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Book Excerpt: Emotional Traps

The following is an excerpt from my book, Emotional Traps: Finding Freedom in Everyday Life. This portion of the book provides an overview of the TRAPS assessment tool, originally designed for pastors to use with their parishioners. Anyone who is asking, “Am I emotionally healthy?” can get help answering that question using my TRAPS model. If you want to find out more, you can find the entire book here or by clicking on the picture below:

tinyTRAPScover

“’What exactly makes a person emotionally healthy?’ This was the question posed to me by my senior pastor that launched the development of this book, and I believe it is a question many Christians are asking today. As churches have become more vocal about the need for counseling, many have begun to make the connection between spiritual growth and emotional health. Books such as Boundaries by Cloud & Townsend as well as Emotionally Healthy Spirituality by Peter Scazerro are examples of books written to help Christians improve life skills and approach their faith journey with emotional balance.

While there are a variety of Christian books available to offer guidance on specific emotional skills, there has not yet been a book devoted to helping Christians assess their own emotional health. Taking a step back and looking at some key areas in your life can help you see a bigger picture of emotional problems that may be holding you back from spiritual growth.

Let me introduce you to the heart and soul of this book: the TRAPS assessment. The following five areas together provide a concrete picture of what makes up one’s emotional health:

Thinking—Are you able to think about your strengths and weaknesses clearly without feeling either prideful or insecure? Do you have a clear sense of how you present yourself to others and how others may see you? Is your understanding and evaluation of events in your life in line with the perspective of mentors or leaders in your life? In this area of emotional health we are looking for self-awareness, insight, and logical, reasonable thinking.

Relationships—Are your relationships moving you forward spiritually and emotionally or dragging you down? Do you interact with others in your life (friends, family, children) in a way that is positive and constructive or are your relationships filled with conflict? Do you have at least 2-3 friends with whom you can share important feelings as well as a larger group or church setting? Here we are looking for a positive and adequate social network as well as identifying your relational patterns and skills.

Addictions—Do you have anything in your life that you are dependent on besides God? Addictions can be to substances like nicotine, alcohol, caffeine, or drugs as well as to food, sex, gambling, television, the internet, money, etc. You might be tempted to skip over this area if you have not been addicted to drugs, but it is important to look for any area in which you may be dependent.

Past—For so many of us, our past continues to impact our present-day lives. For some, there is past trauma or abuse that continues to shape how they see themselves and others. For others, their own mistakes of the past fill them with so much guilt and shame that they feel they can never truly accept God’s forgiveness and be free. In assessing this area, focus both on past trauma/abuse AND on shame from past sins or mistakes.

Self-care—Sometimes the everyday, mundane routines can be as critical to emotional and spiritual health as any of the other four areas. Habits such as eating well, regular exercise, good sleep patterns, clear task and time management, and even proper money management are essential to a balanced emotional life. How do you handle stress day-to-day?  Do you have positive coping skills like journaling or hobbies? Do you demonstrate a level of self-discipline and a healthy lifestyle?

In Chapter 1 we will look at the need for addressing emotional issues in the process of spiritual growth. I will lay out a biblical framework for emotional health: what does God say about taking care of our emotional lives? What role does this have in the process of becoming more like Christ? Chapters 2-6 will take an in-depth look at each of the areas in the TRAPS assessment, focusing on specific problem areas and red flags. Chapter 7 will offer practical suggestions for moving forward once emotional traps have been identified. The final chapter will address medications, including why they are sometimes necessary and why Christians should not be afraid to take medications when they are needed. In the appendix you will find a 100-question assessment tool that you can use as a starting point for personal reflection.

Perhaps you are still not quite sold on the emotional/spiritual connection. Isn’t the Bible all you need to address life’s problems? Some Christians have this point of view: emotional problems derive from sin. Symptoms of depression or anxiety are seen as a result of one’s own sinful lifestyle and behaviors. While it is true that we live in a sin-filled and cursed world, not all emotional problems stem from a specific sin you have committed. Your emotional life is far more complex than this, and there are often factors out of your control that contribute to emotional health problems. I hope that this book can help you understand the big picture of emotional health and offer some ideas for moving forward one step at a time.

