Theoretical Integration and the fictional case of Teresa: A Christian Integrative Position
This is a paper that I wrote for my Theories class. It was my first real attempt to articulate what I had been thinking in terms of integration of psychology and theology.
A Note about integration of Psychology and Christianity
Integration of Christian faith and practice with modern psychotherapy is a struggle fought on two fronts. The founders of psychology uniformly renounced their religious heritage and thought it a neurosis at best. The trend toward sensitivity to the diversity of persons has recently allowed for more acceptance of people's religious heritage, but often religion is seen as oppressive, especially toward women, and intolerant of gay, lesbian, bisexual and trans-gendered persons. Psychology's hostility toward religion has not gone unnoticed among people of faith either. While some religious structures eagerly grasp psychology as operating as an analogue to their own mission in the world, some of a more conservative stripe rail against what they see as the secularizing and syncretising influence of psychology in the Church. Some have even likened psychology to a modern religion, with charismatic leaders and their devotees bitterly opposing those who would deviate from the purity of the 'faith' (Vitz, 1994). Indeed, Hunt (1986) claims, "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 a mental illness [sic]. It is a biological problem or it is a spiritual problem."
There are those however who would labor to integrate the Christian faith with scientific psychology. These have taken the label “integrationists” and have been at their work for at least twenty-five years (Eck, 1996). Integrationists are committed to the idea (sometimes elevated to the status of Creed) that all truth is God's truth, in other words, that truth of special revelation (scripture) will not contradict findings of general/natural revelation (properly conducted science) because each is revelation from God. For these, the flagship journal is the Journal of Psychology and Christianity published by the Christian Association for Psychological Science (CAPS). Additionally there are some popular, Christian authors who take psychological theory and 'baptize' it for consumption by a Christian audience. There are shelves full of volumes by the latter and a smattering by the former. Finally, there are those who would integrate psychology with religion or theology in general. The precedent for this was established at the beginning of modern psychology with the publication of William James's Varieties of Religious Experience. Other outlets for such study include Division 36 of the APA (Psychology of Religion) and such journals as the Journal Psychology and Theology
the Journal of the Scientific Study of Religion and the International Journal for the Psychology of Religion.
What follows is an attempt to authentically (truthfully) examine my own position as a person of faith in the profession of psychology and particularly in the practice of counseling. I will attempt to place myself in one of the camps (integrationist, borrower from psychology, borrower from religion, rejecter of psychology or rejecter of religion.) I intend to be very honest in my presentation, and though I would not claim to have figured out every difficulty with the juxtaposition of science and faith, I am aware that my thoughts could be construed as heretical to either side, Christianity and Psychology speak two very different languages (Dueck, 2002). I like to think of myself as multilingual in that I can communicate in both circles, yet at times important information is lost in translation. My background in the Church has been varied, attending several denominations with diverse teachings and practices. I have chosen in adulthood to commit to the Reformation branch of Christianity's family tree, as a more pure expression of the “faith that was once for all delivered to the saints" (Jude 1:9). I have chosen to go into some depth in this report because the assumptive world is crucial to how I think about clients and the world in general. I will try to support my positions with relevant literature, and, because I believe in its authority, appropriate scripture texts as well.
What is the essential nature of people?
Human beings are spiritual-psycho-social-biological entities with essential unity of nature. Humankind was created by God to be distinct from his other creatures in that they alone would be capable of relationship with God. Capacity of relationship is part of the Image of God (Imago Dei) that was bestowed upon humanity by the Spirit of God. The capacity for relationship with the divine extends to a capacity to truly relate to each as "Thou" ("Du", Buber, 1958.) This is some of what is expressed in the Westminster shorter catechism about the primary end of humanity, namely: "to glorify God and enjoy Him forever." People are capable of glorifying and enjoying God insofar as relationship is possible with God. To have a relationship with a person is not merely to know about a person but to know that person, just as faith is not knowing about God, but knowing God (James 2:19). This answers the primary philosophical question, "what constitutes the good life?" with, "a right relationship with God." Disobedience and the selfish desire to be one's own god destroyed humanity ability to have direct relationship with God. The doctrine of Original Sin teaches that humanity' fell' in relationship with God through an act of selfish disobedience. Augustine thought of sin (concupiscence) as a "privation of good" or a twisting of good gifts that God had given toward one's own ends. Whereas humanity was created to be outward focused, existing in relationship, inwardness and the desire to be god caused a distortion of this design. Humanity is twisted because of sin, not to the extent that we no longer bear the Image of God, but in every way we are perverted from our original purpose of complete relationship with God.
"The sin that limits freedom includes both the personal turning away from God and the corporate power of corrupted social structures, institutions and relationships" (Kotva,1996).
Milne (1982) summarizes the extent of the effect of sin as follows: "Sin affects the whole of a human being: the will (In. 8:34; Rom. 7:14-24; Eph. 2:1-3,2 Pet. 2:19); the mind and understanding (Gn. 6:5; 1 Cor. 1:21; Eph. 4:17); the affections and emotions (Rom. 1:2427; 1 Tim. 6:10; 2 Tim. 3:4); as well as one's outward speech and behavior (Mk 7:21£.; Gal. 5:19-21; Jas. 3:5-9)" (emphasis in original). No part of humanity is exempt from the corruption of sin. Thoughts can be disordered, as can desires, feelings and even conscience. The only way to test whether a deed, word or thought is disordered is to compare it with an objective source, that being God's Word. The prophet Jeremiah (17:9) laments the effects of sin on the heart, "The heart is deceitful above all things, and desperately sick; who can understand it?" For Jeremiah, his own feelings for what is good cannot be trusted; he must compare his desires against the law of God. Christians believe that God is the God of truth (Isaiah 65:16) and that He reveals Himself (1 Corinthians 1:25-26) through nature and by the inspired scriptures (2 Timothy 3:16). God reveals what He is like by His law. Jesus summarized the law of God as "You shall love the Lord your God with all your heart and with all your soul and with all your mind." and "You shall love your neighbor as yourself." The prophet Micah (6:8) described the duty of humankind as "to do justice, and to love kindness, and to walk humbly with your God." The word of God, which reveals His nature, is the only truly objective rule by which we can measure thoughts, feelings, deeds and words because it is a reflection of who God is. Unfortunately, no one is able to keep the whole of God's law because of the natural propensity of humanity toward twisting what is good (Romans 5:10, Ephesians 2:3). God provided Christ to form a new covenant with his people, to restore the relationship that was lost. By dying, Christ satisfied the conditions of the Law and enabled people to again approach God in relationship (Hebrews 6:19-20), not as enemies, but as children. God replaces hearts made of stone with hearts made of flesh (Ezekiel 11:19). Ultimately all deep personality change is directly wrought by God at his pleasure (Philippians 2:13). By his Spirit he gives us true love, joy, peace, patience, kindness, goodness, gentleness, and self-control (Galatians 5:22-23). This does not mean that a believer is free from the influence of sin. On the contrary, suffering is part and parcel of this life because of sin. Disease, difficulties and pathology are all the result of living in a fallen world.
What about objective reality?
