In a 1992 Gallup poll, 66% of the people surveyed said they preferred a mental health counselor who represented spiritual values and beliefs; 81% said they would like their own values and beliefs to be integrated into the counseling process. Perhaps because pastoral counseling is particularly responsive to these needs and desires, it has become a major provider of mental health services.
Pastoral counselors are clergy and others who have received graduate training in both religion and behavioral science for a clinical practice that integrates psychological and theological disciplines. A typical program includes a three-year professional degree from a seminary and a master's or doctoral degree in pastoral counseling, with supervised clinical experience and one's own personal psychotherapy. Many pastoral counselors are certified by the American Association of Pastoral Counselors (AAPC), which also accredits pastoral counseling centers and approves training programs. Pastoral counselors also practice in other institutions and in private offices, and they do consultations for community clergy. In most states, no license is required to perform pastoral counseling, and many persons practicing under the title are parish ministers, priests, or rabbis who are not affiliated with AAPC. A national licensing examination is being developed by AAPC, whose members are also accountable to their faith communities.
What is distinctive about pastoral counseling as a form of psychotherapy? Most pastoral counselors believe there is a God or divine power in whose image we are created. They believe that we yearn for a transforming connection with the divine and that psychotherapy can mediate the loving and healing nature of being itself. Some AAPC members believe in a therapeutic role for spiritual values but not in a divine being. Pastoral counselors may also make therapeutic use of traditional religious resources such as prayer, Scripture reading, and participation in the worship and community life of a congregation. They often pay special attention to the religious history of the client and the client's family, noting how it may contribute either to the pathology or to the resources needed for coping.
False images of the ultimate can distort one's concept of oneself. Characteristics of a client's parents or other childhood authorities may have been projected onto a divine figure. What appears to be the voice of truth in a person's life may actually operate as an idol or false absolute. Mistaken beliefs about oneself, others, and the world may result from participation in an implicit theological drama derived from family history and erroneously supported by religious institutions.
A depressed woman who consulted a pastoral counselor felt unable to express her feelings because of a conflict that originated in her childhood. Her mother had often read to her Jesus' saying "Blessed are they that mourn, for they shall be comforted." But whenever she began to cry, the mother would say, "Shut up; go to your room; don't be a crybaby." She believed her scolding mother instead of the Scriptures and continued to do so into her 40's. She repressed not only sadness but most other emotions, choosing a husband who would not tolerate any expression of disappointment or anger. She was eventually able to demythologize her mother as an ultimate authority and exchange her image for that of a loving God.
A minister who sought counseling strove desperately for affection and approval and could not tolerate criticism or anger from any member of his congregation. In therapy he learned that he was the victim of a false idea of God, created in the image of his demanding, perfectionist father - an image he was finally able to dethrone.
These cases illustrate the unique orientation or listening perspective that pastoral counselors may bring to bear. One psychiatrist has called it "clinical theology" - search for a revelation of love, forgiveness, and good news to people who have been in bondage to their feelings and the past.
Reprinted with permission from the May 1997 edition of The Harvard Mental Health Letter. This article came in response to the question posed to Merle R. Jordan, Th.D., Albert V. Danielsen Professor of Pastoral Psychology at Boston University School of Theology and a Diplomate in the American Association of Pastoral Counselors.