THE THERAPIST’S COUCH AND THE CHURCH PEW

how Jesus brings hope in our suffering

by CHRISTINE SHI

“It’s been a hectic few days. My friends and I just found out that one of our friends has been lying to us this whole semester. She wasn’t enrolled as a student. She had us all fooled—she would work on all our assignments with us, but she never turned them in.”

“Wait, but she did them?”

“Yeah, she did literally everything except hit submit.”

The room fills with silent dismay.

“Yeah, she has a lot of self-destructive behaviors. She’s very depressed…

She needs therapy. We all need therapy.”

Therapy—a modern solution for modern problems?

Today, many are turning to therapy in order to seek answers or change. A 2017 meta‐analysis of studies examining public attitudes towards mental health treatment found that the public generally supports psychiatric help for the treatment of mental disorders with the proportion of respondents recommending professional help falling between 68 and 85%. [1]

So, what really happens in that counseling room? You might picture an inviting couch in a softly lit room with the counselor leaning forward in their seat, nodding and “mhm-ing” intently, occasionally, and thoughtfully, jotting something down on their clipboard. Or, you might be quite familiar with therapy, having received it through Cornell’s Counseling and Psychological Services (CAPS) or a counselor near you. But what is it that therapists are trying to do?

In a Psychology Today article, psychologist Dr. Suzanne Gelb writes, “Therapy is a valuable tool that can help you to solve problems, set and achieve goals, improve your communication skills, or teach you new ways to track your emotions and keep your stress levels in check. It can help you to build the life, career, and relationship that you want.” [2] In other words, the overarching goal of therapy is to help you learn more about yourself and to use that knowledge to move towards your ideal life.

How do therapists do this? Each therapist’s approach is different, even among those who practice the same type of therapy. However, you will often find these common elements in therapy:

1. A therapist listens. A therapist will (I hope) offer you a non-judgmental space to share what you are feeling and what struggles you are facing, without imposing any judgments or demands on you.
   

2. A therapist reinterprets. One technique counselors use is reflective summarizing, where they reflect what the counselee has just said back to him or her—it is purely reflective, with no information added or changed. At least, that’s the goal. In his book Speaking Truth in Love: Counsel in Community, David Powlison, the late executive director of the Christian Counseling and Educational Foundation, writes, “Our every word communicates values, intentions, and worldview ...[and offers] some form of editing or reinterpretation of your story.” [3] The counselor must receive what the counselee is saying, interpret it through a certain lens, and return it to the counselee. And, the counselor’s reinterpretation is shaped by their own beliefs and experiences, as well as the counseling model and psychological theories that inform their counseling practice. Each counselor offers their own presuppositions about the human condition, standards of health, and the nature and means of change:

   • The human condition.
     What is wrong with us? What is the main problem that is at the core of all of our other problems? Why are we not able to function the way we want to, maintain good relationships, and be the people we want to be? Is it unmet needs during childhood? A lack of self-love? A negative self-view?

   • Standards of health.
     Good therapy takes you in a direction; it leaves you better than when you started. This begs the question: how do we define the standard of health that therapy strives toward? Is it the highest amount of positive emotions? A sense of fulfillment in life? Full self-acceptance? The reduction of negative symptoms?

   • The nature and means of change.
     What does change look like and how do you get there? A therapist might hope to see positive change over time by continuously processing and working through negative thoughts and feelings in sessions. Additionally, they might recommend medication or set goals with their client (e.g. exercise three times a week, make a nightly journal entry, or set up an online dating profile) in hopes of catalyzing change.
     

3. After listening, a therapist offers that reinterpretation and a solution—a new way of seeing the problem and a way to change it.

To better illustrate this process of listening and reinterpretation, I will use an example from Speaking Truth in Love. Powlison tells the story of Sabrina, a thirty-one-year-old single woman who came to him for counseling. Sabrina first entered therapy hurt by unfaithful parents, crushed by exacting cultural values, and troubled with social anxiety, loneliness, and discouragement. Her therapist listened and reinterpreted.

This particular therapist’s lens of choice was codependency and dysfunctional family theory. He wooed Sabrina with a story of how her constant feelings of anxiety and depression, her craving for intimacy, and her failures to love were the result of a dysfunctional family who failed to meet her love needs as a child, leaving her “inner child” wounded and desperately striving to fill the empty tank of love. The solution her therapist offered consisted of finding a support group and learning to affirm herself; that is, to offer herself the loving parenting that she needed and longed for.

