The Pastoral Counselor Working with Addictions

Every church, every town, and many families know the dark effects of substance abuse that tear individuals apart. The substance might be alcohol, drugs, or food, but addiction means that a person has crossed an invisible line, before which they could exercise some cognitive discernment and volitional choice about ingesting the substance, and after which their willpower and good intentions are rendered powerless.

In my opinion, addiction groups deserve a special place in the ministry of the church, because when the spiritual fellowship of a Twelve Step program brings an addict into recovery, then pastoral counseling can focus on promoting the developmental maturity that the addictive substance formerly eclipsed.

Recovery from Addiction

Pastoral counselors might consider taking the initiative in contacting the central office of the granddaddy of Twelve Step groups, Alcoholics Anonymous, to see if they want to set up a meeting in the church. This puts several healing powers into motion. It signals to the community at large that this church, through an outgoing spirit of altruistic concern, provides a safe haven for people who are struggling with addiction. 

Church Recovery Groups

AA fosters a spiritual awakening by encouraging participants to humbly surrender to a Higher Power, a ministry that reaches outside of Christianity, yet because AA meetings traditionally end by saying the Lord’s Prayer, assures that Christ is in their midst.

A Twelve Step group in the church strengthens the life of the community as a whole, promoting recovery from addictions that would otherwise ravage marriages, families, and neighborhoods of those living in their grip. 

Pastoral counseling, when it is sought, can help dismantle the rigid personality patterns that contributed to addiction in the first place, and guide the person to repair damaged relationships.

 FOR MORE, READ:

PASTORAL COUNSELING & COACHING:

COMPASS THERAPY IN CHURCHES

 

Tips for Christian Counselors: The Book-Stacking Technique

For counselees who have difficulty standing up for themselves (especially those stuck in the Dependent personality disorder), the book-stacking technique is effective for strengthening a counselee’s courage to say “no” to other people’s undue requests or expectations.

You can help buttress their courage by asking them what they think Paul meant when he said, "I am not seeking to win the approval of people, but of God" (Gal 1:10).

The Book-Stacking Technique

Ask the counselee to stand in front of you with arms extended and palms up. You load them up one by one with several books, saying as you do so, “This represents all the burdens people lay on you without considering how heavy they are.” Once the counselee is loaded to capacity, you say, “Now while you are feeling the weight of these burdens, tell me what you are aware of.”

Book-stacking Technique

Compliment them on any descriptions they offer, and if they miss certain obvious qualities, prompt them with, “What about your body? How does it feel right now when you’ve accepted all of these jobs?” Or, “Can you form a plan in your mind to say ‘no’ to the next person who wants to add another book?”

After waiting for another minute so that the impact of the load can sink into the psyche, you reverse the process by saying, “Okay, each time you tell me to remove a book I will. This will represent you standing up to a person and telling them that you can no longer accept assignments that belong to them.”

Here you will hit a temporary therapeutic impasse, because the counselee will not want to disappoint anyone’s hope or risk their ire. But keep coaching them, so they can successfully assert themselves to remove the books. “Go ahead now, and tell me to remove the first book.”

Learning to Be Assertive

If the counselee complies in a mousey voice, you stop the technique and say something like, “I noticed that you barely whispered that request for me to take a book away. If I were a manipulative person I wouldn’t respond. Try putting some gusto into your voice and demand that I remove the book.”

The counselee does so, and you remove the book.

“That was good assertion. Now ask again and really mean it.”

The counselee does so with even more firmness and you remove another book. 

“Excellent,” you say, “I’m really starting to believe you. Now for the last two books, try actually enjoying your assertion and feeling the relief of not having to carry these books anymore.”

Feeling Relieved

The counselee does so and you remove both books. The two of you laugh and sit back in your seats.

“I want to compliment you for doing a great job asserting your reasonable rights,” you say.

“It was hard at first, but I think I’m getting the idea that the world doesn’t come apart at the seams if I say  ‘no.’”

