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Archive for the ‘Biblical Counseling’ Category

Don’t Hide Your Hurt, Heal Your Marriage

SOURCE:  Taken from an article by Mark Merrill

Wounds in a marriage, big or small, can be difficult to deal with. During a recent conversation with a friend who has been navigating through some painful things in his own marriage, I realized that there’s an important choice that faces every man and woman when dealing with these wounds in marriage. Every husband and wife can either choose to cover festering wounds in their relationship and prevent healing or choose to expose those wounds and promote healing.

There are several reasons why a spouse or couple might try to leave untreated, or even hide, the hurtful wounds in their marriage instead of exposing them. Here are just a few:

Pride – They refuse to admit to their spouse that they’ve done anything wrong in the relationship to contribute to the hurt. Or, they worry about being embarrassed and what a spouse, family, or friends would think if they really knew what happened to them.

Fear – They fear what they might lose if the hurt is exposed, and that loss seems to outweigh any good they might gain from getting healthy.

Shame – They already feel guilty about some of the things they have done or have been done to them, and don’t want or need anyone else to pile on.

Pain – Maybe the pain is all they’ve really ever known and so they just live with it because it’s tolerable.

Hopelessness – They think, “What’s the use. We’ve talked about this over and over, but the same hurtful things are still being done. My spouse is never going to change. Things are never going to be different.”

In one of my posts, “Confession: My Wife and I Struggle Too,” I shared some challenges we’ve had in our marriage. Fortunately, they are all fixable issues we’ve worked through or are working on. What did Susan and I do to address these struggles and the ways we’ve sometimes hurt one another? We looked for credible, encouraging, experienced voices in books, other marriage resources, and seminars. We worked hard to identify problems, confess them, apologize to each other, and commit to working through them–together.

We also recognized that sometimes we needed an outside perspective. We have found those perspectives in places like a marriage class at church, a close, trusted couple we’ve known for years, and a marriage counselor. Yep…Mark and Susan Merrill have needed to lean on a professional counselor a time or two. And we wouldn’t change a thing. Read my previous blogs on 4 Ways to Know When It’s Time for Marriage Counseling and Finding a Good Marriage Counselor: Stacking the Deck in Your Favor. Here are some more steps on How to Heal a Wounded Heart.

So today, instead of ignoring or hiding your hurt, open it up and start treating it. Only then will the healing begin.

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Family Systems Change

SOURCE:  Prepare/Enrich

I’ve always been interested in how my family operated.

I can remember specific times in my life where I could see how I thought my family system was about to change. As a 14 year-old, I wrote a paper about my perspective on my sister’s upcoming wedding. I clearly remember stating my point of view that I was not losing a sister, but gaining a brother. Eight years later, while in college, I lost my grandmother unexpectedly, and I watched my entire family figure out how to handle the new void in the system. And now, I write this newsletter as I await the birth of a new niece or nephew. I know this new baby will again change our family system.

The thing is, change isn’t bad. It’s inevitable though.

Family systems theory, the basis of many counseling programs, sees the family as an emotional unit. When one part of the system changes, the system needs to re-calibrate. Changes in the system also happen when the functioning of a family member changes. The connectedness and reactivity within the family unit make the functioning of family members interdependent. The same happens when a family member is added or removed from the system. Sometimes this transition happens over time such as adding family members through marriage, adoption, or birth. There are other times where it is not planned, like a death in the family.

While change is hard, it can also be beautiful.

Adding family members allows the opportunity to create new bonds and relationships that last a lifetime. But, it’s important to acknowledge that the transition can be bumpy. Some family members won’t be welcoming, some won’t like the change, and others may wish it was like the “old days.”

Don’t feel like you need to combat these feelings.

We have some tips for how to manage when your family system changes:

  • Hear them out.  Listen, listen, and listen some more to your family members who are having a hard time adapting to the “new” dynamics. Their feelings are valid and its crucial to not outcast them in the transition process.
  • Give it time.  Don’t expect your family or yourself to be completely comfortable right away. It’s natural for some time to pass before a new “normal” sets in.
  • Encourage openness.  Embrace change yourself and model for others how to be open to changes that happen in the family system.
  • Establish new bonds.  Identify new family traditions or “special” moments with that new family member. This can be as simple as an inside joke with your new brother-in-law or a special tradition you create each time you have the birth of a new baby.

 




5 Indicators of an Evil Heart

SOURCE:  Leslie Vernick

As Christian counselors, pastors and people helpers we often have a hard time discerning between an evil heart and an ordinary sinner who messes up, who isn’t perfect, and full of weakness and sin.

