It was nearing the end of the academic year, and one of our graduating family therapy students came to my office for a chat. She sat across from me, beaming, full of enthusiasm for her newfound clinical skills. To be frank, I don’t remember much of the conversation. But one sentence lodged forever in my mind. With a glow of delight on her face, she reported what for her was a new and exciting insight: “I don’t need Jesus to be a good therapist!”
Something in me cringed as she said this.
I didn’t take her to mean “I don’t need Jesus, period,” and to some extent, I could agree with what she said. Many excellent therapists aren’t Christians, and Christians have much to learn from them; conversely, being a follower of Christ is no guarantee of clinical wisdom or competence. Nor would I want to endorse the kind of instrumental thinking in which a relationship with Jesus becomes a mere means to some other end, even as worthy an end as becoming a skilled clinician.
Still, I couldn’t suppress the feeling that I had failed somehow in my own vocation as a teacher. I had taken too much of our students’ personal and spiritual formation for granted.
We talked for a while, but I doubt that I had much of anything constructive to say. Eventually we said farewell at my office door, and I never saw her again. But her words haunted me. Something was missing. I wasn’t sure what. But I knew that in some way it had to do with this thing we call “integration.”
But what is integration? And why does it matter?
+ “As my life continues to unfold, God seems to be combining my passion for mentoring graduate students with his vision to reach hurting people. I’ve long been in solidarity with Hispanic people, and I have been uniquely placed to provide clinical supervision as Fuller Psychological and Family Services (FPFS) has begun over the past year to provide therapy services in Spanish.” —Anne Turk Nolty, assistant professor of clinical psychology
INTEGRATION AS INTEGRITY
I have often asked our students, “How many of you came to Fuller because of our emphasis on integration?” Invariably, nearly every hand goes up.
The problem, of course, is that the word integration can connote quite different things to different people. Moreover, it’s easy to forget that the terms psychology and theology each represent a wide range of personal and professional meanings. Part of the difficulty is that, by its very nature, the academy encourages specialization and subspecialization. Expertise, as they say, consists in knowing more and more about less and less. This sets a practical limit on the extent of integration that can occur within each discipline, let alone across them.
That’s not a counsel of despair. Psychology, for example, encompasses a vast domain of empirical research, a complex array of theories of personality and behavior, and an eclectic mix of clinical practices. But no one would seriously suggest that the whole enterprise be abandoned simply because researchers, theorists, and practitioners can’t always agree. Productive and insightful work continues to be done, and many hold out the hope of greater synergy. In recent decades, for example, neuroscience has begun to serve as a common platform for discussion between professionals of quite different stripes, a trend that seems likely to continue.
But there’s an alternative to thinking of integration primarily in cross-disciplinary terms. What, we might ask ourselves, is the perceived problem to which integration is the proposed solution?
To begin with, there is the practical problem suggested above. The state of knowledge in well-established disciplines such as the social and behavioral sciences and biblical studies and theology continues to grow apace. It’s difficult enough for scholars and practitioners to keep abreast of developments in their own fields; it’s more difficult still to develop anything approaching expertise in other domains. The problem is felt keenly by dissertation students. Even if their curiosity extends across disciplines, the pragmatic reality is that they are rewarded more for specialization than cross-bench thinking.
Much of what drives the interest in integration, however, is personal and in some sense political. The relationship between the church and the profession of psychology has often been fraught with mutual suspicion. Many early writings in integration had an apologetic tone, as if a certain level of justification was needed for dabbling in such dark arts as psychology and psychotherapy. The need for such defensiveness seems to have lessened over the decades. But many of our students still come to Fuller over someone’s objections: By all means, study to be a pastor or missionary—is the message they receive, directly or indirectly, but why be a therapist?
The matter can be put in more personal terms. First, students arrive at Fuller with a set of preunderstandings shaped by their families, churches, and other social contexts. For many students, seminary is a profoundly enriching experience. But even enrichment can come at the price of deconstruction, as students have their habits of thinking about God, the Bible, and even themselves challenged in destabilizing ways.
Second, psychotherapeutic practice is neither uniformly nor unilaterally determined by empirical research (nor can we be sure that most therapists are dedicated to keeping up with their academic journals!). Theories of psychotherapy, therefore, with their assumptions about human nature and the well-lived life, often function as worldviews, or “cultures of healing.”1 To some extent, therapy consists of socializing clients into new ways of thinking and being that hopefully lead to greater satisfaction and fewer problems.
This assumes that therapists themselves have been thus socialized, quite possibly into multiple cultures of healing, and in ways that may clash with their pre-understandings. This can lead to a fragmented imagination and a compartmentalization of experience in which a person thinks one way in one context (e.g., church) and another way in the next (e.g., the clinic). The problem is thus one of “coherent construal,” to use Walter Brueggemann’s term: of being able to interpret and experience reality whole, to tell a coherent story about what is happening, how one should respond, and why.2
Beyond mere intellectual interest, therefore, one of the motivations for integration is the sense that one’s personal integrity is at stake: Is there any conflict between being a Christian and being a psychotherapist? The question isn’t unique to the practice of therapy; many Christians experience some degree of compartmentalization of faith and work, confession and profession. But therapists, who are intimately involved in helping people correct the course of their lives, may feel the question more keenly.
