The Clinical ‘Gift of Hospitality’

counselingsexualdisordersIn our last class session we covered Clinical Perspectives on Human Sexuality. We discussed a range of topics, including the purpose of assessment, various assessment instruments, sex history forms, and so on. We also discussed some of the considerations in making counseling safe for discussing sexuality and sexual behavior. I think of this as practicing the clinical ‘gift of hospitality.’ On this topic, I like the points made by Joyce and Cliff Penner in their book Counseling for Sexual Disorders. They say it is important to acknowledge with the person or couple the difficulty in talking about sex – it’s probably better to just say it since it is likely on their minds. It is also important to ask for the information that is needed, and a common mistake is to not get enough information.  According to the Penners, common anxieties for people include:

  1. Sexual terminology –  what words to use to describe their problems or concerns.
  2. Explicit discussion – discussing sex in a more open and explicit manner than they are used to.
  3. Counselor’s gender – it doesn’t matter what the counselor’s gender is, it can be a source of anxiety for different people.
  4. Reporting unacceptable behavior – talking about behavior that might be considered wrong or immoral.
  5. Exposing secrets – fears about discussing things like pornography use, fantasy, abuse, and so on.
  6. Sharing problems that “no one would understand” – another common anxiety, as many people feel alone in their suffering.
  7. Revealing one’s value system – this anxiety has to do with what the counselor will think of the client’s values once they are shared.

By the way, this book was originally published in 1990, but I found out this past fall that they revised it in 2005, and the new edition is available from them directly. This is one of the more helpful, practical resources for the Christian clinician.

Biological Perspectives on Human Sexuality

sexualityandholylongingToday’s topic in Human Sexuality was biological perspectives on human sexuality. Before the lecture on basic anatomy and physiology, we discussed the next chapter from McMinn’s integration resource. I was struck by the observation in the chapter that since the sexual revolution our culture’s understanding of sex has been both reductionistic and humanistic. We have focused on biological explanations of human sexuality and personal choice as it pertains to sexual behavior.

Some would argue that we as a society have few reference points for why people should engage in the some behaviors rather than others. So we end up explaining biological functioning and emphasizing personal choice, and then we leave young people to make their decisions.

Is this really all we have to say about sexuality? McMinn argues that, particularly in the Christian community, there is a need to develop a positive vision for sexuality and sexual behavior rather than limiting our message about sexual behavior to negative consequences as such. This has an impact at many levels, but the obvious connection is in the areas of parenting and sex education.

Human Sexuality Course

sexualityandholylongingLast week I began the Human Sexuality course. It is a cross-listed course in our graduate school for both doctoral-level psychology students and masters-level counseling students. We are going over various perspectives on human sexuality, beginning last week with theological perspectives and sociocultural perspectives. Tomorrow and Wednesday we’ll be discussing biological perspectives and clinical perspectives. 

Once we’ve taken this overview of the various perspectives on human sexuality, we will focus on the clinical dimensions of our work. We begin with the sexual dysfunctions, such as desire disorders, arousal disorders, and so on, then turn our attention to the paraphilias and sexual addiction. We wrap up the course with discussions of gender identity and sexual identity. It is a fast five weeks!

The picture I’ve got here is of Lisa McMinn’s book, Sexuality & Holy Longing. I like it as the integration resource for the course. We read other standard texts, such as Principles & Practice of Sex Therapy, but McMinn’s book is one of the best resources from a Christian perspective. For example, we just read and discussed her first chapter on rites of passage. She deals with the different rites of passages that males and females experience in our culture today. She argues that for males those rites of passage often deal with competencies, while for females the rites of passage center more on physical changes. It was a good discussion, as students often have their own experiences with rites of passage and may agree with or take issues with some of the points raised in the book.

In any case, I appreciated the observation that young people today will have rites of passage, whether or not parents or others are intentional about them. We may not think of our culture as one that has rites of passage, but we do. It is important, then, to consider ways to foster intentional rites of passage. These would be intentional benchmarks or experiences that carry the meaning that a Christian, for example, wishes to communicate in the area of human sexuality and sexual behavior, as well as broader issues of personal growth and maturity.

