Category Archives: christian counseling

September 15, 2011 · 5:10 am

Psychological rubbernecking?


One of the necessary first steps of doing international trauma work is to listen to the stories of trauma. There are two main reasons. First, it can be healing for the teller to tell their story to someone safe and caring (if those leading the story telling project follow some basic rules). Second, stories often reveal useful information that may determine future trauma recovery intervention strategies.

But let us also admit there can be a downside to getting others to tell their story, especially those who are impoverished and in great need:

  • When “helpers” or journalists helicopter in to hear the stories, the victims may not feel free to not tell their stories because of the help they hope to receive
  • Outside helpers may repeat the stories in such a way as to sensationalize or to gain more money for future trips. While some reasons to tell may be noble and good, does the retelling of the trauma put the victim at risk for retaliation?
  • Getting victims to tell their story may first raise hopes for change and then dash them if there isn’t a plan for follow-up
  • Sometimes outsiders listen only to help themselves feel better (see, we cared enough to listen) but not do anything to help

In less than one month I will be on my way to do just this kind of listening in both the DRC and Rwanda. The challenge for us is to listen and invite story-telling in ways that leaves victims with immediate help and hope and a viable plan for the future (as it pertains to what to do about their trauma).

But we face some hurdles in trying to hear the right (real) or most important stories.
1. Hearing the real stories. Sometimes stories get cleaned up in an effort to tell us what others think we want to hear. Other stories are told with a slant in order to avoid stirring up other trouble.

2. Avoiding our own biases. Some victims may be perpetrators even as they are also victims. It is easy to categorize individuals in such a way that we stop listening to the pain or the recovery. We can fail to see how victims handle temptations for revenge or how perpetrators act humanely.

3. Lost in translation. Most of the stories we will hear are going to be told to us in a language other than English. That means the story we hear may be the words of the translator rather than the victim.

There is a fine line between listening for learning or helping and listening for curiosity. It is not always clear where that line is but pray for us as we seek to listen in ways that bring health and a plan for healing. We do not want to merely rubberneck like those driving past a bad accident, looking but not providing any help.

One sign that we are listening well is that the victim not only recalls the terrible things from their past but that they also recall how they survived and have some sense of being empowered in their present and future.

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August 6, 2011 · 2:36 pm

Narrative therapy and emotion 1


This month, Richard Smith and I are teaching an on-line class entitled, Christian Counseling in Postmodern Culture. Dr. Smith is managing the culture side of things in this class and has students thinking about the impact of consumerism, the “empty” self of the modern era, and “infantilist ethos” (from Barber’s 2008 Consumed)

This week Dr. Smith gave the class this quote:

At heart postmodernity [is] the same anthropology: both see humans as primarily units of consumption for whom choice is the defining characteristic… The difference between modernity and postmodernity is not that great looked at in this way: The cult of the autonomous ego, an endlessly acquisitive conqueror and pioneer devolved into a commodious individualism characterized by an unencumbered enjoyment of consumption goods and commodities.  (Brian Walsh and Sylvia Keesmaat).

A mouthful? Boil it down to this…postmodernist philosophy is very much concerned about the self. Not all that new. Now, postmodernism is much more than that and NOT all bad. But my point here is this: a counselor working in this culture must be able to connect with the client and help them construct/reconstruct their story rather than just give them lists of universal truisms to apprehend. Not that there isn’t universal truth but that the approach to them must  done in a dialogical and storying manner.

Enter narrative therapy.

Thus, I intend to blog a bit on this topic during the rest of August by summarizing and commenting on Working with Narrative in Emotion-Focused Therapy: Changing Stories, Healing Lives, by Lynne E Angus and Leslie S. Greenberg (APA, 2011).

Chapter one begins with this statement:

Being human involves creating meaning and using language to shape personal experiences into stories, or narratives. (p 3)

Do you agree? I would argue there is much truth in this. We shape our sense of self from our retelling of our experiences (both in words and in unspoken thoughts/emotions). But, we do not re-tell all of our experiences. Rather, we collect some and ignore others. Part of counseling is to dialog with the clients about how they shape their own narrative.

