Tag Archives: christian counseling

Training Trauma Healers For The Church


Over at our faculty blog site you can find my summary of a recent trauma recovery training for pastors and church leaders. Biblical co-sponsored this training with the American Bible Society in an attempt to bring a well-established, scripture-engaged trauma healing model to the Philadelphia area. Read more about the model and its value as well as see a picture of the training (thanks Heather Drew).

Trauma comes to us in all shapes and sizes. Traumatized outsiders (i.e., immigrants), child sexual abuse, domestic violence, community violence, racial injustice and natural disasters are here, not just something that is “over there.” While we may have more professional mental health resources here than other communities have access to, we still do not have enough to serve the need. And even if we did, the best models of recovery connected traumatized people to their faith and their communities. What better place to do that than in the church?

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Filed under Biblical Seminary, counseling, counseling skills, suffering, trauma

When you imagine something does your brain think you see it?


What is the difference between imagination and reality? Sometimes, not that much.

The February 2014 edition of the Monitor on Psychology (v. 45:2, p. 18) lists a brief note about a study published in Psychological Science that looks at eye pupil constriction when imagining light. Here’s the abstract from the link above (emphasis mine):

If a mental image is a rerepresentation of a perception, then properties such as luminance or brightness should also be conjured up in the image. We monitored pupil diameters with an infrared eye tracker while participants first saw and then generated mental images of shapes that varied in luminance or complexity, while looking at an empty gray background. Participants also imagined familiar scenarios (e.g., a “sunny sky” or a “dark room”) while looking at the same neutral screen. In all experiments, participants’ eye pupils dilated or constricted, respectively, in response to dark and bright imagined objects and scenarios. Shape complexity increased mental effort and pupillary sizes independently of shapes’ luminance. Because the participants were unable to voluntarily constrict their eyes’ pupils, the observed pupillary adjustments to imaginary light present a strong case for accounts of mental imagery as a process based on brain states similar to those that arise during perception.

So it seems that thinking about something causes your brain to respond as if it is really seeing. What might this mean about those who are trying to break free of addictions?

  • Would imagining heroin use create observable changes in they body that would make it harder to maintain abstinence
  • Would recalling sexual images create responses that make sexual addictions harder to break?

So, what is the difference between imagining an affair and actually engaging in one? From a brain perspective, maybe not that much. Certainly Jesus’ expansion of the seventh commandment suggests there isn’t a difference between the two from God’s perspective. And yet, we know that actual adultery creates more damage to more people than merely fantasizing about having an affair.

Rumination: the health killer!

I’m currently teaching students a course on psychopathology. Each week we consider a different family of problems. Thus far we have explored anxiety disorders, mood disorders (depression, mania), anger/explosive disorders and addictions. Soon we’ll look at eating disorders, trauma, and psychosis.

There is one symptom that almost every person fitting one of those above categories experiences–repetitive, negative thought patterns.

Rumination.

The content of the repetitive thoughts may change depending on the type of problem (i.e., anxious fears, depressive negative thoughts, illicit urges, fears of weight gain, fears of being hurt, irritability, etc.) but the heart of the problem is the vicious cycle that negative thought patterns produce.

While there are many very good ancillary mental health treatments (Did you know that daily exercise, getting a good 8 hours of sleep each night, and eating a diet rich in protein supports good mental health and may even prevent re-occurrence of  prior problems?) it is essential for those of us who struggle with imagining negative events to find ways to shut down the production of rumination. Mindfulness techniques, thought-stopping, alternate focus may help to interrupt imaging bad feelings, thoughts, events and thereby interrupt the body reacting as if those bad things are indeed happening.

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

New book of meditations for counselors by Diane Langberg


In our Lives FirstI want to point out and recommend a new collection of meditations designed for counselors and written by Dr. Diane Langberg. This ebook In Our Lives First: Meditations for Counselors (Kindle version first, Nook version to follow) consists of 40 meditations, each with quotes from some of Dr. Langberg’s favorite authors and with questions for you to ponder.