We believe that God has revealed Himself to humanity through direct revelation, prophets, inspired scriptures and finally in the person of Jesus. The study of God's creation is ultimately the study of the Creator because he created by his Word (logos), from nothing (ex nihilo). We have spoken of the effects of the fall on the totality of the person and we included the mind and reason in the tally of victims. It is true that the reason has been distorted, which is why different perceptions of a unitary phenomenon are possible, but there remains in humanity the seed of rationality. Science is a method that attempts to limit the subjectivity of a phenomenon by carefully observing, attempting to predict and by training various "lenses" at it. In the same way, we believe that the scriptures are a valid and reliable measure against which we may measure our observations of humanity and our thoughts about God. Some use the scriptures out of context to support post hoc any opinion that might already have (confirmation bias). Others assume that the entire canon may be used as literal, scientific evidence for phenomena, without respect for literary style and cultural or linguistic context. Proper application of the scriptures follows the meaning of a passage within its context and attends to the aspects of the world in which the text was written and to whom it was written. The science of Biblical Hermeneutics is the method by which the original meaning is drawn from the text (exegesis) rather than imposed upon the text (eisegesis). In sum, the theologian protects herself from misinterpretation of the scriptures by being skeptical of her own insight on the text and consulting other portions of scripture that may explain or enlighten the text. She is careful in this task because she is aware of the noetic effects of the fall (effects on the mind and reason). In the same way, the scientist is skeptical of the first impression of a phenomenon and seeks to test his perception with data, but with caution as he acknowledges that his values will influence his perceptions of the data. God is knowable through his revelation and through nature (Romans 1:20), which is knowable in its own right by careful study. A Christian psychology will apply the findings of psychology, such as the knowledge of social influence and the process of learning, to individuals within the framework of the great Christian themes of creation, fall, redemption and sanctification.
What is the cause of pathology and distress?
Recently there has been a surge of interest in virtue ethics in philosophy particularly since the publication of Alasdair MacIntyre's After Virtue (Murphy, Kallenberg & Nation, 1997). Virtue ethics rely on the idea that there exists a desired end or goal (telos) for the best kind of human life. We posit that the best human life is lived in accordance with the way that God made the world (recall the Westminster Shorter Catechism). Virtue ethics further presume that virtues are not means to an end, such that a virtuous life will be rewarded, but that virtues are themselves innately desirable and good for people. To live according to the structure of the world as God created it is beneficial and good. This is not to say that those who live virtuous lives will never suffer (part of the message of the book of Job), but that justice, mercy, honesty, faithfulness, peacefulness, and the like recreate themselves and improve the quality of a person's life and the life of a community. Virtue is not a method of earning favor with God, but of living according to what he has revealed to be profitable. The Proverbs are full of maxims expressing the social-science wisdom of the ancient Near East. An example of a proverb that teaches about living according to the virtue of justice is as follows: "Bread gained by deceit is sweet to a man, but afterward his mouth will be full of gravel (Proverbs 20:17)." The concept of virtues applies to non-Christians (Aristotelian virtue ethics) as well as to Christians. Non-Christians may have a different idea of the greatest good but can be helped to foster these virtues in their own lives, because a virtuous life and virtuous behaviors are rewarding, a movement toward one's teleological vision.
The ultimate cause of pathology is sin. That is not to say that God punishes people by giving them a mental illness, but no one can deny (for example) that a sexual abuse survivor suffers from the wrongdoing of someone else. By acknowledging sin we remove guilt for the victim (not suffering from her own maladaptive cognitions) and we acknowledge that a definite breech in relationship has occurred which can only be remedied by the power of forgiveness. Whether sin is the direct cause of a mental condition (PTSD from witnessing a violent act) or a distal cause (as all physical illness is caused distally by the fall) the root of all suffering is sin. Because humanity exists in relationship to a loving God whom reveals Himself and desires relationship with his creation, it follows that individual happiness is not the greatest good in life. Rather, cultivation of virtue (or character) often requires people to deny themselves what they think best or even what they feel to be right and true. Proverbs 20:5 says: "The purpose in a man's heart is like deep water, but a man of understanding will draw it out." The surface intent of an action may seem honorable and even virtuous, but the underlying motivation may be self-focused, even in altruism. Again, this is not to say that people should continuously navel-gaze about their deeper motives for seemingly kind behavior, but that critical self-awareness is as justified as scientific rigor. Additionally, not all bad feelings are in truth bad. Guilt is a natural reaction to doing something that is unjust, untruthfut and so on. Guilt, like physical pain tells us that something is wrong. Someone who is numb to all guilt and other emotional indicators is in as much danger of being truly hurt as one who is numb to all physical pain. Excessive guilt and inappropriate guilt are certainly problems, which can be the result of brain chemistry, disturbed relationships, or spiritual distress. Rather than happiness, scripture points us to contentment as a goal (1 Timothy 6:6), not self-fulfillment, but the gratification of living in relationship and accepting the difficulties that our given to us for our growth (1 Corinthians 10:13).
How do people change?
Therapy is dangerous when it helps people to change their negative feelings to more positive feelings without dealing with problematic attitudes, behaviors and character. Symptom reduction for its own sake is worthless. The state of "Feeling good" has never been thought of as an end in itself until recently and for good reason. Feeling good without doing good and striving toward your tel os is worthless.
Paul exhorts the Church at Rome in the 12th chapter of Romans to "rejoice with those who rejoice" and "weep with those who weep." This is Paul's understanding of love and empathy, which are necessary conditions for Christian community in which growth is possible. Scripture speaks of helping people by exhorting them, encouraging them, and disciplining them. Within a loving relationship (one characterized by self giving) a kind rebuke (closest to confrontation in the language of psychology) will lead to change. "A rebuke goes deeper into a man of understanding than a hundred blows into a fool" Proverbs 17:10. Encouragement is another of the tools of change that are prescribed by the scriptures. Encouragement is not built on vague hopefulness or unrealistic optimism, but on trust in the promises made by God and belief that He keeps His promises, known in scriptural language as hope (1 Thessalonians 5:14f). People change because God is gracious and helps them to change, not without human effort. Those who think that they will be able to please God by their own efforts at self-improvement however are mistaken (Ephesians 2:8-9). All real change is wrought by God, not only in believers only but in everyone, because God "sends rain on the just and on the unjust" (Matthew 5:45). Virtues are beneficial to an individual whether Christian or non-Christian, because they are reflections of the character of the God who created the world. Why does counseling work for non-believers? The science of psychology teaches us how we can help people to change their own behavior and learn new ways of thinking and behaving, but caution should be used lest people injure themselves by seeking relief from suffering without recognition and attention to the causes of that pain.
Parameters: Areas of special attention
Suffering
Suffering is not to be avoided at all costs, or despised, or 'fixed', but to be learned from and appreciated for it's growth potential and for it's origin in the wisdom of God. Paul says" rejoice in suffering for suffering produces endurance..." This is the theology of the cross; that suffering was necessary to heal (Isaiah 53:5) and that we share in the suffering of Christ as he shared in our guilt (Mark 8:34). We are refined by suffering (Zechariah 13:9) as gold is by fire, made pure and valuable. Indeed one of the great virtues of Christianity is that of patience, the ability to wait on the promises of God and endure with joy that which is our lot. This is not fatalism, for the Christian has hope in the sustaining power of God.
Work
Freud thought mental health was to be able to love and to work. Christians believe that mental health flows from love and work. There is a special emphasis in Christian theology on the idea of calling (vocare -> vocation). During the Medieval period, the Church taught that sacred occupations were pleasing to God while secular vocations were not. Martin Luther confronted this abuse in the sixteenth century by emphasizing the idea of vocation for each person, which extended beyond occupation
to one's calling in the family and community. He taught that all work is pleasing to
God (Ecclesiastes 9:10) insofar as one is honest, just and fair. The Puritans taught that work was an expression of the talents that God had given to each person and were thus concerned to find what those skills and knowledge were (Exodus 35:31). Puritans were willing to look into the individual in order to advise the correct course of action. They believed that the will of God was not obtained by some oracle or direct revelation, but through observation of the propensities and skills that God had given the person and
by consultation with those who knew that person the best (often parents). Work, done mindfully" as to the Lord" (Ephesians 6:7) was thought to be physically, spiritually and even psychologically healthy (see Richard Baxter's treatise on the Cure of Melancholy and Overmuch Sorrow.) Physical work is not a mean to or an adjunct of a well-lived life, but an essential ingredient and an act of gratitude to God for the abilities He has given.