The authors then make this statement about the work of counseling,

As therapists, it is when we listen carefully to our clients’ most important stories that we gain access to how people are attempting to make sense of themselves in the context of their social worlds. In this way, psychotherapy is a specialized discursive activity designed to help clients shape a desired future and reconstruct a more compassionate and sustaining narrative account of the past. (p. 3-4)

Here they are telling us that our stories we tell are shaped by our emotions and at the same time make sense of our emotions.

What is EFT? It is a therapy that sees emotions as “centrally important in the experience of the self.” (p. 6). It was developed (principally by Les Greenberg) out of humanistic and Rogerian ideas of self-actualization and of counselor activities of being with, following the client and guiding. Throw in some F. Perl’s empty chair techniques as well. EFT focuses on emotions. Adaptive emotions are “the most fundamental, direct, initial, and rapid reactions to a situation…” (p. 7). Maladaptive emotions “…usually involve overlearned responses based on previous, often traumatic, experiences.” By this they mean emotions such as shame and abandonment sadness. They define secondary emotions as those reactions that are intended to protect the primary or most vulnerable emotions. Finally, they define instrumental emotions as those expressed for a motivation to achieve an aim.

Why the focus on emotion? Because they seek the goal of being emotionally congruent and adaptive. In this book, they focus on empathic attunement and changing client narratives.

How? Clients identify, experience, explore, story, make sense of, and flexibly manage their emotions (their words). Therapists notice “meaning markers” that reveal client confusion or conflict with the self.

This book will explore the narrative approach to EFT. “Critical life events must be described, reexperiences emotionally, and restoried before the trauma or damaged relationship can heal. New meanings must emerge that coherently account for the circumstances of what happened and how the narrator experienced it…” (p. 11)

Finally, they say,

…no form of psychotherapy is likely to have a big impact on basic temperament traits, but a client’s specific strategies, adaptations, and their internalized life narratives (i.e., macronarratives) have as much impact on behavior as do dispositional traits. (p. 13)

That is an interesting quote and puts the act of storying as more important than disposition.

So, what we will look at in the remaining 7 chapters is how the authors help facilitate new meanings and change their own narrative. The question for us is whether or not the narrative or re-storying approach to therapy is (a) effective in remediating problems, and (b) fits with Christian faith.

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August 5, 2011 · 11:18 am

Shepherding Survivors of Sexual Abuse • EFCA Today


 

 

 

 

 

 

 

 

 

 

Shepherding Survivors of Sexual Abuse • EFCA Today.

Click the above link for a good read: 6 myths about shepherding sexual abuse survivors. Written by Andrew Schmutzer, OT prof at Moody and editor of the forthcoming multiauthored The Long Journey Home: Understanding and Ministering to the Sexually Abused (Wipf and Stock).

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July 19, 2011 · 9:30 am

The real damage done in abuse?


I’ve written before on the damage done when a community fails to respond to abuse in a justice oriented way. But here is a more succinct and apt quote by Miroslav Volf:

If no one remembers a misdeed or names it publically, it remains invisible. To the observer, its victim is not a victim and its perpetrator is not a perpetrator; both are misperceived because the suffering of the one and the violence of the other go unseen. A double injustice occurs—the first when the original deed is done and the second when it disappears. (italics mine)

Abuse victims sometimes tell us that the most significant damage to them is when community members (family, leaders, peers) fail to “see” or act justly when they hear of the abuse. It was bad enough to be sexually abused (yes, that is real damage too) but far worse to be told it didn’t happen or be told to take it for the sake of the larger community (e.g., you wouldn’t want to harm his reputation, destroy the family, cause others to fall away from Christ, etc.).

