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How
should Christians think about CBT?
by Rev. Glen Scrivener
More on Christian Pastoral
Care here
Cognitive Behavioural Therapy (CBT) is a
- short-term,
- practical,
- client-based,
- collaborative,
- problem-solving,
- life-skill learning
‘talking therapy’ which has had excellent and well documented
success in alleviating certain emotional problems. These problems include depression,
obsessive-compulsive disorders, anxiety disorders, panic attacks,
phobias, post-traumatic stress disorders, eating disorders and, in the
last 10 years the therapy has even been used on the hallucinations and
delusions of schizophrenia sufferers. In general however the therapy works
best on less severe emotional problems where the client desires relief,
is relatively self-aware but is still not able to ‘cure’ themselves.
The theory and practice of CBT can perhaps best be
seen if we trace the history of its development. We can discern three strands of thought
feeding into what we now call CBT.
All three grew out of a dissatisfaction with traditional
psychoanalytic therapies which located the problems in past traumas,
family relations and an intangible, inaccessible sub-conscious. First came the behaviourists. Their rejection of consciousness turned
their attention to conditioning, education, the external
environment. B.F. Skinner, perhaps
its most famous proponent, said:
“The picture which emerges from
a scientific analysis is not of a body with a person inside, but of a
body which is a person in the sense that it displays a complex
repertoire of behaviour.”
Since a person is, at every level, conceived
of as a machine (though a very complex one),
personal problems are therefore problems of behaviour. The person, who is a function of his
make up and environment, needs to behave in a manner better suited to
smooth functioning. In this
system, the environment is the only variable we can alter and so
conditioning through negative reinforcement of bad behaviour (‘stick’)
and positive reinforcement of good behaviour (‘carrot’) is the
path to personal change.
Such stark materialism cannot be accepted by the
Christian counsellor either at the philosophical or practical level. However its methods proved very
successful with problems such as bed-wetting and stuttering. The behaviourists had demostrated that
‘the journey within’ is not always the route to change. Thus the Christian can learn that,
though we are more than bodily, it is not more spiritual to ignore
the material, the environmental, the somatic, in the
treatment of the person.
The second strand contributing to modern day CBT
came from another atheist, Albert Ellis, who developed Rational Emotive
Therapy (RET) in the 1970s. Again
he did so as a reaction to the psychoanoalytic tradition in which he had
been trained. He came to see that
most of the emotional problems that presented to him in counselling were
not a function of either material cause and effect (as with behaviourism)
or a sub-conscious, sub-rational struggle (e.g. between the id and the
super-ego, as in Freud.). Instead,
emotional problems were the rational (or, more usually, irrational)
reactions a person made to their situation.
A client may speak as though a situation (say, the
break down of their marriage) caused their depression. Antecedent event ‘A’ (the
marriage break down) seems like it automatically produces Consequent
emotional state ‘C’ (the depression).
Yet, in counselling, Ellis usually found that behind emotion ‘C’
is Belief ‘B’ (‘I must be a good spouse or I’m worthless’). This belief assesses the event ‘A’ and
assigns to it a significance which ‘A’ does not have in itself
(marriage break down does not make me worthless, my belief is what
assigns that meaning). Thus the
significance which has been assigned by belief ‘B’ is what causes the
depressed emotion ‘C’.
Antecedent
=> Belief => Consequent
emotion
The process of change becomes clear. Once it has occurred, I cannot alter
‘A’ and emotions (C) are notoriously difficult to control, thus ‘B’ must
be altered. If ‘B’ does not
produce an emotional state in which I can function properly, ‘B’ must be
mal-adaptive. The counsellor
therefore seeks to un-earth, counter and replace faulty belief ‘B’,
citing its empirical and pragmatic limitations (i.e. ‘it doesn’t fit the
facts, and it doesn’t make you happy.’) Just as the behaviourist had sought to
alter behavioural habits, the RET therapist views “human beliefs as
mental habits that can be influenced in the same way.” The carrots and sticks of behaviourism
are then used to condition our cognitive habits rather than physical.
