# Difference between nouthetic and integrationist counseling



## Toasty

Those who advocate nouthetic counseling believe that there are certain truths that can only be found in the Bible such as how a person becomes more like Christ and how to overcome sin. Integrationists do not believe this. Is this correct?


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## Romans922

Nouthetic uses the Bible to counsel people. Integrationaists use secular psychology and a little bit of Bible (just enough to make it sound Christian) to counsel people.


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## RamistThomist

Does nouthetic counseling hold that depression is always because of sin?


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## reaganmarsh

ReformedReidian said:


> Does nouthetic counseling hold that depression is always because of sin?



No. Depression may very well be the result of sin (omission or commission), but we recognize that there are legitimate organic reasons as well. For example, one may be on a medicine which reduces the body's serotonin production as a side-effect, and depressive feelings ensue. I don't know any nouthetic counselor who would tell you in that instance that your depression is the result of sin!


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## Peairtach

Interesting thread on Jay Adams' Nouthetic Counselling, here:

http://www.puritanboard.com/showthread.php/66371-Competent-to-Counsel


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## RamistThomist

reaganmarsh said:


> ReformedReidian said:
> 
> 
> 
> Does nouthetic counseling hold that depression is always because of sin?
> 
> 
> 
> 
> No. Depression may very well be the result of sin (omission or commission), but we recognize that there are legitimate organic reasons as well. For example, one may be on a medicine which reduces the body's serotonin production as a side-effect, and depressive feelings ensue. I don't know any nouthetic counselor who would tell you in that instance that your depression is the result of sin!
Click to expand...


I had a conversation with some Reconstructionists on facebook (I know, not scholarly) and they advanced that line. I'm encouraged that nouthetic counseling is not tied to that position).


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## MW

Toasty said:


> Those who advocate nouthetic counseling believe that there are certain truths that can only be found in the Bible such as how a person becomes more like Christ and how to overcome sin. Integrationists do not believe this. Is this correct?



I think evangelical integrationists would agree with the fact that certain truths are only found in the Bible, but they would insist there is a sphere of general revelation in which all humans can find truth. Nouthetic counselling builds on the reformed approach to revelation with an emphasis on the dehumanising effects of the fall and the need for divine grace. It was initially concerned with preserving the distinct charge and perspective of the pastor in caring for souls.


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## NoutheticCounselor

No. In some cases depression can be organic. For example, depression symptoms can be due to cardiac issues, thyroid issues, brain tumors, etc. It is often wise to have a counselee with depression related symptoms to have a physical exam to rule out an organic cause.

It should be noted that Nouthetic Counselors we do not hold to the chemical imbalance theory that is held to by so many "mental health professionals."


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## Pergamum

Hi Chris,

Can you explain more what the "chemical imbalance theory" is, and why nouthetic counselors do not hold to this theory? Do you mean to say that some nouthetic counselors, or all nouthetic counselors do not hold to this theory (i.e. is it your personal belief as a nouthetic counslor, or part of the core beliefs of nouthetic counselors not to believe in the "chemical imbalance theory")?


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## NoutheticCounselor

Pergamum,

It is a complex topic that I will try to sum up in a paragraph or two. Please free to direct message me if you want a more detailed response.

Generally speaking, the chemical imbalance theory is that “mental health” issues such as depression that do not have an identifiable cause (Thyroid, tumor, cardiac, etc) may be due to a chemical imbalance in the brain. There is no definitive tests to determine the imbalance that is widely accepted. In order to treat the perceived imbalance, the counselee is often prescribed medications such as Prozac.

Generally, Nouthetic Counselors are opposed to the idea that a person’s behavior is due to an unproven chemical imbalance. They do not want to call sin a sickness if it is not due to organic cause.
Many Nouthetic Counselors are abandoning the term “nouthetic” and using the generic title “Biblical Counselor” since the theories behind nouthetic counseling have grown since the early days. Unfortunately, it leads to confusion since integrated counselors and deliverance ministries use the title of Biblical Counselor as well.


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## Pergamum

Chris,

Okay thanks. 

*About depression: 
*
Do you affirm or deny the statement, "biological factors are important to understanding depression"?

Do you believe that an affirmation of the statement, "psychological states may be influenced by physical or chemical changes in the brain" to be threatening to the faith? 

My view: Overall, I am glad the chemical imbalance theory is being challenged. However, is denial of this theory an essential part of being a nouthetic counselor? Or can a potential nouthetic counselor be accepted into the movement while affirming that chemical and physical factors sometimes strongly influence one's psychological state? I believe that not only organic damage to the brain, but a number of physical and chemical factors may influence our mood. Yet this appears to conflict with some "biblical counselors" I've spoken to.

http://www.nejm.org/doi/full/10.1056/NEJMra073096

https://www.psychologytoday.com/blog/in-practice/200804/the-chemical-imbalance-theory-dead-or-alive

*
My beliefs about nouthetic counseling in general are these:* (1) I affirm that common grace may provide for us insights which may lead to advancements in the treatment of patients. The bible is sufficient for our salvation, yet it is not a handbook of counseling. Treating the bible as a handbook for counseling misses the point of the bible. (2) I affirm that secular psychologists, through common grace, have contributed to the furtherance of the field. (3) Some areas of psychology are only distantly related to the bible, and yet may be beneficial to society.

A good book I just read is the Book of Woe. It provides good reasons to be generally suspicious of modern psychology: http://www.amazon.com/Book-Woe-DSM-Unmaking-Psychiatry/dp/0142180920/ref=sr_1_1?ie=UTF8&qid=1433628414&sr=8-1&keywords=book+of+woe


*About nouthetic counselors' polemics against integrationists: * 

Another area of concern I have about nouthetic counseling is this: I have heard several pastors who are also nouthetic counselors speak of integrationists as compromisers and not as truly biblical as them, because they also borrow from the world. Is this a fair characterization of the followers of nouthetic counseling? If I were to make a case for integrationism, would you conclude that I was sub-biblical or somehow a compromiser? In what ways has common grace and secular knowledge helped us to advance our knowledge of how to help people with various mental ailments? Must we totally reject any and all contribution to psychology is they be from secular sources?

Here is a critique of Jay Adams here: https://books.google.com/books?id=G6ZUFNi6Js8C&pg=PA9&dq=Criticism+of+Jay+Adams&hl=en#v=onepage&q=Criticism%20of%20Jay%20Adams&f=false

http://www.salvomag.com/unpragmatic-thoughts/?p=305


I believe most of my objections to nouthetic counseling are really reactions to Jay Adams and his writings. I believe Ed Welch and David Powlinson to be much more sound and balanced.


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## Pergamum

Here is a good critique of Jay Adam's counseling methodology: http://theophilogue.com/2007/09/28/psychology-is-the-devil-a-critique-of-jay-adams-counseling-paradigm/



> counseling is more than identifying and confronting sin.





> ...although he has swung the pendulum in the right direction...he has swung the pendulum a bit too far.





> ...not all troubles are sin problems, not all methods include nouthetics...





> Adams is also guilty of a methodological reductionism. By this, I do not mean that Adams does not have many methods. Rather, Adams unfortunately reduces all methods for counseling down to nouthetics. Biblical Counseling = Nouthetic Counseling. In fact, he oversimplifies the nature of real-life counseling by reducing it down to “problem solving,” and then speaking of the “problem” only in terms of sin. However, to be faithful to the biblical sources, one must include a variety of problems as well as a variety of methods. We must “admonish [noutheteite] the unruly,” but we also must “encourage [parameutheisthe] the fainthearted” (1 Thess 5:14).


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## Tirian

this has been a very helpful discussion. thank you


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## Pilgrim

Toasty said:


> Those who advocate nouthetic counseling believe that there are certain truths that can only be found in the Bible such as how a person becomes more like Christ and how to overcome sin. Integrationists do not believe this. Is this correct?



As stated, actually I do not think this is correct. I think even the "worst" integrationists would affirm that "there are certain truths that can only be found in the Bible." The question is to what degree, if any, secular psychiatry and psychology can be integrated (or synthesized) with the Bible in counseling.

If memory serves, Adams has said that nouthetic counseling is basically Van Til's presuppositional apologetic applied to counseling. Hence, no neutrality, no integration.


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## RamistThomist

Just thinking out loud:

*If integrationist counseling (which I have not studied) can legitimately claim insights from general revelation, should not those insights be incorporated?
*Are we Scripturalists after all? Yikes!


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## Pergamum

Here is another thought:

Many Calvinistic Baptists I know (especially those in FIRE) are really into "Biblical counseling" although I have never been a fan. Jay Adams speaks of the goal of counseling as the counselee gaining the fruits of the Spirit. He speaks of every pastor being given a mandate to counsel. 

However....whatever happened to the word "discipleship?" 

There are thousands of pastors every year attending classes in biblical counseling and talking "counseling," "counseling," and more "counseling" but last I checked, to encourage a church member to exercise the fruits of the Spirit was *discipleship* without any renaming of this activity or without providing classes and special accreditation besides ordination. And if pastors are already "competent to counsel" why all the need for special accreditation?

If we are counseling unbelievers to gain the fruits of the Spirit, this is done through "evangelism." 

