Friday, July 18, 2014

Religion and postpartum depression

Kaleigh Velasquez is an undergraduate student here at Trinity Christian College. 
The article that I reviewed deals with postpartum depression and how religion may play a role in overcoming this disorder (Zittel-Palamara, Cercone & Rockmaker, 2009). Postpartum depression is a form of depression that happens after a woman gives birth. The symptoms are similar to major depression and are characterized by anxiety, having a short temper, feeling hopeless or guilty, a decrease in appetite, inability to focus, decreased interest in the baby, and having trouble sleeping.
Postpartum depression is more likely in disadvantaged communities than in advantaged communities and also higher within African American and Latino communities rather than Caucasians. This type of depression affects between 15% to 25% of woman annually, but there are also reports of 34% to 55% of woman suffering (Zittel-Palamara, Cercone & Rockmaker, 2009).
When it comes to treatments, the most common is medication and specifically antidepressants. Even though antidepressants may work for a certain client, many clients claim they take them without knowing their other treatment options. Other medical treatments include alternative medicines and hormone treatments. A medical perspective also uses hospitalization, as well as day and visitation programs. Another form of treatment is psychological based interventions. These include individual and group counseling.
There are different types of treatment that combat postpartum depression, some of them with the use of religion and spirituality. It is said that nearly 60% of the women struggling found strength in religion. There are different ways in which a professionals may introduce spirituality into a treatment. One way is having the professional bring spirituality into the session directly. Another way is having the client bring spirituality into the session willingly (Zittel-Palamara, Cercone & Rockmaker, 2009).
In one study almost two-thirds of the participants disclosed that they found strength from their religion. Of the women in the study, the vast majority reported having limited ability to access postpartum depression care. Over 50% of the women in the study that wanted spiritual guidance reported that it was not hard for them to find postpartum depression care. This study found that a lack of desire to seek spiritual assistance could actually be linked to these women’s longer exposure to mental health issues in their lives before their pregnancy (Zittel-Palamara, Cercone & Rockmaker, 2009) .
Women who believe that they find strength in their religion would be well served to seek treatment for postpartum depression that includes spirituality. When a person is under great stress and feelings of desperation, it is wise to turn to religion and spirituality because it appears to be a positive strategy to cope with these issues. Numerous studies done with people of color and individuals suffering from mental health issues have shown that people who turn to spirituality reported decrease in symptoms, a better outlook, and increased positivity (Zittel-Palamara, Cercone & Rockmaker, 2009).
My understanding of depression leads me to think that even with all the treatment options out there it is hard to find one that relieves the depression. Based on this article, I have learned that religion is a big part in the treatment process for some women. I feel like being prescribed antidepressants could have variable results and finding the strength through religion could be a stable base for some of these women struggling. Many people may need to be prescribed medications but can also focus on religion as part of their treatment plan.
This article leaves me wanting to do more research on the medical based treatments to see how effective/non-effective they are in comparison.  Also, a critique would be for them to do more follow-up studies so they know their results can be repeated.
References:
Zittel-Palamara, K., Cercone, S.A. & Rockmaker, J.R. (2009). Spiritual support for women with postpartum depression. Journal of psychology and Christianity, 28(3), 213-223.   

Monday, June 2, 2014

Self-of-the Therapist in the Living Moment: Dr. Aponte


Jeannette Kiser is a graduate student in the Master of Arts in Counseling Psychology program here at Trinity Christian College.

In the Marriage, Couple & Family Counseling class offered at Trinity Christian College my then professor Dr. Mike Ideran, assigned the class a choice of a written final or a final presentation. My cohort member, Terry Jones, and I felt we would learn more through putting together a presentation on one of the concepts that we learned in class rather than regurgitating information on a test. During one of our subsequent class sessions, Dr. Ideran came in with an article entitled, “Training of the Person of the Therapist in the Academic Setting” (Aponte, et al, 2009).

