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Biblical Counseling Coalition: Grace & Truth

Friday’s 5 to Live By

Friday's 5 To Live By

Each Friday our BCC staff links you to the top five biblical counseling and Christian living blog posts of the week—posts that provide robust, rich, and relevant insights for living.

The Cool god Is a Puny god

Jon Bloom at Desiring God writes:

“Americans, and most westerners, live in cultures governed by the god called ‘Cool.’ Cool doesn’t have a temple we can see or visit, but his images and shrines are everywhere. Cool is a god that we actually invite to take up residence in the unholy of unholies of our fallen nature’s heart-temple. Once there, it entwines itself with our narcissistic selves, becoming part of our desired identity, the self-image we worship.

You can read and reflect on the rest of Jon’s thoughts in The Cool god Is a Puny god.

Two Conferences; One Theme: Christ’s Gospel of Grace

What a unique opportunity—attending the CCEF and ACBC conferences on back-to-back dates in cities in close proximity to one another. Enjoy this introductory video featuring David Powlison of CCEF and Heath Lambert of ACBC as they describe their conference themes: National Conferences. 

Does He Need to Confess Adultery to His Wife?

Russell Moore addresses a difficult question: Does a man who had a brief affair several years ago need to confess it to his wife? Read his response in Does He Need to Confess Adultery to His Wife? 

The “Moses Model”: A Recipe for Disaster?

Sam Storms writes, “Many make the mistake of trying to take an OT model for leadership and applying it to the NT church.” You can read his expanded thoughts on this important issue at The “Moses Model”: Recipe for Disaster?

Psalms Singing in Our Services?

Pastor Brian Croft asks and addresses the question How Do Pastors Incorporate Psalm Singing in Their Worship Services

Join the Conversation

Which post impacted you the most? Why? What blog posts have you enjoyed this week that you want to share with others?

Topics: Five To Live By, People in Need of Care, People Who Offer Care, People Who Train Caregivers | Tags: , , , , , , , ,

Going Back to School

Going Back to School

BCC Staff Note: This blog was first posted at the Lighthouse Community Church blog. It is re-posted by the BCC with the permission of LCC and of the author, Jenn Chen. You can read the original article at Going Back to School.

The Perfect Storm

In May 2014, I printed out my syllabi for two classes. Yes, I’m going back to school!

I have been providing therapy for almost 20 years and as a licensed clinical psychologist for over 10 years. My degrees in Marriage and Family and in Psychology are from well-known Christian institutions. I had training in Christianity and Psychology, cutting-edge psychotherapies, and in neuropsychology. So why am I pursuing a Masters in Biblical Counseling at the Master’s College, especially in my (gulp) forties? (Last time I checked, I thought I just celebrated my 29th birthday…)

Because of God and His grace in my life.

When we first attended Lighthouse back in the summer of 2011, I saw a church pamphlet that stated, “We believe in biblical counseling.” My limited exposure to biblical counseling was in my “Introduction to Integration” (integration of theology and psychology) class. It was given a brief mention in lecture, critiqued as narrow and over-simplistic or even worse, as harmful to the counselee. And it doesn’t involve science (which psychology reifies)!

So I wondered if Lighthouse was the right place for our family, even to the point of discussing it with a fellow Christian psychologist. She encouraged me not to let it stop us exploring Lighthouse. Though I was unaware at the time of any Christian convictions against psychology, I could sense some discomfort at times when people would hear my answer to “What do you do?” (I get that anyways, but in secular settings, I get more “So can you read my mind?” or “So are you analyzing me right now?” discomfort.)

However, Peter and I felt like we were really growing from the teaching in Sunday sermons and continued to come to Lighthouse.

Then God created the perfect storm in my life: severe illness with accompanying panic attacks, no church home, awareness of my very limited faith. Everything I knew was not working, including therapy techniques. In desperation, I signed up for biblical counseling at Lighthouse. And through this, God showed me the core of “issues” I have been struggling with my whole life: my kingdom of shame, control, and fear. He began to show me His kingdom of righteousness, peace, and joy (Romans 14:17). I began learning the sweetness of His Word of life and biblical truth. He began to turn my heart of stone into a heart of flesh (Ezekiel 36:25).

My Journey…

I could go on about how God continues to transform me, but that would be a digression for this blog. I began to read everything I could put my hands on about biblical counseling, and even took a class The Dynamics of Biblical Change through CCEF (Christian Counseling & Educational Foundation: go to CCEF.org for great resources).

Through my own biblical counseling and through reading and class, I became aware of the untruths I had learned in my schooling. In seminary, theology had been difficult for me. In a postmodern era, I became very confused about truth—I began to think it was unknowable, because doesn’t everyone come from a subjective place? And to claim absolute truth can be arrogant and inflexible—no one wants to be either of those. Theology seemed like an ivory tower pursuit that did not pertain to my daily life, so I thought, let the theologians battle it out with each other.

But biblical counseling is applied theology. As Pastor Kim says, what we believe about God affects how we live our lives. And Scripture is filled with knowable truth, especially the life-changing truth of the gospel, not just for our eternity but for each moment in this life.

Also, I had been taught that the Bible addresses issues of ultimacy, while psychology addresses issues of finitude. In non-academic language, this means the Bible addresses our ultimate state (our eternity) of being, while psychology deals with our day-to-day life here on earth (what will end). And as a therapist, we should direct counselees to pastors for issues of ultimacy. Thus, therapy didn’t need to explicitly deal with Scripture, nor did Scripture necessarily entail the answers to psychological questions. At one point, I posited that Scripture told us how we should be ideally, but not how to get there (change our behaviors or hearts).

