# Competent to Counsel



## Semper Fidelis

Have been reading through this book by Jay Adams and, in the main, find it very insightful, especially given where the state of counseling was at the time of writing. For those who have read the book, what are your thoughts?

There are a few things I disagree with as he discourages the seeking of the "Why" of sinful behavior but a lot of that is in reaction to Rogerian counseling. That said, I think Owen's treatment of sin and temptation offers an appropriate explanation of the "Why" we sin and how to do battle with it that I think Adams tends to neglect. Other than that, I think he's got some very solid insights into the need to encourage and enjoin sanctification in believers through Biblical confrontation.


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## Scott1

It's been a long time since I was exposed to this book, and it was in a tangential way through Larry Burkett's Christian Financial Concepts (CFC) ministry. Mr. Burkett used some of Mr. Adams material in this book and had it in his reference list for CFC counselors.

Mr. Burkett used to say the way we handle material things is an outside indication of what is going on inside spiritually, and so financial problems are often a reflection of that. And can be, not always, but can be an indicator of all kinds of sin behavior problems. Financial counselling would often draw out other problems that were being reflected financially.

My recollection is the book was simple, and, at the time (1980's) it was a kind of new idea that sin is at the root of almost all problems. Not environment. Mr. Adams approach is not self esteem oriented, nor does it try to understand the deep recesses of behavioral patterns. As you know, modern psychology is often viewed from the standpoint of behavior determined by environment.

Mr. Adams flew right by all of that, and as I recall kind of separated out severe mental illness and didn't address that much at all, leaving most problems related to a sin problem that could be counseled out of.

Some would say this is simplistic, particularly "experts" who might have a vested interest in counseling vocationally, but it was kind of a groundbreaking concept at the time. I think it came to be called "nouthetic" counseling (a $64 word if ever there was one). And it was very positive in enfranchising non-professional counselors who could use basic biblical principles to help people.

As for general style and approach, compare with _The Handbook for Christian Discipline_. http://www.christianbook.com/handbook-of-church-discipline/jay-adams/9780310511915/pd/0511917 A few things in that book I don't think the author got quite right, a few things seemed annoying simplistic but in the main he did an excellent job bringing out a complex subject in a simple, understandable way. After reflecting a while, the book "grew on me."

You may find this counseling book the same way.


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## rbcbob

Scott1 said:


> My recollection is the book was simple, and, at the time (1980's) it was a kind of new idea that sin is at the root of almost all problems. Not environment.



My copy was published in 1970. This work began the revolution against the Freudian infiltration of the Church. Much needed. That said the revolutionaries went on to establish the rebellion as an institution in its own right, operating outside the Church and independent of the elders whom Christ has given the chief care of souls.

Interestingly some of Adams' disciples have repented of this bypath and returned to see the Church and its pastors as the primary tenders of souls. See _AGAINST Biblical Counseling - FOR the Bible_ by Martin and Deidre Bobgan


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## Pergamum

I was trained in secular counseling while in the army and was tempted to react to that by using Jay Adams. 

But, I have found Welch and Powlison to be much more balanced and less bombastic. "Repent of your sin" is not the solution to everything in the mental realm.


Discerning Reader: Review of Competent to Counsel? by David Powlison

Christian counseling: Nouthetic vs. Biblical « depression introspection


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## Curt

Pergamum said:


> "Repent of your sin" is not the solution to everything in the mental realm.



Amen.


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## jwithnell

I too read Mr. Adams work back in the 1980s. One trend I find peculiar. He advocated a spiritual or biological basis for many (if not all) problems encountered in counseling. Since then, we've seen great advances in treating the biological side. But I've recently read people who were influenced by his work, yet discourage using medications. It makes sense to me that where there's sin, deal with it. When there's a chemical imbalance, treat it medically.


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## Jesus is my friend

Curt said:


> Pergamum said:
> 
> 
> 
> "Repent of your sin" is not the solution to everything in the mental realm.
> 
> 
> 
> 
> Amen.
Click to expand...


Would any solid Nouthetic counselor really say or believe exactly that?


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## Scottish Lass

jwithnell said:


> When there's a chemical imbalance, treat it medically.



Except even the "experts" can't be certain that it exists and/or causes the problems the drugs purport to treat. Listen carefully to the ad for any anti-depressant. "Depression may be caused by a chemical imbalance...." and then proceeds on as though the qualified statement were anything but. 
Adams spends little time on the biological side because he expects a full medical workup to be done early on to rule out/deal with organic causes. If none are found, sin is a reasonable next place to work. He would far prefer hypothryroidism-caused depression to be treated medically. The synthetic hormone treats the root cause of the problem rather than covering it up. The same generally cannot be said for antidepressants.


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## CDM

I was glad to learn Mr. Adams advocating the Christian counselor to stick with the Bible, but there were a couple of things that concerned me. For the sake of space I will mention just one. I am concerned that having unordained people be trained in nouthetic counseling will undermine the pastoral ministry and the gospel it preaches. I do believe there is a danger in creating a class, like “counselor” within the Christian community. These counselors could be put into leadership positions that their churches have not called them to. Sure, one can hope that no office will be created to rival the elders but some within the congregation may seek this counselor out for advice or counsel while eschewing non-nouthetically trained pastor and elders. This circumvents the means of spiritual oversight that Christ has given the Church. These counselors become specialists in an area that pastors should be specialists in—biblical counseling. 

Although, I agree with most of the presuppositions of the book, it was not without its faults. I was not impressed with the Adams use of Scripture. The different translations and paraphrases employed seemed self-serving. The Scripture seemed to be taken and repackaged in a way that would make his case more compelling. One particularly striking example is found in chapter ten (page 212) where the author addresses issues with communication: 



> “Into that idyllic situation [Garden of Eden] Satan introduced the first communication problem by casting doubt upon the Word of God. The Father of Lies (that is, the father of all communication difficulties) questioned the word of God [emphases mine].”



Lies are not “communication difficulties.” While this language may suit the author’s purpose for the chapter it is simply not what the Scripture teaches. Satan had no “difficulty” with the Word of God—he was manipulating it for his own purposes.


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## Marrow Man

A couple of things to add to the discussion. One, Dr. Adams (now at least) does put the counseling ministry back to the authority of the local church. He encourages pastors and elders ("someone with spiritual authority") to do the bulk of the counseling, although he does allow for lay counseling in certain situations (e.g., women counseling women); still, it is down under the supervision of the local session (or similar body). Second, saying that everything boils down to a "repent of your sin" approach is not an accurate representation. Third, he has at least one degree in Greek and often uses his own translation in commenting on the Scriptures. Finally, it's "Nouthetic Counseling," derived from the NT verb _noutheteo_, which means to admonish, confront, or instruct.


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## he beholds

CDM said:


> I was not impressed with the Adams use of Scripture. The different translations and paraphrases employed seemed self-serving. The Scripture seemed to be taken and repackaged in a way that would make his case more compelling. One particularly striking example is found in chapter ten (page 212) where the author addresses issues with communication:
> 
> “Into that idyllic situation [Garden of Eden] Satan introduced the first communication problem by casting doubt upon the Word of God. The Father of Lies (that is, the father of all communication difficulties) questioned the word of God [emphases mine].”
> Lies are not “communication difficulties.” While this language may suit the author’s purpose for the chapter it is simply not what the Scripture teaches. Satan had no “difficulty” with the Word of God—he was manipulating it for his own purposes.
> Chris Mangum



I don't think he's twisting scripture here and I also agree that Satan did question the word of God--or at least may have, if this is an impossible thing to assert. Whether he truly understood God's word and promises, I don't know. But he certainly questioned Eve with it and cast doubt upon it for Eve.
The little I've read of Adams I've liked. And I like Elyse Fitzpatrick, a female nouthetic counselor.


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## Semper Fidelis

Pergamum said:


> "Repent of your sin" is not the solution to everything in the mental realm.



