What Is Tarot Therapy? How It Works in Counseling and Mental Health

There are two responses I get when I mention that I sometimes use Tarot as a therapeutic tool: people either want to talk with me about their horoscope, or they don’t want to talk with me at all.

So first, the obvious elephant in the room: I don’t use Tarot as a form of divination. Therapists don’t agree on much, but there is a general rule that we don’t give advice. If you meet someone who can honest-to-god tell you the future, I’d advise you to listen to them but that person isn’t me.

Why use Tarot Therapy?

My view, and the general party line of most therapists who use Tarot in mental health settings, is that you have more insight into your own needs than I ever will. This can be complicated as our feelings and insights are sometimes hidden just outside of our view. Therapy is about widening that field of view through collaboration. Traditionally, we do this through conversation. But sometimes words alone aren’t enough and that’s where Tarot imagery in psychotherapy can come in.

Using Tarot in Therapy 

In therapy, I use tarot cards as a visual language to support introspection. Each card offers rich imagery that can evoke personal meanings, emotions, and associations. The cards become a kind of mirror, reflecting aspects of your inner world that may be hard to articulate.

This may look like:

• Pulling a card to begin a session or open up discussion

• Exploring a particular life question or emotional theme

• Using imagery to identify subconscious patterns or inner conflicts

There are no fixed meanings here, your personal interpretation of the imagery is what matters most. The process is guided by your intuition and insight, not by the cards themselves

How to interpret Tarot in a therapy session 

When working with tarot in therapy, the goal isn’t to “read” the cards in a predictive sense, it’s to notice what arises within you in response to the images. Here are some reflective prompts to guide your interpretation:

• Gut Reactions 

  Before diving into symbolism or meaning, pause. What’s your gut reaction to the cards in front of you? How do they make you feel? This initial response can offer valuable insight.

• Imagery 

  Notice the visual details. Are there certain colors, symbols, or figures that stand out to you? Are you especially drawn to or turned off by any particular image? These reactions can point to deeper themes or emotions that are asking to be explored.

• Types of Cards 

  Take note of whether your spread contains mostly Major Arcana (representing big-picture themes and life shifts) or Minor Arcana (which often reflect day-to-day experiences). We can discuss this more together. 

• Types of Suites 

  Do certain suits appear more than others? What might that emphasis reveal about where your energy is focused?

  • Pentacles: relate to the physical world, body, work, security.

  • Cups: focus on emotions, intuition, and relationships.

  • Swords: are connected to thoughts, conflict, and clarity.

  • Wands: represent energy, action, and personal growth.

• Numbers

  The numbers on the cards can also provide context. Early numbers like Aces or The Fool can signal beginnings or new potential. Higher numbers may indicate complexity, mastery, or completion. Are there repeating numbers or a noticeable progression? 

My relationship with Tarot

A mentor of mine, Lauren Schneider, has been developing the use of tarot as a projective tool for psychotherapy for the past 30 years. One day, Lauren found herself with a client who felt lost, upset, and didn’t know why. That client was a bit guarded, and Lauren offered that maybe the client might like to draw a card that might symbolize what was upsetting her. Intrigued, the client agreed, chose a deck, and randomly picked a card without looking. After flipping the card over, Lauren noticed that the card was an alternative representation of a classic card: the Moon, with one key difference, in place of what are usually two towers, were two bottles of wine. Lauren mentioned this to the client and asked what problematic drinking meant to her and her family. The client told Lauren that both of her sons were alcoholics, and that her husband had died of alcoholism.

Now, if you ask Lauren, she would tell you that this disclosure might have more sessions as it takes time to build trust and lean into vulnerability. The use of Tarot cards in therapy however, allows us to project our life and feelings onto an image. In this way, the therapeutic relationship becomes about curiosity and mutual interpretation, more than just disclosing what you think may be bothering you.

Tarot and your Brain

Now, you might be the type to think that Lauren had a lucky break or think that she has some mystical ability, but let's take a look into imagery and the brain when we engage with Tarot symbolism. I explain this in terms of the occipital lobe, a primal part of our brain responsible for sight, recognition, and visual memory. The occipital lobe helps us recognize shapes, colors, and patterns. But the meaning we get from the card doesn’t stop there. It gets fed into the Limbic system which is linked to memory, emotion, and intuition. So instead of just seeing some symbols, our brain connects them to feelings, past experiences, and unconscious ideas.

Our brains make meaning out of our senses, and from there we have to pick up the pieces.

Now, this doesn’t mean that Lauren’s client imagined those wine bottles. Rather, that client’s brain was primed to make a story out of whatever she saw. In this way, believing is actually seeing. The conversation that followed and her insight came from that card and not a conversation imbued it with a different meaning. The image itself carried emotional resonance

As they say: take a picture, it'll last longer.

-Written by Matt Nitzberg