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Cognitive Behavioral Therapy

In twenty years of pastoral ministry, it is rare that I come across someone who has benefited from counseling/therapy. Which is odd considering how many people have tried it. This might be anecdotal to me, but when I ask the struggler who has approached me to describe their previous counseling experience, I usually get something like “At first it felt really good to talk to someone, but then it just sort of fizzled out and nothing ever changed.” This leads me to believe that the majority of secular counselors could be replaced by a good and wise friend. Good Will Hunting moments are unicorns.

So when I encounter someone who has benefited from counseling, I tend to notice. In The Coddling of the American Mind, which is essentially a critique of the fragility incarnated in higher education, Greg Lukianoff, one of the authors, overcame (or perhaps learned to cope with) depression using Cognitive Behavior Therapy. The authors of this books are not Christians but are also clearly intelligent, thoughtful, and well intentioned. They go so far as to recommend simple forms of CBT be taught to children as a way of helping them become anti-fragile. I find it interesting to see CBT recommended heartily by two self described liberals who are concerned about the fragility of the up and coming generation, so I thought I would do some exploring. (For an introduction to CBT try The Beck Institute).

I am struck by 2 reasons CBT might be successful, and these are shared traits of the Biblical Counseling that I practice. First, CBT treats the client as an active agent in the change process. This may seem like a no-brainer, but the reality is that for many of the common causes for which therapy is sought, the client is treated like a victim of a disease. The term “mental illness” captures this approach. For example, the practical result for many seeking help for depression, anxiety, and bi-polar disorder is a prescription. The CDC reports that in the years 2015-2018, 13.2% of Americans age 18 and over had taken an anti-depressant in the last 30 days. Since the overwrought response to the pandemic, anti-anxiety prescription use has dramatically increased. This medical model of therapy, whether intentionally or not, minimizes the agency of the individual.

But there are other reasons why counselors may refrain from challenging their clients in all but meaningless ways. In our increasingly Woke culture, a mental health worker at a university might expect a lawsuit or the loss of employment if they challenged the narrative of a client who belonged to an “oppressed” demographic. But it sounds to me like in CBT, a counselor can say “What are you thinking?” and “Does that actually reflect reality?” Like Biblical Counselors, those who practice CBT are willing to challenge their clients views, claims, perspectives, values, and conclusions.

Secondly, as implied in the name, CBT focuses on the thoughts. It’s reasonable to say that a lot of people seek counseling for conditions that are emotional in nature. How do we access the emotions? The short answer is that we have no idea. But we can address the thoughts. Scripture actually uses phrases like “the thoughts of the heart”, or “As a man thinketh in his heart, so is he.” Emotions are tied to our physical bodies, but they are also tied to our thoughts and behaviors. CBT enters the process of counseling through the thoughts as well, “Dr. Beck began helping patients identify and evaluate these automatic thoughts. He found that by doing so, patients were able to think more realistically. As a result, they felt better emotionally and were able to behave more functionally.” There is an echo of noutheteo in this statement, is there not?

But what does it mean to “think more realistically”? Here the paths between CBT and Biblical Counseling begin to diverge in (at least) two distinct ways. The first is that CBT contains no body of universal knowledge from which to define “realistically”. Biblical counselors have the Bible: an unalterable exposition of humanity’s origin and destiny, a unified narrative of redemption assembled across centuries and cultures, and a complete and sufficient body of Truth. Compared to this incomparable resource, CBT is quite limited. Human beings can be ruthlessly honest with ourselves and endeavor to be objective regarding the world around us. But even then – especially then! – the human soul seeks Transcendent Truth that must be revealed by God before it can be discovered by man.