I think one of the reasons we don’t “see” evil is because we find it so difficult to believe that evil individuals actually exist. We can’t imagine someone deceiving us with no conscience, hurting others with no remorse, spinning outrageous fabrications to ruin someone’s reputation, or pretending he or she is spiritually committed yet has no fear of God before his or her eyes.

The Bible clearly tells us that among God’s people there are wolves that wear sheep’s clothing (Jeremiah 23:14Titus 1:10Revelations 2:2). It’s true that every human heart is inclined toward sin (Romans 3:23), and that includes evil (Genesis 8:21James 1:4). We all miss God’ mark of moral perfection. However, most ordinary sinners do not happily indulge evil urges, nor do we feel good about having them. We feel ashamed and guilty, rightly so (Romans 7:19–21). These things are not true of the evil heart.

Below are five indicators that you may be dealing with an evil heart rather than an ordinary sinful heart.  If so, it requires a radically different treatment approach.

They twist the facts, mislead, lie, avoid taking responsibility, deny reality, make up stories, and withhold information. (Psalms 5:810:758:3109:2–5140:2Proverbs 6:13,146:18,1912:1316:2016:27, 2830:14Job 15:35Jeremiah 18:18Nehemiah 6:8Micah 2:1Matthew 12:34,35Acts 6:11–132 Peter 3:16)

2. Evil hearts are experts at fooling others with their smooth speech and flattering words.

But if you look at the fruit of their lives or the follow through of their words, you will find no real evidence of godly growth or change. It’s all smoke and mirrors. (Psalms 50:1952:2,357:459:7101:7Proverbs 12:526:23–2626:28Job 20:12Jeremiah 12:6Matthew 26:59Acts 6:11–13Romans 16:17,182 Corinthians 11:13,142 Timothy 3:2–53:13Titus 1:10,16).

3. Evil hearts crave and demand control, and their highest authority is their own self-reference.

They reject feedback, real accountability, and make up their own rules to live by. They use Scripture to their own advantage but ignore and reject passages that might require self-correction and repentance. (Romans 2:8Psalms 1036:1–450:16–2254:5,673:6–9Proverbs 21:24Jude 1:8–16).

4. Evil hearts play on the sympathies of good-willed people, often trumping the grace card.

They demand mercy but give none themselves. They demand warmth, forgiveness, and intimacy from those they have harmed with no empathy for the pain they have caused and no real intention of making amends or working hard to rebuild broken trust. (Proverbs 21:101 Peter 2:16Jude 1:4).

5. Evil hearts have no conscience, no remorse.

They do not struggle against sin or evil—they delight in it—all the while masquerading as someone of noble character. (Proverbs 2:14–1510:2312:1021:27,29Isaiah 32:6Romans 1:302 Corinthians 11:13–15)

If you are working with someone who exhibits these characteristics, it’s important that you confront them head on. You must name evil for what it is. The longer you try to reason with them or show mercy towards them, the more you, as the Christian counselor, will become a pawn in his or her game.

They want you to believe that:

1. Their horrible actions should have no serious or painful consequences.

When they say “I’m sorry,” they look to you as the pastor or Christian counselor to be their advocate for amnesty with the person he or she has harmed. They believe grace means they are immediately granted immunity from the relational fallout of their serious sin. They believe forgiveness entitles them to full reconciliation and will pressure you and their victim to comply.

The Bible warns us saying, “But when grace is shown to the wicked, they do not learn righteousness; even in a land of uprightness they go on doing evil and do not regard the majesty of the Lord (Isaiah 26:10).

The Bible tells us that talking doesn’t wake up evil people, but painful consequences might. Jesus didn’t wake up the Pharisee’s with his talk nor did God’s counsel impact Cain (Genesis 4). In addition, the Bible shows us that when someone is truly sorry for the pain they have caused, he or she is eager to make amends to those they have harmed by their sin (see Zacchaeus’ response when he repented of his greed in Luke 19).

Tim Keller writes, “If you have been the victim of a heinous crime. If you have suffered violence, and the perpetrator (or even the judge) says, ‘Sorry, can’t we just let it go?’ You would say, ‘No, that would be an injustice.’ Your refusal would rightly have nothing to do with bitterness or vengeance. If you have been badly wronged, you know that saying sorry is never enough. Something else is required—some kind of costly payment must be made to put things right.”1

As Biblical counselors let’s not collude with the evil one by turning our attention to the victim, requiring her to forgive, to forget, to trust again when there has been no evidence of inner change. Proverbs says, “Trusting in a treacherous man in time of trouble is like a bad tooth or a foot that slips” (Proverbs. 25:19). It’s foolishness.

