Category Archives: counseling

January 3, 2013 · 5:30 am

Good trauma telling?


In preparation for the start of our introductory Global Trauma Recovery course here at Biblical I re-read Richard Mollica’s Healing Invisible Wounds book (see previous posts about the book here and here). Mollica reminds us that there is a healing way to tell one’s trauma story…and there are destructive forms of telling the story.

Destructive forms of storytelling?

Trauma victims do need to tell their story. They need to be heard. But some forms of telling do more damage than good. Signs that the telling may not be helpful?

  • Puts victim/teller into high emotions (reliving the experience versus telling about it)
  • Overwhelms the hearer (who then disconnects thereby leaving the victim feeling more alone)
  • Focuses solely on the trauma or trauma symptoms (e.g., the degradation, shame, etc. thus maximizing paralysis and minimizing survival skills, resiliencies, and other important parts of the person’s life)

Facets of healthy trauma telling?

Mollica suggests 4 facets of good story telling

  • Factual re-telling of trauma (however not every graphic detail)
  • Identifying the cultural significance of the trauma experience
  • Gaining existential or spiritual perspective (reframe from larger perspective on self and world)
  • Identifying the teller/listener relationship forming

Notice that the storytelling is not just about what happened. It is also about the significance, looking from God’s perspective (on self, other, world, etc.) and identifying new connections, skills, resiliencies, etc.

Mollica gives these questions for counselors, family, and pastors to help guide a better story. I find them very helpful if one accepts the caveat that they are not all asked in one sitting nor would we demand articulate answers from victims:

  1. What traumatic events have happened?
  2. How are your body and mind repairing the injuries sustained from those events?
  3. What have you done in your daily life to help yourself recover?
  4. What justice do you require from society to support your personal healing?

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December 17, 2012 · 5:15 am

Diane Langberg on Listening to Trauma


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.

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December 13, 2012 · 9:23 am

Want consultation for your difficult trauma cases?


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.

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December 11, 2012 · 5:44 pm

Hope when it won’t get better?


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?

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December 10, 2012 · 3:53 pm

Repost at www.biblical.edu: What is Christian Psychology?


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.

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December 5, 2012 · 10:27 am

Side effects of Counseling?


Next Monday is the last night of my Counseling & Physiology class (well, last night for the students as I have a boatload of papers to read and grade). As you might imagine, we spend a bit of time talking about psychotropic medications, their value, and probable side effects. Most students fall into one of two categories. Either they have personal and (largely) positive experiences with medications or they have concerns about side effects and observe the tendency of our culture to over-medicate.

But, it would probably be good for me to remind students that there are side effects to counseling or therapy as well. Most clinicians are trained to inform their first time clients that things sometimes get worse before they get better. Counseling requires that you attend to your problems, problems that you may have been in denial about. Talking about painful things usually means you think about them more outside of the hour with the counselor. In addition, you may find that the problem you entered with was only the tip of the iceberg. Or, you may find that the work to be done in therapy is much harder and slower than you thought, or the solution much different than you imagined.

There are a few other side effects that are worth pointing out.

  • You may discover you aren’t the righteous victim you thought you were; that you need more grace and mercy than you want to admit
  • You may discover you have bigger blind spots leading to new areas  to die to self
  • You may discover that others can love you despite your flaws
  • You may discover the joy of accepting some things you thought not possible to accept
  • You may discover better goals than the goal of getting beyond your troubles
  • You may discover strengths you didn’t know you had; success with new habits you had previously believed beyond you

Yes, counselors ought to talk to their clients about the side effects of proceeding in therapy (both general and specific to the particular intervention). Not to have this conversation is to not serve the client well. They need to know what they can expect from you and what other options they might choose. Of course, we also should discuss the side effect of doing nothing at all.

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November 28, 2012 · 5:05 am

One Definition of Christian 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?

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November 26, 2012 · 4:56 pm

Do counselors need a brand?


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.

  1. Can you articulate what kind of services you offer that make you unique? (Don’t overreach and make it sound like YOU are the IT factor; don’t put others down).
  2. Do you have a specialty (population, intervention, location, etc.)? Something that you do well? Do you know how to state your strengths in a confident manner?
  3. Can you frame counseling goals in such a way as to make them attractive to those who may have lost hope?
  4. Are you talking to referral sources (church leaders, schools, communities) and educating others about what you do well?

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?”

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November 16, 2012 · 4:22 pm

Things you won’t hear often in graduate counseling programs


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,

  • Counseling is not nice. Most people get into the counseling business because they want to help people and because others have indicated that they have a gift for listening. Without being negative about the work of counseling, Dr. Langberg reminded us that to counsel with others is to invite garbage into your life. People don’t come to counseling to talk about the good things…
  • Similarly, the stuff of counseling is contagious; it will change you.
  • Counseling will expose you. It will expose your limits of patience, rationality, and love. It will expose your baser reasons for being a counselor.
  • Christian counseling is doing God’s work. It is not our work.
  • Christian counseling is doing God’s work for him (not for ourselves or others).

Just a taste. But she concluded with this call,

Listen acutely. Study avidly. Be the Word.

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November 15, 2012 · 9:01 am

The problem of abuse and avoidance of grief


Last Monday night we had the privilege of having Dr. Diane Langberg on campus to speak to our counseling students. One of the 4 talks she did was entitled, “The Spiritual Impact of Child Sexual Abuse.” She stated that it was material that she developed after publishing her book, Counseling Survivors of Sexual Abuse. As you can imagine, she gave us a very powerful talk. But of all the things she said, one idea seemed to hit students and faculty alike. I do not have her quoted here but rather the essence,

  • Grief may be the most powerful emotion in sexual abuse survivors, more powerful than the pain of the abuse
  • Most clients work really hard to avoid grief; encouraging good grief is difficult work

I’m not doing justice to her thoughts here. But, I think she nails it. Sexual abuse destroys relationships, faith, trust, identity, and physical bodies. To grieve is to name and acknowledge what was lost, broken, stolen, etc. and to admit that many of the broken things cannot be restored in this life–at least to the levels that we desire. The work of counseling surely includes coming to a correct understanding about guilt, shame, love, boundaries. The work of counseling is about reconnecting with God and others. The work of counseling is about rebuilding identity. But, all of these activities require grieving what did take place, grieving what was lost (real or symbolic).

Most of us, whether we have suffered abuse or not, would rather not sit with grief. And so, we run. However, if the heart of God is shown in lament for the world that is not as it should be, then we ought not to run from grief.

May God show us how to lament and live in peace at the same time.

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