Brad Strawn on Integrating Religion and Psychotherapy

Brad Strawn on Integrating Religion and Psychotherapy

by Greg Arnold

Psychologist and Christian theologian, Brad Strawn, discusses the "new conversations" happening around the integration of religion and psychology, and the need for clinicians to work through their biases and fears about bringing religion into the therapy room, since "so many people believe in some kind of God."
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The New Conversation

Greg Arnold: You're a professor of integration of theology and psychology at Fuller Theological in Pasadena. You’ve written extensively on the integration of psychology and theology and just co-edited the book, Christianity & Psychoanalysis: A New Conversation. From the perspective of religion on the one hand and psychology on the other, tell me about this new conversation. What was the old conversation, and how does this new conversation set itself apart?
Brad Strawn: Well, there are a lot of conversations going on in this area, and one of the points of this book is to try to be particular and specific. So we're not talking about all of clinical psychology, but about psychoanalytic psychology or psychotherapy, and we asked each of the contributors to be specific about their own Christianity because there are Christianities. There is Catholicism, Anglicanism, Anabaptism, there's Reform, Wesleyan, and the list goes on and on.
GA: Yes, of course.
BS: Part of what we mean by new, however, is that in the history of the relationship between psychoanalysis and Christianity, beginning with Freud, religion has been considered a way that we protected ourselves from the anxiety of fate and those things that we can’t control.
In the history of the relationship between psychoanalysis and Christianity, beginning with Freud, religion has been considered a way that we protected ourselves from the anxiety of fate and those things that we can’t control.
He ultimately captured all of this in his understanding of the Oedipal Complex—the God in the sky is the great patriarch that we project things into. As we grow up, just as a child grows up and eventually doesn't need the father, we also as a society and as a culture would grow out of our need for religion. Science for Freud becomes the new religion, the new way of knowing.

What we argue in the book is that changes in philosophy, in theology and in psychology have allowed for a much more relational understanding of all of those areas. So now we don't have to pathologize religion, but we can recognize that religion serves important functions in culture and there is actually room for it to be considered a viable way of knowing. This allows new conversations to emerge; it’s no longer about psychopathology, but about human flourishing, human knowing, human relatedness, and health. So religion can be a healthy way of interacting with the world.
GA: When you say it like that, it illustrates the common ground between the ostensible purpose of psychotherapy and psychology at large, and what we traditionally consider the goals of religion: Human flourishing.
BS: Right.
GA: It’s good to hear that modern philosophy has shifted to facilitate that. But you did hit on one important criterion for the new conversation, and that’s Christianities. When Freud was saying we're going to grow out of this, how did that contrast with what you're aiming for, which is integration?
BS: Freud had this image of religion as fairly primitive. There were a lot of complex intersecting realities going on at the time, and he was reacting to a number of them. It wasn't a great time to be a Jew, obviously. He ended up fleeing to England to save his own life, which many of his colleagues also had to do, and saw Christianity as part of the problem, which it was.
GA: Sure, but he characterized it as this singular monolithic Christianity with a capital C. How does that get challenged in this new conversation?
BS: It would have been difficult for him to conceive of religion that had a mature component to it. What’s helpful about Christianities is that it opens up the conversation to many other ways of seeing things. There are immature forms of religious experience and mature forms. Erich Fromm was a disciple of Freud, but he went in a very different direction, allowing for the idea of mature religions. D.W. Winnicott is another psychoanalytic thinker who conceives of the maturation of religion. He himself grew up in a Wesleyan tradition and held to it throughout his life to some degree, even though he doesn't espouse much particularity in terms of faith per se.

I think that’s what we get when philosophy, theology, and psychology begin to open up this idea that there are different ways of knowing. We can borrow from the ways that people talk about culture these days. We no longer see certain cultures as being “primitive,” but instead talk about the particularities of a culture. What are the indigenous psychologies within a particular culture or ethnicity or race that cause people to see the world in particular ways? We wouldn't want to talk about them as being immature or primitive. We would want to say, "What do they add to the conversation?"

