Category Archives: Christianity

Overspiritualizing invisible wounds?


When someone suffers an obvious injury to a leg it is clear to us that this injury limits prior capacities for walking, running, standing, and other things we do with our legs. If the injury is slow to heal, would we be likely to tell them to act as if the injury never happened? No. We can see the injury, its effects, and we recognize that recovery may be limited. We would be unlikely to judge the person for failing to run like they had prior to the accident. Of course, physical wounds will prompt spiritual concerns, from “where was God…?” to trusting God for the future even while continuing to experience pain symptoms and the inability to complete tasks that used to be easy.

But what about the wounds we can’t so easily see?

Sadly, I think we spiritualize them and do judge others for having them. Take for example a victim of abuse or trauma that results in a diagnosis of Posttraumatic Stress Disorder. We see no obvious wound. The body looks sound and fit. So, the anxiety we see, the hesitancy to trust others, the mental confusion, the inability to sleep well…these symptoms must be primarily evidence of a spiritual problem, right?

Wrong, at least in part. While we rarely see the damage done to victims of trauma, changes to the brain are nonetheless present. Here’s a couple of things we think we know about trauma and the brain:

  • The brain is an adaptable organ and use-dependent. Activity along neural pathways can become more efficient with practice (i.e., the more something happens, the easier it is for the brain to respond). So, certain pathways and structures in the brain become more easily activated
  • Observing activity brain scans in those who suffered severe traumas such as child abuse, we see evidence that the part of the brain that processes emotion seems to be routinely overactive. Likewise, the part of the brain that provides conscious analysis of where we are in time and space, seems underactive when emotional processing increases. This activity problem (too much in some areas, too little in others) appears to cause individuals to relive/re-experience trauma and have less capacity (in the moment of reliving) to talk back to their feelings (analyze what is happening) or explain it to others
  • Along with these structures, hormone feedback systems appear to produce fight/flight hormones in the presence of triggers

Simplistic as my points above are, I hope you can see that a person has little conscious control over these reactions in any given moment. Now, there are things that can be done to help the brain adapt and respond better, but the fact of being triggered is not the result of not trusting God.

So, consider the multiply-traumatized man in your church who reacts negatively to well-intentioned requests to join a small group or to be prayed over with the laying on of hands. Is this because they do not trust God, are sinfully fearful, or evidence of invisible wounds of PTSD? I suspect some would be inclined to assume this man had a spiritual problem. In fact he may, but the reaction he is having is most likely not that problem.

A Better Question

Recently I asked my students to consider this question: What does faithfulness look like for the Christian who is suffering pervasive panic? Does it mean an absence of fear? Forcing themselves into situations that will flood them with panic? How would you answer this question? Are the evidences of fear in your life a sign you do not trust God? Can you acknowledge fear and still trust God? What does that look like for you?

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Filed under Abuse, Christianity, Post-Traumatic Stress Disorder

Roger Goodell wants to “get it right”: What has to change in the NFL to stop domestic violence


In a press conference today  Roger Goodell apologized for mishandling recent domestic violence scandals and provided specific ways he and the NFL planned to rectify the situation (e.g., education, training, funding national domestic violence and child abuse prevention organizations).

“I got it wrong in the handling of the Ray Rice matter. I’m sorry for that. Now I will get it right.”

Some of the intended efforts should have a positive effect, both for the NFL and for the larger society. However, if Goodell is serious about changing the culture of the NFL and society, he needs to take a step back from these good ideas and start by identifying the roots of the problem. Without getting the root, this problem will not be solved.

