Embodying Integration

A Fresh Look at Christianity in the Therapy Room

Megan Anna Neff, Mark R. McMinn

• Publisher: IVP Academic
• Year: 2020
• ISBN:
  9780830831883
• Topic: Psychologie
• Subtopic: Conseil en psychothérapie

Discussing spirituality and religion in the therapy room is increasingly accepted, some even forgetting that integration of psychology and Christianity was once a rare thing. Yet even as the decades-long integration movement has been so effective, the counselor's lived context in which integration happens grows increasingly complex, and the movement has reached a new turning point. Christian practitioners need a fresh look at integration in a postmodern world.In Embodying Integration, Megan Anna Neff and Mark McMinn provide an essential guide to becoming integrators today. Representing two generations of counselor education and practice, they model how to engage hard questions and consider how different theological views, gendered perspectives, and cultures integrate with psychology and counseling. "Many students, " they write, "don't want models and views that tend to simplify complexity into categories. They are looking for conversation that helps them dive into the complexity, to ponder the nuances and messiness of integration." More than focusing on resolving issues, Neff and McMinn help situate wisdom through personally engaging, diverse views and narratives.Arising from conversations between an up-and-coming practitioner and her veteran integrator father, this book considers practical implications for the day-to-day realities of counseling and psychotherapy. Personal stories, dialogues between the coauthors, and discussion questions throughout help students, teachers, mental health professionals, and anyone interested in psychology and faith to enter—and continue—the conversation.Christian Association for Psychological Studies (CAPS) Books explore how Christianity relates to mental health and behavioral sciences including psychology, counseling, social work, and marriage and family therapy in order to equip Christian clinicians to support the well-being of their clients.

PART ONE

Facing Difficulty

Psychiatrist M. Scott Peck opened one of the bestselling nonfiction books of all time with the now-famous words, “Life is difficult” (Peck, 1978, p. 15). With these three words, he summarized the first conversation that begins almost every counseling and psychotherapy relationship. People come to us in pain, experiencing struggle and hardship and dis-ease of every sort. They come to us for healing and help.

This is our work, perhaps even our calling, as counselors. Because we meet people in pain, we start almost every conversation this way as we create safe spaces where our patients explore life’s difficulties. And in some way that still mystifies us (despite thousands of efficacy studies over many years)—something about allowing space for others’ difficulties is indeed healing and helpful.

Even as we offer space and healing to others, we quietly notice that we ourselves also find life to be difficult. Years of training bring us into the offices where we live out our calling, but training doesn’t fully prepare us to understand the deepest aches of living and dying, to make sense of our years on earth and matters of ultimate meaning.

So here is where we begin our integration conversation, in the mire of life’s pain and deepest questions. Here, where the questions are bigger than the answers, where we lean into uncertainties and doubts, where meaning seems elusive, we find some surprises about God.

1

Lament

How do we make sense of the deep aches in life?

IT WAS A BEAUTIFUL JUNE DAY. We were just leaving the wet, dreary Oregon winter behind and all around me (Megan Anna) the world was thrusting forward with new life. Excited for my first appointment with this new pregnancy and just five days before my daughter’s second birthday, there was much to be celebrating. The life blossoming within mirrored the bustling of life flourishing around me. Just three months prior I’d experienced my first miscarriage. This pregnancy felt different, I was nine weeks along and all signs pointed to new life (i.e., lots of nausea, sickness, and fatigue). The beginning of my appointment began with enthusiasm and warmth—excited to reconnect with my nurse midwife, Vicky. The mood in the room shifted when she began the ultrasound.

While I remember my daughter, Grace, grape-sized and enthusiastically bouncing around, this grape-sized baby was not moving. Perhaps this is a very mellow baby. Grace being a wild and lively toddler who infrequently slept, yes, I could do a mellow baby. Vicky sunk into silence and began looking more intensively at the ultrasound screen. After a few minutes she explained that this was not the size of baby we would expect to see at nine weeks, and that more concerning she wasn’t picking up a heartbeat. There could be a few possibilities: perhaps dating was off and it was too small to yet pick up a heartbeat, or perhaps the baby stopped growing and developing toward life. We needed an ultrasound with higher resolution to confirm. They scheduled me an afternoon ultrasound at the hospital. I knew it in my bones, I saw it in Vicky’s face, but the formal ultrasound was policy.