In addition, somewhere I learned that by being a Christian, I was bringing the Holy Spirit with me into the therapy room, which implicitly made my therapy Christian. I also thought that by bearing another’s suffering, I was acting on a theology of presence in suffering just as Christ bore our suffering.

Also in reading literature on biblical counseling, I realized that in a sense, as a psychologist I work as a “secular clergy.” A church has theology based on its leadership’s understanding of the Bible, of people, and of suffering, which affects that church’s ministry to suffering people. A therapist can also serve as a “priest,” listening to “confessions” and administering “wisdom” and how to deal with suffering. In fact, the word patient comes from Latin as “one who suffers.”

Interestingly, prior to the illness that brought me to biblical counseling, I had been working on a book on the latest psychotherapies. I was laying out how each therapy viewed etiology (cause of the problem), its philosophical underpinnings and assumptions (worldview and view of sufferers), and techniques (how to solve the problem). Biblical counseling speaks to the idea of instead of taking secular therapies and trying to adapt them for a Christian, starting from the beginning with a Christian worldview of the problem and a scriptural solution.

I have been able to use some of what I have learned about biblical counseling with some of my Christian patients and have been blessed to see heart changes. One woman with bipolar has become less reactive—in situations which she would have cursed people out, she has been able to stop and bless them. Another woman who would isolate for days in her room with depression has joined her beginning believer’s class at her local church even though she has been attending there for years. I have also come across challenges, which has caused a deeper desire to learn even more about biblical counseling.

When I originally went to seminary for psychology, I thought I was going to learn how to minister to others through my faith. I learned about how my faith would “inform my practice.” Today, I am going back to school for the gospel and my faith to be my practice!

Topics: Biblical Counseling, Education, Equipping, People in Need of Care, People Who Offer Care, People Who Train Caregivers | Tags: , , , ,

Good News for Single Men

Good News for Single Men

Last night I had a conversation with a handful of single men from our Soma Tacoma family. As a shepherd and elder who cares deeply for the hearts of people, I’d like to speak directly to other single men about a few of the takeaways from our two-plus-hour dialogue.

1.  Jesus wants to “secure your undivided devotion.”

After beginning by affirming my love for these men, we read from 1 Corinthians 7 where Paul makes some interesting statements about singleness and marriage. There is one section, however, that is extremely clear:

“I want you to be free from anxieties. The unmarried man is anxious about the things of the Lord, how to please the Lord. But the married man is anxious about worldly things, how to please his wife, and his interests are divided…I say this for your own benefit, not to lay any restraint upon you, but to promote good order and to secure your undivided devotion to the Lord” (1 Corinthians 7:32-35, emphasis added).

Paul’s call to all single people is clear: as long as you are single, secure undivided devotion to Jesus! When you marry, you add a layer of complexity to your life. Use the extra margin you have today to sharpen your focus on Jesus.

My chief concern for all of our single men is that they passionately pursue…Jesus. Not a woman, but Jesus. Love Jesus, serve Jesus, pursue Jesus, know Jesus, walk with Jesus, be satisfied in Jesus, experience intimacy with Jesus, find every bit of their significance and value in Jesus. Be a faithful disciple of Jesus! THAT is the Father’s chief concern for you, single men.

And though every man I talked with last night is already doing that, the Spirit led me to echo Paul again by saying, “excel still more!” (1 Thessalonians 4:9-10).

2.  Start with the right question.

It shouldn’t be shocking that our evening included a discussion of how to determine which woman one should pursue. As we talked, I heard the essence of a question that I often hear single men ask (and I clearly recall asking myself when I was a single man): Who am I interested in?

I believe when it comes to pursuit, if you start here men, you are starting with the wrong question.

Jesus said the two greatest commandments are to love the Lord your God with all of your heart, soul, strength, and mind; and to love your neighbor as yourself (Matthew 22:36-40). Everything we do should be motivated by love for God in response to what He has done for us in and through Jesus. We love him because He first loved us (1 John 4:10-11), and love for him is what motivates us to lay down our lives for the sake of others (2 Corinthians 5:14-15).

Therefore, starting with the right question means asking, “Who would the Father have me pursue? Who would He have me serve and bless by initiating an intentional friendship?”

Finding a wife should not be your primary motive for pursuing a woman. A single man’s motivation for pursuing a woman must primarily be loving obedience to the Father, and secondarily to serve and bless his sister. Pursuing a woman in Spirit-led fashion, regardless of the outcome, honors God and blesses her.

So, begin by asking the Spirit to make it clear to you who He wants you to pursue. He is your perfect Father, and He knows you (and all of your sisters) better than you know yourself. He is uniquely qualified to guide you. And ask others for help in determining the Spirit’s leading. Don’t feel like it’s totally up to you to sit in the corner, listening to the Spirit, until some woman’s name pops into your head. Process this in community.

(This is nothing new, of course. I remember talking for hours with my friends about the different women we were interested in, trying to determine what we should do next. But we were starting with the wrong question. I wish we’d been armed with the thought that our Heavenly Father had an opinion on the matter. It would have significantly altered the discussion.)

3.  Having a wife doesn’t make you a man. Jesus makes you a man.

As an elder, I know that at times I have inadvertently sent the message that finding a wife makes you more of man. Nothing could be further from the truth.

