Myths of Counseling - Christianity Today

After fifteen years of research, a Berkeley-trained psychologist named Bernie Zilbergeld has decided to speak frankly about his profession. His conclusions are based upon twelve years as a practicing therapist (and five as a patient), in-depth interviews with 140 former patients, and lengthy discussions with a cross-range of 14 colleagues.

Here, in an excerpt from his new book The Shrinking of America: Myths of Psychological Change (Little, Brown, 1983), he examines eight common assumptions about professional counseling.

LEADERSHIP sent this material to four prominent Christian counselors and asked for their reactions. Their comments follow.

Myth No. 1

THERE IS ONE BEST THERAPY

Each therapist tends to believe that his own approach is the best for just about everything. But most of the evidence does not support the idea of a single “best treatment.” Most of the well known methods usually produce similar results for most problems. The same holds true for different formats: by and large, similar changes are reported by those in individual, group, and couples therapy. The unavoidable conclusion is that if you’re suffering from any of the common ailments that people take to psychotherapy-confusion, depression, low self-esteem, distressed relationships or inability to form them, difficulties in decision-making, and so on-you can expect about the same results regardless of which therapy you choose.

There are a few exceptions to this rule: behavior therapy (brief, symptom-oriented treatment aimed at dealing with people’s actions rather than their underlying attitudes) is significantly more effective than other techniques for dealing with some common phobias, sexual problems, and compulsions. There is also an important exception regarding counseling formats: for relationship problems, couples therapy is superior to individual therapy, though this does not rule out separate sessions some of the time.

Otherwise, there is little evidence to suggest that one therapeutic approach or format is better than others-not even psychoanalysis. Freud himself became less sanguine toward the end of his life about the efficacy of analysis, and said so.

Myth No. 2

COUNSELING IS EQUALLY EFFECTIVE FOR ALL PROBLEMS

It has become routine to recommend therapy for almost everything that ails people. But the range of its effectiveness is far narrower than many people think. In general, it works best for the less serious, less persistent difficulties.

The following problems fare best in psychotherapy:

PHOBIAS. The reduction of fear is a common outcome of counseling, and simple phobias, such as fear of small animals or flying, often respond well to treatment, especially to behavior therapy. The results of therapy with more complex phobias such as agoraphobia (fear of open spaces or of crowds), however, are not impressive. For most complex phobias, antidepressant medication alone or in combination with psychotherapy yields better results than therapy alone.

LOW-SELF-ESTEEM. If your main problem is not feeling very good about yourself, counseling may indeed be helpful. In fact, raising a client’s self-esteem may be the most important outcome of counseling, regardless of what kind of problems he brings to it.

SEX PROBLEMS. Brief sex therapy is often very helpful in teaching men to delay ejaculation and anorgasmic women to have orgasms under certain conditions. Success rates for more complex and deep-seated sexual problems such as incompatibility in sexual desire are less encouraging.

MARITAL PROBLEMS. Couples and families often find improvement in the ways they communicate, address problems, and deal with marital and family distress after counseling. This does not mean, however, that all relationship problems improve in therapy, or that such changes are large enough to make a significant difference in family relations.

There are also a number of more basic problems for which current therapy methods are not particularly effective, or for which other approaches seem better. Among these problems:

DEPRESSION. This is the most common complaint of people seeking therapy. It is also one of the most confusing, because it isn’t really one problem but a group of them, which makes it difficult to compare clients in different studies. Despite this, it is clear that non-psychological methods have an edge over therapy except perhaps in the mildest cases. Electroconvulsive therapy is highly effective with psychotic depression. For manic depression (periods of great excitement alternating with periods of severe depression), lithium carbonate is far more beneficial than anything else, and other antidepressant medication (tricyclics and monomine oxidase inhibitors) has proved its worth with most types of depressive disorders.

ADDICTIONS. What Albert Stunkard, a leading authority on the treatment of obesity, concluded over twenty years ago is true today-and applies to smoking, drinking, and drug abuse as well: “Most obese persons will not remain in treatment. Of those that remain in treatment, most will not lose weight, and of those who do lose weight, most will regain it.” Although it is not uncommon to hear of marvelous new approaches and breakthroughs, nothing much works very well, or for very long.

