What Christian Counselors Want Every Christian to Know

1. What Christian Counselors Want Every Christian to Know Jennifer Konzen, PsyD, LMFT, CST, CCDC

2. Classes • 02/24 – Psychology and Christianity: The Historical Battleground and a Disciples Faithful Approach • 03/17 – Understanding Mental Health Throughout the Lifespan: Definitions, Diagnoses, and Neurological Concerns • 03/24 – Treatment for Individuals, Couples, and Families: Anxiety, Depression, and Suicidality • 03/31 – Special Challenges: Sexuality and Drugs • 04/07 – What Every Christian Should Know: Modes of Therapy; Choosing a Therapist; Goals and Process; Maintaining Change; Ethics and Laws of Mental Health

3. Christianity and Psychology The Historical Battleground and a Disciples Faithful Approach

7. Objections to Psychology: Mine • I DON’T BELIEVE IN PSYCHOLOGY • Freud and Jung • Disregard for the spiritual in psychology • Collectivistic vs. Individualistic • Authority • Loyalty to physical and spiritual family • Disparaging, polarizing language

8. Christian’s Objections to Psychology Psychology has its roots in ancient philosophers like Socrates, Aristotle, and Plato. None were worshipers of the true and living God. Freud: He certainly wasn’t a godly man. He was obsessed with sex and linked every problem to the sexual drive. This man had serious problems; even his most devoted followers admitted that. If the root is bad, then the tree has to be bad (John 7:17-18) Jesus met all the needs of the people through the power of the Holy Spirit, and His church should do the same. They don’t have to go to the world to get their needs met but should bring them to Jesus.

9. Objections, cont. • If people will receive the truths of God’s Word, they don’t need any other help. • The sinful nature is not removed by liking yourself, but by starting to live in Christ. • Many Christians leaders have opened the doors to psychology in order to make their faiths more relevant to contemporary culture to the detriment of holding to biblical truths

10. Incompatible Major tenants of psychology that some believe are incompatible with biblical Christianity: 1) We are products of our environment 2) Therefore, we are not responsible or accountable for our actions 3) This leads to placing blame for our actions on anything else but on us, making us victims

11. Psychology’s Objections to Christianity • Organized or fundamental religious practices are often more about rules, obeying, and secrecy than genuine connection with the spiritual (Satir) • Distorted use of Christianity, where Christ and Christian beliefs are often not at all the same • Many claim Christianity but do not use genuine communication styles • Neurotic use of religion: when someone spouts religion and does not live in a right attitude toward humanity or is even harmful toward others • Religious authorities have used their positions of power to oppress others who are not perceived as having the same level of privileged relationship with God

12. Psychology without Spirituality The science of psychotherapy often disregards the importance of the soul which is like someone trying to toast bread in a toaster without plugging it in to the electric outlet Virginia Satir

13. Attempts to Reintegrate • Therapists can help people realize how they may have forgotten about the spiritual dimension and may then have lost their connection to God • Research results show an increase in well being when spirituality is integrated into therapy which shows a clear need for religiously oriented psychotherapy • In the 21st century, there is an atmosphere conducive to integrating the psychological, the scientific, and the religious

14. But Should We: Dilemmas in Integrating Christianity and Psychology • Is Psychology in Opposition to the Teachings of the Bible? • This is an IMPORTANT question • My process in becoming a therapist and sex therapist • During times of distress, it may be difficult for individuals to separate the symptoms of depression and anxiety from spiritual conflicts (or the impact of depression/anxiety on living the life of a disciple) • Psychotherapy might interpret emotional disturbances as pathological rather than valid disturbances due to issues of incongruence between values and lifestyle

15. Dilemmas, cont. • Someone recently recovered from psychosis, whose mental strength is tenuous, or for those whose wounds from a religious system are too raw • Ethical issues of Confidentiality • An exploration of fundamental conservative beliefs might create a serious disturbance in someone’s equilibrium

16. Are there examples of mental illness in the scriptures? • Saul - 1 Sam 16 • “The Lord’s Spirit had left Saul, and an evil spirit from the Lord tormented him. 15 Saul’s officials told him, “An evil spirit from God is tormenting you. 16 Your Majesty, why don’t you command us to look for a man who can play the lyre well? When the evil spirit from God comes to you, he’ll strum a tune, and you’ll feel better.” • “Whenever God’s spirit came to Saul, David took the lyre and strummed a tune. Saul got relief from his terrorand felt better, and the evil spirit left him.” • David – 1 Sam 21:13 • “So he pretended to be insane in their presence; and while he was in their hands he acted like a madman, making marks on the doors of the gate and letting saliva run down his beard.” • “My heart is struck down like grass and has withered;I forget to eat my bread.” (Ps 102:4)

