Pastoral Competence

One of the accusations leveled against conservative believers is the common charge that our pastors are not professionally trained or certified, and consequently, when it comes to counseling parishioners, are in way over their heads. Whether the issue is clinical depression, or dealing with childhood abuse, or fighting addiction, or any other number of serious but common afflictions, the charge is that however exegetically adept a man may be at exposition of the book of Romans, when it comes to issues like these, he is necessarily out of his depth.

And these I have called love, joy, peace, patience, kindness . . .
And these I have called love, joy, peace, patience, kindness . . .

There are a number of observations in response to this, which really need to be taken together as a whole. Any one response, however cogent in itself, will not help us understand what is actually going down.

When it comes to the heart of man, which is, like the rest of him, fearfully and wonderfully made, the mystery of sin can do a lot of mysterious damage, and the impact of the fall can show up in lots of places, including in our physiology. The body is not simply a carrying case for the soul, which in its turn can be easily fixed with spiritual platitudes and nostrums. It ain’t that easy. But neither is the spirit of man helplessly carried along on a river of chemicals, helpfully supplemented by tributaries flowing into it from the local pharmacies. The proper conclusion should be that everyone is in over their heads. The proper demeanor is humility, and OCD ought not to be treated as though it were a busted transmission. In helping people with such issues, we are always dealing with moral agents, and never with a simple mechanism.

Having restricted the likelihood that anyone can just waltz in and “fix things,” it has to be recognized and acknowledged that there are many counselors who do make things worse. This is the case for counselors inside the church, and it also true with secular counselors. The difference is that incompetent pastors will make things worse for free, while secular incompetence charges by the hour. So to resist the therapeutic imperative does not require us to say in response that every conservative pastor knows what he is doing.

At the same time, a pastor can confess himself to be medically untrained, and yet remain a competent (and confident) pastor. This is because the Scripture teaches us how to deal with all sorts of issues that really are spiritual in nature, but which have been medicalized in a society that has become radically therapeutic in its default assumptions.

The fact that one country is clearly here and the other country clearly there does not eliminate the possibility of disputed territory between them. And when the dispute arises, the Canadians do not get to say something like “don’t tell us what the Canadian countryside looks like. We have lived here all our lives.” Yes, quite, but Saskatchewan over there looks an awful lot like North Dakota over here. In either place, as the joke goes, when your dog runs away, you can see his tail for three days.

So I quite grant that we ought not to treat a radical chemical imbalance in the brain with lively exhortations to “pray more” — but it also needs to be said that folks on the other side of the border ought not to treat true gnawing guilt with Zoloft.

So a believing and competent medical doctor and a competent pastor can work together, recognizing that their mutual competencies and areas of expertise do overlap. (Incidentally, granting this does not require us to also assume the expertise of hostile observers from two thousand miles away, provided they also have an Internet connection, a CAPS LOCK on their keyboard, and a spittle-flecked monitor.)

Wise pastors are involved in the cure of souls. Many of the psychological traps our generation is struggling with are caused by (or exacerbated by) true guilt, lack of real forgiveness, and cancerous bitterness. Remove those, deal with those effectively, and a lot of medicine cabinets would be a lot less crowded.   “I myself am satisfied about you, my brothers, that you yourselves are full of goodness, filled with all knowledge and able to instruct one another” (Rom. 15:14, ESV).

So in saying these things, I do not at all deny the effectiveness of some medical treatments in helping deal with some “spiritual” problems. What I am denying is the deity of the certified classes. And in affirming the sufficiency of Scripture, as I do, I am not affirming the sufficiency of pat answers that are festooned with Bible verses. “Brethren, be not children in understanding: howbeit in malice be ye children, but in understanding be men” (1 Cor. 14:20).

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Benjamin Bowman
Guest

If I’m ever in Moscow I owe you a beer for how good of a post this is.

Kevin Bratcher
Guest

Thank you for this!

I see too many Christians jumping on the “It’s a disease” bandwagon for all the popular diagnoses, with little regard to where the wagon’s going or who is driving.

“Because of you, you only, have I suffered a disease that caused all my sins, so that I am blameless when you speak, and justified though you judge”

– Psalm 51:4 – “DSM-V” translation.

holmegm
Guest
holmegm

And I heard him, sort of, grant the reality of mental illness.

A post almost worthy of a politician … something for everyone …

Kevin Bratcher
Guest

…Are you under the impression that there’s no such thing as a mental illness?

holmegm
Guest
holmegm

No, I’m not. Many evangelicals are though.

Rob Steele
Guest
Rob Steele

We really do demand a lot from a pastor. He’s got to be scholar, preacher, counselor, administrator, and faithful steward of the message. Mere human beings are not sufficient for these things.

adad0
Member

Good thing there is The Word, The Spirit and fellowship!????

