Category Archives: christian psychology

What makes you feel like a ______ (man/woman)?


In a weak moment last week when I couldn’t take NPR or news radio I surfed the local radio stations in my car. Here are two phrases I heard in the span of 5 minutes. I have no idea who the artists are nor am I all that interested…

“Man, I feel like a woman.”
“I’m yo man…” (but something about needing to get down at her place because he had a girl at home)”

Suffice it to say I’m not going back anytime soon to the music on the radio. But, I will admit it got me thinking about how we know what feelings are quintessentially male or female. In the first song the woman feels like a woman because she has the power of attraction but does her own thing. In the second song, I assume the male singer feels like a man because he can sexually please a woman all night long.

What makes us male or female? (No, I’m not talking genetics here.) Sometimes we look at behaviors and interests. Sometimes we look at attitudes or attraction to the opposite sex. But most of the time I think we look at how others perceive us. If they treat us the way we think our gender should be treated (or, is commonly treated even if we don’t like it), then we feel like our gender. When we are invisible to others, treated differently (or so we perceive) based on our interests, behaviors, body type, etc. then we may feel that we are not like most of our gender.

Why is this important to consider? I have clients who have wondered about their orientation due to their feeling different than most of their friends of the same gender.

The simple answer is to assume that God makes a diverse group of males and females and that we ought not interpret our differences as having that much meaning. Of course, we rarely find the simple answer helpful. So what are we to do when we do not feel like others of our gender? Is this a big issue out there or just something we counselors see?

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Filed under christian counseling, christian psychology, Cultural Anthropology, Identity, Psychology, sexual identity, sexuality

How do you listen to people’s problems all day long?


This is a question we counselors get from time to time, especially when someone is embarrassed that they need a counselor or think they shouldn’t be having problems (or that they are weak for having them).

Today in staff meeting we watched a video on vicarious trauma. This term has been mis-identified with burnout and secondary trauma. In short it isn’t about our symptoms or having our own trauma but about the changes in us after taking in large amounts of other people’s pain.

Individually, hearing any one person’s problems isn’t much of a burden. But when you add all together it gets heavy at times. What do I mean? Well, we begin to see danger of abuse everywhere. We begin to think that all leaders are abusing power. Interestingly, one of the speakers on the video said that early career therapists tend to struggle more with fears and later career therapists struggle more with cynicism.

Most of the problem is the result of the loss of hope. And yes, therapists sometimes lose hope. That is why we have staff meeting so that we can remember that hope comes not from our ability to change the world but that we fallen creatures look to the power of the cross to change us and our clients.

I’m not sure what nonbelieving clients hope in and how they manage living with the weight of the brokenness in the world.

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Filed under Abuse, christian counseling, christian psychology, counseling, counseling skills, Psychology

Power grabs by therapists


We counselors and therapists have ways of asserting our power over our clients. Usually, we do it via subtle messages and phrases. I was reminded of this fact last week during a seminar by Paul Wachtel of CUNY. He told of a case he had of a semi paranoid and hostile client who made many complaints. After one such complaint against him, Wachtel responded with,

Isn’t it interesting that you see me as being just the way your father was

These type of insights offer pseudo-neutral “observations” that are really accusatory and given to show our intellect (but draws them away from their affective state). Further, when we are irritated and make a statement like this we are really saying that my frustration isn’t about me but is about you. I’m objective here, you are not.

When we give insights to clients we need to ask whether or not the client already understands them, will feel that we are working WITH them (not talking at them), and be motivated to do more exploration. As Wachtel stated, insights are often “implicitly adversarial” (never about us either!).

These kinds of linguistic power grabs aren’t just done by analytic oriented therapists (who might be inclined to make distant insights into clients’ unconscious). Cognitive therapists do the same by implicitly and explicitly telling clients that they are irrational and if only they could think like we therapists, they would be so much better.

Let’s not forget that the words we use with clients tell something about ourselves–maybe more than we wish they would.