What was the result of Sabrina’s journey of self-discovery and healing in therapy? Powlison paints a dismal picture: “After four years in psychotherapy, Sabrina seemed increasingly confused, self-absorbed, friendless, and depressed.” [3] Despite the fact that she felt like she was learning more about herself and making progress, Sabrina was worse off than when she started. There are millions of people like her seeking help in therapy; do they generally fare better than Sabrina? After a few years working as a mental health worker in a locked hospital ward, Powlison writes about his disillusionment with the mental health system:

“It dawned on me that even our ‘successes’ were at best mild. Some people ‘coped’ a bit better after our help. But was it because psychological theory and therapy were true, good, and effective? Or was it because medication and a time-out from life took the edge off? ...because any organized theory about life works better than chaos and obvious delusion? . . . because human kindness works better than life in the jungle? At times I saw symptoms moderated, but I saw nothing that I could call deep, life-renewing change. The word ‘cope’ pressed me down. It is a dismal word: life is hopeless (‘vanity of vanities’ Eccl. 1:2), but some people learn to cope better.” [4]

For all their efforts to pinpoint and address people’s problems, do therapy and modern psychology achieve more than make the depressed and anxious less depressed and anxious, and soothe the most severe symptoms of mental illness?

Is there more? Is there a better hope for the depressed, the anxious, and the lost? Powlison finds the answer in the God of the Bible, about whom he writes, “He understood my motives, circumstances, thinking, behavior, emotions, and relationships better than all the psychologies put together . . . They could never really love adequately, and they could never really reorient the inner gyroscope. God is love, with power.” [5] God is love, with power. Where human kindness reaches its limits, God’s love remains. At best, therapy and psychological theory can help people cope better, but God transforms people from the innermost heart outward.

But, how exactly can Christianity do better? Sabrina’s therapist, the very one whose help over four years failed to make her better, was a Christian! He even “Christianized” his therapy by suggesting that she look to meet her need for love with the unconditional acceptance of Jesus. However, in doing this, he was not really speaking of the Jesus who could change her from the inside out, but of the Jesus who was a bellboy for her inner child’s love needs— just one potential source among many from which Sabrina could sap love. This “Jesus” could not help Sabrina any more than the family theories her therapist offered her.

If you’ve struggled with depression or anxiety and have received (wanted or unwanted) advice from Christians, you might have heard things like, “You can’t be depressed if you are a real Christian” or “Don’t be anxious—just have faith in God and pray.” If these trite, religious phrases have ever been directed at you, I am sorry. I can imagine that you might have felt unheard, uncared for, and judged to be less “Christian” for a struggle outside of your control.

Depression and anxiety are real, even in the Bible. David is described in the Bible as a “man after [God’s] own heart,” [7] but at the time he wrote Psalm 42, he was dealing with accusations from the outside and complex emotions on the inside that led him to ask, “Why are you downcast, O my soul? Why so disturbed within me?” Trusting God does not mean not seeking help; therapy or medication could be the means by which God has planned to help you in your situation. Rather than relying on platitudes, I want to talk about God as an alternative to modern psychological theory and practice by looking at how the Bible explains people and situations more coherently and accurately—namely, how it answers these four questions: Who are we? What is wrong with us? How can this be made right? What are the nature and means of change?

Second, what is wrong with us? “Evil, done by us and happening to us, is the fundamental and pervasive problem in living.” [8] Instead of loving God and loving others, we love ourselves or other things above God and disobey God’s will for our lives—we sin. What happens to us can be a consequence of or provide temptation to sin, but our circumstances do not absolve us from responsibility for our sin. The product of sin is judgment and an eternal death without God.

Sabrina began to see how dysfunctional family theory had named her patterns of anger, manipulation, and social anxiety (“codependent lifestyle”) and, therefore, painted them as a form of personal dysfunction rising from an unmet need for love and acceptance. Maybe it was comforting that her upbringing could be used to justify these harmful patterns, thus moving the guilt from herself onto others who had not given her the love she needed. Thus, she could keep repressing the conflict between what do so that she wouldn’t have to face the hopeless thought that she was bad and powerless to change herself.

Eventually, in what I imagine was a painful process, Sabrina came to see how her anger, manipulative relational tendencies, and fear of people were patterns of sin that arose from her heart, which had been enslaved by a demand for love and affirmation. She imposed this demand on her relationships, manipulating those around her to satisfy her cavernous desire for love and punishing others with anger when they did not love her how she expected. She lived on affirmation from others, so she was uncontrollably anxious about what her friends, her coworkers, and her boss thought of her. She had wronged others and disregarded God. Can you imagine how freeing it was to stop searching for excuses to cover her sins and to see herself clearly as she really was? And yet, at the same time, she couldn’t possibly stand under the weight of her own demons or save herself from the judgment and death that her sin brought on her. This brings us to the third question:

Third, how can this be made right? The solution to the problem of sin is beyond human resources. It lies in God who, by grace and in love, saves us from our sin and suffering through the sacrifice of His Son, Jesus Christ, who, although he knew no sin, became sin, so that in him we might become the righteousness of God. [9] By taking the punishment for sin in our place, Jesus offers us freedom from sin and its result—judgment and eternal separation from God. He allows us to see God, ourselves, and others clearly, and to love God and love others fully. He offers us life with God, full of joy, and peace, and unity, forever. While we did not deserve this gift, we can receive it in full y turning from our sin and accepting Jesus as our Savior.