Capndweeb
Guest
Capndweeb

AMEN! (Yes, I felt caps lock was appropriate just then. Push me on the issue and I shall assail the enemy with an “HALLELUJAH!”)

insanitybytes22
Member

Ha! We do demand a lot of pastors and mere human beings are not sufficient for these things. They just light the path to the One who is.

Becky Pliego
Guest
Becky Pliego

Thank you, Pastor.

adad0
Member

Though you are affirming the propriety of good answers, supported by The Word! : – )

Virgil Hurt
Member

Well said, Doug.

valerieab
Member

“the deity of the certified classes”

When you insert an EGO into an MD, what does it spell?

drewnchick
Member

Did you just come up with that, or have I missed a witty saying all these years? I like…

valerieab
Member

I came up with it maybe 20 years ago and dust it off every once in a while when it comes in handy. ;^)

Rob Steele
Guest
Rob Steele

Megod? Oh, I get it. I once heard a nurse decry the effects of the M-Deity degree. And doctors are notorious in the pilot community for being overconfident of their abilities.

valerieab
Member

Happily, it is not a malady universally suffered by the medical profession.

Ochre
Guest
Ochre
Steve H
Guest
Steve H

As someone who takes medication for mental illness, I would have loved it if my pastor and my Dr. would have been in communication. This is entirely non-existent in my experience. How would one even begin to go about this? Is it even legal (not that I care too much)?
What is interesting is that Psyciatrists will collaborate with Cognitive Behavior Psychologists. IMO those psychologists have invented new techniques to replace the pastor.

Jill Smith
Member
Jill Smith

I think most psychiatrists are not all that good about collaborating with one’s general practitioner, let alone one’s clergyman. I think there is also a tendency for many psychiatrists to see a patient’s religious beliefs as part of their pathology. I have had years of excellent and effective eating disorder treatment, but almost all of my caregivers have seen my Catholic faith as the problem. This might be true if the lunatic thoughts that drive an eating disorder (“God only loves me when I am thin”) were something actually taught by the church!

insanitybytes22
Member

I so agree with you, Jilly. In the secular world, faith really is perceived as a problem, as a disorder. Woe be to anyone who arrives for a mental health evaluation speaking of angels, for example.

I grew up under some pretty horrific conditions, total secularism, militant atheism, and yet the root of any issues I may have had to deal with? Always allegedly faith based. I’ve never experienced any problems within the church, no abuse from Christians. Just the same, my religious beliefs are frequently perceived as part of some kind of pathology.

BooneCtyBeek
Guest
BooneCtyBeek

“The difference is that incompetent pastors will make things worse for free, while secular incompetence charges by the hour.”

I was counseling a couple for marriage problems. They apparently did not like my advice and went to a paid counselor. After a few weeks they made another appointment with me. Asking why, they told me that this other counselor told them the same things but they were paying $60 an hour for it.

They followed through and are doing quite well 20+ years on.

Bike bubba
Guest

It’s worth noting that one of the big reasons credentialism is so big in this area is because the actual record of those doing the work isn’t that hot. One of the bright lights of the profession is, in my mind, Keith Ablow, who while advocating a bigger role for mental health professionals, is at least honest enough to admit there are a ton of things we simply don’t know. And while there are certainly disasters in nouthetic counseling, I can also cite a litany of examples from the “professionals” in secular counseling made “What about Bob?” and “Miracle on… Read more »

drewnchick
Member

And the reason there are a ton of things we simply don’t know is that we (psychologists/psychiatrists) have tossed out the User Manual on life, the universe, and everything, which necessitates a hastening to fill the gaping void in our knowledge base, unfortunately with platitudinous pabulum.

PerfectHold
Guest
PerfectHold

“you yourselves are full of goodness, filled with all knowledge and able to instruct one another”

Does this competency rely on knowledge of Scripture?

Sandra Koke
Guest
Sandra Koke

My experiences line up nicely with the ideas in this post. Three psychiatrists, 2 social workers and maybe 5 years of Zoloft later, I wonder if I could have saved myself a lot of grief if I had had a vibrant faith and Biblical perspective from the outset. I am thankful for the (real) help I received from the medical establishment (of which I am also a member myself), but I’m pretty sure if it weren’t for Biblical principles and Biblical counseling I’d still be on medication and/or in therapy. I have a rampant family history, too – suicide, shock… Read more »

Ochre
Guest
Ochre

Hallelujah! Thanks for sharing this.

Hannah
Guest
Hannah

Thank you for this post! As a Christian and an about-to-graduate nurse, I have worked extensively with some serious psych patients. I have had to deal with both those Christians who think that all mental illnesses can be cured through spiritual intervention and those psychiatrists who think all mentally ill persons just need meds. The reality is that most psych patients have a combination of physical and spiritual factors, with a (smaller) number who may be solely on one side or the other. Thanks for the succinct expression of this!

insanitybytes22
Member

This was awesome. People are mind, body, and spirit and should be cared for as such. Sadly, much of secular medicine and psychology does not recognize the complexity of human beings and treat us accordingly. Even those with genuine chemical imbalances have an emotional and spiritual life.

drewnchick
Member

When you deny the Creator and view His creation as random molecules banging together, why would you conclude anything other than fixing things with encapsulated bits of random molecules?