For these semantical reasons, I remain detached and unaffected by the excitement that so many of my peers possess about 'Biblical counseling" - but I do believe in evangelism and discipleship.


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## Pergamum

ReformedReidian said:


> Just thinking out loud:
> 
> *If integrationist counseling (which I have not studied) can legitimately claim insights from general revelation, should not those insights be incorporated?
> *Are we Scripturalists after all? Yikes!



I would say we must be Scripturalists in things pertaining to the Scriptures. But the Scriptures only speak of the sun rising, and says nothing of the elliptical orbits of planets. Likewise, the Scriptures speak of general principles of happiness or anger, etc, but does not speak exhaustively on these matters. 

Jay Adams seems to equate the role of the counselor to the pastoring/discipleship role of the pastor; but psychologists serve many more functions than merely this. They gather data about societal norms and attitudes, they devise tests to determine fitness for certain tasks (like in the army, etc), they do studies and survey research to track behavioral patterns and determine factors contributing to certain behaviors. Many of their legitimate tasks are only distantly related to the theological statements of Scripture.


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## RamistThomist

Pergamum said:


> ReformedReidian said:
> 
> 
> 
> Just thinking out loud:
> 
> *If integrationist counseling (which I have not studied) can legitimately claim insights from general revelation, should not those insights be incorporated?
> *Are we Scripturalists after all? Yikes!
> 
> 
> 
> 
> I would say we must be Scripturalists in things pertaining to the Scriptures. But the Scriptures only speak of the sun rising, and says nothing of the elliptical orbits of planets. Likewise, the Scriptures speak of general principles of happiness or anger, etc, but does not speak exhaustively on these matters.
> 
> Jay Adams seems to equate the role of the counselor to the pastoring/discipleship role of the pastor; but psychologists serve many more functions than merely this. They gather data about societal norms and attitudes, they devise tests to determine fitness for certain tasks (like in the army, etc), they do studies and survey research to track behavioral patterns and determine factors contributing to certain behaviors. Many of their legitimate tasks are only distantly related to the theological statements of Scripture.
Click to expand...


Scripturalism: that which can be known by Scripture or deduced from Scripture or a necessary inference from Scriptural propositions. Hence man cannot know anything by induction, his senses, science, common sense, intuition, the "light of nature," etc. This is a rough and ready definition. If one is a Scripturalist regarding theological knowledge, no problem. If one applies this definition to knowledge in general...


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## MW

Pergamum said:


> However....whatever happened to the word "discipleship?"



This is what "Shepherding God's Flock" emphasised. As it has progressed it has become less focussed on the pastoral ministry and grown more clinical. I think Dr. Adams' initial reaction was a biblical one -- the pastor has a spiritual charge and psychological practice was invading his sphere of service; it was therefore necessary to reassert the biblical message of sin and grace that the pastor is entrusted to proclaim. The problem now is that the "pastoral" responsibility has been given over to "every believer," and nouthetic counselling is moving in on the psychologist's domain.


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## Toasty

Romans922 said:


> Nouthetic uses the Bible to counsel people. Integrationaists use secular psychology and a little bit of Bible (just enough to make it sound Christian) to counsel people.



Nouthetic counseling teaches that all the information we need to counsel people is found in the Bible whereas integrationists do not.


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## Toasty

NoutheticCounselor said:


> No. In some cases depression can be organic. For example, depression symptoms can be due to cardiac issues, thyroid issues, brain tumors, etc. It is often wise to have a counselee with depression related symptoms to have a physical exam to rule out an organic cause.
> 
> It should be noted that Nouthetic Counselors we do not hold to the chemical imbalance theory that is held to by so many "mental health professionals."



That sounds like a good practice. Having a physical exam to rule out an organic cause would be very wise.


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## Toasty

NoutheticCounselor said:


> Pergamum,
> 
> It is a complex topic that I will try to sum up in a paragraph or two. Please free to direct message me if you want a more detailed response.
> 
> Generally speaking, the chemical imbalance theory is that “mental health” issues such as depression that do not have an identifiable cause (Thyroid, tumor, cardiac, etc) may be due to a chemical imbalance in the brain. There is no definitive tests to determine the imbalance that is widely accepted. In order to treat the perceived imbalance, the counselee is often prescribed medications such as Prozac.
> 
> Generally, Nouthetic Counselors are opposed to the idea that a person’s behavior is due to an unproven chemical imbalance. They do not want to call sin a sickness if it is not due to organic cause.
> Many Nouthetic Counselors are abandoning the term “nouthetic” and using the generic title “Biblical Counselor” since the theories behind nouthetic counseling have grown since the early days. Unfortunately, it leads to confusion since integrated counselors and deliverance ministries use the title of Biblical Counselor as well.



According to those who advocate the chemical imbalance theory, how are chemical imbalances measured and how are there effects tested?


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## Toasty

ReformedReidian said:


> Just thinking out loud:
> 
> *If integrationist counseling (which I have not studied) can legitimately claim insights from general revelation, should not those insights be incorporated?



Yes, I think they should be incorporated. However, advocates of nouthetic counseling think that the truth about how a person becomes more sanctified and how to overcome a sin problem is not found in general revelation. They think that it is found in the Bible only.


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## RamistThomist

Toasty said:


> ReformedReidian said:
> 
> 
> 
> Just thinking out loud:
> 
> *If integrationist counseling (which I have not studied) can legitimately claim insights from general revelation, should not those insights be incorporated?
> 
> 
> 
> 
> Yes, I think they should be incorporated. However, advocates of nouthetic counseling think that the truth about how a person becomes more sanctified and how to overcome a sin problem is not found in general revelation. They think that it is found in the Bible only.
Click to expand...


I have no problem with saying we should go to Scripture for sanctification. But Scripture sometimes points people back to general revelation to learn wisdom, "Go to the ant, thou sluggard."


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## Pergamum

Toasty said:


> NoutheticCounselor said:
> 
> 
> 
> Pergamum,
> 
> It is a complex topic that I will try to sum up in a paragraph or two. Please free to direct message me if you want a more detailed response.
> 
> Generally speaking, the chemical imbalance theory is that “mental health” issues such as depression that do not have an identifiable cause (Thyroid, tumor, cardiac, etc) may be due to a chemical imbalance in the brain. There is no definitive tests to determine the imbalance that is widely accepted. In order to treat the perceived imbalance, the counselee is often prescribed medications such as Prozac.
> 
> Generally, Nouthetic Counselors are opposed to the idea that a person’s behavior is due to an unproven chemical imbalance. They do not want to call sin a sickness if it is not due to organic cause.
> Many Nouthetic Counselors are abandoning the term “nouthetic” and using the generic title “Biblical Counselor” since the theories behind nouthetic counseling have grown since the early days. Unfortunately, it leads to confusion since integrated counselors and deliverance ministries use the title of Biblical Counselor as well.
> 
> 
> 
> 
> According to those who advocate the chemical imbalance theory, how are chemical imbalances measured and how are there effects tested?
Click to expand...


The chemical imbalance theory of depression (or monoamine hypothesis) is still being debated: http://www.researchgate.net/profile/Paul_Lysaker/publication/228350699_The_chemical_imbalance_explanation_for_depression_Origins_lay_endorsement_and_clinical_implications/links/02bfe51013fb23fab4000000.pdf


This theory has taken a lot of bad press lately and many say that the media and "Big-Pharma" hyped this theory to sell more drugs that are selective serotonin reuptake inhibitors, or SSRIs (like Prozac). Also, in studies of school shooters we often see a link between this particular type of teenage violence and high levels of medication with psychiatric/psychotropic drugs.

Many mental health professionals, even while exercising a suspicion of this chemical imbalance theory, still affirm dietary, physical, and organic factors in depression. 

In the past, many spoke of two broad categories of depression, exogenous (depression caused by sources without, or as a reaction to bad life events, sometimes called reactive depression) and endogenous depression (from within). I don't seem to hear that phraseology anymore.

Below are some links:

http://www.scientificamerican.com/article/is-depression-just-bad-chemistry/

Here's a link about a possible chemical imbalance causing schizophrenia: http://www.medicaldaily.com/scientists-prove-chemical-imbalance-theory-schizophrenia-using-brain-model-made-stem-cells-302596

I do believe there are physical factors that contribute to depression (bad health, bad diet, accidents hurting the brain...all would impact brain chemistry). Jay Adams and others sometimes seem to affirm "organic" causes for depression yet deny "chemical causes" for depression. I don't always see this as a valid distinction, since organic changes to the brain also impact brain chemistry. But I do affirm that the "chemical imbalance theory" has been over-hyped, and the critical articles that are now appearing in the secular media are a nice corrective (though I wouldn't yet discount this theory totally, or I wouldn't turn it into a theological platform that "Biblical counselors" must deny the chemical imbalance theory to be a "biblical" counselor).

http://www.peteearley.com/2011/03/21/a-chemical-imbalance-real-or-fiction/



> We have reasons for believing that psychiatric disorders must certainly be mediated by biological factors. For one thing, psychiatric illnesses run in families, even when family members are separated at birth. Research has shown that genetic links, and even specific genes, may be associated with different disorders. Many studies have shown that the biological features of groups of people with illnesses are different from those same features in groups of people without those illnesses. What we don’t have, yet, is a specific reliable test for a certain genotype or enzyme level, or a brain scan finding that indicates that a specific person has a specific disease.