I often ask men, married and single, “How do you know you’re a man?”

I believe there are three main ways for Jesus’ followers to answer this question.

First of all, I know I’m a man because I am a male who has been created in God’s image (Genesis 1:27). Men and women both uniquely image God, and as a man, this uniqueness is reflected in my heart and life.

But secondly, I know I am a man because Jesus is the only perfect man who ever lived. Jesus was, in every sense, the ultimate man. He was the man that Adam failed to be (Romans 5:12-21). Jesus’ success as a man supersedes the failures of every man who ever lived.

And now, I am in Christ (1 Corinthians 1:30). His perfect record is given to me. His performance, His work, His accomplishments, His achievements—it’s all mine, and it all defines me as a man. In any way that I seek to prove my identity as a man, I fail; and in every way I need Jesus to prove my identity as a man, He succeeds. Jesus, the only perfect man who ever lived, is the one who makes me a man.

Finally, as one who is in Christ, the Father affirms His love for me by His Spirit. He also affirms that I am His child. And when He affirms this, He calls me “son.” “The Spirit bears witness with our spirit that we are children of God” (Romans 8:16).

That is how I know I’m a man!

Single men, secure undivided devotion to this One who truly defines you. Love the only One who can deeply satisfy you. Obey the perfect Father who you can trust with your today and your tomorrow. And rest in the fact that you are already a man, made whole and complete by Christ.

Join the Conversation

Which of the three principles most resonates for you? What principle(s) would you add in counseling single men?

Topics: Christian Living, Discipleship, Men/Husbands, People in Need of Care, People Who Offer Care, People Who Train Caregivers, Singleness | Tags: , , , ,

Complaining: Rewriting the Story God Is Writing

Complaining - Rewriting the Story God Is Writing

Summer is a time of fun and leisure—being lazy on the beach and entertaining around the pool. It is also a time for Blockbuster movies—scrolling movie review websites to find great stories to get lost in all summer long only to resurface at the beginning of fall.

The movie industry rakes in billions of dollars from summer movie-goers. We crave great storytelling—whether it be a romantic comedy or an adventurous sci-fi thriller. We each have personal motives for choosing the movies we watch. We may want to see a chaotic world come to a peaceful resolution in two hours or a broken person become whole again by the end of the movie.

This is great for the fantasy world, but it becomes a serious problem when we begin to view real life the way we view movies. We want the romance, adventure, thrill, and drama of our personal lives to be resolved in two hours and to resurface from the story unscathed.

Reality

Reality is too real. Unlike movie spectators, we experience real pain—the pain of divorce, death of loved ones, broken relationships, failed businesses, foreclosures, illnesses, and national unrest. We are shocked and confused when undesirable circumstances in our lives take more than a day to resolve themselves.

Human nature compels us to try to fix the problems in our lives by any means necessary. We get angry and frustrated when we can’t control our circumstances and God won’t act as our personal genie to fix everything with the snap of His finger. We begin to grumble in our hearts only to spew out negative expressions of discontent. We complain against others, the world, and ultimately God about the unwanted parts of our life story.

Biblical Complaining

Throughout the Bible, we read about casting our cares on God (Psalm 55:22; 1 Peter 5:7) and pouring out our hearts to the Lord (Psalm 62:8). God wants us to bring our complaints before Him in such a way that honors Him.

Biblical complaining is pouring out our concerns and feelings before the Lord without attacking His character. This type of complaining always ends with praises for who God is. Psalm 102 is a good example. The psalmist pours out his complaint to the Lord. He is afflicted and overwhelmed. He finds relief only when he reflects on God’s sovereignty and eternal purposes in his circumstances.

Sinful Complaining

Sinful complaining is trying to rewrite the story God has written. We are the characters and God is the author. The novelist will sometimes say that the character they created begins to dictate the story of the novel. Fortunately, that doesn’t happen in God’s story. God is the novelist and we are His characters. We do not possess the power to dictate the story of our lives—but we act like we do. The Bible is written from God’s point of view. He has and is creating the characters and telling each individual story.

Complaining is the symptom of a deep-seated spiritual problem. It is a failure to trust God and to submit to His will. When we complain sinfully, we reject God’s authority, providence and sovereignty over our lives. In Philippians 2:14, we are commanded to “do everything without grumbling.” Why? Because He wants us to “become blameless and pure children of God without fault in a warped and crooked generation—to shine among them like stars in the sky—holding firm to the word of life” (Philippians 2:15-16). Our life circumstances—good and bad—are a part of God’s eternal purposes that are sometimes beyond our understanding.

The Faces of Complaining

Complaining has many faces. It can look like blaming God, unbelief, failing to trust God, rejecting God’s will, and rebelling against God. The story of the Israelites has all five elements of complaining in one event. Numbers 13 and 14 tell the story of the Israelites’ unbelief when God sent men to spy out the land of Canaan. Caleb and Joshua brought back a factual report of the land and a positive charge to obey God. But the other spies gave a bad report causing the Israelites to complain out of fear and disobey God (Numbers 14:2, 36).

