This chapter proposes a way of understanding pastoral diagnosis as a process of discernment that seeks to bring into dialogue alternative ways of knowing, while at the same time being grounded in a larger interplay between knowing and unknowing, which brings a unique experience to the engagement with human distress. The idea of pastoral diagnosis that developed in the 20th century had its roots in the worldwide pattern of religious interpretive systems in general and more particularly in the centuries-old practice of pastoral care from the Judeo- Christian tradition. Implicit in pastoral diagnosis is not only a way of conceptualizing human distress but also a way of engaging human distress with a particular focus on experience. The pastoral experience implied in the process of pastoral diagnosis with its inclusion of various ways of knowing engages the primary, raw, affective aspects of “core-consciousness” that often underlie human distress.