Wednesday, April 24, 2013

The Skilled Helper

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In Gerad Eagan’s seminal work The Skilled Helper, he outlines three stages of skilled helping in the counseling profession. The three stages are; The Current Picture, The Preferred Picture, and The Way Forward. In the current picture, the helper seizes the opportunity to show the client their current circumstance. Many times, a client feels overwhelmed and just having someone walk them through their current crisis can have not only a calming effect, but also enlighten them and sometimes even allow them to devise a solution for themselves. This current picture is a general “snap shot” with “neither too much or too little information.(72) Stage two is the preferred picture. In the stage two the client is shown the skills necessary to create a preferred future. This could be classified as the problem management stage of helping. Stage two then focuses on the payoff for the work and the result of the sessions. In stage three, the helper zeros in on the way forward. Stage three discussions are the strategy sessions that enable the client to create and ultimately execute a change agenda.  The way forward, then, is the apparatus for planning and implementation stage.

Each stage has a set of three tasks that are involved in creating positive change of the client. In stage one, the tasks are helping the clients tell their story, and then helping them clarify a new perspective that will enable them to be more constructive, and finally to help the client focus in on which area will create the most return on their investment of time. Task one really centers on allowing the client to talk through their problem as they see and define it. The skilled helper will listen and nudge accordingly, but not interfere with the story as it takes shape. As Egan puts it, the client is in the driver’s seat of the story’s makeup. (73) Another important aspect of stage one is trust. The relationship hinges on how stage one proceeds.
In task two, the object is to help clients fill in the meaningful and missing details, so that they can be shown a more constructive view f their dilemma. Helpers should be cautious to not direct clients toward conclusions, but instead direct the client to new self discoveries about their own personal journey. Allowing the client to discover for him or herself new perspectives, see blind spots in their own lives, and make connections that may be missing is a main part of task two sessions. (230-231)
In task three, the skilled helper narrows down the issues that are plaguing the client to actionable points that can be dealt with. Attempting to fix too much too soon is a sure fired recipe for disaster and failure. Counselors can help their client to define the most problematic issues, prioritize the strategy for fixing those problems, and, when necessary, to break down larger problems into manageable (bite sized) projects that are a sub-set of the larger problem.  Confrontation and immediacy are major portions of the skilled helper’s job in task three.

Stage two focuses on the future. Task one here challenges the client to visualize a better life. What would a life missing the problem at hand look like? Visualizing the preferred future can open up the client to possibilities they may have otherwise not envisioned. Task two puts the impetus on goal setting. Now that we know the problem and have it defined, and have begun to look and imagine a better situation, what realistic goals can be set to challenge ourselves to reach that future? Likewise, task three deals with motivation. Keeping the client motivated to reach the goals that have been set up. Creating a desire in the client and them asking them to contemplate what they are willing to sacrifice for the preferred future is a core component of stage three. By seeing the sacrifices ahead of time, the client is less likely to see those same sacrifices as insurmountable later.

Stage three focuses on the path. The client should be asking him or herself, “What pathway, what game plan, what approach best allows me to accomplish my goals?” Nevertheless, Egan cautions the helper that, “action—though essential—is valuable only to the degree that it leads to problem-managing and opportunity developing outcomes.” (355) In other words, action for action sake helps no one. It must have a controlled accomplishment scenario to be effect.
In task one; we see that goal setting is now turned into a strategy session, making a battle plan for achieving the goals. Clients can brainstorm the issue taking advantage of the helper’s presence and counsel. As Solomon wrote, “plans fail for lack of counsel, but with many advisers they succeed.” Proverbs 15:22 (NIV)
In task two the objective is an actionable plan. Taking the brainstorming points and boiling them down to an actual task that can be, with deference to the client’s personality DNA, be accomplished. Here a pro/con list can be established to see how the client’s value system best matches strategies proposed.
Lastly, task three takes the strategies and plan and executes them in a clearly defines step-by-step procedure. The procedure will hopefully keep the client from becoming overwhelmed and rushing into stages and problem resolutions that have yet to be addressed.

The last item is the action arrow, which simply put is actually executing the plan. Once accomplished, the process of stage three can be repeated for the next problem on the chain.

