March 30, 2010 · 11:22 am

Book Note: Linkages between stress, inflammation, and mental illness


I am in the process of clearing my desk of semester debris. Well, truth be told, I am in the process of clearing a portion of my desk from said debris. The rest will have to wait. In the process, I came across a book I’ve been meaning to read since the dept. purchased it for me: The Psychoneuroimmunology of Chronic Disease: Exploring the Links Between Inflammation, Stress, and Illness (APA, 2010).

Before you all stop reading, it really is an important work! You should care if you are someone experiencing high levels of stress or if you counsel those who do. AND, there IS an answer (you won’t like it!) that can help given at the end of this post.

Yes, it is very technical. You can’t skim this book easily unless you read only the chapter summaries (not a bad idea!). However, I find it very interesting to read about how well-connected (too well!) our minds are with our bodies. Here are a couple of book highlights

1. Chapter one: Stress activates primary and secondary responses that may actually increase our vulnerability to disease. Secondary? Examples given include alcohol abuse, poor diet, non-compliance with treatments. Primary? Your body does a couple of things in reaction to stress. First, your sympathetic system starts looking for inflammation. Immune cells look for an injury. You have more glucose available to burn and cortisol increases which also works to activate anti-inflammatory responses. Inflammation is the problem (a “rapid and nonspecific response to danger”). Too much inflammation? damaged tissue. Too much anti-inflammatory response? Damaged tissue. Those with depression may have become less sensitive to cortisol and so end up with lots of non-specific inflammation. Maybe this is why depression hurts so much!

2. Chapter 3: Poor sleep has serious health consequences, especially concerning chronic diseases. One study indicates that disordered sleep has a direct link to type 2 diabetes, independent of age and body size. Individuals with sleep apneas have a greater production of inflammatory bio-markers. Women may be at greater risk for cardiovascular diseases due to sleep problems than men. One problem (sleep problems) begets the other (inflammation) which creates a vicious cycle.

3. Chapter 4: “Western diets typically contain an abundance of proinflammatory omega-6 fatty acids and are low in anti-inflammatory omega-3s.” (p. 96). In other words, dietary fish oil helps promote healing and may lower symptoms due to inflammatory diseases. More fish oil, less vegetable oil.

4. Chapter 5: Links between stress, depression, PTSD, hostility and inflammation. Each of these things increases inflammation, increases sleep disorders which in turn…(you get the picture).

Okay, does anything help l0wer stress and increase healthy immune system functioning? This is the answer I promised at the top of this post. Are you ready? It is so simple you will hate it!* (that will be something to explore at a later date–why do we resist the things we CAN do to help our situation?)

1. Diet. Having a better (lower) ratio of Omega-6s to Omega-3s (more cold water fatty fish) seem to lower rates of depression. Higher Omega-3 consumption predicts lower suicidality, lower depression, and bipolar disease. It appears these amino acids help stop the overactive inflammatory response caused by repeated stress.

2. Exercise. It will initially raise inflammation markers (hence why many with RA feel that any exercise creates more pain), but later lower it if continued on a regular basis.

3. Counseling. Cognitive-Behavioral social support interventions have shown to reduce the inflammation effect by lowering stress. be effective in doing just that.

So, encourage your stressed clients or friends (even better, do it with them) to eat well, exercise (just walk!) and seek social support. In doing so, they will find relief from inflammation and the effects on the mind and body. I guess it is time for me to get up from this desk, skip the doughnut, and walk up to the library for a bit of exercise. On the way, I should stop by a colleague’s desk and get him to come with.

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*Simple? Yes. Quick fix? No. Sure bet to solve all our problems? Absolutely no.

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March 29, 2010 · 2:23 pm

Another shot at understanding integration of psychology and christianity


Over the 40 plus years of our profession’s existence, Christian counselors have tried in numerous ways to model the relationship between Christianity/theology/bible and the study of psychology. Unfortunately, many model building efforts created more barriers than dialogue among brothers and sisters. Counselors staked out territory with titles such as biblical counseling, integration, levels of explanation.

However, in recent years, more authors have tried hard to articulate a distinctly Christian view of persons and a humble articulation of the change process that builds on the good insights of others (e.g., McMinn & Campbell’s Integrative psychotherapy, Johnson’s Foundations of Soul Care, Malony & Augsburger’s Christian Counseling, etc.). These authors have taken the time to examine their control beliefs, theological assumptions, and more in order to make their psychology truly Christian and not merely a rehash of secular ideas.

