Monthly Archives: August 2010

August 16, 2010 · 10:33 am

Counseling those with chronic conditions


My friends and colleagues here at Biblical Seminary–Jenn Zuck and Bonnie Steich–are teaching a class this weekend about the role of counseling in helping those with chronic conditions. Need CEUs anyone? Info here.

This is such an important issue given our increase in capacity to manage or maintain life with chronic conditions. Some cancers now are more like chronic conditions. HIV can be a chronic condition. And of course there are the more well-known problems such as MS, chronic fatigue, fibromyalgia, neuropathy, diabetes, liver dysfunction, etc.

How do you respond to those who seem to be struggling with a long-term condition? Especially when the condition is vague and not visible to the eye? Do you get worn out comforting that person?

I just read a study where they assessed whether major life events or daily hassles were more negatively impacting chronic pain conditions. It turns out that daily hassles increase chronic conditions symptoms far more than do major life stressors. It makes sense but also challenges us to consider how we might overlook the “normal” life of counselees and secretly want them to stop their whining and complaining about how hard it is to …

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August 13, 2010 · 5:58 am

Who diagnoses ADHD? Comments on CNN story


CNN has run a story on the issue schools/teachers encouraging parents to get their child tested for ADHD and on medications. You can read it here. The writer quotes a doctor complaining about teachers who suggest diagnoses and treatment. Then parents go to their doctor and ask for meds to treat something that has yet to be properly diagnosed. Being a psychologist I am sympathetic with the Doc–but only to a point. True, many people fancy themselves as experts because a family member or some other experience with a mental health diagnosis. And so, whenever they see something that reminds them of it they talk as if they had done a thorough assessment. The Doc goes on to point out other problems that may create similar symptoms (anxiety, abuse, learning disabilities, etc.)–thus the need for professional evaluation.

But that is where my sympathy ends. Teachers do have front row seats to child problems. We need them to speak up. Yes, they needn’t throw out diagnoses as if they are experts. But we do want them to let parents know that something might be up and the need for further evaluation.

So, who should diagnose? Yes, ADHD is considered a medical diagnosis. But, counselors and psychologists are just as capable of making the diagnosis–sometimes even better.  If a Doc (psychiatrist, physician, etc.) makes the diagnosis, 9:10 times it is on the basis of 30 minutes to 1 hour of an interview with parent and child along with a physical examination. For most people with the symptoms, that is probably enough. However, most psychologists will collect data from 2-3 sources (parent, teacher, church) using interviews, checklists, psychological tests, and even computer based assessments. That kind of assessment may be more capable of ferreting out subtle learning disabilities or learning differences as well as developing a plan of action for changing the environment (school plans (IEP/504), parenting strategies, etc.

It is interesting that the article makes no mention of the use of counselors in this process.

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August 12, 2010 · 5:24 am

Are congregants at fault for pastor burnout?


I’ve written here several times on the topic of pastoral burnout and the need for prevention and renewal for ministry leaders. I came across this opinion piece in the NY Times suggesting that congregants may be a big part of the problem. Consider some of the following quotes by the author (a pastor who may have had problems in his own congregation that bias him a bit). Emphases are mine.

The pastoral vocation is to help people grow spiritually, resist their lowest impulses and adopt higher, more compassionate ways. But churchgoers increasingly want pastors to soothe and entertain them. It’s apparent in the theater-style seating and giant projection screens in churches and in mission trips that involve more sightseeing than listening to the local people.

As a result, pastors are constantly forced to choose, as they work through congregants’ daily wish lists in their e-mail and voice mail, between paths of personal integrity and those that portend greater job security. As religion becomes a consumer experience, the clergy become more unhappy and unhealthy.

Ouch. His words about the demand for experiential highs are pointed, especially the ones about missions trips as sightseeing events.

The unspoken message in such instructions is clear: give us the comforting, amusing fare we want or we’ll get our spiritual leadership from someone else.

I suspect this is one part of the pie. But let us not blame the congregants too much. They want to be part of something great and most pastors want to be something great. The two sides mutually support this kind of problem.

If you read the full-text you will see a link for another recently published editorial about clergy burnout. You can read that one here. There are a number of other resources you can find as hot links embedded in that essay. One factoid is a recent study of North Carolinian Methodist pastors are found to be significantly more obese than the general population of the state. Makes you go hmmm.

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August 11, 2010 · 5:01 am

Are you a risk-taker?


