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Cure of Souls and the Modern Psychotherapies (Excerpt)

October 21, 2011

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(NOTE: The following is an excerpt of a longer article by Dr. David Powlison. You can read the whole resource by visiting Cure of Souls on CCEF's website.)

The epoch of a great revolution is never the eligible time to write its history. Those memorable recitals to which the opinions of ages should remain attached cannot obtain confidence or present a character of impartiality if they are undertaken in the midst of animosities and during the tumult of passions; and yet, were there to exist a man so detached from the spirit of party or so master of himself as calmly to describe the storms of which he has been a witness, we should be dissatisfied with his tranquility and should apprehend that he had not a soul capable of preserving the impressions of all the sentiments we might be desirous of receiving.1

The Counseling Revolution

We live in the epoch of a great revolution. Consider that in 1955, believing Protestants had no comprehensive models of counseling. Theological conservatives had no educational programs to train pastors or other Christian workers in the face-to-face cure of souls. Christian bookstores contained no books on the problems of everyday life and the processes of change. No evangelical, fundamentalist, Pentecostal, or reformed leaders were known for their skill in probing, changing, and reconciling troubled and troublesome people. Practical theology concerned itself with preaching, missions, education, evangelism, liturgical activity, church government, and administration. Good things all! Discipleship programs taught doctrine, morals, and devotional activity. Good things all! But what was the quality of corporate wisdom in comprehending the dynamics of the human heart? How rich was the human self-understanding? How well did the church analyze the destructive and practice the constructive in human relationships? What does change look like, think like, feel like, act like, talk like? How does change proceed? What sustains sufferers and converts sinners?

No systematic analysis of care for the soul grappled with the particulars of how souls needed curing and might find it. In 1955 the churches that took God at his word had little to say about “counseling.” The last significant counseling work from a believing theological standpoint predated the Civil War. Without a well-developed practical theology of change and counseling—and without the institutions, books, and practitioners to embody and communicate such—churchly resources were reduced to religious forms in abstraction from systematic understanding: a prayer, a Bible verse, a worship service, a banished demon, a creed, a testimony, an exhortation, a commitment. Should these fail, there were no options but referral out to the secular experts.2

The counseling vacuum among evangelicals was inversely proportional to the counseling plenum in the surrounding culture. The twentieth century had witnessed the birth and proliferation of the modern secular psychologies, and of those mental health professions that mediated such theories into lives. Secular institutions teamed with the mainline churches, the latter being part product and part coauthor of the emerging therapeutic culture. Modern forms of self-knowledge were psychological or social or somatic or psychosocial or psychosomatic or psycho-social-somatic, per se. In other words, intrapsychic, interpersonal, and bodily phenomena pointedly did not operate vis-à-vis God. Religious beliefs, practices, and experiences might be privately engaging and meaningful, but the God of the Bible was insignificant for objectively explaining and addressing the human condition.

We humans were not made and sustained; our diverse sufferings did not exist in a context of meaningfulness; we were not accountable, observed, and evaluated; we were not condemned; we were not pursued and redeemed. “God” was an objectively weightless concept with respect to the human psyche; the weighty things in our souls had to do with other things. Evangelicals might object to the secularity of the modern and modernist worldview, but they were not doing more than a rudimentary job in offering an alternate analysis and cure. Knowledge and skill to conduct patient, probing, remedial conversation became the province of secularists and liberals.3

The Revolutionaries

But a revolution has occurred in the past fifty years, a counseling revolution. Evangelicals have begun to counsel, to write about counseling, and to educate counselors. They have written best sellers and have founded thriving graduate programs and counseling centers. Everyone agrees that a serious defect needs serious repair: confused, suffering, and wayward people need more than a verse and a prayer. But as in most revolutions, those who agree heartily about the need for change disagree profoundly about the changes needed. Countless gradations and variations exist, but in broad strokes there have been two parties within this counseling revolution.

One group has developed in the footsteps of Clyde Narramore and along the lines of Fuller Seminary’s Graduate School of Psychology. Its core intellectual agenda can be characterized this way: wise counseling requires that evangelical faith be carefully integrated with the theories, therapeutic methods, and professional roles of the modern psychologies. An “evangelical psychotherapy” movement has arisen to tackle this intellectual and educational task, and has set out to address the counseling needs of the church with the specific goods of psychology.

The other group has developed in the footsteps of Jay Adams and along the lines of the Christian Counseling and Educational Foundation’s pastoral training at Westminster Seminary. The core intellectual agenda can be characterized this way: wise counseling recognizes that the Bible mandates development of a comprehensive pastoral theology distinctly different from prevailing cultural paradigms. A “biblical counseling” movement has arisen to tackle this intellectual and educational task and has set out to address the counseling needs of the church with the specific goods of Scripture.4

During the tumult of passions, serene impartiality is impossible, even suspect and undesirable. How can a thoughtful person remain indifferent when the issues at stake are so momentous? The well-being, self-understanding, and practice of real people, the people of God, both corporate and individual, are at stake. Our ability to love and address those outside of Christ is at stake. God’s glory in this therapeutic culture is at stake. How can we know and do what we need to know and do in order to cure souls?