Have you actually read Adams' book or, as you say, you were tempted to read it but did not. One cannot get past the first Introduction to dispel the myth that he ever advocates such a thing. I'm not saying his method has no issues but that is a gross mischaracterization of his work.


CDM said:


> I was glad to learn Mr. Adams advocating the Christian counselor to stick with the Bible, but there were a couple of things that concerned me. For the sake of space I will mention just one. I am concerned that having unordained people be trained in nouthetic counseling will undermine the pastoral ministry and the gospel it preaches.


Are you referring to Adams' work here or derivative works (like the BCF) that made it more of a "manual" approach to the ideas presented? Again, I've only read 7 Chapters so far but it is clear that Adams insists throughout that counseling is within the Church and that the means of grace are essential to the work. He sees "counseling" of one to another more along the lines that we would exhort one another to love and good works. In fact, if anything, I've seen Adams criticized for his insistence that counseling is a work of the minister. Maybe I'm missing something.


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## Stephen L Smith

Semper Fidelis said:


> Maybe I'm missing something.



Rich, I have read much of Adams. He is helpful. However his comments on mental health are a bit extreme. Martyn Lloyd-Jones is more balanced in this aspect. See his books 'healing and the scriptures' and 'spiritual depression'. Lloyd-Jones actually calls Adams 'a reactionist' in the area of mental health. Also Eric Johnson's book 'Foundations for soul care' also points out some of the weaknesses of Adam's approach.

I suffer from Aspergers Syndrome so this is a very relevant issue for me.


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## timmopussycat

Stephen L Smith said:


> Semper Fidelis said:
> 
> 
> 
> Maybe I'm missing something.
> 
> 
> 
> 
> Rich, I have read much of Adams. He is helpful. However his comments on mental health are a bit extreme. Martyn Lloyd-Jones is more balanced in this aspect. See his books 'healing and the scriptures' and 'spiritual depression'. Lloyd-Jones actually calls Adams 'a reactionist' in the area of mental health. Also Eric Johnson's book 'Foundations for soul care' also points out some of the weaknesses of Adam's approach.
> 
> I suffer from Aspergers Syndrome so this is a very relevant issue for me.
Click to expand...

 
Actually MLJ's criticism of Adams seems to arise from a misreading of Adams. If I recall correctly MLJ criticized Adams for rejecting any orgainic origins of mental illnes but Adams in fact does no such thing. That note aside, the MLJ book "Healing and the Scriptures" is extremely helpful. To give but one highlight- somewhere in it can be found MLJ's method of distinguishing between psychological and spiritual conditions, something that can be very helpuful to ministers and lay helpers.


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## Semper Fidelis

timmopussycat said:


> Stephen L Smith said:
> 
> 
> 
> 
> 
> Semper Fidelis said:
> 
> 
> 
> Maybe I'm missing something.
> 
> 
> 
> 
> Rich, I have read much of Adams. He is helpful. However his comments on mental health are a bit extreme. Martyn Lloyd-Jones is more balanced in this aspect. See his books 'healing and the scriptures' and 'spiritual depression'. Lloyd-Jones actually calls Adams 'a reactionist' in the area of mental health. Also Eric Johnson's book 'Foundations for soul care' also points out some of the weaknesses of Adam's approach.
> 
> I suffer from Aspergers Syndrome so this is a very relevant issue for me.
> 
> Click to expand...
> 
> 
> Actually MLJ's criticism of Adams seems to arise from a misreading of Adams. If I recall correctly MLJ criticized Adams for rejecting any orgainic origins of mental illnes but Adams in fact does no such thing. That note aside, the MLJ book "Healing and the Scriptures" is extremely helpful. To give but one highlight- somewhere in it can be found MLJ's method of distinguishing between psychological and spiritual conditions, something that can be very helpuful to ministers and lay helpers.
Click to expand...

 
Right. I keep reading in the above:

1. That Adams attributes all psychological problems with sin
2. He rejects organic problems as a root of some psychological problems

Before he even gets into counseling itself, he dispels, unequivocally, both of the above charges.

I know that no matter what I say after this, that I'm going to be seen as unquestionably supporting Adams in everything but I just have an allergy to misrepresentation of others' views even when they differ from my own. If we're going to criticize a view then let it be upon the basis of truth and not factual misrepresentation.

If I could summarize what Adams has a problem with, it is the idea of mental illness as a category of a problem that falls in a third category between the way the Scriptures characterize our interpersonal problems and those problems that arise from organic or biological roots. That is to say that even the "medical community" struggles with clearly defining what mental illness is as evidenced over the controversy swirling around the creation of the DSM-V. None of these issues are simple but Adams is not completely shooting from the hip in some of his experience.

I'll be straight that I think most reaction to him and his view of sin has to do with his unabashedly Calvinistic view of the Fall of Man. It makes sense to me that semi-Pelagian Christians are going to be repulsed by any suggestion that sin would be at the root of psychological problems. Of course, when Jay Adams notes the effects of the Fall, the reductionist response to that would be "how can you have someone repent of that?" In fact, recognizing that sin is the root of death and misery is a different category altogether than direct moral culpability in a particular sin but I think that is lost on many who criticize him unfairly. Again, I don't mind the criticism but it's hard to spit out the seeds that are mixed in that betray a theological framework and miss the center of the mark from what I've seen.

I'm reading him with interest not because I intend to just template him into my own counseling but because he does have some interesting and valid observations about the physical and psychological effects when one actively suppresses the conscience. I don't think we wrestle with human suffering deeply enough and it's easy to default to medical models for medical illness we cannot put our fingers on and criticize any notion that the healing of some deep problems may come at the end of spiritual growth and wrestling under the means of grace for years. I don't think I'd be so quick to place my finger on the solution to a problem through a confrontational method but, correspondingly, I'm not going to quickly abandon a Biblical anthropology for seemingly easy medical and professional answers which, upon close observation, don't really solve deep-seated problems but have a complex enough taxonomy that one is deceived into trusting that the professional has the answer.


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## rbcbob

Rich, I greatly appreciate Adams. We owe him a debt for his bold stand against the psychobabble which ruled the 20th century. I am also pleased to learn from Marrow Man above that Adams has a healthy regard for counseling to begin in the church with the elders.

In an earlier post I wrote:



> the problem is that Psychiatry has played fast and loose with research, diagnosis and treatment of "behavior problems" for over one hundred years. The etiology of what is now called ADHD tracks back to its earliest nomenclature of Minimal Brain Dysfunction. In the absence of any verifiable biological disease the DSM acknowledged, for instance, that how Ritalin affects the brain and alters the behavior is not known. Problems of behavior are moral problems which may or may not have associated biological factors. The commonplace practice of hitting upon a psychotropic drug which will yield the desired behavior change may well be judged in the future to be malpractice.


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## Marrow Man

One of the first things that Adams and nouthetic counselors often do after an initial counseling session is send the counselee to a medical doctor to make sure that the cause of the problem is not organic (or to treat it medically if it is organic). I'm shared at least one of these stories on the PB before, but the misrepresentations still persist.

A lady began experiencing wild mood swings one day and did not know the reason. She came in for counseling, and the suggestion was NOT "repent you sinner." She was sent to an MD for a physical -- and the result was that a tumor was discovered on one of her ovaries. It was causing her hormones to go wild. The tumor was removed, and the problem was solved. If she had gone to a secular counselor, what would have happened? It's entirely possible that they would have put her on some psychotropic medication, which would have done little or nothing for the organic cause of the problem, and she would be dead today.

In another instance, however, a counselor sent a counselee to an MD for a physical. The MD asked why she was there, and she mentioned the problem she was having (depression or something of the sort). Oh, he responded, if that's the problem, I'll just write you a prescription. So, when the counselee returned to the counselor the following week, she was already on antidepressants. That's the very sort of thing Adams and company want to prevent.


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## py3ak

Marrow Man said:


> One of the first things that Adams and nouthetic counselors often do after an initial counseling session is send the counselee to a medical doctor to make sure that the cause of the problem is not organic (or to treat it medically if it is organic).