Galatians 5:1 says, ‘It is for freedom that Christ has set us free. Stand firm, then, and do not let yourselves be burdened again by a yoke of slavery’ (NIV). I pray that this book will greatly benefit you and help you move forward emotionally and spiritually so that we all may experience the freedom Christ has for us in our everyday lives.”

Click here to check out Kristen’s online course, a self-paced resource to help you work through this book as well as her other books focused on emotional freedom!

 

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Learn. Listen. Love.

When it comes to mental illness, there is a lot we don’t understand. Even neuroscientists who devote their lives to the study of the brain are still trying to figure out the puzzle. Sadly, Christians are often uninformed or misinformed about mental illness, causing too-frequent judgmental responses. And often these responses are systemic and subconscious, so they go undetected by those who perpetuate them. Any stigma or bias against the experience of another individual causes harm and creates shame and blame.

Learn

I believe as followers of Jesus we can do better. I think change can happen when we start by learning. Educate yourself on the latest research on the brain. Read about the symptoms of mental illnesses and find out more about common medications used to treat depression, anxiety and mood disorders. There are some great resources out there, including the National Alliance for Mental Illness and PsyPost.org.

Listen

The next step is to listen. All the statistics and facts and research in the world do not speak to an individual’s situation nearly as well as their own voice. When a friend shares that he or she is struggling with depression or anxiety, just listen. Then listen more. Then keep listening. It is so tempting to put in your opinion, give advice, or turn the conversation back to yourself. Be present with that person and sit with their story.

Love

Finally, may we truly be the Church towards those who are hurting and demonstrate love. Not love if they get better. Not tough love to teach them a lesson. Actual, real, agape love with no strings and no expectations. Love them for who they are and where they are at. Let them be on their own journey and choose to walk alongside. Make a meal, give a ride, babysit, mow a lawn. Whatever your spiritual gift is, use it to love that person who is suffering. When we love, we embody the Spirit of God just as Christ did while on earth. May it be said of the Church that we demonstrated compassion and love to every person we encountered no matter the struggle.

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Is Suicide a Choice?

I recently spoke at a church about suicide and sin. We wrestled over the word “capacity.” At what point does a person’s brain choose for them? Where is the line between sin and a lack of ability? For some, suicide is a deliberate choice made out of desperation. For others, it is final escape from years of being worn down by mental illness. Still others commit suicide in the midst of a psychotic break. Often, unsuccessful attempts are deep cries for help.

One of the things I find most heartbreaking when a public figure dies by suicide is that the world rushes in to judge what happened. I did not know Kate Spade or Anthony Bourdain. I did not know Robin Williams. I cannot speak to the lives they were living or what they may have been going through. But I once sat with a woman living in poverty in a trailer park in Missouri as she got her stomach pumped in the ER. I have comforted children who had already reached places of pain so deep that they had begun to self-mutilate. I have written safety plan after safety plan to help my clients develop options to keep living. I have asked people their reasons for keeping on going. I have listened to people’s “fool proof” plans to kill themselves that in a way brought comfort and a sense of control to them. I have made practice calls with my clients to suicide hotlines in order to break the barrier that might exist in the midst of crisis.

If you have not had the privilege of walking alongside people in their journeys of pain, then you may want to label their experiences. Often, as Christians, we have a certain theology to maintain and we try to fit stories (from “out there”) into our existing worldview. I would challenge you to consider letting the experiences of others shatter your worldview. Broaden your concepts of sin and disease. Step into the heart, mind, and soul of someone who is feeling so lost, desperate, or depressed that death sounds better than life. Develop authentic relationships with people who are different from you. Being a non-judgmental friend just might save somebody’s life.

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Groups, Workshops, and Classes: How the Church Therapist Can Expand the Reach

Church Therapy is primarily focused on providing mental health services such as individual, couple, and family counseling in the church setting. However, the Church Therapist can play a key role in the life of the church in many other ways. In the infographic explaining the Church Therapy model, consultation is mentioned, and this is primarily done with the pastors on specific cases or general questions about mental health issues.

For the general congregation, the Church Therapist can be a valuable resource even for those who do not directly seek counseling services. For example, I lead a weekly Recovery Group that is free and open to anyone. Other ideas could include peer-support groups for mental illness that the Church Therapist oversees as well as issue-specific groups like a trauma group or depression group. This type of group therapy can be billed through insurance companies.

