Faith & Mental Health 3

Lord, we come before you in various states of being scattered.

Would you gather us, turn our hearts towards you,

and may your word and your purposes be accomplished in this time.

In Jesus' name we pray. Amen.

Amen.

All right. Well, thank you, everybody, for being here.

And, yeah, we're looking forward to today.

So the last two weeks, just as a recap,

we were covering kind of questions around causes of mental illness.

That was week one.

And then last week we really looked at can mental illness exist in Christians

and are faithful Christians able to sort of acknowledge the existence of mental illness.

So today we're going to be sort of presupposing that mental illness exists

and that Christians can have mental illness.

We're going to be looking at what specifically do you do yourself

or for a friend or family member if somebody is struggling with mental illness.

So we're going to be going into more specifics in terms of mental health treatment today.

Hi.

As opposed to kind of covering the more broader theological issues.

But we will touch on some different questions around faith and mental health, too.

So as always, we really welcome questions, disagreements, concerns,

and we'd love to hear experiences from you all.

All right.

So maybe we're going to focus today on kind of three questions,

the who, what, when, where, and why of seeking mental health treatment.

So we'll try to bring our professional sides in a little bit

in terms of offering some input on mental health treatment,

as well as obviously talking about the faith aspects as well.

So Stephanie, do you want to start us off with starting us off with the who?

Yeah, yeah.

So in terms of like who does professional mental health treatment,

kind of like the two big categories are therapists

and medication management helpers.

And so in terms of therapists, Elena can talk a little bit about what kind of training goes into that.

In terms of medications, these are generally MDs, APRNs.

They can be DOs as well.

They're people who've kind of had a little bit more of the biology training

in order to kind of differentiate, you know, where are, you know,

in terms of the mind-body connection,

where depression might manifest as lethargy or tiredness or trouble eating.

Is it something related to a thyroid hormone?

Is it a vitamin deficiency?

And so having a little bit of training around how that integrates into the physical body

is part of the work of an MD.

Some of the medication providers will also do therapy.

And so a therapist can have like any number of credentials,

but just kind of depending on the practice,

that would be something important to know,

you know, whether they concentrate mostly on medications for mental health conditions

or whether they also integrate therapy into it.

So sometimes people have split treatment where they have, you know,

one person doing the therapy, one person doing medication management.

But sometimes, and this will usually be in private practice,

where they integrate both with that piece.

But if you want to talk a little bit more about that.

Yeah, so in terms of therapists, like if you're,

I think this is going to be an overwhelming process.

If you're like, I need therapy.

I know I need to talk to someone.

How do I possibly find who I should talk to?

And that's really overwhelming.

And I say that as a therapist,

I think it's really overwhelming to navigate the system.

So a few, we'll kind of get to the general professional side

and then the Christian side.

So in terms of therapists, a lot of people online

can sometimes call themselves therapists or counselors or that type of thing.

It's important to make sure somebody's licensed

if you're looking for a professional mental health treatment.

There's like life coaches and different people

who might have like the term counselor or coach or something like that

who don't actually have a professional mental health license.

So you'll want to look in somebody online,

their profile should list like I'm a licensed social worker,

psychologist, or clinical mental health counselor

in the state of Connecticut.

Or they should be in the process of obtaining licensure,

which means they're still working toward their hours,

but they're under supervision of somebody who is licensed.

And that's fine too.

But sometimes I think I look at certain online profiles

and I'm like, oh, this person's marketing themselves as a therapist,

but they might not be a bad person to talk to for some things,

but they haven't actually obtained a professional licensure to be a therapist.

It's important to note that.

And we'll get into this in a little bit,

but there is a category of biblical counselors.

And we're going to talk a little bit about that

in terms of differences between biblical counselors

and professional mental health professionals.

But biblical counselors are not usually licensed therapists.

I suppose somebody could have a double sort of degree,

but biblical counselors are sort of a separate category.

They have not received professional mental health training.

So in terms of who do you look for,

I think it's really important.

And we're going to talk about like,

do you need to see a Christian?

And we'd love to hear kind of everybody's perspectives about that.

But finding somebody that you trust is really good

and finding somebody who just feels like a good fit.

And I usually tell people like,

if you've gone to see somebody three times

and after the third time, you're like,

I think that's a pretty good sign that you can look elsewhere.

Because if you're really opening up about really vulnerable things,

it's important to feel like the person understands you,

you can trust them.

