Category Archives: Psychology

July 25, 2008 · 4:45 am

When your brain lies to you


Ever were sure of some “objective truth” only to find out that you are wrong?

My dentist told me this week that my brain isn’t telling the truth. After installing a crown on a lower tooth, he asked me how it felt. I stated that the crown was too high and was touching first in my bite. He checked it, concurred, and made some corrections. Then he asked me how it felt. It was better, I thought, but still too high. He checked again with something that tells him how my bite is coming together and that is when he told me my brain is not telling the truth. He stated that the the nerves are sensitive around this newly rebuilt tooth and so it pays attention to that feeling and ignores the rest of the bite sensation.

I’m not surprised. Our brains don’t always tell us the truth. People have phantom pains on amputated legs. Our eyes play tricks on us and so we “see” what isn’t actually there.

Isn’t it hard to accept that some of what we think or perceive isn’t real? It can be quite unnerving.

What about our emotions, assumptions about others, about what God wants us to do? What about our ability to correctly perceive these things? Does our brain/heart lie to us here as well? Have you ever thought someone was mad at you and found out later that it wasn’t the case? Did you ever experience panic over something that turned out not to have happened?

Where are you inclined to hear and believe lies? How did you come to realize you perceived wrongly? What have you done to try to counter these lies, to train yourself to hear the truth?

As to my tooth, I want to believe my dentist. He has a good track record for being right. But right now my mouth says something is wrong. I’m going to make an effort to either ignore the sensation or be mindful of the interesting way the brain works with new information. In a couple of weeks I may change my mind. Maybe my bite is different AND the crown isn’t too high.

2 Comments

Filed under Psychology

Tagged as , ,

July 11, 2008 · 5:00 am

How do you listen to people’s problems all day long?


This is a question we counselors get from time to time, especially when someone is embarrassed that they need a counselor or think they shouldn’t be having problems (or that they are weak for having them).

Today in staff meeting we watched a video on vicarious trauma. This term has been mis-identified with burnout and secondary trauma. In short it isn’t about our symptoms or having our own trauma but about the changes in us after taking in large amounts of other people’s pain.

Individually, hearing any one person’s problems isn’t much of a burden. But when you add all together it gets heavy at times. What do I mean? Well, we begin to see danger of abuse everywhere. We begin to think that all leaders are abusing power. Interestingly, one of the speakers on the video said that early career therapists tend to struggle more with fears and later career therapists struggle more with cynicism.

Most of the problem is the result of the loss of hope. And yes, therapists sometimes lose hope. That is why we have staff meeting so that we can remember that hope comes not from our ability to change the world but that we fallen creatures look to the power of the cross to change us and our clients.

I’m not sure what nonbelieving clients hope in and how they manage living with the weight of the brokenness in the world.

5 Comments

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

Tagged as , ,

July 1, 2008 · 2:02 pm

Power grabs by therapists


We counselors and therapists have ways of asserting our power over our clients. Usually, we do it via subtle messages and phrases. I was reminded of this fact last week during a seminar by Paul Wachtel of CUNY. He told of a case he had of a semi paranoid and hostile client who made many complaints. After one such complaint against him, Wachtel responded with,

Isn’t it interesting that you see me as being just the way your father was

These type of insights offer pseudo-neutral “observations” that are really accusatory and given to show our intellect (but draws them away from their affective state). Further, when we are irritated and make a statement like this we are really saying that my frustration isn’t about me but is about you. I’m objective here, you are not.

When we give insights to clients we need to ask whether or not the client already understands them, will feel that we are working WITH them (not talking at them), and be motivated to do more exploration. As Wachtel stated, insights are often “implicitly adversarial” (never about us either!).

These kinds of linguistic power grabs aren’t just done by analytic oriented therapists (who might be inclined to make distant insights into clients’ unconscious). Cognitive therapists do the same by implicitly and explicitly telling clients that they are irrational and if only they could think like we therapists, they would be so much better.

Let’s not forget that the words we use with clients tell something about ourselves–maybe more than we wish they would.

13 Comments

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

Tagged as , , ,

June 24, 2008 · 5:38 am

Favorite Psychologist in the media?


