Category Archives: christian counseling

October 25, 2023 · 6:00 am

Am I doing this trauma healing thing right? Part 3, 6 red flags that you might need a new helper


In in our series about the challenges of undertaking this journey toward healing after trauma, we began by looking at key landmarks along the way that every pilgrim needs to keep in sight (Part 1). These include taking care of our bodies and becoming curious about what helps us find stability. In Part 2 we looked at some myths and beliefs about healing that can hinder our recovery. In Part 3 I want us to consider some things that “helpers” (AKA, therapists, pastoral counselors, counselors, friends, mentors, etc.) do that hinder recovery. If you spot any of these red flags, it might mean you need to have a heart-to-heart with your helper or, if need be, look for someone new to travel with you on your journey.

Before we dive into the underbelly of bad therapy, I want to remind readers that I really believe in therapy. Good therapy helps us understand ourselves, helps us explore parts we have been too ashamed to look at, and helps us gain perspectives and skills to use in our most important relationships. And bad therapy can take away what shred of hope we have for change. It is this reason why I have spent my career educating and training clergy and mental health professionals on 4 continents. Good therapy and help is possible and most of us helpers want to do what is good and right for you. So, let’s highlight here six red flags, behaviors that DO NOT help, so that both survivors and helpers can avoid them.

Making everything spiritual

Not everyone pursues a faith-based therapist or helper. But many do, and for good reason. Faith, religion and spirituality are core features of most of the world’s population. So, it makes sense that we seek helpers who also share our values. In addition, trauma almost always creates spiritual struggles and at least temporary discontent with previously accepted beliefs. Voicing those complaints and questions to and about God are essential to the journey of recovery and will determine whether faith helps us cope or becomes added strain.

However, when your helper uses every opportunity to infer a spiritual meaning and application while you wrestle with your pain, this might be a red flag. Pain is pain, confusion is confusion. It is okay to sit with it, voice it repeatedly, and not make some eternal or mystical application. When a counselor is quick to make a reference to spiritual meaning in your story, it means they are likely not really sitting with you in the ashes of your pain. They might not be as wrongheaded as the story of Job’s friends who jumped to accusations of sin, but pressuring you to accept a spiritual answer to the deeply painful why trauma or what now questions often invalidates your pain and misses opportunities for needed lament. Some call this spiritual by-passing.

The premature offering of spiritual answers, no matter how accurate, often add to the pain of the one who is suffering.

Rejecting your faith or the changes in your faith.

While forcing spiritual conversations is problematic, so also is it when our helpers challenge our faith, changes in our faith, or even question why we have a particular faith or religious practice. You might think this problem is only found among pastoral or biblical counselors. However, I have witnessed many licensed mental health professionals also evidence this red flag. Consider some of the lines I have had clients repeat back to me from their former helpers:

  • You can’t believe that about God. He wouldn’t do anything to hurt you.
  • If you don’t forgive, you will become bitter and miss out on blessings.
  • If you aren’t in church, you are rejecting God’s goodness.
  • Yes your abuse is bad, but God says…
  • Your faith community is toxic. You need to leave this patriarchal religion.

If changes and discontent in our former ways of construing faith is so problematic, then why are there so many psalms of lament in the Bible? These poems express our deep questions and complaints. In Psalm 42 the writer laments how he no longer leads the worship procession and is now full of questions for God. Does God respond and tell him to stop this line of thinking and feeling? No. Instead, if you accept that the Psalms are given to us by God, then such expressions are invited by God as an act of communion.

Emphasizing techniques while missing the relationship.

There are many therapy models out there in use. Some are general models (e.g., Judith Herman’s three phase model of trauma recovery) and others are more regimented or manualized (e.g., Trauma-Focused CBT). In recent years, there has been a proliferation of EMDR certified specialists. And still many more employ various techniques from many models in an eclectic manner.  

When your helper is overly enamored with a particular technique, it can become a problem as they may not be able to recognize when that beloved technique does not help you. When your therapist wants to jump into “doing stuff to you” then it is likely they aren’t really seeing or hearing you. And just because a particular technique has empirical evidence for success, it doesn’t mean it is right for you. Sadly, when a disciple of a model oversells a technique, the real reason may be that it promotes their own sense of competence as a clinician.

When a therapist suggests a course of action or an intervention, do they take time to explain what positive or negative response might happen? Do they find out how you feel about it? Do they check in with you and notice if you are anxious, concerned, or not having a good reaction? If you are flooded during a session (e.g., frozen, overwhelmed, etc.) and your therapist doesn’t seem to notice, show curiosity, or take the time to help you find ground again, you might need to find help elsewhere. If in response to your stress, they fill up the space with more words of explanation or defense, they might not be as trauma sensitive as they need to be.

