Tag Archive - private practice

Depression: Soren Kierkegaard on Actuality, Freedom and Possibility

July 22, 2009 in Ministry-Theology, Technology-Social Media, Therapy-Psychology with 1 Comment

Today, LifeChurch.tv posted the third of four videos that I shot with them on depression. Monday’s video was An Anchor in the Journey-Exodus 17:1. Tuesday’s video was Depression-At the Movies continued. Today’s video is Walking Through Depression. In today’s video I share about the prophet Elijah wanting to die, and actually asking God to take his life away.

Sometimes our depression becomes so severe that we just can’t even function. It evolves into an anguish that is difficult to cope with at times, and sometimes we wonder if we can move on. That is a difficult place to be, and it is not uncommon among humanity.

One of the things I have been reading a lot about recently is the issue of anxiety, and how anxiety lies between our knowledge of possibilities, and actuality. This is something that Kierkegaard talks a lot about, and I think he has some good things to say on the topic of depression.

kierkegaardKierkegaard is one of my favorite writers, thinkers, philosophers, theologians, and psychologists. Ever since reading Fear and Trembling when I was 22 he has continued to profoundly shape my life and thinking.

So it is not surprising that in the book Depression and Hope by Howard W. Stone, that it is Kierkegaard that has something to say to us on this issue. Let me quote at length the following passage from the book:

Soren Kierkegaard’s understanding of persons–for our purposes depressed persons–also helps us understand hope. In The Sickness Unto Death, he describes persons as possessors of actuality, freedom, and possibility. All three are a part of the authentic self, and a good relationship of all three is necessary for authentic existence. Actuality refers primarily to the past; it includes our context, our psychological predispositions, and choices we have previously made.

Freedom is what we have in the present. It is a finite freedom, exercised within the limits of our situation and abilities, our givens and past choices. Because of our actualities we cannot simply become whatever we want to be ‘if we try hard enough for it.’ We make choices, and act, from the range of options available to us.

Possibility addresses the future. It is what we can become as we use our freedom. In that respect our possibilities are not predetermined. We are not automatons. We can imagine, and within the givens of life we can become something new. Living as an authentic self, according to Kierkegaard, means looking beyond our immediate necessities or past liabilities. We anticipate the future with the awareness that we are free–however limited–to actualize whom we ought to become as faithful Christians and to take responsibility for shaping that future. Continue Reading…

Are You Experiencing Depression?

July 21, 2009 in Ministry-Theology, Technology-Social Media, Therapy-Psychology with 4 Comments

As I mentioned yesterday, I had the opportunity to share some thoughts around depression with LifeChurch.tv. The first video, An Anchor in the Journey-Exodus 17:1 appeared yesterday, and I posted a little more details on my blog, Depression: Getting Honest With Our Journey.

You can check out the second video, Depression: At the Movies continued.

Assessing Depression
There are a variety of factors and tools that one may use in assessing if someone has depression. In therapy, there are usually a few basic questions I ask to better assess what is going on. In my work as a Marriage and Family Therapist one of the main tools that we use is the DSM-IV (i.e. Diagnostic and Statistical Manual for Mental Disorders). Whether or not one believes in diagnosing individuals, some of the criteria they provide is very helpful in getting a sense of the symptoms that one is exhibiting.

51yeqm7b52l_bo2204203200_pisitb-sticker-arrow-clicktopright35-76_aa240_sh20_ou01_As a pastor, leader, or volunteer in the Church you most likely will not look at the criteria in the DSM-IV, but it’s important to have a baseline of criteria that one’s symptoms can be measured against. A book that I have found really helpful is Depression and Hope: New Insights for Pastoral Counseling by Howard W. Stone. In this great book Stone says the following:

Criteria for Depression

Depression, or melancholia, is known in psychiatric terminology as major depression to distinguish it from the normal low periods that many people go through. The psychiatric diagnostic criteria for major depression lists nine symptoms, as follows:

  1. Depressed mood, sadness, irritability part of each day, nearly every day
  2. Diminished pleasure or interest in daily activities
  3. Considerable weight loss or gain, change in appetite
  4. Significant change in sleeping patterns (The most common result is early waking.)
  5. Marked increase or decrease in movement (Most commonly the person physically slows down.)
  6. Fatigue and loss of energy
  7. Feelings of worthlessness or guilt (The feelings are beyond the scope of how people would usually feel.)
  8. Difficulty in concentration
  9. Ideas of suicide or death

To be diagnosed with major depression according to the American Psychiatric Association criteria, persons must exhibit at least five symptoms for a minimum of two weeks, and have either depressed mood or diminished pleasure or interest on most days for at least part of the day (APA 1994). These criteria are a good basis for determining if someone really is depressed. The certainly are not exhaustive but signal that a person’s story may be one of melancholia. (pp. 65-66)

Have you, or are you experiencing any of these symptoms? Have you sought out help for them? Continue Reading…

Depression: Getting Honest With Our Journey

July 20, 2009 in Ministry-Theology, Technology-Social Media, Therapy-Psychology with 2 Comments

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[image by Church Online]

This week I have had the opportunity to share some thoughts around depression with LifeChurch.tv. You can watch the 4:34 minute video, An Anchor in the Journey-Exodus 17:1 as I talk about the importance of seeing our lives as a journey, and the experiences we will come up across during the journey…such as depression.

