Category Archives: christian counseling

March 31, 2009 · 5:42 am

The Value of Psychological Testing


My friend, former teacher, mentor, Ed Welch, has posted a blog on the CCEF website on the topic of psychological testing and how biblical counselors might view it. You can see his blog here as well as my comment on their site: http://www.ccef.org/psychological-tests-are-you-or-against#comment-28

Ed, as you will see, isn’t really against testing, recognizes value in it, but doesn’t really think they are all that special–no more so than a really good interview. And, in part, he is right. A really good counselor/interviewer and learn a lot. In my mind, though, testing provides confirmation of what you are learning about the counselee PLUS uncovers subtle data that you might not get quickly or at all (especially through the more objective forms of testing).

It seems people think about testing in one of two ways: either they think testing uncovers secrets that couldn’t be gotten without a test or they dismiss it as pure theory. It is neither. Good testing provides a response profile that one can look at and compare to either the general population or a specific population. That, in itself, isn’t all that helpful but when combined with a specific assessment question, the examiner can interpret the data and build good hypotheses to direct future counseling and intervention.

I love to do psych testing. I find that interacting with test results and counselees provides dialog points that wouldn’t have been as easily discovered or talked about without the data in front of us. For example, if someone takes a personality test and one of the scales suggests that they are approaching the test in a manner consistent with those who are trying to look better than they really are, that provides an opportunity to discuss an pattern in their life that we might not have had the chance to do so easily.

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March 30, 2009 · 5:51 am

Readings for Christian Psychology


Had a prospective student in recently asking about good readings to start with before beginning the Masters degree. My answer? It depends on your background and interests. So, I’m going to post a few of my recommendations today for the student with a college/university/grad background in psychology but who wishes to be more informed about the Christian world of counseling theory and practice.

Historical and Theoretical Foundations

Eric Johnson’s massive tome, “Foundations for Soul Care” (IVP 2007). At over 600 pages, you might be intimidated but you should try out Part 1 (ch. 1-3) which gives you historical and theoretical backgrounds. The rest is great too (check out p. 172 for a good illustration). Also, the Appendix 1 may help as well.

Eric also edited “Psychology & Christianity: 4 views” (IVP). You can see 4 different stances to christian counseling. The book isn’t the best because it does not, in my opinion, allow each model to be well represented. However, the first chapter does provide historical background and you can see the failings of each of the four views in their debates with each other.

Examples of Christian Counseling

Anything written by David Powlison or Ed Welch (www.ccef.org) will do just fine. Ed’s “When People Are Big…” book is a good start. More recent editions such as his book on addictions and depression are popular reads but helpful. David’s writings are best contained in their (now defunct) Journal of Biblical Counseling or on their website.

If you haven’t read anything by Larry Crabb, one of the most well-known Christian counselors, you might start with his “Finding God.” He has a dozen or more books to choose from but that one may be his best.

Want someone who best illustrates the integrationist model? Try Mark McMinn’s “Integrative Psychotherapy” (IVP). This book may be the most comprehensive effort to articulate both theory and practice by any Christian counselor to date. Or, look at any of Mark Yarhouse’s work. You can find his writings at www.regent.edu or http://psychologyandchristianity.wordpress.com/.

Want more of a theological foundation? Consider C. Plantiga’s “Not the Way its Supposed to Be” (Eerdmans).

There’s way more but that will get you started. If you really need more check out www.christianpsych.org for its lists of good books.

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March 26, 2009 · 5:42 am

Further thoughts about conflict


Whether we are two fighting 10 year olds or 60 year olds, we have a propensity to fight unfairly. Yesterday I mentioned the habit of character assassination. Today, I want to go a little further with these techniques (tongue inserted in cheek).

1. Make sure to start out telling the story in such a way that will emphasize your righteousness (overlooking your own sins) and equally emphasizing the other person’s sins. Be sure to read any and all possible data about the other’s motives in the worst possible light. Never give the benefit of the doubt.

2. If you are defending someone else who has done something wrong, be sure to protect them facing justice.

Some of these thoughts came to me during this week’s sermon on Judges 20. Note how the Levite tells the story about the awful Gibeah men but fails to point out his complicity in allowing his woman to be abused to death. Notice, as my pastor pointed out, how he generalizes from some people’s behavior to a whole people group. Notice also how the tribe of Benjamin fails to hold their own people accountable but closes rank to protect their own. These things are habits we easily engage in if we are not careful.

Or, how about a better way. Follow the model of dealing with conflict by first seeking personal assessment and repentance before pursuing the sins of others.

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March 25, 2009 · 5:43 am

The fine art of disagreeing


Ever noticed that some people can disagree with you to your face but do it in such a way that you are neither threatened nor feeling the need to go to the mat over the matter. What do these folk do differently?

First, they are willing to voice their disagreements. This is preferable to those who agree to your face but tell others they disagree with you.