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## Pilgrim

Whatever view one takes of this, if current trends continue, ere long licensed mental health professionals will be faced with the decision of following the clear statements of Scripture on sexual ethics, etc. or else denying them if they want to remain licensed.


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## Pergamum

Chris,

Yes, homosexuality and transgenderism used to be listed as mental illnesses, and now people are "brave" to announce themselves in such ways. If psychology is truthful in its studies, it will continue to show the negative effects of these lifestyles over time (high rates of depression, suicide, partner abuse, chronic infidelity, etc).

http://cnsnews.com/news/article/michael-w-chapman/johns-hopkins-psychiatrist-transgender-mental-disorder-sex-change


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## NoutheticCounselor

MW said:


> Toasty said:
> 
> 
> 
> Those who advocate nouthetic counseling believe that there are certain truths that can only be found in the Bible such as how a person becomes more like Christ and how to overcome sin. Integrationists do not believe this. Is this correct?
> 
> 
> 
> 
> I think evangelical integrationists would agree with the fact that certain truths are only found in the Bible, but they would insist there is a sphere of general revelation in which all humans can find truth. Nouthetic counselling builds on the reformed approach to revelation with an emphasis on the dehumanising effects of the fall and the need for divine grace. It was initially concerned with preserving the distinct charge and perspective of the pastor in caring for souls.
Click to expand...


For more information, check out the booklet by Jay Adams called _Is All Truth God's Truth_.

http://www.amazon.com/Truth-Ministr...sr=8-1&keywords=ALL+TRUTH+IS+GODS+TRUTH+ADAMS


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## NoutheticCounselor

Pergamum said:


> Here is another thought:
> 
> Many Calvinistic Baptists I know (especially those in FIRE) are really into "Biblical counseling" although I have never been a fan. Jay Adams speaks of the goal of counseling as the counselee gaining the fruits of the Spirit. He speaks of every pastor being given a mandate to counsel.
> 
> However....whatever happened to the word "discipleship?"
> 
> There are thousands of pastors every year attending classes in biblical counseling and talking "counseling," "counseling," and more "counseling" but last I checked, to encourage a church member to exercise the fruits of the Spirit was *discipleship* without any renaming of this activity or without providing classes and special accreditation besides ordination. And if pastors are already "competent to counsel" why all the need for special accreditation?
> 
> If we are counseling unbelievers to gain the fruits of the Spirit, this is done through "evangelism."
> 
> For these semantical reasons, I remain detached and unaffected by the excitement that so many of my peers possess about 'Biblical counseling" - but I do believe in evangelism and discipleship.



Nouthetical Counselors would evangelize an unbeliever before counseling them.


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## NoutheticCounselor

Pergamum said:


> Chris,
> 
> Okay thanks.
> 
> *About depression:
> *
> Do you affirm or deny the statement, "biological factors are important to understanding depression"?
> 
> Do you believe that an affirmation of the statement, "psychological states may be influenced by physical or chemical changes in the brain" to be threatening to the faith?
> 
> My view: Overall, I am glad the chemical imbalance theory is being challenged. However, is denial of this theory an essential part of being a nouthetic counselor? Or can a potential nouthetic counselor be accepted into the movement while affirming that chemical and physical factors sometimes strongly influence one's psychological state? I believe that not only organic damage to the brain, but a number of physical and chemical factors may influence our mood. Yet this appears to conflict with some "biblical counselors" I've spoken to.
> 
> http://www.nejm.org/doi/full/10.1056/NEJMra073096
> 
> https://www.psychologytoday.com/blog/in-practice/200804/the-chemical-imbalance-theory-dead-or-alive
> 
> *
> My beliefs about nouthetic counseling in general are these:* (1) I affirm that common grace may provide for us insights which may lead to advancements in the treatment of patients. The bible is sufficient for our salvation, yet it is not a handbook of counseling. Treating the bible as a handbook for counseling misses the point of the bible. (2) I affirm that secular psychologists, through common grace, have contributed to the furtherance of the field. (3) Some areas of psychology are only distantly related to the bible, and yet may be beneficial to society.
> 
> A good book I just read is the Book of Woe. It provides good reasons to be generally suspicious of modern psychology: http://www.amazon.com/Book-Woe-DSM-Unmaking-Psychiatry/dp/0142180920/ref=sr_1_1?ie=UTF8&qid=1433628414&sr=8-1&keywords=book+of+woe
> 
> 
> *About nouthetic counselors' polemics against integrationists: *
> 
> Another area of concern I have about nouthetic counseling is this: I have heard several pastors who are also nouthetic counselors speak of integrationists as compromisers and not as truly biblical as them, because they also borrow from the world. Is this a fair characterization of the followers of nouthetic counseling? If I were to make a case for integrationism, would you conclude that I was sub-biblical or somehow a compromiser? In what ways has common grace and secular knowledge helped us to advance our knowledge of how to help people with various mental ailments? Must we totally reject any and all contribution to psychology is they be from secular sources?
> 
> Here is a critique of Jay Adams here: https://books.google.com/books?id=G6ZUFNi6Js8C&pg=PA9&dq=Criticism+of+Jay+Adams&hl=en#v=onepage&q=Criticism%20of%20Jay%20Adams&f=false
> 
> http://www.salvomag.com/unpragmatic-thoughts/?p=305
> 
> 
> I believe most of my objections to nouthetic counseling are really reactions to Jay Adams and his writings. I believe Ed Welch and David Powlinson to be much more sound and balanced.



Statement 1:You must rule out organic causes to depression as well as side effects from medications, etc.

Statement 2: I would need more clarification before answering.

I am not going to say that you are a compromiser. It would not be right to make that judgment based upon our limited interaction.


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## Nicholas Perella

NoutheticCounselor said:


> Nouthetical Counselors would evangelize an unbeliever before counseling them.



Evangelizing is the counseling. If the person being counseled would refuse to be counseled at any point (from 1st class to last) knowing they will be evangelized then the counseling would end. It is advertised as Biblical Counseling.

A confessing Christian on the other hand is being discipled. The pastor of the counseled Christian is immediately notified, and the counselee is directed to talk to their session. A relationship is established with the counselee's church and the counselor. Even as to why the person is there with the counselor instead of going to their church is sought. I do not know any further details, but I do know this should be established early even in the questionnaire or personally talking upon the first visit. This is how I remember Dr. Scipione at RPTS applying and instructing Biblical Counseling.


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## NoutheticCounselor

Nicholas Perella said:


> NoutheticCounselor said:
> 
> 
> 
> Nouthetical Counselors would evangelize an unbeliever before counseling them.
> 
> 
> 
> 
> Evangelizing is the counseling. If the person being counseled would refuse to be counseled at any point (from 1st class to last) knowing they will be evangelized then the counseling would end. It is advertised as Biblical Counseling.
> 
> A confessing Christian on the other hand is being discipled. The pastor of the counseled Christian is immediately notified, and the counselee is directed to talk to their session. A relationship is established with the counselee's church and the counselor. Even as to why the person is there with the counselor instead of going to their church is sought. I do not know any further details, but I do know this should be established early even in the questionnaire or personally talking upon the first visit. This is how I remember Dr. Scipione at RPTS applying and instructing Biblical Counseling.
Click to expand...


Dr. Adams refers to evangelism in counseling as "Pre-counseling." 

Sometimes people are referred to a counselor at another church by their pastor. Sadly, some pastors don't counsel at all.


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## Pergamum

Chris,

Do you find it troublesome that Adams redefines the traditional categories of evangelism and discipleship into counseling categories of "Pre-counseling" and "counseling?"

How would you answer this question, "What is the difference between pastoring and counseling?"


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## Pergamum

My general thoughts are that Jay Adams was a fiery pioneer. Like Martin Luther he faced down the psychological establishment and many others followed in his wake to make reformation and to alert the Church to evils. However, like Martin Luther, he often over-spoke. Adams' followers such as Welch and Powlison are much more balanced and irenic. Yet, we all remain indebted to the pioneer even though we may differ a bit from him.


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## Nicholas Perella

NoutheticCounselor said:


> Sadly, some pastors don't counsel at all.



True. Yet what is to be kept in mind is aside from getting into contact with the church if the counselee is a church member as to determine why the person is not going to their church for help, even instead of the counselor, Counseling centers are open to the public at large. So the counselee may not attend a church. Many are just walk-in's. If they are not a member of a church, then a goal, as it should be for any discipling Christian by the counselor, is to eventually have the person attend a church so that the church will take over.

Should a church be doing all of this in the first place? Yes. Do they? Some, of course. Should a church be overseeing the counseling center? Yes. What is a counseling center? an outreach to the community by the church. Is the jargon obnoxiously in the way, because in saying 'counselor' a person is not saying 'pastor'? Sure. To a certain degree I would agree with this. But the church is not the entire community, and a counseling center that does not seek to be the church but an arm of the church is just like learning logic when logic is an arm of theology. Because it is called 'Counseling Center' instead of 'Church Outreach Center' or some other term found directly in the scriptures (because 'outreach center' would not fit this bill either) could simply turn into semantics. There may be a legitimate concern here to this for words do mean something but I do not think that necessarily undermines the counseling effort which is to simply convey the gospel. Yet at some point does this not turn into the church is not the world. The scriptures are not about 'all of life'. So when a restaurant owner is Christian and so therefore has a plan and purpose to turn his restaurant into a place in which the gospel message is conveyed that does not mean the restaurant has to be like the church or is danger of being the church.