Community
Another essential element that is fundamental to understanding the Christian mindset is the idea of the corporate nature of the Church. The Church is a body (corpus) with individual members, which cannot function on their own (1 Corinthians 12:14-20). Mutual love, support, encouragement, and forgiveness help the body to grow. Paul in Galatians 6:2 says that Christians ought to "bear one another's burdens, and so fulfill the law of Christ." Life cannot be successfully lived in solitude. It is the actual care given by the members of the Church that heals, not simply the feeling of affiliation to a group. One who wishes to counsel within the Church or with her members must be open to the differences, doctrinal, practical and political that are inherent in the Church. Additionally, support of the clergy is a unique opportunity within the Church, as burnout is common among ministers who carry the burdens of their congregations and frequently have little in the way of peer support themselves (Doohan, 1982).
Forgiveness and Reconciliation
Forgiveness is the conscious letting go of any claim against another person for something that they did to you. Forgiveness is not forgetting that a wrong happened or inviting another to occur, but a release of judgment against a person. Neither is forgiveness is forbearance, the ignoring of small slights to maintain a relationship. Forgiveness occurs only after a wrong is perceived as such and hard feelings are former against an offender. When these conditions are met, forgiveness must occur for peace within a relationship. This renewal and revitalization of a formerly damaged relationship is called reconciliation in theological terms. Scripture teaches that because God forgives our sins through Jesus, we ought also to forgive each other and be reconciled to them (Matthew 5:24, Luke 17:3-4, Colossians 3:13). In our paradigm of relationship, there is nothing more interpersonally important than forgiveness, because forgiveness heals damaged relationships. Within the field of counseling psychology, important work is currently being done on forgiveness by researchers such as Everett Worthington and Michael McCullough.
Specific Techniques
Christian therapists have borrowed from all major schools of psychotherapy and some have even espoused augmented purist positions such as Christian Cognitive Behavioral therapy (Hawkins, Tan & Turk, 1999). I believe consistency from assumptive-world through technique to be essential. The assumptive world of those who commonly use the technique need not be the same as mine however. For instance, I may use behavioral techniques to modify the contingencies experienced by a person trying to change a behavior without believing that humans are nothing more than stimulus-response creatures. Like Existential therapy, Christian therapy tends to operate on the level of assumptive-world, but there are certain" techniques" that are unique to Christian therapy, namely the spiritual disciplines. According to Eck (2002), "Spiritual disciplines and practices have been utilized over the centuries as means to help people of faith reorder their lives." One of the most fundamental of these is prayer (1 Thessalonians 5:17), which includes individual and corporate expressions of thanks to God and requests of God as well as meditation and "listening" to God. Additionally, God has given "visible words" known as sacraments to his Church for her benefit. Participation in these sacraments with a community of believers is important to vita faith that avoids the polar errors of magical thinking (that the sacrament in itself is a magical tool) and mystical Gnosticism (that only the spiritual is good and that phys1 existence is to be denied). People often use psychotherapy as a secular form of confession, to share troubles with someone else that will not judge, but will offer ho Christian confession is a practice whereby a person acknowledges errors and receive the assurance of God's forgiveness (1 John 1:9). Additionally, fasting, solitude, rest, silence, worship, hospitality and intercession are just some of the Christian discipline that Eck (2002) reviewed as possible therapeutic techniques. Not all of these are possible within the therapeutic relationship alone, they require the Church for full expression.
At one level of analysis, change, both inside and outside of counseling, is the result of the power of God's common grace. At another level, we can study the mechanisms which behavior change is brought about (though we should not confuse changes in behavior with changes of heart). Counseling research needs to continue to look at change is facilitated both within and outside of the counseling relationship. The following are some of the areas identified by Prochaska and Norcross (2003) that are areas of change along with scriptural precedence for their use.
Education – Doctrinal and psychological truths are to be valued and shared with clients. Words of truth (logos) have power (John 8:32).
Corrective Emotional Experiencing - While emotional experiences are to be tested against the light of scripture, feelings of joy, peace, confidence and the like are fro God. Negative feelings, such as guilt and anxiety are to be respected as indicative of a problem.
Modeling and Stimulus control - Modeling is a principle that is recognized in scripture (2 Peter 3:17). Additionally, Paul tells the Church at Philippi to think of things that are true, honorable, just, pure, lovely, commendable excellent and praiseworthy; possibly indicating his recognition of the effect of thoughts and various stimuli on behavior (Philippians 4:8).
Teresa
Presenting Problem
Teresa is presenting to therapy for depression and bouts of angry acting out. Teresa's distress is the result of unjust treatment by members of her family and other significant people in her life, disrupted relationships and her own choices. Teresa lacks community in which to find support and she is not experiencing joy from her work, possibly because she is not well suited for that occupation or has lost a sense of meaning from work.
Historical Factors related to underlying problem
Teresa's family treated her unjustly by depriving her of relationship with her parents. Her absent father and emotionally unstable mother were not available for Teresa to connect with and grow under. Her parents did not seem to be sensitive to the personality of their daughter when they required her to take a care-giving role in the family without adequate adult support. Teresa operated as a caregiver, not with joy, but to gain scant reward from her mother. She was not nurtured to gain meaning from her work, family or faith. Additionally, inequitable treatment by Teresa's mother toward her nieces and nephews caused a breech in her relationship with Teresa. Additionally, Teresa's relationships with other family members has suffered from an unwillingness to address the hurt that they caused by blaming the death of Teresa's mother on her. Teresa is responsible for her part in interpersonal strife, particularly her "raging" against her partner. Rather than simply ignore these incidents, seeking forgiveness and reconciliation to whatever degree possible would be a benefit to Teresa's life.
Current Factors related to underlying problem
Teresa's life is currently stagnant, with no friends, hobbies or leisure activities to give purpose to her life. She is not in communion with her God, nor is she engaged in her Church. Teresa is experiencing a deep depression with thoughts of worthlessness and suicidal ideation. This is a time of great suffering for Teresa which may push her back into community and faith and eventually help her to grow as a person.
Desired outcomes for change
First, Teresa needs to become aware that the physical, social and psychological all work together. She needs to work toward taking care of herself by becoming part of a community and by caring for herself physically through exercise and diet. Additionally, if therapy is successful, Teresa will recognize the interpersonal transgressions committed against her and begin to more toward forgiveness for them rather than stagnating in bitterness and anger. Further, Teresa will own up to the wrongs she has done to others and actively seek to recover those relationships. Teresa has an opportunity to grow from this experience and she can find meaning (spiritually and socially) from her suffering and can work to help those who suffer in like ways (perhaps among other nurses who struggle with guilt feelings.) Finally, through counseling, Teresa will be able to find a vocational role, in her occupation and in the community life that is meaningful and growth promoting.
Strategies & Techniques
Initially, Teresa must be informed of the nature of my theoretical orientation be willing to work with a counselor who identifies as Christian. If Teresa does decide to enter therapy, she in no way relinquishes her right to her own beliefs and has no duty to adopt mine. Teresa would be screened for the possibility that psychopharmacotherapy might benefit her as she is currently having suicidal thoughts and she has a family history that includes self-injurious behavior. Teresa and I will begin to build a relationship of trust and care from which to build our work. We will explore her relationship with her family, her Church and her God. If Teresa is not at first willing explore her faith, we will revisit his issue later when we talk together of meaning in life. We will investigate her social support and think of ways to build new outside relationships of mutual concern and respect. We will think of ways that Teresa can grow, things that she would like to work on in her life that would be beneficial to others and rightly a source of pride for her. We will begin to work on realizing that others have harmed her and that she has every right to be angry, but that to repair the bro relationship, she must actively engage the problem and work toward forgiving the offender. Teresa will not be pressured to forgive anyone for any offense that she de not decide is appropriate, but she would be encouraged to think of interpersonal injustices as real transgressions rather than dismiss them or interpret them as expressions of her own worthlessness. She would be listened to, supported and encouraged during the time that she is climbing out of her depression and challenge, (exhorted) when she began to move more quickly. Behavioral techniques might be appropriate to change Teresa's conditioned reaction to the deaths of her clients.