Secondly, I find it difficult in secular therapy to determine the telos of the counseling because I cannot discern within that counseling paradigm what they think is the telos of the individual. What is the goal? Is CBT’s goal to make people happier or more productive? Do those terms differ from client to client? What if those goals are achieved and yet the counselor knows that the client is still not thinking realistically? Contrast this with Biblical Counseling which knows from our catechism that the chief end of man is to know God and enjoy Him forever. The purpose of man is not to be happy or productive, but to know God and in knowing God, become someone in whom the image of God shines forth. In so doing, a man often finds deep joy and accomplishes great things. But the order can never be reversed or the whole enterprise collapses. When my foster son was a teenager he took to sneaking out of the house at night and running away, which eventually led to the Department of Family Services taking custody over him. In one of the conversations I had with the team (consisting of three or four people) we had an argument that ended with me saying something like, “There’s a lot worse things for ______ than winding up in jail” to shocked faces. Their goal was to cajole him into obeying the rules long enough for him to age out while my goal was for him to learn that actions had consequences, which I considered a step towards some change in his character. Telos makes a difference.

After some research and some pondering, I get how CBT was helpful in Greg’s life. There is enough light in this world to tell the difference between imaginary and reality. There are enough God given faculties within the human soul to do the hard work of challenging our own conclusions and improving our mental processes. What it is missing in CBT is transcendental truth, a clear vision of humanity as made in the image of God with all the moral responsibilities that entails, and we could add to that the Biblical Counselor’s confidences in the redeeming work of Christ, the community of believers, etc… I also wonder how long CBT can endure without being co-opted by the medical model or the politics of progressivism. Still, I can say I am honestly happy for Greg and honestly happy that even little “T” truth is being utilized in counseling. Once the door of truth is cracked open, we can only hope Who might come walking through.

The Redemption of Jordan Peterson

Jordan Peterson is a clinical psychologist who vaulted to public fame (or infamy) following his stand against Ontario’s Bill C-16. As such, a man who would have been solidly a “liberal” in the 80’s and 90’s became somewhat of a hero to conservatives. I first came across him following his interview with Cathy Newman a couple of years ago and watched, with some level of delight, as he calmly articulated responses to what were clearly antagonistic questions. Then followed his uber successful book, 12 Rules for Life, and tours across the world that saw millions of people attend. He is broadly considered by friend and foe alike to be one of most influential intellectuals of the 21st century.

If we accept as axiomatic that academia and the media lean left – like if all passengers on a boat were academics the the boat would be in real jeopardy of tipping over – then it makes some degree of sense that Peterson would be so welcomed into conservative and even Christian circles as a comrade. His hatred of cultural Marxism and his ability to articulate cogent critiques of identity politics made him the natural enemy of the Left. On top of that, he managed to educate large numbers of people to the difference between equality of opportunity and equality of outcome, making the argument that a demand for equality of outcome is contrary to human nature. He argues against the notion that the West is an oppressive patriarchy, and that alone is enough to make one hated in our world.

Nevertheless, Peterson is not a Christian, and certainly not an orthodox one. He is a Jungian who appreciates Jesus Christ as an archetype of good and he is a social critic who understands the Bible to be the most important document of Western Civilization. He longs for a return to Enlightenment ideals where the individual is prized more than the community to which they belong. His books encourage individuals to take responsibility for themselves, so there is a good deal of advice like “Start by cleaning your room.” At least, that is my summary of his beliefs. As such, he does not believe in a literal, historical Jesus whose death can propitiate the wrath of a holy God.

But Christians can learn a lot from both the success and the failure (if I may generalize it that way) of Peterson. We can learn that America needs a dad. Peterson is not the caricature of macho masculinity often put forth as a straw man by egalitarians. He is a straight talker who risked his career for something in which he believed. He preached personal responsibility to a generation from whom little was expected. It shouldn’t surprise us that his audience skewed towards young males who were desperate for someone to tell them that they could and should do something worthwhile with their lives – the very audience that churches are missing. In a touchy-feely world, Peterson was a breath of truth talking fresh air.

In the midst of all of the social unrest being experienced in the United States and the clear Marxist leanings of the many fomenting rebellion, I wondered what had become of him. In 2019 Peterson fell off the map until his daughter – a food blogger/influencer – posted in late winter of 2020 that they were in Russia getting treatment for withdrawals from a drug he had been taking called clonazepam, which is a benzodiazepine. In a new Youtube interview with his daughter, Peterson talks about how he developed the dependency (more on this in a minute) and how it led to a condition called akithisia and then the traumatic treatments he took in order to recover. I think it’s safe to say that Jordan Peterson is hated by many and has endured unjust accusations against his character and his actual positions on many issues. So it must be with some degree of trepidation that he re-enters the public eye having just emerged from an ordeal that many will consider a personal failure on his part.

