For those interested in pictures (from the Rwanda Embassy in DC) and formal information about what the AACC, Dr. Diane Langberg, and others including myself are planning on doing in Rwanda, click the following: MOU AACC alert.
Category Archives: christian counseling
Standing with Rwanda
Filed under "phil monroe", christian counseling, christian psychology, Diane Langberg, Rwanda
Psychopathology Monday
Happy New Year all. Our semester begins today with the first session of Psychopathology for the first year students. Before launching into the various forms of mental illness and emotional maladies, we consider the larger concept of suffering. Without a careful understanding of (a) the nature, causes, and theology of suffering, (b) the meanings of suffering, and (c) our beliefs and responses to suffering, we counselors become a dangerous lot. We fall prey to simplistic understandings and responses–and fall prey to false hope and false despair.
Sound like a great way to start of the New Year? It does to me because we now have an opportunity to look at ourselves and our world with more realistic eyes than we may have during the stress of the holidays.
Coincidentally, we had a Sunday School class yesterday on the topic of suffering. Our church has buried 10 people who died before their time (so it seems to us!) in the past 5 years. Not only have we had these tragedies, we’ve also splanted a church and been in a transitional malaise for maybe 7 years? The class allowed individuals to talk about suffering and heartache. Good class. We heard those who felt that what was going on was a message from the Lord, from those who just felt confused and in pain, from those who felt the nearness of the Lord during these normal ups and downs of life in a fallen world.
What was said in multiple ways was that one’s perspective or expectations about suffering really impact how one feels about the struggle of life. If you expect life to always be healthy then repeated sicknesses and death will set you back. Someone said there that if you lived in a dirt hut that moving into a trailer would seem wonderful but if you lived in a palace, the trailer would seem a terrible thing.
So, what should we think about suffering and the seeming explosion of death and heartache?
- God is saying something AND yet He may not be sending some special message to us
- Our actions may cause some of our own suffering but living more righteous lives does not prevent suffering
- Suffering is to be expected in this world AND yet it is NOT THE WAY IT IS SUPPOSED TO BE
- Isolation and failure to connect to others in suffering ALWAYS makes that suffering worse
- Even those who only observe those in suffering suffer as well and need to connect with others in order to avoid despair
- Good may come out of suffering, but suffering itself is not good
- God, through the cross, bears our suffering and yet it still hurts
- It will not last forever
Finally, how do you respond to suffering? Turn away? Become numb? Angry? Probably all the above, right? Take a moment to consider how you respond to suffering right in front of you and watch yourself for those trite statements that can hurt those who are already in pain.
Share this:
Propaganda is in the eye of the beholder
What is the difference from selling truth to a population and selling propaganda? A razor’s edge so it seems. I suppose another response would be, “I know it when I see it”–the response made about pornography. But what may be truth to you is propaganda to another.
Why am I thinking about this? My recent trip to DC included a trip to the holocaust museum. There, the curator of the new propaganda exhibit took us through his amazing assemblage of Nazi propaganda. Let me give you a flavor:
Propaganda as defined in the museum is, “biased information designed to shape public opinion and behavior.” They go on to say that propaganda is identified as that which
- plays on emotions
- uses a combination of truths, half-truths, and lies
- omits information that might counter its contentions
- simplifies complex information into a slogan
- Attacks opponents (blames them for all problems; negatively portrays them)
- Advertises a cause and uses righteous approach to give the cause meaning
- Targets desired audiences through contextual material
As we went through, here’s what I noticed as well. A propaganda machine works to re-write history; makes the enemy comical (caricatures of Jews evident); emphasizes oration skills; uses media, fine arts, art, color, pictures, emphasizes a logo; targets different audiences in different ways; doesn’t mind opposition but builds on it; keeps people terrified; encourages even demands grassroots involvement; gets the youth involved; portrays self as victim and minority; creates fictitious events (e.g., calls war by another name (retaliation for prior aggression); connects with known trusted and wise individuals or labels (Hitler was alluded to as the Great Physician!); encourages passivity so that the inner circle may act in their stead; and encourages skepticism and cynicism about the criticism they will receive (the Nazis told the people near the end of the war that the Allies would say evil things about them that were going to be untrue. Such activities plant seeds of doubt to encourage those to believe that the holocaust didn’t really happen).
