6 Psychological Well-Being
6.1 Knowing When to Refer
“Sometimes the bravest thing you can do is to ask for help.”
— Anonymous
As spiritual counselors, we hold a unique position in people’s lives. We’re often the first person someone trusts with their deepest fears, struggles, and hopes. People come to us during their most vulnerable moments—when they’re lost, hurting, or desperately seeking direction.
But here’s what many of us don’t realize: we’re often serving as a bridge between someone’s pain and the help they really need.
6.2 The Weight of Being First
When someone books an astrology reading or tarot session, they might really be crying out for help with depression, anxiety, or trauma. They come to us because spiritual guidance feels safer than therapy. It’s less stigmatizing than admitting they need mental health support.
This puts us in a position of enormous responsibility—and enormous opportunity to truly serve.
But it also means we need to know when our spiritual tools aren’t enough.
6.3 The Dangerous Middle Ground
Here’s where many spiritual counselors get stuck: We’re not mental health professionals, but we’re dealing with people’s mental health every day. We want to help, but we don’t always know how—or when to step back.
I’ve seen astrologers try to “fix” someone’s depression with planetary remedies. I’ve watched tarot readers attempt to counsel someone through trauma with card spreads. I’ve heard palm readers give advice about serious anxiety as if it were just a personality trait.
The result? People don’t get the help they actually need, and sometimes we make things worse.
6.4 My Own Learning Curve
Early in my practice, I thought I could handle anything that came up in a session. If someone mentioned feeling depressed, I’d focus on their Saturn placement. If they talked about anxiety, I’d look at their Mercury aspects.
Then I had a session that changed everything.
A client came for a reading, and within minutes, she was describing thoughts of suicide. She wasn’t asking for astrological insight—she was asking for help. In that moment, I realized that knowing her moon sign wasn’t going to save her life.
That’s when I understood: Sometimes the most powerful guidance we can offer is showing someone the door to another room.
6.5 Beyond Casual Words
We throw around terms like “depressed” and “anxious” casually in everyday conversation. “I’m so depressed about this weather.” “That presentation made me so anxious.”
But for someone genuinely experiencing clinical depression or anxiety disorders, these aren’t just feelings—they’re debilitating conditions that can make life feel unbearable.
The difference matters. As spiritual counselors, we need to recognize when someone is describing more than just a bad day or temporary stress.
6.6 Our Sacred Responsibility
While we’re not mental health professionals, we often serve as the first line of support for people seeking guidance. This unique position comes with both privilege and responsibility.
We can:
- Offer compassionate listening
- Provide spiritual insights and guidance
- Help people find meaning in their experiences
- Support them through life transitions
- Recognize when they need additional help
We cannot:
- Diagnose mental health conditions
- Treat depression, anxiety, or trauma
- Replace professional therapy or medical care
- Handle crisis situations alone
- Fix serious psychological issues with spiritual tools
6.7 The Bridge, Not the Destination
Think of yourself as a bridge builder. Your job isn’t to be the final destination for everyone who needs help—it’s to create a safe pathway that leads them where they need to go.
Sometimes that pathway leads to deeper spiritual understanding. Sometimes it leads to therapy. Sometimes it leads to medical care. And sometimes, it leads to immediate crisis intervention.
Recognize the Signs
Learn to identify when someone is struggling beyond everyday stress and worry.
Know Your Limits
Understand exactly where your expertise ends and professional help begins.
Make Compassionate Referrals
Learn how to guide someone toward professional help without shame or judgment.
Create Safety
Know how to handle crisis situations and emergency resources.
6.8 What You’ll Learn in This Chapter
This chapter will give you a basic understanding of mental health from the BioPsychoSocial perspective. You’ll learn about:
- The interconnected nature of mental, physical, and social well-being
- Common signs of mood disorders, anxiety, and more serious conditions
- When and how to make appropriate referrals
- Resources for crisis situations
- How to maintain your role as a spiritual counselor while supporting your client’s overall health
Important: This information is not meant to turn you into a therapist. It’s meant to help you recognize when therapy is needed and how to guide your clients there with compassion and care.
