A Skeptic’s View of Counseling Part 6: Integrationism Redux
Before proceeding with my discussion on integrationist counseling, let me state that I have no dog in this fight. While I have no patience for “psychobabble” in any of its secular or Christian guises, and my libertarian heart wishes to see a wall of separation between our legal and mental health systems, my Lutheran heart balks at what appears to be a “theology of glory” in the Christian counseling movement; ie that all problems of living can be rectified in this life by mere application of some religious programming and activity. I believe that life this side of heaven is and will remain a vale of tears, and that we, however sanctified in this life, will go to the grave, or meet Christ should he return soon, laden with our besetting sins. Our hope is in Christ alone, not our feeble activities and efforts; ie theology of the cross. I say this only because, up until now, a reader might misconstrue me as a gung-ho partisan of Biblical counseling out to bash psycho-heretics who don’t see that way clearly. As I hope you will see at the conclusion of this series, this would be a misconstruction. With that said, let us proceed.
Much criticism has been leveled at JE Adams for too narrow a focus on specific sins rather than the general nature of fallen man and original sin, leading to a reductionistic method ignoring much of life’s complexities. As such, not all counseling can be reduced to confrontation about specific sins. Bradley Cochran at theophilogue.com put it succinctly:
“…Adams unfortunately reduces all methods for counseling down to nouthetics. Biblical Counseling = Nouthetic Counseling. In fact, he oversimplifies the nature of real-life counseling by reducing it down to ‘problem solving,’ and then speaking of the ‘problem’ only in terms of sin. However, to be faithful to the biblical sources, one must include a variety of problems as well as a variety of methods. We must ‘admonish [noutheteite] the unruly,’ but we also must ‘encourage [parameutheisthe] the fainthearted’ (1 Thess 5:14). Adams could have just as easily reduced all counseling down to paramouthetics and walked us through a thousand methods for paramouthetic engagement. With Adams’ reductionistic approach, it does not surprise the reader that he never mentions the biblically revealed methods of admonishing with psalms, hymns, and spiritual songs sung in thankfulness to God (Col 3:16). Such a method seems out of place with Adams’ narrow, cognitively-oriented categories of problem solving.
“Furthermore, since not all troubles are sin problems, not all methods include nouthetics. Most counseling relationships might inevitably involve a need for varying degrees of nouthetic confrontation (as do most real friendships). However, sometimes I have the ‘problem’ of indecisiveness in an important decision. I get counsel from my mentor all the time because he is older than me and sometimes provides a different, more informed perspective on life which enables me to make a better decision. When I go to him for counsel on life’s big decisions, he does not probe my life looking to confront me for some sin (although if he did, he might surely find I am a sinner). Rather, he simply offers his advice, encouragement, prayer, and support. This is right and biblical (25).”
Christian psychiatrist Richard Winter similarly opined:
“Others have suggested parakleo is a more appropriate Greek word to associate with counselling. It means one who ‘beseeches,’ ‘comforts,’ ‘comes to one side,’ ‘entreats,’ and ‘consoles’…both words are applicable to the concept of Christian counselling. At times one is ‘weeping with those who weep,’ ‘bearing one another’s burden’ and at times one is confronting (26).”
Dr Phillips concurs:
“Nouthetic Counseling thus reduced everything to issues of behavior that can be confronted nouthetically. As Adams put it here, ‘when they raise questions about life, pain, meaning, and purpose and the like, though they may not realize it, they are talking about problems with God. Every complaint—and men are full of them—in the final analysis is against God.’ All human problems are thus reduced to moral confrontation (27).”
In other words, those whose only tools are hammers treat all problems as nails. To be fair, these criticisms are leveled specifically at the nouthetic party; CCEF has mitigated these problems to a degree, although it has introduced others (see below).
