From Psychology to Spirituality: Why CBT Opens a Passage (and Doesn't Replace It)

Synthesis of the Marquet series. After walking through the Person → Psyche → Spirituality progression with Denis Marquet (dare to desire, parenting, loving, joy), one question remains, central for many patients at the end of therapy: where does psychology stop, where does the spiritual begin — and why can't we be satisfied with one without the other? This article offers a clinical synthesis of the passage between the two, drawing on my practice as a CBT psychopractitioner, contemporary scientific literature, and a few pioneering figures (Jung, Frankl, Marquet, Welwood).

Introduction: The Limit Felt at the End of Therapy

In many successful treatments, a particular moment emerges. The patient has worked on their schemas, restructured their cognitions, retrained their behaviors. Symptoms — anxiety, ruminations, repeated relational conflicts — have receded. Objectively, they are doing better. And yet something remains: a background question, an existential unease that finds no resolution in classical psychological tools. "Doctor, my life works better, but what do I do with it?"

I have heard this sentence hundreds of times. It does not signal a failure of therapy. It signals a success: the one that has brought the patient to the threshold where psychology ceases to be the relevant tool. This threshold — which I will here call the passage — is a clinical moment as important as the initial diagnosis. Poorly handled, it leads to cynicism ("therapy was useless"), to relapse, or to flight into consumer spirituality. Well handled, it opens onto a new maturity: that of a being who no longer asks psychology for what it cannot give.

Understanding this passage requires clarifying four things: (1) what psychology actually RESOLVES, (2) where it structurally stops, (3) what the spiritual ADDRESSES and that is not within its competence, (4) the golden rules for not confusing the two domains — and especially never to skip the psychic stage under the pretext of spirituality.

1. What Psychology Resolves (Really)

Let's begin by doing justice to contemporary clinical psychology. Cognitive-behavioral therapies (CBT), Young's schema therapy, acceptance and commitment therapy (ACT), mindfulness-based cognitive therapy (MBCT), EMDR, internal family systems therapy (IFS) — this family of tools, evaluated by thousands of controlled studies, resolves major things:

• Early maladaptive schemas (Young): abandonment, mistrust/abuse, defectiveness, subjugation, unrelenting standards. Once identified and reworked, they cease imposing their reading grid on adult life. For a complete mapping, see Young's 18 emotional wounds blocking your happiness.
• Cognitive distortions: negative automatic thoughts, arbitrary inferences, catastrophizing. Cognitive restructuring makes them visible and weakens them.
• Avoidance behaviors: phobias, social avoidance, procrastination. Graded exposure reorganizes neural associations.
• Emotional dysregulation: impulsivity, affective flooding, dissociation. Dialectical behavior therapy (DBT) and mindfulness restore mastery.
• Traumas: through EMDR, through prolonged exposure, through narrative retelling. Traumatic memories stop parasitizing the present.

This field of action is immense. The person leaves therapy with restored functioning: they sleep, work, love, decide, regulate themselves. In the 2010s, CBT became the most recommended therapy by the French Haute Autorité de Santé and the UK NICE for most mental disorders. This is justified: it works. But it works within a precise perimeter. It restores functioning. It does not claim, as a science, to answer the question of why function. And this distinction prepares the passage.

2. Where Psychology Stops — and Why

Scientific psychology, by construction, is a science of functioning. It observes the regularities of the psyche, its dysfunctions, its change levers. It measures, compares, validates. This rigor is its strength. It is also its limit.

Four questions structurally lie outside its field:

a) The Question of Meaning

No anxiety scale, no exposure protocol, no Young schema answers the question: what does my life mean? Psychology can identify that a person suffers from an "existential vacuum" (Frankl's category), measure its severity, spot its correlates (depression, addictions). It cannot provide the content of meaning. It can create the conditions of its search. The content comes from elsewhere.

b) The Question of Death

No therapy abolishes mortality. It can help reduce death anxiety (imaginal exposure, ACT acceptance, work on vulnerability schemas). It cannot give death a meaning. Irvin Yalom, existentialist psychiatrist, explicitly recognizes this: existential psychotherapy touches on an unsolvable human given that each person must inhabit in their own way.

c) The Question of Unconditional Love

Attachment theories (Bowlby, Ainsworth) beautifully describe how love structures itself as a function of early parental responses, how it can be secure, anxious, avoidant, disorganized. They allow healing attachment wounds. But no attachment theory explains why love EXISTS. Why a parent attaches to a child of no direct reproductive use. Why the grief of a loved one can be more painful than the imagined death of oneself. There is in love an excess that overflows the adaptive frame.

d) The Question of Ontological Solitude

Even surrounded, loved, socially integrated, the human being remains alone at the moment of dying, at the moment of choosing, at the moment of suffering. This solitude is not a depressive symptom to treat. It is a human condition to inhabit. Psychotherapy can help tolerate it. It does not dissolve it.

