The Mind Doctors

Mornings are bleak for Sharon. At the end of a restless night she will lie in bed staring at the ceiling until her eyes blur, her mind filled with the dread of another day. Routine household chores have become monumental tasks, and formerly appetizing foods have lost all appeal. The joy of her new son, now six months old, has been overshadowed by self-doubt and sorrow that seem almost unbearable. Her sense of aloneness is not lessened by the presence of others. She thinks endlessly about her failures as a mother and as a Christian.

Sharon is suffering the classic symptoms of depression. Counseling with her pastor has helped in recent months, but signs of progress have been overshadowed by the ominous emotions that remain. Her pastor, concerned that Sharon has not improved more rapidly, recently recommended that she get professional help for her depression.

But that created a new dilemma. Sharon once read several fascinating books about psychology. According to these books, mental health professionals have seduced millions of Christians away from scriptural teachings. Could it be, she wonders, that going to a professional psychologist would be spiritual suicide?

Sharon cannot be alone in her confusion. In recent years, hosts of writers have criticized psychology for being self-centered, humanistic, ineffective, and antibiblical. The result is a wariness that goes beyond healthy skepticism. In fact, overzealous Christian criticism of psychology may have prevented many people from seeking needed psychological help.

The Christian critics of psychology are often respected and well-meaning scholars whose arguments must be considered carefully. But their writings sometimes omit understandings that would foster a more balanced evaluation of psychotherapy.

Questions About Psychology

Sharon’s struggle, and that of many Christians in her situation, centers on a series of important questions:

• Does psychology advocate self-glorification? For the past 50 years, psychologists have been interested in the self. “Self” psychologists, such as Carl Jung, Alfred Adler, Erich Fromm, Abraham Maslow, Gordon Allport, and Carl Rogers, have written about self-esteem, self-image, self-realization, and self-actualization. In his book Psychological Seduction, William Kirk Kilpatrick identifies this emphasis on self as being antithetical to Christian thought. Kilpatrick suggests that psychologists see self as all there is, resulting in a striving to be like God and an unhealthy pursuit of personal happiness.

The concerns of Kilpatrick and other critics must be taken seriously. Some popular psychological writings do emphasize self to the exclusion of concern for others. Book titles such as Looking Out for Number One and Pulling Your Own Strings make this clear. In these and other popular writings, self-esteem and self-glorification, or narcissism, have been confused.

Mainstream psychology’s position on self-esteem, however, can be clarified with the analogy of a marksman shooting at a target. A marksman is more concerned with accuracy than with whether the shot is low or high. Concepts of low or high are only used to improve accuracy. Never would a marksman conclude “the higher the better.” Similarly, psychologists have traditionally been interested in accuracy of self-concept. It may be important to observe whether self-esteem is low or high, but only for the sake of adjustment to accuracy.

Rather than concluding “the higher the better,” the classic self psychologists distinguished accurate self-esteem from the excessive self-love of narcissism. Gordon Allport wrote that narcissism could not be dominant in the psychologically mature individual. Erich Fromm, Albert Adler, Abraham Maslow, and Carl Rogers all emphasized that an individual with healthy self-esteem is rarely selfish.

There is little doubt that the apostle Paul had a healthy self-esteem. He wrote frequently of his accomplishments and encouraged his readers to imitate him. But Paul was not narcissistic, focusing on himself to the exclusion of a concern for others. Moses also appeared to develop an accurate self-esteem, as evidenced by his style of leadership. While humility and narcissism are incompatible, humility and self-esteem are not. Indeed, accurate self-esteem always includes an awareness of personal limitations.

In fact, a Christian therapist can help Sharon to grow toward mature spirituality. While she is depressed, Sharon can focus her attention only on herself instead of God’s character. With the help of a Christian therapist she may end the self-centered condemnation of herself and focus again on God.

• Is psychology humanism? Being a Christian in our psychologically oriented era is often like walking a tightrope. If we lean too far to one side, we may become spiritually insensitive and begin to look to the human experience as the ultimate reality. Admittedly, many of the leaders in psychology have done this. Sigmund Freud, Albert Ellis, and others have professed that God is a human invention. In so doing, they denied the power of God. An atheistic humanism is the result, and it has had an influence on psychology.

But there is another way to lean on the tightrope. If we lean too far to that other side, we may miss details of God’s truth revealed in sources other than Scripture. If Sharon, for example, concludes psychology is antibiblical, she will not get help for her depression despite the availability of effective psychological treatments that have no implicit atheistic assumptions.

It really does not help Sharon and other hurting Christians to bluntly label psychology “humanistic” and dismiss it. We need to distinguish between kinds of humanism and their respective merit or lack of merit. (So orthodox a theologian as J. I. Packer has written appreciatively of “Christian humanism.”) The tightrope requires great balance and careful assessment—before we get on it and as we walk it.

• Are the methods used by psychologists spiritually dangerous? Looking for a psychologist can be likened to shopping for toothpaste. One is immediately overwhelmed by the plethora of brand labels: psychoanalysis, behaviorism, client-centered therapy, cognitive restructuring, transactional analysis, gestalt therapy, and so on.