Pressure to progress, mislabeling your hesitation as refusal.

Therapists love to help people. That is why we do this work. We want to see people get better and we have confidence that healing can and will happen. But sometimes, our motivation to help people also include the hidden desire to feel helpful. This desire can become a demand that the client feels in their bones. “I have to progress and get better or they will become disappointed in me or see me as resistant.”

If you have felt this pressure, take a moment and consider possible roots. Sometimes this fear of being resistant is something the survivor has come to believe about themselves (or, were told by their abusers!). But other times it is a message from their helper. Signs of demands, disgust, irritation, frustration, coercive speech, pouting all point to the possibility that the therapist is communicating to you that you need to get better FOR THEM.

We will explore how to determine if a therapist is right for you in the next post but suffice it to say here, your resistance to an intervention is something to listen to with curiosity. It is the beginning of regaining your voice and power. Instead ask, “What might your hesitation be saying?” Listen to it and don’t immediately judge it. If your therapist does label it as refusal, consider other helpers.   

Therapist talking about self a lot.

Who does most of the talking in your session? You or your therapist? When your therapist talks, is it for the purpose of inviting you to explore your own reflections? Or, when they speak, do they share paragraphs and essays about their work or themselves? How much do they talk about their own experiences? Self-disclosure by the therapist is not always wrong. It can be helpful in tiny doses. But when it happens frequently it often distracts from the work that needs to be done by their client.

Therapy is not the place for therapists to talk about themselves (or to sell their own products). Ask yourself, “do I get to talk about the things that are most important to me during my sessions?”  

Boundary crossings.

Trauma experiences, especially betrayal traumas, often contain boundary violations and maltreatment by someone who was supposed to protect and respect another. When helpers confuse or cross needed boundaries, this can delay healing or cause more harm. What kinds of boundary crossings do I mean? I have witnessed therapists trying to be all things for a client. They are not just the therapist but also become friend, “parent figure,” employer, pastor, landlord, and sadly, sexual partner. This last boundary crossing—sexual and romantic relationships—is always an abuse of power and a violation of the sacred trust of therapy. It is also a criminal act in most jurisdictions and always an ethical breach.

Most crossings are not meant for harm. A client can’t afford therapy so a clinician barters—provides therapy and in re-payment the client performs some work. A client has administrative skills and so the clinician invites the client to help run his or her business. Another client is isolated and so a therapist invites them to their own bible study group. On the surface these might seem mutual and helpful.  But what if the client doesn’t respond well to the therapy? What if the therapist is unhappy with the work completed? What if learning about the personal life of the therapist creates confusion about what is discussed at the next session?

When therapists encourage dual relationships without ample discussion of the possible ramifications, they prioritize their own benefit at the expense of the client’s wellbeing.

I see a red flag, what should I do?

No therapist is perfect, and we all make therapeutic mistakes. It is the response to mistakes that makes all the difference between good and harmful therapies. The question you must ask yourself,

“is it safe to bring up concerns and questions about what happens in therapy?”

Can you talk about the process and raise concerns without your therapist becoming defensive? Most therapists want to provide good care and do not want to do things that harm their clients. So, it stands to reason that many will respond with concern and work with you repair the rupture and find out what works best for you going forward. If, however, you have reason to believe that you will be mis-treated for bringing up a concern, then consider whether it is time to find another therapist.

What comes next?

In our final post of this series, we will explore how to interview for a good therapist and how to determine what model of therapy might be best for you.

For further reading, why do counselors talk about themselves?

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November 29, 2019 · 3:43 pm

Counselor failures: A short series


I recently passed my 29th year anniversary of mental health practice and 18th year as a psychologist. I’m not quite old but also have a few years under my belt. When I first began counseling as a counselor in my very early twenties I was fairly committed to proving my value. I wanted to diagnose problems and offer wise solutions. I’m embarrassed to say that I often thought I could do so in the first 15 minutes of a session. Sometimes I was right, but I can say for sure I hadn’t earned the right to speak. Needless to say, I wasn’t particularly helpful in those early sessions. Thankfully, I learned that if I was going to be helpful I needed to stop worrying about whether I sounded smart and had something valuable to say and instead spend my energy entirely on the work of listening and understanding the person in front of me.

