Category Archives: counseling skills

October 19, 2013 · 5:38 am

The Power of a Counselor’s Words: Guest post over at biblical.edu


I’ve been thinking and musing about the power we counselor’s wield with our words. To be honest, I do so without always being aware of the impact. It is so easy to say, “that’s abusive” to a victim with the idea that I am validating her experience without realizing I have just crushed another part of her life.

So, if you want to read some of these musings and a gentle corrective to those of us who call ourselves biblical counselors, click here to find the blog I posted for October 18, 2013.  [posted prior to leaving for South Africa]

 

Leave a comment

Filed under biblical counseling, christian psychology, Christianity, counseling, counseling skills, Psychology

Tagged as ,

September 18, 2013 · 5:10 am

Study Global Trauma Recovery Online!


Dr. Langberg and I are forming our next cohort interested in studying global trauma recovery principles and practice. If you have thought about getting such training, now might be a good time! Check out this link to our website where you can find descriptions/objectives of courses in the series as well as application materials (see links on the right of the hyper-linked page). 

 

If you aren’t sure about doing the whole series, just try our introductory month-long course. You can get graduate credit gtc-logoor 40 hours of CEs for just $500. Here’s a few more details:

 

 

  • CEs are NBCC approved
  • Class runs November 9th to December 14th (time off for Thanksgiving)
  • Workload is about 10-12 hours per week (readings, discussion boards, brief response papers)
  • 4 required live 1 hour web conference to discuss material with the professors
  • Focus of the class is to explore psychosocial trauma in international settings

 

Related articles

 

Leave a comment

Filed under christian counseling, christian psychology, counseling skills, Missional Church, Post-Traumatic Stress Disorder, trauma

Tagged as , ,

September 11, 2013 · 8:42 am

AACC 2013: Narcissistic Leaders and Systems


Today, AACC’s World Conference begins at the Opryland Hotel in Nashville. This morning, Dr. Diane Langberg and myself will be running a pre-conference workshop entitled: Narcissistic Leaders and Organizations: Assessment and Intervention. I will start us off with a meditation from 1 Kings 1 (ideas I first heard from a sermon by Phil Ryken last year). We will review current explanations of narcissism as well as an emerging model that may be helpful for those who are trying to move beyond seeing narcissists as only arrogant and exploitive.

Can a system be narcissistic?

Yes. Here are some of the features.

  1. Leader exudes god-like status and does not share power; surrounded by yea-sayers, unwilling to tolerate disagreement, accept mentoring and willing to scapegoat others when failures arise
  2. Constituents gain self-esteem/identity from the organization and love of the system is the highest priority; insider status provides immeasurable value
  3. There is an approved way of thinking, one must take sides for/against; constituents justify dictatorial behaviors of leaders
  4. No toleration for admiration of competitors
  5. Inability to assess own weaknesses

But, here is a most interesting fact: most collective narcissistic systems are NOT filled with individual narcissists! There is something  “in the water” that brings non-narcissists together to develop these 4 features (as written about by Golec de Zavala and colleagues in 104:6 of the the Journal of Personality and Social Psychology):

  1. Inflated belief and emotional investment in group superiority
  2. Required continuous external validation and vigilance against all threats of loss of status
  3. Perception that intergroup criticism is a threat and exaggerated sensitivity to any form of criticism
  4. Intergroup violence can restore positive group image (violence may be verbal as well as physical

Why teach counselors about narcissistic systems?

Counselors often interact with church and parachurch systems by consulting with the system, counseling leaders, or advocating for an individual client. It is good to be able to (a) recognize some of the unhealthy egocentric patterns (blind spots) leaders and systems develop, and (b) offer help to individuals and systems that do not get the counselor sucked into the system or unnecessarily alienate the system. I have had the opportunity to work with a significant number of churches and have learned that there are ways to help and ways that I can get in the way, especially if I begin to attack a long held belief system. For example, if parachurch organization A has had a string of CEO/Board conflicts, then I as a counselor may have to navigate some long cherished beliefs about the system when asked to consult on their next hire.

