What about therapy and counselling?

Question 11102

Therapy and counselling make some Christians uneasy, and I understand why. The suspicion is that a secular discipline will quietly relocate the problem from sin to circumstance, tell you that you are fine as you are, and hand you a vocabulary of self-actualisation instead of repentance. That does happen. It is not the whole story.

Other Christians go too far the other way and treat every difficulty as a matter for the professionals, as though the church had nothing to offer beyond signposting. That is not right either. What we need is a way of thinking that can tell the difference, and Scripture gives us more help with this than we usually notice.

Scripture already commends wise counsel

The Bible is not silent on the value of talking to somebody. Proverbs 11:14 says that where there is no guidance a people falls, but in an abundance of counsellors there is safety. Proverbs 15:22 makes the same point about plans failing for lack of counsel. Proverbs 27:9 speaks of the sweetness of a friend’s earnest counsel.

The New Testament assumes something similar in the life of the church. Believers are told to bear one another’s burdens, to encourage one another daily, to confess sins to one another and pray for one another. The verb parakaleo, to come alongside and encourage, describes a whole ministry that every congregation is supposed to be doing.

So the principle behind therapy and counselling is not foreign to Scripture at all. Human beings are helped by being listened to and spoken with wisely by someone outside their own head. The question is never whether that is legitimate. The question is what is being said once the listening stops.

Where the real difficulty lies

Every school of therapy carries assumptions about what a human being is, what has gone wrong, and what a good life looks like. Those are theological questions whether or not anyone says the word theology. A therapist who believes the self is basically good and needs releasing will steer you somewhere different from one who believes you are a creature accountable to God.

This is where genuine care is needed. Some approaches will encourage you to leave a marriage because it no longer serves your fulfilment. Some will treat guilt as a symptom to be dissolved rather than a signal to be heeded. Some will affirm as identity what Scripture calls sin. Those are not neutral techniques, and a believer who hands over the steering wheel without noticing may find themselves a long way from home.

Equally, plenty of therapy and counselling makes no such claims. Cognitive behavioural work on catastrophic thinking, trauma treatment, help with panic responses, practical strategies for obsessive compulsive disorder: much of this is closer to physiotherapy for the mind than to a rival religion. Refusing it wholesale is not discernment, it is a blanket policy standing in for thought.

Therapy and counselling cannot forgive sin

Here is the limit that matters most. No counsellor can absolve you. If your distress is rooted in real guilt over real wrongdoing, the remedy is not a technique for managing the feeling. It is confession and the assurance that the blood of Jesus has dealt with it.

I have sat with people who spent years and considerable money learning to live with a guilt that could have been lifted in an afternoon by the gospel. That is a tragedy, and it is exactly the scenario the sceptics fear. The distinction to hold on to is between false guilt, which needs to be answered with truth, and true guilt, which needs to be answered with forgiveness. Therapy and counselling can be excellent at the first and can do nothing whatever about the second.

Nor can any therapist supply meaning. A person can become extremely well adjusted to a life that is pointing nowhere. 2 Timothy 3:16 says Scripture is profitable for teaching, reproof, correction and training in righteousness, and there is no substitute for that. More on this in my answer on the role of Scripture in counselling.

Choosing well, and asking questions

If you are considering therapy and counselling, do the same homework you would do before major surgery. Ask what approach they use. Ask what they think the goal of treatment is. Ask, if it matters to you, whether they can work respectfully with someone whose convictions are shaped by the Christian faith. A good practitioner will not be offended by any of that.

A Christian counsellor is often a help, though the label alone guarantees nothing. Some are excellent, well trained and biblically grounded. Others have a certificate from a weekend course and a great deal of confidence. Ask about training and accountability just as you would with anyone else, and be wary of anyone who cannot say where their supervision comes from.

Watch also for the warning signs that apply anywhere: a practitioner who isolates you from your church or family, who fosters dependence rather than working towards your independence, who cannot say when the work might end, or who claims authority over decisions that are yours to make. Those are red flags in therapy and counselling exactly as they are in ministry.

The church should be doing some of this

I am persuaded that a good deal of what people currently seek from professionals is what a healthy congregation used to provide. Someone who will listen without hurrying. Someone who has known you for twenty years and can say the hard thing. Older believers who have walked through the same valley and can tell you it does not last forever.

Galatians 6:2 tells us to bear one another’s burdens and so fulfil the law of Christ. That is not a slogan for a church noticeboard, it is a job description. Where congregations actually do it, the need for paid help drops, not because therapy and counselling are bad but because much of what people were paying for is available for free among their own brothers and sisters.

Where it does not happen, we should be honest about the failure rather than criticising people for going elsewhere. If a lonely widow in your congregation is telling a stranger about her week because nobody from church has telephoned, the problem is not the counselling industry.

What about the past?

A particular anxiety attaches to therapies that revisit childhood and early experience. Some Christians regard this as a way of blaming parents and evading responsibility, and it can certainly be used that way. Scripture is clear that each of us answers for our own choices, and no account of our upbringing removes that.

Yet understanding is not the same as excusing. A woman who flinches at raised voices because of what she heard as a child is not making excuses when she recognises the pattern. She is describing something true, and naming it accurately is usually the first step towards no longer being governed by it. Joseph could say plainly to his brothers what they had done to him and still forgive them, and the forgiveness was the stronger for being honest about the injury.

Where therapy and counselling help someone see clearly, that is a servant of repentance rather than a rival to it. Where it becomes a permanent search for someone else to blame, it has stopped helping. The difference usually shows up in whether the person is becoming more able to love and forgive, or less.

Both together, not one instead of the other

The most useful arrangement I have seen is a believer receiving professional help for a specific difficulty while remaining fully in the life of their church. The therapist addresses the panic attacks. The congregation supplies belonging, worship, Scripture and prayer. Neither pretends to do the other’s job.

That combination also protects against the two failures at either end. It prevents therapy and counselling from becoming a substitute religion, and it prevents the church from expecting people to pray away conditions that need treatment. See also my answers on mental illness and on whether Christians should take medication.

And do tell your pastor you are going. Not for permission, which is not his to give, but so that he can pray intelligently and so that you are not carrying it alone. Secrecy is nearly always the enemy in these matters, and a shared burden is already a lighter one.

So, now what?

If you have been putting off getting help because you are not sure it is allowed, consider it allowed. Ask around for a recommendation, ask the questions above, and go with your eyes open rather than either suspicious or naive.

If you are in leadership, ask a harder question. Is your congregation the sort of place where burdens actually get carried, or the sort where everybody says they are fine? What would need to change for someone to risk telling the truth on a Sunday morning?

Where there is no guidance, a people falls, but in an abundance of counselors there is safety. (Proverbs 11:14, ESV)