In order to properly distinguish between pastoral and psychotherapeutic counseling, one must clarify both the interpretive presuppositions underlying each of these professional practices and their respective societal contexts. As a common ground for both kinds of practice, at least insofar as they maintain a distance from the usual medical-scientific model of therapeutic intervention, an ontology of playing is recommended. More precisely, in order for counseling to truly come “into play,” any latent neo-pastoral power discourses must be critically exposed. Psychoanalytic counseling (...) is characterized by rules of abstinence and neutrality as well as by attention to unconscious dynamics, especially those of transference and countertransference. Pastoral counseling, even when it takes place outside of the Ignatian exercises, can still orient itself toward the Ignatian model of spiritual accompaniment, thus requiring a discernment of spirits and a reference to transcendence. Both pastoral and psychotherapeutic counseling can profit from each other. Both must be evaluated in terms of whether, in the course of an authentic communication, they succeed in proposing what truly profits the person seeking advice. All of this applies with special urgency to bioethical decision making and conflict resolution: Persons seeking pastoral advice desire an authentic exposition of the values of the Gospel and their church community in order to reach a well-founded conclusion in conscience. Other persons (or even the same ones) seeking psychotherapeutic help in a bioethical conflict situation desire an empathetic mirroring back of the biographic background framing their decision and of possible psychic consequences that may ensue from their acting accordingly. (shrink)