Leave a comment

Filed under "phil monroe", AACC, biblical counseling, christian psychology, counseling, counseling skills, personality

Tagged as , , , , ,

September 9, 2013 · 7:08 pm

Classroom advice to grad students: Guest post over at biblical.edu


Our faculty blog at http://www.biblical.edu carries my post today. Check it out to see what 3 recommendations I make to our incoming students as they kick off their MA in Counseling program tonight!

 

 

Leave a comment

Filed under "phil monroe", Biblical Seminary, counseling science, counseling skills, Psychology

Tagged as , , ,

August 16, 2013 · 11:49 am

Why counseling? To be fixed or found?


Chuck DeGroat and Johnny LaLonde have written a post that some might find helpful when considering therapy or counseling (I use these words interchangeably). At some point in our lives, we all feel like life is getting out of control. We need help. We begin to wonder if there isn’t someone out there who can help us. But, even as we think these thoughts, we may also think, “what is the point? How can therapy fix this problem?”

Well, to give a partial answer, check out this first post over at Q Ideas. The authors argue that we should all be in therapy. However, they suggest that the purpose of such counseling is not so much to fix our problems but to understand ourselves, to admit our weaknesses, to be “found” or known. Now, these may sound like things that only wealthy people have the time to do. And yet, I would argue that in our isolated, individualized society, the normal communal means of being understood, supported, known, etc. are not often present in our lives.

Three paragraphs in this first post jump out for attention:

Don’t I go to therapy to get fixed? Believe it or not, I don’t advocate therapy because it fixes people. Now, while some forms of therapy help people get past difficulties that stifle them (e.g. panic attacks, major depression, bipolar symptoms), Christians should recognize there is always a deeper and more transformative purpose to counsel and care.

This was the ancient art called curam animarum—the care of souls. And the wisest therapists will foster this process. Now, the vast majority of clinicians practicing today have been trained in fix-it strategies—cognitive and behavioral solution-based processes which are aimed at quick, painless fixes. This is what sells. This is what insurance tends to pay for. But there is a profound difference here—fix-it strategies try to remove pain while deep soul care attempts to learn from it. Sometimes in the process we are afforded the mercy of pain relief. But it is not the goal. And so I counsel people to search carefully, to interview therapists, to ask many good questions.

And then this reflection:

But at the same time, I’m not convinced Christian therapists do this as well as secular therapists at times. Let me explain. Many settle for what Dietrich Bonhoeffer called “cheap grace,” a quick fix approach which stands in stark contrast to the “costly grace” of searching and knowing ourselves, through exploring our stories and examining our motives. This kind of care is, indeed, much more rare. Christian counseling which is reduced to mere Bible memorization, or repentance or a behavioral regimen misses the point.

Fixed and found?

I imagine that the authors would agree that both are possible. Therapy can lead to being fixed and found, to find relief and care for the soul. Therapies that ignore the need for immediate mercy and relief are of little value. I once talked to someone who had just completed a decade of psychoanalysis (3 sessions per week!). His therapist, a well-known analyst had just released him as having completed analysis. My new friend was looking for a therapist to deal with his longstanding panic disorder. I have also seen Christian counselors who have so emphasized discipleship that they paid little attention to easy helps for their addict clients. On the flip side, simple behavior change (now that is an oxymoron!) may provide some relief but miss insight into self and what God is up to in the world. In seeking only relief, we miss out on deepening our relationships with God and others. A superficial life lived may hurt lest, but is it worth living? 

Note at the bottom of the post there is a link to another post about how to choose a counselor. If you are looking for one, consider one who can have difficult conversations with you, one who does not over-simplify the problem, one who cares about your growing relationship with Christ, one who can provide ideas to bring immediate relief, and best of all, one who listens more than talks.

1 Comment

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

Tagged as , ,

August 5, 2013 · 5:47 am

Counselors: How do you deal with attraction to clients?


For my counseling friends, you may wish to read this piece by Ryan Neace about sexual attraction in the therapist office. Do you have someone to talk to in this kind of frank manner about the reality of attraction? How do you handle it?