The article offered many indications of how important family of origin issues are in the life themes of individuals. The article also introduced Terry and I to a rather fascinating individual, Dr. Harry Aponte. Dr. Aponte is a Structural Family Therapist who also teaches at Drexel University in Philadelphia, Pennsylvania. The article further introduced us to his work on the concept of signature theme and the Person of the Therapist Training Model (POTT Model). The POTT model is a training program where one spends a year exploring, working, and resolving their signature themes. Signature themes are struggles or wounds that permeate through an individual’s being without them being aware of them.

In October of 2013 Terry contacted Dr. Aponte to ask if he would be willing to spend 15 to 20 minutes being interviewed by us so that we may further understand his concept of signature themes and the POTT Model. About a month later Dr. Aponte granted our interview. This gracious man provided us with one hour and fifteen minutes of his valuable time. This interview was an amazing experience. The understanding that Dr. Aponte has of working with clients and the therapeutic experience aligns quite well with my view of therapy. We discussed everything from cultural influences (he is Puerto Rican and Catholic “raised in the slums of New York”) to the use of the self-of-the therapist.

The use of the “self-of-the therapist” is realizing that the client gets us (the therapist) as we are. It is the therapist’s responsibility to be aware of what it is that they bring to the therapeutic process (or the living moment). Dr. Aponte suggested a question that therapists should often ask themselves, “What of me is affecting the therapeutic process?” That question is really what the POTT model and signature themes are all about. What about us, good, bad, ugly, indifferent is affecting our therapeutic presence in the living moment?
 
Dr. Aponte states, “I have to take something from my human experience that relates to the core of the other person’s humanity. Yes, I have to recognize our differences. But if I am going to do this work we have to discover our sameness. We all suffer, we all get lonely, depressed, discouraged. We all are longing for love and somehow or other I have to find that very essence of what it is to be human and vulnerable and fallible.”
 
We as therapists have to get in touch and feel “our common humanity” so that we can feel what our clients are feeling, cry when they cry, hurt when they hurt, smile when they smile, etc. In order to do this Dr. Aponte says that we have to open ourselves up to our own brokenness, our own woundedness.

As therapists we must know about ourselves in order to develop the skills and discipline that will allow us to tap into our experiences and figure out how those experiences will fit into our model of therapy. “How do we use ourselves to maximize our effectiveness in the therapeutic process?” When our clients come to us we are joining them in their journey, in that one particular life moment and we are offering to aide them in overcoming the hurdle they are presently facing.
 
Dr. Aponte offers his perspective on the human condition and the role of the therapist. “People are not broken or in need of being fixed. People are on a journey of their own and we are merely meeting them in a moment of their life history.” –Dr. Aponte


References:

Aponte, H.J, Powell, F.D., Brooks, S., Watson, M.F., Lizke, C., Lawless, J. & Johnson, E. (2009). Training the person of the therapist in an academic setting. Journal of Marital and Family Therapy, 35(4), 381-394.

Thursday, May 1, 2014

Creation, Fall, Redemption and the Naturalistic Fallacy

In Christian colleges that have developed from Reformed denominations you will often hear the words:  Creation, Fall, Redemption.  This is the general framework that guides our studies.  God created the earth and it was good.  The physical creation was good and the societal, psychological, spiritual aspects of life were also good.  Then Adam and Eve sinned and the earth was cursed and filled with brokenness.  But God sent his Son.  He died for our sins and started the whole creation – human beings and all – back toward the good and the unbroken.  He redeemed and is redeeming his world. 
 

