Christian counseling: Nouthetic vs. Biblical

Last night, I spent some time on the phone with my husband’s friend’s sister (aka my former pastor’s sister). We’ll call her Natalie.

Natalie was very sweet and kind, really encouraging and strengthening me by sharing her testimony of faith in God. She suffers from anxiety and panic attacks, which has led her to take Paxil (on and off) for the past 7 years. She says the drug has helped her tremendously and who am I to knock the drug (knowing what I know about Paxil/Seroxat) when she has seen the wonders that it has worked in her life?

I briefly explained my story of depression, history of suicide, and diagnosis of bipolar disorder. Although she couldn’t fully relate, she was very sympathetic and understanding. In fact, our conversation was so fruitful, I ended up taking notes!

We briefly touched on the issue of Nouthetic counseling (NC). She has undergone the course and simply needs to be certified. The counselor I currently see is associated with the Christian Counseling Education Foundation (CCEF), which has roots in NC and was founded by the man—Jay Adams—who developed the method. However, CCEF is now known for what is called biblical counseling. The organization has since moved away from pure Nouthetic methods and become more a bit more varied, taking bits and pieces of psychology (and perhaps psychiatry) that line up with the Bible. Adams, disagreeing with the organization’s approach, founded the Institute for Nouthetic Studies and uses the Bible as the sole counseling textbook. According to the wiki entry on Nouthetic counseling, Adams developed the word Nouthetic based on the “New Testament Greek word noutheteō (νουθετέω), which can be variously translated as ‘admonish,’ ‘warn,’ ‘correct,’ ‘exhort,’ or ‘instruct.'”

NC was developed back in the ’70s as a response to the popularity of psychology/psychiatry. Many Christians reject some of the teachings of such popular psychologists as Freud, Jung, Adler, Maslow, etc. Adams’ highly successful book, Competent to Counsel, criticizes the psychology industry and counters its teaching with a Nouthetic approach.

But NC has its Christian critics.

Natalie said that while she enjoyed the Christ-centered foundation that the method is built upon, the Nouthetic method is vehemently against psychiatric medication. Even one of the oft-cited passages on depression in the Bible, Elijah’s experience in I Kings 19, is dismissed as mere “pouting.” NC takes the approach that much of mental illness is a product of a person actively engaging in sin and the person simply needs to get his or her behavior “right with God.” As a result of this teaching, many Nouthetic counselors believe that no amount of medication can “cure” this kind of sin. I have a friend who suffers from PTSD—he endured a lot of trauma as a child—and his symptoms worsened after his experience with a Nouthetic counselor who simply told him that he was the one in the wrong and that he needed to repent of his sin. Although he currently attends a seminary that strongly teaches NC, he is in the extreme position where he feels that no good can come out of it, even with a Bible-based approach that would include the Nouthetic method.

On the other hand, CCEF uses a mix of secular psychology and Nouthetic counseling. CCEF comes from the view of not “throwing out the baby with the bathwater.” While they disagree with many ideas of thought in psychology, they choose the ones that line up with Scriptural principles and apply them. An interesting book on mental illness that’s written from this point of view is Blame It on the Brain? by Ed Welch. While many of our problems and disorders may have their roots in sin, we shouldn’t discount physical factors. For example:

• I’m more likely to have a mixed-mood episodes when I’m severely tired.
• I often suffer from fatigue and irritability during the middle of my cycle (about 12-16 days in) and toward the end of my cycle (25-28 days in)
• A total of 6 hours of sleep over the course of 2 days makes me more susceptible to depression, anxiety, and some paranoia.

Those are just a few of the ways that I keep an eye out on the known physical factors that affect me. But I’m sure there are unknown physical factors in play too and they need to be treated as well.

Depending on the person, a pure Nouthetic approach may work just fine but for someone with a complex history like mine, merely telling me to repent of my selfishness and lack of faith won’t work. CCEF’s biblical approach—using the Bible as the foundation for counseling, not as the only counseling textbook—has helped me to:

• recognize the factors that have shaped me into the person I am,
• evaluate and root out any pervading sin in my life, and
• focus on Christ and his work on the cross to “die to self” and become more like him.

Addendum
First, I revised parts of this post to more away from the word “integrational.” Apparently, it’s a pejorative term that’s thrown around for non-Nouthetic teaching so I wouldn’t want to confuse anyone seeking help who stumbles upon this post.

Second, after rereading this post, I realized that it sounds like a plug for CCEF. The post wasn’t written with that intention but in a way it is. I know how the services that CCEF provides (not only counseling but also conferences, books, etc.) have helped me and this could probably be considered a “customer testimonial.” I haven’t been paid to say anything for or against Nouthetic counseling; this is just an explanation of my experience.