Ann Maree
Hello and welcome to another summer episode of the Safe to Hope podcast. Over the break between storytelling seasons, we’ve been sharing a couple educational type episodes, information that helps to inform some of the dynamics in the stories we offer on Safe to Hope. So in June, Lynna Sutherland and Donna Westcott and I discussed their experiences at PCA General Assembly. That’s the Presbyterian Church in America’s General Assembly, where they meet to… it’s a business meeting, basically where they decide things for the denomination that sometimes impact the members, and this one that Donna and Lena were talking about had significant implications for women, for abuse and for reporting in the denomination. And it’s not just the one denomination, like the PCA, whose governance impacts membership. Often our polity and PCA policy overlap across multiple denominations, and we can see patterns of response sometimes and oftentimes harmful across the board. So all to say, it was very helpful to listen to Lynna and Donna discuss their experience and their takeaways, and that was the first of our summer season. In this episode today, I want to introduce you to another couple, a couple of friends, although the audience should remember Julia Fillnow, as they’ve been clamoring to have her back. Julia, you did such a great job interviewing me at the beginning of this year. I do still really think you need to consider taking over the podcast. She shakes her head no. I think her husband’s shaking his head yes. And friends, you may remember, Julie is not only HelpHer board member, but she’s also my friend who, though unofficially, has been very important as a caregiver for me over these past kind of difficult years. But Julia is a licensed counselor who is certified and specialized in specialized in trauma abuse and addiction treatment. She has worked in private organizations, community mental health agencies, nonprofits and church counseling centers. She is a member of the national professional networks for trauma and addiction therapy and abuse care, and she desires to help build a bridge between the faith and mental health communities, which is why we love having her. That’s what we love seeing happen too. She is particularly passionate about the church’s role in calling to care for the oppressed and heal the wounded. Julia currently works as a therapist in North Carolina. She is married with four children, and she’s married to Patrick, who’s also here with us today. Patrick is a physician and an elder in the church my husband and I have landed, and he has also been a very important, important part of my healing process. And his wisdom, his spiritual wisdom and caregiving demeanor as a physician, I think, is it, he’s naturally that way as a person, and it has really helped my heart have incredible peace. So all that to say, welcome Julia and Patrick.

Julia
Thank you. It’s good to be here. Thanks for having us.

Patrick
Good to be here. Thank you for having me.

Ann Maree
Yes, we do appreciate taking time out of your busy days, lives and family and coming and joining us for this, for this episode. So one of the first things that we talked about doing as a as a team here is just kind of talking about, how did we get connected in the first place? Besides the fact that we ended up in Patrick and Julia’s church, Julia and I had started a relationship about maybe a year sooner, earlier than that, and just struck up a conversation that I wanted to have with her and maybe Julia, you can fill in a little bit about that experience.

Julia
Sure, I had always heard about you, your ministry and what you are doing for women caught in abuse, and was just very impressed by your work and your heart for people. I remember seeing you at a conference. You were actually meeting with our pastor and pastor’s wives. And I remember walking by and just thinking like, Oh, that makes sense. Them sitting down and having a conversation. And was always curious to know what it was that you guys were talking about and and it wasn’t too long after that actually that we got connected through our pastor and his wife, and you asked to meet. And I was very curious, interested to know what it was that you wanted to connect with me on. Unfortunately, I had had some experiences with biblical counselors that the conversation quickly became how I wasn’t quite, quite equipped enough, because I did not have the biblical counseling training. So for you to reach out to me, I was like, Well, this is interesting. This is an interesting pairing. I’m, again, just curious to know what it is that she would like to meet about. And remember that first meeting, and we were sitting outside having coffee, and we were talking about victims, and we were talking about abuse cases, and I remember saying something about victims, and all of a sudden you were like, just the look on your face was like, Well, yeah, obviously it’s like, oh, she knows what she’s talking about. Not that I didn’t think that you did, but there’s an immediate, um, like, mutuality of the relationship of like, yes, we are both in this work. We were both doing it together, and that was really healing for me, having experienced what I had experienced from other people who, again, were suggesting that my training was not quite complete. I was a licensed therapist, but even so, I needed additional training to do, to do counseling in the appropriate way.