Not listening to clients might be the first and most common failure counselors make. It can happen throughout a session or for just thirty seconds during a momentary lapse of concentration. While beginner counselors may struggle to listen well, seasoned therapists can lose their edge without even recognizing it.

Not listening can happen by means of trying to dictate goals. It can happen when we therapists talk about ourselves. It can happen when we misdiagnose a client. It can happen when we are bored, or irritated, or caught up in our own world of pain.

This little series is dedicated to therapist failures. We’d rather believe that our mistakes are really client resistance or family interference. But as we own our mistakes, we acknowledge that counseling is a human interaction that requires our willingness to evaluate our end of that interaction. While this series is written for mental health practitioners, I suspect clients will also benefit from this look inside, if for no other reason than to identify when they are not feeling heard.

Some related thoughts previously written

I’ve written a couple of blogs recently on related topics. The first is embedded in my last blog,

I’m going to skip over the large problem of counselors pressing for any change whatsoever. (Suffice it to say that pressing a client for forgiveness, confession, reconciliation, or any other action rarely works and more often causes harm. You cannot heal a trauma caused by misuse of power with more force–even if your goal is good.)

https://philipmonroe.com/2019/11/24/some-thoughts-on-when-restoration-hurts/

I will write more on the problem of choosing the wrong goals for counselees–or the problem of choosing goals in the first place. A few months ago I wrote about the problem of choosing reconciliation as a goal.

Some years ago, I wrote this list of common mistakes made by novice counselors.

Come back for the first post exploring the setting of goals in counseling and how not listening leads to the likelihood of failure.

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November 24, 2019 · 5:04 pm

Some thoughts on “When Restoration Hurts”


In case you haven’t seen it, Christianity Today recently published an essay entitled, “When Restoration Hurts: Christian counselors grapple with how to encourage reconciliation while protecting victims.” Not quite an expose, it does detail some of the damage done by biblical counselors pressing victims for forgiveness of and reconciliation with those who abused them.

The essay details some of the experience “Amanda” had, both when looking for help as a 17 year old after sexual abuse by her father had come to light and then later when she brought a complaint against the organization that had certified the counselor. The writer of the essay goes on to describe the landscape of biblical counseling, integrationist counseling, and a new version of Christian psychology before returning to the challenge of what Christian counseling care is available for victims and perpetrators. Of concern in this essay is how the biblical counseling group views the bible’s place in counseling victims of abuse.

Before I make my observations, which will only be a small portion of what could be discussed, I want to give some background. I was first trained by CCEF (mentioned in the article) and worked as a part-time counselor there. I still have many friends at that organization. I’m quite impressed with Darby Strickland’s teaching on abuse in families. I’m acquainted with ACBC (formerly NANC) and know many who have been certified by them. I got my psychological training at Wheaton College and there became good friends with Eric Johnson mentioned in the article and was present for the early days of the Christian Psychology movement. Then, I spent 18 years leading a MA counseling program at a seminary. While this background does not mean I am smarter than anyone else, I repeat here to say I know the people and the conversations well. Over the years I have listened to stories of pain and healing at the hands of counselors from all parts of the professional, biblical, and pastoral counseling worlds.

Some Observations

Here are some thoughts of mine about what problems lie behind the misapplication of spiritual principles in these cases of abuse.

Restoration over protection. When restoration is valued over protection, it can only be for the benefit of the one pressing for restoration. What benefit do they get? They get to feel that God is indeed in control. Why do you think that false prophets told the exiles in Babylon that in 2 years they would be back in the land? Was it to earn money? Doubtful. Was it to appear wise? Maybe. But, most of all, it was likely that in repeating this belief (based on knowledge that God would redeem) they could take comfort now rather than sit in the reality that life was broken and not likely going to be restored in their lifetime.

Misapprehending fruit of repentance. I’m going to skip over the large problem of counselors pressing for any change whatsoever. (Suffice it to say that pressing a client for forgiveness, confession, reconciliation, or any other action rarely works and more often causes harm. You cannot heal a trauma caused by misuse of power with more force–even if your goal is good.) One of the great mistakes counselors make is speaking as if they know the heart of another. In no case is this more true than trying to speak with confidence about those who have a long pattern of deception. Tears, time, nice words are not evidences of a changed heart. It is ironic that those who are caring most about righteousness, who seem to be aware of “bad” fruit of not reconciling with someone who has done harm, appear naive in recognizing that tears and the right words are not evidence of change. For example, if a parent who abuses a child seems wholly focused on return home and to church life, is it possible that they only want the benefits of repentance without the work? Might better evidence be a willingness to die to own desires and to ask, “what do those I harmed most need?” while looking for the answer from others.