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## Pergamum

Thanks Nicholas.


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## Toasty

Pergamum said:


> Chris,
> 
> How would you answer this question, "What is the difference between pastoring and counseling?"



Counseling has to do with helping people make godly decisions and helping them with their problems. Pastoring includes counseling. Pastoring involves preaching the word of God, teaching the word of God to large groups or to individuals, discipling others, and administrating baptism and the Lord's Supper.


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## JoannaV

Flee to Christ.
Flee from sin.

In what ways are those two things the same and in what ways are they distinct? Which aspects should counselling address?


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## Pergamum

Here are several more reasons I believe Adams went too far in his denunciations of secular counseling:

(1)From the writings of Adams, he seemed to believe that secularists in the field of counseling were illegitimate. Their theories compete with Scripture, he claimed. They engage in work reserved for Christian ministers.

I believe, however, this goes too far. It is an overstatement. 

If a patient comes to a secular psychologist and desires to lose weight or quit smoking, lessen anxiety, decrease their obsessive hand-washing...etc., an unbelieving psychologist can help them quit smoking, quit drinking, or lose weight, and modify many behaviors and thought-patterns. The goal is limited to the cessation of those behaviors, and the goal is not "total spiritual renewal in every part" of the person. Secular psychology may help in those areas. Likewise, nail-biting, social clumsiness, shyness can all be aided by secular psychologists. While we can admittedly dig deeper and find a spiritual component to most behavior, it is too far to say that all such counseling activities are reserved only for Christians or Christian ministers.

Adams also seemed to indicate in places that counseling was not possible for an unbeliever. He often stated that counseling aims for the Fruit of the Holy Spirit. In other places he indicated that "any positive change flowed from the power of Christ." 

To this I also disagree. This is also overstatement. Some behavior modification can be said to "improve" behavior even when these "improvements" are not the fruit of the Spirit. Quitting nail-biting, smoking, over-eating, obsessively washing your hands, can all be done by unbelievers and the quitting of these dysfunctional behaviors are all good things (improvements), though these "improvements" do not mean that a counselee's soul has improved any. 

Adams also believed that all Christians who are wise and growing are competent to counsel. He also stated that pastors had a unique mandate to counsel. He also indicated that the only true counsel can be found within the church. I believe these are all over-statements.

(2) Second, the model that Adams pioneered was heavy on the role of sin and confronting sin patterns and light on the role of suffering. 

The person being counseled is not always a guilty perpetrator, but should also be viewed as a suffering victim. Adams is unbalanced in this tension between a person being a "sinner" and a "sufferer." I can elaborate on this deficiency further with specific proofs if needed. 

Ed Welch in his article, "Exalting Pain? Ignoring Pain? What do we do with Suffering?" seems to be writing as a corrective to Adams deficient approach. Welch speaks of "pain counselors" who are always focusing on the "why" of pain and the fact of pain and not on the solutions to pain and the "sin counselors" who run the danger of breeding stoics focused on doing the right things but forgetting the compassion of God. It is clear Welch has some secular psychologists, on one hand, and Jay Adams, on the other, in mind.

We often suffer and experience severe psychic trauma due to reasons entirely out of our hands. 

Adams did write a later book _Compassionate Counseling_, perhaps as an attempt to address this issue. In a footnote Adams makes this admission, _"You can read through the indices of book after book - even those about biblical counseling - and find no reference to compassion._" I am glad Adams finally recognized this. Since nobody was written more or longer on biblical counseling then Adams, he must bear a good measure of the responsibility for this lack of compassion and, overall, his legacy of writing overemphasizes the counselee as a sinner and minimizes the emphasis on the counselee as a sufferer.

(3) A third critique: Adams focuses on behaviors overly much and on motivations and "inner" turmoils and struggles too little. 

For Adams, a lifestyle of sin creates sinful behavior patterns. And Adams focuses on these behavior patterns. Adams is heavy on "habit" and light on "motivations." In _Competent to Counsel,_ for example, Adams speaks of the "what" (behavior) of counseling versus the "why" (motivations) involved in counseling. In discussing thing difference between WHAT and WHY, Adams says this:



> "Usual counseling methods recommend frequent long excursions back into the intricacies of the whys and wherefores of behavior. Instead, nouthetic counseling is largely committed to the discussion of what. All they why that a counselee needs to know can be clearly demonstrated in the what. What was done? What must be done to rectify it? What should future responses by? In nouthetic counseling the stress falls upon the "what" rather than on the "why" because the "why" is already known before counseling begins. The reason why people get into trouble in their relationships to God and others is because of their sinful natures. Men are born sinners."



Jay Adams speaks of the habits of sin due to the flesh which become rooted behaviors which must be changed. These habits become the focus and not the inner motivations of the heart.

I believe this to be unbalanced. Later biblical counselors (Welch, Powlison, Tripp) agree with me, and have provided correctives. 

Ed Welch wrote a critique in the article, "How Theology Shapes Ministry: Jay Adams's View of the Flesh and an Alternative" and George M Schwab wrote another critique in the article, "Critique of 'Habituation' as a Biblical Model of Change." These articles can be found in the Journal of _Biblical Counseling_.

Adams goes further and argues that these sinful habit patterns are what the authors of Scripture have in mind when they use the term "flesh" in the NT. Adams utilizes the term "flesh" and speaks of man becoming habituated to sin through the "flesh."

But, as Welch and Schwab point out, sin has its ultimate source in the heart (the body being the instrument of the heart)...no Scripture clearly teaches that the body of a sinful person is gradually programmed to sin to the point where the body can sin by itself, without the agency of the heart (and the motivations of the heart). 

Schwab further points out that Adam's views on this habituation process did not come from Scripture but from secular thinkers William Glasser and O. Hobart Mowrer. If this is true, what does this mean for any debate about "Nouthetic Counseling" standing opposed to anyone wanting to "integrate" the thinking of the world into biblical counseling (if Adams himself was influenced by these secular thinkers). It appears on this point, Adams might have been "integrationist."

Schwab writes: 


> The stimulus for Jay Adams's theory of habit also came from outside the Bible. Adams admits that what radicalized him - what set him free from Rogers and Freud - was the influence of particular secular psychologists, O. Hobart Mowrer and William Glasser. However, Adams claims that the Bible is sufficient for counseling and that all so-called psychological insights must stand the test of Scripture. Yet, some of his "Bible-based" theories and emphases seem almost identical to those of his secular predecessors. Was part of the "grid" through which Adams reads the Bible supplied by these secularists?



I believe that motivation is vital to any counseling situation. We should not merely focus on behavior and assume those motivations to be sin. The counselee will not feel understood and we will not go "deep " enough in counseling if we only focus on behavior and not motivation. This is a major weakness of Adams. 


For these reasons, I would not classify myself as a "nouthetic" counselor. If perhaps somebody responds, "Well, you are NOT a nouthetic counselor anyway, since you are not certified by NANC..." this also seems to fly in the face of Adams's hypothesis that all wise, growing Christians, and especially leaders in ministry, are already competent to counsel. I read avidly from many secular sources about psychology/psychiatry and I believe many of them have arrived at truth even despite their lack of dependency on any known Scriptural insights.


----------



## Pergamum

Another problem in nouthetic counseling under Jay Adams was its appearance and demeanor: It appeared to be harsh, admonishing, distant where sympathy should have existed. Adam's "enemies" do not make this charge; the second generation of Biblical Counselors (followers of Adams) affirm this.

First, it was too formal (and that purposefully so). Adams wrote, "Everything possible must be done to establish among Christians the truth of the fact that by God's ordination the pastor is the professional counselor." (_Shepherding the Flock of God_, 176). And so the counselor must appear "take- charge" or business-like." There was a lot of emphasis on pastoral authority. Whereas many secular counselors tried to appear familial and to create a comforting relationship with the client, Jay Adams seems to oppose this. 

After all isn't “Nouthetic” from the Greek word anyway for “admonishment.” And so nouthetic counselors are "professional admonishers" and no wonder Adams, therefore, encourages them to stay in the role of a pastoral authority, since this brings more weight to one's admonishments. Noutheteo for admonish is a strange words choice when parakeleo or comfort or come alongside of seems much more fitting...yet Adams choose a little-used word fro admonishment over comfort. 

Adams further writes:


> "Probably the chief reason why nouthetic counselors fail is because they sometimes become too sympathetic to the complaints and excuses of the counselee. Frequently when a counselee tells a very pitiful tale, there is the temptation for a counselor to decide that this indeed is a special case."


(Competent to Counsel 58).

Now ask yourself, would you really want to go to a guy who dismisses your deepest aches and anxieties as "complaints" and "excuses" and speaks of your "pitiful tales" in such a tone? 

Even worse, in Adams's _Counsel from Psalm 119_ (on verse 67's comments), Adams refers to those suffering from pain and calling out to God as "whiners" and complainers."

