Category Archives: Uncategorized

January 21, 2013 · 5:45 am

The Christian Counselor’s Greatest Temptation?


Ask any beginning counselor and they will tell you that the one thing they most want to know is, “What do I say? What do I do?”

No one gets into the world of Christian counseling just to see messes. No, we take up the work because we want to see people recover life and health. But with the desire to see others get well, we also face the large temptation to push people into places of health. We want to tell people what to do

  • For those we find disagreeable or resistant: We want to tell them the full extent of their problems (rip the bandages off and make them see!)
  • For those we have compassion: We want to tell them it will be all right
  • For those we see are stuck: We want to tell them specific steps to wellness
  • For those we find to be much like us: We want to tell them they are doing just fine

Telling, exhorting, (or less nice words: cajoling, forcing, pushing) is a great temptation for every counselor. We want to impart our wisdom. We want to feel good by solving other people’s problems. We want others to experience our successes or our love for the Bible.

What does Jesus know and do?§

Do you find it odd that Jesus asks the blind man, “What do you want me to do for you?” Do you think Jesus didn’t know what he wanted? Or what about Jesus’ question, “Who touched me?” after the woman touched the hem of his garment. Did he not already know? We see that Jesus frequently uses the form of question in order to draw out the heart and mind of the person seeking help.

Do you want to be well? Where are your accusers? Where is your husband? Whose image is on this coin? When you went into the desert, what did you go to see? Where is your faith?

While we I don’t intend to argue that Jesus’ question asking somehow makes a rule for us, I do intend to argue that questions are more likely to lead to the client’s active engagement of a topic than telling them the conclusion. When we listen to others tell us values, facts, ideas, it is easy to slip into a passive acceptance or passive neutral stance. But when asked a question, we who answer more frequently engage the question.

§These biblical passages were discussed by Rev. Rick Tyson in our annual worship service at our counseling practice.

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January 13, 2013 · 4:42 pm

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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January 8, 2013 · 10:52 am

Thinking again about justice and righteousness


With the upcoming Justice conference (we’ll be there!), I am thinking again about the relationship between individual righteousness and corporate justice. That thought reminded me further of a post I wrote while in Goma, DRC where justice is not often found–even more so a year later! Here’s what I wrote last October:

Hungering for Justice? A New Read on an Old Verse

During my recent trip to the DRC and Rwanda I practiced French by reading the Bible in French and English. Not sure it helped much but I did discover an interesting difference in Matthew 5:6 between the two translations that made me stop and think.

First the NIV:

Blessed are those who hunger and thirst for righteousness, for they will be filled.

Now the French:

Heureux ceux qui ont faim et soif de la justice, car ils seront rassasiés!

Notice something different? Most English translations use the word righteousness. Those who hunger after righteousness will be filled (or find satisfaction?). Now, when you substitute the word justice–those who hunger and thirst for justice–does it add meaning to you?  It does to me.

Justice? Righteousness? Do you hear differences?¹

When I hear the word righteous, I think of individual holy acts, attitudes, and character. When I hear the word justice, I often think of fairness, judgment, and legal outcomes that make right prior wrongs. In reading this verse in French and in Goma, DRC where so many have no justice and can’t return to their villages due to ongoing conflict, my mind considers that Jesus might be saying that those who hunger and thirst after justice are going to be blessed in a particular way.

Obviously, those who hunger and thirst after righteousness will also long for justice for individuals, communities and states. One cannot be righteous and yet unjust or just and unrighteous. However, it is possible for us to fight against sin in our own lives, practice individual acts of righteousness, and yet forget to pray and work for justice for those who are being oppressed.

Some years ago Carl Ellis, in a class on African American theology, suggested that White evangelical churches often preach and teach about individual righteousness (i.e., what to put off and what to put on) but rarely teach about corporate righteousness unless it is to rail against worldly matters (e.g., abortion, homosexuality, greed, etc.). I do think this is changing as evangelicals are paying attention to matters of justice around the world. Yet, we can be reminded that God cares about those who are unjustly treated. It is not just Abel’s blood that cries out (Gen 4:10) for justice.

Thankfully, there is a just and righteous outcome. The sacrifice of Jesus “speaks a better word than the blood of Abel.” (Heb 12:24). Yet when you read Matthew 5 don’t forget that God is actively blessing those who are oppressed. He will satisfy them by fulfilling their desires. Let us not forget to hunger and thirst after justice for ourselves and for the world.

¹In this post I am not tackling the best translation for the Greek word (δικαιοσύνην) used in this verse. The 92 times it is used in the KJV are all translated righteous/ness. However justice is implied in 2 Peter 1:1 as we have faith due to the righteousness of God.

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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 31, 2012 · 2:33 pm

Who regulates electronic forms of counseling?


As we close out 2012, we continue to have little clarity regarding the regulation of tele mental health services. I received this newsletter from my state licensing board. It nicely reviews some of the ethical and practice matters for mental health services provided in non-face-to-face settings. However, read the “note” at the bottom,

Note:  If psychological services are provided and/or received in a state other than Pennsylvania, the licensure authority in that jurisdiction should be contacted regarding licensure requirements and practice limitations.

