Treating Affect Phobia in Jesus’ Name Powerpoint available at www.Christianpsych.org Treating Affect Phobia in Jesus’ Name Working with the Defenses and Emotions of Christian Clients

The source materials of this model were developed by Leigh McCullough

This presentation is an example of Christian-accommodative therapy It begins with a non-Christian model and makes Christian accommodations to it to bring it in line with Christian beliefs and practice. This practice is the most common way Christians develop therapy models in our day The danger of this approach is the extent to which secularism has distorted the source model The challenge for Christians when they accommodate a secular model is to make sure the final Christian version is as fully Christian as it could be Problem: Most therapy done by Christians today is secular: even when working with Christians, no use is made of Jesus Christ and his redemptive resources

Justifying Christian-accommodative therapy God is the ultimate source of all truth, so utilizing valid knowledge and practices found in non-Christian models of therapy to develop distinctly Christian models is a good thing. Augustine called this “spoiling the Egyptians.” But when we do this, we have to have Jesus in the Center of the therapy, implicitly when working with non-Christian clients, and explicitly when working with Christian clients. Otherwise, we end up practicing secular therapy. I want you to evaluate if the model I’m presenting is still too secular, or if it is distinctly Christian

Christian-derived therapy This approach begins with distinctly Christian resources (the Bible and the Christian traditions) and develops its own unique therapeutic content and practice, perhaps secondarily informed by contemporary psychology. Examples of this include spiritual formation, healing prayer, and biblical counseling. Developing Christian-derived therapy is a primary task mission of the Christian psychology movement

The model is a form of Short-Term Dynamic Psychotherapy (STDP) It assumes that adults are afraid of their emotions, especially their negative emotions It teaches shame/anxiety regulation and resolution to help clients overcome their defenses and process their emotions. Uses systematic desensitization Translates psychodynamic therapy into behavioral terminology and practice There are three foci, each with 2 subcategories

Affect Restructuring (GAF score = 70-80) A GAF score was based on psychological, social, and occupational functioning Affect Restructuring (GAF score = 70-80) Affect Experiencing Affect Expression Defense Restructuring (GAF = 50-80) Defense Recognition Defense Relinquishing Self and Relational Restructuring (GAF = < 50) Self Restructuring Relational Restructuring

A GAF score of 50 is a rough cutoff point for providing STDP, and just doing relational therapy So, a potential counselee must have at least, a moderate level of functioning overall. a few friends, in spite of some conflicts and discomfort in relationships ability to hold a job, in spite of some occupational conflicts and dissatisfaction, poor performance Moderate difficulty w/symptoms, but not incapacitated. Below 50: No friends Severe difficulties in day-to-day functioning Inability to contain affect well enough to control addictions or aggressive impulses Difficulty holding a job.

Affect Restructuring Christians assume that emotions are created by God and a flourishing life experiences and expresses emotions in productive, life-giving ways However, growing up in a fallen world, we learn that certain emotions are “not okay,” so we learn to avoid them So they need to be restructured.

Affect Restructuring Affect Experiencing Exposing counselees to physiological experience of the conflicted emotion, while at the same time lowering the level of the associated anxiety. This is called anxiety regulation.

Affect Restructuring Affect Expression Helping clients experience their emotion while expressing it in healthy ways –according to God’s design plan and consistent with biblical norms This is demonstrated in the Psalms, with God as the conversation partner of the affect expression. This can be practiced with God, with the therapist, with safe others, in journaling, with the two-chair technique

Defense Restructuring A defense is an unconscious structure/activity that keeps a painful, unwanted thought or emotion out of awareness. Problem: Though helpful in childhood, defenses are a result of the fall (consider Adam and Eve hiding from God), and they prevent our knowing and experiencing reality fully and truly, and prevent healing of unresolved material

Defense Restructuring Defense Recognition Recognizing in real time and everyday life one’s phobic avoidance of some positive or negative emotion, manifested in thought or action

Defense Restructuring Defense Relinquishing/Surrender Increasing the motivation to give up a defense Choosing to access one’s true emotions

Self- and Relational Restructuring Humans live in a relational universe Triune God Self Others Material Universe A Four-Dimensional Relational Model Growing up in a fallen world, humans are more or less damaged in their self-representation and relational capacities

