Editorial: Joining the integrative conversation

Reading Time: 5 minutes

https://doi.org/10.52456/WACJO11e

It is a pleasure to introduce this inaugural issue of the Waverley Abbey College Journal. I hope that you will find the articles interesting, serve you and prompt conversation, whether you are a student, practitioner, academic, pastoral worker, or curious reader. Its aim is to provide a space for developing scholarly knowledge for practice that is mindful of a Christian perspective.

All the articles in this issue give an insight into how the authors have reflected on their faith, seeking to live out their beliefs in practice, whether in a professional or personal context. Heather Churchill and Gill Harvey’s articles from a therapy perspective are explicit about the process of ‘reflexivity’, exploring some of their experiences in early life, leading to personal transformation and enriching their practice. Owen Ashley’s article on the Waverley integrative framework (Hughes, 2006; Kallmier, 2011) shows some of his working out of how to apply the framework in practice as a trainer and practitioner, and reveals his passion for the integration of his Christian faith with secular knowledge. In a profound and moving article on his mother’s dementia, Ian Stackhouse raises the question of what it means to be human by drawing on a relational understanding of God. Though differing in their emphases, the articles explore the integration of faith with areas such as psychotherapy, medicine and research methodology. In each article, there is a weaving together of the personal, professional and academic. It seems to me their endeavours are deeply integrative by nature.

Integration is a key process underlying the various courses at Waverley Abbey College. The Waverley integrative framework (WIF), which was originally developed by Selwyn Hughes (Hughes, 2006; Kallmier, 2011), seeks to thoughtfully integrate secular knowledge with a biblical perspective in order to provide a framework for helping relationships through counselling and pastoral care. Since the inception of the WIF, much has been written on the process of integration between the two fields of study: Christian theology and psychology/counselling; for example, Johnson (2010) discusses five main views on the nature of the relationship between the two disciplines, adding to his earlier book outlining four views (Johnson and Jones, 2000). Naturally, these kinds of debates are rarely static, and a more recent argument has been put forward for thinking of integration as ‘embodied’ (Neff and McMinn, 2020), that is, integration as ‘conversation’. Neff and McMinn write, ‘As we bring our messy, embodied lives into conversation with one another, we engage in integration’ (2020,  p5). In their book, there is an emphasis on how integration works in practice, with all the complexities that different contexts and people bring, and on conversation as the process and product of integration. Rather than neatly outlining the theoretical relationships between the two disciplines, they do not shy away from the difficult questions that integration can raise in practice, some of which the authors touch on in this journal.

There has been a ‘relational turn’ over the last couple of decades or so in which a relational perspective on what it means to be human has permeated many academic disciplines from psychoanalysis and psychology to theology, sociology, political science, even archaeology (Dépelteau, 2018). This view recognises that humans are primarily relational with core needs for relationship, developing, and sense-making in relationship. From a therapeutic perspective, the genesis of problems that bring people to therapy is often rooted in relationship, and it is in (therapeutic) relationship that healing takes place. Theologically, humans are viewed as imaging the divine in their capacity for relationship. It is no wonder that those writing on integration have brought this relational paradigm to bear on the task of integrating a Christian perspective with the psychological. Neff and McMinn’s (2020) work is suggestive of a relational epistemology. How do we know what we know? We know it together, in conversation, in relationship, as I suggest in the article with Owen Ashley. We cannot go too far down the scholarly road without considering the relational dimension, whether that be in terms of our relationships to other writers and theorists, our professional peers or our more immediate relational contexts. These all shape, in multi-layered and complex ways, the academic discourse, and there is evidence of this in each of the articles in this issue.

Integration brings together not just the professional and the academic, but the personal and the relational, more fully reflecting the origin of the word ‘integration’ as ‘wholeness’ (Ayto, 2005). I am highlighting the value of academic work that includes the heart, agreeing with Palmer and Zajonc in their argument for an integrative approach to education. They write, ‘using heart in its original sense, not just as the seat of the emotions, but as that core place in the human self where all our capacities converge: intellect, senses, emotions, imagination, intuition, will, spirit and soul’ (2010, p20). As evidenced in the articles in this issue, this integrative approach can be complicated and demanding at times. It is undoubtedly simpler to segregate the various dimensions, insulating oneself from the difficult questions that arise in the integrative space. Moving away from Descartes’ dualistic legacy (Tucker, 2010), an integrative stance engenders wholeness and transformation, potentially enabling people of faith to being able to ‘Love the Lord your God with all your heart and with all your soul and with all your mind’ (Matthew 22:37). It is my hope that you will join the integrative conversation, in all its complexities, whether as a reader or potential author in this journal.

References

Ayto, J. (2005) Word Origins: The Hidden Histories of English Words from A to Z, 2nd Edn., London: A & C Black Publishers, Ltd.

Dépelteau, F. (Ed.) (2018) The Palgrave Handbook of Relational Sociology, London: Palgrave Macmillan.

Hughes, S. (2006) Christ Empowered Living, Farnham: CWR.

Johnson, E. L. (Ed.) (2010) Psychology and Christianity: Five Views, 2nd Edn., Illinois: IVP Academic.

Johnson, E. L. & Jones, S. (Eds.) (2000) Psychology and Christianity: Four Views, Illinois: IVP Academic.

Kallmier, R. (2011) Caring and Counselling, Farnham: CWR.

Matthew 22:37, Holy Bible: New International Version.

Neff, M. A. & McMinn, M. R. (2020) Embodying Integration: A Fresh Look at Christianity in the Therapy Room, Illinois: IVP Academic.

Palmer, P. J. & Zajonc, A. (2010) Introduction, In, Palmer, P. J. & Zajonc, A. with Scribner, W. The Heart of Higher Education: A Call to Renewal: San Francisco, CA: Jossey-Bass.

Tucker, L. M. (2010) Quest for wholeness: Spirituality in teacher education, ENCOUNTER: Education for Meaning and Social Justice, 23 (2), 1-10. References at end

About the author

Dr Janet Penny BA (Hons), MSc, PGPDip, C. Psychol., AFBPsS; HCPC Registered Psychologist, Chartered Psychologist, Associate Fellow of the British Psychological Society

Janet is Deputy Head of Counselling Training at Waverley Abbey College. As well as having a private clinical practice, Janet is a research supervisor for doctoral candidates at the Metanoia Institute and London School of Theology. Her own doctoral research was on power dynamics and the development of intra-cultural competence within Christian counselling. She has many years’ experience teaching in higher education, focusing on the integration of faith and psychology in Christian counselling, and research methodology.

Back to Article List

‘Not a straitjacket’, but creatively flexible: An interview with Dr Owen Ashley on the Waverley integrative framework.

Reading Time: 23 minutes

https://doi.org/10.52456/WACJO111

Dr Owen Ashley currently leads Year 1 of the BA (Hons) Counselling programme and the MA in Therapeutic Counselling and Psychotherapy at Waverley Abbey College. He worked as a counsellor in general medical practice for many years and currently has a private counselling practice. As a practising counsellor/psychotherapist for 30 years, he has 20 years’ experience as a counselling trainer and supervisor. Stress management and Christian theology/spirituality are particular areas of interest. Owen has undertaken a PhD, researching the Waverley integrative framework, which offers an approach to counselling rooted in a Christian perspective, and he has played a vital role in the ongoing development of this model. In this interview with Dr Janet Penny, Deputy Head of Counselling Training at Waverley, he looks back at his own professional journey and that of the framework itself.

JP: Thank you for agreeing to be interviewed today, Owen. I understand you’ve been connected with Waverley Abbey College for some time. How far back does this connection go?

OA: Well, in my conscious memory it goes back to 1986 when Waverley, then called CWR, were putting on a series of day conferences for the Church at large in London at Westminster Central Hall, and I was in London at the time, having gone to college there. The notice came up at my church one Sunday morning, saying, ‘If you’re interested in helping people, there are three courses – Enlightenment, Encouragement and Exhortation’ (nice alliteration!), and their argument was that, in the New Testament, all Christians are asked to be encouragers. The second day of the conference was about enlightenment and they suggested that there’s maybe a bit more wisdom required to impart some enlightenment to somebody. The third day  was about exhortation, where the implications were of being a bit more directive.

So that was in 1986, and at the end of those three days they indicated that if you wanted to explore helping people further, they were running what was then called an Introduction to Biblical Counselling, which was a ten-week course over ten Monday evenings at Westminster Central Hall. I think there were about 40 of us there doing the course, which was close to what is now the Introduction to Christian Care and Counselling course that we run at Waverley.

JP: So, it’s 35 years ago that your journey started with Waverley.

OA: Yes, I was very young then – very, very young!

JP: Of course! Yes, and obviously there have been some changes over that time. Now you’re currently lecturing at Waverley Abbey College. How long have you been lecturing there? And what sort of different roles have you undertaken during that time?

OA: Well, it will be 20 years come April. I was first employed by CWR and seconded to London School of Theology (LST) for a while. (Waverley ran the joint course in Theology and Counselling with LST.) For a number of years, I ran the counselling side of the certificate course (the first-year course at LST). Then subsequently, I taught some modules on the third year of the degree course there. When that joint venture ended, about seven years ago, I ran the equivalent certificate year at Waverley. Also, for a couple of years, I ran year four of our BA Counselling degree programme when we had the Pilgrim Hall campus. Then, in 2005, it went up from three days a week to full-time work when I started the PhD, scrutinizing what is now known as the Waverley integrative framework (WIF)[1]. When the PhD finished, in about 2012, I started leading the MA in Therapeutic Counselling and Psychotherapy programme, which has been running for about eight years. I have been running that ever since and continue to lead the BA Counselling year one, both the residential and day release programmes. So, that keeps me fully occupied!

JP: Yes, it sounds busy, but it also sounds like much of your focus has been on the students that are coming in new at level four, in that very formative stage, and that feels like quite an important point in their journey as they start out.

OA: Yes, I have. And certainly, with the year one programme, I have really enjoyed that journey, often introducing them to lots of concepts – including the Waverley integrative framework and a brief introduction to human development – and seeing their whole journey of self-awareness, transformation and change, and challenging them to think in terms of counselling and psychotherapy, but also in terms of Bible and theology, which are two of my great passions. As someone once said, ‘It’s an Owen-shaped job.’

JP: Yes, I can hear your passion for the work, but also for the particular approach that Waverley has developed – the Waverley integrative framework. What was it that initially drew you to it?

OA: I think that there are several things really. I think the first thing that really appealed to me was that it was an integrative framework. Selwyn Hughes, the founder of CWR who developed the Waverley integrative framework in the UK, was a Pentecostal minister and, through a traumatic experience in his role as a minister, really got challenged to think about the importance of Bible and theology in helping people live well, but also about God’s gift in science and beyond Scripture that could potentially help people. He thought about how we could put together and integrate the best and most relevant aspects of science and Bible to create an even better way of helping people. I still wrestle with some of the big issues and questions that go along with integration, but that kind of integration really appealed to me and still does.

Secondly, the fact that the Waverley integrative framework is a holistic framework. Putting it in biblical language, it is about body, soul and spirit (or body, mind and spirit), and I like that kind of holistic view of human functioning, avoiding the temptation to a more reductionist explanation where it’s all spiritual or all psychological, or for that matter, it’s all organic and physical and about chemicals in the brain. It could be all of them and more. And with the challenges of that broader, complex kind of conception of human functioning and all that can interact within our five areas of functioning, and indeed beyond the five [2] areas of functioning as well, I think holding that kind of holistic model really appealed to me.

Thirdly, the WIF has a very clear and specific view of human motivation around what we would call our spiritual longings for security, self-worth and significance, and that really appealed to me back in 1986 when I first came across it. It shed some light on my own way of thinking about myself and what is motivating me. I think those core longings were really important. I liked that, from the off, the framework was also taught by Selwyn Hughes as a flexible framework. Before he died (when I was just about to embark on my PhD, scrutinizing his model), I remember he said to me, ‘It’s not meant to be a straitjacket.’ I think I heard that from the beginning, back in 1986. But I like how the framework goes deep, and, from a biblical perspective, not just looking at our behaviours or thoughts (our cognitive sense), but also what we might think of as our real core sense of self: our personality, our spirit, our inner being (using biblical language) or the heart of humanity (to use another anthropological term). I think Larry Crabb’s well-known book[3] sums it up: life works best when we start from ‘the inside out’, and this is what we refer to as the spiritual area of functioning. I think the fact that it went to that, the deepest part of ourselves, really appealed to me.