This essay is no attempt at dispassionate history. My commitments and convictions will be obvious in what follows. I believe that the church needs above all else a comprehensive and case-wise pastoral theology, something worthy of the name systematic biblical counseling. But I am no triumphalist. I am as interested in the remaining agenda as in the extant accomplishments of those whom I think are fundamentally on the right track. And I am no sectarian. I am keenly sympathetic to many of the concerns and intentions that energize those with whom I must fundamentally disagree. No one in the body of Christ will “arrive” until we all arrive. And arriving is not only a matter of asserting the bare truth of a systematic model. Truth, love, skill, and institutional structure must all grow to the same stature. That is our Lord’s call to his children in Ephesians 4.

Finding a Workable Taxonomy

Christ’s call to walk and talk worthy of his calling creates an immediate problem of terminology for all of us. Participants in the counseling revolution sharply disagree about how things ought to be run. This is not merely bickering between ideologues over inconsequential matters. None of us should be indifferent to the existence of vastly disparate conceptions of the faith and practice of Christ’s people. People have staked education, career, reputation, institutions, and ministries on significantly differing points of view about what is true and necessary for the health of the church. But how do we talk about the conflict constructively? How can we fairly characterize the different “sides” in the current “counseling wars,” so that matters are clarified not muddied? How do we speak the truth in love in pursuit of a just peace, rather than exacerbating quarrels and perpetuating self-serving caricatures? At the most basic level, what terminology best describes the parties, so that the issues at stake can be seen and discussed without prejudice?

Psychology Bashers Versus Psychoheretics? Unfortunately, when so-called psychology bashers and so-called psychoheretics square off, it produces the edification effect of loud static in the public address system. Sneering obliterates all discussion of profound issues. God’s children are rarely edified by scathing words. When we look at each group through the worst of the other’s language, both groups appear shamefully disreputable. Reckless and factious words fail the test of constructive, gracious, gentle speech to which God binds us and by which he will examine us (Matt. 7:1–5; Eph. 4:15, 29; 2 Tim. 2:24f). In fact, there are some true bashers and heretics around. But provocative language and sweeping generalizations usually serve to provoke, nurture, and justify the worst tendencies in human nature, not the further outworking of our redemption. It is always good policy to interact with the best representatives of a point of view, not the worst representatives. We feel self-righteous when we pose and posture next to our caricatures. We must listen, think, and argue well when we engage a thoughtful disputant.5

I suspect that most of us are brothers and sisters to be dealt with gently. We ought to sympathetically appreciate the other’s honest description of shaping experiences. We ought to acknowledge the valid insights and concerns, even if we end up disagreeing with the conclusions. All of us are more or less ignorant and wayward, beset with weakness (Heb. 5:2). Many well-intended believers on both sides of the debate are more clumsy than perverse. Our sin makes us clumsy thinkers, clumsy practitioners, clumsy theologians, clumsy exegetes, clumsy cultural analysts. We all get pigheaded, shortsighted, particularly stuck in those forms of error that contain partial truths. Yes, all error has a perverse logic, but we may hold to errors and semitruths without being wholly perverted people. May God make us deft—together.

Here is the inescapable fact that we have in common: throughout the twentieth century and into the twenty-first, the Bible-believing church has been woefully weak in the cure and care of souls.6 And Christ would have us do some serious maturing in individual and collective wisdom. Maturing is hard, slow work, made the slower because the issues at stake are momentous. No doubt, the sower of discord and falsehood is always active in hindering the church from growing up toward real wisdom regarding both the ailment and the redemption of our humanity. But the Sower of love and truth seems willing to work amid the tumult of passions over the long haul: over decades, lifetimes, and centuries. Biblical wisdom does not spring full grown from the head of Zeus. It is born small and grows through many trials and missteps, by the sustaining grace of God, toward the fullness of the mind of Christ.