When I talk to people who aren't religious I say,
"Think about religion as a form of culture that brings particular ways of seeing the world and conceptualizing things."
"Think about religion as a form of culture that brings particular ways of seeing the world and conceptualizing things." It's not true or false. It's just what it is. I think that's been helpful for people, particularly those outside of the religious dialogue.
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Therapy is a Moral Discourse

GA: I love the idea of borrowing from our evolving vocabulary about culture, especially in our profession of psychotherapy. We've got a huge vernacular for talking about culture in the therapy room and we can think of religion as a culture and treat it the same way. Intersectionalities, all these blossoming identities, and there's no one integration of psychology and faith because there's no one faith. They're all situated. Let’s take it a step further. Can we, as therapists, view our handling of our own religion and our clients' religion as one more facet of multi-cultural competence, or is there any reason we want to treat it differently than the other trainings we have about multicultural competence?
BS:
I tend not to use the word “competent.” I don't think we can become competent because there are too many cultures and too many religions.
I tend not to use the word “competent.” I don't think we can become competent because there are too many cultures and too many religions. I think we sometimes fool ourselves that we can know enough. When my African-American client who is Muslim is talking, what I know is that this person has a particular way of seeing the world, and my job is to try to understand to the best of my ability how they see the world and where they’re experiencing problems. Where they’re getting caught up in ways of seeing the world that are in conflict with their culture—for example being religious in a secular culture—and helping them figure out how to navigate that conflict.

I believe that psychotherapy is essentially a kind of a moral discourse between two people. The therapist has a particular way of understanding the oughts and shoulds of the world, and the client does as well. We don't do ourselves any good pretending that we can bracket that and leave that out of the room. We have to be honest about that, and at times bring it into the room so we can have open and honest conversations. Not that we as therapists impose that on our clients, but if we don't own where we're coming from, we may in fact be more likely to unconsciously or covertly impose our views on our clients. That's what colonialism was, right? A “white” and “right” way of seeing the world that we now know isn’t the truth.
GA: So it’s important to identify where you're coming from in your own faith tradition, no matter where it is.
BS: Exactly.
GA: Where does the non-religious practitioner fit into this? Can they contribute to the effort to integrate psychology and faith? What does the interfaith dialogue need to be?
BS: A former colleague of mine who is now passed, Randy Sorensen, did some research where he found that good therapy impacted religious clients positively based not on whether the therapist was religious or not, but how open the therapist was to the client's religious experience.
It's the way they approach their clients' religion rather than whether they are religious or not. It's the respect they show for it, the same way they would show respect for a client's culture.
If they didn't pathologize the client's religious experience like you wouldn't pathologize someone's cultural experience, but welcomed it hospitably and made it a place where the client could then explore that in a non-judgmental way, people came out feeling more positive and open about their religious experience than with those practitioners who didn't allow it to be an open and non-judgmental kind of dialogue. I think that's very helpful for non-religious therapists to keep in mind—it's the way they approach their clients' religion rather than whether they are religious or not. It's the respect they show for it, the same way they would show respect for a client's culture.

Religion can, of course, be used in pathological ways, and good therapy ought to help people disconnect from that. But that's not going to be possible if the therapist doesn't want to talk about it or comes in with too many a priori assumptions about religion. So that's where a secular or non-religious therapist can actually contribute to this dialogue, and particularly contribute to good psychotherapeutic work by welcoming a client's religion the same way they would welcome the client's culture or gender or sexual orientation.
GA: So multicultural awareness and sensitivity is going to put us in good stead there. There are lots of ways we can mess therapy up by being closed, rigid, biased, not having identified our own location. Can you talk more about what you see being the positive outcomes for the client when the therapist is aware and open?
BS: What some of the research seems to indicate is that clients are able to examine not only their religious tradition in the way that impacts their psychology and vice versa, but their image of God can also be transformed over the course of therapy. Religious people, like everyone else, often come to therapy because something has happened in their life, or life isn’t working out the way they expected it would. Well, for a religious person, that raises issues of, "Who is God then and where is God and how does God function in the world?" It may be that they've come in with some ideas about God and religion that were functional and helpful for a while, but now are not helpful and functional anymore. That doesn't mean that their earlier thoughts are bad or pathological, but it means that they've got to expand and develop and grow like anything in our lives. It doesn't mean they have to jettison their faith—I think some people feel like they have to leave their faith or say that there is no God anymore—but they can evolve their understanding of God and religion. It's not throwing the baby out with the bathwater, but sifting through the dirty bathwater. A good therapist, whether he or she is secular or religious or of a different religion than their client, can create the space that allows that to happen in ways that are therapeutic.
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So Many People Believe in God

