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Salvation and Psychotherapy
GEORGECARRUTHERSBONNELL Some people still see an almost unbridgeable chasm between psychiatrist and pastor. W h e n driven to one or the other, they expect something different from each. An individual's attitude to religion and psychiatry, his personal theology, the nature of his problem, and his relationship to pastor and doctor will determine his choice between the two. 1 Obviously a person with paranoidschizophrenic tendencies would benefit most from psychiatry, while someone with a personal problem rising from a deep sense of actual guilt might better get help from a clinically-oriented pastor. The gap between pastor and psychiatrist is not really so great. Both psychiatry and religion deal with "health" in the broader sense of the word. Both are concerned with "the mature man." Both are aware of illnessnpsyehogenie and physiogenie. Both seek ways to bring a person to wholeness and health, and both live in a dependently-creative relationship with each other. Often a psychiatrist and a clergyman will agree to work with the same person in a complementary manner using different approaches. A doctor and a minister may both be trained to assist individuals with particular emotional problems. Because men from these two related disciplines work so closely THE REV. GEORGECARRUTHERSBONNELL,S.T.M., with a certificate in pastoral counseling from the Postgraduate Center for Mental Health in New York, has served as pastor of the West Side Presbyterian Church in Englewood, N. J., and the Union Church in Bay Ridge, N. Y. For the past five years he has been pastor of the First Presbyterian Church in Plainfield,N. J,
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together, it would help to develop, in the light of contemporary theology and psychotherapy, a dynamic view that encompasses both salvation and the psychotherapeutic helping process.
The life process of Every-man To be human is to experience existential anxiety. One's very nature makes him vulnerable to the basic anxieties of life. But how does one deal with existential anxiety? The chart below gives a partial answer to that question and is further elaborated in the paper that follows. II
ZV/ Defenses (neurotic and pathological)
R1
Existential anxiety
III Defenses worked tluough in process of ral counseling.
R2
x: the conscious beginning of the psychotherapeutic or pastoral counseling process at a time (generally) of great personal crisis. R1-R2: reality where one inevitably experiences existential anxiety. I All people begin life with existential anxiety. II Idolatry in the form of pathological or neurotic anxiety inevitably emerges. The more extreme the defense against existential anxiety, the more anxious the individual becomes and the more separated he is from his own true self (R1-R2). III In psychotherapy or pastoral counseling, the helper (doctor or pastor) enables the individual to work through his pathological and neurotic anxieties in order to confront and live with existential anxiety. He is then able to realize his own God-given potential as a human being. Some people do not reach a point in life where psychiatric or pastoral counseling is neces&ry. Their neurotic anxieties are minimal, they do not develop crippling defenses, and they are able, therefore, to cope relatively well with existential anxiety.
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Existential anxiety To be alive is to be anxious. The concept of "peace, perfect peace" is a myth and a delusion. So long as we are alive, we experience anxiety in one form or another. It is part of being human. Howard J. Clinebell, Jr., writes: Existential anxiety is the raw material from which all anxiety is formed.,.. It is "existential" in that it is inherent in man's very existence as a self-aware creature. But its impact on the individual can be either creative or destructive, depending on how it is handled.2 Existential anxiety arises out of the basic fact that we are made in the image of God--spatio-temporal creatures on the one hand and self-transcendent beings on the other. W e cannot fully reconcile the two conditions. There is for each of us the threat of circumstances over which we have little control (fate and death), an awareness that we do not have all the answers (emptiness and loss of meaning), and guilt (a sense of separation from our own true self, others, and God). But how does existential anxiety arise? An infant experiences two fears-of falling and of loud noise. Expelled from the security of the uterus, he encounters these as the first threats to his existence. In this state of "original innocence" he considers the world as merely an extension of his own body. His needs for food, for warmth and comfort are met automatically. The infant is all "id." Gradually, however, in the inevitable process of exploration he discovers himself as a separate being from his mother. He smiles, he experiences the first fears of separation, he becomes a being in his own right. He has begun to develop the fragile beginnings of self-identity (ego). There is an interesting parallel between Adam in the Garden and the infant. The child inevitably becomes as God "knowing good and evil" when he develops self-identity (ego) and still later a system o f values (superego). But in the very process he separates himself from his original union with nature (his mother), and now he must ,win unity as a person. Thus arise the first frightening experiences of existential anxiety.
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Man, who lives in the Garden of Eden, in complete harmony with nature but without awareness of himself, begins his history by the first act of freedom, disobedience to a command. Concomitantly, he becomes aware of himself, of his separateness, of his helplessness; he is expelled from paradise, and two angels with fiery swords prevent his return. Man's evolution is based on the fact that he has lost his original home, nature-and that he can never return to it, can never become an animal again. There is only one way he can take: to emerge fully from his natural home, to find a new home--one which he creates, b y making the world a human one and by becoming truly human himself.3 It is easy n o w to see how "natural" it iswin such circumstances--to experience severe existential anxiety. T o be alive is to be anxious! Parents--to a small child --sometimes appear as God did to Adam in the m y t h of the fall: arbitrary, jealous of their prerogatives, and terribly angry!
