The Sun Came Out!

sunrise mural

This week-end marked a new pattern from the usual, eat work, sleep routine. I was off for 4 days for the Easter long week-end. The weather was beautiful. Sunny, clear blue skies, warm weather.

The most perfect weather for Easter sunrise services, gallivanting by bike around the city with my toddler in tow, and planting a new crop in the backyard garden.

One amazing thing about beautiful weather is not only the ability to lift one’s spirits, but also to bring people together.

Since being introduced to Christian communal living 10 years ago in the Downtown Eastside living out the call of radical hospitality has been one of the main ways my family expresses our faith. This call is taken literally from Jesus’ teaching when he was confronted with the role of power and prestige in his day.

Jesus challenged the privileged of his day “When you give a dinner or banquet, do not invite your friends or your brothers or your relatives or rich neighbors, lest they also invite you in return and you be repaid. But when you give a fast, invite the poor, the crippled, the lame, the blind, and you will be blessed, because they cannot repay you. For you will be repaid at the resurrection of the just”. (Luke 14:12-13).

All winter it seems that I have been living for myself; socializing with the people at work I get along with, visiting family, dutifully going to church. But this week-end was different. This weekend I felt alive again because I was able to live out Jesus’ call of inviting people into our home for dinner who cannot pay us back.

This happened on various occasions every day where friends from our church here in the inner city came and dropped in. I was able to be present most of the time and share friendship and a few honest conversations, including some laughs.

This week-end also included gathering with a few other local churches in our neighborhood for Easter Services who have similar values. I reveled in the collective prayers on Easter morning and the strength of each voice and their diverse emphasize on different parts of God’s work (salvation, creation, beauty, atonement, etc). It was incredibly uplifting to be surrounded by such a tangible cloud of witnesses.

It was enough to jolt me out of my eat, work, sleep haze and remind me that, yes, Jesus still dwells in me and sometimes, I get a glimpse of what it is to live in the Kingdom of God.

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CBT for Personality Part 2: From a Christian Perspective

After reflecting further on my original post on CBT for personality, the New Paradigm for CBT I noticed some interesting parallels between my Christian faith and this therapy that may be relevant for both therapists and people seeking help for personality disorders that are also Christian.

In her new paradigm what I noted is that she explains old behaviour and beliefs that were held/used for “good reasons”.  Instead of challenging the old system she introduced a “new paradigm” in a very experiential manner.

It made me think of how Jesus taught about being born again to Nicodemus and how he offers the gift of eternal life to the woman at Jacob’s well.  He does not challenge the old system of sin, but acknowledged it openly and assumed that a person is already understood how the old system did not work and instead they are looking and seeking a new paradigm, this living water, or spirit life that is not based in place or a set of laws but “in spirit and in truth ” (John 4: 24).  Jesus is continuously offering images, and stories to activate the imagination of people to create a “new paradigm” to enter the kingdom of God that is “here but not yet” (common term from Kingdom theology).

Some of the people Jesus encounters, like those with personality disorders have been suffering for many years, like the woman with continuous bleeding.  Those with these physical ailments were also consequently excluded from relationships and the acceptance of society which is similar to the interpersonal difficulties and invalidation that those who have personality disorders experience.

However, unlike CBT personality that reconceptualizes  the world Jesus challenges us to imagine a new kingdom of God that is loving, beautiful, and a place for the broken.  This kingdom of God is not the world- the world is fallen- whereas the kingdom of God is good and allows people to live fully in love.  Paul for example would likely not approve of imagining the world as a good and loving place, but challenges followers to “not conform any longer to the pattern of this world, but be transformed by the renewing of your mind.”.(Romans 12:2).

Jesus does not want us to idealize ourselves in positive terms but to hold a dialectic together of both sinner and a new creation in Christ.  Loved deeply by God, though rejected by others.

We have an initial belief or experience as followers of Christ but that does not always mean that our old beliefs and habits die completely.  We struggle between paradigms slowly through steps of faith and in acting out our faith in obedience (behavioural experiments of sorts) we learn to walk in this new way. 

Ultimately what anchors us in this new life are not just the word and promises of the bible on a page (the challenging of our old system of belief through words and reason) but the discipline of living out faithfully this new life.

In this new system- or more accurately through a God that is who loves us, who is greater than ourselves – we gain the strength and new resources to cope in a new way with the struggles we face in this world.  Our old ways are no longer necessary as we live more deeply into the new way of Christ.

So if I was to use the new paradigm for CBT for personality from a Christian perspective I might initially focus the old as she does on the view of self, others and the world but conceptualize the new through replacing a focus on the world to the Kingdom of God as the new realm to live in.  This new kingdom paradigm could also be anchored through visualization, and experiential elements- encouraging one to actively enter God’s presence using imagery.

Then introducing interpersonal difficulties into this new kingdom/paradigm makes total sense because you are inviting someone to little by little start living in the kingdom of God (“let your kingdom come on earth as it is in Heaven”). For example you could say “If you are living in this new kingdom of God where God loves you, you are forgiven, you have joy, and are special…what happens when someone insults you…?” .

