by: John Townsend, Ph.D.
What is good Christian therapy? If you’ve ever wondered, you’re not alone—many people have wanted to know. It’s important to know, because (as you’ll quickly see when you set out to find a therapist) there are some Christians who do bad therapy, and some non-Christians who do good therapy, and all kinds in between! A long time ago, I went with a friend of mine, who was a pastor, to hear some Christian therapists talk about their profession. I remember one particular therapist getting up and talking about his specialties and training. He was, I thought, theologically accurate—he had the Bible chapters and verses down, and his theology made sense. He seemed a little on the cold side, but he passed the doctrine test. Then a lady came up and spoke, and she seemed a little lost theologically—she couldn’t clearly articulate what she believed. However, she came across as warm and caring, with a lot of personal depth.
I kept wondering what my buddy was thinking. Which of these two therapists would he, with his understanding of theology and the Bible, choose to go to? As we drove away afterwards, I asked him this. Without hesitation, he said he’d much rather go to the second person than the first. It wasn’t the answer I expected! “Why?” I wanted to know. “Because I was safe with her,” he said. “I could tell that this woman would accept and deal with anything I might say, rather than judging me, and I also sensed that she’d be able to feel for me what I couldn’t feel for myself.”
My friend had a point. A good therapist is able to help you by containing aspects of your self that you are unable to tolerate, unable to grieve or feel or experience, talk about, or even recognize in yourself. He or she is like a good parent who sends the message, “I can deal with this black hole part of you. And my being able to deal with it and talk about it means that, in time, you’ll be able to deal with it, too.” This containing of a person’s emotions can make all the difference between competent and incompetent counseling. A therapist who doesn’t have the capacity to be emotionally present with you is not going to do you a lot of good, no matter how theologically sound his or her counseling may be.
The best counseling combines the strengths of both those therapists who spoke that day. It is both theologically sound and psychologically effective: it incorporates the truth and a safe relationship. The good news is that these days, there are a lot of therapists who have not only had solid formal training but have also integrated Christianity into their practice.
Essentials of Good Therapy: the Goal and Focus
Here, then, is a definition of what good Christian therapy is. It is an active and specific involvement in your sanctification. It’s not about restoring your innocence; it’s about redeeming you. People sometimes come to counseling because they want to restore life to the way it used to be. The Bible, however, is not about God returning us to Eden, but about him redeeming us—buying us back. We aren’t innocent any more, but once redeemed, we are integrated, and integration is actually a higher state than innocence. Innocent people repeat the same mistakes (such as innocently dating the wrong person twenty times!), whereas integrated people are aware, understanding both good and bad.
God has a process for taking us from a broken, hurting, dysfunctional state (depression or anxiety, for example) and restoring us so that we can function again. Therapy has a clearly defined place in this spiritual growth process. If you have an issue severe enough to make you to go to the trouble and expense of looking for professional help, it means there’s a specific part of you that’s stuck in the growth process, injured, lacking, or immature. Therapy is very specific—it reaches deep inside to these very places where you’re not growing. For example, you may be depressed. Depression is often about loss: something prevented you from grieving, so you stayed busy all your life and became a rescuer and workaholic, until suddenly, at the age of thirty-four, you collapsed, ate a million doughnuts, and discovered “I can’t control myself!” The therapeutic process would require you to become very specific: What is it about loss that’s so painful that you cannot enter the “house of mourning” that Ecclesiastes 7:4 talks about? This is where therapy fits in.
So there shouldn’t be a conflict between what we learn in church and what we learn in therapy. If you’re going to a healthy church and a healthy counselor, you should see some similarities in what you’re being told. As you continue reading, think about your church, your support group, and the people you hang around with. These people should be working with, not against, your growth process.
Essentials of Good Therapy: the Therapist
Good therapy begins with a good therapist. There are certain key capacities and qualities to look for in a therapist. The first of these is the capacity to apply both grace and truth together. Let me explain.
As you enter the growth process, you will need to keep in mind what Jesus said about it—he said, “It isn’t easy.” That’s my abbreviated version; the original is in Matthew 7:13-14: “Enter through the narrow gate. For wide is the gate and broad is the road that leads to destruction, and many enter through it. But small is the gate and narrow the road that leads to life, and only a few find it.” Don’t ever think that good Christian therapy is Epcott or Disneyland—it is hard work. You look at what you don’t want to look at, admit what you don’t want to admit, confront what you don’t want to confront, and take responsibility for much more than you ever dreamed you’d have to, but that’s what the narrow gate is about.
Good therapy is going to involve pain at some level. That’s because God’s solution to the wrong kind of pain is giving us the right kind of pain—the pain of becoming an honest person, allowing ourselves to be vulnerable, making connections with other people. Good therapy is not about making us feel better all the time. If all your therapist does is nod and confirm, like the little dog figure in the back of your car, you are receiving what we call “grace without truth.” The opposite extreme would be the therapist who’ll tell you your problem without giving you the support you need to bear the truth. That’s truth without grace. Good therapists give you both—truth and grace.