I conclude this point noting that those in the biblical counseling tradition have been quite willing to acknowledge the problem of evil and deception in the human heart. It is strange, then that some hold those who resist reconciliation to a tougher standard than they do those who have been harming others in the dark but now claim repentant hearts.

Restoration to what? One disheartening experience mentioned in the essay is when those in power demand that the primary goal of forgiveness is restoration and reconciliation. The essay quotes Heath Lambert, former ACBC head, “the goal in ministry to an abuser–as long as he will receive such ministry–is to see him be restored to his family, and ultimately to Christ.” In Ezekiel 34 God charges the priests of Israel with abusing the people, as shepherds who feed on the sheep. In chapter 44 he announces judgment on these idolatrous priests. He will restore them but only to the work of cleaning up the mess after the sacrifices. They will not be restored to their previous position. Today, the modern equivalent would be for an abusive church leader to be allowed to clean the church and the toilets but not to preach, teach or lead. Lambert is right in desiring to see restoration to Christ but his apparent assumption that the restoration would be to position (family) seems faulty. The goal should be to be present with the perpetrator on their journey rather than focus on the final destination.

Pride is the issue. “…Several victims pointed out the difficulty of knowing when real change [in perpetrators] has happened, and that it was prideful for their counselor to assume they knew the hearts of their abusers.” Pride is one of the greatest sins of counselors and pastors. We think we know the problem/diagnosis and therefore we know the solution. The great trap for spiritual leaders and helpers is that we want to be seen as such.

Do you want to be a leader? Be a servant. In this case, be a student of those you want to help. Learn from them. Stop trying to dictate what they do and how they do it. When we experience pride as therapists we stop asking questions of ourselves, stop evaluating our motives and our hypotheses, stop desiring to learn. This can happen to licensed therapists as well as pastoral counselors. Those who want to work with trauma should ready widely those who have the most experience with trauma–regardless of their religious and philosophical moorings. Those who want to work with people who have abused power ought to learn from those who have worked most closely with patterns of deception. Don’t assume you know something just because you know basic categories of right and wrong. Your pride may be evident to those practiced in deception who will tell you what you want to hear (your greatness) in order for you to do their bidding.

Nothing harms the bible and Christian counseling more than someone with half understanding of basic ideas acting as if their opinions should be taken as pure doctrine. If you are facing a situation where you are wanting either a perpetrator or victim to progress, take a moment and write down what you think their most pressing need is today. Take a moment to listen well and see if they also agree. When pressures mount to get to some destination, resist it. Pray for God to give light to the path today. Let him hold the concern for where the journey ends. For that we can be sure he will be faithful to complete in his timing.

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September 11, 2017 · 9:19 am

Job Opening: Director of the Graduate School of Counseling at BTS


Folks, most of you know I made a move from Directing the Graduate School of Counseling at Biblical Seminary to a new job at the American Bible Society. BTS is now advertising for my replacement: GSOC Director Ad 9-17 FINAL.  Please share this and pray that they find the right person capable of leading the counseling programs into their next area of growth. The MA counseling program, if I can say so myself, is top-notch and a rare find for those seeking both licensure and biblical-theological depth.

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April 5, 2017 · 6:27 am

Why we need a theology of trauma


[Previously published April 2015 at http://www.biblical.edu. The faculty blog no longer exists there thus re-posting here]

We live in a world shaped by violence and trauma. This week that I write 147 Christian Kenyan university students were killed because of their faith. Such horrific forms of violence shock us. But they shouldn’t given that in our own country violence and trauma are everyday occurrences. While some of our local brothers and sisters face actual death, all of our communities are shaped by soul-crushing abuse and family violence. Take the most conservative numbers we have—1:6 males and 1:4 females have experienced sexual assault before age 18—and realize that a large portion of your friends and acquaintances have traumatic experiences.

In a congregation of 100, 20 of your fellow church members are walking around with invisible wounds of sexual violence on their bodies and souls. And that number says nothing about those walking around with other invisible wounds, such as caused by domestic violence, racial prejudice, sexism, bullying and the like. Were we to include these forms of interpersonal violence the number would likely reach 70!

As my friend Boz Tchividjian asks, what would the sermons and conversations look like if 20 of our mythical congregation of 100 had just lost a house in a fire or a child to premature death? Wouldn’t we be working to build a better understanding of God’s activity in the midst of brokenness rather than passing over pain as a mere hiccup of normal life?