Whether you are struggling with depression yourself, or just know someone who is, I hope that you can resonate with the video and the post below.

I remember where I was at the exact moment I read the words below by Rob Bell in his book Velvet Elvis: Repainting the Christian Faith. I was sitting on our couch in Pasadena, CA and as I read each word the resonance grew deeper and deeper within me until I finally felt like I was hit by a ton of breaks…but at least understood. At least there was some pastor out there I thought, this one in Michigan, who put words to my feelings and thoughts in ways that I was not able to at the time. Bell says,

Once again I am going to give you some numbers, and I hesitate to do so, but it is part of the story and it helps to explain the rest. Two years into it, there were around 10,000 people coming to the three gatherings on Sundays.

In the middle of all this growth and chaos was me, superpastor. I was doing weddings and funerals and giving spiritual direction and going to meetings and teaching and dealing with crises and visiting people in prison and at the hospital–the pace and the workload were unreal.

I can’t begin to describe what it was like because it was happening so fast. One minute you have these ideas about how it could be and the next minute you are leading this exploding church/event/monster. All of a sudden there are all of these people who know who you are and want something from you and think you’re a big deal, and you are the same person you’ve always been. Everything has changed and yet it hasn’t. It’s hard to explain, but I found myself asking, “Where is the training manual?”

Continue Reading…

Dealing with issues around depression, anxiety, etc…

July 19, 2009 in Marriage-Family, Technology-Social Media, Therapy-Psychology with 2 Comments

This last week I had the opportunity to drive up to LifeChurch.tv to film 4 video vignettes on the movie Henry Poole is Here. Without sharing too much in this post, the movie does a great job of really capturing some of the more human experiences we go through during difficult times in our lives. So I shot 4 videos, each about 3-5 minutes long dealing with different thoughts on topics such as depression, anxiety/angst, etc.

If you haven’t seen the movie, I really recommend it. Even better yet, check out LifeChurch.tv’s new sermon series, “At the Movies”, with plenty of opportunities this week for you to view online.

So each day this week (Monday-Thursday) you will see a new video vignette from me over at LifeChurch.tv Facebook page, and you will have the opportunity to interact, comment, ask questions, etc. I hope that what I have to share will be of encouragement to you, and I hope that I can point you towards some great resources as well.

Church Online at LifeChurch.tv is a great ministry, and I really appreciate the opportunity they have given me to talk about such important life issues, especially in such a great online venue where the interaction among people is so authentic and real.

So please let me know if I can be of any help this week as I post videos, interact with content, and point you towards resources on the topics of depression, anxiety, fear, anger, etc.

Premarital Counseling: Before You Say I Do

July 18, 2009 in Marriage-Family, Therapy-Psychology with 1 Comment

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[image by vicnknes]


One of the things that I wish more couples did was seek out premarital counseling. It’s quite shocking to me that very few people go through any type of premarital counseling, therapy, classes, etc. leading into their marriage. We require training and exams for driver’s license’s, to get into school, but one of the most important decisions one can make in life hardly requires anything.

There are lots of great resources out there for Premarital Counseling, but one of my favorites is Prepare/Enrich. My wife and I went through this program with our therapist, and I have recommended it to quite a few couples who have found it to be extremely helpful.

One of its strengths in my opinion is its ability to identify issues that couples need to discuss in counseling before marriage. Usually the key issues that are identified, then become the topic of therapeutic conversation. For example, issues like money, inlaws, sex, education, God, etc. may be ones that couple’s need to talk about with someone.

Most couples go into the engagement phase so head over heels that they aren’t always thinking clearly, or they are fearful of approaching some serious subjects with each other out of fear of actually disagreeing on something, or finding out so close to marriage that they actually don’t see eye to eye. So they just ignore the issues, but inevitable they will not stay hidden but emerge sometime early in marriage.

So if you are going to get married, or about to get married…do yourselves a favor and get premarital counseling.

If you are already married, and did or did not get premarital counseling, can you share your thoughts on your own perspective for either doing, or not doing it?

Improve Your Marriage During Tough Economic Times

July 17, 2009 in Marriage-Family, Therapy-Psychology with 0 Comments

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[image by Stewart]


I came across this post the other day, 15 Ideas To Improve Love And Marriage During Tough Economic Times.

The post is actually great advice for anytime, not just hard economic times. Tess Marshall says:

80% of the people who have lost jobs are men. We live in a society where men are expected to play the role of economic provider. When men lose their jobs they lose their status as a provider and often feel like failures.

Many wives have become the sole provider in relationships, often feeling totally responsible and pressured to bring home more income.

Children who normally have excess now need to adjust to having less. Parents feel guilty for not being able to provide like they have in the past.