Remember, sexual attraction is not limited to just wanting to have sex with someone. Ryan does a good job identifying types of sexual responses to others beyond outright lust and fantasy. Notice also his drawing attention to the myth of the sexual vortex.

“The pastor who refuses eye contact sends a clear message…‘You are seductive. You are a sexual vortex that I may get sucked in to.’ The slippery slope of my lust is your problem. And my ministry is too valuable to allow the likes of you to trip me up.”

Given that we all have examples of counselors and leaders who crossed sexual lines, the myth and fear of the vortex can keep us from addressing needs of others. And, as he notes, it sends a very loud message to some clients (mostly women) that they are a danger at the cellular level). What a burden we place on others!

Two questions for readers:

1. How do you respond to incidents of sexual attraction?

2. How would you want to respond to the question posed to Yalom copied below (about whether he would in a different situation be attracted to a female client)? Redirect? Focus on the “deeper question”? Answer it?

Yalom considers a female client who asks, “Am I appealing to men? To you? If you weren’t my therapist would you respond sexually to me?”

… [Yalom’s answer]:

If you deem it in the patient’s best interests, why not simply say… ‘If everything were different, we met in another world, I were single, I weren’t your therapist, then yes, I would find you very attractive and sure would make an effort to know you better.’ What’s the risk? In my view such candor simply increases the patient’s trust in you and in the process of therapy. Of course, this does not preclude other types of inquiry about the question—about, for example, the patient’s motivation or timing (the standard “Why now?” question) or inordinate preoccupation with physicality or seduction, which may be obscuring even more significant questions. (bold emphasis Ryan’s)

4 Comments

Filed under christian counseling, christian psychology, Christianity, counseling skills, Sex, sexuality

Tagged as , ,

July 31, 2013 · 1:06 pm

Treatment of complex trauma: Why mistrust of the counselor is necessary and good!


I am reading Christine Courtois and Julian Ford’s, Treatment of Complex Trauma: A Sequenced, Relationship-Based Approach (Guilford Press, 2013). I won’t be blogging through each chapter but I do recommend it for those working with adult survivors of child sexual abuse, especially those who are new to “complex trauma.”

The first two chapters give an overview of complex trauma reactions and diagnoses. If you want to know more about complex trauma, see this post about another edited book by these two authors. Chapter three, “Preparing for Treatment of Complex Trauma” begins the meat of the book. In this chapter they take up the ever important issue of empathy, safety, and respect as foundation to therapy. They emphasize the need for,

safety within the therapeutic relationship with a therapist who is empathic and respectful yet is emotionally regulated with appropriate and defined boundaries and limitations. (54)

Challenging Counselor Safety Is Common and Good?

This empathy and trust relationship is both foundation and method of treatment (59). But while the therapist is responsible to see that at safe therapeutic relationship has been built, it requires the client to be involved in building such an environment. The truth is that the client’s role in building safety in the counseling office is by passive and active testing of limits. Most counselors tolerate suspicious questions the first or second time. But, it is important for counselors to,

being prepared to patiently and empathically respond to active or passive tests or challenges to trustworthiness as legitimate and meaningful communication that deserves a respectful reply in action as well as in words. (60, emphasis mine)

If the therapist understands and does not take mistrust as a personal affront, the therapeutic relationship can evolve gradually. The client can begin to recognize  that the therapist actually “gets” why he or she is initially skeptical, self-protective, or “realistically paranoid” and does not pressure the client to be a “happy camper” but instead works to earn trust by being honorable, reliable, and consistent. This also implies a view of the client’s initial mistrust as expectable in light of the client’s history–that is, as a strength rather than as a deficiency or pathology. (63)

Sometimes clients can present in an opposite way–to be entirely deferential and affirming the counselor before a track record can be developed. Therapists with these clients need also to be prepared to encourage a healthy level of distrust.

What is not helpful is “artificial neutrality or passive and intellectualized detachment on the part of the therapist…” (64). It is my sense that we usually do this when we are afraid of the client. Not so much afraid of being injured, but afraid of failing or being consumed by the trauma. Or, we get consumed by our own history. A healthy therapist must stay emotionally present yet aware of own internal machinations. A healthy therapist must be able to predict some of the angst that arises in treatment of complex trauma and able to prepare self and client for this inevitable distress.

