Can an Unregenerate Cognitive-Behavioral Therapist Be Christ-Centered?
My short answer: “No.”
Longer answer to follow. But why am I even asking the question?
- My friend, David Murray, recently posted, Is Cognitive-Behavior Therapy from the Devil?
- His post was in response to my post, “I’m Thinking about Going to the Doctor for Depression Meds”—What Is a Compassionate, Comprehensive Response?
- And my post was in response to David’s post, “I’m Thinking about Going to the Doctor for Depression Meds.”
That’s a lot to follow, I know. Allow me to summarize.
A Summary
In David’s original post, in addition to other comprehensive counsel, David recommended the following to his Christian friend who was struggling with depression:
“Given what you’ve told me about your state of mind, you should ask your doctor about ongoing counseling, preferably from someone with expertise in CBT (Cognitive Behavior Therapy). That will help you re-train your mind/thinking patterns for long-term recovery. If it was a Christian counselor, that would be even better, but make sure they are trained in CBT.”
In my post, I addressed two areas of concern about David’s recommendation:
- Concern # 1: Could an unregenerate cognitive-behavioral therapist provide Christ-centered, gospel-saturated, grace-focused, Jesus-like counsel?
I said that CBT practiced by a non-Christian, by definition, would be a worldview conflict. I noted David’s fine book, Jesus on Every Page, and then noted that a non-Christian therapist could not, by definition, offer a Jesus-focused worldview to Christians struggling with depression.
- Concern # 2: Is cognitive-behavioral therapy, even practiced by a Christian, comprehensive enough to recommend to a Christian struggling with depression?
I said that a Christian practicing CBT would not be practicing comprehensive counseling. Rather, I recommended a more comprehensive biblical counseling approach that includes behaviors and beliefs, but does so much more: it explores biblically matters of the soul, the heart, our relationship to Christ, our emotions, our mindsets, our mood states, our purposes, our social situation, etc. I went to great lengths to note that David’s overall approach was toward comprehensive care, but that I thought his recommendation of CBT was an approach that was far less comprehensive than a biblical counseling approach.
David then responded with his post, Is Cognitive-Behavior Therapy from the Devil?
I have to hand it to my friend, David, that was a catchy title (if somewhat slanted and slanting…).
Moving Forward
David then said:
“In my friend Bob Kellemen’s thoughtful and largely helpful response to my post about going to the doctor to discuss depression meds, he said that his most serious disagreement with me was about my recommendation of Cognitive Behavior Therapy (CBT).”
I don’t think that’s an accurate summary of what I said…
As I noted above, my first concern was about whether an unregenerate cognitive-behavioral therapist could provide a depressed Christian with Christ-centered, gospel-saturated, grace-focused, Jesus-like counsel.
And my second concern was about whether “Christian cognitive-behavioral therapy” was a comprehensive approach to helping a Christian struggling with depression.”
I think it is important that we not conflate those two concerns into one concern, which is what I sense David has done.
Soul Care or Car Care?
In David’s post, he originally made a comparison between taking our car to a non-Christian mechanic and going to see a non-Christian therapist. To his credit, when I interacted with David, he removed that part of his post and agreed that this was a poor comparison. So, please hear me: David does not believe that comparison.
However, that comparison comes up very frequently in these discussions. A similar analogy was also made by a commenter on David’s blog (going to a non-Christian oncologist was compared to going to a non-Christian therapist). So, it is an important perspective that needs to be addressed.
Comparing going to a non-Christian mechanic for my car with going to a non-Christian therapist for my soul is much more than a poor apples-to-oranges-comparison.
It poorly and inaccurately compares an inanimate object (a car engine) to a soul created in the image of God.
Here is the comment I posted on David’s blog before David removed that part of his blog:
“David,
You wonder out loud in this post if concerns about non-Christian cognitive-behavioral counseling is akin to saying you don’t take your car to a non-Christian mechanic. I believe it is totally different.
My car does not have a heart, mind, soul, will, affections, longings, mood states, purposes, mindsets, etc. A person struggling with depression, just like every person, does have a heart, mind, soul, will, affections, longings, mood states, purposes, and mindsets.