What is the root that has to change? Let me list two that must be addressed:

  1. We have to stop treating women as objects to be sought after and conquered. An object has no feelings and can be used however I wish. It has no rights, no value…unless I give it value. When we treat women as objects, then we only give them value when we chase them. And when they displease us, what is the big deal if we attack and treat without regard to their personhood? Last summer I heard an African man say that his wife was property because he had paid a dowry for her. Sure, she was special property and he took great care of her. But still, she was property and he could do with her as he wished. We in the West may think we are enlightened, but when we engage in domestic violence (and DV is more than physical!) we agree with this man–that our wives and girlfriends are property, something to be controlled.
  2. We have to stop treating top athletes as having special privileges, as individuals who do not need to conform to social rules. When you believe the rules do not apply to you, then why not get revenge when someone irritates you? You won’t be held accountable. When you see an attractive woman, why not do everything you can to get her into bed? Faithfulness, self-control, respect for others…those don’t apply. I have been told that women working for the NFL are nearly tortured by efforts to get them into bed; that it is nearly impossible to do their job due to the sexual harassment. Some may suggest that any woman working for the NFL ought to know what she is getting into and so has no right to complain. Others might acknowledge the problem with a sigh but point out that the warfare culture of football, the lure of fame, youthful temptations brought on by sudden riches, and the insatiable competitive spirit are to blame for these misdeeds. Baloney. Youth, money, fame, and testosterone may make it more difficult to do the right thing but the problem started long before these young men got their first football check. They were treated as gods and allowed to keep playing their sport when they acted out. Winning and being associated with winners tempted us to look the other way. How do I know this happens? Because I’ve been in a locker room before. Inappropriate speech was ignored, even laughed at. If you learn that rules don’t apply as a child, why will you behave when you are older?

How about a new institutional organizing principle? Out with self-promotion (and self-protection) and in with… 

In the past, organizations, including religious ones, often made decisions about mis-deeds of members by delivering consequences when it hurt their image (or more accurately, hurt their bank accounts). If we want to put a dent in the number of cases of violence (that is all we can do, keep offenders from re-offending under our own watch), we will have to stop being so concerned about image and start putting the care of the most vulnerable as job one.

Want to change the NFL and the world about domestic violence. Let us each start with ourselves and let us adopt this often repeated line of Jesus

“Anyone who wants to be first must be the very last, and the servant of all.”

That is all there is. Die to self, love others more than yourself. Thank goodness Jesus didn’t merely give us sage advice but led as an example thereby giving us his power to love beyond measure.

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Filed under Abuse, Christianity, Christianity: Leaders and Leadership

Criticism of Biblical Counseling: Are Joyce’s Concerns Valid?


Katheryn Joyce has recently published a long post about the rise of Biblical counseling and the concerns some have about the movement [read it here].

Most people who have thoughts about counseling and Christianity tend to fall into one of to categories: Those who oppose biblical counseling as dangerous and those who oppose the various versions of Christian psychology as shallow and full of humanistic ideology. Very few people try to maintain identity in both worlds. If you have read my “about me” you will find I’m one of those who does accept the label of biblical counseling and Christian psychology (more on this below)

I encourage both proponents and opponents of Biblical Counseling to read her essay. Let me even take the liberty to suggest some starting questions to keep in mind as you read. While the essay may not answer the questions, having them in mind will keep you from solidifying stereotypes of either sides.§ If you are inclined to reject biblical counseling, consider these questions:

  1. Where might I find a more thorough history of biblical counseling and its various permutations?
  2. What main biblical counseling author voices are missing in this piece? [Note that the mentioned ACBC was, until recently, known as NANC (National Association of Nouthetic Counselors)]
  3. What failures in Christian psychology movement(s) led to the need for a biblical counseling movement?

If you are inclined to defend biblical counseling, consider these questions

  1. Even if some of the bad examples of biblical counseling do not represent you or the heart of the movement, what aspects of the movement may support or encourage some of these distortions?
  2. How might you better communicate “sufficiency of Scripture” to outsiders?
  3. Does biblical counseling seek to eliminate symptoms or improve spiritual responses to symptoms? How might it better acknowledge the body when talking about the causes of mental health problems?
  4. Where does fear of “integration” hinder the maturation of biblical counseling as a movement?

Indeed, these questions have already been asked and answers given in a variety of locations. Readers unfamiliar with biblical counseling should start with websites such as this one, CCEF, ACBC, BCC, and the Society of Christian Psychology to find further and deeper readings on related topics.

