Dale Johnson: In our final segment of Mental Health Awareness Month, releasing on this final day of May, we want to tackle a couple of things. Sam is here with me again. Sam Stephens, our Director of Training Center Certification here at ACBC, many of you know him well. I’m so grateful for the friend that he is to me, but also the support that he is in the office. He just does tremendous work, keeping people organized and going. I float ideas and Sam puts them in an organizationed fashion on paper and we make it sing together. I appreciate that, Sam.
We’re going to finish up today. We’ve been talking about this article that came out in the Harvard Review of Psychiatry back in 2020. It’s interesting because now you have a myriad of seculars starting to recognize some of the difficulties with biological psychiatry. We’re going to continue that discussion, but then take it a little bit further so we can see how this comes to land where we are. It is important. And this is only one aspect, what we’re talking about today, what we’re calling eclecticism.
Let me see if I can make this train, Sam, in how we get from our discussion about biological psychiatry, the misrepresentations of literature that describe these problems of mental health. These problems of mental disorders, if you will, the dangers that we see consistently with the biological narrative—it’s detriment of reductionism, not looking at the entirety of humanity, but seeing the primacy of biology over all things and having that as a singular cause of these labels that we give. Most people would hear the labels, for example, of major depressive disorder or generalized anxiety disorder, and the immediate things they think of are not primarily environmental pressures. They typically think, “Well, I have some sort of disease of my brain.” This is what the article in Harvard Review of Psychiatry is trying to demonstrate. That these things have not been demonstrated very clearly and that’s a false narrative. Unfortunately, mass media takes some initial research that’s done in a very hypothetical way, with not even substantiate evidences and gives clickbait for people to read. That’s how things continue to flourish, this narrative continues to flourish.
An interesting thing that happens—and most people don’t realize this, Sam—is that you have sort of this war that’s happening (we’ve mentioned this on the podcast before) between psychiatry and psychology. Most people sort of lump all that together. I get it to some degree. They both adhere to the DSM, the Diagnostic and Statistical Manual of Mental Disorders. But psychology, historically, has really been a promotion of what we would call counseling psychology or psychotherapies. Those are what we would call talk therapies, where we’re going to sit down and we’re going to chat. Most people think about Freud’s couch or they think about sitting in an appointment with Carl Rogers and doing this person-centered sort of client-centered therapy. What’s interesting about the biological narrative is as science begins to demonstrate that it’s not as reliable as people had once hoped, it’s not making the biological connections, demonstrating the causes that are supposed. People are responding, they’re saying, “We have to get rid of this criteria-based medicine. It’s not flourishing in the way that we had hoped.” So much so that you can go read about the National Institute of Mental Health, even now, how they’ve taken out a ton of funding and support in this direction saying, we’re going down a dead-end road spending all this money and we have to do something different. I find that extremely interesting, that they would make decisions like that.
All that to say, we see again—and history is full of this back and forth between psychology as a talk-therapy and then psychiatry wanting to explain in some sort of reductionistic, biological explanation of the problems that we have. It’s had this super strange unintended consequence. And that’s what I want to talk about today, because I want to make the train, if we can, to how it affects biblical counseling to some degree. And listen, this is just one, we could seriously take several months on this subject and start to demonstrate to you the ways that this biological narrative has affected us specifically in biblical counseling. One of those ways is what we’re calling eclecticism.
Now, how do we get here from biological psychiatry? Well, as people respond to this issue of biological psychiatry and they say, “Oh, this is reductionistic. There’s no way that we can take these scientific studies that give correlations and make them causes. We have to do something different. We’re seeing literature that is saying just that. How are people responding? Well, basically what they’re doing is they’re saying, “Okay, the biopsychosocial model, which was grounded in the 1970s, 1980s, and has flourished in psychiatry and psychology since we’re getting too far in this biological reductionistic sort of mentality in how we look at human problems. We want to build this [as we’ve talked about in this article the past month] multi-causal explanations of these problems, bio-psycho-social.” Essentially what they’re doing is they’re reducing man into three basic categories. Some Christian integrationists would also add a fourth category of spiritual. There’s a problem with that.
