Here’s video of Dr. Diane Langberg musing about what she has learned from listening to trauma over the years. (link here) She made this presentation as a part of a larger evening of trauma counseling training at Biblical Seminary, November 12, 2012.
Enjoy. More to come soon.
Last night we ended our counseling & physiology class. All semester we have been looking at counseling through the lens of the body and its problems. All counseling problems are physiological since all counselees come with a body. But of course, some problems have more complex etiology and require counselors to understand how the body is part of the problem and solution. This semester we looked at a wide variety of problems: trauma, anxiety, addiction, sexual problems, bipolar disorder, autism, multiple sclerosis, traumatic brain injury, and much more. In addition, we explored how insomnia is the “mental illness multiplier” and some basic self-care and mindfulness provides much relief across all problems. And yet, we barely scratched the surface of the physical stuff we’d like to know.
But last night, we considered the problem of chronic illness, illnesses like chronic fatigue, fibromyalgia, and irritable bowel syndrome. Here’s the question I posed. What gives us hope when we no longer seek the removal or end of an illness? Most people come to counseling because they want to make their marriages better, end depression, find a new career, etc. But would you go knowing that all you can do is find marginal improvement and new ways to accept a chronic condition?
We discussed the unique problem of receiving endless advice (“Have you tried this? Have you considered that?”), the tendency to resist new ideas even while hoping a miracle will come along, and the fear that others will believe that your chronic condition is, “all in your head.”
Back to the question we asked, “What gives you hope when you don’t hope it will get better?”
Some answered that they found hope in finding other similar sufferers (though some danger in connecting with someone who only wants to vent). Others found hope in those who would be willing to listen and validate and help articulate lament. Still others found hope in those who would help them find just one more thing they can do to cope.
What would you find helpful and hope building?
The faculty blog at Biblical Seminary has posted one of mine about mindfulness from a Christian perspective. Actually, it is a call to develop a theology of mindfulness–or what I prefer to call watchfulness. While you are there, check out some of the other postings by my colleagues.
Next Monday is the last night of my Counseling & Physiology class (well, last night for the students as I have a boatload of papers to read and grade). As you might imagine, we spend a bit of time talking about psychotropic medications, their value, and probable side effects. Most students fall into one of two categories. Either they have personal and (largely) positive experiences with medications or they have concerns about side effects and observe the tendency of our culture to over-medicate.
But, it would probably be good for me to remind students that there are side effects to counseling or therapy as well. Most clinicians are trained to inform their first time clients that things sometimes get worse before they get better. Counseling requires that you attend to your problems, problems that you may have been in denial about. Talking about painful things usually means you think about them more outside of the hour with the counselor. In addition, you may find that the problem you entered with was only the tip of the iceberg. Or, you may find that the work to be done in therapy is much harder and slower than you thought, or the solution much different than you imagined.
There are a few other side effects that are worth pointing out.
Yes, counselors ought to talk to their clients about the side effects of proceeding in therapy (both general and specific to the particular intervention). Not to have this conversation is to not serve the client well. They need to know what they can expect from you and what other options they might choose. Of course, we also should discuss the side effect of doing nothing at all.
Filed under christian counseling, counseling, counseling science
At a recent conference, Diane Langberg submitted the following definition of Christian Psychology. I present it below, verbatim, for your consideration. In some ways she doesn’t say anything new. However, it is quite different from our usual definitions.
Let me explain my seeming contradiction by first giving you C. Stephen Evans definition of Christian psychology,
[It is] psychology which is done to further the kingdom of God, carried out by citizens of that kingdom whose character and convictions reflect their citizenship in that kingdom… (p. 132)
As you would expect, Dr. Evans offers a philosophically astute definition.
Or, consider Eric Johnson’s tome, Foundations for Soul Care: A Christian Psychology Proposal. In this book of 700 plus pages, he explicates a Christian psychology framework as doxological, semiodiscursive, dialogical, canonical, and psychological approach to soul repair. If you are looking for a theologically and epistemologically rich entry point to Christian psychology, I can’t point you to a better place than this book.