I realize this may be the due diligence that one can expect of a counselor, but it is as well to bear in mind that it is not necessarily that simple. It's not as though there were no conditions difficult for doctors to diagnose. Of course if a doctor can't diagnose them, in all probability neither can a counselor; but for that reason it is prudent to bear in mind that a doctor's note of a clean bill of health does not guarantee that counseling is the answer. Neither medicine nor the care of souls are exact sciences.


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## lynnie

We knew an effective counselor who used to say that the hard line Adams crowd had a perspective on human nature that reduced it pretty much down to sin and idols of the heart. But, there is a strong biblical theme that we are hungry and thirsty people, and you don't repent of being hungry and thirsty, you learn to start drinking pure water and eating real food. There are so many biblical promises of God feeding the hungry and filling the thirsty. I know a hard line Adams guy now who is so into repenting of sin that he does not seem to minister to people how to eat and drink. People need help with basic things like bible reading and prayer, which meetings to go to when they are busy and have kids, even how to fellowship in basic ways like how much of your inner life to talk about and to who. It is both, repenting and eating/drinking.

One excellent thing from that book is how marriages would be helped if wives ( or husbands) would do basic Matthew 18. I've met women who refuse to go to the elders but instead gripe all day about hub to their girlfriends. And I know one woman who went straight to the elders, they stepped in, and the marriage was saved. He makes some good points that basic bible passages about conflict certainly apply equally to marriage and must be obeyed.


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## SRoper

py3ak said:


> Marrow Man said:
> 
> 
> 
> One of the first things that Adams and nouthetic counselors often do after an initial counseling session is send the counselee to a medical doctor to make sure that the cause of the problem is not organic (or to treat it medically if it is organic).
> 
> 
> 
> 
> I realize this may be the due diligence that one can expect of a counselor, but it is as well to bear in mind that it is not necessarily that simple. It's not as though there were no conditions difficult for doctors to diagnose. Of course if a doctor can't diagnose them, in all probability neither can a counselor; but for that reason it is prudent to bear in mind that a doctor's note of a clean bill of health does not guarantee that counseling is the answer. Neither medicine nor the care of souls are exact sciences.
Click to expand...

 
That's always been my issue with Nouthetic Counseling, at least my own experience with its practitioners. It seems to assume that doctors can infallibly diagnose and treat organic problems. What if the woman in the story had lived in the 19th C? The doctor would not have found the tumor, and she would undergo counseling for an apparently spiritual problem.

Yes we can only act on the information we have, but we need to have some humility that we don't always know what's going on inside a person--whether physically or spiritually.


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## Semper Fidelis

py3ak said:


> Neither medicine nor the care of souls are exact sciences.



Agreed. I think human suffering is an extremely complex problem. I think Job demonstrates that it is very easy to jump to counsel (in the case of Job's friends) and the reasons for suffering are often inscrutable. I do think Adams offers a critique of counseling where counselors jump to quick conclusions about matters. There is tremendous wisdom and prayer needed.

When James encourages that the Elders pray for the sick there is not a sense in which the elders are there to pray simply to pinpoint a cause but to come alongside and be involved in the suffering of a beloved member of the congregation. Prayer is a means of grace to encourage and for the wise to be in the presence of mourning to simply turn to God Who has reasons why even terrible things are afflicting the soul or body of a man that is beyond our ability to solve. I think, in fact, that our desire to find a definitive medical or spiritual answer to suffering belies a basic trust that God calls us unto in the Book of Job as He challenges Job to stand up to the One he is accusing.

The real problem of suffering and sin is that a Holy God actually does not simply judge human sin through the suffering man brought into the world but answers it in Christ. We have the answer that God provided in the Cross that the root of human suffering has been answered but have to wait, in faith, for the consummation when suffering will finally cease.

I've been reflecting lately as I've been praying for Church members whose parents are in their later years of life and are experiencing the loneliness of the loss of a spouse or the death of friends even as their bodies fail them. I've reminded myself that my later years might be filled with great sadness and that I will not necessarily experience "golden years" of happiness up to death. My hope is not that this life will provide ultimate satisfaction and deliverance from pain or sadness but that my joy is rooted in the Age to Come.


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## Scott1

Semper Fidelis said:


> I've been reflecting lately as I've been praying for Church members whose parents are in their later years of life and are experiencing the loneliness of the loss of a spouse or the death of friends even as their bodies fail them. I've reminded myself that my later years might be filled with great sadness and that I will not necessarily experience "golden years" of happiness up to death. My hope is not that this life will provide ultimate satisfaction and deliverance from pain or sadness but that my joy is rooted in the Age to Come.



Very well said!

Nor is the antidote to such mind-altering medication. Rather, it is involvement in Christ's Body which does not disappear with time, and the love and comfort of its community, and faith, born of the spirit, that increases over time.


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## jayce475

Healthcare teams and doctors spend hours upon hours trying to give some diagnosis based on the DSM, but may not be able to give diagnostic labels. For the most part, if one would bother to read the DSM, it is choke full of *behavioural descriptors* which are then used to derive a diagnostic label. Yes, some cases of mental illnesses may have clear cut organic causes (meaning that a structural dysfunction has definitely caused the symptoms) but these are not the majority. Most, especially depression and attention deficits, fall into the realms of uncertainty, in that there may be observable chemical imbalances but there is no way to determine that these are the cause and not the result/co-occurrence. Who then is to say that the root of the issue is not spiritual in nature? I have encountered kids who hit their parents and showed extreme forms of disobedience. The parents then sought solutions from the team and gained some measure of consolation from a diagnosis of ADHD. It was as though it was not the child who was disobedient, but the ADHD monster within that caused the problem.


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## Marrow Man

lynnie said:


> We knew an effective counselor who used to say that the hard line Adams crowd had a perspective on human nature that reduced it pretty much down to sin and idols of the heart.



I'm not sure who exactly this counselor was describing as "the hard line Adams crowd," but Adams himself would not use the terminology of "idols of the heart," and in part it led to the rift between him and the CCEF folks.



SRoper said:


> That's always been my issue with Nouthetic Counseling, at least my own experience with its practitioners. It seems to assume that doctors can infallibly diagnose and treat organic problems. What if the woman in the story had lived in the 19th C? The doctor would not have found the tumor, and she would undergo counseling for an apparently spiritual problem.



You experience is obviously different, but I don't know anyone who has even suggested that doctors can "infallibly diagnose and treat organic problems." Sometimes they do in God's providence, and that's great. But plenty of folks trust certain medical professionals and others to diagnose mental disorders by using the subjective guide of the DSM-IV (or V now I guess). Though I doubt folks would think it is infallible. But that wasn't the point of the story. There are those who claim that Adams doesn't believe in organic causes for problems, which is a false claim.



py3ak said:


> I realize this may be the due diligence that one can expect of a counselor, but it is as well to bear in mind that it is not necessarily that simple. It's not as though there were no conditions difficult for doctors to diagnose. Of course if a doctor can't diagnose them, in all probability neither can a counselor; but for that reason it is prudent to bear in mind that a doctor's note of a clean bill of health does not guarantee that counseling is the answer. Neither medicine nor the care of souls are exact sciences.



Once again, I don't know of anyone in these circles who would claim that either of these is an exact science. The point of the story was simply to dispel the myth that Nouthetic Counselors like Dr. Adams do not believe in organic causes. The ironic thing, though, is that I do see many folks treating certain segments of the medical community as "infallible" when dispensing certain medicines for certain psychological ailments. It is assumed that there is an organic cause (because science tells us so), and little or no thought is given to determining whether these things may be spiritual in origin.


