by Rob Vitaro
(Presented on April 23, 2007, DeSales University PS455 Senior Seminar)
For the most part, science today does not like to get involved with religion. The idea that one must accept truth without having first put it through the scientific method, testing quantifiable evidence over and over to lend credence to a sound theory, does not make any rational sense. Most scientists would rather leave the two apart as mutually exclusive areas of study that have no business overlapping. Even so, there have been some that have tried to use science as a means to disprove religion. And there are still others in the scientific community who find science to be one of the many tools used to more fully understand the world that they believe to have been created by God. When dealing especially with the social sciences, not to incorporate religion into the human equation seems almost ludicrous, as approximately 90% of the U.S population has some kind of religious belief (Jones, 1996). Given that only 50% of psychologists have religious beliefs (Jones, 1996), it’s not surprising to see that psychotherapists advocate against incorporating their own personal beliefs and value systems into their therapeutic orientation. The following, though, is an attempt to show that all psychotherapists, whether they will admit it or not, do incorporate their beliefs into their practice, and as such professional Christian psychotherapists have their place alongside them.
Every orientation of psychotherapy operates according to a foundational premise regarding human nature. For those practicing psychoanalytic therapy, the psychodynamic theory states that all human behavior is determined by unconscious motivations and instinctual drives. The role of the psychoanalyst is to provide a means for the transference of the client’s deep-seated unconscious thoughts and emotions onto the therapist (Corey, 2005). Behavior therapy involves employing fully-tested exercises that can alter behavior, exercises that stem from classical and operant conditioning and social learning theory. These are the basis for the idea that “the person is the producer and the product of his or her environment” (Corey, 2005). In contrast to these analytical orientations, Gestalt therapy emphasizes a client’s awareness of his or her current responses to the ever-changing environment. It is thought that through this awareness a client can become responsible and make better choices in life (Corey, 2005). Person-Centered therapy takes the humanistic approach that, “people are trustworthy, resourceful, capable of self-understanding and self-direction, able to make constructive changes, and able to live effective and productive lives” (Corey, 2005). Person-Centered therapists guide the client to find the ability within him or herself to make positive change. Still other orientations take a completely different approach to human nature. Albert Ellis’ Rational-Emotive Behavior therapy (REBT) is based on the idea that humans are born with the potential for both rational and irrational thinking, the latter of which leads to emotional disturbance. His “ABC Theory,” that the emotional consequence ‘C’ is actually caused by a person’s belief ‘B’ about the activating event ‘A,’ is central to the therapy, involving a teacher-student relationship in which the client learns about the irrationality of his or her beliefs (Corey, 2005). Aaron Beck’s Cognitive therapy (CT) was developed around the same time as REBT, and is based on the theory that psychological problems stem from cognitive distortions such as faulty thinking, arbitrary inferences, and overgeneralizations. Less confrontive than REBT, CT employs a more Person-Centered approach to allow the client to realize his or her cognitive distortions on their own (Corey, 2005). Finally, Family Systems therapy theorizes that, “individuals are best understood through assessing the interactions between and among family members” (Corey, 2005), and as such these therapists use genograms to visualize family structures and at times arrange actual family involvement in the client’s therapy to bring about positive change (Corey, 2005).
There are still many other orientations of psychotherapy, and most have been peer-approved (to varying degrees) as valid approaches to helping clients with mental health issues, despite the fact that each orientation was created from a uniquely different foundational premise. It could be said that these premises regarding human nature are nothing short of beliefs about human nature, since a person with beliefs of any sort usually acts and responds according to that belief system. If one were to take away any orientation’s foundational belief, their once purposely-employed methods for changing behavior would then be of no value on their own, due to the removal of a standard model of desirable behavior. This notion of desirable behavior is actually part of the orientation’s value system. Despite therapists claiming pure impartiality, they “tend to rate as more successful those clients whose values regarding personal goals in life change most to match the goals of the therapist” (Jones, 1996). Even Carl Rogers, the humanist who founded Person-Centered therapy, was once found to have “systematically rewarded and punished expressions that he liked and did not like in the verbal behavior of clients” (Bergin, 1980). This makes perfect sense when considering that it is
“…necessary when establishing criteria for measuring therapeutic change to decide, on a value basis, what changes are desirable. This necessarily requires a philosophy of human nature that guides the selection of measurements and the setting of priorities regarding change” (Bergin, 1980).