Powlison and later counselors might be the best critics of Adams. Powlison writes:


> Adams tells me I need compassion, identification, and mutuality, but he teaches and models rebuke, proclamation, and authority. He calls me to balance, but doesn't teach me how." ("Review of Hebrews, James, I & II Peter, Jude, by Jay Adams," in the _Journal of Biblical Counseling_ 15, n. 1 (1996): 64).



This is another reason why I do not identify very positively with Nouthetic Counseling, though I very much agree with the writings of the later Welch, Powlison, and the Tripps.


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## Pergamum

Here is Jay Adams's' "Clara" scenario below, which shows the [POSSIBLE] demeanor advocated by Nouthetic Counseling [IF ADAMS IS ACTUALLY ADVOCATING THIS...]:



> Clara comes to you stating that she has filed for divorce on the grounds of mental and bodily cruelty.
> 
> Clara returns for the third session. "I tried to get him here but he had other things to do," she begins. "You know what his other things are, of course. I told you all of them."
> 
> "I don't want to hear such charges behind Marty's back," you respond. "This continuing hostility toward him, even though you told him you forgave him, seems to indicate that you made little or no attempt to bury the issue and start afresh. I don't think that you understand forgiveness. You . . ."
> 
> "Forgive him! You know there is a limit. After he has beat me, and his drinking away our money maybe, but when I came home and found him in my bed with that woman, I can never bury that! He is just an immature, immoral, animalistic pig," she declares.
> 
> You tell her that it will be necessary for her to change her language about her husband and that you are here to help but not to salve her self-righteous attitude and listen to her ever-increasing charges against her husband.



ADDED NOTE: I am trying to gain the context of this example to make sure whether Adams was actually using this as a bad example of counseling or actually advocating this approach. Wayne Mack uses it as a bad example. 


Wayne Mack addresses this further in his article, "Involvement and Biblical Counseling: found here: http://www.tms.edu/m/tmsj5b.pdf

I have heard other instances where folks have gone to Nouthetic Counselors for advice, only to be jumped on by the counselors. Far from being exceptional, this method of jumping the counselee with their own sins seems to be an integral part of the Nouthetic (Admonishing) Counseling Approach, to confront and rebuke for sin rather than to sympathize. 

Mack concludes:



> Though God sometimes chooses to accomplish His work through unlikely ways and unlikely people, the Bible emphasizes (and the above letter illustrates) that God usually changes lives in a
> situation where a relationship of concern and trust exists between the helper and the one who needs help. Thus the counselor must do all he can to wrap the content of his counseling in a package of compassion, respect, and honesty.


----------



## Pergamum

p.s. why do I prefer others besides Jay Adams even though Adams is reformed?

Every once in a while a firebrand sees that the world has totally dominated certain fields of knowledge. In response, they speak out strongly against this secular domination of their own beloved field. They then set up a "Biblical way" of dating, finances, of scheduling your baby's sleep, of schooling, of parenting, etc. This is all good. But, then the rub comes after this, when this firebrand often portrays others as compromising with the ways of the world instead of adopting their way, which is THE way to "Biblically"....put their baby to sleep, date, homeschool, parent, or do counseling....this often reeks of spiritual arrogance and hubris. I believe Jay Adams has done this very thing in psychology. He was very critical of integrationists.

Most people do not even want to own the title of "Integrationist" versus "Biblical" counseling because...after all, if one is an "integrationist" this means that one is ALREADY labeled as having compromised with the world. People then believe that one must either be totally supportive of the Nouthetic approach, or else they are a worldling.


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## Warren

MW said:


> Pergamum said:
> 
> 
> 
> However....whatever happened to the word "discipleship?"
> 
> 
> 
> 
> This is what "Shepherding God's Flock" emphasised. As it has progressed it has become less focused on the pastoral ministry and grown more clinical. I think Dr. Adams' initial reaction was a biblical one -- the pastor has a spiritual charge and psychological practice was invading his sphere of service; it was therefore necessary to reassert the biblical message of sin and grace that the pastor is entrusted to proclaim. The problem now is that the "pastoral" responsibility has been given over to "every believer," and nouthetic counseling is moving in on the psychologist's domain.
Click to expand...

Hour sessions with a layman or pastor-in-training make for a false sense of urgency, and I've come out of a church which "counseled" that way. Only special cases got the pastor's time, if anybody. I was not encouraged to walk faithfully, with boldness and courage, resting in Christ.

I can see why some churches counsel this way: everyone thinks their problems are a big deal. If people believe they need that hour of trust, because their pastor keeps preaching to them to look inside themselves, then soon we have poor, guilt-ridden souls, who only come back to rejuvenate. They've become as slaves to the Law. Eventually, some individuals feel empowered to become counselors, who then give advice to others, which becomes doctrine to follow, not just good advice, because, you see, they can point to some verses to back it up.

Maybe I'm being harsh, but that was my assessment, after leaving that method behind.


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## Pergamum

Here is an interview about Southern Baptists moving to the Biblical Counseling Approach:

http://www.ciu.edu/sites/default/files/Article/2010/11/Conversations%20with%20Biblical%20Counseling/article563_stephenfarra_pdf_18802.pdf



> The role of secular psychology has very little to
> contribute to the church. In laboratory situations,
> human behavior can be observed and conclusions
> of some kinds can be drawn that might be helpful
> to those working in the church. However, an
> overwhelming foundation for counseling for the
> church is discoverable in the triumvirate of
> regeneration, the permanent indwelling of the Holy
> Spirit, and the revelation of the mind of God that is
> revealed on the pages of Holy Scripture.



Notice by the quoted phrase how he gives up the whole argument against the "Integrationists" and grants their position as true - he admits that secular psychology contributes a little to the church.

"The role of secular psychology has very little to contribute to the church. In laboratory situations, human behavior can be observed and conclusions of some kinds can be drawn that might be helpful to those working in the church."

So, even ardent "Biblical" counselors grant that secular psychology may contribute to counseling and come to conclusions which may be helpful to the church through general revelation. Adams, however, says that psychology is not even a legitimate field of science.

---
---

Also, an important note on the "look" of Biblical counseling:

Jay Adams advocates that counselors must look "professional." This means that counselors should look like professional counselors and Nouthetic counselors should refer to parishioners as "counselees." Also, many charge hourly fees, they seek certifications from counseling agencies, and set up appointments. 

In short, they borrow much of the look and "feel" of their profession from secular counselors, even while claiming that counseling is the domain of the church. I see no biblical need for this. Why try to look like the world even while insisting that counseling is the domain of the Church?


----------



## Jeri Tanner

Pergamum said:


> Here is Jay Adams's' "Clara" scenario below, which shows the demeanor advocated by Nouthetic Counseling:
> 
> 
> 
> 
> Clara comes to you stating that she has filed for divorce on the grounds of mental and bodily cruelty.
> 
> Clara returns for the third session. "I tried to get him here but he had other things to do," she begins. "You know what his other things are, of course. I told you all of them."
> 
> "I don't want to hear such charges behind Marty's back," you respond. "This continuing hostility toward him, even though you told him you forgave him, seems to indicate that you made little or no attempt to bury the issue and start afresh. I don't think that you understand forgiveness. You . . ."
> 
> "Forgive him! You know there is a limit. After he has beat me, and his drinking away our money maybe, but when I came home and found him in my bed with that woman, I can never bury that! He is just an immature, immoral, animalistic pig," she declares.
> 
> You tell her that it will be necessary for her to change her language about her husband and that you are here to help but not to salve her self-righteous attitude and listen to her ever-increasing charges against her husband.
> 
> 
> 
> 
> Wayne Mack addresses this further in his article, "Involvement and Biblical Counseling: found here: http://www.tms.edu/m/tmsj5b.pdf
> 
> I have heard other instances where folks have gone to Nouthetic Counselors for advice, only to be jumped on by the counselors. Far from being exceptional, this method of jumping the counselee with their own sins seems to be an integral part of the Nouthetic (Admonishing) Counseling Approach, to confront and rebuke for sin rather than to sympathize.
> 
> Mack concludes:
> 
> 
> 
> 
> Though God sometimes chooses to accomplish His work through unlikely ways and unlikely people, the Bible emphasizes (and the above letter illustrates) that God usually changes lives in a
> situation where a relationship of concern and trust exists between the helper and the one who needs help. Thus the counselor must do all he can to wrap the content of his counseling in a package of compassion, respect, and honesty.
> 
> Click to expand...
Click to expand...


Isn't Jay Adams, in the Clara example, showing what not to do when counseling? And Wayne Mack is quoting Adams' illustration of what not to do? 


Sent from my iPhone using Tapatalk


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## Pilgrim

Jeri Tanner said:


> Isn't Jay Adams, in the Clara example, showing what not to do when counseling? And Wayne Mack is quoting Adams' illustration of what not to do?



That's exactly right. To be so careless would appear to border on (at best) breaking the Ninth Commandment. In our zeal to set forth our views, one would be advised to accurately represent the views of others.

BTW, integrationists hate the book that Madk's article is found in (_Introduction to Biblical Counseling_, ed. J. MacArthur.) I've seen some say it is "worse" than Adams.


