Psychotherapeutic theories cover a vast spectrum of both normal and abnormal behaviours; Pastoral care and Pastoral Counselling encompass many similar areas; however, there are places where the approaches deviate substantially. In this essay we shall critically discuss what that means for the Pastor. It is useful to offer definitions to some of the approaches, so that we can establish where the frameworks overlap and where they diverge; this should assist in identifying areas that give rise to opportunities for a Pastor to fulfil a role of care, a role that is otherwise missed in psychotherapeutic treatments. Discussing the relationship between the two will also highlight places where challenges have arisen that Pastoral care cannot easily bridge. The authority of a professional clinical body with its adherence to ethical standards, alongside its access to treatment facilities and research, mean the Church, in cases of serious mental health problems, must take on a complementary role to provide holistic treatment.
Defining Psychotherapy and its relationship to Pastoral Care
The following definition is taken from the American Psychological Association (APA):
“Psychotherapy is the informed and intentional application of clinical methods and interpersonal stances derived from established psychological principles for the purpose of assisting people to modify their behaviours, cognitions, emotions, and/or other personal characteristics in directions that the participants deem desirable”[1]
Within the field of Psychotherapy there are various disciplines; but as Sobelman notes, the method in which these are applied is often with ‘talk therapy’, a ‘collaborative communication’ between an individual and a trained professional.[2] Here we can see a clear crossover into the realm of pastoral counselling: Pastoral care takes on many forms, but at its heart lies a person-centred focus which relies on communication. Psychotherapy is sought when someone seeks healing for any number of reasons: trauma, destructive behaviour, bullying, narcissism, addiction, or bereavement; Pastoral care and counselling can engage with these problems and will tackle them in a similar method. LandwóJtowicz goes into greater detail when discussing the relationship between the two: he notes that there are three ‘standpoints’ from which one can see the relationship, placing them in positions of ‘opposite’, ‘separate’, and ‘complementary’.[3] The idea of the two approaches being in opposition is based on Freud’s linking of psychotherapy with atheism and naturalism.[4] This removes God’s providence from an individual’s life, making them an autonomous ‘self-absorbed individual’[5] that is shaped by their socio-cultural conditions; this gives rise to an odd dichotomy between radical individualism and radical collectivism.
V.E Frankl’s explanation of the opposition is less contradictory, placing the end goal of a psychotherapist’s work at odds with that of a pastor’s: the former seeking to heal the soul, whilst the latter is seeking to save the soul.[6] Frankl’s observation is aphoristic but relies on an assumption about a pastor’s motivation that may not be present; however, a pastor’s focus will be on a ‘transcendent value’. LandwóJtowicz’ article goes onto note, that it is from this quality that we find the ‘complementary position’: an individual seeks a way to escape themselves, ‘their fixations’, and ‘their mental disturbances’, so that they can focus on something other, to fully engage with society.[7] As Brunsdon argues in his article: definitions of pastoral care are ‘abundant and broad’, but it is with regard to Louw’s definition, that he concludes the primary goal of pastoral care can be seen as change, illustrating a point of overlap between the two approaches.[8]
The Horizontal and Vertical aspects of pastoral care
The horizontal aspect (person to person), and the vertical aspect (person to God), is ultimately what Frankl’s observation highlights. This way of framing care issues can be schismatic and force an either/or approach regarding with whom a client may seek help; this is an unnecessary divide. The idea that a Pastor would emphasis revelation and theology over an individual’s problem, as it was experienced, is unwarranted.[9]Instead, a Pastor can enter into a relationship, with a view of helping; whatever an individual’s emotional situation may be at time, they can then explore life’s larger questions, not only within a faith community, but also in regard to scripture.[10] The postmodern paradigm, that has been underway since the mid-20th century, has seen western society views itself through the lens of subjectivity and relativism which places emphasis on the individual’s story; this has influenced psychotherapeutic theories such as narrative therapy and positive psychology. Narrative therapy seeks to separate an individual from their problem, and through their own sense of purpose guide them through difficulties; an opportunity, at once, arises for the Pastor to underline the Imago Dei, and to emphasis the ultimate dignity and purpose innate within the doctrine. Furthermore, Otto Rank described psychology as ‘the history of the soul’,[11]and thinkers such as Erickson, Moreland and Farris have all espoused the Imago Dei as being property of the soul.[12]By exploring issues of the self, a pastor can extoll the relational qualities of the self, and therefore involve an individual in the idea of a personal God who seeks a relationship.
