CHRISTIAN COUNSELING: ANGELS WORK BELOW
Knowledge that matters in life, or wisdom, is a gift rather than an achievement. It is not something we master or produce but something we receive. Wisdom comes from outside. It is revealed to us. It must master us. We must open ourselves to it and allow ourselves to be changed by it.
I have been a practicing psychotherapist for more than three decades. During this time I have been taught a great deal about counseling by the people I have tried to help. Their influence on me lies not so much in what they have taught me as in how they have changed me. In particular they have changed my attitude towards them over the years and if I do more good as a therapist today it is because they have helped me to view them and to relate to them in a more healing way. In a real sense my apprenticeship as a counselor over the past thirty years can be charted as a change in my attitude toward my clients.
Throughout my student years and into my internship as a Ph.D. candidate I thought of my clients as patients and of myself as their doctor. To my mind they, because they were subject to disturbed thoughts and feelings and exhibited odd, abnormal, strange, self-defeating behaviour they could not help themselves. They suffered from some form of neurosis or psychosis and therefore they needed my expertise. On the other hand I viewed myself as a normal, emotionally healthy individual, who, moreover, had been trained to move these unfortunate individuals toward mental and emotional wellbeing. In short, they were mentally ill and it was my job to (learn to) cure them.
Bound by this attitude I started my internship, the last leg of a lengthy period of preparation toward my doctorate. It was not as if I came unprepared for the role of doctor of psychology. By now I had taken numerous courses in testing, psycho-diagnostics, psychiatry, and psychotherapy. I had spent several years in group therapy by way of a learning analysis. I had accumulated an arsenal of techniques needed to diagnose and to cure a person’s mental illness. On paper at least I appeared to be well equipped. Now it was time to learn to put all this expertise into practice.
I did my internship in a small psychiatric inpatient facility in downtown Amsterdam. Most of the work I did there under supervision was to test inpatients, to diagnose their illness, and to write a psychological report on them. I found that I was well prepared for the job and I did not find the work particularly taxing. However, I was totally unprepared for the negative effect this job was to have on my self-image. So severe was this effect that for a time I began to doubt my own sanity.
As I went about my work identifying signs of pathology in my patients I was forced to admit time and again that I too had some of those symptoms, albeit that my symptoms were less severe. Moreover, as part of our training we were required to take a battery of tests, including the MMPI, which is a test for psychological abnormality. The fact that I scored high on the schizophrenia sub scale made me feel even less certain that I was completely normal. (Subsequently I learned that my high score was due to the test rather than due to my emotional instability. All Christians score high on items such as “I talk to God every day”, which items are said to be indicative of schizophrenia. But I did not know that at the time.)
So here I was after years of difficult education, almost ready to become a healer of psychological disorders and I had come to the conclusion that, like my patients, I was not normal, which meant for me that I was unfit for the job. I began to experience major panic attacks, which I successfully hid from the people at work but which I was unable to keep from my wife.
She became concerned about my state of mind and telephoned my supervisor. He called me into his office and wanted to know the source of my bouts with anxiety. With my cover blown I figured I might as well be honest and told him the whole story. He listened patiently for a while and then he started to laugh. And he said,” So, you think you are a little crazy, is that it?” I told him, “Yes, I’m afraid I am.” Then he stood up, stuck out his hand and said,” Well, join the club!”
More liberating words were never spoken to me. Join the club! We’re all a little crazy. Nobody is completely normal. We are all a bit off, even if some of us a bit more off than others. Suddenly the barrier between my patients and myself was gone. I was no longer “the doctor” and they “the patients”. My clients had taught me that I was like them. They were like me. There was no longer “they” and “I”, only “we”. Moreover, I learned that I did not have to be normal to be a healer. I still had a job!
This experience produced a Gestalt shift in my attitude toward the people whom I tried to help. The change lifted a burden off my shoulders. But now the question became urgent, if I no longer was to be a doctor to my patients, how then was I to relate to those who came to me for help? My solution was to become their friend. I had been taught that psychotherapy is really a kind of friendship-for-pay and that the most effective ingredient in psychotherapy is empathy, or the capacity to feel sympathetically what the client is feeling. Somehow, I knew, if a therapist is able deeply to live into what his client is feeling and is able to communicate this sense of her emotions to her in a caring manner, then that experience of being emotionally understood and cared for has a powerful therapeutic effect on the client. I latched on to this fact in defining my new relationship to my clients.