These four questions — meaning, death, love, ontological solitude — are what Irvin Yalom calls the ultimate givens of existence. They do not belong to a dysfunction to correct. They belong to an encounter to be made. And this is precisely the space the spiritual claims.

3. The Three Waves of CBT: The Threshold Sketches Itself

CBT's evolution over 60 years tells a story: that of a scientific psychology which, while remaining rigorous, gradually recognized the limits evoked above and equipped itself with tools increasingly close to a wisdom of life. This is why we speak of three waves.

First Wave: Behaviorism (1950-1970)

Skinner, Wolpe, Eysenck. Only observable behavior is studied. Emotions and thoughts are useless "black boxes". Therapy rests on conditioning (systematic desensitization, reinforcement). Powerful for phobias and certain anxiety disorders, this wave does not touch the question of meaning: it philosophically rejects it.

Second Wave: The Cognitive Revolution (1970-1990)

Aaron Beck, Albert Ellis. Thoughts (cognitions) matter. They mediate between events and emotions. Cognitive restructuring becomes the central tool. Cognitive therapy wins the scientific war against psychoanalysis in the field of anxiety and depression. But it remains focused on correction: correcting a false cognition, validating a correct cognition. The question "what is a good life?" remains off-field.

Third Wave: Acceptance and Values (1990-Today)

Here the decisive turn occurs. Steven Hayes (ACT), Marsha Linehan (DBT), Jeffrey Young (Schema Therapy), Jon Kabat-Zinn (MBSR), Paul Gilbert (Compassion-Focused Therapy) — all, independently, reintroduce into scientific therapy notions once thought strictly spiritual:

• Acceptance of what cannot be changed (ACT).
• Non-judgmental mindfulness of the present moment (MBSR, MBCT).
• Life values as an existential compass (ACT).
• Compassion toward self and others as a lever of change (CFT).
• The "witness" or "self" state of mind that observes without merging with its thoughts (Schema Therapy, IFS).

These notions were not naively borrowed from spirituality: they were scientifically reworked, operationalized, measured. ACT, for example, is not a watered-down Buddhism. It is a therapy grounded in relational frame theory in behavior analysis, whose convergence with certain contemplative intuitions is a result, not a postulate. The notable fact: at the end of this evolution, scientific psychology has admitted, de facto, that it needed notions that only the spiritual tradition had previously thematized. This is not an ideological rapprochement. It is an empirical convergence: the same levers produce the same effects, called by one name or another.

The third wave is therefore already, structurally, a passage. It does not replace the spiritual. It recognizes its clinical fruitfulness without importing its metaphysics. And in doing so, it prepares the patient for what may come after — or alongside — therapy.

4. What the Spiritual Addresses — and What Is Not Psychology's Business

The spiritual, in its non-religious sense, designates what is at stake in the encounter with the four questions identified above: meaning, death, love, solitude. It is not about adhering to a dogma. It is about encountering these questions and answering them, each person in their own way — with or without established religion.

What the Spiritual Brings

• A perspective of meaning not reducible to immediate utility. Happiness as performance gives way to a form of plenitude, which can be named joy (as with Marquet), eudaimonia (Aristotle), secular nirvana (lay Buddhism), or simply "a deep feeling of being in one's place".
• A non-anxious relationship to finitude. Not the denial of death, but its integrated acknowledgment — which makes present life more intense rather than grayer.
• A form of love that does not depend on reciprocity. Love as a free act, not as a contract. In the clinical literature, this love corresponds to what Fromm called productive love and what positive psychology has measured as self-transcendence.
• A feeling of belonging to something vaster than oneself. This experience — mystical, contemplative, or simply aesthetic before the natural sublime — is correlated in the empirical literature with lasting gains in psychological well-being (studies by Emmons, Keltner, Haidt).

What the Spiritual Should NOT Claim to Do

It is crucial, for honest clinical work, to also set the reverse limits. The spiritual:

• Does not heal an untreated trauma. No meditative practice alone dissolves complex post-traumatic stress. It may make it more bearable, it may prepare therapeutic work, but it does not substitute for it.
• Does not replace work on schemas. Attachment wounds, defectiveness schemas, toxic relational patterns do not disappear by the grace of a silent retreat. They were learned relationally — they must be unlearned relationally.
• Does not resolve clinical symptoms. Severe depression, obsessive-compulsive disorder, bipolar disorder, disabling phobia require precise clinical tools. Prayer, meditation, or contemplation can be adjuvants. Not treatments.