Some people thrive on risk. Normal is boring to them. You might find them taking large risks in a start-up business, a poker table, or the X games. I’ve just finished a book that I think captures the mindset of this population. Freddie Wilkinson has written One Mountain Thousand Summits: The Untold Story of Tragedy and True Heroism on K2 (New American Library, 2010). It is the story of Summer 2008 when 11 men died while trying to descend from the summit of the most dangerous peak.While all mountain climbing has risks and all high altitude climbing has even more risk, climbing K2 is out of this world risky. Wikipedia says 1:4 climbers who make it to the top do not survive the return trip. Even if the 1:4 is overstated, can you imagine engaging in an activity that gives you a 10 percent chance of dying?

What do you think drives folks to take this kind of risk? I’ve been to the top of a couple of 6,000 foot mountains and when you get a clear day it is an impressive sight. I suppose standing on top of a 26,000 foot mountain probably is pretty cool too. But, climbing Everest or K2 requires piles of money, weeks of strenuous preparation, hours of impossible climbing on the last day, probable frostbite, and only a few minutes of being at the top before you have to face the riskiest part–getting down before hypoxia sets in and without being killed in an avalanche. Oh, and you just as likely will see someone in your party die from a fall or from cerebral edema and you won’t be able to help them lest you die helping them.

Back to my question. What drives this kind of risk-taking? Fame? Utter confidence in self (narcissism?)? Excitement?

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August 10, 2010 · 9:58 am

Quote about psychology and conversion


Check out this quote from G. Campbell Morgan,

No psychology will ever effect conversion. Regeneration must affect psychology.

The Gospel According to John, 1908, p. 58; emphases mine

The context of these two sentences are Morgan’s description of Jesus words to Nicodemus in John 3:3. He is not talking about psychology in the more modern sense we might intend today. What he is saying is that one must be “born again” in order to see the kingdom of God. One cannot think, feel, or perceive the real truth about God–no matter how psychologically mature and aware–without the work of the Spirit.

Notice his use of the words effect and affect. I didn’t have great English grammar education so I will assume some of you also might miss the meaning. Here’s my rewrite of his sentences

Psychological maturity cannot bring you to full awareness of God and creation but conversion will definitely impact your psychological well-being, you soul.

If you are interested in reading this book, you can find the full text on-line here. His comments on the interaction between Nicodemus and Jesus are very enlightening and provide a different perspective than is often given. He gives Nicodemus a lot more credit than do many preachers.

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August 9, 2010 · 3:07 pm

When life doesn’t follow the “plan”


One of the more significant causes of emotional/psychological suffering is the experience that life isn’t turning out as expected. While we all conjure up something different when we hear “normal”, we do have something that we assume is the normal expectation for how life should unfold. Most of us assume we will go to college, graduate on time, get married, have kids, start a career (or several over the course of our life), develop economic stability and growth, stay healthy, retire, find fulfillment, etc. Unexpected events will happen, we tell ourselves, but the general plan or trajectory should continue.

But then we hit more than a bump in the road. We don’t get married, can’t have kids, lose a job, divorce, get sick (or watch a loved one die before their time). When we suffer we are forced to come face to face with the fact that life does not have guarantees–except that there will be suffering and that suffering is not something we can get beyond, try as we might.

Christians are not immune from having expectation. In fact, we may have even more than those who don’t have the “hope of heaven.” We assume we will have peace and joy and that God will deliver us just as he delivered Daniel, David, Esther, etc. We recite Psalm 23 but gloss over the hard parts (death, enemies). Or, consider, for example, the pattern found in Psalm 107: Sin/Weakness leads to suffering…the people cry out in their trouble…the Lord hears and saves/blesses them with good things…  We like this pattern and expect to get the “happily ever after” that the pattern seems to promise.

Notice that as soon as God isn’t delivering us from our pain, we begin to look for the reasons. Maybe there is a new technique to prayer to try. Maybe there is a sin to confess. Maybe it is due to judgment on our country for its errant ways. We want to blame someone!

The truth is the “plan” isn’t as detailed as we would like it to be. Yes, there is a normal trajectory of life: growth…maturation…passing on to the next generation. But promises for obtaining specific outcomes are not given. We only assume they are assured until we discover one of our assumptions blown up by reality.

The same goes for our assumptions of the “rescue plan.” Either God does not deliver on his promises to care for his children OR his care looks markedly different from what we assumed it would be. And, it appears that God’s plan for rescue is global rather than individual. He did repeatedly rescue Israel during the time of the Judges…but some years and oppression went by each time and some of the chosen people did not survive.