If the goal of cognitive-behavioral therapy is to help us to change our worldview, our mindsets, and if at the core we are worshiping beings with either foolish or wise mindsets, then I do not want to send my depressed Christian friend is to a non-Christ, non-Jesus, non-gospel, non-grace, unregenerate therapist.”
Another person on David’s site then suggested that David was simply using CBT as a tool and that CBT was not a worldview. I responded with this comment.
“I believe that CBT, in particular as practiced by an unregenerate counselor, is much more than a tool. When trying to help someone “re-wire” (renew) their mindsets, worldviews about what is foolish thinking and what is wise thinking must come into play. There really is no such thing as counseling that is only tool-oriented or technique-oriented. Counseling is soul-to-soul, and worldview-to-worldview connecting. Note that my emphasis, as in my original post, is on the unregenerate practice of CBT.”
A Biblical Understanding of the Soul or a Secular Understanding of the Soul?
Someone also posted on David’s site that:
“This pitting of psychology against the Bible is misguided. People who do so would benefit from an overview course on the history of psychology.”
I did not respond to that comment on David’s site since I was already taking up too much space on David’s site. However, that comment deserves a response.
First, I would not call this “pitting psychology against the Bible.” I would call this, “developing and using a biblical psychology rather than sending Christians to non-Christians for soul help.”
Second, having studied the history of psychology, having taught a graduate course on it for two decades, and having written about it in half-a-dozen books, it is clear to me that there is a biblical psychology and there is a secular psychology. And both have their own unique and committed worldviews that are worlds apart. The unregenerate counselor has a non-grace, non-gospel, non-Christ worldview about people, problems, and solutions. The regenerate counselor seeks to develop a grace-saturated, gospel-centered, Christ-focused worldview about people, problems, and solutions. So, yes, there is an immense difference between a secular psychology and a biblical psychology. Those two worldviews are already pitted against each other.
Are We Talking about the Same Thing?
David then states that he is baffled because he wonders if we are talking about the same thing. He says, “CBT’s basic point is that what we think affects what we feel and do. Therefore if we can change what we think, we can change how we feel and what we do.”
It appears to me that David is now focusing on a “Christian CBT.” At least I think so. I will assume he is.
I would still say, “Christian CBT, even apart from issues of integration of a secular worldview, is not comprehensive enough.”
A comment David made on my post, along with my response, should be helpful.
David said:
“I have not found many biblical counselors who are good practitioners in changing the kind of thinking patterns that I had in view here. They are good for many, many human problems, including some aspects of depression, but there are areas of anxiety/depression that I’ve found need a few sessions of specialist help and can have hugely beneficial impact not just in the short-term but in building new habits of thinking and acting for the long-term. Nothing spooky here! Just well-trained and experienced practitioners who have helped many to see themselves and their world more truthfully and realistically.”
I responded:
“I’m sorry you have not found many biblical counselors who are good practitioners in these areas. I have found many who are. In fact, if we are not good in these areas, I don’t think we are good, compassionate, comprehensive biblical counselors.
That does not mean that every individual counselor is an expert in every area. It does mean that, as Stuart Scott and Heath Lambert indicate in their book, Counseling the Hard Cases, biblical counseling by definition should be able to address the types of issues you mention.
A compassionate, comprehensive biblical counselor should be skilled in the very areas you raise: 1.) changing thinking patterns, 2.) addressing anxiety/depression (see my work Anxiety: Anatomy and Cure as one example, 3.) in building new habits of thinking and acting for the long-term, and 4.) helping others to see themselves and their world more truthfully and realistically.
I believe that biblical counselors do much more comprehensive work than those four areas you outline—but they at least should be able to provide loving and wise counsel in those four areas.”
Why recommend that a depressed Christian go for cognitive-behavioral therapy, when you could recommend that a depressed Christian go for grace-based-spiritual-social-self-aware-relational-rational-mental-beliefs-mindsets-volitional-motivational-behavioral-emotional biblical counseling that compassionately and comprehensively also understands that we are embodied beings (and thus the possible need for medical intervention)?