I saw this quote in the first pages of The Long Journey Home: Understanding and Ministering to the Sexually Abused, to be released soon by Resource Publications, an imprint of Wipf & Stock. I have the typeset PDF and the editor, Andrew Schmutzer, says the book will be released in August. This book (over 500 pages!) may become the place to turn for Christians seeking to understand the scourge of sexual abuse in all its ugly forms. Chapters are written by those who are expert in the social sciences, theology, and pastoral care. The line up is phenomenal. You can see the title page/table of contents (TOC Long Journey Home) to see the gamut of chapters and authors.

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July 14, 2011 · 5:41 am

Whose shame do you carry?


Diane Langberg and I talked recently about the concept of shame. She mentioned reading an interesting mystery that had a couple of lines about shame that might be powerful imagery for some. The novel, C.J. Sansom’s Sovereign, is about a hunchbacked lawyer. About 200 pages in the lawyer has an encounter with King Henry the 8th. The King scorns the lawyer publicly for his hunch (at which everyone laughed).

His first reaction?

“Now I had met him. I felt for a second that he shown me what I was, an unworthy creature, a beetle crawling on the earth.” (p. 221)

Then anger arises in the lawyer. Why? for he recognizes the weight on him is not his own shame, but that of the king.

Whose shame do you carry? Most often we carry either the clear shame of our own misdeeds OR the shame foisted on us by the misdeeds of others. And it seems that the shame put upon us by abuse and maltreatment weighs us down the most. Often those who mistreat us do so in ways to make us believe that in fact we are worthy of shame or that they are righteous in their treatment of us.

What would happen if you saw it not as your own but thrust upon you by those who mistreated you? If you could hand it back (metaphorically), would your own back straighten? Would you feel less dirty and self-negating? If you suffer from shame due to mistreatment, try to imagine that the feelings are not yours but in fact the abusers.  Imagine what life might be like if you were to shed that shame that does not belong to you.

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July 13, 2011 · 5:51 am

Book Note: “Why the Church Needs Bioethics”


Just received a copy of Why the Church Needs Bioethics: A Guide to Wise Engagement with Life’s Challenges (Edited by John F. Kilner; published 2011, Zondervan). Using 3 case studies, a wide variety of authors discuss “better birth” (fertility), “better life”, and “better death.”

Authors include Richard Averbeck (OT and Counseling), Kevin Vanhoozer (theology), DA Carson (NT), and Stephen Greggo and Miriam Stark Parent (Counseling). In addition, there are business, law, medical, education, pastoral care, bioethics, and intercultural ministry authors.

I got a little chance to play a part in this book as a “critiquer” (p. 9) Stephen Greggo authors chapter 3, “Wisdom from Counseling” as a counseling response to the case study of Betty and Tom, a couple who are considering using Betty’s sister’s eggs and Tom’s sperm and to implant embryos into Betty. I got a chance to read and react to this chapter some time ago all because of a little article my wife and I wrote in 2002 and published in 2005.

On page 71, Greggo and Parent say,

A recent search of the leading peer-reviewed journals that inform Christian MHPs [mental health providers] and pastoral counselors yielded only a single article to guide a Christian counselor who might be dialoging with  Betty and Tom.

Their footnotes reveal that they searched The Journal of Biblical Counseling, The Journal of Psychology and Christianity and the Journal of Psychology and Theology between the years 2000 and 2009.

I find it surprising that there are no other articles than ours (full text here) and gratifying to see our essay summarized in this volume. While there are a number of good full length books, there is a serious need for good Christian counseling articles dealing with infertility and assisted reproductive technology (ART) because this is where many counselors start their study on a given topic.

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July 12, 2011 · 10:30 am

CS Lewis on “headship”


Last week my prayer partner John read me a bit from CS Lewis’ “The Business of Heaven“, a daily reader. This little vignette covers the controversial topic of headship. Christians have frequently gotten up in arms over the meaning of headship and submission in the marriage relationship (Ephesians 5:21-33). We can boil most of these arguments down to matters of power. Who gets to be in charge? What is mutual submission? Are you loving right? Submitting right? How often should the decider (thank you George Bush and Saturday Night Live for this wonderful noun) be putting his/her foot down?

