One Big Obstacle to Counseling Success

It was another really hard session – tempers were up and hope was down. Nan and I had tried for months to get this couple on track. They were both devout Christians and really good willed people. It seemed like every positive move was sabotaged by another destructive one. Although we had our suspicions, we couldn’t definitively pinpoint the problem person in the relationship. Was one spouse just too passive or was the other too aggressive? Did we have a well concealed addict and a co-dependent unwilling to speak up?

As it turned out, it was neither. We had an undiagnosed disorder that was unpredictable. You might think figuring this out would be a big victory, but it wasn’t at first. Now we had the task of convincing both spouses that it needed treatment beyond talk – to us and God. It required medication for any real change to take place. But there was resistance. Why? It was a twofold problem. The couple came from a religious tradition that believed that taking medication meant that one lacked faith in God’s power to heal. And the second reason was that to seek a medical solution meant having to humble oneself and admit that they were the problem or at least a large part of it and not their spouse.

What finally happened?  As I said earlier, these people were good willed people who were truly committed to following Christ. Humility paved the way to surrender, and we were able to get them to make an appointment with a psychiatrist, who accurately treated the disorder. After that we were able to make real progress in counseling. Grace reigned as they dealt with issues of resentments and the subsequent forgiveness. Yes, both people did have a part in the problem, but the disorder prevented them from making progress. Instead they got stuck in an endless cycle of blame and defend. The medication changed the entire atmosphere of the counseling sessions. They got unstuck.

What ultimately is needed in these situations? 

• Humility – a willingness to investigate the possibility that you might need additional medical help. Sometimes it is not a belief that holds a person back, but just plain stubbornness (sin). We have actually identified the problem, understand that the most effective solution would be medication, but the person wants other people to accommodate their dysfunctional behaviors rather than have to take a step that feels distasteful to them.

• Kindness – anger will never move a couple or individual forward. 

• Courage – it is difficult to move beyond our fears and closely held beliefs. 

• Embracing Grief – It may require embracing the loss that comes with surrender. What loss? The feeling of loss of control or power, the loss of my belief that I am right and you are wrong or something else similar 

2 Cautions 

Medication alone is not sufficient to deal with the problem -- it takes a combination of medication and counseling to deal effectively with the issue. The second caution is never go off the medication without a doctor's approval. There is a tendency to start feeling much better after a while and then believe that everything is great. You are feeling better because you are taking the medication. Listen to the doctor's instructions carefully and follow his/her advice.

I really love this talk from Pastor Tommy Nelson on his fight with depression. He embodies the things I have been talking about.

 Click the link and enjoy! 

A Christian Looks at Depression 

Proverbs 15:22 (ESV) Without counsel plans fail, but with many advisers they succeed.

Your First Time at Bat

Having been in the counseling room for quite a while now, I sometimes forget how awkward the first encounter with a new therapist must feel to a client. I really do my best to put them at ease, but it’s still usually an adjustment.

I think what often makes the first meeting particularly uncomfortable is when the client is carrying a lot of shame and doesn’t want to talk about it directly. That is really understandable. They may be testing the water for safety. “Can I trust this counselor person? Will he understand me? Will she judge me? Is it really going to help?”

Forming a trust bond is the first important step of good counseling. The clinical term for this bond is the “therapeutic alliance”.  Without a strong therapeutic alliance, no real transparency is likely to occur. And without transparency, any healing will be superficial. 

It’s hard to talk honestly about our failures, frustrations, fears, insecurities, and especially our outright deliberate sins. Most people have spent a lot of their life pursuing “image management.” I know I have. As a matter of fact I probably spent the first several of my own personal counseling sessions trying to look better than I was. It wasn’t until I felt genuine care from my counselor and knew that I was safe, that I could become more vulnerable. But image management can also be a form of denial or deliberate deceit that needs to be broken – especially important with couples counseling.    

I have noticed that for some, it is easier to write about the hard stuff. That is why we use a pretty comprehensive history and intake form. Their outward appearance may not match the pain that is revealed in their intake form or their personal journals. I encourage clients to bring their written thoughts into session when this is the case for them. There is a lot of power released or surrendered in reading one’s private thoughts in front of another person.

As a counselor, I am grateful for the trust that is placed in me and do not take it for granted. For some people it is the first time that they have shared deep wounds, long buried and frightening in intensity. Although often painful to hear, it is an honor to be able to take the journey with a client for the first time. I am proud of them and the courage that it takes to be truthful in sharing the unlovely or horrific.

As we get closer to a new year, I pray for all the people that will step forward and make that first call next year. For some it will be dealing with hurts from the past. For others it will be admitting powerlessness over an addiction or behavior. And for many it will be marital or other relationship issues, both positive (pre-married counseling) or troublesome. 

Regardless, I am hoping that our clients current and future will see Christ as the true healer, and not us. We are simply facilitators – imperfect co-workers in the business of wholeness.