Tag Archives: counseling

January 21, 2008 · 12:41 pm

Science Monday: Suicidality in Teens across Cultures


This week we spend time in our psychopathology class considering the biblical literature regarding causes and effects of suffering. We do this because any course on problems in living must help students first understand the depths and complexities of suffering. Otherwise our study of problems will be rather sterile if we can’t deeply feel the pain. Some painful suffering leads to suicidal thoughts and that is where I want us to go today…

The January 2008 issue of American Psychologist (63:1) considers “Cultural Considerations in Adolescent Suicide: Prevention and Psychosocial Treatment.” Suicide is most likely to be considered by those who feel intolerable emotional pain and perceive no way out of that pain–other than death.

Not surprisingly, there are significant racial and cultural differences in rates of suicide across ethnicities (Native Americans have the highest, African Americans have the lowest in both genders). Culture plays a big role in each ethnicity’s perception of suicide behaviors, choice of help-seeking behaviors, and what might help prevent suicidality. A couple of examples from the article:

  1. African American male emphasis on coolness may protect them from giving into suicide at first but may increase the likelihood of individuals trying “to provoke others into killing them as an indirect method of suicide” (p. 19).
  2. High rates of suicide among Native American youth, “occur in the context of high rates of other risk-taking and potentially life-endangering behaviors” (p. 21).

The authors look at issues including acculturative stress, enculturation, different manifestations of distress, and cultural distrust in trying to treat and prevent suicide across various cultures. They contend that few culturally sensitive prevention and treatment models exist at this point. In other words, we cannot assume that generic methods of encouraging youth to seek help when distressed will be helpful. In other words, if given the chance, we must make sure we try to understand their (not our) perception of their situation, their pain, their family/community, and possible avenues of hope. Further, we must try to understand how they may perceive us (the counselor) due to our own ethnicity and position of power. We must counter our tendency to allow fear to draw us into a position where we start exhorting our teen clients–thereby shutting them down.

Leave a comment

Filed under counseling science, counseling skills

Tagged as , ,

November 28, 2007 · 4:57 pm

Watching student videos


Am grading student videos of their first counseling experience in their very first class. Here are two reflections

1. I’m amazed at the depth of problems their counselees choose to bring up right away. These are people who know they are being videotaped for a class project and though only the grader and the student watch it, it is still taped. And yet, they tell about very personal matters. I’m blessed to be able to hear their life struggle and the student is blessed to hear it as well. I can’t say that I would talk about such deep matters if I were asked to be a counselee for a beginning student.

2. First year counselors do pretty well when it comes to gently attending to their clients and exuding kindness, empathy, and compassion. What is harder is for them to identify and discuss subtle and/or painful emotions expressed by the client. Instead they go for more data from the client. Get more history, more details and maybe it will be better. I think we do this when we listen to our friends. We provide pithy advice, we want to know more details, or worse–we talk about ourselves. My students know not to talk about themselves but yet they struggle to identify and repeat painful emotions.

5 Comments

Filed under christian counseling, counseling skills

Tagged as

November 2, 2007 · 2:29 pm

Women, victimization, & fear


Sarah Lipp (HarvestUSA, Chattanooga, TN office) gave a presentation with the above title. Her focus: What is the experience of women victimized by men; How do such women relate to God as a male being? She started us out with a review of the kinds of victimization experienced (abuse of all kinds (including nagging for sex and/or punishment for not being willing to give more), dehumanization, oppression rooted in the inherent power in masculinity, distortion of the image of God that of females (being treated as only sexual or only trouble). She gave just a couple of stats from the CDC. 18% of women are raped in their lifetime. 51% have been abused. Of those raped, 83% are raped prior to age 25 and 54% before age 18.

So, how do we help?

1. Affirmation. Permission to feel upset and victimized. What happened was wrong. She needs permission to define what happened and own it (name it for what it is). Educate about the patterns and symptoms of past abuse as they impact her life now. Educate on how abuse effects the brain (especially the amygdala’s work in generalizing emotions from the past to present situations).  Yes, the brain is plastic and can be changed but it may be that triggers remain. Teach on PTSD symptoms (re-experiencing, avoidance tendencies, increased arousal). Teach that she is not alone but 40 million others also fit these criteria.
2. Explore how this impacts her experience of her earthly father and males in general (and as a result God). What reactions does she have when she thinks of words such as man/men, daddy, father, husband, etc. What did she learn about herself and men from her family, from her community, from her church, her culture? What has she come to believe? Sarah says that the danger for counselors is to try to fix it. Tell them to think differently. Have compassion
3. Healing gender images. One of the images God gives of himself is female. Sarah isn’t arguing for a feminine God. However, she lists Mt 23:37, Is 51:12, Psalm 131; Acts 9:31; 1 Cor. 1; Isaiah 66:13 as images of the feminine side of God. God images himself in male AND female. Therefore, Sarah argues for starting with (not stopping with) some of the female images of God to see that he cares for her desires and needs as well. God does give maternal pictures of himself and these may be good places to start. To do this, you may have to explore what images she has of women, mothers, feminine. Healthy relationships with same sex members will help here. Once here, you will also need to heal the masculine images of the world and of God. Male is redeemable. This may take a lifetime of relationships with men, 1 at a time.
4. Grief & Redemption. Now that she is not living in denial, she will begin to grieve dashed or unfulfilled desires.  Sitting with the realization of the loss of love and men and women are fallen. This moves us to the possibility of redemption and the transforming power of Christ in men.
5. Dealing with the here and now. How does she discern her past from present. Begin re-writing her story and rewriting facts and feelings from her present perspective. This re-writing actually does change the brain and reduce traumatic fear. Counselor and counselee co-construct a new narrative and speak back into flashbacks. Her re-written story speaks into those flashbacks and in doing so mentally pictures something different. She is free to walk away from that flashback.
6.  Coping with past in constructive ways. Address the destructive means. Yes, repentance necessary but be aware of the body’s impact (look up info on the Endorphin Compensation Hypothesis (ECH) as why many become addicts). Work to avoid seeing destructive patterns as only sin or only body.

Healing must also include faithfully embracing Christ and her vulnerability as a woman.

Suggested reading: Brenda Hunter’s, In the Company of Women; Louis Cozolino’s, The Neuroscience of human relationships.  

13 Comments

Filed under Abuse, Anxiety, biblical counseling, Post-Traumatic Stress Disorder

Tagged as , , , ,