6.9 Your Ethical Foundation
Remember: Prioritizing your client’s well-being is always the most ethical and compassionate action you can take. Sometimes that means doing a reading. Sometimes it means making a referral. And sometimes it means both.
You don’t need to have all the answers. You just need to care enough to help your clients find the right ones.
The most powerful guidance we can offer is showing someone the door to another room.
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6.11 Mood Disorders: When Emotions Take Control
Mood disorders are among the most common mental health conditions you’ll encounter as a spiritual counselor. They involve significant and persistent changes in emotional state that severely impact someone’s ability to function.
6.11.1 Depression: More Than Just Sadness
We all feel sad sometimes, but clinical depression is fundamentally different from everyday sadness or disappointment.
Normal Sadness: - Triggered by specific events - Comes and goes - Doesn’t significantly impact daily life - Improves with time and support
Clinical Depression: - May have no clear trigger - Persistent for weeks or months - Severely impacts work, relationships, self-care - Requires professional intervention
6.11.1.1 Signs to Watch For:
Emotional Signs: - Persistent sadness or emptiness - Loss of interest in activities they once enjoyed - Feelings of hopelessness or worthlessness - Excessive guilt or self-blame
Physical Signs: - Significant changes in sleep (too much or too little) - Dramatic appetite changes and weight loss/gain - Constant fatigue or loss of energy - Physical aches without clear cause
Cognitive Signs: - Difficulty concentrating or making decisions - Negative self-talk or catastrophic thinking - Memory problems - Recurrent thoughts of death or suicide
Behavioral Signs: - Withdrawing from friends and family - Neglecting responsibilities or self-care - Moving or speaking more slowly than usual - Increased use of alcohol or drugs
6.11.2 Bipolar Disorder: The Emotional Roller Coaster
Bipolar disorder involves dramatic mood swings between extreme highs (mania) and lows (depression). It’s not just being “moody”—these are intense episodes that can last days or weeks.
6.11.2.1 Manic Episodes - The Dangerous Highs:
- Abnormally elevated or irritable mood
- Decreased need for sleep (feeling rested after 2-3 hours)
- Racing thoughts and rapid speech
- Grandiose beliefs about abilities or importance
- Poor judgment and risky behavior
- Excessive energy and activity
- Inability to concentrate on tasks
6.11.2.2 Depressive Episodes:
These look similar to major depression but are part of the bipolar cycle.
Critical Point: People in manic episodes often don’t realize they need help. They may feel amazing and resist suggestions for professional care. This is when family involvement becomes crucial.
6.11.3 Persistent Depressive Disorder (Dysthymia)
This is like a chronic, low-grade depression that lasts for years. People with dysthymia may function day-to-day but never feel truly well. They might say things like:
- “I’ve always been this way”
- “This is just my personality”
- “I don’t remember feeling happy”
6.12 Anxiety Disorders: When Worry Takes Over
Everyone experiences anxiety, but anxiety disorders involve excessive, persistent worry that significantly impacts daily life.
6.12.1 Generalized Anxiety Disorder (GAD)
People with GAD worry excessively about everything—work, family, health, money, the future. The worry is:
- Excessive: Far beyond what the situation warrants
- Persistent: Happening most days for months
- Uncontrollable: They can’t just “stop worrying”
- Impairing: It interferes with work, relationships, or daily activities
6.12.1.1 Physical Signs of Anxiety:
- Muscle tension and headaches
- Fatigue and restlessness
- Sleep problems
- Stomach issues and nausea
- Heart palpitations
- Shortness of breath
- Sweating or trembling
6.12.2 Panic Disorder
Panic attacks are intense episodes of fear that come on suddenly and peak within minutes. Symptoms include:
- Racing or pounding heart
- Chest pain or tightness
- Difficulty breathing or feeling like you’re choking
- Dizziness or feeling faint
- Nausea or stomach distress
- Sweating or chills
- Trembling or shaking
- Fear of dying or “going crazy”
The cruel part: Many people develop a fear of having another panic attack, which can lead to avoiding places or situations where they’ve had attacks before.
