Category Archives: Counseling

Reflections on psychotherapy and counseling

Blog, Counseling, Spirituality

Pastoral Counseling

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Pastoral Counseling involves, in addition to skills and practices of professional counseling, a sensitivity to, and appreciation for your faith and spirituality. In addition, it involves a pastoral counselor’s awareness of, and fidelity to, their own spirituality, and to finding the healing spiritual intersection between client’s and counselor’s.

Your faith might be informed by any one of the world’s religions or by a faith of your creation. As a pastoral counselor, I want to know what your faith means you. Does your faith help you grow, heal, love others and yourself? Or, does your faith lead you to self-condemnation and self-loathing?

Brother Michael Gallagher, of the Benedictine Holy Cross Monastery, has defined spirituality as a Grace with which we choose to cooperate. Spirituality presupposes a numinous reality (God, Holy Spirit, Divine Spark, Higher Power, Ground of being, etc.) and how we respond to it. Your spirituality might take the form of occasional to daily meditation and prayer; occasional to daily worship rituals; occasional to regular study and reflection; occasional to regular acts of service to others. It might take the form of a 12-step program, it might take the form of following a monastic rule like The Rule of Saint Benedict. But it only counts as spirituality if we cooperate with it.

All of this is to say that, in addition to all traditional practices of professional counseling, pastoral counseling strives to help people discover the life giving and healing dimensions of their spirituality, and help them find ways to cooperate with it.

Blog, Counseling

Brief Therapy: Effective and Cost Effective

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My goal is to provide you value for your time and money. I start to address your concerns right away. In the words of my Brief Therapy professor, Dr. Jim Bentley, PhD., “I go for the cure in the first session. Sometimes it works!” Of course he was being playful, using words like ‘cure’ but I take his meaning seriously: people come to therapy to get help changing and we can work in ways to help that change happen quickly.

My approach is a form of brief therapy. You get value for your therapy dollars by having your concerns addressed quickly and in a few sessions. You will hear me start by saying “What do you want to address today?” We address what needs to be addressed and we address it in the here and now. We develop and shared agreement on the goal. The sessions include some education, some experiencing, and probably some laughter.

This article by Robert Taibbi L.C.S.W., gives good advice on how to get the most value from your time in brief therapy

Making the Most of Brief Therapy by by Robert Taibbi L.C.S.W.

Blog, Counseling, Spirituality

Naming the Powers

I’m hesitant to use ‘Satan’, ‘Demon’, or ‘Powers’ type language when formulating an understanding the root cause of issues be they spiritual, emotional, or relational. I find that thinking in those terms leads me either to feelings of helplessness or it leads me to adopt a combat and struggle mentality instead of a mentality of compassion and love.

I like Walter Wink’s understanding of ‘Satan’ and ‘The Powers’ as the fallen spirituality at the heart of our institutional and human systems that lead us to use power, coercion, and violence to get what we want or need.

Name-calling is a form of violence. When I call something ‘demonic’ I practice the violence of name-calling. I think it is the subtle and clever nature of evil to tempt us to use its own tools of power, coercion, and violence to confront it. When I indulge in the violence of labeling something as ‘demonic’ I am in the thrall of the very same fallen spirituality that I want to confront. I fall to this temptation when I am frightened by the destructive potentials I see in the person or system.

Having said all that, I recognize that when we ‘name’ our fears [demons] that have control over us, they often lose much of their power. But we need to name them specifically and with compassion, not condemnation. When we name our vulnerable places, our shame, our fears of disconnection; incompetence; loneliness; helplessness; hopelessness; then we start to take away their ‘demonic’ power over us and start to claim our healthy desires and initiate the process of healing.

When I start such name-calling I am indulging in lazy-mindedness and avoiding the work of understanding motivation and needs of the person or system I’m labeling (be it me or a client).

When I start such name-calling, I am indulging in the blame-game and abandoning responsibility to work towards the redemption of the person, system, or situation.

I subscribe to Walter Wink’s formulation:

  • The Powers are created by God [and hence good].
  • The Powers are fallen.
  • The Powers are in need of redemption.

When I adopt this point of view, I can let go of a little of my fear, I can ask the object of my fears such questions as:

  • What wholesome purpose are you working towards or what wholesome desire is driving you?
  • If all things are Gift, in what way are you a Gift to me?
  • How can I best respond to you with Love?

In the therapy process some of the process is making friends with those parts of our selves we don’t like or are frightened by. Those parts may be the feelings of helplessness and hopelessness, or those parts that are frightened or those parts that are in pain. To make friends with our hurting parts is to ask them:

  • How they are working to protect us?
  • How did they grow so strong?
  • What is their wholesome desire for us?
  • What do they want/need?

