing the end of his life and was dreading it. He was born with a birth defect. His father had been alcoholic, and physically and emotionally abusive.
Larry loved and hated his father. During nearly every psychotherapy session he made comments about hating God. He experienced a conflict of love and hate for his father, and he was unconsciously able to partially hold on to the love side of that conflict by projecting the hate side upwards.
“But I did see the light one time, Tom,” he said. Larry had been scuba diving, doing restoration work beneath a large ship, and he became stuck, ran out of oxygen, and knew he was about to die.
“Suddenly there was a beautiful light all around, and I never felt better in all my life, and I was loose, and I came to the top.”
“Did that change any of your thoughts about God?” I asked.
“Aw, no, I still hated God. But, you know, I did see the light two more times.”
Larry went on to describe two additional near-death experiences, with bright light and peaceful feelings, but he was not able to consciously draw comfort from those experiences as he neared the end of life.
Chris was a 64-year-old resident in a nursing facility, and in one therapy session he shared an essay he’d written about mental illness and religious faith.
“In our struggle with schizophrenia, we have much to contend with. The many highs and lows, confusions and crises in the life of a schizophrenic. We try medication, psychiatrists and the like. These things work to a degree, but not something that sustains you or makes you stable. God is good for the mentally ill. The only concern is we have to be careful not to confuse spirituality with our mental illness. Mental illness makes it difficult to believe in God. We are so confused and not sure what to believe anyway with hallucinations and such. God is aware of this, and He knows the plight of the mentally ill.”
Yes, but how might one differentiate mental illness from spirituality?
Certainly, some people with a mental illness do confuse the two. But many individuals experience both a mental illness and a vibrant religious faith, and they can be distinctly different.
What might be characteristics of a wholesome religious outlook versus psychopathological distortions?
Unhelpful and pathological religious elements are characterized by fear, anxiety, avoidance, grandiosity, aggression, subjective idiosyncrasy, irrationality, and hatred. Whereas productive and encouraging spiritual viewpoints include humility, patience, peace, insight, fortitude, and tend to be conventional and doctrinal, as well as rational, and foster love.
In psychotherapy I follow the lead of spiritual symptoms, signals, questions and comments of clients, and help them sort through questions and influences of past experiences, and create space for a life-affirming and personality-broadening religious outlook, based on their individual beliefs, and on our shared existential challenges regarding illness, aging, and death.
copyright 2026 Tom Medlar










2025 Margaret King Zacharias