The Church Therapist can also offer workshops. I offer psychoeducational workshops on my books as well as other helpful materials out there related to emotional health for the Christian life. Workshops can be half-day or full-day, and can be held in the church auditorium to avoid overhead costs of renting space. Making this type of event a norm in your church helps keep mental health at the forefront of conversation and offers people valuable tools for their own positive growth.

Finally, the Church Therapist can teach Sunday School or elective classes on topics related to mental health and the Christian life. I have created an 8-week small group curriculum designed to decrease stigma and educate Christians about mental illness. These classes can provide education for the whole congregation, whether or not they personally struggle with mental health issues. This information helps create a culture of understanding which goes a long way when a person comes to anyone in the church expressing a struggle.

The presence of a therapist on staff at a church creates a culture that has an ongoing dialogue about emotional and mental health issues. This culture, through all the various ways the Church Therapist engages with the congregation, opens doors of safety for those who are suffering so that they can get the help they need.

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5 Tips For Making Your Church Emotionally Safe

Many pastors and churches want to respond well to mental health needs in their congregations and communities, but often they do not know where to start. While it is important to offer ministries such as professional counseling, lay counseling, peer support groups and classes, you can start improving your response simply by increasing the emotional safety of your church. You don’t need to find leaders and start ministries if you don’t have the infrastructure yet. Begin with these 5 simple tips for making your church emotionally safe.

1. Be sensitive

Awareness is the first step towards addressing any issue. Sensitivity begins with educating yourself and those around you about what mental illness is and what it is not. For example, when many people hear the term “mental illness” they picture someone who is psychotic and/or homeless. These stereotypes cause stigma and prevent us from truly understanding the needs around us. Social anxiety, for example, is likely to go quite unnoticed in a church setting because someone facing those symptoms will be likely to fade into the background (or not return if they felt pressure to shake a lot of people’s hands). Someone struggling with depression may seem fine while at church, but they may be in bed most days the rest of the week. Be on the lookout for people who seem to hang out on the fringes of your church and build relationship with them. Do more listening and less fixing.

One side note: if you are not a pastor then it may be helpful to consider that your pastor may be the one struggling with mental health problems. Encouragement and care can be a two-way street, so take time to check on your pastor now and then.

2. Avoid pity

When you develop relationships with those experiencing a mental health disorder, avoid pity. Pity tends to increase shame as people feel like others are simply trying to fix them or make their problems disappear. Pay attention to the person’s strengths — what are their spiritual gifts? What are some ways to get plugged into the church that would not require extensive commitment? Where are they at in the spiritual journey and what wisdom do they have to share with others? Focusing on strengths helps us all see that mental illness does not put a person on the fringes of the kingdom of God. When we pity and marginalize people, we force them out to the fringes of society. But God does not operate this way and neither should the Church. Everyone can be used by God in meaningful and important ways.

3. Talk about mental illness regularly

Stigma increases when we put judgment and labels onto issues that we do not understand. There is much even in the medical and mental health communities that is not yet understood about brain dysfunction. But we do know that the brain is a complex organ in the body that can experience a variety of diseases just like the rest of the body. Talking about mental illness and acknowledging the physical impact of stress, anxiety, depression, trauma or Bipolar Disorder (to name just a few) is important to decrease stigma. Pastors, be intentional about talking about mental illness from the pulpit. Acknowledge the struggle that 1 in 5 American adults face every year as they experience symptoms of a mental illness. List “depression” or “anxiety” right alongside “cancer” or “diabetes” when you are talking about disease, and avoid talking about depression as a spiritual issue that goes away with prayer. My rule of thumb is this: if you cannot replace the words “mental illness” (or the name of a mental health disorder) with “cancer” in your sentence, then you should not say it.  (For example, “My friend told me she has anxiety, and I told her that she should rest in God’s presence and he will remove it” replaced with “My friend told me she has cancer, and I told her that she should rest in God’s presence and he will remove it.” Should we all rest in God’s presence? Yes. Can he heal all diseases supernaturally? Yes. Would you be likely to say that to a person who told you they had cancer? Unlikely.)