GA: So we can get over feeling guilty about religion being on the table, or this idea that it’s not valid to bring religion into the therapy process. It's appropriate for psychotherapy to really work with that.
BS: I think so. We have data that suggests so many people believe in some kind of God—in the United States at least. People are religious. We could get into a whole debate about religion versus spirituality, but in general many people have these religious-spiritual inclinations. So to feel guilty that we're talking about religion seems to be a major mistake. It's part of people's identity, so it needs to be on the table. To leave it out is like leaving out talking about sexuality. How can we do that? That's a whole part of what makes people who they are.
GA: Would you agree that it’s kind of taboo, though, to bring religion into psychotherapy? From the secular side religion is often seen as a kind of pathology, but even on the religious side, people may feel like those issues are better dealt with in a church or a synagogue or a mosque. What has your experience been?
BS: I think sometimes for the religious and even maybe the non-religious, we don't always know what to do with the APA ethic codes. We're so afraid of imposing our views, of taking away the client's autonomy, but we’re beginning to learn how we can hold a client's autonomy in mind even as we're helping them think about the variety of issues they are dealing with. I don't think we do them a favor by not bringing things into the room. I had a professor who would say, "We can expose things without imposing." Of course, that's an art form. There's always a danger that we're going to impose. But I think there is plenty of evidence that therapists impose without even saying things at times, or their very theories have implicit ethics within them that we never think about—for example, the ethic of individualism or autonomy. Those are ethics. Those say things about how people ought to live their lives. So all of our underlying points of view need to come under this more post-modern lens. We need to own what we’re doing.

It’s true that some religious practitioners think that these issues should be left for the church, but I also think that some religious practitioners don't want to bring up religion because it becomes personally challenging to them. It challenges their own countertransference. So if their client is questioning, say, the existence of God or how God works in the world and it's uncomfortable to the religious practitioner, he or she may unconsciously avoid it because it's anxiety provoking. That's something that they need to work out in their own therapy and supervision.
GA: Because they're getting in the way of what's best for the client. I'm glad you admit it's really hard and it's a danger to impose. It's an art. You've got to really do a lot of work. How are we doing as a field at including this in the therapy room, at not imposing, and what can a practicing clinician out there do if they're not in training anymore to advance this effort to integrate faith and psychology and to be more culturally sensitive?
BS: The good news is there are a lot of good resources out there—everything from various models of integrating faith and psychology to how people actually work clinically from various modalities. You can find cognitive behaviorists and how they work with religion, or psychoanalytic or family systems practitioners. Even the American Psychiatric Association is publishing resources about the language of spirituality. I think that's a good way to start and it helps clinicians listen in different ways for issues of spirituality, but the larger issue is still this fear of imposing.
How do we manage the issue that morality and ethics are a part of every psychotherapy?
How do we manage the issue that morality and ethics are a part of every psychotherapy? The most responsible thing we can do is own that and figure out how we use it in appropriate ways that doesn't become coercive, what one of my colleagues would say violent to the therapy.
GA: Absolutely.
BS: But that doesn't mean falling back into this kind of Freudian myth that we can be objective blank screens. I think this is true even with cognitive behavioral people. They pretend that they are not bringing themselves to the work, but they are. So how do we most effectively bring ourselves to the work? That would be the question I'd like to spend more time thinking about.
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Talking Out of Both Sides of Your Mouth

GA: This idea of an objective blank slate is a liability. It's made us at risk for this kind of violent idea that we're mechanics operating on machines and we've just got to get out the owner's manual and look up in the appendix of how to fix this machine. Morally, we have to own what we're bringing to the room. But how do you integrate your whole individual philosophy of embodiedness and embeddedness with the DSM and empirically supported treatments and evidence-based practice? How has that balancing act gone for you personally and professionally?
BS: That’s a great question. I hedge my bets by rarely using insurance as a clinician, which means I rarely have to provide a diagnosis. I think that's how a lot of people work these days because they're so disillusioned. Unfortunately there are a lot of people working in settings where that's not possible for them, and I always wonder if they are just talking out of both sides of their mouths as a necessity. They use the language they need for the reimbursement but they continue to think a different way. I think that's probably how a lot of clinicians tend to operate.