Immediately unbelief arose in their hearts. They chose to believe the bad report and not believe the report God gave to Caleb and Joshua (Numbers 13:31). Next, they failed to trust God when they “lifted up their voices and cried…and wept that night” (Numbers 14:1). Then they blamed Moses, Aaron, and God for bringing them to the wilderness to die instead of leaving them to die in Egypt (Numbers 14:2-3). Furthermore, they rejected God’s will when they said, “Let us appoint a leader and return to Egypt” (Numbers 14:4). Finally, they rebelled against God when they planned to stone Moses and Aaron (Numbers 14:10). As a result, God judged the Israelites causing that complaining generation to die in the wilderness never receiving the Lord’s blessing.

Embracing the Story God Is Writing

At the root of sinful complaining is discontentment. To be discontent is to be dissatisfied. When we are not satisfied with our circumstances, then we are tempted to complain sinfully. There is either something we want that we don’t have or something we have that we don’t want.

Discontentment propagates ingratitude, discouragement, depression, and anxiety. As a result, we view life from our perspective as if we are writing our story and not God.

Cultivate Contentment

Overcoming sinful complaining is found in contentment. Contentment is “an internal satisfaction which does not demand changes in external circumstances” (Holman Bible Dictionary). Although it is a command (Hebrews 13:5), contentment must be nurtured and cultivated. It is a learning process. The apostle Paul says that he has learned to be content in whatever circumstance (Philippians 4:11-12).

To cultivate contentment, first, we must get to know the Author of our lives. Knowing who is writing our story is the basis of contentment. Second, we must know who we are in Christ. We are the characters created in the image of God. We must view ourselves and our circumstances from God’s point of view and not our own. Third, we must embrace this season of life because it is a part of a bigger story. We may not be able to see the whole picture. However, by faith we trust in God’s sovereignty, authority, and providence in fitting our story into His bigger story.

Join the Conversation

Do you complain? Is it biblical complaining or sinful complaining? How can you challenge yourself to turn sinful complaining into biblical complaining by cultivating contentment?

Topics: Bitterness, Christian Living, Faith, People in Need of Care, People Who Offer Care, People Who Train Caregivers | Tags: , ,

5 Ways Training in Biblical Counseling Changes Our Lives

5 Ways Training in Biblical Counseling Changes Our Lives

I have been counseling from Scripture for over thirty years and have been ACBC (NANC) certified for twenty years. For the past several years, I have been the director of a counseling/training center (IBCD—The Institute for Biblical Counseling and Discipleship in San Diego County). For some time, I had been praying that the Lord would send us a happily married woman who could care for the many ladies who come to us for counsel. We also needed someone to help train women who want to learn to counsel in their own local churches. My own wife, Caroline, didn’t really come to mind as a possible solution. My observation had been that most of the women who complete their certification are more driven (“type A”) individuals. Caroline is much more laid back, which is a wonderful calming complement to my very driven personality. She would happily attend conferences at which I would speak, or occasionally quietly sit in with me when I would counsel a woman or a couple.

Then a few years ago, much to my surprise, the Lord put it on her heart to go through the ACBC certification process. She spent many hours reading, studying, and taking the exams. She then completed her fifty hours of supervised counseling under the wonderful expert guidance of Dr. Bob Somerville. For the past few years she has been counseling two days a week for IBCD, plus meeting regularly with several ladies in our church. She also has had opportunities to teach groups of women. I have been amazed at the many good things God has done. Here are just a few examples of how training in biblical counseling has impacted her life and our relationship.

1. She has found significant ministry work to perform in a new phase of her life.

Titus 2:3-4 instructs older women to encourage the young women. While it is hard to think of my lovely, young-looking wife as an “older woman,” she had completed the arduous task of training/home-schooling our three sons and was ready for a new focus in her life’s work. She has flourished in her spiritual care and discipleship ministry to ladies.

One of my fellow counselors says that as he watches the women come and go from meeting with Caroline, it is like she has many daughters for whom she cares deeply. Her sweet, quiet disposition enables her to connect with women in a very special way. They love her. I think that some would move in with us if we would let them!

2. I have seen incredible spiritual growth in her personal life.

I have known Caroline since we were 15 years old. She has always been a godly person. But her involvement in helping others has given her a renewed appetite for God’s truth. She listens to sermons and other Bible teaching with greater intensity. She meditates on God’s Word more than ever. She reads important books. She yearns to find answers from the Word of God to help the women she counsels.

I also see that the Word of God is helping her to address her own sins and weaknesses as never before. She listens to the counsel that she gives to others and is being transformed by God’s Spirit.

3. The spiritual component of our marriage is the best it has ever been.

We enjoy talking over her cases as she seeks my help in applying God’s Word to her counselees. We share insights from Scripture with one another. We pray together for the people we are trying to help.

4. We serve together as a team.

When we counsel couples, while she is careful to follow my leadership, she speaks out much more than before and has important things to say. Others are recognizing her gifts, and her opportunities are expanding. Sometimes when I get invited to speak, Caroline is also invited to speak to ladies. I knew things had really changed when a major counseling conference invited her to speak (and not me).

5. She has become my counselor.

Caroline, by nature, does not like confrontation. During the first thirty years of our marriage she almost never corrected me, perhaps thinking that this was part of being a submissive wife. As she has grown in her understanding of God’s Word, she has come to realize that part of her role as my “helper” (Genesis 2:18; Proverbs 31:11-12, 26) is to address sin in my life to which I might be blind.

While I confess that I have had to learn to receive her correction gracefully (Proverbs 9:8), I am grateful to God that she is the best example I know of someone who gently and spiritually restores the one who is caught in sin (Galatians 6:1). I know that she is on my side and that she is trying to help me to be more Christlike. My soul is enriched by her godly help.