Where the Concerns are Valid

Not acknowledging benefits from psychological research. Joyce notes that a good biblical counseling session looks a lot like a good professional counseling session. Why? Well, it is obvious that change happens best in the context of kind, compassionate relationships. Why the similarity? While it is true that psychotherapists didn’t discover empathy, it is true that psychotherapy research has expanded our understanding of the best way to encourage trust relationships in therapy. In addition, some of the cognitive, affective, and dynamic interventions developed from these models are used within biblical counseling. I have absolutely no problem from biblical counseling deriving benefit from interventions developed in other models of therapy. I only desire biblical counselors or acknowledge that benefit. It is clear Jay Adams benefited from Mowrer (and said so to boot). We can do the same. We can admit that Marsha Linehan has revolutionized our understanding of how we work with people exhibiting symptoms of borderline personality disorder.

Emphasizing false dichotomies. Joyce quotes Heath Lambert in this piece (near the end),

“I’m concerned [that] if we say, ‘Oh my goodness, people with hard problems need physicians and need a drug,’ we’re going to lose much of what the Bible has to say about hard problems.”

The quote above is in the context of dealing with difficult or serious mental illness. He worries that if the church creates two categories of problems (normal and special), those with serious problems will no believe that the bible has things to say about those suffering with suicidal ideation or schizophrenia. It seems that some biblical counselors take a negative stance on psychiatry and medical intervention because they fear doing so will hinder the work of the Spirit through the bible. I would argue that this dichotomy does not need to exist. I agree that the bible speaks to everyone, whether they are having difficulty or easy problems. I don’t think that use of medications or medical practitioners has to hinder pastoral care. The message that others get when we suggest that medical intervention need to be avoided is that somehow it is less spiritual to seek a medical intervention. This is patently false. Now, not every medicine is worth taking. Some may create more problems then they solve. But that fact should not cause us to lump all professional/medical care into the same category.

Where the Concerns are Overplayed

Heath Lambert gets it right when he claims that all counseling models will fail, due primarily to the quality of the practitioner. Biblical Counselors do much work that is commendable and successful. Joyce’s piece may suggest that most biblical counselors are ineffective and incompetent. This is not true. Matthew Stanford suggest he has never seen a biblical counselor do well with difficult cases. That may be the experience of my friend, but I can attest to seeing biblical counselors working well with people with serious personality disorders, delusions and other difficult mental illnesses. Now, the truth is, these counselors have succeeded because they did not follow the stereotype and reject learning from professional psychology. Further, these same counselors did not take “sufficiency” to mean that they could only use the bible in considering how to respond to their clients.

Take a moment and read her piece. Review the questions above and keep an open mind to both sides of this story.

[§ I have written on the relationship between Christian psychology and biblical counseling in the Journal of Psychology and Theology, volume 25, 1997. You can buy that essay here.]

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Filed under CCEF, christian counseling, christian psychology, Christianity, counseling skills, Psychiatric Medications, Psychology, Uncategorized

Responding to Accusations of Racism: Confessing the Sins of our Fathers (And Our Own)


The news and social media seem to be all about race these days. Comments (not necessarily conversations!) range from criticism of police to criticism of the Black community. And surely there are plenty of reasons to criticize. And notice how it is so easy to identify and name the sins of those who are not us! And when others point out our sins, we tend either to get defensive or tell a story. Neither response gets us to where we need to go!

Pointing out the sins of others (individuals and groups) fails to promote healing and reconciliation. As Jesus calls us, we must start with our own log before removing the speck in the eye of the other (Matthew 7:3f). And our own log exists beyond our own specific misdeeds. We must also acknowledge the ways we have participated in and benefitted from the sins of our “own kind” (culture, ancestors, etc.)

Being Nehemiah

By all accounts, Nehemiah was a godly man. I suspect he was born in captivity and so therefore not culpable for the sins that got Judah carried off to Babylon. He was suffering, a servant to a foreign king). And yet, he was moved to confess the sins of his “ancestors” (v. 1:6) as his own. Later, when Ezra reads the law, Nehemiah and the rest hear it then confess the sins of Israel starting with the failures to obey God in the wilderness (chapter 9). They do not call out the sins of their captors (which are evident) or even their detractors but choose to stay focused on their own failings. Not content just to confess, Nehemiah and the returnees sign a covenant and make promises for specific and objective changed behavior going forward (chapter 10).

