The Medical Ministry of a Secular Priest-in-Training (article)

As a psychologist-in-training, I find myself intrigued by the evolving nature of the science and art of psychotherapy and by my own personal development as a therapist. I also believe that religious issues can be unfortunately pathologized, just as biological problems can be minimized, by many psychotherapists today.

Initially trained at a university-based mental health clinic, I often observed (behind a one-way mirror) more-experienced students perform “therapy” with their clients who were from the surrounding community, which included campus students and rural middle-class whites. During group supervision, often called “team,” I was impressed by the sense of confidence and poise displayed by my supervisors as they explained the nature and treatment of our clients’ problems. I was a young apprentice ready to absorb each concept discussed during team. Each word, each analytical term, was sacred and I believed they were the keys to unlocking the kingdom of psychopathology. Terms like “dynamics,” “projective identification,” “corrective emotional experiences,” and, best yet, “core ordering processes” fluttered in my head. I was on my way to becoming a healer of mental maladies myself, a secular priest. One day, I would comprehend these healing mysteries related to the psyche and release my magic on others.

During my second and third years of training, I provided psychological services to clients regularly and it was not uncommon for me to see them for more than six months, even up to one year. As a fervent disciple, I spent a significant amount of time in supervision reviewing my taped sessions each week. But as time passed, doubts began to enter my mind regarding the effectiveness of the approach I was being trained to take. Not only did the secular priests disagree with each other about how to treat these clients but also the “biological” and “spiritual” aspects of my clients’ problems seemed to be neglected. As a scientist, I knew that medications could help people with certain chemical imbalances. When I suggested that some clients might benefit from antidepressants, well-meaning authorities gave me the implicit message to “do more process-oriented work” and to “try therapy first and then medication if needed.”

As a Christian, I knew that spiritual issues could play a major role in the life of human beings but felt the implicit message from the priests that these matters were not as important as “psychological” ones. During one session, I turned the video recorder off for five minutes so I could talk as a Christian to a client who had serious spiritual conflicts, for fear that doing so would be criticized during supervision time. Yet, when my “sin” came to light (through the graduate school grapevine), I was chastised for turning off the tape, not for wanting to help the client. This encouraged me that spirituality could be part of counseling.

At this time I stumbled upon the works of Viktor E. Frankl, such as The Doctor and the Soul and The Will to Meaning, and attended some meaning-centered Franklian conferences in Dallas. Curiously enough, Frankl was never mentioned in our core psychotherapy course at the university, although we did study other existential therapists. As a physician, Frankl emphasized the “whole” care of his patients. He contended that many times biological and psychological explanations of problems seem to contradict each other but can be understood more clearly once we embrace the spiritual aspect of human beings. He believed that conflicts in the spiritual dimension, such as a sense of meaningless, could contribute to depression, anxiety, and other mental maladies. Frankl also encouraged his patients to draw upon the spiritual part of themselves in order to develop powerful coping resources to face, or learn to accept, their conditions. His ideas resonated with some of my own. His theory gave me the freedom to address value conflicts and feelings of meaninglessness with my clients and to encourage them to develop and fulfill meaningful goals, as well as to advocate treatment with psychotropics. Frankl was the iconoclast I needed!

My transition into a medical clinic, where I saw mostly minority and indigent patients, validated and expanded this exciting, meaning-centered approach. I was introduced into a highly integrated biopsychosocial model of treatment. I focused more energy on my initial evaluations than before and I openly asked patients about their spiritual and cultural backgrounds. General practitio-

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ners, nutritionists, social workers, psychologists, and recently chaplains all treated the same patients in order to offer them the best total health care. For me, this echoed Frankl’s concept of the “medical ministry,” a comprehensive approach including the spiritual.

In a setting where each patient had a six-digit number, I actually began to value the uniqueness of each of my patients more than ever before. I varied my counseling approach to their specific situations. Some patients needed encouragement to “keep the faith,” while others had to be challenged. Some greatly benefited from receiving information about their medications, others felt better after seeing a simple friendly smile. Some patients needed to be referred to other specialists immediately, while others agreed to be seen by me for a short while. I learned that as a secular priest, I needed to be flexible and open to each patient. I needed to become “all things to all people,” a concept the Apostle Paul found essential to his “ministry” in the New Testament.

So where do I stand now as a psychologist-in-training? While I still think fondly of my earlier graduate student experiences, I have learned a tremendous amount about therapy from the experts and my patients. My medical ministry with minority and indigent populations has helped me realize what Frankl termed the “incredible resilience of the human spirit.” I have heard countless reports of how patients have found comfort in their faith and family to face all manner of adversity. How many examples of the resilience of the human spirit will we encounter in the therapy room tomorrow?

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