SCHIZOPHRENIA. Almost every medical and psychological intervention imaginable has been employed in the treatment of this group of disorders, which for most people are the essence of insanity. Improvement rates are highest for patients whose problems are of recent onset; chronic patients do worse, regardless of the type of treatment. But it has not been demonstrated that any form of psychotherapy is of significant value in the treatment of this complex and frightening disorder. Anti-psychotic medication is far more effective in reducing such symptoms as hallucinations.

Finally, despite glowing individual case reports it has not yet been demonstrated that psychological interventions are useful with seriously deviant sexual behavior-or with rehabilitation of criminals and prevention of delinquency.

Anthony Storr, a well known British psychiatrist, summed up psychotherapy’s range of applicability this way: “Psychotherapists seem to me to be best at treating the inhibited, the frightened, the shy, the self-distrustful, the fragmented, the overdependent, and the over-controlled. They are far less successful with those who lack control over their impulses. … Patients who show disturbances like over- or undereating; who drink too much, or who smoke compulsively; who steal, who drive dangerously, or who commit sexual offenses or other criminal acts, are poor bets for individual psychotherapy.”

This is pretty much what Freud thought, and subsequent developments have by and large proved him right.

Myth No. 3

BEHAVIOR CHANGE IS THERAPY’S MOST COMMON OUTCOME

This idea is grounded in common sense: people come to therapy with problems, change their behavior, and therefore resolve their difficulties. Changes like this do occur in counseling and are familiar to all of us because they are the ones therapists and clients talk about most.

Often, however, there are cases where the patient feels good about his therapist and his therapy, even though no problems are resolved and no behavior changes are evident. The client feels better nonetheless, simply because he is listened to, understood, valued, and cared for. What some find in religious communities, others find in counseling, and the strength of the bonds between client and therapist or client and group should not be underestimated. They often become the center of the client’s life.

Therapy can also serve as an antidote to loneliness. For a person seeking new friendships, new romances, new sexual relationships, or just the company of others, many therapeutic events, especially groups and weekend encounters, are made to order. As one young man who went to an encounter group observed, “It was the most exciting show I’ve seen in a long time. Here are all these people talking about their problems, hang-ups, and weaknesses, dealing with each other and the leaders in all sorts of ways-a real-life soap opera. It was a voyeur’s delight.”

Two other important and common outcomes of counseling require mention. One is the development of self-understanding, and the other is a sense of an increased ability to cope. Although there is nothing wrong with helping people gain insight into themselves or feel more confident, it is important to keep in mind that there is no automatic relationship between such things and changed behavior. The person who feels better able to cope will not necessarily cope better. The person with greater understanding will not necessarily be able to do anything constructive with this understanding. Therapy is apparently much more successful at making people feel better and more confident, at least for the moment, than it is at changing the way they behave.

The result is that the behavior-changing and problem-resolving effects of therapy are greatly exaggerated, while the extent to which it provides comfort and support is ignored or understated.

Myth No. 4

GREAT CHANGES ARE THE RULE

Therapy success stories usually involve dramatic changes. The client becomes, as Arthur Janov, creator of primal scream therapy, puts it, “a new kind of human being.” Therapy can, we are told, really change your life.

Despite such notions, the evidence is overwhelming that dramatic changes are rare; the typical change is far more modest and very far from the claims that are bandied about. All the therapists I interviewed agreed that truly radical modifications were unusual. It is close to impossible, for example, to turn a chronically depressed person into a happy-go-lucky type.

In short, cures in therapy are not common.

If counseling did indeed produce great changes, the results should be most easily observed among therapists themselves, for they have received more therapy than any other group of people, and they have also had extensive training in methods of personal change, methods they could presumably use on themselves if they wished to.

The material that can be brought to bear on this issue is not as extensive or as rigorous as I would like, but it seems fair to say there is no evidence that counselors do better, feel better, or overcome more problems than anyone else. A survey of seven medical specialties by Medical Economics found that psychiatrists came out on top in more categories of marital problems, including sexual problems, than practitioners of any other specialty. Anyone who keeps company with counselors knows that, no matter what they may be like with their clients, in their personal lives they are no freer than others from pettiness, depression, poor communication, power struggles, anxiety, bad habits, and other difficulties. Nor are the organizations, departments, or clinics that they run.