Confusing these planes produces what John Welwood (1983) called spiritual bypass — the attempt to use spiritual practices or beliefs to avoid painful psychic work. It is one of the most frequent errors observed in "personal development" circles.

5. The Golden Rule: Never Spiritual Before Psychic Work

This rule is not moral, it is clinical. It is observed empirically in patients who attempt the reverse leap, and its violation produces recognizable clinical pictures.

Signs of Spiritual Bypass

• Minimization of difficult emotions in the name of a "higher consciousness". The patient, hurt, angry, jealous, repeats that they "should transcend all this" — and locks themselves into a surface mastery that has not deciphered the emotional message.
• Disembodiment. Body, desire, ambition, combativeness are perceived as "inferior". Earthly life becomes a mere passage to endure. Long-term: depression, loss of vital momentum, sometimes somatization.
• Spiritual judgment on self and others. Those who suffer "haven't done the work". Those who are angry "have work to do". This judgment is itself, paradoxically, a narcissistic defense against an unworked personal pain.
• Addictive quest for retreats and practices. The patient chains workshops, trainings, shamanic journeys, without ever letting anchoring occur in ordinary life. It is a structured flight.
• Inability to set limits. "Everything is love, everything is one" becomes a pretext for not naming abuse, conflict, betrayal. Spirituality becomes an alibi for relational complacency.

Each of these signs has an equivalent in psychodynamic clinical work (defenses: idealization, splitting, projection, intellectualization). The illness is not the spiritual. It is the use of the spiritual as a defense.

What the Rule Implies

The practical rule is therefore simple: the passage to the spiritual is only ethically valid after substantial psychic work. "Substantial" does not mean "completed" — no psychic work ever is. It means: major schemas have been identified and partially reworked, the most massive defense mechanisms have been seen, difficult emotions have been traversed (not just "observed") at least once through to their organic resolution.

From this foundation — and not before — openness to the spiritual becomes enriching, integrative, non-defensive. Before this foundation, it is regularly an escape.

6. Marquet as an Exemplary Figure of the Passage

In contemporary French-language literature, Denis Marquet illustrates with rare clarity how a single author can think both registers without confusing them. Philosopher and PhD in science, he articulates in his work an explicit progression:

• Dare to Desire Everything (article 1) — the Person — listening to deep desires as signals of values. Quasi-strictly clinical stage. Meets ACT.
• Our Children Are Wonders (article 2) — relational Psyche — moving from parental authority to presence. Secure attachment stage, intergenerational transmission. Meets affective neuroscience and mindful parenting.
• Loving to Infinity (article 3) — the threshold — distinguishing fusion-love, contract-love, and conscious-love. Hinge point where psychology touches the spiritual without tipping over.
• Joy (article 4) — Spirituality — joy as a state of being beneath circumstances. Here Marquet explicitly assumes the passage.

What makes Marquet instructive for a clinician is that he never skips the stages. He doesn't write Joy before Dare to Desire. He respects the order: one can only love infinitely after having dared to desire. One can only access joy if one has known how to love. The passage is progressive, cumulative, respectful of the psychic work.

This is exactly the clinical golden rule seen above. And this is why his series can serve, for many patients, as a roadmap of the passage.

7. The Therapist's Role at This Passage

Should a CBT psychopractitioner lead the patient to the spiritual? The clear answer is no. But there are right ways to accompany this passage when it announces itself.

Do Not Lead

The therapist is not a spiritual guide, let alone a guru. Their proper competence is psychological. Any attempt to lead a patient toward a specific worldview (Buddhist, Christian, Stoic, or militantly atheist) is a breach of frame. It uses the therapeutic transference at the service of a personal conviction. It is ethically disqualifying.

Recognize the Signals

On the other hand, the therapist can and must know how to spot signals of a passage beginning in the patient: the question of meaning returning, therapeutic plateau with reduction of symptoms but persistence of a background unease, spontaneous interest in mindfulness, meditation, philosophical reading, etc. Naming this threshold, without pushing, is part of the clinical work.

Orient Without Prescribing

The therapist can suggest resources respectful of the patient's autonomy: secular mindfulness practice (MBSR), philosophical readings (Marcus Aurelius, Epictetus, Seneca — see notably our psychological portrait of Marcus Aurelius), authors like Marquet, Frankl, Yalom. Never a tradition to the detriment of another. Never engagement in a group or school. Autonomy remains central.

Stay Personally Grounded

A therapist accompanying this passage must have worked through it personally. Not necessarily in an established spiritual tradition, but having reflected on the questions of meaning, death, love, solitude. Without this personal work, the therapist risks either bypass (projecting onto the patient their own spiritual flight) or narrow rationalism (mechanically referring every existential question to "a symptom to treat").

