Caring for Body and Soul

Harold L. Senkbeil
Tuesday, July 1st 2014
Jul/Aug 2014

Rev. Harold Senkbeil is a member of the board of directors and executive director of Doxology: The Lutheran Center for Spiritual Care and Counsel, as well as the author of numerous books including Dying to Live: The Power of Forgiveness and Sanctification: Christ in Action.

Tell us about the work you do at Doxology.
After thirty-one years in the parish, it was my privilege to serve as a seminary professor for six years at Concordia Theological Seminary in Fort Wayne. Then, in 2008, I retired. My wife always jokingly says that I retired into full-time work. But I’m now serving at this nonprofit organization called Doxology, and we offer continuing education seminars for pastors in the area of advanced skills for pastoral care. My colleague, Dr. Beverly Yahnke, is a licensed clinical psychologist, so she brings the insights of Christian psychology into caring for people, while I handle the spiritual side of things.

We often hear pastors say that they learned a lot in seminary about the Bible and distinguishing heresy from orthodoxy, but that they weren’t really trained to be able to detect bipolar disorder or chemical imbalances. Are you working at that intersection, trying to bring body and soul together, as it were?
Of course, we want to respect all of the specialized skills in terms of caring for people. The simple fact is that pastors are neither licensed nor equipped to make the kinds of diagnoses that you’re talking about, nor are we for that matter brain surgeons or kidney specialists, either. We want to assist pastors to use their explicitly God-given talents and skills and apply them to the needs of all people, no matter what kinds of dysfunctions or illnesses they may be suffering from. We’re not trying to make psychologists out of pastors, but we’re trying to make pastors better pastors, to be more alert and sensitive to the needs of the people to whom they are ministering.

In other words, training pastors to know when to refer someone to a mental health specialist or professional.
Right, and we certainly do give them a clearer understanding of when it’s time to refer someone to a specialist.

Physicians of the Soul

Let’s explore some general types of cases a pastor might encounter’for example, counseling someone who struggles with depression and other related issues. As a pastor, your call is to soul care. Obviously we’re psychosomatic unities, so we’re body and soul; we’re not ghosts in machines. But it seems the line can be fuzzy between body and soul. How do you know when someone has a spiritual problem, and when they might be suffering from something chemical or physical?
I think the danger is in trying to zero in on one scenario or the other. The reality is that we’re complex beings, and sometimes chemical imbalances or behavioral influences are involved. Luther says that one of the greatest temptations of the devil is misbelief: when a person embraces false understandings of who they are in God’s kingdom, that’s going to influence them in multiple ways. The bottom line is that we want pastors to be alert to all the symptoms’not react just to the symptoms, but to use their God-given vocation to accurately discern what’s happening spiritually with any individual. As the person begins to receive specialized help from a clinical psychologist or medical physician, the pastor should maintain a connection with that individual and continue to provide spiritual care.

So pastors are specialists in their own right, but not specialists in chemical disorders.
Precisely. Actually the longer heritage of pastoral care calls pastors “physicians of souls.” My understanding is that the term “physician” was used in the spiritual dimension long before it was used in the biological or physical dimension. And that involves accurate diagnosis and responsible treatment. The reality is that since we are fallen human beings, the law and the gospel need to be applied to every individual, no matter what their circumstance. Even when they’re in comparatively good health, be that physically or mentally, they still need spiritual care. This is an ongoing reality for every Christian.