17. Examples, cont. • Nebuchadnezzar – Daniel 4 • “He (Nebuchanezzar) was driven away from people and ate grass like the ox. His body was drenched with the dew of heaven until his hair grew like the feathers of an eagle and his nails like the claws of a bird…. ‘I, Nebuchadnezzar, raised my eyes toward heaven, and my sanity was restored.’ ” • Jeremiah - Jeremiah 20:14,18 • “Cursed be the day I was born… Why did I ever come out of the womb to see trouble and sorrow and to end my days in shame?” • Demon possessed man – Luke 8 • “For a long time this man had not worn clothes or lived in a house, but had lived in the tombs.” • “Though he was chained hand and foot and kept under guard, he had broken his chains and had been driven by the demon into solitary places.”

18. Jesus “When his family heard about this, they went to take charge of him, for they said, ‘He is out of his mind.’” (Mark 3:21)

19. How do the scriptures mention mental health? • Deut 28:28 - The LORD will afflict you with madness, blindness, and mental confusion… The sights you see will drive you mad… the LORD will give you an anxious mind, eyes weary with longing, and a despairing heart… You will live in constant suspense, filled with dread both night and day, never sure of your life. • Is 53:4 - Surely he has borne our grief • Jonah 2:5-7 - "I sank beneath the waves, and the waters closed over me. Seaweed wrapped itself around my head… my life was slipping away.” • 1 Peter 5:7 – cast all your anxiety in him • 2 Cor 10:5 – taking every thought captive

20. Historical Aspects of Psychology • Definition of the Greek word Psychology = the study of the soul • Psychopathology = the suffering of the soul

21. Jesus “My soul is overwhelmed with sorrow to the point of death” (Matthew 26:38)

22. Defining Psychopathology • Ancient cultures: All illness attributed to Gods, elements, nature • Medieval period: Mental illness = demons, magic, witchcraft, the devil; superstitious and or religious (spiritual forces causing mental problems) • Mechanization (1300’s – 1700’s) – brain and body (nerves, muscles, conduction), phrenology (“you ought to have your head examined”) • Quantification (19th century) –research, counting, measuring, experimental, statistics

23. Psychopathology, cont. • Naturalism (Renaissance to early Modern) – evolution,comparison between animals and humans, inherited characteristics, child development • Asylums • Humanitarian Reform (early 1900’s on) – social agitation, education, attention to environment and lifestyle, humane care • Current: scientific study of mental disorders; psychiatric deviation from normative behavior; neurology/the brain • Who defines norms? • When does deviation become pathology?

24. Modern Psychology • Freud and Psychoanalysis • Behaviorism • Humanism • Cognitive Behaviorism • Family Systems • Integrative Psychology: Biopsychosocial

25. Defining Diagnosis • Diagnosis: A. the process of determining by examination the nature and circumstances of a diseased/disordered/dysfunctional condition B. the decision reached from such an examination • How do we diagnose? • Medical model: tests, exams, screenings • Signs and Symptoms • DSM: Diagnostic and Statistical Manual of Mental Disorders • List of “syndromes” (characteristic pattern of symptoms)

26. The Diagnostic Manual • The DSM: Diagnostic and Statistical Manual of Mental Disorders • What is the DSM? • APA • Purpose and Use • According to DSM-5, “The diagnostic criteria identify symptoms, behaviors, cognitive functions, personality traits, physical signs, syndrome combinations, and durations that require clinical expertise to differentiate from normal life variation and transient responses to stress.” (APA, 2013, p. 5).

27. Precursors of the DSM • 1840 census • Two categories: idiocy and insanity • 1880 census • 7 categories of insanity established: mania, melancholia, monomania, paresis, dementia, dipsomania, and epilepsy (Halter et al., 2013) • 1918 manual • American-Medico-Psychological Association (known now as the American Psychiatric Association) and the National Commission on Mental Hygiene • Statistical Manual for the Use of Institutions for the Insane – 22 categories • Kraeplin’s theories – German psychiatrist • 1949 ICD • The World Health Organization (WHO) published the sixth edition of the International Classification of Diseases (ICD) • First time to include psychiatric disorders • Disorders of character, behavior, and intelligence

28. History of DSM • DSM I (1952) • Principally theoretical • Not well received in medical community • Influenced by the maladjustment model and Sigmund Freud • Two main categories: Organic brain dysfunction and socio-environmental stressors • Socio-environmental stressors effect on individuals' biological constitution and patients’ inability to adapt to such pressures • DSM II (1968) • 182 categories • Term “neurosis” (from Freudian thinking) • Additional diagnostic categories • Individuals psychiatrically normal but need an examination by a psychiatrist • Transient Situational Disturbances: disturbances of psychotic proportion where clearly transient reactions are due to overwhelming environmental stress

29. History of DSM • DSM III (1980) • Move away from Freudian approaches • 265 Categories • Added PTSD, ADD • Removed homosexuality and added ego-dystonic homosexuality • Increased pharmacological agents • Concern with a re-medicalization of psychiatry: adopted by insurance providers for reimbursement • Best seller; Anyone can diagnose!

