Category Archives: Psychology

Suicide education and prevention in the church


Suicide is in the news these days. Military suicides are off the charts. Bullied teens are in the news this week along with a nationally known pastor’s son. Suicide is an important topic! We need to talk about why, for some, suicidal thoughts (fairly common across the population) become plans and actions. We need to explore what helps reduce suicide as a desirable option. We need to talk about how to care for those left after the horror of suicide.

But here’s a question: Have you ever heard a sermon or a Sunday School lesson on the topic of suicide?

I can’t say that I have.

This week I was sent a survey about graduate theological education and suicide assessment and prevention training. Our counseling students get a bit of education on suicide assessment in a couple different courses. They read an article or two on the topic. Not really enough but our challenge is to know what to cut in order to fit more suicide material into the program.

The result is that most learn in the middle of a crisis. Not really the best plan.

If you are looking for materials, let me point you to a few:

1. National Action Alliance for Suicide Prevention.

2. CCEF. Use their search tool to find their resources in this packed website (some free, some cost a bit). Jeff Black’s article on understanding suicide is helpful. There are several blogs that are free.

3. Al Hsu’s book, “Grieving a Suicide.”

4. American Foundation For Suicide Prevention.

If you google suicide and christian, you will notice that the vast majority of material is about whether or not suicided individuals can still go to heaven. While this is an important question, it appears that we have spent more time on this topic than on that of prevention and intervention.

Maybe we can do a bit better than this? Let’s commit to talking about it rather than being afraid.

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Filed under Depression, Psychology

What if your spouse acts the part of empathic listener (but really isn’t)?


You’ve had a bad day. Your spouse comes home and you proceed to tell them about your difficult, frustrating day. When you finish telling your tale of woe, your spouse says the following (with appropriate feeling)

Wow, that really was a tough day. I’m sorry it has been so hard for you. Why don’t you take it easy and I’ll handle…[whatever menial task you would normally do right now]

Normally, this validation would feel quite nice. But what if you knew that your spouse didn’t really feel the warm fuzzies they were trying to send your way? What if they were only saying what they thought you wanted to hear?

Would you still feel loved because of the effort they made? That they wanted to “fake it ’til they make it”?

A recent This American life radio episode covers this very issue. The fifteen minute episode tells of a man with Aspergers who needed to learn how to love his wife and did so by observing and mimicking others who had better social skills. At one point in the show, the interviewer asks his wife if it matters to her that her husband doesn’t feel the empathy he is trying to convey.

Her answer? No.

What would your answer be?

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Filed under love, marriage, Psychology, Relationships, Uncategorized

What PTSD might feel like


If you haven’t experienced PTSD from a traumatic experience, you might wonder what a traumatic reaction might feel like. What I give below is just a teeny window. Note that what I write about is NOT PTSD but shares some of the same features on a very small and temporary scale.

Imagine the following:

You are sleeping peacefully but at 3:30 am by a horrible metallic crash just outside your home. You recognize the sound as a car crash. What follows that sound is continued crashes, spinning tires, shifting gears, more smashing sounds, shifting gears, then your house rocks when the vehicle hits your porch. You grab your glasses and stumble to your feet, find your pants and start for the phone to dial 911. Without yet seeing what is happening, you imagine that someone is choosing to smash another vehicle in order to get revenge. In a flash you imagine someone very angry who may be dangerous. You try to dial 911 but its dark and you are not yet awake. On the 3rd try, you get it right and the operator comes on the line. She asks several questions (who are you, spell your name, where do you live, what is your nearest cross street, what is your telephone number, what is the emergency, is anyone hurt, etc.). You struggle to answer these questions because of the distress of the situation and the tightening knot in your stomach. You hang up and look out the window. The sound of the offending vehicle dies away. You look outside and see a smashed car crossways the road. It is dark so you cannot tell if anyone is in the vehicle, if anyone is hurt, if danger is outside. You feel paralyzed and sick to your stomach. Should you go outside and see? What if the violent person is still out there?

Soon, the police arrive and neighbors pour out of houses. You venture out to learn that a drunk driver lost control and smashed into a parked car. the driver ended up on your neighbor’s grass and the repeated smashes were the result of his attempt to get back onto the street. Each neighbor describes what they heard or saw. The police arrive and take their reports and photographs. As neighbors share stories and laugh (even the one whose car was destroyed), you feel your stomach relax and you return to you bed for what is left of the night.

The next day, you go to work a bit more tired than usual. You tell a colleague or two about the experience. You perform your duties without significant difficulty. BUT, at moments of silence, you keep hearing the noises of the smashes, spinning tires, more smashes. You feel your stomach tense. You feel embarrassed that you struggled to communicate to the 911 operator. You feel embarrassed about your hesitation to go outside. You feel somehow that you would have failed to protect your family if they were really in danger (due to paralysis). You remember 2 other times you didn’t respond well to a crisis. The next night, you find yourself wound up and unable to sleep.