I think there's a whole subset of people who want to keep thinking about therapy as art and to do that we have to be creative in other ways. So maybe we don't take insurance, but maybe we have sliding scales that are ridiculously low at times. I see people at times working for well under the going rate for Pasadena. I work a lot with students from other clinical programs who are in training who I hope are going to go out and do the same kind of thing because they've experienced that with me. Here at Fuller we think a lot about how our students can use the best clinical training they can with underserved populations.
It's almost a Trojan horse model—they do the work that they have to do, but they're still bringing their deeper vision to the work.
It's almost a Trojan horse model—they do the work that they have to do, but they're still bringing their deeper vision to the work.

Good therapies always have this core of humanism in them. They're real-life people here that we're trying to help and we're creative and we're flexible, but maybe there are some things that some people just can't do. They won't do. I can't see myself ever working in a setting where I had to use an empirically validated treatment manual. But that's me. That's not everyone's story. I'm not trying to be dogmatic about this.
GA: The medical model has brought about a real identity crisis in the field. A lot of people are talking out of both sides of their mouth.
BS:
Morality is not just a concern of religious people. There is secular morality.
Morality is not just a concern of religious people. There is secular morality.

I came to psychology because my experience in the church, the Christian church, was that there was a lot of good information about what one shouldn't do, but its models for transformation were a bit thin. You might argue that’s because my particular Christian tradition had disconnected itself from some of the ancient wisdom of Christianity.

What I discovered studying psychology in college was that it was offering models for how people transform and change. I thought, if I could bring that together with my Christian faith, what a powerful model that would be. So that's one of the ways I've understood what psychology could bring to religion.
GA: So what could a church pastor learn from studying psychology?
BS: Well, think of group therapy and all of the wonderful tools it has brought to church communities. Most churches now have therapeutic support groups for people struggling in various ways, and the psychological issues get pretty tricky in groups, really fast. Yalom’s theories on interpersonal processes in group therapy have been tremendously helpful for both lay people and professionals in helping to guide group work. We think about group dynamics, about transference, about procedural learning, about behavior.

Sometimes the church can be just as prejudiced and afraid of psychology as psychologists can be of religion, so we’ve needed translators who could bridge the gap and show that these secular theories are not dangerous or bad or a threat their faith.
GA: Do you think it’s useful for pastors to get psychotherapy training?
BS: Well, I think one of the things you have to dig down into is their presuppositions about truth. At Fuller, where I teach, we say all truth is God's truth. So it doesn't matter if Freud or Ellis or Skinner discovered it. Or a contemporary neuroscientist discovered it. If it's true, then it's useful. Of course this can be used in improper ways as well, so again we're back to ethics.

Some Christian groups dichotomize between nature and grace—God is involved in grace, but nature is something entirely different; psychology is nature and therefore not useful. All we need is in the Bible. That’s one example.

Other Christianities—and this is why Christianities is a really important concept—would say there is no dichotomy between God and nature. The person who discovered penicillin may or may not have been a Christian, but who cares? Penicillin cures and heals people, and curing and healing and restoring humans is part of the religious impetus some groups would argue.

If I were working with a pastoral care group, I would try to assess how they think about nature and how they think about how God works in the world and would try to tease out whether they think that all truth is God's truth or only the truth that comes from scripture.
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Community and Interconnectedness

GA: But this inclination to dichotomize is not just a religious inclination. There's this sort of militaristic atheism that states: "We're science. They're not." And that's just as damaging and unproductive.

