I. What works in psychotherapy?
Anything that is compatible to the spirit of logotherapy works. Dr. Graber drew from the work of Dr. James Crumbaugh who helps to shed light on this important question. Crumbaugh claims that certain elements must be available: catharsis, relationship/encounter, prestige suggestion, reeducation, and commitment to new goals. Perhaps another way to illustrate this point is with an equation:
Catharsis → Relationship/Encounter → Prestige Suggestion → Reeducation → Commitment
Catharsis is the initial point by which one relieves bottled-up psychic energy. This point lends itself to openness to new encounters/relationship such as the one with the therapist. This ‘openness’ is further developed in the prestige suggestion moment when the counselee recognizes the therapist as one to be trusted or as an expert of sorts. Prestige Suggestion occurs as a result of the symbols of trade (white coat, collar, etc.) and initially helps the client find a comfort zone in knowing they are relating to someone who understands them.[i] Upon the reduction of the symptoms, following catharsis, is when the counselee is able to become oriented in the direction of meaning and ultimately attitudinal adjustment. It is important to note that “existential analysis may give us insights into the problem or situation at hand, but we need to move into commitment to something or someone.”[ii] Self-chosen goals lend to discovering renewed purpose and fulfillment as the outgrowth of meaning.
Not to the exclusion of other theories or psychoanalytic insights, Dr. Crumbaugh states:
…logotherapy is the most direct distillation of what leads to psychotherapeutic success because it incorporates the essential elements he described. Furthermore, it engages the client holistically: physically, psychologically (intellectually and emotionally) and spiritually. It awakens his [Frankl’s] will to meaning.[iii]
Therefore, authentic “therapeutic success” is not measured by returning one to mere baseline functioning, but beyond this to the noögenic dimension whereby the human being is able to achieve meaning in one’s life.
II. The Delicate Balance of Psycho-spiritual Integration:
People approach pastoral counselors/psychologists because they tend to have a higher trust level in our opinion and hence give greater credence to our assessment. It therefore is our responsibility to act only in the realm of what we know and what we are trained to understand. Going beyond the scope of one’s knowledge can lend itself to iatrogenic or helper damage since the counselee assigns a spiritual status to the work of the pastoral counselor/psychologist that may or may not be unfounded.[iv] Dr. Ann Graber states that this type of abuse was strongly warned against in the work of Dr. Viktor Frankl who was well aware of this danger and referred to it as psychogenic damage, drawing from the work of Dr. Eberhard Schaetzing, who termed it ‘ecclesiogenic neurosis’ [or clergy induced damage, my emphasis].[v]
Since the clergy in pastoral counseling/psychology may be viewed as the “voice of God” it is pertinent that one does not use his/her position to, knowingly or unknowingly, exaggerate the crises brought before them. One must be careful of suggesting to the counselee such things as: ‘this is God’s Will’; ‘offer up your suffering’; ‘let go and let God’; ‘God is in charge’, etc. Such clichés may exaggerate the crises without actually intending to do so. For example, of course clergy believe ‘God is in charge’, but to suggest such a spiritualistic content to the crises with such words, could be interpreted by the counselee in such a way that they begin to believe that one is not in charge of his/her life and therefore any act of responsibleness would be rendered futile. This is absolutely dangerous in such circumstances. It may also suggest that God is not pleased with the situation. Any ‘ecclesiogenic’ action on the part of the clerical therapist can contribute to the exacerbation of fears, guilt, anxiety, depression or any other various forms of psychogenic neurosis lending to an increased sense of hopelessness. Pastoral Counseling in the psychoanalytic setting requires astute attention to this matter.