Dr. Diane Langberg (pictured above in the banner of this blog) is a practicing as a psychologist for the past 4 decades. Regular readers of this blog will know her as one of the leading experts in all things related to PTSD, trauma recovery, and christian counseling. For years she has been writing books and articles as well as speaking around the world on matters near and dear to her heart. For those of you familiar with Dr. Langberg, you may recognize some of the stories and ideas in the meditations. Many of these have appeared in some form in her Christian Counseling Today column or in her lectures.

If you are a people helper (professional or lay; clinical or ministerial) and have ever felt burned out by the work you do, I highly recommend these meditations. As Dr. Langberg tells us, the work must be in us first.

*******

Bias alert: I helped edit this volume. I do not gain any monetary benefit from sales. 

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Filed under biblical counseling, Biblical Reflection, christian counseling, christian psychology, Christianity, Meditations

The Power of a Counselor’s Words: Guest post over at biblical.edu


I’ve been thinking and musing about the power we counselor’s wield with our words. To be honest, I do so without always being aware of the impact. It is so easy to say, “that’s abusive” to a victim with the idea that I am validating her experience without realizing I have just crushed another part of her life.

So, if you want to read some of these musings and a gentle corrective to those of us who call ourselves biblical counselors, click here to find the blog I posted for October 18, 2013.  [posted prior to leaving for South Africa]

 

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

Pastoral Counseling for Sex Offenders: 3 Dos and 3 Don’ts


As the church does a better job in understanding the epidemic of sexual victimization (1:3 women, 1:5 men report unwanted sexual contact by age 18), the church also faces the challenge of understanding how to care for sex offenders in the community. Gone (hopefully!) should be the days where a congregation just ignores offenders and acts as if their sins are in the past needing no further follow-up. And we don’t want to swing to the other extreme of making it impossible for sex offenders to be part of the church community. Rather, the church will best represent Christ to victims AND offenders when it exemplifies the grace of limits to offenders.

The local pastoral counselor (whether in the church or in a para-church organization) will be called upon to participate in the care and counsel of a sex offender. In preparation for this eventuality, every pastoral counselor should embark on their own continuing education. Read books (start with the difficult book Predators by Anna Salter), meet your local ADA who prosecutes sex crimes and find out what is required of offenders after they leave prison, find local clinicians who specialize in treating the various kinds of offenders (e.g., adolescents, adults, Internet based, those who have been incarcerated, etc.)

Dos and Don’ts

After improving your understanding of the nature of sexual offending and the available resources, consider these three dos and don’ts in order to avoid some serious pitfalls

  • Do treat them as fully bearing the image of God, just as you would a victim of a sex crime. Your relationship with the offender should not be a barrier to their ongoing growth and sanctification. Do you share the same mercy and grace as you would to someone you may feel more compassion? Do you see them as less human? Your compassion should lead you away from an adversarial or judgmental approach to them (this does not mean you won’t be firm or even skeptical!). Accusations, no matter how accurate, rarely lead to transformation in another. Instead validate their feelings and experiences. They will have lost much: friends, family, finances, standing. While it came at their own hand, you surely want to validate this experience.
  • Don’t treat all sex offenders the same. Recognize differences between adolescent and adult offenders, Internet only offenders and direct contact offenders. You do not want to have a one-size-fits-all approach for supposed fairness reasons. If you don’t have training in understanding these differences, do not assume you already know how to counsel these individuals. Get training, supervision, and consider referrals.
  • Do assess on a continual basis. As with all clients, a competent counselor never stops assessing for treatment readiness, commitment to change and growth, commitment to the grace of restriction, insight and more. Does your client show a growing evidence of empathy towards victims and the community? Does your client evidence a thirst for community supports and accountability (vs. passive acceptance)? Does your client give evidence of being solely focused on personal experience; give evidence of resistance and bitterness that others do not offer blanket trust?
  • Don’t use words, time, or other factors in determining growth and repentance. Far too frequently, churches use the right words, a few tears, and the passage of time to indicate when they reduce oversight over an offender. These are not good indicators of change! In addition, do not confuse repentance with a requirement for reconciliation. Do not neglect the matter of restitution but do not hold requirements of victims to return to a former level of intimacy with the offender. Not all that is broken in this life can be fixed in this life. Do not fall prey to the fantasy that all things are restored and reconnected in this life. Yes, our God can work miracles, but he also gives grace to us to continue with our thorns in the flesh.
  • Do set specific goals. Whenever we provide counseling for chronic issues, it helps to set goals that can be evaluated even as there may be a long road still to go. A competent counselor agrees upon goals with a client. Some of these goals might include (a) growing in empathy for others, being able to sit with the experience of others without bringing up one’s own, (b) deepening Gospel understanding about sin and impact of evil without either despair or superficial repentance, and (c) accepting limits and little trust as a way of life.
  • Don’t be caught off guard by common concerns of the offender. In my experience, offenders often have these questions that repeat on a fairly regular basis: Where can I worship? When can I come to church? Why can’t I worship with my family? When will I be done and be treated like anyone else? Doesn’t [victim] bear some blame? Why does [victim] get to make decisions about my worship? Why am I treated as a leper?  These questions are important and being prepared for them means the counselor can more likely respond with compassion and clarity. This can only better serve the offender and reduce the bitterness that comes from unanswered questions.