Ann Maree
Yeah, and I did want to speak to you because of the lack that I found in my nine years of training. So I did all theological training, and I’ve talked about this often on different podcasts and in Substack articles, but I think the result of my education was just to inform me of how much I didn’t know. And then, as I’m talking to licensed counselors and finding out, oh, wow, they have a lot of knowledge that I could really benefit from, which in turn, would help the people I help and benefit them. And just my eyes being wide open, and I think it’s the abuse cases that really brought it, brought me to that point of knowing I didn’t learn what I needed to learn to help these people. Licensed professionals did. They have the language. I’m just starting to read it. They’re repeating the same things. I’m like, wow, boy, have I missed out. So that was one of the things, but I think it’s just Julia. I might not say that about every licensed counselor she’s she’s so absolutely a joy to talk with, and we do have commonality. There is that understanding between us. But I don’t know if I’ve ever, like publicly said anything to you, but just apologies, asking forgiveness from the biblical counseling community on their behalf for making you feel less than. You know the Bible is not licensed to biblical counselors, and I know that you speak Scripture a lot, and so I’m sure that your your clientele is also benefiting from your relationship with the Lord, which is as important as the biblical theology that you have as well. So on behalf of biblical counselors everywhere, please accept our apology and are asking you for forgiveness for creating that diminishing effect.

Julia
That’s meaningful. Thank you, and it goes both ways. I think sometimes the impression from licensed counselors is unhealthy. Our impression of biblical counselors, and as we’re going to discuss, there’s so much that you offer in your training as a counselor, how Scripture informs life, how it informs godly living, how it informs our character, how relate to ourselves, how relate to God, how we relate to other people. And you know, we’re we live in an age of outrage. If you don’t believe what I believe, then you’re the enemy. Rather than sitting down and having conversation, tell me about your training. How did you get to the place where you are? How do you use your gifts, your strengths, your abilities, and the training that you’ve received to care for people. So it’s not, it’s not that a certain group of people are the bad guys. It goes both ways. 

Ann Maree
Yeah, we need each other. Yes. I mean, that’s what Paul talks about in Ephesians, anyway. We are the church. And then just getting to know Julia, you too. I mean, Patrick, you are, we are very interested in whole person care, and you are at the forefront of what we would say we are not trained to do, for sure, and that is medical. And so I think even conversations with you have been so rich and apply to the to the mental health thinking, but anyway, yeah, or how you heard about me, or what fears you had as an elder for me coming to your church. 

Julia
I remember one of the first prayers you prayed, and Ann Maree was there. And after you prayed, you sat down, and I think I looked at you, and I was like, and I think I just mouthed Ann Maree.

Patrick
Yeah, I mean, I think the what comes to mind is when you first started coming to our church, and how excited we were to get to know you better, you and your husband and get to do life more together. And it has been a joy to get to know you more.

Ann Maree
Ditto, you know, yep. So what we’re going to do here today, besides have fun talking to each other is we’re going to talk about each of our individual professions, if you will, our and some of the strengths that we each see in our individual caregiving, in our individual training, and then also some of the weaknesses that we see, and I want you to just keep listening to us, because I want you to hear the value of how we fill each other’s gaps in some ways. One of the things that I want to set the tone for right off the bat, and that is that for the biblical counselor, I’ve stopped kind of referring to that role as a biblical counselor, because, as I’ve said to Julia, that implies that professionals aren’t using Scripture in their counseling. Instead, I think lay counseling is much more descriptive of what we do, it’s in the church. It’s in a team, on a team, and it’s a compliment to the others on the team, especially the professional counselor who’s helping a woman in crisis. We do talk a lot about teams at HelpHer, we encourage churches that reach out to us to form a team when there’s a report of abuse or a crisis of any kind, and that can be anyone from a pastor, with an elder, with a deacon, with a lay counselor, with a church advocate, and then with a professional licensed counselor, a physician and a professional advocate. We benefit greatly from, like I said, each other’s wisdom, and then also, as as many of you probably know, crises can absolutely drain support systems, and so we are there for each other as well, and filling in gaps physically, even, you know, taking time when somebody else can’t being there when somebody else can’t on the team. And then there’s the insight and perspective. So that’s just a big, big deal at HelpHer. And so what we’re doing now here is breaking down those professions. Or roles, and, like I said, highlighting strengths and weaknesses. So I’m speaking for the lay counselor, slash, if you will, biblical counselor, just so you all relate to the terminology. Julie, of course, is speaking to the clinical and Patrick to the medical. And I would say, I think, as a lay counselor in the church, I think the greatest strength that we have is God, right? We have access, we have a spot in the throne room, and we are privileged to approach God with our cares and concerns and those of others and he relates to us comprehensively. That doesn’t mean it doesn’t happen in other professions, but that is, I think, one of our greatest strengths, but, but that’s not to say that God is not in the clinical counseling model, but I do sense this victim counselee-centric approach in clinical talk to me a little bit about the nature of the self.