Ellis listed many maladaptive beliefs a person
could hold which would prove counter-productive in the world as we find
it. Self-deification was one – the notion
that I always ought to be held in high regard by others and that life
always ought to go well for me. Yet Ellis warns us away from such a
view, not so much because of its falsehood but because it will cause
emotional problems in the world in which we live. As to other maladaptive beliefs he
writes in “The Case Against Religion” that “the concept
of sin causes virtually all psychopathology.”
and that self-interest and self-direction are emotionally healthy,
inferring from this that no Christian could be. All this warns us that the standards
for rationality will be crucial in any cognition-based therapy.
We now turn
to the third strand
contributing to CBT. Aaron Beck
was developing his Cognitive Therapy (CT) at about the same time as Ellis
and along similar lines.
He again challenged the older psychoanalytic theories which held
that negative thoughts and emotions “were symptomatic of
other problems (low self-esteem, projection of un-acceptable impulses).
[Such older theories saw] no benefit in directly changing the
thoughts. In Beck’s mind
[however], the distorted thinking is not the symptom of the problem; it
is the cause of the problem.”
This seems
to be Ellis’s insight repeated.
Yet we can discern three ways in which Beck and the CT school bring
improvements to the actual process of change through cognitive
restructuring:
Firstly,
Beck identifies the specific cognitive content involved in emotional
disorders:
|
Cognitive
Content, which
leads to…
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Emotional
Disorder
|
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Devaluation/loss
|
Depression
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Danger/threat
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Anxiety
|
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Situationally-specific
dangers
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Phobias
|
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Unjustified
intrustion
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Paranoia
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Transgression
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Anger
|
Second,
Beck and the CT fraternity have developed tailored techniques for uncovering
both the negative automatic thoughts (NATs) and the underlying
assumptions and core beliefs (or schemas). We will discuss these techniques below.
Thirdly,
Beck puts a high degree of value on the client’s own abilities to uncover
and diagnose faulty cognitions.
There is therefore an emphasis on homework outside counselling
and, within it, what Beck calls ‘collaborative empiricism’. This refers
to the joint efforts of counsellor and client in gathering
information and looking for patterns.
Between
these three strands – behaviourist, RET and CT – CBT has grown up as a
practical method of handling emotional problems.
It may be
asked where behaviour fits back into this process. It certainly does not occupy the prime
place that it did for Skinner et al. With Ellis and Beck we have a new
confidence that factors within can be altered, not only the
environment without. Yet behaviour remains important since the notion
that ‘you feel the way you think’
is readily extended to the truth that you act the way you feel. In general there will be a flow of
causality from thoughts to feelings to behaviour. Yet it also cannot be denied that
causation often flows back in the other direction (think, for instance,
of the emotional effects of alcoholism or self-starvation). Thus behaviour has a deserved place in
cognitive therapy (the B belongs to CBT).
This importance comes in two ways, firstly as new beliefs are
acted upon in the counsellees environment (this itself will be a part of
reinforcing the new beliefs).
Secondly, behavioural change is required to break out of Schema
Maintenance,
Schema Avoidance
and Schema Compensation
where certain behavioural patterns are bound up with faulty cognitions.
The same techniques applied to bad thought habits are applied to bad
behavioural habits. In this way the counsellee is freed not only from the
underlying beliefs that have dominated but also the behaviours which both
flow from and re-inforce such beliefs.
Thus CBT
represents a small number of different counselling schools which
understand the process of change to involve the re-habituation of
thoughts and (secondarily) behaviours.
The underlying assumption is that faulty emotions and behaviours
flow from faulty thinking. It
could be crudely diagrammed as follows:
Thoughts =>
Feelings => Behaviours
These
thoughts are themselves the result of faulty beliefs which underlie them
and need to be confronted and changed. Sanders and Wills picture it as
three concentric circles: Core Beliefs are at the centre, Underlying
Assumptions are the middle layer and the outer layer represents Automatic
Thoughts.
The process
of change for CBT happens in stages: (1) the rationale for therapy is
explained, (2) precipitating events are discerned (3) automatic thoughts
are examined then (4) underlying assumptions and beliefs (schemas) are
uncovered, (5) challenged, (6) replaced and (7) the new beliefs
maintained.