The Three Domains Of Integrationist Psychology



The three domains of integrationist psychology are “Symptom-focused,”  “Schema-focused,” and “Relationship-focused” areas. These are also classified as functional, structural, and relational domains. McMinn and Campbell identify these three domains as an incorporation of the Imago Dei in counseling, and I agree—especially in view of my Trinitarian understanding of the Imago Dei and the nature of man as a Tripartite creature. The domains fit nicely into a reversed view of man’s dilemma as stated in 1 Thessalonians 5:23: “Now may the God of peace Himself sanctify you completely; and may your whole spirit, soul, and body be preserved blameless at the coming of our Lord Jesus Christ.” Paul sees man here as a spiritual, soulical, and physical creature vying for the love, care, and affection desired on each level. Paul lists them in order of their eternal importance. Each domain of man is seen in his conscious (or unconscious) efforts to find peace. Our spirit is, then, our God consciousness, our soul is our self consciousness, and our body is our environmental consciousness. The psychological domains simply put them in antithesis to the biblical order, which makes sense because man tends to focus on environment ahead of the spiritual.

Domain one, then, is symptom focused because it gives attention to our environmental issues—our behaviors, thoughts, and feelings. In one example, it is possible to become so burdened by the pressures of society that we can begin to have physiological symptoms based on that stress.  In the soul-care paradigm, the wise counselor can help the client navigate life to avoid pitfalls and traps that lead to the stress filled condition.  In the medical-care paradigm, the physician can prescribe drugs, such a xanax, to treat the anxiety caused by the stress, but does little to help relieve the root cause, instead focusing on the symptoms. (Many good, Christian doctors will attempt to do both.)

The counselor practicing soul care can move to level two, focusing on the soul, or self consciousness. In the medical-care paradigm a physician will refer a client to a therapist for this area. The soul-care paradigm will focus on discovering deep seated issues within the individual’s background that creates pressures and fears that lead to high anxiety.  The term “baggage” comes to mind. Counselors talk about what “baggage” are we carrying from our past that makes us who we are today. Did our fathers ignore us? Did our older brother outshine us? Did our mother and father divorce, leaving us with a sense of un-fulfillment, or a parent die leaving us with separation anxiety? This baggage weighs us down and keeps us from achieving our full potential, which the Christian counselor would say was weak at best anyway. The writer of the Bible book of Hebrews said that because “we are surrounded by so great a cloud of witnesses, let us lay aside every weight (i.e. baggage), and the sin which so easily ensnares us, and let us run with endurance the race that is set before us, looking unto Jesus, the author and finisher of our faith, who for the joy that was set before Him endured the cross, despising the shame, and has sat down at the right hand of the throne of God.” Hebrews 12:1-3 (NKJV) Let us face the facts; everyone of us has a scarred and marred soul because somewhere, sometime, someone let us down; and the fact that we are marred from God’s perfect image because of our sinful nature and actions. Nevertheless, the Bible provides a prescription for healing the scars and allowing us to lose the weight of those bags by moving forward with Christ. The integrationist approach marries, then, the best of psychology (losing the baggage) and spirituality (laying aside every sin) into soulical care.

The third domain is the reconnectivity (as I see it) of God’s Spirit and man’s spirit. Man is born with a dead spirit thanks to the sin of Adam. (see Romans 5) The medical-care paradigm has nothing to offer here. Neither does psychology, for that matter. This is the realm of clergy and the soul-care paradigm. Relationships that are broken on the human level can be repaired, and even healed. But they cannot exhibit the type of freeing joy that they deserve until forgiveness and unity are achieved at a level only God can provide. I have personally seen over the last five years of my ministry marriages restored after divorce papers were filed (with three separate couples!) because of God’s intervention at this level. When the couples began to climb the relational triangle together with the Lord, as they drew closer to Him, they naturally drew closer to each other. Man cannot have a proper relationship with his fellow man, until he has a proper relationship with God.

Thursday, February 14, 2013

Attack Anxiety: A Modern Look At An Old Problem



Attack Anxiety:
A Modern Look At An Old Problem

But now thus says the Lord, he who created you, O Jacob, he who formed you, O Israel: “Fear not, for I have redeemed you; I have called you by name, you are mine. When you pass through the waters, I will be with you; and through the rivers, they shall not overwhelm you; when you walk through fire you shall not be burned, and the flame shall not consume you. For I am the Lord your God, the Holy One of Israel, your Savior. I give Egypt as your ransom, Cush and Seba in exchange for you. Isaiah 43:1-4 (ESV)