Opportunities to reflect on creation, fall, and redemption often arise in the field of social psychology.  Social psychology looks at how an individual affects and is affected by others.  The topics in social psychology include romantic relationships, prejudice, persuasion, conflict, and conformity.  Psychologists have unearthed some well-supported findings on these topics.  One finding is that men everywhere are more likely than women to be found in socially dominant roles; things like CEOs, politicians, and religious leaders.  Women, on the other hand, are overly-represented in more help-giving roles; things like nursing, education, and counseling.  So is this role distinction an intentional part of God’s creation?  Or does it exist because of the fall?  Or is it part of God’s ongoing redemptive work?  Another well-supported finding is social facilitation:  we do easier tasks better when we are around other people.  You can get a better work-out when you jog with a friend.  You can lick 200 envelopes faster if you’re not alone.  So is social facilitation part of God’s creation?  Part of the fall?  Or part of God’s ongoing redemptive work?  It is tempting to say that because it is universal, well-supported, and scientifically sound that it must be part of God’s creation.  It’s easy to say that something exists because God made it that way. 
 

I think this temptation stems from our acquaintance with other sciences.  When you learn about the biological processes of photosynthesis you know that because it is universal, well supported, and scientifically sound that God probably created it that way.  Yet we must be careful not to fall into a naturalistic fallacy.  We mustn’t say; “that which is, is good.”  Just because you find something everywhere does not mean that it is God’s original creational intention.  For example, researchers in the biological sciences have discovered that skin cancer is naturally occurring and can be found everywhere.  Does that mean that God included cancer in his creation?  On the sixth day, did he survey all he had made, and did his eyes fall on skin cancer, and did he say, “It is very good”?    
 

Now consider an example from psychology.  One of the most well-supported findings in social psychology is the self-serving bias.  We think highly of ourselves to an unreasonable degree.  When something good happens it is because we brought it about, when something bad happens it is because of factors beyond our control.  When we get an “A” it is because we studied hard.  When we get an “F” it is because the teacher is too hard.  Psychologists have found time and time again that most people have a self-serving bias.  So is this part of God’s creation?  Part of the fall?  Or part of God’s ongoing redemptive work?  Did God create us to always take credit for the good and never take responsibility for the bad?
 

Our world is so entirely affected by the fall that it can sometimes be difficult to pull apart what exists because it was part of God’s plan for the world, what exists because of the fall, and what exists because of God’s grace to us after the fall.  Understanding Gods good and perfect will for our world is no easier than understanding God’s will for our own personal lives.  We must be careful and prayerful when we consider these things.  We must not assume that because we have discovered a scientific fact or law that it is thereby God’s law.  It could be the law of sin working in our own members. 
 
 Jessica L. Clevering, PhD, Assistant Professor of Psychology, Trinity Christian College

Tuesday, April 1, 2014

Psychological impact of self-forgiveness

Authored by Rebecca Schichtel,  who is an undergraduate student here at Trinity Christian College.
 
When a cognitive process is disrupted, it can cause an abundance of problems. As sinful human beings, it is important for us to learn to forgive ourselves. We are imperfect and flawed. Without the ability to forgive ourselves, we can fall into an unhealthy pattern of negativity and self-depreciation. Two psychologists, J. H. Hall and F. D. Fincham studied some factors that could affect people’s likeliness to forgive themselves (as cited in McConnell & Dixon, 2012).. This article focuses on how perceived forgiveness from God affects self-forgiveness (McConnell & Dixon, 2012).
 
Before focusing on how perceived forgiveness affects self-forgiveness, this article began by briefly analyzing a few other factors. In comparing guilt and shame in this context, shame appeared to have a more negative effect on self-forgiveness than guilt. This could be because guilt seems to center around other people, whereas shame tends to center around the person feeling guilty. This focus on oneself could lead to self-disapproval and evasion, which could lead to a damaging cognitive pattern. Hall and Finchman (as cited in McConnell & Dixon, 2012) also compared empathy and conciliatory behavior. Empathy was found to be only slightly related to self-forgiveness. Surprisingly, when attributions were studied, they were found to be completely separate from self-forgiveness. Hall and Fincham had thought that inner attributions would have inhibited true self-forgiveness because the person would place a great amount of responsibility on him- or herself. Moreover, Hall and Finchman studied how the severity of transgressions affected people’s ability to forgive themselves. They found that altering the perception of the severity of transgressions did have an effect on self-forgiveness because the offenders may have seen more severe wrongdoings as too terrible to allow self-forgiveness (as cited in McConnell & Dixon, 2012). Finally, the authors dove into the idea of perceived forgiveness, particularly perceived forgiveness from God, as increasing people’s likelihood of forgiving themselves.
 