JP: Yes, it sounds as though, even right from the start, Selwyn wasn’t afraid to really wrestle with what the deep motivations and longings of people were and to get into some of the complexity and messiness of what it means to be human.

OA: I think what occurs to me, Janet, as you talk about the messiness and complexity, some would critique that kind of integrative approach, saying we just need the Bible and that tells us all we need to know. I understand where they’re coming from, and part of me would applaud that kind of emphasis of Scripture being relevant and central to wellbeing, but what I would say, and what I think Selwyn came to realise, is the Bible is not the only gift God has given us: He has also given us the gift of science. We can come to understand that not only is Jesus the Lord of salvation – which, of course, the Bible is focused on and says a lot about – but Jesus is also the Lord of wisdom, of creation – which takes us beyond the canon of Scripture to the gift of creation and science. Science, at its best, helps us understand how creation works, and, of course, how we as humans, in the midst of creation, are designed to work best. So, rather than thinking in terms of either/or, it is understanding that, with some kind of scrutiny and judgment, we can take the best of modern science not to undermine our understanding of Scripture, but to use it to embellish and fill out areas that the Bible doesn’t talk about. Neuroscience is an obvious example because the writers of the Bible didn’t have the understanding of that subject, which we have now through the study of science. It can be hard work trying to wrestle with both the Bible and science, but I think there is a prize at the end of the rainbow. We’re trying to mix up all these different ways of thinking and knowing, and grappling with that complexity. I think it’s still a worthy journey to take students on, and I’m on that journey myself, of course.

JP: You’re saying that it would be simpler just to take the Scriptures, the simplicity of that. But you’re also saying that there’s a both/and, integrating other understandings that God has gifted us in science and secular knowledge. As you say, that can be quite an interesting, messy and challenging conversation, but one that’s worth it.

OA: Yes, definitely, I would say so, in the sense we’re talking about integration – of Bible and science – but also, even in modern secular counselling models, there is the wrestling, working with clients and the complexity of holding an integrative stance. It sometimes occurs to me that it might have been easier for me to be purely (if there is such a thing as ‘purely’), psychodynamic, which is one of my original trainings, or purely cognitive behavioural therapy or purely person centred, having a simpler road map or lens through which to think about what we’re doing with clients. Having a single therapeutic approach however, means that you miss out on the richness of the diversity of different approaches and, more broadly, those linked to the Bible and theology as well.

JP: Those strengths that you’ve mentioned (richness of diversity of difference approaches), would you say you still regard those as strengths of the Waverley integrative framework now?

OA: I think the short answer would be yes, but I’d need to qualify that as it dips into part of my own journey and indeed part of Waverley’s journey in wrestling with the framework and the different contexts it can be used in. Back in the 1980s, it was a kind of pastoral care model for the Church. But then, working with LST and the first certificate course in counselling in 1998 and subsequently the Diploma in Counselling, students being out there in the ‘marketplace’ and wrestling with the framework in newer broader contexts – how does the model fit in those contexts? If it is a Christian-based, Bible-based model, when you’re working, hopefully with anybody and everybody in a fair and open way, how does that work? Can it make that journey?

Amidst those kinds of questions, and thinking those issues through myself, I felt God led me to think about the whole model more deeply and hence I did my PhD and the book[4] that has emerged from it. I was really wrestling with this issue of context, and I extended the view of humans to one which was more holistic. So what the initial framework taught in 1986 – those five areas of functioning – still holds true for me. But I have added a sixth area of functioning – the outside world. I’m happy to go with five areas of internal functioning, but I’ve always had the conviction that you can’t understand people in isolation, just purely internal, looking into themselves in isolation. Those areas of functioning always exist in lots of external context systemically. So it imbibes that notion of the outside world, the immediate outside world of our first attachments, family, the town we may be brought into, the culture we grew up with and then our broader awareness of planet Earth. As we grow up, all those contexts and more are really significant in the way we can understand any individual developing and growing. Still a holistic framework but I tried to expand the scope of what constitutes holistic, both interior and exterior – holistic but a broader concept.

There is the challenge of using the model flexibly as different contexts have emerged and people have thought ‘How do I use this model in a context with people who may or may not be atheist? Or they may be theists, but Muslims or Buddhists or any other theistic model?’ ‘How does this work in that context?’ I think we’ve been wrestling with that as well. It is something I’ve tried to articulate in my book, The Bible, Wisdom and Human Nature. This issue of talking and thinking about things Christianly or biblically, but understanding that doesn’t mean, when you’re working with people who are atheists or Muslims, for example, that you have to be talking explicitly about Scripture. Jesus is the Lord of creation, wisdom and (as Eric Johnson once said provocatively in a journal article) of psychology and science. So, it may be a lot more implicit, but we can still put the two together without undermining either.

JP: It sounds as though, through your own clinical work and PhD, you’ve really held onto the essence of what the framework is – its biblical roots and its general principles. But there’s also been a deepening and a broadening of the framework. You have identified perhaps something of a gap in the framework. As you look at it now, are there still potential limitations of the framework at this point?

OA: A few thoughts come to mind, and one is not quite directly the framework itself, but how we use the WIF. I think the worst thing we could do with this model, or indeed any model of counselling, is to be enslaved to it as if it says everything, covers everything and you treat it almost like the law that you’ve got to abide by or else something terrible will happen. It is particularly easy for first year students to have a quite rigid, inflexible view of the WIF – how to use it and what it constitutes. I think back to Selwyn’s comment: ‘It’s not meant to be a straitjacket.’ The WIF is a series of principles. If you believe in them, you want to hold onto them. Yet what that might look like in practice could be very varied and I suspect would be. So, I think that’s danger number one, not maybe quite directly of the framework itself, but how it’s used. Being a leader for year one students, for those are coming across it for the first time, I really try to emphasise that one needs to think about it flexibly and contextually.

I think the second challenge would be the way it was originally taught. We teach three phases of the counselling process: helping the client tell their story; coming to an understanding, diagnosis or (in cognitive behavioural therapy (CBT) terms) conceptualisation, which then provides the foundation for phase three; the resolution of the problem. I think the challenge with that three phases approach is it most easily fits in terms of secular models with a CBT structured approach. I suspect that, where students adhere to that more structured way of working, the WIF counselling process will fit more neatly. Where students don’t, for whatever reason – they identify with a more person-centred way of doing the process or indeed a psychodynamic way – that structured linear, step-by-step approach may be more challenging for them. It may be harder for them to adopt the counselling process in the way it is set out. Being aware of that – more so now than ever, and more so than Selwyn Hughes would have done back in 1986 when I was taught it – is why, in explaining the principles of the three phases in year one, I really lay it on thick that in real life it is more organic, it’s messier. But I think the WIF does have an educational value in terms of helping people get round the complexity of not only of the five areas of functioning but how you might apply that in practice. I teach it heavily laced with an emphasis on how one has to connect with the client and go with the flow of what is happening in the moment. It may be more of an implicit process for some people, depending on how they use it, or it may be something more explicit, depending on the client and the individual student who’s using it.

JP: Your comments are reminding of the discussion by Gregory Bateson that ‘the map is not the territory’[5]. It sounds like you’re holding in tension the need to give a degree of clarity and a map, as it were, to students, but also alerting them that they don’t need to hold on to that at the expense of what is happening in the process with the client.

OA: Yes, that’s right. We know that one of the factors that influences a good outcome is, of course, being tuned into the client’s learning style and their needs at any point in time. Some clients might really need and appreciate a quite explicitly structured approach. In my own private practice, there are clients who need and value an explicitly biblical approach, in which case, I can use the WIF framework in a much more explicit manner, whereas for another client it might be unethical to do so. There is the issue of discernment, whatever theoretical frameworks we adhere to, always discerning how we might use it flexibly and creatively in service of the person in front of us and, of course, treating them as unique. Equally, what they need in the beginning of the counselling process may be quite different by the end of it. There can be flexibility through a series of counselling sessions with one client.

JP: It takes me back to what you said about Selwyn’s comment that the WIF is not a straitjacket but there is a need for flexibility.

OA: Part of my own journey is the question of how I use it in different contexts. I’ve used it, as you know, as part of the work in the doctor’s surgery in Reading where we both worked for some period of time. I used the framework to run stress management courses, offering five sessions on the five areas of functioning. I offered a voluntary sixth session for anyone interested in looking at a Christian approach more explicitly and answers to issues of stress from that perspective. I found a practical, ethical and creative way of trying to be true to who I was and yet be sensitive to context. We also taught general practice registrars a brief two-day counselling skills course, and, again very loosely, we used the five areas of functioning. It was a way of helping the registrars think holistically, and I think it really illustrates the points of the principles: if you believe they do apply universally, which I do, that they can be used with sensitivity to the context. The WIF talks about spiritual needs, so when I was talking to the folks in that context and doctors coming from all faith backgrounds, or none potentially, I would tell them that if the word ‘spiritual’ isn’t part of their worldview, then they might want to change it for words like ‘foundational needs’, ‘basic needs’ or just ‘needs’. It really does illustrate the importance of not getting hung up on the words or language but find different ways of communicating the same themes.

In counselling, whatever our approach is, one of the tasks is to find a shared language that doesn’t trip people up but still conveys the same principles. It is a case of finding the appropriate words, metaphors or images. Perhaps use different metaphors to convey the same issue or hold the same issue together for a client. With an accountant, I might use the language of a bank balance with incomings and outgoings. With an artist, I might think of a different metaphor to use. That shows the creative potential of the framework both in the stress management courses and in terms of training others. I’d be creative in the clinical process with clients as well. I work with quite a number of Christians, including church leaders, where we can talk about Bible and theology in a very appropriate and relevant way. I might then think about the Waverley framework in a more explicit way to help them think about their core spiritual longings. That, to me, is the ongoing creative use of the framework. I think that is the spirit of what Selwyn Hughes meant when he said that it’s not meant to be a straitjacket that we somehow are rigidly enslaved to.

JP: I was really struck by your phrase about how the principles apply universally but there is the need for sensitivity to context. There’s something that speaks so universally about what it means to be human in the framework, but then there is flexibility with a sensitivity to context in how you work that out.

OA: Yes, the word ‘spiritual’ for people from a Christian worldview is Christ-centred spirituality, whereas we could still think about an atheist having a spirituality. It may be a nontheistic spirituality, may even be a materialistic spirituality, a kind of sense of worldview or big picture, spirituality of existential issues, the essence of meaning, purpose and things like that. I think that’s another point of crossover and that’s the kind of language one could use to convey similar principles.

JP: Yes, and maybe part of the longevity of the WIF is that it does speak to those core human basic needs universally.

OA: I am certainly convinced of that. If you think of the core needs for security and belonging, they map on to the whole world of attachments and secure insecure attachments to find a secure base, as one well-known attachment theorist wrote about[6]. Also, with purpose and significance, I think of the core CBT schemas of powerlessness – the idea that ‘I haven’t got an impact’, which is really kind of what we mean by significance. Recently, it thrilled me when I read some of the developments in CBT around the core problematic schemas. I think it was Judith Beck who added a third one, which was around self-esteem, and I thought that seemed to map onto the development of the model from Larry Crabb[7] (from whom Selwyn Hughes originally developed his model), who focused on two core spiritual longings of security and significance (with Selwyn adding a third one of self-worth). I can see a parallel with the developments in CBT and what they call their core problematic schemas around these issues. In my mind, it alludes to this issue of integration. I suspect that Selwyn, when he was developing his own model back in the 1980s and when second wave CBT was really coming into its own, may well have therefore borrowed some of those insights in his integrative approach to understanding our core function. He also borrowed from Erik Erikson’s eight stages psychosocial model[8], particularly the first three quite explicitly. Security, self-worth and significance relate to Erikson’s first three developmental phases around trust, autonomous self and initiative, which is significance and impact really. You can see how he’s borrowed from the theories that were around in the culture of the day, which is both helpful but also a challenge when those emphases or theories may have adapted and moved on. That has been part of our work at Waverley Abbey College, helping the WIF develop and move along as well.

JP: Yes, so given that, how do you think the Waverley integrative framework might develop?