30. History of DSM • DSM IV (1994) • More diagnoses - 297 • More research: Literature reviews; empirical basis for disorders; field trials • Homosexuality removed entirely • Inclusion of distress, impairment and functioning • Personality disorders changed

31. Current DSM • DSM-5 (2013) • Lifespan or developmental perspective • To help with clinical assessment and treatment • New classifications and some renaming: dysthymia is now persistent depressive disorder • Dimensional: mild, moderate, severe; rating scales • Include more on genetics, neuroscience • Goal to include more worldwide representation and less pharmaceutical influence • Psychopathology on continuum with normality • Danger of over-diagnosis

33. A Disciples Faithful Approach to Mental Health

34. God’s response to Our Challenges • God grieves when we grieve • “In all their affliction He was afflicted” (Is 63:9) • “Surely He has borne our grief…” (Isaiah 53:4) • “His soul was grieved for the misery of Israel” (Judges 10:16)

35. Scriptures that Guide My Work • Prov 20:5 – purposes of a man’s heart are deep waters, a man of understanding draws them out • Rom 14:5 – Each one must be convinced in his own mind • Mark 7 and 8 – Jesus healing the deaf and the blind • Prov 4:7 – though it cost all you have, get understanding • Is 58 – well watered garden • Luke 7:13 – His heart went out to her (moved in his gut)

36. The Balance • “I have become all things to all men so that by all possible means I might save some.” (1 Cor 9:22) • “Every good and perfect gift comes from above, coming down from the Father of the heavenly lights.” (James 1:17) • “Be careful that no takes you captive through philosophy and empty deceit based on human tradition, based on the elemental forces of the world, and not based on Christ.” (Col 2:8) • “If any of you lacks wisdom, he should ask God.” (James 1:5) • “Turn your ear to wisdom, and apply your heart to understanding.” (Prov 2:2)

37. Mistakes Christians Make • Practicing outside your scope of competence : ) • All you need is the bible (dichotomous view) • If you are strong spiritually, you should not need… • Discipling is always enough • Swinging pendulum – medication is always O.K., therapy is always needed

38. Judgment: What people say • Judgment about Depression: • You’re just making excuses • You are such a party pooper • Judgment about Anxiety • You just need to calm down • You just need to chill • It’s not that big a deal • Judgment about Suicidal Ideation/Attempts • You’re just looking for attention • You’re being manipulative • You have a history of this

39. Take the Quiz

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44. After Baptism: Now What • Distrust, guilt, anger, hurt, low self-esteem: • all magically disappear • You need to repent • Get over it and Move on • Forgive • Pat answers, cliches, trite explanations, clueless challenges

45. Rejoice Always • We sometimes think that “becoming a disciple is… a vaccination against disorders of mental health.” • Beware the thinking “if I were a better disciple” “if I prayed harder” “If I had better quite times” • Biologically based mental health disorders • John 9:3, 2 Cor 12:7-10 – “disease occurred independent of sin for the sole purpose of glorifying God and testifying to his power.” (Shapiro & Shapiro, p. 16) • Beware relying on medicine/doctors too much • Asa: “Though his disease was severe, even in his illness, he did not seek help from the Lord, but only from the physicians.” (2Chr 16:12

46. Rejoice Always “Even the disciple who suffers from one of these biologically based psychiatric disorders is not absolved from the responsibility of putting his or her challenge into spiritual context and learning to stay faithful to God.” Mike and Mary Shapiro

47. Why seek Therapy? • Safe – Confidentiality laws, ethics, HIPPA compliance • Objective – well sort of • Qualified – hopefully • Experienced • Not reactive – well sort of • Receive a diagnosis – hmmm • Support • Treatment Plan • #1 Reason – they only focus on you for that full hour (my paid friend)

48. Support you can provide • Offer support and referrals: Set up a support network; get them involved with a small group; refer to professionals; attend sessions with them • Affirm and support their need for help • Refer family members to support • i.e. Helping a spouse of a disciple dealing with depression, helping family members who have lost someone to suicide

49. Your Job • Spiritual walk • Fellowship • Discipleship • Psychotherapy and/or Medication • Collaboration with therapists • Prevention (exercise, hobbies, nutrition, open discipling relationships)

50. Deeper Understanding of God Who is He How does He Feel How does He See You