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Filed under christian counseling, christian psychology, Communication, counseling, counseling skills, Psychology

Last Practicum Monday: Christian counselors in a secular world


Today marks the end of the 2007-8 school year for our MA Counseling students. Some have completed their final credits and others are half-way to their diplomas but I’m sure all are glad the school year is over.

Our students here do fieldwork in a variety of settings: churches, christian private practices, nonprofit social services (hospice, pregnancy centers), and secular or state/federal financed mental health facilities. Those who work in secular settings are often faced with questions about their faith from colleagues and supervisors. Are they going to try to get their clients saved? Will they leave their faith at the door? And students struggle to know what to do with helping clients in some ways (new communication skills) but not being able to help them in deeper ways (putting trust in God during difficult times). Just how should Christians working in secular mental health agencies function? 

First, I very much believe that Christians should be in all aspects of society if they have any hopes of being salt and light in the world. Far too frequently we sequester ourselves from the world and then wonder why they persist in using caricatures of us.

So, if we are going to be in the world but not of it, how might we do it as counselors in a secular setting? I suggest 3 things to consider as we interact with supervisors/colleagues, clients, and our own self:

1. When dealing with an  Agency/Supervisor/Colleague

  • Get to know your context and its/their history with Christians and Christianity
  • When you hear slams or other suspicious questions be sure to explore the “back story” and validate, if appropriate, the bad experiences with naive or offensive behaviors by Christians
  • Discern who you might be able to have a reasonable conversation with regarding the nature of faith and psychology, philosophy of science, ethical care of people (including the exploration of their faith traditions), and the fact that all counseling is evangelistic to some construct of health). In this conversation be sure to using starting points that the other will understand (e.g., ethics, empirical evidence, concerns, etc.) just as St. Paul does at the Areopagus.
  • Communicate that you do not see your job as coercing anyone. You are not responsible for our clients behavior, neither are we for their beliefs. When we raise questions about faith it is to provoke their thinking a bit further

2. When dealing with clients

  • Be sure to ask early in clinical work about faith traditions, current practices, and experiences. These questions fit with what the AMA suggest as important for healing, as community and spiritual resources are quite powerful in the medical literature
  • When given an opening (e.g., questions about God, faith, etc.) pursue gently NOT with statements but questions that may reveal further beliefs, fears, wants, desires, demands, etc.
  • Further, ask how they came to believe what they do believe
  • Point out inconsistencies in belief/behavior; raise possibilities, pros/cons, potential places for hope that may lead to further discussion of God’s handiwork in their lives; Point out places where they seem to recognize their inability to love enough, tolerate enough (gently of course)
  • Be wary of the habit of “telling” others the truth. Many times clients already know the “right” answer. Exhortations may be useful at times but more often than not they cause individuals to become passive–even when they agree with your point.
  • Be ready to answer their questions about YOUR faith with honesty (e.g., what does belief in God look and feel like when everything is caving in?). Be sure not to sugarcoat the Christian life. Be ready to talk about your hope in a broken world (not just for eternity but for now)
  • And if you do talk about your faith, immediately turn it back to them for them to react, explore, challenge, etc.

3. To ourselves

  • Answer the following questions
    • Can I work with integrity within this system?
    • Is giving a “cup of cold water” (e.g., better communication skills) enough for right now?
    • Can I defend what I do say about the Christian faith in my sessions?
    • Am I giving the impression that I believe that there are many ways to God?
  • Develop a theology of mercy ministry akin to God’s providing rain, sun, and health to the just and unjust alike

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Filed under christian counseling, christian psychology, Christianity, church and culture, counseling, counseling and the law, counseling science, counseling skills, Evangelicals, philosophy of science, Psychology, teaching counseling

Are counselors and psychologists an impaired lot?


We’re closing in on the last of the school year. Two weeks to go. Tonight in our ethics class we’ll be discussing the matter of abuse of power, impaired clinicians, and similar issues. In the world of counseling we discuss the problem of impaired counselors/students/trainees when we talk about those who,

(a) do not have the requisite skills, 
(b) have character/attitude deficits, or
(c) reactions to current crises,

AND are unwilling or unable to repair the situation.