Sometimes after the first time,

especially if it's your first time going to therapy,

it might feel so weird

that you might not necessarily feel connected

to that person right away.

But three times I think is usually enough

to have a gut feeling of like,

is this good or not good?

It's also great to get referrals from friends

or our elders to make professional mental health referrals.

So if you can get a recommendation,

like, oh, someone I know saw so.

And so that can be nice

just to have a little bit of a personal connection.

So yeah, those are a few notes.

Anything you'd add to that, Stephanie?

No, I think, and we can talk a little bit more

as we segue into kind of something we've heard often is,

you know, does my therapist or psychiatrist

need to be a Christian in order to really kind of understand that?

And I think we've, we talked about this a little bit

and we landed on, you know, it could be helpful,

but I think that depending on kind of what that topic

might look like,

but really that idea of, you know, opening yourself up,

do you feel like this person is trustworthy and competent?

Those are probably going to be more important.

And other factors such as like,

if they take your insurance,

if they're geographically located,

if they don't take insurance,

are they affordable in some way?

Those might be more salient factors

than is this person a Christian?

And I think I would also note that

even if someone is saying like,

oh, I'm a Christian therapist or psychiatrist, right?

That that spectrum of Christian beliefs

is so big as well

that even if they're saying that they're Christian,

that doesn't necessarily mean

that they hold the exact same beliefs,

core beliefs as you and the sense of the world.

And so even figuring out kind of where they might be

and how that translates into the therapy process

is something that shouldn't be assumed.

Were you going to say the term biblical counselor

and Christian counselor interchangeably,

or are there two distinctions?

Two distinctions.

So biblical counseling,

and we'll talk about that.

We might say biblical counseling for our next section,

but biblical counseling is folks

who are not trained mental health professionals.

Like they don't have graduate level training

in mental health treatment,

but they've gone through a program

for biblical counseling,

which is really the process of using prayer

and scripture exclusively

to treat mental illness or mental health diagnoses

versus a Christian counselor.

Usually a Christian therapist will be a Christian

and perhaps bring in prayer

or other sort of biblical principles

or things like that,

but they're also employing psychological treatments

that are sort of more broadly used.

So I'm curious.

So yeah, Stephanie and I had some different ideas around

when is it helpful

that you probably should see a Christian?

When does it more important to see someone

who is competent in your area

that you're seeking treatment for?

And there's a lot to be said about that,

but I'd love to hear from people

just as you think about seeking

mental health treatment therapists,

like how important does it feel to you

that they're a Christian or not?

And what have been your experiences with that?

Either way, we'd love to hear.

Either yours or people that you know.

Yeah.

I think for me,

as a person that's been recently

trying to seek that out,

I think it's been harder for me

trying to seek out a Christian therapist

or counselor or anything

because I feel like in a lot of different ways,

especially in the area that I live in,

I'm surrounded by

therapists that don't look like me

or don't understand

where I'm coming from.

It's like sometimes struggling mentally

in a,

like my day-to-day life

or like Christian life.

It's like,

it just seems so complicated

to talk to a certain type of people

sometimes.

Yeah.

I think that's like

the best thing for me.

It's like other aspects of identity

can matter too.

Yeah, for sure.

For sure.

Absolutely.

Yeah.

How about other people

who feel it's important

to see a Christian

or maybe hasn't been

pros and cons?

I think it's important.

Mm-hmm.

Yeah.

Tell me,

yeah,

say more what,

what has been,

yeah,

what has been helpful for you

about seeing a Christian?

They're saying beliefs

based on what God teaches us

in the Bible

and treating each other

and how to do

a Christian from God.

Mm-hmm.

Mm-hmm.

Yeah.

Yeah.

Because non-Christians

might not have,

they probably don't have

all the same values

and goals.

Mm-hmm.

Mm-hmm.

Mm-hmm.

Yeah.

Right.

And this is where

we kind of talked

a little bit about,

you know,

if you can't find

a Christian therapist,

that maybe it could be

enough that they're

faith-affirming,

right,

and so that they're

not trying to,

you know,

impose any sort of

their beliefs

or worldviews on you,

but really trying to

work within your framework

of understanding

and how you feel,

you know,

your goals are influenced

by Christianity.

And so I think that

there's a difference

between,

you know,

a therapist who's kind of

maybe actively telling you

some of the things

that you're bringing

into the room

are not helpful

and kind of dismissing it

versus somebody

who is genuinely curious

about, you know,

what matters to you

and how can we

work around this issue

so that what matters to you

gets accomplished.