One thing I have noticed in recent years is the increased optimism regarding pharmaceuticals for the treatment of anxiety or depression or PTSD in the Christian counseling community, even among the theologically conservative. I think Jordan’s case is worth noting because he is a trained clinical psychologist with a philosophy of personal responsibility, and yet he came to be physically dependent on a drug without really being aware of what was happening.

So my vast readership, being known for their intellectual acumen, no doubt have picked up on my use of “physical dependency” as opposed to “addiction”. Is this a legitimate biblical distinction, or is this just semantics? In Ecclesiastes 2:3, the Preacher says that “I sought in mine heart to give myself unto wine, yet acquainting mine heart with wisdom”, which I take to mean that he made sure that wine never conquered his will or his desire. But that’s a dangerous game to play. In our modern era we might imagine someone with some disease choosing to use marijuana – as opposed to a stronger opiate – to manage pain, all the while hating the disease and the treatment. And while Peterson does say that he originally took the drug to manage a severe reaction to food poisoning (clonazepam being a treatment for seizures), the narrative appears to move on to increasing the dosage (under the care of a doctor) to help with the anxiety brought on by his wife’s cancer. In other words, in his case the inner man condition – anxiety – was being treated with an outer man solution, drugs. Like the preacher of Ecclesiastes, Peterson never gave his mind or will over to the drug but the side effects were so devastating that he chose some startlingly extreme treatments in order to overcome them.

This is all part of how we understand human nature in the community of Christ and more specifically among those engaged in counseling. Unlike the materialist, we believe that man has a soul as well as a body. We use terms like “inner man” to describe the reality that while we have a physical brain, we also have a Mind/Heart/Will which are affected by the body, but distinct from it. Humanity is a fusion of these parts and that fusion is made even less distinct since the Fall, when man was separated from God and lost the inner compass that rightly oriented him to his place in the world. As illustrated by Peterson’s experience, there is a very real danger when we choose to treat the issues of the inner man with an outer man solution.

I used to hear things like “We’re agnostic about drugs” from people in the pastoral/counseling community. But I’m not sure that’s sufficient. And I certainly think those who lean towards viewing them as a benefit court danger. (Obviously not many biblical counselors are medical professionals and so great care should be taken as there is an intersection of jurisdictions here.) Is there any counselor or pastor who has yet to run across a case of a believer who developed an addiction to a prescribed medication? I know of believers serving as missionaries who became addicts due to depression and anxiety. I know of families that were destroyed by prescribed pain medication that led to decade long addictions. It’s hard for me to reconcile the risks posed by these drugs against any possible benefit for the treatment of spiritual or soulish issues. Our posture and our prayer ought to be towards helping people out from under the power of every worldly influence and into the liberty of Christ. It has been something like 15 years since my biblical counseling training and my position has only hardened against the use of drugs to treat inner man issues.

So will Jordan Peterson be able to redeem himself? Will he one day have the influence that he used to have? Peterson himself, in classic Peterson talk, says that people will have to come to their own conclusions about whether he is a trustworthy source of influence. It’s hard to imagine the media giving him a pass.

But I certainly know that Jesus Christ can redeem Jordan Peterson. I listened to a conversation Peterson had with Dennis Prager, wherein Prager talked about good and evil and then stated to Jordan that he could tell Jordan is good. Jordan awkwardly tried to field that powerful compliment by saying something along the lines of how he hoped that his life in some way approximated goodness. I appreciate so much that Peterson recognizes that genuine goodness is hard (nay, impossible!) to achieve. We can only “approximate something like goodness”.