The evil person will also try to get you to believe

2. That if I talk like a gospel-believing Christian I am one, even if my actions don’t line up with my talk.

Remember, Satan masquerades as an angel of light (2 Corinthians 11:13–15). He knows more true doctrine than you or I will ever know, but his heart is wicked. Why? Because although he knows the truth, he does not believe it or live it.

The Bible has some strong words for those whose actions do not match their talk (1 John 3:17,18Jeremiah 7:8,10James 1:22, 26). John the Baptist said it best when he admonished the religious leaders, “Prove by the way you live that you have repented of your sins and turned to God” (Luke 3:8).

If week after week you hear the talk but there is no change in the walk, you have every reason to question someone’s relationship with God.

Part of our maturity as spiritual leaders is that we have been trained to discern between good and evil. Why is that so important? It’s important because evil usually pretends to be good, and without discernment we can be easily fooled (Hebrews 5:14).

When you confront evil, chances are good that the evil heart will stop counseling with you because the darkness hates the light (John 3:20) and the foolish and evil heart reject correction (Proverbs 9:7,8). But that outcome is far better than allowing the evil heart to believe you are on his or her side, or that “he’s not that bad” or “that he’s really sorry” or “that he’s changing” when, in fact, he is not.

Daniel says, “[T]he wicked will continue to be wicked” (Daniel 12:10), which begs the question, do you think an evil person can really change?

Helping victims of domestic abuse: 4 pitfalls to avoid

SOURCE: Dr. Diane Langberg/Careleader.org

To understand domestic abuse properly, let’s start with the word abuse, which comes from the Latin word abutor, meaning “to use wrongly.” It also means “to insult, violate, tarnish, or walk on.” So domestic abuse, then, occurs when one partner in the home uses the other partner for wrong purposes. Anytime a human being uses another as a punching bag, a depository for rage, or something to be controlled for that person’s own satisfaction, abuse has occurred. Anytime words are used to demean or insult or degrade, abuse has occurred. And anytime there is intimidation and threats and humiliation, abuse has occurred.

Domestic abuse is something you as a pastor may encounter, or it may be a “silent sin” within the church that goes unseen. Either way, it is a reality, and one for which we must be prepared. But how do we do this? How can we prepare to minister to victims of domestic abuse? Below, I share four common pitfalls of pastors and leaders, then conclude by explaining how the church is called to act in these situations.

Pitfall #1: Not realizing the frequency of abuse

We need to realize just how frequently abuse happens. We are surprised by it in the church, but statistically 20 percent of women in this country will experience at least one episode of violence with a husband or partner.

That’s almost one-third of women, and that includes women in the church.

20% of women in this country will experience at least one episode of violence with a husband or partner.

Further, more than three women are murdered each day by their husbands or boyfriends.

Or here’s another statistic: pregnant women are more likely to be victims of homicide than to die of any other cause.

That is astounding. And again, those numbers don’t change when you survey women within the church.

Pitfall #2: Not calling abuse what it really is

One of the most important things we can do is call abuse what it really is, because people have a tendency to rename abuse into other things. For example, an abuser might say, “I was upset from a bad day at work … which is why I turned the table over, broke the dishes, and hit my spouse,” or “It was a mistake.” Abusers use words to minimize what has been done and make it seem normal. And unfortunately, those trying to help do the same thing, saying things like “Can’t you forgive so-and-so for that mistake?”

But domestic abuse is not a mistake. It is abuse; it meets the definition of abuse. So we have to call it what it is, because we are called to the truth. We have to call things by their rightful name. By changing the wording, we diminish the gravity of the sin.

Pitfall #3: Encouraging submission despite abuse

Sadly, many women have been beaten, kicked, and bruised, and then return home in the name of submission. Worse, many of these women have been sent home in the name of submission. But submission does not entitle a husband to abuse his wife.

Unfortunately, this instruction is one of the biggest mistakes pastors and church leaders have been known to make. So many women are sent home by church leaders to be screamed at, humiliated, and beaten, sometimes to death. Their husbands can break their bones, smash in their faces, terrify their children, break things, forbid them access to the money, and all sorts of things, but they are told to submit without a word and be glad for the privilege of suffering for Jesus.

