Over the past couple weeks I have been reminded of the necessity of a good licensed Christian therapist when dealing with mental health issues. I am also aware that some people think that the terms "Christian" and "licensed therapists" are oxymorons. So I thought I'd ask some Christian therapists that I know and trust to explain their approach to therapy. Our first chat is with Shirley Miller, a Marriage and Family Therapist. Check out her website and FB page to learn more about her!
The Cave Place: If/How do you use prayer during a session?
Shirley Miller: I rarely use prayer in a session unless I am specifically requested to do so by a client, or if I’ve worked with the clients for a long time and the particular session seems to cry out for prayer. This does not reflect on how I feel about prayer. I pray for my clients. However, I have followed a pattern that a former therapist used with me when I was seeking help. A majority of my clients seek me out (as I did him) because they want a therapist who holds a Christian world view. Most of them are church attenders and are somewhat well versed in scripture. Some of them have been disillusioned with how they feel the church has responded to their need. Some of them carry guilt that “if they were just walking with God”, they would not be depressed or anxious. For these reasons, I initially leave out anything related to “the church” or “religion” and first seek to make them feel fully accepted and safe. I want them to feel able to share from the depths of their souls without anything that might trigger a false sense of “religious” guilt.
TCP: If/How do you use scripture during a session?
Miller: To continue my thoughts from how or whether I use prayer, I rarely use scripture in early sessions. Again, this does not reflect on how I feel about scripture. It is the basis for everything I believe and practice. But, if someone has experienced hurt in the context of the church, scripture can induce false guilt or add to the feeling that “I wouldn’t be in this place if my walk with God was better”. I often talk about the differentiation (from my point of view) between guilt and shame. Hopefully guilt instructs and motivates change. Shame often condemns us in a way that makes us feel that change is impossible and keeps us stuck. When I feel it’s beneficial to bring in scripture, one of my favorite passages is Psalm 139. No matter who we are or what we’ve done, we are “fearfully and wonderfully made”. And we can never escape from the God who pursues us. How hopeful is that?! Scripture presents complex principles that are paradoxical. Life is like that, too. I love when scripture can enter a therapeutic session because it has the power to instruct us and change us in a way that we cannot accomplish on our own.
TCP: What model of psychotherapy do you mostly practice?
Miller: I’m a big believer in using Cognitive Behavioral therapy. To me it fits well with discovering God’s truth and renewing our minds. Like most therapists, I use multiple models of therapy as they fit the situation, the specific client and my own personality. I believe it’s important to discover the various reasons why a problem originated. That may include genetics, family dynamics, early experiences, and other factors. Once those are discovered, it is easier to employ Cognitive Behavioral methods to change the way we view and frame the world around us. Two areas that I want to continue to brush up on and research are Attachment and Neuroplasticity. They relate to our relationship with God and his built in plan for healing and health.
TCP: What is your view on medication?
Miller: While medication is a decision between the client and their Psychiatrist or Primary Care Physician, it is often my role to refer for a possible prescription or explain how medications work before the client sees their physician for help. Because brain chemistry plays into our moods in such a huge way, medication can be key in lifting someone from depression or easing anxiety. Yet, it’s important to realize that these things are best addressed in a complete way. Eating habits, sleeping patterns, exercise and talk therapy are very important to a complete treatment plan. Sometimes medication is needed just to lift the clouds enough to implement other therapies. Talk therapy becomes a cornerstone in challenging skewed belief systems so that the client has the internal tools to deal with any ongoing predispositions toward depression and anxiety.
TCP: Describe how you adjust secular psychology to fit your theology.
Miller: Perhaps the adjustment comes so naturally to me that I barely notice that I do it. Science informs us and is useful for diagnosis and treatment. But God is the foundation. He’s the Creator, Sustainer, Redeemer, Healer, and most of all, the originator of Truth. Every psychological concept gets adjusted to fit this construct.
TCP: What secular psychological beliefs do you not agree with?
Miller: There is currently an ad that keeps showing up on my Facebook page for an online therapy service. Their byline is, “You deserve to be happy”. I cringe every time I see it. I don’t recall any place in scripture where we are promised “happiness” - which, of course is a very subjective term. We are promised that God will never leave us or forsake us. We are promised that our needs will be met. We are promised salvation, forgiveness, peace. But God is not a lucky charm who will ensure worldly wealth, an absence of sickness or sadness or death. And, while the Holy Spirit indwells me, I don’t find my answers by “looking inside myself”. God reveals truth. Jesus is the way, the truth, the life. If I want to know truth about myself, I need to ask God to help make me willing to be vulnerable to what He reveals. I picture Jesus carrying a lantern and entering every segment of my life, empathizing with my pain and reminding me that there is nothing in me that He doesn’t know, that He didn’t die to redeem and that He doesn’t long to heal.
TCP: What Christian views of mental illness do you not agree with?
Miller: I once heard a pastor chastise his parishioners for seeking therapy, calling therapists “paid friends”. I still get churned up when I think about how many hurting people he might have damaged that day. There’s also a common view that “walking with the Lord” ensures mental health. The church has generally learned not to think that way about sickness, but often fails to view the brain as another organ of the body - susceptible to illness and vulnerabilities simply due to genetics. Then throw in traumatic experiences or “inherited” unhealthy belief systems, and help is often best sought through professionals. God can choose to cure fatal disease, but often has us follow the journey with medicine. I believe it is the same with mental health and addictions.