Pastoral Care and Counseling
Pastoral Care and Counseling. The pastoral activity of caring for the spiritual needs of individuals in their whole being, to restore the relationship with God, fellow beings, and oneself.
While pastoral care and counseling is not a biblical term as such, we find it explicitly described in the NT as a spiritual gift (“exhortation” [NKJV], “encouragement” [NIV and others], Rom 12:8), as well as an office in the church (“pastors” as distinguished from prophets, apostles, evangelists, or teachers, Eph 4:11). Pastoral care and counseling, while generally viewed as a basic task of any church pastor, may also be seen as a spiritual gift that not all parish pastors have to an equal measure. Reversely, it can be a specialized profession beyond the confines of a local church, supported by an endorsement through Adventist Chaplaincy Ministries (ACM) as a “chaplain” or as a “pastoral counselor.”
History. The Church, throughout history, has always viewed the care for its members as of utmost importance—starting with choosing deacons to serve for physical needs (Acts 6; 1 Tim 3:8–13), to the writing of letters, some of which were written to churches, others (pastoral letters) to individuals (Timothy and Titus). In any case, NT epistles were written to comfort, encourage, and exhort the recipients rather than intended as scholarly theological treatises. In the early church pastoral care and counseling was provided as a word of advice for wise living.
Taken to an extreme, the desert fathers and mothers, who from their experience of solitude (literally in the desert), were seen as having deeper insight into life and thus provided counsel to those seeking help. Later on in church history, the priestly office with its rituals was providing for the spiritual needs of church members. The sacraments, especially confession and absolution, were seen as the means of restoring the relationship with God.
With the rise of Protestantism, words, or better still, the Word, once again gained more prominence over the ritual. Pastoral care and counseling focused on preaching and teaching a liberating gospel message. Individual visitation and conversation, development of personal piety (see Pietism) were included in the pastoral portfolio. During the 20th century, the appearance of psychotherapeutic schools brought diverse discussions and approaches to pastoral care and counseling, ranging from critical distance to all things “psychological” (e.g. E. Thurneysen with his kerygmatic pastoral care or J. E. Adams with his nouthetic counseling) to an uncritical espousing of psychotherapy as pastoral care and counseling (e.g. D. Stollberg’s claim that “pastoral care is psychotherapy in a church context,” or H. Clinebell with his groundbreaking “Basic Types of Pastoral Care and Counseling”). The 21st century is experiencing a revival of a theological focus, including a more holistic approach, integrating rituals and spiritual exercises as part of the caring process.
Within Seventh-day Adventism, pastoral care and counseling has received comparatively little attention because of a traditional focus on being a prophetic movement and having an evangelistic calling to fulfill (Rev 14:6–12). Furthermore, there has been a rather long-term skepticism towards psychology—or certain methods of psychotherapy—dating back to the warnings of Ellen G. White against mesmerism, hypnotism, and any forms of mind control. Such warnings and the well-founded reasoning behind them (the freedom of the human being) often have been generalized to include everything psychological, not recognizing that psychology simply is “the study of the mind and behavior” (APA) in other words, nothing but the scientific observation of God’s creation. Over time, the Adventist educational system did develop study programs in psychology and counseling—from bachelor to doctoral level, but still hardly offered any specialized programs in pastoral care and counseling.
Theology. The Seventh-day Adventist concern for the whole person with the call for the development of physical as well as mental and spiritual propensities (1 Thess 5:23) is an invitation to reflect more fully on nature and the need for pastoral care and counseling. The focus on the Bible as the foundation of our faith certainly will not limit, but rather enlighten, the discourse.
If there is agreement that the primary task of pastoral care and counseling is to restore the relationship with God, and subsequently human beings and oneself, we find the first intervention of pastoral care and counseling in paradise right after the fall: “The Lord God walking in the garden in the cool of the day . . . called to Adam and said to him, ‘Where areyou?’” (Gen 3:8, 9). Obviously, the omniscient God did not need to be informed of the whereabouts of Adam. It rather is the existential question that, in principle, describes the starting point of all pastoral care and counseling. It is a question of fundamental orientation—not for the one asking, but for the one being asked. Where are we in relationship to God, life, and love? How do we experience ourselves? These kinds of questions are being echoed again and again in the Bible—in different forms and contexts (Gen 4:9; 16:8; 1 Kgs 18:21; Jonah 4:4; John 5:6, etc.), but always are a starting point of an attempt at restoration of the relationship between humans and God.