We will now
assess what we see as the benefits of CBT before discussing some
draw-backs which a Christian practitioner would have to bear in mind.
Benefits of CBT
1)
Beliefs are foundational
Our
problems (those not a result of being victims of the curse) do indeed
flow out of wrong beliefs. Romans 14:23 states “whatever does not proceed
from faith is sin.” Jesus defines
sin as the fact that “men do not believe in me” (John 16:9). Wrong beliefs are foundational, not
only to wrong behaviour, but, more basically, wrong being. To believe rightly is the fundamental
issue of life.
2)
Our emotional state is clearly affected by our
thinking
Paul learns
the secret of contentment in all circumstances. (Phil 4:11) He clearly frames his experience of
life according to certain truths that give him comfort no matter the
environment.
Martin
Luther has said:
“For
the Holy Spirit knows that a thing has only such meaning and value for a
man as he assigns to it in his thoughts.”
Luther is
often quoted as support for Christian CBT. See here
for many examples of preaching to yourself from his Galatians
commentary. See also Martin Lloyd
Jones in his classic Spiritual Depression.
“…the
ultimate cause of all spiritual depression is unbelief… What about
treatment? … the first thing we have to learn is what the Psalmist
learned [from Psalm 42-43] – we must learn to take ourselves in hand… we
must talk to ourselves instead of allowing ‘ourselves’ to talk to us!… I
suggest that the main trouble in this whole matter of spiritual
depression in a sense is this, that we allow our self to talk to us
instead of talking to our self… This is the very essence of wisdom in
this matter. Have you realized
that most of your unhappiness in life is due to the fact that you are
listening to yourself instead of talking to yourself? … The main art in this matter of
spiritual living is to know how to handle yourself. You have to take yourself in hand, you
have to address yourself, preach to yourself, question yourself. You must say to your soul ‘Why art thou
cast down’ – what business have you to be disquieted? You must turn on yourself, upbraid
yourself, condemn yourself, exhort yourself, and say to yourself, ‘Hope
thou in God’ instead of muttering in this depressed and unhappy way. And then you must go on to remind
yourself of God, Who God is, and what God is and what God has done and
what God has pledged Himself to do.” Martin Lloyd Jones, Spiritual
Depression, Pickering & Ingliss, 1965, p20-21
It seems a Christian
thing to reframe our thoughts on better grounded beliefs and in this
way to address our feelings.
3)
Right behaviour must come from a right heart
A
behaviourist model goes with Aristotle’s ethics rather than Christ’s.
Aristotle believed act leads to being (I play the violin to become a
violinist). Jesus said the
opposite, “A good tree produces good fruit.” (Matt 7:17). This is to say: being leads to act (the
one who is a violinist will play the violin). This is crucial for understanding grace
– the indicatives precede the imperatives. Without such an understanding, a
legalistic, earning, works mentality will pervade our pastoral care and
the grace of Christ will be lost.
CBT fits
well with this model of being-then-act.
The Christian counsellor can be true to the techniques of CBT when
he/she says ‘understand the truth of who you are, conform your thinking
to that reality and then act out of that centre.’
4)
CBT’s order of: beliefs => thinking =>
emotional state => action can be seen throughout the Scriptures.
Think of
how Moses or Paul tried to encourage generosity. (Ex 25:2; 35:4-29; Deut 15:7-11; 2 Cor
8-9). Only those whose hearts had
been changed by the Lord’s prior goodness were to give. For those who were moved to give it is
not difficult to recontruct the stages of their discipleship along the
lines of: belief; changed thinking; a resultant (grateful, cheerful,
generous) emotional state; followed by the behavioural change.
5)
Scripture exhorts us to challenge our thinking.
Deut 9:4-6:
“Do not say in your heart… Know therefore… Remember and do not forget.”
Psalm
42:5,11; 43:5: Why are you cast down, O my soul, and why are
you in turmoil within me? Hope in God
Romans 12:2: Do not be conformed to this world, but
be transformed by the renewal of your mind, that by testing you may
discern what is the will of God, what is good and acceptable and perfect.
6)
Our discipleship should be marked by such reformation of our minds
The New
Testament word for repentance, ‘meta,noia’,
is literally a word for changing of mind.