Pennsylvania cannot regulate what we do elsewhere. However, they do not seem to regulate the provision of telehealth to PA consumers by outsiders. This will remain a gray issue until either (a) a legal ruling in a case or (b) states explicitly limit the practice of telehealth.

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December 15, 2012 · 8:29 pm

Mandated reporting of violence risk?


Likely, you are participating in the current national soul-searching after the latest tragic school shooting/mass murder. In our angst we ask, “Why God?” and “What can we do to try to stop this kind of senseless killing?”

It is the second question that is on my mind right now.

Political debates will abound about gun control measures or the right to bear arms. In my humble opinion it is time to move beyond that debate and address the treatment of those who are most at risk to engage in mass killings. I have no idea about the mental status of this most recent killer but that shouldn’t stop us from trying to figure out how to better care for such individuals.

Who is at risk? A complex matter

Violence risk assessments have morphed over the years from clinical judgment (turns out our intuition wasn’t very accurate!) to an actuarial approach looking at factors like: active psychotic symptoms, family problems, history of aggression/domestic violence and or criminal behavior, social withdrawal/skills deficits, and substance abuse. But of course, there are many who have positive indicators on several of these factors who are in no danger of becoming a mass murderer. Still others meet none of these risk factors and yet become killers. [Read Randy Otto’s short paper on violence risk assessment and discussion of the historical, clinical, and environmental factors of violence risk]

One possible (partial) solution

Right now mental health professionals and educators are required to report possible child abuse. In addition, we counselors have duties to warn and protect when our clients indicate they are an imminent (meaning, immediate) danger to self or other. Sadly, many adults in high risk categories are not likely to be in treatment (due to costs, treatment availability and refusal) and may have enough sense not to make threats to those who are obligated to report.

So, what might we do to help those who do come in contact with at-risk individuals? In some states, all civilians are required to report potential child abuse. What if we develop a reporting mechanism for civilians to report those who are making statements about violent acts?

To make this procedure work, there are some additional changes we would have to enact (some of which are not simple)

  • We would have to engage in a large public awareness campaign and to train law enforcement and even mental health professional to recognize risk factors
  • We would need to develop humane but required treatment protocols
  • We would need to stop cutting public funds for mental health (and increase quality of community mental health care providers), and
  • We would need to consider limiting some of the currents rights to decline treatment when a number of the risk factors are present (this is, of course, no small matter. In this country we have the right to be insane…as long as we don’t hurt others).

Some need a rescue

Soon after the Connecticut shooting, The Huffington Post ran an op ed blog post by a mother of a mentally ill young man. It went viral as it was “a gorgeously written piece” by a mother whose son’s behavior terrified her. She well described the isolation and inability to find proper treatment and care for a son she loved but could not control. Almost as soon as her piece went public, others outed the writer as a person with mental illness who publicly blogged about wishing to strangle her children (see above link for that story). Despite her lack of judgment in prior writings, the original piece reminds us that there are many families suffering without avenues to help the ones they love. If we are going to make progress in quelling mass violence, we had better start building better mechanisms to treat the mentally ill and to support their family members.

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October 10, 2012 · 5:04 am

Global Trauma Recovery Institute website launched


We’ve finally gotten Global Trauma Recovery Institute off the ground with our web presence and our upcoming courses! Check out the download forms on the right side of the GTRI page for application, course abstracts, and information on small group consultations with Dr. Langberg and myself.

To refresh your memory, we have a 3 course design for continuing education and training regarding the work of global trauma recovery facilitation. Courses are designed to be at the postgraduate level and each course is divided into two parts, an online portion and an on campus portion. While the online portion can be taken alone, those who wish to be eligible for the immersion portion must complete all three online and on campus portions.

These three courses will prepare participants at a beginning stages of facilitating recovery efforts in the places God has placed on their hearts. We will be exploring the nature and impact of a variety of traumas, how best to listen, learn from, and engage a particular culture, and how to collaborate with local caregivers to improve existing trauma recovery efforts.

In addition, we offer individual or group case consultations. Our first group consultation cohort will begin January 11, 2013 and meet monthly for six months (in Jenkintown, PA). Sign up now since we will only be taking 6-8 for this cohort.

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September 25, 2012 · 2:26 pm

Book note: Unbroken, the story of Louis Zamperini’s traumatic WWII experiences and survival


Just finished Laura Hillenbrand’s Unbroken: A World War II Story of Survival, Resilience, and Redemption (Random House, 2010). She tells the story of Louis Zamperini’s early life (which depicts the miracle of his surviving childhood and his own juvenile delinquency) leading up to his Olympic experiences in Berlin and then his airmen experiences in the Pacific. In May, 1943, while looking for another plane that didn’t return to base, Zamperini’s plane goes down in the middle of the South Pacific. Against the odds, he and 2 others survived.

Actually, the miracle that he survived could be said about his entire life: impoverished immigrant family, juvenile delinquency, being an Airmen, surviving a plane crash in the middle of the Pacific, surviving on a flimsy raft for 47 days without any food or water other than rain or raw fish here and there, surviving torture by the Japanese for a couple of years and then, finally, surviving PTSD and accompanying alcoholism.