4. Be knowledgeable about resources

Take time to find out where there are Christian counselors and mental health agencies in your area. Call them and find out which health insurances they take or if they have waiting lists. Find out if there are emergency services in your area for those who are feeling unsafe or suicidal. Ask if you can visit or tour the closest psychiatric hospital and find out their visiting policies. Gather a list of hotlines, including the National Suicide Hotline (1-800-273-8255) or others local to your area. Call them to see what you can expect when someone calls. Also remember that your church is a resource. Just as you might make meals or babysit or visit those who are sick, do all of those things for people who are experiencing depression or other mental health symptoms.

5. Walk alongside

Mental illness is not always chronic. But even with single-episode illnesses, symptoms do not “clear up” in a short amount of time. Someone may experience a depressive episode, for example, anywhere from two weeks to a year or more. Others may have chronic symptoms that do not ever fully go away even with treatment. Still others may go through cycles where they are well for a time and then re-experience symptoms. If you become frustrated when someone is depressed, begins to feel better for a while, and then re-enters a new depressive episode, you are not creating emotional safety for that person. Be willing as a church to walk alongside those with mental illness for as long as it takes. Even if that means they have more emotional needs than others might. As you walk alongside, do not presume to know what a person needs. Ask how you can be of help, and if they are not sure then just be consistent in checking on them or making a meal “just because.” Showing that you care can go a long way towards creating trust and emotional safety.

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I Have a Mental Illness and It’s Time I Talked About It

I have had a mental illness since I was four years old. But let’s start with last Friday. I got a concussion and a pretty bruise on my face after I fainted. Why did I faint? Because my brain is broken and sometimes it takes over my entire body.

Before I tell you my diagnosis, I want you to know that this is the first time I am openly talking about this. And last week’s incident made me realize that I do all the things I fight against when it comes to stigma and mental illness. I compare myself to other people who have emotional pain and mental health challenges and I decide not to talk about me because I feel like it’s not such a big deal compared to what others go through. I minimize my experience and brush it off as something I can live with. And I can. I’ve gotten good at living with it and hiding it. Sometimes I’ve called it my “kryptonite.” This is the one thing in my life that can take me down and render me absolutely powerless. And this week showed me that my mental illness can cause other damage too. I’m lucky that my concussion wasn’t worse.

Ok, so here goes: I have a mental illness. It is called Blood/Injection/Injury type Specific Phobia. I remember so vividly the first time I learned that it had a name and research to back it up. Doctors my whole life had just basically said, “Well, that’s weird.” I’ve been tested for seizure disorders (with no results or explanations doctors have found worthy of writing in my chart). But a kind mentor who is a psychologist opened up the DSM (IV at that time) when I was in college and he showed me myself in those pages. He was the first person that knew what I had and could show me a diagnosis in black and white.

Specific phobias are different because avoidance is usually the best way to function most of the time. If you have a fear of snakes, don’t go to the reptile exhibit. Sounds easy, right? But sometimes life doesn’t let you avoid everything, and in my case like all humans I occasionally need medical treatment. Or I hear people talk about their medical experiences. Or someone I love is in the hospital. These encounters don’t happen every day, so it is easy for me to minimize. But the reality of my mental illness is that sometimes I cannot stay present with a person telling me the story of their pain. And I cannot go visit people in the hospital. And I have to work harder than everyone else to go get bloodwork done. And I have to let my husband take our children to any difficult medical appointments. And I only have those children because I found out about natural childbirth and realized I could have a needle-less and hospital-free childbirth. Which I did, twice.

I have had two rounds of treatment for my phobia, once in college (after I learned it was a thing) and once about six years ago (when my counselor training came in handy and I did it to myself). Systematic desensitization is the most effective treatment, and in my first treatment experience I had about ten sessions with a counselor working through a hierarchy of anxiety-producing things while practicing relaxation. We started with the easiest and worked our way up to me going and getting my flu shot (yes, that was the hardest medical trigger I could even face at the time). And I did it. That treatment helped me overcome the anxiety enough so that in my adulthood I would not choose to avoid medical treatment altogether. At that time, I knew that I would be entering into grownup life and I could make my own decisions. Which meant if I wanted to avoid the doctor or dental work or hospitals, I could. But that can come with some serious consequences, and so my first round of treatment helped me be willing to face adult decisions.

