A Change of Heart

Posted on July 18, 2010

[Leslie Vernick LCSW is our guest blogger for the month of July, and this is her third post. Leslie is a licensed clinical social worker, popular speaker and author of 6 books on Christian living. She is the Director of Christ Centered Counseling and you can visit her at www.leslievernick.com or read her weekly blog at leslievernick.blogspot.com]

Ten years ago my mother became very ill. A persistent cough and difficulty breathing sent her to her doctor for help. Bronchitis was the diagnosis, antibiotics the cure. “Don’t worry,” he said. “You’ll be much better soon.”

My mother didn’t feel better, she got worse. She wheezed. She couldn’t sleep. Her breathing became labored. Her doctor now added asthma to her diagnosis and prescribed an inhaler plus new antibiotics. But my mother’s symptoms didn’t subside and eventually she required an ambulance ride to the hospital. There she received the bad news that she didn’t have bronchitis or asthma after all. She had lung cancer.

Last week I blogged about David’s sin against Bathsheba and her husband, Uriah, and diagnosed it as an abuse of power. David came from humble origins but for some time after he became king, he felt entitled to use his position to get whatever he wanted.  He commanded Bathsheba to his bed and sent Uriah to the front lines of battle when an unplanned pregnancy resulted. This diagnosis of David’s abuse of power startled some readers who e-mailed me privately to let me know that they had never thought of David’s sin in that way.

As Christian counselors, it’s especially crucial that we name a problem correctly. I’m not only referring to DSM-IV TR accuracy. For us to be most effective we must not only look at the symptoms someone presents but also the deeper heart themes that rule him or her.

Whether or not we ever write an official diagnosis on an insurance form, when we counsel someone, we have particular ideas about what is going on in a person’s life and heart that shape the direction we take in counseling. For example, if King David had come to you or to me for counseling over this situation in his family life and ministry, how different would his treatment protocol have been if we had diagnosed his problem as an adulterous affair, an inappropriate sexual relationship, or sexual addiction? What would have been the outcome if we had focused on treating David’s depression rather than confronting his abuse of power as Nathan did?

People come to a therapist because they don’t feel good either emotionally, spiritually, and/or relationally. They want our help and their goal is to feel better. How we define “what’s wrong” impacts not only our understanding of them and their problem, but the kind of treatment plan we implement. An antibiotic is great medicine for someone sick with bronchitis, but it is impotent against cancer. In the same way sometimes I’m afraid that when we focus on treating symptoms, we may inadvertently enable our clients to remain blind to the growing cancer (sin) in their own heart.

Let’s look briefly at an actual case I worked with. I’m providing only the bare bones to illustrate my point but if you’d like, you can read more about it in my book, How to Live Right When Your Life Goes Wrong, (chapters 1 and 8).

Jack came to see me with his wife Mary as a last resort. Mary said “I can’t live like this anymore. Jack’s always mad at me. He screams and curses and I feel like I’m going to have a nervous breakdown.” She continued, “We’ve been to lots of therapists and nothing has made any significant difference in our relationship. I’m ready to end it.”

Jack reluctantly acknowledged his behavior was hurtful to Mary but defended himself by saying that he wouldn’t get so mad if Mary didn’t annoy him all the time. She wouldn’t shut up when he didn’t want to talk anymore. She didn’t respect him like he wanted. She was disorganized and from Jack’s perspective not submissive enough.

Mary defined their marital problem as “I don’t know what to do to make Jack happy.”  In the past, counselors focused on helping Mary better meet Jack’s needs, biblical roles for marriage, communication and conflict resolution skills and some anger management techniques for Jack. But just like my mother, those treatment plans weren’t working. Jack and Mary’s marriage was getting sicker and sicker.

It was time to reevaluate the diagnosis. First, Jack’s anger problem isn’t because of Mary or his disappointing marriage. Couples therapy is as ineffective to solve their problem as my mother’s antibiotic treatment was to cure cancer.  Jack’s angry responses are not because of what Mary does or doesn’t do. Jesus tells us, “Out of the overflow of our heart, our mouth speaks” (Luke 6:45). A difficult marriage or person doesn’t make us respond with fits of rage. Jesus says however, those angry words that come out of our mouth expose something going on in our heart.

Jack’s ugly temper was the fruit, not the root of his deeper heart issue. What was going on in Jack’s heart that needed radical treatment?  This may sound simplistic but in a sense it was. Jack wanted what he wanted and used biblical support to defend that he should get what he wanted. For example, he’d say, “I’m not asking for anything unreasonable. I just want her to listen to me when I want to talk with her.” Or “I just want her to show respect and stop arguing with me.”

When Jack didn’t get what he wanted, he became demanding and threatening. He used his temper to bully Mary so that she’d give in.  When she refused or failed to do what he demanded, he used ugly words to punish her.

The tricky thing about this kind of case is that there is an ounce of truth in some of Jack’s statements. Of course it would be nice if Mary would respect or accommodate her husband, but if we turned our attention toward helping Mary as a treatment goal, we would be misdiagnosing what’s wrong and allowing Jack’s problem to get worse. No one always gets what he or she wants all the time and important growth is processing maturely our legitimate feelings of hurt, anger and/or disappointment when we don’t get everything we want or feel we need.

James asks, “What is the source of conflicts and quarrels among you? (James 4:1).  Pride and selfishness is James’ diagnostic assessment. In this case Jack felt entitled to get what he wanted from Mary because he believed her role as his wife was to always meet his felt needs. She had no right to say “no”.  Jack didn’t see Mary as a person created in God’s image who had her own needs and feelings, desires and dreams. Rather, Jack related to her as an object to control, someone to use to get love, support, physical affection, and to make his life easier.

Although Jack gave lip service to the sinfulness of his temper outbursts, Jack continued to use rage to get what he wanted because it worked. Jack had never been confronted with his selfishness and entitlement thinking, or his lack of love and his unbiblical ideas about marriage in any of his previous counseling although most of it was done by pastors and Christian counselors.  There is no real change on the outside until we confront and work through what’s going on in the heart.

A change for Jack isn’t merely learning anger management or conflict resolution strategies, but like King David, Jack needed to repent of his self-centeredness and lack of love. Then treatment could focus on Jack learning to love his wife as a person separate from him as well as teaching him how to tolerate his own unpleasant feelings when Mary doesn’t love him perfectly or like he wants her to.