First, we ought to be aware of those who are attracted to being counselors. Jeffery Barnett, et al, report the following data from other studies (as cited in the 2007 Professional Psychology: Research & Practice, 38(6), pp 603-612):

  • 70% of female psychologists had been either sexually or physically abused as children
  • 33% of male psychologists report the same
  • 33% of psychologists report being abused as adults
  • They feel the effects of these difficulties (and other family crises) just as non counselors
  • They may be less likely to get help due to knowledge and professional identity
    • 60% acknowledged being significantly depressed during some point of their career
    • 29% reported being suicidal at some point
    • 4% had made suicide attempts

Gizara & Forrest (2004 Professional Psychology: Research & Practice,35(1), pp 131-140) reported supervisors experiences of trainee impairment in APA accredited internships (doctoral level). Many of the supervisors had a hard time defining impairment in counseling but had sort of what I call the “I know it when I see it” mentality. What they often described were the disruptive, persistent relationalconflicts that are obvious to most. They did identify that it is hard for supervisors to address these matters because they (a) are trained to be empathic and to try to save everyone, and (b) not wanting to deal with conflict, destroy a career, or make oneself vulnerable to attack that they are holier than thou.

But, I noticed not much discussion or research regarding the one who doesn’t have obvious abrasive relational skills who is prone to using clients and others to make themselves feel good. This kind of person is dangerous not because they disrupt the counseling center but because they are so well liked that they make others overlook “minor” ethical infractions. Further, the person is rarely cognizant of their using others for their own sense of well-being.

To answer my question. No, I don’t think counselors are an impaired lot–at least any more than others. If we are aware of what drives us to be counselors (the good AND the self-serving), are willing to be counseled, discipled, held accountable, etc. (are willing to be transparent), and see our work as God’s first, then I think we are rather a safe lot.

Watch out for those of us who think we have arrived or no longer need teaching. I’m reminded of Aslan’s question to Prince Caspian at his coronation:

Aslan: Do you feel yourself sufficient to take up the kingship of Narnia?

Caspian: I-I don’t think I do sir. I’m only a kid.

Aslan: Good, If you had felt yourself sufficient, it would had been a proof that you were not.     

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Filed under Abuse, biblical counseling, christian counseling, christian psychology, counseling, counseling science, counseling skills, Psychology, Relationships, self-deception, teaching counseling

Take your first course at Biblical, get a free gas card!


Okay, so it might not be an even swap, but it will pay for your gas to get to Biblical this summer. If you’ve never taken a course at my fine institution, here’s a little incentive for you to do so. We’re offering 2 counseling courses (Leslie Vernick’s 1 weekend course on Destructive Relationships and another 2 weekend course on counseling people with addictions) and two other courses. One course is mostly on-line with just one campus visit (Group life in an eWorld). So, check out this PDF flyer for details or www.biblical.edu for more details such as class dates/times.

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Filed under Abuse, addiction, Biblical Seminary, christian counseling, christian psychology, teaching counseling

Practicum/Ethics Monday: Multiple Relationships


All counseling ethics codes address the potential problem of multiple or dual relationships (when counselors have other relationships with their clients or former clients (e.g., counseling a friend or a child of a friend, having a former client as a business partner, etc.). Some codes make it appear that dual relationships are either always or likely wrong and so should be avoided. The AACC code is a bit more liberal in that it (rightly) defines the problem as increasing the problem of exploiting or harming the client. However, this code explicitly defends the biblical nature of dual relationships since we are all brothers and sisters of the same body. Other codes have recognized that it is not possible to always avoid dual relationships. But all codes remind the counselor that it is their duty to defend the healthiness of any dual relationship. In essence, it will be “guilty until proven innocent.”

There are 3 forms of dual relationships (sexual and client; nonsexual social and client; financial and client). Not every dual relationship is with the client (e.g., a counselor has a relationship with the mother of a teen client, a client is under discipline at your large church where you provide consultation to the elders). Dual relationships may happen AFTER counseling is over (begin a friendship with a former client). Finally, it is not merely harm or exploitation that may be the negative outcome of a dual relationship. A counselor may find that a dual relationship hinders or decreases her effectiveness to provide adequate care. [See Lamb et als article in the 2004 Professional Psychology: Research & Practice (35:3), pp 248-254 for a study on these issues].

