Academic journal article Journal of Psychology and Christianity

The Heart of the Matter

Academic journal article Journal of Psychology and Christianity

The Heart of the Matter

Article excerpt

A psychotherapist enters clients' lives for a relatively short period of time compared to their whole lifespan. It is not unusual for the therapeutic relationship to end, and the clinician to never again hear from former clients. However, on rare occasions, I (Heather) have had the privilege of witnessing the continued miracle of God's healing work in a client's life many years later.

This case study is a joint effort between a former client (who chose to use the pseudonym Joy) and me and is written almost a decade after our final session. The termination of therapy was necessitated by her geographic move, a premature interruption in the healing process which was frustrating to us both, particularly as exciting in-roads were being made in therapy. Unfortunately, whether through life circumstances or the managed care health system, not being able to see a client through to the end of their process is often the norm rather than an isolated occurrence. This case study serves as a reminder that God continues the healing process beyond the parameters of a specific therapeutic relationship. It also offers a glimpse into a therapeutic process from the unique perspectives of both therapist and client. With the current emphasis in the field tending towards manualized approaches to therapy, Joy's reflections highlight the central role of empathy and presence over specific techniques. Finally, it shows that what initially appears to be the most obvious therapeutic approach may not necessarily be what will be of greatest benefit to the client.

Following is an account, from the perspective of both therapist and client, of the key elements of therapeutic change within a weekly counseling relationship that lasted several months short of two years. Joy's verbatim contributions are indented for ease of following which of us is writing at a given time.

Taking Heart The Beginning of Therapy

Joy's presenting problem involved incessant struggles with decision making. She found herself paralyzed by the many available options, unable to take action. This was negatively impacting her work, marriage, and relationships. It was clear that Joy was highly performance-oriented, wanting to do what was right in the eyes of both God and others, yet always feeling as though she fell short. While she had functioned competently in the past, the energy required to maintain her carefully created personal façade had dissipated to the point that she could no longer keep it up.

Cognitive/behavioral therapy initially looked like a good treatment option, as Joy was well tuned-in to her thought processes, motivated to work on them, and familiar with the approach from previous counseling experiences. Several months before I saw her, Joy had written the following in her prayer journal:

The façade that I created doesn't have a heart, it only has rules and requirements and expectations to be reached. And once reached, these 'shoulds' are readjusted to a higher level. Every decision is calculated, every result evaluated. It's a life devoid of passion and empathy. When faced with my patterns of selfcondemnation and pride, my solution seems to be a fierce determination to overcome the old patterns, to master the new 'right way' of living, trying desperately to restore my internal equilibrium and prove myself 'good and acceptable' after all. Aaagh! I'm like a person who is proud of how well they are working on becoming more humble. I know that my self cannot be trusted so what's to keep me in my pride from just substituting one lie for another? I want to cast out the Accuser but I'm afraid that I will then let in the Excuser or worse. I'm still stuck with the same old sin self.

I did not read this journal entry until recently, after Joy and I began to collaborate on writing this case study, so found it interesting to note that even prior to coming to see me, Joy had written about having a "façade" without a "heart," devoid of "passion and empathy. …

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