If you like thinking about epistemology and yet still interested in application to real life, you ought to check out John Coe and Todd Hall’s Psychology in the Spirit: Contours of a Transformational Psychology (IVP, 2010). I’m just getting into it and so do not have much to say just yet. However, this is a great time to be a Christian psychologist. After a decade or more of avoiding these kinds of treatises for being practical (to a fault) and superficially Christian in our psychology, we have something substantive to sink our teeth into. This is no superficial treatment of Christian theology and human efforts (and their failings) to understand the nature of persons-in-relationship. For example,

1. They start out with the Fall. They acknowledge its full impact on human knowing and observing, that psychology from human eyes will always contain some distortion.

2. They acknowledge that redemption and not merely creation is what shapes our identity. “By creation, human love, and natural goods, we discover a “self.” By redemption and transformation, we are enabled to slowly die to our autonomous self and open to our new identity as self-in-God.” (p. 35)

3. “Ultimately, we are not merely arguing for a new model or a way to relate psychology to Christianity; rather, we are arguing for a new transformational model for doing psychology and science, which inherently and intrinsically is already Christian and open to the Spirit.” (ibid)

4.   They are interested in a spiritually formative and relational psychology that cares about the person, the process, and the product (p. 37)

I’m looking forward to the ride. Not sure I’m going to be happy. I’ve read a bit further and am not sure why they spend more time knocking down models that most of us would consider their first cousins (e.g., Christian psychology). That seems to be something from our profession’s past that isn’t as helpful. However, I really appreciate that an early chapter tells both of their stories; their maturation through a period where their faith wasn’t as central to their work as Christian professors of psychology. Often, these kinds of books do NOT include admissions of growth and change. Too often, authors act is if they have always thought this or that way.

I’ll keep you posted with book notes as I go.

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March 26, 2010 · 9:00 am

Life as a preacher’s wife? book notes


I received a free copy of You Can Still Wear Cute Shoes: And Other Unlikely Great Advice from An Unlikely Preacher’s Wife from the publisher (David C Cook, 2010). The author is Lisa McKay. You can find her at http://www.apreacherswife.com.

Since there are few books out there for pastor’s wives, I decide to check it out. Right out of the starting blocks, Lisa addresses two common concerns:

1. Is his calling my calling too? I’ve heard a number of pastor’s wives who appreciate their husband’s ministry calling but do not own it for themselves. Others do. Is this essential?

2. Appearances. What are the pressures for appearing as a pastor’s wife? Can I be me?

To the first issue, she says one of the reasons is this (quoting another pastor’s wife): “The hardest thing for me is everyone wanting a piece of my husband and not acknowledging me in the least…I feel like the person in the background who is here only to take care of the kids so he can be free to take care of everyone else.” (p. 24). Lisa goes on to articulate through story and verse that the wife is called too. Don’t get hung up in the how but that the calling, at a minimum includes trust, obedience to Christ, and hope. To the second issue, no you don’t have to wear doilies. Be more concerned with cultivating Godly character.

The books won’t knock your socks off with new ideas. However, Lisa does a great job identifying the key challenges pastor’s wives face, pointing them to Scripture, focusing on simple truthes and being wary of the stuff that can build up inside her heart. She covers everything from parenting to having friends in the church to not defending pastor husbands (not having hissy fits in the church). This is an easy read and a good reminder for all on how to live under pressure.

Her final chapter is written for the pastor. My only disappointment in this book is that she didn’t triple the length of this chapter and really speak boldly to pastors about their care of their wives.

One great aspect of the book is that she includes so many quotes from other wives and application questions at the end of each chapter for the reader to consider.  On top of that, she’s quite humorous. No bitter pastor’s wife here!

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Filed under Christianity, church and culture, pastoral renewal, pastors and pastoring, Uncategorized

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March 25, 2010 · 5:02 am

Considering a doctoral program?


In recent weeks I have had several students ask me about the pros/cons of doctoral programs in psychology. I would point those who know they want to attend a traditional clinical psych program to this book by the APA. It offers lots of helpful data on programs and what they require.