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## Pergamum

Jeri:

If you are right, I am glad to see Adams doesn't advocate that.

It appears Wayne Mack is quoting Jay Adams and then making an assessment of Adam's example. Adams's example is found in"The Christian Counselor's Casebook" page 186 if anyone can look it up for us. Wayne Mack's assessment if found in the volume he authored with John MacArthur, _Introduction to Biblical Counseling_, in the chapter entitled, "Developing a Helping Relationship with Counselees," on pages 173-174.

The example and the quotes appear also in pages 72-73 of this PDF, and it is not clear whether Adams is advocating this example or using it as a bad example (as Mack does): file:///C:/Users/Trevor/Downloads/pastorcounseling.pdf

It appears that Mack is using the "Clara Scenario" as an example of what a counselor should not do.

Can anyone verify these quotes for us?


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## Pilgrim

_The Christian Counselor's Casebook_ is a companion volume to _Competent to Counsel_ and _The Christian Counselor's Manual_. The book appears to simply consist of many hypothetical scenarios, each followed by 3 questions about what the counselor should do in the situation, no doubt based on the teaching contained in the other two volumes. It is basically a workbook. There is a preview online here as well as at Amazon.

Here are a couple of reviews that explain the nature of the book: 



> If you nibble on this book with some friends, a case at a time, it can help you hone your skills as a counselor. Adams goal is to teach readers to be more perceptive and accurate in identifying common problems. In addition, Adams tries to give practice in applying the Scriptures to these problems wisely. How do you help someone salvage a marriage, or conquer depression, or learn to be a good friend? Adams provides plenty of practice is a variety of scenarios. He is intentionally ambiguous and open-ended (reviewers really must read introductions before writing reviews!) because counselling so often starts that way.





> The Christian Counselor's Casebook provides a diverse and challenging set of case studies to prepare the serious Christian Counselor with practice in advising individuals, couples, and families. However, this book should not be used alone. It can only be understood in coordination with The Christian Counselor's Manual (also by Jay Adams).


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## Pergamum

So it could be that Adams did not advocate the example given about "Clara" but merely put the example in there for discussion? That is good to know.

Do you believe it to be a fair critique of Nouthetic Counseling that it is too confrontational? Counseling is more than just identifying and confronting sins. Where does comfort come in?

Also, you used the word "Integrationist" negatively (example: Integrationists hate Macks' book). Do you believe that any "integration" with insights found in secular psychology is anathema? The folks at CCEF seem to be able to not "throw the baby out with the bathwater" but they seem to accept insights gained from general revelation. They also critique the views of Adams quite a lot. I have followed the critiques made by Powlison and Welch (second generation Biblical Counselors) about Nouthetic Counseling and have largely not gone to secular sources of critique. 

The Bible is not a handbook of counseling verses. Though all insights gained from non-biblical (secular) study will accord with the Word. 

I've heard the mantra a lot, "The Bible is sufficient." Many apply this to psychology. But we need to explore what this means. Is the Bible "sufficient" for cardiology or pharmacology or engineering or auto mechanics? The Bible speaks on broad truths such as the nature of man, etc, but I see no problem with science telling us that there are genetic and possible chemical/biological factors that impact whether one may get depressed or not. Science can tell us statistically how some behaviors are linked to others. Not everything is primarily a spiritual problem. All problems are not sin problems.


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## Pilgrim

Pergamum said:


> So it could be that Adams did not advocate the example given about "Clara" but merely put the example in there for discussion? That is good to know.
> 
> Do you believe it to be a fair critique of Nouthetic Counseling that it is too confrontational?



Someone like "Marrow Man" who (I think) knows Adams personally would be in a much better position to render a verdict. But I think he may just be getting back from GA. But as the Amazon review I posted above states, the book consists of a series of scenarios that are left ambiguous and open-ended. For example, the first one is a woman calling you saying she has a gun to her head. It is a book of hypothetical cases to be "solved" in accordance with the principles taught in the other books. 

I think the "Clara" scenario is intended to be an example of a counselor who has done a very poor job and now must try to fix it. The second "problem" listed under this scenario (on p. 187) is "Did you err in past counseling sessions? If so, in what?" I think that pretty much speaks for itself. Mack says it is because the counselor took an "auto mechanic" approach to counseling and did not develop a relationship with the counselee. The third "problem" is "What will have to be done next?"


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## Pergamum

Ok, thanks Chris.


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## Pergamum

One troubling aspect of nouthetic counseling is their denial of the genetic/biological/chemical factors upon the mind. Mental problems are said to be "autogenic" - originating in the false thinking habits of the counselee. 

Here is a question from the Nouthetic Counseling website:


In response to the question, "Can Nouthetic counselors deal with mental illness?" The website answers by denying that mental illness exists at all. 



> You need to understand that apart from injuries, tumors, and other brain problems, there is no such thing as mental illness. Those who use this terminology—unless they are speaking metaphorically—are using words inaccurately. All true "illness" is organic.



And again:


> All true "illness" is organic. Yet, these people, by adopting medical terminology, cloud the issue. How could a non-organic entity (whatever it may be) cause a non-organic illness?



Adams says:



> What then, is wrong with the “mentally ill”? Their problem is autogenic; it is in themselves. The fundamental bent of human nature is away from God. Man is born in sin, goes astray “from his mother’s womb speaking lies” (Psalm 58:3) and will therefore naturally (by nature) attempt various sinful dodges in an attempt to avoid facing up to his sin. He will fall into varying styles of sin according to the short-term successes and failures of the particular sinful responses he makes to life’s problems. Apart from organically generated difficulties, the mentally ill are really people with unsolved personal problems.


https://drgrcevich.wordpress.com/2015/01/28/jay-adams-and-the-foundations-of-a-movement/


This seems an over-corrective to secular psychology (which makes everything into a disease). 

Scripture, however, does not seem to demand us to believe that all unpleasant mental states are the result of sin or are "autogenic." I see nothing in the bible that demands that I deny that chemical, genetic, and biological factors greatly impact my mental well-being. 

For example:
(1) War veterans suffering from Post Traumatic Stress Disorder (PTSD) don't seem to suffer due to their own sin. Is confronting them about their sin habits the answer?
(2)How about adult victims of childhood sexual and physical abuse? Maybe they just need nouthetic confrontation? 
(3) Or postpartum depression in which a woman is hormonally imbalanced? Nouthetic counselors, while admitting there are "organic" reason for mental problems, deny the "chemical model" of depression. Most Nouthetic Counselors seem to deny that people can be depressed because their "chemicals are not balanced" and thus in need of possible medication. Nobody has yet clarified how one can affirm the physical and organic, yet deny the genetic, biological, and chemical. 

Why isn't lacking of the right chemicals in the right quantities considered a "brain problem" and accepted by nouthetic counselors. The monamine theory of depression may still be up in the air and unproven. But what if science eventually proves that it is, in fact, true that chemical imbalances contributes to depression? I see nothing in the Bible that demands that we deny this position. It is not a theological necessity; yet many nouthetic counselors are not merely suspicious but dogmatic against the monoamine theory of depression. 

(4) Chronic pain often causes lack of sleep, which often causes erratic thinking patterns. Obviously a sin problem [sarcasm]. 

Body and mind are closely bound. Physical ailments impact the mind even when the structure of the brain is not changed due to injury. For example, the Self-Confrontation materials sold by BCF Ministries teach that depression is due to the sins of "unbelief" and "self-indulgence": http://www.bcfministries.org/. I believe Nouthetic Counseling does not consider physical/chemical/biological problems enough. Sometimes people get depressed due to exhaustion and lack of sleep. 

There are also genetic/familial links to some conditions which prove them to have a chemical/biological/physical component. Depression and suicide often runs in families, even when the children have never known the parents enough to learn their sin-patterns and habits of behavior. Identical twins, for example, have been found to have stronger concordance for suicide than fraternal twins, even when they are raised separately. Studies of people who were adopted and subsequently died by suicide have found suicide to be more common among these individuals’ biological parents than their adopted parents. I fear Nouthetic counselors will totally overlook such empirical data when treating depressed and suicidal patients since they do not take seriously the contributions of secular science.


----------



## Pilgrim

I think some of your questions are good ones. But some other ones, like your comment about chronic pain, appear to be strawmen. If I recall correctly, in another thread on this subject, you had mentioned that you had only read one Adams book. Is that still the case? Several of his more foundational books are available on Kindle, sometimes for as little as $3-$4. I've found that whatever the subject, it is a good idea to go straight to the source rather than rely on critiques by other authors or to perhaps impute the faults of some avowed disciples to him when in fact he might find fault with their approach. 

In general, "integrationist' applies to people like Dobson, Minirth and Meier and so on, at least with regard to popular teachers and authors of the recent past. The likes of CCEF and Bob Kellemen are less abrasive than Adams and maybe don't press the antithesis (or whatever) quite as much. I don't think CCEF is quite as opposed to medication. But they are still basically "Biblical counselors" as opposed to the kinds of integrationists noted above. Despite differences on certain things, Adams has endorsed Ed Welch books. Many evangelicals (much less non-evangelicals) are still going to see CCEF or Kellemen as being somewhat extremist in their wariness toward and/or rejection of (as the case may be) much of modern psychology and psychiatry. 

