Can an Unregenerate Cognitive-Behavioral Therapist Be Christ-Centered?
My short answer: “No.”
Longer answer to follow. But why am I even asking the question?
- My friend, David Murray, recently posted, Is Cognitive-Behavior Therapy from the Devil?
- His post was in response to my post, “I’m Thinking about Going to the Doctor for Depression Meds”—What Is a Compassionate, Comprehensive Response?
- And my post was in response to David’s post, “I’m Thinking about Going to the Doctor for Depression Meds.”
That’s a lot to follow, I know. Allow me to summarize.
In David’s original post, in addition to other comprehensive counsel, David recommended the following to his Christian friend who was struggling with depression:
“Given what you’ve told me about your state of mind, you should ask your doctor about ongoing counseling, preferably from someone with expertise in CBT (Cognitive Behavior Therapy). That will help you re-train your mind/thinking patterns for long-term recovery. If it was a Christian counselor, that would be even better, but make sure they are trained in CBT.”
In my post, I addressed two areas of concern about David’s recommendation:
- Concern # 1: Could an unregenerate cognitive-behavioral therapist provide Christ-centered, gospel-saturated, grace-focused, Jesus-like counsel?
I said that CBT practiced by a non-Christian, by definition, would be a worldview conflict. I noted David’s fine book, Jesus on Every Page, and then noted that a non-Christian therapist could not, by definition, offer a Jesus-focused worldview to Christians struggling with depression.
- Concern # 2: Is cognitive-behavioral therapy, even practiced by a Christian, comprehensive enough to recommend to a Christian struggling with depression?
I said that a Christian practicing CBT would not be practicing comprehensive counseling. Rather, I recommended a more comprehensive biblical counseling approach that includes behaviors and beliefs, but does so much more: it explores biblically matters of the soul, the heart, our relationship to Christ, our emotions, our mindsets, our mood states, our purposes, our social situation, etc. I went to great lengths to note that David’s overall approach was toward comprehensive care, but that I thought his recommendation of CBT was an approach that was far less comprehensive than a biblical counseling approach.
David then responded with his post, Is Cognitive-Behavior Therapy from the Devil?
I have to hand it to my friend, David, that was a catchy title (if somewhat slanted and slanting…).
David then said:
“In my friend Bob Kellemen’s thoughtful and largely helpful response to my post about going to the doctor to discuss depression meds, he said that his most serious disagreement with me was about my recommendation of Cognitive Behavior Therapy (CBT).”
I don’t think that’s an accurate summary of what I said…
As I noted above, my first concern was about whether an unregenerate cognitive-behavioral therapist could provide a depressed Christian with Christ-centered, gospel-saturated, grace-focused, Jesus-like counsel.
And my second concern was about whether “Christian cognitive-behavioral therapy” was a comprehensive approach to helping a Christian struggling with depression.”
I think it is important that we not conflate those two concerns into one concern, which is what I sense David has done.
Soul Care or Car Care?
In David’s post, he originally made a comparison between taking our car to a non-Christian mechanic and going to see a non-Christian therapist. To his credit, when I interacted with David, he removed that part of his post and agreed that this was a poor comparison. So, please hear me: David does not believe that comparison.
However, that comparison comes up very frequently in these discussions. A similar analogy was also made by a commenter on David’s blog (going to a non-Christian oncologist was compared to going to a non-Christian therapist). So, it is an important perspective that needs to be addressed.
Comparing going to a non-Christian mechanic for my car with going to a non-Christian therapist for my soul is much more than a poor apples-to-oranges-comparison.
It poorly and inaccurately compares an inanimate object (a car engine) to a soul created in the image of God.
Here is the comment I posted on David’s blog before David removed that part of his blog:
You wonder out loud in this post if concerns about non-Christian cognitive-behavioral counseling is akin to saying you don’t take your car to a non-Christian mechanic. I believe it is totally different.
My car does not have a heart, mind, soul, will, affections, longings, mood states, purposes, mindsets, etc. A person struggling with depression, just like every person, does have a heart, mind, soul, will, affections, longings, mood states, purposes, and mindsets.
If the goal of cognitive-behavioral therapy is to help us to change our worldview, our mindsets, and if at the core we are worshiping beings with either foolish or wise mindsets, then I do not want to send my depressed Christian friend is to a non-Christ, non-Jesus, non-gospel, non-grace, unregenerate therapist.”
Another person on David’s site then suggested that David was simply using CBT as a tool and that CBT was not a worldview. I responded with this comment.
“I believe that CBT, in particular as practiced by an unregenerate counselor, is much more than a tool. When trying to help someone “re-wire” (renew) their mindsets, worldviews about what is foolish thinking and what is wise thinking must come into play. There really is no such thing as counseling that is only tool-oriented or technique-oriented. Counseling is soul-to-soul, and worldview-to-worldview connecting. Note that my emphasis, as in my original post, is on the unregenerate practice of CBT.”
A Biblical Understanding of the Soul or a Secular Understanding of the Soul?