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## ChristianTrader

SRoper said:


> py3ak said:
> 
> 
> 
> 
> 
> Marrow Man said:
> 
> 
> 
> One of the first things that Adams and nouthetic counselors often do after an initial counseling session is send the counselee to a medical doctor to make sure that the cause of the problem is not organic (or to treat it medically if it is organic).
> 
> 
> 
> 
> I realize this may be the due diligence that one can expect of a counselor, but it is as well to bear in mind that it is not necessarily that simple. It's not as though there were no conditions difficult for doctors to diagnose. Of course if a doctor can't diagnose them, in all probability neither can a counselor; but for that reason it is prudent to bear in mind that a doctor's note of a clean bill of health does not guarantee that counseling is the answer. Neither medicine nor the care of souls are exact sciences.
> 
> Click to expand...
> 
> 
> That's always been my issue with Nouthetic Counseling, at least my own experience with its practitioners. It seems to assume that doctors can infallibly diagnose and treat organic problems. What if the woman in the story had lived in the 19th C? The doctor would not have found the tumor, and she would undergo counseling for an apparently spiritual problem.
> 
> Yes we can only act on the information we have, but we need to have some humility that we don't always know what's going on inside a person--whether physically or spiritually.
Click to expand...

 
How would you have had a 19th C, Jay Adams to have dealt with such a situation?

Also, I think everyone admits that physical/chemical problems can lead to emotional problems but what about Spiritual/Emotional fixes leading to physical/chemical improvement? Or does everyone believe that this is a one way street only?

CT


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## py3ak

Semper Fidelis said:


> py3ak said:
> 
> 
> 
> Neither medicine nor the care of souls are exact sciences.
> 
> 
> 
> 
> Agreed. I think human suffering is an extremely complex problem. I think Job demonstrates that it is very easy to jump to counsel (in the case of Job's friends) and the reasons for suffering are often inscrutable. I do think Adams offers a critique of counseling where counselors jump to quick conclusions about matters. There is tremendous wisdom and prayer needed.
> 
> When James encourages that the Elders pray for the sick there is not a sense in which the elders are there to pray simply to pinpoint a cause but to come alongside and be involved in the suffering of a beloved member of the congregation. Prayer is a means of grace to encourage and for the wise to be in the presence of mourning to simply turn to God Who has reasons why even terrible things are afflicting the soul or body of a man that is beyond our ability to solve. I think, in fact, that our desire to find a definitive medical or spiritual answer to suffering belies a basic trust that God calls us unto in the Book of Job as He challenges Job to stand up to the One he is accusing.
> 
> The real problem of suffering and sin is that a Holy God actually does not simply judge human sin through the suffering man brought into the world but answers it in Christ. We have the answer that God provided in the Cross that the root of human suffering has been answered but have to wait, in faith, for the consummation when suffering will finally cease.
> 
> I've been reflecting lately as I've been praying for Church members whose parents are in their later years of life and are experiencing the loneliness of the loss of a spouse or the death of friends even as their bodies fail them. I've reminded myself that my later years might be filled with great sadness and that I will not necessarily experience "golden years" of happiness up to death. My hope is not that this life will provide ultimate satisfaction and deliverance from pain or sadness but that my joy is rooted in the Age to Come.
Click to expand...

 
That's a beautiful post, Rich. All Christians, but especially those who will engage in the work of counseling, need to understand as clearly that Psalm 88 is also a reflection of Christian experience, and indeed, that our sinless Head gave us those words. How thankful we can be that it is not the sum of Christian experience, and that we have been given ways to mitigate the pain and difficulty here; but they are merely mitigations. Pain and sorrow are an intrinsic and inevitable part of the present constitution; but in the new heavens and the new earth, they will be no more. Weeping may endure for a night - but joy cometh in the morning, in the dawn of God's new day when the sons of God will again shout for joy at the new world God has made.


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## Marrow Man

py3ak said:


> All Christians, but especially those who will engage in the work of counseling, need to understand as clearly that Psalm 88 is also a reflection of Christian experience, and indeed, that our sinless Head gave us those words. How thankful we can be that it is not the sum of Christian experience, and that we have been given ways to mitigate the pain and difficulty here; but they are merely mitigations. Pain and sorrow are an intrinsic and inevitable part of the present constitution; but in the new heavens and the new earth, they will be no more. Weeping may endure for a night - but joy cometh in the morning, in the dawn of God's new day when the sons of God will shout for joy at the new world God has made.



Wonderfully put, my friend.


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## SRoper

Semper Fidelis said:


> py3ak said:
> 
> 
> 
> Neither medicine nor the care of souls are exact sciences.
> 
> 
> 
> 
> Agreed. I think human suffering is an extremely complex problem. I think Job demonstrates that it is very easy to jump to counsel (in the case of Job's friends) and the reasons for suffering are often inscrutable. I do think Adams offers a critique of counseling where counselors jump to quick conclusions about matters. There is tremendous wisdom and prayer needed.
> 
> When James encourages that the Elders pray for the sick there is not a sense in which the elders are there to pray simply to pinpoint a cause but to come alongside and be involved in the suffering of a beloved member of the congregation. Prayer is a means of grace to encourage and for the wise to be in the presence of mourning to simply turn to God Who has reasons why even terrible things are afflicting the soul or body of a man that is beyond our ability to solve. I think, in fact, that our desire to find a definitive medical or spiritual answer to suffering belies a basic trust that God calls us unto in the Book of Job as He challenges Job to stand up to the One he is accusing.
> 
> The real problem of suffering and sin is that a Holy God actually does not simply judge human sin through the suffering man brought into the world but answers it in Christ. We have the answer that God provided in the Cross that the root of human suffering has been answered but have to wait, in faith, for the consummation when suffering will finally cease.
> 
> I've been reflecting lately as I've been praying for Church members whose parents are in their later years of life and are experiencing the loneliness of the loss of a spouse or the death of friends even as their bodies fail them. I've reminded myself that my later years might be filled with great sadness and that I will not necessarily experience "golden years" of happiness up to death. My hope is not that this life will provide ultimate satisfaction and deliverance from pain or sadness but that my joy is rooted in the Age to Come.
Click to expand...


Thanks for this post, Rich.



Marrow Man said:


> You experience is obviously different, but I don't know anyone who has even suggested that doctors can "infallibly diagnose and treat organic problems." Sometimes they do in God's providence, and that's great. But plenty of folks trust certain medical professionals and others to diagnose mental disorders by using the subjective guide of the DSM-IV (or V now I guess). Though I doubt folks would think it is infallible. But that wasn't the point of the story. There are those who claim that Adams doesn't believe in organic causes for problems, which is a false claim.



I totally agree that Adams does not ignore organic problems. The problem I've run into is that there is a hidden assumption that doctors can determine organic causes with certainty. It's ironic because Nouthetic counselors are very skeptical of much of psychiatry, but if a family doctor has ruled out an organic cause, then, there you go, the problem must be spiritual.

---------- Post added at 03:10 PM ---------- Previous post was at 02:46 PM ----------




ChristianTrader said:


> How would you have had a 19th C, Jay Adams to have dealt with such a situation?
> 
> Also, I think everyone admits that physical/chemical problems can lead to emotional problems but what about Spiritual/Emotional fixes leading to physical/chemical improvement? Or does everyone believe that this is a one way street only?
> 
> CT


 
To answer your first question, I think it's best to come along side the whole man rather than trying to parse things into organic=physicians, spiritual=counselors. One consequence of the latter approach is that you have a sort of Nouthetic-counciling-of-the-gaps; as medical science advances it's tending to find more and more organic causes for things. Instead we should see that often the same problem needs to be approached from both the medical and spiritual side.

I think physical-spiritual is often two-way but not to the extent that we have mind-over-matter. Being totally in line with scripture spiritually is not going to make an ovarian tumor go away.


----------



## cajunhillbilly53

I remeber Jay Adams from Westminster. He was a character for sure. A lot of his personality went into his books. He is a forceful kind of a guy. A force of nature LOL


----------



## Pergamum

Semper Fidelis said:


> Pergamum said:
> 
> 
> 
> "Repent of your sin" is not the solution to everything in the mental realm.
> 
> 
> 
> 
> Have you actually read Adams' book or, as you say, you were tempted to read it but did not. One cannot get past the first Introduction to dispel the myth that he ever advocates such a thing. I'm not saying his method has no issues but that is a gross mischaracterization of his work.
> .
Click to expand...