6.12.4 Obsessive-Compulsive Disorder (OCD)
OCD involves unwanted, intrusive thoughts (obsessions) and repetitive behaviors (compulsions) aimed at reducing the anxiety those thoughts create.
Common Obsessions: - Fear of contamination or germs - Need for things to be symmetrical or “just right” - Intrusive thoughts about harming others - Religious or moral concerns
Common Compulsions: - Excessive hand washing or cleaning - Checking locks, appliances, or other items repeatedly - Counting or arranging items in specific ways - Seeking reassurance from others
6.13 Psychotic Disorders: When Reality Becomes Unclear
Psychotic disorders involve a significant break from reality. These are serious conditions that require immediate professional intervention.
6.13.1 Key Features of Psychosis:
Hallucinations: - Hearing voices when no one is speaking - Seeing things that aren’t there - Feeling sensations that others don’t experience - Smelling or tasting things that aren’t present
Delusions: - Fixed, false beliefs despite evidence to the contrary - Paranoid beliefs (everyone is against them) - Grandiose beliefs (they have special powers or importance) - Bizarre beliefs that don’t make logical sense
Disorganized Thinking: - Speech that jumps between unrelated topics - Made-up words or phrases - Thoughts that don’t connect logically - Inability to maintain a conversation
Disorganized Behavior: - Inappropriate responses to situations - Strange posturing or movements - Extreme agitation or complete withdrawal - Neglecting personal hygiene or safety
6.13.2 When to Act Immediately
Call for emergency help if a client: - Expresses thoughts of harming themselves or others - Shows signs of severe psychosis (hearing voices, bizarre delusions) - Appears completely disconnected from reality - Is in immediate physical danger due to their mental state
6.14 Red Flags: When to Refer
Always refer when you notice:
Immediate Safety Concerns: - Any mention of suicide or self-harm - Thoughts of harming others - Severe psychotic symptoms - Complete inability to care for themselves
Significant Impairment: - Unable to work or maintain relationships - Dramatic changes in functioning - Severe mood episodes lasting weeks - Substance abuse combined with mental health symptoms
Beyond Your Scope: - Client asking for therapy or medication advice - Trauma that requires specialized treatment - Eating disorders or self-harm behaviors - Any condition that needs medical evaluation
6.15 How to Make Compassionate Referrals
Making a referral doesn’t mean you’re giving up on someone—it means you care enough to ensure they get the best possible help.
6.15.1 The Gentle Approach:
“I can see you’re really struggling with this, and I want to make sure you get all the support you need. While I can offer spiritual guidance, what you’re describing sounds like it might benefit from professional counseling as well. Have you considered talking to a therapist about this?”
6.15.2 Normalizing Mental Health Care:
- “Many people find therapy helpful during difficult times”
- “It’s actually a sign of strength to reach out for professional support”
- “Think of it like any other health issue—you’d see a doctor for a broken bone”
- “Therapy can work alongside spiritual guidance to support you”
6.16 Your Role vs. Professional Help
Your Role as a Spiritual Counselor: - Provide spiritual insights and guidance - Offer compassionate listening - Help clients find meaning in their experiences - Support them through life transitions - Recognize when additional help is needed
Professional Mental Health Role: - Diagnose mental health conditions - Provide evidence-based therapy - Prescribe and manage medications - Handle crisis interventions - Treat trauma and severe mental illness
6.17 Protecting Yourself and Your Practice
Working with people in mental health crises can be emotionally draining. Remember:
- Set clear boundaries about what you can and cannot do
- Document referrals you make for your own protection
- Have a list of resources readily available
- Take care of your own mental health
- Seek consultation when you’re unsure about a situation
Remember: The greatest service you can provide is knowing when you’re not the right person to help—and caring enough to find someone who is.