Like these two examples, many of our current definitions focus on matters of epistemology, theology, and psychology. Many definitions also emphasize the work of critical evaluation of existing psychological theory and research.
Now turn to Dr. Langberg’s definition. Notice how she emphasizes the character, the preparation, and actions of the counselor. Notice further that the focus on outcomes is bidirectional–on counselee and counselor.
Christian psychology as practiced in the counseling relationship is a servant of God, steeped in the Word of God, loving and obeying God in public and in private, sitting across from a suffering sinner at a vulnerable crossroad in his/her life and bringing all of the knowledge and wisdom and truth and love available to that person while remaining dependent on the Spirit of God hour by hour. That work, no matter what you call it, will be used by God to change us into His likeness; that work will result in His redemptive work in the life sitting before us; that work will bring glory to His great Name.
What I take from Dr. Langberg’s definition is an emphasis on action, the Spirit’s work and the counselor’s work (in self and other). While the epistemological definitions are necessary if we are going to think critically about our work, so to is this action-oriented definition. It reminds us that for all our thinking and theorizing, it is God’s work in our private and public lives that is used to bring healing and hope to others.
Your thoughts?
Just read Lori Gottlieb’s “What Brand is Your Therapist?” NY Times Magazine essay. It is a worthy read for all new (and some of you older) therapists out there. I say this not because I agree with her methods or goals (i.e., easy clients who don’t cry), but because it points to the need to sell/brand as a counselor.
Those of us who get into the helping business rarely think about these things. Lots of people need help. I want to help people. Voila, I can make a living helping those in need. To accomplish this goal, we spend most of our time in school trying to learn that art of therapeutic relationships, diagnostics, and intervention strategies.
All good, but something is missing! Your brand!
As Lori points out (or more specifically, her branding consultant),
“Nobody wants to buy therapy anymore,” Truffo told me. “They want to buy a solution to a problem.” This is something Truffo discovered in her own former private practice of 18 years, during which she saw a shift from people who were unhappy and wanted to understand themselves better to people who would come in “because they wanted someone else or something else to change,” she said. “I’d see fewer and fewer people coming in and saying, ‘I want to change.’ ”
There is truth here. Given the economy, given the culture, given the flood of counselors in some locations, therapists do need to find ways to let people know what they provide. And yes, selling is important. Preachers sell when they preach (otherwise, they should just read Scripture and sit down). So too, counselors sell to interested clients.
What is your brand?
Now, our sales need to be honest and accurate. We don’t sell quick fixes (though we might sell short-term solution focused interventions such as marriage tune ups or parent training). We don’t sell change we can’t deliver. But within these parameters, we ought to consider branding our work. My friend and career counselor, Pam Smith, encourages her clientele to develop elevator statements (be able to articulate what you do in the space and time of an elevator ride). I imagine that branding is similar.
While developing a brand won’t make you a better therapist, the lack of some semblance of brand probably means few will find out what kind of therapist you really are. Don’t be turned off of branding just because there are those who care more about having a brand than actually doing something of value. Maybe a better way to think about it is to ask, “Lord, in what ways do you seem to be calling me to your mission?”
Filed under christian counseling, counseling, counseling skills
Last Monday night we had the privilege of having Dr. Diane Langberg on campus to speak to our counseling students. One of the 4 talks she did was entitled, “The Spiritual Impact of Child Sexual Abuse.” She stated that it was material that she developed after publishing her book, Counseling Survivors of Sexual Abuse. As you can imagine, she gave us a very powerful talk. But of all the things she said, one idea seemed to hit students and faculty alike. I do not have her quoted here but rather the essence,
I’m not doing justice to her thoughts here. But, I think she nails it. Sexual abuse destroys relationships, faith, trust, identity, and physical bodies. To grieve is to name and acknowledge what was lost, broken, stolen, etc. and to admit that many of the broken things cannot be restored in this life–at least to the levels that we desire. The work of counseling surely includes coming to a correct understanding about guilt, shame, love, boundaries. The work of counseling is about reconnecting with God and others. The work of counseling is about rebuilding identity. But, all of these activities require grieving what did take place, grieving what was lost (real or symbolic).