And I think also

just kind of even

within Connecticut,

it may not even be an option

to see a Christian psychologist

or therapist

because they are few

and far between.

And so I think

having somebody

who is faith affirming

or at least open

and not trying to

kind of tell you

it doesn't matter

would be an appropriate

place to go.

So with that,

like,

when we get,

like,

stuck in that,

like,

we're going to build

telling us all the things

that we need,

like,

want to hear

versus some of the hard things

that we need to hear.

So just,

like,

I don't understand,

like,

you know,

I don't think I could,

like,

do the same thing

because,

like,

we have to be

little Christian people

in order to talk about

our struggles

and mental health

and,

like,

all these other issues

we have.

Like,

people outside of our circle

can't give us advice

or feedback

on,

like,

the good of the world

and stuff

that they don't believe

or what we believe

or how do we,

you know,

what they believe

until,

like,

we get to know them.

and their jobs

not to allow us

to get to know them

or be like that

more so

for them to help us

understand us.

So I'll know me.

Yeah.

Yeah.

No,

I think those are

good points.

A couple thoughts,

you know,

kind of along those lines

of,

like,

when do you,

when is it most helpful

to seek out a Christian

versus maybe when is it

not something

absolutely necessary?

I think,

so,

for instance,

like,

if your mental health

concerns are very

sort of interwoven

with spiritual concerns

as well,

so perhaps maybe

if you've experienced

spiritual abuse

and,

or abuse in a church context

and your,

your mental health

is very much tied

with,

like,

trying to find a way

forward in your faith

despite having experienced

spiritual abuse,

for me,

that would be harder

for me to see

not a Christian

for that personally,

right,

because it's like,

oh,

I really want someone

to help me find a way

forward in my faith.

Like,

and myself personally,

I've seen a few therapists,

I think two are Christians

and one is not

and I've had a really

good experience

with my current therapist

who's not a Christian

but I've had a different

kind of really valuable

experience with therapists

who are Christians,

I think just depending

on kind of what

you're looking for,

so if,

you know,

there's this spiritual

abuse issue

wanting to understand

how depression

and faith go together,

a Christian therapist

is probably best

for that

if you can find one.

If it's like,

for example,

you're dealing

with a tic disorder

and you need

a very specific

form of treatment,

it's called habit

reversal turning,

like to help you

not sort of prevent

verbal or motor tics,

it might be nice

to see a Christian

for that,

right,

like,

all things being equal,

I would probably

always rather see

a Christian

who had equal

competency

to somebody

who's not a Christian.

At the same time,

if there's no

Christian therapist

who specialize

in tic disorder

treatment

and there's

a non-Christian

therapist

who does,

who,

yes,

tic disorder

is like involuntary

noises or movements

that sometimes

people can engage in

and there's somebody

who has that special

area of competency

who's not a Christian

who's still open

to and receptive

to you talking

about your beliefs,

in that case,

I'd say,

hey,

it might be a good

idea to seek

the treatment

from somebody

with that specific

expertise.

Obviously,

there's a lot

of gray areas

in there.

Anxiety,

depression,

can sometimes

have an aspect

of faith,

but there's also

aspects that are

not about faith

and so I think

it really,

yeah,

I think it depends

on kind of

the amount

of specialty

that you need

in a provider

and like Stephanie

was saying,

unfortunately,

Connecticut

is not abundant

with Christian

therapists in general,

especially those

who have openings,

so we,

which is

a problem.

I've never lived

in a state

where it's such

a problem.

It's really hard.

So I think,

you know,

keeping in mind

the idea

of common grace,

like that God

has provided

knowledge and resources

and training

to many people

who could be helpful

and may or may

not be as helpful

as a Christian

therapist for certain

things,

but also could have

specialized areas

of competency

even if they're

not Christians.

Yeah,

anything you would

add to that,

Stephanie?

I think on the

medication piece,

I think it's

like just easy,

a little bit easier

to draw the comparison

to like,

do we need

a Christian

primary care doctor?

Do we need

a Christian OB-GYN

who has all

the same values

around like,

when does life start,

right?

And you may have

different views on that,

but I would say

the majority of people

who are able

to find a primary care

doctor that they

can click with

or an OB-GYN

who is competent

to perform a C-section,

like they kind of

are able to work

with you around that.