My second systematic desensitization came when my dad was in the ICU for three weeks. I went to the hospital every day to be with my dad and my family. I spent hours in the waiting room, only to actually see my dad for about 30 seconds. I went in with my husband the first time and told him I would be staying no more than 30 seconds. It might have been 10 honestly. I knew I needed to get in and get out and succeed so that I could teach myself it was okay. And I did. After about a week, I could sit with him for 15 minutes, and eventually I think I made my way up to an hour. I wish I could say that that cured my fear of hospitals, but sadly I would have to start all over again if someone in my family was hospitalized. I can’t visit someone once. It has to take 3 weeks.

You might not think that my unusual illness has intersected with my faith, but it most certainly has. Like many other Christians with all kinds of mental illnesses, I hoped at one point that Jesus would be enough to carry me through and overcome my challenges. In college there were many ministry opportunities, and one of them was visiting AIDS patients in a nearby hospital. Of course I thought this was very worth doing, and I asked Jesus to let faith be enough for me to do his work. With great faith and a lot of prayer I signed up for that ministry and attended the training. I made it through literally three minutes of that training before I had to get up and leave the room. I stood outside the door crying, trying not to faint, and wrestling with myself. I asked Jesus why he wouldn’t help me overcome this since my heart was so very much in the right place. As the training video continued to play, the leader came out to the hallway and asked if I was okay. I told her a brief version of my story and how I wanted to be able to minister to anyone. She said some of the kindest words I had ever heard: “Kristen, you don’t have to be able to do everything.”

I have come to accept the fact that my mental illness will be understood by very few people. I have come to accept the fact that I am not able to do everything. Anxiety gets in my way, and when I do not flee fast enough, it takes me down. Literally. Hard smack on the concrete floor. (And no, I did not go to the emergency room last week… But I had my husband do a phone consult with a medical professional for me and I have been resting at home non-stop since it happened.) My phobia interferes with my ministry and sometimes it changes my ability to be a present counselor. If I do not flee fast enough, my brain will check out for me. My mind has a mind of its own.

I am still afraid that people reading this will think I am being dramatic. Even others who have a mental illness might judge me because what they face is far more pervasive. But I decided to tell my story because we need to stop comparing ourselves and let every story stand alone. I decided to tell my story because we need to name mental illness and broaden the picture of what those words mean. I decided to tell my story because I know first hand that faith is not enough to overcome illness. Miracles can happen, and if I ever visit you in the hospital or donate blood or listen to your story of surgery then you will know that a miracle has occurred. Until that happens, I will name my illness and honor the limitations it places in my life. If I had not been afraid to seem weird or disruptive last week while sitting with another person’s pain, I would have laid down on the floor first so that my fainting would not injure me. I let stigma stop me, and I don’t plan to do that anymore.

 

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Christ in Counseling

Mention the words “church” and “counseling” in the same sentence and I assure you the response will be surprising. While the Church has been a place people have turned to during emotional struggles for centuries, the development of modern psychology has sparked an intense debate within the Church. What causes mental illness or emotional struggles? What is the best way to address those issues? Should a pastor provide counseling or is that the job of a professionally licensed therapist? Does embracing certain aspects of psychological study mean we are compromising our faith?

Many have jumped to conclusions about the Church Therapy model, asserting that I have somehow sold out on my faith because I have studied psychology and advocate for professional licensure. Previously on Twitter, a person I do not know who has never asked a single question about this model wrote to me: “Counseling minus Christ equals deception.” Whoa. I have learned not to take these comments personally, but it did get me thinking about how to articulate my views on the role of Christ in counseling. First of all, I want to clarify that the Church Therapy model is primarily focused on counseling those who are already following Christ. Of course there may be some who are in a seeker-phase of the spiritual journey, but typically those who come to a church for counseling are already Christians. I do not believe it is the role of a counselor to proselytize in a counseling session, so for this reason Church Therapy does not seek to gain new converts.

Counseling in the Church Therapy model is part of the discipleship process as spiritual growth and emotional health provide increased freedom. Christ is 100% at the center of this process because he alone is able to supernaturally change lives. However, that does not mean that my primary methods are quoting Scripture or praying with clients. At times these can be helpful, but more often psychological strategies such as Motivational Interviewing or Cognitive Behavioral Therapy are far more effective in helping a person overcome various emotional challenges. For this reason, training in the Bible is not enough to train a person to be an effective counselor. Even basic helping skills like active listening, though useful on some level, are not enough to train a person to be a competent counselor.