Criticisms:
Your use of the masculine pronoun for God throughout betrays your religion's patriarchic structure and sexism.
I have used the masculine pronoun for God throughout because God chose to revea himself as Father in the scriptures. God however is fully" other" and gendered pronouns are not ideal when speaking about God. There are passages in which GOI conceptualized in feminine (to ancient Hebraic peoples) terms. Galatians 3:28 provide the Church with God's norm of equality among people: "There is neither Jew nor Greek, there is neither slave nor free, there is neither male nor female, for you are al one in Christ Jesus." Indeed, while the sexes may at times be seen to have different roles, the essential worth of both sexes is emphasized in both the Old and New testaments.
A theoretical treatment of Teresa's bisexuality is conspicuously absent from your theoretical structure. Your homophobia is obvious and you are treading into unethical territory if you refuse to treat someone of a same-sex orientation.
Historic Christian thought and Biblical interpretation have agreed that all sexual behavior outside of the bonds of marriage is displeasing to God. Whether the Bible draws out homosexual behavior as in some way different than other forms of sexual impurity is hotly debated (see essays by Hays and Johnson in Murphy, Kallenberg & Nation, 1997). Gay, Lesbian and Bisexual relationships may well be proven to be biologically influenced, normal variations of sexual behavior. The message of the Christ has always been one of forgiveness and reconciliation to all people and Gay, Lesbian and Bisexually identified people are to be treated with compassion and understanding like all others. Without getting into a full exegetical and hermeneutical study of the "homosexual" passages in the Bible and the ordination and meaning of marriage, I have chosen to pass over this part of Teresa's life, focusing instead on her experiences of other's wrongdoings.
Isn't this rather escapist, particularly saying that God is responsible for human change?
The charge of escapism is well taken. Christian truths have had to be guarded against error for millennia. The truth of God's providence has led some to think of God as a vending machine, in whom you deposit prayer and from whom you receive "blessings." The doctrine of God's power (omniscience) is a guiding framework that leads one to thankfulness for His mercies and patience in hard times, but does not negate hard work by individuals and community (Philippians 2:12-13). Additionally, in those times that God chooses not to heal (2 Corinthians 12:7) trust in God is not undermined. The Pop Christian emphasis on "let go and let God" may well be mistaken, but the charge of charge of escapism is not warranted for orthodox belief in the omniscience of God.
Isn't this taking common ritual to an extreme, this sort of magical thinking could very seriously injure some people, especially those who are dependent or whose psychoses hinge around spiritual themes.
It would seem that ritual is a source of healing and change, and that this is an elaborate theoretical (theological) underpinning for ritual, particularly those that are situated within an organized religious framework. God made humanity to order their lives around ritual and routine. Simply because ritual on its own (without God as the object) is effective in bringing relief to some problems does not make it logically necessary that Christian ritual is only another of the same and not spiritually beneficial. God made prayer for people, not to give Him a method to know our wishes, but so that we would have the opportunity to express our needs and thanks to Him, but this does not preclude people from praying to other objects.
Your lip service to the ideal of" science" is admirable, but you do not address those points at which psychology and theology have diverged. What say ye?
I have yet to see a list of scientific facts that are contrary to scripture. It is important to note that psychology has almost no proven "laws." Theoretical formulations are constantly in the process of revision. Theology too is to be approached with humility, for the whole of the God's mysteries are not accessible or revealed (Isaiah 55:8-9). I am a proponent of solid, thoughtful research to investigate how people think, act, relate and thrive in the world.
So, you can only work with Christians and specifically those Christians who believe as you do, isn't this rather limiting and intolerant of others religions?
Christianity is a broadly diverse set of religious denominations that share some feature in common but have wild differences in other areas. Christian counseling should not 1: practiced in exclusion of the Church community or separate from the support of clergy (pastors, ministers and priests). Christian counseling respects the theological and practical differences of the client while maintaining adherence to one's own understanding of God. Christian counseling probably works best when an individual': pastor and congregation are also available for support. The Christian religion is necessarily exclusivist in that we believe that Jesus is the only way to God. Respect for the belief systems and mode of thinking of individuals with different heritages is not only possible but proper. Therapy will likely work best when the therapist and client' E worldviews are in essential agreement (Prochaska & Norcross, 2003), but productive work with members of other faith communities is possible.
What is your multicultural stance, certainly the history of Christianity has been all about changing people's customs into Christian ones that reflect European values.
Abominations have been committed in the name of Christianity as they have in the name of many other religions. The New Testament records the broadening of the faith community from exclusively Jewish to inclusive of all other ethnic groups (Acts 11). Justice requires that all people are to be valued equally, whatever their race, origin, ethnicity, sexual orientation or creed. Tolerance does not require silence and acceptance of all practices as equally valid however. From a theological perspective, every person is of inestimable value and therefore is worthy to be though better than one's self (Philippians 2:3). It is important to study and understand multiple perspectives and to be sensitive to possible misunderstanding and difference of perspective. Additionally, the modern American way of life is certainly not an ideal which should be imposed upon others.
So you will just shame people into trying harder to fix themselves. This can hardly be called therapy and may indeed be both harmful and unethical.
In the book of Job, Job's three friends counsel him after he has lost his health, family, and all that he owned to natural disasters and enemies. Their tactic is to point out that Job must have done something wrong that he was being punished for and should therefore repent. Job (16:2) calls these friends "miserable comforters" ("worthless counselors" in the New Living Translation). His wife has another tactic, she tells him to, "curse GOD and die" (Job 2:9). The danger of the system outlined above is that too quickly it would degenerate into blaming and faultfinding without focus on the suffering person who has come in for help. Understanding humanity's fallen condition does not necessitate judgmental attitude. Judgment is the Lord's; we are to bear one another's burdens (Galatians 6:2) and share in their joys and suffering (Romans 12:15). This is the calling to all believers. The Christian therapist is to apply the findings of science within this framework.
References
Benner, D. G. & Hill, P. C (Eds.) (1999). Baker encyclopedia of psychology and counseling(2nd ed.). Grand Rapids, MI; Baker Books.
Doohan, H. (1982). Burnout: A critical issue for the 1980s. Journal of Religion and 1-:21, 352-328.
Dueck, A. (2002). Babet Esperanto, shibboleths, and Pentecost: Can we talk? Jour Psychology and Christianity, 21, 72-80.
Eck, B. E. (1996). Integrating the integrators: An organizing framework for a multifaceted process of integration. Journal of Psychology and Christianity, 1. 115.
Eck, B. E. (2002). An exploration of the therapeutic use of spiritual disciplines in clinical practice. Journal of Psychology & Christianity, 21, 266-280.
Ganz, R. (1993). Psychobabble: The failure of modern psychology and the Biblical alternative. Wheaton, IL.: Crossway.
Hawkins, R. S., Tan, S. Y., & Turk, A. A. (1999). Secular versus Christian inpatien cognitive-behavioral therapy programs: Impact of depression and spiritua being. Journal of Psychology & Theology, 27,309-318.
Holy Bible (English Standard Version). (2001). Wheaton IL: Crossway Bibles.
Hunt, D. (1986). Beyond seduction: A return to Biblical Christianity. Eugene, OR: Harvest House.
Kotva, J. L Jr. (1996). The Christian case for virtue ethics. Washington D.C: Georgetown University Press.
McCullough, M. E., Pargament, K. I., & Thoresen C E. (eds.) (2000). Forgiveness: J practice and research. New York: Guilford.
Milne, Bruce (1982). Know the truth: A handbook of Christian belief Downers Grove, Inter Varsity.
Murphy, N., Kallenberg, B.L & Nation, M. T. (Eds.) (1997) Virtues & practice in tht Christian tradition: Christian ethics after MacIntyre. Harrisburg, P A.: Trinity International.
Prochaska, J. 0., & Norcorss, J. C. (2003). Systems of psychotherapy: A transtheoretical approach (5th ed.). Pacific Grove, CA: Brooks/Cole.