Another criticism has been raised vis-a-vis the amount of time appropriate to spend with a client who may not be meeting the therapist’s expectations for problem resolution. According to Phillips:
“One can be sympathetic of this approach(ie nouthetic counseling – ed) because it aims to forestall what Adams called ‘blameshifting’ and the victim mentality. However, the liability is that it gives insufficient attention to the important contexts and causes of sin and that it leads to a highly pragmatic and behaviorist approach to the human person. In his PhD thesis The Biblical Counseling Movement: History and Context, David Powlison wrote that
“‘Adams’ counseling was oriented towards producing specific action, toward building new skills and habits in his counselees. His counseling was a training program in problem-solving, a ‘how-to’ course in godly living. He exhorted his readers, ‘Problems must be viewed as projects, not topics.’ … He believed that motivated counselees could change relatively rapidly but not instantly. He thought most discrete problems could be significantly remedied in six to twelve weeks if both counselor and counselees stayed on task.’
“Adams push for instant results, his rapid but superficial methodology meant that more complicated cases could fall through the gaps. In an article that Richard Winter wrote titled, ‘Jay Adams – is he really biblical enough?’ Winter said
“’I would imagine that those who find it difficult to change rapidly do not stay with Jay Adams in counseling and are seen by him, not as failures in his theory or method, but rather as people who are in deep rebellion or sin. It goes without saying that this may be damaging to such individuals (28).'”
This is an odd position for a system which claims to uphold the sufficiency of Scripture, given Scripture’s silence on how long a counseling relationship should continue. One might retort that stringing a counselee along for an hefty hourly fee sounds mercenary, but if the counselor is up front with him that the desired result may require a long haul then the counselee is free to dispose of his time and money as he sees fit. Once again, though, this accusation of quick fix applies to the nouthetic rather than the Biblical counselors.
Both Biblical and nouthetic counseling claim the high ground of sufficiency of Scripture, but supporting that claim might prove difficult. Characteristic of Biblical counseling is concept of “idols of the heart,” which are anything challenging one’s devotion to God. In an article entitled “Idols of the Heart and Vanity Fair” Powlison stated:
“The notion of idolatry most often emerges in discussions of the worship of actual physical images, the creation of false gods. But the Scriptures develop the idolatry theme in at least two major directions pertinent to my discussion here. First, the Bible internalizes the problem. ‘Idols of the heart’ are graphically portrayed in Ezekiel 14:1-8. The worship of tangible idols is, ominously, an expression of a prior heart defection from YHWH your God.3 ‘Idols of the heart’ is only one of many metaphors which move the locus of God’s concerns into the human heart, establishing an unbreakable bond between specifics of heart and specifics of behavior: hands, tongue, and all the other members. The First Great Commandment, to ‘love God heart, soul, mind, and might,’ also demonstrates the essential ‘inwardness’ of the law regarding idolatry. The language of love, trust, fear, hope, seeking, serving—terms describing a relationship to the true God—is continually utilized in the Bible to describe our false loves, false trusts, false fears, false hopes, false pursuits, false masters (29).”
The problem with this metaphor is that that is not how Scripture uses the phrase. Since Powlison, like Adams, adheres to the Reformed faith, let us look at how The Reformed view Ezek 14:1-8. John Calvin wrote: “First, he says that they have set up idols in their hearts; by which words he means that they were addicted to superstition, so that idols obtained a high rank in their hearts…so on the other hand the Prophet says that these men had given supreme sway to idols (30).” Per Matthew Poole: “Have set up their idols in their heart; resolved idolaters, their heart was totally addicted to their idolatrous worship and ceremonies; immersed in it (31).” Since the idols Ezekiel referred to were literal rather than metaphorical, there is no reason to interpret the text metaphorically. Adams similarly opines:
“It would be interesting—perhaps even very helpful—IF we were told in the Bible that we could look for, and discover, distinct, so-called ‘idols of the heart,’ but what Solomon, speaking to God, said is ‘You know the heart, for You alone know every human heart. (1 Kings 8:39 HCSB).’
“It would make counseling easier, I agree, but, then, there’s that clear statement that ‘God alone knows the heart.’
“It’s time, therefore, for those who do so, to stop devising systems for doing what He ‘alone’ can do. Besides, the Bible doesn’t speak of ‘idols of the heart’ anyway. It does speak in Ezekiel—once—of the idols that the Israelites were carrying on/in (both prepositions are used) their hearts as they were being deported to Babylon to remove idolatry from their midst. They took them along in their minds since they could not carry the physical idols themselves. But there is nothing about producing idols in the heart. By the way that you continually hear about idols of the heart, you’d think that the Bible required counselors to look for them. It doesn’t (32).”