Second, they do it in such a way as to not diminish you as a person. I’ve noticed that some people are expert in making others feel important–even as they may completely disagree with an idea. They validate you as a person. They assume you mean well and are authentic in your ideas and beliefs.

On the flip side, those who approach the fight looking to drag character into the matter, who assume you are duplicitous or have a hidden agenda, get our defenses up. It is a sure way to kill a relationship (marriage, work, family, etc.) to start a conversation challenging someone’s honesty and accusing them of not being upfront.

I think we are most likely to do this if we have been meditating on some real or perceived unfairness in the relationship.

But what if you really think the person isn’t being honest with you or themselves? Should you bring it up? It is my experience that the more attention to pay to their concerns (whether obvious or partially hidden), the more likely you can have a worthwhile conversation and either the dishonesty will reveal itself or it will become less of an issue. Of course this isn’t always true, but often, in most relationships.

So, if you can honor 1 Corinthians 13 in your disagreements, you will enrich your relationships with others and master the fine art of disagreeing with others in love.

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March 13, 2009 · 3:38 am

Physiology Phriday: Anticipation and Anxiety


Anticipation and its relationship to anxiety.

This week we have been thinking about how we evaluate our world. Evaluations or judgements come from a variety of locations. Our expectations and desires prep us to look for certain kinds of “data.” Our histories and past perceptions prep us as well. Finally, what is actually happening is part of the data we use to evaluate ourselves and our world. Notice that we aren’t as logical and objective as we’d like to think. Instead, we ANTICIPATE life and then respond to data that fits into that anticipation.

The primary feature of chronic anxiety is that anticipation of negative, dangerous outcomes. The anxious person views ambiguous data (e.g., a boss who is grumpy, a funny feeling in the chest, etc.) and reads that data in the worst possible light (I’m going to get fired, I’m having a heart attack).

If the problem is bad habits in thought patterns, it would make sense that the treatment ought to be to challenge these logical fallacies with the truth. And while cognitive counseling does indeed work (clear data that one can challenge and reject anxious, ruminative thinking) most find that counseling stops anxiety from growing but doesn’t often stop it from starting in the first place. This struggle to fight anxiety leaves many Christians feeling quite guilty for not trusting God more. 

But what about the amygdala? There is significant research that anxious people have very activated flight/fight activity in the amygdala. In fact, brain scans of this area show greater activity in anxious people than non-anxious people even when they are responding to neutral events. Thus, the anxious person’s brain is in a chronic state of hypervigilance even when nothing is going on. Hypervigilance maintains higher levels of norepinephrine the body, which in turn keeps the adrenal system in high alert. Medications (of the SSRI and NSRI type) have the capacity to positively impact serotonin and Norepinephrine and thereby allow individuals to decrease the negative hormonal activity in the brain.

Which comes first?

So, does biological hyperactivity in the amygdala result from either bad experiences or bad thinking? Or does a predisposition towards overactivity of this part of the brain encourage negative and anxious thinking, forming a vicious cycle? 

Seems to me good treatment needn’t answer this question. Good treatment would include (a) medications that might make it easier to slow down the anxiety processes (biology and behavior), (b) recognition that vigilance can be directed via counseling work away from the feared object and to a better understanding of the brain, and finally (c) that one changes the goal from cessation from fear to a more godly and humble response to Jesus in their fear.

What I mean by (b) is that the anxious person see themselves as like unto a person with colorblindness or dyslexia. In each case, the brain functions in a way to send the wrong messages. The dyslexic person learns to recognize the problem and designs a means to compensate in order to truly see the right order of letters/words. The anxious person accepts that their brain sends certain messages but that their job is to stay remember that while something real is happening it is not necessarily the way their brain is putting the “facts” together. Thus, the work is not to remove the fear but to practice a better response to it.

Ironically, when the person reinterprets the stimulus differently, they do see a marked reduction in fear triggers.

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March 6, 2009 · 5:30 am

Physiology Phridays: Deep Brain Stimulation


Next fall I will teach “Counseling & Physiology” for the first time so I am beginning now to plan through such a course. It’s my intention to use Fridays to blog on counseling stuff related to the brain and biology. Here’s my first post:

The March issue of the APA Monitor on Psychology magazine has an article on the use of deep brain stimulation for chronic and untreatable depression (after failures with medicine and ECT). DBS is a surgical procedure, first pioneered to stop Parkinsonian tremors, where electrodes are placed in the subgenual cingulate region and a “pacemaker” produces electrical current to the electrodes on a continuous basis. You can read about DBS here on wikipedia. The studies are small as of yet but the FDA has already approved this procedure for OCD patients.

This surgical procedure seems to produce positive feelings and relief from the depression. So, does this mean that depression is merely a biological problem? No. This is why medicines are quite helpful but it is counseling that maintains the relief from depressive symptoms.

Bottom line: Depression is a multi-faceted disorder–both from an etiological standpoint and from a treatment standpoint. One must consider biology, spirituality, cognition, and behavior. These areas are not mutually exclusive as work in one area has impact on the others. Efficacious treatment not only seeks to resolve the depression but also to consider how to live well–whether in a depressive state or not.

