I actually don't use four card readings very much. When I do, it's usually as an unexpected pop-out card that underpins the whole reading.
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Sometimes, you might be like, okay I just did this past present future reading. Now what?
So here we got:
1: Recent Past
3: Near Future
This is especially useful if you get a result that has a lot of turmoil, or is emotionally heavy. Some advice on how to weather the storm is a simple addition to empower you with some clarity of action.
1 2 3 4
The Four Cardinal Directions
My friend and colleague, Rita Morgin, uses this spread for healing, using the different associations she has with four cardinal directions. My personal associations are a little different. North - Fire, South - Water, East - Earth, West - Air. Rita, on the other hand has North - Air, and South - Fire, which is more common. What matters is what meaning YOU bring into the cardinal directions. Are you thinking of them in terms of astrology? Are you thinking of them in Biblical terms from Revelations? For more on elements read about the The Elements of the Tarot
The Self-love Tarot Spread by Interrobang Tarot.
This is excellent when you are having a hard time seeing your self clearly, or when you are having a hard time with shame spirals or otherwise feeling lousy about yourself for things said, done, or not said, or not done.
Note: I'm not sure where I first learned the four cardinal directions spread, nor the past present future advice spread.