Vitz, P.C. (1994). Psychology as religion: The cult of self-worship. Second edition. Grand apids, MI; Eerdmans Publishing Company.
A Note about integration of Psychology and Christianity
Integration of Christian faith and practice with modern psychotherapy is a struggle fought on two fronts. The founders of psychology uniformly renounced their religious heritage and thought it a neurosis at best. The trend toward sensitivity to the diversity of persons has recently allowed for more acceptance of people's religious heritage, but often religion is seen as oppressive, especially toward women, and intolerant of gay, lesbian, bisexual and trans-gendered persons. Psychology's hostility toward religion has not gone unnoticed among people of faith either. While some religious structures eagerly grasp psychology as operating as an analogue to their own mission in the world, some of a more conservative stripe rail against what they see as the secularizing and syncretising influence of psychology in the Church. Some have even likened psychology to a modern religion, with charismatic leaders and their devotees bitterly opposing those who would deviate from the purity of the 'faith' (Vitz, 1994). Indeed, Hunt (1986) claims, "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 a mental illness [sic]. It is a biological problem or it is a spiritual problem."
There are those however who would labor to integrate the Christian faith with scientific psychology. These have taken the label “integrationists” and have been at their work for at least twenty-five years (Eck, 1996). Integrationists are committed to the idea (sometimes elevated to the status of Creed) that all truth is God's truth, in other words, that truth of special revelation (scripture) will not contradict findings of general/natural revelation (properly conducted science) because each is revelation from God. For these, the flagship journal is the Journal of Psychology and Christianity published by the Christian Association for Psychological Science (CAPS). Additionally there are some popular, Christian authors who take psychological theory and 'baptize' it for consumption by a Christian audience. There are shelves full of volumes by the latter and a smattering by the former. Finally, there are those who would integrate psychology with religion or theology in general. The precedent for this was established at the beginning of modern psychology with the publication of William James's Varieties of Religious Experience. Other outlets for such study include Division 36 of the APA (Psychology of Religion) and such journals as the Journal Psychology and Theology
the Journal of the Scientific Study of Religion and the International Journal for the Psychology of Religion.
What follows is an attempt to authentically (truthfully) examine my own position as a person of faith in the profession of psychology and particularly in the practice of counseling. I will attempt to place myself in one of the camps (integrationist, borrower from psychology, borrower from religion, rejecter of psychology or rejecter of religion.) I intend to be very honest in my presentation, and though I would not claim to have figured out every difficulty with the juxtaposition of science and faith, I am aware that my thoughts could be construed as heretical to either side, Christianity and Psychology speak two very different languages (Dueck, 2002). I like to think of myself as multilingual in that I can communicate in both circles, yet at times important information is lost in translation. My background in the Church has been varied, attending several denominations with diverse teachings and practices. I have chosen in adulthood to commit to the Reformation branch of Christianity's family tree, as a more pure expression of the “faith that was once for all delivered to the saints" (Jude 1:9). I have chosen to go into some depth in this report because the assumptive world is crucial to how I think about clients and the world in general. I will try to support my positions with relevant literature, and, because I believe in its authority, appropriate scripture texts as well.
What is the essential nature of people?
Human beings are spiritual-psycho-social-biological entities with essential unity of nature. Humankind was created by God to be distinct from his other creatures in that they alone would be capable of relationship with God. Capacity of relationship is part of the Image of God (Imago Dei) that was bestowed upon humanity by the Spirit of God. The capacity for relationship with the divine extends to a capacity to truly relate to each as "Thou" ("Du", Buber, 1958.) This is some of what is expressed in the Westminster shorter catechism about the primary end of humanity, namely: "to glorify God and enjoy Him forever." People are capable of glorifying and enjoying God insofar as relationship is possible with God. To have a relationship with a person is not merely to know about a person but to know that person, just as faith is not knowing about God, but knowing God (James 2:19). This answers the primary philosophical question, "what constitutes the good life?" with, "a right relationship with God." Disobedience and the selfish desire to be one's own god destroyed humanity ability to have direct relationship with God. The doctrine of Original Sin teaches that humanity' fell' in relationship with God through an act of selfish disobedience. Augustine thought of sin (concupiscence) as a "privation of good" or a twisting of good gifts that God had given toward one's own ends. Whereas humanity was created to be outward focused, existing in relationship, inwardness and the desire to be god caused a distortion of this design. Humanity is twisted because of sin, not to the extent that we no longer bear the Image of God, but in every way we are perverted from our original purpose of complete relationship with God.
"The sin that limits freedom includes both the personal turning away from God and the corporate power of corrupted social structures, institutions and relationships" (Kotva,1996).
Milne (1982) summarizes the extent of the effect of sin as follows: "Sin affects the whole of a human being: the will (In. 8:34; Rom. 7:14-24; Eph. 2:1-3,2 Pet. 2:19); the mind and understanding (Gn. 6:5; 1 Cor. 1:21; Eph. 4:17); the affections and emotions (Rom. 1:2427; 1 Tim. 6:10; 2 Tim. 3:4); as well as one's outward speech and behavior (Mk 7:21£.; Gal. 5:19-21; Jas. 3:5-9)" (emphasis in original). No part of humanity is exempt from the corruption of sin. Thoughts can be disordered, as can desires, feelings and even conscience. The only way to test whether a deed, word or thought is disordered is to compare it with an objective source, that being God's Word. The prophet Jeremiah (17:9) laments the effects of sin on the heart, "The heart is deceitful above all things, and desperately sick; who can understand it?" For Jeremiah, his own feelings for what is good cannot be trusted; he must compare his desires against the law of God. Christians believe that God is the God of truth (Isaiah 65:16) and that He reveals Himself (1 Corinthians 1:25-26) through nature and by the inspired scriptures (2 Timothy 3:16). God reveals what He is like by His law. Jesus summarized the law of God as "You shall love the Lord your God with all your heart and with all your soul and with all your mind." and "You shall love your neighbor as yourself." The prophet Micah (6:8) described the duty of humankind as "to do justice, and to love kindness, and to walk humbly with your God." The word of God, which reveals His nature, is the only truly objective rule by which we can measure thoughts, feelings, deeds and words because it is a reflection of who God is. Unfortunately, no one is able to keep the whole of God's law because of the natural propensity of humanity toward twisting what is good (Romans 5:10, Ephesians 2:3). God provided Christ to form a new covenant with his people, to restore the relationship that was lost. By dying, Christ satisfied the conditions of the Law and enabled people to again approach God in relationship (Hebrews 6:19-20), not as enemies, but as children. God replaces hearts made of stone with hearts made of flesh (Ezekiel 11:19). Ultimately all deep personality change is directly wrought by God at his pleasure (Philippians 2:13). By his Spirit he gives us true love, joy, peace, patience, kindness, goodness, gentleness, and self-control (Galatians 5:22-23). This does not mean that a believer is free from the influence of sin. On the contrary, suffering is part and parcel of this life because of sin. Disease, difficulties and pathology are all the result of living in a fallen world.
What about objective reality?
