Category Archives: counseling

February 16, 2011 · 9:57 am

More on Narcissism


Hadn’t read my Monitor on Psychology (Feb 2011 edition) til this morning and saw that the cover story is on the possible rise of narcissism in young folk these days. Now, this magazine is popular and doesn’t go too deep into reporting on research…and I haven’t followed up on the studies to read them for myself, but…

  • one study has 80% of middle school students scoring higher on self-esteem in ’06 than ’88
  • Another shows an increase in the lifetime prevalence of NPD
  • However, no nationally representative samples comparisons have been done to really shed light on whether a rise is truly taking place
  • One meta study of 85 studies (between ’82 and ’06) suggests an increase of narcissism among college students

The article goes on to muse about whether materialism and social networking lead the way toward narcissism but also wonders whether the decrease in availability to easy credit will lower the self-promoting trend a bit.

In an ironic twist, it appears that the DSM 5 may not include NPD as a diagnosis. Rather. It will include a more general diagnosis (see below taken from the DSM5.0rg site). Strangely, one of the “types” is NOT narcissism.

The essential features of a personality disorder are impairments in identity and sense of self and in the capacity for effective interpersonal functioning. To diagnose a personality disorder, the impairments must meet all of the following criteria:

A.    A rating of mild impairment or greater in self and interpersonal functioning on the Levels of Personality Functioning.

B.    Associated with a “good match” or “very good match” to a personality disorder type or with a rating of “quite a bit like the trait” or “extremely like the trait” on one or more personality trait domains.

C.    Relatively stable across time and consistent across situations.

D.    Not better understood as a norm within an individual’s dominant culture.

E.    Not solely due to the direct physiological effects of a substance (e.g., a drug of abuse, medication) or a general medical condition (e.g., severe head trauma).

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February 14, 2011 · 5:59 am

Resources about narcissism?


Cover of "The Drama of the Gifted Child"

Cover of The Drama of the Gifted Child

A few weeks ago I was asked about resources on the topic of narcissism, things a person struggling with some of the features might read to better understand their inner world. I didn’t have any really great “lay” materials on the topic so I’m going to poll the audience. A perfect entry for Valentine’s Day when we celebrate those people who make us feel special!

Narcissism is an ugly word if it is used about you, as in, “you’re so narcissistic!” This usually means someone sees us as being self-centered.

The truth is…most of us have a touch of it at times. We desire affirmation, we fantasize about being recognized for our achievements, we want to be special (or at least seen that way), we have times of feeling entitled and may even manipulate the feelings of others to get what we want. Our focus on self may limit our empathy towards others. We may be haughty. All of have some of these features some of the time. Some of us have these features most of the time.

Having these feelings doesn’t mean we are personality disordered. But, our willingness to acknowledge and work on being more other centered MAY reveal whether we meet diagnostic criteria. Meaning, if you can admit to the problem and improve your capacity for empathy then you probably aren’t meeting criteria for a personality disorder.

What causes narcissism?

The simple Christian answer is sinful self-focus. But since ALL of us are sinners and flawed…can we be more specific why some people seem to struggle more with the problem, why some have an enduring bent  or a fixed pattern of relating to the world? One theory suggests that narcissistic features arise out of a lack of mirroring which results in a deep fear that we aren’t special…or worse, are worthless. There is likely some truth to this. However, it seems that some narcissism is encouraged in a me-first culture.

Resources?

So, what resources do you know that get at some of these experiences, desires, feelings of narcissism that could help a person be more aware of their impact on others.

Here’s a few reads I know about:

1. Drama of the Gifted Child, by Alice Miller. A classic psychodynamic read about our emotions. She does a nice job illustrating the fears/cravings of narcissism and borderline features and how we all have a touch of these. Not necessarily helpful in what to do about the experience but good to delve into the experiences of depression, grandiosity, denial, and self-contempt and what these do for us.

2. Re-inventing Your Life, by Jeffrey Young. In particular, look at chapter 16. In fact, if you follow the link, you can search “entitlement” in the “search inside” box on the left and once you get results, scroll down to the one on p. 314. You can read a bit of the chapter to see how the authors do a good job describing the common symptoms of narcissism.

3. Anatomy of Secret Sins, by Obadiah Sedgwick. Well, not exactly about narcissism but definitely about uncovering our true self-centeredness. Sedgwick lived between 1600 and 1658! Excellent read on the problem of self-deception.