Join the Conversation

How has being trained as a biblical counselor changed your life and relationships?

Topics: Biblical Counseling, Education, Equipping, People in Need of Care, People Who Offer Care, People Who Train Caregivers | Tags: , ,

Christian Identity: Counseling a Person Who Is a Victim and a Perpetrator

The BCC Weekend Resource

BCC Staff Note: On weekends we like to highlight for you one of our growing list of free resources. This weekend we highlight a video by Ed Welch in which he discusses Counseling a Person Who Is a Victim and a Perpetrator. This video originally appeared on CCEF.org. You can view the original resource here.

Is your counselee a victim or a perpetrator? That can be an easy distinction in some cases. But what about when they’re both? Ed Welch discusses how to counsel a person who is both a victim and a perpetrator.

Topics: People in Need of Care, People Who Offer Care, People Who Train Caregivers, Video | Tags: , , ,

Friday’s 5 to Live By

Friday's 5 To Live By

Each Friday our BCC staff links you to the top five biblical counseling and Christian living blog posts of the week—posts that provide robust, rich, and relevant insights for living.

Keep It Vertical

We live in a day and in a society where our stand for Christ is less and less appreciated. Julie Ganschow reminds us in these situations to, “Be encouraged when your faith brings ridicule and rejection into your life and keep that vertical view in mind!” Read her further words of encouragement in Taking the Vertical View When Ridiculed.

What Do You Call Your Counseling?

At his RPM Ministries site, Bob Kellemen lists dozens of names/labels for counseling—from the biblical counseling world, from church history, and from the Bible. Read his thoughts at What Do You Call Your Counseling? 

Take It Back to Jesus

At the Gospel-Centered Discipleship site, J.A. Medders encourages us to help people to focus on Jesus. When people have complaints or concerns about “religion” or “the church,” Take It Back to Jesus.

Forsaken Faith

Randy Alcorn writes:

“The percentage of college students today who grow up in Christian homes and later turn their backs on Christ is stunning, almost beyond belief. I believe it’s vital that parents and church leaders understand some of the major reasons behind this trend—and know what they can do now to help their children prepare for the challenges ahead.”

Read Randy’s words of counsel in Forsaken Faith.

God’s Gospel, God’s Commands, and God’s Mission

Trevin Wax reminds us that, “‘Gospel-centered’ has become a buzzword and risks losing its meaning. What do we mean by this terminology?” Visit his site and view the video where he and other leaders address this question and more in God’s Gospel, God’s Commands, and God’s Mission.

Join the Conversation

Which post impacted you the most? Why? What blog posts have you enjoyed this week that you want to share with others?

Topics: Five To Live By, People in Need of Care, People Who Offer Care, People Who Train Caregivers | Tags: , , , , , , ,

Helping a Counselee Understand Chemical Imbalance

Helping a Counselee Understand Chemical Imbalance

Note from the Author: Special thanks to Laura Hendrickson, M.D. and former psychiatrist for her help with this article.

Often counselees are told by their doctors that they have a “chemical imbalance.” Their underlying diagnosis may be depression or bipolar disorder. Those diagnosed as “bipolar” are, many times, told they are like the diabetics who must have insulin. They must take a mood-stabilizer medication and possibly an antidepressant to keep the chemicals in their brain in proper balance. Those diagnosed as “depressed” are frequently told they, too, have a disease of a chemical imbalance in their brain which the medicine will correct.

Is this correct? Let me explain why I believe it is not.

In the brain there are chemicals called neurotransmitters. These neurotransmitters (dopamine, norepinephrine, and serotonin) are like tiny chemical bridges that allow electrical activity to move from cell to cell in the brain. Electrical activity shows that a brain is alive or can show seizure activity. What the electrical activity is not is the person’s thoughts. Actually, scientists do not know how a person thinks a thought.

What doctors do know is that the antidepressants change the balance of the neurotransmitters in the brain. Actually they change the balance to extremely abnormal levels. It is also known that the antidepressants will, for most patients, lift their mood. What is not known, however, is how (by what pharmacological means) that the depressive mood is altered. It is theorized that the patient’s mood is lifted because the medicine changes the balance of the chemicals. Therefore, it is assumed that the depression is caused by a neurotransmitter “chemical” imbalance.

It may seem odd to pastors and other non-medical people that doctors would give a medicine when they don’t clearly understand how it works, but that is common in medicine. For instance, it was probably 100 years before doctors discovered how aspirin reduced fever, but they gave aspirin anyway because they knew it worked.

It also may seem odd that doctors are sometimes so quick to diagnose someone as having a chemical imbalance instead of sending them to their pastor or a counselor to learn to control their thoughts, to correct their emotions, or respond better to difficult circumstances. The reason so many doctors do this is they are taught in medical school to view people as if the physical body is all there is. In other words, people are sophisticated physical organisms, so if they are depressed, they must be victims of a physical disease. Doctors tend to look at things through their “medical model.” So, when a patient experiences painful emotions, these are thought to be due to a physical cause, such as (they theorize), a “chemical imbalance,” instead of coming from the inner man (the heart, soul, or mind).

It is important to remember that doctors give antidepressants because they work for some people not because they really know how or what is really causing almost all depression. In fact, they cannot test a patient for neurotransmitter levels in their brain without doing a biopsy of their brain which, of course, they don’t do.

