The Biological and Biblical Dangers of Problem-Centered Counseling
In our recent book, Christ-Centered Ministry versus Problem-Centered Counseling, we reveal the origins of problem-centered counseling. We say that the psychological counseling movement inherited problem-centered counseling from, among other things, the Mesmerian and Freudian precursors. We show in our current book and in past writings the parallels between the psychological counseling movement and the biblical counseling movement and particularly both movements' orientation to problem-centeredness.
The American Association of Christian Counselors (AACC) is re-offering a program titled "Caring for People God's Way II." AACC claims that "More than 50,000 individuals and churches enrolled in the original program." Their first come-on question for their $400 enrollment fee is: "Do you find that family and friends often come to you for help with their problems?" (Bold added.) This is just one of numerous examples of how problem-centered counseling has become the be-all and end-all of those who call themselves Christian counselors.
Talking about problems should not be the central content of personal ministry in the Body of Christ. Problems should be seen as opportunities for drawing close to the Lord and for growing spiritually. We are not saying, "Do not talk about problems!" This is not an either-or situation; it is a matter of where the emphasis lies and how problems are addressed and used to motivate a believer to turn to the Lord, follow Him, and be further transformed into the likeness of Christ. We are advising believers to minimize and generalize talking about problems and to maximize and specialize in using problems as reminders to draw close to God. Preoccupation with problems and seeking solutions through counseling often inhibit spiritual growth. Put simply, Christ must be the center of Christ-centered ministry, whereas problems tend to be the center of problem-centered counseling.
In certain situations there are biological and biblical reasons why one should not use problem-centered counseling.
Problem-centered counseling can be particularly dangerous where there are undetected physical disorders. During the history of psychiatry and psychotherapy, there have always been and still are undetected physical diseases that were and are treated as mental disorders. Two examples are general paresis, caused by the spirochete of syphilis invading the brain, and pellagrous psychosis, caused by a dietary deficiency of nicotinic acid. In both cases numerous people who have suffered from these diseases were labeled schizophrenic and treated accordingly. The following account is just one of many case histories involving misdiagnosis.
A twenty-two-year-old woman exhibited certain symptoms similar to those of schizophrenia. Rather than suggesting a comprehensive physical exam, the psychiatrist to whom she was referred diagnosed her condition as schizophrenia and treated her accordingly. However, it was later discovered that her depression and hallucinations were due to pellagrous psychosis, which had been brought on by a crash diet and near starvation conditions.
Treating such a person with psychotherapy or psychotropic medication, instead of treating the physical problem, not only prevents possible cure, but also adds even more horror to the agony of the disease itself. Can you imagine how many people have suffered from such physical diseases and have been treated psychologically by a psychiatrist or psychotherapist because of ignorance of the real problem? Even Parkinson's disease was once considered a mental disorder and treated by means of psychotherapy.
This raises the whole problem of misdiagnosis and the tendency to refer people to psychotherapy. There have been and still are great numbers of individuals erroneously referred to psychotherapy who are really suffering from physical disorders. Sydney Walker III, a neuropsychiatrist, says:
Each year, hundreds of thousands of Americans who are actually suffering from common medical conditions such as hyperthyroidism, Lyme disease, and even poor nutrition are misdiagnosed with psychiatric disorders. Studies show that the rate of misdiagnosis is more than 4 in 10.
There is a whole range of bodily disorders that have mental-emotional, behavioral symptoms. Some of these biological disorders are in their embryonic stages—not yet detectable. These symptoms can result in personal discomfort and interpersonal problems. Very often, in the absence of a verifiable disease, problem-centered counselors will deal with such problems as psychological or spiritual problems. However, a Christ-centered minister will help persons, whatever the origin of the symptoms, by moving as rapidly as possible from problem-centeredness to Christ-centeredness and by using the problems as a catalyst to draw closer to Christ. We are both biological and spiritual beings. Therefore, when appropriate, the helper will suggest that the seeker look into his physical condition.
There are doctrinal reasons why a person seeking ministry should not discuss certain problems of living with others and why helpers should neither encourage them to do so nor participate in such talk. We discuss only four of the many biblical doctrines violated by psychological and biblical problem-centered counseling approaches.
Violating the One Flesh of Marriage
Marriage provides many opportunities for spiritual growth. But instead of using these constructively, partners often focus on problems, blame each other, and want the other partner or circumstances to change. Instead of seeking the Lord to work in their own lives, they go to counseling, talk about their problems, and expect the counselor to do something (change circumstances or the other partner). Quite often people want the counselor to help the other partner see their point of view. If the counseling does not fix the problems, the people feel they have done everything they can, figure there is no hope for change, and move into the direction of separation and divorce—all at the expense of their precious children's well-being.