Wherever you fall on this discussion of the meaning of the Ephesians 5 passage, the following from Lewis is quite apt:

We must go back to our Bibles. The husband is the head of the wife just in so far as he is to her what Christ is to the Church. He is to love her as Christ loved the church–read on–and gave his life for her (Ephesians 5:25). This headship, then, is most fully embodied not in the husband we should all wish to be but in him whose marriage is most like a crucifixion; whose wife receives most and gives least, is most unworthy of him, is–in her own mere nature–least lovable. For the Church has no beauty but what the Bridegroom gives her; he does not find, but makes her lovely. The chrism of this terrible coronation is to be seen not in the joys of any man’s marriage but in its sorrows, in the sickness and sufferings of a good wife or the faults of a bad one, in his unwearying (never paraded) care or his inexhaustible forgiveness: forgiveness, not acquiescence. As Christ sees in the flawed, proud, fanatical or lukewarm Church on earth that Bride who will one day be without spot or wrinkle, and labours to produce the latter, so the husband whose headship is Christ-like (and he is allowed no other) never despairs… (p. 169-170)

There is a lot of substance in the above quote. You might do well to read it again, slowly. I gather a couple of crucial points.

  • You want to see Christlikeness in a husband? Much easier to see it in a difficult relationship than in an easy one. It is easy to love the most lovable.
  • Headship is not about being the decider so much as it is about being the first to sacrifice his desires for hers.
  • Sacrificial living is not acquiescing to another’s desires. That is a weak way of relating to others. A thoughtful person may well say “no” to another’s wishes when humbly considering that the request is not good or healthy or is unjust. And yet, many of our denials of other’s wishes are less about right and wrong and much more about personal freedom and control. There is great power in choosing to set aside personal desire for the sake of another.
  • The same can be said for women who are trying to figure out how to “submit” to “unworthy” husbands. However, this biblical passage has much more to say about the sacrificial, others-focused husband.

Lewis goes on to say that he does not mean to baptize difficult or miserable marriage. There is no extra value to martyrdom. He only wishes to remind us that it is easy to point out the flaws of another in such a way that makes our self-serving choices legitimate. Even when we must refuse a loved one or confront them about their flaws, it should be done for their sake, and not our own.

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June 20, 2011 · 10:36 am

Must Read: Diane Langberg on “Trauma as a Mission Field”


My supervisor, mentor, and colleague, Dr. Diane Langberg has been telling us for some time that “trauma is the mission field of our time.” Recently, however, a few Christian NGO/Missions leaders have heard this line in one of her talks and have become electrified by it. I cited it last week in a board meeting at Biblical as I was trying to make the case that developing postgraduate trauma training at Biblical fits our mission: following Jesus into the world.

But, some of you have not heard her give one of these talks. For you, I point you to the World Reformed Fellowship website so you can read a report she made on June 5 regarding the problem of trauma and the opportunity of the church to have a hand in healing this man-made scourge. Below is an excerpt of that short report. Do go to the WRF link and read it in its entirety. The report is not long but it is powerful and includes a couple of specific comments from two leaders in Africa.

We are the church. That means we are the body of Jesus Christ and He is our Head. In the physical realm, a body that does not follow its head is a sick body. That is also true in the spiritual realm. We are His people and I believe with all my heart He has called us to go out of ourselves and follow Him into the suffering of this world bearing both His character and His Word. And we do go – we send missionaries and the Scriptures; we provide food, clean water, education and jobs for many. And we should. We have rarely, however, seen trauma as a place of service. If we think carefully about the extensive natural disasters in our time such as earthquakes, hurricanes and tsunamis and combine those victims with the many manmade disasters – the violent inner cities, wars, genocides, trafficking, rapes, and child abuse we would have a staggering number. I believe that if we would stop and look out on suffering humanity we would begin to realize that trauma is perhaps the greatest mission field of the 21st century.

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June 14, 2011 · 2:49 pm

Competing Models of Christian Counseling? Who is Right?