We believe that God has revealed Himself to humanity through direct revelation, prophets, inspired scriptures and finally in the person of Jesus. The study of God's creation is ultimately the study of the Creator because he created by his Word (logos), from nothing (ex nihilo). We have spoken of the effects of the fall on the totality of the person and we included the mind and reason in the tally of victims. It is true that the reason has been distorted, which is why different perceptions of a unitary phenomenon are possible, but there remains in humanity the seed of rationality. Science is a method that attempts to limit the subjectivity of a phenomenon by carefully observing, attempting to predict and by training various "lenses" at it. In the same way, we believe that the scriptures are a valid and reliable measure against which we may measure our observations of humanity and our thoughts about God. Some use the scriptures out of context to support post hoc any opinion that might already have (confirmation bias). Others assume that the entire canon may be used as literal, scientific evidence for phenomena, without respect for literary style and cultural or linguistic context. Proper application of the scriptures follows the meaning of a passage within its context and attends to the aspects of the world in which the text was written and to whom it was written. The science of Biblical Hermeneutics is the method by which the original meaning is drawn from the text (exegesis) rather than imposed upon the text (eisegesis). In sum, the theologian protects herself from misinterpretation of the scriptures by being skeptical of her own insight on the text and consulting other portions of scripture that may explain or enlighten the text. She is careful in this task because she is aware of the noetic effects of the fall (effects on the mind and reason). In the same way, the scientist is skeptical of the first impression of a phenomenon and seeks to test his perception with data, but with caution as he acknowledges that his values will influence his perceptions of the data. God is knowable through his revelation and through nature (Romans 1:20), which is knowable in its own right by careful study. A Christian psychology will apply the findings of psychology, such as the knowledge of social influence and the process of learning, to individuals within the framework of the great Christian themes of creation, fall, redemption and sanctification.
What is the cause of pathology and distress?
Recently there has been a surge of interest in virtue ethics in philosophy particularly since the publication of Alasdair MacIntyre's After Virtue (Murphy, Kallenberg & Nation, 1997). Virtue ethics rely on the idea that there exists a desired end or goal (telos) for the best kind of human life. We posit that the best human life is lived in accordance with the way that God made the world (recall the Westminster Shorter Catechism). Virtue ethics further presume that virtues are not means to an end, such that a virtuous life will be rewarded, but that virtues are themselves innately desirable and good for people. To live according to the structure of the world as God created it is beneficial and good. This is not to say that those who live virtuous lives will never suffer (part of the message of the book of Job), but that justice, mercy, honesty, faithfulness, peacefulness, and the like recreate themselves and improve the quality of a person's life and the life of a community. Virtue is not a method of earning favor with God, but of living according to what he has revealed to be profitable. The Proverbs are full of maxims expressing the social-science wisdom of the ancient Near East. An example of a proverb that teaches about living according to the virtue of justice is as follows: "Bread gained by deceit is sweet to a man, but afterward his mouth will be full of gravel (Proverbs 20:17)." The concept of virtues applies to non-Christians (Aristotelian virtue ethics) as well as to Christians. Non-Christians may have a different idea of the greatest good but can be helped to foster these virtues in their own lives, because a virtuous life and virtuous behaviors are rewarding, a movement toward one's teleological vision.
The ultimate cause of pathology is sin. That is not to say that God punishes people by giving them a mental illness, but no one can deny (for example) that a sexual abuse survivor suffers from the wrongdoing of someone else. By acknowledging sin we remove guilt for the victim (not suffering from her own maladaptive cognitions) and we acknowledge that a definite breech in relationship has occurred which can only be remedied by the power of forgiveness. Whether sin is the direct cause of a mental condition (PTSD from witnessing a violent act) or a distal cause (as all physical illness is caused distally by the fall) the root of all suffering is sin. Because humanity exists in relationship to a loving God whom reveals Himself and desires relationship with his creation, it follows that individual happiness is not the greatest good in life. Rather, cultivation of virtue (or character) often requires people to deny themselves what they think best or even what they feel to be right and true. Proverbs 20:5 says: "The purpose in a man's heart is like deep water, but a man of understanding will draw it out." The surface intent of an action may seem honorable and even virtuous, but the underlying motivation may be self-focused, even in altruism. Again, this is not to say that people should continuously navel-gaze about their deeper motives for seemingly kind behavior, but that critical self-awareness is as justified as scientific rigor. Additionally, not all bad feelings are in truth bad. Guilt is a natural reaction to doing something that is unjust, untruthfut and so on. Guilt, like physical pain tells us that something is wrong. Someone who is numb to all guilt and other emotional indicators is in as much danger of being truly hurt as one who is numb to all physical pain. Excessive guilt and inappropriate guilt are certainly problems, which can be the result of brain chemistry, disturbed relationships, or spiritual distress. Rather than happiness, scripture points us to contentment as a goal (1 Timothy 6:6), not self-fulfillment, but the gratification of living in relationship and accepting the difficulties that our given to us for our growth (1 Corinthians 10:13).
How do people change?
Therapy is dangerous when it helps people to change their negative feelings to more positive feelings without dealing with problematic attitudes, behaviors and character. Symptom reduction for its own sake is worthless. The state of "Feeling good" has never been thought of as an end in itself until recently and for good reason. Feeling good without doing good and striving toward your tel os is worthless.
Paul exhorts the Church at Rome in the 12th chapter of Romans to "rejoice with those who rejoice" and "weep with those who weep." This is Paul's understanding of love and empathy, which are necessary conditions for Christian community in which growth is possible. Scripture speaks of helping people by exhorting them, encouraging them, and disciplining them. Within a loving relationship (one characterized by self giving) a kind rebuke (closest to confrontation in the language of psychology) will lead to change. "A rebuke goes deeper into a man of understanding than a hundred blows into a fool" Proverbs 17:10. Encouragement is another of the tools of change that are prescribed by the scriptures. Encouragement is not built on vague hopefulness or unrealistic optimism, but on trust in the promises made by God and belief that He keeps His promises, known in scriptural language as hope (1 Thessalonians 5:14f). People change because God is gracious and helps them to change, not without human effort. Those who think that they will be able to please God by their own efforts at self-improvement however are mistaken (Ephesians 2:8-9). All real change is wrought by God, not only in believers only but in everyone, because God "sends rain on the just and on the unjust" (Matthew 5:45). Virtues are beneficial to an individual whether Christian or non-Christian, because they are reflections of the character of the God who created the world. Why does counseling work for non-believers? The science of psychology teaches us how we can help people to change their own behavior and learn new ways of thinking and behaving, but caution should be used lest people injure themselves by seeking relief from suffering without recognition and attention to the causes of that pain.
Parameters: Areas of special attention
Suffering
Suffering is not to be avoided at all costs, or despised, or 'fixed', but to be learned from and appreciated for it's growth potential and for it's origin in the wisdom of God. Paul says" rejoice in suffering for suffering produces endurance..." This is the theology of the cross; that suffering was necessary to heal (Isaiah 53:5) and that we share in the suffering of Christ as he shared in our guilt (Mark 8:34). We are refined by suffering (Zechariah 13:9) as gold is by fire, made pure and valuable. Indeed one of the great virtues of Christianity is that of patience, the ability to wait on the promises of God and endure with joy that which is our lot. This is not fatalism, for the Christian has hope in the sustaining power of God.
Work
Freud thought mental health was to be able to love and to work. Christians believe that mental health flows from love and work. There is a special emphasis in Christian theology on the idea of calling (vocare -> vocation). During the Medieval period, the Church taught that sacred occupations were pleasing to God while secular vocations were not. Martin Luther confronted this abuse in the sixteenth century by emphasizing the idea of vocation for each person, which extended beyond occupation
to one's calling in the family and community. He taught that all work is pleasing to
God (Ecclesiastes 9:10) insofar as one is honest, just and fair. The Puritans taught that work was an expression of the talents that God had given to each person and were thus concerned to find what those skills and knowledge were (Exodus 35:31). Puritans were willing to look into the individual in order to advise the correct course of action. They believed that the will of God was not obtained by some oracle or direct revelation, but through observation of the propensities and skills that God had given the person and
by consultation with those who knew that person the best (often parents). Work, done mindfully" as to the Lord" (Ephesians 6:7) was thought to be physically, spiritually and even psychologically healthy (see Richard Baxter's treatise on the Cure of Melancholy and Overmuch Sorrow.) Physical work is not a mean to or an adjunct of a well-lived life, but an essential ingredient and an act of gratitude to God for the abilities He has given.