Marriage counseling is big business in the world and in the church. As more and more people have been going to marriage counseling, more and more have become divorced, and this includes professing Christians, who are divorcing at about the same rate as unbelievers.
What does the Bible say?
Submitting yourselves one to another in the fear of the Lord (Eph. 5:21).
Wives, submit yourselves unto your own husbands, as unto the Lord (Eph. 5:22).
Husbands, love your wives, even as Christ also loved the church, and gave himself for it (Eph. 5:25).
Based on these verses, we conclude that the following problem-centered counseling activities are unbiblical:
1. It is unbiblical to discuss martial problems with others or complain about one's spouse in each other's presence. If a husband is loving his wife as Christ loves the church, he will not be exposing her weaknesses and failures to others (including the children). If the wife is honoring her husband, submitting to him (as the church to Christ) and loving him (Titus 2:3-4), she will not be exposing his weaknesses and failures to others (including the children). Of course, there are necessary exceptions, such as physical or sexual abuse in a family or such sin as pornography, illegal drug use or drunkenness, which should be brought to the attention of the church leadership and, in cases where civil laws have been broken, should be brought to the attention of civil authorities.
2. It is unbiblical to discuss marital problems with others or complain about one's spouse in his/her absence. Proverbs 18:17 says, "He that is first in his own cause seemeth just; but his neighbour cometh and searcheth him" (Prov. 18:17). Very often one spouse will attempt to get a counselor or friend to see a situation from that spouse's perspective by talking about the other spouse in his/her absence. The one who is first to state the case may gain support from the counselor or friend, but the truth may be revealed later. Furthermore, this kind of gossip leads to a further rift in the marriage relationship. It ends up being the kind of gossip that separates people. Proverbs 17:9 advises, "He that covereth a transgression seeketh love; but he that repeateth a matter separateth very friends."
3. It is unbiblical to discuss marital problems with others for the purpose of getting a spouse to change. If people are in a personal conflict with another person and believe that it is primarily the other person's fault, they are wasting a valuable opportunity if they are trying to change the other person or simply hoping for the other person to change. Such conflict can be an exceptional opportunity for spiritual growth. If one's eyes are on the other person and that person's need for change, one can get bogged down and waste the opportunity. Every difficulty in life is an opportunity for spiritual growth (Romans 5:1-5; Romans 8:28-29). So often believers pray for God to change the other person when they themselves are in a perfect place to draw close to the Lord, to come to know Him more deeply, and to love Him more completely. All believers have numerous opportunities to focus on their own relationship with Christ, to look to Him to work in their own lives for spiritual growth, and to confess their own sins rather than the shortcomings and failures of others. Shifting the focus to how others must change defeats the purpose of spiritual transformation and growth (see Genesis 3:12-13).
Dishonoring Father and Mother
Problem-centered counseling, when looking for the source of problems in a person's upbringing, usually leads a person to violate God's commandment to: "Honour thy father and thy mother: that thy days may be long upon the land which the LORD thy God giveth thee" (Exod. 20:12). Even if a seeker is having problems, the fifth commandment must be obeyed. This commandment requires just what it says—honor to mother and father. This would necessitate not dishonoring mother and father to a "third party," especially when they are not there to respond (Proverbs 18:17).
Problem-centered counselors often permit their counselees to dishonor their mothers and fathers. They often encourage and participate in the process. Those who follow the Freudian formula will dishonor their mothers and fathers by blaming them for their current problems and particularly by blaming their mothers. It is unbiblical to do so.
Christ-centered ministers do not need to talk about the seeker's mother and father, but will encourage the direction away from parental blame and towards a focus on growing spiritually in the likeness of Christ. Jesus, the Word of God, and the work of the Holy Spirit will be the emphasis. After all, every true believer has been born again and has a new Father, a new family, and an indwelling Holy Spirit.
Blaming the Past
Brethren, I count not myself to have apprehended: but this one thing I do, forgetting those things which are behind, and reaching forth unto those things which are before, I press toward the mark for the prize of the high calling of God in Christ Jesus (Phil. 3:13, 14).
There are good reasons why the Apostle Paul, under the unction of the Holy Spirit, set himself as an example to follow. Though it is unbiblical to do so, many problem-centered counselors emphasize and dwell on the past. Dwelling on the past can be a great impediment to pressing "toward the mark for the prize of the high calling of God in Christ Jesus."