Mental health awareness isn’t about becoming a therapist. It’s about becoming a more compassionate, responsible spiritual counselor who truly serves their clients’ highest good.
Sometimes the most powerful guidance we can offer is showing someone the door to another room.
6.18 📝 Practice Sections
6.18.1 🌟 Exercise 1: Case Study Analysis
Instructions: Read each client scenario carefully. Look for both everyday stress AND potential warning signs of serious mental health issues.
For each case, decide: - Would you continue the reading as normal? - Shift the focus gently? - Suggest a mental health referral?
Write your reasoning for each decision.
Client A - Maya, 28:
“I’m so stressed about this job interview next week. I haven’t been sleeping well at all - maybe 2-3 hours a night for the past month. Everything feels overwhelming right now. My boyfriend says I’m being dramatic, but I just can’t stop worrying about everything. Yesterday I cried for like 3 hours straight over nothing. I feel like such a failure at everything I try.”
Warning signs you notice:
Your decision (continue/shift/refer):
Your reasoning:
Client B - David, 35: “Things have been weird lately. I know someone’s been following me - probably from my old job. They’re definitely watching my apartment. I can hear them talking about me through the walls sometimes. My family thinks I’m paranoid, but I know what I’m experiencing. I haven’t left my place much in the past few weeks because it’s not safe. Can you see in my chart who’s doing this to me?”
Warning signs you notice:
Your decision (continue/shift/refer):
Your reasoning:
Client C - Sarah, 42: “I’ve been going through a divorce, and it’s been really hard. Some days I feel completely hopeless, like nothing will ever get better. I’ve been drinking wine every night to sleep, and my appetite is gone - I’ve lost about 15 pounds without trying. My kids are staying with their dad for now because I just… I can’t handle taking care of anyone right now. Sometimes I wonder if they’d be better off without me.”
Warning signs you notice:
Your decision (continue/shift/refer):
Your reasoning:
Client D - Alex, 24:
“I need to know if Mercury retrograde is causing all this chaos in my life. Everything’s been amazing lately - I haven’t needed much sleep, maybe 3 hours a night, but I feel incredible! I’ve started three new businesses this month and I know they’re all going to make me rich. My friends are being so negative about my ideas, but they just don’t understand my vision. I can see connections between everything now - the universe is definitely speaking to me directly.”
Warning signs you notice:
Your decision (continue/shift/refer):
Your reasoning:
Client E - Jordan, 30: “I’ve been feeling really anxious about social situations lately. It started a few months ago when I had a panic attack at work. Now I’m constantly worried it will happen again. I’ve started avoiding meetings and social events because my heart races and I can’t breathe properly. I keep checking my pulse and googling heart attack symptoms. My doctor says my heart is fine, but what if they missed something?”
Warning signs you notice:
Your decision (continue/shift/refer):
Your reasoning:
6.18.2 🎯 Exercise 2: Referral Roleplay
Setup: Find a practice partner (another spiritual counselor, friend, or even practice alone using a mirror).
Instructions: Take turns playing client and counselor. Use the scenarios below or create your own.
Scenario 1: The Overwhelmed Client Client role: You’re experiencing severe anxiety that’s affecting your work and relationships. You mention not being able to leave the house some days and having panic attacks.
Counselor role: Practice expressing concern and suggesting professional help without making the client feel judged or dismissed.
Scenario 2: The Crisis Client Client role: You’re going through a difficult time and mention feeling like “it might be better if I wasn’t here anymore.”
Counselor role: This requires immediate referral. Practice staying calm while prioritizing safety.
Scenario 3: The Resistant Client Client role: You show signs of needing help but resist suggestions about therapy, saying “I just want to know what my chart says.”
Counselor role: Practice gentle persistence while respecting boundaries.
