Old Heaters & Extra Doorknobs

I recently opened a new  counseling office at St. Philip’s Episcopal Church in the Donelson area of Nashville.  (I am not doing counseling there myself, but am renting that office to other therapists.)  I did the re-decorating of the office myself.  When I first went to the office, it needed a little work.  There was peeling paint, missing trim on the walls, and old light fixtures.  There were also some peculiar things in the office.  The remnants of an old wall heater remained attached to the wall and oddly, there was a second doorknob on the door to the office.  I could see why the heater had been abandoned and why it would be a challenge to remove from the wall without having to do major repair to the wall, but that extra doorknob, I could only imagine how that might have come to be.  Only one of the two doorknobs actually worked.  So, I imagined that at some point the original doorknob had stopped working and was replaced, but the knob was not replaced in its original position, but a new doorknob was placed above the first on the door.  I could not remove the non-functioning doorknob without replacing the whole door.  So, I painted around them both.  

The Work of therapy is not unlike the office.  Like the new office bore the marks of those who had inhabited it previously, our lives and relationships do bear the marks – positive and negative – of our previous experiences.  When we take time to tend to the needs of our internal world, there is much work that can be done to bring about change.  We can replace things that used to work, but no longer work.  We can add things that are missing – new skills, new understandings, and the like.  The work that we do on ourselves can radically change who we are. I could have written about how sometimes, we avoid working on things in our lives because the task seems too big or we fear it will cost too much to do the work we think we need to do.  That might have been a valid reflection, however, I began to think about how in the work of therapy, there are sometimes things about us that just do not seem to change.  For an individual, there seem to be some things about our core personality that remain true no matter what.  John Gottman, in his study of marriages, has noted that two-thirds of the things that couple’s fight about are things that cannot be resolved.  They are issues that cannot be changed or issues that have no easy resolution. 

Part of the work of therapy, is realizing that some things about us or our situations cannot be changed. Such things must be examined and understood as best as possible, but the work of therapy becomes acceptance of the given reality and to working with it.  This can be challenging depending on what the issue is.  However, we can learn to accept and adapt.  We cannot always remove the extra doorknobs of our lives or repair the ones that are broken.  We cannot always remove the things that no longer work without doing more damage or creating more difficulty.  So, we learn to make peace with what is.  We stop fighting against what cannot change and learn to accept.  This may mean accepting certain things about ourselves or about those close to us that are difficult, but it is possible to learn to make peace or adapt. 

If you would like to see before and after pictures of the office, visit https://www.counselingatstphilips.com/news

 

The Story of "Dan"

This is the client story shared at the Pastoral Counseling Centers of Tennessee’s Fundraising Concert Last Night.  It includes a few more details that time allowed last night.  Dan’s story reflects some of what is so meaningful about the work of Pastoral Counseling.

Dan was one of the first clients I ever saw when I came to the Pastoral Counseling Centers of Tennessee (PCCT)  as a trainee.  I saw him regularly for several years.  At one time, Dan had been a fairly successful musician, but that was before he was diagnosed with a pretty serious mental illness.  When I first met him, Dan was receiving medication and case management from another agency, but he had come to the Pastoral Counseling Center because he had a strong sense of faith and he wanted counseling that would reflect his love of God.  He had had seen at least two counselors before me at PCCT.   Early in my work with Dan, he was very focused on his own needs and had a very limited way of looking at the world.   He had a very simplistic and concrete way of seeing the world; almost childlike in many ways.   He sometimes still had delusions of being attacked by Satan and being burned by the fires of hell.  He would call me in between our sessions   sometimes when he was feeling anxious about something and tell me that he was being burned from the inside out by the fires of hell.  I had no way to make sense of this, but I would listen to him and talk with him about the various anxieties in his life, and I would pray with him.  As we talked through the years, he would sometimes tell me of a dark time in his life when he was not medicated for his mental illness and when he often used illegal drugs and alcohol.  He told me of other things that he had done that he was ashamed of and we would talk about those things.   Dan had a guitar, but he had not played in a long time because he associated the guitar with those dark times in his life.  He said he missed playing and so I began to help him think of ways that God could redeem his guitar and take it back from those dark places.  We talked about how his guitar could be a way of mediating God in his life and the creativity of playing could connect him to God’s creativity.  He began playing his guitar regularly and reported that it was a soothing activity.  He would play when anxious and found some relief in that.  Though he had very little money and resources, he began to save money and periodically he would purchase other guitars until he own at least four different types of guitars.   He grew to enjoy finding the various sounds and tunes he could get from each of these guitars.

 Over time, Dan had moved from being focused more on himself to telling me that he really wanted to figure out how to show love to others.  He really wanted to find a way to share the gift of his music with others.  He developed an amazing sense of gratitude.  In the past few years he had been getting “meals on wheels” and he expressed gratitude for those meals every day.  He would describe to me the content of the meals in detail to me and then would say, “I can’t believe how lucky I am that I get this great food every day.”  At Christmas he would sometimes receive boxes from a local church and he would become tearful as he would describe to me the contents of those boxes and he would say, “I can’t believe people are so good to me.” 

     When Dan would feel overwhelmed by the things of his life, he would come and talk things through with me and he would always come back to an affirmation that he knew that God loved him and things would be okay.  I tried to work with him so that his experience that God would provide him could help him avoid feeling anxious, but he seemed to always have something that he was concerned about.  Dan took the bus to our offices and he would sometimes arrive an hour or more before his appointment.  I would apologize to him that he had to wait to see me and he would say, “It’s okay Chris, the people here are so nice and it is so peaceful here, I can just feel the love of God when I am here.”