OA: I think the future is really exciting. Over the past eight years, we have had students doing master’s degrees at Waverley. Your own role, Janet, heading up the research is a really exciting development that will really add into this ongoing dialogue around scrutinizing the model and keeping up to date with modern research and science. Indeed, our own students are contributing to the body of research; for example, it was thoroughly exciting when, three or four years ago, one of our students did her research on the initial impact of the Waverley integrative framework on our first-year students. You can imagine I was interested in what they were going to say! This year, we have a student looking at the Waverley framework, the issue of it’s not meant to be a straitjacket and how students in practice embody the framework.

I’m really looking forward to that kind of research and the opportunity for our students to have an ongoing voice, so I think that’s really exciting for the future. I’m also looking forward to having more diverse voices from our student body. This year one of my first-year students noted that the key voices we often cite – who indeed have explicitly written on the framework, including my own book – are all men, thinking of Ron Kallmier[9], Larry Crabb[10], Selwyn Hughes[11] and myself. I thought, Oh yes, I hadn’t quite thought of that. I said, ‘Well actually you’re right, but you know what?’ – and it was a female who asked the question – ‘You can be part of the solution to that, to take up the baton.’ We had lots of ‘Hallelujahs!’ from the female students as well as the male students. It is not only the male–female balance that needs to be addressed but to include more fully people from other cultures and other backgrounds. I really think it is a great opportunity for students from a whole diverse range of backgrounds to get involved in the ongoing research dialogue and the process of writing in articles and journals – our own as well as other journals. I think there is a great melting pot of potential there.

JP: Oh, that sounds so exciting! In a way, it coheres with your own theoretical development of putting the WIF within its wider context, involving people from a wider context to think about how the WIF can be developed, like a kind of social epistemology – ‘How do we know what we know? We know together, in dialogue with others.’

JP: How do you think Selwyn would react to where the WIF is now?

OA: I think he would be really thrilled. It really struck me how open he was for those ongoing dialogues. I somewhat provocatively and mischievously said in an article in Accord Magazine[12] about my research that ‘It’s never completed, it’s never perfect.’ I added that if you think it is, you are probably going down the road of idolatry – which is a sin. So even if you don’t think the framework needs revising, you do (that is, you need revising!). It’s a way of getting students to think about how they hold any model, including the Waverley integrative framework. I think Selwyn would be really up for the debate, the scrutiny and the research, so I think we’re still on track, and I think if Selwyn was here, he’d say something similar.

JP: Yes, that’s interesting. He really set about an on-going process, developing something that has flexibility and room for growth.

OA: Yes, absolutely.

JP: As we’ve been talking, what has struck you? What has stayed with you or surprised you in terms of our conversation?

OA: It has reminded me, in miniature, of my experience at the recent Association of Christian Counsellors’ conference where there were about 400 delegates, and I realised I’d probably talked to and taught about a quarter of them – about 100 of them over the last 20 years. Thinking about my involvement with Waverley and the way the framework has developed, its starting place and where it is now, there has been quite a parallel with my own life and professional and personal journey. I think that parallel has really hit me. It has got me thinking quite deeply about things, fond memories and how time has gone by, but also the kind of ongoing open-ended journey that we are on. I want to say thank you for giving me the opportunity to put the story together as much as one can do in in a relatively brief period of time.

JP: My own reflections are that it reminds me of the mustard seed parable: how from the trauma and story of one person, this model has been developed, grown and impacted hundreds of students at Waverley, as well as clients through your own clinical and pastoral work. This growth is replicated in different ways over and over with each person who learns the WIF, so it is a kind of living embodiment of that parable. I think it has just left me feeling a great warmth for the WIF and that sense of connection with it again that I’ve always had.

OA: Of course, the WIF is not perfect because it doesn’t say everything, but that kind of passion for the WIF is important for me because I couldn’t teach it if I didn’t believe in its core principles. I couldn’t stand up and teach it with conviction and passion if I didn’t. I think there is always things to change and adapt, but I think the core elements, as I was taught back in 1986, for me still hold truth. And that means great joy.

Footnotes

[1] The Waverley integrative framework was previously called the Waverley model. The terms ‘model’ and ‘framework’ are used interchangeably in this interview.

[2] The Waverley integrative framework posits five areas of human functioning: rational, physical, emotional, volitional and spiritual. For more information, see Ashley, O. (2017) The Bible, Wisdom and Human Nature: Developing the Waverley Model of Counselling, Farnham: CWR, and Kallmier, R. (2011) Caring and Counselling, Farnham: CWR.

[3] Crabb, L. (2013) Inside Out, (Revised and updated) Colorado Springs: Navpress.

[4] Ashley, O. (2017), The Bible, Wisdom and Human Nature: Developing the Waverley Model of Counselling, Farnham: CWR.

[5] Gregory Bateson discusses the ideas of Korzybski, in Bateson, G. (2000) Steps to an Ecology of Mind, Chicago: University of Chicago Press.

[6] For further information on attachment theory see, e.g., Holmes, J. (2014) John Bowlby and Attachment Theory, London: Routledge.

[7] Crabb, L. (2013) Understanding People: Why we long for Relationships, Grand Rapids: Zondervan.

[8] Erikson, E. H. & Erikson, J. (1998) The Life Cycle Completed: A Review, New York: W. W. Norton & Company, Inc.

[9] Kallmier, R. (2011) Caring and Counselling, Farnham: CWR.

[10] Crabb, L. (2013).

[11] Hughes, S. (2006) Christ Empowered Living, Farnham: CWR.

[12] Published by the Association of Christian Counsellors (www.acc-uk.org).


About the authors

Dr Owen Ashley BSc (Hons), MA (Couns), PhD, MBACP Reg. (Snr. Accred), PG Cert HE, ACC (Accred)

Owen worked as a counsellor in general medical practice for many years and currently has a private counselling practice. Owen has undertaken a PhD, researching CWR’s Waverley Counselling Model. As a practising counsellor/psychotherapist for 30 years, he has 20 years’ experience as a counselling trainer and supervisor. Stress management and Christian Theology/Spirituality are particular areas of interest.

Dr Janet Penny BA (Hons), MSc, PGPDip, C. Psychol., AFBPsS; HCPC Registered Psychologist, Chartered Psychologist, Associate Fellow of the British Psychological Society

Janet is Deputy Head of Counselling Training at Waverley Abbey College. As well as having a private clinical practice, Janet is a research supervisor for doctoral candidates at the Metanoia Institute and London School of Theology. Her own doctoral research was on power dynamics and the development of intra-cultural competence within Christian counselling. She has many years’ experience teaching in higher education, focusing on the integration of faith and psychology in Christian counselling, and research methodology.

Back to Article List

I never intended to do a doctorate!

Reading Time: 25 minutes

https://doi.org/10.52456/WACJO112

Introduction

In this article, my personal journey of transformation through the pursuance of research and study as an adult is outlined. The golden theme throughout being the immense growth and development that I have experienced as a result. Now in my mid-sixties, I am probably the most surprised person in the world to find myself in the fourth year of a doctoral programme and in the process of writing my thesis, having carried out qualitative research entitled ‘A narrative exploration of the influence of a fundamentalist religious upbringing on mental health and wellbeing in adulthood’. It has been an enormous privilege to work on this project with the volunteer co-researchers (this is the term used for participants in this study), namely qualified counsellors, from across the Abrahamic faiths, who have generously given of their time and energy as we have shared stories relating to the research topic. During this process I have frequently reflected on the long journey I have undertaken: from the 15-year-old girl who left school without any qualifications to the present day.

Becoming a researcher

It seems important to acknowledge at this point that I never set out to be a researcher and, for most of my life, it has been as far away from my thinking as the moon is to earth. Yet for many years, I have been aware of a thirst for knowledge, the result of which has been that I have spent a lot of my adult life in learning environments. My first encounter with research was on my first undergraduate degree many years ago. I am unable to recall much detail, in terms of subject or process, except that I was left with the firm belief that research equalled statistics and was therefore not for me. There is no doubt that, at that time, any interest in research was killed off, and for many years, the quarterly Counselling and Psychotherapy research journal of the British Association for Counselling and Psychotherapy was promptly thrown in the bin on arrival! Nonetheless, despite this personal rejection of research, I ran a thriving private practice, and successfully worked with clients and supervisees for many years, eventually becoming an accredited member of Association of Christian Counsellors and senior member accredited with the British Association of Counselling and Psychotherapy. In addition, I have been a tutor for three different training organisations and, until a couple of years ago, delivered counselling-related training workshops at a local college of further education. My passion for learning has facilitated engagement in personal therapy, supervision, workshop attendance, reading and participation in many courses and workshops over the years, all of which have contributed to immense personal and professional development.

Personal and professional development

Undoubtedly, the term ‘personal and professional development’ is commonly used and has become a big industry within the counselling and psychotherapy profession. This is not surprising, given the requirements of the professional bodies for practitioners to engage with the continuing professional throughout their careers, with frequent acknowledgement of its contribution to ethical practice. Moreover, ongoing development is regularly acknowledged as a foundational building block, not only for counsellors in practice, but also for student counsellors not yet seeing clients. As current leader of the personal and professional development module on the BA (Hons) Counselling programme at Waverley Abbey College, I seek to convey the crucial nature of ongoing development to clinical practice through my lectures to year one trainees. Certainly, ongoing development is vital to my work as a therapeutic counsellor, supervisor, researcher, and trainer, whether it is in relation to looking into a specific presenting issue or undertaking more formal training. Yet, it seems completely astonishing that despite universal acknowledgement of the importance of continuing growth and learning to clinical practice, and that a wide variety of activities exist, there is no current agreed definition (McLeod & McLeod, 2014:9). Despite this, the emphasis of its crucial nature is not diminished by many psychotherapeutic professionals. As a supervisor, I regularly urge supervisees to not simply engage with the continuing professional development requirements as a tick-box exercise to meet the annual obligations, but rather to view this as an opportunity to fully participate with curiosity and enthusiasm, as personal and professional growth intertwine. Undeniably, the assertion that we have a responsibility to ‘know ourselves as much as we hope to know others’ (Adams, 2014:17) grounds counsellors and psychotherapists in the sobering reality of their duty of care to clients, with personal training and growth surely being a mandatory part of this. Further, while some writers exhort practitioners to reflexively engage in their own growth, so that they can become more complete people (Wilkins, 1997:1), others stress the importance of considering ‘the engine that drives us’ (Bager-Charleson, 2012:5). In other words, the necessity for thinking about our motivation for engaging in this work is vital. Moreover, many practitioners willingly participate in workshops, courses, personal therapy, spiritual direction, supervision, further academic training, and read books, research articles and blogs. These activities, combined with rewarding work with clients, supervisees and students, have provided me with a profound sense of purpose and meaning, so it is not surprising that, for a long time, I held a strong belief that this rewarding professional life would take me happily into eventual retirement.

Studying for a masters’ degree

However, this changed dramatically one day in 2013. I was idly browsing through a brochure of counselling degree programmes run by Waverley Abbey College when an advertisement for the Masters’ of Arts in Relational Counselling and Psychotherapy degree (now the Master of Arts in Therapeutic Counselling and Psychotherapy) leapt out of the page at me, and I became convinced in those moments that I needed to explore the possibility of applying for the course. So I ‘pushed the door’ gently only to find that it flew open, and I subsequently embarked on three years of masters’ level training without any real idea of what it involved, or that a research project and resultant dissertation were required in partial fulfilment of the qualification. I now realise that those three years were a time of profound personal and professional growth, especially on the topic of integrating a spirituality into practice – a key reason for my interest in the first place. Most notably though, I was catapulted into the discovery of qualitative research for the first time, which was life-changing, even though the carrying out of five semi-structured interviews, the transcribing of the conversations and the analysis process of immersion in the data, and then extracting super-ordinate and sub-ordinate themes as appropriate to the methodological double hermeneutic of the interpretative phenomenological analysis (Smith et al, 2009) were onerous. Similarly, the writing of my dissertation entitled ‘An exploration of counsellors’ lived experiences of the impact of client spirituality when bereavement is the presenting issue’ was both exhilarating and exhausting at the same time. Yet, my interest in research was ignited as never before, with the foundational philosophical underpinnings of the qualitative nature of the research project authentically paralleling the theoretical and philosophical orientation of my work with clients. However, at the point of submission, I vowed to myself that I would never subject myself to the demands of such rigorous work again.