Practice these compassionate referral phrases:
Expressing Concern: - “I can see you’re really struggling with this…” - “What you’re describing sounds incredibly difficult…” - “I’m concerned about how much this is affecting your daily life…”
Suggesting Help: - “While I can offer spiritual guidance, what you’re experiencing might benefit from professional counseling as well…” - “Have you considered talking to someone who specializes in…” - “It sounds like you could use some additional support beyond what I can offer…”
Normalizing Mental Health Care: - “Many people find therapy helpful during challenging times…” - “It’s actually a sign of strength to reach out for professional support…” - “Think of it like any other health issue - you’d see a doctor for a physical problem…”
After each roleplay, discuss:
- What felt natural and what felt awkward?
- How did the “client” receive the referral suggestion?
- What would you do differently next time?
Your reflections:
6.18.3 📋 Exercise 3: Self-Check on Sensitive Topics
Step 1: Identify Your Triggers
Write down 2-3 topics that would make you deeply uncomfortable due to lack of expertise or personal unease:
Common trigger topics:
- Detailed death predictions
- Graphic descriptions of trauma
- Requests for medical diagnosis
- Severe mental health crises
- Requests to harm others
- Explicit sexual content
- Extreme religious conflicts
Your personal trigger topics:
Step 2: Create Your Response Plans
For each trigger topic, prepare two approaches:
Example Topic: Detailed death predictions
Plan A - Gentle Redirection:
“I understand you’re concerned about timing, but I focus on helping people understand life patterns rather than predicting specific events. Let’s look at what your chart suggests about your life purpose and growth opportunities instead.”
Plan B - Professional Referral:
“Questions about mortality often come from deeper concerns about purpose and meaning. While I can offer spiritual insights, these existential questions might be beautifully explored with a counselor who specializes in life transitions and meaning-making.”
Your Topic 1: _______________
Plan A - Gentle Redirection:
Plan B - Professional Referral:
Your Topic 2: _______________
Plan A - Gentle Redirection:
Plan B - Professional Referral:
Your Topic 3: _______________
Plan A - Gentle Redirection:
Plan B - Professional Referral:
6.18.4 📊 Weekly Practice Checklist
This Week’s Goals:
Beginner Level:
Intermediate Level:
Advanced Level:
6.18.5 🎯 Crisis Resource Quick Reference
Keep these numbers handy:
Immediate Crisis: - Emergency Services: 911 - Crisis Text Line: Text HOME to 741741 - National Suicide Prevention Lifeline: 988
Your Local Resources:
Mental Health Crisis Center: _______________
Local Therapist Referrals: _______________
Psychiatric Emergency Services: _______________
Community Mental Health Center: _______________
6.18.6 📈 Weekly Self-Check: Referral Readiness
Rate your confidence this week (1 = Need more work, 5 = Very confident):
Assessment Areas:
Recognizing signs of serious mental health issues
Making compassionate referrals without judgment
Handling my own discomfort with sensitive topics
Knowing when to prioritize safety over continuing a reading
Having appropriate resources readily available
Reflection Questions:
- Which type of mental health concern feels most challenging for you to identify?
- What made the referral roleplay easy or difficult?
- How will you continue building your confidence in this area?
Space for your weekly reflections…
6.19 📝 Knowledge Check Quiz
1. Which of the following signs might indicate that a client should be referred to a mental health professional?
- Persistent feelings of hopelessness
- A desire to understand their astrological chart better
- Occasional stress about work
- Curiosity about how astrology can help their relationship
2. According to the BioPsychoSocial model, mental health is influenced by:
- Only brain chemistry
- Only psychological factors
- Biological, psychological, and social factors working together
- Only social circumstances
3. When someone mentions having thoughts of suicide during a session, you should:
- Continue the reading to distract them
- Give them astrological advice about better times ahead
- Immediately refer them to mental health professionals
- Schedule them for a follow-up reading next week
4. The difference between normal sadness and clinical depression is:
- Depression lasts longer and significantly impacts daily functioning
- Depression only affects women
- Sadness is always temporary
- There is no real difference
5. Scenario: During a consultation, a client reveals they have been experiencing severe depression and have had thoughts of self-harm. How should you respond?