This new Christian interpretation of Padesky’s paradigm doesn’t just apply to those with personality disorders but I can see how it would be useful for each one of us to conceptualize in our imagination what it is like to live more fully in the kingdom of God.  It might also be helpful for those who struggle with deep shame, despite intellectually accepting that “God loves me” or “I am deeply loved”.

Kind of exciting!

Questions? Comments?

The Sins of our Fathers..

In the bible there are numerous passages in the old testament that reference later generations bearing the iniquity of their fathers (Exodus 20:5, Deuteronomy 5:9, Exodus 34:6-7).  When I first read these passages I thought this was especially cruel and unfair.  Why should those who have done nothing suffer because of the sins of others? 

What I realized recently while working in mental health is that this is not an order of divine punishment but it is the unfortunate effect of sin.  When a father sexually abuses his daughter she will likely suffer greatly in this life through the destruction of her self-image and sense of safety. She may have lifelong depression, borderline personality, an eating disorder, or post-traumatic stress disorder.

Other verses point that one should not be punished for the sins of their abuser (Ezekial 18:20) in this present world.  Justice should be fair- the victim should not suffer further or be blamed.

Unfortunately blaming the victim has been part of our world for some time, even in Jesus’ time people were looking to understand suffering and illness and pinpoint to a person’s sin.  For example Jesus is asked whether it is the sin of the blind man or his parents that caused him to be blind from birth.  This seems so foreign today to us as we know that blindness is a generally a genetic condition. 

However mental illness is a good comparison: even counsellors find ourselves asking is it this person’s “negative thinking pattern” or “lack of motivation”,or  “personality traits” that keeps them ill or is it “genetic” or due to childhood abuse/trauma.  We want to know the why because we think it can free a person from its trap.

Jesus does not buy into this dualistic thinking as he simple states that “Neither this man nor his parents sinned, but this happened so that the work of God might be displayed in his life.” This statement alone would seem to mock the person’s plight and suffering if Jesus did not continue to bring miraculous healing and restore the man’s sight.  In this instance Jesus not only cures the sight of one man but brought new perspective to the discliples, the man’s family, and the larger society on illness, sin, and God’s restoring love for broken and wounded people.

Judging from the last few posts you may start to understand that I am starting to feel the weight of trauma, hardship and suffering that I am beginning to witness in my work.  I grieve the sins of fathers, neighbors, mothers, grandparents, wars, and societies that have hurt children; I wish that children did not have to bear that heavy burden as alluded in the old testament.  I have clients that say they cannot remember anything from their childhood and call it “horrible” and “awful”.  Although Jesus does not join in the condemnation of parents or the blind man in the aforementioned story he does have strong words for those who harm children. 

 “If anyone causes one of these little ones—those who believe in me—to stumble, it would be better for them if a large millstone were hung around their neck and they were thrown into the sea. ” (Mark 9:42)

For all those affected by the sin of their fathers that I work with I hope to develop Jesus’ view of seeing them as instruments of God’s grace and restoration, rather than just as people I am “helping” or providing “psychoeducation”. I hope that Jesus’ promise for freedom could be experienced by all like the woman who had bled for twelve years. That those who have been hurt and metaphorically bleeding out could courageously reach forward to Jesus and receive these words “Daugther[son], your faith has healed you. God in peace and be freed from your suffering”.  (Mark 5:34).

 

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Healing from God and Healing from Therapy

The most visible part of Jesus’ ministry was healing people.  Jesus healed people of long-lasting illnesses, defects from birth, demon possession, raised the dead, but most of all he healed people from their sins.  His physical healing always had the ultimate message that pointed to the redemption of the whole person: body, soul and spirit.  I similarly believe that God has the power to heal today into our broken world- that this is his way of showing signs of his Kingdom for the lost and weary travellers of this earth.

There is a statistic from the World Health Organization that in 2030 depression will be the world’s largest health burden affecting more people than any other disease.

http://news.bbc.co.uk/2/hi/8230549.stm

If this will be the biggest disease burden of this world, where is Jesus and how is he working in the world for the healing of this condition?

We have often looked to Jesus to only heal physical symptoms, and are hesitant to ask God to heal mental health conditions, like depression.  This is in part because the church has viewed mental illness with stigma and often blames the individual, or family.  It is also because people, like myself, have prayed for the healing of people’s minds and addictions to no avail.  It is hard to find many stories of God’s miraculous healing of depression or schizophrenia.  Perhaps we lack faith, perhaps we do not fully understand the spiritual-socio-biological interactions of depression.

In fact, this is probably one of the main reasons that I decided to get training in social work and counselling.  I wanted more skills and tools to support, love, and promote the healing of people around me who struggled with trauma, addiction, and mental illness.  In our little church of about 20 or so people on any given Sunday I would guess that about 50% of people in the room have a diagnosed mental health condition (including substance abuse).  Some are on the paths to healing by slowly regaining independence and faith in God, while others feel like they haven’t received much relief from God or from therapy or medications.