Sam, I want you to talk for just a second about if we divide man that way, what’s the implication relative to the Bible? The Bible says something different about anthropology. Talk for a second about the biopsychosocial model, which by the way is being critiqued in a major way in the last decade, but I want you to understand it first and then we’ll see some of the implications and how that fleshes down to us and how people are responding to that criticism. Sam, just take a second and explain biopsychosocial and how that divides man in an unnecessary and unbiblical way.
Sam Stephens: Sure, I think the implication here is the partnership of what we would identify or what has been identified in the past as the helping professions. You get similar implications in thinking about man in a tripartite aspect, that we’re made up of body, the material, but also a division of soul and spirit. And the way this is traditionally been viewed in the past is that each of these compartmentalized aspects of man has a different representative of the helping professions that can speak to that very particular compartment of man. The way that’s traditionally been seen is the traditional medical professions for the body. Who would have any big argument there, right? Broken body, and people who can mend bones and flesh in the material part of man, but the soul and spirit have been a lot more controversial. The spiritual aspect has been said to be the compartment of man that the minister, the gospel proclaimer, the pastor speaks to, but the soulish aspect would belong to the psychologist or in this case, the psychiatrist.
In my dissertation research, I focused on a pastoral psychologist—a self-proclaimed pastoral psychologist—named Wayne Oates. He taught at Southern Seminary for several decades and this was very much his approach to soul care. It was an eclectic approach on two fronts. One being that we need to understand man in this divided anthropology that there’s an aspect that’s totally legitimate for us to minister the Scriptures to, but there are other problems that people face that are linked to these various compartments and that is the territory completely for the other helping professions. In his outworking of pastoral counseling, for example, he saw that it was his role as a faithful minister of the gospel to come in and play one part of many. The implication here is that the Scriptures may speak to some of our problems, but there are other aspects that it does not speak to.
I think this is a problem on two fronts. Most clearly anthropology—nowhere in the Scriptures do we see this idea of man being compartmentalized and divided in such a way that you’ve got a team of helpers that speak to very different parts of man that really don’t ever overlap or speak to each other. That’s very foreign to definitely the Hebrew idea of anthropology that we see in the Old Testament, but New Testament as well. That’s just a foreign idea. But also I think it goes into two things that you may speak to. One is a metaphysical outlook—I know we’re getting kind of philosophical here—but this idea that there are many different worldviews, but all these worldviews really do correspond and correlate just fine. There’s the naturalistic worldview. There’s a spiritual worldview, but they really can work together and correspond just fine. There’s this idea of pluralism and then an idea of pragmatism and these both feed into eclecticism. All these different worldviews. There are many different ones, they all have different ideas of our reality and where we fit into it but they all really fit together. No problem. And then pragmatism says that truth is really grounded in utilitarian aspect, right? Whatever works, whatever helps, however we define that, that is true.
When these two things come into play (which I think they work really well with this divided anthropology), so now all three aspects anthropology—metaphysics, our view of reality, and even our idea of truth and pragmatism—all of these feed into the method of eclecticism. Now, there are many tools. There are many legitimate tools. If our listeners have listened to our last two podcasts on biological psychiatry, something shouldn’t make sense to you. If mental disorders are rooted in biology, how does talk therapy helped? It just doesn’t make sense. If I have a biomedical disease, I can talk until I’m blue in the face, it’s not going to resolve an organic issue. If emotional or behavioral problems are rooted in organic cause, how is talk therapy of any sort (and there are over 500 psychotherapies out there), how is that going to address an organic mono-causal explanation of mental disorders? Just doesn’t make sense. That idiosyncrasy, how is that explained? It’s explained this way: We’ll divide up man into many compartments, we’ll redefine truth, we’ll allow different worldviews to speak into it and it becomes kind of a hot pot, if you will, of approaches and methods.
