Tag Archives: healing

Eradication or remission: With what healing do I bless you?

What do you say when you bless a sick person?

  • “I hope you get well soon” or
  • “I hope you feel better soon?”

Both, of course, are expressions of love and a sick person probably gets the love, no matter what you say. I wondered, however, why I almost always say, “I hope you feel better soon” just like my mother.  Maybe get well, seems like a demand; while feel better is more tentative, more humble. When I say “I hope you feel better soon,” I think it is flavored with, “I am not sure where this is going. I don’t feel comfortable promising wellness. But I am hopeful.”

The other day some Circle Counseling clinicians got into the subject of getting well and feeling better applied to mental health. We discussed whether mental health was more about eradication (well) or more like remission (better). I had never really thought through the difference. Eradication vs. remission is often the tension cancer patients feel, right? They wonder “Is there a cure or will I have to worry forever?” That kind of tension also applies to mental illness. “Does being well mean I am just like I remember good times in my past — a return to normal? Is it acquiring an idealized future — what I always thought I should be?” Or is mental health feeling, thinking and behaving better, beginning where I am now and moving on?

Need to talk about power

I think eradication was paired with remission in our dialogue because people in the U.S. assume power is at their disposal or should be. Around here, successful treatment for many means eradication of the invading illness. Something like “Vaccinations would have provided a no-fly zone against the virus if people had just gotten one, two, three and now four!”

Like I was asking last week, many Americans see healing as an act of power. Should Jesus followers all be like Jesus and eradicate disease and mental illness with a word, a touch, or a prayer? Or is healing more typically resting at the feet of Jesus, having faith in the storm, and persevering in trust? In a powerful country, psychotherapists might lust for power — the power of my work, my touch, my method. I heard a different take when I talked to a person last week who lives half-time in Ecuador. They said it would be much more likely there to see health in terms of one’s relational context and one’s daily process. People there never expect to have power, so they are more comfortable with unpredictable destinations and more attuned to feeling present in their relationships and circumstances. They do not find suffering sinful.

But here, I think it is good for me to answer the questions. Am I more of a psychological technician, eradicating mental illness and discomfort? Or am I providing space for health to unfold? If the latter, I might be able to promise raising your pain tolerance instead of implying all pain is an anomaly. In a recovery mindset, I might admit I don’t know the meaning of your suffering, or whether some ideal of wellness might really be a trap!

I’m glad I travel with people who ask good questions.  At one point last week, I listened to an Indian psychotherapist (his choice of label) explaining why Native people might not take advantage of the services of the counseling center on the reservation. The elders told him the center’s idea of “wellness” was mostly about becoming individualized (as opposed to tribal) and medicalized. If one is poor or constrained by colonization, “getting well” might mean eradicating who one is to become more “white” and more acceptable to the power structure. One’s setting or one’s relationships might be the cause of mental illness, not only what is happening inside. If a person refused mental health care, that might be the same thing as resisting the indignities of colonization, the end of which would likely improve their mental health!

Eradication/Medical model

I was not sure the interesting binary argument we therapists were making between eradication and remission was reasonable. Aren’t most mutually exclusive labels easily placed on a spectrum that meets somewhere near the middle? But once I started looking, I found a lot of eradication models that feel pretty exclusive, mostly coming from the world of medicine, from which psychotherapy emerged. They looked a bit one-sided, as in this definition: “The biological approach of the medical model focuses on genetics, neurotransmitters, neurophysiology, neuroanatomy, etc. Psychopathology says that disorders have an organic or physical cause. The approach suggests that mental conditions are related to the brain’s physical structure and functioning” (link).

I usually love science. It is unintentionally miraculous. But I don’t love it when it dominates us. So I have mixed feelings about some relatively-recent approaches from the medical end of the spectrum that propose and sometimes promise eradication of mental health issues. Here is a collection.