A couple of recent pieces have me thinking about (a) models of Christian counseling and, (b) the intramural conversation amongst Christians on which model is most Christian. One piece is David Powlison’s article in the Summer 2011 issue of the Westminster Today magazine (this link is to the magazine site but the current issue is not yet up). The second is by Ed Welch–a blog on Biblical Counseling Coalition website.

This is not a new topic for me. From my “About Me” page you can see that I have training in biblical counseling and also in clinical psychology. I respect the folks at CCEF who had a huge impact on my life and thought–especially that lovely editor they employ ;). While getting my PsyD I published on the historic divide between biblical counselors and Christian psychologists and the need to build bridges. I’m an associate editor for Edification, a Christian Psychology peer-reviewed journal.

All that to say, I have some thoughts on some ways we might move beyond right/wrong while still being concerned about building a clear, cogent, God-honoring model of Christian counseling.

Drop the labels

Yes, we should drop our labels. What is the difference between a Christian counselor, Christian psychologist, integrationist, or biblical counselor? These differences are as varied as the numbers of people who use them. Yes, there are probably some benefits to communicating a personal stance with one of these terms. But, for every benefit, there are probably any number of negatives, including the use of the label as a curse. “Are you that kind of biblical counselor” (whatever kind you find offensive)? “Are you a Christian who happens to be a psychologist or a Christian psychologist?”

In addition to dropping labels, we should also drop broad brush judgments. Calling Christian psychologists “syncretistic” is offensive and ill-fitting. Calling biblical counselors “psychology bashers” does not accurately portray their nuanced approach. Saying that psychology and biblical counseling is “fundamentally incompatible” (from either side of the debate) ignores the benefits that both sides gather from each other.

No labels? What then?

Facets. I’m sure there going to be problems with this idea too but let us choose to focus on facets of counseling models. For example:

  • How does Scripture shape counseling foundations and goals?
  • How do we learn from, utilize, and critique psychological constructs, data, etc?
  • How does typical human development trajectories influence our understanding of the change process?
  • How do we learn from those who do not share our epistemic foundations?
  • How do we articulate diverse counseling goals (suffering well? symptom reduction? discipleship? skill acquisition? insight?) as all working toward the common goal of glorying God and enjoying him forever.

Listen first, repent first

In Ed’s blog post (linked above on the BCC site), he captures the most essential characteristic needed if we are going to learn from each other. We ought to,

listen and enter into the world of the other person (or in this case the other counseling perspective) in such a way that the person representing the perspective says, “Yes, that’s me. You understand.”

It is a sad thing that we counselor types start with diagnosing other model builders without listening first to both the content of that model and the person behind it. We treat our fellow counselors in ways we would never treat a client. How should we listen to others? Can we see what they see? Can we see what they see that we tend to ignore? Can we see the benefits of what they do and the potential liabilities they see in our model?

Be willing to repent where you have unfairly labeled, categorized, and marginalized one who was working for Christ’s kingdom–even if you think you have been hurt more.

List own weaknesses first

Most debates, whether between thinkers or spouses, rarely succeed in winning over the other person. Why? Because we are too busy defending, explaining away, pointing out the weaknesses of the opponent to actually deal with reality.

Wouldn’t it be refreshing to hear a counseling model builder express his/her models weaknesses or needed growth points first before exploring the deficits of the another? “My model doesn’t yet have a good understanding of ____. Your model does so much better with that and I want to learn from you.”

Build the center

Rather than start with the differences (which do indeed exist), what if we cataloged the similarities and areas of agreement among Christian models of counseling? In addition, what if we recognized those things we might not have noticed with out the help of those outside our own community. For example, Scripture may speak a great deal about loving neighbors but a particular model of psychology may flesh out what loving a very unique population of client ought to look like. Even if Scripture is sufficient, we do not diminish it when we acknowledge we hadn’t made a particular application without our neighbor’s help.

