Biblical counseling has been around, in one form or another, as long as Christians have looked to the Bible for answers. For some, the humanistic foundation of secular psychology undermines their God-centered worldview. Biblical counselors believe that the Bible addresses all the problems in life, which can be found through thoughtful and prayerful guidance. It has been described as "...a partnership between two people who are seeking God's wisdom -- a wisdom that goes to the heart of the matter" (Welch, 1997).  

David Powlison received his A.B. from Harvard College and worked four years in psychiatric hospitals before attending seminary. He graduated with a M.Div. from Westminster Theological Seminary and began a 30 year career in biblical counseling. Along the way he received his Ph.D. from the University of Pennsylvania in the history of science and medicine with a focus in the history of psychiatry. He has written numerous articles and books on counseling and on the relationship between faith and psychology including Speaking Truth in Love, Seeing with New Eyes, and The Biblical Counseling Movement: History and Context. David edits and writes for the Journal of Biblical Counseling which is scheduled to launch in an on-line format next year. He teaches as a faculty member for the Christian Counseling and Educational Foundation (CCEF) in Glenside, PA and also serves as a visiting professor at Westminster Theological Seminary.

Dr. Powlison generously adds his response to the VRT series. As a bonus, I've linked to pages on his website where he gives more detailed responses on video.

What is the role of religion or spirituality in your clinical practice?

Religion or spirituality is not a sector of some people's lives, but a dimension in every human life. It's a dimension in the same way that, in the four-dimensional space-time continuum, you can't go anywhere outside of time. Similarly no one escapes dealing with God, wittingly or unwittingly-in every thought, word, action, desire and life experience. Each of us faces essentially the same existential questions.

This has many implications. For example, I am more like the people I counsel than different. We will have significant differences in life experience, in personality, in the complexity or straightforwardness of our struggles, but we are like in kind. The notion of a common "human nature" puts us all on the same level. "No temptation overtakes you that is not common to all," as 1 Corinthians 10:13 puts it. This fundamental commonality means that as a counselor I never make the "us-them" move of reifying diagnostic categories. Yes, I pay close attention to the severity of what a person struggles with, but it's never as though "You are the sick, and I am the well; you are the patient, I am the doctor." Both of us suffer in various ways; both of us sin by our own version of obsessive self-absorption. [See Dr. Powlison responding to this question on video here]

How does your technique or theory differ from mainstream psychotherapy?

There are hundreds of variants in mainstream psychotherapy. Since cognitive behavioral therapy (CBT) is so well known, I'll offer a broad strokes comparison with the core of CBT's theory and technique.

There are apparent similarities. Many elements of constructive human conversation look similar at first glance. I care about people, psychotherapists care about people. I ask questions; they ask questions. I aim to facilitate changes (in perception, belief, values, choices, feelings); they do the same. Such similarities are like the similarities between different religions.

But the closer you look at what actually happens, the more radical the differences appear. Perhaps the biggest difference is this: CBT seeks to change your self-talk. It's essentially self-referential, not relational. It's about changing how you talk to yourself. But I don't want you to spend so much time either talking to or listening to yourself. My goals are essentially other-referential and relational. I want to overthrow self-obsession. I want both of us to learn to listen to God and talk with God. That's what all the Psalms are doing. This Copernican revolution of putting God at the center also changes how we view and treat others. We learn to relate in the same ways and in the same terms as we are being related to. And, along the way, how we talk to ourselves also changes. [Video response here]

A new client comes to therapy reporting his main problem is feeling detached from God. How would you proceed?

First, I want to know, "Who is the ‘God' that you feel far from?" As a Christian, I believe that God is a self-defining, self-revealing, active Person. He is not whatever we imagine him to be. God shows and tells who he is, but often people feel far away from a ‘God' that does not exist, a fabrication rather than the true God.

A second question is equally important: "What is happening in your life?" We face two kinds of evils as broken people in a broken world. Evils arise from within us (our sinfulness). Evils beset us from outside (the hardships of being sinned against, bereavement, pain, disability, etc.). Often, a person who feels detached from God is going through some traumatic suffering, or is experiencing some moral failure, or is living within a false frame of reference and chasing rainbows. The real God's mercies reach into our elemental human struggles and troubles: "He forgives all my iniquity; he redeems my life from the pit" (Psalm 103).

My third question is, "When you feel detached from God, what else are you attached to? To feel far from God doesn't mean that you now live in a vacuum or that God is far off. The human soul never lives in a vacuum; we always attach to something. What is the something that you are preoccupied with that is not the one true God? Answering that question opens a wide door to significant self knowledge and to grasping the real mercies of God in Christ.

What is the relationship between sin and psychopathology?

Sin is the ultimate ‘psychopathology.' Sin in the biblical view is not simply the high-handed actions we do-e.g., committing adultery, abusing a child, nursing a grievance, or complaining and gossiping. Sin includes high-handed things, but runs far deeper into who we are. It is the perverse inner bentness that erases God from his universe and skews all our perceptions, purposes and choices.