Andrew Lohr
Member

‘A good friend could tell you what I’m telling you,’ an OK Christian counselor told me. ‘80% of what an M.D. can do for you a good friend could do for you,’ wrote an M.D. (40 or so years ago), in a book called “Confessions of a Medical Heretic;” 10% of cases are hopeless; in the other 10% a doctor can make a difference. I’m sure the percentages have changed toward the doctor, but a chunk of stuff is still plain wisdom. And one thing driving Martyn Lloyd-Jones, M.D., from medicine into preaching was indexing his boss’s notes about patients,… Read more »

Scott Cottrill
Guest
Scott Cottrill

After graduating with a masters degree in counseling psychology in 1980, I decided to take a few years off and work before going on for my PhD. I had dreams of being a “Christian psychologist”, but once in the work force, I became disillusioned by the almost universal credibility so-called psychological experts were given, especially in Court. I’ve renounced most of the psychobabble and believe that nouthetic counseling is the most effective form of counseling for those in need of counseling. This is not to say that there aren’t true medical conditions requiring medicative intervention. However, most people do not… Read more »

Andrew Bieber
Guest
Andrew Bieber

Amen!

Crowhill
Guest

I distrust psychologists and professional counselors immensely. IMO they start with a completely loony anthropology and add dysfunctional left-wing social ideas on top. Having said that, there are some things where you really do need professionals. Addiction, for example.

ArwenB
Guest
ArwenB

depends on the counselor.

Sometimes it can be enormously helpful to have a completely neutral party hear your woes and help you hear all the excuses you are making.

Whether you pay the neutral party in cash or in a round of drinks at the local hole-in-the-wall, well….

Ryan Sather
Guest
Ryan Sather

Wise counsel and a very helpful and balanced view. Thanks for writing this.

adad0
Member

R.S., frequent readers of this blog must have noticed your constructive and positive comment!

(It is possible for comments to be both constructive and negative.)

‘ Hope this is the start of a constructive trend, more positive than negative.

Some might even be praying for it! ; – )

Bro. Steve
Guest
Bro. Steve

Whenever I mentioned in a sermon the huge problem of over-prescribed antidepressants in America, I got immediately challenged on the subject, usually with resentment and hurt feelings. “There are people who really need this!” Yes, of course. I get that. But is it really true that one person in eight needs drugs just to cope with life? And if it’s not, can we shift the discussion of competency to the medical community where far too many doctors have become pushers and have made their patients into junkies? (http://www.cbsnews.com/news/study-shows-70-percent-of-americans-take-prescription-drugs/)

Scott Cottrill
Guest
Scott Cottrill

Our local hospitals are ruled by the exit questionnaires that ask about your experience being treated during this visit. If the patient doesn’t give a 4/5 or 5/5 the doc is penalized by the hospital and hospital by the insurance companies. The result is anyone who complains of pain is given excessive prescriptions for opiates. Doctors in turn are becoming drug pushers, and unfortunately it’s all perfectly legal. Then when they are effectively hooked, there is this other segment of the medical community who deal with addiction therapy. They over-prescribe drugs like Suboxone and Subutex in such high doses that… Read more »

holmegm
Guest
holmegm

What’s puzzling though is how you “know” this.

Do you also know what percentage of people should need heart drugs? What if the actual number just “sounds” too high to you?

Something to think about, anyway. Check out Against Depression, by Peter Kramer, for some thoughtful discussion. Thought-provoking, anyway.

Conserbatives_conserve_little
Guest
Conserbatives_conserve_little

The way the laws are currently set up, such a collaboration is highly unlikely. HIPAA laws are pretty much designed to isolate the patient. Thank the about ration industry fro that one

Jane
Member

“Abortion industry”?

Conserbatives_conserve_little
Guest
Conserbatives_conserve_little

Do you think they didn’t have a hand in it?

ArwenB
Guest
ArwenB

She’s just confirming the true identity of your apparent typo.

Dee Parsons
Guest
Dee Parsons

My husband is a cardiologist and I am a nurse. HIPPA does not prevent collaboration so long as the patient approves, in writing, on the sharing of information. This means that the pastor and doctor cannot do an end run around the patient without his/her knowledge.

ashv
Guest
ashv
Brian Carn
Guest
Brian Carn

Hello Brothers and Sisters in the world and in Christ that use to chart with me on my Official face-book Page. Out of my busy times in the ministry i took this time to tell everyone to please be aware of fake profile claiming to be me on face-book as i just shut down my face-book profile and also ask my agents to shut there down also..Do not accept any friend request or add anybody clamming to me on face-book again, As am no longer on social network.I will tell everyone about myself as I Prophet Brian Carn was born… Read more »