The doctoral journey

In fact, the irony is that, despite the promise I made to myself that evening in the relief of completion, a few short weeks later I started to mindlessly google doctorate in psychotherapy (D. Psych.) and doctor of philosophy (PhD) opportunities within the United Kingdom, and once again, the ‘door flew wide open’ and within a short time I became a doctoral candidate at the Metanoia Institute/Middlesex University. Thankfully, I was aware that time that central to the achievement of a doctoral degree was a robust research project, even though I was unsure of the research topic at that time – apart from something to do with trauma and spirituality.

Why this doctoral programme?

There are at least five types of doctoral degrees awarded in the UK (Smith, 2009). However, the one that I am currently on was attractive because of its crucial work-based nature aimed at mid-career counsellors and psychotherapists. In fact, a core aim of the programme is to enable professional practitioners to continuously evaluate their own practice while holding awareness of assumptions and being mindful of research developments within counselling and psychotherapy (Du Plock & Barber, 2016) – an obvious opportunity for growth and development. Also appealing were the programme’s aims, described as being ‘about continuing professional development into continuous development of their profession’ (Goss & Stevens, 2016:19). For me, the emphasis on the important role that counselling and psychotherapy research has in informing practice at the micro-interactions with individual clients and supervisees at the macro-level of the profession was attractive given the research-practitioner gap.

The development of the research topic

Without doubt I am an insider-researcher into the influence of a fundamentalist religious upbringing on mental health and wellbeing; my own familial environment in my formative years was deeply embedded within fundamentalist religion. In fact, the conceptual roots of this study are situated in Wales back in the mid-1950s where I was born: second of three children into a working class, nuclear Welsh family, multi-generationally situated within chapel religiosity dating back to the Welsh revival (1905–1906). My early years are recalled as happy and secure as my life was safely based in the community of a small Welsh town where everybody knew everyone and cared for each other like family. This socio-cultural heritage remained intact until my mother was ‘love-bombed’ (Singer, 2003:114) and radically converted to a fundamentalist, evangelical, high-demand, cult-like group when I was just three years old. Naturally, I have no memory of that momentous parental decision, which dramatically altered my developmental experiences, as over time the form of familial Christianity became based on very ‘all or nothing’, literal and dogmatic rules, which permeated every aspect of life. Suffice it to say that I have come to understand that during those growing-up years I lived in constant hyper-arousal, hyper-vigilantly attuned to others with adrenaline constantly flooding my system, thus illustrating that ‘even if children are at home with their biological parents, they may still be poorly regulated’ (Gerhardt, 2004:75). During the many years since childhood, I have often wondered about the effects of this sort of upbringing on the mental health and wellbeing of us three children, later in life.

However, in addition to my own reflections on these matters, it was therapeutic work with one client [1] during the first year of the doctoral work that enabled significant development in the refinement of my research topic.

While the client identified relational problems as his presenting issue, it became apparent that there was more to his story than he was seemingly aware of. During the assessment appointment, I enquired about his family of origin, and he replied that his mother was ‘passionately Christian’ while his father was ‘very judgmental and an authoritative narcissist’. Over the weeks, the client revealed more about the family dynamics during his formative years, home was ‘a fortress’ because, although they were an extremely religious Christian family, they did not attend church or Sunday school at all, but instead they operated ‘like a cult’ with his patriarchal father being ‘the highest authority’. In alignment with my core theoretical modality, a person-centred way of working seemed most appropriate, and the client responded positively to the non-judgmental environment, the empathy, unconditional positive regard and genuineness, and started to put some ‘loving distance’ (Lagone, 2016 cited in Aguado, 2018:4) in place within previously enmeshed family relationships. In fact, when ending counselling, the client’s feedback was that he felt that he had grown greatly through our work together and yet, with the benefit of hindsight and subsequent learning, I now wonder whether I was working with his pseudo-personality (Jenkinson, 2008). I wish I had known then that a dysfunctional family can operate like a cult (Aguado, 2018) and that the client might have benefitted from specialist help rather than traditional psychotherapy. However, the recognition was that the client’s background was like mine, and this was pivotal to the refinement of the topic because the importance of therapists recognising the potential influence of a fundamentalist, religious upbringing on mental health and wellbeing became clear. Certainly, prior to our work, the client was unaware that his adulthood relationships were being detrimentally impacted by the relational religious dynamics of his growing-up years. Alongside, I became aware that other people had also experienced the devastation of therapists failing to recognise the significance of such a childhood.

Furthermore, the portfolio of work produced in partial fulfilment of the doctoral requirements was also significantly influential to the fine-tuning of the topic as documents such as a review of personal and professional development, a reflexive research journal, a critique of my masters’ research, a learning agreement (research proposal) and a written summary of the knowledge gained from attendance at professional knowledge seminars have been written. A significant ‘growing edge’ during this time has been to embrace openness and creativity in my work, which is unsurprisingly counter-intuitive to me, given the rule-based nature of my upbringing.

Philosophical positioning

In contrast to the masters’ research experience where all elements of the design were prescribed, at doctoral level the ‘mapping of the territory’ (Finlay & Evans, 2009:14) has involved greater choice. However, alongside the options for choices around the methodology and methods has come responsibility to be clear about my philosophical positioning, about ‘what can be known (ontology) and how it can be known (epistemology)’ (Etherington, 2016:87). Crucially, the importance of the influence of a researcher’s beliefs and values on the research itself is emphasized by Penny (2021) who has utilised the visual image of Bond’s Pond (1995, cited in Palmer & Woolfe, 2000:319) by effectively applying the model to the inter-related layers of the research process. Such graphic illustrations have helped me to understand that my current philosophical position has considerably evolved from the absolutist, positivist influences of a fundamentalist religious childhood, which had an intrinsic conviction that we had ‘the truth’ and were the only ones who possessed it. Indeed, my present perspective is that there are striking parallels between the indoctrination characteristics of positivism in my growing-up years and the ontological and epistemological positions of positive quantitative researchers who ‘aim for truths’ (Finlay & Evans, 2009:19). Moreover, positivism can be critiqued for over-simplifying the intricacies of human experience, while failing to consider the subjective nature of independent human experiences (Langdridge, 2004).

Consequently, my philosophical stance is firmly located within an anti-positivist, constructivist-interpretivist, and relativist ontological position, and this informs my work as a practitioner and researcher (Penny, 2021), being based on the conviction that there is not one truth that can be discovered by hypotheses testing, as human beings are ‘not passive phenomena waiting to be measured’ (Langdridge, 2004:252). Rather, there are a variety of understandings in existence with experiences being formed and processed through words, and a diversity of applied interpretations (Finlay & Evans, 2009) as indicated in my relativist ontological position combined with a constructivist stance. This perspective additionally enables me to hold the belief that ‘perception and cognition are active processes in which anything ‘given’ is actually a product of processes, of selection and construction’ (Hammersley, 2013:35). Without doubt, my firm belief is that this position also blends well with an interpretivist position, which emphasizes the essential nature of ‘draw[ing] upon our human capacity to understand fellow human beings ‘from the inside’ – through empathy, shared experience and culture etc.’ (Hammersley, 2013:26). Additionally, the social constructionist perspective is integrated into my philosophical position because it recognises that ‘people’s perceptions and experiences are socially, culturally, historically, and linguistically produced’ (Finlay & Evans, 2009), which is a crucial consideration given the focus of my research study. This stance allows me to be authentically true to my personal beliefs, values and theoretical orientation as an integrative practitioner with a person-centred core, prioritizing as it does, the centrality of relational connection and the intrinsic value of a person’s truth around their phenomenological, lived experiences, whether in the therapeutic space or the research environment.

Not surprisingly, these carefully thought through personal beliefs and values have naturally led to qualitative methodologies where the focus is on language and the ‘deep’ (Bottery & Wright, 2019:113) investigation of the subjective experience of the phenomenon in question rather than the adoption of the ‘Newtonian spirit’ (Finlay & Evans, 2009:20) and realist ontological perspective of the ‘broad’ (Bottery & Wright, 2019:113) quantitative testing of hypotheses, with numbers and statistics being used in a deductive process of data extraction. While the alternatives of action research or a mixed methods approach do exist of course, qualitative studies interest me because they ‘engage with exploring, describing, and interpreting the personal and social experiences of participants’ (Smith, 2015:21). They also seek to understand the richness and complexity of subjective experience (Bright, 2013) and the ways in which people make meaning in their lives (McLeod, 2015:92). In short, qualitative methodologies involve observing, describing and interpreting the way that people experience, act on, or think about themselves, their experiences and the world (Bazeley & Jackson, 2013). Yet despite the influential emergence of qualitative research across many areas of the social sciences, such methodologies are harshly critiqued by those entrenched in a quantitative mindset for being a random collection of different approaches, all based on differing ontological and epistemological positions (Hammersley, 2013:ix). Consequently, the argument is that there is little to unite qualitative researchers apart from resistance to quantitative ideology. However, the same accusations could also be made towards quantitative investigators who frequently debate the status of randomized control trials versus surveys or questionnaires, for example. Moreover, qualitative inquiry mainly concerns itself with seeing through the eyes of research contributors, description of context as important, flexibility, lack of structure and concepts and theory (Bryman, 2008). There can therefore be little doubt that a qualitative approach is most suited for exploring the research questions posited for this study being, ‘might a fundamentalist religious upbringing be an influential factor on mental health and wellbeing in adulthood? What are counsellors’ experiences?’. Nonetheless, it was essential to consider a variety of qualitative methodologies before the eventual decision to use narrative inquiry was made.

Narrative inquiry

One of the key strengths of narrative inquiry is that it is founded on the centrality of narrative to our human experience, given that storytelling is fundamentally important in life (Atkinson, 1998). This enables meaning to be gained from human experiences (Polkinghorne, 1988) through the provision of symmetry, ‘to our very sense of selfhood… [as] we creative a narrative identity’ (Smith, 2015:89; Smith & Sparkes, 2008), as narrative inhabits both our internal and external dialogues. Moreover, it is also suited to the exploration of extended narratives within socio-cultural contexts, such as growing up within fundamentalist religious environments, being underpinned by constructivist and constructionist epistemologies. Furthermore, storytelling is culturally universal (McAdams, 1993) and historically traditional, with the passing of tales from one generation to another being commonplace. It is also viewed as being both accessible and pleasurable, as it bridges both theory and practice, as well as offering diversely exciting approaches to research inquiry (Squire et al, 2014:94).

Conversely, critiques of narrative inquiry as a methodology include accusations that its origins are complicated (Squire et al, 2014); that it is simply an umbrella term for a conglomeration of methods (Langdridge, 2004; Mischler, 1986; Squire et al, 2014); and for its relatively new emergence into interdisciplinary practice in the last decade or so. This methodology is also criticised for lacking structure and instructions on how to carry it out (Squire et al, 2014). Additionally, some maintain that it is too restrictive because it focuses on just the narrative (Smith et al, 2009), but it is also accused of being too broad in relation to meaning making, given that one of the functions of narrative is to demonstrate someone’s way of organising events and experiences about self and others (Polkington, 1988). Much of the criticism, however, steadfastly ignores the healing effects and reorganisation of memories, which can result from the ‘narrative stream’ (Rosenthal, 2003:923) of storytelling, and the fact that other literature soundly backs-up ‘life-story research’ (Etherington, 2009:225) as a suitable approach for counselling and psychotherapy research, which ameliorates much of the disapproval. Further, much of the criticism of narrative inquiry is made of it as a whole methodology rather than one version, and it is therefore likely that the careful choice of one specific form of it could potentially counter much of the condemnation. On this basis, the decision was made that the reflexive (Etherington, 2004), collaborative approach (Arvay, 1998; Arvay, 2002; Arvay, 2003), which is also profoundly relational centred (Finlay & Evans, 2009) was the style of narrative inquiry most suited to this research study because not only does it align with my philosophical positioning, but it is respectfully well-suited to the sensitive nature of the research topic.