Yet, we continue to imagine trauma as some sort of abnormal state.

Ruard Ganzevoort[1] tells us that, “When one looks at issues like these, we must conclude that our western societies are to no less degree defined by violence and trauma, even if everyday life is in many ways much more comfortable” (p. 13). Thus, Ganzevoort continues, we must “take trauma and violence not as the strange exceptions to an otherwise ‘nice’ world” (ibid, emphasis mine). He concludes that while we have a strong theology for sinners, we have a less articulated theology for victims.

What if we were to read the Bible in such a way to build a theology of trauma for victims? What would it look like? I would suggest that Diane Langberg’s maxim sets the stage quite nicely: the cross is where trauma and God meet. Jesus cries out due to the pain of abandonment by the Father. Since we do have a high priest who understands our trauma (Hebrews 4:15), we can read the entire canon from the frame of trauma—from the trauma of the first sin and death to the trauma of the cross to the trauma just prior to the coming new heavens and earth.

Key Themes in a Theology of Trauma

Reading the Bible through the lens of trauma highlights a few key themes beyond the foundation of a God who Himself knows trauma firsthand in the unjust torture and death of Jesus:

Anguish is the norm and leads most frequently to questions

When more than 40% of the Psalms are laments (and that doesn’t count the primary themes of the prophets!) we must recognize that anguish is most appropriate forms of communication to God and with each other. But we are not alone in the feelings of anguish. God expresses it as well. Notice God expresses his anguish over the idolatry of Israel (Eze 6:9) and Jesus expresses his when lamenting over Israel (Luke 13:34) and cries out in questions when abandoned by the Father (by quoting—fulfilling—Psalm 22).

Despised and rejected, a man of sorrows, acquainted with grief.

Peace happens…in context of chaos

Psalm 23 comes to the lips of many during times of trouble as it expresses peace and rest during times of intense trouble. Shadows of death yet comfort; enemies around yet feasts. Peace happens but rarely outside of chaos and distress. Consider Jeremiah 29:11, frequently quoted to those going through hardship to remind them that God has a plan. He does have one, but recall that the plan was to live in exile among those who see the Israelites as foreigners and second-class citizens!

The kingdom of God in the present does not promise protection of bodies

Try reading Psalm 121 aloud among those who have survived genocide or been raped repeatedly by soldiers. “The Lord will keep you from all harm.” Really? You lost 70 family members? You cannot maintain your bladder continence due to traumatic injury to your bladder? Where was your protection? Our theology of God’s care must take into consideration that He does not eliminate disaster on those he loves. Recall again the trauma wrought on those God chose to be his remnant. They were the ones ripped from families and enslaved by the Babylonians.

God and his people are in the business of trauma prevention, justice, and mercy responses

The kingdom of God is not for those who have pure beliefs. The kingdom of God is for the poor in Spirit, the persecuted, those who provide mercy and those who hunger for justice (Matthew 5). True or pure religion is practiced by those who care for the most vulnerable among us (James 1:27). Jesus himself is the fulfillment of healing as he claims Isaiah 61 as fulfilled in his personhood and mission (Luke 4:18-21). We his people are the hands and feet to carry out that binding up and release from oppression.

Recovery and renewal during and after trauma likely will not eliminate the consequences of violence until the final return of Jesus Christ

Despite our call to heal the broken and free those enslaved, we are given no promise that the consequences of violence are fully removed until the final judgment. Rarely do we expect lost limbs to grow back or traumatic brain injuries to be erased upon recovery from an accident. Yet sometimes we assume that traumatic reactions such as startle responses, flashbacks, or overwhelming panic should evaporate if the person has recovered. A robust theology of trauma recognizes we have no promise of recovery in this life. What we do have is theology of presence. God is with us and will strengthen us guiding us to serve him and participate in his mission to glory.

There is much more to say about a theology of trauma for victims. We can discuss things like theodicy, forgiveness, restorative justice, and reconciliation. But for now, let us be patient with those who are hurting as they represent the norm and not the exception. And may we build a missional theology of trauma, not only for victims, but also for all.

[1] Ganzeboort, R. Ruard (2008). Teaching that Matters: A Course on Trauma and Theology. Journal of Adult Theological Education, 5:1, 8-19.

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January 12, 2017 · 5:43 am

PTSD: A New Theory? An Old Treatment


Researchers Liberzon and Abelson at the University of Michigan have published an essay articulating a new way of conceptualizing what is happening in the brains of those with Posttraumatic Stress Disorder. While you can’t read their essay for free, you can read this good summary here.