The word for discipleship ‘maqhth,j’ has clear cognitive
overtones (it is the word from which we get mathematics). Our repentance and discipleship is a
matter of continual cognitive challenge and conformity to God’s word.
7)
We ought to be challenged to live consistently with
our beliefs.
CBT works
by drawing links between what we think, what we feel and what we do. Any Christian will want to monitor their
integrity in this.
8)
The gospel of grace speaks into the very heart of
our core beliefs.
McMinn
notes this as a major reason why Christians ought to embrace much of CBT.
God’s unconditional love and acceptance in Christ addresses our deepest
needs for security, worth, acceptance and love which CBT uncovers but
cannot finally deal with.
9)
There is a clear place for the use of Scripture
Since the
heart of the therapy is challenging beliefs, the Bible can be used by the
Christian CBT practitioner as an integral tool. In fact one could argue that Christian
CBT can function more truly as CBT since the Bible provides an
authoritative standard far superior to the empirical or pragmatic
standards used in secular treatment.
10)
Feelings are given relative but (hopefully) not
absolute importance.
Emotions
are neither all powerful nor insignificant in CBT. They are neither beyond all question
nor beyond all control. Instead
feelings are acknowledged as reactions.
Christians can agree to this.
There is a story concerning Robert Murray McCheyne in which he
counselled a woman who said she needed more joy. McCheyne replied that she did not need
more joy, she needed more Christ.
Joy will follow from the appreciation of Christ. In this way feelings are addressed (and
addressed in the strongest possible way) yet priority is given to gospel
truth over subjective experience.
11)
CBT’s pragmatism makes it less wedded to
anti-Christian world-views
Since it is
not so interested in the deepest ‘why’s of emotional distress but rather
the ‘how’ of recovery, there is far less humanistic baggage attached to
CBT. (Of course the pragmatism itself expresses an anthropology etc which
needs to be thought through). It
is much easier therefore to integrate CBT techniques into Christian
counselling than, say, Rogerian or Gestalt therapies!
12)
The counsellor-client collaboration is healthy
This is
especially important if a Christian sees a non-Christian CBT
practitioner. Unlike some other
psychotherapies, the client is not submitting themselves wholesale to the
counsellor’s world-view. Yet also in Christian settings a more
collaborative style suits the mutuality of Christian life together and
models that every Christian is ‘competent to instruct one another.’
(Rom 15:14).
13)
The tools used to uncover faulty thought patterns
and beliefs are excellent
This is
perhaps the chief contribution which CBT makes to Christians offering
pastoral care. We have always
known that beliefs and thought-patterns are life-altering, but three or
four decades of clinical practice at ‘digging down’ into the beliefs of
counsellees has produced very useful tools which can also be used by the
Christian.
Identifying Negative
Automatic Thoughts (NATs)
·
Ask directly
– What are you telling yourself when you feel X…
·
Guided
discovery (ask around the issues, get them to unearth)
·
Note
emotional change as they speak – these are ‘hot cognitions’
·
Worst
consequence scenarios – What would be so bad if…?
·
Imagery
(some NATs are images) – Do you have a picture of yourself or of your
environment when this is happening?
·
Exposure
exercises – go to uncomfortable situations either physically or in your
mind. How are you now thinking?
·
Offer
multiple suggestions of what the NATs may be
·
Offer
suggestions opposite to client’s expected response. They will usually say
‘No, no, I’m telling myself X’
Question
the assumptions underlying the NATs:
·
What
would be so terrible about X?
·
What
would it be like for you not to do or feel X?
·
What does
it say about you that you have done or felt X?
·
Are there
verdicts being passed on you from God, the world and yourself associated
with X? What are they? Could you
put them in words?
·
On what
basis are these verdicts being passed?
·
On what
basis are you believing them?
At
this stage, CBT identifies the faultiness of such thinking as certain
cognitive errors:
- Mind
reading:
e.g. ‘I know what they’re all thinking…’
- Crystal
ball:
e.g. ‘I know what’s going to happen now…’
- Catastrophizing: e.g. ‘It’s all over now. X
is out of the bag, all hell will break loose.’
- Emotional
reasoning:
e.g. ‘I feel X so strongly, therefore it must be a fact.’