I wish God would simply heal people, that we wouldn’t need psychotherapy or pharmaceuticals for mental health issues. I also wish that we did not need anti-retrovirals or chemotherapy for HIV/AIDS and cancer, but we do.

As a Christian therapist I have read the scientific research on mental illness.  Most medications address symptoms, rarely do they provide a cure and its’ success varies widely depending on the condition and the medication.  Similarly, psychotherapy fails many people and is not the cure-all for mental health issues although some forms of psychotherapy can provide lasting and improving relief from symptoms.  Interestingly enough, some people do not develop long-term symptoms and may have spontaneous remission or “natural” recovery with limited or no pharmaceutical or psychological interventions.

Prayer does not always cure.  The church regularly fails to care and love those struggling in their midst.  We fail to be a family of faith that treats each person as an equally beloved child of God.

Although the role of the therapist is not explicitly a biblical one, it will become increasingly important as the mental illness becomes more prevalent and recognized in our world.  Being a Christian therapist allows one to offer the most effective treatment available, while also believing in God’s ability to take care of a person in a way that reaches beyond what our limited understanding has discovered. Being intentionally open to the Holy Spirit, while using sound therapeutic judgement and evidence-based practices are ways of operating ethically and faithfully as a servant of Christ working within a secular medical system.

What are your experiences with mental illness and Christian faith/the church?

If you are a Christian therapist, how have you seen God work or what success have you seen within therapy?  What has surprised you?

What tension do you see between healing from God and healing from therapy?

The Dialectics of God’s Love and Radical Acceptance (DBT musings part 3)

Dialectical Behavioral Therapy has the aim of teaching people to both accept themselves as they are and at the same time realize their need for change.  It works on shifting a person’s assessment of themselves (and the world) from one of dialectical thinking (either all good or all bad) to one of non-judgement, and acceptance.

In the previous post, commenter Sean challenged the view that Christians can be non-judgemental in all circumstances and clearly differentiated circumstances which warranted  refraining from judgement (being judgemental) and those that warranted judgement (i.e. to identify sin.).  This is a dialectic in itself and merges well with DBT’s aim to encourage its participants to both accept themselves and realize their need for change.

This dialectic of acceptance and change is one that is inherent in the Gospel.  We learn through Jesus that God loves the world so deeply that he gave his only son (John 3:16).  However, God’s love requires reciprocation, action, and relationship as the rest of the verse says “whoever believes in him will not perish but have everlasting life.

Time and time again in the New Testament Jesus demonstrates God’s extravagant love to those considered the most outcast, hated (not loved) and rejected including the Samaritan woman at the well (John 4), the woman who lavished him with perfume (Luke 7), the tax collector (Luke 19), etc.  He was accused by the religious of frequenting with “sinners and tax-collectors”.  This likely aggravated the religious folk because they feared that he was accepting of sin, as it seems contradictory that you could both accept and reject at the same time.  Indeed it can be.

The key to handling this dialectic is forgiveness.  God’s amazing ability and offer to forgive to all who seek it provides a true and radical acceptance a bridge between being who we are and changing to becoming more like God/Christ.

When Jesus teachers his disciples to pray he teaches this practice of continually coming to God in for forgiveness, realizing that at the same time we are his beloved Children, we are also deeply fallen and sinful creatures who need God’s love.  Many people get stuck in this process.  They find it hard to let go and believe that God could truly love them and forgive the things in the past that were truly sinful.  Another problem we have is blindness to our own sinful nature- especially as people who have been trying to follow God for a little longer- we haven’t committed some of the “big” sins and so we figure we are “Ok” and fail to look more deeply at the nature of our selves and have come to accept too much of our desires and yearnings that are in fact more worldly (“Me” centred) rather than Godly (God-centred).  So we both need acceptance and forgiveness to engage in the radical acceptance and transformation that God offers through Jesus.

You may wonder how this differs from the “Radical Acceptance” espoused in current psychological treatments.   Radical Acceptance in DBT is based on Buddhist principles that we will endure pain but we have a choice to suffer- radical acceptance may entail accepting a situation or a person as they are rather than striving to change it, or bemoan it.   To stop dwelling on things that we may or may not have control.

There are passages in the bible and whole books (Job) which talk about suffering.  Paul regards suffering as purposeful,cleansing us from selfishness, as a place of joy (Colossians 1:24) and connecting us to Christ’s suffering (2 Cor. 1:5-7). Jesus also admonishes us that those who follow Him will be persecuted for righteousness. In this way Radical acceptance may at times be advisable to Christians.  In addition the reasons or results of enduring pain, for the Christian, may be different from those espoused by Radical Acceptance in DBT.

Enduring pain seems justified for those who suffer apart from their actions, but can Christians advocate radical acceptance when suffering is self-inflicted?

That’s a very good question.

What do you think?