 

Additional links to check out:

1. Church Ministry to Sex Offenders 

2. Sex offenders vs. Sex Abusers?

3. Search “sex offender” in search box in the upper left for more blogs on this topic

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Filed under biblical counseling, christian counseling, christian psychology, Uncategorized

The Wonderful False World of Conferences


I’ve just returned from four plus days of conferencing with the American Association of Christian Counselors. I am told about 7500 of us were there. I had the good pleasure of presenting, listening, discussing, learning, and debating. I renewed old acquaintances and made new ones that I hope to keep up with long after the conference. As one who loves learning and debating, conferences are nearly required activities. Sure, I get my continuing education credits (CEs) met but even more so, I get to try on new ideas and debate old ones. It is 4 days of stimulation of thoughts, ideas, and feelings.

But it is also false.

At conference hotels, someone makes all your meals, cleans up after you, makes your bed, refreshes your towel and makes you feel important when the concierge asks, “anything else I can do for you.” During and after sessions where I am the presenter, I have all sorts of folks who want to solicit my opinions and wisdom. They seem to like me and some even want to emulate me. They ask me for coffee and my business card so they can connect more later. Conferences also include plenty of socializing. Everyone is happy to be there, wears their good clothes, has interesting things to say, and seems to be the most reasonable people on the planet. No one seems to have much emotional or relational baggage at these conferences. There are no kids to reprimand, fights with spouses, and conflicts to navigate.

Oh, and when the main speakers appeal to our work as “kingdom critical”, I am reminded that I am indeed important to God and the world. Without me, the world as we know it would not exist.

You see the falseness when conferences scratch that itch for intellectual and relational stimulation and tempt us to believe that this is how life should be. My wife and children don’t hang on my every word, aren’t interested in being my concierge, and no one freshens up my room for me when I leave for the day.

Don’t get me wrong. I love conferences. Ideas flow afresh. Collaborative arrangements solidify. My mind and heart are filled. But, I also need to remember that I and the rest of the attendees aren’t really as special as we imagine. This is a Sabbath from the real work and not where life is really lived.

It was probably good that one of my presentations was on the topic of narcissism. I might need to re-read my notes again.

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Filed under christian counseling, christian psychology, self-deception

Solving the problem of isolation among counselors around the world


Last night, Diane Langberg, myself, and AACC hosted a small meeting of friends interested in starting counseling associations in their home countries. We had visitors from Romania, Ukraine, Lebanon, Brazil, Ghana, Nigeria, and Rwanda. Each representative gave a bit of a status

A few of the attendees

A few of the attendees

update for their country.  Each of these countries has Christian counseling activities (counseling, training, etc.) underway in their country and each wants to  be better able to hold these counselors to a higher standard of skill and ethics. Some of the countries have formed associations and are applying for government recognition. Others are in the process and are looking for more help in developing association standards.