Read the book of you are interested in the life of airmen in WWII (it is amazing how many died in noncombat crashes). Read the book if you are interested in hearing how psychological trauma from war and torture often impacts a person. Read the book if you like surprising endings.

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September 18, 2012 · 2:09 pm

Individual or collective responsibility in matters of justice?


If you read blogs you likely follow current news and are aware that a you tube movie trailer has spawned protests, violence and death in Muslim dominated countries. Haven’t seen the movie and don’t intend to. From what I hear it paints Islam and the Prophet Mohammad is some rather unflattering (and for Muslims, offensive) light.

For most Americans and Westerners, it can be hard to understand the reaction. No one (I think) believes the American Ambassador to Lybia had anything to do with the production of the movie or was in support of it’s depictions of Islam. Yet, it would appear that some thought it reasonable to take his life in response to the film’s damage. The same would be true for lesser forms of violence in other parts of the world (car burnings, threats to life, destruction of US property in foreign territories)

Is it religion or culture?

Though we could easily chalk reactions by Muslims up to religion, I think culture may play a greater role in this one. We Americans, apart from religion, see the world as individual. We are concerned about individual justice and individual fairness. It is hard for us to accept responsibility for things we didn’t do. For example, you might hear someone grouse about affirmative action, “I didn’t enslave anyone, why should they get a leg up that I didn’t get.” Or, if a member of my church is exposed for a heinous sin, I’m sad, maybe a bit embarrassed, but I certainly don’t feel I ought to bear ANY of the responsibility for his or her crimes.

Much of the rest of the world doesn’t see it this way. If someone in your family does wrong, your whole family suffers disgrace. If someone in your community does wrong, it is as if the whole community gets a black eye. It is less about individual sin and much more about corporate sin and shame.

Is there a biblical answer to this?

While in NO way validating the senseless revenge attacks on innocent victims, I think it important to consider whether there is a biblical response to the strong individualist-communitarian tensions we feel when it comes to corporate sin and righteousness. If you are looking for a single verse, there isn’t one. However, it is interesting to see OT leaders lead in corporate confession of sin–even if they themselves were not guilty. There is an emphasis on “we”. Jeremiah’s lament, Nehemiah’s confession of sin, the minor prophets warning of destruction to the entire northern kingdom are all examples of this “we.” Maybe even more provocative is that of the destruction of Aachan’s family and animals for his sin or the salvation of Rahab and her family for her individual righteousness.

You might argue that this is an Old Testament thing, however, the community language continues in the New Testament, even if less pronounced. There is focus on unity of the body, Christians as all attached to the head, Jesus, refusal to allow sin by other members to continue within the body, and finally, serious warnings given to entire Churches in the book of Revelation.

While you and I should not adopt and “eye for an eye” motto nor seek to punish those who are innocent of crimes, maybe Christianity isn’t quite so individual relationship with Jesus as we’ve painted it to be in the West….

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September 14, 2012 · 3:46 pm

Thomas Szasz, critic of psychiatry, dies


Did you see the obituary notice for Thomas Szasz, a 92-year-old psychiatrist who made it his life’s work to attack his own profession? If not, read the NYT’s article here. Szasz’ beef with psychiatry centered on two complaints: the diagnostic system treated individuals as having “things” rather than describing what they do (thus making it seem like people have diseases AND the coercive nature of treatments (forced treatment and meds for psychotic individuals.

What makes Szasz important to Christian counseling is that many biblical counselors and nouthetic counselors touted Szasz in their criticism of secular psychology and psychiatry. The Bobgans and Jay Adams used Szasz quotes to bolster their own criticisms.

How he was right AND wrong about diagnoses

Szasz was right in that DSM diagnoses tend to treat problems as discrete disease states when in fact they are descriptions of clusters of symptoms. More Venn diagram than discrete thing. Yet, Szasz and his ilk often used examples of diagnoses that he thought were not disease states. Well, some of these diagnoses have turned out more disease than not disease. Take ADHD for example. Many critics complained that there wasn’t anything that could be seen under a telescope…thus ADHD isn’t a real disease. Well, we can see significant differences in brain activity in the frontal lobes of those carrying the diagnosis. While we can’t yet point to a specific cellular structure or gene (and we likely never will since it is more complex than just biology), we are understanding the biological aspects of a number of mental health diagnoses.

Szasz was right that some portions of psychiatry treated those diagnosed as victims and ignored responsibility. Interestingly, as our understanding of genes and brain functioning have improved, the victim mentality has decreased. We are doing better in identifying responsibility even as we are more articulate about the effects of the Fall on the body.

We should thank critics like Szasz for pointing out serious flaws in the foundation of mental health philosophy and practice. And yet we should avoid the all/nothing approach that Szasz and his opponents took in criticizing or defending psychiatry. One common human reaction is to either (a) always look to be the critic, or (b) always look to explain away criticism. Both responses are normal but disastrous to helping others.

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