Neurotic and pathological anxiety H o w do people, all of w h o m k n o w existential anxiety, move from this to relatively severe experiences of neurotic and pathological anxiety that propel some of them finally into the hands of a pastoral counselor or psychotherapist? Again we turn to H o w a r d Clinebell, Jr., for elaboration of a previously quoted statement: Existential anxiety is the raw material from which all anxiety is formed . . . . but its impact on the individual can be either creative or destructive, depending on how it is handled. That which one uses to cope with existefitial anxiety is, psychologically speaking, one's "religion." This may be one of many forms of idolatry-the deification of possessions, health, "success," alcohol, the state, a church, one's family, making these matters of "ultimate concern" (Tillich). Neurotic problems can also be understood as attempts to avoid existential anxiety.... If one attempts to cope with existential anxiety by pseudo-religious (i.e., idolatrous) or by neurotic means, the inevitable results are the diminishing of the creativity, awareness, and authenticity of one's life. 4
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journal of Religion and Health
In other words, the way we eh0ose to handle existential anxiety is our religion, because this is our "ultimate concern." The biblical writers never concerned themselves with atheism. In fact, the word is not used in the Bible. They were concerned with idolatry, which took many forms. Even the divinities people worshipped did not concern the prophets so much as the forms their worship took. Behind every life interest there is some aim or objective that has grasped the worshipper and has become the binding force of his lifemhis religion. Erich Fromm, in his brilliant Psychoanalysis and Religion, reversed Freud's interpretation of religion as the collective childhood neurosis of mankind and suggested that neurosis is "a private form of religion, more specifically . . . a regression to primitive forms of religion conflicting with officially recognized patterns of religious thought. ''5 Many neurotic patterns of behavior are actually forms of religion that shape and direct a person's whole way of life because these are his "ultimate concern." A hang-up over authority figures may be a contemporary kind of ancestor worship. Obsessive-compulsive forms of behavior may actually be a private kind of ritual. Exclusive obedience and blind loyalty to nation, party, or religion can become a sophisticated form of totemism. The list could be lengthened with parallels drawn from primitive forms of religion. While we may disagree with Freud that all religion is a childhood neurosis, we heartily agree with Fromm that neurosis is a private form of primitive religion. Man is naturally a religious creature. This is a part of his humanity. He cannot live in perfect harmony with God and his fellow~ereatures precisely because he is human. He does not know what the future holds, he has no grasp on any absolute, he knows that life is bounded by death, he lives with a sense of guilt at being out of touch with the supernatural This raises all sorts of existential anxieties that drive him forward in his search for some form of religion, some binding, all-embracing way of belief that gives minimal security in a world of change. Especially when he has not developed a sense of basic trust he cannot live with relativities, so he builds all sorts of absolutes that work for a while but that break down under stress and leave him floundering
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about in a morass of neurotic and pathological anxieties that can lead to physical and emotional illness as well as more immediate forms of self-destruction. He may ultimately try to build the universe around himself. This will drive him even further toward ultimate despair. Most people today display in their behavior relative degrees of this terrible eondition of deterioration. Existential anxiety, therefore, almost inevitably drives us to idolatry. In a world without absolutes, we build absolutes in the form of Bibles, creeds, ehurehes, economic systems, nations, ways of life (democracy, etc.), ethical values and standards. Marx was right when he said that man makes idols of those institutions or ideologies from which he derives meaning and direction. At the same time he failed to recognize that communism can also become one of these idols. In a state of anxiety regarding one's finitude men seek to eternalize themselves. Man tries to prolong the small stretch of time given to him; he tries to fill the moment with as many transitory things as possible; he tries to create for himselfa memory in a future which is not his; he imagines a continuation of his life after the end of his time and an endlessness without eternity.6 This eternalizing may take other forms, such as striving for notoriety, scrambling for personal wealth, transforming churches into busy institutions, escaping into second childhood, etc. W h e n the anxiety of guilt prevails, a person seeks escape in forms of national or religious pietism that create black and white situations placing the individual on one side over against another, that transform complex ethical issues of contemporary life into a simple choice between right and wrong. The anxiety of meaninglessness, which most severely affects contemporary life, drives us to seek false idols or institutions. W e find ourselves at this point in hearty agreement with Dr. Tillich when he wrote: "Attempts to overcome estrangement within the power o f one's estranged existence lead to hard toil and tragic failure. ''T Idolatry also leads to certain pathological perversions (neurotic and psychotic) whereby the individual seeks to run away from existential anxiety by
388
]ournal of Religion and Health
reinforcing his idols, by attacking his detractors, and by emotional escapes from reality through which he cuts himself entirely off from the world in which he lives (schizophrenia). The relationship between existential and pathological anxiety provides a theological and philosophical meeting ground for psychiatry and religion. Here is a solid basis for a congenial theological, psychological, and phil6sophical understanding of anxiety. Because a mere reinforcing of idolatry often leads to further pathological anxiety and because people are very unsure of their little idols, the result is an unbroken vicious cycle. Frequently today there is a breakdown of every value system and no idolatries take their place. Though some modern idolatries are just as vicious as ever, others appear rather innocuous, sentimental, and irrelevant. More people than before seem to have no particular value system. They are caught in cycles of pathological anxiety that have no specific reference to idolatry in any form. This merely intensifies their feelings of finitude, guilt, and meaninglessness so that they see no exit from their situation. They often do not even know they are existentially estranged. They simply feel lost. This is enough to make anyone ill. His particular illness symbolizes his chosen idolatry, which protects himself against any threat to what he considers essential to life. The greater the threat and the stronger the anxiety, the more the individual is found to rely on his basic style of life. The vicious cycle continues, intensifying itself till a breakdown occurs that throws him into total confusion. The role of religion A truly religious person lives by faith. He builds highways where no paths ever existed. He smooths out the rough roads and levels the hills. The idolator lives by faith in a book, a creed, a church, or a political system. He is rarely adventurous or genuinely creative. He sticks to the known roads. The only way we can learn to live b y faith is to work our way back through pathological and neurotic anxiety till once more we can live with existential anxiety.
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The most expeditious way for us to do this is to develop a "religious" point of view. In the earliest days of psychoanalysis, religion was considered a neurotic condition of the mind. When one sick patient after another presented a sick religious outlook, therapists began to feel with Freud that religion is the one "obsessive neurosis of mankind." N o w many therapists recognize the need for religion--a binding force that brings meaning and direction to the psychotherapeutic process. They would agree that psychotherapy is a process of salvation whereby a person is enabled to live in a relatively effortless manner, relieved of the tyranny of extreme anxiety. Psychotherapy, friendship, marriage, and religious worship all may provide this healthy and living environment that is basic to all human development and growth. Psychotherapy, then, "is evidently a truly religious experience and religion at its maturest is the fullest attainment of the aims of psychotherapy. ''8 Psychotherapy and religion follow different roads leading to the same goal of salvation. Freud did not slam the door of psychotherapy against religion. He simply maintained that from his point of view, faith in God and religion per se were products of a sick mind. Let us be quite clear on the point that the views expressed in my book form no part of analytic theory. They are my personal views, which coincide with those of many non-analysts and pre-analysts, but there are certainly many excellent analysts who do not share them.9 Freud referred to himself as a "secular pastoral worker," and on one occasion wrote to his friend, the Rev. Oskar Pfister: In itself psychoanalysis is neither religious nor non-religious, but an impartial tool which both priest and layman can use in the service of the sufferer. I am very much struck by the fact that it never occured to me how extraordinarily helpful the psychoanalytic method might be in-pastoral work, but this is surely accounted for by the remoteness from me, as a wicked pagan, of the whole system of ideas,l~