That being the case, to ask if psychotherapy is spiritually dangerous is like asking if toothpaste is white: it depends on the brand. Add to this the complication that all psychotherapies are delivered by a person with his or her own distinct spiritual values, and the possible combinations of values and therapies are endless.

Unfortunately, critics of psychology have often evaluated the spirituality of the discipline by investigating only a few of the available psychotherapies. In The Psychological Wayl The Spiritual Way, Martin and Deidre Bobgan describe the danger of psychological methods of treatment. The Bobgans have raised some important objections to mainstream psychotherapies, but most of their critique centers on the fringes of psychology—with the fringes then representing all psychology.

If Sharon had recently read their book, she might anticipate a psychologist almost certainly using methods such as scream therapy, encounter groups, est, arica, and transcendental meditation. But, in fact, these techniques are rarely used by most psychologists (we each finished doctoral programs in psychology without studying any of them). Referring to such techniques when criticizing psychology is the equivalent of using the National Enquirer to criticize journalists.

Given all this, the best question for Sharon is not the broad “Are psychotherapies spiritually dangerous?” Instead, with the assistance of a pastor or informed friend, she might better ask, “Is this particular psychotherapy, being delivered by this therapist, spiritually dangerous to me?”

•Is psychotherapy effective? Kilpatrick and the Bobgans have questioned the effectiveness of psychotherapy. Both cite a fascinating study of the outcome of psychotherapy, conducted and reported by Hans Eysenck in 1952. Eysenck found subjects receiving psychotherapy had improved less after treatment than a group of subjects receiving none.

Kilpatrick and the Bobgans fail, however, to report as well that Eysenck’s data have subsequently been analyzed by psychologist Allen Bergin. Bergin reported that Eysenck’s analysis was contaminated by using different standards of improvement for the two groups of subjects. Also, Bergin objected to counting those who dropped out of treatment as treatment failures. From the same data that Eysenck used to conclude 39 percent improved with therapy, Bergin found 91 percent improved. It is a stunning discrepancy, showing how both research and its reporting can be guided by personal values and prior beliefs.

Numerous subsequent studies have indicated that Bergin’s interpretation may have been correct. A 1980 review of 475 research studies on psychotherapy outcome suggests that psychotherapy is at least modestly effective.

Again, rather than using broad strokes, we do better by considering a particular therapy for a particular person: “Is there a psychotherapy that will be effective for this client with this therapist?” In Sharon’s case we can be quite hopeful. A recent study showed that 15 of 19 depressed clients recovered completely within 12 weeks of beginning cognitive psychotherapy (a therapy that focuses on thoughts rather than emotions).

• Can psychology tell us anything the Bible cannot? Most critics of psychology take the position that theology has authority over psychology. Thus, psychology must be filtered through Scripture, and information inconsistent with Scripture must be rejected. We agree that Scripture is authoritative, but filtering psychology through Scripture has led to a faulty conclusion: that psychology can add nothing to Scripture in our understanding of human nature.

First, insisting that the Bible replace an academic discipline presumes that the Bible has something to say about all the questions asked in that particular discipline. But the authority claimed by Scripture is not authority over the countless details of human science and art. It is a more basic, fundamental authority over our perspective toward faith and life in general. Few Christians today would say we need know nothing more about chemistry or physics than the Bible teaches. The same holds true for psychology, itself a science.

Second, Christians should keep a two-way street open between the disciplines of psychology and theology. By giving theology uncritical authority over psychology or any other science, we prevent reciprocal feedback that may benefit theology itself. Consistency with established belief does not automatically make something true. (The message of Christ was rejected by many because it was not “orthodox.”) Theology is a human endeavor and, as with all human endeavors, humility befits it. That, if nothing else, is the hard lesson of the Copernican controversy, in which the church rejected the “unorthodox” theory that the Earth revolves around the sun.

Finally, many Christians fail to integrate theology and psychology simply because they do not accept psychology as a science. Instead, they treat psychology as theology or philosophy. But as a science, psychology uses assumptions and methods different from other disciplines. In science, theories come, compete with one another, are empirically tested, and go, as the field tries to edge toward truth. If a psychological concept offends you, then pluck it out—another will be waiting to take its place. Psychology is best viewed as a set of proposed theories rather than a set of established facts. When it touches on truth, it touches on God’s truth, because all truth is God’s truth.

Considering Psychotherapies

There are dangers intrinsic to psychological methods and practices. In her depression, Sharon may herself not have the energy and the mental acuteness to maintain a healthy skepticism while examining psychotherapies. So she needs the help of her pastor, a friend, a spouse, or a parent. It is important to explore a psychologist’s credentials, values, and treatment preferences prior to beginning any kind of therapy. Such an exploration is neither impolite nor unexpected.

We recommend four specific questions be asked before entering a therapeutic relationship with a psychologist:

• What are the psychologist’s religious values? For many years, psychologists believed that the personal values of a professionally trained psychologist would not affect psychotherapy. We now realize this is unrealistic and that the personal values of therapists may indeed affect outcome of some treatments. Treatment for phobias and stress-related physical disorders will be relatively unaffected by religious values. But religious values are more important in the treatment of other difficulties, such as anxiety disorders, depression, and marital problems.