In these ways, we are working to redeem those fallen and death dealing parts of ourselves, to respond to them with love and healing.

Blog, Counseling

10 Things to do when someone you know may be suicidal

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SAVE | Someone You Know Is Suicidal.

  1. Let them know you are concerned
    • “When you say ‘sometimes I just want to end it all’ I take it seriously”
    • “You seem especially (down, angry, withdrawn, sad, …) lately and I’m concerned”
  2. Ask them if they are suicidal. Be direct, avoid euphemisms.
    • “Are you thinking about killing yourself?”
  3. Explore their thoughts and plans
    • “Have you thought about how you might kill yourself?”
    • “Do you actually have the [gun, pills, rope, …] available?
    • “How likely are you to act on these thoughts?”
  4. Decide how dangerous the suicidal threat stands
    • Emergency: they have a concrete plan, access to the plan, and feel likely to act
    • Urgent: concrete plan, but don’t have access to plan, or don’t feel like acting on it now
    • Important: vague plan, no access, credibly affirm they won’t act on thoughts
    • There is no unimportant threat
  5. Take action to reduce the threat
    • If the threat level is Emergency
      • take them to hospital emergency room, or
      • call 911 (ask for mental health officer if your community has them)
    • If threat level is Urgent
      • ask for commitment to not act on plan without calling and talking to someone (you, suicide hotline, pastor, emergency room, therapist)
      • reduce lethality of plan
        • remove guns, pills, alcohol, …
        • arrange for them to not be alone
      • commit to helping them find professional support
    • If the threat level is Important
      • commit to helping them find professional support (MD, psychiatrist, mental health therapist)
      • follow through till they get help
  6. Acknowledge the reality and depth of their pain
  7. Affirm your care and concern
  8. Affirm that things can get better
  9. Commit to follow-up
  10. Follow-up
Counseling

Family of Choice

“Stay connected with your support network” is a key item in the list of self-care advice therapists give people struggling with depression. The others are:

  1. take your medications as prescribed
  2. get 30-40 minutes of exercise daily,
  3. eat healthy,
  4. get enough rest,
  5. call for help if you are at risk of hurting yourself.

I want to talk about  the idea of ‘Family of Choice’ that I hope is part of your support network. By definition, we all have a ‘Family of Origin’, the family into which we were born and/or raised. Most of us grew up knowing at least the immediate members of our Family of Origin our parents, siblings, grandparents, aunts and uncles. In our modern families, the family of origin often includes step-parents and siblings as well. Out of all our relationships in the world, often our family of origin is the most familiar to us. Here is a diagram describing the typical experience of someone who knows their family of origin and has a wide range of relationships beyond their immediate family:

Known Family of Origin
Known Family of Origin

In some situations, for instance people brought up and lost in a foster care system, might not know their family of origin or their family of origin is the foster care system:

Unknown Family of Origin
Unknown Family of Origin

In some isolating situations, someone may have very few relationships outside their family of origin:

Isolated family from society
Family Isolated from Society

Now let me talk about a ‘family of choice.’ We don’t have any choice in our family of origin, it is what it is. Sometimes our family or origin is destructive and dangerous to our mental, emotional, and sometimes physical well-being. Sometimes, as mentioned above, we don’t even know our family of origin. But we can look for and include people in our lives with the qualities of character and behavior to help us find safety, connection, and growth. A family of choice, might be 5-7 people with the following qualities of character:

  • Listening: they have the capacity to listen and really hear what we have to say.
  • Respect boundaries: they take ownership of their own thoughts, feelings, behaviors and attitudes and allow us to own our ours.
  • Confidentiality: they do not betray confidences
  • Honesty: they can give us accurate feedback when we ask for it.
  • Accountability: when they make a mistake, they acknowledge it and work to do better.
  • Loving: they have our best interests at heart

Of course, to build such a family of choice, we need to reciprocate with the same qualities ourselves. If we are lucky, some but not all of our family of choices members might be part of our family of origin:

Family of Choice
Family of Choice includes some Family of Origin

But if nobody in our family of origin qualifies, if none of them help us feel safe, secure, and connected, there is no law that we have to include them in our circle of family of choice:

Family of Choice disconnected from Family of Origin
Family of Choice separate from Family of Origin

Who do you include in your family of choice? Who do you want to or need to add? Can you tell them you want them as a family of choice member? If you can, they are probably a good candidate.

Counseling, Spirituality

Struggle for Blessing

Genesis, chapters 31-33, tells the story of Jacob returning to face his older brother, Esau, whom he had cheated out of Esau’s birthright and their father’s, Isaac’s, blessing. Afterwards Jacob ran away in fear for his life. Years later, he goes back, fearfully hoping for reconciliation and forgiveness with his brother. The night before he meets Esau, Jacob spends the night alone, wrestling with a man (?), an angel (?), God (?). During the struggle, Jacob is injured but he continues to struggle demanding a blessing before he releases his opponent (?).

