The purpose of counseling
“Do you think I’m crazy?”
When people come to see me for counseling, the most common question they ask is, “Do you think I’m crazy?” They usually ask this as we’re ending our first session. They sometimes say, “You must think I’m crazy,” or “I bet you’ve never heard anyone this messed up before.” The assumption they have about counseling is that it is for crazy people. They never define what “crazy people” are, but they are pretty sure they must be one if they are in my office.
The people who ask this question understand they are in a therapist’s office for a reason. They might not be able to articulate what brings them in there or why the feel or think a certain way, but they know that coming to see me must serve a purpose. There are different schools of thought in regards to counseling, and these schools do not define counseling in the same ways because they have different agendas.
Additionally, every individual approaches therapy with an agenda—even the therapist, and this agenda is heavily influenced by a person’s worldview. A worldview is the way a person understands the world, how it works, and, in some cases, how it should work. Agenda, as I mean it here, refers to a directional component of worldview. For example, if your worldview maintains that people should care for those less fortunate, then how you shop, how you give, and how you vote will likely be driven by that agenda some sort of agenda.
Even though schools of thought, individuals agendas, and personal worldviews may vary, I have found all of these aspects of mental health have three things in common.
Counseling acknowledges something is not right. The something can result in mild annoyance or major breakdown. Some schools of therapy teach that how we think about things is the problem, the something. Some teach that our struggles result from the conflict between the conscious and the unconscious. Some say a lack of self-acceptance is the problem, and others teach that our problems result from unbalanced chemicals in the brain. Whatever the approach, there is an acknowledgement that something is not as it ought to be.
Counseling includes a call to action. However deterministic a person’s view of humanity might be, all schools believe that the individuals for whom they provide services are called to do something. Sometimes, this something might be as simple as gaining new insight into why we do certain things, and other times it might involve making drastic changes to how a person lives his or her life and interacts with others.
Counseling encourages continued work. Change is hard, and all schools of counseling agree an individual must actively participate in his or her own treatment. Work can involve anything from continuing to take medication, continuing to attend therapy sessions, or continuing to engage in introspection.
We can identify these three aspects in every type of counseling. Cognitive behavioral therapy argues that how we think about things is wrong; and, therefore, we need to challenge those thoughts. For example, a therapist might suggest journaling daily to see if other unhealthy ways of thinking, or cognitive distortions, arise. Reality therapy says our dissatisfaction is because our needs are not being met, and we are called to take responsibility by making choices that yield different results. Biblical counseling would say sin is the problem; therefore, we need to repent and seek God on a daily basis to be healed.
How does my worldview impact how I approach counseling?
Counseling acknowledges something is not right. As a Christian, I think the primary something wrong with the world is sin, not just our own sin, but sin as a result of the fall. This means that we are not just perpetrators of sin, but victims of sin as well. A person with a history of abuse who lashes out violently at others has been harmed and harms others. It also means our brains do not function perfectly. A person is always responsible for their actions and their choices; however, they are not always responsible for their situation.
Counseling includes a call to action. Because a person is responsible for his or her choices, often the call to action will include a blending of approaches. If there is sin, they should repent. If they fall into the trap of thinking things that aren’t true, they need to explore the rationality of those thoughts. If, after speaking with the therapist and the doctor, they think medication might be a helpful tool alongside therapy, then that is something to pursue. If their lifestyle choices and social systems contribute their distress, they may want to reconsider how they manage those relationships.
Counseling encourages ongoing work. Because we are fallen creatures living in a fallen world, we cannot expect to get things right all the time. We can expect problems, and we can expect to fall short of perfection, even when we are diligent in preserving our mental, physical, and spiritual health.
How do we recognize where sin ends and mental illness begins? What role do grace and prayer play in recovery? Where does medication come in? These are questions I have as a therapist and as an individual in therapy.
Two final thoughts:
Counseling here specifically refers to counseling in a more formal capacity, but we need to ask similar questions as we talk with friends and loved ones about their lives and ours. This is especially pertinent for those serving in ministry.
The goal of therapy is not happiness, contentment, or peace. The goal is truth. If we want to have any semblance of the former, we must build on a foundation of the latter.
If you have any questions about steps you can take to pursue treatment or support those you love, please contact me at benton@lamppostcounselingcenter.com.