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Journal of Religion and Health
Pfister, a pastor and a psychoanalyst, though he stood at the opposite pole from Freud in religious conviction, was one of Freud's warmest and most personal friends. He was, in fact, a friend of the whole Freud family. When Freud published his "completely negative attitude to religion, in any form and however attenuated," he feared that his views--though well known to Pfister-would be painful to his friend. In more recent years, men in both fields have come to recognize the similarity of the process of healing in psychotherapy and religion. A psychotherapist can indicate how certain forms of religion have arisen from the culture in which they are associated. He can point out some of the real motives behind much piosity, and he can show how a neurotic's thinking about God is related to infantile parental projection; but he cannot disprove religion itself. Oskar Pfister was quick to point out that Freud "grew up in proximity to pathological forms of religion and regarded these as 'religion,' " while he (Pfister) "had the good fortune of being able to turn to a free form of religion which to you [Freud] seems to be an emptying of Christianity of its content, while I regard it as the core and substance of evangelism. T M Psychotherapy and religion, using somewhat different tools, reach out for the same end: the redemption of the whole person. The psychotherapist describes this "redemption" in secular terms and the pastor uses theological jargon, but they are not as far apart as would first appear. Christian psychotherapy, though some of its techniques may not be part of the secular therapist's process, provides a wider frame of reference for all therapy. When therapy begins with the conviction that in, behind, and through the process is the healing power of Christ, when it envisages even hopeless vegetables in state hospital wards as children of God, when over and above the process of reconciling ego and id the therapist never loses sight of his objective of helping a man discover in himself limitless resources of healing and beyond himself an overreaching reason for being--when these become the guiding convictions of his life--a therapist can do much for his patient. Redemption of the whole person, then, is central to psychotherapy and
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religion. Both speak in terms o f the mature man. Both seek to release the client from immature forms of thought and behavior. Both recognize the fact that a man cannot be emotionally immature and religiously mature. A close study of Erik Erikson's Childhood and Society (Chapter 7m"Eight Ages of Man") 12is fundamental to any genuine understanding of religious development. Until recently, traditional Christianity could not provide a basis for religion and psychotherapy. For centuries, Christian theologians peered at man through the binoculars of Greek philosophy. Through one side they beheld man as spirit related eternally to God. Through the other they saw a physical creature destined always to be a part of nature. This split concept resulted in a cleavage that portrayed the soul as clean and pure, the body as evil and dirty. In the end it produced salvationistic, other-worldly forms of Christianity that are even today largely unrelated to the flesh-and-blood realities of life. The Hebrews saw man in psychosomatic union. There was no soul. W h e n a man died, he was stone-cold dead, and only in some bodily resurrection at the end of time was there hope for any kind of life after death. Today we have begun to recapture aspects of this concept and apply it directly to contemporary life. Listen to Paul Tillich: Salvation is healing . . . . It is astonishing how many of our profoundest modern insights into human nature are anticipated in these [biblical] stories. They know that becoming healthy means becoming whole, reunited, in one's bodily and psychic functions. They know that the mentally sick are afraid of the process of healing, because it throws them out of the limited but safe house of their neurotic self-seclusion, they know that the process of mental healing is a difficult and painful one, accompanied by convulsions of body and soul. They tell of the relation of guilt and disease, of the way in which unsolved conflicts of our conscience drive us to those cleavages of body and soul which we call sickness.TM From a Christian point of view, salvation is now regarded not as transcending one's humanity, but as fulfilling it by involvement in the day-to-day fleshand-blood crises of life. W e today are the product of every stage of human
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evolution, and we contain within ourselves vestigial and continuing remnants of all preceding levels of development--physical, emotional, and intellectual. Salvation--spiritual or psychotherapeutic--involves the incorporation of all these forces into one's style of life, so that the individual, instead of being at war with himself, becomes at one with himself. These resources are not his. They become his only as he reaches down within himself and lives in harmony with a ~orld that is infinitely wider than himself. This reaching down and back brings him into contact with all creation and the Creator. Many early translations of the Bible substituted the word "health" for "salvation." ("This day health has come to this house.") The biblical writers used many words to describe salvation, each of them meaningful in itself and conveying something of its total import. Words like "adopted sons of God, .... reborn," "recreated," "resurrected, .... redeemed" all were verbal vehicles that conveyed to firstcentury men and women the contemporary meaning of psychosomatic health. 14 Dr. Joseph Haroutunian, in one of a series of lectures on "Christian Humanism," declared: The problem of man is to glorify God in his creation. We want to glorify God but we don't have anything to glorify God with. Theocentric theology must be humanistic theology. Authentic human existence involves also theological existence.15 A dynamic view of salvation implies that God is immanent in his creation, working constructively in the lives of men. So far as humanity is concerned, the line of God's eternal activity coincides with the line of history, so that incarnation is not God breaking into history in the man Jesus Christ, but God's purposive activity in history on behalf of mankind coming to peak and fulfillment in the man Jesus Christ. Perhaps the handle that helps provide a theological basis for pastoral counseling and psychotherapy is the imago dei. Traditionally we have presented a spiritualized version of Christ, an emasculated, namby-pamby Jesus who lacks masculinity, virility, humanity. He is the kind of Christ most normal people could not stand to have in their homes and their businesses; yet Chris-
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tians often pawn him off on others. The imago dei cannot be known except through the full humanity of Jesus. If we stick with his full humanity, the image of God will shine through. Because of existential estrangement, this image is shattered in all men except Christ, who alone became fully man. By fulfillment of Christ's humanity, the image of God came through strong and clear. According to Paul Tillich, Christ overcame in himself the existential estrangement of death, meaninglessness, and unrelieved guilt, so that in him and him alone the New Being emerged. The N e w Being is the Mature Man, the whole man--the one toward whom all pastoral counselors and all psychotherapists look, Ideally and theoretically speaking, if pastoral counselors and psychotherapists were able to move their counselees through the total process of healing and maturation, they would finally stand together in one spot with a new being, a whole man or woman, a person who has experienced total salvation ( salvus -- health). Common goals
Once w e discover that the religiously-oriented therapist and the pastoral counselor share a common dynamic view of salvation, we can agree on certain common goals and objectives.1~ 1) Both therapist and pastoral counselor agree that it is essential for an individual to develop a reason for being, a religion, a binding conviction that brings meaning and direction to his life. In the process of counseling, analysis and synthesis go hand in hand. While the therapist takes a generally more objective point of view than does the pastor of "religion," both begin where the client is and work from there. In the process, neurotic overtones are removed and the individual develops a healthy frame of reference. The therapist who favors a religious orientation but is not at home with the patient's religious outlook may encourage the individual to seek spiritual help from his pastor. Thus therapist and pastor work together on different levels and in different areas of the person's life. A pastor trained in counseling can often help his parishioner relate his religious convictions to the process of therapy.