Biblical Counselors and the Field of Medicine

Biblical counselors should have great respect for doctors and the training they have had. However, we ought to acknowledge that the “practice of medicine” is, to a certain extent, an educated guessing game. Therefore, we must be careful not to be intimidated into taking medications which may unnecessarily mask symptoms that we should be dealing with biblically. Also, these medicines may cause difficult and sometimes permanent side effects including, for some people, extreme difficulty withdrawing from the medication.

Side effects of antidepressant withdrawal are crying spells, worsened mood, low energy, trouble concentrating or sleeping, suicidal thoughts, anxiety, panic attacks, irritability, impulsivity, aggressiveness, self-harm, confusion, memory problems, hallucinations, flu-like aches and pain, fever, sweats, nausea, vomiting, abdominal pain, spinning feeling, unsteady gait, headache, tremor, numbness, tingling, electric zap-like sensations in the brain or body, ringing in the ears, drooling, slurred speech, muscle cramps, uncontrollable twitching of the mouth.[i] Certainly not every patient experiences all the withdrawal symptoms to their full extent, but research has shown that “as many as 78 percent of patients have withdrawal reactions when they stop their antidepressants, depending on the particular drug.”[ii]

There are legitimate physical causes for depression such as hypothyroidism or side effects to medications such as steroids or some high blood pressure medicine. Those can be and should be treated medically. However, the vast majority of depressed patients are diagnosed as having a chemical imbalance, told dogmatically that they have a disease, and must take medicine to treat it so that they can either get well or, at least, remain stable. This is simply not true. Neither is it the biblical method for learning how to manage our emotions.

For those pastors and counselors who have counselees already on antidepressants and desiring to get off, I highly recommend that you (and possibly the counselee) read The Antidepressant Solution by Dr. Joseph Glenmullen (Free Press Publishers, 2005). It is important to warn the counselee who desires to come off his medication, not to take himself off of them without consulting with his doctor first. A person who does not heed this warning runs a great risk of having severe rebound symptoms (and possibly of being placed on an additional psychiatric medication!). Therefore, his doctor needs to guide him in a safe process. For those not already on antidepressants, they should be encouraged to seek help from their pastor or a biblical counselor who will give them hope from the Lord and help them learn to cope with their problems in a way that gives God glory and will ultimately give them peace of mind.

If asked, most doctors will admit that the chemical imbalance diagnosis is their “best guess” and that the medicines do have unpleasant to even severe side effects to say nothing of the withdrawal effects. “In fact, leading psychiatrists such as Dr. David Healy don’t even believe in the “chemical imbalance” theory any more. Now researchers agree that whatever antidepressants do, they do not correct an imbalance.”[iii]

When Jeremiah was depressed, he remembered certain things about God’s perfections and it gave him hope:

“This I recall to my mind, therefore I have hope. The LORD’s lovingkindnesses indeed never cease, for His compassions never fail. They are new every morning; great is Your faithfulness. The LORD is my portion,” says my soul, “therefore I have hope in Him” (Lamentations 3:21-24).

The true believer’s hope is in the Lord. Christians are to be controlled by the Holy Spirit whose fruit is love, joy, and peace instead of controlled by a mood altering medication. The chemical imbalance theory of depression is not true. What is true is that depression is a very real and miserable emotion. Your counselees who struggle with depression need help and hope that honors God and enables them to give Him glory.[iv]

Why are you in despair, O my soul? And why have you become disturbed within me? Hope in God, for I shall yet praise Him, The help of my countenance, and my God” (Psalm 42:11).

Join the Conversation

What is your perspective/conviction regarding “chemical imbalance”?

BCC Staff Note: The BCC, as a true coalition, has a diversity of perspectives on biblical counseling and the complex body/soul relationship. We recommend several resources for further study. Chapter 28 of Christ-Centered Biblical Counseling addresses this issue. We also recommend Dr. Charles’ Hodges book, Good Mood Bad Mood. Additionally, yesterday’s post at the BCC by Pastor Dave Dunham, Counseling People Struggling with Obsessions and Compulsions reflects on these complex body/soul issues.


[i]Glenmullen, Joseph. The Antidepressant Solution (New York, New York: Free Press, 2005), p.135.

[ii]Glenmullen, p.1

[iii]Doctor Laura Hendrickson (former Psychiatrist and MD) in e-mail correspondence with Martha Peace, June 2005.

[iv]For a biblical counselor in your area look on the www.biblicalcounseling.com web site under “find a counselor.”

Topics: Biblical Counseling, Medication, People in Need of Care, People Who Offer Care, People Who Train Caregivers, Psychology and Christianity | Tags: , , ,

Counseling People Struggling with Obsessions and Compulsions

Counseling People Struggling with Obsessions and Compulsions

Katelynn was trapped in her apartment over a long weekend. She was convinced that there was blood outside her door which was going to contaminate her.

Sasha was overcome with dread that she was going to yell out foul language during worship service, or while reading Scripture to her child. James was so consumed with the fear that he might be lying that he could never give a straight answer, only “maybe” would do.

These are real people. All of them have varying degrees of what is sometimes labeled obsessive-compulsive behavior (OCD). Caring for each of them requires incredible sensitivity, patience, and biblical counsel.

Freedom from Obsessions and Compulsions

OCD involves both obsessions and compulsions. Obsessions, properly defined, are intrusive, unwelcome, distressing thoughts or mental images. Compulsions are behaviors performed in a vain attempt to exorcise the fears or anxieties caused by an obsession. It’s necessary to understand both elements clearly if counselors are going to be helpful.