For those not sure what they want to do or if they should pursue doctoral studies, consider the following. If readers have additional questions we should consider, post them in a response and we’ll expand on these. This is my first pass:

What career doors do I want to open that are not available to me now? Do I want to teach? Do I see myself in private practice? In a research job? in the business world?

The PhD in Clinical Psych from an APA accredited program (and with an APA approved predoctoral internship) probably opens the most doors of all. This degree allows you to teach in both undergrad and grad depts., work in research settings, government settings, private practice, etc. There are specific kinds of jobs that it might not help: such as an area focusing entirely on social psychology or developmental psychology.

One caveat. If you want to teach in a MA Counseling program that is either seeking or already obtained CACREP accreditation (counseling accreditation sponsored by the ACA), you will need a PhD in Counselor Education (which entitles you to work towards an LPC credential). This is a recent and troubling change (turf warfare with psychology).

Part of your work dream should answer whether or not you are looking to work in either a secular or faith environment. Now, you can change your mind but there will be some doors that are easier to open with secular degree and other doors that a Wheaton/Fuller/Regent degree will open more easily.

What areas of counseling/psychology most excite you?

Try to be creative here. Think more than just private practice, 50 minute hour. Who do you know who is doing what you would like to do? Find out where they got their education? Be bold, ask them (even if you do so by email) what they would recommend as an educational route to do the kind of work they do now.

Programs tend to have both a model of psychology (some are CBT others are more analytic) and a focus (specialties). Further programs tend to either be scientist focused or practitioner focused.

Many programs are generalist, but it is helpful to have a specialty. Child? Forensic? Neuropsych? Geropsych? Marriage & Family?

Look at what the professors are publishing at the schools you are thinking about attending. Anything there excite you? FYI, professors love those who are excited to help them with their research

PhD or PsyD?

There are some differences. Typically, the PhD student completes a very rigorous dissertation (has more coursework in research and stats) but has fewer practice hours (maybe 800 total) leading up to their yearlong pre-doctoral internship year.

PsyD students tend to have a less rigorous dissertation (though my PsyD program acted more like a PhD) but have far more practice hours under their belts (maybe 2000!).

PsyDs do get teaching jobs but less likely in undergrad programs because of old assumptions (i.e., PsyDs are practitioners and PhDs are scientists).

Secular vs. Christian programs?

The first question: what is your current theological/biblical literacy level? How well do you understand the depths and complexities of your faith? How well versed are you in the controversies surrounding Christianity, Psychology, biblical counseling, integration, etc.? Your answer will dictate how ready you are to jump into a PhD or PsyD in clinical psychology. If your faith is weak, then you may want to strengthen it in an MA program at a Seminary. Or do some reading on your own. Psychology is not just an art and science, but a philosophy. You want to know what philosophy, even religion, you are imbibing. Sometimes the glittering images of psychology cause students to neglect the source of the power of change.

Practical matter: Christian doctoral programs in Psychology tend to be a year longer (because of extra bible/theology courses). Being a graduate of these programs will not harm you in secular settings (usually) if the program is accredited by the APA.

Obviously, programs and schools have identity. You graduate from Harvard, you get an identity. You graduate from Fuller, you get an identity—fair or not.

In my experience, secular programs tend to have less issues about a student’s Christian faith than do quasi-Christian programs or those housed in catholic institutions. These programs have had more fundamentalist-liberal wars and so you find faculty more sensitive.

If a student has a strong theological base, I would probably go for a secular institution unless you want the Wheaton/Fuller credential to open Christian doors.

Counseling Psychology vs. Clinical Psychology programs?

Not much of a distinction here anymore. I think the clinical one is more valuable (my bias) but once you have the degree, no one explores your transcript.

Would you rank the Christian doctoral program?

No. Each one has their own strengths and liabilities. I would look at the professors at each and what they are writing/doing. Try to go learn from some professors you’ve come to respect. For example (and this is a limited sample. Some schools I haven’t really known much about)

Regent University (VA Beach): Mark Yarhouse, Jen Ripley and Bill Hathaway are topnotch Christian psychologists. With Mark you get the sexual ethics research as well as someone well-versed in Puritan writings. With Jen, you might get access to her and Ev Worthington’s work (forgiveness, couples, etc.). Of course Ev is at VA Commonwealth and so you might want to go right for him.