Now, let me tell you about the reactions we had as we went though the exhibit. The Rwandans with us gasped and gaped at times. They realized that someone(s) masterminding the Rwandan genocide must have read the Nazi playbook. They reminded us that one such mastermind in Rwanda was a PhD in history and was behind the use of the Radio propaganda. They repeated over and over, “this is what happened to us.” Several of us also realized that in child sexual abuse, many of these same behaviors are used (whether consciously or not) to avoid detection. The perpetrator grooms the victim, rewrites history, tells half-truths, makes themself the victims, and even may try to plant seeds of doubt about the truth.
One more thought? Could we also say that sometimes Christian organizations use some of these tactics. Scare a population by making a caricature of the government, report only half the truth, make self as victim, excuse unchristian behavior as necessary.
While I don’t think the answer is that we ought to all become horrible skeptics in order to avoid propaganda, I do think we ought to be highly sensitive to those behaviors and attitudes that do not reflect the proper character of Christianity. We must not use tactics unbecoming of Christ–even if for a good end.
I leave you with this thought: Isn’t there a good use of propaganda? I believe so. Can you give some examples where you are getting “good” propaganda?
Share this:
Filed under Abuse, christian counseling, Cognitive biases, deception, Rwanda
End of semester thoughts
Looking at a stack of papers I need to grade and yet not feeling the energy to do so. Late night classes take more out of me than I care to admit. My physiology class ended with student presentations and a look at bipolar disorder. As we concluded the class, I asked them to remember that,
- Even with all the advances in neuroscience, we must humbly admit we still know little how we are fearfully and wonderfully made.
- It is good for counselors to keep learning about the body and at the same time hold what they know lightly. Tomorrow may bring evidence to the contrary
- Yet, what we know about the body can be helpful. We ought not to look down upon our ignorance but remember that doctors do not always explain or walk with patients
- There are great medical interventions available, but (and that but shouldn’t diminish what I said before it),
- Over and over we saw that the basics (maintaining balance in life, self-care, mindfulness) are so important to health, perspective, etc. No, they aren’t magic interventions. Yes, they pay-off over time rather than immediately.
On this last point I am pondering a bit and so let me be hyperbolic. Most people who come to see me for paid counseling come because they think (naively) I have some expertise that will shed light on their situation and a solution to their problems. They want me to do something. Why else pay that kind of money? And yet much of what I have to offer isn’t rocket science. Beyond a few fun techniques, what I have to offer is a listening ear, a willingness to walk with the other person in their travail, and encouragement to keep going back to the basics. Most people like the first two but balk at the last one. Why do we balk at going back to the basics? Two reasons: (1) we want something that will fix the problem NOW, and (2) we’ve tried the basics and they didn’t seem to work (see reason 1).
Examples of what I mean.
- If you are a parent and you go to a counselor to deal with your young child’s behavior problem. More than likely, you will get some counselor telling you to use some reinforcement strategies. And what do many parents say? “I tried that and it didn’t work.” Chances are they did try it and either they didn’t keep at it or they didn’t realize they were doing something that reinforced the wrong thing, or they had a misguided view of what success should look like
- A couple is struggling with fighting. They go to the counselor who encourages them to return to the basics of respectful talk. Usually, they will feel like they have already tried it–and it didn’t work. Chances are… You get the picture.
In physiology, we see that care for the body includes mindful meditation (My friend and former professor says a substitute word would be “watchfulness”) on the world as God sees it, developing and maintaining good circadian rhythms, watching food intake, exercise, maintaining healthy relationships and social supports. In every mental illness, these things are shown to decrease the severity of symptoms and delay relapse.
Here’s the problem: we forget the basics and because they don’t give immediate results, we go searching for other fast-acting mechanisms. For example, I want to feel safe. Instead of engaging in centering prayer over the long haul, I fall prey to the temptation to act in such a way to avoid all possible danger–thereby increasing my fears of danger.
If I don’t exercise (and I don’t much) I rarely get immediate feedback that my body is falling apart. If I don’t eat right, I don’t immediately gain 10 pounds. If I don’t pray, I don’t immediately get embittered. So, I assume that these basics aren’t all that important. Or, I know they are important but since they don’t pay off now, I don’t do them. I only do what demands I do it to avoid a crisis.
How do we stay on track with the basics? We need another person(s) willing to keep us on a short leash. As a kid I ran because I had a friend who was going to wonder where I was. As a doctoral student, I played basketball at 6 am because my peers would ask me where I was. I lost some weight a couple of years ago because my wife and I worked together. Notice that the social accountability is a key facet to help us build the disciplines long enough to see that the pay off is more than can be delivered by an exciting new technique.