Pitfall #4: Protecting the institution of marriage instead of the victim

Domestic violence is a felony in all fifty states. So, to send people home and not deal with it, not bring it into the light, and not provide safety is to be complicit in lawbreaking, which is also illegal. In sending women home, the church ends up partnering in a crime. But it is not the church’s call to cover up violence. Paul says in Ephesians 5 to expose the deeds of darkness so the light can shine in. That’s the only way there is hope for truth and repentance and healing.

I also find one of the things that confuses Christians is we think that if we take the wife and children out of their home to bring them to a safe place, for example, we are not protecting “the family.” We say that we have to protect the family because it is a God-ordained institution, which it is. But what we forget is that God does not protect institutions, even ones He has ordained, when they are full of sin.

It’s easy for us to forget that truth, and particularly when we know those who are abusive, we tend to want to believe them. We don’t understand how incredibly deceitful and manipulative they are, deceiving first themselves and then others. We think we can tell when people are lying—even though the Scriptures say we are all so deceitful, we can’t even know the depths of it. But we are deceived into thinking that they wouldn’t do something so severe. And while we think we are doing the right thing by believing or trusting them, we are actually completely opposed to Scripture.

The calling of the church

The church is called to be the church. What that means is that we are called to protect the vulnerable and the oppressed; that’s all through the Scriptures. And we are called to hold others accountable, despite the tough road to repentance, even if they are our best friends.

So when a pastor hears from a woman that she is being abused in her home, the first step is to find out what that means. It could be verbal abuse, or it could be that her life is in danger, and she and her children need to be taken out of the home and put in a safe place.

Unfortunately, though, not all victims of domestic abuse feel that they are able to leave, a source of frustration for many caregivers. The vast majority of women in these situations love their husbands and want their marriage to work, and many times, the husband assures her that he won’t do it again. She wants her husband, so she keeps going back. So while we want to ensure her safety by not sending her back to an abusive home, we also want to give her the dignity of being able to make her own decision, which he does not give her.

We must also have the humility to involve other authorities like the police, if need be. They are God-given authorities for matters such as these, but it can be a bit of a revolving door. If she wants to report the abuse to the police, go with her to the police. If she needs to file a protection order, go with her to the courthouse. We must walk with her as she makes her decision.

As pastors and leaders, we must not minimize abuse, nor should we teach women that submission means being a punching bag, even a verbal one. We also cannot minimize the gravity of the issue or be naïve to its prevalence in the church. Instead, the church is called to love and protect those who are vulnerable, to walk with them and care for them well.

3 Common Mistakes of Addicts’ Families

SOURCE: Taken from an article by 

Families of addicts feel desperate to help their loved ones stop abusing drugs or alcohol. However, if their desperate, though understandable, responses to their loved one’s behavior are not informed by biblical principles, they will unwittingly and sometimes tragically do more harm than good. Here are some of the common mistakes families of addicts make, followed by tips on how to help families become aware of what they need to change.

Mistake #1: Trying to control the addict

Sometimes families try to control the behavior of an addicted member by limiting that person’s access to funds, monitoring his or her time, or keeping constant tabs on the addict’s whereabouts.

Unfortunately, this approach frustrates the addict and becomes an excuse for him or her to entrench deeper into drug or alcohol abuse. Though trying to control a loved one’s addiction is counterproductive, it is understandable. Families are desperate to keep their loved one from taking illegal drugs or drinking alcohol. And they may experience a small measure of peace when they know their loved one isn’t getting into trouble. But such a high level of control is impossible to maintain in the long term. Plus, exerting so much control stresses out family members who end up becoming more aware of all the many things they can’t control while trying to police their loved one. Dr. Joseph Troncale, medical director at Retreat Premiere Addiction Treatment Centers in Lancaster County, PA, says, “Family members with addicted loved ones would do well to consider becoming familiar with Al-Anon1 principles: (1) you didn’t CAUSE the addiction; (2) you can’t CONTROL the addiction; and (3) you can’t CURE the addiction.”

Mistake #2: Enabling the addict

Trying to love the addict, some family members enable that person to continue his or her destructive behavior. “They’re trying to please this family member and make him or her happy, and they do so in ways that are just encouraging sin. Rather than taking a stand and reproving, they’re encouraging the sin to take place,” said Dr. Mark Shaw, executive director of Vision of Hope in Lafayette, IN, and an ordained minister, biblical counselor, and certified drug and alcohol abuse counselor.2

The family may also enable out of fear of losing the relationship (e.g., a child has threatened never to speak to his parents again if they don’t pay his rent) or of violent retaliation (an addict may lash out violently if kept from her drug of choice). If fear for one’s safety motivates an enabling situation, you should address this first.