Dale Johnson: Yeah, that’s exactly right. The seeds of the biopsychosocial model were born early in integrationist thinking. In 1935, we see Anton Boisen creating clinical pastoral education. That’s exactly what he was doing and he was just saying, “Yeah, the psychiatric ward is not as helpful to me. So I need some sort of spiritual advice along with this physical care.” The idea of the CPE model (Clinical Pastoral Education) was born where we have a team of influencers, right? The pastor, he’s less influential, but the doctor and the psychologist/psychiatrist. They’re all on this team of care, and they all have their own domains and their own responsibilities. That was prominent in 1935 beginning, really back into the previous decade, but prominent then in 1935, this was taught primarily at seminaries. This was born out in the modern pastoral care movement, starting in the 1940s, moving forward. And this was the approach. The pragmatic approach is not wanting to dismiss “science,” in this versioning of psychotherapeutic approaches and so on. They wanted to incorporate this and that’s making a statement. It’s making a statement about the Bible and about the relationship of the church to care for people, that it’s insufficient. That, in my view, becomes problematic.
Those things reigned in the early-middle and the latter part of the 20th century until where we are now talking about biopsychosocial. We see this same type of movement happening as a response to biological psychiatry. You see this ebb and flow. “Should we do talk therapy? Or should we not?” What’s interesting is in the last decade we’ve seen so many questions about biological psychiatry that now all the psychologists are saying, “Yeah, that’s what we’ve been saying—our talk therapy gives equal outcomes to some degree on some of these issues. So, how can these things be organic?” It begins to raise some of these problematic questions. So what do we do? Well, what we have to do then is each section of man has its own domain and we say, “Well, okay, that’s your domain, we don’t want to cross over into that. We want to deal with our domain. But when you’re dealing with that part of humanity, the biological part, that may be true. But the way I think about it’s also true, okay?” Demonstrated, as you just mentioned, with over 500 different types of talk therapeutic approaches.
What does that say about counseling psychology? Well, first a novice observer would recognize that that’s confusion. There’s no semblance of one streamline of truth. We like some of the things the previous guy said but we want to alter a little bit because it doesn’t fit completely our worldview so we’re going to create a whole new system of approach in how we’re going to help people and eclecticism begins to be born. I was asked one time, Sam, you and I teach at Midwestern Baptist Theological Seminary, biblical counseling. I was teaching through this process about secular psychology and how it was developed and how it came to be, and the three forces of psychology, some of you have taken intro to psychology, you’re familiar with this. You have your psychoanalytic approach, what was called psychodynamic approach to therapy. This was Freud: The id, the ego, the super-ego, the whole iceberg idea of the conscious and the subconscious, where your problems lie in psychosexual stages of development and so on and so forth. Then you had sort of a movement away from that where people started to imbibe the naturalism of Darwinian thinking even more. It landed on behaviorism, that’s sort of the second force, primary approach is we’re no more than just sophisticated animals and we respond instinctually so if we want to fix people, we just need to train them in some way with positive and negative reinforcement and so on. And then we get to a third development, humanistic psychology, which is your Rogerian, Maslovian type approach. Man is actually good and inherently so, and we need to help him become better, self-improvement, all the rest of it, right?
And as I was teaching this one of my students said, “You know, Dr. Johnson, you’ve taught us about three forces of psychology, where are we at now? What’s the fourth force?” I pause for a minute and I’m curious not knowing exactly what to say. I’ve never been asked that question before. As I pause, I began to think about what I see happening in the secular world. What we see happening in the secular world is not a reduction of theories and therapies, it’s actually a massive increase. One therapy comes in vogue for a certain type of treatment of a person. And then over time, it goes out of vogue because it wasn’t as reputable as people thought, the outcomes were not as great as people thought and there’s something that’s now in vogue that replaces it, and so goes the war, right? I began to think, “Okay. This is really interesting.” You look at some of the textbooks of Intro to Psychology or Counseling Theory from a secular perspective and that’s sort of how they approach it. They’ll talk about ten or fifteen major theories that have been really dominant and sort of set the stage for other theories in the past. Then it’s sort of a conclusion.