This last one is the one I want to hang out with for a bit. I had a former client who I had known and highly respected before we started counseling. At the beginning we explored the potential harm that might come from this dual relationship. Both of us deemed that we could manage the slight dual relationship. And I think we did well and the client found the counseling helpful. However, there was a period in the counseling where the client became severely depressed and suicidal. I found myself less willing to hospitalize because I had an image of this client in my head that was much more stable than was actually true. Now, I never like or want to hospitalize. Most psych hospital stays provide protection but little more in the way of healing. But, I know I would have been much quicker to pull the trigger (bad pun I guess) if I hadn’t previously formed an opinion of health before starting the counseling relationship. We should not forget the possibility of reduced effectiveness in dual relationships.

Let me take this one step further. You may have a client who shares your same faith or doctrinal positions, graduated from the same school (but a different time). Any of these connections MIGHT cause you to be less effective in your work because of bias, groupthink, etc. These are not reasons to NOT counsel them but things to keep in mind. Reduced effectiveness because of dual relationships should not be neglected just because we are too busy talking about the rare counselor who decides to have sex with his clients.

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Filed under christian counseling, christian psychology, counseling, counseling science, ethics, Psychology

Practicum and Ethics Monday: Deficient Trainees


Since both of these classes are in progress here at Biblical, I thought I’d bring up a rather touchy subject: impaired students. Ruth Palmer, Gwen White, and Walter Chung (a Biblical grad!) all of Eastern University have recently published an article in the Journal of Psychology and Christianity(2007, 27:1, 30-40) entitled, “Deficient Trainees: Gatekeeping in Christian Practitioner Programs.”

Palmer et al surveyed profs in master’s level counseling related departments at Christian colleges and universities to find out, 1. what percentages of students were perceived by the profs to be professionally deficient, to have received help or dismissal. 2. Whether or not the schools have formal gatekeeping procedures. 3. Whether senior level faculty and junior level faculty perceive the pressures of dealing with impaired students differently, and in part, 4. Whether views on grace, calling, and gifting have any effect on how faculty respond to deficient students.  Their study replicates one done on secular campuses.

Before I mention the results, it would be good to consider why this is important.

1. Because faculty are obligated to protect the public. The authors quote from the ACA code of ethics, “Counselor educators, throughout on-going evaluation and appraisal, are aware of and address the inability of some students to achieve counseling competencies” (ACA, 2005, Section F.9.b) (p. 31). This is a relatively new topic amongst programs. Previously, we merely taught our students but it was up to licensing boards to weed out incompetency. Not so any longer. And rightly so is this change. We have an obligation to remediate problems before sending folks to their fieldwork sites. When we bless a student with an internship, we are saying they are ready to work at an entry level. When we find students with significant relational, behavioral, motivational problems prior to graduation, the authors remind us that the data are “strongly linked to subsequent poor performance in clinical work. (p. 31)

2. Counseling programs tend to attract people who are working out their problems. In fact, the authors point to a study that reported first year counseling students showing more severity of problems on MMPI scales. (This may be partially explained away by the common tendency of students to think they have all the disorders of the DSM). While this isn’t necessarily a bad thing (could mean that students are more likely to be cognizant and empathetic to the trials of life), it becomes a problem when said students are either unaware of the extent of the problems, unwilling to work on these problems, or so overwhelmed in the moment as to not have the capacities to deal properly with the problem. I find most students very committed to personal growth and change. There are those, however, who are so desirous of the prestige of the position or of looking good that they cannot bear to admit their flaws. The authors point out the crux of the problem. “…there is a tendency of impaired students to resist submitting to ‘the very therapeutic process through which they wish to lead others,’… (p. 31)

3. Finally, turning a blind eye to student problems and/or mismatch in skill/profession/calling is akin to walking around the man and left to die on the side of the Jericho road (Luke 10).