If you try to search for books on this topic, you will discover (not surprisingly) most are written to those who either have to live with the person or are trying to get free of them. Few are written to the person with the problem.

Any resources you might add to the list?

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February 10, 2011 · 5:26 am

When theory, technique and person combine…


Am trying to write an academic journal article on clinical applications of Christian Psychology. Heady…I know. Too heady for me I think. However, in my study I ran across these quotes from

Leitner, L.M. (2007). Theory, Technique, and Person: Technical Integration in Experiential Constructivist Psychotherapy. Journal of Psychotherapy Integration, 17, 33-49.

From his abstract:

From an experiential constructivist position, the distinction between the therapist as a person, the therapist’s theory of psychotherapy, and techniques used within the therapy room is, in some ways, forced and arbitrary.

He starts out this article, after the abstract with,

“Becoming a psychotherapist is not about assembling a bag of tricks and learning the formula for matching tricks (i.e., techniques) with problems. What you do as a therapist emerges from who you are in the therapy room. And, when an intervention comes from who you are, it is no longer a technique.”

SO, it stands to reason that we ought to view therapists in their sessions in order to see what kind of people they are. We therapists often think in terms of theory to practice. But practice probably reveals a truer picture of our theory.

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February 8, 2011 · 11:26 am

Godly depression?


Last night my psychopathology class focused on the topic of depression. We covered the usual stuff: various experiences and features of depression and bi-polar disorder, potential medical causes, common medical and psychological treatments, etc.

Depression, as you most likely know, comes in all sizes and shapes and is multifactorial in etiology. Depression involves the body, the mind and spirit, and the environment. Thus, treatments should also cover the gamut, focusing on thoughts, faith, body, and environment. I ended the class pointing briefly to the fact that the English Puritan treatment of depression covered pretty much the same. They encouraged their parishioners to treat their despair and melancholy with these ideas,

  1. Seek the benefit of “Physick” or medical interventions
  2. Accept the comfort of Scriptures and in community with friends (and they also counseled others to avoid over-use of exhortation)
  3. Be mindful of God’s present and past mercies
  4. Utilize the sacraments and other spiritual disciplines
  5. Avoid too much time in introspection, but
  6. Examine oneself to see if there are also hidden issues to be dealt with

Notice the “heart surgery,” as one of my students put it in her paper, doesn’t happen til much work has been done to stabilize and comfort the despairing individual.

KEY QUESTION: Is there such thing as Godly depression?

If so, what would it look like? This question comes out of the view that depression and accompanying hopelessness reveals, to some degree, that a person is failing to trust the Lord.

Or does it? Is it possible to be depressed and spiritually mature? I believe so. So, what signs might you look for to determine that the person in front of you was experiencing a Godly depression? Was St. Paul despairing to the point of death but wholly trusting the Lord at the same time? (2 Cor 1:8f)

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February 5, 2011 · 12:12 pm

Single session therapy?


Anybody ever found just one session of counseling productive (meaning you only went once but it was extremely helpful)?

Counseling takes time…usually. You want to get to know your client, hear their history, learn how they think and feel, what they have already tried, and walk with them into some new ways of thinking or responding to their life situations. This kind of work takes time, a lot of time in some cases. And the solutions take even more time.

But I suspect there are some folk who could benefit from just 1 hour of troubleshooting. If you have had one of those experiences, what happened? What was helpful?

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February 2, 2011 · 5:36 pm

Forthcoming:collaborative book addressing sexual abuse


Andrew Schmutzer, an OT professor at Moody, is editing a collaborative approach to the topic of sexual abuse. Chapter writers include psychologists, theologians, and pastoral care providers. The book is due out this coming July/August and is to be published by Wipf & Stock.

Title: The Long Journey Home: Understanding and Ministering to the Sexually Abused

Check out the Long Journey Home TOC for chapter titles and contributors (including your’s truly). My chapter is intitled, “The Nature of Evil in Child Sexual Abuse: Theological Consideration of Oppression and its Consequences”

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January 25, 2011 · 5:45 am

Free Career Counseling Clinic!