Thus, there is an important sense in which “the integration of psychology and theology” can be understood in academic and interdisciplinary terms, and much fruitful work has been done on that basis. To think of integration as a matter of integrity, however, emphasizes a more personal dimension. Social psychologist Ken Gergen has called it “multiphrenia”: a problem of identity, a “splitting of the individual into a multiplicity of self-investments.”3 It’s a good description, I believe, of what happens to students during their formative but frequently confusing years of graduate training.
What’s needed is a coherent narrative framework capable of holding together a developing sense of vocation as Christians and as therapists. In Fuller’s Marriage and Family program, that framework is provided by the biblical motif of peacemaking. Other models, of course, are possible. But formation requires some coherent framework, and we believe that peacemaking, along with what we call the attendant “clinical virtues”—humility, compassion, hope, and Sabbath rest—provides one that is true to the narrative of Scripture. I sketch that framework briefly below.
“A part of our role is how does God use us in that transformation process [of therapy] to challenge, to question, and to help people see the consequences of [their choices]. Another part is this beautiful intimacy when people share their lives with you in that very sacred place where, because you’ve given them that faithful, unconditional love and empowerment, now they can share their hearts and their secrets at a level of knowing and being known at the very core of their being. That is a sacred privilege for therapists. . . . We’re on our knees before God here.”
PEACEMAKING AND THE CLINICAL VIRTUES
The early chapters of Genesis provide a leitmotif that runs through the biblical narrative. What God creates is good, even very good—but sin spoils and defaces that good creation, and humanity bears the consequences. A doctrine of sin should encompass more than just the conscious and individual violation of moral norms. We are not only disobedient, but also broken and bent; we not only create and perpetuate suffering, but through our relationships we also suffer what stems from the brokenness of others.
A peacemaking perspective assumes that creation was originally suffused by shalom, a rich biblical term for peace that conveys much more than the mere absence of conflict. Shalom is the presence of contentment, wholeness, and justice. Sin sunders shalom; in Cornelius Plantinga’s memorable phrase, a world broken by sin is “not the way it’s supposed to be,” not the way God intended.4
Psychotherapists must deal with brokenness of every kind: physical, emotional, spiritual, relational. The work can be difficult and draining. Under professional strictures of confidentiality, therapists find themselves carrying burdensome stories of suffering that they cannot tell to others. Many Christian therapists, moreover, work in contexts in which explicitly sharing the gospel with clients would violate ethical norms. What vision, then, will sustain them in their work?
The high-water mark of the Beatitudes is the call to be peacemakers (Matt 5:9), nestled in the context of Jesus’ teaching about the kingdom of heaven (Matt 5:3, 10). All of his disciples must understand themselves as citizens of that kingdom, making peace by participating in the ongoing work by which God is restoring shalom to creation. Disciples who would also be psychotherapists must bring that kingdom orientation to their work. What we thus call the clinical virtues are not ad hoc character qualities that simply make one a better therapist; they draw their unity from the internal logic of the Beatitudes.
Jesus holds up a surprising list of people as exemplifying God’s kingdom—at least surprising to those whose imaginations have not been shaped by a right understanding of prophecy (see, e.g., Luke 4:14–30; Isa 61:1–2). In Matthew 5:3–6, Jesus calls the poor in spirit and the meek blessed, together with those who mourn and hunger for justice. In Luke 6:20–22, it’s the poor and the hungry,the distraught and disenfranchised. God’s kingdom, in other words, comes by grace rather than merit and must be received as a gift. It does not belong to those whom we would vote as most likely to succeed.
The clinical virtue appropriate to such a state of affairs is humility. It is not necessarily those who come from privileged backgrounds and model families, for example, who make the best therapists. People who aspire to assist others in navigating their brokenness must know their own with clear-sighted honesty. Against the modern, almost gnostic worship of technical know-how, the humble Christian therapist stands amazed—Who, me?—at the privilege of helping others find and nurture moments of wholeness and peace.
This is active work: peacemakers are not peace-wishers. People who humbly grieve brokenness—both their own and that of others—hunger to see God make things right. And they are not content to sit idly by. Blessed through the knowledge and experience of God’s mercy, they in turn embody that mercy for others (Matt 5:7).
This is expressed through the clinical virtue of compassion, a word whose root means “to suffer with.” A therapist’s compassion, motivated by the desire to see one’s client move toward wholeness, is the foundation of the healing relationship. Many who seek counseling will say that their therapist is the first person who truly listened to them, who truly understood. No longer invisible, no longer isolated in their suffering, troubled clients begin to perceive glimmers of hope.