- Self-labelling
/ blame:
e.g. ‘X makes me an idiot!’ ‘X makes me ugly!’
Beneath
these faulty cognitions are the schemas or core beliefs that feed such
thinking. CBT also offers helpful techniques in bringing these to the
surface.
To
identify core beliefs, look for…
·
‘If…, then…’
statements: ‘If I’m X, then I’m a failure.’
·
‘Shoulds’
and ‘Musts’
·
Themes in
the NATs
·
Family
sayings, mottoes, memories
The
CBT practitioner should then get the counsellee to put this core belief
into words. Make them identify it
as a rule: e.g. “I need everyone in my environment to be ok with me or
else I will be destroyed.” Simply
the process of articulating this rule – exposing it as the dominating
force in a person’s every decision, act and feeling – is incredibly
powerful. In Christian contexts it
should lead to heart-felt and deep confession.
Yet
it is precisely at this point that the Christian must part company with
the non-Christian CBT counsellor.
For at this point the non-Christian CBT counsellor is committed to
changing beliefs for the purpose of alleviating emotional distress. The false belief is jettisoned largely
because it is maladaptive for the person’s current environment. It would
feel better for the counsellee to do away with it. The Christian confronts this idolatrous
commitment and sorrows over the unbelief. A good outcome for the Christian
undergoing CBT may well not be the glad heart but rather the
broken and contrite heart. The Christian’s priority is not, primarily,
the alleviation of distress, but the uncovering of unbelief of which the
distress is a symptom.
This
moves us onto…
Draw-backs
of CBT in a Christian context
1)
What
is the motivation for change?
If the
motivation for change is the relief of emotional discomfort or the
cessation of behavioural compulsions, the entire process is set on a
decidedly selfish footing. So many
of our core beliefs are self-centred strategies for minimizing the pain
of vulnerable engagement with God and His people. The question must be asked, ‘Will CBT
simply substitute one selfish strategy for a smoother running selfish
strategy?’
This is an
issue in any counselling situation yet one that is a particular
temptation with CBT’s problem-solving focus. Christian counsellors must repent of
seeking such small goals with their counsellees as ‘a smoother running
emotional and behavioural life.’
Our goals must be to create a deeper thirst for Jesus Christ, a
deeper confession of sin and weakness, a firmer trust in His blood and
grace, a closer walk with Him day by day.
To focus on short-term, practical relief from certain behaviours
and feelings could simply produce a white-washed tomb.
The pastor
using CBT must ask, Is the goal of therapy relief from certain feelings
and compulsions or is the goal a deeper repentance of idols, a firmer
trust in the true and living God, a heightened longing for Christ’s
return and a greater freedom for service. CBT by itself is inherently selfish and
pragmatic. CBT will not push Christian counselling in the direction of
other-centred submission to God and His people. The pastor will need to
be very clear that this is the priority.
2)
What
are the grounds used for assessing beliefs as rational/irrational,
valid/invalid?
The
rationality of a person’s thinking is generally judged on empirical and
pragmatic grounds.
That is to say ‘Does it fit the facts?’ and ‘Does it work?’ On the first we must ask, What counts
as ‘the facts’, and how is a person to weigh the relative importance of
differing standards? (More on this
below). As to the second, the Christian
simply must not decide his/her beliefs according to ‘what works for
them’.
3)
If
empirical testing is used, how do the ‘facts’ of the Bible inter-relate
with the ‘facts’ of experience (even if scientifically derived).
It might be that the process of empirical testing
(using the judgements of the world) work against the belief-level
repentance required by the word of God.
Imagine a person who presents with a performance
anxiety and whose NATs are along the line of ‘Everyone at work thinks I’m
incompetent.’ A CBT counsellor may
prescribe a long list of homework exercises examining the counsellee’s
past performance appraisals and interviewing co-workers about their
abilities. However it is quite
conceivable that the counsellee’s problem is itself this obsession with
the approval of others and the homework simply feeds this obsession. In the end, the CBT counsellor might
well diagnose this underlying obsession as the problem. Yet the route
towards diagnosis has largely modelled a dependence on the opinion of
others. The testing process could
well foster an initial sense of walking by sight and fearing men, before
(under Christian direction) it eventually resolves into walking by faith
and fearing only the Lord.
