My Theoretical Understanding and Its Use in Pastoral Psychotherapy

I have found the psychoanalytic/psychodynamic tradition to be the richest in psychology in terms of appreciating people’s complexity and depth, recognizing the power of motivations outside our conscious awareness, and amassing over a century of clinical wisdom. Even with the significant contributions of later innovations such as object relations theory (ORT), I seem to keep going back to the “founding fathers”: I am amazed at how Freud’s pioneering work is being validated by new research in neuroscience (what he always thought would happen!), and Jung’s concepts of the collective unconscious, archetypes, individuation, integration of the shadow, and the role of deep symbols still resonate with myself and many clients. ORT provides a helpful vocabulary to express the intuitive reality that our experiences with our earliest caregivers shape the internal template through which we approach (and often misinterpret) our later relationships.

To this primary orientation I would add contributions from family systems theory (FST), cognitive-behavioral therapy (CBT), narrative therapy, the personality typology of the Enneagram, and the holistic wisdom of a mind/body/spirit approach. FST is invaluable for understanding the web in which issues that may initially seem to be individual problems are intricately connected with, and interdependent upon, longstanding patterns within families, churches, communities, and organizations; I find Harriet Lerner’s feminist FST perspective especially helpful in naming practical tools for “changing the dance.” Out of FST also comes my occasional use of the genogram to provide a visual map of complex, intergenerational similarities, differences, strengths, and disorders.

I think we are also wise to make use of CBT techniques and approaches, not at the expense of a more depth-oriented psychodynamic understanding, but with the recognition that CBT often makes use of our best to-date research on how our brains operate. The idea that we can change our thinking and thereby our emotions and choices is deceptively simple but powerful, and links up with the theological perspective of engaging our will to cooperate with God’s grace. Additionally, in its focus on faulty thinking or “core negative beliefs,” CBT can help identify bad theology or distorted God-images that may underlie clients’ habitual (re)actions.

From narrative therapy I am mindful that there is much healing in the ability to tell our story, claim our journey, recognize our agency (as well as instances of our lack thereof) in its process, and expand our perspective in how we view what has happened to us. Often when people start out in a place of chaos and “stuckness,” our listening to and witnessing their stories empowers them to hear their own voice and sometimes reveals ways in which God has been present and at work throughout their life circumstances.

Though there is not as much academic research around it, I consider the Enneagram to be a valuable lens for understanding and empathizing with the wide variety of core fears, desires, and motivations people carry. Don Riso and Russ Hudson in particular (www.enneagraminstitute.com) have developed this system into a fine art merging psychological knowledge, Western and Eastern spiritual wisdom, and practical exercises for growth according to a person’s temperamental makeup and developmental status. Some clients benefit immensely from doing their own work with the Enneagram, whereas with others I do not mention it but often use it internally to increase my sense of what their inner dynamics might be. Similarly, having some basic training as a Reiki practitioner, I often hold in the background an awareness of what I am feeling in my body’s chakras (energy centers) as I listen to clients, or, conversely, what particular psychospiritual issues have been associated for centuries with various physical ailments clients may describe.

Perhaps the approach I most identify with in discerning how to be with a client in the moment is Harry Stack Sullivan’s interpersonal psychiatry. His refreshingly honest writings and his commitment to demystifying therapy-speak bear out his conviction that “we are all simply more human than otherwise.” When in doubt of where to go therapeutically, I prefer to err on the side of being “real” with my clients, seeing if we can explore together what parataxic distortions (though I seldom use that awkward term!) might be going on, and recognizing that what we call psychopathology often is present alongside significant gifts and creativity. Whether mind, spirit, or body holds a client’s “presenting problem,” I believe with Paul Tillich that healing in one of these dimensions often brings healing in the others as well. And I find it wonderfully encouraging to read in books such as Thomas Lewis, Fari Amani and Richard Lannon’s A General Theory of Love that contemporary neuropsychiatry is confirming what pastoral theology has known all along: whatever the method of therapy, or whether it is “therapy” at all, it is love that heals.