Tag Archives: Psychology

May 7, 2013 · 5:10 am

Of dogs and addictions


Our six-year-old cocker spaniel has learned a new trick. After having lived with us for over 1.5 years, she has figured out that she can open the pull-out cabinet drawer that contains our trash. This only happens when we leave her penned in the kitchen. I suspect we left some wonderful smelling meat scraps in it one night and the desire enabled some higher level problem-solving skills (she’s not the brightest dog in the world). Now that she has learned how to do this, we’ve taken to bungy cording the drawer. A few nights ago, we forgot and came home to a mess of coffee grounds and torn up trash all over the floor.

Interestingly, our dog responds in quite a predictable manner. Normally, when we come home, she is at the door to greet us by dancing around and putting her front paws on our legs. But each time we have come home to a mess she has made, we see her cowering and ready to bolt. The last time we came home to this mess, she squeezed out the door before we could get into the house so she could run away. No, we don’t beat her. She knows she has done wrong.

I’ve wondered what goes on in her head during the time she is into the trash. Does she know it is wrong? When does she start feeling bad. The moment we arrive? Has she been cowering and feeling guilty as soon as she spreads trash around? One more funny behavior: when we send her to her crate (in the basement) for a time out, she goes right away. But then, after a bit, we see her outside of her crate but sitting patiently. Then, she’s at the bottom of the stairs looking to see if we will let her up. Then, her front paws on the first step, waiting in anticipation that we’ll say all’s forgiven.

And this relates to addictions how?

Most individuals who struggle with an addiction have the strong feeling of guilt even as they partake. Guilt rarely is enough to stop us from acting out. Even knowing that we may well be caught does not stop us as much as you might think it would. The desire to have what is right at our fingertips can easily overwhelm all sensibilities and logic–that will race back to us as soon as we finish partaking or as soon as someone finds out. Our initial response may include running away. Guilt and shame prevail for a time and then we creep back into life hoping that the troubles we have caused will blow over and life will return to normal.

Of course, we are not dogs and so we must use the gifts God has given us (a brain capable of higher order planning, the Spirit) to learn from our mistakes and misdeeds. We can

  • remove ourselves from proximity to the addictive agent
  • plan for accountability, especially during vulnerable times
  • examine the roots, shoots, and fruits of our addictions with a trusted friend/counselor
  • remind ourselves of the power to say no and the foolish, false promises of addiction

For more of what I have written about addictions and interventions search the word in the seach box at the top of this page.

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March 19, 2013 · 5:54 am

Getting the Right Treatment for Sexual Abuse? 7 Questions to Consider


You will find the theme of sexual abuse all over the news these days, from clergy sexual abuse to teacher-student improprieties. This level of public discussion allows some victims to feel empowered to speak about past abuse. Hopefully these same individuals find the courage to seek out a counselor to address ongoing struggles with memories, shame, and self-doubt.

But will just any counselor do?

How can you know if the counselor you’ve picked is the right one? Are there questions you can ask to determine whether you are getting good care? Check out the following questions.

How does my counselor handle my disclosure of sexual abuse?

It takes great courage to tell another person about violations of body and soul. Victims fear not being believed, blamed, or worse, having their secret told to others. Thus, when a person sets aside those fears and speaks of what has been hidden, it is a great honor to be blessed with that story. Consider these questions to see how your counselor rates:

