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.
Watching Bessel van der Kolk’s live CE presentation on trauma and attachment from the comforts of a counseling office (far better than sitting in a hotel room since we can get up and go to the bathroom and make snarky comments from time to time).
He is focusing on neuroscience and the role of the body in trauma and trauma recovery. Here are a couple of tasty quotes:
Just a reminder to those of you who are counselors and therapists out there, starting in January, Dr. Langberg and I will be offering group and individual consultations to mental health professionals seeking help for their domestic and international trauma recovery cases. We will be running a once a month group consultation on Fridays beginning mid January (runs for 6 months) here in the Philadelphia region. If you have any interest in joining the group or having your own private consultation, please check out our website for application and consent forms: http://globaltraumarecovery.org/group-consultation/
Group consultations are a great way to get feedback on a difficult case, learn from peers, as well as easier on your pocketbook.†
†consultations can not be considered supervision as we have no authority over your practice.
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?
For many of you this is the season of buying Christmas presents. For me, it is the season of paper grading time. I have 46 term papers due tonight. Thankfully, I do have a TA helping with grading for the first time in a VERY long time. So, that is my excuse for no new posting today. However, our faculty blog is reposting a version of my recent blog on Dr. Diane Langberg’s definition of Christian Psychology. Alone, her definition isn’t intended to be comprehensive (as she does not choose to define psychology). Probably would be better to title this a definition of Christian psychotherapeutic intervention. The focus in this definition is on the character of the therapist and the submission to the Spirit’s working in the life of the counselee. The point of the definition is to remind us that we can define the boundaries of psychology from a Christian perspective and yet fail to see the relational aspects of the work that we do.
If you missed it, this link will show you the original post here on November 26 and some helpful questions and comments.
Filed under christian psychology, counseling, counseling skills, Psychology
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
In my last post I made mention of Dr. Langberg’s presentations last Monday night. One of her talks was entitled, “Ten Things About Counseling You Don’t Usually Hear in Graduate School.” At some point we may be able to upload video of that talk but just to whet your appetite, here are a couple of her 10 items,
Just a taste. But she concluded with this call,
Listen acutely. Study avidly. Be the Word.
Filed under Christianity, counseling, counseling skills, 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
At the recent AACC conference Dr. Michael Lyles, a board member of AACC and practicing psychiatrist, stated the following,
A diagnosis is only a word on a page if it doesn’t serve a function.
What kind of function was he thinking about?
I’m a firm believer that our current DSM diagnostic system is at once both flawed and useful. It is flawed in that DSM diagnoses don’t address causes or do much to point to treatment. It is useful when used carefully to help differentiate between overlapping sets of symptoms–even as it needs considerable overhaul to do a better job. Take differentiating between Major Depression and hypothyroidism instigated depression. The two look identical. But using a multiaxial diagnosis, a person could rule out Major Depression if they were able to make a positive diagnosis of low/inactive thyroid function.
So, until we have a better nosological system (i.e., a replacement for the DSM), I will continue to use it. In years to come we will, however, recognize it for the blunt instrument that it is.
Right Diagnosis…Wrong Focus?
Consider the following case study (not a real person, devised from several stories) as an illustration for the problems we have moving from current diagnostic categories to proper treatment.
Tom is 27, married, father to one young daughter, working part-time as a youth pastor and going to seminary full-time. He comes to counseling on the encouragement of his primary care doctor. One month ago during final exams and an overly busy ministry schedule, Tom began experiencing rapid heartbeat, shortness of breath, feelings that he was losing his mind, and chronic fear of dying. After experiencing 4 panic attacks in rapid succession, he began worrying that something was terribly wrong and that he was about to die. His doctor first ruled out a physical origin for these symptoms, taught him breathing and distraction exercises to interrupt the buildup of panic, prescribed an anti-anxiety medication, and recommended he make an appointment with a therapist. During the first session, Tom details his history of stress, reports he has been able to forestall 2 more panic attacks but admits he still struggles with fears of dying, lacks assurance of salvation, and feels flooded with guilt that he worries so much. Upon further exploration, Tom believes the bible teaches him that he should not fear if he has “perfect love”. He has read all of the verses about anxiety and feels condemned for his struggle.
Tom meets criteria for Panic Disorder, without Agoraphobia. This is a highly treatable problem and within a few short sessions, Tom is likely to gain mastery over his body in that he will no longer evidence panic attacks. This, of course, is not the same as saying he will stop experiencing worry, guilt over his chronic worry, or start having assurance of his salvation. Logic, disputing worries, distractions, exploring and altering core beliefs may help reduce the symptoms that brought Tom to his doctor and counselor. A good Christian counselor may also be able to reconnect Tom to Scripture in ways that help him experience God’s care for him in spite of his fears (e.g., hearing the gentle voice of Luke 12 vs. a harsh rebuke).
But has the diagnosis been properly made? Yes. Tom met the criteria for an anxiety disorder. No. Tom’s counselor also helped him discover a deep layer of shame that may have been the source of his anxiety. Without the latter, the former is not altogether helpful.
So, should the diagnosis be an anxiety disorder or shame? Until we have shame as some form of a diagnosis, I’m okay with maintaining the anxiety disorder as a good description of external symptoms. But, Tom and others like him will need wise counselors who can dig a bit to discover diverse multiple shaping factors (e.g., biopsychosociospirtual) that lead to a common expression of symptoms.
What good is a diagnosis? I concur with Dr. Lyles: not much.
Musings on Faith and Psychology 