Community
Another essential element that is fundamental to understanding the Christian mindset is the idea of the corporate nature of the Church. The Church is a body (corpus) with individual members, which cannot function on their own (1 Corinthians 12:14-20). Mutual love, support, encouragement, and forgiveness help the body to grow. Paul in Galatians 6:2 says that Christians ought to "bear one another's burdens, and so fulfill the law of Christ." Life cannot be successfully lived in solitude. It is the actual care given by the members of the Church that heals, not simply the feeling of affiliation to a group. One who wishes to counsel within the Church or with her members must be open to the differences, doctrinal, practical and political that are inherent in the Church. Additionally, support of the clergy is a unique opportunity within the Church, as burnout is common among ministers who carry the burdens of their congregations and frequently have little in the way of peer support themselves (Doohan, 1982).
Forgiveness and Reconciliation
Forgiveness is the conscious letting go of any claim against another person for something that they did to you. Forgiveness is not forgetting that a wrong happened or inviting another to occur, but a release of judgment against a person. Neither is forgiveness is forbearance, the ignoring of small slights to maintain a relationship. Forgiveness occurs only after a wrong is perceived as such and hard feelings are former against an offender. When these conditions are met, forgiveness must occur for peace within a relationship. This renewal and revitalization of a formerly damaged relationship is called reconciliation in theological terms. Scripture teaches that because God forgives our sins through Jesus, we ought also to forgive each other and be reconciled to them (Matthew 5:24, Luke 17:3-4, Colossians 3:13). In our paradigm of relationship, there is nothing more interpersonally important than forgiveness, because forgiveness heals damaged relationships. Within the field of counseling psychology, important work is currently being done on forgiveness by researchers such as Everett Worthington and Michael McCullough.
Specific Techniques
Christian therapists have borrowed from all major schools of psychotherapy and some have even espoused augmented purist positions such as Christian Cognitive Behavioral therapy (Hawkins, Tan & Turk, 1999). I believe consistency from assumptive-world through technique to be essential. The assumptive world of those who commonly use the technique need not be the same as mine however. For instance, I may use behavioral techniques to modify the contingencies experienced by a person trying to change a behavior without believing that humans are nothing more than stimulus-response creatures. Like Existential therapy, Christian therapy tends to operate on the level of assumptive-world, but there are certain" techniques" that are unique to Christian therapy, namely the spiritual disciplines. According to Eck (2002), "Spiritual disciplines and practices have been utilized over the centuries as means to help people of faith reorder their lives." One of the most fundamental of these is prayer (1 Thessalonians 5:17), which includes individual and corporate expressions of thanks to God and requests of God as well as meditation and "listening" to God. Additionally, God has given "visible words" known as sacraments to his Church for her benefit. Participation in these sacraments with a community of believers is important to vita faith that avoids the polar errors of magical thinking (that the sacrament in itself is a magical tool) and mystical Gnosticism (that only the spiritual is good and that phys1 existence is to be denied). People often use psychotherapy as a secular form of confession, to share troubles with someone else that will not judge, but will offer ho Christian confession is a practice whereby a person acknowledges errors and receive the assurance of God's forgiveness (1 John 1:9). Additionally, fasting, solitude, rest, silence, worship, hospitality and intercession are just some of the Christian discipline that Eck (2002) reviewed as possible therapeutic techniques. Not all of these are possible within the therapeutic relationship alone, they require the Church for full expression.
At one level of analysis, change, both inside and outside of counseling, is the result of the power of God's common grace. At another level, we can study the mechanisms which behavior change is brought about (though we should not confuse changes in behavior with changes of heart). Counseling research needs to continue to look at change is facilitated both within and outside of the counseling relationship. The following are some of the areas identified by Prochaska and Norcross (2003) that are areas of change along with scriptural precedence for their use.
Corrective Emotional Experiencing - While emotional experiences are to be tested against the light of scripture, feelings of joy, peace, confidence and the like are fro God. Negative feelings, such as guilt and anxiety are to be respected as indicative of a problem.
Modeling and Stimulus control - Modeling is a principle that is recognized in scripture (2 Peter 3:17). Additionally, Paul tells the Church at Philippi to think of things that are true, honorable, just, pure, lovely, commendable excellent and praiseworthy; possibly indicating his recognition of the effect of thoughts and various stimuli on behavior (Philippians 4:8).
Presenting Problem
Teresa is presenting to therapy for depression and bouts of angry acting out. Teresa's distress is the result of unjust treatment by members of her family and other significant people in her life, disrupted relationships and her own choices. Teresa lacks community in which to find support and she is not experiencing joy from her work, possibly because she is not well suited for that occupation or has lost a sense of meaning from work.
Historical Factors related to underlying problem
Teresa's family treated her unjustly by depriving her of relationship with her parents. Her absent father and emotionally unstable mother were not available for Teresa to connect with and grow under. Her parents did not seem to be sensitive to the personality of their daughter when they required her to take a care-giving role in the family without adequate adult support. Teresa operated as a caregiver, not with joy, but to gain scant reward from her mother. She was not nurtured to gain meaning from her work, family or faith. Additionally, inequitable treatment by Teresa's mother toward her nieces and nephews caused a breech in her relationship with Teresa. Additionally, Teresa's relationships with other family members has suffered from an unwillingness to address the hurt that they caused by blaming the death of Teresa's mother on her. Teresa is responsible for her part in interpersonal strife, particularly her "raging" against her partner. Rather than simply ignore these incidents, seeking forgiveness and reconciliation to whatever degree possible would be a benefit to Teresa's life.
Current Factors related to underlying problem
Teresa's life is currently stagnant, with no friends, hobbies or leisure activities to give purpose to her life. She is not in communion with her God, nor is she engaged in her Church. Teresa is experiencing a deep depression with thoughts of worthlessness and suicidal ideation. This is a time of great suffering for Teresa which may push her back into community and faith and eventually help her to grow as a person.
Desired outcomes for change
First, Teresa needs to become aware that the physical, social and psychological all work together. She needs to work toward taking care of herself by becoming part of a community and by caring for herself physically through exercise and diet. Additionally, if therapy is successful, Teresa will recognize the interpersonal transgressions committed against her and begin to more toward forgiveness for them rather than stagnating in bitterness and anger. Further, Teresa will own up to the wrongs she has done to others and actively seek to recover those relationships. Teresa has an opportunity to grow from this experience and she can find meaning (spiritually and socially) from her suffering and can work to help those who suffer in like ways (perhaps among other nurses who struggle with guilt feelings.) Finally, through counseling, Teresa will be able to find a vocational role, in her occupation and in the community life that is meaningful and growth promoting.
Strategies & Techniques
Initially, Teresa must be informed of the nature of my theoretical orientation be willing to work with a counselor who identifies as Christian. If Teresa does decide to enter therapy, she in no way relinquishes her right to her own beliefs and has no duty to adopt mine. Teresa would be screened for the possibility that psychopharmacotherapy might benefit her as she is currently having suicidal thoughts and she has a family history that includes self-injurious behavior. Teresa and I will begin to build a relationship of trust and care from which to build our work. We will explore her relationship with her family, her Church and her God. If Teresa is not at first willing explore her faith, we will revisit his issue later when we talk together of meaning in life. We will investigate her social support and think of ways to build new outside relationships of mutual concern and respect. We will think of ways that Teresa can grow, things that she would like to work on in her life that would be beneficial to others and rightly a source of pride for her. We will begin to work on realizing that others have harmed her and that she has every right to be angry, but that to repair the bro relationship, she must actively engage the problem and work toward forgiving the offender. Teresa will not be pressured to forgive anyone for any offense that she de not decide is appropriate, but she would be encouraged to think of interpersonal injustices as real transgressions rather than dismiss them or interpret them as expressions of her own worthlessness. She would be listened to, supported and encouraged during the time that she is climbing out of her depression and challenge, (exhorted) when she began to move more quickly. Behavioral techniques might be appropriate to change Teresa's conditioned reaction to the deaths of her clients.
Criticisms:
Your use of the masculine pronoun for God throughout betrays your religion's patriarchic structure and sexism.