But the problem of isolation may not be solved by an association. Each person who spoke raised 2 serious concerns:

  1. Our secular colleagues think we are not professionals but merely faith healing quacks
  2. Our pastor friends think we are not really Christian because we have studied psychology and counseling

It is apparent that we need to do a better job to communicate and illustrate how Christian counseling can be biblically AND psychologically sound. If we do not, any association built will merely become a ghetto. This is not to say that we shouldn’t build associations. The opposite is true. But, unless we learn to speak theologically about the nature and purpose of counseling, we likely won’t get very far.

Reducing Isolation with Technology?

I’m curious if anyone might have ideas about the best way to have these friends stay in contact and to share documents that might help each other develop their own associations. We have a number of ethics codes here in the US but I imagine that some significant portion of those codes may not be appropriate in other contexts. If our friends in Ghana develop an ethics code, wouldn’t it be great if they could easily share it with associations in other African countries. So, is there an existing, SIMPLE, low-bandwidth, platform out there that works best for staying in touch and sharing items and yet is protected by login?

I long for the day when those who are resource rich (content) will be willing to freely distribute to brothers and sisters around the world, and that day when we all eschew holding tightly to those resources in order to build our own kingdom. I am indeed grateful for the leadership AACC is taking in bringing these individuals together and to resource them in some very generous ways! May we all follow suit!

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Filed under AACC, christian counseling, Christianity: Leaders and Leadership

Why counseling? To be fixed or found?


Chuck DeGroat and Johnny LaLonde have written a post that some might find helpful when considering therapy or counseling (I use these words interchangeably). At some point in our lives, we all feel like life is getting out of control. We need help. We begin to wonder if there isn’t someone out there who can help us. But, even as we think these thoughts, we may also think, “what is the point? How can therapy fix this problem?”

Well, to give a partial answer, check out this first post over at Q Ideas. The authors argue that we should all be in therapy. However, they suggest that the purpose of such counseling is not so much to fix our problems but to understand ourselves, to admit our weaknesses, to be “found” or known. Now, these may sound like things that only wealthy people have the time to do. And yet, I would argue that in our isolated, individualized society, the normal communal means of being understood, supported, known, etc. are not often present in our lives.

Three paragraphs in this first post jump out for attention:

Don’t I go to therapy to get fixed? Believe it or not, I don’t advocate therapy because it fixes people. Now, while some forms of therapy help people get past difficulties that stifle them (e.g. panic attacks, major depression, bipolar symptoms), Christians should recognize there is always a deeper and more transformative purpose to counsel and care.

This was the ancient art called curam animarum—the care of souls. And the wisest therapists will foster this process. Now, the vast majority of clinicians practicing today have been trained in fix-it strategies—cognitive and behavioral solution-based processes which are aimed at quick, painless fixes. This is what sells. This is what insurance tends to pay for. But there is a profound difference here—fix-it strategies try to remove pain while deep soul care attempts to learn from it. Sometimes in the process we are afforded the mercy of pain relief. But it is not the goal. And so I counsel people to search carefully, to interview therapists, to ask many good questions.

And then this reflection:

But at the same time, I’m not convinced Christian therapists do this as well as secular therapists at times. Let me explain. Many settle for what Dietrich Bonhoeffer called “cheap grace,” a quick fix approach which stands in stark contrast to the “costly grace” of searching and knowing ourselves, through exploring our stories and examining our motives. This kind of care is, indeed, much more rare. Christian counseling which is reduced to mere Bible memorization, or repentance or a behavioral regimen misses the point.

Fixed and found?

I imagine that the authors would agree that both are possible. Therapy can lead to being fixed and found, to find relief and care for the soul. Therapies that ignore the need for immediate mercy and relief are of little value. I once talked to someone who had just completed a decade of psychoanalysis (3 sessions per week!). His therapist, a well-known analyst had just released him as having completed analysis. My new friend was looking for a therapist to deal with his longstanding panic disorder. I have also seen Christian counselors who have so emphasized discipleship that they paid little attention to easy helps for their addict clients. On the flip side, simple behavior change (now that is an oxymoron!) may provide some relief but miss insight into self and what God is up to in the world. In seeking only relief, we miss out on deepening our relationships with God and others. A superficial life lived may hurt lest, but is it worth living? 