So how can it be that I claim Christ is at the center yet I highlight modern psychological techniques as superior methods for therapy? Perhaps an illustration would help clarify this point. A couple of years ago, I walked alongside some friends whose baby had lost oxygen for nearly 15 minutes at birth. He was rushed into the NICU and placed on a cooling pad, an advanced treatment for babies at risk for brain damage at birth. The baby had to be on the cooling pad for 72 hours before any testing could be done to assess brain damage. During this time the goal was to slow the development of brain cells in order to stop any further damage. That was the longest 72 hours I have ever experienced as we prayed and fasted and poured everything we had into seeking a miracle for this baby (who the doctor’s warned would probably be very brain damaged). Every day that I see that little boy, who has little to no signs of brain damage today, I see a walking miracle. Was Christ at the center of his healing? Absolutely. Did the doctors use a modern method to facilitate that process? Yes.

Using researched strategies to address mental health issues is no different. We no longer have to accept the ideologies of Freud, Jung or Skinner in order to believe that modern psychology has a lot of knowledge to offer. Even most secular counselors do not hold tightly to these early definitions of psychology. The Church Therapy model connects biblical, psychological and biological truths in order to most effectively move a person towards healing and life change as they deepen in their walk with Christ.

Unfortunately, even many Christian counselors do not view counseling as part of the discipleship process and they counsel many non-believers. They can help them change certain aspects of their life, help them cope, or improve their communication skills. But this does not move them into deeper relationship with Jesus. The Church Therapy model is a true integration of Christian faith and psychological study. Both are in mind at all times as the Holy Spirit moves in the midst of effective therapeutic strategies.

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Pastor Training Video: Psychological First Aid

I’m excited to bring you this brand new Pastor Training Video on the topic of Psychological First Aid (PFA). In this video, I overview the 8 core actions of PFA which are used when responding to crisis situations. This can be a help for church staff members, ministry leaders, or lay volunteers.

Watch the video here (under 10 minutes) and then check out these additional resources where you can learn much more about PFA:

Free online courses:

https://learn.nctsn.org/enrol/index.php?id=38

https://www.coursera.org/learn/psychological-first-aid

World Vision PFA Field Guide:

https://www.wvi.org/health/publication/psychological-first-aid

 

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What is Mental Illness?

I often speak about the Church’s response to “mental illness.” Often used interchangeably are words like “mental health issues” or “emotional struggles.” Defining these terms is important in this dialogue, as doing so ensures that we all know exactly what types of problems we are trying to address.

The Diagnostic and Statistical Manual, 5th Edition (DSM-5) states this definition:

“A mental disorder is a syndrome characterized by clinically significant disturbance in an individual’s cognition, emotion regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning” (p. 20).

The term “mental illness” can conjure up a variety of images, including other problems (such as homelessness or addiction issues) that sometimes co-occur with severe and chronic mental illnesses. Movies like A Beautiful Mind or Girl, Interrupted portray psychotic symptoms that are present with disorders such as schizophrenia. But are these mental models accurate when we think of the term “mental illness”? When we speak of the Church’s response to mental illness, are we simply trying to reach these severe cases?

Mental illness is far more common than we realize. According to the National Alliance on Mental Illness, in any given year 20% of American adults experience symptoms of a mental illness.  This means that 1 in every 5 people are experiencing symptoms of depression, anxiety, bipolar disorder, adjustment disorders, PTSD and many other mental illnesses each year. Some may argue that those statistics might not represent the Church, as a faith and hope in Christ would offer a way out of these symptoms. However, if the Church is doing its job to reach the hurting, then our churches should be filled with more suffering, not less.

Notice that the statistic says 1 in 5 each year. That means that mental illness is not forever. Many people experience a single episode of depression that resolves with temporary medication and treatment and they never experience mental illness again. For others, mental illness is a chronic disease that requires life-long management. The Church can and should be a beacon of hope to the suffering, and hopefulness has a healing impact spiritually, psychologically, and biologically. But as with any illness, simply becoming a Christian will not make the symptoms go away. It is in this way that we as the Church must have a continual response of acceptance, love, and understanding to avoid stigmatizing and shaming those who continue to struggle throughout their journey with Christ.