Vital things to remember about those who struggle with OCD is that they typically understand their obsession is illogical, and they also typically receive no pleasure from doing their compulsions. Attempts to help them should be exceedingly sensitive. The absurdity of the compulsion or the obsession should not be the focus of the counseling sessions. Rather, good counselors will attempt to be sensitive to the frustration and despair that a person with OCD may feel. They will also want to consider a number of issues related to causation.

Sensitivity is crucial for a number of reasons, but not least because there is a real possibility of biological causation as one important factor. Some counselor may too quickly overlook or dismiss the biological, believing it will remove personal responsibility from the individual. But the science pointing to biological factors should be taken seriously.

Biblical counselor Michael Emlet has pointed out several possible connections to biology. In his helpful booklet OCD: Freedom for the Obsessive Compulsive, he points readers to research that found OCD was more frequently present among identical twins than among fraternal twins. Furthermore, he points out that children with strep throat may develop a sudden onset of obsessive compulsive behavior which is relieved through treating the strep with antibiotics.

Jeffrey Schwartz too has demonstrated, through the use of PET scans that individuals suffering with obsessive-compulsive behavior actually present a sort of “overheating” in the basal ganglia (see Brain Lock). The frontal regions of their brains are overacting. An insensitive counselor will dismiss the biological, but a good counselor will encourage their counselee to seek appropriate medical attention to determine if any organic or biological causes may be contributing to or exacerbating their condition.

To counsel someone struggling with OCD without considering the biological factors is to fall prey to a kind of reductionism. Not only does such an approach feed the criticisms that is at times leveled against biblical counselors, namely, that they do not take science seriously, but it is also equally as reductionist as some secular approaches, only from a different angle. Some secular models of help do not treat the whole person, but rather reduces them to their biology. Such approaches have one tool in their tool belt: medicine. On the other hand, a biblical counselor unwilling to consider possible organic factors that may be involved in a case is reducing a person to their spiritual nature, a sort of gnostic approach to counseling that is neither Christian nor fundamentally helpful.

Working with James

Working with James has required this kind of careful analysis. James is a seemingly strong believer. He has a great grasp of the Scriptures, studies them often, and is concerned deeply about his obedience to Christ. He cannot, however, shake the feeling that he is going to lie. We discuss principles governing truth and falsehood. We discuss how it can be sinful to demand a level of certainty that God does not allow. He understands and can articulate these truths, but he has a real disconnect when it comes to applying them to his own life.

As two strong believers we are struggling together to work through this issue, it seems that getting a full physical examination might be next step for him. This doesn’t mean that James doesn’t also have heart issues that he needs to work through. He does, and we are doing that too. Some of his progress, however, may be stalled until we can determine what’s going on under the surface of his phobia; it might be a biological issue. Biblical counseling aims to treat the whole person as a whole person, so we want to carefully consider all the factors: spiritual, emotional, relational, psychological, and biological.

With James, progress has been slow. Every step forward has been met with another challenge. The list of phobias he has seems to grow. I am reminded often of 1 Thessalonians 5:14. Paul’s words to the church in Thessalonica have become a motto for Biblical counselors everywhere. He writes:

“And we urge you, brothers, admonish the idle, encourage the fainthearted, help the weak, be patient with them all.”

These words remind us of the importance of case-specific-counseling. Each individual needs a response that is relevant to their struggle. The idle need to be admonished, Paul says, but the fainthearted need encouragement. Different approaches are needed for different circumstances. The one thing that ought, however, to govern all cases is patience. This has been evidently true in counseling those who struggle with obsessive-compulsive behavior.

Obsessions are slavery, and those who have repeatedly given in to their compulsions only tighten their grips. Breaking those chains is not a quick process. Counselors must plan for the long-haul; they must focus on long-term discipleship not immediate repression of behavior.

It is possible to resist urges. In fact studies have proven that after fifteen minutes of refusing to indulge a compulsion the urges often dramatically decrease. That is not the same, however, as suggesting that the urges just go away. Psychologist Jeffery Schwartz often tells his patients that the urges may never go away completely, but he insists that this should not be their goal.

The biblical counselor’s goal for a counselee is not that they would be totally temptation free, but rather that they would consistently increase in faithful responses. Victory is not the absence of struggle, but the growing response of faithfulness in the midst of the struggle. As Alasdair Groves so eloquently puts it:

Struggle is not a bad thing. Instead, struggle is the glorious work of God as he redeems and sanctifies fallen hearts. Most men take a negative view of struggle because it is painful, exhausting, and they know they should not love the sins they are tempted to love. Struggle, however, is God’s ordained way of working righteousness into our lives, transforming men into people who radically own it when they say “No” to temptation. (Journal of Biblical Counseling 27:1, 22-23)

Celebrating Victories

The goal is to say “No.” Saying “No” consistently, however, takes time and spiritual discipline. It also takes a counselor who is committed to patient reiteration of biblical truth. It takes a counselor who encourages the small evidences of hope. Celebrate the little victories more than you condemn the occasional failures. With both James and Sasha that has meant reminding them that they have demonstrated the possibility of resisting their urges. The occasional failure does not undo all the work that God has already done in them. We look often at Romans 6 after a bad week.

In Romans 6 Paul speaks of believers who “submit their members to sin as slaves of unrighteousness” (v. 13). Because OCD feels like a slavery, and because they understand that giving in to compulsions is a form of submitting to slavery this is a relevant passage for them.

