A Little Post About Little Sleep

Disclaimer 

As the title suggests, this is not a detailed post about sleep. Such a post might put you to sleep!

Nor is this post providing medical advice about sleep. However, it is a little post about how a biblical counselor might respond if a counselee says,

“I’m not sleeping well…”

A Question About Biblical Counseling and the Sleepy Counselee… 

Let’s assume that your counselee has made this comment about poor sleep. Let’s assume that you have listened well, collected data, and connected soul-to-soul (we don’t just do data collection; we also do soul connection). What now?

For several reasons, people often ask me about biblical counseling and the body.

• People know that I see biblical counselors as “soul physicians of embodied-souls.”
• I write frequently about comprehensive soul care for the whole person.
• On Twitter/X, I post blogs like this: Do Biblical Counselors Focus on the Soul, or on the Body, or on the Embodied-Soul?

So, I’m not surprised that this Sunday afternoon I received this question from Shane on Twitter/X:

Bob, Greg Gifford made a comment in his latest book, Lies My Therapist Told Me, stating:

“When you go to biblical counseling, the counselor should say, ‘Hey, your sleep seems really off. You should talk to your doctor.’ “If your biblical counselor says, ‘Hey, your sleep seems really off. I am going to make it a part of your homework to eat salads, get rid of caffeine, and sleep eight hours per night,’ then your biblical counselor has just stepped into medical, which is not their lane.”

How would you respond to Gifford given your framework above? Agree? Disagree?

My Initial Reflections… 

Here’s how I responded to Shane’s question (with some expanded content added here). In my initial response, I said:

“Shane, it is timely that you should ask this question. Greg’s book just arrived this afternoon via Amazon, and I was browsing it just now while watching the Cubs’ game. Needless to say, browsing a book while watching baseball is not sufficient to develop an informed decision about individual quotes.

I did notice that Gifford includes an entire Appendix providing counsel for, “Habits for a Healthy Brain.” Like Greg, I’ve blogged about issues related to biblical counseling and the body, (after studying God’s Word cover-to-cover, and after reading 1,000s of pages of research on this). So, it appears that Greg and I would share the perspective that the biblical counselors could write/blog about healthy brain habits. So, it would seem to me that if we can both write about it, then we could also talk in counseling about healthy brain habits—if we were well-researched about those matters (if we were competent to counsel on those issues).

So, while I can’t offer an informed interpretation of Gifford’s quote until I read his whole book (while not watching my beloved Cubbies), given my biblical and extra-biblical research on embodied-souls, I can share a brief response about how I might engage with a counselee who brought up sleep issues.”

My Initial Biblical Counsel About Sleep

Of course, just like Greg’s comment should be read within the context of his whole book, so my brief response here should be read within the context of my other, more extensive writings, such as these: 161 Resources for Counseling the Whole Person: Soul Physicians of Embodied-Souls.

You’re counselee reports that they are not sleeping well. You then listen well. What’s next?

I might begin by saying something like this:

“Now that I understand more about your sleep issues, here are a few thoughts for us to consider…

First, you may want to go to your doctor. However, realize that your doctor might treat only your body, and not your embodied-soul. And, depending on your doctor, he/she might be quick to prescribe meds before addressing other issues and options. So just be wise and discerning.”

By the way, this caution about doctors focusing on a materialistic approach, aligns with Greg Gifford’s own experience. In Appendix A: My Visit to the Psychiatrist, Greg tells the true story of going to a psychiatrist to test out what type of counsel he would receive. Among Greg’s stated concerns was a lack of sleep. Gifford summarized the response of his psychiatrist (a medical doctor), like this:

“What’s interesting is that Dr. Jones was willing to provide an antidepressant after no blood test, no labs, and never having taken one of my vital signs. However, the medication route was available for me” (252).

This is why I would encourage any counselee struggling with sleep to consider talking to their doctor. It is also why I would caution any counselee that their doctor—whether a general practitioner, an internal medicine specialist, or a psychiatrist—will most likely look at their sleep issue only from a materialistic, body-only perspective.