My Pennsylvania Psychologist came this week and is on psychology in the media. One article talked about the ways psychologists and therapists are portrayed in movies. I guess some are sensitive about the bad portrayal of some therapists and that it might stigmatize or put off the public from using our services.

So, what therapists in the movies or on TV are your favorite? Who is the most lifelike?

My personal favorite is Bob Newhart. Not for accuracy but for comedy.

13 Comments

Filed under Psychology

Tagged as , , ,

June 23, 2008 · 1:00 pm

Last Practicum Monday: Christian counselors in a secular world


Today marks the end of the 2007-8 school year for our MA Counseling students. Some have completed their final credits and others are half-way to their diplomas but I’m sure all are glad the school year is over.

Our students here do fieldwork in a variety of settings: churches, christian private practices, nonprofit social services (hospice, pregnancy centers), and secular or state/federal financed mental health facilities. Those who work in secular settings are often faced with questions about their faith from colleagues and supervisors. Are they going to try to get their clients saved? Will they leave their faith at the door? And students struggle to know what to do with helping clients in some ways (new communication skills) but not being able to help them in deeper ways (putting trust in God during difficult times). Just how should Christians working in secular mental health agencies function? 

First, I very much believe that Christians should be in all aspects of society if they have any hopes of being salt and light in the world. Far too frequently we sequester ourselves from the world and then wonder why they persist in using caricatures of us.

So, if we are going to be in the world but not of it, how might we do it as counselors in a secular setting? I suggest 3 things to consider as we interact with supervisors/colleagues, clients, and our own self:

1. When dealing with an  Agency/Supervisor/Colleague

  • Get to know your context and its/their history with Christians and Christianity
  • When you hear slams or other suspicious questions be sure to explore the “back story” and validate, if appropriate, the bad experiences with naive or offensive behaviors by Christians
  • Discern who you might be able to have a reasonable conversation with regarding the nature of faith and psychology, philosophy of science, ethical care of people (including the exploration of their faith traditions), and the fact that all counseling is evangelistic to some construct of health). In this conversation be sure to using starting points that the other will understand (e.g., ethics, empirical evidence, concerns, etc.) just as St. Paul does at the Areopagus.
  • Communicate that you do not see your job as coercing anyone. You are not responsible for our clients behavior, neither are we for their beliefs. When we raise questions about faith it is to provoke their thinking a bit further

2. When dealing with clients

  • Be sure to ask early in clinical work about faith traditions, current practices, and experiences. These questions fit with what the AMA suggest as important for healing, as community and spiritual resources are quite powerful in the medical literature
  • When given an opening (e.g., questions about God, faith, etc.) pursue gently NOT with statements but questions that may reveal further beliefs, fears, wants, desires, demands, etc.
  • Further, ask how they came to believe what they do believe
  • Point out inconsistencies in belief/behavior; raise possibilities, pros/cons, potential places for hope that may lead to further discussion of God’s handiwork in their lives; Point out places where they seem to recognize their inability to love enough, tolerate enough (gently of course)
  • Be wary of the habit of “telling” others the truth. Many times clients already know the “right” answer. Exhortations may be useful at times but more often than not they cause individuals to become passive–even when they agree with your point.
  • Be ready to answer their questions about YOUR faith with honesty (e.g., what does belief in God look and feel like when everything is caving in?). Be sure not to sugarcoat the Christian life. Be ready to talk about your hope in a broken world (not just for eternity but for now)
  • And if you do talk about your faith, immediately turn it back to them for them to react, explore, challenge, etc.

3. To ourselves

  • Answer the following questions
    • Can I work with integrity within this system?
    • Is giving a “cup of cold water” (e.g., better communication skills) enough for right now?
    • Can I defend what I do say about the Christian faith in my sessions?
    • Am I giving the impression that I believe that there are many ways to God?
  • Develop a theology of mercy ministry akin to God’s providing rain, sun, and health to the just and unjust alike

3 Comments

Filed under christian counseling, christian psychology, Christianity, church and culture, counseling, counseling and the law, counseling science, counseling skills, Evangelicals, philosophy of science, Psychology, teaching counseling

Tagged as ,

June 16, 2008 · 12:54 pm

Are counselors and psychologists an impaired lot?