Many well intentioned Christ-Followers have quoted Philippians 4:6-7, “Do not be anxious about anything, but in everything by prayer and supplication with thanksgiving let your requests be made known to God. And the peace of God, which surpasses all understanding, will guard your hearts and your minds in Christ Jesus” (ESV) in an attempt to help others who wrestle with anxiety disorders and other health problems that cause worry. I have even said in my messages that worry is a sin, and, as a matter of point, UNWARRENTED worry IS a sin! Jesus told us that worry was useless in the day to day ebb and flow aspects of life. In His sermon found in Matthew 6, Jesus said, “Therefore I tell you, do not be anxious about your life, what you will eat or what you will drink, nor about your body, what you will put on. Is not life more than food, and the body more than clothing? Look at the birds of the air: they neither sow nor reap nor gather into barns, and yet your heavenly Father feeds them. Are you not of more value than they? And which of you by being anxious can add a single hour to his span of life? And why are you anxious about clothing? Consider the lilies of the field, how they grow: they neither toil nor spin, yet I tell you, even Solomon in all his glory was not arrayed like one of these.” (6:25-34 ESV) In other words, Jesus told us that worrying about our daily needs is sinful, because it shows a lack of trust in God’s providing grace for His children.

These admonitions from Jesus and Paul should not; however, cause us to beguile those who suffer from disorders that are medically caused. Certain disorders, such as Phobias, Obsessive/Compulsive Disorder (OCD), and Post Traumatic Stress Disorder (PTSD) are very real and very common maladies found in the human condition. With Phobias, the problematic element may be as simple as light claustrophobia, where an individual cannot ride on an elevator, to as damaging as agoraphobia where the individual has a fear of leaving their house or apartment. Phobias can stem from childhood trauma, and treatments vary widely. With OCD, the subject is obsessed with a particular thought that is anxiety provoking, and therefore acts in a compulsive manner because of the obsession.[1] With PTSD, as the name suggests, the patient has been through a traumatic event that causes vivid memories of the event, despite a myriad of efforts to keep these memories at bay, including avoidance of persons and places associated with the event. These represent a small sample of the types of anxiety disorders that can cause Believers to worry.

Nevertheless, the Bible has much to say that can help the afflicted and we, as those wishing to help others cope with what life has dealt them should know. For instance, a passage in Isaiah forty three speaks of God’s ability to watch over us, even in times of great crisis. For those suffering with PTSD, they can be assured that even when life seems about to flood them with worry or burn them up with the fires of stress, the Father will not allow them to drown or be swept away, nor will He allow them to be consumed by their fears and stress. We can reassure one suffering from a phobia that Paul admonished Timothy to remember that, “God gave us a spirit not of fear but of power and love and self-control.” ( Timothy 1:7 ESV) and that David told his subjects that, “He who dwells in the shelter of the Most High will abide in the shadow of the Almighty. I will say to the Lord, “My refuge and my fortress, my God, in whom I trust.” For he will deliver you from the snare of the fowler and from the deadly pestilence. He will cover you with his pinions, and under his wings you will find refuge; his faithfulness is a shield and buckler. You will not fear the terror of the night, nor the arrow that flies by day.” (Psalms 91ESV) When we reach out to help one suffering from OCD, may we like Pater encourage them to, “Cast…all your anxieties on him, because he cares for you.” 1 Peter 5:7 ESV) Or Like Asaph, let them know that we, “cry aloud to God, aloud to God, and he will hear me. In the day of my trouble I seek the Lord; in the night my hand is stretched out without wearying; my soul refuses to be comforted. When I remember God, I moan; when I meditate, my spirit faints. Selah You hold my eyelids open; I am so troubled that I cannot speak. I consider the days of old, the years long ago.” (Psalm 77 ESV)

King Saul is a wonderful example of what can go wrong when anxiety goes unchecked. He was somewhat bi-polar, jumping from extremes. He would go from fits of uncontrollable rage to weeping bouts of depression and exuberance in victory. His fear drove him to make horrid decisions, such as keeping his men from eating until the battle was over, a decision that led to near defeat because of its rash stupidity. (Thank goodness for Jonathan’s level headedness!) (1 Sam 14:24ff) Fear, leading to jealousy, caused him to hate David, his champion and son-in-law, simply because of a few simple girls’ song. (1 Sam 18:1ff) And, unfortunately, his anxiety over his perceived abandonment led to the greatest of his spiritual defeats, seeking the witch of En Dor. (1 Sam 28:1ff) This sows the effect anxiety can have on Believers and the fall out and collateral damage effected on those around them.

