How do we make sense of spirituality and the psychotic experience? Psychiatrists often struggle to make sense of, and to make progress with, people suffering from psychosis and to support their personal journeys towards recovery. Yet while psychosis is at the heart of psychiatry, psychiatrists have often dismissed or regarded with distrust the spirituality that is valued by many of their patients. In this paper I will explore these issues from three perspectives; the psychiatrist’s understanding of psychosis and spirituality; the role of spirituality in individual’s recovery and the implications for clinical practice – practical spirituality.