Wheaton: There are a number of great faculty there. But let me mention just three. Sally Schwer Canning is doing child and urban stuff. Bob Gregory is doing neuropsych stuff and William Struthers just published on porn and the male brain.

George Fox: At Wheaton I came to really respect Mark McMinn. He is now at George Fox (Oregon). He’s great to study under for psych testing and his integrative model. Plus, if you get in on his research team, he’ll teach you how to be a survey king or queen. He is a publishing machine!

Biola: Todd Hall and Jon Coe just published a key work called Psychology in the Spirit. It is going to be a significant work.

On-line vs. residential programs

Online programs only if they are APA accredited (psychology programs that is). You have to be a self-starter. These still get negative reactions from some of those in the position to hire you. In the PhD in counselor ed, both Regent and Liberty have programs with good quality eworlds.

Residential provides lots of time to interact with profs on a daily basis. There isn’t a way to really do this in the on-line programs (which tend to have lots of students in them!). You can get good peer relationships in on-line programs, sometimes even better than in person.

I’m sure I’ve left something out. What else should we consider? Of course, you should get your MA from Biblical Seminary. That way, you will be prepared to think Christianly, biblically, and yet able to think psychologically about the world. 😉

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March 24, 2010 · 5:33 am

Andy Crouch Coming to Biblical–FREE event


Andy Crouch will be here at Biblical Seminary on May 26 as our next speaker in our lecture series: Conversations on Christianity & Culture. His presentation is entitled: Playing God: Christian Reflections on the Use and Misuse of Power. I highly recommend you signing up  here for this free event. Andy is easy to listen to and careful in his presentations. The previous link will tell you more about him and about Biblical if you need more info.

The topic of power is very apropos whether you are thinking about church politics, abortion issues, healthcare reform or abuse of authority in the church.

Sign up for it since we have limited space. You will want to reserve your spot so you don’t have to watch a simulcast screen in an overflow room.

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March 23, 2010 · 11:19 am

Pastoral sexual abuse a conspiracy?


Heard a radio personality discussing the Pope’s letter to Irish Catholics. He was unhappy with the content of the letter, specifically the Pope’s failure to accept responsibility for abuse by Irish priests. He commented that given the sexual abuse scandal around the world in the Church, there had to be a specific conspiracy, going to the top, to keep covering these matters up; to keep transferring offender priests to new locations.

Given the authority lines in the Catholic church, a planned conspiracy is possible. But, what do we make of these same problems in Protestant churches? Especially in independent churches where there is no authority beyond the local body? Sadly, we see the same cover-up, the same attempts to move someone on without blowing the whistle.

Why? Is it a conspiracy? Yes, but not like the radio host was thinking.

The most obvious answer to the why question has to do with the fact that all, since Adam, are inclined to hide sin; to cover up and deny the truth. SO, it stands to reason that we see this as a universal phenomenon. People, especially those with power, want to look good and deny problems. Even more so when the truth might remove them from power.

But there are some other reasons as well. Worries about defaming Christ, causing “unnecessary” anxiety, “wasting” a gifted person’s ministry just because of one problem. These kinds of reasons are secondary. They make it easier to swallow the denial and deception. Like the parable of the talents, we find excuse for why we bury things. But they are not the primary reason.

I think the radio host wanted to be able to accuse the leadership of the Catholic church. Popes had to know and agree with these cover-ups that allowed abuse to continue. They may well have. But, a far more insidious conspiracy lies in each of our hearts; one that will destroy us if we turn a blind eye to it.

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Filed under Abuse, Biblical Reflection, Christianity, Christianity: Leaders and Leadership, church and culture, deception, self-deception

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March 17, 2010 · 11:38 am

Infidelity: personality or opportunity?


On the way to work today I heard a radio personality muse about the rampant sexual infidelity among politicians and sports figures. They talked about how people (i.e., men as the stereotype goes)  in power have much more opportunity for sexual acting out because they have more women offering themselves to them. Probably true…

But, is it that they have more opportunity (and thus more chance to give in to temptation) or is it because they have a personality that sets themselves up for infidelity? And would  you have a different answer if we were talking about bribe taking or other financial temptations instead of sexual indiscretion?

I think they are the same AND I think every has opportunity (some more than others). What matters is one’s perceptions of self and others. While personality plays a part of our self awareness, the drive to win, be the best, to get the prize, listening only to one’s fans, the sense that you are better than others also is formed from self-talk. Thus, opportunity makes it possible but failure to be self-critical is the key feature that makes opportunity become reality.

