- Association of Certified Biblical Counselors - https://biblicalcounseling.com -

Reorienting the Therapeutic

Dale Johnson: This week on the podcast, I am delighted once again to have with us, Dr. Sam Stephens. Sam serves here on our staff at ACBC as the Director of Training Center Certification and we love having this brother around.

Something that faces us in the culture today, especially for us who counsel and who counsel from a biblical perspective, are ideas of the therapeutic world. It’s not uncommon for us when we’re trying to counsel biblically that we encounter folks who think in the normal way that our culture talks about counseling, which is from a therapeutic mindset. I think it would be helpful if we talk through some of this to help our listeners understand the issues they’re going to encounter when they talk with someone who has adopted a therapeutic mindset. This person is not distinctly evil or malicious in what they’re wanting to accomplish. They are just being a product of the culture we live in. What I want you to do first is just help us to connect this idea of the therapeutic mindset. What do we mean by that, how do we see this mindset appear in the counseling room, and how do we think well about it?

Sam Stephens: When we talk about the therapeutic, I think the term mindset is helpful. You can also use the term worldview. To put it succinctly, I would define it as a mindset that is determined to satisfy the self. There’s been different terms used in history to help illustrate this. Whether that be a focus on self-actualization (a term popularized by Maslow), self-fulfillment, or self-esteem, we’re in a search for wholeness. We’re in a search for purpose. We’re in a search for identity and what that looks like. And today, the therapeutic mindset coincides with the advent of modern psychology. Psychology is a pretty large term, but boiling it down, it is a redefinition of who man is. Man defined as more of a machine, a sum of various parts. Also, man as the center of his or her own universe. Many of these theories don’t have a place for God in them. There’s no economy for God. There’s no place for God. It is very atheistic or paganistic.

So, on one hand, it’s this focus on self, this search for self. All those things are in play. And as you noted also, we live in a culture that is, in many facets, obsessed with psychology. I don’t think I’m overplaying that that term. Have you heard of concepts like extrovert, introvert, codependency, dysfunctional? All of these are psychological concepts. These all came out of theories that were trying to replace a biblical worldview with this therapeutic idea.

And if you want to think of it at even a larger 30,000-foot view, the therapeutic is focused on, as one author put it, eradicating disease. Now this is not disease in the sense of what we think about most often. Instead, it’s disease as anything that would cause discomfort. Anything that would cause unpleasant feelings. We want to eradicate that; we want to move away from that. We don’t want to consider it all joy, when we encounter trials and suffering. We don’t want trials and suffering at all. And the therapeutic mindset, in either implicit or explicit ways, has reinforced that major search that man has gone after. How do we live our best life now? How do we avoid any discomfort or pain? How do we achieve all our dreams and desires that we have come up with ourselves? And modern psychology has in many ways come in to fill that gap. How do we redefine man’s problems? How do we come up with new solutions to those problems? I think in many ways that is what the therapeutic mindset is all about.

Dale Johnson: The difficulty with the therapeutic mindset is you mentioned things like: psychology promotes an atheistic base, psychology promotes a humanistic perspective. And sometimes in the church, we may not even recognize how those things influence us. But we use the language that you just described daily. We are saturated with these ideas. I think it’s important that we see just how influenced, impacted, and saturated we are with this language of the therapeutic mentality. So, as we work through this a little bit further, how do we help somebody who comes in and they’re broken? They have language that they’ve couched their problems in. They’ve had maybe an identity that’s been built by the way they have been told to think about their problems. And so, when somebody comes in who struggles with the therapeutic, as some sort of frame of reference, how do we go about helping them?

Sam Stephens: That’s a great question. And I think for many of our listeners who are actively engaged with discipleship and counseling ministries, this probably is not going to be as foreign to them as they would think. They probably don’t think in the terms of the therapeutic. But when bringing it down to a very practical level, these are these are individuals, counselees, that have carried away with them either medicalized, psychological, or psychiatric labels, in the form of diagnosis or self-diagnosis. They read a popular journal article, they’ve taken a personality test, and they’re very much trapped in this framework of their own making. So, in many ways, they’re stuck. What I’ve found with counselees that have come to me, and individuals that I’ve been working with, there’s very much the idea of, “Well, I’ve got a lot of tools to cope with my struggles,” but the common denominator across the board is a lack of hope. And what makes this even more devastating to me is that these counselees that I’m talking about are believers.