Mistake #3: Ignoring the needs of other family members

Often, families ignore the needs of other family members by focusing all their attention on caring for the addict. When this happens, those who are ignored can become bitter toward their parents or their addicted family member because the addict receives all of the attention, time, and resources. Siblings become bitter because their college funds are used to fund rehab. Spouses give up on marriages because their partners are consumed with their child’s addiction. Children who would excel in school don’t because a parent’s addiction robs them of the support and encouragement they’d typically receive. Neglected family members are often tempted to turn to unhelpful ways of coping with the pain and instability caused by living with an addict.

How to help the families of addicts recognize the effects of their actions

While it may be clear to you that the family is hurting their loved one or that they are not acting in his or her best interest, the family members may not be aware of this. In fact, they may believe that their approach is wise, is in the best interest of the family, and keeps the loved one from living on the street. So how do you get them to see what they’re doing wrong?

One of the best ways to do this is to ask them questions that help them see the effect their behavior is having upon their loved one. Author, counselor, and CareLeader.org’s own Dr. Jeff Forrey says that questions should elicit facts that help loved ones see the consequences of their actions.

He also points out that while it is important to help people understand the impact of their choices, it’s also important for family members to realize what’s not happening as a result of their choices. For example, ignoring the actions of an addicted family member may keep the peace, but the addict does not learn how his or her behavior is affecting others, and family members do not learn how to deal with conflict. Devoting hours to controlling behavior may not seem detrimental to the mother of an addict until she is led to realize how other family members are being neglected.

Guiding families to wiser responses

Once family members become aware of the immediate consequences of their behavior, you can also help them think through the long-term implications of their behavior. Once they realize the futility of their actions, here are a few truths that you may want to guide families of addicts to realize.

Truths for those who tend to control
Help family members realize there is so much that they can’t control. Consider reminding the family that God is the one who is ultimately in control of the situation and that He is able to rescue and work all things for good. Philippians 3:21 reminds us that His power “enables him to bring everything under his control.”

Families attempting to control an addict often fear the consequences of addiction. Remind them that God has a history of using bad things—even the consequences of sin—for good and, ultimately, His glory. This is a difficult truth for family members to accept, especially because ultimately it means wrestling with the idea that God could use even the death of their loved one for His purposes. Even the most mature believers may struggle to be at peace with the simultaneously heartbreaking and comforting realities of God’s sovereignty. So be patient with families struggling to embrace the idea that God is in control.

You can also explore other possible motives family members may have for trying to control the addict. A desire to keep others from finding out about the situation can be problematic, for example, when it is rooted in the family’s desire to protect its own reputation.

You can explain to families that the addict is worshipping the substance: the alcohol or drug has become his or her god, and no amount of human control can break the bonds of spiritual slavery at play.

As you suggest new ways family members can interact with the addict, a simple verse like Proverbs 3:5 can help family members: “Trust in the LORD with all your heart and lean not on your own understanding.” Encourage family members to pray and trust that the Holy Spirit will help them learn to embrace God’s ways of responding to sin and not trust their instincts.

Truths for those who enable
Remind families with tendencies to enable that protecting the addict from experiencing the consequences of the behavior shows a wrong understanding of how God loves His children. The family members may think they are showing God’s love, forgiveness, and mercy, but forget that God still allows His children to reap what they’ve sown. When dealing with an addict, Christians can and should allow people to experience the consequences of their behavior.

Proverbs 3:12 reminds us of another side of God’s love: “The LORD disciplines those he loves, as a father the son he delights in.” And Ephesians 5:11 states that Christians are not called to hide but to bring to light the sins of others: “Have nothing to do with the fruitless deeds of darkness, but rather expose them.”

When counseling an addict’s family, help them consider whether their response is somehow facilitating addictive behavior. Disciplining an adult child, spouse, or other adult family member may not be possible or appropriate. But you can help them see that taking steps to stop destructive behavior (not enabling, but allowing people to experience the consequences of their behavior) is consistent with God’s character.

Psychiatric Meds: Should I or Not?

SOURCE:  Brad Hambrick/CareLeader

“Pastor, should I take psychiatric meds?”

Let’s begin this discussion by placing the question in the correct category—whether an individual chooses to use psychotropic medication in his struggle with mental illness is a wisdom decision, not a moral decision. If someone is thinking, “Would it be bad for me to consider medication? Is it a sign of weak faith? Am I taking a shortcut in my walk with God?” then he is asking important questions (the potential use of medication) but placing them in the wrong category (morality instead of wisdom).