Julia
So psychology essentially started as a movement about in the 1800s on the cusp of the scientific method and discoveries. And what psychology was endeavoring to do is to discover human behavior, describe human behavior, understand where it came from, and ultimately it was secular in its approach. So God was not involved. God was not a major player in how human beings were created and what motivated human beings. One of the incredible strengths of psychology as we know it is that there is ultimately a study of the person, a study again, of why they do what they do, where it comes from, what drives their behavior and what it looks like, both individually in the person, based on their story and as they’re relating to other people. So we call that observational science. And there are many, many theories that come out of that observational science about people and about therefore, what treatment should look like. There’s a lot of different theories, and honestly, it’s hard to say what the strengths and weaknesses are of clinical counseling just in general. It’s actually probably better to look at each category of theory and break down, what are the pros and cons of each of those, and where does the Bible inform each of those theories, which is probably a strength and also a weakness, because you don’t have any particular therapist, or each therapist is coming from their own perspective, and so there’s not a consistent way that clinicians practice, if that makes sense.

Ann Maree
Yeah, thank you. And you’re confirming what I just said, but also the reason I approached you in the first place, and that being observation science. And what I would say on my side of the camp is we need to exegete the Scriptures, yes, but we need to exegete the person as well, and with as much intensity as we do the Word of God. And I think that’s where that partnership can really thrive between the two professions. Now, Patrick, you are the scientist in the room. So can talk to us a little bit about what you’ve learned about science and Whole Person Care?

Patrick
Sure. So one thing that I think is interesting to think through about science is that we… in science, we actually don’t prove anything, but we are asking questions, gaining knowledge, and we are trying to increase in our confidence of a particular approach, and that there’s a lot of things in Medicine that that, I think, give the clinician opportunities for humility, and that’s one of them, because clearly, something that we’re doing routinely now we will not be routinely doing in 10 years. And when you’re in medicine for any period of time, you see those changes. One of the great things about medicine is that you don’t just have to rely on your own experience, that if you’ve never thought about something, if there is a different presentation in a patient. You can look to the literature, you can look to colleagues, and you can also ask for help, because there’s many different specialties in medicine. And one of the I’m a primary care provider, and one of the things I think we are experts in is to know when we need to ask for help. 

Ann Maree
That’s a good thing to be an expert in. I would appreciate that in my physician. Thank you. Yeah, and I hear a lot of hand in hand between the two sciences that you’re talking about. As well. I think going back to the lay counseling model, we also would say dignity is a very important issue. I think that could be one point where the three of us could expound and say, we all agree, meaning we are all created in his image and in God’s image. So we are approaching human beings as image bearers and having value and being worth being cared for, yeah, if either of you could talk to some of that as the strengths too, kind of embedded in your discipline.

Patrick
One of the other clear strengths of medicine is the rigor in training that physicians go through. The shortest amount of time it takes to be a physician is seven years. So there’s four years of medical school and then at least three additional years of residency training. And there the way of training in medicine, a lot of the training starts with the least experienced person in the room trying to explain what is going on with patients to the more experienced people in the room, which is another opportunity to learn how much you don’t know, and to learn humility.

Ann Maree
So that thing that I just said earlier about my education, showing me that what I didn’t know that was a good thing. That’s part of what I paid for. Absolutely you paid for it, too? I get it and hearing again, the humility that that require, not requires, but builds in a person… I know, Julia, your training also is pretty intense. I was ridiculed at one point, and this is not a condemnation in any way, but of the amount of hours I had to do under supervision versus how much a professional counselor has to do. What is that like? What is your training like?

Julia
I’m interested to know how many hours you’ve had.