Gerald Corey is one of the leading guys, he’s written several Intro to Psych books. He’s a very popular secular guy. If you take an Intro to Psych class you might read a Gerald Corey book. His conclusion in his books, the way he deals with it, it’s sort of an eclectic approach. He says, “Well, we love these things about this theory but we don’t like these things about this theory. Let’s just incorporate the things that we think are helpful.” It’s sort of building this toolbox mentality as a counselor. “Well, if I’m dealing with trauma, I need this in my toolbox because I think pragmatically, it’s the best approach to dealing with that person because this is what’s at play here, this biological aspect or this psychological problem.” So we’re going to use some sort of approach that we think is appropriate. You see what happens? It begins to evade truth as something that we’re as people called to conform to, and it begins to disseminate a multiplicity of truths with its own authority in a particular domain—our biology, our psyche, or some sort of spiritual aspect of humanity. It builds this idea to eclecticism.
My response to my student was, “Man, we are really moving into this era of eclecticism, where we’re not wanting to decry any one particular theory as if it’s totally missed the boat. We want to pragmatically pick and choose what we think is most helpful.” And here’s the thing that I see happening and we ask the question, Sam, how is this impacting us? The eclecticism idea is definitely happening in the secular world, but it’s also happening in Christian integration and this is really what has happened over a long period of time. You know, the integrationist argument to say, well there are some helpful things, never clearly defining how we arrived at those ideas of what’s healthy.
Sam Stephens: And I think it’s really important to emphasize this. They never do. There’s a broad assumption that integrating these opposing worldviews, these systems of thinking. And if you’ve listened to any of our podcasts, especially this month, you see, they are grounded in a very, very different worldview, right? There’s this general assumption that integration is possible, and then it should happen. But what’s given in many of these—and I’ve read many, many integration books, I’m reading a fairly new one right now, because I just want to see what’s going on in that field—it’s the assumption that, “Yeah, it should happen. It can happen.” They’re just talking about doing it.
I want to challenge our listeners, you need to be thinking about those types of things. Is it even possible? And even if it is, which I would argue it’s not, should we do it? And that’s an ethical question, right? But to your point, what gives way is biblical fidelity. That happens every time because this is human nature. The truth of the Scriptures conforms to what we think is right. My students ask legitimate questions: “What helps? What should we be doing in counseling? What works?” But I always want to define for them, we need to define what helping and working is, and we need to make sure those definitions come from the Scriptures and not just what we think is the newest fad in clinical effectiveness. That’s again, you mentioned clinical pastoral education, that was very much what it was about. There were good motives there but they became very, very man-centered. In fact, Anton Boisen himself, his whole philosophy was living human documents. What was the sole source of the content of his whole approach to care for the individual person’s perceived needs and those types of very pragmatic efforts of pursuing what is true. Very utilitarian.
Dale Johnson: Yeah, that’s right. I mean, as we talked about this category of integrationist, they are sort of built to be very susceptible to eclecticism. Eclecticism doesn’t uphold truth as a primary issue, right? Because if we’re willing to sort of adopt different pieces and parts, the approach of pragmatism, we value the Scripture so we want to incorporate them as best as we can. You’re reading this book, as you mentioned, and there are several others that are out there, but what you see happen, particularly among integrationists is, I’ll give you an example. When I was coming through, I did a bachelor’s degree in psychology. If you wanted to pursue something in the field of psychology or psychiatry you did a master’s that was very specialized in a particular area. If you wanted to be a psychodynamic therapist you would go and train particularly for that role. If you want to be a cognitive-behavioral therapist, that’s exactly what you went and trained to do. Now it is seemingly more of an eclectic approach. It’s, “We want to give you lots of tools in the toolbox so that you can handle different issues.” Integration seems to be continually moving in this direction where you have some integrationists who propagate and who are known for implementing cognitive-behavioral therapy or EMDR therapy for example, or some other therapy depending upon what they’re specializing in, whether it be trauma, or emotional issues, or whatever the case might be. We see this constant adapting and adopting, eclectically, different types of therapies or different types of approaches, techniques, methodologies, systems, that can’t be separated from the whole worldview system to secular worldview system itself. And this is a part of what has expanded, if you will, integration’s approach to problems.