In other words, the Biblical counseling pot is calling the Christian counseling kettle black; that is to say, each adds to Scripture in its own way.
Can the same be said of nouthetic counseling? Phillips answers with an emphatic yes, charging nouthetics with being a baptized form of behaviorism:
“If counselors must ignore idols of the heart, then what must counselors look for according to Jay Adams? With B.J. Skinner the answer is simple: behavior.
“I do not say that the Nouthetic focus on only behaviour can never work. In fact, I do believe that in many contexts it can be useful. I can say this because I take an integrationist approach. Precisely because people are so complex and different, we must remain open to a creative application of a variety of approaches and not get locked into just one. But that is precisely what the one-size-fits-all Nouthetic paradigm denies when it rejects the entire discipline of psychology and psychoanalysis. It is the same problem with all the other psychological theories that use a single-factor explanation to explain all of experience…
“The Nouthetic model fails to understand people as God actually created them because it fails to attend to the whole of their life experience. It circumscribes the behavioral to being the most important and denies the relevance of issues that may be upstream of behavior… Given its behaviorist orientation, the Nouthetic model tends to reduce all human neurosis to either organic dysfunction or sin. Emotional, social or psychological problems that do not fall into one of those two categories didn’t seem to exist for within Adams’ schema. Not surprisingly, therefore, sociocultural and interpersonal trauma received scant treatment in Adams’ voluminous writings. By reducing all human problems to issues that can be addressed with either medication or direct moral confrontation, the Nouthetic model ended up excluding vast swabs of the human person from the picture.
“Again it is worth repeating that even when the problems that sin creates are manifested in issues of specific behavior, in order to address these issues it is sometimes necessary to back upstream and consider the broader effects of fallenness in the entire network of a person’s social, relational, emotional and psychological background. These more diffuse issues can sometimes be like pealing off the layers of an onion before you even get to the point of being able to deal with the specific areas of sin and idolatry. It is this aspect which Nouthetic counseling functionally denies. ‘Nouthetic counseling in its fullest sense,’ Adams once wrote, ‘then, is simply an application of the means of sanctification.’ Seeing everything in terms of behavior and sanctification led Adams to minimize the sense in which meeting one’s psychological and social needs can also play an important role in a counselor’s goals(33).”
According to Winter:
“Jay Adams’ methods of counselling are strikingly similar to behavioural counselling. Certainly with his analysis of presentation problems, performance problems, and pre-conditioning problems he could have taken this straight out of a behavioural textbook. He also stresses ‘modelling,’ ‘role-play,’ ‘homework’ and other things which are common in behaviouristic jargon. He emphasises that in doing the right thing, practising the right response, the right feelings and attitudes will follow.
“Jay Adams would presumably say that he found these methods in scripture and that he has not borrowed from the behaviourists. But can he insist, as we have seen earlier, that the behaviourists do not have any insights true to the way we are made (34)?”
Journalist Kathryn Joyce observed:
“In practice, despite its rejection of secular psychology, biblical counseling draws both on psychoanalysis, with its focus on getting to the root of problems, and on behaviorism, with its stress on correcting habits. A constant refrain in biblical counseling is the command for counselees to ‘put off’ bad and sinful thoughts, and to ‘put on’ biblical, God-pleasing thoughts instead (35).”
To paraphrase these three observers: if nouthetic and Biblical counseling walk and quack like integrationist ducks, then integrationist ducks they are; what is really at the heart of the issue between the schools is the degree and manner of integration. One might argue that the nouthetic and Biblical schools filter secular technique and doctrine through the sieve of Protestant orthodoxy and radically reinterpret what passes through the screen, but that leaves us with the issue of the porosity of the filter. The picture changes from one of two radically opposed positions to that of ends of a spectrum, and which end is most consistent with the teachings of Scripture.
(29) republished at http://www.ccef.org/idols-heart-and-vanity-fair
(30) Calvin’s Commentaries (Grand Rapids, MI: Baker Books, 1993)
(31) Poole, Matthew. A Commentary on the Holy Bible (Carlisle, PA: The Banner of Truth Trust, 1975)