What is their new theory? the neurobiological problem of PTSD is “disrupted context processing.” In simple terms, I fail to respond to the “stimulus” in its proper context when I am triggered by old experiences in a new setting. Even more simply, when I wake up on full alert in the middle of the night after smelling wood-smoke in my sleep I initially fail to recognize the context (my neighbor burns wood) and immediately think my house is on fire (as it once was). Thankfully, the alertness is less than it used to be and I don’t always get up to check on my house.

The authors suggest that 3 separate and current brain models are inadequate in their scope of understanding the brain’s activities in PTSD. From their perspective the “fear model” (Fight/flight learning), the “overactive threat detection model” and the “executive functioning model” work best when integrated into one unified theory with their new label. And, in true humble researcher fashion, they request help in testing this model to see if indeed it can carry the freight.

An Old But Essential Treatment?

It is good to have a better handle on what is happening in the brain when someone experiences PTSD. Neurobiological research is growing by leaps and bounds. It is hard, frankly, to keep up. And yet, let us not forget an old but essential part of PTSD treatment, the person of the therapist. Humans are designed to be in relationship. PTSD has a way of shattering connections with others and thus the treatment must reverse the disconnect. Being present and bearing witness to trauma will always be the first and primary intervention every therapist must learn. Our temptation is that we want to move beyond the bearing witness phase into change phases. While this is understandable (we want others to get better as fast as possible), we sometimes want this for our own reasons–to avoid the pain we experience in sitting with traumatic experiences of others.

Let us remember that we therapists (and pastors, friends, etc.) are the primary intervention when we are present with those who suffer, when we become a student of their suffering. All other treatment activities stem from this foundation. To use a different analogy, consider Dr. Diane Langberg’s meditation, “Translators for God” (Day 26 of In our Lives First). In this meditation she describes the experience of being translated in a seminar. The translator must fully understand both languages in order to accurately communicate the speaker’s words into the heart language of the hearers. Counselors are translators for God and for healing. And yet, if they do not deeply learn the heart language (pain and trauma experience) of the client, they will not be able to connect the client to healing and to the God who heals.

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December 24, 2016 · 8:00 am

Your lack of self-care harms others, so what are you going to do about it?


Advent and the end of the year provide opportunities for some self-reflection in preparation for the start of the coming year. So…how are you doing? Are you taking care of yourself? This is especially important if you are a service provider such as a counselor or caregiver. 

Last October, a meta analysis of healthcare providers’ self-care (or lack thereof) and its relationship to quality of service indicates a clear negative relationship: lack of self-care leads to great likelihood of harm to patients. 

Eighty-two studies including 210,669 healthcare providers were included. Statistically significant negative relationships emerged between burnout and quality (r = −0.26, 95 % CI [−0.29, −0.23]) and safety (r = −0.23, 95 % CI [−0.28, −0.17]). In both cases, the negative relationship implied that greater burnout among healthcare providers was associated with poorer-quality healthcare and reduced safety for patients. 

What is even more telling is that patients can tell and do perceive when we are burned out. You think your bitterness, your lack of sleep, your losing your first love of helping isn’t showing? It is. 

Now, there are many reasons why we don’t steward ourselves (hearts, bodies, and minds) well. Sometimes we are in systems that actively discourage taking care of the self. In Christian settings, focusing on the self doesn’t seem to comport with “being poured out like a drink offering.” Others of us never learned how. Still others struggle with guilt. How can I take care of me if others have less help than I do? Yet others don’t take time to pour back in to self because it isn’t comfortable. Serving others is easier and provides more immediate rewards.  

What is your reason? 

If you were going to do something on a consistent basis to recognize your need to be cared for, what would you do? For your spiritual needs? Professional growth? Physical needs? Relational needs? See if you can come up with one thing for each arena–things you can do on a consistent basis. For example, you might decide to read Diane Langberg’s daily devotional for the next 40 days, In Our Lives First, as a means to do something for both your ministry skills growth and spiritual vitality. 

Don’t over-think it. What is just one thing you can do (or stop doing if it isn’t helping) to make your self a bit more refreshed? 

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December 16, 2016 · 11:15 pm

Over-confidence? Under-confidence? Assessing counselor tendencies


Every counselor desires to be effective, to handle client concerns and problems with competency. We do this work because we long to see others recover quickly and we do not want to get in the way of needed and desired growth. Early career counselors often feel out of their league and so seek out all the help they can get: supervision, books, essays, and peer-consultation. This is the proper way to learn and become better at our craft.