We’re closing in on the last of the school year. Two weeks to go. Tonight in our ethics class we’ll be discussing the matter of abuse of power, impaired clinicians, and similar issues. In the world of counseling we discuss the problem of impaired counselors/students/trainees when we talk about those who,

(a) do not have the requisite skills, 
(b) have character/attitude deficits, or
(c) reactions to current crises,

AND are unwilling or unable to repair the situation.

First, we ought to be aware of those who are attracted to being counselors. Jeffery Barnett, et al, report the following data from other studies (as cited in the 2007 Professional Psychology: Research & Practice, 38(6), pp 603-612):

  • 70% of female psychologists had been either sexually or physically abused as children
  • 33% of male psychologists report the same
  • 33% of psychologists report being abused as adults
  • They feel the effects of these difficulties (and other family crises) just as non counselors
  • They may be less likely to get help due to knowledge and professional identity
    • 60% acknowledged being significantly depressed during some point of their career
    • 29% reported being suicidal at some point
    • 4% had made suicide attempts

Gizara & Forrest (2004 Professional Psychology: Research & Practice,35(1), pp 131-140) reported supervisors experiences of trainee impairment in APA accredited internships (doctoral level). Many of the supervisors had a hard time defining impairment in counseling but had sort of what I call the “I know it when I see it” mentality. What they often described were the disruptive, persistent relationalconflicts that are obvious to most. They did identify that it is hard for supervisors to address these matters because they (a) are trained to be empathic and to try to save everyone, and (b) not wanting to deal with conflict, destroy a career, or make oneself vulnerable to attack that they are holier than thou.

But, I noticed not much discussion or research regarding the one who doesn’t have obvious abrasive relational skills who is prone to using clients and others to make themselves feel good. This kind of person is dangerous not because they disrupt the counseling center but because they are so well liked that they make others overlook “minor” ethical infractions. Further, the person is rarely cognizant of their using others for their own sense of well-being.

To answer my question. No, I don’t think counselors are an impaired lot–at least any more than others. If we are aware of what drives us to be counselors (the good AND the self-serving), are willing to be counseled, discipled, held accountable, etc. (are willing to be transparent), and see our work as God’s first, then I think we are rather a safe lot.

Watch out for those of us who think we have arrived or no longer need teaching. I’m reminded of Aslan’s question to Prince Caspian at his coronation:

Aslan: Do you feel yourself sufficient to take up the kingship of Narnia?

Caspian: I-I don’t think I do sir. I’m only a kid.

Aslan: Good, If you had felt yourself sufficient, it would had been a proof that you were not.     

9 Comments

Filed under Abuse, biblical counseling, christian counseling, christian psychology, counseling, counseling science, counseling skills, Psychology, Relationships, self-deception, teaching counseling

Tagged as , ,

June 9, 2008 · 11:43 am

Practicum/Ethics Monday: Multiple Relationships


All counseling ethics codes address the potential problem of multiple or dual relationships (when counselors have other relationships with their clients or former clients (e.g., counseling a friend or a child of a friend, having a former client as a business partner, etc.). Some codes make it appear that dual relationships are either always or likely wrong and so should be avoided. The AACC code is a bit more liberal in that it (rightly) defines the problem as increasing the problem of exploiting or harming the client. However, this code explicitly defends the biblical nature of dual relationships since we are all brothers and sisters of the same body. Other codes have recognized that it is not possible to always avoid dual relationships. But all codes remind the counselor that it is their duty to defend the healthiness of any dual relationship. In essence, it will be “guilty until proven innocent.”

There are 3 forms of dual relationships (sexual and client; nonsexual social and client; financial and client). Not every dual relationship is with the client (e.g., a counselor has a relationship with the mother of a teen client, a client is under discipline at your large church where you provide consultation to the elders). Dual relationships may happen AFTER counseling is over (begin a friendship with a former client). Finally, it is not merely harm or exploitation that may be the negative outcome of a dual relationship. A counselor may find that a dual relationship hinders or decreases her effectiveness to provide adequate care. [See Lamb et als article in the 2004 Professional Psychology: Research & Practice (35:3), pp 248-254 for a study on these issues].