Share this:
Prevention services for pastors?
Ran across a new set of stats about pastor health in the last few weeks. Nothing surprising, just more confirmation of the same story. A Cheryl Shireman reports on data from over a thousand pastors who attended 2 conferences. Some of her stats…
- 57% of pastors would leave if they had a better place to go–including secular work
- 77% report not having a good marriage
- 72% felt they were unqualified or poorly trained by seminaries to lead the church or counsel others
- Only 38% report personal devotions outside of sermon prep
- 38% are divorced or going through one
- 30% admitted a sexual encounter with a parishioner
Let’s assume that most pastors enter the ministry fit (false assumption!) for the trials and tribulations and spiritually mature. What can a church do to maintain that pastor’s health (and his/her family as well)? We surely don’t give them combat pay. While most get vacation and health benefits, few report getting ongoing discipleship or training beyond the annual preaching conference.
Here’s an idea I’ve surfaced here before. What if pastors were required to have a mentor? What if churches provided $1000 a year for use in preventative counseling or confidential spiritual direction? What if pastors had to complete a confidential “check-up” each year? On this last item, I suspect that I could provide an assessment (cheap, easy to complete questionnaires for pastor and spouse plus 3 hours of follow-up interview and goal setting) for under $400.
If these recommendations came before your congregation, what would the reaction be? Would there be resistance? Worry about expenses? Openness? I’m curious…
Share this:
Chronic pain and the Christian faith
Last night’s Counseling & Physiology class covered the topic of chronic pain. There are a number of syndromes and disorders that cluster around pain as the presenting problem: Chronic Fatigue, Fibromyalgia, Irritable Bowel Syndrome, Rheumatoid Arthritis, Osteoarthritis, back pain, etc. Depending on which research study you read, some 9-17% of the population struggles with some form of chronic pain.
While these various forms of pain are quite different, there are some commonalities. Chronic and diffuse pain sufferers frequently experience some form of inflammation, fatigue, sleep disruption, negative mood, and poor memory (its hard to pay attention to new information when you are weighed down by pain). We don’t really know what causes what but we do know that these symptoms form a vicious cycle. If you don’t get restorative sleep, you experience more fatigue, you are more prone to negative thought patterns, your pain levels go up, memory goes down…and thus you don’t sleep well the next night, and so on. Researchers describe this vicious cycle in terms of “allostatic load”–the deleterious effects of chronic stress hormones without restorative sleep.
Because of the diffuse nature of pain (vs. focal) and the lack of obvious objective evidence of that pain (a big red spot, a swollen limb, etc.), chronic pain sufferers and their families struggle to understand whether or not the pain is real and what they are truly capable of doing. How do you measure pain levels? It’s pretty subjective! Thus, it encourages more “I should be able to…” thinking in all parties. Those not suffering chronic pain do more damage by implying that the person is just looking for attention, is just being lazy. Those suffering pain who either deny the pain and try to do too much or refuse to engage the world and withdraw from it do damage to themselves–real physical damage.
As with all physiological problems, one’s mood, one’s perceptions, one’s focus, one’s stress levels impact severity of the problem. While chronic pain is not just in one’s head, how one responds to chronic pain may help alleviate or elevate the pain sensations. Ironically, many pain sufferers resist counseling because they fear that others will believe that their symptoms are all in their head. Those who refuse to acknowledge the psychological factors in pain sensation and management miss out on important means to cope with the pain and to lower pain perceptions.
Chronic pain sufferers must accept the need to adjust their lifestyle to accommodate more rest. They must fight to get the best restorative sleep possible. These are probably their primary practical responses–even above medical treatments (and I’m not knocking medical treatments nor saying that just getting sleep will solve the problem).
One of the biggest challenges for pain sufferers is the matter of hope and faith. When we suffer problems, we often hope they will go away. And when they do not, or only get marginally better, it is easy to slide into despair. Despair usually is the result of things not going the way we hoped or expected they would. Part of dealing with chronic pain is grieving what is lost in order to accept–even enjoy–what strength and health we do have. Without hope, we lose what self-efficacy we once had, thus not doing the basic care-taking activities within our grasp. Interestingly, one of the clearest signs of this struggle is the massive dropouts in pain management research. Frequently, dropouts number about 50% in these studies. This means that before a study gets too far along many are dropping out because they assume the new treatment isn’t going work.