Ann Maree
I’m embarrassed to tell you.

Julia
Yeah, there’s a lot of support and training of the clinician. We go to school for two years. We’re heavy into textbooks and theories, understanding psychopathology, studying the DSM. We’re trained in counseling individuals, families, groups, marriage counseling, so we’re getting a lot of book knowledge, but at the same time, we’re doing internships in our areas of interest. I went to school for counseling in a social work program, and they were very open to have me get an internship in a church Counseling Center, which sometimes the impression out there is that secular therapists and secular programs can want to dissociate religion, spirituality from the counseling program, and I just didn’t find that… maybe my program was unique, but they were very much encouraging spirituality into whole person care. So while I was getting the foundational knowledge of counseling skills and understanding human behavior is also practicing, but I was practicing under the supervision of …it’s a supervisor who, through their licensing board, has gotten permission to supervise clinicians. I had to tape sessions; they were sitting in on sessions. I never practiced by myself, and I was so grateful as a very green physic or as a very green counselor who had a cape on and wanted to change the world. I needed to be humbled, and I wanted also to learn from these supervisors and proctors who were really shepherding me and what counseling and care looked like after graduation. I also had to continue in supervision. I had to continue to get continuing education credits in order to then apply to become a counselor. At the same time I was doing that post grad, I was also working towards my addiction certification, and that took three years of full time work, plus continuing education, plus supervision, plus sitting for an exam and the licensing exam for my clinical licensure.

Ann Maree
Yikes, just the word exam makes me cringe. Yeah. I don’t know if you can speak to this, Patrick, but what is your experience when you’re working with someone who is also being cared for by someone like Julia? Is that, can you, can you read that at all? Is there any patterns or…

Patrick
Well, I frequently am encouraging my patients to see counselors and therapists, and I’ve even thought you like, we have this routine of doing a routine physical exam, like I wonder if we should have mental and emotional routine exam. 

Ann Maree
Good idea. 

Patrick
And clearly it’s a discipline that is extremely helpful for people, and because we’re, you know, whole… we’re physical, emotional, spiritual, psychological, mental people, everything affects everything, and it’s difficult as a physician to help in the same way that a counselor can.

Ann Maree
How about tie in the religious experience? How about if the person is also connected to a church, whether that be the pastor, close relationship, or just attending, or even having a lay counselor experience in the church. Does that add, take away, if so, how?

Patrick
There’s a lot of loneliness. And I think anytime there’s people in you know, one of my patients lives that are pouring into them, that are listening to them, and that are helping, I mean, is, is a huge benefit. And, yeah, I think there is a lot of resiliency that patients experience from being in tight-knit community and and even, yeah, just having people that are for them, even regardless of training. But I think if there are people that are in patients lives, that are trained that adds benefit for the patient.

Ann Maree
Yeah, and I’m going to guess you’d say the converse is true as well, if they don’t have those religion support systems, clinical therapist, health is going to suffer. Health is going to suffer. Probably, yeah. He’s shaking his head, yes.

Patrick
Correct, yeah.

Julia
So well. And the medical system right now, as we know it in America, isn’t built to honestly care for whole people care, whole person care, which is why Patrick has decided to practice a different kind of medicine which required him to go out on his own so that he could have more time with patients and build relationship and open up conversations about what’s really going on in their lives. Don’t exactly know the numbers, but I think there was a study within the last 10 years, actually last 20 years, that out of 135,000 cases, if the physician is asking questions related to past trauma. So have you ever had a negative experience in your family of origin. Have you ever experienced any kind of sexual abuse? They found that the number of visits required in the calendar year decreased by nearly 50% 

Ann Maree
Yikes. 

Julia
Yeah, and it wasn’t just the asking of the questions. It was actually in the building of the relationship. So you’re asking these questions, but you’re also opening up the possibility of down the road and future clinic visits that you know you can continue to talk about these things, and actually, what you have experienced in your past is coming up in the present, and so many of your physical symptoms are related to past trauma and also current trauma. So we’re working on asking question better questions, both in in the medical field and also in the clinical field, to get them connected with a physician who is attentive to all of their needs.