But what happens when we begin to feel competent and confident? Do we stop feeling needy? Stop seeking input? If we do stop pursuing growth and increased competency, skills and capacities will erode. We might think all is well, we’ve got this under control, but in reality we would enter dangerous territory. Imagine wanting to be an Olympic athlete and yet forgoing training.

Erosion happens.

So, should we want to feel less competent? No. The goal is not to feel ineffective nor to lack confidence in what we do. I would not want a second-guessing surgeon to operate on me. Rather, it is important to maintain regular (not obsessive!) self-examination and invitation to others to give you input and feedback.

For the possibly under-confident counselor:

Where do you feel you need help, are less competent than you would like? What are your common responses to that feeling? Who have you talked to about this problem? Where have you sought help? What continuing education have you completed? While it is good to get help to “know what to do” don’t forget that a large portion of therapeutic success is attributed to who you are in the session. Be sure to focus on your listening, and “bearing-witness” skills. Remember to be a student of the client.

For the possibly over-confident counselor:

Do you still have supervision? If not, why not? Look over your caseload. Who are you working with who you have not reviewed assessment, diagnosis and treatment plans with another (note: peer supervision can be done without revealing confidential or private information)? When was the last time you verbalized your case conceptualizations with a critical eye to the potential myopia that plagues us all? What continuing education have you completed that can revise and improve your skills?  While relationship-building skills are the most important, do not stop learning and growing in knowledge and understanding.

It is good to remember that  our skills WILL erode without attention, just like muscles with grow flabby without exercise. One such muscle for the Christian counselor is that of prayer. Consider your recent counseling activities and ask how prayer has fit into your work. Is it a perfunctory or an afterthought? Does is change depending on how you feel about your competency? What does it reveal about your therapeutic operating system (e.g., what is the source of power to change?)

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October 28, 2016 · 1:28 pm

Does your counselor have these two important skills? 


I love working with counselors-in-training. We get to discuss everything from diagnoses to interventions, ethics to theology, character development to politics. I know I’m biased but along with the population of Lake Wobegon, our students “are all above average.” 

That said, there are two extremely difficult counseling skills every student needs to learn–frequently the hard way. To be an effective counselor, you have to be able to conceptualize a person and their presenting problems well (e.g., wrong assessment leads to wrong treatment) and you have to maintain a clinical alliance throughout the course of treatment. Of course, a counselor needs to be of good and mature character. She needs to have a bank of excellent questions to ask, a knowledge of common intervention strategies, and a good ear to hear what the client is trying to express. These things are necessary foundations for the skill of conceptualization and alliance.

Conceptualization

When you come to counseling to discuss a challenge in your life you want the counselor to be able to understand and put your situation into proper perspective. You expect them to have some expertise beyond your own–otherwise why go? As you tell your story, it always has missing and disjointed parts. There are dead ends and mysteries that may start out feeling important that in time become less a focus than other issues. Your counselor needs to put the problems you raise into some context. What lens to view the problems should be used? 

  • Is the conflict between a mother and teen best understood by the lens of enmeshment, Attention-Deficit, autism, sinful pride, depression, anxiety, rebellion or…?
  • Is the conflict between a husband and wife best understood as lack of knowledge, demandingness, personality disorder, emotional abuse, etc.

An effective counselor uses multiple lenses to view his counselee and holds those lenses loosely in recognition that first impressions need refinement. 

Do you feel heard or pigeon-holed by your therapist? Does your therapist discuss possible ways to look at the problem you have and thus different ways to approach solutions? 

Alliance

Alliance is a hard thing to describe but it encompasses a trust relationship where therapist and client work in concert to explore and resolve a problem. There is agreement on the problem definition and the process of therapy.  There are several things that seem to be part of this concept but fall in two key categories: techniques and stance. A good therapist asks great questions that enable a person to feel heard as they tell their story. A good therapist validates the person even if they do not agree with interpretations of the client. A good therapist makes sure that the client knows they are more than the sum total of their problems. Finally, a good therapist checks in with a client to find out how they are experiencing the therapy session and approach. But good questions and feedback are not the full picture of alliance. The therapist needs a stance that reflects being a student of the person; of collaboration over action. It reflects an understanding of pacing and the client’s capacity to process information.  

A counselor can understand a problem but if they rush ahead or lag behind in pacing, the alliance will fail. Consider this example. Therapist A meets with a client with a domestic violence victimization problem. It is clear to the therapist that the client needs to move out and that the client is resistant to this idea. The clinician presses the client to leave and challenges her to see her husband as an abuser. While the counselor may be correct, the confrontive and authoritative stance is unlikely to bear much fruit and will either create defensiveness or passivity in sessions. One sure sign of poor alliance is when a therapist is constantly thinking about how to get his or her client to do something. 