And so,

again,

just trying to think

about,

you know,

mental illness

is different in some

ways,

but in a lot,

you know,

there's a lot of

overlap too

with kind of how

it manifests in the

body and how do we

choose our primary

care doctors,

right?

And we think about

other factors.

So it's just kind of

sometimes helpful

to think about

how do we treat

other medical

professionals as well

and what do we

expect of them.

I think psychiatric

or mental health

problems are different

because they deal

with our mind

and thinking

and our emotions.

We're just going

to a primary care

provider.

Yeah,

no,

absolutely.

Or an OB-GYN

or a whole other

cardiologist.

And I would say

like this is where

we try to balance

a little bit

about the sense

of like the brain

is an organ too,

right?

It's a physical

thing that also

can fail us

in the ways

that our hearts

can fail us

and our livers

can fail us.

And so there is

something about

medical care

kind of bringing

it back up

to a working state

that is very

similar to,

you know,

my liver is failing

and I need to

talk to somebody

about what I can

do to prevent

further damage,

how can I

kind of live

with this as a

chronic condition,

right?

I think that that

is true for a lot

of mental health

conditions as well.

And then I agree

that I think that

there is a certain

vulnerability to

talking about

the past

and emotions

and how we're

dealing with that

that can,

that is a,

that is a little

separate from

just a very

straightforward

like procedure

kind of a thing.

But I would say,

you know,

in areas of

an eating disorder

where your

electrolytes are

out of balance

and your heart

is at risk

or where somebody

is psychotic

and it's due to

in part to a

dopamine imbalance

or there's somebody

who,

yeah,

exactly,

but,

you know,

how do drugs

affect our bodies,

where are the

damage,

you know,

where are the

effects,

that kind of a

thing.

I think that

there is,

there is still

kind of more

clear biological

reasons and in

that case,

somebody with a

biological training

can be helpful

and I don't,

and it's a really

hard balance.

I think you're

right that it's,

you know,

we tended towards

like a very

materialist view

sometimes,

you know,

in secular culture

of,

you know,

mental health

is just

neurotransmitters

kind of running

amok or

it's just

like neural

circuitry kind

of a thing

versus maybe

sometimes over

spiritualizing,

you know,

some of the

depression and

anxiety,

but I think

we're really

trying to find

kind of that

balance of how

do we integrate

both because it

is really a

combination of

both.

And our problem

with psychiatric

mental health

disorders is that

our brain is

enclosed in our

cranium and we

can't visualize it

like we can't

with other parts

of our body,

we can't

with an X-ray

a cat,

an MRI,

et cetera,

et cetera,

all this testing,

we're actually

looking at the

organs.

It's not that

easy with the

brain.

Yeah,

absolutely.

Yeah,

and that's why

it is so hard

to comprehend,

right?

I think that

kind of that

overlap of

neurology and

psychiatry is

sometimes tricky,

but where,

you know,

scans are able

to tell us,

oh,

here's a tumor

that's causing

you,

you know,

damage versus,

oh,

here are these

things,

you know,

hormones and

neurotransmitters,

it's a little

bit harder.

It's easier

for therapy,

you can go in

there and do

surgery or

whatever you

need to do,

you know,

an ablation

and in the

brain,

you can't

do that.

It's challenging.

Or they used

to and it

did not turn

out so hard.

I said,

well,

they used to

do surgery

for kind

of,

like,

you know,

like that

could not

be treated,

you know,

mental health

conditions.

I think you

had a question

too,

or a comment.

I had a

comment,

yeah,

I was going

to speak

to the

vulnerability.

I think it's,

you know,

when I break

my arm,

I don't mind

someone looking

at it and

sharing that,

but when,

if someone has

something more

personal or

more mental

going on,

I think there's

a big vulnerability

aspect and

treatment is not,

it's not that

simple and it

doesn't always

make sense to

us and we

don't really,

you know,

we get kind

of caught in

our own mental

fog because,

you know,

broken arm,

I can trust

almost anybody

in a scrub

outfit for,

but other,

issues is not

that easy.

Yeah,

absolutely.

And I think

kind of to what

Stephanie was

saying,

for different

people,

the medication

prescribing piece

could be different

from the therapy

piece.

For me,

personally,

I'm more

comfortable seeing

somebody,

like medication

prescribers usually

see like once a

month or once

every few weeks.