  • A TV station gushed: “Repetitive transcranial magnetic stimulation is a depression treatment that is “turning lives around in five days.” By adding imaging technology to the treatment and upping the dose of rTMS, scientists have developed an approach that’s more effective and works more than eight times faster than the current approved treatment for the world’s leading cause of disability.
  • The medical terms are Psilocybin and MDMA. The terms you know are ‘shrooms and ecstasy. Psychedelics have resurfaced as a means to treat stubborn disorders. Psilocybin (the essence of mushrooms) has been used for severe depression and MDMA for PTSD. One of my clients ended up in psychotherapy because an uninvited night of ‘shrooms unveiled an inner world he never dreamed he contained.
  • Ketamine injections have become a new mental health industry, lately. The anesthesia has been found useful for treating depression, PTSD, social anxiety and OCD. Mindbloom is the company that a new client connected with; the effects were real, but apparently short-lived for them.
  • I am not sure I think of EMDR as a “medical model” in essence. But it is another way to short-cut lengthy talk therapy. I’ve done some training myself. It gives a lot of authority to the technician. Brainspotting seems, to me, like a more easy going, user-friendly version of EMDR. Both use bi-lateral stimulation of the brain to allow for entrenched feelings and patterns to be accessed and renegotiated.

Remission/Recovery Model

I hesitate to say the “remission” end of the spectrum is more “right-brained,” but there, I said it. While the medical model gets more specific and tiny all the time, right down to your neurotransmitters, the recovery model allows for a wider range of possibilities and contexts for the state called mental health. The documentary Bedlam is one of the latest critiques of the results of the medical model the recovery model seeks to correct.

The recovery model takes a holistic view of a person’s life. The Substance Abuse and Mental Health Services Administration (SAMHSA) defines recovery from mental disorders and/or substance use disorders as “a process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential.” SAMHSA outlines four dimensions that support recovery: 1) Choices that support physical and mental well-being, 2) a safe place to live, 3) meaningful occupation and participation in the community, 4) supportive relationships of love, emotional availability, and respect.

The recovery model is in direct response to the unmet promises of the medical model. Rather than focusing on “the elusive state of return to premorbid level of functioning” these are more systemic approaches emphasizing “one’s personal ‘resilience’ and control over problems and life” (NCBI). For instance, the medical model makes many promises to alleviate depression, the leading cause of disability  worldwide (WHO). The recovery model is honest about the shortcut approaches that sometimes prove ineffective and discouraging.

In the case of depression, a sufferer is moving toward recovery when symptoms respond to treatment and diminish, however slowly. Remission is achieving a symptom-free state and returning to normal functioning. After several month s of remission, one enters the recovery stage (more). For many people, looking for remission may be more satisfying than never achieving eradication. Finding a new normal, rather than lamenting the lost one, allows a person to live the life they have.

With what healing do I bless you?

I think I can bless someone with “Be well.” Whatever wellness you have in your present state today, I hope you can have it rather than lusting for what you don’t have and condemning yourself for not being healthier. If you don’t see yourself in the light of the medical industry’s “gaze” and label yourself according to your faults, I think you’ll find amazing tools there to use.

I also think I can bless someone with “I hope you’ll feel better.” Whatever process of development or recovery you are in, there is hope of appreciating it, moving beyond it, or suffering it creatively. You have personal resources – some you know about and some which are yet to be fully realized or even discovered. You are valuable as you are right now and there are likely people who can see that. Even when you feel ill and less capable than you desire, what you bring to the community is worthwhile right now and will likely grow in blessing as you learn to love and share your true self.

The hidden work of healing in psychotherapy

When I wrote my dissertation, I had the joy of flying here and there to meet with Christian therapists who formed counseling centers associated with churches. One woman in Chicago was having an awkward time talking about how church life integrated with her professional life. She hadn’t shared very much about how her faith informed her psychotherapy and she hadn’t heard much about what her colleagues thought about it. She sheepishly admitted, “I pray for my clients every day. Do you think that is OK?”

What do you think? Is it OK?

As a client, you may need to talk this over with your therapist, if you want your faith taken seriously. Maybe they don’t pray for you. You may also need to talk to them if that’s an area you did not expect to be a part of therapy, or you don’t want it to be, or you can’t trust them with it. The integration of Christianity/spirituality and psychotherapy is not clear for many people, some therapists included.

This has only happened once, but it did happen when a couple came in for marriage counseling. It was apparent the husband was not feeling it. Arms crossed. Short answers to begin with. But we seemed to be getting somewhere. We made another appointment. But the wife called me the next day and said, “He looked at your website and it looks like you are Christians. He can’t handle that. Thanks anyway.” I still think about that. Circle Counseling is a means for many churches to do the work of healing. But some will not be able to handle the thought that I might be praying for them!