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Filed under Cognitive biases, ethics, personality, Psychology, Sex

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March 16, 2010 · 9:41 am

Cancer stories


We’ve all heard them. We’ve all told them. Either our own or someone else’s. If you are the person telling the story, you likely are trying to encourage hope and fight in the cancer sufferer. If you are the person listening to the story, you likely want to desperately believe that the miracle or cure story is going to be your story.While the success story of another is momentarily comforting, it doesn’t last.

Truth is, you don’t know your own story, whether you have cancer or not. You don’t know if you will live to be 100 or die tomorrow. Most of the time we don’t think about our mortality. Life is too busy to contemplate morbid thoughts.

Cancer in you or your loved one changes that. You wonder what your story is. You hope it is not like one person’s story and you try to hope that it is like the success stories you hear. But, you just don’t know.

Along with the stories come treatment recommendations and advice. These can be helpful, confusing, contradictory, or downright hurtful. It is true that your doctor matters. It is true that some traditional treatments are very effective and also very damaging. It is true that some have benefited from alternative or complementary treatments. It is also true that people die from both. What is also true is that the plethora of advice adds to the confusion.

Here might be some better things we can do and say:

1. What would you like me to pray for?

2. What is your next treatment decision and who are you talking to?

3. Can I ______ (something specific)?

And if you know the person well, you might ask:

1. What “stories” are you meditating on that you need to stop?

2. What is the one thing that is true for you right now? Or, what manna is God giving you for today?

3. What information would be helpful for your next decision?

4. Let’s talk about something other than cancer…how’s your garden coming?

5. What stories would you like to hear right now?

For counselors out there. It is a good reminder to limit the number of stories we tell our clients. These can encourage. Yes, it is true, people do get over depressions or anxiety attacks. They do repair broken marriages. These stories may encourage the person to take a step of faith. Or, they may cause them to stop, because those stories aren’t theirs.

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March 15, 2010 · 9:23 am

How the church misrepresents healing of addictions


Now, a post title like this deserves a long and fair answer. Lacking the time, I’m only going to address one issue–that of the healing process with addictions. If you ask a person in AA how they defeat addictions they will quickly point out the need for God (or higher power) and the need for community in changing their lifestyle. They need a sponsor, they need to feel they are fighting with others to maintain their sobriety. Will power will not be enough.

I suspect that most Christians would agree. But, here’s the problem. When we are asked about the healing agent for any sinful or repetitive problem, we point to Jesus. True, without God we do not have a shot of defeating our nemeses. When we talk like this it can sound like an isolationist, just me and God, healing process.

One of my students said it well. When he got saved out of his addictions he got new friends, new discipleship activities, and a new view of the reality of addictions (friends died). He had new activities to replace the old, new reinforcement patterns, etc. And, while he points to the saving grace of God, it wasn’t an isolating event.

That is our problem. We continue to think of our sanctification as a me and God experience. AA does a better job (often) than the church in reminding each other of the need for support without any condemnation for needing years and years later.

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March 12, 2010 · 9:10 pm

Do you have a pet psych test?


Uh, by that I mean whether or not you have a favorite psych test. We’ll save tests for pets for another day.

There are many out there who love the Myers Briggs (MBTI). Others love the DISC. When people have a pet test it is usually because the test provides a quick and dirty profile in order to understand and categorize a person’s behavior. Actually, and sadly, we often like certain tests because they allow us to pigeon hole others (as in, “your such a J”).

But, I do have favorite tests. I love to review the couple version of the 16PF with both long-time marrieds and those seeking pre-marital counseling. When I was doing parent competency assessments, there were a number of lesser known tests that illustrated a parent’s capacity to be flexible (and so hopefully less rigid and abusive). When it comes to personality assessment, the MMPI-2 and the Rorshach (Exner scoring) are my favorites.

But lately, most of my assessments have been with pastors. I’ve found a number of great little tools to illustrate compassion fatigue and other at-risk problems. These assessments lack the depth and rigor of a personality test but work great as conversation starters and self-evaluation tools. With these I don’t have to explain what they mean.

How about you? Got a favorite test you’ve taken? Given? Why is it your favorite?

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