Note at the bottom of the post there is a link to another post about how to choose a counselor. If you are looking for one, consider one who can have difficult conversations with you, one who does not over-simplify the problem, one who cares about your growing relationship with Christ, one who can provide ideas to bring immediate relief, and best of all, one who listens more than talks.

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

Telling Painful Memories: Recommendations for Counselors


[What is below was shared with Rwandan caregivers and counselors. It is written in simpler English and has no footnotes. Academically oriented readers will recognize the interventions come from narrative exposure therapy models for children].

Counselors invite others to tell their stories of pain, heartache, fears, and traumas so that they can find relief from their troubles. However, not every way of talking about past problems is helpful and some ways of talking can actually harm the person. So, it is important that all caregivers and counselors understand how to help others tell their difficult stories in ways that invite recovery and do not harm.

Good Storytelling Practices

Counselors who do the following can encourage healthy and safe storytelling of difficult events:

  1. Allow the client to tell their story at their own pace without pressure
  2. Allow the client not to tell a part of their story
  3. Use silence and body language to show interest
  4. Encourages the use of storytelling without words (art, dance, etc.) or with symbols
  5. Ensures the difficult stories start and end at safe points
  6. Encourages good coping skills before story telling
  7. Points out resiliency and strength in the midst of trauma
  8. Encourages the story to be told from the present rather than reliving the story

Unhelpful Practices

Here are some things that we should avoid doing when helping another tell a difficult story

  1. Frequent interruptions
  2. Forcing the person to tell their story
  3. Asking the person to relive the story
  4. Avoiding painful emotions
  5. Exhorting the person to get over the feelings; telling them how to feel
  6. Only talking about the trauma, ignoring strengths and other history
  7. Ending a session without talking about the present or a safe place

**Trigger Warning: rape, threatened violence

A Case Study With 2 Storytelling Interventions

Patience, a 13 year old girl, suffered a rape on her way to school last month. The rapist’s family paid a visit to the girl’s family and offered money as a token of penance. The girl’s father accepted the money because, “nothing can make the rape go away so we will take the money for now.” Patience was told by some family members to not tell anyone about the rape and to just act as if it never happened. However, Patience is suffering from nightmares, refuses to go to school, and sometimes falls down when she catches a glimpse of the rapist in town. Her father has threatened to beat her if she doesn’t return to school or help out with the chores at home. Her favorite aunt, a counselor/caregiver, learns about the rape and asks her to come for a visit in a nearby city.

[Warning: these two interventions are not designed to rid a person immediately of all trauma symptoms. In addition, these interventions must be used only after a counselor has formed a trusting relationship with the client.]