How might this apply to our current situation? Can those who are white (no matter the economic class) confess benefits of privilege not available to many of our brothers and sisters of color? Can we do so without deflecting to the flaws and sins of those who respond sinfully to racializations?

Can we acknowledge the massive impact of hundreds of years of discrimination and why it makes sense that resulting poverty, destruction of families, and hopeless still show up today? Can we own our sins with the detail shown us in Nehemiah? Can we covenant to be different? Will we call our families and communities to be different?

Maybe then we might be free to point out the sins of those who are “other.” Until then, let us let the Holy Spirit be the one to teach “them” about following Jesus.

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Filed under Christianity, Race, Racial Reconciliation, Relationships

Piercing Words From Cry, The Beloved Country


Just returned from 2 weeks in Uganda and Rwanda (more on that in subsequent posts). During interminable transit time to and from Kigali I read Alan Paton’s “Cry, The Beloved Country.” Missed reading that as a student and after last year’s trip to South Africa, I needed to read it. Without giving away too much of the story, one of the characters in the book is going through his son’s papers after his murder. His son had been an activist against the then mistreatment of Black Africans in South Africa. One of the papers said this:

The truth is that our Christian civilization is riddled through and through with dilemma. We believe in the brother of man, but we do not want it in South Africa. We believe that God endows men with diverse gifts, and that human life depends for its fullness on their employment and enjoyment, but we are afraid to explore this belief too deeply. We believe in help for the underdog, but we want him to say under. And we are therefore compelled, in order to preserve our belief that we are Christian, to ascribe to Almighty God, Creator of Heaven and Earth, our own human intentions, and to say that because he created white and black, He gives the Divine Approval to any human action that is designed to keep black men from advancement.

The truth is that our civilization is not Christian; it is a tragic compound of great ideal and fearful practice, of high assurance and desperate anxiety, of loving charity and fearful clutching of possessions. (p. 187-8)

This quote struck me so not because of the focus on Black/White relations but because it also fits other ways we struggle to respond to the “underdog.” We want to feel pity but rarely do we want to give up the power to enable the underdog to be one of us. For “other” to be one of us, we would have to cede power and that creates anxiety.

If you haven’t read the book for a while or never did, I commend it to you.

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July 16, 2014 · 4:26 pm

Traumatic Nightmares? Two Treatment Possibilities


Many who suffer from PTSD or other traumatic reactions also experience chronic nightmares. It is bad enough to have to deal with intrusive memories and triggers during the day but being robbed of peaceful sleep can send you over the edge, both in terms of physical and emotional health. Christian counselors may be tempted to ignore these nightmares (how can you stop something you have little control over?) or overly spiritualize the content of the dream.

But we ought not neglect the problem of nightmares. It is well-known that reductions in quality of sleep make all mental illnesses worse. Nightmare sufferers understandably avoid sleep but of course this creates a vicious cycle of insomnia, anxiety, and increased avoidance strategies.

There are two intervention options (among many) that appear to have fairly robust positive data indicating helpfulness. (For detailed descriptions of these two and others including the analyses of value, see this pdf): Prazosin (medication) and Imagery Rehearsal Therapy (IRT).

Prazosin is an anti-hypertensive (alpha blocker) that may work on the problem of too much norepinephrine in PTSD patients. It seems to improve sleep length and REM time. Interestingly, beta blockers have been found to increase nightmares rather than reduce them. I am no physician and so cannot evaluate the value of this medication for clients but would encourage clients with chronic, severe and re-occurring nightmares to talk with their doctor about whether Prazosin might work for them. The studies I have reviewed primarily examined the value of this medication for veterans with extreme nightmare problems. The most significant downside to medication treatment is that it only works when the medication is taken. Stop the medication, the nightmares may come back. However, some relief may be beneficial and thus the medication then has value.