I'm more

comfortable,

and you don't go

super in-depth,

it's more about

side effects and

kind of like for

some medication

prescribers.

so that doesn't

feel as important

to me if they're

a Christian,

versus therapy,

an hour a week

really diving into

your trauma and

your life history

and your emotions,

that might be more

important to see a

Christian for many

people, right?

So it can kind of

vary based on the

level and that like

what you're looking

for, yeah, if you're

looking for medications

or therapy, but

that's a great point.

Yeah.

I think it's also

helpful to recognize

the wide spectrum

of self-identified

Christians.

like Stephanie

was saying.

Like you could go

to a Christian

therapist and

still be like,

oh, like this

person does,

you know,

is not on the

same level in

terms of thinking

about God and

holiness.

Yeah.

It's true.

I used to drive

to Hartford to

see a Christian

therapist who

ended up wanting

to realign my

heart chakra.

right.

Yeah.

I've, uh, there's,

yeah, there's a

lot.

And so you can't

kind of tell from

somebody's website

profile all the

time, like what

Christian means.

And so that's why

often asking the

elders, asking a

friend for a

Christian therapist

recommendation.

Good.

Uh, yeah.

How often or how

likely is it that you

can in your first

session ask, like

spend time asking

them about them,

like interview them

as you're okay.

Yeah.

I didn't know what

that was like.

Yeah.

I think you

definitely can.

They, people have

different comfort

levels on what

they're willing to

answer depending

on their style and

kind of their

training and things

like that.

But especially if

you told them,

Hey, it's important

that somebody is

like understanding

my beliefs.

And that's why I'm

asking.

I feel like most

people would really

want to work with

you on that.

I would say.

Yeah.

Right.

I think it depends

on kind of what

type of therapy

they're trying to

do.

Right.

So again, if it's

like very behavioral

focused learning

skills, they probably

are happy to tell

you their credentials

and kind of where

they're coming from

and their philosophy

around it.

But if somebody's

like, Hey, how

many kids do you

have?

And like, where

do you live?

Like, that might

come off a little

different.

But you can ask

and it's up to

them to say, Oh,

I answer this and

that.

So you can ask

whatever you want

and they can,

they can answer.

Yeah.

Carolyn.

How do you guys

think about it?

Because you both

are Christians

who are therapists

but wouldn't

necessarily promote

yourselves as

Christian therapists

in your work

environment.

Yeah.

I mean, it's,

yeah, so we,

we work with a

wide variety of

students, mostly

students who

aren't Christians.

Christians.

And so I'm, I'm

really like, I

never hide it,

right?

Like I'm never

trying to hide

anything.

And if somebody

asks, I'll

absolutely tell

them.

And I think

it's pretty

widely known

at our, in

our setting

that we are

Christians.

Um, but if

somebody is not

a Christian and

that's, they're

not coming in

for Christian

concerns, it

might not be

relevant for me

to share that,

you know, probably

won't be helpful

for them in that

moment.

But I also

don't like keep

it a secret.

Um, I think

it's tricky in

terms of kind

of as a culture,

we are shifting

towards, you

know, like what

are our identities

are various

identities and

really wanting a

match in terms

of identities.

What, you know,

race, gender

orientation,

religion, that

kind of a thing.

And so sometimes

it just isn't

possible.

Um, but sometimes

we do get like

quote unquote

matched.

And I think it

is actually

interesting that

like most of

the people, at

least in my

experience who,

who are even

asking for a

quote unquote

Christian therapist

when they talk

about the things

that are bringing

them in.

Um, it may just,

it may be more

that they just

want somebody

who's not going

to judge them,

right?

Like who's not

going to say,

oh, your belief

in God is so

infantile versus

like here is my

thing that I'm

dealing with that,

that I'm wrestling

with the Lord that

really needs like

biblical, you know,

biblical advice to

weigh on, right?

And so I think a

lot of that desire

is around like,

which is common to

all of us, right?

It is, can you

understand me?

Can you respect

me?

Um, and so again,

I think that that's

kind of the more

salient factors when

we are limited, you

know, the side of

heaven with who is

available and who

can see us.

Yeah.

I have a kind of

generalized question.

So I'm just curious,

in general,

psychologists like you,

how much do they

understand like the

pharmacology involved,

like the different

antidepressants like

benzodiazepines and

SSRIs, SNRIs,

tricyclic antidepressants,

do most psychologists

understand that?

I wouldn't say so.

Yeah.

Yeah.

I think, yeah, which

is definitely good to,

I mean, I have a general

idea, especially more

SSRIs because that's,

you know, I hear about

them more anecdotally

and take them.