Every year our postgrad students run a free career counseling advice clinic. This year it is going to be run on 1/31/11 from 7:30 to 10 pm. You can partake of this in two ways

  1. Come to campus (200 N. Main Street, Hatfield, PA 19440) and meet face to face
  2. Call in (great if you don’t live in this area!)

If you are stuck and need a jump start on your career options and/or want to have your resume evaluated, this is a great opportunity at no cost to you. And you don’t just get a student, you get a student being supervised by our professors who have a ton of career counseling experience.

Call NOW for an appointment time that works for you. This is only 1 week away and space is limited! For more info, click the link above.

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January 18, 2011 · 7:48 pm

Adult Asperger’s?


DSM-IV-TR, the current DSM edition

Image via Wikipedia

In last night’s Psychopathology class I was discussing the significant changes throughout the history and editions of the Diagnostic & Statistical Manual (I-VI), especially in regard to the growth of mental health diagnoses. That led us to talk about a couple of diagnoses, once added, that have become “popular.” By popular I don’t mean en vogue or fun or the like. What I mean is that there has been a significant increase in the usage of that diagnosis.

What diagnosis? Asperger’s Syndrome.

Why? Some feel it is because the diagnosis is known and now those who went undiagnosed now are more likely to receive a correct diagnosis. Others feel that therapists are over diagnosing–lumping in every kid who has any hint of a social quirk.

It will be interesting to see what happens to the numbers being diagnosed when DSM5 comes out (2013?) and Asperger’s is subsumed into a generic Autistic Spectrum Disorder. I’d be willing to bet that fewer people will get the diagnosis because of stigma alone.

Whether over or under used, there are adults who meet criteria for this diagnosis and who might be helped (along with their spouses) if they had some hooks to use to understand what was happening in their relationships. If you are involved in counseling folks who meet criteria for this diagnosis…or think you might, check out the this website.

Click the link “tests” and check out a couple of the free adult forms you might use in the diagnostic process. They may not be quite as robust in their statistical properties, but they do give you a good way to narrow the conversation with your clients.

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January 5, 2011 · 5:06 am

Additional information on the March 2011 sex trafficking and abuse conference at Biblical Seminary


I’ve mentioned the conference before here on this site. But here is additional information for those considering the conference in order to acquire either graduate academic or continuing education credit.

NOTE:

  • Conference dates: March 17-19
  • The conference is free for all attendees, only those who want CEs or grad credit will have to pay a fee
  • A PDF of the information below is available here: Please pass on to anyone who might be interested.

Continuing Education at Biblical Seminary

March 17-19, 2011

The Biblical Call: A Christian Response to Human Trafficking and Sexual Abuse[i]

Mental health professionals and clergy interested in attending this seminar may be able to acquire 10 contact hours of continuing education by attending this conference. Biblical Seminary is an accredited graduate institution and thus is qualified as a pre-approved provider of continuing education in the form of graduate coursework by Pennsylvania’s State Board of Social Workers, Marriage and Family Therapists, and Professional Counselors (§47-49.36) and Pennsylvania’s State Board Of Psychology (§41.59). (Attendees who wish to receive academic credit should follow directions in the footnote below.)

While Biblical Seminary provides verification of attendance and a transcript showing completion of the CE course, attendees are responsible to verify acceptance of these hours by their particular licensing boards prior to registering and paying for CEU credits.

The following information may be used to apply for approval to your licensing body.

Speakers:

Diane Langberg, PhD; Bethany Hoang, MDiv; Pearl Kim, JD; Robert Morrison, MBA; Philip G. Monroe, PsyD

Seminar Overview:

This conference continues the “Conversations on Christianity and Culture” series focusing on sexual violence and injustices in a variety of contexts: domestic and international settings and sexual abuse in Christian communities. Attendees will explore these issues from biblical, psychological, legal, and sociological perspectives. The conference will conclude with a focus on practical intervention and prevention strategies.

COST:

The conference is free for all attendees. Register here. Those who wish to receive CE credits will be charged $20.00 per CE unit (0-9 credits) or $180.00 for all 10 CE units. Attendees will be billed following the conference and certificate of attendance will be held until payment is received.