It would seem that for a therapist to remove his or belief and value system from the therapy room is not only nearly impossible, it is entirely impractical, for it would defeat the very purpose of the therapy they wish to employ. To put it another way,
“…an ethically relativistic stance is illogically inconsistent with the goals of behavior (and other) therapies because whenever therapists advocate and pursue specific goals of change (which all therapists do) they cease to be relativists… Therapists who adopt a relativistic stance cannot logically challenge destructive client values because all values are assumed to be equally worthwhile” (Bergin, Payne, & Richards, 1996).
So if beliefs and values are foundational to a psychotherapist’s orientation, couldn’t the Christian beliefs found in the Bible be used as the foundation of a Christian psychotherapist? Despite what should be an obvious “yes” given the argument above, there is still a strong anti-religious sentiment within the field of psychology. It began with Sigmund Freud, who believed that religion was a collective neurosis, “sustained by an infantile attachment to a caring parental figure” (Rizzuto, 1996). More recently, Albert Ellis said that, “Religiosity, therefore, is in many respects equivalent to irrational thinking and emotional disturbance,” and that, “The less religious [people] are, the more emotionally healthy they will tend to be” (Ellis, 1980). Some psychologists have even arrogantly claimed it a good thing that the religious beliefs of most Americans and psychologists differ so greatly. “We should both expect and demand that the values of psychotherapists be more carefully reasoned and, on the whole, more adequate than the values of the general public” (Walls, 1980). Clearly, Christian psychotherapy has some barriers to break through for widespread recognition from the psychological community as a valid orientation. What follows is a framework for the successful implementation of Christian psychotherapy.
The core of Christian theology is based on the Bible, the text most Christians call the Word of God, which contains the words that Jesus spoke, as well as principles of living a successful life of meaning and purpose. The Bible does not promise a life absent of problems and difficulties, but it does offer many methods of coping with those problems and difficulties. As such, the Bible is used as the foundation for Christian psychotherapy. Many biblical principles can be put into a psychotherapist’s practice, but three key areas that closely resemble current psychotherapeutic methods are repentance, forgiveness, and service.
When the Bible uses the word “repent,” it is in reference to sin, sin meaning any thought or deed in direct opposition to God or His will. Though many think the word repent only means to stop doing something wrong, the actual meaning of the original Greek word used means “to change one’s mind.” Cognitive-Behavioral therapists may recognize this as cognitive restructuring (Propst, 1996), the idea of eliminating faulty and maladaptive thinking patterns and creating new, healthier ones, which then leads to changes in behavior. (This is not to say that the Christian psychotherapist believes that all faulty thinking patterns are the result of the client’s sin; rather, it is the belief that the existence of sin itself in the world is what causes most people to fall prey to maladaptive thinking patterns.) Thus for the Christian client, new and healthy thinking patterns can be derived from the scriptures of the Bible that contain truth, which could be in direct contradiction to what the client’s current thoughts are. Meditating on these truths should then theoretically lead the client to healthier behaviors, and this has been shown to be successful (Propst, 1996).
Since Christianity is founded on the belief of God’s mercy and forgiveness, Christians are asked to forgive those who may have wronged them in some way. This is obviously not an easy task to accomplish for some people who have been terribly hurt by someone, especially by a close friend or family member. It is the Christian belief that, for those that do forgive, there is a release of a carried burden handed over to God. This release that comes from forgiveness is another familiar concept to some of the psychotherapy orientations (Bergin, Payne, & Richards, 1996), but not all of them. Some forms of therapy only require the emotional release of hurt feelings of anger, sadness and betrayal. Although there may be a suggestion to confront the person who hurt them, it simply ends at that point of seeming vindication (Bergin, 1980). The Christian psychotherapist recognizes that for the client to truly be free from the hurt they must forgive the other person and then let justice be served in some other way, outside of themselves. One study has even shown that forgiveness may lower someone’s high blood pressure, one of the body’s physical reactions to stress and anger (Pinsky, 2006).
The acts of service illustrated and taught by Jesus and the apostle Paul are directly related to interpersonal relationships. The idea of laying down one’s life for another, while poignantly displayed literally by Jesus’ death, figuratively means putting the emotional and physical needs of another before one’s own. This has direct application to marriage counseling (Sperry & Giblin, 1996), where in such cases both spouses can each promote a more loving and appreciative atmosphere in the home through continual acts of service toward one another. There have also been applications of service in dealing with antisocial clients and clients with drug abuse in that paying back society through service offers a form of reconciliation with the client and society at large (Bergin, Payne, & Richards, 1997).