My internship experience had convinced me that I knew only too well what the people I tested were feeling. In fact that was the problem. Their feelings were so familiar to me that they became a threat to my self-definition as a normal person. Now that the requirement of being completely normal was gone I could embrace this empathic ability and put it to work. What had been my problem now became my stock in trade. During the next decade, first as a psychologist in a psychiatric hospital and then as the director-therapist of a Christian counseling agency I practiced empathy in therapy and with considerable success.
I tried hard primarily to relate to my clients at an emotional level. I worked hard to become a sympathetic ear. I developed a reputation of being a good listener. People said I was easy to talk to. I became the trusted confidante of many and I relished the role, as I do today. I deeply appreciate the trust people place in me when they let me into their lives. My definition of an effective counselor at that time in my career was that he or she is a person with open ears, a closed mouth, a clear head, and, above all, a warm heart.
My definition of myself as an empathic friend of my clients also meshed well with my picture of myself as a Christian. My favorite text at that time was Paul’s statement in I Cor. 9: 22b, “ … I have become all things to all sorts of people so that by all possible means I might save some”. I made myself available to listen to people at all hours of the day. I was able to rejoice with those who were glad, and especially to weep with those who were sad. I felt very virtuous, the epitome of what a Christian counselor should be. I was also rapidly developing a king-size Messiah complex.
Two things started to happen that made me realize I was on the wrong track. First, instead of finishing therapy with me, some of my clients simply stayed away after a number of sessions. I think these clients at first liked the warmth of being totally understood and cared for. But the amount of goodness I was exuding toward them was so great that it became hard to take. I think that after a while their sense of reality told them it was time to terminate therapy. The trouble was that I was being such a nice guy that they could not tell me why they were quitting. So they simply stayed away.
The other thing that was happening was that I was burning out rapidly. I felt everyone’s problems were on my shoulders. I no longer enjoyed my work. Therapy became a heavy-duty chore for me. I knew of course that being a counselor is a stressful occupation at the best of times. But I also suspected that the stress I felt was related significantly to the way I defined myself as a therapist. Something had to change if I was to continue to be an effective therapist and once again my clients showed me the way.
Two paradoxical sets of events helped me to change my attitude toward my clients. The first was that sometimes clients improved even when I did a poor job of helping them. The other was that sometimes clients failed to improve no matter what I did to try to help them. I discovered that my clients had resources, either in themselves or in their support community, which at times enabled them to resolve their personal problems without my help, and I realized that my current approach to therapy was not tapping into these strengths. I also realized that therapy occurs in the context of life and that life is bigger than therapy. There can be (sometimes legitimate) considerations in the client or in her community outside the context of the therapy hour that prohibit a therapist from moving a client in a healing direction. In short, I was learning about the limitations of therapy. No therapist is in complete control of the healing process. To be effective therapists need the support of their clients and of the clients’ support communities. At its best therapy is a cooperative, collaborative, inter-subjective process, in which therapists, clients and the people in the support community are co-responsible for the success of counseling.
My mentor, Dr. H.R. Wijngaarden, who was professor of Conflictuology at the Free University of Amsterdam, repeatedly warned us as students, “ People are the worst material to work with, you cannot cut them to size like two by fours.” I remember responding to this warning by saying, “Yes, professor, but that is also their glory.” Fact is that one cannot manipulate people toward emotional health. One can only get them to cooperate in this process. Therapy is an interpersonal affair in which two people work together toward the goal of emotional health. I knew this was true in theory when I was a student. Now I was seeing this truth confirmed in practice.
At about the same time I began to realize that therapy is more a matter of being than of doing. For me this means first of all that my capacity to help a client is limited. But even though I cannot always help a person I can always be of help to that person. I can make myself available to help when the opportunity arises. Therapy is a complex activity that requires the use of many skills. But when all is said and done it is a matter of being with and staying with our clients as they struggle toward emotional healing. Therapy is the process of resolving personal problems or healing emotional hurts by wearing them down, by outlasting them. This is especially true for depression. You help people out of their depression by staying with them through their depression.