2 Comments

Filed under Abuse, counseling science, counseling skills, Post-Traumatic Stress Disorder, Psychology, ptsd

Tagged as , , , , ,

July 25, 2013 · 5:59 am

Telling Painful Memories: Recommendations for Counselors


[What is below was shared with Rwandan caregivers and counselors. It is written in simpler English and has no footnotes. Academically oriented readers will recognize the interventions come from narrative exposure therapy models for children].

Counselors invite others to tell their stories of pain, heartache, fears, and traumas so that they can find relief from their troubles. However, not every way of talking about past problems is helpful and some ways of talking can actually harm the person. So, it is important that all caregivers and counselors understand how to help others tell their difficult stories in ways that invite recovery and do not harm.

Good Storytelling Practices

Counselors who do the following can encourage healthy and safe storytelling of difficult events:

  1. Allow the client to tell their story at their own pace without pressure
  2. Allow the client not to tell a part of their story
  3. Use silence and body language to show interest
  4. Encourages the use of storytelling without words (art, dance, etc.) or with symbols
  5. Ensures the difficult stories start and end at safe points
  6. Encourages good coping skills before story telling
  7. Points out resiliency and strength in the midst of trauma
  8. Encourages the story to be told from the present rather than reliving the story

Unhelpful Practices

Here are some things that we should avoid doing when helping another tell a difficult story

  1. Frequent interruptions
  2. Forcing the person to tell their story
  3. Asking the person to relive the story
  4. Avoiding painful emotions
  5. Exhorting the person to get over the feelings; telling them how to feel
  6. Only talking about the trauma, ignoring strengths and other history
  7. Ending a session without talking about the present or a safe place

**Trigger Warning: rape, threatened violence

A Case Study With 2 Storytelling Interventions

Patience, a 13 year old girl, suffered a rape on her way to school last month. The rapist’s family paid a visit to the girl’s family and offered money as a token of penance. The girl’s father accepted the money because, “nothing can make the rape go away so we will take the money for now.” Patience was told by some family members to not tell anyone about the rape and to just act as if it never happened. However, Patience is suffering from nightmares, refuses to go to school, and sometimes falls down when she catches a glimpse of the rapist in town. Her father has threatened to beat her if she doesn’t return to school or help out with the chores at home. Her favorite aunt, a counselor/caregiver, learns about the rape and asks her to come for a visit in a nearby city.

[Warning: these two interventions are not designed to rid a person immediately of all trauma symptoms. In addition, these interventions must be used only after a counselor has formed a trusting relationship with the client.]