 
I've read many of Adam's books and I read _Competent to Counsel_ twice (because I thought I reacted too negatively against it the first time, the second time I felt more assured in my estimation that Dr Adams tried to swing the pendelum too far back the other direction and discounted too much of the physical as well as the many legitimate uses of psychology). I find in Welch and Powlison more balance and a less caustic tone. 

Modern secular psychology turns everyone into a victim, Adams, in over-reaction appears almost to turn everyone into a perpetrator. 

Here is a quote from the link that I provided above that illustrates that dangers of downplaying the physical (or giving the medical/physical side lip service only):



> I have a friend who suffers from PTSD—he endured a lot of trauma as a child—and his symptoms worsened after his experience with a Nouthetic counselor who simply told him that he was the one in the wrong and that he needed to repent of his sin. Although he currently attends a seminary that strongly teaches NC, he is in the extreme position where he feels that no good can come out of it, even with a Bible-based approach that would include the Nouthetic method.


----------



## Pilgrim

Dr. Adams has a blog that he and his associate Donn Arms update regularly. The category Adams Answers, which answers critics of his method, may be of particular interest.


----------



## Semper Fidelis

Pergamum said:


> Semper Fidelis said:
> 
> 
> 
> 
> 
> Pergamum said:
> 
> 
> 
> "Repent of your sin" is not the solution to everything in the mental realm.
> 
> 
> 
> 
> Have you actually read Adams' book or, as you say, you were tempted to read it but did not. One cannot get past the first Introduction to dispel the myth that he ever advocates such a thing. I'm not saying his method has no issues but that is a gross mischaracterization of his work.
> .
> 
> Click to expand...
> 
> 
> I've read many of Adam's books and I read _Competent to Counsel_ twice (because I thought I reacted too negatively against it the first time, the second time I felt more assured in my estimation that Dr Adams tried to swing the pendelum too far back the other direction and discounted too much of the physical as well as the many legitimate uses of psychology). I find in Welch and Powlison more balance and a less caustic tone.
> 
> Modern secular psychology turns everyone into a victim, Adams, in over-reaction appears almost to turn everyone into a perpetrator.
> 
> Here is a quote from the link that I provided above that illustrates that dangers of downplaying the physical (or giving the medical/physical side lip service only):
> 
> 
> 
> 
> I have a friend who suffers from PTSD—he endured a lot of trauma as a child—and his symptoms worsened after his experience with a Nouthetic counselor who simply told him that he was the one in the wrong and that he needed to repent of his sin. Although he currently attends a seminary that strongly teaches NC, he is in the extreme position where he feels that no good can come out of it, even with a Bible-based approach that would include the Nouthetic method.
> 
> Click to expand...
Click to expand...

 
How does your quote apply to Adams precisely? Was this "nouthetic counselor" Jay Adams that is referenced? Also, you have not defended your charge that Adams chalks *all* resolution to problems to repentance from sin. Please substantiate. You have read the book twice and it ought to be easy to demonstrate.


----------



## calgal

Jay Adams and co have one huge fatal flaw: they do not understand that mental illness is as real as cancer, alzheimers, diabetes and any other chronic illness (these have in the past been called demon possession. The changes in brain chemistry from such things as a fall, a blow to the head, seizures, dehydration etc not to mention schizophrenia, bipolar (ever see someone cycle? it is scary) and other known mental illnesses are quantifiable and measurable but Mr. Adams and his followers call every mental illness, every episode of depression, anxiety etc "sin" and that both diminishes God and is toxic to the patient. Is this an inexact new and rather imperfect science? As inexact as treatment of cancer was until DNA was discovered, as inexact as treatment of diabetes was until insulin was discovered. My question to you is this: when someone with schizophrenia comes to Mr. Adams or one of his followers, will they refer the schizophrenic to a psychiatrist or call the condition sin and call "treatment" done?


----------



## Scottish Lass

calgal said:


> Jay Adams and co have one huge fatal flaw: they do not understand that mental illness is as real as cancer, alzheimers, diabetes and any other chronic illness



Can you substantiate this claim?


----------



## Ask Mr. Religion

I guess I stand with MacArthur:


My view of Biblically-based counseling is defined by seven core elements (adapted from _Counseling: How to Counsel Biblically_, John MacArthur, et al.):

*1. God is at the center of counseling.*
God is sovereign, active, speaking, merciful, commanding, and powerful. The Bible is authoritative, relevant, and comprehensively sufficient for counseling. God has spoken truly to every basic issue of human nature and to the problems in living.

*2. Commitment to God has epistemological consequences.* 
First, other sources of knowledge must be submitted to the authority of Scripture. The sciences, personal experience, literature, and so forth may be useful, but may not play a constitutive role in counseling.

*3. Sin, in all its dimensions (motives, behaviors, acts done, acts received), are the consequences of the Fall and our own actions.* 
Sin includes wrong behavior, distorted thinking, an orientation to follow personal desires, and bad attitudes. Sin is habitual and deceptive, and much of the difficult in counseling consists in bringing specific sin to awareness and breaking its hold.

*4. The Gospel of Jesus Christ is the answer.*
Forgiveness of sin and the power to change into His image.

*5. The biblical change process which counseling must aim at is progressive sanctification.*
Change is metaphorically, not actually, healing. The metaphor captures ongoing repentance, renewal of the mind to Biblical truths, and obedience in the power of the Holy Spirit.

*6. The situational difficulties people face are not the random cause of problems in living. These difficulties operate within the sovereign design of God.*
They are contexts in which hearts are revealed and faith and obedience are purified through the battle of the Spirit and the flesh.

*7. Counseling is fundamentally a pastoral activity and must be church-based.*
It must be regulated under the authority of God's appointed church leaders.

AMR


----------



## beej6

Someone remind me to come back to this thread. I may be the only Reformed psychiatrist in existence (smile). I've also read Adams and have profited from him. 
I would suggest to all to also read Powlison's _The Biblical Counseling Movement_ (which I am part way through).


----------



## jayce475

calgal said:


> Jay Adams and co have one huge fatal flaw: they do not understand that mental illness is as real as cancer, alzheimers, diabetes and any other chronic illness (these have in the past been called demon possession. The changes in brain chemistry from such things as a fall, a blow to the head, seizures, dehydration etc not to mention schizophrenia, bipolar (ever see someone cycle? it is scary) and other known mental illnesses are quantifiable and measurable but Mr. Adams and his followers call every mental illness, every episode of depression, anxiety etc "sin" and that both diminishes God and is toxic to the patient. Is this an inexact new and rather imperfect science? As inexact as treatment of cancer was until DNA was discovered, as inexact as treatment of diabetes was until insulin was discovered. My question to you is this: when someone with schizophrenia comes to Mr. Adams or one of his followers, will they refer the schizophrenic to a psychiatrist or call the condition sin and call "treatment" done?


 
Gail, look at this page from the site Rich linked to. Nouthetic Counselors Oppose the Use of Medicine, Don't They?

---------- Post added at 04:42 PM ---------- Previous post was at 04:36 PM ----------




beej6 said:


> Someone remind me to come back to this thread. I may be the only Reformed psychiatrist in existence (smile). I've also read Adams and have profited from him.
> I would suggest to all to also read Powlison's _The Biblical Counseling Movement_ (which I am part way through).


 
BJ, could you give your take on this article?  The chemical imbalance myth


----------



## Pergamum

Rich,

My thoughts on Jay Adams are as follows:

In General:His 3 main theses in Competent to Counsel are all correct, namely that (1) modern psychology is, by and large, bad theology, and (2) that psychologists have become a new priest-caste, and (3) the Bible contains info useful in counseling and pastors ought to use the bible and reclaim their rightful role in soul-care. These three main theses are all true.