What I want most for Jordan is for him to discover that the goodness of Jesus Christ is not just a metaphysical goodness, but an incarnated, historical reality. In other words, I want Jordan to become a believer in Jesus. I actually find myself affectionately minded towards him in this regard in that, though I have never met him, I am moved when I consider this possibility. And it isn’t so that the influence he holds in society could be used for the fame of Jesus, although that is an exciting thought as well. I would just love to see this man-who has looked evil in the eye and exerted all of his strength to try to do something noble with his life and who has remained thankful despite all the evil he has suffered-to enter into the Rest of Jesus Christ and know that we are not saved by our own goodness, but by the Goodness of God.

Get Your Hands off my Kid

I was probably somewhere between 10 and 12 years old when some friends and I went to a waterpark in Sapporo, Japan (where I lived as a kid). We were making our way from the outdoor pool to the indoor pool when someone grabbed me, lifted me up, and threw me across the water. I heard the man say, in broken English, “We don’t want your kind around here!” (BTW, incidents like this, while memorable, were relatively few and I am incredibly grateful for a chance to grow up overseas.)

If we were horsing around or causing problems in general I don’t remember, but it’s possible. Nevertheless, had my dad been there, I’m certain he would have said something like “Get your hands off my kid!” I know because that’s what I would say if someone did that to my kid. A dad can spank, yell, bop, ground, and within reason do pretty much whatever he wants to with his kids because his kids belong to him. But if something doesn’t belong to you, as I say to my 3 year old frequently, get your hands off of it.

I suppose in our upside down world that some explanation is necessary when stating that children belong to their parents. Axiomatic principles are the hardest to explain because they need no explanation, like the wings of an airplane need no feathers. But when a society loses its grip on the axiomatic, those who state the obvious are gawked at like a man dressed up like a lady used to be gawked at. You know, back when something as axiomatic as male and female was still understood.

So parents have authority over their children the way that an author has authority over his writing. Copyright laws are the legal reflection of something that is already there. Nature decrees and wise men weave those decrees into statutes. Because parents bring children into the world, those children belong to them, and parents have a right to tell others to get their hands off their kids. And not just physically – their hearts belong to us as well as their bodies. This is the God-ordained government of the family.

(There does come a point where a parent loses their authority over their children. The first is when they abuse their authority via violence or refuse to accept their authority via neglect. Both instances should be obvious before a child is removed from their home. The second is when the child matures to the point of being responsible for their own well being, which is the goal of good parenting.)

I have ministered to children and youth in my community for the last twenty years, so I have been around the block and speak with some experience. I have also fostered children, which is an incredibly hard job and I, who did not excel at it, have a huge appreciation for those who do it well. I have seen cases of abuse and neglect first hand, so I know those things really do happen. But what happens far more frequently is that parents, particularly Christian parents, are unaware of how many people have their hands on their kids. Here’s a short list:

The most obvious one is the influence of media/technology. I would guess that every youth pastor in America has heard these words from a parent, “I had no idea they were looking at that!” So if your kids have a phone, a tablet, a TV, or a friend with any of those, they’ve probably seen things that they should not. It wasn’t too long ago that Youtube Kids, which advertises itself as family friendly and safe, had a video of a lady being interviewed by a kid about her abortion. It’s not just pornography, although there is an abundant supply of every deviant behavior known to mankind, it’s also the ideology of a screwed up culture that they are imbibing.

Or what about the public education system? How many hours do your kids spend away from you every day being exposed to all sorts of nonsense by other kids, teachers, curriculum, etc…? Think about the sheer number of hours your children are NOT surrounded by godliness, truth, and virtue in a given week. Do you really think school is a “safe place”? This one is worthy of a complete post, so maybe I’ll get around to it soon.

Another bizarre abdication of authority I have witnessed over and over again is the parent who thinks they have no right to interfere in their kid’s friendships or romances. Many kids don’t handle peer pressure well, and while they want to do right their vertebrae has not quite solidified yet. They may actually be relieved when their parents don’t allow them to hang out with the crowd to whom they cannot say no. Along those lines, I frankly have to exercise self-restraint at the moms I have met who know their daughter (young teenage daughters, mind you) is having sex (often with a much older boy) and keeps this from the father. I have also met dads who thought he had no right to tell his daughter that that boy isn’t coming over anymore. Again, I am not advocating some kind of isolationist mentality, but if your kids are going to form terrible relationships at least put up some resistance instead of enabling them. Teach your kids what a true friend is and whatever you do, don’t let your kids get their idea of a healthy romantic relationship from TV or (what used to be called) sex-ed.

