Heart and Soul, A Theological Exploration of Psychotherapy

Although I work full time as the lead pastor of a local church, with both an M.Div and a D.Min under my belt, I recently enrolled clinical counseling program through Tyndale University in Toronto. There is a bit of a long story behind this statement. When I left my previous ministry post I didn’t yet know where the Lord was going to lead me next, or even if he wanted me to continue in pastoral ministry at all, so I signed up to get trained as a psychotherapist, thinking it would be a good fit for me, should I discern that my days as a pastor were truly over.

As God would have it, my next ministry assignment opened up sooner than I expected, and I started pastoring another church—the church I currently serve at—before I had even completed one course in my degree. I still saw a great deal of benefit in completing my training as a therapist, however, so I rolled back my course load to parttime studies and started doing both: pastoring a church fulltime and earning a degree in counseling on the side.

Though it has been a challenge to balance the demands of church life and my studies at the same time, I have found this training to be indispensable to my work as a pastor. Even if I don’t ever go into clinical practice (the jury’s still out on that question), the things I have already learned about neuroscience, personality, emotional systems and psychopathology have helped make me a more effective pastor. Over the next few months at terra incognita, I intend to explore how, in a series that I’m calling "Heart and Soul, A Theological Exploration of Psychotherapy." I hope to share some of the things I’m learning in my studies, on the one hand, but also to discuss important connections between pastoral work and psychotherapy, on the other.

As just a sample of what some of those connections might look like, let me share a few thoughts about a book we read in a course on psychopathology I took this spring. It was called Blossoms in the Desert, and it was written by a psychiatrist named Dr. Thomas Choy, drawing on his many decades of experience as the head psychiatrist of a schizophrenia program in a Toronto hospital. Although Choy is a person of faith, his book is not explicitly Christian, rather it is focused on the “success stories” he has experienced with schizophrenia patients over the years, exploring what contributed to their success and encouraging people to reimagine what treatment for the severely mentally ill might look like.

What stood out to me as a pastor, however, was the emphasis Choy places on the role of hope in a schizophrenia patient’s recovery. Choy is not speaking about hope here in the Christian eschatology sense of the word—the final hope of redemption to eternal life that is ours in Christ. He is speaking more narrowly about the tenacious hope for recovery that seems to have played such a key role in the many success stories he has personally witnessed. Choy defines hope simply as “the expectation that what we choose today will affect what happens tomorrow,” and he suggests that it is this kind of hope that motivates patients to make the kind of choices that will result in their wellness rather than choices that will deepen their unwellness.

Choy offers some approaches to treatment that encourage this kind of hope in particular: using a strengths-based paradigm for treatment, helping patients make meaning out of their experience, and defining recovery not in terms of “being healed from mental illness” but in terms of discovering a new way of to live as a person with mental illness. If we only focus on the magnitude and severity of what is lost through mental illness, he argues, it can only lead to hopelessness and despair. Real life-transformation can happen, though, when we redefine what recovery means and reframe what it looks like.

Because I read Choy’s book as a pastor, as much as I did as a student of psychotherapy, I found myself resonating deeply with his definition of hope and the role it plays in helping people recover from severe mental illness. If hope really is an “expectation that what we choose today will affect what happens tomorrow”—even if that’s not the whole of what hope is, but only a part of it—then this kind of outlook is probably just as important for the mentally well person as it is for the mentally ill.

Oftentimes in Christian circles, our definition of hope is more deus ex machina than this, a mere blind trust that God’s gonna make it all work out; that Christ will return and take us home before the world becomes unlivable, or if we should die before that day, then the Lord will keep our souls safe and sound in heaven with him, when we do. And I’m sure there is some merit to this way of conceiving of hope. In the end our hope is in God and not in our own hard effort.

However, it is quite possible, and even pretty helpful, to adapt Choy’s definition of hope in a way that aligns very well with a Christian hope. Because, there is a profoundly Christian way of defining hope as the “expectation that what we choose today will affect what happens tomorrow.” All it takes is to acknowledge that, theologically speaking, the Lord Jesus sets the human will free, enabling it to choose to love and serve him, and inasmuch as this is a genuine freedom, our choice of him can be said to be a genuine choice. Even though it begins with God, and is empowered by God, and is brought through to completion in God, still, once God has taken the gracious initiative like this, our response is freely chosen.

So is our choice to pray, or worship, or witness, or meditate on the Word, or any other of the myriad of things that Christians do as an expression of their faith. And as far as I can tell from the Scriptures, these things really do have an affect on what happens tomorrow, because these are the means by which God ordained that we would grow in the things of Christ and he would accomplish his purposes in our lives.

In this way, hope is not just for the schizophrenia patient—though it is absolutely vital for the schizophrenia patient—but it is equally vital for all of us. Because what steps of devotion and commitments of discipleship would we make, if we really believe that God would use those steps, and honor those commitments, to make a difference in the world?