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Religious thought then moves beyond neurotic conflicts and anxieties, beyond an all-demanding id or a ruthlessly repressive superego, beyond emotional distortions to a pattern of creative self-acceptance in which he finds himself at home with society, with his own true self, and ultimately with God and the universe. His intellectual convictions merge with his sense of emotional security and he finds life worth living and death merely the fulfillment of birth and growth. 2) Both therapist and counselor replace stern authoritarianism with a kindly, healing authority figure who eventually guides the individual out of dependency toward personal autonomy. The individual, within a permissive atmosphere, works out his negative and positive feelings of transference toward the authority figure of the therapist, while the Christian pastoral counselor, working on a different level, helps his client develop a brother-sister relationship in Christ. In both situations, anger and aggression are worked through, fear and guilt are relieved, so that stronger feelings of affection and trust toward others can predominate. The client, less threatened by inner conflicts than before, is able more easily to keep in close contact with the realities of his life situation. Christianity then is a great attempt to escape from the authoritarian fatherfigure and the archaic aspects of the super-ego. It is pre-eminently a son and brother religion rather than a father religion. But the central drama of Christianity shows that it is not possible to surmount the guilt of rebellion against the father without the sacrifice of atonement whereby the great revolutionary leader was himself slain in the role of the divine scapegoat. 17 Both processes of salvation may follow different routes, but they arrive at the same goal of reducing passive-aggressive feelings toward authority figures and of encouraging a genuine sense of personal autonomy. 3) Both pastor and therapist can look upon themselves as intermediaries of healing power that comes from beyond. Healing is recognized as coming through the agent counselor in a healthy personal relationship between him and his client or as rising within the client when obstacles are removed from the path along which the patient moves to wholeness and health. The
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Christian doctrine of grace, developed along therapeutic lines, suggests that in all of life there is a basic tendency toward healing, integration, health, and wholeness that manifests itself in any person as inhibiting anxieties are worked through and defenses gradually removed. J. A. C. Murray suggests that the path of psychotherapy is strewn with wrecks caused by heedless amateurs who without training or tools rushed in where angels fear to tread. He also observed that those equipped with the skills of physical science but blind to spiritual resources have come upon genuine spiritual need and anguished searching for the unknown God, and attributed these yearnings to neurotic craving for a father figure who would carry them through the adult storms of life. It is precisely here that Christian psychotherapy ... can never fall into either of the two errors already mentioned. It has far too much reverence for the dignity and integrity of man, ever to descend to the level of the bungling amateur; and it has far too much sensitivity to the voices of God, ever to let i~s science be earthbound. TM The pastor and the religiously-oriented therapist, no matter how they label these healing powers, if they recognize them as coming from beyond or from within, are in a stronger position to help their clients in the most creatively possible way. 4) Both pastor and therapist can believe in "original sin," though it may be differently interpreted by each counselor. Both are aware of the terrific unconscious forces of human personality that literally tear an individual apart. Freud, at a time when men believed in human perfectability, was very pessimistic: I do not break my head very much about good and evil, but I have found little that is "good" about human beings on the whole. In my experience most of them are trash, no matter whether they publicly subscribe to this or that ethical doctrine or to none at all.TM Karl Menninger took a more contemporary look at man, but was very little more optimistic:
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Journal of Religion and Health
It is nothing new that the world is full of hate, that men destroy one another, and that our civilization has arisen from the ashes of despoiled peoples and decimated natural resources . . . . It is true, nevertheless, that in the end each man kills himself in his own selected way, fast or slow, soon or late. We all feel this, vaguely; there are so many occasions to witness it before our eyes. 2~ A contemporary Christian interpretation of original sin describes it as a state of mind, as "Sin" in the singular, out of which all "sins" arise. So long as one does not become too moralistic in his interpretation of "sins" and is at the same time aware of the continual battle between id and superego, neurotic behavior has some interesting and not coincidental similarities with the socalled "seven deadly sins" of orthodox Christian morality. 5) Both aim at reducing guilt while fostering social responsibility. Psychoanalysis has destroyed m u c h puritan morality that judges individuals by external behavior with no genuine concern for causative factors in the person's unconscious. While a pastoral counselor can often best help an individual deal with a genuine sense of guilt, both pastor and therapist can deal with neurotic forms of guilt and their origins deep within the individual. Karl Menninger indicates that some psychoanalysts still make almost a religion of nonjudgmentalism, adopting a laissez-faire attitude to their patients' behavior outside the consultation room. At the same time, he holds to a more rational position . . . by conceding the point of view of society and of the law and of religion--that "sin" is alluring and that, if we yield to it, we have to pay for the "fun." But the psychiatrist's further assumption is that sin is not nearly as much fun as it is made out to be, that it is usually painful and in a large sense unwanted by the individual, and that there are better ways than punishment to influence people to avoid it. 21 While psychotherapy sensitizes the pastoral counselor to conditioning forces within human personality, the pastoral counselor can keep the therapist aware of the need for responsible behavior even as his patient is working through deeply-rooted and terribly troublesome drives and conflicts. 6) More recently, though the therapist still is concerned primarily with
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individual therapy, both recognize the impact of socio-cultural-economic factors upon a person's development. While Freud declared that neuroses rose from a conflict between the drive for pleasure and the crushing control of a ruthless superego, therapists like Horney and Fromm recognize the shaping force environment has on the development of personality. These more contemporary therapists and others dip i n t o anthropology, history, economics, and sociology to develop their more catholic approach to human development. Therapists and pastoral counselors see more clearly today that you cannot treat the individual apart from his total environment. The social gospel proclaimed by more contemporary-minded Christians falls closely in line with the latest discoveries of leaders in other fields. Salvation to the pastoral counselor is a great deal more than "saving souls," and mental health to the therapist consists of something more than a simple resolution of conflict between id and superego. We have come a long way toward finding a common theological foundation for the pastoral counselor and the religiously-oriented therapist. W e have not resolved all the ambiguities and complexities of the situation, but we can agree that salvation and mental health have a great deal more in common than most people suspected even two decades ago. References
1. According to a recent survey, 42% of all people with emotional problems go first to their pastor for help. See Gurin, Gerald, et al., Americans View Their Mental Health. New York, Basic Books, Inc., 1960, p. 307, 2. Clinebell, Howard J., Basic Types of Pastoral Counseling. Nashville, Tenn., Abingdon Press, 1966,p. 249. 3. Fromm, Erich, The Sane Society. New York, Holt, Rinehart & Winston, 1955, pp. 24-25. 4. Clinebell,op. cit., p. 249. 5. Fromm, Psychoanalysis and Religion. New Haven, Yale University Press, 1950, p. 27. 6. Tillich, Paul, Systematic Theology, Vol. 1. Chicago, University of Chicago Press, 1957, p. 69. 7. Ibid., p. 80.
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8. Guntrip, Henry, Psychotherapy and Religion. New York, Harper & Bros., 1956, p. 199. 9. Freud, S., Psychoanalysis and Faith: The Letters of Sigmund Freud and Oskar Pfister, trans, by Eric Mosbacher. New York, Basic Books, Inc., 1963, p. 117. 10. Ibid., p. 17. 11. Ibid., p. 122. 12. Erikson, E. H., Childhood and Society. New York, W. W, Norton & Co., 1950. 13. Tillich, The New Being. New York, Charles Scribner's Sons, 1955, p. 37. 14. For further elaboration on this idea see Grant, F. C., An Introduction to New Testament Thought. New York, Abingdon Press, 1950, p. 250. 15. At Union Theological Seminary, New York, on July 9, 1962. 16. Some of the ideas in this section are derived from Pfister, O., "Neutestamentliche Seesorge und Psychoanalytiscbe Tberapie," imago~ 1934, 20, 425. 17. Flugel, J. C., Man, Morals and Society. New York, Viking Press, 1961, p. 273. 18. Murray, J. A. C., An Introduction to a Christian Psycho-Therapy. Edinburgh, T. & T. Clark, 1938. 19. Freud, Psychoanalysis and Faith, op. cir., p. 61. 20. Menninger, Karl, Man Against Himself. New York, Harcourt, Brace & Co., 1938, p. VII.
, Theory of Psychoanalytic Technique. New York, Basic Books, Inc., 1958,
21. p. 97.