Controversial Ministries
Psychiatry and Psychopharmacology are two of the disciplines within the field of Psychotherapy that pastoral care must ultimately acquiesce: a pastor is unlikely to have the expertise to diagnose or treat complex mental health issues unless medically trained themselves; to do so may result in further trauma to an individual. However, an area of interest and overlap is within Deliverance Ministry; empirical data shows that, regardless of one’s own view of the ministry, parts of the demographic still turn to a Pastor for a final spiritual authority. Most notably the sociological survey conducted in 2017 by Giordan and Possamai indicated that 5% of the case study participants, believing themselves possessed, went on to take part in ritual exorcism.[13] Drawing from Illueca’s article, we can see that patients with dissociative conditions are the most likely candidates to seek this type of Pastoral care; regardless of spirit possession being real or not, it is perceived as being real by a number of patients, and therefore requires the involvement of a religious authority over that of a medical authority. The Roman Catholic Church, the Anglican Church in the UK, and the Episcopalian Church in the U.S have all continued to support this type of ministry. They take on a complementary role once more, highlighting the need for consultation with a therapeutic expert, and seeking an alternative explanation before engaging in any ‘spiritual intervention’.[14]The Church of England even issued guidance on the matter in 1975 and reviewed their approach as late as 2012 considering developments in psychotherapeutic theories.[15]
Conversion therapy has also encountered increased media scrutiny in the UK, as Parliament discuss legislation and potential banning. It should be noted that Conversion Therapy is a branch of Cognitive Behaviour Therapy, and the more extreme practices (electric shock, chemically induced nausea, and chemical castration) were historically conducted by mental health professionals when WHO (World Health Organisation) considered homosexuality a mental health disorder; this was not reclassified until 1992. The Pastoral approach had always been prayer ‘healing’ and counselling.[16]However, evidence suggests, that this approach can also prove harmful:
There is an increasing amount of quantitative evidence that exposure to conversion therapy is statistically associated with poor mental health outcomes including suicidal thoughts and suicide attempts.[17]
The National LGBT survey 2017(commissioned on behalf of Government Equalities Office) forced the UK government to explore legislative and non-legislative options for banning Conversion Therapy in 2018; interestingly, the Church of England’s National Assembly in 2017 had already passed an endorsement of the memorandum against conversion therapy.[18]Although this may appear progressive, it must be noted, all denominations of the Church continue to be divided on issues relating to the theology and pastoral care of the LGBT community.
Conclusion
Pastoral care and counselling continue to modernise at pace with up-to-date psychotherapeutic theories. This brings challenge and opportunity; yet the best care is provided when all avenues are explored, when pastoral care works in tandem with the latest theories. For the Pastor, there is no theological conflict within this:
‘Carry each other’s burdens, and in this way you will fulfil the law of Christ’
Galatians 6:2
[1] John C Norcross, ‘An Eclectic Definition of Psychotherapy’, in What is Psychotherapy? Contemporary Perspectives, Ed. J.K Zeig & W.M Munion (San Francisco: Jossey Bass: 1990) p218-220 [2] Dr S Sobelman, “Psychotherapy Definition – Dr. Steve Sobelman (drstevesobelman.com)” (accessed 25/11/2021) [3]Landwójtowicz Paweł., 'Priesthood and Therapy – the Perspective of Pastoral Counselling,' Studia Humanitatis 2, (2019). [4]Landwójtowicz Paweł., 'Priesthood and Therapy – the Perspective of Pastoral Counselling, [5]Landwójtowicz Paweł., 'Priesthood and Therapy – the Perspective of Pastoral Counselling [6]Landwójtowicz Paweł., 'Priesthood and Therapy – the Perspective of Pastoral Counselling [7]Landwójtowicz Paweł., 'Priesthood and Therapy – the Perspective of Pastoral Counselling [8] Alfred R Brunsdon, ‘A three musketeering approach to pastoral care: Reflections on collaboration between pastoral care, narrative therapy and positive psychology’, Verbum et Ecclesia 35.1 (2014) p2 [9] Alfred R Brunsdon, ‘A three musketeering approach to pastoral care p4 [10] Alfred R Brunsdon, ‘A three musketeering approach to pastoral care p4 [11] Otto rank, ‘Psychology and the soul’, Journal of Religion and Health, 35.3 (1996) p193 [12] Matthew J. Churchouse, ‘Distinguishing the Imago Dei from the soul’, The Heythrop Journal, 62.2 (March 2021) p270-277 [13] Marta Illueca, ‘Interdisciplinary Perspectives of Spirit Possession and Deliverance Ministry’, The Journal of Pastoral Care and Counseling, 72.4 (2018) p271 [14] Marta Illueca, ‘Interdisciplinary Perspectives of Spirit Possession and Deliverance Ministry’ P273 [15] Church of England Official documentation <Guidelines for Good Practice in the Deliverance Ministry (churchofengland.org)> (accessed 27/11/2021) [16] Conversion Therapy: An evidence assessment and qualitative study< https://www.gov.uk/government/publications/conversion-therapy-an-evidence-assessment-and-qualitative-study/conversion-therapy-an-evidence-assessment-and-qualitative-study > (accessed 30/11/2021) [17]Conversion Therapy: An evidence assessment and qualitative study [18]Conversion Therapy: An evidence assessment and qualitative study