I have used the masculine pronoun for God throughout because God chose to revea himself as Father in the scriptures. God however is fully" other" and gendered pronouns are not ideal when speaking about God. There are passages in which GOI conceptualized in feminine (to ancient Hebraic peoples) terms. Galatians 3:28 provide the Church with God's norm of equality among people: "There is neither Jew nor Greek, there is neither slave nor free, there is neither male nor female, for you are al one in Christ Jesus." Indeed, while the sexes may at times be seen to have different roles, the essential worth of both sexes is emphasized in both the Old and New testaments.
A theoretical treatment of Teresa's bisexuality is conspicuously absent from your theoretical structure. Your homophobia is obvious and you are treading into unethical territory if you refuse to treat someone of a same-sex orientation.
Historic Christian thought and Biblical interpretation have agreed that all sexual behavior outside of the bonds of marriage is displeasing to God. Whether the Bible draws out homosexual behavior as in some way different than other forms of sexual impurity is hotly debated (see essays by Hays and Johnson in Murphy, Kallenberg & Nation, 1997). Gay, Lesbian and Bisexual relationships may well be proven to be biologically influenced, normal variations of sexual behavior. The message of the Christ has always been one of forgiveness and reconciliation to all people and Gay, Lesbian and Bisexually identified people are to be treated with compassion and understanding like all others. Without getting into a full exegetical and hermeneutical study of the "homosexual" passages in the Bible and the ordination and meaning of marriage, I have chosen to pass over this part of Teresa's life, focusing instead on her experiences of other's wrongdoings.
Isn't this rather escapist, particularly saying that God is responsible for human change?
The charge of escapism is well taken. Christian truths have had to be guarded against error for millennia. The truth of God's providence has led some to think of God as a vending machine, in whom you deposit prayer and from whom you receive "blessings." The doctrine of God's power (omniscience) is a guiding framework that leads one to thankfulness for His mercies and patience in hard times, but does not negate hard work by individuals and community (Philippians 2:12-13). Additionally, in those times that God chooses not to heal (2 Corinthians 12:7) trust in God is not undermined. The Pop Christian emphasis on "let go and let God" may well be mistaken, but the charge of charge of escapism is not warranted for orthodox belief in the omniscience of God.
Isn't this taking common ritual to an extreme, this sort of magical thinking could very seriously injure some people, especially those who are dependent or whose psychoses hinge around spiritual themes.
It would seem that ritual is a source of healing and change, and that this is an elaborate theoretical (theological) underpinning for ritual, particularly those that are situated within an organized religious framework. God made humanity to order their lives around ritual and routine. Simply because ritual on its own (without God as the object) is effective in bringing relief to some problems does not make it logically necessary that Christian ritual is only another of the same and not spiritually beneficial. God made prayer for people, not to give Him a method to know our wishes, but so that we would have the opportunity to express our needs and thanks to Him, but this does not preclude people from praying to other objects.
Your lip service to the ideal of" science" is admirable, but you do not address those points at which psychology and theology have diverged. What say ye?
I have yet to see a list of scientific facts that are contrary to scripture. It is important to note that psychology has almost no proven "laws." Theoretical formulations are constantly in the process of revision. Theology too is to be approached with humility, for the whole of the God's mysteries are not accessible or revealed (Isaiah 55:8-9). I am a proponent of solid, thoughtful research to investigate how people think, act, relate and thrive in the world.
So, you can only work with Christians and specifically those Christians who believe as you do, isn't this rather limiting and intolerant of others religions?
Christianity is a broadly diverse set of religious denominations that share some feature in common but have wild differences in other areas. Christian counseling should not 1: practiced in exclusion of the Church community or separate from the support of clergy (pastors, ministers and priests). Christian counseling respects the theological and practical differences of the client while maintaining adherence to one's own understanding of God. Christian counseling probably works best when an individual': pastor and congregation are also available for support. The Christian religion is necessarily exclusivist in that we believe that Jesus is the only way to God. Respect for the belief systems and mode of thinking of individuals with different heritages is not only possible but proper. Therapy will likely work best when the therapist and client' E worldviews are in essential agreement (Prochaska & Norcross, 2003), but productive work with members of other faith communities is possible.
What is your multicultural stance, certainly the history of Christianity has been all about changing people's customs into Christian ones that reflect European values.
Abominations have been committed in the name of Christianity as they have in the name of many other religions. The New Testament records the broadening of the faith community from exclusively Jewish to inclusive of all other ethnic groups (Acts 11). Justice requires that all people are to be valued equally, whatever their race, origin, ethnicity, sexual orientation or creed. Tolerance does not require silence and acceptance of all practices as equally valid however. From a theological perspective, every person is of inestimable value and therefore is worthy to be though better than one's self (Philippians 2:3). It is important to study and understand multiple perspectives and to be sensitive to possible misunderstanding and difference of perspective. Additionally, the modern American way of life is certainly not an ideal which should be imposed upon others.
So you will just shame people into trying harder to fix themselves. This can hardly be called therapy and may indeed be both harmful and unethical.
In the book of Job, Job's three friends counsel him after he has lost his health, family, and all that he owned to natural disasters and enemies. Their tactic is to point out that Job must have done something wrong that he was being punished for and should therefore repent. Job (16:2) calls these friends "miserable comforters" ("worthless counselors" in the New Living Translation). His wife has another tactic, she tells him to, "curse GOD and die" (Job 2:9). The danger of the system outlined above is that too quickly it would degenerate into blaming and faultfinding without focus on the suffering person who has come in for help. Understanding humanity's fallen condition does not necessitate judgmental attitude. Judgment is the Lord's; we are to bear one another's burdens (Galatians 6:2) and share in their joys and suffering (Romans 12:15). This is the calling to all believers. The Christian therapist is to apply the findings of science within this framework.
References
Benner, D. G. & Hill, P. C (Eds.) (1999). Baker encyclopedia of psychology and counseling(2nd ed.). Grand Rapids, MI; Baker Books.
Doohan, H. (1982). Burnout: A critical issue for the 1980s. Journal of Religion and 1-:21, 352-328.
Dueck, A. (2002). Babet Esperanto, shibboleths, and Pentecost: Can we talk? Jour Psychology and Christianity, 21, 72-80.
Eck, B. E. (1996). Integrating the integrators: An organizing framework for a multifaceted process of integration. Journal of Psychology and Christianity, 1. 115.
Eck, B. E. (2002). An exploration of the therapeutic use of spiritual disciplines in clinical practice. Journal of Psychology & Christianity, 21, 266-280.
Ganz, R. (1993). Psychobabble: The failure of modern psychology and the Biblical alternative. Wheaton, IL.: Crossway.
Hawkins, R. S., Tan, S. Y., & Turk, A. A. (1999). Secular versus Christian inpatien cognitive-behavioral therapy programs: Impact of depression and spiritua being. Journal of Psychology & Theology, 27,309-318.
Holy Bible (English Standard Version). (2001). Wheaton IL: Crossway Bibles.
Hunt, D. (1986). Beyond seduction: A return to Biblical Christianity. Eugene, OR: Harvest House.
Kotva, J. L Jr. (1996). The Christian case for virtue ethics. Washington D.C: Georgetown University Press.
McCullough, M. E., Pargament, K. I., & Thoresen C E. (eds.) (2000). Forgiveness: J practice and research. New York: Guilford.
Milne, Bruce (1982). Know the truth: A handbook of Christian belief Downers Grove, Inter Varsity.
Murphy, N., Kallenberg, B.L & Nation, M. T. (Eds.) (1997) Virtues & practice in tht Christian tradition: Christian ethics after MacIntyre. Harrisburg, P A.: Trinity International.
Prochaska, J. 0., & Norcorss, J. C. (2003). Systems of psychotherapy: A transtheoretical approach (5th ed.). Pacific Grove, CA: Brooks/Cole.
Vitz, P.C. (1994). Psychology as religion: The cult of self-worship. Second edition. Grand apids, MI; Eerdmans Publishing Company.