In David’s post, he also says:
“If our thoughts are fixated on spiritual matters like God, sin, and guilt, paralyzing and debilitating us, then usually scriptural truth can transform us over time by renewing our minds. But what if our thought habits are on everyday matters like being obsessed with cleaning door handles, or irrational fears about our health, or phobias about open spaces? What if we’ve got into any number of negative thought patterns about our children, our ability to cope, our work situation, etc.? That’s where CBT can be so helpful. (Yes, with Scripture, prayer, fellowship, etc. too).”
To me, this creates an unbiblical dichotomy between the sacred and the secular, between the spiritual and the non-spiritual. Biblical counseling, as Scott and Lambert (see above) illustrate, addresses all of the issues mentioned by David—in a compassionate, comprehensive way.
“Stop It!” Counseling?
David then discusses “Stop It!” Counseling. Whether intended or not, that reminds me of the old Bob Newhart skit on “Stop It!” Counseling. That’s certainly not what robust, rich, relational biblical counseling is all about.
David believes you need extra help to stop habitual thinking—and says that extra help is CBT. I happen to disagree that CBT is necessary for stopping habitual thinking.
I believe that the comprehensive means of grace given to us are effectual in helping us to stop conforming to the thinking of the world (about all types of life issues) and to start renewing our minds so we think like Christ (about all types of life issues).
David might counter by saying that, “CBT is one of those means of grace.”
I would counter by recommending the much more rich, robust, relational, comprehensive, compassionate biblical counseling, and not CBT.
Join the Conversation with Three Questions
David leaves you with the question: “Is CBT of the Devil?”
I leave you with two questions:
“Can Unregenerate Cognitive-Behavioral Therapists Provide Christ-Centered, Gospel-Saturated, Grace-Focused, Jesus-like Counseling?”
“Is CBT Comprehensive Enough, or, Should We Recommend Compassionate, Comprehensive Biblical Counseling?”
RPM Ministries: Equipping You to Change Lives with Christ’s Changeless Truth
Sorry, just read this and am going to just jump in…
On David’s point above re: “But what if our thought habits are on everyday matters like being obsessed with cleaning door handles, or irrational fears about our health, or phobias about open spaces? What if we’ve got into any number of negative thought patterns about our children, our ability to cope, our work situation, etc.? That’s where CBT can be so helpful. (Yes, with Scripture, prayer, fellowship, etc. too).”
I think a huge problem with the CBT vs BC discussion is the idea that it lies all within ourselves that these things can be changed. Scripture, prayer, and fellowship seem to be but a footnote. If we approach life this way, Christ redemptive work of ongoing sanctification of the believer is replaced by us simply “choosing to think/do one way over another.” Yet the Scripture is reminding us of something much deeper, and I think this is where Bob is going with all of this – it’s a heart issue. You can rearrange fruit all day and change the way we “supposedly think” but all is lost when problems arise again and i cannot keep myself from thinking a certain way any longer.
If we don’t learn that we are not able in and of ourselves to simply change, we miss the point that we were in need of a savior in the first place. So, either God is speaking the truth when he says in Jermiah 17:9 that “man’s heart is deceiptful above all things and desperately sick,” and in Gen 6:5 that “the Lord saw that the wickedness of man was great in the earth, and that every intention of the thoughts of his heart was only evil continually” or God’s a liar.
I’m not trying to inflame or disrespect, i’m just saying that it is, at the end of the day, a worldview issue – either God and his word are right and true and we need to fold our thinking, behavior, and solutions to our problems under HIS word, or we simply need to choose whatever other worldview we want to chose with all it’s implications about who we are and why we do what we do.
Bob,
Just found this article at the bottom on David’s comment section. I’m that “someone else” and have moved this discussion to your sight.
You wrote:
Someone also posted on David’s site that:
“This pitting of psychology against the Bible is misguided. People who do so would benefit from an overview course on the history of psychology.”
I did not respond to that comment on David’s site since I was already taking up too much space on David’s site. However, that comment deserves a response.
First, I would not call this “pitting psychology against the Bible.” I would call this, “developing and using a biblical psychology rather than sending Christians to non-Christians for soul help.”