Secondly, make sure the therapist is credentialed. Who would go to an attorney who, while more than willing to take your case, has only been trained as a plumber? All fifty states require certain credentials and licenses. Make sure that the person has been accountable to some qualified and qualifying institution.
Thirdly, find out whether the therapist has the ability to be emotionally present and have a safe relationship with you. This is critical. Your therapist need not have had the same issues or life experiences as you’ve had (being married or single, male or female, for example) in order to be of help to you; however, he or she must be a person who has integrated enough of life’s experiences to be able to be present with you as you examine your experiences. Can you tell that he or she is “there” with you and really cares about and empathizes with your deeper feelings? This ability cannot be overstated.
A fourth criterion in choosing a therapist is a good reputation. Find out what you can about the person from pastors, counselors, or friends you think are normal and balanced. Good therapists tend to stay around a long time and do reputable work; bad ones tend to either develop a cult or move to another state to get away from legal proceedings! Reputation is important.
Essentials of Good Therapy: the Therapeutic Approach
Next, let’s talk about the therapeutic approach. If a therapist claims to do Christian therapy, that’s a significant claim that needs to be substantiated. Some therapists will openly tell you, “I’m a Christian, but I don’t do Christian therapy, I do good therapy.” They may not have had the opportunity, resources, or formal training required to offer Christian therapy, and they don’t want to mislead anybody. I’d respect that—it would be worth looking further at that person’s work to see if it’s sound. If a person does offer Christian therapy, however, that’s a claim that needs to be examined against a different standard. How does this person’s work fit with theology?
It’s a good idea to ask a Christian therapist what his or her view of good Christian therapy is. Look for one who understands what the Bible calls “the whole counsel of God” (Acts 20:27, NKJV), recognizing the Bible as having overarching themes and principles. Avoid people who do what I call “scotch-taping”—patching scriptures together, a verse here, a verse there. It can be an indication that someone hasn’t thought through biblical issues.
Next, consider the theory on which the therapy is based: behavioral, analysis, Gestalt, existential, humanistic, or Rogerian, to name a few. Whatever the theory may be, does your therapist have one? It’s important that a counselor consider the theories proposed by others and decide what he or she believes, both about the counseling process and the conditions needed for emotional healing. To illustrate this, let me remind you of your own spiritual journey. There were many points of doctrine you had to study—the Holy Spirit, the Trinity, and the Church, for example—in order to define what you, as a Christian, believed, and which approach you could identify with. In the same way, a therapist studies and embraces certain theories about therapy.
In searching out a good therapist, you need to ask, are the theories underlying his or her practice consistent with the Bible? Further, are they research-friendly? In developing our therapeutic model, Dr. Henry Cloud and I spent many, many hours studying the Bible, but we also allowed good research to illuminate and lend support to what has already been revealed by God.
Besides being consistent with the Bible and informed by research, a good therapeutic approach pays attention to deeper issues within us. It is not focused solely on external behavior. I remember a woman who came to see me for an eating disorder. I said, “Have you ever tried to get help for this before?” She named a Christian therapist and said he’d told her that her bulimic behavior was a sin. “So what did he tell you to do about the sin?” I asked. “He said I should stop doing it.” But she couldn’t stop. Finally the therapist said that since he’d already told her what to do, and she hadn’t complied, there was no point in her seeing him any more.
I suppose this woman’s behavior may have had some sinful aspects to it, but what the therapist had overlooked entirely was that there were some very painful realities deep within her heart, driving that behavior. She was the “nice guy” who felt like she owed it to everybody to say yes, so the only thing she felt she had any control over was her eating. She needed somebody to dig down into her soul and find out why she was so afraid that if she got close to someone, she’d be controlled. This is what I mean by “paying attention to the deeper issues within.” It’s what Jesus refers to when he tells us to take a look at the cup, and before we wash the outside of it, wash it out inside, where it’s dirty (Matt. 23:25-26). Of course, it is equally ineffective to pay attention only to the inner world. A good therapist has to be able to look at both the inside and outside, since the outside (the person’s behavior and choices) does matter as well.
Good Christian therapy also incorporates certain values. There are critical values we must all agree on—honesty, trust, truth, integrity, love, relationship, and God’s help, for example. It‘s important, in a Christian therapy session, to talk about what’s right and what’s wrong. It’s the rights and the wrongs that keep us on the path toward either life or destruction.
The therapist’s approach will also be heavily influenced by his or her view of sin and its effects on our behavior and thinking. There are some very incomplete views of sin out there in the Christian therapy world, like the one described earlier: “That’s a sin, so stop doing it.” Another common view of sin (one I would not agree with) holds that people are basically good and simply need to be restored to the innocence they all once had. This is not what the Bible teaches about our condition.
The Bible talks about two kinds of sin, external (the “acting out”) and internal (our stances toward life, like being deceptive, or not taking responsibility). There is also a difference between “sin by me” and “sin against me.” Every psychological, emotional, or relational struggle is some combination of “sin by me” (such as my own envy or self-centeredness) and “sin against me” (such as another person’s controlling or dominating me). Therapy should take into account these differences.