When it comes to psychological issues, rooted not in chemical imbalance but perhaps in early trauma or abuse of some kind, do you think that professional psychologists can be of value? Not just psychiatrists, but psychologists? Or do you think those fields are working too much on non-Christian assumptions?
The reality is that all of these fields have developed in terms of their unique science in understanding the nature of the human being, be it biological or mental, emotional, or whatever dimension of their life. These fields I would understand as gifts of God, and of course they need to be used with competence, intelligence, and integrity, and they would always have to come under the judgment of the word of God. Just as a pastor would refer someone with a broken leg to a medical physician, so someone who was dealing with chronic depression needs to be referred to a licensed clinician. But, of course, they are not all created equal, are they? It’s therefore vital that the pastor know which competent clinicians he can refer to with confidence. I think that means sitting down with people in his community, interviewing them, and understanding their spiritual point of view. Sadly, sometimes people who advertise themselves as specializing in Christian psychology may come from an inadequate knowledge of their field of psychology, or, sadly, just as often they come with a skewed understanding of the Scriptures and the Christian faith. And in that case, I would say it would be more useful to have a thorough-going secularist who is simply honest and open to the area of spiritual care done by the pastor, rather than exposing that parishioner to someone who is going to lead them astray, spiritually speaking.

Sound Theology and Mental Health

This can happen even with professionals trained in a seminary context, where an unhealthy theology is introduced into the equation.
Sound doctrine is healthy teaching’teaching that leads to health. That’s the kind of approach we need when we’re teaching the faith and ministering to people.

I think that part of the tension is that if you have a broken leg, you don’t really care if the nurse or doctor who sets it is an atheist or a Mormon; but when it comes to issues involving psychiatry or psychoanalysis, there seems to be an overlap with spiritual care. We ask ourselves where we’re going to find someone who can be a counterpart to us as pastors, someone who is not going to work against our attempt to minister the law and the gospel to the ill person.
That’s very true. Of course, that’s where knowledge of the professionals in your area is important, and also consulting with trusted colleagues. Perhaps there’s an adjudicatory from one’s own denomination who has experience with area counselors and therapists, or also some trusted colleagues from another denomination. I think that’s always good and useful information. There’s nothing like actually sitting down with a therapist and asking pointed questions about how they understand the place of faith related to a person’s mental and emotional health, and how they would proceed. For example, have they had any experience working on a consulting basis with members of the clergy? In most cases, I would highly recommend that the individual you refer grant you permission to consult periodically with the therapist, providing some assistance to the therapist regarding the patient’s spiritual treatment, and vice versa’what symptoms are arising in the context of the psychological care that would be of use to you as a physician of souls?

So that your ministry of absolution to a sinner isn’t working against someone who is telling them that sin isn’t even involved in the first place.
Precisely. Or certainly that the therapist would take it upon himself or herself to be the one who does the absolving when that’s out of their sphere of reference, or they’re not really authorized in that area, either. That was an interesting point in my earliest conversation with Dr. Yahnke. I asked her, “How does your work as a clinical psychologist differ from mine as a pastor?” And she said, almost without batting an eye, “That’s easy: you deal with the forgiveness of sins.” So I knew we were on to something.

What do you think about the state of Christian counseling and its many varieties?
I thank God for Christian counselors. As I mentioned, I’m privileged to work with one of the very best right now. I pray that there would be many other men and women who go into this field and learn all they can in state-of-the-art research into cognitive and behavioral therapy. I think that’s probably the most beneficial approach that can be gained in the area of Christian psychology. And at the same time, these individuals should have a thorough grounding in Holy Scripture and Christian doctrine. Frankly, there are very few competent programs for training such individuals. My colleague, Dr. Yahnke, had to strike out on her own to get the full dimension in terms of her training in both science and theology. It would be wonderful if there were graduate schools that would produce such individuals. There are some, but not as many as we need. As I mentioned earlier, just because people identify themselves as Christian counselors, this doesn’t in itself indicate that they are people to whom we can refer with confidence. We have to interview them to understand what they have come to believe regarding the intersection of psychology and the spiritual life, and most importantly, how they would proceed in a given case and a consulting relationship with a Christian pastor.

Tuesday, July 1st 2014

“Modern Reformation has championed confessional Reformation theology in an anti-confessional and anti-theological age.”

Picture of J. Ligon Duncan, IIIJ. Ligon Duncan, IIISenior Minister, First Presbyterian Church
Magazine Covers; Embodiment & Technology