Friends and colleagues, we are not so different from King David or Jack. We may not have the power of a king, but we all seek some kind of control over our kingdoms and the people in them. Just like Jack and David, our heart is full of pride, anger, envy, selfishness, greed, fear, lust, and laziness and if we’re not mindful, we will be just as tempted by them and just as blind to them as King David and Jack were.

As Christian counselors, I pray that we press hard to expose the heart issues, the things that keep us stuck, keep us sick, keep us from being all that Christ calls us to be both in ourselves as well as with those God allows us to serve.

Loving God Through Knowing Him

Posted on April 18, 2010

[April is our month for guest bloggers, and this weeks blog is written by Valerie Murphy  LCPC, SD, BCPCC, Director and Therapist for Foundation Counseling and Training]

Over the last few years, I\’ve sensed a heart-felt pull to discover what it means to know God in such a way that it leads me to an ever deepening desire to be like Christ… by that I mean to be like Christ in full surrender and in freedom from the attachments to \”be like God.\”  This being like God has been Satan\’s pull into the worldly perspective since the fall, just as He had enticed Adam and Eve through false logic and reason, to pull away from God and to go it on their own.

To expand this theme, I\’d like to start with a personal story about my life that I believe pertains.  My husband and I are approaching the empty nest stage of family relationship with our adult children (or at least it appears it will happen in the not too distant future!).  Out of the emptiness we foresee with the upcoming loss of our children\’s presence, we now have a new addition of a tiny toy poodle to our family and are expecting one more from another litter shortly.  Clearly the addition of these puppies is a way of adding interest in our home and to fill a love spot for us until the grandbabies arrive. 

As we\’ve been learning all the ins and outs of current trends in puppy training, we\’ve studied the pack mentality of the dog.  Successful training from this viewpoint requires us, as owners, to become the \”leaders of the pack,\” or if you will, the Alpha dogs within our home.  In watching videos and reading current literature on this subject, I\’ve begun to realize a very deep draw inside myself which is very different from all the pulls over the years where I\’ve desired to \”do things on my own\” or to follow my own visions and plans or my own ideas of what my life should look like.  Rather, this draw is to truly live out life under the \”Leader of our pack;\” our Alpha Jesus Christ, under the authority of God the Father through the Holy Spirit.

The desire to do things on my own or for the sake of \”my own kingdom\” is, I believe, the \”tragedy\” that is referred to by Oswald Chambers in his book, The Place of Help.  Oswald Chambers states that, \”not until we realize that there is something tragic at the basis of human life shall we recognize the love of God,\” or I believe truly KNOW Him.  As I\’ve looked at the \”tragedy\” of life for myself, my clients and the world at large, perhaps it isn\’t so bad after all to follow a Leader that sets a vision for the good of all, has plans in place, disciplines and guides us in our roles, and walks with us on our journey of representing Him.  It is not the vision that I or those I serve might design; yet we have to remember that, like Christ, we do each have a God-given role.   Though the priorities and plans He establishes as our Leader are different than those we envision, we do walk in good stead as we \”imitate Christ\” in surrender and abandonment to the One True God.

Part of my journey with knowing God and the Biblical encouragement for my clients in falling under God\’s leadership has been further developed as I\’ve delved into the depth of our Leader\’s care and the fulfillments He has shared with mankind from the beginning.  In Genesis there was profound satisfaction innate in the garden; free of the left-empty longings and the desires that exist on the fallen earth.

The 21 P\’s

Can you imagine participating in the PRESENCE of the CREATOR (Gen 1:26-27) in the paradise garden that God created for man?  God shared His PERSONAL TOUCH (Genesis 2:7) and very breath with His creation.  He filled the earth with the abundance of His PRAISE (Gen 1:31; 2:12).  There was PERMANENCE (Gen 1:30) with all His shared Words, as well as, the PEACE (Gen 2:2) and rest that only He can bring.

From the beginning mankind was deeply connected to God and held a certain PRESTIGE (Gen 1:27), having been made in Their image.  Man was given a specific POWER (Gen 1:28, 2:19), PURPOSE (Gen 1:26) and set PRIORITIES (Gen 1:28) which included a mandate of PROCREATIVITY (Gen 1:12, 28) and PRODUCTIVITY (Gen 2:15).  Genesis expresses God\’s clear PRIZING (Gen 1:28) of His created ones.

God was abundant in His PROVISION (Gen 1:30; 2:7; 9; 10; 16) for man.  He formed a special PLACE (Gen 2:8) full of life and an extravagance of food, drink and PLEASURE (Gen 2:9) for the senses.  There was an abundance of treasures as well.  PROTECTION (Gen 2:17) was given through God\’s request to limit the eating of a certain fruit from a specific tree within this garden of delights.

God was full of praise for His creation, yet he also left man with the POTENTIAL PROMISE (Gen 2:18) of relational satisfaction with the coming of the PRESENCE of the OTHER (Gen 2:22) that became a PROMISE FULFILLED (Gen 2:23) in the creation of woman.  This relationship of mankind was truly good and ignited PASSION (Gen 2:24) from a sense of PURITY (Gen 2:25).

As I study the greatness of God within these brief chapters of His Scriptures, I want to be like Christ and to follow Him to God and out of what Oswald Chambers refers to as the \”not reasonable but tragic.\”  I believe this tragedy is founded on Satan\’s lure upon mankind\’s thinking from the very beginning for us to imagine what it would be like to \”be like God.\”  The identification of the left-empty P\’s that motivate our clients, as well as ourselves, uncovers the deepest longings, desires and the drives that lead  us away from God\’s plans for us and that motivates us to replace our following of Christ and the promptings of the Holy Spirit with our own misguided leadership.     

This is just the beginning of what it means for me to know God and to encourage my clients in knowing Him.  He formed each one of us individually from the beginning.  He has the perfect fulfillment of all that we could ask or imagine according to His plans and work within us.  He knows our deepest hungers, thirsts and needs (and He knows puppies will not fill them)! 

Lord, help us to turn away from our drives to be like You, to satisfy ourselves and our visions, and to essentially replace You as the Alpha and the leader of the pack.  Let us turn towards being image bearers of Yourself through being like your Son in full surrender to You and Your Glory!

I would appreciate any of your thoughts.

Implications of the Resurrection for Christian Psychology

Posted on April 11, 2010

[For the month of April we have a variety of guest bloggers. This week\'s post is authored by Dr. David Jenkins, Associate Professor of Counseling, Center for Counseling and Family Studies at Liberty University in Lynchburg, VA]

When Eric Johnson asked if I would be a guest blogger, I knew the post would take place a couple of weeks after we celebrated Easter.  I have always appreciated the Society for Christian Psychology and the simplicity of its mission statement.  So my first thought on what this blog\’s focus would be was, \”What are the implications of the resurrection for the theory, research, and practice of Christian psychology?\”  While continuing to prayerfully consider what my contribution might be, I became increasingly convinced that this was the direction to take the discussion.  It was reassuring to have the presentation topic confirmed.  I became a bit unsettled, though, because as I spent time pondering this topic, I realized I had taken it for granted and not really thought through this before-at least not in any kind of systematic way.  \”Yikes,\” I thought, \”I\’m supposed to blog on this for public display to the SCP!\”

So what follows are some thoughts about what difference the fact of the resurrection of Jesus Christ makes for Christian psychology.  While I hope I can inform to some degree, my intent is more to spur some discussion among you.  I\’ll present some general thoughts first and then some implications for the theory, the research, and the practice of Christian psychology.

 General Implications

Because of the resurrection, Christian psychology should be characterized by pervasive qualities of:

 Theory Implications

Higgins (2004) identified aspects of useful theory.  Useful theories are: testable, coherent, economical, generalizable, and explanatory.  Interestingly, he added a sixth aspect beyond these common five-generativity.  Isn\’t that fascinating?  Good theory should also \”give birth and life\” to further theory.  I believe a suitable word to go along with this is \”heuristic\”-the theoretical work of Christian psychology should guide in the investigation and discovery of who God is, what He\’s like, and what that means for those created in His image. 

The resurrection means that what we presently see, touch, hear, smell, and taste is not all there is to this story of being human.  We are not in a \”closed\” universe, meaning that God has always been and remains active and immanent.  Surely, this ought to stimulate \”holy\” (i.e., set apart) theory that\’s qualitatively different than what modern psychology presently offers.  And as Christian psychology seeks to recover and nurture its historical identity found within biblical Christianity, \”resurrecting\” that identity after a century of neglect, division, and abuse seems like an appropriate way to describe this effort.  In what ways do you believe the theory of Christian psychology is shaped by the resurrection?

 Research Implications

Jones (2002) described functions of research: modification, illustration, explanation, exploration, affirmation, prediction, and correction.  Although space doesn\’t permit elaboration on each of these functions, a couple of examples will clarify this point.  The resurrection \”modifies\” what I know and believe about persons created in the image of God.  The resurrection \”illustrates\” the pattern of creation, fall, and redemption present in the universe, but particularly in human beings.  You could construct similar thoughts regarding the other functions of research.

Beyond these implications, the resurrection should affect the \”content\” of Christian psychology\’s research as well as its \”process.\”  Probably more than any other, the general implication of hope should influence our research.  Topics such as resilience, optimal functioning, and the power of a well-lived life seem uniquely suited to a discipline whose foundational beliefs include the resurrection.  What other research content and process areas do you believe are uniquely shaped by the resurrection?

 Practice Implications

Sizemore (2006) outlined elements of a counseling model derived from a Christian psychology perspective.  He included elements regarding the nature of epistemology, persons, health, pathology, and treatment.  What we believe about what we know and how we know it is radically affected by the resurrection.  Let\’s face it-even the apostle Paul identified the resurrection of Jesus Christ as the defining issue of the reality of our faith.  To believe in the resurrection requires us to step outside of naturalistic approaches to our work with persons.  Once again, I believe the general issues of hope, death as a precursor to life, freedom, making God known, transformation, and purpose influence my intentionality as a practitioner of soul care.  How is your work with people affected by the resurrection?

 Conclusion

I love Jesus…and, really more importantly, He loves me!  I am a living example of the resurrection power of Jesus Christ.  Some of you may know part of my story, and the details really aren\’t that important to our purposes here.  But just know that God took me from hopelessness, death/destruction, bondage, darkness, distortion, and futility.  He brought me lovingly and radically into hope, life, freedom, knowledge of Him, transformation, and purpose!  I\’m certain many of you can testify to the same \”resurrection power\” in your own life.  May God continue to bless this project of Christian psychology and those who are part of it!

I look forward to your comments and contributions!

 References:

Higgins, E.T. (2004). Making a theory useful: Lessons handed down. Personality and Social Psychology Review, 8(2), 138-145.

Jones, I.F. (2002). Research in Christian counseling: Proving and promoting our valued cause. In T. Clinton & G. Ohlschlager (Eds.), Competent Christian counseling (pp. 641-657). Colorado Springs, CO: Waterbrook.

Sizemore, T.A. (2006). The five domains: A Christian psychology model for counseling. Retrieved August 6, 2007, from Society for Christian Psychology Web site: http://www.aacc.net.net/email/media/scp_2.ppt

Two Types of Suffering

Posted on March 21, 2010

[by Leslie Vernick, DCSW, LCSW. Leslie is in private practice, Director of Christ-Centered Counseling www.leslievernick.com, and is our blogger for the month of March. This is her fourth blog]

Scott Peck opens his best-selling book, The Road Less Traveled with the statement \”Life is difficult.\”  Trials and troubles come to saint and sinner alike. No one is immune. But it is often suffering that brings a person to the counselor\’s office. As Christian counselors we have a unique opportunity when people are hurting because they naturally seek answers from God, often asking the questions, Why God? Why this? Why now? Why me?

I\’ve come to understand that there are two types of suffering; necessary suffering and unnecessary suffering. It\’s important that we learn to distinguish them because we will approach them differently in the therapeutic process.

Let\’s first look at necessary suffering. Necessary suffering is important. It is part of God\’s plan to teach us to stay away from dangerous things as well as to mature us. When a child puts her hand on a hot stove, the pain warns her to remove her hand immediately. If she ignored her pain it would result in more intense suffering and perhaps even permanent damage (which is unnecessary if she listened to her pain).

The apostle Paul tells us that suffering builds character (Romans 5) and James tells that we can experience joy in the midst of our trials and troubles if we remember that they are used to build perseverance which help us run the race of faith with greater endurance (James 1:2,3).

Suffering is necessary because it wakes us up from our spiritual sleepiness and teaches us what really matters. Whether we realize it or not, even as believers, many of us are held captive to the lie that we need something other than God to fulfill us and make us happy. When we put our hope in something or someone other than God to give us what only he can give, he will surely frustrate us. He doesn\’t do it to punish us but rather to rescue us from our disordered attachments and delusions; from our foolishness and self-deception. Sorrow teaches us to let go of our love affair with false or lesser things and seek harder after God.

Necessary suffering is used by God to dismantle our internal story line about how life should work, what brings inner happiness and what\’s truly important. Life\’s disappointments and sorrows are unwelcome but necessary gifts to help us see view reality correctly. C.S. Lewis writes, \”God whispers to us in our pleasures, speaks to us in our conscience, but shouts in our pains; it is His megaphone to rouse a deaf world.\” Necessary suffering helps us find God and our true selves instead of losing our way through life feasting at the table of cheap substitutes.  

Necessary suffering is a result of living in a sinful and broken world. Things are not as they should be. Our goal with individuals who are in the midst of this kind of suffering is to help them express their honest emotions, grieve their losses, and to eventually find hope or some purpose in the midst of them. Like mining for diamonds in the mud, the Christian counselor helps his/her client extract what\’s good from the bad, what is beautiful from the ugly. Jesus said, \”I have told you these things, so that in me you may have peace. In this world you will have trouble. But take heart! I have overcome the world.\” (John 16:33). We are not alone in our suffering. Jesus knows the pain of living in a broken down world. He is present to help us, to guide us and to comfort us. Our suffering is not meaningless and God will redeem it if we let him.

In contrast, unnecessary suffering results from our poor response to necessary suffering. It rises out of our unrealistic expectations, the lies we believe (our tell ourselves), our bad habits, poor choices, and our negative emotions such as self-pity, envy, greed, jealousy, resentment, pride, and shame. This kind of pain results from our immature or rebellious way of handling life and our inability and/or refusal to see things truthfully.

When working with someone experiencing sorrow upon sorrow, in addition to being empathic with whatever necessary suffering they are experiencing, we must help our client understand the ways she may play an active role in creating unnecessary suffering.

Let me give an example. A woman shared with me that her only son was recently killed in a motorcycle accident. She said, \”I can\’t be thankful for all things but I have learned I can be thankful in all things\” (1 Thessalonians 5:18).

She continued, \”I am thankful that I had him with me for 24 years. I\’m thankful that he died doing something he loved. I\’m thankful that he knew the Lord and I\’ll see him someday. I\’m thankful that I have so many friends who are helping me through this horrible time.\”

This woman was hurting but her grief in facing such a loss was not compounded by additional pain she would have experienced had she told herself such things as, \”God must be punishing me for something I\’ve done.\” Or \”If only I hadn\’t allowed him to buy that motorcycle, he\’d still be alive.\” Or \”Why my son? It\’s not fair. I only had one child and now he\’s gone.\” Or \”My life is ruined, I\’ll never be happy again.\”

She didn\’t isolate or withdraw from her social support and she worked hard to remind herself of God\’s goodness and love even in the midst of a tragedy. Necessary suffering was doing its work in her life and wasn\’t intensified by additional sorrow that wasn\’t necessary.

On the other hand I\’ve had many clients who live in a chronic state of misery because of their unrealistic expectations, poor choices, or negative lifestyle habits yet they fail to connect the dots that their suffering is self imposed and unnecessary if only they would change their ways.

 Most of the time there is some combination of both kinds of suffering. Understanding the difference, has helped me to be wiser in the way I approach those that are hurting.

Creativity in Counseling, Part 3

Posted on March 14, 2010

[by Leslie Vernick, DCSW, LCSW. Leslie is in private practice, Director of Christ-Centered Counseling www.leslievernick.com, and is our blogger for the month of March. This is her third blog]

In my past two blogs I\’ve invited discussion about creative techniques we can implement to help our clients experience deeper truth or make positive changes. As we\’ve learned, showing is always more potent than telling in the counseling process. How we do that can take a multitude of approaches and this week I\’d like to share some specific ways I\’ve incorporated illustration and story in my practice.

Barker (1996) holds that metaphor and stories are particularly useful to do the following:

Illustrate a particular point

Suggest possible solutions to a problem

Promote insight or awareness

Motivate or plant ideas in a counselee\’s mind

Overcome and bypass resistance

Reframe or redefine the problem

Remind people of their resources

The creative use of illustration, story, and metaphor were an integral part of Jesus\’ teaching style and are generously woven throughout Scripture. They help us grab a hold of deep spiritual truths as well as bypass the watchdog left brain.

Illustration:  We all experience counselees who typically blame their poor reactions to provocative situations on an external stressor instead of taking personal responsibility for how they\’ve handled the situation. During a session they may say something like, \”If she wouldn\’t have aggravated me I wouldn\’t have yelled at her that way.\” The implication being that it is his wife\’s fault that he lost his temper and that the goal of counseling should be to get his wife to stop doing whatever upsets him.

I don\’t have the space in this blog to flesh all the different approaches one could take in this case and there may be a time where talking with the wife about her provocative behavior is appropriate. However, I have found when trying to break through these kinds of circular interactions, quoting scripture (or assigning it as homework) regarding how one should speak or  the consequences of biting and devouring one another, usually fails to produce the desired internal change of greater personal reflection and acceptance of responsibility.

But here is an illustration that stops the blame game. In my office I keep a small jar of seemingly clean water. Unknown to my clients, at the bottom of the jar is some dirty sediment. When a person is habitually blaming outside forces for his or her own poor response, I\’ll pull the jar off my shelf and hold it by the bottom so that the sediment is unseen. I ask him if the water looks clean. He usually nods, yes.

Then I vigorously shake the jar of water. The sediment becomes obvious and the water is now dirty. I ask, \”Did shaking the jar make the water dirty?\”

The immediate answer is often \”yes\”. Then he pauses and reflects a little more, realizing that shaking the jar didn\’t make the water dirty, it was already dirty, shaking only made the dirt obvious.

This opens a window to explore his new awareness and what it means for his interactions with his wife. Certainly people and life provoke us, but what comes out of our mouth in those moments has more to do with the contents of our heart, than the particular situation. My jar illustration shows Christ\’s words, \”Out of the overflow of the heart, the mouth speaks.\” (Luke 6:46). I could have shaken (provoked) the jar until my arm fell off and if the water was truly clean, it would not have become dirty. Shaking simply exposed the dirt that had been there all along.

This simple yet powerful illustration helps people see that their reactions and responses to difficult people or situations expose the darker contents of their own heart. These qualities usually stay hidden (at least from our client\’s own awareness) until provoked. Seeing the dirty contents of one\’s heart is a good thing so that we can begin to repent, take responsibility and change.

Story:  In my counseling practice I often tell stories or assign my clients to read stories or watch movies as homework. The editors of Futurist magazine assert that storytellers will be the most valuable workers in the twenty-first century.

I worked with a woman who felt depressed and was morbidly obese. In addition she chronically masturbated and fantasized how her life \”could\” be but never actually did anything to change it. Please understand that I am not commenting on whether or not masturbation is biblical in this blog nor am I presenting an entire case. I\’m showing how I used a story to get her unstuck.

After some time of trying all sorts of approaches, I finally asked my client to read the fairy tale \”The Little Match Girl\”.  If you recall, the story is of a poor girl who froze to death by lighting matches trying to stay warm while having fantasies of a crackling fire, a Christmas dinner, and a loving grandmother.

The story helped my client see herself and her own impoverished, empty life. She saw how she used masturbation (lighting matches) and fantasy to warm herself instead of connecting with and loving real people as God has made us to do. Most importantly it motivated her to move forward in making healthy changes because she could now see that she too, was freezing to death.  

Let me close with a short story I sometimes use with a client when he or she is quite sure the difficult moment they are in will last forever or means that nothing good will ever come of it. You can find various versions on the internet. It goes something like this:

There was an old farmer that had only one horse and one day his horse ran away. The neighbors came to console his terrible loss. \”This is awful,\” they cried.

The farmer said, \”Oh I don\’t know, it could be good or it could be bad.\”

A month later the horse came home – this time bringing with her two beautiful wild horses. The neighbors became excited at the farmer\’s good fortune. \”Such lovely, strong horses,\” they exclaimed. \”What a fortunate man you are.\”

The farmer said, \”Oh I don\’t know, it could be good or it could be bad.\”

Some days later the farmer\’s son was riding one of the wild horses when he was thrown and broke his leg. The neighbors said, \”Such bad luck!\”

The farmer said, \”Oh I don\’t know, it could be good or it could be bad.\”

A war came and every able bodied young man was send into battle. Only the farmer\’s son was exempt because he had a broken leg. The neighbors said, \”This is good, he doesn\’t have to go away.\”

And by now you know what the farmer said.

None of us know what good things can come from the bad things we experience or what difficulties we will encounter even in life\’s blessings. Suffering and blessing is in all things. It\’s not either/or, but both/and.

 

Barker, P.(1996). Psychotherapeutic Metaphors: A guide to Theory and Practice. New York: Brunner/Mazel.

Creativity in Counseling, Part 2: The Art of the Therapeutic Question

Posted on March 8, 2010

[by Leslie Vernick, DCSW, LCSW. Leslie is in private practice, Director of Christ-Centered Counseling www.leslievernick.com, and is our blogger for the month of March. This is her second blog]

As an author, I\’ve struggled to show instead of simply tell what I want to convey to my audience. I\’ve found that this same writing principle of \”show, don\’t tell\” works best in the counseling office as well. Dr. Burns (from last week\’s blog) showed his client that she wasn\’t having a heart attack through her experience of jogging in place. Telling her wasn\’t enough to convince her. To explore a different avenue for creativity in counseling, I want to look at the art of asking good questions.

Therapeutic questions are most often used to gather information and orient ourselves as clinicians as to what brings the client to our office. We want to understand how she perceives her current life problems as well as explore what precipitated them, how she has coped, as well as what solutions, if any, she has tried to resolve her pain. As a wrench is to a plumber, a scalpel is to a surgeon, and a paint brush is to an artist, the question is the basic tool of the therapist. Learning how to use this tool competently is as much an art as it is a skill.

All of us have learned about asking good questions in graduate school, but perhaps some of us haven\’t taken the time to master some of the finer or more subtle ways we can use this important tool in the therapeutic process. Talented artists don\’t paint pictures using a single brush. They learn which brush is required to make a bold stroke versus a fine line. They study and repeatedly practice what kind of angle and exactly how much weight to apply to the brush in order to achieve their desired results. In a similar way, as clinicians we can use a well worded or wisely timed question to turn the corner beyond fact finding or data gathering and move our client toward change. 

When I was beginning my counseling career, I often felt like I was stumbling in the dark. After gathering my information and forming my hypothesis, I wasn\’t sure how to take my client from point A to point B. I knew where I wanted to go (sort of), but wasn\’t sure how to get her there. Instead of asking the right question that might help my client see her way forward, I pushed rather than invited, taught instead of showed, and sometimes preached rather than simply be present. 

Perhaps because I was so guilty of these missteps, I readily see them with the Christian counselors I supervise as well. Instead of helping someone grow to become more aware of themselves and/or God and his truth through the use of good and well timed questions, we lecture, teach, or preach.  But Jesus masterfully wielded the right question at just the right time in order to bring individuals into greater awareness, to challenge wrong thinking, and to influence them toward deep and significant change.

Let\’s briefly look at 3 types of questions Jesus asked in order to see how we might sharpen our therapeutic tool in a more creative way.

1. Teaching Questions: Instead of telling someone what to believe, Jesus often used questions to challenge wrong thinking or bring about greater awareness of a spiritual truth. For example, Jesus asked:

\”Do you think that these Galileans were worse sinners than all the other Galileans because they suffered this way…Or those eighteen who died when the tower in Siloam fell on them. Do you think they were more guilty than all the others living in Jerusalem?\” (Luke 13:1-4)

  \”Which of you, if his son asks for bread, will give him a stone? Or if he asks for a fish will give him a snake?\” (Matthew 7:9)

\”Is not life more important than food, and the body more important than clothes? …Who of you by worrying can add a single hour to his life, and why do you worry about clothes?  (Matthew 6:25-29)

Jesus used these questions to correct wrong thinking and help individuals to see God and life in fresh new ways.  

Instead of telling or teaching the truth, here is an example how one might use questions to help a client think more biblically.

\”What do you think it means in Romans 12:21 when it says that we\’re not to be overcome with evil but to overcome evil with good?  How might that truth help you decide how to handle the situation we\’ve just talked about?  What would good look like here?\”

2. Challenging Questions: In addition to teaching someone new ways of thinking there are times our clients are caught in faulty and deceptive beliefs. Below are some questions Jesus asked to challenge and cast light upon deeply entrenched beliefs in order to invite a person toward greater truth and healing.

\”And if Satan casts out Satan, he is divided against himself; how then shall his kingdom stand?\” (Matthew 12:26-29)

\”Do people pick grapes from thorn bushes, or figs from thistles?\” (Matthew 7:16)

\”If any of you has a sheep and it falls into a pit on the Sabbath, will you not take hold of it and lift it out?\” (Matthew 12:11)

In last week\’s case example, Dr. Burns could have asked his client, \”Do you believe you can jog and have a heart attack at the same time?\”  He didn\’t directly ask her that question, yet embedded in his request to jog, it was an obvious challenge to her faulty belief.

Here\’s an example of a question I\’ve used to challenge the head/heart division that many of my clients experience when they say, \”I know that in my head, but not in my heart.\”

            \”When your thoughts and feelings are contrary to what God says, who wins?\”

3. Confronting Questions: As Christian psychologists and counselors, we are not merely truth seekers, we are called to be truth tellers. How we tell the truth however, is important. Jesus often used a piercing question to confront a particular sin or heart attitude.

\”Why do you look at the speck of sawdust in your brother\’s eye and pay no attention to the plank in your own eye?\” (Matthew 7:3-5)

\”Why do you call me Lord, Lord, and do not do what I say?\” (Luke 6:46)

Confronting sinful and/or immature attitudes and behavior is not easy while still maintaining a good therapeutic relationship. We have been taught not to use why questions because they usually put someone on the defensive. However, we can ask probing questions without using the word why. Here are some examples.

\”You\’re right, it\’s not fair that your parents (or whoever) treated you so sinfully, but what does it cost you to stay stuck in resentment and anger for this long?

 \”You tell me that you want to honor God and be a good husband. But what happens to you when you also want your wife to listen to you and she is too busy or isn\’t interested? What happens to you and in you when you don\’t get what you want from your wife?\”

Within the therapeutic hour there are many choices and decisions we make regarding what strategy to use for a particular client and his/or her situation. A well timed and thoughtful question can open otherwise closed doors.  I welcome further dialogue on ways that others have used questions to show, not tell.

Do No Harm

Posted on February 7, 2010

(by Philip G. Monroe. Associate professor of Counseling & Psychology at Biblical Seminary. Dr. Monroe is our blogger for the month of February and this is his second post. Dr. Monroe maintains his own blog at http://www.wisecounsel.wordpress.com/)

Every counseling ethics code in existence includes this principle: Do no harm. This maxim is drilled into the heads of counseling students (and any other medical professional as well). Our work should help, not hurt. Who could disagree?

But pause for a minute and consider how you might evaluate whether an intervention helps or harms. What criteria will you use? From what vantage point will you evaluate the criteria you choose? If a medical treatment extends life for an ill patient that would seem good-unless it keeps them alive and in a vegetative state with no possibility of recovery. Some would then wonder if the treatment was indeed best. Or, is it harmful if marriage counseling encourages truthfulness between spouses leading to the revelation of a terrible betrayal leading on to divorce and financial ruin? If honesty is your criteria for helpfulness, then the intervention is sad but helpful. If stability is your criteria, then such counseling is harmful. We could go on and on. Do we use client interpretation of whether treatment is helpful or counselor observation? Do we consider the difference between short and long term evaluation? And importantly for Christians, do we consider only statistical analyses or do we also consider biblical categories (e.g., intervention \”A\” leads to increased positive affect but encourages clients to pray to another deity).

Despite the muddy water I just churned up, I want to argue that Christian psychology is well poised to help Christian counselors provide treatment that does not harm. This society includes some of the best philosophers, theologians, sociologists, clinicians, and researchers of our day. These members are interested in looking at how people grow and change, how the bible connects with everyday life, common human struggles and effective interventions, etc.

How then do we go about refining our practices and avoiding harm? Let me suggest some steps we might take:

That would be a good start. Now, I\’m not under some delusion that we will agree completely on any one of these issues. But, clarifying agreement, identifying disagreement might bring our work into better focus. I suspect we will find much that ought to be fixed and a sadly needed increase in Christian counselor humility.

Should Christian Psychology Become a Profession?

Posted on January 31, 2010

(by Philip G. Monroe. Associate professor of Counseling & Psychology at Biblical Seminary. Dr. Monroe is our blogger for the month of February and this is his first post. Dr. Monroe maintains his own blog at http://www.wisecounsel.wordpress.com/)

Right now, in the Commonwealth of Pennsylvania, lawmakers are considering a bill that would place more restrictions on who can provide counsel. Currently, the state has a number of mental health credentials. Among those is the Licensed Professional Counselor credential for those with a requisite master\’s degree and post graduate supervised practice. If passed, the new bill will not only protect the title of \”Professional Counselor\” but also the practice of professional counseling. Per the law, one may not \”style\” themselves as a counselor unless they are licensed as such.

Who does this effect? This will especially impact the many Christian counselors who are not licensed but practice a form of counseling (aka biblical counseling, Christian counseling, etc.). While these counselors do not provide diagnoses or bill insurances they do collect fees, keep progress notes, maintain confidentiality, and provide counsel for those struggling with issues such as anxiety, anger, depression, marital conflict and the like. So, the 64 million dollar question: Do these unlicensed Christian counselors \”style\” themselves as professional counselors? And who decides the line between the two? As an aside, the bill does contain an exemption for pastoral counselors. Pennsylvania does not yet define that title but in other locales that title is reserved for those ordained, trained in a pastoral counseling graduate program, and doing work in church-related institutions.

Here\’s where the bill gets interesting. It describes what typifies a profession that might overlap with counseling but have a separate (and thus exempted) identity and practice. Here are some of the criteria they might use to discern a separate profession (note my bolded text to emphasize interesting details):

1.  The group\’s activity and focus must be based on an identifiable body of theoretical knowledge which, although it may include areas of common knowledge shared with social work, marriage and family therapy, and professional counseling, is demonstrably different, in the aggregate, from the body of theoretical knowledge underlying social work, marriage and family therapy, and professional counseling.

2.  The group must regulate entrance into professional membership by means of standards of knowledge, training and proficiency generally accepted by the profession with which it identifies.

3.  The group\’s activity must be guided by generally accepted quality standards, ethical principles and requirements for an independent profession.

4.  The group must exhibit the ordinary accoutrements of a profession, which may include professional journals, regional and national conferences, specific academic curricula and degrees, continuing education opportunities, regional and national certification and awards for outstanding practice within the profession.

Thus, the state will consider whether one is a qualified member of a profession (and in compliance with that profession\’s standards) AND counseling only in the scope of this profession.

This leads me to ask two questions. Does Christian psychology fit the definition of a profession? Should we seek to form our own credentials?

Like all good academics, we like to pose questions and avoid answering them. However, I do have some thoughts. First, we do have a theoretical knowledge base that is unique in its scope even if embryonic in its application. Second, while we do not have our own standards of practice, our parent organization, The American Association of Christian Counselors (AACC), does. And other Christian counseling membership organizations do as well. However, our biggest problem is that we do not limit members to only those who meet an observed standard of practice. There are no proficiency exams to hinder some from entry (again the AACC is now working to change this for their organization). Finally, there are many who would resist the separation of Christian psychology or Christian counseling as a distinct profession on the grounds that it would either ghettoize Christian counselors or lead to innumerable ideological authorities (biblical counselors vs. Christian psychologists vs. Reformed counselors vs. Catholic therapists, etc.). It is my opinion that our Society is enriched because we do NOT see ourselves as a profession. Thus, we have philosophers, theologians, psychologists, pastors, biblical counselors and many more within our ranks. We are well suited to avoid groupthink, in my humble opinion.

What do you think? Should Christian counselors seek their own professional identity and licensing body? What are the pros and cons of doing so?

The Glory of God Composed of Form and Splendor – part 2

Posted on December 28, 2009

[Eric Johnson is our guest blogger for December. Eric is the Director of the Society for Christian Psychology and professor at Southern Baptist Theological Seminary. This is his fourth post].

Last week I began a discussion based on a distinction borrowed from the great 20th century Catholic theologian Hans Urs von Balthasar, that glory is composed of both form and splendor. I will assume the reader has read that introduction as we explore this week the implications of that momentous distinction.

In art, physical form has to do with spatial arrangement of the features, say, of a statue. A beautiful statue looks good. But we are interested in psychological or spiritual form-something invisible-and therefore not something we can see with the physical eye, but something we arrive at by means of inference and wisdom.

God is the source and measure of glory; indeed, glory is the biblical term for the beauty of God. God\’s glory is the \”sum of his attributes,\” his greatness and goodness, his meaningfulness. God is the essence of perfect, infinite form and splendor. So God\’s form is the perfect configuration of psychological and spiritual features: God knows everything (including absolute self-awareness); always thinks clearly; is completely content,  but has emotional richness that corresponds to the rest of reality perfectly (including true empathy); acts determinedly and wisely; and (in the Trinity) consists of strong, loving persons-in-communion.

Last week we defined splendor as the depth dimension of a form, its inner radiance that \”shines out\” from the form. God is also the essence of perfect, infinite splendor, so he is the deepest of beings: he loves that which is lovely-himself supremely and all creatures, especially insofar as they resemble him-and he hates that which is ugly-sin; he regards all things in proportion to their true value with respect to himself; he always acts according to his preeminent values; and he \”sees through\” mere appearance and promotes depth in those made in his image.

Being the Son of God in human form, Jesus Christ is the perfect human representation of God\’s form and splendor. The Gospels are important because they provide narrative descriptions of his glory, \”glory as of the only begotten from the Father, full of grace and truth\” (Jn 1:14). Jesus Christ shows the human race flawless human form and consummate depth of splendor. Being increasingly conformed to Christ (in his form and splendor) is the goal of human life (Ro 8:29; 2Co 3:18).

So it is God\’s intention that humans made in his image are created to realize the greatest form and splendor of which they are capable as finite creatures. Having good form means having healthy thinking and emotions, well-functioning memory, the ability to freely act so as to realize one\’s realistic goals, and good relationships. Modern psychology has explored many of these features.

Having a high degree of splendor means being deep, rather than superficial, being focused on the important things in life: supernatural reality more than natural, people more than things, being and doing good more than simply looking good; but also having regard for the weak, hurting, broken, and sinners, and all creatures in proportion to their actual value before God, yet hating sin. Obviously modern psychology has not focused much on splendor.

This doxological focus (doxa = glory, Gk) makes human development central to God\’s purposes. Children obviously manifest God\’s glory, but it is good to develop into increasingly well-formed creatures with greater splendor. Because of their limited formal capacities, children necessarily act with less splendor than adults, because adults can do what they do intentionally for the glory of God; children cannot, at least not as fully as adults.

Glory of course is not the possession of anyone except God. To be human is only to be a means of God\’s glory; by grace God permits humans to participate in his glory. The more well-formed our souls and the more splendorous their form, the greater glory we are capable of receiving from God in worship, love, and gratitude and expressing in our voices, lives, and relationships.