Between my OB visit and hospital ultrasound I returned to my car on the fifth floor of the parking garage. Sitting in the passenger seat in the darkness, I called my husband and told him we were having another miscarriage. Mostly, I held it together; I hold things together under stress. But after hanging up the phone, in the safety of the dark parking garage, I allowed myself space for not holding it together. I contacted the terror, dread, anger, and pain. Warm tears ran down my cheeks as I lashed out in anger. The words I muttered with clenched fists: “Why? Why again? No, not again.” I’m not sure who those words were directed to: perhaps God, the universe, perhaps my body which I felt was betraying me. I spoke angry, tearful words of lament. In that moment they needed out, they needed to be voiced.

At one level, some may wonder if this is a story about grief or lament; it can be confusing to differentiate the two. Lament is relational. It’s taking our grief and pain and expressing it to one who will listen. It’s one thing to feel a sorrow, and quite another to express it boldly. By clenching my fists and crying out to God, I expressed the ache in my soul and trusted my grief to the possibility that someone might be listening. In this, lament is grief, directed at God, with a particular shape or form (Brueggemann, 1995).

So what is lament? It first involves suffering. But suffering itself is not enough. Second, lament also requires crying out, giving voice to the ache deep in our bones. We plead for someone to hear our pain. Third, lament expresses resistance for the way things are, and calls for the other to be moved in sorrow and act to make things better. Perhaps paradoxically, the final part of lament is experiencing some confidence and trust in the person receiving our words. In the wake of his blood cancer diagnosis, J. Todd Billings (2015) writes: “As strange as it sounds, prayers of lament in a biblical pattern are actually a form of praise to God and an expression of trust in his promises” (p. 43). Similarly, M. Elizabeth Lewis Hall (2016) writes, “biblical lament contains an unexpected element that differs radically from ‘sorrow, regret, or unhappiness’; it contains sometimes exuberant praise to God” (p. 221). And so, lament contains deep sorrow and suffering as well as its expression and cries for change, but it also holds the possibility of connection and even grateful reflection toward the other who receives our expressions of pain.

Medical settings are often places of lament. Anyone who has spent time in an oncology unit knows the deep questions and longings that stir in the human soul, and they have witnessed the cries of anguish that emerge from those questions and longings. Kathleen O’Connor (2002) begins her fine book on Lamentations by recounting sitting with her husband in a hospital oncology room, noting the quiet wisdom of the nurses and staff. She writes:

They accepted fear and rage, along with the physical and spiritual manifestations of disease. They spoke with their patients as human beings, learned about their families, their lives, and treated them as agents in their own care. Together they enacted the theological insight at the core of this book that I call “a theology of witnessing.” (p. xiii)

These are poignant words showing how lament brings suffering into a relational space where others bear witness to the weight of the world. And so it is also in the psychotherapy office, whether situated in a medical setting or somewhere else. We are called to be those who bear witness to suffering, pain, struggle, despair, and anger. And if we are to be these witnesses, we desperately need a theology of witnessing.

As counselors and psychotherapists, we might lean toward understanding lament as an individual phenomenon, but it can also be a collective activity. I (Mark) recently listened to a profound sermon by an African American telling his story of living in a country where black male bodies are distrusted and maligned. During the sermon the speaker mentioned “black lament”—words that pierced my heart. In the Quaker tradition we sit in silence for a time—usually between five and fifteen minutes—after a sermon, and it seemed clear to me that day that we were a congregation sitting together in lament. As a predominantly white group, we probably could never fully understand black lament, but we could at least sit before God and cry out for justice and shalom.