The therapeutic process also needs to address the concept of splitting (that is, divisions, or incompatibilities within us). Generally speaking, what often brings people into a depression, divorce situation, or state of anxiety is some division within themselves. They have two opposing parts of themselves. For instance, a young man comes in and describes how he wants to be loving, but every time he gets close to a girl, he bails. He has a conflict inside himself: every time he gets close, he’s afraid he’s going to need somebody, and because he was raised in a shame-based environment, he’s afraid that if people get to know him, they won’t like him. So while he may be capable of being very friendly, he also has this weakness, and he hates and condemns himself for it.
We all have these splits. A good therapeutic process can throw some light on how you might be divided within. Perhaps you can’t put your strength and weakness together (that’s one kind of split), or maybe you always see yourself as the victim and someone else as the perpetrator (that’s another). The therapist can help you see what your split is, so that between sessions, you’re alert for whether you’re still doing it. You begin to realize, “Oh, I get close, and then I run from the closeness,” or “I get angry when I’m sad, and instead of being able to grieve, I cause a fight.” This “head-scratching” is one of the best things you can do in the growth process.
So far, we’ve looked at the goal and focus of Christian therapy, the qualities needed in the therapist, and some essentials of a good therapeutic approach. Now let’s look at the therapeutic path itself.
Essentials of Good Therapy: the Therapeutic Path
First and foremost, a path is a good thing to have. You need to be able to find out what your issues are, what caused them, why you continue them, and what the resolution is. I’ve known friends who’ve been in therapy for years and admit, “I’m not sure what my issues are, let alone what we are doing about them!” You should, at some point, be able to understand your issues: you should be able to say something like, “I’m finding out that I’m addicted to selfish people because I can’t hold onto my boundaries,” or “I’m always angry when anyone confronts me because, inside, I feel like a child instead of an adult.”
The path goes further, defining what you need to do to resolve your issues. A person with a detachment disorder, for instance, may find that the path involves taking risks to be vulnerable and talk about inner stuff—a difficult task for that person. The path often involves doing the hard thing, the very thing you hate to do because you haven’t ever been able to do it. A good therapist will encourage you to do the hard but healing thing.
Secondly, there needs to always be a balance, in that path, of grace and truth. Grace is unmerited favor—the therapist is for you no matter what, whether you’re right or wrong, lovable or ugly. The Christian therapist’s view is “I’m for you and God is for you. You and I are working together with him.” That means there’s a real relationship, a real attachment in which counselor and counselee value each other. But there should be truth too, not grace alone. If you’re not getting confronted on something—large or small—pretty regularly, there may be something wrong! Confrontation is necessary, in the right doses.
Thirdly, the path must include structure. The structure of therapy is very important: arrangements concerning payment, session times, cancellation, paging, emergencies, and phone calls need to be very clear. You need a therapist who can set limits and hold to them. Many people come into therapy never having had good structure, and the structure of therapy itself helps them to set better limits in their outside life. A fourth essential of a clearly defined path is the understanding that growth and change are sometimes invisible. That’s the whole point of Jesus’ parable of the seed and the sower (Matt. 13:1-23). Things happen in your heart, and that’s what causes you to become more honest in your relationships or to feel renewed courage or love. A path that’s concerned only with changing your outward behavior is incomplete. “I’m having down thoughts.” “Well, then, think up thoughts.” That’s a little like telling someone to fight gravity—it’s beyond us! First you need to find out why you have down thoughts, so that you can challenge that thinking. And then, you need the support and grace to begin to do things differently. First the invisible growth, then the outward change—that’s always the order.
There is a fifth essential in laying out the growth path: the therapist needs to differentiate between resistance and fragility. Some people get stuck in their growth because of a resistance. They can’t take needed growth steps—for instance, confronting a boyfriend or wife—because of a stubbornness inside: “I just don’t want to! I want them to change, and then I’ll change.” It’s a two-year-old mindset that needs to be confronted. On the other hand, some people get stuck because of fragility. They are hurt or undeveloped in some area—weak, unloved, self-hating, or weighted down by guilt. You don’t confront, in these instances—you offer help and structure. You build up the weak part, giving it what it needs. All of us have resistance and fragility. A good therapist can recognize and respond to each appropriately. Finally, I want to address the matter of prayer and Bible in therapy. Some people conclude that a therapist who doesn’t pray or read the Bible with them is not doing what God called them to do. This is not always true. Let’s not confuse the spiritual disciplines with the elements of growth. If the elements of growth are present—grace and truth, time, the process, insight, confrontation, and love—that’s what counts. They are what heal us.
Often prayer and Bible reading are appropriate—they can very well fit with what God is doing and with the issue you’re working on. In certain situations, though, they can work against the therapeutic process: for example, some people, every time they get close to feeling an emotion, want to move to prayer to get away from their feelings. Or, when they have to admit to something bad, they avoid doing so by bringing God into it. The therapist has to evaluate what is helpful and what is not and must be given room to do that. Christian therapy is a process that can produce excellent fruit in your life. You will find that a good Christian therapist, one who puts into practice the essentials we’ve discussed, brings people through a process that starts inside, with who they are, and moves outward toward who God is. That’s how God redeems us, sanctifies us, and heals us.