“I wonder if for homework this week you might practice some assertion when you feel it is appropriate? Next week we can talk over what happens.”

“Yes, I’d like to. And I’m saying that because I mean it!”

For more, read:

Christian Counseling That Really Works

Christian Counseling

Pastoral Counseling Tips: How to "Sit" on a Feeling

The Rhythm Between Suppression and Expression

The constant shift between expressing and restraining emotions that goes on in normal social discourse is like the rhythm between the accelerator and brakes in driving a car across town. People need both functions in complementary interplay all the time in order to safely arrive where they are heading. 

Through modeling and coaching about how to diplomatically communicate feelings to others, you help counselees mature in personality and relationships.  You help them become more open about recognizing when they are having an emotion, and then thinking about the context of the feeling: 

• "What is stirring up this feeling?"

• "Am I reacting to something in the present or reactivating a memory from the past?"

• "Do I need to alter my thinking in order to change the feeling?"

• "Do I need to express the feeling or simply be aware that I’m experiencing it?”

There is real wisdom attached to the notion of counting to ten before expressing a strong feeling. This ability to “sit on a feeling” long enough to reflect on it, prior to conveying it to others, is called emotional suppression. 

"Sit" on a Feeling

You educate your counselees that while emotional repression is unproductive, emotional suppression is a perfectly healthy adult relational skill that assists them to overlook or diminish feelings that would be disruptive or even harmful if expressed. By the same token, you lead them to intentionally express any emotion that contributes to their well-being or helps another person to understand them better. There is room for expressing hurt, disagreement, or even anger, but only after enough reflection has transpired that they can do so diplomatically.

Likewise, counselees need encouragement and sometimes modeling to know how to express praise, compliments, enjoyment, and excitement without getting so carried away with these positive feelings that they become histrionic. Even feelings like love often need a little coaching so that the counselee expresses caring without becoming invasive or presumptuous with another person.

Express Feelings

One caveat about working with feelings lies in giving up the need to make a counselee happy, whether at the end of each session, or as a consequence of the course of counseling. Some individuals create such conflicted circumstances that happiness will elude them for many years, while others cling to rigid personality patterns that perpetuate misery.

Here we must surrender any vestiges we have of a “Messiah Complex.” We can’t heal all people all the time, but we can accept the reality that we do the best we can, stopping short of taking responsibility for a person’s life and choices—even God doesn’t do that!  

Most sessions can end with a 

pleasant emotional tone, in that the pastoral/therapeutic bond creates a 

fellowship that does indeed bring comfort.

 For more, read:

PASTORAL COUNSELING & COACHING:

Compass Therapy in Churches

Christian Counseling Techniques for Repressed Emotions

The Meaning of Repression

In the larger scope of counseling, you are working with individuals who are sometimes repressing, sometimes suppressing, and sometimes expressing their emotions. By creating a warm interpersonal climate that is conducive to emotional exploration and discovery, you help counselees learn to sense and manage their feelings in personal and interpersonal ways.

Freud discovered the defense mechanism of repression, which occurs when a person feels temporarily overwhelmed by a powerful emotion. It takes a considerable expenditure of physiological energy to push an emotion out of awareness and keep it from re-emerging. This drastic measure is accomplished through a series of instantaneous maneuvers. The repressed emotion is disowned so that it takes the appearance of something foreign and threatening, not something that belongs to the person. 

Repression

The person blocks it from cognitive assimilation by locking it in the dungeon of muscle tension, which entails tensing the interlocking actin and myosin protein molecules in millions of muscle fibers that extend throughout the body, forming bands of muscular armor that keep the emotion buried and inaccessible, a kind of iron curtain that bars the emotion from consciousness. 

This is why counselees are “in the dark” about feelings they have repressed, and it is why these feelings cannot be brought into the light of awareness without a temporary sense of anxiety and foreboding.