Therapists face hopelessness on a daily basis, and therefore need the virtuous disposition of hope themselves. Compassion, after all, is difficult to sustain. In addition to the emotional demands of what happens inside the therapy room, therapists have their own personal concerns with which to contend (and for which they need self-compassion!). Burnout and emotional exhaustion, feelings of futility and meaninglessness are ever-present possibilities, and the therapist’s own hope-full or hope-less attitude will be communicated to clients through the therapeutic relationship.
For Christians, hope entails cultivating the enduring ability to imagine present challenges in terms of the future promised by God. Even small steps toward peace can be celebrated for their participation in the divine work of restoring wholeness to creation. Every therapist faces days or weeks in which clients seem stuck with no progress in sight, tempting therapists to blame their clients’ “resistance” or to give up altogether. But as N. T. Wright reminds us:
You are not oiling the wheels of a machine that’s about to roll over a cliff. You are not restoring a great painting that’s shortly going to be thrown on the fire. . . . You are . . . accomplishing something that will become in due course part of God’s new world. . . . [W]hat we do in Christ and by the Spirit in the present is not wasted.5
Wright admits that we cannot know exactly how such things will come to pass. But we shouldn’t underestimate the value of knowing that our work is not wasted. At times, therapy can be an agonizingly slow process of growth. Against the background of a results-oriented, quick-fix culture, this can be discouraging to therapists and clients alike, and a temptation to despair. A robust eschatological vision—the vision of a hopeful future under the sovereign promise of God—may be just what a Christian therapist needs to be sustained in the virtues of humility and compassion.
Finally, therapists have long been taught the need for self-care. Some have gone as far as to propose it as an ethical imperative, since therapists who neglect their own needs risk endangering their clinical competence.6
From a peacemaking perspective, however, the language of “self-care” is too narrow; Sabbath rest, rightly understood, provides the more appropriate image. We may think of Sabbath as a break from work, and busy therapists may indeed need the enforced rest. But rest is neither an end in itself, nor a means to “enhancing the efficiency of [our] work.”7
Rather, through Sabbath rest, we cultivate a right relationship to work itself. Even God rested (Exod 20:8–11)—and we are not God. Moreover, we rest, and grant rest to others, as a sign of remembrance that we have been rescued from slavery by God’s mercy and might (Deut 5:15). In these ways, Sabbath brings us back full circle to humility, for in our rest, we remember that God’s work precedes and gives meaning to our own.
The clinical virtues of humility, compassion, hope, and Sabbath rest are narrative-dependent. In other words, their meaning and unity derive from their place in a shared story. We can consider them as character qualities, but only in the sense that they are appropriate to being a character in a particular story: the story of God’s ongoing restoration of shalom.
“We can’t just think of spirituality as an experience of transcendence. It’s something that radically changes lives, that changes the way we understand ourselves and the way we are in this world. Here in the School of Psychology that’s something that the faculty are very committed to doing: enabling our students to have an educational experience that is transformative to who they are as people, that shapes them and forms them, and that convicts and propels them to go out and serve in this world.”
+ PAMELA EBSTYNE KING is the Peter L. Benson Associate Professor of Applied Developmental Science. This quote is taken from an Integration panel convened for the School of Psychology’s 50th anniversary.
WHY INTEGRATION MATTERS
The model of integration as integrity, within the vocational narrative of peacemaking, is the product of a departmental history that is too long and complicated to tell here. Suffice it to say that Marriage and Family was once a ministry program within the School of Theology; changes to state licensing laws prompted us to relocate to the School of Psychology in 1987. The troubling conversation mentioned above happened during the early years of that transition, when we were still adjusting to our new institutional home and trying to identify our distinctives.
Today, marriage and family students are introduced to the peacemaking framework in their first quarter. Simultaneously, in their first and second quarters, they participate in small groups, led by faculty, to explore their own personal narratives in connection with peacemaking and the virtues. Then, in the spring quarter of both their first and second years, the students, staff, and faculty of the program gather off-campus for a day of worship, meditation, and conversation. It’s indicative of the graduate school subculture that many of us enter the day feeling too busy to take that time away from our work. But it’s a testimony to the wisdom of Sabbath that by the end of the day, we wonder why we waited so long.
Integration as integrity is necessarily about formation. Whether we intentionally engage in formational practices or not, the fact remains that students will be formed by their seminary experience, sometimes in ways that pose unintentional challenges to a coherent sense of identity and vocation.
As suggested earlier, this kind of challenge is not unique to the study of psychology or even to seminary. Nor is peacemaking only relevant to Christians training as therapists. If Gergen is right, then multiphrenia and a piecemeal sense of identity is more and more becoming the norm in highly technology-dependent societies. Graduate school may exacerbate the condition, and training to be one who is paid to guide people through the ups and downs of their lives raises the stakes.
Integration matters because integrity and a coherent sense of identity as one whom Jesus has called to be a peacemaker matter. Do you need a relationship with Jesus in order to be a good therapist? Well, in some sense, no. But that’s asking the question the wrong way around. Can the rigors and challenges of learning to be a good therapist become the testing ground for a coherent identity as a peacemaker? Yes. And if I had a chance to do that fateful conversation over again—who knows—this time I might have something more constructive to say.