Friday, April 3, 2009

The Trouble with Counselling Theories

When I first started counselling nearly 20 years ago, I was so anxious to find a "correct" theory that would somehow cover each case I encountered. Now I concentrate on clients and develop a theory or even use "mini-theories" with each person.

I wouldn't say that trainees shouldn't learn about the various theories -- indeed I taught the rudiments of such theories to undergraduates at a tertiary college for more than a decade (http://www.myauz/ianr)! However, the danger with theories is that we may too easily force the experience of the client into our web of concepts, falsifying what is being said to us.

Moreover, for Christian practitioners, the secular theories have been shaped by non-christian "basic driving forces" (Dooyeweerd) that severely limit their wholesale acceptance by Christian practice. (As Christians though, we should be equally aware of where our own thought and practice is compromised by unchristian driving forces such as the dualistic motive of nature-grace.)

None of this should be interpreted as saying that theory, hypotheses, concepts and explanatory frameworks are unnecessary. But, the adoption of one set of concepts to cover all clients' difficulties is altogether too limiting.

Monday, February 9, 2009

Finding Purpose in Your Pain?

I recently read Purpose in Your Pain by V. Gilbert Beers. He tells the story of how his family lost a 26 y. o. son in a car accident and vividly recounts the aftermath faith-wise, emotionally, physically and so on. Superb writing and an excellent read on the subject.

Of course, nothing can prepare one for events like these. Presently, in our state of Victoria, we are experiencing a terrific bushfire outbreak that has taken some 180 lives and still counting plus 4 hundreds hospitalised, the worst disaster of this type to afflict our country.

Beers' book stuck me on two counts: first, his explanation of why a son or daughter's loss hurts so much is described in terms of it being an attack on the structure of the family's and each member's identity. We grieve not only the loss of that person but because that person was part of how we were defined or constituted in this temporal life, we have to grieve and repair the loss of a part of our corporate being, which we can never find again in this existence. We lose the person but we also lose our selves because the relationship with that person was part of our selves.

However, we must also remember that our identities are supratemporal not just temporal. We are souls not just temporal bodies with the full meaning of the body being concentrated in the soul and the temporal meaning of the soul being expressed in the body. Nevertheless, the nondual relation between the soul and body means that when the body suffers, so too does the supratemporal soul.

Moreover, Beers spoke later of the wounded healer, a concept well-known through Henri Nouwen's writings. We are able to comfort others perhaps only to the degree that we also know suffering and minister to others out of 'the school of suffering' we have gone through. Beers argued that suffering can become redemptive in the lives of others. A wise woman has said that 'the value of suffering does not lie in the pain of it . . . . but what the sufferer makes of it' (Mary Craig) or we could add, what we are made in rightly using our suffering.

Don't know whether this suggestion means that I can find a purpose in my suffering. In any case, the 'purpose' only becomes apparent when I look back at a later time and see how that experience of suffering becomes to be used for the good of others. That good may be seemingly simple: having suffering I can go and sit with someone who is suffering and not be conflicted by thoughts of not knowing what to say. Often the suffering person needs someone who can sit with her in her pain and not try to problem-solve for some loss than is not amenable to problem-solving.

Thursday, October 16, 2008

Writing a Journal Article

Philosophia Reformata began in 1936 in The Netherlands by scholars interested in Christian Scholarship and particularly related to the outstanding achievement of Herman Dooyeweerd (1894-1977) whose magnum opus, De Wijsbegeerte der Wetsidee (A Philosophy of the Law-Idea) in 3 volumes had been published in Dutch (1935-1936). This work was later translated, edited, and elaborated further by Dooyeweerd and others, appearing in English as, A New Critique of Theoretical Thought (1953-1958).

I have just finished writing a journal article for Philosophia Reformata entitled, Out of the Abundance of the Heart: Implications for Christian Psychotherapy. In the article I have first outlined Dooyeweerd's views relating to the supratemporal heart or soul. The second part of the article deals with the implications of Dooyeweerd's Ideas for psychotherapy. One major implication I would like to emphasise is Dooyeweerd's belief that the realisation of an appreciation for God's sovereign reign over all of life required daily conversion of the heart, the supratemporal core of our being.

Friday, August 22, 2008

Depression as emotional and social disconnection

Many models are used to try to understand depressive mood disorder (DMD). A productive model is to understand DMD as caused by family levels of emotional and social disconnection. For example, if parents are unable/don't give appropriate amounts of emotional nurturance then the infant/child does not learn how to connect emotionally to them and then to others. Psychotherapies tend to work because all involve relationship with a therapist who actively but often implicitly offers a relation. And, much of what therapists do encourages greater contact through behavioural or 'action' assignments or directly through 'interpersonal therapy'. In these assignments, it should not be forgotten that all aspects of the person are involved, not just cognitive, emotional or 'behavioural' facets. At another level, families can sometimes be isolated and cut off from the mainstream culture because of their religious or ethnic allegiances. These links also imply disconnects with school and work situations where the differentness of the family may not be tolerated or understood. The latter raises the question of the character of the culture in which widespread DMD arises. Present western societies are dominated by the clash between a drive to subdue the natural world through science and technology on the one hand, and the equally urgent desire to promote the autonomy of the human personality on the other. My present thesis is that each of these idolatries -- for each idolatrises some relative part of temporal reality -- promotes societal disconnection: each does this by not only suppressing a fair estimation of its opponent's claims but also by wholesale distortion a range of other normative considerations. Such action has culture-wide grievous effects, which are also found in the psychological area of mood disorders.

Monday, June 30, 2008

Using rational therapy sceptically

I have viewed the family of rational therapies with some scepticism after unsuccessfully using such therapies in my own life. Yet, I know numbers of people find such procedures helpful.

I even know of those who have been helped by me using rational-cognitive methods even though I do not believe the theory that what we believe/think creates disabling moods! Yet, some clients are helped by this approach but not all.

Interestingly, even Albert Ellis at 90 years of age disagreed with the adage that one could use any technique as long as it was consistent with his rational-emotive behaviour therapy (REBT). In fact, he contended that one could use any technique even if it was inconsistent with REBT because the client's well-being had to come before any theory!! (See Ellis' Foreword to The Rational Emotive Behavior Therapist's Pocket Companion at http://xrl.in/85u.)

Others may put these puzzling effects down to the placebo effect (http://xrl.in/85u). However, I am more impressed with the 40-30-15-15 therapy component rule (see http://www.brieftherapysolutions.com.au/BSFTWhatWorks.html). According to this rule, 40% of therapeutic effectiveness is apportioned to extra-therapeutic factors such the strengths of clients and 30% to the therapeutic alliance. Techniques are said to contribute 15% with the placebo effect also contributing another 15%.

Hence, when we revisit the above apparent anomaly, it makes sense that REBT may fail to help me in my own life but still work with one of my clients. With a client, she is getting the benefit of the therapeutic alliance, which doubtless enhances the effects of the other three sets of factors.