Our economy offers us an opportunity to grow, become stronger, and keep our marriage happy, healthy and intact.

Continue reading to check out the 15 helpful tips that she discusses.

Do you have any other tips that you would suggest?

Book Recommendation: The Mystery of Marriage

July 16, 2009 in Marriage-Family, Therapy-Psychology with 0 Comments

41R3EY2E5AL._BO2,204,203,200_PIsitb-sticker-arrow-click,TopRight,35,-76_AA240_SH20_OU01_The Mystery of Marriage: Meditations on the Miracle is a book that I read probably back in 1999, or 2000, after I was required to do a book report for one of my family counseling classes in seminary. This book was one of a handful of books recommended by my professor, and at the time I thought, well, I’m interested in marriage, at least at some point in my life, so I might as well start reading now.

What attracted me initially to the book was the title. It wasn’t a self-help style book, or here is “seven steps to a great marriage”, or the “ten things you better do before you say I do, or else your marriage is doomed”…type of book. Instead it was simple:

The Mystery of Marriage

I liked that, because for all I knew from experience at the time was that women were definitely a mystery at times, as men could be as well, and if God could bring two people together in marriage, it was definitely a mystery that could not be reduced to simple steps. It was also a miracle, hence why Mike Mason meditates on it. Meditation conjures up the idea of something that takes patience, work, concentration, etc…you don’t think of ten easy steps, or eight sure fail rules, when the word meditation is in the mix.

And his table of contents was very different than any table of contents I have ever read concerning books on marriage. Short. Simple. Mysterious. Here is the table of contents.

Foreword
Preface
Prologue
Otherness
Love
Intimacy
Vows
Sex
Submission
Death
Epilogue
The Lover’s Hermitage

I think this is the best book of all the books I have read on this topic. It is beautifully written, and Mason does a great job of exploring difficult themes in marriage, while maintaining a sense of mystery, and not talking things to death, or laying them out in steps. So if you aren’t into easy steps, this is a great book for you.

And for those of you who are single, or who think they are light years away from marriage, I found this book to be a great prepping tool before marriage. Mason gives great insight into the single mind, and the struggle one has, and the desire one has to be single, yet also to be married. It is a great read.

Have you read this book before? What did you think of it?

Two Questions I Have For You About Being Married

July 15, 2009 in Marriage-Family, Therapy-Psychology with 1 Comment

There are two questions that I often think about in terms of marriage, and it’s these two same questions that I often like to ask couples…so I am going to pose them to you. Here they are:

What is the most rewarding thing about being married?

What is the most difficult thing about being married?

6 Marriage Books That I Highly Recommend

July 14, 2009 in Marriage-Family, Therapy-Psychology with 7 Comments

There are lots of good books on marriage, but I want to mention just six of them here that I highly recommend. And in recommending them, let me just give one brief statement of why I like them.

As For Me and My House: Crafting Your Marriage to Last by Walter Wangerin Jr.

  • I love Wangerin’s approach in talking about marriage here.  He doesn’t write about steps to follow, but really approaches the topic from a real narrative standpoint, sharing story after story that the reader can enter into and relate to about marriage.

Hold Me Tight: Seven Conversations for a Lifetime of Love by Sue Johnson

Passionate Marriage: Keeping Love and Intimacy Alive in Committed Relationships by David Schnarch

  • Schnarch’s discussion on “differentiation” is very valuable.  I love his insight.

Sacred Marriage: Celebrating Marriage as a Spiritual Discipline by Gary Thomas

  • His first chapter on how marriage is about “holiness and not happiness” is paradigm shifting in most of our views.  It was mine.

The Mystery of Marriage: Meditations on the Miracle by Mike Mason

  • This is my favorite book on marriage.  Not steps, just a deep, philosophical and theological look at marriage that is quite refreshing.

The Seven Principles for Making Marriage Work by John Gottman and Nan Silver

  • I mentioned this book last week, but it’s a great book with some very practical tips and exercises for couples.

What books would you add to this list and why?

imarriage brings you "real-time" updates on marriage

July 13, 2009 in Marriage-Family, Technology-Social Media, Therapy-Psychology with 0 Comments

For the last week I have been talking a little about marriage, whether it be a quote from a good book, to some thoughts on some benefits for couple’s therapy.

Today I want to introduce you to a great tool on Twitter. It’s called imarriage and it’s the brainchild of Marc Payan.

What does imarriage do? imarriage is:

“Aggregation of real-time updates on relationship and marriage news, research, and global trends.”

I have been following imarriage for quite a while and have gotten to know Marc Payan online, and hopefully in person one day soon. In fact, as I get closer and closer to talking about the influence of technology and social media on marriage and family therapy, I’m sure you will be hearing more from Marc on this site.

If you aren’t on Twitter, but you are a marriage and family therapist, work with couples, etc., this alone should be worth your time. With almost 4,000 people following the updates it has become quite an influential site for what is going on in the world of marriage, family and relationships.

But if you aren’t going to get on Twitter, then check out the website Marriage Tweets, which is one and the same.
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