- Offer astrological guidance to help them feel better
- Provide general support and recommend they seek help from a mental health professional immediately
- Assure them that their chart shows things will improve soon
- Avoid discussing their feelings and focus on the astrological reading
6. Which of these is NOT a sign of a manic episode?
- Decreased need for sleep (2-3 hours feeling rested)
- Racing thoughts and rapid speech
- Persistent sadness and withdrawal
- Grandiose beliefs about abilities
7. A client describes hearing voices that others can’t hear. This is an example of:
- Normal stress response
- Hallucination requiring immediate professional help
- Spiritual awakening
- Temporary anxiety
8. The most compassionate way to make a mental health referral is to:
- Tell them they’re too sick for spiritual guidance
- Express concern and explain how professional help can work alongside spiritual guidance
- Refuse to continue any sessions
- Give them a business card and end the session
9. Generalized Anxiety Disorder is characterized by:
- Fear of specific objects only
- Occasional worry about normal life events
- Excessive, uncontrollable worry about many things that impairs daily life
- Only physical symptoms like headaches
10. As a spiritual counselor, your role when encountering mental health issues is to:
- Diagnose and treat the condition yourself
- Ignore mental health signs and focus only on spiritual guidance
- Recognize signs and compassionately refer to appropriate professionals
- Tell clients to just think positively
6.20 📊 Self-Assessment: Mental Health Awareness
Rate yourself honestly (1 = Need work, 5 = Very confident):
Recognition Skills:
How confident are you in recognizing when a client’s issues may be beyond the scope of astrology and require professional mental health support?
How well can you distinguish between normal stress and serious mental health concerns?
How comfortable are you identifying signs of depression, anxiety, or psychotic symptoms?
Referral Skills:
How comfortable are you with referring clients to mental health professionals when necessary?
How confident are you in making referrals without clients feeling rejected or judged?
How well can you maintain your therapeutic relationship while encouraging professional help?
Resource Knowledge:
How well do you understand the mental health resources available for referral in your community?
How prepared are you to handle crisis situations (suicidal thoughts, severe symptoms)?
How knowledgeable are you about different types of mental health professionals and their specialties?
Professional Boundaries:
How clear are you about what you can and cannot address as a spiritual counselor?
How comfortable are you with saying “This is beyond my expertise”?
How well do you balance spiritual guidance with mental health awareness?
Your Score Guide:
- 48-60: Excellent mental health awareness
- 36-47: Good foundation, some areas to strengthen
- 24-35: Adequate knowledge, focus on weak areas
- 12-23: Significant learning needed
- Below 12: Prioritize mental health education immediately
Reflection Questions:
- Which area scored lowest? This needs immediate attention for client safety.
- What specific mental health topic do you need to learn more about?
- What will you do this week to improve your mental health awareness?
Space for your reflections…
6.21 🎯 Action Steps Based on Your Assessment
If you scored 12-23 (Immediate Priority):
If you scored 24-35 (Focus Areas):
If you scored 36-47 (Strengthen Skills):
If you scored 48-60 (Maintain Excellence):
6.22 🚨 Emergency Resource Checklist
Print this out and keep it accessible during all sessions:
Crisis Situations - Call Immediately:
- Emergency Services: 911
- Crisis Text Line: Text HOME to 741741
- National Suicide Prevention Lifeline: 988
- Crisis Chat: suicidepreventionlifeline.org/chat
Immediate Referral Required When Client Shows:
Your Local Resources (Fill in now):
Mental Health Crisis Center: _______________
24-Hour Crisis Hotline: _______________
Local Hospital Emergency Room: _______________
Community Mental Health Center: _______________
Trusted Therapist Referrals:
6.23 Chapter Reflection
Think about a time when you or someone you know needed mental health support. How did it feel to ask for help? How can this experience inform how you approach referrals with your clients? Remember: referring someone for mental health support is an act of love, not failure.
6.12.3 Social Anxiety Disorder
This goes far beyond shyness. People with social anxiety have intense fear of: