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Psychology and Spiritual Care: Approaches to Ministerial Health
by Beverly K. Yahnke
I appreciate the invitation
to be with you this morning. You have asked that I talk with you quite candidly
about "Christian psychology" and as a result we will explore together the array
of hope and horror that term evokes. I am delighted to see the leadership of
our church continuing to examine the challenging terrain of ministerial health.
Ive come to the realization that we in the church have often neglected
the genuine emotional and spiritual needs of our workers; Ive also come
to the realization that those needs cannot be met exclusively in an environment
of clinical care, nor can such needs be met exclusively in an environment of
spiritual care. Our conversation today has an important and ultimate goal:
shaping our intentional efforts to enhance the effectiveness of the care
provided for the called and ordained servants of Christ.
My objective this morning is to invite critical thinking, not to make pronouncements. I would like to debunk some of the harmful myths endorsed by psychology and I would also like to deconstruct some of the destructive myths about psychology popular among many in the church today. The challenge today is to sharpen our thinking so that we can speak with one another more insightfully and with greater precision regarding these issues:
1. In what ways have some within the church abdicated appropriate care for self and sheep?
2. What are the perils of neglecting psychological tools?
3. Why is Christian psychology regarded with such suspicion by many (particularly clergy)?
4. What is Christian psychology and how does it differ from secular psychology?
5. What are the limitations of Christian psychology which invite partnership with spiritual care?
6. In what ways can Christian psychologists collaborate with clergy to provide spiritual care?
Perils of Neglecting
the Tools of the Christian Psychologist
Ill begin with a summary reporting of a conversation I had in my office about 4 weeks ago. A single, female Lutheran school teacher requested an appointment. She said she would like to be seen as quickly as possible. During our first conversation, the following profile emerged: she had felt profoundly depressed for over 3 years; only recently had she sought counsel from her pastor; he told her that her depression was caused by guilt and shame; he encouraged her to participate in individual confession and absolution - she did, although feeling coerced to do so. "I didnt want him to be disappointed with me." The depression didnt remit. She was ashamed to report that to her pastor.
He informed her that we are all fallen creatures living in imperfect bodies, living under the theology of the cross. The depression she was suffering was her cross to bear obediently and humbly. He assured her that he would pray for her and he invited her to receive the Sacrament frequently to provide her with strength at this difficult time of testing.
Her depression plummeted to despair. Every evening she found herself tying a plastic garbage bag around her head before she went to bed. Thanks be to God, she never found the courage to leave it on. She reported to her pastor, Im losing control and Im very afraid I may hurt myself. She told him about the plastic bag ritual. She asked, "do you think I need to see a doctor or get some help?" He told her, "NO." That in fact to do so would be to turn her back on Gods plan for her help and healing. All she needed would be provided to her in Word and Sacrament.
At the intake this woman said, "I feel as if Im betraying God and my pastor by being here." The only reason she came in was that she feared she would succeed in killing herself, and she understood that suicide was not Gods will for her. This woman had been my student in a PSYC 101 class at Concordia Wisconsin and she said, "you didnt look demonic to me, even though you were a psychologist. Can you help me? Youll never tell my pastor that I came in to see you, and I wont have to tell him either. Hell never need to know Ive done this."
Although this is indisputably the most flagrant abuse Ive come across in the last decade, two things concern me: 1) This is a horrendously acute variation on a theme of resistance to or rejection of Christian psychology by clergy who have been given charge over their flocks; Some of our Christian brothers are not only resistant to Christian counseling but actively vilify its use for help and healing. 2) Well never know how many church workers suffer silently in response to their own false beliefs that Christian psychology is demonic or contrary to Gods will. 3) The phrase, "Word and Sacrament" is not a palliative mantra: teaching, preaching and spiritual care are crucial: the phrase is not magical. Im very happy that Rev. Senkbeil is here to offer his valuable insights concerning the magnitude of care which is intended when a clergyman purports to offer spiritual care to one of the flock.
Some fearsome facts must be extracted from the case study. Among some of our clergy there is a stunning ignorance regarding basic medical facts and medical emergencies. And, in my humble lay opinion, there is also an outbreak of false teaching to insist that Gods Word precludes, or discourages psychiatric care. Finally, its difficult to miss the astonishing exegesis to presume that when one receives, by faith, the gifts given by the means of grace, that one would not profit from any additional support or any other assistance.
Perhaps most frustrating for me is that I had no consent to talk with her pastor, and as a result could not confront him without jeopardizing the confidentiality of my client. Worse, I can only imagine what other members of his flock may be suffering unnecessarily.
We have just had an illustration of the sentiment given us by David Hunt1 writing in the book Beyond Seduction. He tells us that "the average Christian is not even aware that to consult a psychotherapist is the same as turning oneself over to the priest of a rival religion. For there is no such thing as mental illness. It is a biological problem or it is a spiritual problem." This is a view more popularly espoused by Jay Adams in his book Nouthetic Counseling2. Hunt speaks with the same ill-informed zeal as those who intoned authoritatively that the world is flat.
Hence, I begin by inviting you to agree that there is a clear and specific need for care which supplements spiritual care. My purpose this morning is clearly not to talk about the abstract theoretical, historical and philosophical nuances of psychology -- as captivating as such ideas may be. Instead I will speak in capital letters and large font about the realities of Christian psychology vis-à-vis spiritual care.
Why the Preference for Christian Counseling in Lieu of the Spiritual Care of Ones Pastor?
Ive come to believe that many of the people in our churches who have heard the powerful Word of Holy absolution still remain broken and isolated in mind and spirit. Our pews are filled with countless spiritual Humpty Dumpties whose sin has fractured their lives into pieces which seem unlikely to ever fit together again. These souls have shoddily bandaged themselves back together as well as theyre able; but the pain continues and there is no expectation that there will be healing. The penitent does not expect that forgiveness of sin which restores his relationship with God could allow restoration of his relationship with others, nor provide healing in his own heart.
For many, the wreckage of sin is easy to fathom. For others, the insidious nature of sin has infiltrated countless dimensions of life yet they have blustered on, seemingly unresponsive to the toxic side effects of sin. I believe healing will require two extremely skilled professionals:
1) a physician of the soul, expert in the patient diagnosis of wounds which are left by sin, one who understands how to apply the powerful medicines of a loving Lord so that each redeemed life can be restored.
2) a physician of the mind and body, expert in the diagnosis of mental and emotional wounds who understands how to apply the powerful tools of science so that each redeemed life can be restored.
Healing which invites
collaboration between these physicians serves Gods children best.
We learn a great deal about the nature of Christian counseling as we begin to examine why it is that many individuals will prefer counseling to spiritual care. Those both in and outside of the formal church are seeking Christian counseling:
Sadly, some who characterize themselves as Christians often find the church unnecessary to the nurture of their belief and see the church as entirely unrelated to the healing of their hurts. Many have come to believe that ones "soul" really means ones "self." As a result for many people, spirituality is deeply narcissistic, deeply and uniquely personal, and lacking roots in any authentic tradition or confession of faith.
Yet, spirituality is indisputable in again. For some, seeking Christian counseling is just another in a series of consumer efforts in service of self-satisfaction, a chronic search for the ultimate spiritual elixir. Ive come to believe, however, that there is an earnest desire for many people to connect with genuine spiritual roots. There are a variety of compelling reasons why many choose to begin that important journey outside the church. Why seek Christian counseling instead of spiritual care?
Some would have us believe that the church isnt getting the job done -- that the church has in fact abdicated its role in help and healing. The church tells us to bear our cross and grow in faith. The message is often translated as "Word and Sacrament are wholly sufficient, so buck up, get over it, get on with it. When were honest the evidence suggests that the church has not routinely ministered to the emotional needs of its flock. Our clergy preach and teach holiness, but it can be misunderstood, often resulting in people seeking services outside of the church because they have come to intuit that problems are not very holy things to have.
David Belgium writing in his text, Guilt: Where Religion and Psychology Meet3, reports that "those in church who have committed adultery, or whose marriages are falling apart will seek services outside of the church because none of them believe that any of the nice people of their church have serious problems, or that they could ever receive the understanding, forgiveness, healing and social encouragement needed for new life within the church." In despair, the sinner struggles in solitude and must practice hypocrisy. Often, people in pain feel shame. Shame separates people, despair separates people, and for most of us, we would prefer not to be separated in that way from our pastor -- a man whom we generally have come to like and respect. In fact, we would often prefer to be ensconced in the treacherous safety of our perfect, public facade rather than to risk having any other human being know about our failures, fears and sin.
For some who do seek spiritual care, the pastor often makes clear at the outset that absolute candor is essential to healing. Delany, writing in his text, The Value of Confession4, explains that in spiritual care "there must be no glossing over, no palliation, no hiding of motives and no holding back the truth, no sparing of our pride. The pastor must know us as we really are in Gods sight; even though we shall never feel like looking him in the face again."
For a teacher, or a DCE to talk with his or her pastor is often extraordinarily difficult. For a pastor to admit to personal trouble or helplessness within earshot of his circuit counselor is no easy thing. Most of the pastors who come into my office have not and will not talk with their circuit counselors about the issues which have brought them in for care. Teachers rarely talk to their principals or pastors. Privacy is everything and pain continues unabated for the sense of shame is palpable as is the fear of judgment. The church work world is a place where, in the minds of many, seeking care may be regarded as a weakness, if not an acknowledgment of personal failure. That may well be the reason that for most clergy who need psychological care, it is usually the pastors wife who begins treatment.
Those among us who embrace liturgical worship may object saying that the church has always provided Gods healing through his means of grace. We point to the powerful transformation and healing in the Real Presence of Christ offered in Word and Sacrament each Lords day. Yet, those who write eloquently about liturgy underscore the fact that the purpose of liturgy may be very different from what people believe they need. Rev. John Pless5 reminds us, "the liturgy does not exist to provide motivation for sanctified living or therapy for psychological distresses -- but the forgiveness of sins."
If youve taken the cultural temperature lately, youre keenly aware that in postmodern times, we live in a culture highly unaware of the existence, nature and consequences of sin. As a result, forgiveness is not always prized. Forgiveness of sins, life and salvation cant be experienced viscerally, emotively. As a result, for many Christians living life at the perimeter of the church, the eternal gifts of God simply arent a big deal. What is a big deal, in the mind of many, is my pain, my dysfunction, my confusion, my estrangement from my spouse. When my church and my pastor dont talk about such very real things, I presume I will need to seek help elsewhere.
One woman made the observation, "our church doesnt believe in depression." I asked her why and she observed if they believed in it how come we only pray for people with heart attacks and strokes. If we believed depression could be real, we would pray for the people who suffer with it, wouldnt we?
Clergy Characteristics Which Increase the Likelihood That Individuals Will Seek Care Outside of the Church
Clergy, church workers and the flock at large may be reluctant to seek care from a pastor for a wide array of reasons which I think include:
1) Anti-incarnational Clergy
In the minds of some, clergy appear to be viscerally unacquainted with pain, confusion, failure and despair. Some appear to be entirely above that or out of touch with that. Kenneth Leech6 in his book Spirituality and Pastoral Care observes that "many clergy should realize that people deliberately keep 7/8 of their lives and experiences hid from their pastor because many clergy often stick out in the most painfully anti-incarnational ways."
2) Indiscreet Clergy -- Violating Confidentiality
There is raging suspicion and a too frequent experience that a pastor is likely, even with the best of intentions, to share the content of our most private life with another. In the last 2 months, for example, I had a pastor make a phone referral, report some detailed information before he added, "now she confessed to me, and I dont know whether or not shell tell you about it. But you need to know this." One teacher said, "I know how much my pastor has told me about other staff -- why on earth would I ever trust him with this?"
3) Shame Hurts Valued Relationships
We value our relationship with our pastor and we surely are reluctant for him to know our hearts are already bruised. Nevertheless, for those of us who have been living under the weight of one sin or another, we expect that Gods faithful servant must bring His strong Word to bear on the troublesome situation.
4) Requesting Pastoral Care May be Seen as an Imposition
Many who need the care of a pastor will seek Christian counseling simply because they dont want to impose or intrude. They see their pastor as a busy man with important things to do. A counselor is an employee. A client is entitled to healing for hire: you can buy as much time, and caring and concern as you need. You dont enter the counselors office as a supplicant. You are entitled to the therapists undivided professional attention. And you can rely on the fact that you will be seen once weekly for an hour, instead of whenever the pastor may suggest meeting again. Christian counseling offers predictable continuity of care, meeting once weekly, insuring that momentum of treatment will be sustained.
5) Spiritual Care is Not "In"
Psychology is in. Counseling is healthy, endorsed by employers, doctors, lawyers and Indian chiefs. Anyone can begrudgingly point to the cultural windsock which is blowing in the direction of self-improvement. It is a noble thing to do. People refer other family members to a counselor who has been helpful, they refer their friends and their childrens teachers. A counselor is flattered when a client refers others for his or her care. Seeing ones pastor is more commonly shrouded in shame and secrecy. In fact, some people will refuse to see their pastor simply because they must walk past the volunteers and the church secretary to get into his office.
6) Pastor is Not Perceived as "Expert"
Pastor may be seen as a well-intentioned, nice man who would have insufficient resources to be helpful. In the language of one man who wanted to stop having an affair, but who had talked with his pastor, "I dont want someone to just listen to me or pray for me; I need someone to help me." Were consumers; we want the best services available. The State Board has licensed counselors to be competent in providing care. We trust that they are well trained and well equipped to help.
7) Pastor Has Been Called to Point to Law/Gospel
We dont necessarily want to be confronted with Gods Law when we are bruised and feeling vulnerable. We are looking for someone to be our advocate, to understand and excuse our frailty. We are searching for someone who can deal with the fall-out of sin without wagging the concrete tablets of the Law in our direction. We want empathy, support and compassion. Were not necessarily eager to ante up for a dose of the truth. The counselor, as an employee, is hired to be our advocate and to assist us in achieving the objectives we have outlined as important. And we are entirely prepared to continue looking through the Yellow Pages until we find a well credentialed counselor, sufficiently enlightened to agree with us.
Why There is a
Preference For Many to Seek Christian Counseling as Opposed to Secular
Some individuals will seek secular counseling, but others will seek Christian counseling:
1) Some believe that it is a safe and caring place - there will be no one on the lunatic fringe with noses and eyebrows pierced.
2) It is perceived as a link to the traditional value systems: even those with no church affiliation who come to a Christian counseling office are seeking traditional values - particularly as they arrange counseling for their children.
3) Some believe that they will be invited to bring the resources of their faith with them into the process of self-examination and health.
4) Some individuals report that they have felt so distant from and separate from the church that they want to learn how to find God once again. They have often come to believe that the circumstances surrounding their current pain have either been caused by God, or alternatively may be healed by God.
And perhaps there is no
better forum than this to report that some of the people who are so desperately
trying to find God once again are our teachers, and occasionally our clergy.
Ive stopped being surprised at the spiritual paralysis which has
afflicted some individuals who serve the church. The shame of these servants
is, perhaps, the greatest of all and their pain and helplessness the most
acute, for they know they have lost something which was once precious and
As one teacher told me, "imagine me waltzing in to talk with my pastor and saying, Ive been spiritually dead for the last 7 years - Im a fraud, a hypocrite." Or, a clinically depressed pastor who reported, I havent prayed a prayer outside of a Sunday service in years. Im going through the motions at church -- I just do the dog and pony show and then go home -- you want me to talk with my circuit counselor about that? Get serious. Just help me -- youre a Christian counselor.
What is Christian Psychology?
To help you appreciate just how outrageously complex a question that is, I will ask you to gather together a room full of theologians and ask them precisely what each them believes it means to be a Christian. Now, savoring that moment, Ill invite you to speculate what happens when one gathers together a room full of clinical practitioners and asks them what is the nature of psychology. We begin by acknowledging that the task will exceed the likelihood of consensus every time.
In an effort, though, for you to taste the many flavors of opinion regarding Christian psychology, Ill offer you a brief glimpse into my recent search to add a new clinical psychologist to my staff. Each applicant knew the clinic was named "Christian Counseling Services." Each applicant knew that the clinic served Christians referred by their pastors and parochial school principals.
One applicant was a Hindu woman, who was entirely persuaded that she would be an excellent Christian counselor. She reported, "I have read many of your Bible stories and they are very sweet." "I could read a few more of them if you believed it would be helpful."
Another applicant sent in an ichthyus colored in crayola (she was an art therapist) with crayoned statements in the margins, "God loves us." "God wants us to be happy." "God will help us accomplish all of our goals."
In summary, others included:
*a minister certified and ordained by the state of Arizona
*a nationally certified therapeutic massage and bodywork therapist
*a chiropractor who had really "gotten into his spirituality"
*a holotropic psycho-spiritual integration therapist - I dont even know what that is
*a well credentialed psychiatrist who reported he has gone to church on and off through the years
I had no idea what many of
these people professed, or whatever possessed them to believe that they would
be construed as Christian psychologists. Many had previously worked at
Christian agencies -- scary isnt it?
For most of them, a Christian psychologist was understood to be a licensed psychologist who would work with Christians. (Much as one would be called a child psychologist: one need not be a child to work with children -- one need not be a Christian to work with Christians.
Most applicants were somewhat taken aback when they learned that my concept of a Christian counselor varied radically from theirs. I might also mention that I received countless applications from born again Christians who wanted to counsel -- but who had absolutely no clinical training whatsoever to do so. They had also worked at church based Christian agencies in the past.
So, sadly, we have to acknowledge that the moniker "Christian Psychologist" may mean absolutely nothing in terms of a psychologists beliefs, attitudes and values or preparation. There is cause for suspicion. More clearly stated, there is cause to invite careful scrutiny of what Christian counseling means in the professional practice of each therapist whom you may endorse.
Most Christian psychologists invite conversations regarding the nature and practice of their faith. Many of the pastors with whom I have consultative relationships required an office interview, or a phone interview or lunch so that they were certain what it was that I believed. I respect enormously those clergy who want to be confident just what it is that their church work staff, or their parishioners would hear from me if they came into my office.
The three common litmus test questions which have emerged in those interviews include: what is my clinical opinion regarding abortion, my clinical opinion regarding divorce and less frequently, an invitation to talk about the ways in which secular counseling differs from Christian counseling.
As a Lutheran Christian counselor I will safely announce that sin is at the heart of every human problem. And while the church can never condone nor excuse willful sin, the church must understand that people within it may well suffer from emotional symptoms that are not the result of personal, unconfessed sin. I will also announce that the nature of ones mental and emotional health can radically disrupt an individuals cognitive ability to respond to spiritual care, and may in fact radically change his willingness to avail himself of the means of grace. Yet the issue is not whether our emotional problems are spiritual -- they surely have spiritual components -- but how can we best treat people experiencing these problems?
What Makes a Therapeutic Process Distinctly Christian or Psychological?
It is a process for which one receives extensive post-graduate training in medical diagnostic evaluation, psychometric measures, and treatment modalities and strategies. The training requires that the Christian psychologist be immersed in science -- learning what it is that the research teaches about depression and its healing, anxiety and its healing, personality disorders, Schizophrenia and its management and the like. The clinical training requires thousands of hours of supervised clinical experience beyond the Ph.D. Before any psychologist can interact independently with a patient, he or she has spent at least 3,000-5,000 hours of one-on-one time with clients, each hour, resulting in a written analysis of the treatment session, a detailed review of the case with a clinical supervisor, during which time the Christian psychologist hears again and again the complexities of how it is one can most effectively reach deeply into the labyrinth of human experience with the best likelihood of helping. A Christian psychologist is rigorously trained as a scientist to practice an art called "psychotherapy."
There are some incredibly good reasons to be reluctant to work with secular psychologists on issues where heart, soul, mind and body meld together. I have often wondered if much of the resistance to Christian psychology in general has its genesis in the belief that all psychologists must have at some time vowed allegiance to the creed of secular psychology.
Although not every secular psychologist would confess any particular creed in its entirety, most will endorse many of its component features. I wont for a moment pretend that the outline which follows is exhaustive. Instead Ill offer for your review the most common errors which I have heard emerge as I speak with my Christian clients who have worked with secular counselors. Sadly, many of these clients had labored under these secular myths for years without Christian guidance.
Selections From the Creed of Secular Psychology
1) Find your own truth and find comfort in it.
Truth, of course, in these post-modern times is what has become important to you. Unless the truth you profess is dangerous to yourself or to others, therapists are very affirming of the truth professed by each client so as not to appear intolerant or ill-bred. Therapists will, nevertheless, instruct you that you cannot expect your truth will be shared nor respected by others. In like fashion, values are situational and influenced enormously by the cultural tidal wave of the moment. Diversity is the only uniform value and empathy is the rule.
The obvious corollaries include:
a) The therapist will not judge you or your behavior, or your values
b) The therapist will not hold you to any standard of conduct higher than civil law
c) The therapist will not be so myopic as to presume to impose his truth upon you
d) The therapist is not there to give advice -- the therapist exists to assist you to articulate the goals which express what it is you choose to accomplish, and then to help you to meet the goals you have established for yourself.
2) We create and shape
ourselves, and work to achieve every good gift.
Taking care of #1 is at the heart of all success and every good thing: self-esteem is a noble pursuit and all-sufficient goal. As a result, narcissism is rampant. Secular psychology teaches that one must have all of ones own needs met before one can expect to meet the needs of others. We strive for self-actualization, self-interest, self-fulfillment, self-enrichment as reasonable and primary goals.
Positive thinking has taken the place of faith. Were less concerned that behavior may result in eternal damnation. We will, however, become mightily concerned if we learn something will diminish our IRA or our self-esteem.
3) We must accept and forgive ourselves.
This, of course, presumes that there is no such thing as veridical sin before Almighty God. We need only to examine and understand the justifiable reasons for our actions, reassure ourselves of our overarching good intentions in support of our own absolution, review the many, many good things which we have done...which, in balance, more than outweigh a momentary excess or lapse in judgment.
The corollaries here include:
*That we never need to seek forgiveness, for we can forgive ourselves.
*If we cannot forgive ourselves, we must have insufficient self-esteem, or must have misunderstood crucial elements of our early history.
4) There are some things
in life over which we may not be able to exercise control, and as a result, for
which we are not responsible.
Dysfunction can preclude personal accountability. History and histrionics allow us to claim victim status. When one defines some behaviors as illnesses we cannot insist on ones effort in the service of healing or recovery. Instead, the job of the secular therapist is to educate and support the individual in their present condition and assist them to make the best choices possible in light of their illness.
5) People are innately good.
This captures the spirit of Carl Rogers early in his career that humans are at heart good and decent creatures. There are no bad people only bad environments. The goal of life is learning to accept ourselves and change our environments.
6) There are 12 steps to health and success.
The secular priest says do these things and you will be healthy, wealthy and wise. Psychologists prompt change but rely on individuals to use their personal resources for their transformation. Some of the pop psychology today is ludicrous in its claim for our natural inclination to evolve towards healing. The secular therapist is not there to point to the Gospel and forgiveness of sins as transformational. St. Paul has taught us, I cant succeed, the truth of the matter is, Im not particularly interested in doing whats right...I see my sin and need a savior. Patrick Kilpatrick in Psychological Seduction 7 makes the point clearly, that at best, Psychology repairs; Christ raises from the dead! And when youre dead in trespasses and sin but you have to rely on your own resources, that doesnt offer a great deal of preliminary momentum.
7) Happiness is a sufficient therapeutic goal.
If we are able to reorganize our lives and families in such a way that we are happy, we will have succeeded. For example, if our marriage makes us unhappy and causes pain we can be sanctioned to euthanize the marriage, and put it out of its misery. If we are unhappy we need to learn how to extract from our colleagues, our family and our friends whatever will make us happy. Many therapists who tout this model will pronounce a cure and terminate therapy when symptoms of personal discontent and unhappiness have been relieved. Perhaps youve seen the bumper sticker which illustrates this mentality: Life is not a dress rehearsal, be happy now.
8) There is no meaning to be found in suffering.
Suffering is best explained as a roll of the circumstantial dice. (Goal--well try to keep you as hopeful and optimistic as we can for as long as we can). All of the richness of the theology of the cross is lost completely. Interestingly, if we look at Freuds early writing he tells us that only religion can answer the question of the purpose of life, concluding one can hardly be wrong in the idea of having a purpose stands and falls with the religious system. In his later work he goes on to reverse his preliminary impression, instead saying that it is pleasure which is our purpose in life.
Creedal Excerpts From Christian Psychology
Fortunately, the Christian psychologist confesses an entirely different creed, and as a result, the value of Christian psychology rests in the fact that two baptized children of God have come together. One seeks help, the other desires to use every gift God has given in service of his brother. They agree to meet together regularly, welcoming the resources of their faith into the process of healing, problem-solving and increasing personal understanding and laboring together in the direction of effective change. The Christian psychologist will use the tools of science to assist individuals to understand how God would have us meet some of our foremost needs which include: meaning and identity, forgiveness, love, hope and community.
The Christian psychologist is first and foremost a Christian: an individual who by Gods grace has come to believe and is willing to teach that the incarnation, death and resurrection of Jesus Christ allows baptized, repentant and believing Christians to stand before Almighty God, wrapped in the holiness of Christ, absolved of their sin and justified in this moment and even through eternity.
The Christian psychologist is an individual who has been given to understand that Gods presence and gifts are as real and as available in this moment of history as they were when Christ walked the earth -- who has come to believe and is willing to teach that healing and nurture and strength and hope and forgiveness are given when Gods strong Word is preached and His sacraments are administered faithfully. The Christian psychologist has come to believe and is willing to teach that God is in fact present in His Word and in the bread and wine wherein we receive Christs Precious Body and Blood given us to eat and drink each Lords Day. And, He is present in the most miraculous way to nurture, sustain us and transform us when and as He wills.
The Christian psychologist is an individual who understands and is eager to share that Gods love does not preclude hardship or suffering; that His love does not insure a flaw-free life, but that, in fact the very heartbreaks of life or the terrors of mind and spirit which may besiege us can be used magnificently by a loving Lord to discipline, shape us and draw us ever nearer to Himself.
Most of the Christians I talk with can recite the comforting words, "My grace is sufficient for you and my power is made perfect in your weakness." Yet, like all of us from time to time, these same Christians can remain battered by failure, hurt and despairing in response to a multitude of personal atrocities which confound us.
The Christian psychologist has come to understand and is eager to share that faith is capable of embracing suffering, transforming our experiences into episodes which quicken us. Christian psychologists are reminded again and again that although God surely doesnt send the Job-sized trials and tribulations, He does permit our turmoil to draw us closer to Him and thereby accomplishes His purposes in us and through us, and often in spite of us. And the Christian psychologist offers his client the promise that God is faithful and will always provide the miracle of sufficient grace one moment at a time.
A Christian psychologist is acquainted with and perhaps, even more desirable, has been a recipient of spiritual care. An individual who has come to understand that by Gods grace, we daily engage in bludgeoning the old Adam, with complete self-surrender to the grace help and judgment of God in confession. And in His absolution, we are restored so that He may reign over our whole lives, setting us completely free to serve Him. Only faith allows a Christian psychologist to enter a treatment room, with the prayer that even in the most difficult circumstances God will equip us to serve Him and do His work, for we are in the midst of so many of His children who continue to hurt and ache for all manner of healing.
The Christian psychologist does not presume to practice without personal prayer. He cannot close His day without remembering his patients in prayer and commending them to Gods care and keeping.
The prevailing goal of Christian psychology is to endeavor, with Gods help and mercy, to bring about insight regarding the deterrents to health which may rest in fear, early family dysfunction, the accretions of personal history and unexamined habits. Its companion goal is to assist in the effort to bring about fundamental change in the client which may include his behavior, skills, his personality, the nature and style of his thinking, and assisting the client to understand the nature and influence of his emotional responses.
Limitations and Misuses of Christian Psychology
1) Using psychological services without offering provisions for spiritual care, or in lieu of spiritual care completely.
When any new client comes into my office, I ask him or her whether or not they are a member of any church family. If so, I inquire whether or not they have been able to talk with their pastor about the issues which have concerned them. Until the last several years, I was too naive to make the same inquiry of teachers, principals, clergy or families. My naiveté led me to believe that certainly church workers would have a spiritual support net available to them.
I have come to understand more clearly, however, that it is most often the teachers, principals, clergy and families who have fallen through the holes of the spiritual support net. Living in a stained glass fish bowl has often prompted these workers to crave privacy and fear exposure, and do absolutely everything in their power to sustain the facade that all is well.
Perhaps Districts may need to reconsider how spiritual care resources can be offered privately to church workers outside of their home church, or outside of their Circuit. I recall mentioning to an area pastor recently that I should probably add one new office to the clinic, more accurately, a small chapel and hire him to provide the spiritual care which church workers have said they desire, but will not seek unless they were confident of absolute privacy, impartiality and confidentiality.
One example comes clearly to mind. An extraordinary teacher whose service to this church body has been exemplary has suffered with undiagnosed depression for the last 9 years. he and I have worked together now for about 10 months. The man respects his pastor enormously but cannot and will not seek spiritual care from him at a time I believe such care is pivotal for his treatment while healing. There are no other spiritual care resources available to him which he can or will access.
The key observation appears to be that when District or seminary administrative action results in any recommendation concerning Christian counseling, such recommendations should always be paired with an offer or suggestion concerning how that individuals spiritual care needs can be addressed. To overlook this opportunity to provide ammunition for those who would otherwise argue that psychology is somehow the new and improved healing gospel. We recall Bonhoeffers 8 observation, "No psychology helps me to find the way to another persons soul."
2) Communicating the expectation that once an individual is in treatment, the situation has been repaired and the individual making the referral can disengage from the problem.
Unlike car repair, there are no money back guarantees in psychotherapy. A districts duty has not been discharged because the church worker has been compliant in seeking counseling. In fact, situations may worsen as treatment confrontations begin. It remains important for there to be ongoing communication between referred worker and referral maker. One teacher, whose principal had suggested counseling made the observation, "Fine: he sends me off for counseling - now he assumes he has dealt with the situation. Im still going to need some help coping with some things in that classroom and hes sent me to you -- kind of like hes washing his hands of the whole problem. Youd better be good because hes certainly not going to do anything more to help me."
3) The use of psychological services as a disciplinary tool:
In South Wisconsin we recently had the opportunity to review an unpublished paper written by a member of the Marquette University psychology faculty. Dr. Saunders charged in that article that making referrals for clergy or seminarians to seek psychological care could be understood as a punitive action.
Some may perceive the recommendation to seek Christian counseling as a punitive action if important and fundamental needs have not been addressed at the outset. I will make the observation that a referral for Christian counseling is rarely a point of beginning. More ordinarily it is a natural outgrowth of a process of intervention. Often, the intervention will have required careful attention to reconciliation efforts which are consistent with the teaching of Scripture.
Other could misunderstand a referral for Christian counseling if they imagine that a seminary or District President is simply seeking some kind of "scientific wiggle room," or seeking some psychological facts which will make some kind of "case" against the individual being referred. Its my personal opinion that it is an abuse of authority if seminaries and District Presidents use psychological evidence as a "smoking gun," with which one aims for another, instead of using ecclesiastical authority, administered with a pastors heart.
I believe it is important to make clear my personal bias that the authority and reliance upon psychology must stop where the authority of and reliance upon Scripture begins.
4) Coercion to seek care is a clear misuse of Christian psychology.
One of the fundamental tenets of Christian psychology is that the individual who seeks care believes that the care can be helpful, and that the decision to receive care reflects a free and personal choice. Ideally, the individual beginning treatment has come to understand that a need exists. And, that individual has also come to believe that treatments exist which can assist him to move towards accomplishment of clinical goals which he has personally endorsed. These are the circumstances under which we find clinical treatment to be ideal, of course.
District Presidents and seminaries can assist in the effort to insure that recommendations and referrals are not perceived as coercive.
A pastoral letter sets the scene for a referral and is likely to shape the church workers attitude regarding the receipt of a referral. The fact that it is a pastoral letter suggests that it is written out of love with a desire to offer very real help.
The pastoral letter is best positioned when it rests on the scaffolding of a preceding personal conversation. The letter serves to summarize and clarify your concerns and hopes.
The pastoral letter should probably have the following component parts, particularly if it is being addressed to an individual who is likely to be resistant to a Christian counseling referral.
1. Outline the concerns with objectively verified evidence which has given rise to the concerns, and point towards hoped for outcomes in service to the flock for whom this man is responsible to God.
2. To the extent that it is possible, identify specific behaviors or patterns of behavior which most people would agree are inappropriate, dangerous, non-doctrinal or incompetent.
3. Outline how a process of Biblically governed reconciliation has been received: avoided? rejected? Create a paper trail and report it with detail here.
4. Offer the names of Christian psychologists, approved by Value Options/ previously Value Behavioral Health. Invite him to talk to these psychologists regarding the nature of their beliefs systems, if he has any concerns. Assure him that he will be pleased to know that the clinicians being suggested to him have worked effectively with a variety of LC-MS clergy and church workers. Perhaps the psychologists offered for his review could be profiled in some meaningful way regarding the nature of their belief system. We know how little information can be conveyed by the term "Christian psychologist."
5. Assure the individual being referred that there will be no need for full disclosure of all psychological information and then invite his prayerful consideration of the opportunity, offering additional possibilities for conversation. If at all possible, try not to link lack of compliance with counseling to any threat or change (for example restricted status). This comes perilously close to coercion.
6. Finally, if there are ultimatums, they ought to refer specifically to behaviors which are unacceptable and have not changed in compliance to meet a standard you, or a Board have deemed reasonable.
Be willing to agree that if
the troublesome behaviors can be changed without benefit of counseling that you
will welcome an opportunity to review his plan in service of that goal, and,
that you will also be eager to review with him the outcome or success of that
5) Insisting on full disclosure of all psychological information is a misuse of Christian Counseling.
Reasonable arrangements concerning the limits of disclosure can be negotiated with the individual who is being referred. As I talked with one man whom President Meter referred for counseling, he began by saying, "So I suppose youre going to write down everything I say and tell President Ron Meyer everything and I dont like that one little bit."
When a client walks into my office - I am his employee. I am his advocate and I will do everything I reasonably can to serve him. I am also naturally interested in serving the church, but I will not undermine my clients well-being under any circumstances. I make clear to the client that I will release absolutely no information to anyone without his explicit consent. The clergyman I mentioned before looked surprised and said, "what if he calls you and asks?" I confirmed that no information will leave my office without a clients personal review and approval.
The truth of the matter is that there are some things you simply do not need to know: It is not crucial for the District President to know the sordid details of the mans childhood and youth. It is not appropriate that every clinical burp and gurgle be given over for a District Presidents review. Quite honestly there are many things about this man you neither deserve nor need to know.
There are some rare circumstances, however, when an institution employs the psychologist. For example I was able to work with the psychological screenings for the Concordia Wisconsin presidential search. The university was my boss. And as a result, right up front, each nominee learned that he could choose not to answer any questions, but that all information I gathered would be presented to the Board of Regents. In this case, not even the nominees ever saw their complete profile. This should rarely be the case, particularly in a psychotherapeutic setting.
Presuming there is a case where you have referred a man for counseling, you will need to know what is going on in the counseling process. You will require the mans consent to release clinical information concerning his treatment: There are some very reasonable facts which are most often disclosed when a superior advises a subordinate to seek care:
1. Is he showing up? Has he attended one session and then fallen off the radar?
2. Is he working on the presenting problems? Or is he blaming, accusing and ranting?
3. Is he making progress as expected?
4. When is he to be discharged from treatment?
5. Has he achieved the treatment goals specified?
6. What treatment goals were not met?
7. What recommendations will assist this man personally, spiritually and professionally?
8. In what way can the circuit counselor or District President assist this man, his family and/or congregation while in treatment and beyond?
6) Implying that
Christian counseling can only be useful in response to pathology dysfunction or
failure is a misuse of counseling.
Seeking psychological services can be a reflection of healthy and prudent behavior. Interestingly, some of the most frequent consumers of psychological services include teachers and medical professionals -- those who are well educated and who have a vested interest in functioning optimally.
Although clergy and Christian teachers are well educated, I would be fascinated to see data regarding the frequency of teachers in the church who seek services compared to non-church work teachers who seek services. The stigma exists in our church body as a powerful deterrent to seeking care.
I had lunch with a former student who has subsequently been ordained and is now serving in the Holy ministry. He reported that his circuit counselor "has a pastors heart, and is very caring, but just cant be helpful right now." This man just needed to think about professional pathways, evaluation of gifts as he evaluates a D.Min. a Th.D. or a Ph.D. and ponders what it might be like to leave the parish for academe. We had a wonderful lunch that was really a heartfelt, caring counseling session.
District Presidents may need to understand that counseling referrals can be given in response to positive, growth oriented situations. Perhaps District Presidents can be use referral for leadership development and skill enhancement as well as for train crashes.
7) Allowing for any inference that psychological testing will allow one to make decisions regarding a mans fitness to be called into the Holy ministry, or to maintain his call within a given congregational setting.
Many look at psychological testing of any sort with great skepticism: "someones going to show me some ink blots and tell me Im not fit to be a pastor? - Get serious." The function of psychological tests is to measure the differences between individuals or between the responses of the same individual on different occasions. Thats all it does.
For many there is great misunderstanding of psychological testing methods and purposes. The purpose of any psychological testing is to create good clinical hunches regarding what the needs, concerns or opportunities for growth may be in any individual. At best, testing creates a clinical profile which invites an extended clinical conversation with the client.
There is no single test which calibrates clergy psychological fitness. We ought not to imply that there is. We wonder why people may become defensive!! I can give test batteries which will characterize a person and outline his many traits such as: leadership, conformity, depression, passivity, organizational ability.
The bottom line is that to imply that psychological data will be used for the exclusive purpose of determining "fitness" is yet another misuse of Christian psychology.
Psychological testing can accomplish the following objectives with a remarkable degree of effectiveness:
1. Creating a personality profile.
2. Assisting in the assessment of vocational aptitudes - particularly in the case where a man may be transitioning into another vocation.
3. Measuring intelligence
4. Identifying patterns of conduct which may identify at risk behaviors
5. Providing some reasonably objective and normative information
But someone must then
determine that "x" represents sufficient leadership, and "y" represents too
much dependency. Nevertheless, if a seminary student is in the bottom 2% of all
males in the categories of leadership, confidence, assertive communication and
the like, our hypothesis is that this man is likely to profit from a crash
course in skill building, or is likely to have an incredibly difficult time in
his vicarage or first parish.
8) Presuming Christian psychology meets all spiritual needs.
I am indebted to Rev. Senkbeil, who, in his book Dying To Live9 helped me to understand that the healing of all guilt and shame begins with telling the truth before God. It is in the provision of spiritual care, after all, where the penitent hears the very absolution of God from the mouth of his pastor. It is in the provision of spiritual care wherein by grace, through faith the penitent takes possession of the forgiveness of sins and receives the very life of Christ as the new man rises to live again.
Psychotherapy can never capture the present and eternal possibilities offered for our healing by Gods means of grace offered by Gods called servant. However, to the extent that Christian psychology and its tools are not misused, the less cause these is for skepticism, resistance and outright refusals for church workers to avail themselves of the services suggested.
The opportunity to think through a variety of these issues has prompted me to be so bold as to make some recommendations. My intention would be to reduce clergy misunderstanding, suspicion or vilification of the practice of Christian psychology when it is practiced in harmony with spiritual care.
I would invite a rigorous and ongoing re-evaluation of what I hope is a mandatory course or series of courses in pastoral counseling at the seminaries wherein learning objectives include:
*Mastery of some fundamental medical information regarding mental health.
*Mastery of some fundamental strategies to assess the need for medical care.
*An appreciation for the contributions of Christian psychology.
*Understanding the nature of Christian psychology and the art of spiritual care.
*A desire to create collaborative relationships with clinicians so that spiritual care and psychological care can jointly serve the very real needs of hurting hearts and souls.
Lest I be accused of casting
worrisome looks only at our seminaries, allow me to be evenhanded. It occurs to
me that a number of the institutions in the Concordia University System have
programs in psychology. It troubles me greatly that although our church has
been blessed with theologians whose task it is to assist the laity in our
understanding of Gods Word and the Confessions, the wealth of that wisdom
is not brought to bear in psychology programs. It troubles me that our
universities are not identifying such programs as programs in Christian
psychology, and in fact careful examination of the content of curricular
materials suggests that psychology students are not being called to examine
past and present psychological thought and experience through the lens of
faith. Any integration of faith and psychology must rest on the premise that
the content of our faith, as revealed by Scripture, is Truth. And that Truth
should be the common denominator of any Christian psychology program.
Undergraduate and graduate education in Christian psychology must begin by insuring that the expression of our faith has not been relegated to an obscure rationale statement in a syllabus. It would be my expectation that the nature of instruction, inquiry and learning at the Christian university should be distinctly different from the academic experience which one would have at a secular university. Youll recall I began this presentation by telling you just how difficult it is to find a rigorously trained Christian counselor. Why cant our LC-MS institutions meet this incredible need proudly? If we intend to train Christian psychologists (and we should), we must assist them by utilizing their reading, writing, thinking, discussion and worship to boldly examine and understand how Gods Truth must be brought to bear in evaluating both the wisdom and wickedness of man.
I find it of great interest that several recent surveys of Protestant clergy, and a recent interview given by Rev. John Oberdieck (Director of Continuing Education in St. Louis) point again and again to a prevailing desire among clergy to become more knowledgeable about counseling. Some surveys point to over 70% of clergy who would actively seek the opportunity to enroll in carefully, intentionally designed, continuing education programs which have counseling as the focus. The truth of the matter is that for many men, this is an area of perceived personal and professional vulnerability.
One clergyman reported to me -- "Im way over my head, but everyone seems to think this is my job. I wonder how excited theyd be if I told them - Im winging it here guys. I dont really know what Im doing."
Perhaps pastoral conferences can continue this conversation and wrestle publicly with the connection between Christian counseling and spiritual care as you are doing here today. The goal will never be a perfect consensus of opinion and practice, the goal and the intention would be to shatter the myths so as to acknowledge, identify and meet real needs of mind, body and spirit.
Perhaps we can invite greater discussion concerning the viability of Christian counseling in newsletters, interpersonal conversations, and public statements from a variety of well respected, well-placed Synodical personages. As long as we continue treating Christian counseling like a daffy, eccentric aunt in the attic - there may always be reluctance if not shame associated with seeking such services.
We need to be clear in closing. Christian psychology is not to be confused with secular psychology, which elevates radical individualism, skepticism and rejects Truth. Instead, Christian psychology is the best amalgam of Gods truth as revealed to us by science, serving Gods Truth as revealed to us in His Holy Word.
Carlson10 makes the point clearly: "What the emotionally wounded need is for the body of Christ to be a place of love, acceptance, encouragement, forgiveness, and compassion. They need a place where Christ is lifted high and Gods Word is never compromised but also where there is openness to use all available methods of healing that are not contrary to His Word."
As a result, Christian psychology has much to offer the wounded in our midst. Christian psychologists in collaboration with spiritual care givers have remarkable gifts to give the fragile weary, angry, disillusioned or guilt-worn souls who continue to endeavor to serve their Lord in the pulpits and classrooms where He had called them.
1. David Hunt, Beyond Seduction: A Return to Biblical Christianity. Eugene, OR: Harvest House Publishers, Inc., 1986.
2. Jay Adams, Competent to Counsel: An Introduction to Nouthetic Counseling.Grand Rapids: Zondervan Publishing House, 1970.
3. David Belgium, Guilt: Where Religion and Psychology Meet. Minneapolis:Augsburg Publishing House, 1963.
4. Selden P. Delany, The Value of Confession. Milwaukee: The Young ChurchmanCo., 1914.
5. John Pless, "Divine Service: Delivering Forgiveness of Sins," Logia (1966) V (4)
6. Kenneth Leech, Spirituality and Pastoral Care. London: Sheldon Press, 1986.
7. Patrick Kilpatrick, Psychological Seduction. Nashville: Thomas Nelson Publishers,1983.
8. Dietrich Bonhoeffer, Spiritual Care. Jay C. Rochelle (Trans. with comments by JayC. Rochelle), Philadelphia: Fortress Press, 1985.
9. Harold Senkbeil, Dying to Live: The Power of Forgiveness. St. Louis: ConcordiaPublishing House, 1994.
10. Dwight Carlson, "Why Do Christians Shoot Their Wounded?" Christianity Today1998, pp34-35.
Beverly K. Yahnke, Ph.D. is the Clinical Director of Christian Counseling Services which is located in Wauwatosa, Wisconsin - firstname.lastname@example.org. These remarks were made at the Midwest Ministerial Health Conference, October 1, 1998. The conference was entitled "Christian Psychology and Spiritual Care."
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