Second, having studied the history of psychology, having taught a graduate course on it for two decades, and having written about it in half-a-dozen books, it is clear to me that there is a biblical psychology and there is a secular psychology. And both have their own unique and committed worldviews that are worlds apart. The unregenerate counselor has a non-grace, non-gospel, non-Christ worldview about people, problems, and solutions. The regenerate counselor seeks to develop a grace-saturated, gospel-centered, Christ-focused worldview about people, problems, and solutions. So, yes, there is an immense difference between a secular psychology and a biblical psychology. Those two worldviews are already pitted against each other.
First, the comment in reference was to David’s original article not you. It was said in reference to Eph. 4:22-24, which is really a form of CBT and not some revolutionary approach to counseling established in the 1970s (some people really believe this). Please do not take me out of context.
Second, your achievements in the field of psychology are impressive and I certainly do not have your erudition. The one history of psychology course I had followed the three major traditions of psychology from their roots in philosophy (empiricist, rationalist, and materialist). Then the course went on to look at psychology in a social context (Darwin, Freud, et. al.) and concluded with enduring issues, such as neurocognitive studies. From your own studies and lecturing, you will know that much of what is called biblical counseling today is really just a form of psychology cloaked in a biblical worldview. Psychology is psychology (study of the mind), you are making the distinction between biblical psychology and secular psychology. My purpose was to talk about psychology.
You talk about soul care, but how do you understand the soul? I do not know this for certain, but from what you have written and the way you isolate emotions, feelings, etc. it appears to me that you believe in functional psychology. Thomas Aquinas taught this form of psychology, and John Locke said it was useless reasoning. Who is right? Some matters may be settled in our own minds but sometime they are really not as settled as we like to think they are–its always profitable to study where we have been again and again and be challenged.
May we never arrive, but only arrive when our Savior welcomes us home.
Chris
Chris,
Thanks for jumping over to this site. As for taking out of context, if I’ve done that, I apologize. I see my response still as accurate, even if the issue is whether CBT is really Ephesians 4:22-24. I do not believe CBT is Eph. 4:22-24, at all. There is so much more richness in Ephesians 4:22-24, especially in context, than anything in secular psychology. Also, I wasn’t trying to appear erudite (I can barely spell the word). However, your comment said that if anyone even had one course in the history of psychology, they would understand the issue as you do. I have had a course or two, and understand it differently. Doesn’t mean I’m right, but I have studied the history of psychology.
Second, In some ways I believe that biblical counseling should be psychology from a Christian worldview–depending on how we define that. I don’t think it is “cloaked” in a Christian worldview. Our approach to the soul and counseling should be bathed in a Christian, Christ, grace, gospel, cross, resurrection, Creation/Fall/Redemption/Consummation worldview.
Third, no, I am not a functional psychologist or a functional biblical counselor (by the way, if we are defining this the same, many of the Puritans would have said they were functional biblical counselors–meaning they sought to understand the various basic functioning capacities of the imago Dei). I believe we are one wholistic being with a complex blend of interrelated capacities. But if I understand the point of your comment here, it is that I might be a functional psychologist and yet Locke said I was wrong, so why am I so sure of my beliefs? Is that the gist? I readily admit that I am learning, as is David Murray, as are you. Is the implication of that that I/you/we should not have convictions after years of study and ministry? Yes, we ought to hold them humbly, but still with conviction, as you obviously do. So, like you, I have not arrived, but, like you, I will share my convictions about this vital issue of how we minister to Christians who are depressed.
In Christ’s Grace,
Bob
Thanks Bob.
We are all learning, especially me.
Psychology is not automatically secular psychology or biblical psychology, it is just psychology–a neutral study of the psyche (this is my point). I agree with you, secular psychology is atrocious and has no place in the church, but psychology as a neutral discipline does. When psychology is filled with a biblical worldview it becomes biblical psychology and that is Ephesians 4:22-24. What makes Ephesians 4:22-24 alive in the soul is the work of the Spirit.
My point with Aquinas and Locke was not to accuse you of anything but to illustrate the complexity and obscurity of the issue. I do know that there is a lot of confusion in this area, especially concerning the mind-body problem. I agree with you, “I believe we are one wholistic being with a complex blend of interrelated capacities.” We have a body-soul but due to sin, death rips them apart. I also believe the soul is immaterial and body material, but how do these interact? Many at this point embrace substance dualism, but his is fraught with the immaterial/material interaction problem. Here I hold to idealism, they interact ultimately in the mind of God according to his eternal purposes and other minds.