Ann Maree
I envision, I don’t know if I’ve seen it yet, but to have that connected to the pastoral lay counselor relationship, what you know, what a team that could be. But also, I think, learning from you, what what you’ve just been telling me, and that would lead me to just talk about some weaknesses that the lay counseling model, the church model, has actually, I’m going to read something out of Restoring the Shattered Self, which is a book by Dr Heather Gingrich. We’re going to have her on our show next year, but she does encourage teams. She’s, of course, a licensed professional counselor, and in the back of this book, she has a chapter called How the Church Can Help, and she lays out for each individual role how they could be helpful. This is what let me see. I can read the lay counseling one, let me see if the pastoral one might apply as well, but lay counseling, she said, “can be helpful to those with complex PTSD, as long as they are under supervision and do not attempt to go beyond their level of expertise. The safest model would be one in which the counselee is also seeing a professional counselor and has given consent for there to be some level of ongoing communication between the professional counselor and the lay counselor. This would obviously only work if there is mutual respect between the counselors and they are not working at cross purposes.” I think Julia was describing that earlier, and then the pastor… well, I mean, it may not seem like this is helpful, but I think I really think it is. And I think Patrick was kind of alluding to this in some way, “pastors can be encouraged to preach on topics that address issues like those with complex PTSD and what they face, for example, sermons that address the evils of abuse.” I mean, evil is not this is me saying this not Heather, evil is not a topic of limits in the church, right? “Acknowledge the reality of suffering and encourage individuals to seek answers to hard questions that can give trauma survivors permission to be more open about their struggles.” And I would imagine that if they’re more open in the church, they’re more open in the physician’s office and the counselor’s office. And then she goes on to say, “once the survivor is identified in the church, leaders can help them access the help they need, whether that involves resources within the church or referral to counselors or others, such as social workers, medical doctors and lawyers.” So there are roles, and that doesn’t even include the shepherding role. So that leads me to talk about just one of the weaknesses in the biblical lay counseling model. There really isn’t any training. And I’ve said this often. You’ve heard me say it before, probably of the person you know. We are wholly taught about the Scriptures. We have one class in a DMin; Doctor of Ministry program on anthropology. And so we are very versed in the head knowledge, and we are not as versed in the people sitting before us, but I would, I wouldn’t say that there’s not any weaknesses in the other models, either, the other discipline. So maybe either of you, both of you, could talk to some of the weaknesses you recognized in your profession. 

Patrick
I think one of the weaknesses in medical training and in the practice of medicine is that it can be reductionistic at times, we spend whole semesters on one system of the body, or months at a time on the cardiovascular system, and then the endocrine system, and then immunology. And it almost gives the sense that they are… the systems in the body are independent of one another. That’s not typically the goal of the training, but I think that can be an unfortunate outcome of some of the ways in which physicians are trained, and then even the entire medical model where there is a focus on a specific diagnosis. Which is extremely important to have the right treatment, you need the right diagnosis, but there that can also be reductionistic, where you have a thyroid problem or you have a endocrine problem, as if everything doesn’t affect everything, including physical, emotional, spiritual. I think especially there can be a lack of like, understanding of the sufferer, understanding of the story, and that’s not entirely the physician’s fault when the average primary care visit is seven minutes.

Ann Maree
Okay? No wonder my mom’s been complaining about her PCPs, okay, anyway…

Julia
Yeah, and I think as therapists too, not every therapist, of course, but there can be an over emphasis and reductionism and in terms of us using diagnosis and psychopathologizing clients, and that can also lend itself to well, because you’re bipolar, because you’re borderline, then this is the specific treatment. Rather than understanding the person’s story and also giving hope to them that this diagnosis is not deterministic. It doesn’t mean that this is your what your future is going to look like, that there is hope and healing. And that’s what I appreciate from Scripture, from your model is in a helpful way, giving hope to clients, that there is change and there is healing.

Ann Maree
I’m going to jump right back into a strength as long as you’re talking diagnostics. I mean, Patrick just said it. I’ve been saying it to my elderly parents over and over, the right diagnosis will get you to the right treatment and the right beneficial care. Sadly, that is one of our weaknesses in the lay counseling, biblical counseling movement, and not having been trained how to diagnose. Can you speak a little bit to that type of training for you, Julia?