So, the adage, “Go to a biblical counselor for soul issues. Go to a doctor for body issues,” is incomplete counsel. We are not only bodies; we are not only souls; we are embodied-souls. A competent soul physician is a soul physician of embodied-souls.

My Next Biblical Counsel About Sleep 

In the next part of my response to Shane’s question about biblical counselors and sleepless counselees, I said:

“What if your biblical counselor says something like this? ‘I am NOT going to make your embodied-soul, your sleep, your physical health, your physicality, your physical responses to anxiety, OCD, depression, grief, etc., any part of our counseling. Nor are we ever going to make your physical being any part of our counseling. And we will never dialogue about potential physiological interventions.’

Then your biblical counselor has stepped away from seeing you biblically. As the Biblical Counseling Coalition Confessional Statement explains, biblically, we are embodied-souls who are a complex unity of: relational being, spiritual being, social being, self-aware being, rational being, volitional being, emotional being, physical being.

I recommend that you work with a biblical counselor who addresses your whole person as an embodied-soul.

The Bible consistently describes us as a complex interconnected, interacting unity of body/soul—embodied-soul. See, 560 Biblical Passages on Embodied-Souls.

Jesus ministered to us as embodied-souls. See, Jesus: Soul Physician of Embodied-Souls, where I collate and interact about 102 Gospel passages; 618 Gospel verses, where Jesus focused on ministering to, caring for, and healing the body—the embodied-soul. In that post, I shared five implications we can derive for today from those 618 biblical passages about Jesus as Soul Physician of embodied-souls.

1. Since Jesus, the Soul Physician, models soul care for embodied-souls, we should seek to minister comprehensively to the whole person.

2. Since Jesus’s mission was an embodied-soul mission, we should seek to minister to people comprehensively as embodied-souls.

3. Christlike soul physicians are soul physicians of embodied-souls.

4. We point people not to ourselves, but to Jesus, their Soul Physician of their embodied-soul.

5. As biblical counselors, if we minimize or neglect ministry to the whole person—to the embodied-soul—then we are not Jesus-like soul physicians.

Because we are embodied-souls, because we are physical beings, because we are soul physicians of embodied-souls, there is a place for physiological interventions as one aspect of comprehensive biblical counseling. For one example, see: Anxiety and Our Physical Bodies: God’s Care for Embodied-Souls. For another example, see, Of Spirituality and Ice Cubes.”

My Summary Response 

I then summarized my response to Shane’s question about biblical counselors and sleep-deprived counselees.

“In summary, we do not become medical doctors, nor do we usurp the role of medical doctors, by being biblical counselors who see people as embodied-souls. Every person we counsel is a physical being, and biblical counselors can become informed about physical issues relative to specific life struggles. Greg was informed enough to publish in his book counsel about: 1. Restorative Sleep, 2. Healthy Eating, 3. Moderate Activity/Exercise, 4. Rest. If we have studied about sleep-related issues, if we are informed about sleep-related issues—from an embodied-soul perspective—then engaging briefly about those issues—as a part of comprehensive embodied-soul care—can be a normal part of comprehensive, competent biblical counseling.

Biblical counselors addressing the whole person is nothing new in the history of nouthetic-biblical counseling.

• • Greg Gifford himself traced Jay Adams’s nouthetic counseling lineage to behavioral psychology—which addressed physical, biological issues, including sleep, habituation, de-habituation, and re-habituation.
  • Jay Adams used his understanding of the neuroscience of his day to support his nouthetic counseling model.
  • In What About Nouthetic Counseling? (1976), Adams specifically mentioned the importance of sleep studies as one of the particular areas that he found helpful in his ministry as a nouthetic counselor. ‘I have profited greatly, for instance, from the results of the work done at the Harvard sleep labs (and elsewhere). This sleep study I consider to be a valid and worthwhile enterprise for psychology.’

