Making the decision to see a therapist can be quite difficult in itself, but for the Christian there may be added concerns about compatibility between worldviews. There may be questions about whether the therapist will respect your religious beliefs, minimize them, or treat them as part of the problem. How should a believer go about choosing a therapist, and what factors should be considered?
Presuppositions of Secular Psychology
As you are reading this, you may be wondering if it even matters whether your therapist has the same worldview as you. By contrast, other readers may have been warned about the evils of psychology by their pastor or friends. What is the truth?
Asking yourself these questions is a good start. Speaking to His disciples when He sent the apostles out to testify about Him, Jesus said “be shrewd as serpents and innocent as doves,” (Matt 10:16, NASB). The environment called for discernment and wisdom two thousand years ago, and it still does today.
One metaphor that will help you apply wisdom to your decision is the taxi. Therapy is like an Italian taxi, and you the tourist. It is a tool to take you to your destination. The important distinction is the person behind the wheel, as without a driver the taxi goes nowhere. Like your taxi driver, any therapist should listen to you when you tell them where you want to go (e.g., the Anxiety Reduction Inn, the Piazza di Agoraphobia Amelioration, or Museo di Marital Satisfaction). However, if you and your taxi driver are not speaking the same language there will be problems. It can be better if your taxi driver is speaking the same religious language that you are.
For example, suppose you are feeling depression and regret over something you had done wrong as a teen. Both the Christian and secular therapist should show empathy and respect for that situation. However, the Christian counselor can help you to ask for and receive forgiveness. A secular therapist would likely help you assuage your guilt by reasoning that you made the best choice you could, given the circumstances. They could possibly miss the confession and restoration aspect. Thereafter, in order for you to protect your psychological wellbeing, you must maintain the position that the act was a necessary choice at the time; however, your religious beliefs would likely be contradicting that story. The result could be increased confusion.
Romans 8:1 tells us there is no condemnation for those who are in Christ. Similarly, a secular therapist could be telling you there is no judgment because there was no sin. If both views say there is no judgment, what’s the difference? James 5:16 tells us to confess and receive forgiveness. A Christian therapist can lead you in the process of redemption and restoration as part of the healing process. Without this unique perspective, you could be missing out on one of God’s most important blessings. In other words, it’s important for your taxi driver to be speaking your language.
Here are a few ways languages differ. Generally speaking, traditional psychology espouses an evolutionary paradigm. Humans are generally good, and left to themselves, will grow and flourish in healthy, productive ways. There is not a concept of sin; instead it is usually called maladaptive or anti-social behavior. In secular terms, you are healthy when you are able to achieve your goals, engage in pro-social relationships, adapt to stressors, and live according to your moral framework. Those may indeed be good things (as they are part of God’s design); however, the greatest marker of health is missing, your relationship with God. Consider Jesus’ words in Mark 8:36 about gaining the world and losing the soul. Are you really helped if you cure your depression but move away from God in the process?
At the bottom of the issue, the most fundamental aspect is need. What does a person need to be healthy? The answer will be different from a secular worldview (e.g., actualization, adaptation, etc.) than a religious one (i.e., salvation & sanctification), and since you are seeking help with mental or social health, the distinction is an important one. Your taxi driver should take you where you need to go.
What is True?
In the preceding taxi metaphor, psychological principles were represented by the taxi. Does the taxi’s engine start and run properly? Does the transmission work? In short, does the car work? Just as you would want to ensure a car works before you drive, a therapist validates his theories via scientific scrutiny.
Over the years scientific scrutiny has cast doubt on some ideas we now consider strange, such as Freud’s Oedipus complex, and in general Freud’s analytic theory has been abandoned by most practitioners in favor of newer approaches. That taxi does not get much use these days. Why, you ask? Researchers learned more about the human psyche and biology, and as a result they developed more effective ways of treating problems than the prolonged psychoanalytic approach.
On the other hand, numerous principles of psychological thought have survived great scrutiny. One could say that many of those ideas come from biblical roots. For example, cognitive behavioral theory (CBT) attempts to change a person’s thought patterns in order to reduce presenting problems. Research has shown us that neurological pathways (thought patterns) are like ruts. The more we use them, the deeper they get. This can be to our advantage, when learning to ride a bike, for example, or to our disadvantage, such as when dwelling on worrisome thoughts. CBT helps us create new pathways by changing our thinking. The Bible is replete with proverbs telling us to put our mind on good things. “As a man thinks within himself, so he is” (Proverbs 23:7). Again, Philippians 4:8 says to dwell on things that are true, pure, lovely, and good. Finally, science is catching up with Scripture!
Four Approaches to Integrating Biblical and Scientific Knowledge
Perhaps you have decided a Christian therapist is the best choice for you. You are looking for someone who speaks your language and uses therapies that are scientifically validated, and it is time to choose one who matches your beliefs. There are four ways a therapist might resolve the two forces of biblical and scientific thought.
The first approach separates the two ideologies into separate camps. This group believes just as mechanics fix cars and medicine fixes the body, psychology fixes the mind and religion the soul. This kind of Christian counselor identifies herself as a believer, but she does not bring that aspect of herself into the counseling relationship. Therefore, your sessions will be secular in nature.
At the opposite end of the spectrum is nouthetic counseling. In this approach, psychology is seen as entirely vapid. Since no good can come from it, only Scripture is available to the counselor. While some religious people strongly support this approach, others view it as an overreaction.
Between these two extremes is an approach some call the “tossed salad”. People who practice this approach toss in both ingredients of religious knowledge with psychological techniques. This is a step in the right direction; however, it is not without problems. Specifically, the underlying presumptions of a theory may contradict Scripture. For example, humanistic approaches emphasize the underlying goodness of man, while the Bible has a good deal to say about man’s depravity. Therapists would do well to consider the theology of their theory. Is it on a trajectory that agrees with the Bible?
The final, and perhaps best, approach marries empirical evidence with biblical values by interpreting each theory through the lens of Scripture. For example, Rogerian theory postulates that people are intrinsically good and are internally motivated to achieve their maximum capacity when they experience unconditional acceptance and positive regard. Indeed, research has shown that 40% of the change in counseling comes from the client-therapist relationship. However, Rogerian therapy contradicts the biblical idea of sin. How does this final approach to mixing these two ingredients work in this practical example?
The Bible tells us that we are “fearfully and wonderfully made” (Ps 139:14), “a little lower than the angels” (Ps 8:5), precious to God, His children (Rom 8:14), and so on. Furthermore, we are told to love others as we love ourselves (Lev 19:18). This is all to say we have value, and we should value ourselves. God loves us very much, and it is wrong to browbeat or show disdain toward others. Christian Rogerian therapy shares the love of God to others, shows patience, and embraces a non-judgmental attitude. At the same time, we tell the truth in love with the realization that the heart is deceitful (Jer 17:9) and people are often motivated by selfish sinful desires.
Where the Rubber Meets the Road
Given the principles that secular psychology has some presuppositions that do not square with biblical truth, that research can help us find truth anywhere, and that it is important to find a therapist who can balance biblical principles with psychological treatments, what should you do? A good first step is seeking help at a Christian counseling firm. Ask your therapist questions and read about them on their website. Listen to what they say and any advice they give. Consider how that mirrors (or contradicts with) your biblical values, and give them an opportunity to explain if there is a disagreement. Look for a counselor who will not only help you solve your problem here in this world, but will also bolster your relationship with your Savior and prepare you for your life in the next world.