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Salvation and Psychotherapy
GEORGECARRUTHERSBONNELL Some people still see an almost unbridgeable chasm between psychiatrist and pastor. W h e n driven to one or the other, they expect something different from each. An individual's attitude to religion and psychiatry, his personal theology, the nature of his problem, and his relationship to pastor and doctor will determine his choice between the two. 1 Obviously a person with paranoidschizophrenic tendencies would benefit most from psychiatry, while someone with a personal problem rising from a deep sense of actual guilt might better get help from a clinically-oriented pastor. The gap between pastor and psychiatrist is not really so great. Both psychiatry and religion deal with "health" in the broader sense of the word. Both are concerned with "the mature man." Both are aware of illnessnpsyehogenie and physiogenie. Both seek ways to bring a person to wholeness and health, and both live in a dependently-creative relationship with each other. Often a psychiatrist and a clergyman will agree to work with the same person in a complementary manner using different approaches. A doctor and a minister may both be trained to assist individuals with particular emotional problems. Because men from these two related disciplines work so closely THE REV. GEORGECARRUTHERSBONNELL,S.T.M., with a certificate in pastoral counseling from the Postgraduate Center for Mental Health in New York, has served as pastor of the West Side Presbyterian Church in Englewood, N. J., and the Union Church in Bay Ridge, N. Y. For the past five years he has been pastor of the First Presbyterian Church in Plainfield,N. J,
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together, it would help to develop, in the light of contemporary theology and psychotherapy, a dynamic view that encompasses both salvation and the psychotherapeutic helping process.
The life process of Every-man To be human is to experience existential anxiety. One's very nature makes him vulnerable to the basic anxieties of life. But how does one deal with existential anxiety? The chart below gives a partial answer to that question and is further elaborated in the paper that follows. II
ZV/ Defenses (neurotic and pathological)
R1
Existential anxiety
III Defenses worked tluough in process of ral counseling.
R2
x: the conscious beginning of the psychotherapeutic or pastoral counseling process at a time (generally) of great personal crisis. R1-R2: reality where one inevitably experiences existential anxiety. I All people begin life with existential anxiety. II Idolatry in the form of pathological or neurotic anxiety inevitably emerges. The more extreme the defense against existential anxiety, the more anxious the individual becomes and the more separated he is from his own true self (R1-R2). III In psychotherapy or pastoral counseling, the helper (doctor or pastor) enables the individual to work through his pathological and neurotic anxieties in order to confront and live with existential anxiety. He is then able to realize his own God-given potential as a human being. Some people do not reach a point in life where psychiatric or pastoral counseling is neces&ry. Their neurotic anxieties are minimal, they do not develop crippling defenses, and they are able, therefore, to cope relatively well with existential anxiety.
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Existential anxiety To be alive is to be anxious. The concept of "peace, perfect peace" is a myth and a delusion. So long as we are alive, we experience anxiety in one form or another. It is part of being human. Howard J. Clinebell, Jr., writes: Existential anxiety is the raw material from which all anxiety is formed.,.. It is "existential" in that it is inherent in man's very existence as a self-aware creature. But its impact on the individual can be either creative or destructive, depending on how it is handled.2 Existential anxiety arises out of the basic fact that we are made in the image of God--spatio-temporal creatures on the one hand and self-transcendent beings on the other. W e cannot fully reconcile the two conditions. There is for each of us the threat of circumstances over which we have little control (fate and death), an awareness that we do not have all the answers (emptiness and loss of meaning), and guilt (a sense of separation from our own true self, others, and God). But how does existential anxiety arise? An infant experiences two fears-of falling and of loud noise. Expelled from the security of the uterus, he encounters these as the first threats to his existence. In this state of "original innocence" he considers the world as merely an extension of his own body. His needs for food, for warmth and comfort are met automatically. The infant is all "id." Gradually, however, in the inevitable process of exploration he discovers himself as a separate being from his mother. He smiles, he experiences the first fears of separation, he becomes a being in his own right. He has begun to develop the fragile beginnings of self-identity (ego). There is an interesting parallel between Adam in the Garden and the infant. The child inevitably becomes as God "knowing good and evil" when he develops self-identity (ego) and still later a system o f values (superego). But in the very process he separates himself from his original union with nature (his mother), and now he must ,win unity as a person. Thus arise the first frightening experiences of existential anxiety.
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Man, who lives in the Garden of Eden, in complete harmony with nature but without awareness of himself, begins his history by the first act of freedom, disobedience to a command. Concomitantly, he becomes aware of himself, of his separateness, of his helplessness; he is expelled from paradise, and two angels with fiery swords prevent his return. Man's evolution is based on the fact that he has lost his original home, nature-and that he can never return to it, can never become an animal again. There is only one way he can take: to emerge fully from his natural home, to find a new home--one which he creates, b y making the world a human one and by becoming truly human himself.3 It is easy n o w to see how "natural" it iswin such circumstances--to experience severe existential anxiety. T o be alive is to be anxious! Parents--to a small child --sometimes appear as God did to Adam in the m y t h of the fall: arbitrary, jealous of their prerogatives, and terribly angry!