  1. Symbolic story telling. The aunt tells Patience that keeping a story bottled up inside can cause problems, like shaking a bottle of soda until it bursts out. Using a long piece of rope (representing her entire life) and flowers (representing positive experiences) and rocks (representing difficult experiences), the aunt directs Patience to tell her life story. They start with her first memories of her mother, father and two brothers. She tells of her going to school, the time when her mother got really sick but then got better again, the time when her cousins moved away, and the time when a boy told her he liked her. Patience noticed how she had many flowers along the rope and only a few rocks. Then, they put a large stone down on the rope representing the rape. Patience had difficulty saying much at all. She remembered being afraid, the weight of the man, the pain, and worry that her family would reject her. She remembered getting up and going to school and acting as if nothing happened. Her aunt noted that Patience was a strong girl—she had gone to school for a week before telling her mother. So, Patience placed a tiny flower next to the rock to represent that strength. After stopping for a cup of tea and some bread, the aunt asked Patience to notice how much more rope was left. This represented her future. Patience was surprised to see the rope and said that she didn’t think she would have a future now that she was spoiled. Her aunt encourages her to consider what she would like to be in her future. They continued to discuss this over the next day. By the time Patience returned home, she was able to see that she still had a future. Seeing the rapist still bothered her. However, she was able to go to school with two friends along a new path so that she would feel safe. Patience kept a drawing of the rope with the flowers and rocks and extra rope to remind her that she had a good future.
  2. Accelerated Storytelling. About six months later, Patience visited her aunt again. She was still going to school and able to do more chores (getting firewood and buying food in the market). However, she still suffered from nightmares and sometimes fell down when she heard footsteps behind her. This time, her aunt asked her to help create a “movie” of event. Before Patience was to narrate the rape, they first recounted the safety she felt at home before the rape and the safety she felt when she told her mother about the rape and was comforted. Next, her aunt asked her to identify all of the “actors” in the play: her mother, father, herself, brothers who went to school without her, classmates, teacher, and rapist. Patience then made a figurine out of paper for each actor and drew a small map of her village including the path from home to school. Then, the aunt asked her to tell her story as fast as she could from safe place to safe place and to only look at the figurines (and to move them along the map). Her aunt noted those places where Patience slowed down in the story. When she paused, the aunt asked her to try to keep moving. Once the story was complete (when she told her mother about the rape), she asked Patience to tell the story backwards as quickly as possible. Then, she instructed Patience to tell the story forwards again twice as fast. However, this time, Patience stopped part way through the story. She added one detail she had not disclosed before. She recalled that a young boy of about 5 was peering at them from behind some bushes. Her aunt encouraged her to finish the story and thanked her for her courage. Patience indicated that she was so ashamed of being seen in such a position. Again, her aunt thanked her for working so hard but asked her to tell her story forwards and backwards one more time. Patience noticed that she was less upset by the presence of the 5 year old than she had been the first time through the story.

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Filed under Abuse, counseling, counseling science, counseling skills

Tuza 2.0: Day Five


[June 27, 2013]. Day two of our three day conference. Today Dr. Barbara Shaffer talked about the problem of marital rape and reviewed 6 common characteristics of some abusive spouses. The participants were very involved in this presentation and the discussion about sex in marriage provoked some interesting debates among the group. The large group discussed the matter of dowry. In Rwanda, a husband’s family agrees to pay an amount to his bride’s family. The price is in terms of a number of cows. A friend told me that nowadays, “cows are kept in the bank.” This tradition gives many men the belief that they have purchased their wife. Now the wife is his (cherished) property. As such, he has rights to her body. Based on the conversation, I would argue that the concept of marital rape might indeed be foreign. One participant asked how 1 Corinthians 7 fit into this discussion. We were able to examine that this passage offers women the right to control their husband’s bodies just as much as he gets to have a say about her body. Not being sure where everyone stood in the debate, I concluded with a reminder that Philippians 2 requires that we emulate Christ in not demanding what we are due but giving it up so as to shine like stars.

After lunch Dr. Langberg presented on dissociation and a group of Rwandan counselors illustrated a counseling scene of dissociation and a counselor’s techniques in calming and grounding. Very well done! Just before the end of this day’s training, Rowan Moore gave a talk about child abuse. Kivu boats

Before dinner, we hired a local young man to take us out onto Lake Kivu in his boat. Ten of us motored out toward Peace Island. We didn’t have enough time to go all the way to Napoleon Island but we rounded several small islands and enjoyed the setting sun. We passed several fishing boats netting the tiny fish that are in the lake. We could feel the stress of the day fade with the lap of the waves. [photo courtesy Laura Captari]

After dinner, we had an evening of celebration. We identified our Barnabas’ (each person secretly wrote notes of encouragement and prayer to another). And of course, there was dancing and laughter. I have come to love the fluid hand motions during dancing and the energetic movements of men and women. Sadly, I  cannot dance to save my life. I have not rhythm. Of course, there was a dance where I had to be front and center. I tried hiding behind a camera but even that did not save me. Still, it was sweet medicine after 2 days of talking trauma, abuse, and violence.

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Filed under AACC, Abuse, counseling, counseling skills, Rape, Rwanda, Uncategorized