Doing reflexivity: A collaborative narrative approach

The collaborative, narrative approach (Arvay, 1998; Arvay, 2002; Arvay, 2003) is the product of ‘methodological innovation’ (Squire et al, 2014:vii) being a bespoke development in response to the originator’s identification of a lack of an extant qualitative methodology, which sufficiently embodied participants stories. It has clearly stated aims, being to be ‘collaborative, to attend to power relations within research, and to deal with issues around voice and representation’ (Arvay, 2003:163). Unsurprisingly then, its key concepts focus on relational-centred collaboration and reflexivity, the purpose being to ‘co-create research environments that are participatory and emancipatory’ (Arvay, 2003:163). As already stated, the suitability of this approach to the research topic is obvious, given that those who experience a fundamentalist religious upbringing were commonly silenced in their developmental years, and may never have verbalized this aspect of their story as adults. Moreover, the seven-stage structured process, being ‘setting the stage – a reflexive preliminary interview; the performance; co-constructing the research interview; the transcription process; four collaborative interpretative readings; the interpretative interview; writing the narratives and sharing the story’ (Arvay, 2003:163) arguably counters the common perception of narrative inquiry as unstructured. Although, as the originator acknowledge, the collaborative, narrative approach (Arvay, 1998; Arvay, 2002; Arvay, 2003) is acknowledged to be ‘extensive, time-consuming and very personal’ (Arvay, 2003:163) and consequently seen as demanding of all co-researchers, although a transparent strength is its respect for the integrity of participants stories through the provision of numerous opportunities for collegial critical reflexivity (Guccione & Wellington, 2017). This in turn, enables the avoidance of ‘methodolatry’ (Reicher, 2002; Wellington, 2013) and the maintenance of doctorateness.

Carrying out the research

It has been a privilege to utilise the specific tools and methods of the chosen methodology as, while the whole research process has unquestionably been rigorous, demanding, and time-consuming, the pertinent importance of this study has been obvious at each stage of the journey. For example, at recruitment stage, the number of expressions of interest in participation were astonishing, and while some people dropped out once the level of required commitment was understood, purposeful sampling was used to gain as much representation as possible across the Abrahamic faiths, with eight co-researchers being invited to proceed (although one later withdrew due to the commitment required), providing proof of the recognised demands of the chosen methodology. Additionally, I initially had the pleasure of meeting in person with each co-researcher. Even though this entailed travelling all over the United Kingdom, it was an honour to share both our own stories (unusually, the methodology allows me to share elements of my own story), and anonymized clients’ stories on the research subject. Throughout the seven-stage process, the seven remaining co-researchers were actively engaged in the collaborative, reflexive and analytical work, and when the Covid-19 virus abruptly interrupted the plan to meet again for an interpretative interview, following the four interpretative readings, working online via a secure platform was then collaborative agreed for the remaining conversations.

The current position

The work with the co-researchers is now complete, and I remain profoundly and deeply grateful to each one of my co-researchers. They have generously shared their stories and committed a great deal of time and effort in collaborative, reflexive and relational-centred pursuance of utilising a methodology that, while complex and time-consuming, has been respectful to the stories that have been told. All the co-researchers, including the person who withdrew just before analysis stage, have given very generously of themselves, and I am indebted to each one of them. However, it has become apparent that their giving has not been totally altruistic (as indicated in their reflexive feedback at the end of our work together) because while research can never be therapy, it can certainly have therapeutic benefits. I have also been profoundly impacted by the depth of connection with each co-researcher, the similarity of stories in some cases and all that has been mutually shared cannot be under-estimated.

However, there is still a great deal of further work to do as I am currently in the process of developing the findings of my research and re-engaging with the literature in a systematic and comprehensive way while also writing up my thesis of 65,000 words (+/- 10%). All of this is an extremely onerous process, especially given the added isolation and loneliness of disconnection from family and friends in this Covid-19 era, and I am constantly mindful of the need to attend to my own self-care by walking in nature daily to restore perspective and with the recent re-discovery of an old hobby of cross-stitch being creatively rewarding.

Reflections on this journey of personal and professional development from a Christian worldview

Despite the restrictive nature of my fundamentalist religious upbringing, I continue to acknowledge some beneficial gains, including the acquisition of knowledge about religious matters from a young age, foundational beliefs and values and the sense of belonging obtained from the religious community I grew up in, all of which provided me with the foundational building blocks of my current, much-evolved faith and resilience. Yet, in common with some of my co-researchers, I also link both physical and mental health challenges in adulthood to the unhelpful familial environmental dynamics of a ‘them and us’ culture; feeling different; imposed ‘all or nothing’ rules and authoritarian, parental fear mongering. Alongside, from my Christian perspective, I have an anchoring sense of God’s hand on my life in a transformative sense, and I am often drawn to the Japanese concept of ‘Kintsugi: the art of precious scars’ (Lifegate, 2021) and the art of repairing brokenness with gold, silver or platinum so that the broken bowls can become more beautiful than before. Time and time again, I have also been reflected on the Waverley integrative framework (Ashley, 2017; Waverley Abbey College, 2021) and an imago Dei understanding of what it is to be a relational human being, given the relational joys and sorrows that can ensue. This framework also helpfully suggests that there are five areas of human functioning – physical, emotional, rational, volitional and spiritual – in existence. This holistic conceptualisation of humanness has been helpfully informative to the research process for this study, which has been intrinsically relational centred. Alongside, focusing on my own value of integrity, in line with my Christian faith, has been helpful in consideration of quality control in terms of examining the validity and reliability of the work, including the continual assessment of risk to all stakeholders. Further, understanding my own wounds and journey of recovery (Zerubavel & O’Dougherty, 2012), while also being mindful of the ‘power and privilege’ (Oakley et al, 2020) that a researcher has and recognising any emergent seedlings of a ‘hero complex’ (Oakley et al, 2020), has been crucial.

Furthermore, throughout this doctoral journey, I have often recalled the pivotal but rare occasion, in my experience, when I heard God tell me that it was right to apply for the masters’ level training at Waverley Abbey College although, of course, at the time I was totally unaware of the transformative opportunities that would result. Moreover, I also frequently remember the period of chronic illness I experienced some 20 years ago now when, despite the hopelessness of that situation, God promised to ‘restore the years that the locusts [had] eaten’ (Joel 2:25), and reassured me with verses of scripture such as ‘I know the plans I have for you, declares the Lord, plans to prosper you and not to harm you, plans to give you hope and a future’ (Jeremiah 29:11). At the time, it seemed impossible that these promises would be fulfilled, and yet I am enormously grateful for restoration and transformation and recognise that the inter-weaving of personal and professional development has been central to it all. Indeed, I have often used the metaphor of a ‘plait’ to describe the inter-related characteristics of my journey to date, which is ironic given that for the majority of my growing-up years I wore my hair in plaits, as long hair for women was a mandatory requirement within the religious culture I grew up in.

Looking forward

In addition to the completion of my thesis, one of the big things on my horizon now is my doctoral oral examination. However, as time has gone on, the ‘win’ of becoming a doctor has become less important than being part of the infinite learning game whether I successfully pass my oral exam or not. The detrimental impact on my learning if this does not happen will be limited and may even increase my motivation. However, given all the hard work and effort that has gone into this research project, my hope and prayer is that my defence of my thesis will be successful, as my belief is that God will use this research work in even greater ways in the future. Certainly, the original aims remain, (to enable co-researchers to tell their own and/or anonymized clients’ stories on the research topic, to psycho-educate professionals to recognise and understand the influence of a fundamentalist religious upbringing on mental health and wellbeing in adulthood, and to add to the sparse extant literature on this largely hidden topic), and they continue to be my motivation. Nonetheless, as I reflect on this powerful journey of learning, I am so thankful for my faith, which has anchored me throughout and continues to do so, and that I did not treat the developmental requirements of my profession as a simple tick-box exercise.

Footnotes

[1] The client’s details have been altered and anonymised.

References

Adams, M. (2014) The Myth of the Untroubled Therapist, Private Life, Professional Practice. Hove: Routledge.

Aguado, J. F. (2018), How a Dysfunctional Family Functions like a Cult. ICSA Today. 9(2) pp. 2-7.

Arvay, M. J. (1998), Secondary Traumatic Stress: Stories of Struggle and Hope. PhD dissertation. Canada: University of Victoria.

Arvay, M. J. (2002), Putting the heart back into human science research. In: Raskin, J. D. & Bridges S. K. (eds) Studies in Meaning: Exploring Constructivist Psychology. New York: Pace University Press.

Arvay, M. J. (2003), Doing Reflexivity: a collaborative narrative approach. In: Finlay, L. & Gough, B. (eds) Reflexivity. A Practical Guide for Researchers in Health and Social Sciences. Oxford: Blackwell Science Ltd. pp.163-175.

Ashley, O. (2017), The Bible, Wisdom and Human Nature: Developing the Waverley Model of Counselling. Farnham: CWR.

Atkinson, R. (1998), The Life Story Interview. London: SAGE Publications Ltd.

Bager-Charleson, S. (2012) Personal Development in Counselling and Psychotherapy. London: SAGE Publications Ltd.

Bazeley, P. & Jackson, K. (2013), Qualitative Data Analysis: Practical strategies. London: SAGE Publications Ltd.

Bottery, M. & Wright, N. (2019), Writing a Watertight Thesis: A Guide to Successful Structure and Defence. London: Bloomsbury Academic.

Bright, G. (2013), Making sense of ‘ologies’. In: Bright, G. & Harrison, G. (eds) Understanding Research in Counselling. London: SAGE Publications Ltd. pp. 55-94.

Bryman, A. (2008), Social Research Methods (3rd edition). New York: Oxford University Press.

Du Plock, S. & Barber, P. (2016) Facilitating high achievers to tell their stories of professional entrepreneurialism. Lessons from the doctorate in psychotherapy by professional studies. In: Goss, S. & Stevens. C. (eds) Making Research Matter. Researching for change in the theory and practice of counselling and psychotherapy. Abingdon: Routledge.

Etherington, K. (2004), Becoming a Reflexive Researcher: Using Our Selves in Research. London: Jessica Kingsley Publishers.

Etherington, K (2009), Life story research: A relevant methodology for counsellors and psychotherapists. Counselling and Psychotherapy Research. 9(4) pp.225-233.

Etherington, K. (2016), Personal experience and critical reflexivity in counselling and psychotherapy research. Counselling and Psychotherapy Research. 17(2) pp.85-94.

Finlay, L. & Evans, K. (eds) (2009), Relational-centred Research for Psychotherapists. Exploring Meanings and Experiences. West Sussex: John Wiley & Sons Ltd.

Gerhadt, S. (2004) Why love matters. How affection shapes a baby’s brain. Hove: Routledge. New York: The Guildford Press.

Goss, S. & Stevens, C. (2016) Introduction. In: Goss, S. & Stevens. C. (eds) Making Research Matter. Researching for change in the theory and practice of counselling and psychotherapy. Abingdon: Routledge.

Guccione, K. & Wellington, J. (2017), Taking Control of Writing your Thesis. London: Bloomsbury Academic.

Hammersley, M. (2013), What is Qualitative Research? London: Bloomsbury Academic.

Jenkinson, G (2008), An investigation into cult pseudo-personality: What is it and how does it form? Cultic Studies Review, 7(3), pp. 199-224.

Jeremiah 29:11, Holy Bible. New International Version, UK.

Joel 2:25, Holy Bible. King James Version.

Langdridge, D. (2004), Research Methods and Data Analysis in Psychology. Harlow: Pearson Education Ltd.

Lifegate (2021), Kintsugi: the art of precious scars. Available at: https://lifegate.com/kintsuigi [accessed: 30/01/2021].

McAdams, D. (1993), The Stories we Live by: Personal myths and the making of the self. New York: Guildford Publications Inc.

McLeod, J. (2015), Doing Counselling Research (3rd edition). London: SAGE Publications Ltd.

McLeod, J. & McLeod, J. (2014), Personal and Professional Development for Counsellors, Psychotherapists and Mental Health Practitioners. Maidenhead: Open University Press.

Mischler, E. (1986), Research Interviewing: Context and narrative. Cambridge: Harvard University Press.

Oakley, L., Fenge, LA, & Taylor, B. (2020), ‘I call it the hero complex’ – Critical considerations of power and privilege and seeking to be an agent of change in qualitative researchers’ experiences. Qualitative Research in Psychology. Available at: https://doi.org/10.1080/14780887.2020.1718813

Palmer, S. & Woolfe, R. (2000), Integrative and Eclectic Counselling and Psychotherapy. London: SAGE Publications Ltd.