The counsellor will have to use judgement as to
when the testing may exacerbate the problem.
4)
In Christian CBT the Bible can be used out of
context and against its intention.
The clear
place for an empirical standard against which to judge faulty cognition
gives the Bible a prominent place in Christian CBT. However, if this is the only way the
Bible is used (to ‘bash’ faulty thinking and behaviour) its intention as
testimony to Christ is twisted into a simple behavioural manual. The Bible ought to have a prominent
place in heralding the new identity of the Christian who is clothed in
Christ. It is this prior
indicative, known only by faith and not by sight, which the word
proclaims and which ought to shape our core beliefs. The Christian CBT practitioner must
therefore ensure that the bible is not simply employed as law but, far
more, as gospel.
5)
On what grounds can the counsellor or client
determine that a particular emotion must be relieved (thus necessitating
a belief-change)?
Could there
not be a case when an unpleasant emotion
ought to be endured precisely because it is produced by a true and
unalterable belief? Does CBT
provide reliable guidance on when emotions are truly problematic.
One wonders
what a CBT counsellor would have made of Luther’s Anfechtung (deep
sense of sin). Stanton and Jones
wonder if the question would come: “What evidence is there that God
exists or that he cares for your behaviour?” “The goal would be to eradicate the
thought because it bothers the client.”
CBT itself
cannot tell you what levels of emotional distress are right and
healthy. Again, the Christian
sitting under the word must use judgement.
6)
It
is not wise and persuasive words that are required but a demonstration of
the Spirit’s power.
At the core of CBT is the challenging of irrational
beliefs with logical standards.
However the deceitful and unfathomable heart
will take more than good reasoning to shake it from its madness. The truth of God’s gospel must be
driven home to the counsellee with living power by the Spirit. Faith does not come by reasoning but by
hearing and hearing through the word of Christ. Therefore there ought to be a healthy
dose of proclamation to pastoral counselling, a worshipping community to surround
it and the regular table fellowship of the Lord’s Supper. All the means
of grace ought to be employed by the Christian counsellor. This goes far beyond pointing out
faulty cognitions!
It is not our intellects that need changing but our
hearts. The heart is the
centre of a person according to Jesus and the source of our thoughts and
actions.
Our true hope is in the change of hearts.
This means:
a)
we
will not look for non-rational means (the heart is not an
anti-intellectual concept in the Bible)
b)
we
will employ emotional, artistic, sensory means also
c)
true
change is ultimately the work of God.
7)
Mental rehabituation can be every bit as legalistic
as behavioural rehabituation
An internal
rather than external focus does not equate to a grace-based rather than
works-based focus. That is to say,
CBT does not save itself from the works charge of behaviourism simply
because it focusses on mental rather than behavioural habits. It is
entirely possible to perform behaviours which are faith-based and equally
possible to change mental habits on a works basis. A counsellee’s desire for a
righteousness of their own could well drive their mental re-habituation
(especially if they know that their pastor will hear all about their
mental habits the following week).
Again it
must be clear that being leads to act.
The Christian does not ‘change the tape’ in order to think their
way to a new mind-set. The
Christian is new and now thinks out of their new centre in
Jesus.
It is significant
that Paul’s two great mind renewal verses (Rom 12:2 and Eph 4:23) both
have ‘renewal’ in the passive. We
cannot think our way to renewal but are renewed as our minds are
acted on by a truth beyond us. For
this reason, the words we say to ourselves may be important, but the
words said to us are crucial. That
is our next point…
8)
Truth spoken to ourselves is important, but truth
spoken from beyond ourselves is even more vital.
The alien
word of an alien righteousness comes best from another. As important as it is to ‘change the
tape’ on your automatic thoughts and ensure your self-talk is godly and
true, God has ordained that our beliefs are shaped from outside
ourselves. Faith comes by hearing
and God gives us communities and preachers within them to proclaim a
truth from beyond. It is often
said that the gospel is not in us – it is above and beyond us in
Christ. Putting ourselves in the
way of gospel preaching and speaking the word to one another in community
ought to be our primary means of ‘changing the tape.’