  Throughout the time I knew him, Dan would sometime wind up in the hospital with various medical issues.  A year or so ago, he was in the hospital and had a pretty serious condition that he feared would take his life.  Because he was so afraid of dying, he called the office and asked if I would come to visit him.  I know it is not in the counseling rule book, but I went to visit him in the hospital.  He was panicked as he told me that he was afraid to die because he was afraid of going to hell.  I told him, “Dan, I don’t know anyone who has loved God more than you.  I cannot imagine why you would  wind up in hell.”    Dan told me that there were three things that he wanted to tell me that he had never told me before.  There in his hospital room, Dan confessed to me the secrets that he had never told me in the years that we had been visiting.  I have to confess that there was nothing in that confession that shocked me and nothing that  I thought was that bad.  However, for him, these were the dark things that made him feel ashamed – things he had feared confessing to anyone and things that he felt would keep him from God’s grace.    We talked that day about scriptures of forgiveness that he knew and I prayed with him that God would forgive him and comfort him.  Dan was released from the hospital a couple of weeks later and moved to a skilled nursing facility.  I got a call a few weeks later that Dan had died.  I felt sure that Dan had died with a bit more peace than he had lived with in his life.  Dan was one of the more challenging clients I ever had and I know we gave him help and comfort in his life, but I learned so much from my time with him.  In the later years of our relationship as he would find joy in the simple things in life and as he would be grateful for the smallest of gifts he challenged me to deal with my own materialism and to appreciate all that I had.  Dan was grateful to God though he did not have much of what we generally might think brings happiness.  He did a great deal with very few resources.  Dan did amazing things with his limited resources.  He carefully budgeted his money and he would pay me $15 cash each time at each session he had with me.  I am grateful for the donors who support the work of PCCT with their time and money because they make it possible for people like Dan to be seen by our counselors.  It is truly a blessing to be a part of this work.

Counseling, Psychotherapy, and Pastoral Counseling

I have been a part of several conversations recently that involved questions about the perceived difference between counseling, psychotherapy, and pastoral counseling.  There are volumes and volumes written on each of these things and the differences between them.  I don't know that I have a great deal to add, but I would like to offer my general reflections.  In common usage, counseling and therapy are used interchangeably.  However, technically there is a difference.

Many occupations and disciplines use the concept of "counseling".  For the most part, counseling does involve listening to a person and helping them with some decision, skill, or problem.  For the most part, counseling involves less in-dept responses.  Counseling involves applying a particular body of knowledge to a particular problem.  Counseling is more technique-driven and would be more instructional.

Psychotherapy also involves listening to a persons problems and does operate from a particular base of knowledge, but is generally more focused on insight.  A psychotherapist is going help a client reflect on various aspects of his or her life that might provide insight into the person's current complaints or struggles.  Which aspects of life become the focus of conversation will usually be driven both by the person's presenting issues and the theoretically orientation of the therapist.

In Tennessee, Pastoral Counselors can be licensed.  Those who are licensed are called Clinical Pastoral Therapists.  These therapists or those who are certified by the American Association of Pastoral Counselors are a special type of psychotherapists that use the spiritual resources of faith in their understanding of their clients.   There are numerous books written on pastoral counseling and what makes it unique -- each with its own twist - and each is often quite deep and theoretical.  This is why pastoral counselors often have difficulty articulating what it is that they do that is different from other therapists.  Below is my latest attempt to summarize what we do.  Even in reading this, there are questions about what this theory actually means in practice, but it is an attempt to capture it.  The statement below was recently written for a congregation in Nashville to help them better understand the work of the Pastoral Counseling Centers of Tennessee.



The question about what makes the counseling at the Pastoral Counseling Centers of Tennessee (PCCT) unique is a common one.  The short answer to the question involves some version of the fact that our counselors have a theological education and we offer financial assistance with our fees. The identity of our therapists as representatives of various faith groups is part of our identity; however, exactly what that means is more complex.   The training and experience of our therapists means that they attempt to understand their clients and do therapy with them in a way that is different than the counseling or therapy offered at other places.

In a world where diagnostic labels abound and managed care dictates modality of treatment, length of treatment, and frequency of treatment, PCCT offers something more personal.  We are capable of using the common diagnostic labels of our mental health peers, but we intentionally seek to see each person beyond those labels and understand the richness of each person’s life and how the various components of a person’s life interact to influence their faith, mental status, emotions, and relationships.  This holistic approach to therapy seeks to understand the underlying issues of a person’s presenting problems.  This approach to therapy requires attention to the development of a relationship that goes beyond the application of a particular technique.  This approach to therapy attempts to see each person in the fullness of what they were created to be and help them identify and overcome obstacles to living into that potential. We often refer to this as “Seeking to embody God’s healing presence.”  In the process of relationship, we use the tools that other qualified psychotherapists might use, but we also can call our training in theology, scripture, church history and the traditions of our faith when they might be helpful.  Our goal is to sit with clients as they sort out their struggles and make meaning of their lives.  We do not rush to answer the difficult questions for them and we do not leave them alone and lost. 

The style of therapy that we foster and promote has proven again and again to be healing and meaningful for our clients.  We believe it is the most excellent care.  We are committed to the idea that God does not just love those or offer healing to those with financial means, but God reaches out to all people.  For this reason, we seek to offer our services with financial assistance for those that cannot afford our regular fee.  We want to make our style of therapy available to anyone who wants it.  Because we want to represent the faith traditions in which we were nurtured and the community of faith as a whole, it is part of our identity and mission that we be intimately connected to local congregations.  Our offices are all located in space provided by local congregations.  We seek to offer training and other benefits to local clergy and the congregants they represent.  We are grateful to each individual and each congregation that supports us through their prayers and through their financial gifts.  Through this support we are able to bring God’s healing to the community of Middle Tennessee.