Penny, J. E. (2021), The ‘research pond’; underlying assumptions in research, Waverley Abbey College Journal, in press.

Polkinghorne, D. (1988), Narrative Knowing and the Human Sciences. Albany: State University of New York Press.

Reicher, S. (2000), Against methodolatry: some comments on Elliott, Fischer, & Rennie. British Journal of Clinical Psychology, 39 pp.1-6.

Rosenthal, G. (2003), The Healing Effects of Storytelling: On the Conditions of Curative Storytelling in the Context of Research and Counselling. Qualitative Inquiry, 9(6) pp.915-933.

Singer, M. T. (2003), Cults in our Midst: The Continuing Fight Against their Hidden Menace. San Francisco: Jossey-Bass.

Smith, J. A. (2015), Qualitative Psychology, A Practical Guide to Research Methods. (3rd edition). London: SAGE Publications Ltd.

Smith, N-J (2009), Achieving your Professional Doctorate. Maidenhead: Open University Press.

Smith, J. A., Flowers P., & Larkins, M. (2009), Interpretative Phenomenological Analysis, Theory, Method and Research. London: SAGE Publications Ltd.

Smith, B. & Sparkes, A. C. (2008), Narrative inquiry in psychology: exploring the tensions within. Qualitative Research in Psychology, 3(3) pp.169-192.

Squire, C. & Davis M., Esin C., Andrews M., Harrison B., Hyden L-C., & Hyden M. (2014), What is Narrative Research? London: Bloomsbury Academic.

Waverley Abbey College (2021), Farnham, Waverley Abbey College.

Wellington, J. (2013), Searching for ‘doctorateness’. Studies in Higher Education, 38(10) pp.1490-1503.

Wilkins, P. (1997) Personal and Professional Development for Counsellors. London: SAGE Publications Ltd.

Zerubavel, N. & O’Dougherty Wright, M. (2012), The dilemma of the wounded healer. Psychotherapy, 49(4) pp.482-491.

About the author

Gill Harvey MA, BA (Hons) therapeutic counsellor, supervisor, researcher and trainer, Registered BACP (Senior Accredited), BPS Affiliate Member, ACC (Accredited)

Gill is a therapeutic counsellor, supervisor, researcher and trainer, working mainly in private practice. Having obtained her MA at Waverley Abbey College in 2017, she became a doctoral candidate at the Metanoia Institute, carried out a qualitative research study and is currently writing up her dissertation entitled ‘A narrative exploration of the influence of a fundamentalist religious upbringing on mental health and wellbeing in adulthood’. Gill is registered with ACC (Accredited) and BACP (Snr Accredited). She is particularly interested in the relationship between counselling and spirituality as well as early developmental religious experiences and adult mental health and wellbeing.

Contact: counselling@gillharvey.co.uk
Tel: +44 (0) 7531 046796
Website: gillharvey.co.uk/

Back to Article List

Critical reflexivity: A personal account of my counselling career and journey

Reading Time: 20 minutes

https://doi.org/10.52456/WACJO113

Introduction

As I look back over my counselling career, I recognise that I have experienced resistance and suspicion from a number of Christians and Christian leaders in the UK towards counselling and counselling training. As I have reflected on this resistance, I have reached the conclusion that this response has often been driven by the belief that counselling will either challenge or weaken a person’s Christian faith and/or that Christian faith and beliefs will not be respected during counselling training (Clarkson, 2003: 203; Delaney et al., 2007; Winfrey, 2007; West, 2011, a; West, Biddlington & Goss, 2014).

In addition, I have experienced hostility and avoidance by some within the counselling profession to the notion of integrating a Christian worldview with counselling and psychotherapy. Whilst in recent years I believe the profession has become more open to spirituality (Bartoli, 2007; Delaney et al., 2007; Gingrich & Worthington, 2007), nevertheless, I agree with others that there remains a level of avoidance of working with a client’s religious and/or spiritual issues (Macmin & Fosket, 2004; Gubi, 2009; Harborne, 2012).

I believe the conflict I experienced from these two groups created in me a passion to create and develop three professional higher education counselling programmes, all underpinned by a Christian worldview/anthropology. However, in order to dig deeper and reflect more on my passion to create these programmes, over the last couple of years I have engaged more extensively with the task of critical reflexivity. In this short paper, I will endeavour to define the difference between reflection and reflexivity and explain how, in undertaking the task, it has assisted me to become more aware of how my history, beliefs and values have shaped and impacted my counselling work and career as a trainer.

My overall aim for this article is that it will help explain the importance of critical reflexivity for personal growth, demystify the process and encourage readers to engage with critical reflexivity in order to discover some of their own hidden motivations in their life choices and counselling journey.

A contentious concept?

It is important to acknowledge that the task of critical reflexivity has, at times, been a contentious concept in the world of psychotherapy: some people strongly appreciating the task and others believing it should be avoided (McLeod, 2001; Mruck & Breuer, 2003). Those who argue against critical reflexivity frequently come from a positivist position, which regards knowledge and truth as that which can only be verified by objectivity and observation and discovered through scientific enterprises (McLeod, 2003; Gemignani, 2017). From a positivist perspective, personal experience is thus viewed negatively and rather seen as a potential source of bias (Hansen, 2004; Ponterotto, 2005; Alvesson &Sköldberg, 2009).

Therefore, prior to defining the difference between reflection and critical reflectivity, it is important to briefly mention my own personal ontological and epistemological position.

My ontological and epistemological position towards reflexivity: A critical realist position

An ontological perspective is a way of understanding the core nature and being of a person (McLeod, 2001). Epistemology, on the other hand, is concerned with how we determine what is true, providing the rationale for the assumptions that have been formed and which underpin beliefs (Bager-Charleson, 2012: 86). Various ontological and epistemological approaches can be taken, where at one end of the continuum lies the positivist approach (where reality is perceived as objective and independent of human ways of knowing) and at the other end lies a relativist approach (where reality and human knowledge are seen as being socially and culturally constructed) (McLeod, 2001: 184; Alvesson & Sköldberg, 2009).

I believe that both my view of reality and my theory of knowledge (ie my ontological and epistemological assumptions) are ‘intertwined’ (Etherington, 2004:71) and sit between a positivist and a relativist position in that I acknowledge that there is a reality that exists independently from an individual’s perception. However, I also believe that truth can be socially constructed. It is for this reason that I have personally found the philosophical approach of critical realism convincing.

Critical realism, originating from the work of Bhaskar, is complex to define, since there are a variety of approaches and methodologies that fall under this approach (Archer, et al., 2016). Nevertheless, in basic terms, it is an approach that accepts that there is an objective reality, but also recognises that an individual’s personal and subjective interpretation plays a part in explaining and defining reality (Almashy, 2015; Taylor, 2018). Critical realism is therefore a position that sits between positivism (an approach which emphasises empiricism and objective facts) and social constructionism (which accepts a socially constructed view of reality) (Hansen, 2004; Peters, et al., 2013; Zachariadis, et al., 2013; Taylor, 2018).

I have found the approach plausible, not least because I reject a positivist approach on the basis that I believe there is a subjective element to knowledge that cannot always be explained by observable evidence and scientific findings (Costley et al., 2010). I also reject a purely social constructionist approach in that I do not believe reality should be totally, as Alvesson & Sköldberg point out, ‘limited’ to considering how it is socially constructed (2009; 37).

There have been criticisms of the critical realist approach; for example, it has been challenged for not providing a methodology as to how the two positions can be combined (Alvesson & Sköldberg, 2009). Nevertheless, I find the approach credible and one that sits comfortably with my Christian faith in that I believe Christians should admit that they do not know or own the whole truth: ‘the truth is with God’ (Losch, 2018: 164). However, the position’s acceptance that there can be a subjective and socially constructed view of reality enables Christian faith to be seen as a ‘legitimate form of knowing’ (Martin, 2001: 248).

I have therefore adopted a critical realist position towards the task of critical reflexivity – a position that values the role of personal experience and perceives knowledge in part as co-created with others in the context of a story (Howard, 1991; Reason, 1994; Denscombe, 2003; Etherington, 2004; Li Mao et al., 2016).

Reflection and reflexivity; defining the difference

To define the difference between reflection and reflexivity, the work of Donald Schön (1983), considered by many to be the pioneer of reflective practice (Kinsella, 2007), is of value.

Schön differentiated between two activities: ‘reflection-in-action’ and ‘reflection-on-action’ (Costley et al., 2010: 122). He described the former as having the capacity and ability to draw on knowledge and conviction in order to deal with changing events, a ‘thinking on our feet’ approach (Costley et al., 2010: 122). ‘Reflection-on-action’, however, he defined as the task of critically reflecting on experience after the event has occurred in order to gain a fresh understanding that promotes learning and improves future action (West, 2000; Kinsella, 2007).

Admittedly there has been some confusion over the precise meaning of the terms and Schön has been criticised for failing to adequately clarify the difference between them (Smith 2001; Brockbank & McGill, 2007). Nevertheless, Schön’s concept of ‘tacit knowledge’ is helpful, in that it recognises that a practitioner knows more than they realise and by engaging in ‘reflection-on-action’ they have the potential to discover some of the tacit knowledge that has guided their practice so far (Kinsella, 2007: 396).

Wright and Bolton’s (2012) distinction between reflection and reflexivity is also helpful. They define reflection as an exercise that looks ‘outwards towards others’, taking into account any relevant customs, traditions and surroundings that might be important (2012: 37, 38). Reflexivity on the other hand is described as paying attention ‘inwards’ almost a ‘dialogue with the self’ as a person critically reflects on their thought processes, their values and their actions (Wright and Bolton, 2012: 38).

To be reflexive, therefore, it is important to find a way of ‘standing outside of self’ in order to reflect on and question how one’s beliefs, assumption, prejudices and behaviour might have impacted practice (Bolton, 2010: xix, 13). In other words, reflexivity is a step further than reflection. It is a deeper process that a person can engage with in order to uncover the possible unconscious motivations that might have impacted the development of their work (Cresswell, 2007; Kinsella, 2007; Bager-Charleson, 2012; Etherington, 2017). Reflective practice has also been described as ‘single loop’ and ‘double loop’ learning, with single loop being a reflection that can challenge and bring about change; double loop on the other hand being reflexivity that can enable challenge and question of one’s own assumptions, values and practice (Brockbank & McGill, 2007: 51; Bolton, 2010).

Putting it into practice: Interpersonal process recall

To uncover any hidden motivations for my passion to deliver counselling programmes underpinned by a Christian worldview and to train students to integrate faith/religion/spirituality with counselling, I decided to adopt a narrative approach to critical reflexivity, one which facilitated me to retell and investigate my story (McLeod, 1997; Etherington, 2017). Since I am a visual and imaginative person, I decided to use a variation of the technique of interpersonal process recall (IPR), a model developed by Kagan and others (Kagan & Schauble, 1969; Wosket, 1999)[1], to assist me in engaging with this task.

Using IPR, in my mind’s eye, I took myself back in time to a number of defining moments in my career and replayed these events as though they were occurring in the here and now. As I did this, I paid attention to my thoughts, feelings, values and actions. My belief was that as I engaged with IPR, more material would be revealed because I was fairly sure that underneath my story, there was, as Rennie (1994: 242) notes with storytelling, ‘more going on than is being told’. In other words, I wanted to dig down and discover some tacit knowledge that I was possibly unwilling or unable to allow myself to access.

Unconscious intersubjectivity

In addition to using IPR, I also read Bager-Charleson’s comments on ‘relational research reflexivity’ and ‘unconscious intersubjectivity’ (2016: 58-70; 64). As I allowed myself time to reflect back on my counselling journey, I recalled two key events relevant to my professional life.

The first event occurred right at the very beginning of my counselling training (which was in a secular context) in the mid-1990s, and, as I visualise it now, I can remember it as though it was yesterday. In the training session, the leader played a tape recording of a counselling session, during which the counsellor started to proselytise and tried to ‘convert’ the client to their Christian faith. I remember feeling embarrassed, partly ashamed of being a Christian and incredibly uncomfortable as my peers started to discuss how appalling the counsellor’s behaviour was. At this point in time, I had not developed a clear understanding of what was ethical behaviour, or not, and just remember feeling silenced, saying absolutely nothing.