Educational Objectives:

  1. Become familiar with the psychological and sociological data regarding domestic and international trafficking phenomena and also sexual violence within Christian settings
  2. Describe common community and individual consequences resulting from these sexual traumas
  3. Consider biblical and theological factors relating to sexual violence
  4. Identify effective and practical interventions as well as preventative actions to treat and stop sexual slavery and sexual violence

Tentative Schedule:

Thursday, March 17

Speaker Title Time length
B. Hoang Biblical Call: Response to Violence (obj. 3) 1:15
D. Langberg Biblical Call: Global Violence against Women and Children (obj. 1-3) 1:15

Friday, March 18

Speaker Title Time length
B. Hoang International Human Trafficking (obj. 1) 1:15
D. Langberg Domestic Human Trafficking (obj. 1) 1:15
Breakout Sessions (choose two as each session is repeated; total length: 2:30)
B. Hoang Follow up from morning session (obj. 3) 1:15
D. Langberg Follow up from morning session (obj. 1-3) 1:15
P. Kim Spiritual Warfare and Criminal Prosecution (obj. 3) 1:15
R. Morrison Mobilizing all Christians in Effective Action Against Human Trafficking (obj. 4) 1:15

Saturday March 19

Speaker Title Time length
D. Langberg Sexual Abuse in Christian Organizations (obj. 1-4) 1:00
Panel (all speakers) Panel Discussion (obj. 1-4) 1:30

[i] This course is also available for one (1) academic credit. Credit students will be required to complete additional readings and coursework after the seminar. Those interested should view the course syllabus on our school’s website and complete a brief, online non-degree application. Cost for a one credit course is $447.

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December 21, 2010 · 4:02 pm

Christian anxieties?


In light of the holiday stresses and anxieties, I bring you a couple of thoughts regarding “Christian” anxiety.

Everyone faces anxiety at times in their life (unless you lost your amygdala) But some anxieties are unique to evangelical Christians:

1. What if I am out of God’s will? What if I make the wrong choice?

2. What if I committed the sin of blaspheming the Holy Spirit?

3. What if I am missing out on the blessing of God? What does it mean if I don’t feel thankful?

4. What if God wants me to stay in this awful situation? What if my situation is God’s punishment for previous sins?

5. What if I’m not sure I believe? Am saved? Have faith?

6. Is God holding out on me because I have weak faith?

I’m sure there are more you could list (feel free to add to this!) that are unique to Christians.

When working with someone struggling with these kinds of intrusive spiritual fears (aren’t all fears intrusive?), I have noted that they often

  • struggle with frequent guilt
  • are comforted by voices around them telling them that they are okay…but the comfort doesn’t last very long as cognitive efforts to convince them they are wrong fail
  • work very hard to do Christian service–sometimes to the point of compulsion

If you or someone you love struggles with these fears consider the following recommendations

1. Listen for the deepest concern. What if’s are almost always present in anxiety. What if I’m not saved? What if God isn’t going to give me my desires? Instead of responding to the surface fear, listen between the lines for deeper concerns (without debating them). For example, fears about not being sure about faith may really be a deep sensation of guilt and or failure to be perfect.

2. Validate AND encourage re-evaluation of the meaning of the fears. Always begin with validation—communicating that (a) it is clear the counselee has a real problem that needs attention, (b) such concerns are painful, BUT—and this is important—, (c) it might be possible that they have mis-identified their spiritual problem. Fear tends to deceive the mind and misdirect attention away from more important matters (e.g., a worry about germs focuses attention on cleanliness but away from underlying fears of being out of control).

3. Counter fear with STOP and MEDITATE techniques. Most people have their self-soothing techniques. Unfortunately, some of these can add to the anxiety. For example, repetitive “Lord save me” prayers will only lead to more belief that you may not be saved. Look for these repeated responses to fear and try to stop them–even if they seem rather religious in nature. Instead, look to meditate on some other part of the bible or of the character of God–something completely out of the orbit of the fear.

4. Develop alternate goals. Most anxious people would like not to be so. Who can blame them? But eliminating anxious spiritual thoughts may not be a good goal. And, the efforts to do so may only increase the spiritual angst. Yes, medication and preceding efforts may reduce anxiety, often the fears remain active in the background. An alternate goal might include (a) resisting the old dialog that engages the fear as important, (b) choosing to use the stimulus of the fear to focus on a specific person in need (a shut-in who needs a call, praying for someone else, etc.). These alternate tasks will reduce the anxious person’s thoughts about self…and thus reduce their anxiety.

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