So-called psychology bashers—those who believe in the sufficiency of Scripture for generating a comprehensive counseling model—do fundamentally disbelieve the modern psychologies, taking them to be systematic counterfeits and pretenders in the final analysis. They believe that the Bible fiercely resists syncretism. But they still claim that something can be learned from the psychologies: wrong does not mean stupid; error must borrow elements of truth to be plausible; God often allows observant and persuasive error to expose lacunae, crudities, and distortions in his own children’s thinking and practice. That Scripture is “sufficient” to transform us never means that the Bible is “exhaustive.” It does not mean that the Bible’s message for us is accessed and communicated only through proof-texts. All application of Scripture demands that we engage in a theological and interpretive task. Good, true, faithful theology is closely grounded in the text but often says a somewhat different thing than the text says because it is speaks to a different set of questions.7 Face-to-face ministry must use the Bible in the same way; ministry is not simply a matter of inserting proof-texts into conversation. All ministry demands sensitivity and flexibility to the varying conditions of those to whom one ministers.8

Though one might find some exceptions, most supposed psychology bashers are not anti-counseling. Most work to develop and practice loving and effective cure of souls as the alternative to secular or quasisecular psychotherapy. The debate is not whether to counsel; the debate is about what sort of counsel to believe, what sort of counseling to do, what sort of cure to offer.

So-called psychoheretics—those who believe that Scripture does not intend to be sufficient for generating a comprehensive counseling model— do see an essential role for the secular psychologies. Psychological disciplines offer some sort of necessary truth; psychological professions offer some sort of necessary and valid practice. But the so-called psychoheretics still claim that the Bible must provide the final authority. That Scripture is not sufficient does not mean the Bible is irrelevant or that it ought to be subordinated to secular psychologies, but that the Bible itself mandates looking and learning from outside. The Bible itself resists biblicism.

Though one can find exceptions, most supposed psychoheretics are not out to swallow the camel of secularity and foist it on an unsuspecting church. Many work to critique the secularity of the modern psychologies and to screen out what seems to fail the test of Scripture. Why do they become psychologists? Glaring defects in the church’s current understanding and practice are the main reason they expend time and effort to do hard study of human beings. In this culture, that often means to study psychology. Where else is one permitted and disciplined to gaze steadily into the complications and miseries of the soul? Where else do defective relationships come under scrutiny? Where else can one be taught to probe the details of life lived, and then to offer timely and patient aid? Theological and pastoral training typically does not look closely enough or get hands-on enough to engender case wisdom and a patiently probing counseling process.9

Theologizers Versus Psychologizers? Polemical language tends to subvert understanding and godliness by superheating the conversation.

Perhaps we could describe the “bashers” and “heretics” more calmly by alluding to the practice of different intellectual disciplines, as theologizers and psychologizers respectively. These terms, too, quickly become misleading. In reality, both parties claim to be in the same business. Both claim to think theologically about psychological matters, and both claim to do Christian ministry with those who experience problems in living.

Those who pursue a systematic pastoral theology specifically discuss psychological experience through the lens of explicitly biblical categories. They seek to interpret the case-study realities of life lived. Their view of theology is that it is about the interior and horizontal dimensions no less than the vertical. Good theology interprets psychological phenomenon, and good pastoral practice addresses psychological and interpersonal problems. As a God-centered theory of human personality, biblical counseling claims to offer a psychology that systematically differs from the various secular personality theories. As a gospel-centered approach to helping people, biblical counseling claims to offer a psychotherapy qualitatively different from the various secular psychotherapies.

On the other side, those who pursue an integration of or dialogue between Christianity and psychological theory specifically claim to do theology. They seek to unfold the implications of the doctrine of God’s common grace with respect to intrapersonal and interpersonal problems, and regarding the methods of skillfully addressing such problems. There is solid theological rationale for viewing secular disciplines as fit subjects for hard study. The stuff of psychology does not necessarily wholly overlap the Bible. They frequently view their counseling practice as a communication of God’s grace to people whose church experiences have often fed legalism and dishonesty. Where the church has been brusque, they aim to offer an incarnation of grace, a generous and accepting attitude in which trust and honest conversation can flourish. In sum, both parties claim to be both theological and psychological.

Pastoral Counselors Versus Psychologists? How about using occupational categories to characterize the contemporary debate? Is this simply a turf war between pastors and psychotherapists? It is clear that the pastoral counselors strongly value explicit ministry of the Word and see the crucial significance of the local church where God works through both authoritative and mutual counsel. They think that counseling theories and practices should operate under theological accountability. It is equally clear that the psychologists strongly value state licensure for professional identity and because it makes possible insurance reimbursements as a fiscal underpinning. They resist coming under ecclesiastical jurisdiction for their ideas and their practice. But one cannot draw lines in the sand regarding occupational title or the educational background that qualifies for an occupation.

On one side, the “biblical counseling” group includes many people with training, experience, and credentials in social science and mental health fields: psychologists of various sorts, psychiatrists, neurologists, psychiatric nurses, social workers, MD general practitioners, graduate students, former psychology majors.10 They know the psychologies from the inside. They usually appreciate the observational detail and credit the intention to be helpful. But they think the theories are pervasively flawed and the therapies finally impotent. The Bible and theology probe the human heart far more graphically, make better sense of life lived, and bring the living power of Christ to turn lives upside down.

