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This article examines the adaptation of theory and practices from narrative therapy for pastoral and spiritual care, here referred to as narrative spiritual care. Beginning with a brief rationale for the use of narrative approaches in pastoral and spiritual care, the author then describes a recent development among some narrative therapy practitioners that attends to affect in narrative conversations. Drawing upon studies in neuroscience and physiology, practitioners such as Marie-Nathalie Beaudoin and Jeffrey Zimmerman incorporate mindfulness practices and body-based questions into their narrative therapy conversations. This “affective turn” is contested in the field of narrative therapy. The author examines the debate and then goes on to explore the value of the affective turn in the practice of narrative spiritual care.