Again, this little vignette does not make a PTSD diagnosis. Those who have experienced terrible traumas (e.g., sexual assault, witnessing sudden death or forced to participate in a killing) would likely feel this event is simplistic. They are right and yet, you might see how the body/mind may respond to a crisis or the perception of a crisis.

  • Experience of danger
  • Inability to get away from it
  • Horror response
  • re-experiencing intrusive memories
  • Hypervigilance
  • Attempts to shut down the intrusive memories and emotions

Notice in this situation, some of these PTSD symptoms are not present and not likely to form. the problem resolves quickly and, more importantly, the shared conversation with neighbors afterwards reduces much of the isolation that is often common in traumatizing experiences. And yet, notice that sounds of the accident keep coming back to the person. In addition, this person feels some level of guilt and shame about the response to the event. This feeling can increase isolation and negative ruminations about personal failures.

Given this situation and it’s randomness, the person is not likely to remain distressed. Symptoms such as these tend to fade quickly. If, instead, the scenario contained sexual violence by a loved one, confusing physical responses, threats to one’s life if you cried out, you can quickly see how the symptoms would not easily fade but would grow in intensity, frequency and duration.

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Filed under Psychology, ptsd, trauma, Uncategorized

Psychopharmacology for counselors? Take a class at Biblical!


This summer, Jim Owens, PsyD will be offering a one weekend class (Aug 23-24) entitled, Essential Psychopharmacology for Counselors. Jim is a board member here at Biblical and has extensive training in psychopharmacology. In fact, he is board certified by the Prescribing Psychologist Registry. He will review traditional and alternative medicines commonly used today as well as best practices for engaging prescribers. In his course description he says,

The ever-growing use of medications, both traditional and complementary, to treat mental health problems, has both helped and harmed many people. Approximately 80% of all psychoactive medicines are prescribed or recommended by non-specialists, who frequently have little time, training or experience to accurately diagnose the person’s condition. Therefore, trained counselors and psychotherapists are in a crucial position to aid their clients in getting appropriate treatment. This involves knowing some basics regarding which available talk therapies as well as medications are most likely to be helpful for those struggling with certain problems. It is also important to know how to interact with your clients’ physician(s) and other health care providers.

Get CEs!

The course is 1 graduate credit (includes some pre and post course work) OR, 9 CE hours for counselors. Biblical is an approved provider of CES for counselors by NBCC. To read more on costs and other CE approved courses this summer, click here.

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Filed under Biblical Seminary, christian counseling, christian psychology, counseling, counseling science, counseling skills, Psychiatric Medications, Psychology

Could surprise divorce cause PTSD?


A former student (HT Armando!) sent me this link today about a woman who experienced PTSD like symptoms after receiving an out-of-the-blue text from her husband telling her he was leaving and divorcing her.

She experienced flashbacks, nightmares, became hyper-alert to dangers, unable to sleep and other such symptoms that are common to PTSD. She did not have an actual or perceived threat on her life–a necessary requirement for the current diagnosis of PTSD. However, she did seem to respond to the surprising evidence that her husband had deceived her for some time as having been “sleeping with the enemy.”

This question for you is whether you think it harms those who suffer classic PTSD (i.e., those who do experience a threat on their life) to lump them together with those who have similar symptoms from non-life threatening trauma. Yes? No?

I have observed pastors in significant conflict with church leaders exhibit PTSD like symptoms. I have observed individuals who learn in late adolescence or adulthood that their parents were actually adoptive parents. It appears that some of the same symptoms exhibited by those who experienced rapes, car crashes, or war trauma show up in some individuals whose world is turned upside down by another’s deception and duplicity.

So I ask the question again: What is gained or lost by expanding PTSD diagnosis to include those with similar symptoms but without the threat of physical injury or death?

Here’s one gain and loss for someone having this kind of divorce reaction. Those who have the symptoms without the physical threats may find some comfort in knowing their reactions are had by many others. However, I would imagine that most of these same people may find their symptoms abate more quickly than that of those who see actual death and destruction. Thus, a diagnosis of PTSD may end up hurting them due to an over-estimation of recovery time needed.

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Filed under counseling science, Post-Traumatic Stress Disorder, Psychology

“Schizophrenic and Successful”? What are the factors in success?


This recent New York Times Opinion Page essay is written by Law Professor, Elyn Saks. She tells a bit about her diagnosis of Schizophrenia years ago and her fight against those who thought that she would not amount to much. While we shouldn’t assume that everyone who struggles with delusions and hallucinations will rise to Dr. Saks level of accomplishments, we should take note where we give in to hopelessness when someone we love receives such a similar diagnosis. Such hopelessness will surely hamper our loved one’s prognosis for recovery.