Neurotic and pathological anxiety H o w do people, all of w h o m k n o w existential anxiety, move from this to relatively severe experiences of neurotic and pathological anxiety that propel some of them finally into the hands of a pastoral counselor or psychotherapist? Again we turn to H o w a r d Clinebell, Jr., for elaboration of a previously quoted statement: Existential anxiety is the raw material from which all anxiety is formed . . . . but its impact on the individual can be either creative or destructive, depending on how it is handled. That which one uses to cope with existefitial anxiety is, psychologically speaking, one's "religion." This may be one of many forms of idolatry-the deification of possessions, health, "success," alcohol, the state, a church, one's family, making these matters of "ultimate concern" (Tillich). Neurotic problems can also be understood as attempts to avoid existential anxiety.... If one attempts to cope with existential anxiety by pseudo-religious (i.e., idolatrous) or by neurotic means, the inevitable results are the diminishing of the creativity, awareness, and authenticity of one's life. 4
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In other words, the way we eh0ose to handle existential anxiety is our religion, because this is our "ultimate concern." The biblical writers never concerned themselves with atheism. In fact, the word is not used in the Bible. They were concerned with idolatry, which took many forms. Even the divinities people worshipped did not concern the prophets so much as the forms their worship took. Behind every life interest there is some aim or objective that has grasped the worshipper and has become the binding force of his lifemhis religion. Erich Fromm, in his brilliant Psychoanalysis and Religion, reversed Freud's interpretation of religion as the collective childhood neurosis of mankind and suggested that neurosis is "a private form of religion, more specifically . . . a regression to primitive forms of religion conflicting with officially recognized patterns of religious thought. ''5 Many neurotic patterns of behavior are actually forms of religion that shape and direct a person's whole way of life because these are his "ultimate concern." A hang-up over authority figures may be a contemporary kind of ancestor worship. Obsessive-compulsive forms of behavior may actually be a private kind of ritual. Exclusive obedience and blind loyalty to nation, party, or religion can become a sophisticated form of totemism. The list could be lengthened with parallels drawn from primitive forms of religion. While we may disagree with Freud that all religion is a childhood neurosis, we heartily agree with Fromm that neurosis is a private form of primitive religion. Man is naturally a religious creature. This is a part of his humanity. He cannot live in perfect harmony with God and his fellow~ereatures precisely because he is human. He does not know what the future holds, he has no grasp on any absolute, he knows that life is bounded by death, he lives with a sense of guilt at being out of touch with the supernatural This raises all sorts of existential anxieties that drive him forward in his search for some form of religion, some binding, all-embracing way of belief that gives minimal security in a world of change. Especially when he has not developed a sense of basic trust he cannot live with relativities, so he builds all sorts of absolutes that work for a while but that break down under stress and leave him floundering
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about in a morass of neurotic and pathological anxieties that can lead to physical and emotional illness as well as more immediate forms of self-destruction. He may ultimately try to build the universe around himself. This will drive him even further toward ultimate despair. Most people today display in their behavior relative degrees of this terrible eondition of deterioration. Existential anxiety, therefore, almost inevitably drives us to idolatry. In a world without absolutes, we build absolutes in the form of Bibles, creeds, ehurehes, economic systems, nations, ways of life (democracy, etc.), ethical values and standards. Marx was right when he said that man makes idols of those institutions or ideologies from which he derives meaning and direction. At the same time he failed to recognize that communism can also become one of these idols. In a state of anxiety regarding one's finitude men seek to eternalize themselves. Man tries to prolong the small stretch of time given to him; he tries to fill the moment with as many transitory things as possible; he tries to create for himselfa memory in a future which is not his; he imagines a continuation of his life after the end of his time and an endlessness without eternity.6 This eternalizing may take other forms, such as striving for notoriety, scrambling for personal wealth, transforming churches into busy institutions, escaping into second childhood, etc. W h e n the anxiety of guilt prevails, a person seeks escape in forms of national or religious pietism that create black and white situations placing the individual on one side over against another, that transform complex ethical issues of contemporary life into a simple choice between right and wrong. The anxiety of meaninglessness, which most severely affects contemporary life, drives us to seek false idols or institutions. W e find ourselves at this point in hearty agreement with Dr. Tillich when he wrote: "Attempts to overcome estrangement within the power o f one's estranged existence lead to hard toil and tragic failure. ''T Idolatry also leads to certain pathological perversions (neurotic and psychotic) whereby the individual seeks to run away from existential anxiety by
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reinforcing his idols, by attacking his detractors, and by emotional escapes from reality through which he cuts himself entirely off from the world in which he lives (schizophrenia). The relationship between existential and pathological anxiety provides a theological and philosophical meeting ground for psychiatry and religion. Here is a solid basis for a congenial theological, psychological, and phil6sophical understanding of anxiety. Because a mere reinforcing of idolatry often leads to further pathological anxiety and because people are very unsure of their little idols, the result is an unbroken vicious cycle. Frequently today there is a breakdown of every value system and no idolatries take their place. Though some modern idolatries are just as vicious as ever, others appear rather innocuous, sentimental, and irrelevant. More people than before seem to have no particular value system. They are caught in cycles of pathological anxiety that have no specific reference to idolatry in any form. This merely intensifies their feelings of finitude, guilt, and meaninglessness so that they see no exit from their situation. They often do not even know they are existentially estranged. They simply feel lost. This is enough to make anyone ill. His particular illness symbolizes his chosen idolatry, which protects himself against any threat to what he considers essential to life. The greater the threat and the stronger the anxiety, the more the individual is found to rely on his basic style of life. The vicious cycle continues, intensifying itself till a breakdown occurs that throws him into total confusion. The role of religion A truly religious person lives by faith. He builds highways where no paths ever existed. He smooths out the rough roads and levels the hills. The idolator lives by faith in a book, a creed, a church, or a political system. He is rarely adventurous or genuinely creative. He sticks to the known roads. The only way we can learn to live b y faith is to work our way back through pathological and neurotic anxiety till once more we can live with existential anxiety.
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The most expeditious way for us to do this is to develop a "religious" point of view. In the earliest days of psychoanalysis, religion was considered a neurotic condition of the mind. When one sick patient after another presented a sick religious outlook, therapists began to feel with Freud that religion is the one "obsessive neurosis of mankind." N o w many therapists recognize the need for religion--a binding force that brings meaning and direction to the psychotherapeutic process. They would agree that psychotherapy is a process of salvation whereby a person is enabled to live in a relatively effortless manner, relieved of the tyranny of extreme anxiety. Psychotherapy, friendship, marriage, and religious worship all may provide this healthy and living environment that is basic to all human development and growth. Psychotherapy, then, "is evidently a truly religious experience and religion at its maturest is the fullest attainment of the aims of psychotherapy. ''8 Psychotherapy and religion follow different roads leading to the same goal of salvation. Freud did not slam the door of psychotherapy against religion. He simply maintained that from his point of view, faith in God and religion per se were products of a sick mind. Let us be quite clear on the point that the views expressed in my book form no part of analytic theory. They are my personal views, which coincide with those of many non-analysts and pre-analysts, but there are certainly many excellent analysts who do not share them.9 Freud referred to himself as a "secular pastoral worker," and on one occasion wrote to his friend, the Rev. Oskar Pfister: In itself psychoanalysis is neither religious nor non-religious, but an impartial tool which both priest and layman can use in the service of the sufferer. I am very much struck by the fact that it never occured to me how extraordinarily helpful the psychoanalytic method might be in-pastoral work, but this is surely accounted for by the remoteness from me, as a wicked pagan, of the whole system of ideas,l~