These are these our brothers and sisters in Christ and they are left utterly hopeless. Here’s what I found, using a case study to illustrate this for our listeners, with a couple that I worked with in their mid-60s. I’ll call them Bruce and Jan. Bruce had recently been given a psychiatric diagnosis. He didn’t know how to deal with it. In working with them over several weeks into a few months, I found three major areas that I saw were under attack directly because of this therapeutic worldview. This worldview that he didn’t even know he was entrenched in. And these areas were questions of identity, questions of responsibility, and a question of purpose.

And those three topics are themes that keep coming up in my counseling. Identity is under attack, purpose is under attack, and responsibility. And it’s part of my responsibility and duty as a biblical counselor to help shine a light on wrong thinking, wrong perspectives on these topics, and show them what the Bible says.

I’ll look at identity for example, I think this is probably one of the most obvious ones. This came to me one day as I was working with a counselee who had been diagnosed with clinical depression. And I listened to how he described his problem and he kept saying to me, “I’m depressed, I’m depressed, I’m depressed, I am anxious.” Or I’ve heard others say, “I’m obsessive,” or these types of things. And what kept coming to my mind was the way that they described a problem. When was the last time I talked with someone and they said “I’m cancer.” It is a very different way of thinking about it. A medical diagnosis came from a doctor, but in many ways their very identity became tied to this diagnosis. He couldn’t see beyond the fact that depression was him, anxiety was her, and even though there’s no really agreed upon, objective, or scientifically verifiable definition of mental illnesses or disorders, it’s all over the psychiatric literature. Because a doctor in about 15 minutes said, this is what you are, this is what you have, their lives have been forever changed.

With Bruce, it had been something very similar to that. He had lived his entire life. He was in his later years and his identity now had been told by a medical professional. A medical professional had told him, “This is who you are,” and he could not see beyond that. And that impacted not only his own personal life, but his marriage was impacted, his work ethic was impacted. Every aspect of his life was impacted because someone had said, “This is who you are.” And he had walked with the Lord for many years. So, in battling with this identity that he had been given by his doctor, there’s a couple things that I wanted to bring up with him. Number one, Bruce, you are made in God’s image. You can know God as creator, sustainer, provider, and friend in the midst of your difficulty. The Bible presents a message of spiritual hope and peace that therapeutic categories can never bring. So, dealing with this idea of identity, that’s very much what I wanted to bring to the table. Help unveil the fact that your life does not have to be determined by a diagnosis or an outlook that you’ve adopted. But that the Bible provides so much hope and so much promise because Christ is the one who determines who we are. God is the one who determines who we are, not ourselves.

Dale Johnson: That’s so helpful. I think it really helps to couch for us who we are in the Lord Jesus. That we’re not driven by feelings and emotions and even labels that we may be given. Now, there are several other ways you mentioned, am I accountable? In Freudian thinking, then psychological thinking, and therapeutic thinking moving forward, one of the key elements that has happened in our culture is the relinquishing of responsibility. When we think about relinquishing of responsibility it’s driven by blame-shifting for all the problems that we have. And the Bible really describes the problems that we face often in distinct terms. And so, one of the things that you have to help the counselee with, especially when they have a framework of a therapeutic mindset, is are they accountable? And often they wonder that, so how do you help them work through that idea?