From my brief reading of Greg’s book, other than the quote you mention which I apparently have not gotten to, I picked up that Greg would definitely see us as embodied-souls and that the metaphysical mind and the physical brain do interact and impact each other. He specifically says, “The brain and the mind are intimately connected in their operation” (85). He includes an entire section on “how the body, and especially the brain, influences the mind” (90-101). He also points out that “issues of the mind and the brain can be difficult to separate” (101). I assume, therefore, that Greg and I would both say that: 1.) We should not medicalize every issue. 2.) We should not over-spiritualize issues in such a way that we ignore, minimize, or deny that we are embodied-souls, 3.) We should not counsel as if the brain/mind, body/soul are not a complex, interactive, interconnected unity.

But again, I need to read Greg’s book more closely, and with less competition for my attention… What do you think, Shane?”

Competent to Counsel

I then wrapped up my interaction with Shane by discussing competency.

“I believe competency is a huge issue in biblical counseling. You can read more about my thoughts on counselor competency here: We Confuse the Sufficiency of Scripture with the Competency of the Counselor.

So, someone unstudied (uninformed), definitely should stay in their lane of competency. If someone has done no study about embodied-souls, no study about restorative sleep, healthy eating, moderate activity/exercises, and rest, then they should avoid discussions of those issues and stay in their lane. If that is what Greg means, and if he is talking about individual counselor competency, then I agree.

“The Cubs won, so maybe I can read with more focus now…”

As a biblical counselor who is a soul physician of embodied-souls, if you want to become more competent in addressing the physical body/the embodied-soul, here are some resources:

• Embodied Holiness: The Biblical Call to Bodily Care by Lainey Greer.
• Be Well: Learning to Steward Your Health by Lainey Greer.
• 60 Christian Books on the Body and Soul (Embodied-Soul)
• 128 Free Resources for Counseling the Whole Person: Soul Physicians of Embodied-Souls

An Addendum from Jay Adams 

Recall what Greg Gifford said,

“When you go to biblical counseling, the counselor should say, ‘Hey, your sleep seems really off. You should talk to your doctor.’ If your biblical counselor says, ‘Hey, your sleep seems really off. I am going to make it a part of your homework to eat salads, get rid of caffeine, and sleep eight hours per night,’ then your biblical counselor has just stepped into medical, which is not their lane.”

Jay Adams, the founder of modern nouthetic biblical counseling would like to have a word with Greg Gifford.

In What About Nouthetic Counseling? (1976), Jay Adams discusses how nouthetic counselors address with counselees the issue of sleep—including suggesting ten specific physiological interventions.

“Question: You say a lot about the possible significance of sleep loss. Suppose sleep loss is important. What do I do to get to sleep when I find myself having difficulty doing so?” (61).

“Answer: This is a very important question. First, before I answer that one for you, let me review briefly what I have been saying about sleep loss. The Scriptures are clear that we must not do anything that injures our bodies (cf. I Cor. 6:15, 19). Christians have an additional reason to care for the body. Paul says that the Christian’s body is the temple of the Holy Spirit. Therefore, significant sleep loss becomes an issue of importance, if loss of sleep does, in fact, injure the body. Sleep loss studies show that it does (cf. Segal and Luce: Sleep and Insomnia)” (61).

Notice:

• Adams “says a lot about sleep and sleep loss.”
• Adams views addressing sleep loss in nouthetic counseling to be “a very important question.”
• Adams links sleep loss to the Bible’s teaching about the spirituality of the body.
• Adams supports his view on sleep loss with a clinically-informed, science-informed sleep loss study.

Adams then specifically insists that nouthetic counselors must know how to counsel people about the physical issue of sleep and sleep loss.

“So it is important to know how to tell the counselee to find sleep when it tends to elude him. The following factors may be advised:” (61).

Adams then outlines ten specific words of counsel that nouthetic counselors should give counselees about the physical intervention of sleep (61-62). These include what Adams considered to be evidence-based, clinically-informed content that nouthetic counselors should be aware of and share with counselees, such as, “Drink some milk before retiring. There is some evidence that milk contains chemical elements that help you to sleep” (62).