  1. Symbolic story telling. The aunt tells Patience that keeping a story bottled up inside can cause problems, like shaking a bottle of soda until it bursts out. Using a long piece of rope (representing her entire life) and flowers (representing positive experiences) and rocks (representing difficult experiences), the aunt directs Patience to tell her life story. They start with her first memories of her mother, father and two brothers. She tells of her going to school, the time when her mother got really sick but then got better again, the time when her cousins moved away, and the time when a boy told her he liked her. Patience noticed how she had many flowers along the rope and only a few rocks. Then, they put a large stone down on the rope representing the rape. Patience had difficulty saying much at all. She remembered being afraid, the weight of the man, the pain, and worry that her family would reject her. She remembered getting up and going to school and acting as if nothing happened. Her aunt noted that Patience was a strong girl—she had gone to school for a week before telling her mother. So, Patience placed a tiny flower next to the rock to represent that strength. After stopping for a cup of tea and some bread, the aunt asked Patience to notice how much more rope was left. This represented her future. Patience was surprised to see the rope and said that she didn’t think she would have a future now that she was spoiled. Her aunt encourages her to consider what she would like to be in her future. They continued to discuss this over the next day. By the time Patience returned home, she was able to see that she still had a future. Seeing the rapist still bothered her. However, she was able to go to school with two friends along a new path so that she would feel safe. Patience kept a drawing of the rope with the flowers and rocks and extra rope to remind her that she had a good future.
  2. Accelerated Storytelling. About six months later, Patience visited her aunt again. She was still going to school and able to do more chores (getting firewood and buying food in the market). However, she still suffered from nightmares and sometimes fell down when she heard footsteps behind her. This time, her aunt asked her to help create a “movie” of event. Before Patience was to narrate the rape, they first recounted the safety she felt at home before the rape and the safety she felt when she told her mother about the rape and was comforted. Next, her aunt asked her to identify all of the “actors” in the play: her mother, father, herself, brothers who went to school without her, classmates, teacher, and rapist. Patience then made a figurine out of paper for each actor and drew a small map of her village including the path from home to school. Then, the aunt asked her to tell her story as fast as she could from safe place to safe place and to only look at the figurines (and to move them along the map). Her aunt noted those places where Patience slowed down in the story. When she paused, the aunt asked her to try to keep moving. Once the story was complete (when she told her mother about the rape), she asked Patience to tell the story backwards as quickly as possible. Then, she instructed Patience to tell the story forwards again twice as fast. However, this time, Patience stopped part way through the story. She added one detail she had not disclosed before. She recalled that a young boy of about 5 was peering at them from behind some bushes. Her aunt encouraged her to finish the story and thanked her for her courage. Patience indicated that she was so ashamed of being seen in such a position. Again, her aunt thanked her for working so hard but asked her to tell her story forwards and backwards one more time. Patience noticed that she was less upset by the presence of the 5 year old than she had been the first time through the story.

1 Comment

Filed under Abuse, counseling, counseling science, counseling skills

Tagged as , , , , , , , ,

July 15, 2013 · 5:56 am

Tuza 2.0: Day Five


[June 27, 2013]. Day two of our three day conference. Today Dr. Barbara Shaffer talked about the problem of marital rape and reviewed 6 common characteristics of some abusive spouses. The participants were very involved in this presentation and the discussion about sex in marriage provoked some interesting debates among the group. The large group discussed the matter of dowry. In Rwanda, a husband’s family agrees to pay an amount to his bride’s family. The price is in terms of a number of cows. A friend told me that nowadays, “cows are kept in the bank.” This tradition gives many men the belief that they have purchased their wife. Now the wife is his (cherished) property. As such, he has rights to her body. Based on the conversation, I would argue that the concept of marital rape might indeed be foreign. One participant asked how 1 Corinthians 7 fit into this discussion. We were able to examine that this passage offers women the right to control their husband’s bodies just as much as he gets to have a say about her body. Not being sure where everyone stood in the debate, I concluded with a reminder that Philippians 2 requires that we emulate Christ in not demanding what we are due but giving it up so as to shine like stars.

After lunch Dr. Langberg presented on dissociation and a group of Rwandan counselors illustrated a counseling scene of dissociation and a counselor’s techniques in calming and grounding. Very well done! Just before the end of this day’s training, Rowan Moore gave a talk about child abuse. Kivu boats

Before dinner, we hired a local young man to take us out onto Lake Kivu in his boat. Ten of us motored out toward Peace Island. We didn’t have enough time to go all the way to Napoleon Island but we rounded several small islands and enjoyed the setting sun. We passed several fishing boats netting the tiny fish that are in the lake. We could feel the stress of the day fade with the lap of the waves. [photo courtesy Laura Captari]

After dinner, we had an evening of celebration. We identified our Barnabas’ (each person secretly wrote notes of encouragement and prayer to another). And of course, there was dancing and laughter. I have come to love the fluid hand motions during dancing and the energetic movements of men and women. Sadly, I  cannot dance to save my life. I have not rhythm. Of course, there was a dance where I had to be front and center. I tried hiding behind a camera but even that did not save me. Still, it was sweet medicine after 2 days of talking trauma, abuse, and violence.

