The perceived causal relationship between body and mind is central to various psychotherapy theories. This paper speculates on the evolutionary aspect of this relationship since the Big Bang, as well as on causality and on how these issues are relevant to psychotherapy practice, especially in the Zeitgeist of a growing confidence in genetics, biochemistry and, by implication, in evolutionary psychology. Our long evolutionary journey out of inorganic matter poses many challenging questions. It is contended that Darwinian Theory can only offer a partial explanation of human behavior and psychopathology, and that issues other than distal etiological (i.e., bio-evolutionary) factors, namely proximate, existential, systemic, teleological and even cosmic considerations, must also inform our theories and thus the practice of psychotherapy. This contention is discussed in a very broad context by drawing on geo-physical, psychodynamic, constructivist, systemic, Western philosophical and Eastern (e.g., Buddhist) considerations.