Sam Stephens: That’s right. In fact, the text that I’m reading right now actually wants to couch the whole practice of integration no longer as a building of a particular model, but a conversation. And so the emphasis is on existential experience, human experience. It’s on creating space for embracing healthy self-concept. I think a lot of that is the natural outflow of embracing an eclectic approach to method and counseling. We’re in early, early years, especially in the history of integration. There was an emphasis on building models and many of these guys were committed to a particular at least branch of a major psychotherapeutic approach like cognitive behavioral therapy or something like that. But now it is very broad, much of that is lessened and it becomes much broader. And again you see a watering down of the aims of counseling and it becomes this very hard to pin down and define pursuit. It’s all process, and this is kind of repeating in history too. You see this and again, modern pastoral psychology, it’s all coming around full circle and I think it also pairs very well with our cultural milieu right now.
Dale Johnson: That’s exactly where I want to go, Sam. What we saw unfold in the literature in the 1940s—for example, in the modern pastoral care movement, guys like Seward Hiltner and later in CAPS—is exactly what we see unfolding today. Here’s the sad part, at least in my opinion. I would expect to see this in your integrationist theory, in your integrationists in their approach. That’s certainly true. And it makes sense to me, right? That they would do that because that’s their philosophical approach. What I’m sad to say is, I see this happening in the biblical counseling movement. I think those of you who are attuned to what’s going on in the biblical counseling movement, you can see some of this unfolding and happening right now. And that ultimately, it makes me sad. Now, I want to caveat this because I want to explore a little bit more, but we see in the biblical counseling movement some of the same language—that we’re some sort of spiritual guide on a team to approach how to help a person to be healthy, that sort of thing. I think that is very dangerous language and listen, this is not hypothetical, we know how that ends because we saw it arise in the 40s, 50s, and 60s and we know what it’s done to the church in relation to discipleship and care. It’s divorced us from it. This is what makes me nervous is we see eclecticism going from the secularist, and we follow the pattern in the Christian world in integrationism. And then also now we see it happening to some degree in those who are claiming to be biblical counselors.
Now I want to make very clear that this is not a statement against science. I’m going to go all the way back to Dr. Adams and I want to make sure we clarify this particular issue about science because for far too long biblical counselors have been labeled as anti-science. That’s unfortunate because it’s not true. From the beginning, the new movement was made very clear by Dr. Adams, and this is what he said. I’m going to quote directly, “I do not wish to disregard science, but rather welcome it as a useful adjunct for the purposes of illustrating, filling in generalizations with specifics and challenging wrong interpretations of Scripture. Thereby forcing the student to restudy what he believed to be the ultimate truth, which was Scripture.” I echo completely Dr. Adams’s approach there regarding science. It is to be revered, to be respected, to be acknowledged, but as science, as what it intended to be in helping us to understand a little bit more about the created world in those things that can be verified and retested and demonstrated.
I want to caution us here because I think it’s important. But let’s explore this idea just briefly. I know we’re going a little bit long today but this is an important issue to me that I continue to see unfolding. I don’t know if it’s academic respectability, where we fear not fitting in with a broader culture, but I see this influence of the secular world and we begin to adopt it for some reason. Maybe it’s an issue we feel uncomfortable with, so we sort of default to what’s being said in the secular culture right now, related to things like abuse or whatever the case might be. And we see this adoption of eclecticism that this language of, you know, these methodologies have been super helpful to help people in trauma or help people in OCD or whatever the case might be. If they’re helpful, that’s pragmatism and we say we want to go adopt those methodologies and those techniques and incorporate those in the biblical counseling. Well, those things give you a faulty aim. They don’t give you primarily a spiritual aim and they’re resting on a different authority, not the Scripture. This is my big problem.