This last one is the one I want to hang out with for a bit. I had a former client who I had known and highly respected before we started counseling. At the beginning we explored the potential harm that might come from this dual relationship. Both of us deemed that we could manage the slight dual relationship. And I think we did well and the client found the counseling helpful. However, there was a period in the counseling where the client became severely depressed and suicidal. I found myself less willing to hospitalize because I had an image of this client in my head that was much more stable than was actually true. Now, I never like or want to hospitalize. Most psych hospital stays provide protection but little more in the way of healing. But, I know I would have been much quicker to pull the trigger (bad pun I guess) if I hadn’t previously formed an opinion of health before starting the counseling relationship. We should not forget the possibility of reduced effectiveness in dual relationships.

Let me take this one step further. You may have a client who shares your same faith or doctrinal positions, graduated from the same school (but a different time). Any of these connections MIGHT cause you to be less effective in your work because of bias, groupthink, etc. These are not reasons to NOT counsel them but things to keep in mind. Reduced effectiveness because of dual relationships should not be neglected just because we are too busy talking about the rare counselor who decides to have sex with his clients.

2 Comments

Filed under christian counseling, christian psychology, counseling, counseling science, ethics, Psychology

Tagged as , ,

June 2, 2008 · 5:24 am

Practicum and Ethics Monday: Deficient Trainees


Since both of these classes are in progress here at Biblical, I thought I’d bring up a rather touchy subject: impaired students. Ruth Palmer, Gwen White, and Walter Chung (a Biblical grad!) all of Eastern University have recently published an article in the Journal of Psychology and Christianity(2007, 27:1, 30-40) entitled, “Deficient Trainees: Gatekeeping in Christian Practitioner Programs.”

Palmer et al surveyed profs in master’s level counseling related departments at Christian colleges and universities to find out, 1. what percentages of students were perceived by the profs to be professionally deficient, to have received help or dismissal. 2. Whether or not the schools have formal gatekeeping procedures. 3. Whether senior level faculty and junior level faculty perceive the pressures of dealing with impaired students differently, and in part, 4. Whether views on grace, calling, and gifting have any effect on how faculty respond to deficient students.  Their study replicates one done on secular campuses.

Before I mention the results, it would be good to consider why this is important.

1. Because faculty are obligated to protect the public. The authors quote from the ACA code of ethics, “Counselor educators, throughout on-going evaluation and appraisal, are aware of and address the inability of some students to achieve counseling competencies” (ACA, 2005, Section F.9.b) (p. 31). This is a relatively new topic amongst programs. Previously, we merely taught our students but it was up to licensing boards to weed out incompetency. Not so any longer. And rightly so is this change. We have an obligation to remediate problems before sending folks to their fieldwork sites. When we bless a student with an internship, we are saying they are ready to work at an entry level. When we find students with significant relational, behavioral, motivational problems prior to graduation, the authors remind us that the data are “strongly linked to subsequent poor performance in clinical work. (p. 31)

2. Counseling programs tend to attract people who are working out their problems. In fact, the authors point to a study that reported first year counseling students showing more severity of problems on MMPI scales. (This may be partially explained away by the common tendency of students to think they have all the disorders of the DSM). While this isn’t necessarily a bad thing (could mean that students are more likely to be cognizant and empathetic to the trials of life), it becomes a problem when said students are either unaware of the extent of the problems, unwilling to work on these problems, or so overwhelmed in the moment as to not have the capacities to deal properly with the problem. I find most students very committed to personal growth and change. There are those, however, who are so desirous of the prestige of the position or of looking good that they cannot bear to admit their flaws. The authors point out the crux of the problem. “…there is a tendency of impaired students to resist submitting to ‘the very therapeutic process through which they wish to lead others,’… (p. 31)

3. Finally, turning a blind eye to student problems and/or mismatch in skill/profession/calling is akin to walking around the man and left to die on the side of the Jericho road (Luke 10).