Imagery Rehearsal Therapy (IRT) is a short-term therapy that does not work on the actual content of the traumatic experience or attempt to treat PTSD. Instead, it treats nightmares as a primary sleep disorder problem. There are variations on IRT but most versions last between 4 and 6 sessions and may be delivered in individual or group formats. Sessions include education about the nature of nightmares, sleep hygiene protocols, and the imagery replacement protocol. While some of the IR protocols are done imaginally, others ask nightmare sufferers to (a) write down the details of the distressing nightmare, and (b) write a new ending to the nightmare. As Bret Moore and Barry Krakow describe, the therapist does not dictate the new outcome of the revised dream but encourage the sufferer to “change the nightmare anyway you wish” (Psychological Trauma, v. 2, 2010). The nightmare sufferer then rehearses (multiple times) the new ending and is instructed to ignore the old nightmare.

Sound goofy? How is it that a person can just decide to have a different dream? However, the evidence that this therapy works is quite robust. Numerous studies with veterans and civilians indicates it is effective in reducing unwanted nightmares. Most treatment protocols suggest starting with nightmares with content unrelated to actual traumatic events.

Thus, Christian counselors ought to review these two treatments and consider learning the IRT protocol to bring relief to chronic nightmare sufferers.

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Filed under christian counseling, christian psychology, Christianity, counseling, counseling science, counseling skills, Post-Traumatic Stress Disorder, Psychology, Uncategorized

Should therapists talk about themselves to clients? Surprising information


How do you feel when your counselor begins to self-disclose during a session? When they do, is it helpful or a lapse in their judgment?

This is a common conversation in counselor training programs. Generally, most models of counseling and therapy discourage counselor-self-disclosure; some models do so more than others. The reasons for discouraging counselor self-disclosure vary from breaking the unconscious projection (analytic) to just confusing clients because we change the subject from client to counselor.

But a recent article in the April 2014 Journal of Counseling Psychology, suggests that self-disclosure might actually help more than we think. Henretty, Currier, Berman, and Levitt completed a meta-analytic review of 53 studies examining counselor self-disclosure versus non disclosure. And “overall” they found that clients have favorable perceptions of disclosing counselors.

Why? It appears that when a client perceives great affinity/similarity with a counselor, they rate that counselor higher. Also, when a counselor reveals something difficult or painful (a vulnerability?), it makes them more human to their clients. Some examples of this negative valence might include, “when you said that, I felt really sad.” Or, “Let’s talk about your anxiety, having suffering with it some years ago, I suspect you…”

Not so fast!

So revealing similarities with clients and being human make clients feel more similar and possibly more understood. This makes sense. Client/Counselor matching seems to correlate with better outcomes. However, before counselors go talking about themselves they ought to consider a few things.

  1. Why am I doing this? Is what I have to say for them or really for me? (Too often, we speak to talk about self)
  2. Is what I say really going to keep my clients focused on themselves or distract them to my story?
  3. Am I sure that what I say will show similarity? The truth is that we *think* we have a similar story but the times we are sure we know what our clients are feeling we are most likely to stop listening and then miss the client.
  4. How often do I do it?

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Filed under christian psychology, Christianity, counseling, counseling science, Psychology, Uncategorized

Urban trauma or bad kids?


Psychiatrist Michael Lyles gives an excellent presentation on the nature of urban trauma at the 2014 ABS Community of Practice. He points out how much of what gets labeled as uncaring violence is better seen through the lens of urban trauma reactions. In addition, he discusses the response of the church. Not to be missed!

Michael Lyles – COP 2014 from American Bible Society on Vimeo.

After his presentation, Police chaplain and urban pastor Rev. Luis Centano gave this response regarding trauma in the city of Philadelphia.

Rev. Luis Centeno – COP 2014 from American Bible Society on Vimeo.

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Filed under Abuse, christian counseling, christian psychology, Christianity, counseling, Psychology, ptsd, trauma

Theological reasons to not use corporal punishment?


Victor Vieth has published an essay looking at the use of the bible to validate corporal punishment. What makes this essay interesting is not that he is arguing against the use of physical punishment but that he is writing to child protective services officials on how to respond to those who believe it is okay. I encourage you to read the full text here.

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Filed under Christianity, parenting

Does spiritual maturity reduce spiritual distress?


I’ve posted another blog over at the BTS faculty blog site musing whether spiritual maturity leads to less or more spiritual distress. See if you agree. Post here.

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Filed under Biblical Reflection, Christianity, Doctrine/Theology