 Better questions would be:
  • How do I determine if medication would be a good fit for me and my struggle?
  • What types of relief should I expect medication to provide, and what responsibilities would I still bear?
  • How would I determine if the relief I’m receiving warrants the side effects I may experience?
  • How do I determine the initial length of time I should be on medication?

In order to answer these kinds of questions, I would recommend a six-step process. This process will, in most cases, take six months or more to complete. But it often takes many months for doctors and patients to arrive at the most effective medication option, so this process does not elongate the normal duration of finding satisfactory medical treatment.

Having an intentional process is much more effective than making reactionary choices when the emotional pain (getting on medication) or unpleasant side effects (getting off medication) push a person to “just want to do something different.” With a process in place, it is much more likely that what is done will provide the necessary information to make important decisions about the continuation or cessation of medication.

Preface: This six-step process assumes that the individual considering medication is not a threat to self or others, and is capable of fulfilling basic life responsibilities related to personal care, family, school, and work. If this is not the case, then a more prompt medical intervention or residential care would be warranted.

If you are unsure how well your church member is functioning, then encourage him to begin with a medical consultation or counseling relationship. If he would like more time with his doctor than a diagnostic and prescription visit, suggest that he ask the receptionist if he can schedule an extended time with the physician for consultation on his symptoms and options.

Step 1: Assess life and struggle

Most struggles known as mental illness do not have a body-fluid test (i.e., blood, saliva, or urine) to verify their presence. We do not know a “normal range” for neurotransmitters like we do for cholesterol. The activity of the brain is too dynamic to make this kind of simple number test easy to obtain. Gaining neurological fluid samples would be highly intrusive and more traumatic than the information would be beneficial. Brain scans are not currently cost-effective for this kind of medical screening and cannot yet give us the neurotransmitter differentiation we would need.

For these reasons, the diagnosis for whether a mental illness has a biological cause is currently a diagnosis-by-elimination in most cases. However, an important part of your church member’s initial assessment should be a visit to his primary care physician. Encourage your church member to:

  • Clearly describe the struggles/symptoms he is experiencing.
  • Describe when each struggle/symptom began.
  • Describe the current severity of each struggle/symptom and how it developed.

As the person prepares for this medical visit, it would be important for him to also consider:

  • What important life events, transitions, or stressors occurred around the time his struggle began?
  • What is the level of life-interference he is experiencing as a result of his struggle?
  • What lifestyle or relational changes would significantly impact the struggle that he’s facing?

Step 2: Make needed nonmedical changes

Medication will never make us healthier than our current choices allow. Our lifestyle is the “ceiling” for our mental health; we will never be sustainably happier than our beliefs and choices allow. Medication can correct some biological causes and diminish the impact of environmental causes to our struggles. But medication cannot raise one’s mental health potential above what that person’s lifestyle allows.

Too often people want medication to make over their unhealthy life choices in the same way they expect a multivitamin to transform an unhealthy diet. They assume that the first step toward feeling better is receiving a diagnosis and prescription. This may be the case, and there is no shame if it is, but it need not be the guiding assumption.

Encourage your church member to look at the lifestyle, beliefs, and relational changes that his assessment in step 1 would require. If there are choices he could make to reduce the intensity of his struggle, is he willing to make them? Undoubtedly these changes will be hard, or he would have already done so. But let him know that they are essential if he wants to use medication wisely.

As your church member identifies these changes, he should assess the areas of sleep, diet, and exercise. Sleep is vital to the replenishing of the brain. Diet is the beginning of brain chemistry—our body can create neurotransmitters only from the nutrition we provide it. Exercise, particularly cardiovascular, has many benefits for countering the biological stress response (a primary contributor to poor mental health). The first “prescription” should be eight hours of sleep, a balanced diet high in antioxidants, and cardiovascular exercise for at least thirty minutes three days a week.

A key indicator of whether your church member is using psychotropic medication wisely is whether he is using medication (a) as a tool to assist him in making needed lifestyle and relational changes, or (b) as an alternative to having to make these changes. Option A is wise. Option B results in overmedication or feeling like “medication didn’t work either” as he continually tries to compensate medically for the volitional neglect of his mental health.

Step 3: Determine the nonmedicated baseline for mood and life functioning

This is an important, and often neglected, step. Any medication is going to have side effects. The most frequent reason people stop taking psychotropic medications, other than cost, is because of their side effects.