In addition, focusing on the past majors on what was done to the old man of the flesh, which is to be put off rather than to be "healed" or fixed. Turning to the past to find reasons for present problems places blame on others and circumstances rather than on one's own responsibilities and possibilities. Because of the nature of memory, remembering the past cannot be done without enhancing, embellishing, omitting, or creating details to fill in the blanks. Therefore, this is a faulty method of help because of the brain's limited ability to remember and tendency to distort.
Christ dealt with every believer's past at the cross when he died for their sins. When believers identify with Christ's death and resurrection they are free from the past of the flesh as well as the power of the flesh. They have a new life in Christ and are to live according to that new life. Attempts to heal the hurts of the past are futile because one is not to heal that which is to be counted dead and buried. Such attempts give power to the flesh and will result in fleshly living in place of walking according to the Spirit. Christ-centered ministers will encourage and help a seeker to leave the past at the foot of the cross and to "press toward the mark for the prize of the high calling of God in Christ Jesus."
Centering on Self and Empowering the Flesh
That ye put off concerning the former conversation the old man, which is corrupt according to the deceitful lusts; And be renewed in the spirit of your mind; And that ye put on the new man, which after God is created in righteousness and true holiness (Eph. 4:22-24).
Then said Jesus unto his disciples, If any man will come after me, let him deny himself, and take up his cross, and follow me (Matt. 16:24; also see Mark 8:34 and Luke 9:23).
I am crucified with Christ: nevertheless I live; yet not I, but Christ liveth in me: and the life which I now live in the flesh I live by the faith of the Son of God, who loved me, and gave himself for me (Gal. 2:20).
As we have said elsewhere: The client (i.e., the self) comes with a problem. The counseling is directed at the self with the problem. Thus, problem-centered counseling is actually self-centered counseling. The two are inextricably linked. It would be appropriate to refer to this unbiblical activity as problem/self-centered counseling.
Focusing on Problems
A person seeking counsel generally does so because there is a problem. Thus, the problem becomes the center of the counsel. Problem-centered counseling spends much time going over problems (often in great detail) to discover the source of the problems. However, this long process ends up being guesswork. Psychological counselors may attempt to find the source in the unconscious and the past (parents and circumstances) or in the person's present circumstances and erroneous thinking. Biblical counselors may attempt to find the source in what they refer to as the idols of the heart (Jeremiah 17:9-10) and/or to identify sins related to Bible verses, e.g. drunkenness (1 Cor. 6: 9-11). Nevertheless, just as Job's three friends pontificated much about the source of Job's problems, they were only guessing according to their own limited knowledge and understanding. They ended up falsely accusing Job and misrepresenting God. Only God knows the heart and what must be changed. People can see outward sin and may be called to confront such when necessary, but too much problem-centered counseling is based on assumptions about the person. Even if the source could be accurately identified, does that bring a solution or merely a reason or excuse for the problem?
According to Psychotherapy Networker, a journal for mental-health professionals, "80% of therapists in private practice do couples therapy" (Vol. 26, No. 6, p. 28). Think about the following scenario:
A couple with a problem comes to a therapist for counseling. In order for the counseling to be done the couple has to describe the problem. He says, she says, and then typically the therapist asks questions that lead more deeply into the details of the problem. The two spouses often challenge one another or sometimes disagree with each other's assessment of the problem. The therapist has been trained not to take sides but to referee the interactions over the airing of problems, typically without judgment, though this is changing among some counselors who now want to take sides. When the therapist knows enough, suggestions and recommendations are made to improve the problem with a hopeful commitment on the part of one or both spouses to work on improving the problem. A future appointment is scheduled for the couple to come back and report on their progress with the problem or lack of it.
Whether it's a couple or an individual, the scenario is quite similar. The problem, whatever it might be, is central to all the conversation carried on. Because the counselor's role is problem solver, the problem-centered counselor has to know about the problem. The problem-centered counselor needs to hear the problem explained; try to understand it according to some theory or guesswork; and offer some kind of solution. En route to suggestions and assignments, if given, there will no doubt be a violation of the biblical principles described in this article: violating the one flesh of marriage, dishonoring Father and Mother, blaming the past, centering on self and empowering the flesh.
Looking unto Jesus
In Christ-centered ministry the person coming alongside does not need to know the specific problems or the details. Neither is there a necessity to guess at what might be the source. Instead, both the seeker and helper are to deal with life biblically and spiritually. Walking according to the Spirit is living by Christ's life and therefore walking in love.