Techniques to Handle Repressed Emotions 

Good counseling makes the unconscious conscious by creating an interpersonal atmosphere of trust and acceptance, releasing previously bound up energy and repressed emotion into spontaneous catharsis. 

For this reason, you don’t need to feel alarmed if your counselee experiences a few minutes of crying, wringing the hands, or grimacing. Rather, you coach them as gently as possible into a Lamaze-like birth of emotion by employing two techniques:

1) Expanding the affect, and 2) Normalizing a feeling. 

You do this by saying:

“This is very good that you’re in touch with this feeling…Breathe and let it flow …It’s safe here…That’s good, stay in touch with this emotion while it flows through your body…It’s okay to have this feeling, it can’t hurt you now…Relax and give this emotion a new voice. You’re taking this feeling out of the dark and bringing it into our presence, where we can finally understand what it’s been trying to say.”

You can see as the person responds to your coaching how the feeling is un-repressed before your eyes. It will grow more vivid and intense only to a certain point. But when the muscular and psychological resistance melts enough to allow the counselee to surrender fully to the feeling, it quickly passes through the body and is integrated into the whole of their human nature. Then lo and behold, it dissipates to the point where it no longer bothers them. 

Emotional Catharsis

3) Immediately following an emotional catharsis, you soothe a person’s temporary loss of control by saying, “That was excellent emotional expression.” Often they will smile with pride, a kind of self-congratulation for the courage they expressed to stay in touch with the emotion long enough for it to pass, like a kidney stone, through their system. 

4) Next you move into debriefing, which means talking over the original situation that led to the repressed emotion, and exploring healthy ways to handle similar situations in the counselee’s current life. You might say:

“What have you just learned from this powerful emotion?” 

Or, “Now that you’ve brought this old memory into awareness, what do you think about it?”

Your counselees will tap into your relaxed curiosity and articulate their own creative insights.

Some particularly traumatic events in a counselee’s history may need several passes in order to fully assimilate and work through, as when there exists considerable bitterness in divorce after twenty years of marriage, or when sexual abuse or rape is involved. 

The healing can take place over the course of several months, but eventually the trapped emotions of rage, terror, or grief pass through the self system so that the spiritual core—not the repressed emotions— can take its rightful place as the center of the self. Other less intense emotions, however, can be assimilated almost immediately and not present any further problems.

For more, read:

Pastoral Counseling & Coaching:

Compass Therapy in the Churches

The Pastoral Counselor and the Avoidant Worrier

I can identify with the avoidant Worrier pattern because in my seminary years I was haunted by it. I cared a great deal about Christ, and had even left medical school in response to God’s call on my life. I read through the entire Bible several times, attended church weekly, and went to Campus Missions Fellowship on Friday nights. Yet I was still aware of a distance between me and other people. 

Why did I feel so alone? The depression felt like a gunnysack of concrete on my chest, the hopelessness like a fist gripping my stomach. I finally resolved to see a pastoral counselor at a nearby church, a very human man who seemed warm enough to entrust with my heart-wrenching worries.

He responded empathetically and astutely. After asking a number of open-ended questions, he said, “Dan, I really feel for your pain. It seems to me that somewhere along your development you found human emotions too painful to handle, and that you created a rift between your mind and your heart. So your mind kept developing, and that’s why you’re so academically gifted, but your heart got left behind, and that’s why you feel so excluded from human community.”

I felt my whole body relax. At last someone had found words for my deep dilemma, and that meant there might be a way out. It wasn’t easy but I did outgrow the trap of my former Weakness-stuck life. 

Yet I didn’t leave the Weakness compass point behind, because in the course of building Compass theory, I came to discover that it houses the root source of humility, a quality that Jesus ascribed to himself when he said, “Take my yoke upon you and learn from me, for I am gentle and humble in heart, and you will find rest for your souls” (Mt 11:29).