If your church member is not careful, he will merely want to feel better than he does “now.” Initially “now” will be how he feels without medication. Later “now” will be how he feels with medication’s side effects. In order to avoid this unending cycle, there needs to be a baseline of how he feels when he lives optimally off of medication.

One of the reasons postulated for why placebos often have as beneficial an effect as psychotropic medication is the absence of side effects. Those who take a placebo get all the benefits of hope (doing something they expect to improve their life) without any unpleasant side effects. Getting the baseline measurement of how life goes when one simply practices “good mental hygiene” is an important way to account for this effect.

“As I practice medicine these days, my first question when a patient comes with a new problem is not what new disease he has. Now I wonder what side effects he is having and which drug is causing it,” says Charles D. Hodges, MD, in his book Good Mood Bad Mood.

There is another often overlooked benefit of step 3. Frequently people get serious about living more healthily at the same time life has gotten hard enough to begin taking medication. This introduces two interventions (medication and new life practices), maybe three or four (often people also begin counseling or being more open with friends who offer care and support), at the same time. It becomes very difficult to discern which intervention accounts for their improvements.

Writing out his answers to the following questions will help your church member discern if he needs to move on to step 4 and make the needed assessment in step 5.

  • What were the struggles that initially made me think I might benefit from medication?
  • How intense were these struggles, and how did they manifest themselves?
  • What changes did I make in my lifestyle and relationships to alleviate these struggles?
  • How effective was I at being able to make the needed changes?
  • How much relief did the lifestyle and relational changes provide for my struggles?
  • How do I anticipate medication would assist me in being more effective at these changes?

Step 4: Begin a medication trial

If your church member’s struggles persist to a degree that is impairing his day-to-day functioning, then you should encourage him to seek out a psychiatrist or other physician for advisement about medical options. In this conversation, he should consider asking the physician the following questions:

  • What are the different medication options available for the struggle I’m facing?
  • What does each medication do that impacts this struggle?
  • What are the most common side effects for each medication?
  • How long does it take this medication before it is in full effect?
  • If I choose to come off this medication, what is the process for doing so?
  • What have been the most common affirmations and complaints of other patients on this medication?

These questions should help him work with his doctor to determine which medication would be best for him. Remind your church member that he has a voice in this process and should seek to be an informed consumer with his medical treatment, in the same way he would for any other product or service.

In this consultation your church member will also want to decide upon the initial period of time to remain on the medication (unless he experiences a significant side effect from it). In determining this length of time, he would want to consider:

  • His physician or psychiatrist will make recommendations based upon additional factors (beyond the scope of this article)
  • Staying on the medication a minimum of at least twice the length of time it takes to reach its full effect
  • Significant life stressors that would predictably arise during this trial period (e.g., planning a wedding)
  • How long it would take to make and solidify changes that were difficult to make without medication (see step 3)

Once this set period of time is determined, your church member’s goal is to continue implementing the changes he began in step 3 while monitoring (a) the level of progress in his area of struggle and (b) any side effects from the medication.

Step 5: Assess level of progress against medication side effects

Near the end of the trial period, your church member should return to the life assessment questions he answered at the end of step 3. He should compare his ability to enjoy and engage life at this point with his answers then. The questions to ask are:

  • What benefits have I seen while on medication?
  • What side effects have I experienced?
  • Is there reason to believe my continued improvement is contingent upon my continued use of medication?
  • Are the side effects of medication worth the benefit it provides?

The more specific he was in his answers at the end of step 3, the easier it will be for him to evaluate his experience at the end of step 5. At this point, encourage him to try to be neither pro-medication nor anti-medication. His goal is to live as full and enjoyable a life as possible. It is neither better nor worse if medication is part of that optimal life.

Step 6: Determine whether to remain on medication

At this point in the process there are several options available to the individual; this is more than a yes/no decision. But any option should be decided in consultation with the prescribing physician or psychiatrist. Your church member can decide to:

  • Remain on medication because the effects are beneficial and the side effects are minimal or worth it.
  • Opt to stage off the medication because the benefits were minimal or the side effects were worse than the benefits.
  • Stage off the medication to see if the progress he made can be maintained without medication, knowing that if not, he is free to resume the medication without any sense of failure.
  • Opt to try a different medication for another set period of time based on what he learned from the initial experience.

Regardless of what he chooses, by following this process he can have the assurance that he is making an informed decision about what is the best choice for him.