In our work as psychotherapists, we encounter both individual and collective lament. Our patients bring their individual pain, but they also bring ways of being wounded in an unjust and difficult world. Many of us are comfortable with grief work, and while lament and grief work certainly overlap they are also distinct from one another. Biblical theologian Clifton Black (2005) suggests that while grief has traditionally been understood by psychotherapists as progressing through stages, lament is not something we move out of, as all of life and joy is intertwined with death this side of Eden. Lament leads us deeper into the “inmost heart of God” (p. 53). When it comes to lament and grief, Christianity has much to offer the world of counseling, and arguably the whole Western world.

LAMENT AND FORMFUL GRIEF

Walter Brueggemann (1995), a biblical scholar who has written extensively on lament, notes how Elizabeth Kübler-Ross’s work on the stages of grief has helped make grief formful. He suggests that lament is similarly formful. In other words, there are particular community standards that make lament bearable and somewhat predictable, and may even make it meaningful. Form helps contain the messy process occurring in the aftermath of loss.

Drawing on the structure of the Psalms, Brueggemann suggests that formful lament consists of an address to God, complaint, confession of trust, petition, words of assurance, and a vow to praise. This formful lament helps “define the experience of suffering” (Capps, 2005, p. 71). It also seems reasonable to argue the inverse—that if lament is given no place, no voice, in our places of worship and psychotherapy offices, then it lacks form, and the experience of suffering becomes undefined and amorphous, easily obscuring whatever hope and meaning could otherwise be found.

A Recipe for Disaster

It seems that for modern, Western Christians we are stuck between a rock and a hard place when it comes to expressing our grievances. Consider that the church has largely lost the prayers and avenues of lament that traditionally played a rich part in our tradition (Billman & Migliore, 1999). There are exceptions, such as the black church and feminist theologies, where lament has been done relatively well, but for the most part we have overlooked lament in our communities of worship. Hall (2016) notes that only about 4% of hymns in contemporary hymnals reflect the sort of lament that is present in 40% of Psalms—the Hebrew hymnal. If the “rock” is the lament-limited church, the “hard place” is increased exposure to crises and conflicts for which lament is the appropriate response. Perhaps the absence of lament has given way to expressions of anger expressed through disembodied forms (e.g., network media, social media, and so on). A fragmented lament finds life in new forms, as poet Rainer Maria Rilke writes: “Killing is one of the forms of our wandering mourning” (May, 1983, p. 125). Because we are not a culture that knows how to lament, we often let our mourning wander into destructive places. Complaint is one such place insofar as it divorces our grievances from a real relationship with God and becomes more grumbling about God than crying out to God (Hughes, 1993).

Christians who are psychologists and counselors often struggle to know how much of their personal faith to disclose to their patients. This is a complex and nuanced matter that goes well beyond the scope of this book, but one advantage of disclosing something about our faith to patients should be mentioned here. If our Christian patients know we share their faith, then bringing up spiritual struggles allows for the possibility of lament rather than complaint. That is, pain and struggle and confusion and anguish can be voiced in a context where belief is still a firm foundation and where hope lingers, however faintly, on the horizon.

Not having a culture of lament, or collective public spaces for lament, leaves us in a precarious situation of learning how to lament privately, or not learning at all. Given these modern-day tensions, it makes sense that conversing with ancient texts and non-Western cultures is essential to cultivating a framework for lament. Conversation with the Hebrew Scriptures can be especially helpful in providing language and a landscape for engaging lament.

How We Look at a Thing

Perhaps the complexity of the church’s history to lament can be illustrated by how we interpret Jeremiah 31:15-17. Here, the imagery is of Rachel lamenting the loss of her children to the Babylonian exile:

A voice is heard in Ramah,

lamentation and bitter weeping.

Rachel is weeping for her children;

she refuses to be comforted for her children,

because they are no more.

Thus says the LORD:

Keep your voice from weeping,

and your eyes from tears;

for there is a reward for your work,

says the LORD:

they shall come back from the land of the enemy;

there is hope for your future,

says the LORD:

your children shall come back to their own country.

Where do your eyes land as you read this passage? In many of our Christian traditions we have tended to jump to the end, to the comfort of God’s promise that Rachel’s children will come back. And, in fact, after seventy years of Babylonian captivity the children of Rachel returned t...