The second incident occurred about a year into my counselling training. The course required me to have personal counselling and I duly formed a therapeutic relationship with a counsellor in my locality. Whilst I found the counselling immensely helpful (in that it assisted me to stand back and consider my childhood experiences from a more objective stance), the issue that troubled me most was one that was directly related to my Christian faith. However, I felt I could not discuss this with my counsellor (even though I was aware she was a Christian) because I believed it was not acceptable to discuss my faith issues in therapy. The issue was that I had become a Christian at the age of 15, having come from a non-Christian background and whilst I had discovered a faith that was very real and important to me, I constantly struggled with the feeling that God was disappointed with me. So I took the problem to my pastor, who merely told me that God loved me and I was to accept this in faith.

With hindsight, and with so much more understanding and clarity now, I realise that, as a Christian, whilst I profoundly disagree with Freud’s assumption that faith in God is a mere ‘wish fulfilment’ and something to overcome (1927/1973), I believe he was right in determining that faith, at times, can be a projective system; this supposition being supported in later years by much independent research (Rizzuto, 1979; Brockaw & Edwards, 1994; Kirkpatrick, 1999; Aten & Leach, 2009)[2]. In my case, in childhood I had experienced both my mother and father as being constantly disappointed with me and it would have been of immense therapeutic value if I had been able to explore in therapy the link between my early life experience and my relationship with God.

The impact of these two events on my motivation and passion for creating higher education counselling programmes, which train students to competently and ethically integrate Christian faith/religion/spirituality with the practice of counselling, seems blindingly obvious now, but until I had engaged in the critical reflexive task, they had both remained largely unknown. In undertaking the critical reflexive task, it also assisted me to consider in more depth how much of my counselling development and my career as a trainer has been undertaken at an unconscious level in order to resolve some of my own past difficulties.

Further motivational factors

Over the years, I have faced considerable opposition (within the counselling profession and within my Christian community) to any notion of integrating Christian faith/religion/spirituality with counselling. Again, as I allowed myself to go back in time and replay some of the early events in my counselling career, I remembered the level of frustration I experienced and how, at one point, the opposition seemed sufficiently difficult that I felt like giving up on the whole process.

As I questioned and asked myself what it was that had made me doggedly continue to pursue this path, I became convinced that, in the main, it was the work I had undertaken with a number of my clients. I have assisted many clients over the years when their religious/spiritual issues have impacted their psychological difficulties. I have personally witnessed the subsequent therapeutic change that has occurred as a result of exploring these issues in therapy. In addition, I have sought feedback from clients when we have concluded therapy and asked them what aspect of therapy they felt had been the most helpful. With all my Christian clients, the answer has invariably been the work that we have undertaken together in the spiritual area. (The work has ranged from helping clients to explore unhelpful spiritual beliefs, expressing anger towards God, discovering God’s unconditional love, and working with spiritual abuse.) As I critically evaluated my work, I realised how much this was a significant influence and motivational factor in my passion for training students to ethically integrate Christian faith/religion/spirituality with the practice of counselling.

Acknowledgement of faith

I recognise that permeating many of the reflections in this paper has been the importance of my Christian faith. I believe it is important to acknowledge this for three reasons.

Firstly, as West (2011, b,196) notes, Christian faith and spirituality are topics that evoke fervent reactions and responses. Secondly, I believe it is important to recognise that holding a faith and Christian beliefs points towards a lack of neutrality (Robson, 2002). I am in agreement with West’s epistemological position that, for Christians, it can be ‘exceedingly difficult’ (2011, b:196) to adopt ‘a neutral position’ on the issue of faith. Furthermore, I agree with Bergin (1980) that attempting to adopt a ‘value-free’ position is completely unattainable (1980, 97).

Thirdly, as Bager-Charlson (2016) points out, it can be valuable for researchers to ‘position their knowledge… in a sociocultural context’ (2016: 61). This is of particular relevance to me in that, in recent years, those holding a Christian faith have been identified as belonging to a specific socio-cultural group (Knox et al., 2005; Cragun & Friedlander, 2012; Greenidge & Baker, 2012). As I have reflected on my efforts and motivation to combine the two paradigms of faith/religion/spirituality and counselling, I have been struck by how, in many ways, this has mirrored my own personal internal journey. In order to be true to myself, over the years I have felt the need to acknowledge to myself and (when appropriate) to others, the ‘spiritual’ and ‘Christian’ part of myself, since that is core to who I am as a person. On the other hand, my ‘professional self’ has also demanded recognition. Integrating these two parts of self has been a parallel process in many ways to that of my passion to train students to integrate the paradigm of faith/religion/spirituality with the paradigm of psychology and psychotherapy.[3]

The Waverley integrative framework

Before concluding (in this, the first issue of the Waverley Abbey College Journal), it seems fitting and important to make some mention of the Waverley integrative framework and the task of critical reflexivity.

I believe the critical realist and relational approach to reflexivity, as set out in this paper, fits well with the Waverley integrative framework for a number of reasons. Firstly, the holistic approach taken by Hughes takes into account a number of areas of human functioning, including the relational and spiritual area (Hughes, 2002). Secondly, the framework’s ontological underpinning recognises human individuals as being created in the image of God: imago Dei (Hughes, 2002:139) and thus human beings can be perceived as relational at the core of their being (Green, 1999; Vanderploeg, 1981; Miner and Dowson, 2012; Hobson, 2019). Thirdly, Hughes proposed that all human beings are driven by deep needs/longings for security, self-worth and significance (Hughes, 2002:139). The search for love, security, meaning and purpose is congruent with the writings of many other theorists (Bowlby, 1969, 1973, 1980, Cassidy, 1999: 3-20; Gerhardt, 2004). Finally, the approach is integrative and open to both theological insights and psychological insights (Hurding, 1986: 300; Hughes, 2002; Kallmier, 2011: 131-181) and thus takes into account Christian faith (which might be considered subjective and socially constructed) and psychological understanding (based on observable facts).

Concluding reflection

In conclusion, I admit that undertaking the reflexive task is not for the faint hearted as, at times, I have found it to be a painful and poignant experience, often reducing me to tears. I certainly have realised the truth of Josselson’s argument, namely that reflecting on our work is sometimes a task we ‘must do in anguish’ (Josselson, 1996, as cited by McLeod, 2001: 198).

In addition, as I have engaged with the task of critical reflexivity over the last couple of years, I have realised that the task takes time (Dyer and Hurd, 2016). Memories have taken a while to surface and it has made me appreciate even more that this is not a cognitive exercise, but rather a pulling out of memories, some of which are quite deeply buried and some intensely painful, even traumatising. My experience has been that described by Bolton (2010: 8) when she observes that the more one tries to focus and reflect, the more ‘elusive’ the memories can be.

However, whilst painful, I have found the task of critical reflexivity has been of great value, enabling to reflect deeply on my personal and professional journey and to become more aware of how my values, beliefs, experiences and context have influenced and impacted my work (Alvesson, et al., 2008; Bager-Charleson, 2012; Etherington, 2004).

Footnotes

[1] Interpersonal Process Recall (IPR) is a model developed by Kagan and his colleagues, which assists counsellors to reflect upon their work with clients and to discover unconscious perceptions and motivations that the counsellor is often not immediately aware of (Cashwell, 1994). The main aim of IPR is to increase self-awareness in order to benefit the therapeutic relationship and the work the counsellor undertakes with their client (Kagan & Schauble, 1969; Wosket, 1999).

[2] The research gives evidence that a person’s relationship with God can sometimes correspond with, and mirror, the quality of the attachment relationship they experienced with their care-givers in childhood.

References

Almashy, A. (2015) ‘The Central Arguments of Critical Realism and Positivism Approaches and an Evaluation of their Impact on Proposed Research’. International Journal of Current Research. 7 (12), pp.23867-23870.

Alvesson, M., Hardy, C. & Harley, B. (2008) ‘Reflecting on Reflexivity: Reflexive Textual Practices in Organization and Management Theory’. Journal of Management Studies. 45 (3), pp. 480–501.

Alvesson, M. & Sköldberg, K. (2009) Reflexive Methodology: New Vistas for Qualitative Research. (2nd edn) London: Sage Publications.

Archer, M., Decoteau, C., Gorski, P., Little, D., Porpora, D., Rutzou, T., Smith, C., Steinmetz, G. & Vandenberghe, F. (2016) What is Critical Realism? [Online]. Available at http://www.Asatheory.org/current-newsletter-online/what-is critical realism. (Accessed September 2020).

Aten, J. D. & Leach, M. M. (2009) A Primer on Spirituality and Mental Health. In: Aten, J. D. & Leach, M. M. (eds.) Spirituality and the therapeutic process: A comprehensive resource from intake to termination. Washington, DC: American Psychological Association, pp. 9-25.

Bager-Charleson, S. (2012) Personal Development in Counselling and Psychotherapy. London: Sage Publications.

Bager-Charleson, S. (2016) Relational research reflexivity. In: Goss, S. & Stevens, C. (eds.) Making research matter: Researching for change in the theory and practice of counselling and psychotherapy. New York, NY: Routledge/Taylor & Francis Group, pp. 58–70.

Bartoli, E. (2007) ‘Religious and spiritual issues in psychotherapy practice: Training the trainer’. Psychotherapy: Theory, Research, Practice, Training. 44 (1), pp. 54–65.

Bergin, Allen E. (1980) ‘Psychotherapy and Religious Values’. Journal of Consulting and Clinical Psychology. 48 (1), pp. 95-105.

Bolton, G. (2010) Reflective Practice, Writing and Professional Development. (3rd edn) London: Sage Publications.

Bowlby, J. (1969) Attachment and Loss. Volume 1. London: Hogarth Press.

Bowlby, J. (1973) Attachment and Loss: Separation, Anger and Anxiety. Volume 2. London: Hogarth Press.

Bowlby, J. (1980) Attachment and Loss: Sadness and Depression. Volume 3. London: Pimlico (First published Hogarth Press).

Brockbank, A. & McGill, I. (2007) Facilitating reflective learning in higher education. [Online]. Maidenhead : Open University Press, 2007. Available at: http://search.ebscohost.com/login.aspx?direct=trueanddb=cat03387aandAN=roe.566239andsite=ehost-live. (Accessed: 17 May 2019).

Brokaw, B.F. & Edwards, K.J. (1994) ‘Exemplary approach to operationalizing psychoanalytic theory and religion: Commentary on the relationship of God image to level of object relations development: Reply’. Journal of Psychology and Theology. 22 (4), pp. 374–376.

Cashwell, C.S. (1994) Interpersonal process Recall. American Counselling Association. [Online]. Available at: http://www.counseling.org/resources/library/eric%20digests/94-10.pdf. (Accessed August 2019).

Cassidy, J. (1999) The Nature of a Child’s Ties. In: Cassidy, J. & Shaver, P.R. (eds.) Handbook of Attachment: Theory, Research and Clinical applications. London: Guildford Press, pp. 3-20.

Clarkson, P. (2003) The Therapeutic Relationship. (2nd edn) London: Whurr Publishers.

Costley, C. & Gibbs, P. (2006) ‘Researching others: care as an ethic for practitioner researchers’. Studies in Higher Education. 31 (1), pp. 89–98.

Costley, C., Elliott, G. & Gibbs, P. (2010) Doing Work Based Research: Approaches to Enquiry for Insider-Researchers. London: Sage Publications.

Cragun, C. L. & Friedlander, M. L. (2012) ‘Experiences of Christian clients in secular psychotherapy: A mixed-methods investigation’. Journal of Counseling Psychology. 59 (3), pp. 379–391.

Creswell, J.W. (2007) Qualitative Inquiry and Research Design: Choosing Among Five Approaches. (2nd edn) London: Sage Publications.

Delaney, H. D., Miller, W. R. & Bisonó, A. M. (2007) ‘Religiosity and Spirituality Among Psychologists: A Survey of Clinician Members of the American Psychological Association’. Professional Psychology: Research and Practice. 38 (5), pp. 538–546.

Denscombe, M. (2003) The Good Research Guide. (2nd edn) Berkshire: Open University Press.

Dyer, S. L. & Hurd, F. (2016) ‘What’s going on? Developing reflexivity in the management classroom: From surface to deep learning and everything in between’. Academy of Management Learning and Education. 15 (2), pp. 287–303.