Does this depress you? It can. Especially when we take note of more and more suffering and see less of the “normal” life we once expected. As we age we notice that death is everywhere–as if it wasn’t there so much when we were younger. If it doesn’t depress you, you may find yourself struggling with bitterness. How can God really exist or be good?

Or, you can consider John Calvin’s words (thanks John Freeman for showing them to me) and consider one blessing amidst the disrupted “plan.”

With whatever kind of tribulation we may be afflicted, we should always keep this end in view–to habituate ourselves to a contempt of the present life, that we may thereby be excited to meditation on that which is to come. For the Lord, knowing our strong natural inclination to a brutish love of the world, adopts a most excellent method to reclaim us and rouse us from our insensibility, that we may not be too tenaciously attached to that foolish affection…the whole soul, fascinated by carnal allurements, seeks it felicity on earth. To oppose this evil, the Lord, by continual lessons of misery, teaches His children the vanity of the present life.(as quoted in L. Boettner’s Immortality, p. 31)

If Calvin stopped there we might think he was a stoic–one who hated any pleasure. However, he is not. He says this “contempt” of this life should not lead to hate pleasure or “ingratitude” for good things.

So, consider for a moment what “plan” you expected and your reaction to not getting it. Or, better yet, what “plan” did you expect that you actually got but then found out that said plan didn’t deliver the goods you thought were to come with it?

How might your mood, your attitude, your perspective change if “the plan” was focused on meeting/seeing God each day? What would you stop striving for? What would you set aside as a waste of time? What would you notice that right now escapes your glance?

One final comment. I don’t think that this change in “plan” reduces the pain of suffering or stops our goal-directed activity in this life. We are designed to growth, develop, change, find pleasure, pursue economic stability for self and other. Further, suffering always hurts, no matter what good comes of it. Just because good comes from pain doesn’t mean pain is itself good. Our problem is that we sometimes often forget a deeper design of relationship with God.

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August 2, 2010 · 5:42 am

Backsliding?


I’m planning a series of writings on issues that Christians often bring to counseling; where they bring unique and significant questions that are difficult to answer. One of those issues is the topic of backsliding. We all know that the word backsliding carries the meaning of slipping away from a habit, identity, belief, etc. In Christian circles it means that one who was once active in their faith has stopped living it out or altogether moved away from said faith. One of my favorite quotes on this topic is from Tolstoy,

Quite often a man  goes on for years imagining that the religious teaching that had been imparted to him since childhood is still intact, while all the time there is not a trace of it left in him. (Confession, 1983 reprint, p. 15)

When someone is in this position, they often ask questions about how it happened or what the future will hold. I’ve just run across a sermon by G. Campbell Morgan on the topic (The Westminster Pulpit, v. 1, 1954). The full text can be found here.

There are several things I found helpful:

1. His take on Deuteronomy as the law of love and containing the treatment of the disease of backsliding.

2. His take on how backsliding happens.

What is this process [of backsliding]? Mark three things…. The first is purely personal, perhaps hidden from men, the corruption of the self. The second is the sequel to self-corruption, the making of a graven image. Finally, the overt act of evil.

What is self-corruption? It is the devotion of the life to something lower than the highest. The first movement of backsliding may be accomplished without committing any sin which the [present] age names vulgar. In the moment in which a man takes his eye from the highest and sets it upon something lower, be the distance apparently never so small, he has set himself upon the decline which ends in the desert and in the agony of rejection. (p. 100)

3. His conception of idolatry.

You say….”I have set up no graven image.” Remember, the graven image is always the figure of that which lies behind it. When a man has corrupted himself, the issue is always that he thinks falsely of God. Man is so linked to deity in the very essential of his being that he will form his conception of God upon what he is in himself….He is forever projecting his own personality into immensity, and calling that God. (p. 101)

4. His closing on the promise: If you seek him, you shall surely find him…

If you seek him with all your heart and soul you will find him….Will he come with flaming and flashing glory? In all probability, no. Will he come with some new sense of his coming, making you thrill in every fiber of your being? In all probability, no. It is far more likely that he will come with a still small voice…. Trample your pride beneath your feet, Crucify your prejudice….

One of the struggles I hear in “backsliding” or relapsing sinners is that they (and me too!) look for Christianity to provide the same stimulus as an addiction. We look for God to give us the high, the excitement, the freedom from pain. He may, but never in the way that an addiction or a sin pattern might provide (in the short run). The struggle I hear is that when God does not supply an equally exciting substitute for the addiction then the person wonders if God is real or if the fight for freedom from addiction is really worth the effort in the end.

If you know someone with this struggle, send them the link to the chapter. It may provide a bit of relief.

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