When people experience guilt and shame, they “can experience guilt and/or shame ‘internally’ in relation to their selves and ‘horizontally’ in relation to other persons, but also ‘vertically’ in relation to God” (McConnell & Dixon, 2012, p. 32). It has been shown through studies that people who feel guilt and shame will be more likely to forgive themselves if they receive forgiveness from other people, such as the person who had wrong done to them. Spinning off of that idea, Hall and Finchman tested “the hypothesis that self-forgiveness is a possible antecedent variable of perceived forgiveness from God in personal instances” (as cited in McConnell & Dixon, 2012, p. 33). They did this by presenting three questionnaires to “evenly distributed” (McConnell & Dixon, 2012, p. 33) groups of participants. The participants also received the questionnaires in varying order to eliminate order as a variable. One questionnaire asked about adjective ratings (ARG), one asked about God image inventory (GII), and the other was about self-forgiveness. In the end, they found that personal “perceived forgiveness from God is significantly correlated with self-forgiveness” (McConnell & Dixon, 2012p. 36).
 
If people are forgiven by those they hurt, by other people around them, and by God, would it not make sense that they would have an easier time forgiving themselves? If people hurt others around them, and those who were hurt will not forgive them, it would be more difficult to forgive themselves. The good news is that we do have a forgiving God, a God who will forgive all our sins no matter what we have done. Seeing God in this light can help people forgive themselves because if the Creator of the universe is willing to forgive them, why should they not forgive themselves? Unfortunately, many people do not see God this way, and many have a contradictory belief that even though we have a forgiving God, God would not be willing to forgive them personally.
 
Perhaps the knowledge that perceived forgiveness from God can help people forgive themselves, ultimately allowing them to live a more comfortable and more joyful life, can be used in therapy. People who cannot forgive themselves may have illogical thinking processes involving thoughts about how terrible they are, that there is nothing that they can do to change that, and because they are so dreadful, God would not possibly be able to forgive them. Perchance this type of faulty thought process could be stopped through cognitive therapy. If people could see the areas that do not match up, maybe they could come to see they are forgiven and then eventually be able to forgive themselves.
 
Thought stopping could also break the chain of actions that can come from this type of thinking. If people think they are terrible, they do not think they deserve to be forgiven. That could lead to them feeling there is no point in trying so they do more things that make them feel worse. Stopping those thoughts would also stop that chain of disagreeable actions (McConnell & Dixon, 2012).
 
This article helped me understand more about the cognitive side of therapy. It made me think about how people think and how those thoughts can be changed. It made me think about why certain processes of thought should be changed and how just faulty patterns of thinking can change your whole life. I can completely see how this would be related to depression or possibly post-traumatic stress disorder. How we think and what we focus on can have such a greater impact than I thought.
 
All in all, it seems the forgiveness of self might be closely connected with perceived forgiveness from God. If this is the case, it could be very beneficial to bring people’s spiritual and religious views into the light of conversation in therapy. If people are able to work through the difficult feelings of shame and guilt vertically, they might have an easier time doing the same internally. I wonder whether those who have not been forgiven by those they hurt would be able to forgive themselves without the knowledge that God forgives them. This makes me wonder what is the best way to help people through situations where they might never be forgiven entirely by those they hurt. They still need to learn to forgive themselves.  
 
References
 
McConnell, J. M., & Dixon, D.N. (2012). "Perceived Forgiveness from God and Self- Forgiveness." Journal of Psychology and Christianity 31 (1), 31-39.