Sorry, I rambling and taking up entirely too much of your space!
Shalom,
Chris
Chris,
Could you give me an example of a neutral study of the psyche? Do you mean research psychology that attempts to quantify and describe? For example, studying how people typically respond to death/dying?
If that is what you mean, then most/all biblical counselors would/do value research psychology that stays in the domain of descriptive research without offering prescriptive cures. When it moves to prescriptive cures that is psychology as psychotherapy and that is value-laden. When secular psychologist attempt to build theories about people, problems, and solutions, that is also value-laden.
In my thinking, theories of people, problems, and solutions cannot be neutral. Likewise, prescriptive cures/therapy cannot be neutral.
Research can be neutral. However, research is not always neutral–because researcher bias in framing the questions/research comes into play, as does research bias in interpreting the raw data.
Bob
You wrote:
Could you give me an example of a neutral study of the psyche? Do you mean research psychology that attempts to quantify and describe? For example, studying how people typically respond to death/dying?
Glad you asked, let me give an example. I already mentioned Ephesians 4:22-24 so I will use this. Putting off an old behavior, adapt one’s thinking, and putting on a new behavior describes an empiricist and rationalist approach to psychology—today’s CBT. This is one example of what I mean by neutral psychology. It is simply a psychological process ordained by God. As we know, in the secular world, people can become more virtuous by applying this process or even more wicked—they are under the influence of Satan. In the biblical psychological framework, we know the Holy Spirit empowers people to put off the old sinful man, renew the mind, and put on the new man—the psychological process is always the same in both cases, however. This is what I mean by neutral psychology.
Research psychology is certainly an application as well, especially when it comes to the signal detection theory, perception thresholds, conditioned reflex, etc. but again all this falls within the empiricist tradition of psychology. The same would be true for observing people’s responses to death and dying, denial, anger, bargaining, etc., or any type factual data.
Let me provide some of my observations and a danger I see as not understanding the neutral elements behind psychology. I will not mention any names, but in the biblical counseling literature, I have read some people make an organic/non-organic dichotomy that is not biblical. This dichotomy assumes fundamentally a materialist understanding of a person because it negates true psychological problems related to disordered thought processes. I’m sure you are familiar with the reasoning, if a counselee is not responding to biblical counseling he or she is rebelling against God or has an underlying bodily problem. This is simply not true. Not only does this assumption violate Scripture, but also it cannot account for otherwise normal people experiencing a traumatic event, become clinically depressed, and recover after a period with no intervention. Phantom pain is another example. Pain is perceived from a missing limb but when the person views the other limb in a mirror (as if having both limbs) the pain goes away.
I also recall reading in a reputable book that said the brain cannot make us sin. What does this say about human depravity in body and soul? After reading this, I said to myself this person has limited experience in a hospital or psychiatric setting. People have had calcified tumors in specific parts of the brain that lead to premeditative homicidal behaviors. After removing the lesion, the person is not a sociopath and does not recall the behaviors. These are not just isolated instances either. Sometimes people with strokes will have a complete reorganization of behavior causing immoral acts, not to mention those with Lewy body dementia who become extremely self-centered. Aside from brain problems, problems with the liver can lead to a build of ammonia in the blood and this can lead to aggressive and assaultive behavior. The brain can make us sin, so can our bodies.
This leads to my final point. When I come across clinically depressed Christians—those who are suicidal and so consumed by despair that they cannot get out of bed to go to the bathroom. I wonder about the effectiveness of biblical counseling in the way I have come to understand it from the movement (I do not question the effectiveness of the means of grace blessed by the Holy Spirit, however). This person will need a multidisciplinary approach based upon research that worked in the past and counseling that is biblically oriented. He may benefit from electroconvulsive therapy, deep brain stimulation, and a regime of antidepressants (materialist approach). As his mood lifts, he will need some simple basic command direction behavioral therapy—“Sit up, get out of bed” (empiricist approach). As he responds to behavioral therapy, he will need cognitive therapy to help him think more effectively—“Let us set a goal today and walk to the nurses’ station. How do you feel about that?” (rationalist approach). Ongoing counseling will undoubtedly consist in an overlap of these approaches, expanding more into the underlying issues that led to the man’s depression.