But, but, you know,

I think it's important

to consider somebody's

like degree specialty

really for, for what

you're going for.

So if you are wanting

medication advice, if

your psychologist is

giving you medication

advice, that's a red

flag actually, because

like somebody should

really have the degree

training like Stephanie

to be able to weigh in

on that.

And so sometimes people

try to kind of get

outside of their area of

expertise and weigh in

on what you, it's

appropriate for your

therapist to say, hey,

I would really encourage

you to take medication.

That's appropriate.

Or at least get a

medication consultation.

To get a consultation,

exactly.

But it wouldn't be

appropriate for them to

say, I think you

should consider it.

Yeah.

Yeah.

Yeah.

Exactly.

And, right.

And I think, again, it

speaks to the brokenness

of the mental health care

system because there is

such a shortage of

like medication, mental

health medication

providers that PC, like

primary care doctors,

are often doing the

medication piece.

And there was a, there

was like a movement

around, which is not to

say that PCPs can't do

a good job, but just

there is not somebody

who necessarily has that

specialized training.

And also there was a

movement in Connecticut

to allow psychologists

to go through some

training to prescribe

medications.

And that may happen,

but psychologists to

prescribe medication

because that would at

least widen the group

of people who can, who

can help with that

piece.

But I think there were

enough concerns raised,

at least in this moment,

to kind of put a pause

on that.

Yeah.

Some psychologists

wouldn't prefer to do

that.

Well, there's so much, so

much good discussion.

Maybe we should move on

to the what.

But if we would love to

hear other comments too,

as we have time at the

end about whether or not

to see a Christian, when

to see a Christian or not,

there's a lot to think

about there.

So in terms of the what

is therapy, I mean, I

think this is not

necessarily always obvious,

right?

Especially if you haven't

been to therapy, like

when you go, what exactly

do you do?

Like what can you

expect?

What can you not expect?

So there are different

types of therapies.

Generally, individual

therapy, you're sitting

down one-on-one with a

professional talking

about what's bothering

you, and they're

helping you relieve

your symptoms.

But that can look so

many different ways, of

course.

And so a very general

sketch of what things

could look like.

One form of therapy is

called CBT, cognitive

behavioral therapy.

anxiety.

This really lends

itself well to anxiety

disorders.

It's especially commonly

used for anxiety

disorders, often for

depression, usually used

for OCD in some

capacity.

So this type of therapy

is really focused on

helping change your

thoughts and how helping

change your thoughts can

help you feel better.

So for example, let's

say somebody has really

severe test anxiety, like

a student has bad test

anxiety.

Every night before a

test, they're throwing

up, they can't sleep,

they can't function the

day before because

they're convinced they're

going to fail, even

though they've never

failed a test before.

That person would be a

really, really good

candidate for CBT because

the therapist would say,

hey, like, let's kind of

examine the facts.

Like, you've never, you've

never failed a test

before.

It's unlikely that you're

going to fail it this

time.

Obviously, it's a little

bit more in-depth than

that, but that's kind of

the general approach is

helping them change their

thoughts and beliefs and

helping them think more

sort of realistically and

less self-critically.

So I think CBT often can

feel pretty comfortable for

Christians because it does

align with our, as

Christians, our belief in

right thinking and right

beliefs.

So even Stephanie pointed

out this verse when a

psalmist is asking, where's

your God?

These things I remember as I

pour out my soul, how I

used to go to the house

of God under the

protection of the mighty

one with shouts of joy and

praise among the festive

throng.

Why, my soul, are you

downcast?

Why so disturbed within me?

Put your hope in God, for I

will yet praise him, my

savior and my God.

So this person is kind of

doing CBT on himself, right?

Here he's saying, why are you

so downcast?

Remember these things,

remember these truths.

And that's oversimplified,

but that's generally what

CBT is trying to do.

CBT is often usually more

time limited, so it can be

like 10 sessions and it's

more targeted.

So that is one form of

treatment that's out there.

Basically, so like if I'm

talking with Stephanie and

I'm the therapist and

Stephanie's coming in and

saying, hey, I'm really

anxious about what people

are thinking about me, I

can't get it out of my

head what people are

thinking about me, then I

would talk to Stephanie and

say, okay, let's like write

down your thoughts.

So I would have Stephanie

keep track of her thoughts

throughout the day.

Like she'll say like, oh, I

think somebody hates me.