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Pfister, a pastor and a psychoanalyst, though he stood at the opposite pole from Freud in religious conviction, was one of Freud's warmest and most personal friends. He was, in fact, a friend of the whole Freud family. When Freud published his "completely negative attitude to religion, in any form and however attenuated," he feared that his views--though well known to Pfister-would be painful to his friend. In more recent years, men in both fields have come to recognize the similarity of the process of healing in psychotherapy and religion. A psychotherapist can indicate how certain forms of religion have arisen from the culture in which they are associated. He can point out some of the real motives behind much piosity, and he can show how a neurotic's thinking about God is related to infantile parental projection; but he cannot disprove religion itself. Oskar Pfister was quick to point out that Freud "grew up in proximity to pathological forms of religion and regarded these as 'religion,' " while he (Pfister) "had the good fortune of being able to turn to a free form of religion which to you [Freud] seems to be an emptying of Christianity of its content, while I regard it as the core and substance of evangelism. T M Psychotherapy and religion, using somewhat different tools, reach out for the same end: the redemption of the whole person. The psychotherapist describes this "redemption" in secular terms and the pastor uses theological jargon, but they are not as far apart as would first appear. Christian psychotherapy, though some of its techniques may not be part of the secular therapist's process, provides a wider frame of reference for all therapy. When therapy begins with the conviction that in, behind, and through the process is the healing power of Christ, when it envisages even hopeless vegetables in state hospital wards as children of God, when over and above the process of reconciling ego and id the therapist never loses sight of his objective of helping a man discover in himself limitless resources of healing and beyond himself an overreaching reason for being--when these become the guiding convictions of his life--a therapist can do much for his patient. Redemption of the whole person, then, is central to psychotherapy and
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religion. Both speak in terms o f the mature man. Both seek to release the client from immature forms of thought and behavior. Both recognize the fact that a man cannot be emotionally immature and religiously mature. A close study of Erik Erikson's Childhood and Society (Chapter 7m"Eight Ages of Man") 12is fundamental to any genuine understanding of religious development. Until recently, traditional Christianity could not provide a basis for religion and psychotherapy. For centuries, Christian theologians peered at man through the binoculars of Greek philosophy. Through one side they beheld man as spirit related eternally to God. Through the other they saw a physical creature destined always to be a part of nature. This split concept resulted in a cleavage that portrayed the soul as clean and pure, the body as evil and dirty. In the end it produced salvationistic, other-worldly forms of Christianity that are even today largely unrelated to the flesh-and-blood realities of life. The Hebrews saw man in psychosomatic union. There was no soul. W h e n a man died, he was stone-cold dead, and only in some bodily resurrection at the end of time was there hope for any kind of life after death. Today we have begun to recapture aspects of this concept and apply it directly to contemporary life. Listen to Paul Tillich: Salvation is healing . . . . It is astonishing how many of our profoundest modern insights into human nature are anticipated in these [biblical] stories. They know that becoming healthy means becoming whole, reunited, in one's bodily and psychic functions. They know that the mentally sick are afraid of the process of healing, because it throws them out of the limited but safe house of their neurotic self-seclusion, they know that the process of mental healing is a difficult and painful one, accompanied by convulsions of body and soul. They tell of the relation of guilt and disease, of the way in which unsolved conflicts of our conscience drive us to those cleavages of body and soul which we call sickness.TM From a Christian point of view, salvation is now regarded not as transcending one's humanity, but as fulfilling it by involvement in the day-to-day fleshand-blood crises of life. W e today are the product of every stage of human
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Journal of Religion and Health
evolution, and we contain within ourselves vestigial and continuing remnants of all preceding levels of development--physical, emotional, and intellectual. Salvation--spiritual or psychotherapeutic--involves the incorporation of all these forces into one's style of life, so that the individual, instead of being at war with himself, becomes at one with himself. These resources are not his. They become his only as he reaches down within himself and lives in harmony with a ~orld that is infinitely wider than himself. This reaching down and back brings him into contact with all creation and the Creator. Many early translations of the Bible substituted the word "health" for "salvation." ("This day health has come to this house.") The biblical writers used many words to describe salvation, each of them meaningful in itself and conveying something of its total import. Words like "adopted sons of God, .... reborn," "recreated," "resurrected, .... redeemed" all were verbal vehicles that conveyed to firstcentury men and women the contemporary meaning of psychosomatic health. 14 Dr. Joseph Haroutunian, in one of a series of lectures on "Christian Humanism," declared: The problem of man is to glorify God in his creation. We want to glorify God but we don't have anything to glorify God with. Theocentric theology must be humanistic theology. Authentic human existence involves also theological existence.15 A dynamic view of salvation implies that God is immanent in his creation, working constructively in the lives of men. So far as humanity is concerned, the line of God's eternal activity coincides with the line of history, so that incarnation is not God breaking into history in the man Jesus Christ, but God's purposive activity in history on behalf of mankind coming to peak and fulfillment in the man Jesus Christ. Perhaps the handle that helps provide a theological basis for pastoral counseling and psychotherapy is the imago dei. Traditionally we have presented a spiritualized version of Christ, an emasculated, namby-pamby Jesus who lacks masculinity, virility, humanity. He is the kind of Christ most normal people could not stand to have in their homes and their businesses; yet Chris-
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tians often pawn him off on others. The imago dei cannot be known except through the full humanity of Jesus. If we stick with his full humanity, the image of God will shine through. Because of existential estrangement, this image is shattered in all men except Christ, who alone became fully man. By fulfillment of Christ's humanity, the image of God came through strong and clear. According to Paul Tillich, Christ overcame in himself the existential estrangement of death, meaninglessness, and unrelieved guilt, so that in him and him alone the New Being emerged. The N e w Being is the Mature Man, the whole man--the one toward whom all pastoral counselors and all psychotherapists look, Ideally and theoretically speaking, if pastoral counselors and psychotherapists were able to move their counselees through the total process of healing and maturation, they would finally stand together in one spot with a new being, a whole man or woman, a person who has experienced total salvation ( salvus -- health). Common goals
Once w e discover that the religiously-oriented therapist and the pastoral counselor share a common dynamic view of salvation, we can agree on certain common goals and objectives.1~ 1) Both therapist and pastoral counselor agree that it is essential for an individual to develop a reason for being, a religion, a binding conviction that brings meaning and direction to his life. In the process of counseling, analysis and synthesis go hand in hand. While the therapist takes a generally more objective point of view than does the pastor of "religion," both begin where the client is and work from there. In the process, neurotic overtones are removed and the individual develops a healthy frame of reference. The therapist who favors a religious orientation but is not at home with the patient's religious outlook may encourage the individual to seek spiritual help from his pastor. Thus therapist and pastor work together on different levels and in different areas of the person's life. A pastor trained in counseling can often help his parishioner relate his religious convictions to the process of therapy.