Faith is not that things will go my way right now but that God is in control, cares/protects me, and is working for my ultimate redemption–even when the opposite seems to be true. Faith is acting in a manner consistent with said assumptions even while grieving over real losses. Such faith enables us to be mindful of our thoughts so that we do not practice into beliefs counter to what we have come to know as true.
The chronic pain sufferer who grieves well (asks God for relief, stays in community with others, seeks relief through human means yet has an attitude of waiting on the Lord, and yet still willing to explore and confront hidden sin in self) begins to see that in the midst of the pain, God is there and providing momentary help. Such a person need not act as if the pain were nothing but will look for and rejoice in 5% improvement, 10% more comfort, etc, rather than demanding complete healing as the determinant as to whether God is present with them in their distress.
Share this:
Measuring minor victories
One person’s victory is another person’s reminder of failure.
I put my socks on by myself this morning. A minor victory don’t you think? No, not for most of you. Normally–and that word is loaded–I put my socks on every morning without thinking about what I’m doing. However, I hurt my back on Friday afternoon and couldn’t move without help. It hurt to sit, stand, lie down, cough, sneeze or do anything at all. It is amazing how the lumbar muscles connect to just about every other muscle group.
With high doses of anti-inflammatory meds, muscle relaxants, and walking (yes, quite counter-intuitive), I was able to put on my socks by myself by Sunday.
Funny how something we do without thinking one day becomes a huge accomplishment the next day. What changed? My perspective and my standards. If my perspective and standards remain the same, then I don’t view putting on my socks as a minor victory but as sign of continuing failure.
What minor victories do you overlook in your life because your standards and perspective are based on a set of assumptions that no longer fit? What minor victories do you dismiss as meaningless because they don’t seem to make a dent in the progress toward your desired goal? Maybe you handle a difficult situation with grace but because it didn’t turn out well you deem your graciousness to be of little value. Maybe a family member gets up and goes to work despite crushing depression but because they do it without joy, you don’t see the minor victory. Maybe a couple fights without curses and put-downs. Is it yet another minor victory?
This is Thanksgiving week. Let us take special notice of God’s grace and power when we observe minor victories in ourselves and those around us–especially in those areas of chronic struggles.
Share this:
Filed under christian counseling, Desires
When Sex in Marriage Doesn’t Work
Today is the first full day of the CCEF annual conference in Valley Forge, PA. The conference is entitled, “Sex Matters” and so all plenary and breakouts are on said theme. It is not too late to drop by if live in the area and want to register. I believe they will still take walk-ups.
Besides the faculty-led plenary sessions, Lauren Winner (Girl Meets God; Mudhouse Sabbath, & Real Sex) will speak on Saturday. For those of you who can’t come, CCEF sells mp3 downloads on their website.
I will be providing an hour long seminar entitled, “When Sex in Marriage Doesn’t Work” at 4 pm today. We will focus on desire, arousal, technique, and relationship problems (whether perceived, physical or emotional) couples sometimes encounter. Slides and an additional home-grown sex therapy questionnaire is available here (#16 on the list, scroll to the bottom).
The best part is that after I’m done, Biblical Seminary is hosting a pizza party for current students and alums (5:30p) at our information table.
Share this:
On-line counseling courses through Biblical Seminary
Those interested in taking an on-line, graduate-level counseling course might wish to consider this new joint offering from my school, Biblical Seminary, and the Christian Counseling & Educational Foundation (CCEF).
Counseling in the Local Church (2 credits)
The course is taught by Dr. Tim Lane, Director of CCEF and runs from 1/18/2010 to 3/19/2010. It is completely on-line with mp3 lectures, assignments, and threaded discussions with others in the class. You can register here for this class. If you have Internet access and an undergraduate degree, you can take this class.
Later in Spring 2010 we will offer David Powlison’s Dynamics of Biblical Change.
CCEF started Biblical’s counseling program back in the mid 80s and has continued to lend their faculty to courses here and there at Biblical. They have been offering on-line and residential courses (non-accredited credits) for 25 years. In my personal opinion, our joint venture brings together quality biblical counseling and theological expertise with practical and professional counseling expertise!