The local church already participates in this to some extent when it provides baptisms, marriage ceremonies, and so on. But the church may want to think more about what it means to grow into manhood or womanhood, and which rites of passages are appropriate in communicating a ‘coming of age’ if you will. Again, the argument is that these will occur in the life of the young person, so the church may want to be intentional about it.

Avoiding Cynicism

anthologyToday was the first day of the Integration Capstone course. We read the first eight chapters of the book Psychology & Christianity Integration. It is a collection of the most influential articles that have had an impact on the Christian integration movement. I was thinking of it in these terms: Which articles would I want to make sure students read before they left the program? There are some real gems here. But I’ll write about some of those at another time.

One thing that I found important was the concept of simplicity. Most people I know who go to a Christian integration program have a fairly straightforward faith. There’s a simplicity to it. Then they study psychology for five years, and what seemed simple becomes increasingly complex. In some ways, it should become more complex. We all continue to learn and grow. But there is also a simplicity on the other side of complexity. (Someone said this, and I don’t know who it was to give them proper credit, but I should be clear that it isn’t original with me.) I think it is important to recognize this and not to leave people to just sit with the complexity, particularly if that leads to cynicism. One of my favorite professors in my program once told me that cynicism is the death of spiritual maturity. I didn’t understand what she meant at the time, but I have a much better sense for it today. 

There is a risk of becoming cynical in the study of psychology. Cynicism includes the idea that we do not trust the motives of others, that we can become jaded. This can affect how we think about and experience a host of our most important relationships, including our relationships with clients, colleagues, students, family members, neighbors, fellow believers in the church, and God. 

So we do well to train students to become psychologists while retaining the truth of their Christian convictions and what originally inspired them to want to study psychology from a Christian perspective. We can recognize and model elements of faith that is vibrant on the other side of the complexity seen in the study of psychology. We can also show them what it means to take rists, to trust others, to study the character of God, and take other steps that can offset the tendency toward cynicism.

This is actually an element of what has been referred to as personal integration. It involves attending to the spiritual life of the psychologist (or the student in training to become a psychologist). In many respects, it lays the foundation for the other kinds of integration, including worldview, theoretical, applied, and role integration.

Book Contract Signing Party

marital conflictJim Sells and I just returned from what we dubbed a book contract “signing party.” Actually, it was breakfast. But we received our contract from InterVarsity Press for the book, Resolving Marital Conflicts. The book is for pastors, counselors/lay counselors, and others interested in an accessible model for helping couples resolve conflict.

The model itself can be found in more of an academic form in Chapter 14 (“Attending to Marital Conflict”) the book Jim and I wrote titled Family Therapies: A Comprehensive Christian Appraisal, also from InterVarsity. This new book, Resolving Marital Conflicts, will unpack that model and apply it in practical ways to the kinds of issues pastors and lay counselors in particular address in their ministry.

Integrative Approaches – 5

Integrative ApproachesWe met as a faculty recently to discuss Chapter 5 of Integrative Approaches. This chapter is titled “The Pursuit of Truth: (Epistemology: Ways of Knowing).” It opens with a compelling example of Entwistle discussing his take as a psychologist on someone suffering from a delusion, while others (the patient) see that experience as truth, and still others experience it as demon possession. He uses this to get the reader into a discussion of epistemology or ways of knowing.

Entwistle espouses the view of “tentative certainty.” This is critical realism as contrasted with naive realism (my perceptions all correspond to reality) and anti-realism (my perceptions do not necessarily correspond to reality but are shaped by biases, assumptions, and so on).  

According to Entwistle:

Critical realists take a middle ground, believing that, while assumptions and biases color perception, reality imposes some limitation on interpretation. The critical realist thus recognizes that assumptions and biases affect data interpretation, but also believes that assumptions and biases can be evalued (at least to some degree), and that interpretations can be judged by their fitness with the data. (p. 87)

I have also described myself as a critical realist – at least in contrast to other approaches to the relationship between science and religion that undermine integration, such as perspectivalism. In any case, we had a good discussion that contrasted critical realism with common sense realism, which comes out of the tradition of Thomas Reid and others. Current proponents of common sense realism include Alvin Plantinga, one of the foremost epistemologist of our day, who developed what he refers to as Reformed epistemology.