People seeking counseling and psychotherapy are often struggling with issues of guilt, grief, broken relationships, broken spirits, and/or broken bodies. It takes courage to come to counseling, prepared to engage in the struggle, knowing it may include facing real pain. It takes faith to hang onto the trust that there is a blessing to be claimed that is worth fighting for.

As a pastoral counselor, I believe in the hope of healing: physical, emotional, relational, and spiritual. As a pastoral counselor, I work to remember I am not God. I do not heal. Instead I strive to serve as God’s hands, ears, and heart, as a companion in the night of struggle, as my clients strive for blessings in their brokenness.

Counseling

Freedom from ‘Shoulds’

Squelching my anger sent me to counseling the first time. I grew up believing that good people don’t get angry. I believed I was a bad person if I felt angry, much less expressed anger. I thought “Thou shalt not get angry” must have been one of the Ten Commandments. My family taught me those beliefs.

I have since learned the Bible really teaches “do not let the sun set on your anger” (Eph 4:26). I understand anger as a God given alarm system to help me know something is wrong, something I need to pay attention to and resolve: either by giving up false hope and expectations, or by taking action to protect myself or to confront the threat.

The cognitive/behavioral schools of counseling teach that we suffer when we live by distorted thoughts and beliefs. These theories name “shoulds, musts, and oughts” as a type of thinking error. I lived by the thinking errors that ‘I should not get angry.’

Sometimes we confuse the ‘shoulds’ we have been taught, (by family, church, culture) with reality. As pastoral counselors, we practice being sensitive and respectful of our client’s spiritual beliefs and emotional feelings while helping them to give up false and unhealthy beliefs, and to make life giving choices.

Counseling

Attachment, Life Cycle and Spiritual Journey

The Buddha teaches that our suffering comes from our attachments to our ideas and beliefs about ourselves, the world, and they way things should be. To avoid suffering, we need to give up our attachments.

In a conversation with a Japanese Buddhist friend, he explained to me that in Buddhist cultures like Japan, they recognize that adolescents and people in general developmentally need to make attachments to family, culture, and self-identity before they move on in the spiritual journey towards detachment.

In the field of psychology, John Bowlby has demonstrated that secure attachment between primary caregiver (typically the mother) and child in early childhood gives children the security and confidence to grow into independence, exploring their world with confidence, and returning to the safety and protective field of the caregivers presence when needed. (as cited in Karen 1994)

Erik Erikson created the psycho/social model of development identifies various developmental crises that we go through on our journey towards our full humanity.(Newman) These stages are:

  • Trust vs. Mistrust;
  • Autonomy vs. Shame and Doubt;
  • Initiative vs. Guilt;
  • Industry vs. Inferiority;
  • Group Identity vs. Alienation;
  • Individual Identity vs. Identity Confusion;
  • Intimacy vs. Isolation;
  • Generativity vs. Stagnation;
  • Integrity vs. Despair;
  • Immortality vs. Extinction.

Each of these crises could be interpreted as moving from a necessary attachment to detachment, which leads to developing the strength and resilience to prepare for the next stage of attachment/detachment crisis.

The Christian Myth (myth meaning a truth larger than the the story itself) demonstrates this reality in the movement of Jesus from birth to attachment to his Father God, and attachment to his ministry and friends, to his painful agonizing surrender and detachment from all of those: betrayed and abandoned by friends, mocked, scorned and tortured, and feeling abandoned even by God (“My God why have your forsaken me?”). All of this served as necessary steps in preparation for his new life as resurrected and living God.

Counseling sometimes accompanies people in their discovery of old attachments they need to let go of, discovering new stages of life and meaning and new attachments, of sometimes accompanies people through the painful periods, and always looks forward to new experiences, to resurrection, and to new life.

Karen, R (1994). Becoming attached: first relationships and how the shape our capicity to love. Oxford University Press, Oxford.

Newman, B & Newman, P (2003) Development trhough life: a psychosocial approach. Wadsworth/Thompson Learning. Belmot, CA.

Counseling

Encouragement

My ninth grade PE coach made us jog a mile as warm-up for our day’s activities. I experienced those four laps as an interminable distance that I barely had the strength and stamina to finish. I plodded, pounded, huffed and puffed along and felt miserable. Then one day, a classmate, who ran cross-country and was always nearly a lap ahead of everyone else, said “Come on Jay, stick with me. You can do it. Just stretch your legs out a little more.” And from that day forward, I had a companion; I ran with a friend, I ran lighter, with more energy, and with joy.

Sometimes counseling works like my friend, a little encouragement, a little coaching, and having someone alongside you during the journey.