  • Does my counselor show evidence of great care for my story? Do they treat it as precious? Once you have told the story, what do they do next? While we counselors hear many tales of woe, it can be tempting to ignore sexual trauma, especially if it happened many years ago or is especially horrific. Some counselors think that past experiences should remain there. They choose to focus only on present problems. Or, counselors can dive into the story and unintentionally force the client to talk too much about the abuse before trust has been fully established.
  • Does my counselor seem in a rush to “get beyond” my abuse to forgiveness, confrontation or reconciliation? There is a place and time to talk about these matters. However, if you have just started telling your story and these topics are their prime focus, then you know that they are most interested in getting to the end of the story, the happily ever after part. The impulse to get to the end will inevitably make you feel like your abuse was a mere trifle.
  • Does my counselor seem to have an unhealthy interest in all the details of my abuse? Counselors who ignore your abuse story are not the only danger. Counselors who dive into your story with great relish may cause you to feel re-victimized. There is a time and place for telling the story in greater detail (so as to process what you have come to believe about yourself and others). Those who rush in to the gory details seem to think that all story-telling is beneficial (see this link for the difference between bad and good trauma storytelling). By the way, a counselor who offers you private access (texting, emailing, late-night phone calls, house visits) without limits and boundaries may be offering you something that is for them and NOT you.
  • Does my counselor let me set the pace of counseling? The heart of abuse is oppression and stealing voice and power (I’ve written more about that in my chapter in this book). A good therapist may unintentionally re-enact abuse when they use their position to coerce clients to meet their own agenda. A benign dictator is still an oppressor! A common question I have received from beginning counselors goes something like this, “How can I make [name] tell me about her abuse?” My answer? You should not try to force her. What happened to her was coercion. You can provide a small modicum of healing by allowing her to decide when and if she will tell you anything. “But, won’t that mean that [name] will not get better?” Yes, it means her recovery will take longer. But consider this: you are undoing her abuse experience by giving her power to decide what she does with her body, including her mouth. It is true that there will be some pushing and prodding, but it should be gentle with the client feeling that he or she has the power to say no or to slow down the process.
  • Does my counselor educate me about trauma symptoms and typical treatments? Trauma symptoms (intrusive memories, hypervigilance, attempts to avoid triggers, numbing, etc.) are not just a psychological phenomenon. The whole body has been traumatized. Your counselor should be able to talk about the effect of trauma on the brain at a lay person level. Further, your counselor should be able to tell you what we *think* we know about the biology of trauma and what we still do not know. (By the way, if they are too enamored with one particular theory or cure-all treatment…RUN).

 A quality counselor will also talk to you about the typical 3 phase model of trauma recovery. They will educate you why it is important to develop good self-care strategies and to eliminate harmful behaviors (addictions, cutting, risky behaviors) before entering into the work of processing memories. They will tell you that safety and stabilization phase (first and ongoing) is about finding ways to stay in the present and to reduce dissociation. When you do tell your story in greater detail, the effective counselor always leaves room in each session to help you leave the office well.

  • When my memories are fuzzy, does my counselor urge me to try to remember? The very nature of talking about past events (whether happy or horrific) brings old memories to the surface. Inevitably, a client will recall some feature of their abuse they had not remembered for some period of time. Or, they will recall something in a very different light and as a result it will feel like a brand new memory. However, your counselor should not be intent on finding lost memories. There are two reasons for this. First, memories can be constructed. When details are vague, our minds may have ways of filling in the blanks with false ideas (However, the likelihood of constructing an entire memory of abuse ex nihilo is rather rare. In my 24 years of counseling, no abuse victims in my office ever reported having NO lasting memory of abuse. All recalled many details even if some details were not). Second, God may have a reason for keeping certain memories from you. Not everything needs to be remembered to get well.
  • What goal does my counselor seek? Counseling works best when counselee and counselor agree on goals and the means to get to those goals. Do the goals your counselor seeks make sense to you? Some goals are unrealistic and even dangerous. “Completely healed” or “as if it never happened” are unlikely and could even be dangerous in that they would make you vulnerable to re-victimization. Goals to confront, cut-off, or reconcile may be legitimate but expectations and safety plans must be reviewed ahead of time. Consider also that reconciliation may not be a good idea.

Your Questions?

I have just touched the surface on a few questions. You might have many other questions you’d like answered. Feel free to suggest questions here and I will attempt to answer some over the next few days.