But I think also where I'm seeing it from my non-religious side of the fence is this call to morality or this idea that Christianities, many of them modern, mature, intelligent, contemporary Christianities, have a great authority and ability to speak to the call to humanism and bringing morality back into our endeavor.
BS: One of the things that modern Christianity can also help with is a call back to community and interconnectedness. Ethics can become very individualistic. The great philosopher Alasdair MacIntyre says our ethic is primarily what he would call emotivism, which is “whatever feels good to me is right.” I think a lot of psychological theories have that ethos embedded within them, whereas many religions posit that your individual rights end at your communal responsibility. Victor Frankl said this years ago in one of his books.
GA: The counterpart is this kind of just reification of the individual, a kind of inward, isolating journey to health. That mental health is achieved inwardly. So your work is saturated with this sensitivity to how healing relationships are and can be. It has to happen between persons, not within persons.
BS:
One of my frustrations with contemporary spirituality is that it tends to be, at least in the United States, so individualistic and inward—"Well, as long as I'm not hurting anyone else it's okay."
One of my frustrations with contemporary spirituality is that it tends to be, at least in the United States, so individualistic and inward—"Well, as long as I'm not hurting anyone else it's okay." But what counts as hurting people? It may not seem like you’re hurting people by consuming all these resources, but in truth you really are hurting people. We've got to come back to this communal ethos. One of the things that's essential to me as a psychologist and a Christian is this idea that we are always inextricably linked to others, and that's both how problems come about and how healing comes about. There's just no isolated self. We are always selving and always contextualized and always embedded and always embodied.

I suppose some would call me radical in that sense. I have colleagues who really cling to an individualistic psychology and spirituality. I think you can make the argument that much of contemporary evangelicalism in the US is quite individual and that the worship experiences they have are in fact quite consumeristic. They're just consuming Jesus—it's sort of the person and God or the person and Christ—which I don't really think is what the gospel is all about.

Folks who think more like me tend to be theologians and hopefully more will come into the integration-of-psychology conversation. In the book I wrote with Warren Brown, The Physical Nature of Christian Life, we talk about how there really is no isolated Christian, no isolated person, and that religion is always going to be experienced and needs to be experienced in these communal sorts of ways.
GA: Before reading your work I'd never encountered a fully Christian thinker espousing this deeply relational embodied philosophy. I'm finding I'm confronting my own prejudices about Christianity as I do more investigating. I think that my former critiques of Christianity have been toward this more immature Christianity, the more consumerist Christianity, not having been aware of the more mature Christianities, as you call them.
BS: I think that Christianity, like anything else, is also a sort of developmental process. James Fowler, who taught at Emory University, compared his work with Kohlberg's work on stages of moral reasoning and suggested that there are stages that religious people go through. So maybe thinking about faith as individual and private is a developmental phase. Maybe as people grow and develop and have more life experience, they will come to recognize that life is more interconnected, relational, communal. However, Fowler would say, and I'd agree, that not everybody moves to the same level.

I think those Christians who embrace this relational theology may be better at being hospitable to people who are not of their faith tradition than those who don't. I think there's a more protective defensive way of viewing others when you see religion as kind of ethereal, as spiritual, as otherworldly, as “what I do now to get to another place.” If bodies don’t matter and we’re just waiting for the afterlife, then I don’t really care about my body or your body; I don’t care if you’re hungry or poor or living in an oppressive regime. In other words, the here and now is not my focus. But if I think of religion as experienced in the here and now, as embodied not just in the soul but in the body, in the senses, then the call of God is more of an action, a call to love all people, whatever they believe, or whatever they come from, or whatever they look like.
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Seeing Beyond the Soul

GA: So it’s seeing beyond the soul?
BS: Right. If bodies are important, if souls aren't saved but humans are saved, then humans need to be fed and clothed and protected and not raped and not abused as children and not under the oppression of a dictator. The implications of the two ways of thinking can be profound. I have some friends who ruin my theory, however. They cling to an individualistic soul concept with fervor, and yet they're the ones visiting people in prison, bringing food to the hungry. So there are no absolutes here.
GA: Do you have any closing thoughts you want to leave our readers with about why this is important, what they can do, what you've learned in your efforts?
BS: I think just that there is a lot of room for both religious and non-religious clinicians and researcher to help each other. At the end of the day we're trying to help people live more productive, healthy, flourishing lives. But we need to ask what we mean by healthy and flourishing, and where did we get those ideas? There are all of these underlying belief systems that we’re not owning.
A lot of therapists who say they care about relationships might not realize that some of the theories they're practicing are highly individualistic.
A lot of therapists who say they care about relationships might not realize that some of the theories they're practicing are highly individualistic. But if they could take a look at that, I think they could then begin to make some adjustments and think about it differently.

