DOXOLOGY Notes: Intersection of Psychotherapy and Pastoral Care

In my last post I praised the recent DOXOLOGY retreat which I was privileged to attend. Beginning with this post, God willing, I want to give a series of summations and reflections on what I heard and learned at DOXOLOGY. I will follow the outline notes that all of us received in our handy-dandy binder, along with some of my hand-written notes and some reflections and commentary as I look back on the points made by the two presenters. While I hope that these posts of summary and reflection are helpful to all who read them, please let me say at the outset that they are not intended to replace attending and taking part in DOXOLOGY first-hand. Though I joyously want others to know what great things are to be had at a DOXOLOGY retreat, nothing can compare to "being there" and experiencing everything, from the worship to the sessions to the camaraderie. Dr. Harold Senkbeil and Dr. Beverly Yahnke deserve all the credit for anything good and salutary you may find here, and, of course, any inaccuracies due to things such as distraction while listening, failing memory or illegible handwriting, belong solely to me. I hope you enjoy these posts, and I especially hope that they will spark a desire for my brothers in the pastoral office to attend DOXOLOGY themselves.

The topic of psychotherapy may make some pastors a tad uncomfortable. I know that it used to raise the red flags for me. “What does secular, humanistic counseling have to do with the pastor’s task of preaching the Gospel of Jesus Christ and giving out His life-giving Sacraments?” I used to ask. Too often we pastors, at least some of us, tend to dismiss wholesale the psychological disciplines and helps.

In recent years, though, I am coming to appreciate the First Article gifts of wisdom and cures in the mental health disciplines, both for myself and for my parishioners. No, that does not make me a “counselor” or “psychologist,” nor will I try to play one in my study or on TV. Yes, treating the mind and addressing human behaviors, healthy and unhealthy, are salutary and just down-to-earth helpful human endeavors.

The first session of DOXOLOGY addressed “Word, Sacrament and Psychotherapy.” Dr. Beverly Yahnke did a great job of showing the healthy intersection of psychotherapy and pastoral care while at the same time opening our eyes to the specific problematic aspects of the psychological disciplines. Let’s call it learning to cut with a scalpel rather than an axe. Instead of dismissing psychotherapy wholesale (the axe approach), let’s learn to receive the good First Article gifts that come down from the Father of lights in this area while steering away from those aspects that reject God and faith (the scalpel approach).

Since Dr. Yahnke has discovered first-hand the bias that many psychologists have against God and faith, she helps us discern the wheat from the chaff in the realm of counseling. Of course, secularists in the field reject all expressions of faith. Empathic responders ignore faith and respond merely to feelings. For them the counseling relationship is paramount and most helpful. On the other end of the spectrum we may encounter nouthetic counselors who reject all secular methodology and believe that the only useful treatment consists of repentance, forgiveness and trust in God. Finally, we can learn to spot the integrationists, those who take the best of the psychological methods and subject them to Scripture. In this realm, which I understand Dr. Yahnke to advocate, psychology has its salutary place, but it stops where God’s Word and the state of the soul begins. Think of an intersection, and not just a one-way road.

Many of us may already be familiar with the “creed of secular psychology,” but it’s always helpful to review it. In secular psychology, we are told to find our own truth, after all everyone has his/her own truth, and then we are told to find comfort in that self-determined truth. We are also told to take care of number one, shaping ourselves, working to achieve whatever good gift we determine we may want. And, of course, we must learn to forgive ourselves. Along with that comes the notion that we are not responsible for many of the things that are wrong in our lives. After all, people are innately good, says the secular psychological creed. Other tenets to this creed include: following a program (a certain number of steps) leads to health and success; happiness is a sufficient therapeutic goal; suffering is meaningless; and the therapists themselves are essential for healing.

With such humanistic underpinnings, we may wonder why our good laypeople so actively prefer psychotherapy to a pastor’s spiritual care. Here’s where the rubber of DOXOLOGY hits the road for pastoral work in the congregation. (And pastors, go ahead and get that little target out and place it right between your eyes. That’s what this part of the presentation did for me and, I would guess, many brothers also in attendance.)

Why do our good lay folk prefer psychotherapy to good ol’ Christ-centered spiritual care from one’s pastor? Dr. Yahnke gave these reasons:

• Even the best of Lutherans uses “pre-emptive personal pardon.” In other words, our good lay folk are quite used to saying, “I can forgive myself,” and hence they see and feel little need for the pastor or the church.
• Many in our pews simply are not aware that their pastor desires to offer spiritual care. As Dr. Yahnke would plead on behalf of her fellow laity: “Pastor, teach us what you do in offering Confession and Absolution, praying with us, and giving blessings.”
• Often we pastors (yes, I include myself in this indictment) are too engaged with the job of running the parish, the “organizational jungle gym,” as Dr. Yahnke called it. How many times have you, pastor, said, “I’m just too busy”?
• Pastors may be regarded as out of touch with real life. Our people may wonder if we really do get dirty with sin, sickness, and other problems. They may wonder if we know the challenges of being a father, and if we struggle with that parenting stuff as they do.
• Not everyone trusts his/her pastor to honor a confidence. Let that one sink in, brothers, especially when we gather together over food and libations and “let our hair down” with each other! Our people need to hear plenteous reassurances that all they discuss with their pastor will be kept confidential.
• Fear of the pastor’s personal judgment is a sufficient deterrent to seeking pastoral care. As Dr. Yahnke quipped, they may very well fear the pastor more than they fear God Himself. They know He is just and good; they’re not so sure about the pastor.
• Pastors may be so light-hearted and upbeat that they are unapproachable. (Very interesting, I thought.) Would the light-hearted, ever-upbeat pastor really take the dark secrets of the soul seriously?
• Finally, pastoral care is not “in,” that is, it is not socially sanctioned. Everyone knows about running to the counselor in time of need, but going to one’s pastor? Well, it’s not quite the culturally acceptable or common thing.