Myth No. 5

THE LONGER THE THERAPY, THE BETTER THE RESULTS

The fact is that no relationship between results and duration of counseling has been demonstrated. A number of reviews of the research conclude, to use the words of psychologist Lester Luborsky and his colleagues, that duration “seemed to make no significant difference in treatment results.” The results of brief treatment (twenty-five sessions or less) seem to be no less positive than those of therapies lasting two, three, ten, or even twenty times as long.

Why, despite the lack of evidence for the idea that longer is better, do most therapists continue to believe otherwise and pressure clients into believing the same thing? One reason is simply a matter of training. Once the idea of lengthy therapy is accepted, it is easy to find interesting things to fill the time, all of which are then used to rationalize the necessity for taking a long time.

Long counseling is also fostered by a desire for effectiveness. If what has already been done has not worked, there is a tendency to believe that more of the same or more of something else will help. Another important reason for lengthy therapy is that it is good for therapists. The longer the counseling they do, the more secure are their finances and the less need they have for new referrals.

Myth No. 6

THERAPY CHANGES ARE PERMANENT OR AT LEAST LONG-LASTING

If you become more assertive, less depressed, better able to express yourself, or make other forms of progress in counseling, it is an article of faith among therapists and clients that these changes will persist. This belief is one of the main reasons that therapists have not done many follow-up studies to determine how former clients are doing.

What evidence we do have only partly supports the idea that changes persist for long periods. They do for some people, but relapse rates of over 50 percent are not uncommon, and for treatment of addictions they can go over 90 percent. It should tell us something when the highly respected behavior therapist Arnold Lazarus finds a relapse rate of 36 percent among his former clients.

Myth No. 7

AT WORST, COUNSELING IS HARMLESS

Given the reckless abandon with which therapy is recommended to everyone, people clearly believe it can only be for the good. The idea has long been held by therapists that at worst, counseling can only fail to help you change.

A moment’s thought should be sufficient to indicate that a method powerful enough to produce positive change is also capable of producing harm, a conclusion supported by many studies. One review of studies of marital and family therapy states that “on the whole . . . it appears that 5 to 10 percent of patients or of marital or family relationships worsen as the result of treatment.” A large study of encounter groups found that 16 percent of the participants were worse off after the groups than before, and that their deterioration seemed a direct result of being in the groups.

Some clients with no history of severe disturbance become psychotic during counseling, some commit suicide, and some do other things that clearly indicate a worsening of their condition. A number of the clients I interviewed said, usually reluctantly, that therapy had been harmful. It is no longer unusual to meet people who are looking for, or starting out with, a therapist to resolve problems caused in a previous therapy.

Myth No. 8

ONE COURSE OF THERAPY IS THE RULE FOR MOST CLIENTS

In the past, most clients participated in only one course of therapy in their lives, but this is no longer true. One of the most consistent and important effects of counseling is a desire for more counseling. These days continuing interminably with one therapist or having several courses of treatment is the rule. Whether or not the results are positive, many participants want and get more, something observers have called the “salted peanut effect.”

My colleague Bernard Apfelbaum was consulted by a client who had been in psychoanalysis for thirty-one years, four times a week, without a break, and I recently read of a woman who had been seeing a psychiatrist for twenty-seven years. It is not unusual to hear of such “lifers”-clients who have been with the same therapist for fifteen, twenty, or more years.

It makes sense that those who fail to get relief in one therapy would seek another, and the professional literature is full of examples. Thus one therapist writes of a thirty-two-year-old client: “By the time he was referred to me, he had received-in addition to [six years of] psychoanalysis and his brief bout with behavior therapy-drug therapy, electro-convulsive therapy, primal therapy, transactional analysis, transcendental meditation, and existential therapy. He still suffered from agoraphobia and other phobias, bathroom rituals, and other obsessive-compulsive problems.”

People also go for more counseling when new problems come up, when they feel a desire for more growth, or when they experience any one of a number of dissatisfactions. The message conveyed in therapy and in the culture at large is that if you experience almost any form of discontent, you should get expert assistance. Given the American penchant for relying on experts, and the aggressive efforts of those experts to persuade us that we are in great need of their services, it is hard to see an end to the cycle.

This is unfortunate, because many clients are going to be disappointed, for two reasons. First, there is absolutely no evidence that professional therapists have any special knowledge of how to change behavior, or that they obtain better results-with any type of client or problem-than those with little or no formal training. In other words, most people can probably get the same kind of help from friends, relatives, or others that they get from therapists. Second, as we have seen, people are not all that easy to change. We simply cannot alter our lives in the ways we now think we want to.