How Worry Affects You (and others)

SOURCE:  Tim Lane/CareLeader

Surprising ways worry affects your people

Any quick search on Google or Amazon will confirm what we all already know: worry is harmful to our bodies. Here are a few physical symptoms associated with worry:

  • Difficulty swallowing
  • Dizziness
  • Dry mouth
  • Fast heartbeat
  • Fatigue
  • Headaches
  • Muscle aches
  • Muscle tension
  • Nausea
  • Rapid breathing
  • Sweating
  • Trembling and twitching

You can almost get exhausted and anxious reading that list. All of these can be experienced to varying degrees depending on how severe a person’s worrying is. Most of the people in your church can probably identify many of these anxiety-producing experiences.

Unfortunately, this is not the only way people in your congregation are impacted by worry. If not addressed, it can have a bigger impact on one’s overall health. People who worry consistently are more prone to the following physical consequences:

  • Suppression of the immune system
  • Digestive disorders
  • Short-term memory loss
  • Premature coronary artery disease
  • Heart attack

In light of this, it is not surprising when we discover the original meanings of the words we use today to talk about worry and anxiety. The English word worry comes from the Old English word meaning “strangle.” The word anxiety is of Indo-Germanic origin, referring to suffering from narrowing, tightening feelings in the chest or throat.

Statistics reveal that nearly 20 percent of people living in the United States will experience life-debilitating anxiety annually. That is nearly 65 million people! In 2008, American physicians wrote more than 50 million prescriptions for anti-anxiety medications and more than 150 million prescriptions for antidepressants, many of which were used for anxiety-related conditions.

What would the doctor say?

Physicians and counselors will tell you that diet, exercise, rest, and some kind of meditation is a proven help to the person  struggling with anxiety. Sometimes medication, when taken wisely, can be helpful. You can use your body to fight what is actually trying to undermine it. No one can deny that. But is there another part of dealing with worry that you could share with those imprisoned by worry?

While these things are important, the people in your church also need to know how to connect to God when worries come. We all need God’s grace even if we are going to pursue exercise and diet in a way that is most helpful. Let’s consider the most fundamental aspect that must undergird everything else we do when taking care of our bodies.

What would Jesus say?

Jesus lived at a time in human history that was very unpredictable and less safe than ours. It was a world in which worry was epidemic, too. In every instance where He encouraged people not to worry, He did so with compassion because He knew firsthand what it felt like to be a human being. In Luke 12:32, He spoke these encouraging words to anxious people: “Do not be afraid, little flock, for your Father has been pleased to give you the kingdom.” Those simple words sum up all that Jesus said over and over again. He commands them not to worry, but His command is one of encouragement, not shame.

Here are a few simple but profound phrases and truths based upon that passage that you can share with those in your congregation.

Do not be afraid …

Jesus knows that worry is a serious problem. He knows it is bad for you physically, as well as spiritually, and He gets right to the point because He loves you. His commands are always for your good. Whenever you are struggling with worry, it is connected to your relationship with God. The word worry that Jesus uses means “a divided mind.” Within the broader context of His teaching, Jesus says that worry happens when you try to love God and something in creation at the same time. As soon as you do this, you have begun to put your hope and security in something other than God. Anything else besides God is unstable (money, a relationship, a job, education, your own moral record, obedient children, your health). Do you see why Jesus is so straightforward? He cares for you. He knows that you can’t serve two masters (Matt. 6:24).

Little flock …

Don’t let this little phrase that Jesus utters evade you. Don’t miss those two powerful words:little flock. While Jesus challenges you to not worry or fear, He speaks to you as one who belongs to Him, whom He is shepherding and for whom He laid down His life. You are unimaginably dear to Him and loved by Him. You are one of His sheep. Be reassured—He cares for you and loves you even as you struggle with worry, even as you forget Him and His care and give in to your tendency to worry. You may be prone to wander, but you will always be part of His flock.

For your Father has been pleased to give you the kingdom …

Your Father is not only going to care for you now, He is in the process and will ultimately give you His kingdom. Your future is certain and you can begin to experience it even now, because His kingdom has broken into your life by the presence of the Holy Spirit. He is a deposit guaranteeing that you will get it all one day. So, right now, in the ups and downs of life, the stresses and strains of the uncertain future, let the certainty of your eternal future be what you cling to.

With all of this in mind, encourage those in your congregation to allow the truth of God’s care for them to work its way into their daily life. We are to prioritize the kingdom by viewing everything through the lens of our faith. When we begin to live for God instead of the things of the world, we may find that our tendency to worry will lessen and our response to God and to the world, spiritually and physically, will change dramatically.

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