Leave a comment

Filed under AACC, Abuse, counseling, counseling skills, Rape, Rwanda, Uncategorized

Tagged as , , , , ,

July 7, 2013 · 2:42 pm

Tuza 2.0: Day Four


[June 26, 2013]

The conference has begun. We have 30 high level caregivers here, 17 of whom attended Tuza 1.0. One of the things we expect is that all of the planning as to how long things will take does not ensure we will be able to stay on schedule. While we expect it, it requires a lot more cultural sensitivity and flexibility than us Westerners usually like to display. When I go to a conference, I don’t want to “waste” time playing games and getting to know my neighbors. Just fill my head up with knowledge, thank you very much. But that is not the way most of the world lives. So, our conference began, appropriately so, getting to know each other. Truth be told, this kind of beginning is necessary if we are going to trust each other!

Our first session included a short review of basic helping skills followed by a roleplay with Carol King. After a large group discussion, we broke attendees up into groups of 4 to form quads (counselor, counselee, and 2 observers). Many attendees remarked at how helpful the quads were for practicing skills. It seems that most have not had this experience before.

After coffee break (coffee plus a bowl containing a little donut with peppers and carrots inside and little fried (whole) fish!), one of our attendees presented a case for large group discussion. The case was of a teen who had experienced sex trafficking and was severely wounded in an attempt to kill her.

Our afternoon session featured a presentation by Dr. Barbara Shaffer on the topic of domestic violence. She spoke about the common cycle of domestic violence (tension building–>violence–>calm), the basis for protection from the scriptures, and gave basic goals when meeting with a person who is domestically abused.

During our large group discussion, we heard from several men and women that men are increasingly abused in Rwanda society. There was some discussion about how much this is an issue. It appears that since the genocide, women have had greater need to be independent and so traditional relationships between men and women are disrupted. Women, these individuals claimed, are more likely to be argumentative than in past eras. Also, we learned that in a separation, children under 7 may be forced to go with the father (or his family) since children belong to the father and not the mother. Not all attendees agreed with this view. We ended the day with small group discussions about how to tell when a person is experiencing domestic violence and how to engage that person in some basic information gathering and invitation to talk further.

One of the major changes we have in our schedule is the fact that we decided it was important to translate in real-time. We had planned that English proficiency would be high enough to do the training in English. However, it appears that substantial concepts are being missed. Even though this doubles the time it takes to do a talk and training, we  believe this is best for the attendees. We give them written text of the talk in English and at the same time give it orally in English and Kinyarwandan.

Some of us ended our work day with a fun swim in Lake Kivu. The water was a perfect temperature and clear many feet down. We swam for about 40 minutes then got ready for dinner. The swim was refreshing after a long day of concentrating and listening. Listening across accents and experiences can really wear you out.

A Funny Anecdote:

Charging phones and readers can be quite a challenge in Africa. You can have a converter and the right plug and find out that your device will not charge. For some reason, I could not charge my phone or nook while in Kigali. However, I was grateful to find that I could charge my devices in my room here at Bethany Centre. Well, last night I awoke at midnight to flames shooting out of my converter right at my head and mosquito net. I yelled, “FIRE” and quickly yanked the blackened plastic out of the wall while sparks continued to fall on flammable material. Thankfully, nothing caught on fire. I opened the patio door and threw the converter outside. My room stunk of that awful burnt plastic smell. In my stupor I wondered if I should call the front desk and ask them to make sure there wasn’t any ongoing problems with the outlet. As I stood thinking about it, I heard/saw outside flourescent lights grow tremendously brighter and then explode, first one, then another, then another. Deciding that I now needed to call the front desk, I turned the light on so I could dial the phone. The overhead light also exploded and sparks fell to the bed/net below. Again, I pounced wanting to make sure nothing caught fire. It did not. I used my phone light to dial the front desk. Minutes later, a sleepy voiced answered. I requested someone come soon to check on me and to ensure something wasn’t terribly wrong. No one came. The next morning I related my story and learned that several others had no power and their lights blew as well. Later we learned that some wires crossed and caused the power surge. It ended well and we had no further electrical problems the rest of the conference.

Leave a comment

Filed under AACC, Africa, christian counseling, counseling, counseling skills, Post-Traumatic Stress Disorder, Psychology, Relationships, Rwanda

Tagged as , ,