The major point to direct them to, however, is Paul’s main point: you don’t have to do it. Paul’s whole point in Romans 6 is that the believer is “free from sin.” We may submit to sin, but we don’t have to. We can instead submit to God.

Furthermore, we discuss the work of the Spirit in their lives and point to the evidence that they can do this. They have done it many times. The goal is to encourage them towards increasing faithfulness. Their failure this week is not a complete failure, it’s a setback. We can still move forward. Only a patient counselor, however, will see this reality. The impatient counselor focuses on every failure, every setback, every false message that the counselee encounters. The impatient counselor is looking for the “cure,” the complete removal of temptation and struggle, but God does not promise us or our counselee such things. We must, then, rethink our definition of “victory.” We must be patient with the counselee.

Scripture-Informed Counseling

The Scriptures not only informs the way we counsel, but they inform the counsel we give too. Obviously what marks out biblical counseling as distinct is the fact that it takes its direction from the Bible. So our counsel derives from the Scriptures. It is the Scriptures that offer significant hope, even to those who struggle with obsessive compulsive behavior.

The primary means for treating mental disorders like OCD has largely been medication. But medication may not prove effective and is often accompanied by serious side effects. The dramatic side effects of so many medications make them often very undesirable. Patients are torn between which symptoms are worse: those derived from their OCD or those derived from the medication given to treat it. The Scriptures, in turn, offer a different approach to treating obsessive compulsive disorder.

The Scriptures tell us we can change by means of “renewing the mind” (Romans 12:2). In counseling James, Sasha, and Katelynn, we have naturally focused on their thoughts and what alternate truths combat the false messages their brains are sending them. We try to look for root issues and points of connection to other issues.

The OCD may in fact be a symptom. In one case study Dr. Steve Viars explained how one counselee’s obsession with driving on odd number streets was actually an attempt to self-atone for lustful thoughts (see Counseling Hard Cases).

In Katelynn’s case, her contamination fears manifested most clearly when she was involved in stressful social contexts. Fear of man dominated her so much the she was overcome with severe social phobia. She would leave parties and replay every scenario, every conversation, critiquing and berating herself for her supposed failures. Her cleaning compulsion was actually an attempt to divert her attention, to repress her thoughts.

As we began to address her social phobia biblically the need to act out the compulsion decreased significantly. Giving biblical truth to reshape and reorient the counselee goes a long way towards bringing remission to their obsessive compulsive behavior. This is what makes biblical counseling distinct from other approaches.

No struggles are ever simple. Treating those who struggle with OCD is a process that requires sensitive, patient biblical counsel. Biblical counselors should take science, sanctification, and Scripture seriously. As they do, such counselors will be exceedingly useful to those they counsel.

Join the Conversation

In your counseling of people struggling with obsessions and compulsions, who do you take seriously science, sanctification, and Scripture?

Topics: Anxiety, Biblical Counseling, People in Need of Care, People Who Offer Care, People Who Train Caregivers, Psychology and Christianity | Tags: , ,

Does Gospel = Jesus?

Does Gospel Equal Jesus

BCC Staff Note: This blog was first posted at Tim Lane’s ministry site and is re-posted by the BCC with Tim’s permission. You can also read the original post here.

A Good Problem

Much is being said about “Gospel-centered” ministry. This is a good problem, by the way! I could not think of a better substitute for other problems brewing in our churches on a weekly basis. Still, definition is needed.

My concern is that the term “gospel-centered” can almost objectify what is ultimately intended to describe a relationship. Even the word “grace” can serve in a similar way. Each word is accurate, but a relationship with the person of Christ is inadvertently eclipsed.

Why is this so important? If you are not careful, you can make the Christian life about what you believe rather than in whom you believe.  In other words, rather than focusing on the Blesser, you focus on the blessings.  It’s a subtle shift. This can impact the way we think about the change process.

One may “meditate” on their justification, adoption, or their regeneration (or any of the other blessings that are ours in Christ). These are wonderful realities to reflect upon but not apart from talking to and interacting with the One who has made these blessings possible. Without knowing it, Christian growth is driven by right thinking and not right relating. While right thinking and doctrine is important, right relating is foundational. Right thinking may leave you in your own mind while right relating takes you outside of yourself.

Change

My standard definition of change goes something like this:

A thoroughly Christian understanding of change is not less than behavioral but more; it is not less than cognitive, it is more; it is covenantal.

The word “covenant” means relationship. Christian change has at its center, not a discipline or some secret knowledge or technique but a Person, Jesus.

In his helpful book, The Work of Christ, Robert Letham says:

“As far as we are concerned, union with Christ begins to be a reality when we trust in Christ for salvation….Union with Christ is, in fact, the foundation of all the blessings of salvation. Justification, sanctification, adoption and glorification are all received through our being united to Christ” (80).

I think that sums it up. Union with Christ is key. The Apostle Paul, in his letter to the Ephesians, repetitively uses the word “in.” We are in Christ. What a strong way of describing how intimate this relationship is.

Topics: Faith, Gospel-Centered Ministry, People in Need of Care, People Who Offer Care, People Who Train Caregivers | Tags: , , , , ,

About the BCC

The BCC exists to strengthen churches, para-church organizations, and educational institutions by promoting excellence and unity in biblical counseling as a means to accomplish compassionate outreach and effective discipleship.