Which leads to the question of how the church can help. Prayer relaxation techniques, Scripture meditation, vivo exposure and certain anti-anxiety medication are all treatment options, and with the exception of the medications most are available to be used by the church.


[1] McMinn and Campbell. 226

Wednesday, October 10, 2012

Evolutionary Psychology

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Evolutionary Psychology takes its roots from Darwinism, combining psychology and evolution to form a basis that psychology, or the function of the mind, is directly related to the function of the brain. In-other-words, that the way we have learned to process and think has developed evolutionally as our brains have developed physically. Our minds evolved along with our brains.
The basic problem with this can instantly be seen. It means that what we think, as a part of natural selection, is the best of us, or at the least the best of our evolved thinking.  Because natural selection does not allow weaker traits to pass along genetically, then according to Evolutionary Psychology, our thinking should also eliminate lesser or undesirable traits in the psyche as well.

This can be seen in the Evolutionary Psychologist’s attempts to explain erratic and sometimes criminal behavior. How else could abhorrent behaviors be explained by the psychologist?  If the brain has evolved, eliminating less desirable traits, how then can psychosis still exist? While at the same time as sad as it is ironic, one such debate revolved around the subject of rape. The authors of a book on Evolutionary Psychology speculated that rape is not a pathology, biologically speaking. [1]  They contended that rape was a biological desire for reproduction, and if consent was not granted, rape was a product of the desire for this biological function. Because natural selection had not eliminated the act, it must not be a weaker or undesirable trait.[2]  The authors called rape, “a natural, biological phenomenon that is a product of the human evolutionary heritage, akin to a leopards spots of a giraffes elongated neck.”[3] This horrible example of Evolutionary Psychology is to ethics an anathema. As eminent (infamous, more likely) philosopher and Darwinian champion Peter Singer writes, “(we) must face the fact that we are evolved animals and that we bear the evidence of our inheritance, not only in our anatomy and DNA, but in our behavior too.”[4] Evolutionary Psychologists are pressing hard for the thought that we are not only biologically evolved, but moralistically and ethically evolved as well. There is not room for the total depravity of man (Romans 3:23), much less the ethical depravity. Evolutionary Psychology is then a pseudoscience that allows for an anything goes society.

As for the Mind Body Problem (MBP), this concept is nebulous and abstract and rather “heady.” Nonetheless, there are parts that can be argued for or against. First, the dualist expression of a duality of soul and body is a legitimate point, scripturally and psychologically.  As Beck writes, most clinical psychologist practice a dualistic model, whether they would admit to it in professional circles or not.[5]

The ground work was done by Rene Descartes. In his work he basically came up with a theory that states (in my very down-to-earth language) that the mind and body are an integrated unit. While they are two substances, they are intertwined and affect one another. i.e. it is possible for the body to be so damaged it causes the mind to loose rational thought.  This dualist nature, often aligned with Cartesian Dualism, shows that there is a “mind”, (the old stand-by: I doubt / therefore I am.) Because we know there is a body by empirical means, the only remaining question is, does the body HAVE to have a soul? J. P. Moreland would surmise that the answer is yes. While Descartes would say the body and soul are together, but that they are aggregate. A better understanding is that the body REQUIRES a soul for life.



As for the assertion that God cannot be empirically seen, he is correct. And there is a reason for that. Faith is the foundation (hupostatsis) of things of which we are confident (elipso), the evidentiary proof of things that cannot be empirically seen. There is no need for faith if we can see God visually. But we can see the activity of God. One cannot see the wind, but the presence can be clearly seen, (leaves blowing; pressure on our neck, etc). To deny God because of a lack of empirical evidence is the essence of unbelief. However, this works toward his demise as well. You cannot disprove a negative. He cannot, prove that God is a chemical reaction, and therefore, scientifically, he cannot say definitively that there is no God. As Soren Kierkegaard wrote, “faith, when properly observed, evokes awe, not explanation.”[6]


[1] Pearcy, Nancy. Total Truth. Wheaton, Crossway Books. 2004. 210
[2] Ibid. 211
[3] Ibid. 211
[4] Singer, Peter. A Darwinian Left. New Haven. Yale Press. 2000. 6
[5] Beck , James and Bruce Demarest. The Human Person. Grand Rapids, Kregel. 2005. 178.
[6] Kierkegaard, Soren. Fear and Trembling. translated by Alister Hannay. New York, Penguine Press. 1982. 107.