Many therapists believe they are well prepared for Christian clients but are not themselves professing Christians. We are skeptical of this, and recommend that Christian therapists be consulted for problems that might relate to issues of faith.

•How much experience does the psychologist have with this kind of problem? Professional degrees and a wealth of experience do not necessarily imply competence. Some paraprofessional counselors are as effective as the best professionals. But according to much of the published research, experienced therapists seem to do better therapy. Sharon’s symptoms will be most effectively treated by someone who has specific experience treating depression. Psychologists who feel unqualified are typically willing to refer to other therapists who have had more experience with the particular problem.

•What psychotherapeutic techniques will the psychologist use? This question is not typically asked of psychologists and may evoke a startled reaction. But if, as the critics of psychology suggest, some techniques are spiritually dangerous, the informed consent of the client becomes important.

Sharon might find a variety of responses to this question, and she may not recognize the technique described by the psychologist. But after getting the psychologist’s perspective on the technique to be used, additional information can be obtained by visiting the local library or perusing a general psychology textbook. In addition, many pastors are informed about current psychological techniques and the theological issues relevant to each.

Most psychologists have been trained in one or two specific approaches and will not be able to “switch hit,” using any approach desired by the client. If a client insists on a specific therapy, psychologists will usually refer to another therapist.

•What are the chances of success? As we said earlier, psychologists have admitted that counseling is not equally effective for all problems. After the first few sessions, most experienced therapists will have a good estimate of potential treatment success. Of course, these estimates are hunches and cannot be considered completely accurate. In Sharon’s case, the possibilities are varied. If this is her first serious depression and if there are not physiological causes, she would be expected to improve rapidly with some forms of cognitive therapy. If, however, she has been seriously depressed before or if there appear to be physiological imbalances, treatment might involve medication in conjunction with psychotherapy and could be lengthier.

A Valuable Controversy

One goal of Christian life is growth, and the debate about the place of psychology in Christianity can be healthy and productive for those struggling with the issues. Unfortunately, the potential Christian psychological client is often hearing only one side of the debate. Christians need to evaluate evidence on both sides carefully to make fully informed decisions. Only an openness on both sides and a frank exchange over all the issues will ultimately lead to refined integration we can call a true Christian psychology.

If Sharon decides to seek professional counseling, there is a potential for her to learn to view herself and her situation more accurately, and, as a result, alleviate her depression. There is also the potential that—even with a Christian psychologist—she might be challenged in her faith as she confronts the dangers identified by psychology’s critics. But such challenges are part of natural Christian growth. In either case, under the care of a competent Christian psychologist, Sharon can benefit from the process, grow emotionally, and move ahead in her spiritual pilgrimage.

The Most Common Psychotherapies

The concerned person seeking psychotherapy is likely to encounter one or more of the following:

• Psychoanalysis. Formulated by Sigmund Freud, psychoanalysis is based on the assumption that psychological symptoms result from unresolved conflicts in the unconscious. Psychoanalytic treatment is usually lengthy and intensive, requiring great motivation and financial resources.

• Time-limited dynamic psychotherapy, TLDP is a recent derivative of psychoanalytic therapy. While the assumptions are similar, clients in TLDP are encouraged to set specific treatment goals, and length of treatment is usually limited to six to eight months.

• Behavior therapy. Emphasizing childhood experiences much less than psychoanalysis, the behavior therapies are a set of techniques designed to modify specific behaviors and thereby change disturbing emotions. They are especially helpful in overcoming phobias, such as fear of heights, flying, or animals.

• Assertiveness training. Assertiveness training teaches clients to express their feelings openly. Among other things, it is helpful for persons who have difficulty saying no to requests and accepting compliments about themselves. Properly understood, assertive behavior is honest, socially appropriate, and considers the welfare of others.

• Rational emotive therapy, RET is founded on the assumption that most emotional symptoms are the result of faulty thinking patterns. A client missing a promotion, for instance, would be counseled to stop thinking of that as a career-ending catastrophe.

• Cognitive therapy. Cognitive therapists attempt to identify and change distorted thinking patterns in clients, similar to practitioners of ret. By learning to change unhealthy automatic thoughts, clients are often able to overcome depression and anxiety disorders in three to four months. A woman, for instance, who tells herself, “No one likes me,” will be counseled instead to tell herself, “Not everyone likes me, but many people do.”

• Client-centered therapy. Founded by Carl Rogers, client-centered therapy focuses on clients’ conscious experiences rather than the unconscious. It requires empathy, “unconditional regard,” and personal adjustment on the part of the therapist.

• Transactional analysis, TA is an approach to psychotherapy considering the person in three components: adult, parent, and child. It advocates balance and awareness of these three parts of the personality.

By Mark McMinn and James Foster.

Mark McMinn is associate professor of psychology at George Fox College, Newberg, Oregon, and a licensed, practicing psychologist. James Foster is associate professor of psychology at George Fox College, specializing in developmental psychology. McMinn and Foster have authored numerous journal articles on the integration of Christianity and psychology.

Have something to add about this? See something we missed? Share your feedback here.