EDIT: While I recall him criticizing some of Adams' thought in the past, Kellemen has a good post in appreciation of Adams here. 

I'm not familiar with BCF. I can find no discussion of it in the PB archive or on another site I checked that is dedicated to Biblical counseling. Is it a mainstream group?


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## Pergamum

No. I have now read extensively about Adams and also several books by Adams (the _Christian Counselor's Manual_, _Competent to Counsel,_ strangely, a book on _Preaching with Purpose_ and the _Grand Demonstration_...a theodicy of sorts that was really good, as well as a book about self-esteem, and I browsed a book about how people change but chose another author on the same subject). The best book I read by Jay Adams, ironically, was not about counseling at all, but about Marriage, Divorce and Remarriage. I enjoy Welch, Powlison, and Tripp much better. Wayne Mack and Stuart Scott are also okay. 

There seems to be growth and development in the Biblical Counseling movement. 

You sound like you freely admit that Adams is abrasive in his writing. He seems overly polemical and reactive against secular psychology, I believe. 

BCF is the Biblical Counseling Foundation. I am trying to see if they are affiliated with others who call themselves "Biblical Counselors."

Here is a good blog post about "Maximizing and Minimizing Mental Illness" where he responds to Bob Kellemen: http://headhearthand.org/blog/2013/04/16/maximizing-and-minimizing-mental-illness/


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## Pergamum

Chris,

Would you call someone an "integrationist" if they admit that counseling and psychology can gain insights from secular research? It appears many in the CCEF camp do not throw out EVERYTHING proposed by secular psychology, but filter it through the lens of Scripture. 

Is natural revelation capable of making insights into counseling? If so, soes this mean that the Bible is not "sufficient" for psychology, or merely that the Bible was not written as a counselor's handbook?

Again, here is this cartoon below. Do you think it gets the point across adequately?


----------



## Nicholas Perella

Pergamum said:


> Do you believe it to be a fair critique of Nouthetic Counseling that it is too confrontational? Counseling is more than just identifying and confronting sins. Where does comfort come in?



When you say things like this it is obvious that you have not been taught correctly, or not studied the relevant material as to what an excellent Biblical counselor teacher or their books discuss. I say this not being an avid Biblical Counselor student, but I have taken a seminary course on Biblical Counseling and read some of Adam's books. 


or when you say:



Pergamum said:


> I've heard the mantra a lot, "The Bible is sufficient" and then many apply this to psychology. But we need to explore what this means. Is the Bible "sufficient" for cardiology or pharmacology or engineering or auto mechanics? The Bible speaks on broad truths such as the nature of man, etc, but I see no problem with science telling us that there are genetic and possible chemical/biological factors that impact whether one may get depressed or not. Science can tell us statistically how some behaviors are linked to others. Not everything is primarily a spiritual problem. All problems are not sin problems.



Sadly it does not foster any motivation or does not make it worth the time to conduct an interaction with everything you are saying, because that could take a lot of time when the relevant material is available. There are courses available that take weeks to go over everything you introduced and books of length.

I think there is a real concern, and I do not doubt there are legitimate concerns, as I mentioned in an earlier post of mine. Yet when somebody has to point out what a book is about, The Christian Counselor's Casebook, it demonstrates just how much there needs to be said to explain this subject matter.

I would take take Pilgrim's advice _not_ with a grain of salt.



Pilgrim said:


> I think some of your questions are good ones. But some other ones, like your comment about chronic pain, appear to be strawmen. If I recall correctly, in another thread on this subject, you had mentioned that you had only read one Adams book. Is that still the case? Several of his more foundational books are available on Kindle, sometimes for as little as $3-$4. I've found that whatever the subject, it is a good idea to go straight to the source rather than rely on critiques by other authors or to perhaps impute the faults of some avowed disciples to him when in fact he might find fault with their approach.


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## Nicholas Perella

Pergamum said:


> No. I have now read extensively about Adams



That is good to hear.


Pergamum said:


> You sound like you freely admit that Adams is abrasive in his writing. He seems overly polemical and reactive against secular psychology, I believe.



I know Adam's is toward their theorizing. I think their theories are wrong also. Yet of course if studies by secular psychologist produce fruit it is not because of what they know but it is in spite of their theorizing that facts can be interpreted. It is stolen capital that secular anybody demonstrates any semblance of what is true. I still think that without the gospel in evangelizing and discipling that any real compassion will not be demonstrated. All the glory goes to God and a secular anybody does not know that. A real change and a turning to God is by the work of the Spirit for without Him the will is not renewed to truly know His ways.


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## MW

Pergamum said:


> Mental problems are said to be "autogenic" - originating in the false thinking habits of the counselee.



Chemicals do not determine the content of thought. Thought is the person thinking.


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## Pergamum

Nicholas Perella said:


> Pergamum said:
> 
> 
> 
> Do you believe it to be a fair critique of Nouthetic Counseling that it is too confrontational? Counseling is more than just identifying and confronting sins. Where does comfort come in?
> 
> 
> 
> 
> When you say things like this it is obvious that you have not been taught correctly, or not studied the relevant material as to what an excellent Biblical counselor teacher or their books discuss. I say this not being an avid Biblical Counselor student, but I have taken a seminary course on Biblical Counseling and read some of Adam's books.
> 
> 
> or when you say:
> 
> 
> 
> Pergamum said:
> 
> 
> 
> I've heard the mantra a lot, "The Bible is sufficient" and then many apply this to psychology. But we need to explore what this means. Is the Bible "sufficient" for cardiology or pharmacology or engineering or auto mechanics? The Bible speaks on broad truths such as the nature of man, etc, but I see no problem with science telling us that there are genetic and possible chemical/biological factors that impact whether one may get depressed or not. Science can tell us statistically how some behaviors are linked to others. Not everything is primarily a spiritual problem. All problems are not sin problems.
> 
> Click to expand...
> 
> 
> Sadly it does not foster any motivation or does not make it worth the time to conduct an interaction with everything you are saying, because that could take a lot of time when the relevant material is available. There are courses available that take weeks to go over everything you introduced and books of length.
> 
> I think there is a real concern, and I do not doubt there are legitimate concerns, as I mentioned in an earlier post of mine. Yet when somebody has to point out what a book is about, The Christian Counselor's Casebook, it demonstrates just how much there needs to be said to explain this subject matter.
> 
> I would take take Pilgrim's advice _not_ with a grain of salt.
> 
> 
> 
> Pilgrim said:
> 
> 
> 
> I think some of your questions are good ones. But some other ones, like your comment about chronic pain, appear to be strawmen. If I recall correctly, in another thread on this subject, you had mentioned that you had only read one Adams book. Is that still the case? Several of his more foundational books are available on Kindle, sometimes for as little as $3-$4. I've found that whatever the subject, it is a good idea to go straight to the source rather than rely on critiques by other authors or to perhaps impute the faults of some avowed disciples to him when in fact he might find fault with their approach.
> 
> Click to expand...
Click to expand...


Nicholas,

The second generation of Biblical Counselors (who know best what Nouthetic Counseling first taught) themselves critique the confrontational approach of Adams. I merely echo their own critiques. These Second Generation Biblical Counselors themselves seem to state that they want to bring the movement more into balance (i.e. stressing that the counselee is also a sufferer as well, and not just a sinner). This is not merely my critique, but a critique first raised by those "in the know" of the Nouthetic Counseling movement. 

Here is a book review where Adams is called not only "confrontationl" but also "polemical" and "bold" and "brash": http://www.reformation21.org/shelf-life/the-biblical-counseling-movement-after-adams.php

I am not saying anything new, but only repeating (in milder tones even) what others more knowledgeable than myself have already written:



> For instance, Lambert is right to remind us that the biblical counseling movement began with bold strokes. Adams' emphasis on being "nouthetic" or confrontational was, in part, a response to the non-directive humanistic therapy dominant at the time. We also learn that Adams' polemic style was intentional, designed to wake the church up to its slide into psychological error and the untapped riches of God's counsel. But it was Adams' very boldness and brash style that ended the development for many. TO this day, some find the very serious claims of biblical counseling easy to dismiss because of the manner in which they were delivered. In fact, Lambert reports several lost opportunities for engagement with the broader Christian counseling movement along the way because of Adams' "vociferous," and what some at the time described as, "irascible and sectarian" tone (p.104). However, Lambert goes on to contrast Adams' combative tone with Christian integrationists with the more irenic approach taken when interacting with secular psychologists. Lambert explains, "Why the harshness with integrationists and the patience with secularists? The obvious answer is that, as a Reformed evangelical, Adams did not expect unregenerate persons to believe the Bible's teaching on how to counsel in a gospel-centered way. On the other hand, he had very little time for Christians who should know better . . ." (p.110). But perhaps we need to move beyond framing Adams' harshness as a strategy, even a poor one, and call it a mistake. After all, as biblical counselors don't we all, Adams included, need to remember that "pleasant words promote instruction" (Prov.16:21)?



Even Pilgrim in his post above speaks of other writers as "less abrasive" than Adams.