Jesus: Gentle and Humble of Heart

 

When you are counseling someone who manifests worry, you can discern rather quickly whether this worry is transitory, which usually responds well to brief situational coaching, or chronic and pervasive worry, which calls for insight and support through short-term counseling, or personality reconstruction in long-term pastoral psychotherapy. 

When you encounter a chronic Worrier pattern, here are some insights you might offer:

1. Worry is a choice, not a necessity, although it often feels necessary to worry.
2. Worry actively distrusts God’s involvement in life (most people never think of worry this way, but rather “sanctify” their worry as though it is a virtue).
3. Worry translated into action steps has redemptive value, but worry for worry’s sake creates meaningless misery.
4. Counselees can transfer the energy it takes to worry into prayer for guidance and positive steps for change.

At a physiological level, chronic worry may reflect the biochemical condition of major depression, a genetic disorder arising from the body’s inability to produce enough catecholamine molecules in neuronal synapses. So it is a good idea to meet with a psychiatrist or family doctor who is acquainted with major depression, and who can act as a medical referral for counselees whose symptoms seem unabated by psychological and spiritual counseling strategies.

In this case, you can say to your counselee: “I have a hunch that a portion of your pattern of worry and withdrawal is biological. I suggest that you see Dr. _________ and explain your symptoms, because taking an appropriate antidepressant is like receiving a prescription for eyeglasses: it helps the world come into better focus so that you can feel more confident in facing life.”

If the counselee follows through and receives a prescription, you continue right along with the pastoral counseling and coaching, helping them integrate the effects of the meds with their personality and relationship development.

By way of an overall counseling strategy, keep before you the Compass Model, so that at times you can guide the counselee’s attention to growth steps in Assertion, and other times developing Strength or Love. By the same token, you don’t push too hard, because you respect the secret security these counselees draw from the Weakness compass point, since as long as they stay there they don’t have to take risks or assume responsibility. 

Worrier Self Compass

So you relax, even when they express uncertainty, self-doubt, and fear, and in so doing, you create an interpersonal atmosphere that de-catastrophizes their worry, offering your calmness to counter their anxiety (Strength), your practical suggestions to counter their learned helplessness (Assertion), and your faithful caring to counter their depersonalization (Love).

You don’t take on the unrealistic project of turning them into industrious and confident persons, but rather assist them through either an extended course of counseling, or occasional meetings, to construct a developmental bridge that helps them move from fear-filled existence to a more abundant life. 

In a pastoral context, you can pray that they receive the spiritual empowerment of fortitude. At the end of a session, will courage to them by affirming their gradual progress and conveying warm encouragement.

Pastoral Counselors Need Both Love and Assertion

Most people I’ve met who have gone into counseling as a vocation say they did so because they cared about others. They wanted to help heal persons who were hurting. Yet there is a paradox in counseling, in that counselees can resist a counselor’s assistance as much as they receive it. This means you can’t maintain a naïve belief that loving counselees is enough to make them whole. 

In fact, loving care can get you in a lot of trouble if you cross certain boundaries with the counselee, developing too much interpersonal intimacy. Many counselors undergo the inglorious experience of falling in love with one of their counselees. This doesn’t mean that the counselor acts on this sentiment, because it is equally feasible that the counselor will recognize the inappropriateness of deepening a misguided love bond, and will confide in a supervisor or else do the inner work of intercepting the subjective side of love, transmuting it back into objective caring by not giving it room to grow.

It is wise to understand that the counseling platform allows for such profound communion of souls that transparency can succumb to infatuation, where professional caring takes a headlong fall into the ditch of a love affair. In the years before having sex with counselees became public knowledge as a glaring legal and professional breach of ethics, counselors sometimes took such liberties. Now, however, it is at the top of everyone’s list—counselors and counselees alike—to channel caring into facilitating the growth and coping skills of the counselee without becoming enmeshed in a romantic/erotic mess.

It is erroneous to think that pastoral counselors, because of their consecration to God and assimilation of Christian doctrine, are immune from such temptations, for they certainly are not. Yet that immunity is available, and it comes through the awareness that the Love compass point needs effective balancing with the Assertion compass point in the pastoral counselor’s life and practice.