9)
CBT is in danger of defining the problem so that
the solution is within my grasp
This is not
simply a problem for CBT but for all reactive counselling. However CBT is more problem-solving
focussed than most and so seems to promise easier answers than most.
Whenever
the problem is defined as less than the curse of all creation, my
desperately fallen flesh, the power and policy of hell and my
wrath-deserving sin, then the solution will be something less than Christ
– His life, death, resurrection and return. Instead the solution will be thought of
as some power of change within me and the gospel of redemption will be
turned into a religion of repentance.
The
Christian using CBT ought to linger long at the diagnosis stage. We must face the awfulness of our
wretched core beliefs and wonder at our own faithlessness and
idolatry. As we seek to challenge
and replace these ‘schemas’ we must realize that such repentance does not
atone for them – only the blood of God is sufficient for our wicked
unbelief. We rejoice at the change
that God may choose to grant as we examine our thinking, feeling and
acting, but we continually confess that it is entirely beyond us. If CBT simply revealed our inability
to change it would have served a wonderful gospel purpose. Yet the Christian counsellor must watch
that the solution-oriented drive of CBT does not then proclaim a hope
outside of Christ.
Conclusion
With the 9
caveats expressed above, the Christian pastor can use CBT techniques to
great effect in pastoral ministry.
In 1-1 contexts presenting issues can be used as a starting point
for discussing deeper issues of the heart. Through these lines of questioning,
idolatrous commitments are uncovered and seen more clearly. As Proverbs 20:5 says, “The purpose in
a man’s heart is like deep water, but a man of understanding will draw it
out.” CBT techniques can assist in
this ‘drawing out’ process.
In the
wider context of the congregation, the questions generated by the CBT
fraternity can be used by all who are seeking to ‘confess [their] sins to
one another’
and to ‘speak the truth in love.’ In going beneath surface issues, these
techniques allow a deeper sharing of life and a more profound revelation
of the depths of our sin and thus the depths of Christ’s covering.
CBT should
never be seen as the solution but as one tool which, when guided by
Scripture, can help diagnose the problem.
The success of CBT ought not to send us back to the secular
therapist but back to our Bibles where we will see again the tremendous
importance of our beliefs and thinking. Cognitive restructuring was first
God’s idea and while non-Christian practitioners may have refined some
few techniques in the area, they must be deployed in the context in which
God intends such mind renewal.
That context is in the prior indicatives of the gospel, in the
community of believers, alongside the preaching of the word, in
dependence on the Spirit’s power, in recognition of our own impotence and
in waiting for Christ’s return which is the only true salvation from our
fallen state.
BIBLIOGRAPHY
Martin
Lloyd Jones, Spiritual Depression, Pickering & Ingliss, 1965
Richard
Gross, Psychology: the Science of Mind and Behaviour, Third Edition,
Hodder & Stoughton, 1996
Stanton L.
Jones & Richard E. Butman, Modern Psychotherapies: A Comprehensive
Christian Appraisal, IVP, 1991
Mark
McMinn, Cognitive Therapy Techniques in Christian Counseling, Word
Publishing, 1991
Roger
Hurding, Roots and Shoots: A Guide to Counselling and Psychotherapy,
Hodder & Stoughton, 1986
Roger
Hurding, The Bible and Counselling, Hodder & Stoughton, 1992
Neil T.
Anderson, Terry E. Zuehlke, Julianne Zuelke, Christ Centred Therapy,
Zondervan Publishing House, 2000
Michael
Neenan & Windy Dryden, Cognitive Therapy: 100 Key Points &
Techniques, Brunner-Routledge, 2004
Michael
Neenan & Windy Dryden, Cognitive Therapy in a Nutshell, SAGE
Publications, 2006
Zindel V. Segal, J. Mark. G. Williams,
John D. Teasdae, Mindfulness-Based Cognitive Therapy for Depression,
The Guildford Press, 2002
Diana
Sanders & Frank Wills, Cognitive Therapy: An Introduction,
SAGE Publications, 2005
Ruth
Williams, Making Sense of Cognitive Behavioural Therapy, Mind
Publications, 2001
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