Love is always the issue in the Christian life. Love is to be nourished and encouraged in one another. There should be a constant flow of love, which includes mercy and truth. Love also includes obedience to the Lord. Therefore, if there is known sin, the flow of love is diminished.
The focus of ministry should not be on the problems. Focusing on the problems and rehearsing wrongs committed against oneself tend to increase the intensity of the problems. Therefore talking about problems is discouraged and seeking the Lord and His Word is encouraged.
What? How can problems be handled if they are not carefully described? First of all, God knows the problem completely. He knows what needs to be changed in each person involved. The person who comes alongside will only get a partial view at the most.
In Christ-centered ministry, the emphasis is on Christ and Him crucified and all that involves. As Paul declared, "But we all, with open face beholding as in a glass the glory of the Lord, are changed into the same image from glory to glory, even as by the Spirit of the Lord" (2 Cor 3:18). As we know Christ more and focus on Him—His love, His sacrifice, His patient endurance, His long-suffering, His peace, His joy—we become more like Him. Then as the fruit of the Spirit grows in our lives, we will learn to love the way He loves, rest in His peace that passes understanding, and even experience His joy—the kind of joy that enabled Him to endure the cross.
The Christ-centered helper and the seeker will be studying and applying the Word of God. They will be spending time in God's Word so that the Holy Spirit will have opportunity to work in them both.
For the word of God is quick, and powerful, and sharper than any two-edged sword, piercing even to the dividing asunder of soul and spirit, and of the joints and marrow, and is a discerner of the thoughts and intents of the heart. Neither is there any creature that is not manifest in his sight: but all things are naked and opened unto the eyes of him with whom we have to do (Hebrews 4:12-13).
All scripture is given by inspiration of God, and is profitable for doctrine, for reproof, for correction, for instruction in righteousness: That the man of God may be perfect, thoroughly furnished unto all good works (2 Timothy 3:16-17).
The Christ-centered helper will enter this relationship with the understanding that encouragement and guidelines will be given for the seeker to know the love of Christ in a greater way and to be conformed unto His image. The seeker can learn and use suggestions from the helper. However, the seeker has the final responsibility to discern and do the Lord's will as he goes before the Lord in prayer and seeks help from the only true Counselor.
Brethren, if a man be overtaken in a fault, ye which are spiritual, restore such an one in the spirit of meekness; considering thyself, lest thou also be tempted. Bear ye one another's burdens, and so fulfil the law of Christ. For if a man think himself to be something, when he is nothing, he deceiveth himself. But let every man prove his own work, and then shall he have rejoicing in himself alone, and not in another. For every man shall bear his own burden (Gal. 6:1-5).
A Christ-centered helper moves a person as quickly as possible from problem-centeredness to Christ-centeredness. The helper does not need to know the problem, let alone the details of the problem. Without the client being permitted to talk about the failures of Spouse, Father, or Mother, without the client being able to talk at length about the past, and without the client avoiding self denial, a psychological or biblical problem-centered counselor would probably not know what to do and would even be perplexed. However, any biblical counselor would be unbiblical to encourage or even pursue such talk.
On the other hand, there is much to talk about and do in Christ-centered ministry because it teaches and proclaims Christ and Him crucified and all that the Word says about Him. Nevertheless, because the direction is always towards Christ and the believer's relationship with Christ, the counselor must say with John the Baptist, "He must increase, but I must decrease" (John 3:30). The work is ongoing, but the helper fades more and more into the background.
Christ-centered ministry encourages both denying self and living for and growing in Christ. No one else can do what needs to be done in the seeker as much as what the Lord and the seeker can do together. As Paul urged believers:
Wherefore, my beloved, as ye have always obeyed, not as in my presence only, but now much more in my absence, work out your own salvation with fear and trembling. For it is God which worketh in you both to will and to do of his good pleasure. Do all things without murmurings and disputings: that ye may be blameless and harmless, the sons of God, without rebuke, in the midst of a crooked and perverse nation, among whom ye shine as lights in the world; holding forth the word of life (Phil 2:12-16 a).
Nothing the world offers can even touch what is available to every true believer for living life to the fullest, for growing into the likeness of Christ, and for ministering life to one another. May each of us take courage and minister God's love in mercy and truth and avoid the dangers of problem-centered counseling.
(PAL V12N3 - March-April 2004)
PsychoHeresy Awareness Ministries
4137 Primavera Road
Santa Barbara, CA 93110