I could keep going, but what I really want to communicate to parents is that it really is ok to get those hands off your kids. It’s ok to take away their phones. It’s ok to contradict what they are taught at school. It’s ok to to impart your beliefs to your kids, because God knows that this is not a neutral world we are living in. When it comes to germs and physical safety, our world is filled with helicopter parents. But when it comes to their hearts, parents are MIA. Don’t be that parent. If you do not exercise your responsibility to govern your household, somebody else will.

Why Do Babies Die?

Periodically I am asked questions in my pastoral capacity and over the years this one has come up several times, so I thought I would share the way I answer. If you read history you will know that infant mortality was incredibly high in the past, but with the advancement of better medical practice the current rate for the US is 5.9 deaths per 1000 healthy births (up to age 1). In a way this makes the loss of a baby even more poignant as the experience may not be shared by as many people and the loss seem so preventable.

When people ask me to speak to this tragedy, I know there are a lot of possibilities as to where they are coming from. They may have a holistic grasp of the Bible and know that death is the punishment for sin, so they may just be looking for comfort through the hope of the gospel. On the other hand, they may think that God just wants everyone to be happy and so they cannot reconcile their loss with their concept of God. I’m sure there are a variety of other thoughts and emotions that these dear people may be experiencing based on their own personalities, relationships, and circumstances. Based on this, I try to speak truth that is helpful across different spiritual maturity levels and even applies to those who are unbelievers. Here it is:

Most parents would do absolutely anything and give up absolutely anything to prevent the death of their child. But God gave His Son up freely to death. He knows what it is to lose a child, but He also knows that there is hope beyond that loss. His Son died so that our sons and daughters could have eternal life. God gave up His child so that we could have hope for our children. So I don’t know and can’t tell you exactly why this has happened to you, dear friends, and not happened to others. But I do know that your prayers of grief do not fall on deaf ears and a stony heart. The Father only has to glance over to see the nail scars of Calvary’s cross in the hands of His Son to remember what that terrible time of separation was like. But just as the eternal Father and Son have been re-united, so will every parent and child who put their trust in the Son.

Obviously, I don’t have that paragraph memorized and say it quite the same way every time. There are several reasons I choose this approach. First, it is the kind of truth that I imagine I would want to be reminded of if I were enduring such a loss. Systematic theologies and sentimental bromides would both seem out of touch for such a moment in life, but the reminder that God is a Person and not a force, the gospel is a story and not a formula, and loss is a prelude to a greater salvation all seem like sweet and tangible truths to the hurting.

Second, it defuses any anger towards God without calling grieving parents out on the carpet. Truth is always truth, but we can be wise and gracious in how we handle truth, especially with those going through terrible grief. Anger towards God is always unjustified, but a polemic attack on grieving parents lacks the seasoning of grace. By reminding these parents that we do not serve a God who stands aloof from our suffering but has Himself entered into our suffering, perhaps we can prevent any tares of bitterness from finding soil to root in their hearts. I imagine that if I were to have to endure the loss of a child, these would be the kind of thoughts that I would want to have about God’s nature and God’s love and God’s salvation.

Third, it is full of the hope of the gospel. It is hard for me to sit back and think about the fact that my children are destined to die. We brought life into the world, but the life we gave is not eternal in nature. Only God can bestow life eternal. Recognizing that God is not the culprit but the Redeemer is hugely hopeful in the midst of suffering like this. This may also offer an opportunity to share the hope of the gospel. I recently found out that my grandfather’s relationship with the Lord changed dramatically and for the better after the death of my Uncle John, who passed away as a child. I don’t know for sure what his spiritual condition was like before that, but I know that in that loss he recognized his need for the Lord. If we are wise and loving, we may find that during these times of sorrow there is an opportunity to share that same hope.