I think I'm a bad friend.

Somebody's mad at me.

She'd write down the

thoughts.

Then she would bring it

back to session.

This is what might happen.

And then I might say, okay,

let's go through these.

Like, do you think that's

true?

What alternatives to that

might there be?

What are you believing

about yourself that might

not be true?

If I was a Christian CBT

therapist, I might say, what

what is God?

What might God say that

might be different from

what what you're saying?

And I think there's a lot

around CBT of just even

so sometimes people are

like, oh, I just feel

really tense in my body.

I feel really anxious.

I can't sleep.

You know, they've kind of

gotten all the medical

piece checked out, but

they're not aware of kind

of what are the thoughts and

circumstances that are

bringing out that tenseness

or inability to sleep.

So I think part of therapy

is even learning how do we

monitor the thoughts that

are going through our head?

Where are we noticing that

we're getting really upset?

Right.

You know, and so learning how

to pay attention to our

thoughts is kind of that

first step.

And then like Alina was

saying, really questioning

ourselves a little bit like,

oh, even if this feels

really true, you know, my

friend didn't respond to a

text message for a couple

hours, they must be really

mad at me.

And even if that feels

true, is there a way I can

talk back to myself, ask

myself like, okay, you

know, is it possible my

friend kind of got busy and

forgot to respond and

they'll respond later?

Is it possible that maybe

their phone broke or

something like that?

Right.

So again, taking a step

back, differentiating

between like what that

automatic way of assuming

somebody is mad at us or

not liking us and being

able to question, well, what

evidence do I have for this

or against this?

And is there a slight

possibility it's not so

personal as, oh, my friend

deliberately is ignoring me

because I did something

wrong to them.

Yeah.

So I think we're in CBT.

So is it the form of like

stop thinking that?

Uh-huh.

So like.

Kind of.

Yeah.

Yeah.

So like.

Go ahead.

So I think the idea of like

kind of stopping in that

moment to notice what's

happening and then thinking,

you know, kind of paying

attention to what are our

thoughts in that moment?

And is there a different

way to think about it?

And is there maybe a

different way to act around

it?

Might be kind of.

That's what I would say.

It was introduced to me

like in school.

Not like I went to school

before, but like.

Uh-huh.

We had to go to groups.

I went to a private school

in Arizona.

It was like kind of

Christian-based little bitch.

But it was like.

Yeah, very intense.

But it's like it was

introduced to us.

That's like.

From acting on impulse.

Stuff like that.

Card stuff.

Right.

People were playing.

Yep.

Yep.

Yep.

In and down.

Faking and riding.

Yeah.

But mostly like.

Just geared towards like.

Yeah.

I think it was like

you're doing like.

Inxiety.

Right.

Uh-huh.

Uh-huh.

Yeah.

And I think it speaks

to kind of like how

in the moment when

our feelings can feel

just very overwhelming.

We're just kind of

in that mental fog.

Right.

Is there a way

to take a step

back from that?

Calm our bodies

down a little bit

so that the part

of our brain

that's like fight or

flight isn't just

kind of blaring.

Um.

And be able to

kind of make choices

that are more helpful

to kind of our goals

in life.

Stephanie can talk

a little bit about

psychodynamic treatment.