Results of the study? The authors got responses only from 1/3 of the surveyed professors (the surveyees should be ashamed at their lack of cooperation with this important study! They ought to know better having all been through programs that value the research question). But from respondents they found,

  • Faculty of CCCU estimate an avg. of 10.9% of impaired students in their program (SD=9.89; I would have liked to see the modal response since the range was from 0% to 50%!! reported). This fits with the prior secular program survey.
  • Interventions with these impaired students only happens about 50% of the time (again a big SD with response rates ranging from 0% – 100% (yeah, right!)). 38% of faculty reported interventions less than 20% of the time.
  • What are some of the bigger reasons for not addressing these matters formally? Fears of lawsuits, institutional pressures (we need students to survive!), fear of poor teaching evals by junior faculty, and inadequate administrative support.
  • They suggest the need to have departments talk regularly about policies, students, and the need to follow-up with potential or actual problems.

Do we ever have impaired students at Biblical? Of course. But I am determined at dept chair to help those in need find help. I remember being a student at another seminary and seeing those that EVERYBODY knew should never be a pastor or a counselor and yet NOBODY (student or teacher) said a word. So, we have 6, 12, and 18 month evals collecting data from the student, profs of each class, peers, mentors, and supervisors to help catch a remediate problems when they exist and to encourage on-going personal growth even when they don’t exist. It still surprises me when I find counseling students balking about getting some of their own counseling. We really do want to be the one who has it together, don’t we. Me included.

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When a good label loses its value, or, should we rethink labels altogether?


Ever found a word, term, idea that had great meaning for you become useless or degraded because it became popular? Well, maybe that only happens to academic and clinical types. As a counselor terms like idols of the heart, Biblical counselor, integration, christian psychology all are meant to help individuals identify themselves and shape a conversation. At Biblical Seminary, we are attempting to train students to think “missionally.” When we started down this path, not many were using the word. But now it seems everywhere and used in so many ways that make you question whether the word really has any meaning.

So, I’ve had these thoughts from time to time but last night I was reading Paul Wachtel’s (professor at CUNY) “Relational Theory and the Practice of Psychotherapy” and he had this to say about one of his terms, relational. You could easily replace all the relational words with your own favorite term.

[The relational movement] is a loose coalition that is encouraging a diversity in viewpoint rather than seeking to impose a new orthodoxy. But this diversity of meanings also introduces confusion. Students in particular often are unclear about just what it means to be relational, both theoretically and clinically. Some, for example, (mis)understand being relational as being almost relentlessly self-referentially interpreting everything that transpires as being about the therapist.

In part, the problem lies with the very success of the relational movement. As the term “relational” has come into broader and broader use in recent years, there has been a corresponding decrease in the degree to which it communicates a clear and unambiguous meaning. This is perhaps an inevitable cost of success; relational perspectives have become increasingly prominent in the field of psychotherapy, and we have reached a point where many people want to jump onto the bandwagon. As more and more people use the term, sometimes more as a token of membership in a movement to which they wish to belong than as a substantive reference to a clearly specified set of theoretical premises and practices, the ripple of meanings makes a phrase like relational psychotherapy less than ideally precise.

Labels like relational, object relational, classical, or contemporary Freudian (to use examples from the psychoanalytic realm) often serve less as a medium of illuminating discourse than as a functional activity of boundary making, akin to the way our animal cousins leave their  scent to mark off the boundaries of their territory. “I belong here, you belong there,” may be a sentence; but it is a sentence whose message is not very different from what is conveyed by the glands of our mammalian kin. (pp 7-8)

He goes on to say that words should not merely make boundaries but to “alter and complicate” them through the act of conversation. While there are boundaries, they do move and change and no one human created word will adequately separate the sheep and goats, to mix my metaphors.  