The fact that pastoral care in the Bible often starts with a question is not a methodological gimmick, but has far deeper meaning: it emphasizes the individual ability, freedom, and responsibility of human beings to reflect, make meaningful moral judgments, and choose between options. While in the creation account both animal and human beings were blessed to procreate, the call—and therefore propensity—to “rule” is unique to humans (Gen 1:22, 28). The creation story provides an anthropology of a free-willed human being, created in the image of God, speaking of human dignity and responsibility—both of which need to be reflected in pastoral care and counseling.
This ideal is limited, of course, by the fact that since the fall we are of a sinful nature (Ps 51:6; Rom 3:12). While this does not change the God-given value as a human being (John 3:16), it certainly may cloud judgment, reduce options (oftentimes limited to choosing the lesser evil), and decrease our abilities to reflect or even take responsibility (e.g., in cases of mental illness or incapacity). Hence pastoral care and counseling also needs to follow the calling to “be merciful, just as your Father also is merciful” (Luke 6:36).
Pastoral care and counseling recognizes that sinfulness, neediness, and fallibility are not only issues of the counselee but of the counselor as well. Therefore, any provider of pastoral care will show humility and in principle accept reciprocity of process (Gal 6:2; Jas 5:16), i.e. make sure he or she obtains sufficient pastoral care and supervision of him or herself.
Whereas pastoral care and counseling always is a relational matter—both in format and purpose—the characteristics above are central to pastoral care and counseling, while methodological considerations are secondary. The idea of a biblical one-size-fits-all approach to pastoral care and counseling will not do justice to the individuality of proponents and the uniqueness of situations, nor would it reflect the diversity of the Bible, a collection of 66 books written over a long period of time and cultural developments. Some examples may suffice to demonstrate widely diverging approaches that can be found in the Bible.
Parables are often used in the Bible as a means of pastoral care. When Nathan came to David after he had committed adultery and subsequent murder, he used a parable to help David recognize his sin (1 Sam 12). Pastoral care providers often are good storytellers, helping their counselees find the point of a “message” for themselves, thus protecting their dignity as well as placing responsibility on them. At times the “parable” is tangible, as in the case of Jonah (Jonah 4:6–11), or even drastic to the point of being offensive, as in the case of Hosea (Hos 1:2). Jesus Himself was a master storyteller. Looking at His parables from a pastoral care perspective will open new horizons of appreciation and understanding.
Dreams are one way how God communicates with humankind. Therefore working with dreams is a legitimate aspect of pastoral care and counseling. Joseph utilized this approach while in prison (Gen 40) and certainly did more than “predicting” what was to come (this was already accomplished by the dreams). Daniel had at least two occasions to work with dreams in the life of Nebuchadnezzar (Dan 2 and 4). However, the story of Daniel also cautions against a guru mentality in dream interpretation (Dan 2:26–27), while other texts even question dreams as such (Eccl 5:3.7; Zech 10:2). Interpreting dreams or telling dreams of a pastoral counselor as a means of pastoral care should therefore be utilized with caution, especially in some cultures.
Conversations are always part of the process in pastoral care and counseling. However, at times the approach Jesus took seems odd at first sight. “Do you want to be made well?” (John 5:6) would not be a polite question for a hospital chaplain to ask someone confined to his bed. However, as the story at the pool of Bethesda unfolds, this man apparently needed to learn to take responsibility for his own life (John 5:7, 11, 14). Similarly, Jesus calling a woman a dog is not a recommended conversation opener in pastoral care, but served a very specific purpose, i.e. teaching the audience a lesson, when meeting with the Syrophoenician woman (Mark 7:27–28). In another incident Jesus offers pastoral care by asking for a favor (John 4:7), providing dignity and responsibility to the woman at the well – a theme that can be seen throughout the ensuing conversation. Especially the different types of conversations illustrate once again how “methods” need to be adjusted to the specific situation.
Rituals can be part of pastoral care as well. Rituals are understood here as formalized acts with religious symbolic meaning such as the ordinance of foot washing, communion, laying on of hands, or anointing of the sick. Within the Adventist tradition, there is a certain reluctance towards rituals, most likely going back to an aversion against a Roman Catholic ex opere operato (the rather magical understanding that a sacrament works in and of itself, independent of the people involved) and to a Zwinglian tradition of celebrating communion once a quarter only. Nevertheless, the Adventist understanding of human nature, perhaps even our appreciation for the sanctuary service with all its sensual, tangible practices of dealing with problems and guilt, should be an encouragement for a kind of pastoral care that utilizes enacted gospel (rituals) to heal and restore.