Tuesday, March 25, 2014

2014 Psychology Renewed Conference


Additionally, CEUs will be available for LPCs and LCPCs for a small processing fee. Please contact Michael DeVries with questions at michael.devries at trnty.edu

Sunday, March 2, 2014

Loving the Deviant of the Group


The following blog entry was adapted from a chapel speech given by Dr. Clevering on October 30, 2013

One of the great things about finding a major in college is that you get insight into the Bible from a whole new perspective.  A history major might learn more about ancient Mesopotamia and therefore have a better understanding of the culture and customs of the people surrounding Israel.  An English major might learn about syntax and parallelism and have a better appreciating of the poetry of the psalms.  And a psychology major may have insights into Jesus’ social interactions.

One passage which I feel I understand better as a psychologist is Luke 19:1-10.  This is the story of Jesus meeting Zaccheus, the tax collector, and going to eat with him.    

To understand the psychology in this story we also need to understand the historical setting of the story.  Zaccheus was Jewish.  And he collected taxes from the Jews on behalf of the Romans.  If that weren’t bad enough, the taxcollectors in those days were allowed to charge people whatever they wanted so long as the Romans got their portion.  That meant the tax collectors got to line their own pockets with a lot of extra cash.  So we can’t think of these tax collectors as just an ancient version of the IRS.  Tax collectors were pretty shady characters and they fraternized with the enemy.  In fact, because of their interactions with the Roman gentiles they were considered to be unclean by their fellow Jewish countrymen. 

As a tax collector, Zaccheus is what we would call an in-group deviant.  In-group deviants are in your in-group.  They have an association with you.  When you use the pronoun “we” it includes them.  They belong to one of the groups you belong to.  Other people make a connection between you and them.  But they are different, and weird, and just not normal.  They don’t go along with the group norms.  They are an embarrassment.  The term deviant refers to the fact that they deviate from what is expected.  They deviate from how everyone thinks they should behave.  Deviants don’t do what they’re supposed to do and don’t think how they’re supposed to think. 

Zaccheus was an in-group deviant.  He was Jewish, he lived among his fellow Jews and counted himself as a belonging to the Jewish people.  And yet he collected taxes for the Romans.  He associated with gentiles and took money from his own people.  So nobody liked him.   

Studies show that people tend to dislike an in-group deviant even more than someone from a rival group.  One interesting study was conducted at a university which was known for being a party school.  It was not cool to be studious at this university.  The students at this university were asked to rate how much they would like to be friends with several types of people.  One type was someone at their own school who spent a lot of time studying.  Another type was someone from a rival school who spent a lot of time studying.  The people at that university said they would rather be friends with the studious person from the rival school than someone from their own school who was studious.  In other words, it is easier to love a Roman than someone from your own group who collects taxes for the Romans. 

This is why Jesus’ behavior is so fascinating.  In the book of Matthew Jesus verbally commanded us to love our enemies.  That is really hard.  But we can often get away with thinking we do this.  After all, an enemy is an abstract concept.  Enemies are not in your in-group.  They aren’t your people.  You don’t feel a connection to them.  You don’t come into contact with them often so it’s easy to love them in theory.  But then in the story of Zaccheus, Jesus commands us by example to love our in-group deviants.  This is so much harder. 

Just think how easy it is to talk about accepting each other’s differences and how hard it is to love that guy who always sits with you in the cafeteria making awkward comments and asking you to explain all your jokes.  How easy it is to accept the guy in the cool car driving by you on the road and how hard it is to love your clueless upper-class roommate who has no idea what it really means to work hard for something.  How easy it is to attend a civil discourse presenting both sides of a political debate and how hard it is to love your best friend from high school who insists on posting the most ridiculous, biased, political nonsense on facebook.  How easy it is to volunteer at an agency working with people recovering from addictions and how hard it is to love and forgive the person in your own family struggling with addiction.  How easy it is to have an international-style worship service and how hard it is to love that member of your church who let slip a racist comment the other day. 

Those people just don’t get it.  They are so embarrassing.  They are so frustrating.  They are so hard to love. 