Honestly, given the reputation of Christians these days, I might feel like that man who never came back — I mean, the Russian Orthodox Church is sponsoring a war right now! The MCC Rep for Korea gave an amazing report the other night about our peacemaking efforts there; but he had to note how the South Korean churches are dominated more by capitalism, nationalism and anticommunism than they are patiently and deliberately fermenting the hearts and minds of people into new wine. Christian psychotherapists don’t always know what they are doing either. Even though the guild guidelines include competency in spirituality these days, the teachers seem to sideline it more and more. I think many therapists leave their faith outside the door to their office.

We are healers

Various conversations about prayer and counseling made me want to clarify what I think I am doing. I realized I have an assumption that has kind of been hidden, since I am concerned about people who might walk out of my office at the least hint of Jesus. (That happened once in ten years, and I have not forgotten!). I may not advertise the “contemptible” name Christian, too much but I definitely am a healer in the name of Jesus.

Some people do not think psychotherapy “qualifies” as a healing profession. That’s for actual doctors. I admit I was concerned I might be asked what kind of healing profession I was in when I dashed over to the convention center with all the other health workers to get the vaccine when it first came out. I was afraid I might get a “You are not what we meant” look. But as the mental health crisis deepens in the U.S. I believe, more than ever, we need Jesus to heal us, heart, soul, mind and body.

Back in the 80’s our community took a field trip to the first Vineyard church, led by John Wimber. His congregation separated from Calvary Chapel when they took the call to follow Jesus literally and reluctantly decided that call meant healing people like Jesus did. This conviction was not new at all in the history of the church, but it seemed new to them.  After a lot of failure, a woman was healed, much to Wimber’s surprise. He was in the act of explaining to her husband why not all people are healed but the husband was looking over his shoulder at his wife getting out of bed!  An outbreak of healings and other experiences with the Spirit followed.  The population of the church boomed. Wimber called their new ministry “power evangelism” – people came to faith because they encountered the living God.

The first disciples described in Acts demonstrate the same conviction. I think all Jesus followers have a part to play in healing individuals, societies and the creation. “Power evangelism” is an improvement over “God is not answering the phone anymore;” but it also strikes me as the kind of thing an American would invent and package. Americans tend to think power is their birthright or their birthright has been stolen, one or the other. And don’t get me wrong, I think encountering the Spirit among the people of God in Yorba Linda is great. But Jesus did a lot more work in a hidden way than as a rally leader. He was fermenting new wine more than just crushing grapes.

Hidden spiritual work

Another therapist I interviewed in California during my research had a Bible on her office table and told me she usually prayed with her clients.  I was surprised! I was so circumspect, myself, a person would have to go to the website to find out I was a Christian before they asked me. And many people never find out. I don’t think they need to deal with whatever the Bible symbolizes to them or whatever a white, Christian, male might symbolize to them before we get there.

But I do pray for them. As a Jesus follower, it might be malpractice for me not to pray for my clients! I don’t remember ever praying with one. But I can’t help praying for them. I come with the One who comes with “healing in his wings.”

My work, like the ministry most Jesus followers do, is more along the lines of Matthew 6:6: But when you pray, go into your room, close the door and pray to your Father, who is unseen. Then your Father, who sees what is done in secret, will reward you.” There is a “hiddenness” to the work of the Spirit. Like it is often said, the work of the Spirit is like salt in your dinner, or yeast in your bread dough, or a breeze coming on you when you sit on your stoop in August, entering in and invisibly changing things.

Healing is more patiently, deliberately fermenting; it is much more about love than power. The church and the counseling center are crucial vehicles for the transformation of the individuals and the whole world but Jesus does the healing. We never see just exactly how he does it.

Ripe in their time

When I am with clients, my prayer is less like an event and more like a presence. I am a living prayer. I am the presence of God’s love. Another interviewee in my research project was not sure what would happen to her if she revealed to her colleagues how she loved her clients. “How could I not?” she asked. I can’t help it, either. And why, in Jesus’s name, would I? As they enter and as they leave (or after I click them in and out of Zoom!), I intercede for them. Sometimes I wake up in the night and feel like praying some more. God is healing all the time. The unceasing prayer I embody is part of the Sprit’s work.

I’ve never had anyone ask me to pray for them. I hope that is because they get the idea what we do is not about me. It’s not about my special prayer. Not about my power. They have access to whatever power they need. The Spirit of God is with them and for them just as I am with God and I am with them and for them. If they did ask me to pray before they left (after they visited the website, I guess), I think I would say, “I’m not sure about that. We can explore it some more next time.”