There are two important factors that predict both recovery from mental illness and future recurrence of symptoms.

  1. Acceptance of diagnosis and treatment compliance
  2. Absence of family and social stressors

These factors are found in nearly all forms of mental illness, but especially pertinent for depression, mania, and psychotic disorders. When a person accepts the existence of a problem and commits to a treatment strategy, they are likely to be more cognizant of the signs and symptoms re-appearing and therefore willing to seek additional help. When medications create irritating side effects, the committed person will either find ways to tolerate these irritations or work with their doctor to find alternative treatments.

The absence or minimization of family stress requires the family or community to not behave in ways that exacerbate the problem. The family must also accept the limitations and not act in ways that place unrealistic expectations on the patient. This of course requires a great deal of sacrifice–on top of existing grief and loss over relationships that will not be what they could be (e.g., caretaking a spouse with mania, supporting an adult child who needs a sheltered environment). This means releasing the demand for the patient to reciprocate empathy or have insight about their impact on the family. Still further, when we loved ones maintain a hopeful perspective–identifying a patient’s value, capacity, and possibility for a future–we offer that person the greatest chance for success.

For some, success may mean being able to hold down a steady cashier job. For others, success may mean staying out of the hospital. Still others may rise to Dr. Saks level of success in academia. If you have a family member who suffers with mental illness, work hard to see them beyond their illness and evaluate their current capacities (rather than by their best or worst day). Oh, and be sure to find someone to talk to. Your family member isn’t the only one who needs help coping with a difficult world!

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Filed under counseling, counseling science, Psychology

A Danger in Christian Counseling Theory?


The faculty blog at Biblical Seminary (where I teach) has published an edited version of an older post here on this site. If you like cheeky titles, try this on for size:

Christian Counseling Theory and the Bible: A Dangerous Mix?

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

What happens after a trauma may be the key in the formation of PTSD


Thanks to a friend I read this essay today about a possible way to model PTSD formation–by considering what does or does not happen in the trauma victim’s social environment after the trauma experience. The article discusses 2 different studies, one animal and the other human.

The animal study concludes that kidnapping a mother rat from her pups for more than 15 minutes will result in anxious activity upon reunification in the same cage where the trauma happened. Mother and pups will continue to be over-reactive well beyond the event. However, if mother and pups are reunited in a new environment, the trauma reactions (racing around, stepping on each other, aggressive behaviors) seem not to be present. Might it be that they have a shared job of exploring the new environment?

The human study points to the importance of having reunification symbols or rites of re-entry when bringing child soldiers back into the community. This appears to have value over just quietly pretending that nothing happened.

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Filed under Abuse, counseling, counseling science, Post-Traumatic Stress Disorder, Psychology, trauma, Uncategorized

Do psychological explanations of behavior absolve wrongoers?


If I describe the psychological characteristics of a violent person (e.g., has autism, a brain tumor, or a history of child sexual abuse), does that tend to be heard as absolution for crimes committed? In turn, does that make you skeptical about the value of psychology?

My latest edition of the American Psychologist (2012, v. 67:9) has a brief comment/discussion about the phenomenon of public skepticism of the field of psychology. The comments refer to a previous article published by the same journal earlier in the year. That essay reviewed common reasons for skepticism and how the field should counter them.

I’m not going to discuss the initial article nor whether or not the rebuttals are helpful. What I want to point out is one comment by Newman, Bakina, and Tang. They provide an anecdotal experience of suspicion after making public statements to a newspaper following criminal behavior. They noted that a person wrote a letter to the editor stating, “These remarks consist of convoluted thinking that absolves all participants of any personal responsibility for what happened.” In response, here’s what Newman et. al have to say,

This anecdotal experience reflects a more general finding. Laypeople are suspicious of accounts of human wrongdoing that feature situational/contextual factors (as typical of social-psychological explanations), and they prefer dispositional ones. Clearly, the letter writer would have been much happier if the psychologist’s comments had focused on how cowardly and immoral the [criminals] were. (p. 805, emphasis mine)

Do you agree? Do we prefer characterological reasons for behavior rather than descriptive/contextual discussions? Do we think that discussions of context or mindset absolves others from responsibility for wrong behavior? Having taught physiology to counseling students, I can say that some students find discussions of brain abnormalities (an example of one contextual matter) as tantamount to saying that the person must not be responsible for their actions.

How do we do a better job in being highly descriptive of human behavior without denying moral responsibilities? (i.e., that I cannot help certain matters but yet I am still responsible for what I do)

 

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Filed under christian counseling, christian psychology, Psychology

Diane Langberg on Lessons for Counselors


Back in November, Diane Langberg presented 10 things that counseling students might not normally hear about during their academic training. Click here for the video.

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Filed under Biblical Seminary, christian counseling, christian psychology, Christianity, Psychology, teaching counseling