Human beings seem to have a natural tendency to shun people who struggle with psychological disturbances in their lives. Therapy runs counter to that tendency. Therapists join people in their distress, and they stay with them. They show solidarity with people who suffer from some abnormality in their lives and they do not give up on them. Such therapy has the character of being faithful toward one’s neighbour. I think this notion of faithfulness gave me a more realistic understanding of what it means for me to be a Christian in my counseling. Perhaps the most essential characteristic of the biblical message about God is that he is faithful. He is faithful to his creation and to human beings in the sense that he is and stays with them and does not abandon them. He is present in their lives, in my life as well and as the recipient of his faithfulness I am privileged to pass some of that faithfulness on to my fellow human beings. Christian counseling is pipeline activity. In this respect II Cor. 1:4 is a more appropriate text, where Paul testifies to the fact that God “… comforts us in all our troubles, so that we can comfort those in any trouble with the comfort that we ourselves have received from God.”
In summary, my understanding of my role as a therapist had changed. At this point in my career I saw it as my task to be and stay with my clients in their struggle toward emotional health and to keep myself available to help them when the opportunity would arise. In addition, I became aware that I was not in complete control of the therapeutic process. To be successful in therapy I learned that I had to depend on my clients and I found I could depend on the cooperation of my clients. This implied that I now viewed them more as persons with resources of their own and less as patients or as sufferers of some diagnosed set of psychological abnormalities.
A surprising byproduct of this change in viewpoint was that therapy became easier and more enjoyable for me. It became important to me to get to know my clients as human beings rather as mere objects of my counseling activity. I discovered that human beings are probably the most interesting of God’s creatures on earth and that each person is in a real sense totally different from the others. I also learned that people who struggle with personal problems are anything but dull. Each has a fascinating life story to tell that is full of insights worth knowing. I realized then how much my clients were teaching me about life and with each additional client I wondered what new insight this person might teach me.
At about that time my pastor and I decided to facilitate a biweekly support group for depressed members of the church. The objective of this group was not for us to offer expert advice to them as to help them to be of help to one another. In this group people spoke freely about their struggles with suicidal thoughts, and with their inability to get anything done. They told how hard it was to cope with the side effects of medication and with their family and friends’ lack of understanding about depression. These were hardly uplifting topics, but what surprised us was that this group could weep one moment about the sadness of someone’s life and the next moment laugh with abandon about some funny incident in that person’s life. We were further surprised by how sensitively and wisely the group members responded to the problems that were presented. These people truly were able and willing to support one another, not only during the time we met but also in the days between our meetings. In spite of their depression they were in touch with life, they dealt with real life issues and were compassionate toward one another. I found myself wanting to be with these people and looked forward to our biweekly meetings.
It will be clear how much my attitude toward my clients, and with that my approach to therapy, had changed from the time I started my career. Then I saw them as helpless, rather pitiable individuals. Now I wanted to be with them! But I had one more lesson to learn from my clients about my clients. I have had this lesson confirmed time and again in my dealings with psychologically disturbed people, but the person who more than anyone has taught me this lesson is a woman whom I will call Julia.
Julia is a woman in her late thirties who suffers from chronic schizophrenia. Since the time of her adolescence she has been in and out of psychiatric hospitals, half way houses and group homes. When I first met her she had just finished a two-year stint in a group home run by Christians. This program had done her more good than any other previous program. She was now able to live on her own and to hold down a low stress job, even if only with difficulty. For as long as she can remember she had been on a heavy dose of anti-psychotic medication. These drugs served to keep the monsters at bay, but their side effects added to her difficulty to keep herself gainfully employed.
Julia called me one day with the request if I would be her special friend for a while. The leader of the group home from which she graduated had been her friend till now, but he had told her he was too busy and referred her to me. Julia assured me that being her special friend would only take one hour per week of my time. I accepted her invitation and from there on we met every Tuesday night for coffee at her place. During these visits Julia told me in detail what it was like to suffer from chronic schizophrenia.
Psychotic episodes come and go, she told me, and she described what it is like to feel one coming on. You wake up one morning, she said, and you find your thought processes don’t work, you can’t think straight and it is extremely hard to formulate a logical sentence. In the meantime you are bombarded by a flood of stimuli that make no sense at all. Your mental life is chaotic. It’s like being paralyzed from the neck up, or like a mental version of Tourette syndrome. It is extremely difficult to get your thoughts together. It takes enormous mental effort to keep some sort of control over your thinking and to maintain some sort of order in your mind. Then there are the voices to make matters worse. They threaten you, they terrify you, they hurl obscenities at you and they are so real that it becomes impossible to ignore them. People tell you that there is really no one there, that it is all in your head, but you don’t believe them because the sense perceptions you have are too vivid to be denied. You really hear voices that really are not there and you are frightened out of your mind.