What therapy, professional or not, can accomplish is nicely captured in an old French maxim: “To cure sometimes, to help often, to comfort and console always.” Therapy in our time can do no more-we will be lucky if it can do this much-and in the long run neither clients nor therapists benefit by pretending otherwise.

RESPONSES

Louis McBurney, M.D., founder of Marble Retreat, Marble, Colorado

If I were less secure in my profession, I might feel threatened these days. MD magazine published an article last August entitled “The Shrinking of Psychiatry” that included the stereotypic image of psychiatrists as seen on TV and in the movies. The article, like Dr. Zilbergeld’s book, was not very flattering.

The Zilbergeld excerpt addresses psychotherapy, not psychiatry per se, an important distinction. Many psychotherapists are not psychiatrists, and many psychiatrists do not use psychotherapy as their primary treatment. Others do-including myself.

Here are eight responses to Dr. Zilbergeld’s myths:

Myth #1: I do not think this myth is very widely held. Of course certain schools tout their methodology as the only true therapy, but if that were true, I suppose most everyone would be using it. My training at the Mayo Clinic under a decidedly eclectic approach makes me agree with Zilbergeld that there is in fact no one best therapy.

Myth #2: I heartily agree that counseling is not equally effective for all problems. That is why diagnostic evaluation is so important. It is important for pastoral counselors as well as other mental-health professionals. Many disorders deteriorate with psychotherapy but respond beautifully to pharmacological treatment. One example is given by Dr. Zilbergeld: manic-depressive illness.

However, I want to clarify one statement. Lithium carbonate is effective in controlling the swings into euphoric, hypomanic behavior but does not necessarily control the depressive side of the disorder.

I would also question the statement about marital counseling not producing changes “large enough to make a significant difference in family relations.” I have often seen significant improvements after counseling couples and would like to encourage pastoral counselors to work toward the same.

Myth #3: Behavioral change may not be the most common outcome, but it is a distinct possibility. We are often working primarily toward change in attitude and thought patterns, with the resulting relational change as an important secondary goal. Thus when we work with an individual on guilt or resentment, the effects of forgiveness show up in changed behavior toward self and others.

Myth #4: I agree; miraculous change does not often occur. However, with the added impact of the spiritual dimension, the possibilities are greater. Dr. Bill Wilson at Duke has reported significant differences in counseling when the Christian factors of conversion, redemption, prayer, and supportive community are part of the therapy experience.

Myth #5: Again, I agree; my own work is brief, intensive psychotherapy focused in two weeks. At times, however, a continuing counseling relationship seems helpful. I disagree with Zilbergeld’s statement that “most therapists continue to believe otherwise and pressure clients into believing the same thing.” Most psychiatrists I know are very busy and have enough to do without trying to create dependency.

Myth #6: Therapy changes are like other forms of learning; they indeed deteriorate if not reinforced. This is where the support of a Christian community becomes vital.

Myth #7: Here I want to add my emphasis to his caution about therapy’s “harmlessness.” The therapist is not powerless or inconsequential and may do more harm than good. That is why selection is so critical.

Myth #8: It is not surprising that many people have more than one course of therapy. Life stress waxes and wanes as the years go by, and those who have trouble coping often seek help out of fear, loneliness, or sadness.

In conclusion, I am glad to see Dr. Zilbergeld point out that psychiatry and psychotherapy do not offer miracle cures any more than a dose of castor oil did a century ago. Both may produce a purge, but a purge may not be needed.

On the other hand, my experience in psychotherapy has been more positive than the general tone of his writing. I believe there are three explanations for this:

Fitting the treatment to the diagnosis. Many people can be helped by the specific approaches of behavioral therapy, marital/family counseling drug/alcohol treatment, or psychopharmacology.

Careful selection of the therapist. You do not go to an attorney for heart surgery, nor even to anyone who calls himself a cardiovascular surgeon. You check out credentials and reputation. Likewise, a psychotherapist needs to pass the test of Psalm 1. You may be sure any counselor reflects his own value system and maturity.

The added dimension of Christianity as a relationship with the living Lord. The truths of Jesus’ teaching on self-acceptance, individual worth and value, finding meaning in commitment to God and fellow man, the importance of our thought life, the necessity of forgiveness, and the healing power of love are timeless. Furthermore, the power available through prayer, the written Word, the indwelling of God’s Spirit, and the supportive community of faith helps produce significant and lasting change.