Results of the study? The authors got responses only from 1/3 of the surveyed professors (the surveyees should be ashamed at their lack of cooperation with this important study! They ought to know better having all been through programs that value the research question). But from respondents they found,

  • Faculty of CCCU estimate an avg. of 10.9% of impaired students in their program (SD=9.89; I would have liked to see the modal response since the range was from 0% to 50%!! reported). This fits with the prior secular program survey.
  • Interventions with these impaired students only happens about 50% of the time (again a big SD with response rates ranging from 0% – 100% (yeah, right!)). 38% of faculty reported interventions less than 20% of the time.
  • What are some of the bigger reasons for not addressing these matters formally? Fears of lawsuits, institutional pressures (we need students to survive!), fear of poor teaching evals by junior faculty, and inadequate administrative support.
  • They suggest the need to have departments talk regularly about policies, students, and the need to follow-up with potential or actual problems.

Do we ever have impaired students at Biblical? Of course. But I am determined at dept chair to help those in need find help. I remember being a student at another seminary and seeing those that EVERYBODY knew should never be a pastor or a counselor and yet NOBODY (student or teacher) said a word. So, we have 6, 12, and 18 month evals collecting data from the student, profs of each class, peers, mentors, and supervisors to help catch a remediate problems when they exist and to encourage on-going personal growth even when they don’t exist. It still surprises me when I find counseling students balking about getting some of their own counseling. We really do want to be the one who has it together, don’t we. Me included.

3 Comments

Filed under christian counseling, christian psychology, counseling science, counseling skills, Psychology, teaching counseling, Uncategorized

Tagged as , ,

May 26, 2008 · 5:20 am

Top 10 Counselor Nightmares


No classes today because of the holiday. Next week, we’ll be discussing the perils and pitfalls of being a counselor. In partial jest here’s my “top 10” counselor nightmares. A few of these happened to me, some happened to my friends and others are just fears: 

10. Someone from your past shows up as a counselee or at a seminar you give and they know all your immaturities

9. You run into a counselee from a couple of years ago and although they are grateful for your help,  you don’t remember ever meeting them before

8. Spending the whole hour with a new client and your fly was down and open the whole time

7. Same as 8 but you passed gas

6. Its time to pray at the end of the session and as you go to pray for them you can’t remember their name and so you have to pray for your “brother” instead.

5. You worked really hard helping a resistant client learn something and then they come in and tell you that their aunt told them this amazing thing (the thing you have been trying to tell them for 6 months) and now they wonder why you didn’t help them.

4. You come to the waiting room only to find you double booked by mistake.

3. You’re at the hospital having a colonoscopy and you find out the nurse assisting is your client who probably hates you

2. You fall asleep in session for a few minutes and wake up wondering how long it has been and whether they noticed or not (they did!)

1. Subpoena and/or call from the licensing board

3 Comments

Filed under Psychology

Tagged as , ,

May 22, 2008 · 10:04 am

Subtle Racism: How do you know it’s happening?


“You just know.” Well, how DO you know? It seems that in the US minorities are well aware of both explicit and implicit or subtle racialization. But on the other side, dominant culture (White) folk are quick to point out that certain comments (“you are so articulate” to a Black man) might not be racist. Stupid but not racist. So, whose being over-sensitive?

The latest American Psychologist (63:4) has comments and author reply to a previous article by Derald Wing Sue et al on the topic of microaggressions(in vol. 62, entitled: Racial microaggressions in everday life: Implications for clinical practice). 3 of the 4 commenters were defensive of Sue’s allegations of these microaggressions. And Sue replied saying that their defensiveness is ample evidence that white people can’t take the reality of racism. They always want to find other reasons for racist activity (i.e., oversensitivity of minorities).

End result? No good dialogue; distance; defensiveness. One guy questions one of Sue’s hypotheses in his article and suggests an alternative (innocently portrayed). Sue replies and says he of course considered (and rejected) that hypothesis and that the guy has a problem because he can’t deal with the reality of racism.

What got the commenters up in arms wasn’t the science in the article but Sue’s personal story of being asked to move to the back of a small prop plane to balance the weight out when 3 late arriving white businessmen were not asked to move. In a personal story, we make ourselves vulnerable to attack because it is our perceptions that we state as reality that tempt others to challenging what we “saw”. 

Unfortunately, the inability to talk about microaggressions is based on the problem of defensiveness of both sides and feelings of invalidation when one questions our sense of the world.

Leave a comment

Filed under Black and White, Psychology, Race, Racial Reconciliation

Tagged as , ,