On the other side, the “psychologist” group includes many people with theological training, experience, and credentials: pastors, elders, deacons, seminary graduates and professors, laycounselors, graduates of pastoral counseling programs, members in good standing of local churches. They know and believe their Christian faith from the inside. But they find the operative faith and practice of their ecclesiastical training and setting all too often ignorant, peremptory, and pat. Psychology, despite obviously bumbling the closer it gets to ultimate issues, validates neglected dimensions of human experience, prompts intellectual curiosity, and encourages the patient pursuit of both self-knowledge and case wisdom. In sum, neither mental health nor ecclesiastical experience offers a predictable guide to the issues at stake.

Biblical Counseling or Christian Counseling? What about the names the groups have largely adopted as self-designations: biblical counseling (as in Journal of Biblical Counseling) and Christian counseling (as in American Association of Christian Counselors [AACC])? Each group finds the other’s self-designation objectionable. The label biblical counseling seems to presume that whatever advocates believe and do comes with the full authority of the Bible, further implying that anything else is unbiblical. What if what they teach and do falls short of offering wise biblical help for strugglers? Similarly, the label Christian counseling seems to presume that what advocates believe and do is distinctly Christian. What if what they teach and do is at odds with their professed faith? In both cases, the reality beneath the label is a complex maybe/maybe-not. The terms biblical and Christian are precisely what is at stake and up for debate in the present tumults.

Here is further dilemma in coming up with accurate terminology. In the landscape of Christians-who-counsel, it has become harder to keep the parties straight because they seem to have moved closer together in the past twenty years. There have been significant developments on both sides.

The psychologists became more explicitly biblically oriented in the 1990s than they were in the 1970s and 1980s. Larry Crabb and the AACC are only the most visible exemplars of how the evangelical part of the evangelical psychotherapists’ dual identity is no longer an embarrassment to professional identity. A more holistic view of human nature has emerged among many evangelical psychotherapists. Some still attempt to sector off “spiritual” problems from “psychological, emotional, relational, mental” problems, attempting to validate their professional existence and activity as something qualitatively different from cure of souls. But many at the leading edge of the profession see that the divide between “spiritual” and “psychological” problems is artificial and problematic. Advocates have been won to John Calvin’s foundational insight that true self-knowledge and knowledge of the true God are interchangeable perspectives. This more holistic gaze has affected professional self-image. Increasingly, Christian counselors seek to express an explicitly Christian identity by defining their work of counseling as care for the soul, or eldering, or ministry for Christ that must be more closely linked to the church. The psychotherapists have come to sound more like the pastoral counselors and pastoral theologians who followed Jay Adams.

Meanwhile, the “biblical counselors” have also changed. Their writing now evidences a broader scope of concerns and concepts than they had in the early 1970s. They have supplemented, developed, or even altered aspects of Adams’s initial model. They are paying a great deal of attention to (1) intrapersonal dynamics such as motivation theory, self-evaluation, belief, and self-deception; (2) the impact of and response to varieties of suffering and socialization; (3) the compassionate, flexible, probing, and patient aspects of counseling methodology; (4) nuances in the interaction between Christian faith and the modern psychologies; (5) the practicalities of marital and familial communication; and (6) the cause and treatment of so-called addictions.11 The model of biblical counseling is now more detailed and comprehensive about any number of “psychological” matters.

So, the psychologists seem more biblical and the biblical counselors seem more psychological. What does this apparent convergence mean? Are the parties heading toward a rapprochement or toward a more profound collision? Or are they moving toward an as yet unimagined realignment?

I believe that the two visions are still fundamentally incompatible. But I also believe that our current situation is ripe for a fresh articulation of the issues. Half-truths and good intentions— all too easily corrupted by posturing, tunnel vision, and parochial ignorance—can appear in a very different light when they are reframed within a more comprehensive call and truth. I hope that we, the body of Christ, can identify where ideas and practices are fundamentally incongruent. Such incongruities ought to be openly stated and debated, so that the church can evaluate positions and choose wisely. We may also find places of unexpected agreement that bid us to cross or realign current party lines. Some apparent differences may prove to be either the same thing stated in different words or complementary things that can be accounted for within a common model. After all, we serve the living God who masters history to his glory and our welfare. He will not leave his children bedraggled by ignorance, incompetence, quarrels, and confusion. In the rough-andtumble of our gropings after him, in our uneven hearing and partial seeing, he manages to triumph in and through us.

So what taxonomy should we use? I suggest that we use language that is minimally prejudicial and maximally descriptive of the sticking point. The core question turns on the intent and scope of Scripture, the nature of pastoral theological work, and the degree of significance attached to what the church can appropriate from the world. In short, is the engine of counseling theory and practice external or internal to the Faith?

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