Psychotherapy and Pastoral Care. There are two polar extremes in the relationship between pastoral care and psychotherapy. One is overly cautious and suggests psychotherapy is not needed, even detrimental. This view denies the realities of mental health problems and is not typical of the Adventist approach in other fields of medicine. The other extreme is replacing pastoral care with psychotherapy. While the old Latin term for pastoral care, cura animarum, actually translates as the composite psychotherapy from the Greek psychē (“soul”) and therapeia (“healing”), the former ultimately deals with the transcendent, and the latter with the immanent aspects of reality. Therefore, the one cannot replace the other. Both have their place, their specific professional training, and their unique tasks.
Nevertheless, there is a lot of overlap. If one’s relationship with God is right, one’s relationship with other people and oneself will change as well (Luke 10:27). Therefore, theologically informed theories and models of psychotherapy can be helpful for better understanding and implementing pastoral care and counseling. The three classical schools of psychotherapy can serve as an example and point of reference here.
Psychoanalytic or psychodynamic traditions, bound to names like Sigmund Freud and Carl Gustav Jung, are the oldest in modern psychotherapy. According to this school of thought, problems are rooted in an individual’s past (early childhood), leading to a rather deterministic worldview, thus reducing the concept of personal freedom and responsibility. Despite the problematic issues within psychoanalytic traditions, there are some valuable concepts for pastoral care providers, e.g., transference, defense mechanisms, or the subconscious with its influence on human behavior. In terms of methods, utilizing dreams and imagination may be something to explore for pastoral care and counseling. Freud’s strong emphasis on sexuality as the major drive in life has been off-putting to many (including Jung), yet it simply could be understood as a force of life, as well as in the historical context of the Victorian age, totally tabooing human sexuality in a rather unhealthy manner. Contemporary discussions of sexual violence (in churches), gender identity, and the prevalence of sexuality suggest that while there is well-founded criticism of some of Freud’s ideas, it nevertheless still has high relevance.
Cognitive Behavioral Therapy (CBT) oftentimes has a special attraction for Adventists with their cognitive outlook and their concern about the right behavior (lifestyle issues). It is based on the idea of changing behavior by learning and unlearning. However, from a theological perspective, it should not be forgotten that classical behaviorism, associated with John B. Watson and B. F. Skinner, was rather reductionist and mechanistic. Even CBT at times is still criticized for being symptom-focused, rather than looking at the bigger picture, the whole person. Questions about where a behavior is coming from (the past) or what purpose it might serve (the future), appear to be irrelevant in that school of thought. However, CBT at its best offers a broad spectrum of methods to adjust dysfunctional behaviors and correct wrong thinking by unlearning and re-learning.
Humanistic traditions are often discredited as “atheist” in Christian circles. This is both, historically and philosophically, a misrepresentation. It certainly needs to be acknowledged that “humanism” (as psychotherapy in general) usually presents itself as agnostic. However, humanist schools teach and practice an attitude towards counselees that should readily be integrated into any pastoral care and counseling. Thus Carl Rogers’s concepts of “unconditional positive regard” and “growth potential” are akin to the biblical idea of dignity and responsibility (even sanctification), though Adventist theology would always link back to “Christ who strengthens me” (Phil 4:13). The same is applicable to the optimistic view of humans being good. While the Bible certainly teaches the sinfulness of fallen human nature (Rom 3:10–20), the gospel message speaks of restoration. Such a perspective certainly will increase the desire in pastoral care and counseling to be “fellow workers for your joy” (2 Cor 1:24), helping people to live up to their God-given potential.
Clearly, pastoral care and counseling can benefit from insights of modern psychotherapy but needs to carefully test concepts and methods against biblical anthropology. From an Adventist perspective, this includes a wholistic view of human beings (mind, body, soul cannot be separated, 1 Thess 5:23), an inherent dignity and worth as God’s creation (Gen 1:27), the freedom to choose (Gen 2:16, 17), and a responsibility for their decision (Gen 3:9–20). Furthermore, the differences between pastoral care and psychotherapy and the respective professional boundaries should be respected.
Conclusion. Pastoral care and counseling is a term with varying definitions and realms. In a broad sense, it can refer to any pastoral work, from “feeding the flock” (Ps 23:2), to a ministry of healing of the wounded soul (Ps 23:3) and exhortation (Ps 23:6). With this definition, usually a clergy person is envisioned who has been specially set aside for this ministry. In a more narrow definition, it would describe the activity of counseling individuals, couples, or groups of people by talking with them professionally, including religious resources offered in the respective faith community (e.g., Bible, prayer, blessing). This more functional understanding may not be limited to district pastors but can include elders, deacons, chaplains, or professional pastoral counselors. In any case, from an Adventist perspective, pastoral care and counseling will be rooted in biblical anthropology, will be Christ-centered, ethically limited to one’s training and abilities, empowered by gifts of the Holy Spirit, and thus always be a deeply spiritual venture.