Shirley Miller, M.S., L.M.F.T.

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.

Robert Scholz, LPCC & LMFT

The Cave Place: Welcome to Cave Chats. Today we'll be chatting with Robert Scholz, who serves as the assistant director at Pepperdine University's Counseling Center. He also oversees their program related to alcohol and drug use and is a professor in the graduate school of psychology. 

The Cave Place: For our first round of content on The Cave Place, we are focusing on educating ourselves and discussing issues of faith related to different kinds of depression and anxiety. So first, can you share with us a little bit about your understanding of the different kinds of depression and anxiety, situational and chemical, and some of the ways that they might overlap. 

Scholz: From a science standpoint, there are different ways we diagnose depression. There are different kinds of depression diagnoses including major depression and bi polar disorder, which has a component of depression, and disorders like adjustment disorder. But when we think about a chemical depression, we're thinking of depression where there has truly been an impact on the brain and how the brain functions. And often times that's more in line with what we refer to as major depression. Then there's situational depression that is often times in response to a very specific trigger in somebody's life. Sometimes there is something specific we can tie it to and the depression or anxiety ends after a period of time. And sometimes the depression from that situation affects a person physically and it can turn into something more advanced. 

The Cave Place: So you're saying that something that starts out as situational depression can become chemical if not dealt with properly? That makes sense. So as Christians we believe in the concept of sin and we believe that there are things we can do that separate us from God. Obviously, sin and spiritual things can play a role in depression, so can we chat a bit about the role of sin and possible guilt as a cause of certain types of depression or anxiety? 

Scholz: That's a great question and I think often times for Christians, when they sin and therefore violate their value system, it brings up some discomfort. For some people it makes them very anxious. For other people, it makes them feel depressed and shameful. When they don't have proper healthy outlets to examine and process those feelings, the thoughts become more and more internalized and, over time, can even effect how the brain functions. In some of those situations where people have done something they are keeping a secret, something that is festering, that can bring out a mental health issue. 

The Cave Place: What do you think grace has to do with all this? 

Scholz: When I think of grace, I think of forgiveness, but sometimes it's hard for people to embrace that God forgives them so they have a hard time forgiving themselves. I think that's one of the things that can trigger depression and/or anxiety. Likewise, there's like a parallel process that happens with those in their life. Sometimes when a person sins, those around them don't know how to be with the person in their imperfection. And even in some faith communities people get shut out, which leads to isolation, which exacerbates the isolation that depressed people are already feeling. So a big part of treatment is teaching people how to forgive themselves and teaching them to remember that in the scriptures, there's a place for grace. That's why we really value the inclusion of friends and family in somebody's treatment because as they start to receive grace from friends and family, they can start to forgive themselves as well. 

The Cave Place: So we've talked about situational depression. But what about what might be referred to as chemical depression or when someone is going about life and something triggers this depression or anxiety that's been under the surface their whole life. Maybe they had some signs of it, but didn't really know what it was. And because we do believe in sin, we tend to want to place blame on one thing and try to figure out what we did wrong. How do you navigate that with students, communicating to them about the biological side of mental health from a Christian perspective? 

Scholz: The topic of depression is not your typical Sunday morning sermon topic or what people learn in Sunday school. And so I do think sometimes Christians attribute their negative feelings to something they've done wrong, when maybe it has nothing to do with that whatsoever. Just like with any other illness, if you're feeling symptoms from a cold or you may showing signs of being diabetic or having high blood pressure, it's all about educating the people around you. It may in fact have nothing to do with anything you've done and may be more in fact to do with how you are wired and how your body is responding to things at this time in your life. The 

The Cave Place: Right. Well, that's all the questions I have for you. Thank you so much for chatting with us and hopefully we all learned something new.