Meanwhile, Therapist B meets with the same client and explores the ambivalence she has towards her husband and the abuse. Options are discussed, less for movement sake and more for examination of fears and opportunities, hopes and despair. Both therapists have the same sets of good questions, but one is more aware of the pacing of the client and meets her where she is where the other one forces a pace the client is not ready to match. This does not mean a counselor never pushes a client but it does mean they never do that without the understanding and agreement of the client. 

Alliance is not a static feature. It grows and shrinks during the course of a relationship. There are ruptures and hopefully repairs. Sometimes a rupture leads to an even stronger alliance if the repair leaves the client feeling cared for and respected. Ruptures are not always caused by the counselor but it is the counselor’s job to notice and to work to resolve. 

Do you feel like you are on the same page with your therapist? Do you have evidence (not just fears) that your counselor is frustrated by you? When you have a “miss” in a session, does your therapist acknowledge it and talk about how you are feeling about therapy? If you bring up an rupture, are you listened to? 

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October 18, 2016 · 11:15 am

Does trusting God remove anxiety?


Over the years of doing therapy with Christians I have noticed how many feel guilty for their anxieties. “If only I could trust God more…I say I believe he is good but clearly I don’t trust him because I can’t stop being anxious.” Still others express distress that their faith in God does not change their feelings of hurt over past relational wounds and fears it will never get better.

It seems we believe this maxim: If I really trust in God, I will be at peace. I will not struggle with the brokenness around me or with the unknown future.

Is this true? Is it possible to trust God fully and experience chronic negative emotion?

Let me suggest a better maxim and then illustrate it with a couple of Psalms.

Because I trust God completely, I bring him my angst again and again.

At the recent #CCEF16 conference on emotions, David Powlison referred to Psalm 62:8a, Trust in him at all times, O people; He noted that this assertion is strong. But what does it look like in action? David pointed us to the next line (8b) Pour out your hearts to him, for God is our refuge. Trusting God looks a lot like venting, crying out in our confusion, sharing our fears and despairs.

Take a closer look at this Psalm. The writer is under assault by others. He likens himself to being a tottering fence, something easily knocked over. He is asking his enemies, “how long are you going to harm me?” He knows their intent. But their evil is the worst sort, one that pretends to be good but is really evil. They take delight in lies. With their mouths they bless, but in their hearts they curse. It is likely the psalmist could say, “with friends like this, who needs enemies?”

So, how does he talk to himself? Look at the cyclical pattern: reminder-pain-reminder-warning-reminder

  1. He starts with some truth. My only rest (or silence/peace) is in you God. You alone are my fortress. I will never [ultimately] be shaken.
  2. He laments. But you enemies are trying your best to destroy me, a weak, tottering fence.
  3. He reminds himself. Remember, look for rest and peace in God alone, it is only there you can find it, even when the ground is shaking
  4. He warns self and others. Don’t trust in your position, don’t trust in ill-gotten gain. And if God blesses you, don’t trust in the blessing
  5. He cycles back to truth. Remember this one thing: God you are strong AND loving. You will remain righteous in your dealings with us.

While the Psalm ends, I suspect the writer could easily have kept the pattern going, as in starting again with the first verse or adding more to the pattern.

This pattern of truth, honest admission of pain, reminder of truth is a far better picture of the reality of life hidden in Christ than the false stoic (or Zen) image of being unperturbed by the chaos in and around us. God does not remove us from the storm. Instead, we express our trust (as much to remind ourselves as in bold assertion), we lament, we groan, we pour out our troubles and we circle back to the one truth we can hang our hope on.

You can see this pattern also in Psalm 42 and 43 with slight variations: Remember when I used to be out in front leading the worship but now my tears are my only food. Why am I like this? I hope in God. But I am downcast. Day and night God is loving…but it seems you have forgotten me in my oppression? Vindicate me. You are my stronghold so why is this not getting better? Free me so I can worship you…yet I am still in despair even as I hope in you.

If you feel guilty much of the time when thinking about your level of trusting God, consider this alternative narrative: it is the greatest act of trust to keep bringing God your troubles, even when things or your response to them do not get easier.

So, does trust in God remove our anxieties? Not as much as we might think. But, if you could no longer feel guilty about your angst, might you in fact feel more peace as you trust God through the storm?

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