8. A Clinic of the Threshold: Four Typical Situations

In my practice, four configurations regularly return at the moment of passage.

Situation 1: The patient who "has everything they want". Professional success, stable couple, healthy children, solid finances. And a feeling of emptiness that grows. Classical CBT tools no longer have traction — there is no major schema to rework, no salient dysfunctional cognition. This is the prime case of the passage. Therapy becomes existential dialogue, exploration of deep values, questioning of the relationship to time and finitude. Situation 2: The patient in unfinishable grief. Loss of a child, a young spouse, a parent traumatically. The grief work in the classical sense (Bowlby, Worden) has been properly conducted. The person functions. And a question remains: how to live knowing. Here psychology has done its work; the rest belongs to a spiritual register (in the secular or religious sense) that each must find on their own. Situation 3: The mid-life patient. Between 40 and 55 years old, a tipping point occurs for many. The structuring projects of the first half of life (building a career, founding a family) are accomplished or lost. The question of after arises. Jung spoke of individuation of the second half of life: a reorientation that structurally touches the spiritual, independently of beliefs. The ACT or schema therapy therapist working with patients in this period must know that the work will, naturally, extend beyond the symptomatic field. Situation 4: The patient emerged from a limit experience. Serious illness, accident, resolved major depressive episode. The experience has broken ordinary evidence. The person can no longer live "as before". They seek a frame of meaning. The therapist is not there to give it — but to accompany the search without short-circuiting it by a premature return to "normality".

In all four cases, the same rule holds: the psychological tool has accomplished its work; refusing the passage now would be therapeutic rigidity. And simultaneously: leading the patient to a particular spirituality would be an ethical transgression. The in-between is narrow, and this is where the clinician's maturity plays out.

Conclusion: Psychology as Threshold, Not Terminus

Clinical psychology is an admirable discipline. It has allowed millions of people to cross sufferings that, a century ago, would have been experienced as fate. It has operationalized the idea that a significant part of human suffering is modifiable — through knowledge, through work, through speech, through exposure, through acceptance.

But it is not everything. And recognizing it as a threshold, not as a terminus, is probably the most important maturity a patient — and a therapist — can reach.

The third wave of CBT (ACT, mindfulness, schema therapy, compassion-focused therapy) is already, structurally, a recognition of this threshold. It integrates into scientific clinical work notions (acceptance, values, presence, compassion) that have traversed the history of human wisdoms. It does so without proselytizing, without metaphysics, but with clinical honesty: these notions work, and it would be dogmatic to reject them on the grounds that they resemble what spiritual traditions have always said.

For a patient, the practical lesson holds in three points:

Do not skip the psychic work. See a therapist when suffering settles in, use the tools, traverse the emotions, understand the schemas. Without this foundation, any later passage will be compromised.

Recognize the threshold when it comes. The feeling that "therapy has done its job but something remains" is not a failure. It is a success that calls for a continuation of another nature.

Freely choose one's way of passage. Secular meditation, philosophy, humanitarian engagement, artistic practice, religious tradition if it speaks — or nothing formalized, simply a more conscious way of inhabiting the everyday. The essential is that it be a free choice based on real psychic work, and not a flight from it.

Denis Marquet writes somewhere that joy is not a reward of spiritual work — it is the witness that one has stopped fighting against life. One could say the same of the passage from psychology to spirituality: it is not an escalation, a progress, a promotion. It is the recognition, at a given moment of an individual trajectory, that the psychological tool has done what it could do, and that it is time to inhabit the human question otherwise.

For personalized support around these questions — end of therapy, existential passage, mid-life work, or simply clarification of the relationship between psychic work and the search for meaning — video sessions are open. The frame remains that of a CBT psychopractitioner: rigorous, respectful of autonomy, non-proselytizing. It is precisely this frame that allows the passage, when it comes, to be honest.

Gildas Garrec, CBT psychopractitioner in Nantes

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Further Reading

• Dare to Desire Everything: Denis Marquet and CBT on embracing desire
• Our Children Are Wonders: Marquet, parental CBT and transforming connection
• Loving to Infinity: Denis Marquet, CBT and love as transformation path
• Joy: Denis Marquet, CBT and the spiritual dimension of well-being
• Young's 18 Emotional Wounds Blocking Your Happiness

Recommended reading:

• Schema Therapy — Jeffrey Young
• Acceptance and Commitment Therapy — Steven Hayes
• Man's Search for Meaning — Viktor Frankl
• The Art of Loving — Erich Fromm
• Loving to Infinity — Denis Marquet