Acknowledge differences

We will not see eye to eye. We will disagree. Let us acknowledge these where they arise. Let us make sure the differences are real and categorize them into those that are peripheral and those that are substantial. For example, David Powlison speaks about the need for a counseling/care for the soul model back in the 1950s. Despite quality practical theology and discipleship programs, he asked,

But what was the quality [in the 50s] of corporate wisdom in comprehending the dynamics of the human heart? What sustains sufferers and converts sinners? Westminster Today, 4:1 (2011), p7

Right away I ask myself, are these the only two options (sustaining, converting) for Christian counselors? Is it possible also to have the role of treating symptoms? Teaching skills? Reducing suffering? I’m fairly sure that this initial difference is not really there. I suspect David does not reject mercy ministry to reducing suffering. But in dialog, he and I might end up agreeing that some biblical counseling models fail to focus on skill intervention in their quest to address the human heart. And we would likely agree that some christian psychology models fail to address the spiritual discipline of suffering well and the need for conversion. Might we end up agreeing that we want a full-orbed model that neither diminishes nor over-promises symptom care or sanctification?

Promote each other

Finally, we do well to promote each other at our conferences and learning communities. We encourage wide-ranging reading, critical interactions (note, not criticizing), and sharpening of each other. And we commit to lovingly correcting those of our “friends” who speak ill about our neighbors. We reject the fear of defending an outsider for fear of being rejected ourselves. 

 

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May 31, 2011 · 5:40 am

Healing, recovery, restoration and other words for “getting better”


Recovered. Healed. Better. Restored. Resolved. Whole. What words do you use when describing positive change regarding traumatic events like abuse, the pain of adultery, or other like experiences? And more importantly, what do those words convey to yourself and others?

Why am I thinking about this? Soon, I will begin teaching an on-line summer class called “Healing Trauma in International Settings.” To be honest, I’m a little uncomfortable with the title I chose. Words matter and “Healing” conveys a message. Imagine replacing “healing trauma” with

Trauma treatment

Trauma recovery

Trauma care

Now, maybe I’m being overly sensitive but consider some of these other kinds of problems we face

  • You break your tibia during an aggressive move on the basketball court. Your leg heals and you go back to your basketball playing. Here we use healing to denote that you regained your former capacity to play sports. You are back to normal or near normal.
  • You cut your finger while slicing vegetables. You go to the hospital to get stitches. While you have a scar, your finger heals and you use it again. In time you have only a slight scar to remind you of that day.
  • Your house sustains a fire. You lose belongings. Your insurance company restores your house and replaces your possessions.
  • Your car is stolen. The police recover it and return it to you (with fuzzy dice attached)
  • You have a protracted conflict with a family member. At some point, you have a heart to heart and resolve your differences.

My examples all convey a resolution of a problem where the problem recedes, maybe even disappears. But what about trauma? Is there a form of resolution and healing of rape or sexual abuse or domestic violence where the memories disappear? Should there be? Wouldn’t forgetting these experiences place the person in danger of living in unreality and, in some cases, at risk of re-injury? Here are some important questions:

  • What does healing from an affair look like? How do you know you have “recovered”? What symptoms or experiences would remain?
  • What does healing from a rape look like? What would be expected if you “pretty well recovered”? What is to be expected to not change?

As a counselor I do not want to under or over-sell the recovery process. Victims do find tremendous healing but to assume all vestiges of a traumatic experience go away would be false. Unfortunately, we who have not been traumatized sometimes expect the kind of recovery where victims go back to a way of life and thinking as if the trauma never happened.

If we are honest, we wish to live in a world without lasting consequences from sin and suffering.

We want people to “get over” their pain and go back to a way of life as if it never happened. It would be like asking a person who lost a leg to hope they will run exactly like they did before losing the leg. Indeed, they may run again. But never as fast and never as easy. There will be a stump to care for, a hip to learn new motion, phantom pains to re-interpret, and limits to accept.

This world of limits is one God wants us to live in and one we detest. Our first parents saw the limits of their wisdom and desired to get wisdom on their own. We too love the happily ever after story where humans obtain health and healing apart from limitations. We tell the stories of miraculous healing as if we no longer live in a broken world.

Let us endeavor to tell true stories of healing that glorify God and remind us that we depend upon him for every breath.

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