This glory framework gives Christians a different way of viewing psychopathology.  Sin is the worst kind of psychopathology because it radically compromises our ability to participate in God\’s glory. Sin\’s essence is anti-glory.  Part of sin\’s effects was the damage of the soul\’s form evident in distorted thinking, inappropriate emotions, and personality disorders, so this kind of damage should be of concern to Christian counseling, since it can inhibit our ability to participate in God\’s glory. However, sin\’s effects are most evident in the compromise of splendor. The more sinful we are, the less devoted to God we are and the more focused we are on this creation as an end in itself (so it becomes an idol), so those who live lives distracted by the superficial (fame, fashion, power, possessions) lack splendor. Low levels of splendor, then, is a greater problem than poor form in Christian counseling. Interestingly, having damaged form leads to increased suffering, but suffering promotes our deepening and so our splendor.

Christ came to earth and died and was raised to heal our form and deepen our splendor. Some healing in our form is possible in this life, but its complete healing is reserved for heaven. However, in light of the foregoing, we might expect more healing on earth in our capacity for splendor, as we grow through suffering in worship, wisdom, faith, hope, and love. Christian psychotherapy and counseling is doxological as it participates in the glory of Christ\’s salvation by helping to bring healing to the human form and increase human splendor through the resources of Christ\’s life, death, and resurrection.

Disordered Loves and Depression: A Personal Response to Interpersonal Distress

Posted on October 11, 2009

[by Leslie Vernick, DCSW, LCSW. Leslie is in private practice, Director of Christ-Centered Counseling www.leslievernick.com, and is our blogger for the month of October. This is her second blog]

  One of the essential elements to good mental health is having loving connections with others. Research in positive psychology shows a strong relationship between having a good social support system and the ability to withstand life\’s stressors. (See Sonja Lyubomirsky, The How of Happiness, chapters 5 and 6; and Jonathan Haidt, The Happiness Hypothesis: Finding Modern Truth in Ancient Wisdom chapters 6 and 7)  An old Jewish proverb wisely reminds us, \”Sticks in a bundle are unbreakable.  Sticks alone can be broken by a child.\”  The consequence of disconnection and broken relationships is often depression.

Listening to depressed people over a number of years and their own explanations as to why they thought they were depressed, led me to look at depression through the lens of relationships.  I\’ve often discovered that beneath a person\’s depression was a past relationship wound that was affecting present functioning and/ or a present relationship difficulty that was denied, unresolved, or not being addressed in a godly way. I also found that people often struggled with depression because they and/or their loved ones lacked the skills to make or keep authentic, supportive relationships. 

 Psychologist Richard O\’Connor confirms this idea in his book Undoing Depression. He writes, \”Depression is both caused by and a cause of poorly functioning relationships.\”  The National Institute of Mental Health (NIMH) indicates that the highest rates for depression for both men and women are among those who are separated and divorced.  The condition of a marital relationship is a significant factor in predicting depression, especially in women.  The NIMH reports, \”Lack of an intimate, confiding relationship, as well as overt marital disputes, have been shown to be related to depression in women.  In fact, rates of depression were shown to be highest among unhappily married women.\” (www.nimh.nih.gov/publicat/depwomenknows.cfm). 

 The bible confirms the importance of fellowship and relationship (Romans 12:10).  In addition to making us physical and spiritual beings, God made us relational beings.  The two greatest commandments God gives us have to do with loving connection (Mark 12:29-31).  We are to love him first and to love others deeply from the heart (1 Thessalonians 4:9, 10; 1 Peter 1:22).  God tells us that we will find meaning, purpose, and identity through our connection with him and with others. (See for example Paul\’s teaching in 2 Corinthians 5:16-21; 6:11-13; 8:5-7.)

 Working with depressed individuals on their relationship distress and helping them build stronger interpersonal connection is certainly part of good treatment. But I\’m wondering as biblical counselors, if we are not uniquely equipped (and called) to also help a person recognize and repent of his or her disordered loves.

 Let me give you a couple of cases where I\’ve chosen to focus on the latter rather than the former as a strategy in my counseling.  I\’d welcome dialogue from readers as to how and when you do this as well.

 Tom was separated from his wife, Joyce. Their marriage was short lived and tumultuous from the start. Both are professing believers, this is Tom\’s third marriage, Joyce\’s second. They met in a singles ministry and his goal in counseling was to \”feel better\” and \”to learn how he can win his wife back.\” We\’ve worked on some things he can do to tackle his anxiety and depressed mood as well as to communicate more effectively with his wife but Tom reports, \”It\’s not working, and I fear she\’s seeing another man.\” His next question was, \”Can I start seeing someone else, just as a friend?\” Although he already knew my answer, he added, \”It\’s easier to deal with the hurt and rejection if I know I have someone else to be with.\”

 In another case, Donna has lived with chronic depression most of her marriage. She has been in personal as well as marriage counseling for years to cope with her unhappy marital relationship. She is bitter and feels hopeless that her marriage will ever change. Her main complaint is that she feels gypped that her husband isn\’t romantic and doesn\’t engage her in intimate or meaningful conversations. I\’ve met Donna\’s husband. He is kind and has many strengths, but she\’s right. He is emotionally unavailable and isn\’t likely to change into the man her heart longs for.

 As biblical counselors, how do we encourage Tom to put his hope in God instead of a female friend while experiencing the pain of rejection? How do we speak to Donna\’s despair and longings in a way that brings hope to her heart – not the hope of a good marriage, but hope in the goodness and love of God in spite of a mediocre marriage?

 Both Donna and Tom\’s love for God was real but secondary to their other loves. They made the love of a human being rather than God\’s love primary to their emotional well being. We all know that God commands us to love him first and most, not because he needs our love but because he knows it is in our absolute best interest for us to put him first and order our other relationships around that center.  Without a secure foundation in God\’s love, all of us search for human love to fill us up and make us feel valuable and worthwhile.  This strategy always fails because human love was never designed to totally fulfill us and make us happy.  No one will ever understand us and care for us as much as we want.  Only God\’s love is that good and his understanding that complete.  Even the best human love is laced with finite limitations and sin.

How a person handles the inevitable disappointment of human relationship limitations will either drive them to seek new relationships in unhealthy ways, engage an addiction for relief, lament in despair and depression, or it will drive them toward God.  C.S. Lewis wrote, \”God whispers to us in our pleasures, speaks to us in our conscience, but shouts in our pains; it is His megaphone to rouse a deaf world.\”  Relational disappointment can lead us out of illusion and into truth and reality. Sorrow teaches us to let go of our attachments to false or lesser things and to seek after God.

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