What the Love compass point of the Self Compass enables you to do is forgive counselees for the mistakes, broken resolutions, and sometimes glaringly immature attitudes they will reveal to you, while nurturing them with a long-term sustenance much akin to Christ’s love for his disciples.

The Assertion compass point, on the other hand, lets you stand apart from the counselee, holding your own as a person in your own right, so as not to become drawn into the counselee’s habitual way of relating to people. For if a counselee can draw you into their normal interpersonal style and get you to agree with their perspective, then you will completely lose your power to effect constructive change in their life. Put differently, you give up the need for your counselee’s approval and gain the ability to tell them the actual effects of their distorted personality patterns, truncated human nature, and self-defeating communication style.

Assertion lets you express yourself in ways that include professional knowledge you’ve acquired from study, training, and experience. Assertion lets you make tentative hypotheses about a counselee’s unconscious dynamics, even though such information is often startling at first, or runs counter to their conscious self-image. Of course, you don’t allow your assertion to become headstrong or brash, because the balance of the Love compass point is there to reign you in, reminding you that love is patient, kind, and not rude or arrogant.

Think about this polarity for a moment. Picture the ways you show the Love compass point in your personal and professional life: caring, forgiving, nurturing, supporting. Now move to the opposite compass point and picture the ways you manifest Assertion: expressing, diplomatically confronting, negotiating, and challenging. Now let the two polarities move into a dynamic rhythm that encompasses many shades and nuances of Love and Assertion, working synergistically to give your personality and interpersonal communication a balance of loving assertion and assertive loving. 

It is reassuring to know that if you become too loving, sliding into subjective caring that becomes inappropriate, you can recover quickly by moving into assertion and making choices that restore balance. Or if you stay too long in Assertion to the point of getting argumentative, contrary, or unforgiving, you can recover your balance by moving into Love.

The key to this attitudinal and behavioral flexibility lies in existential openness to God’s guidance. Just as the disciples needed open minds and flexible personalities in order to keep hearing and benefiting from Jesus’ interactions with them, so the Holy Spirit can spontaneously move within your personality and behavior, both in counseling sessions and in your private life. And your ability to guide counselees toward Christlike wholeness radiates from your own continued growth in Christ.

The Holy Spirit and Pastoral Counseling

It is perfectly appropriate for a pastoral counselor to suggest that God is present in counseling, offering redemptive hope that helps remove obstacles blocking the way to wholeness.

In some contexts, a pastoral counselor’s freedom to invoke God’s blessing through prayer is part of the counseling process. This is especially true in pastoral ministry, spiritual direction, and church-based counseling centers. On the other hand, there are contexts in which it is unwise to mention God in a personal way, such as the name of Christ.

Even so, there is a considerable range of opportunity where spirituality is welcomed covertly, if not overtly, and this may be where a significant number of the new generation of pastoral counselors find themselves.

The Spirit Moves Where The Spirit Wills

As a professor at a graduate school of psychology, I found myself in one of these places. While affiliated with a Christian denomination, the university reached out to students of all races and faiths, and pursued academic excellence within a context that celebrated and extended the spiritual and ethical ideals of the Christian faith.

Yet Christian witness or prayer was not acceptable in the classroom. I understood and accepted this. Nevertheless, some students knew of my relationship to Christ, and perhaps because of that saw me more as a pastoral counselor than a professional psychologist. Greg was such a student.

Following a class one afternoon, Greg called me aside in the hallway and said, “Dan, can we talk privately?”

“Sure,” I said. I opened the door to an empty classroom and we sat down in two desks. “What’s on your mind?”

“Well,” he said, looking suddenly unsure, “I just wanted to get something off my chest and you’re the one I’ve chosen.”

“I’m honored. Go ahead.”