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January 31, 2013 · 6:37 pm

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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January 26, 2013 · 11:03 am

“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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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 7, 2013 · 11:19 am

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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December 21, 2012 · 10:54 am

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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December 10, 2012 · 3:53 pm

Repost at www.biblical.edu: What is Christian Psychology?


For many of you this is the season of buying Christmas presents. For me, it is the season of paper grading time. I have 46 term papers due tonight. Thankfully, I do have a TA helping with grading for the first time in a VERY long time. So, that is my excuse for no new posting today. However, our faculty blog is reposting a version of my recent blog on Dr. Diane Langberg’s definition of Christian Psychology. Alone, her definition isn’t intended to be comprehensive (as she does not choose to define psychology). Probably would be better to title this a definition of Christian psychotherapeutic intervention. The focus in this definition is on the character of the therapist and the submission to the Spirit’s working in the life of the counselee. The point of the definition is to remind us that we can define the boundaries of psychology from a Christian perspective and yet fail to see the relational aspects of the work that we do.

If you missed it, this link will show you the original post here on November 26 and some helpful questions and comments.

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November 28, 2012 · 5:05 am

One Definition of Christian Psychology


At a recent conference, Diane Langberg submitted the following definition of Christian Psychology. I present it below, verbatim, for your consideration. In some ways she doesn’t say anything new. However, it is quite different from our usual definitions.

Let me explain my seeming contradiction by first giving you C. Stephen Evans definition of Christian psychology,

 [It is] psychology which is done to further the kingdom of God, carried out by citizens of that kingdom whose character and convictions reflect their citizenship in that kingdom… (p. 132)

As you would expect, Dr. Evans offers a philosophically astute definition.

Or, consider Eric Johnson’s tome, Foundations for Soul Care: A Christian Psychology Proposal. In this book of 700 plus pages, he explicates a Christian psychology framework as doxological, semiodiscursive, dialogical, canonical, and psychological approach to soul repair. If you are looking for a theologically and epistemologically rich entry point to Christian psychology, I can’t point you to a better place than this book.

Like these two examples, many of our current definitions focus on matters of epistemology, theology, and psychology. Many definitions also emphasize the work of critical evaluation of existing psychological theory and research.

Now turn to Dr. Langberg’s definition. Notice how she emphasizes the character, the preparation, and actions of the counselor. Notice further that the focus on outcomes is bidirectional–on counselee and counselor.

Christian psychology as practiced in the counseling relationship is a servant of God, steeped in the Word of God, loving and obeying God in public and in private, sitting across from a suffering sinner at a vulnerable crossroad in his/her life and bringing all of the knowledge and wisdom and truth and love available to that person while remaining dependent on the Spirit of God hour by hour. That work, no matter what you call it, will be used by God to change us into His likeness; that work will result in His redemptive work in the life sitting before us; that work will bring glory to His great Name.

What I take from Dr. Langberg’s definition is an emphasis on action, the Spirit’s work and the counselor’s work (in self and other). While the epistemological definitions are necessary if we are going to think critically about our work, so to is this action-oriented definition. It reminds us that for all our thinking and theorizing, it is God’s work in our private and public lives that is used to bring healing and hope to others.

Your thoughts?

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September 29, 2012 · 11:57 am

Self-care or stewardship?


Last night, Dr. Tan (Fuller) spoke on the topic of self-care. During the presentation he interacted with Dr. Sally Schwer Canning’s short essay in a previous Journal of Psychology & Christianity issue (2001, v 30, p 70-74). Dr. Canning raised some concerns about self-care and “balance” language. We all know that we can get out of balance and that we do need to do things to care for ourselves. However, there are times, Dr. Tan said, that we are put out of balance by God. He reminded us of Paul’s statement that he was overwhelmed to the point of despairing of life. He was ship-wrecked and more.

In the name of self-care, we sometimes put up inappropriate boundaries.

Both Tan and Canning suggest that “stewardship” may be a better image for us to us? How are we stewarding the gifts and resources we have, even when life is out of balance?

What do you think? Does stewardship get the same point as self-care?

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