-
-
*Here are some further thoughts about Jay Adams;*

-He was reacting against the psychological establishment. Therefore, much of what he says is reactionary and bombastic. Adams was a controversialist and he often found himself in the middle of arguments. this seemed to be part of his personality and it comes out in his writing. 
--Because of this, some of the local pastors I have met who most adored Jay Adams were also controversialists as well and these two followers of Adams that I knew were very hard to get along with. Perhaps the tone of his writing attracts fellow controversialists.

-Part of the mission of his book is to reclaim counseling from the hands of the psychologists and his main argument is that pastors ought to care for souls. That is good, but he advances his cause by painting a picture of psychology as wholly anti-god. In truth, however, psychology has many useful functions. The models of Welch and Powlison show us how one can be discerning, even while refusing to be dismissive of the legitimate findings of psychological research.

David Powlison, who seems to respect Adams, writes:



> For example, some of Jay Adams’s written statements sound dogmatic, harsh, polemical, triumphalistic, simplistic, legalistic, impudent, reductionistic. Many readers have reacted to this, sometimes with violent antipathy.



Many of these harsh dogmatic statements are directed to other schools of Christian psychology, a real turn-off.

-
-
-
also,
-His means of helping people is through counseling, i.e., talking. Therefore, non-talk approaches are minimized in his book. This eliminates pharmacological approaches to treatment (at least to the pastor-counselor), which can prove useful in many cases. In some of Adams writings, however, he does state that he is not opposed to medication, but he writes with a strong suspicion against the practice of medicating.

Though, even on this point, I have found Adams to be more balanced than I initially read him (partly because some of his statements sound very dogmatic against medications in some places, but then he qualifies those statements in other places).

-Adams, on page 37 (?) of Competent to Counsel states that nouthetic counselors ought to work side by side and back to back with physicians. Adams states that his approach is not scientific or medical but presuppositional, but nouthetic counselors often make sweeping scientific and medical statements that are sometimes unsubstantiated. Nevertheless, physicians often are consulted and often appear at nouthetic counseling meetings.

-Adams approach is entirely too confrontational. If I am not wrong, he himself describes his approach as a confrontation between the patient and the Word of God. 

-Adams spoke out not just against secular psychologists but also proved to be very polemical towards fellow Christians who he referred to as "integrationists" and much of my dislike for Adams' writings stem around this area of unnecessary harshness towards those who differed with Adams as to what role psychology could play.



Also, below Powlison writes about Adams propensity to identify all problems that are not purely organic to be sin problems:



> As we have seen, Adams considered the diagnosis “sin” appropriate for the
> gamut of normal problems in living: interpersonal conflict, unhappy emotions, bad
> behavior, faulty beliefs, and typical reactions to suffering. But he also believed it applied
> to the most extreme problems in living: “schizophrenia” and other forms of bizarre
> behavior.66 The extremes of bizarre behavior – the “mentally ill” – played a significant
> part in Adams’s articulation and defense of his system. He believed that most “mental
> illnesses” could be unmasked as instances of things the Bible treated under the category
> of sin. Just as he reacted to defining the pastor as one who offered consoling promises to
> sufferers, so he reacted to defining the pastor as one who should deal with nothing
> “more serious than a psychic scratch,” referring more difficult problems to mental health
> professionals.




David Powlison writes below about Adams and the issue of organic disorder. It does appear that Adams wrestled with this issue and was sometimes open to medication. Adams wrote much about schizophrenia and sometimes denied that this disease was mainly organic:



> Moral causes of bizarre behavior might be mingled with physiological factors.
> 
> Adams was interested in ostensible organic concomitants to bizarre behavior:
> Not all peculiar behavior, of course, stems from specific acts of sin; there are
> people who have toxic problems, tumors on the brain, brain damage, etc., who
> because of physical damage or chemical malfunction perform badly. Such organic problems, external to moral responsibility, might come into play and
> modify the counselee’s capabilities to some undetermined degree. Adams never got
> more specific than saying “to the extent that it is possible to do so” organically impaired
> patients were responsible to obey God.79
> 
> In Adams’s view, physiological impairment was an indirect consequence of the problem of sin,one component in that comprehensive
> impairment characteristic of the “fallen” state of humankind:
> 
> ...
> In treating people whose behavior was peculiar, Adams was amenable to
> cooperation with physicians, and to a cautious use of both medical treatments and
> medical research in seeking to disentangle vexing cases.
> 
> Adams’s discussion of organic components to bizarre behavior was typically hedged and tentative, a contrast to
> his typical style. For example, while he generally opposed psychotropic medications,
> finding “the excessive use of pills among psychiatrists and physicians alarming,” he granted that “not all medication is unnecessary.”82 When he wrote regarding depression
> that “The physician might uncover some of the infrequent cases of chemically-caused
> depression and in very serious cases may help the pastor to engage in meaningful
> counseling by temporarily administering antidepressants,”83 he did not seek to resolve
> either the ambiguities of “chemically-caused” or to define the parameters of “serious.”
> In Adams’s proposed reconfiguration of the professional landscape, he reassigned
> psychiatrists to explore such organic problems and not to intrude into the functional
> problems. “That there is much for the psychiatrist to do medically to help persons
> suffering from problems in living whose etiology is organic cannot be questioned.”84
> 
> He never gave a more specific answer to the question of disentangling organic from moral
> etiologies.



This all sounds very good above, and Adams makes this generalization (which I also believe to be true):



> The number of people “whose problems are organic in origin (as over against those who are simply not ‘making it’ in life because they are not solving
> life’s problems biblically) is negligible.”




However, in response to psychological pain due to abuse Powlison says the following of Adams;



> In Adams’s view, “sinful influences” and “acts of abuse” only gained purchase in the
> human soul because of the susceptibility of sinful hearts to embrace sin or to react to sin
> sinfully.



So, pain from abuse, too, is due to sin it seems from Adams. This appears to "blame the victim" in cases of abuse where the abused party suffers long-term negative effects from the abuse.

Powlison again:



> To many critics, Adams view of the dislocation in human nature was too narrow
> as well as too shallow. Certain emotional and psychological dimensions of human woe
> did not immediately reduce to outworkings of the problem of personal sin. Inner misery,
> mental illness, psychological dysfunction, and social maladjustment could not always be
> explained either as sin or as organic dysfunction.




Is the counseleee more of a sinner or one sinned against:

-People who come for counseling are hurting. Whereas many psychologists stress their victim status, Adams often stressed the counselees' own patterns of sin. Powlison has this to say:



> Adams writes of both the sin nature and of being sinned against. When it
> actually comes down to his theory of pathology, however, he lays most of
> the responsibility at the feet of the individual.
> 
> ...
> The outworking of Adams’s actual theory and counseling practice paid little attention to
> being sinned against, and in effect treated the impact of such things as negligible.
> 
> Again, Adams’s failings were specifically biblical failings. The evangelical
> psychotherapists thought that Adams had almost wholly missed the point made in
> numerous psalms, that counselees were often more sinned against than sinning. The God
> of the Bible cared for those who had been sinned against, and he would meet people in
> their sufferings just as he gave grace to them in their sins. God called those who
> ministered in his name to an analogous love and patience towards the oppressed, sinned
> against, misled.
> 
> Adams was often charged with being one of “Job’s counselors” in the
> way his confrontational model moved rapidly past suffering as somewhat irrelevant in
> comparison to the need to address responsible behavior.
> Adams and the evangelical psychotherapists clashed over the



The person who suffers mental anguish is often both a sinner and a victim, but Adams' approach over-emphasizes one aspect (the sinner) while modern psychology emphasizes the other (man as a victim).

Concerning suffering, Adams says many good things and is a good antidote to philosophies that would cave in to pity when encountering suffering. Nevertheless, Powlison summarizes the critiques of some towards Adams below:



> The moral strenuousness of Adams’s discussion of suffering caused many of the
> most impassioned outcries against his model of counseling. Many critics thought that he
> sounded heartless to afflicted people and passed too quickly over their suffering.