So I would say

like in terms of therapy

right like Elaine

is talking about

skills based

targeted

sort of treatment

and that's one

big category

and the other

is a little bit

more process oriented

and so kind of

that question of

you know how much

is a therapist

going to disclose to you

like here it might be

where the therapist

is what you're

bringing into the room

is what we're

working with

and so they might

be a little less

inclined to tell you

like all about

themselves because

they don't want

that to get in

the way of

focusing on kind

of what you're

working through

and so psychodynamic

psychotherapy you

know might be kind

of where Christians

get a little like

about it because

it's associated

with Freud who

said a lot of

different things

and I would say

you know don't

throw the baby

out with the

bath water with

this one because

I do think that

there was a lot

of wisdom in

this type of

therapy which is

really about

acknowledging the

conflicts and

emotions and

desires we might

have how those

might be unconscious

and instead kind

of acted out in

different ways and

when we bring it

into awareness how

do we make

choices about it

right because I

think it's hard to

make good choices

about how we're

acting if we're not

even sure what is

the thing underneath

that's driving it

and so it might be

for example right

like a mother going

to therapy saying

you know I really

love my child but

also like I kind

of hate my child

sometimes right or

it's like really

hard to be a

caregiver for

somebody who is

really debilitated

like I want to

help them but

also I just want

to do my own

thing and be

independent and I

think sometimes that

can feel threatening

to us as Christians

because we want to

be pure and holy

and blameless before

the Lord but I

would also question

like are we

thinking that God

can't handle the

spectrum of emotions

and the complexity

of emotions that we

bring before him

and that there is a

way in which when

we're able to

acknowledge these

desires and

conflicts that

were again you

know we're not

just talking to

the therapist but

also realizing

like bringing

this before the

Lord and submitting

this to him and

saying like yeah I

really desire to be

a better mother or

a better spouse and

also I have all these

other desires so like

Lord this is something

we're going to have to

work on together right

this is about inviting

the Lord into the

specifics of our

situation rather than

holding our desires at

arm's length and like

kind of denying and

being like oh no no

no like I really love

being a mother a hundred

percent of the time you

know and so I think

there is something

about understanding the

specificity of our

wounds that allows

Jesus to speak about

who he is specifically

in a way that is really

beautiful and so that

you know we kind of

came up with a vignette

together of you know

maybe there's a person

who growing up you

know their parents had

really high expectations

for them and nothing

was ever good enough you

know and then they you

know did decently in

life but also kind of

struggled with a sense

of never being good

enough feeling inferior

and so they start

feeling depressed or

really anxious if they

fail a test or whatever

they go to therapy

they're working through

what it means that

their family of origin

you know maybe never

outwardly abused them

but also emotionally

weren't really there for

them and so what does

you know that's part of

the work of therapy and

then maybe as a

Christian it's also being

able to receive from the

Lord that he is our

Abba Father that he

delights in us that we

are his beloved right

and that might be

different than somebody

who is working through

in therapy somebody

whose parents really

did like physically

abuse them and there's

a lot of trauma to

unpack around that and

maybe in that case

bringing that hurt

before the Lord looks

like really resting in

God as a refuge and a

stronghold and a

protector right and so

there are these kind of

like beautiful images in

the Bible that speak to

all these different

aspects of who God is

that I think therapy

can help us kind of

uncover like what is it

that we are struggling

with that maybe the

Lord can speak to

specifically in a you

know a verse or a

picture or a promise

that helps us so so

that's kind of the you

know where I would say

like the process you

know and then maybe

you're you're really

angry at your therapist

for canceling on you

last minute right and

so again like that's

part of the process of

like oh well when you

canceled on me it made

me feel like I wasn't

important and that's

something I've

struggled with that's a

specific wound right and

so I think again just

kind of maybe we talked

a little bit about last

week right we tend to

kind of gloss over the

hard parts right because

we're like Jesus covers

everything and but I

would kind of push back

a little and say you

know I think that we

should probably understand

ourselves a little bit

better and the things

that we're struggling

with in order to be able

to invite Jesus to to

speak to that

so we'll run through a

couple other forms of

treatment and then we'd

love to hear questions or

comments too so DBT

dialectical behavioral

therapy is kind of like

CBT but it's more based

on behavior change so this

kind of therapy is really

good for a lot of things

but especially people who

are in crisis of some kind

like perhaps they're

dealing with self-harm

urges and this therapy

really teaches specific

behaviors to deal with

crisis so for instance

let's say there's somebody

who is really feeling like

rejected by other people

and rejected by friends

and I look on Instagram

and see everyone going to

parties they feel really

left out and really

worthless and they might

experience urges to cut or

injure themselves or other

forms of self-harm so

dialectical behavior therapy

would teach this person's

skills to avoid that acting

on that urge so that might

be like okay dip your face

into cold water or it could

be like deep breathing or

intensely exercising or

all of which are to like

activate kind of a different

part of our bodies exactly

exactly and I would say for

most people there is a need

to then also process at some

point in time like why do you

feel worthless like why do you

why are you going on

Instagram you know some of

these other questions but it's

really hard to process deeper

issues if you're feeling an

intense bodily urge to like

self-harm or some of the

panic or some of these other

things so DBT can really help

with those behaviors

EMDR maybe some of you have

heard of this is a specific

form of trauma processing

so it involves kind of

talking through verbally talking

through a traumatic memory and

then the therapist uses kind of

different techniques to help

your body respond differently

and kind of calm your calm your

nervous system so oftentimes if

we've experienced a traumatic

incident even years years years in

the past our body and our

emotions still respond to that

incident even years later so the