We’re beginning, to some degree and as a result of this whole mental health confusion that we’ve been talking about all month, we’re seeing this affect us in a lot of ways and we have to make that connection. One of the ways we’re seeing it affect is people are saying, “Well, I just want to be more broadly educated.” And that’s all fine, but you have to do it with a discerning heart from the Scriptures, right? I’m for education, pursue it to the highest level that you can. I’m not against it, but you have to do it with a discerning mind, not simply trying to incorporate everything you learn into what ought to be practiced. In fact, sometimes the things we learn, we have to discern between good and evil as it relates to the Scriptures. This approach to saying I have this toolbox, and I’m just going to fill this toolbox up with all these different eclectic approaches thinking that now this adds to my significance, my ability to be respected even outside of the biblical counseling movement. This is a word of caution. I think that we have to be very careful about what we’re willing to adopt, what we’re willing to practice, what we’re willing to promot. All the while, if we’re not careful, what’s happening (and again, this is not an experiment—we’ve seen this happen in the middle of the 20th century), if we’re not careful, we see what is harmed most is our fidelity to Scripture, and Scripture is no longer seen as that which is the only thing, the Word says, will not fade away. It will last forever and now it becomes questioned as if is it sufficient truly to deal with the problems that we’re facing.
Sam Stephens: And I would just add to that. History has proven this to be true. As methods diversify, the goals become compromised. This happens, and I see this in integration literature, what’s actually even happened in the language instead of Christian counseling, it’s turned into some sort of vague spirituality. In fact, the book that I’m reading right now (again, published in 2020), the integrationist speaks of counseling Buddhists. And the Buddhist clients tell them, “I’ve got questions about life and worldview.” And you know what the integrationist says? “These are really interesting questions, these are difficult questions to answer.” I wrote in the margin, Dale, because I write in my margins, “This is not a difficult question to answer.” The answer is Jesus. The answer is Christ. We need Him. Buddism is not going to save you. And so what’s happened is, there’s a reimagining of theology, right? We use the theological terms, but we reimagine them. And now we’re rethinking them to create space for conversation. It all devolves in there. It opens the door for progressive Christianity. This has been the story.
I’m not a big self-promoter, but I do want to encourage anyone interested in this topic. Dale and I both have written about this in SBC context in particular, you should read our books. We talked about how this is actually fleshed out in real life and you see the impacts in pastoral counseling specifically. But again, history does repeat itself. If we diversify the methods, we move into this eclecticism, we assume that we have all the foresight and knowledge to choose between what’s right and wrong and all these secular theories and always 100% of the time use them accurately without fault, we’re fooling ourselves. And that will lead to a compromised goal. The goal of counseling will change drastically from what it should be.
Dale Johnson: Yeah. And there’s a lot more, we’ve gone way over time but this is a very important topic. We will, on the podcast in the future talk more about this subject because I do think it’s one that needs our attention. I think it’s one that needs careful thinking. I’m not saying that we have it all figured out, that’s certainly not the case, but it is one that I find intriguing and we have to be cautious about, right? It’s okay. That the secular world wants to do that, that’s their business. But when it starts to encroach upon the way we think about Christianity, the way we think about human beings, biblical anthropology, and how we help people who are struggling, it becomes a problem. And we need to be very very cautious about our approach of eclecticism. It makes us feel better that we have tools that we can use at our beck and call that we think will help people to some degree. And this doesn’t mean that, I don’t seek in any way possible to help relieve pressure on someone. That’s not what I’m saying. But when we approach life from this eclectic perspective it has a devolving aspect of the way that we see humanity and certainly the way that we see the value of Scripture and its sufficiency.