Adams’s list includes other folk wisdom, case wisdom, and basic common sense advice such as, exercising before going to bed, “don’t watch TV when you ought to be sleeping” (62), do a hard day’s work, and “take a relaxing hot shower” (62). Adams’s counsel also includes advice sure to be an encouragement to many, “sexual relations leading to orgasm (in marriage) helps” (62).

Adams then summarizes how this connects to nouthetic counseling.

“All or some of these factors will apply to each counselee who is having sleep problems. Often counselees need instruction and suggestions. Persons who have followed these instructions report that their sleep problems evaporate quickly” (62).

According to Adams, counselees need nouthetic instruction that offers specific physiological interventions.

According to Greg Gifford, the founder of the modern nouthetic biblical counseling movement—Jay Adams—”has just stepped into medical, which is not their lane.”

(As a side note, it is interesting that Adams supports his physical intervention approach with non-peer reviewed empirical data. “Persons who have followed these instructions report that their sleep problems evaporate quickly.”)

An Addendum from Mike Emlet

I appreciate what Mike Emlet says in his Journal of Biblical Counseling article, A Biblical Rationale for Embodied Spiritual Practices.

“While our focus as biblical counselors is to bring the truth and perspective of God’s Word to bear on the particulars of our counselees’ lives, we must remember they are embodied people! When you encourage your counselee in practices that engage the body, you help them become more fully human; it reminds them that they are indeed bodily creatures. You are helping them ‘taste and see’ that the Lord is good. Not just telling them true things that you want them to think harder about but helping them engage their five senses as they relate to God” (27).

Emlet then offers several suggestions for how biblical counselors remain attentive to the body in biblical counseling sessions. Among those suggestions, Emlet shares:

“Ask about sleep, schedule, diet, and exercise. I find there is a correlation between lack of consistency in physical disciplines and lack of consistency in spiritual ones. In 1 Timothy 4:8, Paul does say that physical training is of some value!” (28).

“Consider giving homework that encourages counselees to get outside and use the beauty of creation as a springboard for praise and prayer. Calvin considered the natural world a ‘theater of God’s glory.’ Belden Lane notes something similar about Jonathan Edwards. ‘[He] perceived the physical world, when appreciated with the new spiritual sense that regeneration brings, as offering direct training in the multidimensional way of knowing that is necessary for meeting God. This is a knowing that involves tasting and delighting—not just an apprehension of the mind, but an intimate engagement of all the senses as well’” (28).

“Ask about bodily symptoms that can be associated with anxiety, depression, or trauma such as distractibility, fidgeting, crying, dissociation, etc. Consider concrete ways to respond to these physical manifestations of distress. What bodily practices can you use to orient them toward God while you are with them and when they leave your office? I’ll mention two that may calm anxious hearts and bodies: deep breathing and grounding.

Slow, deep breathing activates the parasympathetic nervous system, which slows a racing heartbeat and rapid breathing. So, when we use our bodies in this way, we are aligned with how God created us. We don’t do slow, deep breathing as an activity unto itself. We are seeking to remember that it is in God we live and move and have our being. Our very breath is given by him. As we breathe, we remember that we are in God’s presence and under his watchful, caring eyes. Todd Stryd wrote an in-depth article on how this might look.

Grounding helps a person who is experiencing anxiety or other bodily symptoms, such as dissociation, to focus on the here and now. How do you harness the body for good in that moment? Typical approaches have a person notice things around them that they can see, touch, hear, or smell. Sometimes it’s as simple as having someone concentrate on the wood or fabric of the chair they are sitting on, or the feel of their feet on the floor. Grounding can help bring a person who’s panicked or distracted into the present moment. We are grateful for this. But as Christians, we want to do even more in the moment. We want to assist in slowing down the person’s runaway body and orient them to the Lord’s presence” (29).