Since the question of whether or not evangelization or preaching to non-Christian clients is occurring in the therapy room will no doubt come into play when discussing Christian psychotherapy, the subject of the ethics involved with this form of therapy must be addressed. A Christian psychotherapist can work with both Christian and non-Christian clients, and there may be sessions where spiritual issues never arise. The three biblical principals explained above, as well as many others, can stand on their own with only the therapist knowing their true origin. (Since the methods are for the most part shared by other orientations, this is not deception.) The real problem that comes into play is when it is appropriate to discuss spirituality. While not uncommon for the therapist to bring up spiritual issues with the known Christian client, it would be inappropriate to discuss them with the client whose spirituality is unknown unless that client himself initiated the topic on some level. This is of even more importance when counseling non-Christians whose lifestyle choices are in direct opposition to the Christian therapist’s own values and morals. For example, the homosexual who comes to the Christian psychotherapist asking existential questions and experiencing the moral dilemma of whether what they are feeling is right or wrong has voluntarily opened the door to a discussion of spirituality. But the same homosexual who comes asking for help because of a communication breakdown with their partner has not brought up any morality issues, and it would be unethical to go down that road of discussion; in such a situation the therapist deals only with the issue at hand. Highly contentious issues for Christians such as abortion, divorce, homosexuality, and sex outside of marriage must be dealt with delicately and within the standards outlined in the American Psychological Association’s Ethical Principles of Psychologists and Code of Conduct, specifically Section 2.01 (b):
“Where scientific or professional knowledge in the discipline of psychology establishes that an understanding of factors associated with age, gender, gender identity, race, ethnicity, culture, national origin, religion, sexual orientation, disability, language, or socioeconomic status is essential for effective implementation of their services or research, psychologists have or obtain the training, experience, consultation, or supervision necessary to ensure the competence of their services, or they make appropriate referrals” (2002).
This means that if at any time the therapist feels that they cannot appropriately handle a client’s problem for whatever reason, they should refer them to another therapist. It is important to highlight that in the section noted above that religion is one of the considerations therapists must have an understanding of (Bergin, Payne, & Richards, 1996), which indicates that secular psychotherapists must also be aware of their own ability to advocate changes in a person who may not agree with their belief system. As a way to resolve these issues, it is in the best interests of clients for psychotherapists, both Christian and secular alike, to clearly make known what they believe and how they work. Bergin sums this up rather well in saying,
“…it would be honest and ethical to acknowledge that we are implementing our own value systems via our professional work and to be more explicit about what we believe while also respecting the value systems of others… Then people would have a better choice of what they want to get into, and we would avoid deception” (1980).
Psychotherapists claim that the ideal form of therapy will not impose a belief or value system on a client through the therapy. Hopefully, it is now obvious that this is not possible. The problems that clients come to their therapists with are often complex issues that overlap between the psychological and the spiritual. The emotional distress of the depressed client who wonders why they are alive or what their purpose is for living isn’t just experiencing psychological distress, but spiritual distress as well. Some psychotherapists may claim to have no religious values but because they deal with these kinds of clients so frequently they constitute what some have called a “secular priesthood” (Jones, 1996). The methods of therapy they employ are based on the standards that they have deemed to be acceptable healthy living and to claim that there is no imposition of those beliefs onto clients is either unexamined at best or subversive at worst. It would behoove all psychotherapists to realize that, “Since we expect our clients to examine their perceptions and value constructs, we ought to do likewise” (Bergin, 1980).
American Psychological Association (2002). Ethical principles of psychologists and code of conduct. American Psychologist, 57, 1060-1073.
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Jones, S. L. (1996). A constructive relationship for religion with the science and profession of psychology: Perhaps the boldest model yet. In E. P. Shafranske (Ed.), Religion and the Clinical Practice of Psychology (pp. 113-147). Wasington, DC: American Psychological Association.
Pinsky, M. I. (2006, July 10). Boiling mad? Chill with some forgiveness: Cooling that hothead may improve your health, says a psychologist and minister. The Orlando Sentinel, p. C1.
Propst, L. R. (1996). Cognitive-behavioral therapy and the religious person. In E. P. Shafranske (Ed.), Religion and the Clinical Practice of Psychology (pp. 391-407). Wasington, DC: American Psychological Association.
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Walls, G. B. (1980). Values and psychotherapy: A comment on “Psychotherapy and religious values.” Journal of Counseling and Clinical Psychology, 48, 640-641.