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Journal of Religion and Health
Religious thought then moves beyond neurotic conflicts and anxieties, beyond an all-demanding id or a ruthlessly repressive superego, beyond emotional distortions to a pattern of creative self-acceptance in which he finds himself at home with society, with his own true self, and ultimately with God and the universe. His intellectual convictions merge with his sense of emotional security and he finds life worth living and death merely the fulfillment of birth and growth. 2) Both therapist and counselor replace stern authoritarianism with a kindly, healing authority figure who eventually guides the individual out of dependency toward personal autonomy. The individual, within a permissive atmosphere, works out his negative and positive feelings of transference toward the authority figure of the therapist, while the Christian pastoral counselor, working on a different level, helps his client develop a brother-sister relationship in Christ. In both situations, anger and aggression are worked through, fear and guilt are relieved, so that stronger feelings of affection and trust toward others can predominate. The client, less threatened by inner conflicts than before, is able more easily to keep in close contact with the realities of his life situation. Christianity then is a great attempt to escape from the authoritarian fatherfigure and the archaic aspects of the super-ego. It is pre-eminently a son and brother religion rather than a father religion. But the central drama of Christianity shows that it is not possible to surmount the guilt of rebellion against the father without the sacrifice of atonement whereby the great revolutionary leader was himself slain in the role of the divine scapegoat. 17 Both processes of salvation may follow different routes, but they arrive at the same goal of reducing passive-aggressive feelings toward authority figures and of encouraging a genuine sense of personal autonomy. 3) Both pastor and therapist can look upon themselves as intermediaries of healing power that comes from beyond. Healing is recognized as coming through the agent counselor in a healthy personal relationship between him and his client or as rising within the client when obstacles are removed from the path along which the patient moves to wholeness and health. The
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Christian doctrine of grace, developed along therapeutic lines, suggests that in all of life there is a basic tendency toward healing, integration, health, and wholeness that manifests itself in any person as inhibiting anxieties are worked through and defenses gradually removed. J. A. C. Murray suggests that the path of psychotherapy is strewn with wrecks caused by heedless amateurs who without training or tools rushed in where angels fear to tread. He also observed that those equipped with the skills of physical science but blind to spiritual resources have come upon genuine spiritual need and anguished searching for the unknown God, and attributed these yearnings to neurotic craving for a father figure who would carry them through the adult storms of life. It is precisely here that Christian psychotherapy ... can never fall into either of the two errors already mentioned. It has far too much reverence for the dignity and integrity of man, ever to descend to the level of the bungling amateur; and it has far too much sensitivity to the voices of God, ever to let i~s science be earthbound. TM The pastor and the religiously-oriented therapist, no matter how they label these healing powers, if they recognize them as coming from beyond or from within, are in a stronger position to help their clients in the most creatively possible way. 4) Both pastor and therapist can believe in "original sin," though it may be differently interpreted by each counselor. Both are aware of the terrific unconscious forces of human personality that literally tear an individual apart. Freud, at a time when men believed in human perfectability, was very pessimistic: I do not break my head very much about good and evil, but I have found little that is "good" about human beings on the whole. In my experience most of them are trash, no matter whether they publicly subscribe to this or that ethical doctrine or to none at all.TM Karl Menninger took a more contemporary look at man, but was very little more optimistic:
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It is nothing new that the world is full of hate, that men destroy one another, and that our civilization has arisen from the ashes of despoiled peoples and decimated natural resources . . . . It is true, nevertheless, that in the end each man kills himself in his own selected way, fast or slow, soon or late. We all feel this, vaguely; there are so many occasions to witness it before our eyes. 2~ A contemporary Christian interpretation of original sin describes it as a state of mind, as "Sin" in the singular, out of which all "sins" arise. So long as one does not become too moralistic in his interpretation of "sins" and is at the same time aware of the continual battle between id and superego, neurotic behavior has some interesting and not coincidental similarities with the socalled "seven deadly sins" of orthodox Christian morality. 5) Both aim at reducing guilt while fostering social responsibility. Psychoanalysis has destroyed m u c h puritan morality that judges individuals by external behavior with no genuine concern for causative factors in the person's unconscious. While a pastoral counselor can often best help an individual deal with a genuine sense of guilt, both pastor and therapist can deal with neurotic forms of guilt and their origins deep within the individual. Karl Menninger indicates that some psychoanalysts still make almost a religion of nonjudgmentalism, adopting a laissez-faire attitude to their patients' behavior outside the consultation room. At the same time, he holds to a more rational position . . . by conceding the point of view of society and of the law and of religion--that "sin" is alluring and that, if we yield to it, we have to pay for the "fun." But the psychiatrist's further assumption is that sin is not nearly as much fun as it is made out to be, that it is usually painful and in a large sense unwanted by the individual, and that there are better ways than punishment to influence people to avoid it. 21 While psychotherapy sensitizes the pastoral counselor to conditioning forces within human personality, the pastoral counselor can keep the therapist aware of the need for responsible behavior even as his patient is working through deeply-rooted and terribly troublesome drives and conflicts. 6) More recently, though the therapist still is concerned primarily with
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individual therapy, both recognize the impact of socio-cultural-economic factors upon a person's development. While Freud declared that neuroses rose from a conflict between the drive for pleasure and the crushing control of a ruthless superego, therapists like Horney and Fromm recognize the shaping force environment has on the development of personality. These more contemporary therapists and others dip i n t o anthropology, history, economics, and sociology to develop their more catholic approach to human development. Therapists and pastoral counselors see more clearly today that you cannot treat the individual apart from his total environment. The social gospel proclaimed by more contemporary-minded Christians falls closely in line with the latest discoveries of leaders in other fields. Salvation to the pastoral counselor is a great deal more than "saving souls," and mental health to the therapist consists of something more than a simple resolution of conflict between id and superego. We have come a long way toward finding a common theological foundation for the pastoral counselor and the religiously-oriented therapist. W e have not resolved all the ambiguities and complexities of the situation, but we can agree that salvation and mental health have a great deal more in common than most people suspected even two decades ago. References
1. According to a recent survey, 42% of all people with emotional problems go first to their pastor for help. See Gurin, Gerald, et al., Americans View Their Mental Health. New York, Basic Books, Inc., 1960, p. 307, 2. Clinebell, Howard J., Basic Types of Pastoral Counseling. Nashville, Tenn., Abingdon Press, 1966,p. 249. 3. Fromm, Erich, The Sane Society. New York, Holt, Rinehart & Winston, 1955, pp. 24-25. 4. Clinebell,op. cit., p. 249. 5. Fromm, Psychoanalysis and Religion. New Haven, Yale University Press, 1950, p. 27. 6. Tillich, Paul, Systematic Theology, Vol. 1. Chicago, University of Chicago Press, 1957, p. 69. 7. Ibid., p. 80.
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8. Guntrip, Henry, Psychotherapy and Religion. New York, Harper & Bros., 1956, p. 199. 9. Freud, S., Psychoanalysis and Faith: The Letters of Sigmund Freud and Oskar Pfister, trans, by Eric Mosbacher. New York, Basic Books, Inc., 1963, p. 117. 10. Ibid., p. 17. 11. Ibid., p. 122. 12. Erikson, E. H., Childhood and Society. New York, W. W, Norton & Co., 1950. 13. Tillich, The New Being. New York, Charles Scribner's Sons, 1955, p. 37. 14. For further elaboration on this idea see Grant, F. C., An Introduction to New Testament Thought. New York, Abingdon Press, 1950, p. 250. 15. At Union Theological Seminary, New York, on July 9, 1962. 16. Some of the ideas in this section are derived from Pfister, O., "Neutestamentliche Seesorge und Psychoanalytiscbe Tberapie," imago~ 1934, 20, 425. 17. Flugel, J. C., Man, Morals and Society. New York, Viking Press, 1961, p. 273. 18. Murray, J. A. C., An Introduction to a Christian Psycho-Therapy. Edinburgh, T. & T. Clark, 1938. 19. Freud, Psychoanalysis and Faith, op. cir., p. 61. 20. Menninger, Karl, Man Against Himself. New York, Harcourt, Brace & Co., 1938, p. VII.
, Theory of Psychoanalytic Technique. New York, Basic Books, Inc., 1958,
21. p. 97.