Sam Stephens: Sure. I think you’re exactly right. In some approaches you wouldn’t even ask this question, for example in the therapeutic practices of Abraham Maslow and Carl Rogers. There’s nothing to be responsible for. You live your life as you see it, you set the pace in and the objective and go for it. In the case of Bruce, it was very much that the disorder made me do it. It was this victim mentality that biology and circumstances have determined his behavior. In this circumstance, Bruce had really been impacted by this. He was no longer the loving, gentle, kind man that his wife knew him to be. His motivation for living had changed. It was very self-focused, very self-centered. His wife had turned into basically a slave for him and she was very burdened because of that. Who is this man that I live with now?” was the question on her mind. And when I confronted Bruce with this, he just brought me back down to his diagnosis. Well, this is my identity. I can’t do anything about this. I’m trapped. I have no resources. I have no tools. All I have is maintenance.

Dale Johnson: And she feels helpless too because he’s throwing out the right identity.

Sam Stephens: Exactly, and so when you look at the Scriptures blame shifting is not new. This is something that we see from the very beginning of man, but it does not negate responsibility and consequences. Obviously, we see that in the fall of man—and so what I wanted to call him to remember is that we are held responsible to God. And no diagnosis, no matter how severe it may be and the implications and the circumstances surrounding it, none of that can negate that fact. I think about Deuteronomy 4:9, a verse that I shared with him, “Only give heed to yourself and keep your soul diligently, so that you do not forget the things which your eyes have seen and they do not depart from your heart all the days of your life; but make them known to your sons and your grandsons.” This is the thing we see all over the Old Testament, and the New Testament as well. Remember, remember, remember. And it’s about God and his faithfulness, but also our responsibility to live according to his ways. This is lost in the therapeutic because there is no objective truth. And God is taken out of the picture completely.

Dale Johnson: The interesting thing is that we’re not saying that a person doesn’t feel despair or emotional distress. That is certainly a part of the reality of our human existence. The Bible makes very clear that we all struggle with despair and difficulty in so many ways. So we definitely aren’t negating that idea. We’re saying even in and through that, the power of the Word and the comfort that Christ gives through what he’s done in the past and what he’s promising in the future, gives us responsibility to respond to the Lord appropriately. And now maybe one final thing and we could probably go a lot of different directions, is we also see a person, when they are captivated in that mindset, often is curious as to who’s in control in this situation. The therapeutic drives the idea that we should be self-empowered, that we should be able to cope through different mechanisms to overcome whatever difficulty we might be experiencing and feeling. So how do we help a person to think through, in that moment, who’s really in control and what is their responsibility? Because often what happens is the person feels the pressure on themselves that they have to do something with their own power to overcome this. They wonder why are they not good enough to accomplish that. And it leads to further despair and hopelessness. So, how do we help them think about this issue of control?

Sam Stephens: Well this very much ties into the other two points with Bruce. He had lost sight of his responsibilities as a husband and subsequently the joy in their marriage. They had a beautiful long marriage at this point and all of that had been really stolen away from them. When you think about the topic of purpose, the question is, “What is the aim of my life?” The Westminster Confession says this, “Man’s chief end is to glorify God and to enjoy him forever.” The therapeutic worldview says this, “The chief end of man is to enjoy my life as I make it and to hold on to it as long as I can.” As you can tell, these are very different approaches to life and the purpose of life. I find people in the situation are captivated by despair. And the only tools that the world gave Bruce were pain management symptom relief and left him with the idea that, “Now it’s up to you to rebuild a life that you want.” Pretty hopeless, full of despair and that couple came to me with a lot of questions and not many answers. So what I was able to show them was, “Let’s reclaim the joy of our salvation and what God saved us for: which is to know him well, to serve him, and to use this life for his glory.” What a different way to think about our problems. What a different way to think about the circumstances that we find ourselves in. And then we really can say, as James says, we can consider even difficulties a joy.

Dale Johnson: Even talking about this makes me zealous for the hope that we have in the Lord Jesus. And when we engage people on this level, it’s not for the purpose of condemning all that they’ve heard in the sweeping flow of our culture. That’s normal in the world that we live in and Christians are going to be doing this all the time: helping people to think outside of the way the world thinks. And this excites me that we have an opportunity to engage someone in their difficulty and helped take some very unbiblical thinking and route them back into firm, solid, hopeful, biblical truth.