The passage ends with Zaccheus having a change of heart – He gave half of his possessions to the poor.  Jesus then declares “Today salvation has come to this house, because this man, too, is a son of Abraham.  For the Son of Man came to seek and to save what was lost” (Luke 19:9-10) Jesus reminds everyone that Zaccheus is a son of Abraham.  He reminds everyone of who Zaccheus belongs to.  We must seek the ability to love our in-group deviants because they belong to us and we belong to them. 

Tuesday, February 4, 2014

Christians and help seeking behaviors


Megan Hanfee-Major is a sophomore at Trinity Christian College double-majoring in Psychology & Communication Arts/ Theatre. Originally from New Richmond, WI, Megan plans to continue her education in Psychology by pursuing a M.A. degree with an emphasis that has not yet been determined. She hopes to eventually serve God's people through a career in counseling, perhaps integrating her love of theatre into the therapeutic process


In an article in The Journal of Psychology and Christianity entitled “Measuring Protestant Christians' Willingness to Seek Professional Psychological Help for Mental Illness: A Rasch Measurement Analysis” (2012) researchers Kenneth D. Royal of the University of Kentucky and Juan Michael Thompson of the University of Louisville attempt to see whether or not self-professed Christians that attend a Protestant- based church are likely to seek professional help with mental illnesses.  This is a particularly interesting topic considering the differing views within Christianity concerning the classification of mental disorders as illnesses or demonic or the like.  The authors’ methods are fairly simple; they conducted a survey within churches regarding the likelihood of seeking professional psychological assistance when dealing with a mental illness.

The survey used was a simple 10 question one with statements such as “If I were experiencing a serious emotional crisis at this point in my life, I would be confident that I could find relief in psychotherapy,” that the participant reacted to.  Overall the results showed that, generally, the group of 540 was not likely to seek professional help although the majority believed that professional intervention could help with their psychological problems.  However, the respondents generally did feel that if they had been feeling depressed or distressed for a long period of time or if they felt as if they were having a mental breakdown that they would seek help (Royal & Thompson, 2012).

The researchers reflected upon previous work done in this area and concluded that “religious” people are less likely than the average person to seek out treatment when a psychological problem arises.  They cite that the most commonly held reason why people in general do not seek help is the stigma attached to receiving psychotherapeutic assistance.  Does this mean that Christians feel this even more strongly?

This would make sense.  Perhaps Christians feel that they should be equipped to manage any sort of distress they encounter in their life because Christ has set them free from bondage.  And while this is true, many people know and are realizingthat just because Christ has gifted us with freedom in His name we can still face trials.  In fact He assures us we will face trials.  And because He knows this He encourages us to lean on our brothers and sisters in the faith for support.  It is unfortunately  still a commonly held belief (especially for Christians) that we should be able to handle our problems on our own and reaching out for help is a sign of weakness.

Another factor that should be considered is that Christians will often reach out to leaders in their churches (pastors, elders, etc.) for assistance in a crisis.  A person of this standing may not be equipped and trained to handle situations involving some mental illnesses, but  may provide valuable insight when dealing with problems such as depression.  Although this may not be the most effective solution it is one many people feel more comfortable with (again, it has less of a stigma attached).  I have to wonder how this study would be able to consider this in their data.

It doesn’t seem like the people involved in the survey were against the idea of seeking treatment altogether.  The majority said that they would consider it- as a last resort.  What causes this mindset?  Why do Christians (those who should understand somewhat the level of human fallibility) especially shy away from seeking out psychotherapeutic help during times of trial and when concerning mental illness?  But the most important question, I think, is how do we combat this?  How can we remove as much as possible the negative connotations associated with receiving psychological help when needed and make it a better option in the minds of people, but especially Christians?  How can we show Christians that dealing with their problems professionally is not a sign of weakness or incompetence, but of faith in that they care enough about their whole-body health to seek support?

References:


Royal, K. D., & Thompson, J. (2012). Measuring protestant Christians' willingness to seek professional psychological help for mental illness: A Rasch measurement analysis. Journal of Psychology & Christianity, 31(3), 195-204.