With all of this in mind, our people may not perceive their pastors as “experts,” but they know that they want the best services available. Also, our people begin to suspect that clergy cannot really do anything to help, especially if we clergy trivialize what we have to offer. How many of us pastors have thought, or even said, “Well, I only have God’s Word and Sacraments”? Yes, that may be “all” we have, but there’s no “only” about it. They really are mighty powerful tools—the Holy Spirit’s tools—for healing our most infectious contagion called sin and death, and thus affecting our health in other ways as well.

What can we pastors to do remedy this disconnect that truly exists in the minds and expectations of our people? Dr. Yahnke again made an appeal to pastors, as if speaking for all of our lay people, but I’ll speak from pastor to pastors.

We pastors must speak powerfully in the face of our post-modern culture. After all, our sheep are grazing in those pastures every day. Our people need to see that spirituality as revealed and given in the Scriptures is the real venue to genuine happiness. We pastors need to preach regularly on vocations such as mother and father, on the holy estate of marriage, and on receiving the love of the living God and His eternal yet presently life-changing gifts.

Our people do not want us to “get in the way” of God’s Word. They want us to talk about God and His Word, yes, but they also want us to talk in understandable ways and in terms that show we understand the life in which they live, work, rest and play.

While we pastors know it intellectually, we certainly do well to hear our people tell us: “Sir, we would see Jesus.” In all that we do and say, in all of our preaching and teaching, our people want to see Jesus. And, as Dr. Yahnke mentioned, we do well to boil it all down to two sentences or concepts that we want our people to take home with them.

We pastors also need to hear this one from Dr. Yahnke. Speaking for our good lay folk, Dr. Yahnke said, “We need both reverence and joy.” I love that coupling of terms and notions. Yes, our people need to see us act with reverence in the Divine Service and in prayer offices. That reverence underscores, as she said, the reality of Christ’s presence among us. However, our people also need to see the joy we have at being in His presence, proclaiming His words of forgiveness, life, and salvation, and giving out His gifts in water and meal. Our people do need to see us conducting the liturgy, as well as our whole office, with real life joy, not as mechanical automatons. Reverence and joy need not be mutually exclusive.

Our people need to hear their life’s issues cast into religious language, into terms that show they are dealing with spiritual realities, not just the day-to-day challenges that come rushing at them.

Related to this, our people would tell us they need to hear us, their pastors, talk about idolatry, the idolatry of their daily living—with idols such as money, success, and their own man-made, self-devised answers to their various problems. Dr. Yahnke offered a great picture for this when she referred to Luther’s treatment of the First Commandment in the Large Catechism. We need to hear our people speaking her words: “Pastor, super-size our Catechism.” I take that to mean, “Show us how our daily idolatries go against God and His will for us to look and cling to Him for every gift and blessing.”

Here’s one final thing Dr. Yahnke suggested that we pastors can do to teach and remind our people that we are there, in the congregation, to be their “spiritual physician.” Our people need to hear us preach about the implications of faith not only in eternity (“Jesus died for us, and someday we’ll get to go to heaven and be with Him.”), but also in time. After all, our hope in Christ is not only for “eternal life”; it’s also for life now. We need to preach not only “justification”—yes, it’s the central doctrine!—we also need to preach the hope that’s present now, the eager expectation that our gracious, forgiving, loving Savior is at work now to help and heal us with His cross-won forgiveness and His resurrection life.

Dr. Yahnke’s outline for this first session of DOXOLOGY ends with some questions upon which we pastors do well to reflect. I cite them here for my brothers in Office because, after all, a little reflection and self-evaluation can’t hurt…too badly…can it? (Good lay folk who read this, feel free to "turn the volume down" now. If you do choose to read these reflection questions for pastors, please don’t go to your pastor and say, “Hey, you’d better think about these things, Buddy.” ☺)

• How is it that my parishioners actually see me?
• Am I regarded as approachable? Too busy? Too aloof?
• What are the chief characteristics that I would appreciate in a pastor to whom I would turn for help?
• What are my expectations about how another pastor would treat me?
• What areas of my ministry do I want to examine mindfully in light of this conversation?
• What is my current comfort level in providing care to people who have spiritual and emotional problems?
• What is my level of comfort in collaborating with Christian psychologists or other mental health providers?