So, what do we do with labels if they lose explanatory power when others find them helpful? Get rid of them? Or, do we use them with greater and greater humility. I like Wachtel’s description of the problem with another set of labels, 1person and 2 person approaches to counseling (1 person refers to analysis where the client monologues and interacts with their own psyche and 2 person approaches tend toward a relational, experiential interaction). Wachtel holds a 2 person theory. But here’s what he says,

To begin with, it is worth noting that the distinction [between the two labels] is almost always employed by putative two-person thinkers, as a critique of one-person modes of thought. There are rather few writers who defiantly proclaim, “I am a one-person theorist and proud of it,” although there are, of course, many writers who declare themselves to be proponents of the models that are called one-person models by two-person theorists. Writing as someone who, if the dichotomy is usable at all, would without question fall on the “two-person” side of the divide, I must say I find it disquieting to be characterizing competing theorists in a way they do not acknowledge as the basis of their own thinking.

This lack of acknowledgment on the part of “one-person” theorists, of course, does not in itself invalidate the critiques. It is certainly possible that critics of one-person models are recognizing something about the theories they are criticizing that their advocates do not. Indeed, in certain respects I myself believe this to be the case. It does, however, raise a question as to whether there might be a way to frame the critique that would be more illuminating and experienced as less of a straw man by more traditional theorists.” (p. 11)

I think Wachtel is helpful here and I have said similar ideas in the past. We need to be willing to come at a situation with differing dividing markers than we may have used in the past. For us Christian counselors, this is especially true. Mark McMinn considers himself to be an integrationist. But, his recent book, reviewed here, shows willingness to describe his model in ways that might make older integrative folks uncomfortable (i.e., giving Scripture trump power). So, we need new ways of looking at the data and less focus on division and more focus on description. Maybe we take a little longer look to see what is shared in our venn diagrams… 

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Filed under book reviews, christian psychology, Communication, Cultural Anthropology, Doctrine/Theology, Great Quotes, missional, Missional Church, Psychology

Context and our perceptions


It shouldn’t be a surprise that context is everything when it comes to perception. Win the the 10 million dollar lotto and then have your car run over by a Mack truck (assuming no one was in it) and you probably laugh it off and go buy your dream car. Context changes how you perceive the event.

I had two reminders of the effect of context last Friday. First, I was on my way to a meeting and listening to an NPR show. The host of the show was interviewing Gary Marcus, NYU psychology prof and author of Kluge (a book on the mind). Though parts of his interview annoyed me greatly, he talked about contextual perceptions by pointing out this research tidbit (my words not a quote).

If researchers ask individuals (a) if they are happy, and (b) how many dates they have had lately they get one set of results. If they reverse these questions, the answer to the happiness question is clearly influenced by the answer to the dates question. I may in fact be happy until you remind me that I haven’t had any dates lately.

Second, at my meeting we were discussing perception of change in clients. Imagine this scenario:

You are working for 6 months with a man helping him to accept responsibility for his addictive behavior (you can substitute addictive with just about anything that needs change). The change has been painstaking but he has indeed begun to see his self-deception and begun to stop blaming his past for his present behavior. About this same time you hear that his wife would like to come in to a session. You invite her and when she comes with her husband you ask him to tell his wife what he has been learning. As he does you see her roll her eyes and smirk. You check in with her and she is absolutely livid. From her vantage point he hasn’t changed a bit. Sure, he’s not drinking anymore, he’s not beating her up, but did you know that he’s become rather obsessed with work, he still doesn’t call to tell her that he’ll be late and he won’t stop overspending each month. And worse for her, now he wants to have sex (in the past he avoided her) all the time. You acknowledge he has lots of work to do but you also realize she feels threatened to admit he has begun to change. If she does, maybe he’ll stop…

Notice how context influences our perceptions. If you think someone has come miles and miles in personal growth you likely get pretty excited. If, however, you focus on how far they have to go, your perceptions will be a bit more pessimistic.

Now here’s the challenge. How do we stop believing that our context is the only context for viewing experiences? It takes openness and empowerment and ability to see two things at once without demanding that one view overpower another. As Christians we must live in this bifurcated life. We are sinners…saved by grace. We are maturing…but never arriving. We are mistreated…and protected by God.

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Filed under Abuse, christian psychology, Cognitive biases, Insight, Psychology, Relationships