“My life has fallen to pieces. Ever since elementary school, I had only one goal in life and it didn’t matter what it cost to get there.”

“That’s unusual clarity and single-mindedness. What was the goal?”

“To become a National Football League player. And finally, last spring, I was recruited.”

“That’s great news. Congratulations.”

Greg’s face turned to stone and he shook his head. “That’s when it happened,” he said. “I had a great spring training and a strong start to the season. But then I got hepatitis.” His eyes watered and voice broke. “They hospitalized me. My skin turned yellow.”

“I am so sorry,” I said.

“It gets worse. The doctor said there was permanent liver damage—that I could never play football again….”

We sat searching each others' eyes for a long minute. I let my face express the shock and sorrow I felt.

Finally, placing my hand over my heart, I said, “This is truly tragic. How have you possibly coped?”

“That’s just it,” he said. “I haven’t. I withdrew from my wife to the point where we hardly talk anymore. I withdrew from the players because it was excruciating to watch them working out. And I withdrew from God because I don’t believe he exists any more.”

Another silence.

Now I knew why Greg had chosen me. Paradoxically, he had sought out a person of faith in order to confess his loss of faith.

“Greg, I believe you of all people have every right to challenge God’s existence,” I said. “Do you care to share more about that?”

He nodded. “Yes. I always thought it was God calling me into professional football. I asked his help all the times I felt crushed by opposition or numb with pain. I thought he had big plans for me. And then when I finally became a pro and got my uniform and saw my name on the locker, he gave me hepatitis. What kind of God does that to a child he loves!”

I suddenly felt as helpless as Greg did. I had no answer for God. It would have seemed trite to quote a scripture or ask if he still attended church. At times like this I can wonder why I got into counseling in the first place. Some problems seem too profound to fix.

“So that’s why I came to you today,” said Greg, breaking through my internal anguish. “I want you to pray for me.”

My mind became a freight train: Oh-my-goodness-what-have-I-got-myself-into-I’m-not-supposed-to-witness-to-faith-in-Christ-here!

Fortunately another voice, a calmer one with a different message, whispered within me: Dan, it’s okay to offer a healing prayer when a person asks for spiritual help.

“All right, Greg,” I said. I bowed my head. “Dear Father, you’ve heard Greg pour out his pain and confusion today. All his hopes have been destroyed; all his dreams shattered. Can you please, in your brilliant capacity for resurrection, restore this young man to a life filled with meaning and fulfillment? I praise you and thank you in Jesus’ name, Amen.”

I looked up, but Greg still had his head in his hands.

“Greg,” I said gently. “Would you like to say a prayer too?”

He hesitated. Then he said, “Oh Lord, I am so sorry I have forsaken you. I never even said goodbye. I just tightened my heart and shut you out. Just like I shut out Marilyn. And all you both ever did was try to love me and help me through life. Please come back to me. Please don’t leave me all alone….”

My heart caught. I sat waiting for Greg to finish the prayer. But he didn’t, at least not that I could see. Instead, he began to tremble. I thought immediately, Oh no, I’ve done it now…I pushed this student over the edge…he’s having a panic attack.

The trembling increased and so did my heart rate, until Greg suddenly sat bolt upright and practically shouted, “I feel him, Dan. I feel God. He is right here with us!”

It took a moment for me to understand that this was no psychotic break, but a glorious visitation by the Mighty Counselor himself.

I watched as Greg looked upward, directly over my head, beaming like a child chucked under the chin—a six-foot-six two hundred and fifty pound young man being hugged and loved by his heavenly Father.

When we did finish up our impromptu session that day, I left campus appreciating more than ever that we are not alone as pastoral counselors. We are not left fending for ourselves with mere counseling theories and clinical techniques. The Holy Spirit moves where the Spirit wills, and that especially means moving where people are broken and needing one called alongside to help them, one like you or me and the Lord. 

Greg later told me that God had led him to become a football coach, a calling that he greatly enjoyed in service of his Lord and Savior.