Someone also posted on David’s site that:
“This pitting of psychology against the Bible is misguided. People who do so would benefit from an overview course on the history of psychology.”
I did not respond to that comment on David’s site since I was already taking up too much space on David’s site. However, that comment deserves a response.
First, I would not call this “pitting psychology against the Bible.” I would call this, “developing and using a biblical psychology rather than sending Christians to non-Christians for soul help.”
Second, having studied the history of psychology, having taught a graduate course on it for two decades, and having written about it in half-a-dozen books, it is clear to me that there is a biblical psychology and there is a secular psychology. And both have their own unique and committed worldviews that are worlds apart. The unregenerate counselor has a non-grace, non-gospel, non-Christ worldview about people, problems, and solutions. The regenerate counselor seeks to develop a grace-saturated, gospel-centered, Christ-focused worldview about people, problems, and solutions. So, yes, there is an immense difference between a secular psychology and a biblical psychology. Those two worldviews are already pitted against each other.
Are We Talking about the Same Thing?
David then states that he is baffled because he wonders if we are talking about the same thing. He says, “CBT’s basic point is that what we think affects what we feel and do. Therefore if we can change what we think, we can change how we feel and what we do.”
It appears to me that David is now focusing on a “Christian CBT.” At least I think so. I will assume he is.
I would still say, “Christian CBT, even apart from issues of integration of a secular worldview, is not comprehensive enough.”
A comment David made on my post, along with my response, should be helpful.
“I have not found many biblical counselors who are good practitioners in changing the kind of thinking patterns that I had in view here. They are good for many, many human problems, including some aspects of depression, but there are areas of anxiety/depression that I’ve found need a few sessions of specialist help and can have hugely beneficial impact not just in the short-term but in building new habits of thinking and acting for the long-term. Nothing spooky here! Just well-trained and experienced practitioners who have helped many to see themselves and their world more truthfully and realistically.”
“I’m sorry you have not found many biblical counselors who are good practitioners in these areas. I have found many who are. In fact, if we are not good in these areas, I don’t think we are good, compassionate, comprehensive biblical counselors.
That does not mean that every individual counselor is an expert in every area. It does mean that, as Stuart Scott and Heath Lambert indicate in their book, Counseling the Hard Cases, biblical counseling by definition should be able to address the types of issues you mention.
A compassionate, comprehensive biblical counselor should be skilled in the very areas you raise: 1.) changing thinking patterns, 2.) addressing anxiety/depression (see my work Anxiety: Anatomy and Cure as one example, 3.) in building new habits of thinking and acting for the long-term, and 4.) helping others to see themselves and their world more truthfully and realistically.
I believe that biblical counselors do much more comprehensive work than those four areas you outline—but they at least should be able to provide loving and wise counsel in those four areas.”
Why recommend that a depressed Christian go for cognitive-behavioral therapy, when you could recommend that a depressed Christian go for grace-based-spiritual-social-self-aware-relational-rational-mental-beliefs-mindsets-volitional-motivational-behavioral-emotional biblical counseling that compassionately and comprehensively also understands that we are embodied beings (and thus the possible need for medical intervention)?
In David’s post, he also says:
“If our thoughts are fixated on spiritual matters like God, sin, and guilt, paralyzing and debilitating us, then usually scriptural truth can transform us over time by renewing our minds. But what if our thought habits are on everyday matters like being obsessed with cleaning door handles, or irrational fears about our health, or phobias about open spaces? What if we’ve got into any number of negative thought patterns about our children, our ability to cope, our work situation, etc.? That’s where CBT can be so helpful. (Yes, with Scripture, prayer, fellowship, etc. too).”
To me, this creates an unbiblical dichotomy between the sacred and the secular, between the spiritual and the non-spiritual. Biblical counseling, as Scott and Lambert (see above) illustrate, addresses all of the issues mentioned by David—in a compassionate, comprehensive way.
“Stop It!” Counseling?
David then discusses “Stop It!” Counseling. Whether intended or not, that reminds me of the old Bob Newhart skit on “Stop It!” Counseling. That’s certainly not what robust, rich, relational biblical counseling is all about.
David believes you need extra help to stop habitual thinking—and says that extra help is CBT. I happen to disagree that CBT is necessary for stopping habitual thinking.
I believe that the comprehensive means of grace given to us are effectual in helping us to stop conforming to the thinking of the world (about all types of life issues) and to start renewing our minds so we think like Christ (about all types of life issues).
David might counter by saying that, “CBT is one of those means of grace.”
I would counter by recommending the much more rich, robust, relational, comprehensive, compassionate biblical counseling, and not CBT.
Join the Conversation with Three Questions
David leaves you with the question: “Is CBT of the Devil?”
I leave you with two questions:
“Can Unregenerate Cognitive-Behavioral Therapists Provide Christ-Centered, Gospel-Saturated, Grace-Focused, Jesus-like Counseling?”
“Is CBT Comprehensive Enough, or, Should We Recommend Compassionate, Comprehensive Biblical Counseling?”
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