Julia
Yeah, I’m constantly assessing where my clients are and what problem is in the room. Not that the problem is the person, but there’s, there is danger when you don’t get the right diagnosis in the clinical sphere. So for instance, anxiety and OCD are two different things. I treat anxiety in a different way than I treat OCD. If I were to treat OCD, the way that I treat anxiety, it exacerbates the symptoms, so I want to be very careful and cautious to know the diagnosis, because that does influence the treatment for the client.

Ann Maree
Yeah, yep,

Julia
And it’s sort of like in the medical field, if somebody comes to Patrick, I don’t know you can give an example of like, there’s a different treatment for a cough versus lung cancer. And if you were to treat a cough a certain way, it’s not going to treat the underlying cancer, and it will only make the cancer grow.

Ann Maree
Won’t address the problem.

Patrick
Yeah. I mean, just a couple thoughts come to mind, yeah, the same symptoms can be from different causes. So you could have shortness of breath because of heart failure or kidney failure, and those treatments would be different and almost opposite in some cases where, if you’re treating the shortness of breath with the wrong diagnosis, you would make it worse instead of better.,

Ann Maree
Yeah we’re going to jump into that pretty soon, talking about that “doing no harm.”

Julia
And for us, there’s great accountability in our diagnoses. So Patrick’s license and my license forms actually protection for our patients and our clients that I have to prove my diagnosis if I have to get on the stand. So because of that, I’m very I’m typically very slow in making a particular diagnosis. And I also want to make sure that I have sort of the proof to back up what I see.

Ann Maree
Yeah, and again, that kind of zeros in on our lay counseling model, that lack of knowledge and diagnosis because we’ve been trained to look for sin, whereas whole persons are not just sinners, they’re also suffers. They’re saints. They’re saints who suffer. They’re saints and sufferers who sin. And I appreciate hearing you you just slip, you know, reminding us slowing it down, slowing down the diagnoses to get the right care. 

Julia, what are some of the other weaknesses in the clinical model? Even versus like the lay counseling model as it relates to good and evil and just everything that we learn about when we’re talking from Scripture.

Julia
Yeah, because psychology began in the secular world, it tends towards humanism, which essentially means that the person is in control of their lives, and the person is basically good. And as a believer, I can like… I don’t buy that…you know, wholesale. I understand the nuances and complexities, but a lot of the theories and the methodologies drive that kind of view of the person that they are basically good. And if you have that framework of understanding people as basically good, you miss out on evil. So we do have a very strong study of psychopathology, but the problem of evil goes unanswered. So when we’re talking about psychopathology, we are saying that this person’s behavior goes against cultural norms and is limiting their life in certain ways. But where does evil come into play with that?

Ann Maree
Yeah. I actually just went to a webinar yesterday, the author of a book called DeMystifying Evil, and brought up the same thing. She’s also a psychologist in that’s all for today, and we do thank Julia and Patrick for making this happen, for thinking carefully and thoughtfully through some questions and the discussion. Like I said, there’s a whole lot more we could have touched on.

[closing]

Safe to Hope is a production of HelpHer. Our Executive Producer is Ann Maree Goudzwaard. Safe to Hope is written and mixed by Ann Maree and edited by Ann Maree and Helen Weigt. Music is Waterfall and is licensed by Pixabay. We hope you enjoyed this episode in the Safe To Hope podcast series. 

Safe To Hope is one of the resources offered through the ministry of HelpHer, a 501C3 that provides training and resources for those ministering in one-another care and advocacy for women in crisis in Christian institutions. Your donations make it possible for HelpHer to serve as they navigate these crises. All donations are tax deductible. If you’d be interested in partnering financially with the ministry, go to help her dot help and click the give link in the menu. If you’d like more information or would like to speak to someone about ministry goals or advocacy needs, go to HelpHer.help. That’s help her dot help.

[disclaimer]

We value and respect conversations with all our guests. Opinions, viewpoints, and convictions may differ so we encourage our listeners to practice discernment. As well. guests do not necessarily represent the views and opinions of HelpHer. It is our hope that this podcast is a platform for hearing and learning rather than causing division or strife.

Please note, abuse situations have common patterns of behavior, responses, and environments. Any familiarity construed by the listener is of their own opinion and interpretation. Our podcast does not accuse individuals or organizations.

The podcast is for informational purposes and is not a substitute for professional care, diagnosis, or treatment.

[end]