Erich Fromm, in his book on psychoanalysis and religion, made a distinction between cure of the soul and social adjustment therapy. For him, social adjustment therapy was just helping a person function better in the crazy society they already live in. His question was: Is that really what psychotherapy is supposed to be about, or is it about creating people who flourish and can become thinkers and can transcend some of the disease that might be in the culture around them? So one of the things I'd like to end with is this idea that psychologists are in a particularly interesting position to think about ourselves in the area of social justice as people who work for social equality. But to do that we're going to have to step back and critique our own discipline.
GA: Beautiful. I for one welcome the inclusive conversation, the new conversation. I'm happy to be a part of it. Thank you so much for sharing your time.
BS: Thank you. It's been a pleasure to chat with you.

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Brad StrawnBrad D. Strawn, PhD, received his B.A. in psychology from Point Loma Nazarene University (PLNU: San Diego, CA), his M.A. in theology from Fuller Seminary (Pasadena CA), and his Ph.D. in clinical psychology from the Graduate School of Psychology at Fuller Seminary. After completing a one-year internship at The State University of New York at Stony Brook, he taught for 10 years in the department of psychology at PLNU where he served the last two years as department chair. Brad also conducted a therapy practice in San Diego and obtained advanced psychoanalytic therapy training at the San Diego Psychoanalytic Institute. Brad is an ordained Elder in the Church of the Nazarene.

Brad’s three great intellectual passions have always been theology, psychology and Christian higher education, and in 2006 he left PLNU to become Vice President for Spiritual Development and Dean of the Chapel at Southern Nazarene University (SNU: Bethany, OK). At SNU Brad oversaw the campus spiritual development programs, served as campus chaplain, and taught in the departments of theology and psychology.

Brad maintains his academic interests by publishing and editing in integrative journals such as the Journal of Psychology and Theology, Journal of Psychology & Christianity, Pastoral Psychology, Homiletics, and is the co-editor of the 2010 book “Wesleyan Theology and Social Science”. He is co-author (with Dr. Warren S. Brown) of The Physical Nature of Christian Life: Neuroscience, Psychology & the Church. In 2014 he co-edited (with Earl Bland) the book Christianity and Psychoanalysis: A New Conversation (IVP Academic). Brad is a regular presenter at Christian universities and churches. He is also a frequent presenter at the Christian Association for Psychological Studies, and the Society for the Study of Psychology and Wesleyan Theology.

In the fall of 2012 Brad joined the faculty of Fuller Theological Seminary, Graduate School of Psychology (Pasadena, CA) as the Evelyn and Frank Freed Professor of the Integration of Psychology and Theology. In this role he teaches, mentors doctoral students and oversees the integration curriculum and the yearly Integration Symposium, a yearly lecture series on the integration of psychology and theology. Brad also maintains a private practice in Pasadena where he works with adults and couples.

Brad enjoys exploring bookstores, listening to music, and spending time with his wife L. Suzanne Strawn and his two teenage boys Evan and Keaton.
Greg Arnold, MA resides in Fort Collins, CO with his lovely wife, cats, dog, and thousands of pet bees. He holds an MA degree in Counseling Psychology. Under the employ of Psychotherapy.net he works with universities to integrate the inspiring real work of expert therapists-on-video into the teaching and training of the next generation of great psychotherapists.
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CE credits: 1
Learning objectives:
  • Understand the historical context for the rift between religion and psychotherapy.
  • Describe Strawn's conception of the "new conversation" happening between theologians and the field of psychology and psychotherapy.
  • Compare and contrast the integration of religion and psychotherapy to multicultural concepts of knowledge. 
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