I do not know how the biblical counseling movement has changed over the years, but some of the arguments advanced by you seem to be the same—psychology bad, all psychology is secular psychology. I would actually understand the treatment regime above as a multidisciplinary approach to biblical counseling, even though it includes components of the psychological process and even secular professionals valuing empiricism.
I hope this answers your question.
Chris,
Thank you for making the time for a thoughtful reply. A thorough response to your comment could take a book, much less a comment on a blog post, so I have to be brief.
You said, “I already mentioned Ephesians 4:22-24 so I will use this. Putting off an old behavior, adapt one’s thinking, and putting on a new behavior describes an empiricist and rationalist approach to psychology—today’s CBT. This is one example of what I mean by neutral psychology. It is simply a psychological process ordained by God.”
Perhaps we are talking past each other or simply defining our terms differently. I don’t see CBT putting off/changing thinking, putting on as neutral at all, as I described in the fourth post in this series. Yes, the “category” of put off/put on can be neutral, but we’re talking about the real life belief systems of the therapist directing the process–those underlying beliefs about what to put off/on and why/how are not neutral. But again, we might be defining “neutral” differently. Perhaps part of this is I’m not talking simply theoretically but actually–real people with real belief systems practicing therapy with real people.
You conclude with this, “some of the arguments advanced by you seem to be the same—psychology bad, all psychology is secular psychology.” Honestly, after four thorough posts not saying that, I’m not sure how else to communicate that I am not saying that. The “category” of “psychology” or studying the soul is a neutral “category.” However, I am saying that all the theoretical psychology–theory-building about people, problems, and solutions is always value laden. Their is a Christo-centric psychology theory-building and there is a non-Christo-centric psychology theory-building. I’m not saying all psychology is secular psychology. I’m stating the more obvious: all secular psychology in terms of theory-building is foundationally non-Christo-centric.
Bob
Sorry about the length of my last post. I appreciate the dialogue and will look forward to future interaction.
Chris
Bob, you seem to refer to the mind/soul interchangeably? Is that an accurate assessment? Could it be that if the mind (brain) is damaged then CBT would be very helpful as one part of healing? Of course this would be in addition to the other means of grace (fellowship, Bible Study, prayer, Biblical counseling etc.) {As I read Dr. Murray I can see that he would consider all of these things highly necessary as well.} I imagine that if other parts of my physical body were broken I would do physical therapy. In addition, I would continue to fellowship, Study the Bible, pray etc because it’s almost certain that soul distress (depression/anxiety/discouragement) could set in because of my physical distress. We are so connected soul-mind-body. I like Dr. Murray’s post with 6 steps to better thoughts feelings and actions. I can see that this would be very beneficial for every day life as well as the big life altering events that may happen.
Al,
That’s a good question. Thank you for the opportunity to elaborate.
When I use “mind” I am not thinking of the physical brain–when I am thinking physical, I try to consistently use “brain.” We have a physical/material brain and we have an immaterial mind. The Bible uses a number of terms to describe the inner person/the immaterial soul: soul, mind, heart, will, longings, yeser (Hebrew for the imagination), etc.
So, I use mind/soul interchangeably to designate our inner person. I do not use mind/brain interchangeably. However, God did create us as complex body/soul (brain/mind) beings.
We could take David’s 6 steps to better thoughts and feelings, which perhaps he derived from CBT (I am not sure), and I believe we could derive much more robust counsel from a comprehensive, compassionate examination of God’s Word. So, would CBT heal a physically damaged brain? If by that you mean, would David’s 6 steps heal the physically damaged brain? I would say again, why limit ourselves to these non-comprehensive, and in my thinking, non-Christo-centric suggestions, when we could provide the person with more robust, grace-focused biblical wisdom principles for our mind, emotions, behaviors.
People act as if the options are: CBT or nothing. When I have been saying the options are CBT or the much richer, grace-focused “biblical counseling.”
Bob