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## Pergamum

MW said:


> Pergamum said:
> 
> 
> 
> Mental problems are said to be "autogenic" - originating in the false thinking habits of the counselee.
> 
> 
> 
> 
> Chemicals do not determine the content of thought. Thought is the person thinking.
Click to expand...


http://www.theguardian.com/science/blog/2010/nov/05/phineas-gage-head-personality



> Similarly, most popular accounts of Phineas Gage describe him as having undergone profound personality changes because of his injury. He is often reported as having permanently lost his inhibitions, so that he started to behave inappropriately in social situations. Some reports state that became violent and "uncontrollable", and even that he started to molest children.



Chemicals and damage do, in fact, seem to alter thought processes and content. Our thoughts change as brain chemistry or structure changes. 

Can you explain how alcohol impacts the thought processes? Or Alzheimer's disease changes personality? Or the very strange case of the secret CIA MK-Ultra experiments where LSD was shown to alter a person's sense of reality and induce paranoia and anxiety, etc. Some medicines reduce feelings of anxiety, which produces a change in anxious thoughts.

Many people speak of drugs, pot, Ritalin, libido-dampening drugs, all changing aspects of a person's personality. How is a person's personality changed without a concurrent change in thought processes and/or content? In several court cases, otherwise law-abiding persons were shownto exhibit substance-induced personality changes. http://occmed.oxfordjournals.org/content/29/4/131.full.pdf

A person thinking is impacted by a great many factors, some of which are biological and chemical. If the mind is similar to a driver and the brain is the car, major changes to the car will impact how the driver sits and responds. The driver is not the car, but changes to the car impact the driver.


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## MW

Pergamum said:


> Similarly, most popular accounts of Phineas Gage describe him as having undergone profound personality changes because of his injury. He is often reported as having permanently lost his inhibitions, so that he started to behave inappropriately in social situations. Some reports state that became violent and "uncontrollable", and even that he started to molest children.
Click to expand...


And how did this make the man think that God does not exist or that God will not judge his actions? Capacity and characteristics of thought might change. But the things which are thought are driven by personal factors for which the person himself is responsible.


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## Pergamum

Matthew:

Do you believe that the mentally deficient are just as guilty as the mentally sound and will be judged the same way for the same actions on the day of judgment? 

Person A is mentally sound and healthy and punches a stranger. Person B has been judged an imbecile from birth and cannot read despite adulthood and has the thoughts and impulse-control of a young child, and punches a stranger. Are they to be judged the same?

Physical states and capabilities matter when it comes to moral guilt and responsibility. One's mental capacity impacts one's responsibility. Moral responsibility is linked to sanity and mental capacity.


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## MW

Pergamum said:


> Person A is mentally sound and healthy and punches a stranger. Person B has been judged an imbecile from birth and cannot read despite adulthood and has the thoughts and impulse-control of a young child, and punches a stranger. Are they to be judged the same?



Suppose a young child punches a stranger, what then? The judgment is the same, but the way it is addressed and rectified depends on the capacity of the individual.



Pergamum said:


> Physical states and capabilities matter when it comes to moral guilt and responsibility. One's mental capacity impacts one's responsibility.



The testimony of the Lord is sure, making wise the simple.


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## Pergamum

MW said:


> Pergamum said:
> 
> 
> 
> Person A is mentally sound and healthy and punches a stranger. Person B has been judged an imbecile from birth and cannot read despite adulthood and has the thoughts and impulse-control of a young child, and punches a stranger. Are they to be judged the same?
> 
> 
> 
> 
> Suppose a young child punches a stranger, what then? The judgment is the same, but the way it is addressed and rectified depends on the capacity of the individual.
> 
> 
> 
> Pergamum said:
> 
> 
> 
> Physical states and capabilities matter when it comes to moral guilt and responsibility. One's mental capacity impacts one's responsibility.
> 
> Click to expand...
> 
> 
> The testimony of the Lord is sure, making wise the simple.
Click to expand...


Suppose an infant flails about and hits its mother, knocking her to her death over a cliff. Is the judgment to be the same?

Intentionality and moral capacity both seem critical when assigning guilt.


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## MW

Pergamum said:


> Suppose an infant flails about and hits its mother, knocking her to her death over a cliff. Is the judgment to be the same?
> 
> Intentionality and moral capacity both seem critical when assigning guilt.



A life is lost and it could have been avoided by a change of action. Educating for morally responsible action is the important thing. The infant must be educated according to his capacity. Diminished capacity does not alter the need for instruction or remove accountability for the action. "Capacity" and "content" are two different things.

If it were otherwise we could not affirm that the fear of the Lord is the beginning of wisdom. The process from that point might be slower or faster depending on the individual, but we must be committed to the process. Diminished capacity might require more work, that is all.


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## Nicholas Perella

Pergamum said:


> It is not merely my critique. I am sure the movement has done its best to revise that view and distance itself from its image of being highly confrontational, and yet confrontation is part of the package as a whole.



I understand. But it is either Adam's you are critiquing or "the movement". This abstract movement of your design that has to accept the "whole" package does not line up with the following:

Galatians 6:1


> Brothers, if anyone is caught in any transgression, you who are spiritual should restore him in a spirit of gentleness. Keep watch on yourself, lest you too be tempted.



or

Ephesians 4:2


> With all humility and gentleness, with patience, bearing with one another in love



I would not say these verses are "confrontational".


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## Pergamum

Nicholas,

I think my critiques are mostly with Adams. And even then, more with his earlier writings than his later. And even then, only with certain aspects of his teaching. Overall, we must thank God for this pioneer. 

My position is as follows: 

(1) Chemicals/hormones/genetics/biology play a role in one's mental state. 
(2) Confronting sin may have its place; but sympathizing with the sufferer is often warranted. 
(3) Secular science has contributed to our knowledge of the mind and thought. Secular science can offer insight into psychology. The insights of general revelation can be incorporated into psychology. Is the Bible sufficient? Yes. Is the Bible sufficient for cardiology, or engineering, or chemistry or auto mechanics? Well...that is a different question. 
(4) I think mental illness actually exists and is not merely a fictitious social construct. While our society is "over-psychologized" and "over-medicated" and while the DSM is perpetually changing and some new disease springs up every few years (like ADHD), there is such a thing as mental illness. And some medications and therapies besides talking to a pastor are sometimes warranted.

I am not sure if I would be labeled an "integrationist" or not. I am suspicious of Dr James Dobson, for instance and Gary Chapman’s The Five Love Languages, and many others (most others) - but I think Adams simply over-stated his case. I am a big fan of Welch, Powlison, and Tripp. 

Thanks for your interactions.


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## Pilgrim

Perg,

I think the cartoon is a crude straw man. Honestly I don't see much further basis for discussion if you continue to insist that it accurately represents Adams, much less CCEF, Kellemen, Lambert, etc. I don't know that there is quite as much distance between the two generations as you seem to imagine. You appear to be more accepting of secular psychology than at least some of the 2nd generation is. It seems that the main differences are more of an acknowledgement of suffering and an acknowledgement that SSRI and similar medication can be helpful in some cases, albeit apparently on a much more limited basis than integrationists and secularists. SBTS got rid of their integrationist counseling department and brought in Stuart Scott (who came from Masters) and Lambert.

Many psychologists and psychiatrists have acknowledged that what they do has considerable overlap with religion or theology and that they have basically intruded on a realm that used to be considered religious before the likes of Freud came on the scene. And I think we would all admit that much of what they've come up with is utterly incompatible with the Bible. But too many Christians insist on equating those fields with orthopedics or cardiology, as the cartoon does. Do you know of anyone who argues that some aspect of modern orthopedics or gastroenterology is unbiblical? 

WRT Dr. Murray, I have to admit to being somewhat disappointed (and even somewhat shocked) at a few of the posts I've seen from him on this general subject, especially given the fact that he is at PRTS. I have to admit to not knowing a great deal about PRTS and I haven't read a ton of Murray in general. Admittedly I had a certain conception of what to expect from someone writing under the "Puritan" banner. The Puritans were known as physicians of souls. I identified much more with Dr. Kellemen's posts in that regard. I think that Dr. Kellemen's educational and vocational background should be noted when it comes to his evaluation of psychiatry, psychology, etc. One could certainly argue that he is wrong, but he's certainly no stereotypical "fundie Bible-thumper" with some piece of paper from a dubious Bible college. But many would nonetheless say that the cartoon applies to him and anyone that he trains.

I also think the "abrasiveness" thing can be somewhat overemphasized. (They say that Athanasius was abrasive.) People suffer for various reasons. Some of it is self-inflicted, some not. A confrontational approach is called for in some cases. By that I mean what Nicholas pointed out. But even that is often reacted to with cries of "Legalism!" and so on. "Who are you to judge?" It is much easier to go off and take some pills that are diagnosed after a 20 minute visit instead. 

In many of Adams books on counseling and related issues (_More than Redemption_ comes to mind) he stated that he had not had time to be as thorough as he would have liked but he put them out anyway in an attempt to help. He hoped that others would come behind him and take up the cause. Certainly he has agreed more with some of those who followed than others.


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## MW

Pergamum said:


> And some medications and therapies besides talking to a pastor are sometimes warranted.



What drug gives a person thoughts of a gracious God? Medications and therapies are not going to address the person's intellect and will in forming beliefs.


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