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March 5, 2009 · 11:24 am

Jack Miller on repentance (again)


If you haven’t seen Jack Miller’s little book on repentance I encourage you get ahold of the new edition published by CLC publications (2009). The cost is under 8 dollars! Jack Miller wrote the first edition in 1975 under the title, “Repentance and the 2oth Century Man”. This one, entitled: Repentance: A Daring Call to Real Surrenderalso includes a foreward by Andree Seu (World Magazine) and an epilogue by Miller’s widow, Rose Marie.

Here’s why I find this little book very helpful. It clarifies the subtle but oh-so-important differences between true repentance and penance; between true repentance and regret. It reminds us that repentance is a daily moment-by-moment attitude but is not something that is full of shame and morose feelings. 

As someone who works with Christians struggling with addictive patterns, I find one of the greatest challenges is to help clients move from penance to repentance and from guilt to freedom. This book ought to help with both.   

For those unfamiliar with Jack’s legacy, he started New Life Presbyterian Church in Glenside (my church) and out of that church a number of other churches were planted as well as the founding of World Harvest Missionwhich has 170 missionaries now in 15 countries–including Uganda where missionaries were intimately involved in the care of those suffering through last year’s ebola outbreak.

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February 25, 2009 · 5:14 am

Breaking down Christian Counseling barriers


Maybe it’s a stage of life, maybe I’m hallucinating, but it seems to me that the divisions withing Christian forms of counseling are exploding. And to that I can only say hurrah!!

Let me give you the clifnotes version of American Christian counseling history (minus many important details) starting with the 20th century:

  • Fundamentalist/Modernist fallout after the turn of the century builds division between fundamentalist/evangelicals and academics, including psychology. Division over naturalism
  • Christians authoring psychology related books (Boisen, Clinebell, Hiltner, Narramore) in 30s-50s
  • Creation of Christian Association of Psychological Studies in 1956 by Dutch Reformed pastors but later broadened to include those wacky Californian evangelicals interested in psychology. Writings at this time were broadly evangelical but often contemporary psychology models with bible verses attached. Beginnings of the integrationof psychology and Christianity movement with creation of doctoral training programs by Fuller Seminary and others.
  • Jay Adams counters in late 60s and early 1970 (Competent to Counsel) with nouthetic counseling model to return to the power of the Scripture to change people and to throw off the humanistic clutches of psychology. Numerous models of biblical counseling birthed. Most prominent: CCEF
  • Divide between Biblical counseling models and professional Christian Psychology widens in the church. Much maligning of each other. To associate with one meant no possible association with the other. Biblical counseling avoids professional jargon; integrative psychology pushes for meeting state licensing standards
  • Biblical Counseling moves in 1980s from predominantly deconstructive and critique oriented to more positive model building
  • 1990s: some beginnings of dialogue between key thinkers/authors in biblical counseling and integration movement. Integrative clinicians see benefits of the biblical work done by biblical counselors, see problems with many superficial integrative models, and both sides seem to be less separatistic and more open to learning from each other
  • Now in the 21st century: A new version of Christian Psychology willing to embrace biblical counselors, psychologists, theologians, etc. and desiring to build a robust, biblically founded understanding of people informed by psychological research.

Okay, that’s in broad brush strokes and I left out huge developments and individuals. But yesterday I received a survey about biblical counseling programs. It’s clear our old divisions and categories no longer work. Now, today I get an advertisement for a biblical counseling conference that includes a wide variety of speakers. We are truly crossing lines! I’m interested to see what comes of this in the next 5 years.

FYI, interested in a fuller history? Start with the 1st chapter in Eric Johnson and Stan Jones’ “Psychology and Christianity: 4 Views” book. Follow their reference list. Then check out David Powlison’s U Penn PhD dissertation on the history of Jay Adams. Neftali Serrano published his PsyD dissertation on the beginnings of CAPS. That will whet your appetite.

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February 18, 2009 · 1:57 pm

Access to short christian counseling articles


I’ve noticed that the American Association of Christian Counselors has made many of their magazine (Christian Counseling Today) articles available for free on their www.ecounseling.com website. You can search by author or keyword to find what you might be looking for.  

My 800 word essay on repentance after abuse can be found here. A longer and very helpful article by another psychologist on the 12 features of spiritual abuse can be found here.

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February 16, 2009 · 2:23 pm

Wanna see a MA Counseling program in action?


For those of you in the Philadelphia region and considering an Masters degree in Counseling you are hereby invited to our March 9th “taste of Biblical Seminary.” This open house is just for those interested in a counseling degree and will expose attendees to what we do at Biblical. You’ll come hear from profs and students, have a meal with us, have time to ask current students anything you want, and then sit in on our classes. You’ll leave with a very clear sense of what we are about.

For more information and an opportunity to have a meal with me, check out this pdf on our website: http://www.biblical.edu/images/embark/PDFs/infoeventmar09.pdf

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