Madeleine Davies

Bible therapy? CBT and Scripture

In Uncategorized on January 5, 2016 at 10:53 am

There is a famous passage in the Bible where Paul tells the early church to “take captive every thought to make it obedient to Christ”. Deploying the language of war, he lays claim to a divine power that can be mobilised to destroy arguments and “every pretension that sets itself up against the knowledge of God”. Just how difficult it can be to take control over thoughts is articulated by John Donne in the Holy Sonnet that begins “Batter my heart”, in which he urges God to take his heart by force. “Reason, your viceroy in me, me should defend, / But is captive, and proves weak or untrue.”

The idea of an internal war, of the fight to lay hold of our thoughts because of the sway they enjoy over our feelings, is central to the principle of cognitive therapy. In fact, Dr Pablo Martinez, a Spanish psychiatrist, believes that we can find in Paul’s instruction “the embryo of cognitive therapy”. 

His belief that “cognitive behavioural therapy has a strong biblical foundation” is founded in several texts, which he explored at a recent conference on emotional health and Christian theology. A favourite is Psalm 103, in which the psalmist repeatedly exhorts himself to praise God (“Praise the LORD, O my soul; / all my inmost being, praise his holy name”) before rehearsing the blessings God has shown to men. For Dr Martinez, this is cognitive therapy in action, somebody purposefully taking captive his thoughts. He gives his patients the illustration of a mind with two rooms: a cellar which is “the place of problems, with reasons to be worried and anxious” and the attic “where you can see the view, a place of light, vision and encouragement”. In this psalm he sees David making a effort to ascend to gain a more helpful perspective, “working himself up to go up to the attic to see the blessings and panorama of his life”. He points too, to Philippians 4:8 in which Paul instructs the believers to think about “whatever is true, whatever is noble, whatever is right, whatever is pure, whatever is lovely, whatever is admirable”.

Dr Martinez’ observations were well-received at the conference. He is a gently-spoken doctor whose own battle with a rare eye disease informs “A Thorn in the Flesh”, in which he suggests acceptance of chronic suffering can be achieved through God’s grace. But it was interesting to hear other Christian perspectives on cognitive therapy, particularly given its prominence in the NHS and Christians’ reported concerns about receiving therapy from those who do not share their faith.

For Dr Rob Waller, a consultant psychiatrist working for the NHS in Scotland, the first of three “irrefutable laws” for the church in its approach to mental health, is that grace must come before works. While there is a place for “work-based” treatments such as CBT, we should put grace, integration and redemption first, they must never be subject to the precondition that people first secure their own recovery. His observation that “there are many times in the church where we bring in works where grace should operate” might hark back to an age-old dispute about salvation and the primacy of grace over works, but it is also a reminder to churches not to isolate those suffering from mental distress, placing pressure on them to first attain recovery on their own before finding a place in a loving community.

Tara Gormley, a clinical psychologist who has explored the relationship between Christian faith and psychology is wary about how the captive thoughts verse has been interpreted in the past. “Psychology says the more distressed you are about having thoughts, the more likely you are to have them,” she said. “If you are told you must taken them captive, that just increases the emotion that goes with these thoughts and they are going to come back again and again”. She believes not only that psychology could gain from addressing faith as one aspect of the patient, but that the church could gain greatly from a better grounding in psychology. For example, Christians may repeat to one another Christ’s instruction “do not worry” but the key to breaking worry may be exploring people’s beliefs about it – for example, that it is uncontrollable or in some way a helpful behaviour.

What all three speakers had in common is a commitment to building a church that is better equipped to responding to the needs of those with mental health problems, and challenging Christians’ perceptions of problems such as anxiety and depression. Just as one person may need to hear that the principles behind cognitive behavioural therapy are compatible with the Bible, a congregation may need to go beyond a single verse about not worrying to explore what psychology teaches about why people worry. Tara Gormley’s own research suggests that “misunderstandings of the Bible or the Christian God, and problems in faith” can be unhelpful to Christians suffering from psychological distress. But while the church has plenty to learn from psychology, the reverse is also true. Gormley believes that Christians “possess a wealth of resources that have long been neglected in psychological literature, clinical training and practice in the UK”. Interestingly one study has shown that patients who receive a Christian form of CBT from a non-Christian therapist report better outcomes than those who receive it from a fellow believer.

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