Now, we have a chance to work together to provide on-line students with quality teaching from CCEF but now for academic credit. (You must have an undergraduate degree already)
What can you do with these credits? Well, for one, you could apply them to a number of Master’s degrees at Biblical. They could count as elective credits in our MA Ministry, MDiv, or MA Counseling program. Second, you might seek to have them transferred to your own local graduate school program. Biblical Seminary is ATS and Middle-States accredited and so will be considered a legitimate institution. However, you should know that every school sets its own polices regarding transfer of credits. Usually they look to see if the course fulfills a course they would have required in their own program. Remember that it is up to you to find out if they will transfer.
Or, you can just take them because you want to be enriched! We’d love to have you as a student!
Share this:
Stress & Christian mindfulness, part 2
In the last post I reviewed some simple definitions of mindfulness, including some of the Buddhist ideas behind a version of mindfulness. In this post I want to consider how mindfulness, when reconsidered in the light of Christian thought, can be a valuable part of counseling practice.
A thought about mindfulness and the brain
Let me detour to one more thought about biology and mindfulness. What happens in the brain when a person is practicing mindfulness? Thought and feeling patterns result in neural activity in the brain (or is it the other way around?). Repeated neural activity creates stronger connections between neurons (increased synaptic activity and denser connections with neurons in the same neighborhood. Repeated activity leads to greater blood flow and activation in particular regions of the brain. Neuroscientists call this neuroplasticity.
Thus affective and cognitive patterns can indeed change your brain. Think about this. What patterns of thought do you engage in on a repetitive basis? Do you have a habit of fantasizing? Mulling over bitter or jealous thoughts? While some of these may come naturally to you, what you do with them may actually change or strengthen neural connections in the brain–for better or for worse.
Is mindfulness healthy or relativistic?
Mindfulness, no matter whether you take a religious, consciousness, or relational approach to it, includes the stepping back from shoulds, oughts, and other judgments. One might think that this would be dangerous for Christians. Within Christianity, there are rights and wrongs, truth and lie, righteousness and unrighteousness. The Bible is, among other things, the single guide for Christians to determine how to live for God. SO, it begs the question whether Christians should be wary of anything that seems to let go of shoulds and oughts?
Another view of shoulds and oughts
In my experience, those suffering from anxiety and depression suffer from a disorder of judgments. They are flooded by shoulds and oughts. Their self-talk does not seem to come from the Lord but are already laced with prejudice. “You should have been more vigilant against danger AND you weren’t. You’re a failure.” “You shouldn’t be rebellious BUT you are always a screw-up.” “I shouldn’t have to suffer this way AND God must not care for me.” Notice that most of these forms of judgment are careful consideration of the facts and experiences but well-formed opinions that may be based on only a smidgen of the actual events in their present circumstances. Notice that these forms of ruminative thinking come in disguise as careful, logical thinking. They are not. What they are narratives–well-practiced narratives–that have an already formed conclusion that we repeat regardless of the actual facts of our lives.
Mindfulness, then, is stepping back from these narratives. Mindfulness is a practiced discipline of just noticing and describing events so as to process them more carefully instead of automatically repeated a script or mantra. Mindfulness provides the opportunity to discover “what is” rather than compound suffering by focusing on what we just assume. Consider Dan Siegel (The Mindful Brain, p. 77)
When the mind grasps onto preconceived ideas it creates a tension within the mind between what is and what “should be.” This tension creates stress and leads to suffering.”
While I’m sure I would vigorously disagree with Siegel on what a preconceived idea is, on what can be healthy “should be’s”, and much more, he has a point worth considering. Have you ever engaged in a fantasy conflictual conversation with someone you are about to meet. You play out yourself winning, being mistreated, standing up for what is right, and so on. Notice how such conversations aren’t useful. They only increase your level of stress because your brain responds to the inner drama as if it were really happening, when it has yet to happen. In this way, Siegel is right. We create tension that leads to suffering.
Using mindfulness in Christian Counseling
I’m running out of room here and won’t be able to do justice, in this post, to the most practical part of mindfulness. [Isn’t that just like us academics. We spend all our time pointing out problems but we never solve anything!]. Mindful practice may include time practicing being present in one’s surroundings. The counselor may encourage clients to take in their surroundings. While many thoughts may race through the brain, the mindful person may choose to not follow them but “drink in” the creation beauty around them–things growing, art, or anything that is a delight to the senses. This form of discipline must be practiced in de-stressed times so that it will be available during a crisis–just like a basketball player practices free-throws over and over so as to make the shot when there is only 1 second left on the clock.
Such work is the work of taking every thought captive. and resting (a la Psalms 131) without grasping after things “too wonderful” for us.
Musings on Faith and Psychology 