These truths of the Gospel that I’ve just shared are all things that Sabrina had heard in church before, but now, they were being introduced in a new context, intimately related to her life. Sabrina rediscovered Jesus—no longer seeing Him as existing to fulfill her need for affirmation, but loving and obeying him as her precious Savior who came to save her from her sin and God’s judgment, forgives her as she turns to him, and helps her to actually change.

Fourth and finally, what are the nature and means of change? Change looks like shaping our desires, thought processes, behaviors, feelings, and values to be increasingly like Jesus, in loving God and other people. This change is the aim of Biblical counseling, happens progressively over a lifetime through the work of God in our hearts, and is helped by people speaking truth in love to each other (counseling being a specific version of this).

Because God opened Sabrina’s heart to see beyond her own expectations and consider others’ needs, she began to experience small victories over her anger and manipulative tendencies. He opened her eyes to clearly identify how her craving for human approval played out in her life, and helped her find identity in her status as a beloved daughter of God rather than in others’ others’ judgements. This gave her the strength and courage to love people in those situations rather than demanding their affirmation. By offering her a space each week to evaluate the desires and false beliefs that were producing sin in her life and to counter these with Biblical truth, biblical counseling was one of the means of grace that God used to help her in this journey.

This was a lifelong journey. Even amidst great improvements, Sabrina would still get upset when people didn’t meet her demands and worry about what others thought of her. But, if the best one can do with Jesus is constantly strive towards a goal that can’t be reached in a lifetime, how is this any better than the “coping,” apart from Jesus, offered by therapies and psychological theories?

The answer is that while one is just a lifelong journey with no end in sight, the other is a lifelong journey to a promised destination. Those who have trusted in Jesus and devoted themselves to following him have an eternal hope of being made perfect without sin. “When he appears we shall be like him, because we shall see him as he is.” [10]. The last book of the Bible tells of the future that awaits Jesus’ followers: “He will dwell with them, and they will be his people, and God himself will be with them as their God. He will wipe away every tear from their eyes, and death shall be no more, neither shall there be mourning, nor crying, nor pain anymore, for the former things have passed away.’” [11]. This is a beautiful promise and is the eternal reward that makes the lifelong pursuit of Christlikeness infinitely better than lifelong coping.

It would be ridiculous to see so many people seeking answers from secular psychological models if they did not capture parts of the truth. Cognitive theory reflects an important aspect of how we work: our beliefs shape our thoughts and actions. Psychoanalysis realizes that much of our motivations and thoughts are hidden to our conscious selves—“The heart is deceitful above all things.” [12] Dysfunctional family theory illustrates how parents’ sins affect their children.

But these theories, for all their layers of explanations, can only achieve part of the truth. Cognitive theory is limited if there is no solid foundation of the alternative beliefs with which you attempt to replace your current beliefs. Psychoanalysis fails to acknowledge bad behaviors as sin, not just a result of unconscious thoughts and feelings. Dysfunctional family theory enslaves people to an insatiable craving for love and affirmation. The more you meet and see into the inner lives of people like Sabrina, whose searching for answers have only led them deeper into despair and emptiness and anything but life-renewing change, the thinner these theories seem.

Modern psychological theories and the therapists that use them offer kindness, common-sense observations of people, and strive to replace unhealthy beliefs and behaviors with those that lead to happier, fuller lives.

The best thing about the biblical narrative is that it’s not just a narrative. Not only does the Word of God offer a coherent, resonant explanation for the human condition, but “the Word became flesh” [13] in Jesus Christ, who gives us himself—the real and living and personal God—as a solution for our otherwise hopeless condition. Now, does that fill you with hope?

SOURCES

[1] Angermeyer, Matthias C., Sandra van der Auwera, Mauro G. Carta, and Georg Schomerus. “Public Attitudes towards Psychiatry and Psychiatric Treatment at the Beginning of the 21st Century: A Systematic Review and Meta-Analysis of Population Surveys.” World Psychiatry 16, no. 1 (2017): 50–61. https://doi.org/10.1002/wps.20383.

[2] Gelb, Suzanne. “What Really Happens in a Therapy Session.” Psychology Today. Sussex Publishers, December 5, 2015. https://www.psychologytoday.com/us/blog/all-grown/201512/what-really-happens-in-therapy-session.

[3] Powlison, David. Speaking Truth in Love: Counsel in Community. Greensboro, NC: New Growth Press, 2005, 160-161.

[4] Powlison, 89.

[5] Powlison, 89.

[6] Powlison, Speaking Truth in Love, 155-156.

[7] 1 Sam. 13:14 ESV

[8] Powlison, Speaking Truth in Love, 171.

[9] 2 Cor. 5:21

[10] 1 John 3:2b

[11] Rev. 21:3-4

[12] Jer. 17:9

[13] John 1:14