Change is usually gradual in most lives (even those reborn), as it was with Peter, Paul, and you. But it can be real. Professional psychotherapists must admit as much, while Christian counselors must be patient in looking for evidence of Christ’s love at work.

* * *

David G. Benner, chairman of psychological studies department, Wheaton (Ill.) College

For several decades, psychology has stood, in its popular form, as the major secular religion of our culture. Martin Gross developed this thesis in The Psychological Society, arguing that we uncritically accept the inflated claims of the mental-health professions in spite of the relative absence of proof. Paul Vitz further developed this critique in Psychology as Religion, and more recently William Kirk Kilpatrick did the same in Psychological Seduction-both of these writing from a Christian perspective.

These critiques have gone largely unnoticed in the mental-health professions but also in the church and in society at large. We have wanted to believe Zilbergeld’s myths. Most regrettably, the mental-health professionals have wanted to believe them. The emperor really has contended he was clothed in magnificent robes, and any doubts were allayed by society’s adulation. Few have dared to whisper the unthinkable, and those who have have usually been ignored.

Zilbergeld’s critique is important. There may be basis for quarrel with some of his specific charges (for example, that drugs are more successful than all psychological therapies in treating depression). However, his basic assertions are accurate, and a shrinking of our expectations is appropriate.

We have either tended to believe psychotherapy was a golden road to freedom, self-actualization, and wholeness for all people regardless of what ails them, or we have believed it could do nothing a listening friend couldn’t do. The truth is somewhere between. The sooner we recognize this, the sooner the mental-health professions can get on with the task of discovering what kind of therapy works best for what kind of person with what kind of problem. Then Christian pastors and lay helpers will know better when to make a referral, meanwhile being encouraged to see the positive effect they can have in many situations.

* * *

Jay E. Adams, dean, Institute of Pastoral Studies, Christian Counseling and Educational Foundation, Laverock, Pennsylvania

The matters discussed in this reprint are important. Time magazine, in reviewing Zilbergeld’s book, also cited New York psychiatrist Robert Lang’s book, Psychotherapeutic Conspiracy, in which he declares, “We don’t know the underlying basis of change.”

What should we learn from these observations?

1. That Christian counselors have been wasting their time and money studying with non-Christian counselors. If what Zilbergeld says is true, they were receiving nothing worthwhile in return.

2. That Christian counselors have been deceiving both themselves and their counselees whenever they have identified one or more of these non-Christian systems with biblical teaching. Under the slogan “All truth is God’s truth” (with which no intelligent Christian could possibly disagree), just about any and every sort of non-Christian principle, practice, and methodology has been justified, often in a most cavalier fashion. Some of us who have been exposing this deception over the years have been heaped with scorn. Maybe Zilbergeld’s book will at last awaken the scorners to the realities of the situation, since it is clear that the results of God’s truth are neither “modest” or “short-lived.”

3. That Christian leaders should stop wasting time trying to integrate (the great buzz word of eclectic Christian counselors) biblical teaching with these systems that offer so little promise. Instead, let us join in the intensive, exciting, fresh study of the Scriptures in relation to human problems and needs.

Zilbergeld says, “The unavoidable conclusion is that if you’re suffering from any of the common ailments … you can expect about the same results regardless of which therapy you choose.” Of course, he did not examine the results of Christian counseling based entirely on the Scriptures. Had he done so, it is my opinion he could not have made such a statement.

“Truly radical modifications were unusual,” he notes. What could be more radical than the New Birth? What could be more radical than a husband exchanging his years of adultery and lying for an entirely new way of life? What could be more radical than the changes in the apostle Peter? Yet these, and hundreds like them, are everyday occurrences in the counseling offices of innumerable pastors across the land. And they are lasting.

How long will Christians continue crawling around the psychiatrists’ table looking for crumbs with which to “supplement” what the Bible says? It is a book “breathed out by God and useful for teaching, for conviction, for correction and for disciplined training in righteousness, in order to make the man of God adequate, and to equip him fully for every good task” (2 Tim. 3:15, 17). These four steps present a complete process of change:

Teaching-presenting a standard given by God that no other system has

Conviction-the Spirit’s work in the heart that shows us our failure to live according to God’s standard

Correction-the process of confession and forgiveness that turns us from wrong patterns

Disciplined training in righteousness-the process by which the Bible trains us in alternative ways of living

This is radical change, and it is entire. The Bible pronounces it “adequate.” The fruit of the Spirit is just that: fruit produced by God through his Word, not through the hopeless systems of men. When will the church learn?