Most of us, whether we have suffered abuse or not, would rather not sit with grief. And so, we run. However, if the heart of God is shown in lament for the world that is not as it should be, then we ought not to run from grief.
May God show us how to lament and live in peace at the same time.
Filed under Abuse, christian counseling, counseling, Diane Langberg
There was a recent conference in Tennessee where the authors of the recently published, “Five Approaches to Counseling and Christianity” (IVP) presented their approaches, dialogued with each other, and showed brief vignettes of their counseling model in action. You might like to see some of the papers and slide presentations by each of the authors. Do so by following this link. At the bottom of each bio, you can find the link to their presentation. They do not have the video clips of counseling available. I, for one, hope they make them available for sale. Despite the diversity of theories, I suspect their actual counseling activities do not differ all that much.
Phil
I have another post over at the Biblical Seminary faculty blog describing three reasons why we require our counseling students to attend our program retreat each fall.
Filed under Biblical Seminary, christian counseling, counseling
I’ve written about this topic here and here before. In those posts I argue that there is a better question for counselors to consider than the one of culpability. Last night, we started the 2012 edition of Counseling & Physiology with the question of culpability and whether or bodies/brains can cause us to sin outside of our will. We also looked at our tendency to focus on judging whether a person is culpable for their sins (e.g., someone with Tourette’s who swears, someone with a TBI who is easily enraged, someone who is chronically anxious or still another who falls prey to addictive behavior). One of my main goals was to get students thinking about whether they under or overestimate the body’s role in counseling problems.
In the second post listed above I indicate the possibility of a better question than culpability. However, one of my students last night raised a question that went something like this,
Doesn’t the fact that you will choose how to respond to a client indicate that you have to judge the cause of the problem? If you encourage a client to consider psychoactive medications, aren’t you suggesting it is a body problem? If you focus on habits or heart issues, aren’t you assuming the problem is primarily a spiritual, will or behavioral control problem?
This was a great question and my answer was something like the following.
No and yes. Functionally, you will choose an area to work first. This does not mean you think that the type of intervention you choose indicates the main problem. It may only indicate that you think one intervention is an easier entry gate to counseling than another.
Here’s an example. Even if my client is severely depressed and I believe that the primary cause of this depression is their longstanding bitterness and anger towards God, I may encourage a psychiatric evaluation and the consideration of an antidepressant. It may be that once their mood improves, we can make better progress in investigating some spiritual matters in their life.
Human sins and weaknesses have multi-factored sources
Have you ever thought of the various sources of human sin? Here’s a visual of all of the things I think of that are a part of nearly every human sinful behavior. The sizes of the factors surely change depending on the situation. For some, will, high-handed rebellion, may be most of the pie. In other cases, bodily weakness may be the prime source. Also, some of these surely overlap and are not distinct. I may have started out in a rebellious state when I started doing drugs. Now, my body and psychological habits are equal players in why I maintain a drug habit.
What else would you add to this chart? Note that I place “will” in the smallest concentric circle. I imagine that we have far less conscious control over sin than we sometimes ascribe. Habits, unconscious motivations, and foolish (unthinking) choices probably dictate more of our behavior than our direct, willful, planned rebellion. Of course, none of this has ANY influence over culpability or morality as Scripture clearly indicates our guilt even when we are unaware of the Law’s commands. When Jesus says, “Father, forgive them for they know not what they do,” it tells us that consciousness of sin has little to do with our need for forgiveness.
Filed under biblical counseling, christian counseling, christian psychology, counseling, sin
Musings on Faith and Psychology 