Also, Adams focuses much on conscious thoughts and behaviors and this leads some to charge him with being simplistic and even behavioristic. Powlison writes:


> This focus on conscious behavior and thoughts made Adams’s counseling process rapid, but superficial. His counseling, when successful, largely consisted in helping people replace identifiably ungodly habits with purportedly godly habits:











Three final areas of possible difference with Adams are: (1) The Bible was not written as a counselor's textbook, (2) some truth or knowledge about human behavior can be gained through common grace investigations by even secular psychologists. First, I do not see a system of counseling to be found in Scripture. I see info we can use to draw some conclusions, but the main purpose of Scripture is not as a counselor's handbook. Second, Adams often calls other evangelical "Christian" counselors on the carpet and calls many of them compromisers for using insights gained from secular psycholology. But, I believe that this, too, is a legit practice as long as we do so in discerning fashion.


----------



## jayce475

Pergamum said:


> Second, Adams often calls other evangelical "Christian" counselors on the carpet and calls many of them compromisers for using insights gained from secular psycholology. But, I believe that this, too, is a legit practice as long as we do so in discerning fashion.



Pergy, could you give some more elaboration on the differences between these counselors whom you think are legit and Jay Adam's methods? I don't side with Adams per se, but I would like to get a better idea of what alternatives there are and whether they are in line with the theses you had pointed out.


----------



## Pergamum

Addendum;


Adams' approach to guilt is often flawed. For instance, he seems to deny the notion of false guilt:



> "Shall we seek to remove guilt feelings (that is, false guilt)? Never; instead we must acknowledge guilt to be real and deal directly with it. Psychological guilt is the fear of being found out. It is the recognition that one has violated his standards. It is the pain of not having done as one knows he ought to do."




From Competent to Counsel, pg. 14. However, I believe that false guilt is a real entity that must also be counseled against and is particularly common in religious circles.

---------- Post added at 07:33 AM ---------- Previous post was at 07:25 AM ----------

Jason, 

I believe that Welch and David Powlison and Tripp share most of the same presuppositions of Adams but their tone is less polemical, they are less likely to attack other Christian psychologists or call them compromisers and they are more open to ideas such as false guilt and the legitimate contributions of even secular psychology. Also, they better acknowledge that the counselee is a hurting victim in need of comfort and not primarily a sinner in need of confrontation and repentance. Finally, they seem to dive deeper into motivations and heart-issues, whereas much in Adans' writings concerned behaviors and the modification of those habits and behaviors. Many of the practices, however, seem very similar and Powlison writes with much respect concerning Jay Adams, and Powlison's writings helped me to reread Adams in a more positive light whereas I was pretty negatively disposed towards Adams after my initial reading of several things he wrote on schizophrenia.

---------- Post added at 07:38 AM ---------- Previous post was at 07:33 AM ----------

Jason,

I think Ed Welch, David Powlison and others are less polemical, less likely to accuse other Christian psychologists with whom they differ of being compromisers, are more likely to incorporate the legitimate findings of psychology into their practices, and they seem to stress motivations and heart-issues to a greater degree whereas Adams often stressed behaviors and habits and the modifications of those behaviors and habits.


----------



## calgal

Scottish Lass said:


> calgal said:
> 
> 
> 
> Jay Adams and co have one huge fatal flaw: they do not understand that mental illness is as real as cancer, alzheimers, diabetes and any other chronic illness
> 
> 
> 
> 
> Can you substantiate this claim?
Click to expand...


Sadly I can:

OAIM What Is Biblical Counseling

Jay E. Adams states the following in the book “The Big Umbrella”:

“In this country, because of a prestigious alliance with the A.M.A., a psychiatrist is required to have an M.D. But you will soon agree that Freud was right if you read the articles written by some psychiatrists complaining about the necessity to take medical training that they never use in their work and soon forget. The point is this: there is nothing a psychiatrist does with his medical training that a physician couldn’t do just as well, or better. And the physician could do it in conjunction with a pastoral counselor. The psychiatrist may write prescriptions for tranquilizers or other pills now and then, but a physician does that all of the time. There is no need for a specialty in order to prescribe pills.”

Jay Adams The Big Umbrella, p.6, Presbyterian and Reformed, 1972.


----------



## Marrow Man

Pergy, we differ (to some degree) on our estimation of Dr. Adams, but I appreciate your thoughts in post # 38 above and find them to be very reasonable.

An additional thought on this issue, with regard to the abrasiveness of Dr. Adams' personality (from someone who has benefited, in person, from both Dr. Adam's gentleness and directness): I remember listening to an iTunes lecture by John Frame, where he mentioned that in church history, you have periods where a reformer comes along and shakes things up a bit (to correct false teaching and the like), followed by a systematizer who is able to put all these things together for others afterward to benefit. And the two are not the same. You need both the lightening rod and the thoughtful person to work through the issue(s), and it often takes a long time. Frame's examples were for two different periods of church history. In the early church, the controversy was over the Trinity, the forceful person was Athanasius, and the systematizer was Augustine. During the Reformation, the issue (or one of the issues) was justification, the forceful man was Luther, the systematizer was Calvin. Perhaps we see something similar in Christian counseling -- with Dr. Adams being the forceful man and folks like the Tripps and Welch helping to develop the teaching. And while there are some differences, the groups are largely in agreement. After all, Dr. Adams does recommend books by folks like Ed Welch.


----------



## py3ak

beej6 said:


> Someone remind me to come back to this thread. I may be the only Reformed psychiatrist in existence (smile). I've also read Adams and have profited from him.
> I would suggest to all to also read Powlison's _The Biblical Counseling Movement_ (which I am part way through).


 
Come back to this thread! I would be very interested to hear what you have to say about psychiatry and counseling.


----------



## Pergamum

Tim, 

Yours seems like a fair assessment. I have often wondered whether Adam's real or perceived abrasiveness was not necessarily due to what he was facing. Now, that he has cleared the way a bit, the more likeable systematizers like Welch and Powlison can emerge.


----------



## Scottish Lass

calgal said:


> Scottish Lass said:
> 
> 
> 
> 
> 
> calgal said:
> 
> 
> 
> Jay Adams and co have one huge fatal flaw: they do not understand that mental illness is as real as cancer, alzheimers, diabetes and any other chronic illness
> 
> 
> 
> 
> Can you substantiate this claim?
> 
> Click to expand...
> 
> 
> Sadly I can:
> 
> OAIM What Is Biblical Counseling
> 
> Jay E. Adams states the following in the book “The Big Umbrella”:
> 
> “In this country, because of a prestigious alliance with the A.M.A., a psychiatrist is required to have an M.D. But you will soon agree that Freud was right if you read the articles written by some psychiatrists complaining about the necessity to take medical training that they never use in their work and soon forget. The point is this: there is nothing a psychiatrist does with his medical training that a physician couldn’t do just as well, or better. And the physician could do it in conjunction with a pastoral counselor. The psychiatrist may write prescriptions for tranquilizers or other pills now and then, but a physician does that all of the time. There is no need for a specialty in order to prescribe pills.”
> 
> Jay Adams The Big Umbrella, p.6, Presbyterian and Reformed, 1972.
Click to expand...

 
I fail to see how that supports your claim--nowhere in that quote does he deny the existence of mental issues. He simply questions/rejects the need for a specialist merely to prescribe drugs that cover up rather than treat the problem. Are you saying a physician is not qualified to treat any mental issues?


