The biopsychosocial model is at least the putative standard in American Psychiatry. In this paradigm, the psyche is understood to be an emergent property of continuous interaction between biology, psychology and the social environment. Adding a spiritual dimension to the model may be useful, and some mainstream analytic theorists have addressed religion and psychoanalysis. Many, if not most, mental health professionals consider that religion and spirituality are not within the prevue of psychoanalytic work. We argue that the subject merits serous consideration. Religious convictions that many do not accept, or even find destructive, often dominate this discussion. Other theological perspectives exist, but few practitioners know or understand them. We explain our position using the psychoanalytic thinking of Heinz Kohut, and the theological work of Freidrich Schleiermacher, Martin Buber and Gabriel Marcel. We summarize aspects of their work and show that critical elements from each can be integrated with psychoanalytic self psychology. For all these thinkers, relationship is critical. Kohut’s essential insight is that regulation of our self-experience is dependent in part on the empathic responsiveness of others. Richard Neibuhr thought it is necessary to see the roots of Schleiermacher’s theology “in his vision of man as a being who is essentially determined by his living relationship to others as well as the Other.” Schleiermacher’s focus was god-consciousness, and he understood sin as that which disrupts god-consciousness. Buber showed how all life is relational and that relationships can be either I-Thou (direct, engaged, mutual, present and open to the other) or I-It (detached, objective, and not mutual). The I of I-Thou is different than the I of I-It. For Buber, God is the ultimate Thou. Our human connection to God, which is related to Schleiermacher’s god-consciousness, can emerge in I-Thou relationships. Therefore, Buber is deeply concerned that relationships facilitate and not preclude I-Thou. There is a parallel to Schleiermacher’s understanding of sin, since both men understand that relationships to God and our fellow humans are fundamentally related. Marcel uses Buber’s thinking to explore some of the specifics of relationship. We apply this integration of theological and psychoanalytic theory to clinical situation, illustrating how it affects the way clinical material may be understood and interpreted. I-Thou moments in therapy are described, including unusual times when a profound, immanent consciousness of the sacred occurred in the treatment hour. Current theory and practice of psychoanalysis, psychology and psychiatry is lacking when it either 1) ignores or has no way to understand that people have been genuinely helped by religious experience or 2) engages in reductionist efforts to explain religious experience as a manifestation of something else, such as childhood neurosis. We show how the work of these thinkers may help address the problem in a way that is not limited to specific religious doctrines or confessions. It can add a valuable dimension to psychoanalytic theory and practice—even for those who hold no religious belief.