* * *

Gary R. Collins, professor of psychology, Trinity Evangelical Divinity School, Deerfield, Illinois

Eric Sevareid once suggested that the biggest business in America is not making steel, cars, or televisions, but “the manufacture, refinement, and distribution of anxiety.” The only thing bigger is the business of anxiety reduction!

Americans have an insatiable desire to be happy and free from anxiety. That is why, says Zilbergeld in his book, the United States has become “the world capital of psychological-mindedness and therapeutic endeavor.” Selling therapy has become a big business, and Zilbergeld is not the first to write an expos. Several others have attacked the counseling professions, sometimes with more vehemence than knowledge of the facts.

But Zilbergeld is a member of the psychological guild, an experienced therapist with impeccable credentials. He clearly did his homework. His book is intellectually stimulating, well written, fair, and nonpolemic. It deserves careful reading.

I will limit myself to three observations:

1. What he says about the value of therapy is essentially correct. During the past thirty years, literally thousands of research studies have examined this ground, and the results-as reported in the professional journals and encyclopedic volumes such as Garfield and Bergin’s massive Handbook of Psychotherapy and Behavior Change-have demonstrated what Zilbergeld reports. There is little evidence that professionals “obtain better results-with any type of client or problem-than those with little or no formal training. In other words, most people can probably get the same kind of help from friends, relatives, and others,” including pastors.

2. What’s good for the goose is good for the gander. Some Christian writers have reacted with glee to the news that secular counseling is of limited value. After announcing, “I thought so,” they (and I) have proclaimed that biblically based counseling alone is superior.

But where is the evidence? We who are Christians expect psychologists and psychiatrists to rigorously study their own work. Meanwhile, what research has been done on the effectiveness of Christian counseling? Almost none.

I wonder if we have swallowed our own set of myths. What if we reread the Zilbergeld material, substituting “Christian counseling” for “therapy” and “pastor” or “lay person” for “therapist”? Consider, for example, the following two paragraphs:

If you’re suffering from any of the common ailments that people take to pastoral or lay counselors-confusion, depression, low self-esteem, distressed relationships or inability to form them, difficulties in decision-making, and so on-you can expect about the same results regardless of which person or approach-Christian or secular-you choose.

Anyone who keeps company with Christians knows that, no matter what they may be like with their clients, in their personal lives they are no freer than others from pettiness, depression, poor communication, power struggles, anxiety, bad habits, and other difficulties. Nor are the organizations, departments, or churches that they run.

I don’t want to believe such conclusions, and my point is not to be critical. Before we judge a profession, however, we need to take a close look at ourselves. Zilbergeld’s work and the research of his professional colleagues is a model of honest self-evaluation that we Christians should applaud and then emulate.

As a Christian who is a psychologist, I believe many of our approaches do help people. But it is sad that we have not been able to raise the motivation or funds to study our counseling methods with scientific rigor.

3. What Dr. Zilbergeld says about psychological change can be encouraging.

In his book (although not in this excerpt), he concludes that while professional therapy is “overpromoted, overused, and overvalued, it can be beneficial when used prudently, with clear understanding of its powers, limitations, and risks.” In spite of the myths, we would be inaccurate to conclude that all professional counseling is useless. The research shows that many therapists can and do help.

The research also shows that non-professionals give help. While some pastors and lay counselors undoubtedly do more harm than good (although we don’t have research data to prove that), it is clear that ordinary people can be very effective in helping, encouraging, and supporting one another. That, of course, is what the Bible teaches.

We can also help ourselves. Zilbergeld admits there is little research on the value of reading or listening to sermons, but he concludes that most of us can benefit from such influences. People are not as fragile or psychologically crippled as some would have us believe. We can work on our own problems if we are willing to take the time and risks.

The Christian would add that for real growth to occur, we need the insights of Scripture, the support of fellow believers, and the indwelling presence and guidance of the Holy Spirit. These, rather than “the selling of therapy,” are the true foundations of anxiety reduction and the basis of psychological change.

And that is no myth.