----------



## jayce475

calgal said:


> Scottish Lass said:
> 
> 
> 
> 
> 
> calgal said:
> 
> 
> 
> Jay Adams and co have one huge fatal flaw: they do not understand that mental illness is as real as cancer, alzheimers, diabetes and any other chronic illness
> 
> 
> 
> 
> Can you substantiate this claim?
> 
> Click to expand...
> 
> 
> Sadly I can:
> 
> OAIM What Is Biblical Counseling
> 
> Jay E. Adams states the following in the book “The Big Umbrella”:
> 
> “In this country, because of a prestigious alliance with the A.M.A., a psychiatrist is required to have an M.D. But you will soon agree that Freud was right if you read the articles written by some psychiatrists complaining about the necessity to take medical training that they never use in their work and soon forget. The point is this: there is nothing a psychiatrist does with his medical training that a physician couldn’t do just as well, or better. And the physician could do it in conjunction with a pastoral counselor. The psychiatrist may write prescriptions for tranquilizers or other pills now and then, but a physician does that all of the time. There is no need for a specialty in order to prescribe pills.”
> 
> Jay Adams The Big Umbrella, p.6, Presbyterian and Reformed, 1972.
Click to expand...

 
In healthcare, we know it when our fields are dodgy in some sense. What I do in speech therapy generally has much less evidence compared to physical therapy and I accept that in some settings where it is practised, it is pointless. Psychiatry is a much less clearcut field than many other specialties and there are valid reasons to question the need for the specialty of psychiatry in the first place. Where the bible does not give answers, in this case on the presence and nature of the organic bases of some of the mental illnesses, we look to natural revelation. Perhaps at some point it will do us good if we look at the clinical research out there pertaining to this question rather than debating on our interpretations of what a pastoral counsellor says about it. That said, the world of research is often fraught with dishonesty and controversy, so we often would then need to tread carefully.


----------



## Stephen L Smith

Pergamum said:


> Three final areas of possible difference with Adams are: (1) The Bible was not written as a counselor's textbook, (2) some truth or knowledge about human behavior can be gained through common grace investigations by even secular psychologists. First, I do not see a system of counseling to be found in Scripture. I see info we can use to draw some conclusions, but the main purpose of Scripture is not as a counselor's handbook. Second, Adams often calls other evangelical "Christian" counselors on the carpet and calls many of them compromisers for using insights gained from secular psycholology. But, I believe that this, too, is a legit practice as long as we do so in discerning fashion.



Rich, I agree with the emphasis here. As I mentioned previously, Lloyd-Jones (who was very sound theologically!!) and Johnson say the same thing.


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## Marrow Man

The one caveat I would add to those emphases is that 1) a robust doctrine of sola Scriptura will confess that the Scriptures are sufficient in all matters of faith and practice, which would include the area of pastoral counseling and 2) the problem with secular methodologies is that they do not have a correct doctrine of anthropology and thus will tend to misinterpret data in this area.

Take the area of addictions, for example. I think it was Ed Welch who pointed out that the reason that secular counseling speaks of addictions as "diseases" is because they literally have no categories to deal with this. Bondage to sin simply is not part of their worldview, and labeling it as a disease is the way it looks from a naturalistic perspective.


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## MW

I wonder how much confusion on this subject might be cleared up by considering the particularity of grace. Biblical counselling presupposes the transforming power of grace. OTOH, the unbeliever is given over to a reprobate mind, including whatever therapies he relies upon to help him find meaning in life. Again, all things are working together for the good of those who love God, especially the good of being conformed to the image of his Elder Brother. OTOH, wretchedness is the constant companion of wickedness so that the unbeliever really should find no comfort at all in his state of rebellion against God.

Psychiatry and psychology, like other branches of philosophy, serve as descriptions of the human condition. The only prescription for the vanity and misery of human life is to be found in the gospel which preaches repentance unto life. Being renewed in the spirit of one's mind is absolutely prerequisite to putting on the new man which after God is created in righteousness and true holiness. And apart from holiness there is no genuine happiness.


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## Iconoclast

> wretchedness is the constant companion of wickedness so that the unbeliever really should find no comfort at all in his state of rebellion against God.


Matthew your post brought to mind two passages;


> 19I create the fruit of the lips; Peace, peace to him that is far off, and to him that is near, saith the LORD; and I will heal him.
> 
> 20But the wicked are like the troubled sea, when it cannot rest, whose waters cast up mire and dirt.
> 
> 21There is no peace, saith my God, to the wicked.





> 3Thou wilt keep him in perfect peace, whose mind is stayed on thee: because he trusteth in thee



The unbeliever does not live in the "real world" in that he or she attempts to re-define God's world...into their own fantasy world. This does not lend itself to proper mental health.


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## calgal

Iconoclast said:


> wretchedness is the constant companion of wickedness so that the unbeliever really should find no comfort at all in his state of rebellion against God.
> 
> 
> 
> Matthew your post brought to mind two passages;
> 
> 
> 
> 19I create the fruit of the lips; Peace, peace to him that is far off, and to him that is near, saith the LORD; and I will heal him.
> 
> 20But the wicked are like the troubled sea, when it cannot rest, whose waters cast up mire and dirt.
> 
> 21There is no peace, saith my God, to the wicked.
> 
> Click to expand...
> 
> 
> 
> 
> 
> 3Thou wilt keep him in perfect peace, whose mind is stayed on thee: because he trusteth in thee
> 
> Click to expand...
> 
> 
> The unbeliever does not live in the "real world" in that he or she attempts to re-define God's world...into their own fantasy world. This does not lend itself to proper mental health.
Click to expand...

 
No but people who are believers or unbelievers that are mentally ill or mentally unstable live in a world full of "noise" if you will. Noise being anything from the voices in their heads (that only are quieted by medications) to the more "mundane" feelings of anxiety, fear, depression and the noise can be so loud nothing else including logic, reason, the voice of God Himself can be heard clearly. The noise muffles and alters everything around it and the role of meds is to shut the noise down long enough for the patient to think clearly. That is why my mommy is on Mellaril: her brain chemistry has been physically mutated by an act of God and she does not think clearly: she is getting worse thanks to a couple brain scars on a couple lobes. And when the seizures got bad, she was told she was possessed by the devil. Mommy is an atheist. Sadly one of the side effects of Mr. Adams and the Nouthetic counselors are that the folks who show anything resembling a breakdown shut up and shut down. Because if they say what they feel they are either demon possessed or they must not have faith. THAT is my problem with Mr. Adams and his followers. There ARE mental illnesses out there and physical illnesses which have a symptom of depression (or a side effect of sorts). Incidentally some of the most mentally deranged folks I have had the pleasure of meeting are quite devout (at least they will tell you they are)


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## Scottish Lass

calgal said:


> and physical illnesses which have a symptom of depression (or a side effect of sorts).



Again, Adams completely believes this. A physical workup is the step after the initial counseling session. Organic/physical causes can be determined and treated, thus actually solving the depression rather than simply adding an antidepressant drug to the problem without solving the thyroid imbalance or whatever is causing the depression. Medicine interaction is a leading cause of depression, for example.


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## Pilgrim

*Different emphases in sanctification?*

I'm sure it doesn't apply in every case, but it seems to me that those who line up with Dr. Adams tend to have more of an emphasis on the use of the law in sanctification whereas many (in my experience) who would identify with the CCEF approach would also tend to identify with more of a Sonship emphasis. 

The connection came to mind for me when reading this post on the law and sanctification on Dr. Adams' blog. Counseling is not mentioned in the post, but its implications on the subject at hand here seem pretty clear to me. 

Thoughts?


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## beej6

I am loathe to criticize Dr. Adams because while I know when he wrote CTC (late 1960s), I cannot tell for example when this online article when written:

Nouthetic Counselors Oppose the Use of Medicine, Don't They? - Institute For Nouthetic Studies

That article which Jason linked to has a simplistic model of how psychotropic medications work, that they simply "inhibit the body from functioning as it should." 

As to Jason's other article (see post 37), I would say that psychiatrists (and others who prescribe psychotropics; actually 2/3 of all psychotropics are prescribed by other than psychiatrists) depend on grace more than other doctors! While I can tell you how the medication works, and the theory of "chemical imbalance" (again, simplistic) as to why a certain person may have a certain illness, there is a "black box" in the middle because it is not always a one to one relationship. And yes, I do explain this to my patients.


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