Self- and Relational Restructuring Self-Restructuring Differentiating one’s old self and new self based on Christ’s life, death, and resurrection Undermining the power, orientation, and living patterns of one’s old self Building one’s new self in relationship with others, especially God, in union with Christ and dependence on the Holy Spirit Integrating all of one’s actual self into the new self

Self- and Relational Restructuring Undermining old self patterns of perceiving and relating to others Building new self patterns of perceiving and relating to others, including God, through healing relationships with others, including God and mature humans

Affects and Affect Phobia in Short-term Tx Affect, emotion, and feeling will be used as synonyms Affective understanding has neurological primacy over language-based understanding Affects can be stored in memory (emotion schemes) Affect is a primary motivator Feelings are meaningful. They are signs (past, present, future) Emotions are bodily states One can fear internal objects, like feelings

Emotions and Action Orientation Activating emotions (tend to motivate us to action Anger/assertion, sadness/grief, fear/terror, enjoyment/joy, interest/excitement, closeness/tenderness, positive feelings toward the self, sexual desire Inhibitory emotions (tend to shut us down/freeze/hide) Anxiety/panic, shame/humiliation, guilt, emotional pain/anguish, contempt/disgust)

The Bivalence of Emotions Positive emotions Contentment, joy, peace, love, interest/excitement, closeness/tenderness, positive feelings toward the self, healthy sexual desire Negative emotions Anxiety/fear, anger, sorrow, shame, guilt, emotional pain/anguish, contempt/disgust

The Productivity of Emotions Each emotion is meaningful and can be experienced and expressed productively or unproductively Productive experience/expression brings relief, healing of the self and one’s relationships, and works according to God’s design plan, e.g., grief, motivating anger, care for others brings closeness Unproductive expression makes things worse e.g., self-pity, whining, acting out, mindless catharsis (ranting, hysterical sobbing); it causes harm to self and others

Because fear is related to shame and anxiety, Tx of affect phobia can be understood as teaching shame and anxiety regulation. An effective Tx for phobias is called systematic desensitization This involves “graduated exposure”

Systematic desensitization

Three steps in systematic desensitization of affect phobia 1. Exposure to feared affect 2. Automatic response prevention (discouraging the maladaptive response: the defense) 3. Shame/anxiety regulation (decreasing shame/anxiety during exposure and response prevention) If shame/anxiety gets too high, therapist offers strategies to reduce anxiety

Affect phobia is also likely strongly related to shame and guilt, which Christianity directly addresses through the cross Union and communion with Christ: understanding and experiencing the presence of Christ in prayer, meditation, guided imagery, the two-chair technique, and other strategies God’s grace/gospel: understanding and experiencing this doctrine, Christ in the gospels Christian counselors and others can model love and grace in their counseling dialogues

Defenses help people avoid conscious conflict “The purpose of defensive behavior is to limit or even eliminate from consciousness the activating affect, the inhibitory affect, or both.” (36) When strong, the inhibiting affect becomes a defense—a “defensive affect” (p. 40)—because it gets in the way of healthier ways of functioning. Examples of defensive affect: regressive rage, exaggerated grieving, weepiness w/ no relief, desperate longing

Relationship is necessary to modify our internal-relational world Mature others can be a “container” for our emotions, providing ‘scaffolding” that enables us to experience our distress and express it in productive ways God can also be that container—infinite in size—with whom we can experience our distress and to whom we can express it in productive ways (e.g., lament)

Affect Phobia, Psychodynamic Conflict, and Malan’s Two Triangles Relational Triangle Conflict Triangle Self Present Others Inhibiting Affect (shame, anxiety, guilt, pain, disgust) Defenses True Feelings 1.Actual feelings (whatever they are) 2. Ideal feelings (what one should feel in this situation) Past Others

Formulating the core psychodynamic conflict An example Look for inhibiting affect (A) Look for defense (D) Look for true emotions Actual emotions (AE) Ideal emotion (IE)

A Christian Accommodation: The Two Pyramids Relational Pyramid Resolution Pyramid Triune God Jesus Christ Present Others Inhibiting Affect (shame, anxiety, guilt, pain, disgust) Self Defenses Past Others True Emotions 1. Actual emotions (whatever they are) 2. Ideal emotions (what one should feel in this situation)

Restructuring in Therapy Creation grace goal of all therapy: “re-experiencing the old, unsettled conflict, but with a new ending.” (Alexander and French, 1946) How does Christian therapy uniquely fulfill this universal therapy goal? With the redemptive grace resources of communion with God and union with Christ in his life, death, and resurrection