Etherington, K. (2004) Becoming a Reflexive Researcher: Using Our Selves in Research. London: Jessica Kingsley Publishers.

Etherington, K. (2017) ‘Personal experience and critical reflexivity in counselling and psychotherapy research’. Counselling and Psychotherapy Research. 17 (2), pp. 85–94.

Freud, S. (1927/ 1973) The Future of an Illusion. Robson-Scott, W.D. & Strachey, J. (translators & eds.) (1973). London: Hogarth Press.

Gemignani, M. (2017) ‘Toward a critical reflexivity in qualitative inquiry: Relational and posthumanist reflections on realism, researcher’s centrality, and representationalism in reflexivity’. Qualitative Psychology. 4 (2), pp. 185–198.

Gerhardt, S. (2004) Why Love Matters: How Affection Shapes a Baby’s Brain. Hove: Routledge.

Gingrich, F. & Worthington, E. L., Jr. (2007) ‘Supervision and the integration of faith into clinical practice: Research considerations’. Journal of Psychology and Christianity. (Clinical supervision). 26 (4), pp. 342–355.

Green, J.B. (1999) ‘Scripture and the Human Person: Further Reflections’. Science and Christian Belief. 11 (1), pp. 51-63.

Greenidge, S. & Baker, M. (2012) ‘Why do committed Christian clients seek counselling with Christian therapists’? Counselling Psychology Quarterly. 25 (3), pp. 211–222.

Gubi, P. M. (2009) ‘A qualitative exploration into how the use of prayer in counselling and psychotherapy might be ethically problematic’. Counselling and Psychotherapy Research. 9 (2), pp. 115–121.

Hansen, J.T. (2004) ‘Thoughts on Knowing: Epistemic Implications of Counseling Practice’. Journal of Counseling and Development. 82 (2), pp. 131–138.

Harborne, L. (2012) ‘Rebranding on the Agenda’. Thresholds. Summer (2012) BACP, p.4.

Hobson, G. (2019) Imago Dei: Man/Woman Created in the Image of God. Oregon: Wipf & Stock Publishers.

Howard, G. S. (1991) ‘Culture tales: A narrative approach to thinking, cross-cultural psychology, and psychotherapy’. American Psychologist. 46 (3), pp. 187–197.

Hughes, S. (2002) Christ Empowered Living. (Originally published 2001 by Nashville: Broadman & Holman Publishers). UK edition published 2002, Farnham: CWR.

Hurding, R. (1986) Roots and Shoots: A Guide to Counselling and Psychotherapy. London: Hodder & Stoughton.

Kagan, N. & Schauble, P. G. (1969) ‘Affect simulation in interpersonal process recall’. Journal of Counseling Psychology. 16 (4), pp. 309–313.

Kallmier, R. (2011) Caring and Counselling. Farnham: CWR.

Kinsella, E. A. (2007) ‘Embodied Reflection and the Epistemology of Reflective Practice’. Journal of Philosophy of Education. 41 (3), pp. 395–409.

Kirkpatrick, L.A. (1999) Attachment and Religious Representations and Behaviour. In: Cassidy, J. & Shaver, P.R. (eds.) Handbook of Attachment: Theory, Research, and Clinical Applications. London: Guildford Press, pp. 803-822.

Knox, S., Catlin, L., Casper, M. & Schlosser, L.Z. (2005) ‘Addressing religion and spirituality in psychotherapy: clients’ perspectives’. Psychotherapy Research. 15 (3), pp. 287–303.

Li Mao, Akram, A. M., Chovanec, D. & Underwood, M. L. (2016). ‘Embracing the Spiral: Researcher Reflexivity in Diverse Critical Methodologies’. International Journal of Qualitative Methods. 15 (1), pp. 1–8.

Losch, A. (2018) ‘Appreciating Faith and Culture in an Age of Scientific Reasoning: On Constructive-Critical Realism’. Theology Today. 75 (2), pp. 154–166.

Macmin, L. & Foskett, J. (2004) ‘Don’t be afraid to tell. The spiritual and religious experience of mental health service users in Somerset’. Mental Health, Religion and Culture. 7 (1), pp. 23-40.

Martin, R.K. (2001) ‘Having Faith in our faith in God: Toward a Critical Realist Epistemology for Christian Education’. Religious Education. 96 (2), pp. 245-261.

McLeod, J. (1997) Narrative and psychotherapy. [Online]. London: SAGE, 1997. Available at:http://search.ebscohost.com/login.aspx?direct=trueanddb=cat03387aandAN=roe.727906andsite=ehost-live. (Accessed: June 2019).

McLeod, J. (2001) Qualitative Research in Counselling and Psychotherapy. London: Sage Publications.

McLeod, J. (2003) Doing Counselling Research. (2nd edn) London: Sage Publications Ltd.

Miner, M. & Dowson, M. (2012) ‘Spiritual experiences reconsidered: A relational approach to the integration of psychology and theology’. Journal of Psychology and Theology. 40 (1), pp. 55–59.

Mruck, K. & Breuer, F. (2003) Subjectivity and reflexivity in Qualitative Research. [Online]. Available at http:// qualitative research. net. home. Vol. 4, no 2. (2003). (Accessed February 2019).

Peters, L.D., Pressey, A.D., Vanharanta, M. & Johnston, W.J. (2013) ‘Constructivism and Critical Realism as alternative approaches to the study of business’. Industrial Marketing Management. 42, pp. 336-346.

Ponterotto, J. G. (2005) ‘Qualitative research in counseling psychology: A primer on research paradigms and philosophy of science’. Journal of Counseling Psychology. (Knowledge in Context: Qualitative Methods in Counseling Psychology Research). 52 (2), pp. 126–136.

Reason, P. (1994) Participation in human inquiry. Thousand Oaks, CA: Sage Publications, Inc. [Online]. Available at: http://search.ebscohost.com/login.aspx?direct=trueanddb=psyhandAN=1995-97607-000andsite=ehost-live. (Accessed: 10 May 2019).

Rennie, D. L. (1994) ‘Storytelling in psychotherapy: The client’s subjective experience’. Psychotherapy: Theory, Research, Practice, Training. 31 (2), pp. 234–243.

Rizzuto, Ana-Maria (1979) The Birth of the Living God. London: University of Chicago Press.

Robson, C. (2002) Real World Research. (2nd edn) Oxford: Blackwell Publishing.

Schön, D.A. (1983) The Reflective Practitioner: How Professionals Think in Action. New York: Basic Books.

Schwartz, R.C. (1995) Internal Family Systems Therapy. London: Guildford Press.

Smith, M. K. (2001) Donald Schön: learning, reflection and change. [Online]. Available at http:// the encyclopaedia of informal education.www.infed.org/thinkers/et-schon.htm. (Accessed May 2019).

Taylor, S.P. (2018) ‘Critical Realism vs Social Constructionism and Social Constructivism: Application to a housing research study’. International Journal of Sciences: Basic and Applied Research. 37 (2), pp. 216-222.

Vanderploeg, R. D. (1981) ‘Imago Dei, creation as election: foundations for psychotherapy’. Journal of Psychology and Theology. 9 (3), pp. 209–215.

West, W. (2000) Psychotherapy and Spirituality: Crossing the Line Between Therapy and Religion. London: Sage Publications.

West, W. (2011, a) Practice around Therapy, Spirituality and Healing. In: West, W. (ed.) Exploring Therapy, Spirituality and Healing. Basingstoke: Palgrave Macmillan Publishers, pp. 214-223.

West, W. (2011, b) Research in Spirituality and Healing. In: West, W. (ed.) Exploring Therapy, Spirituality and Healing. Basingstoke: Palgrave Macmillan Publishers, pp. 189-202.

West, W., Biddington, T. & Goss, P. (2014) ‘Counsellors and religious pastoral carers in dialogue’. Thresholds. Summer 2014, pp. 21-25.

Winfrey, D. (2007) ‘Biblical Therapy: Southern Baptists reject pastoral counselling’. Christian Century. January 2007, pp. 24-27.

Wosket, V. (1999) The Therapeutic Use of Self. London: Routledge Press.

Wright, J. & Bolton, G. (2012) Reflective Writing in Counselling and Psychotherapy. London: Sage Publications.

Zachariadis, M., Scott, S. & Barrett, M. (2013) ‘Methodological Implications of Critical Realism for Mixed-Methods Research’. MIS Quarterly. 37 (3), pp. 855–879.

About the Author

Heather Churchill MTh. (Middx); BA (Hons. Brunel) – Registered Member, MBACP (Senior Accredited) Counsellor/Psychotherapist; Registered Member, ACC (Accredited Counsellor and Supervisor)

Heather Churchill has many years of experience as a trainer, counsellor/psychotherapist and a supervisor. She has co-authored two books (Insight into Helping Survivors of Childhood Sexual Abuse and Insight into Shame) and has published a number of articles in the Accord Journal of the Association of Christian Counsellors. In her private clinical practice, Heather specialises in counselling adults who have experienced abuse in childhood. She is currently conducting a reflexive audit on the work she has undertaken in developing higher education counselling training within a Christian paradigm.

Back to Article List

Held in love: A theological and pastoral response to dementia

Reading Time: 20 minutes

https://doi.org/10.52456/WACJO114

When a person contracts dementia – surely the biggest medical challenge that we face in the next few decades – the image often used by friends and family is of someone being lost to us. In one sense, that is exactly how it feels. With my mother, the loss was gradual. Over a period of time, roughly ten years, she ceased to be the mother I knew. In the last few months of her life, in a care home, she barely knew who any of us were. The idea that she might have a son and daughter, not to mention a husband who for many years had been her main carer, was something of an amusement to her. Yet as much as my mother ceased to be the person I knew, and as much as I grieved her decline, the truth (at least the truth of how I experienced it) was that she became more my mother over those ten years than she had ever been. After she died, I pondered how this might be.

It occurs to me now, just over a year and a half on, that maybe I had been in massive denial or maybe that I had allowed sentimentality to cushion me from the harsh medical facts. I have been a pastor long enough, journeying with people as they come to terms with the vicissitudes of life, to know that both were possibilities. But what I prefer to believe – and I use the word ‘believe’ advisedly – is that, in caring for my mother in dementia, I had stumbled upon an understanding of personhood that lies at the very heart of Christian revelation. It is this ‘stumbling upon’ that forms the central argument of this paper: the way in which caring for someone with dementia tutors us, or can tutor us, into a more relational, less functional understanding of being human. Furthermore, as the paper develops, I would like to explore this not only in the context of human relationships but in the most fundamental sense of relationship to God, leading on finally to some tentative reflections as to how the phenomenon of forgetfulness (the punchline of so much humour that surrounds dementia, but also a growing fear among people in western societies) in fact provokes surprisingly rich and deeply biblical reflections on resurrection and the memory of God.

That it is over a year now since my mother passed away means, hopefully, that these reflections will be less subjective than they might otherwise have been had I written them in the immediate aftermath of her death. But then again, what kind of theology would we be talking about that was not provoked by deeply personal responses to the human condition? I offer these reflections without apology, as something of a tribute from a son to his mother, and in the hope that they might offer spiritual and theological resources as we face this most modern condition.

As a matter of fact, much of what I stumbled upon through the experience with my mother had been present, as I look back, in the no less immediate circumstances of my work as a pastor. It is not unique to me (for I have heard it reported by many pastors), but my own experience of visiting people in care homes had already revealed that there was much more going on in people with dementia than neurological science could possibly tell us. Through what is sometimes referred to in dementia studies as lucidity, there had already been many occasions when, through the simple practice of praying with people or singing hymns, one became aware, to quote pastor/writer Dave Hansen, that it was possible to ‘reach the soul with end-runs around brain damage.’[1] On one occasion, I started praying Psalm 23 with an elderly gentleman with dementia, only for him to finish it off by memory and conclude with a prayer.

Of course, all such phenomenon – and it is at the very least a kind of phenomenological occurrence – can no doubt be explained neurologically, in much the same way as so called ‘near-death’ experiences can be explained neurologically. Even so, at the risk of falling foul of a soul/body dualism, which I am keen to avoid, such experiences as pastoral practitioners encounter on the field, and which relatives experience as they care for their loved ones, had at least prepared me for the possibility. I was to encounter in the most fundamental of relationships – a parent and child – that just because a person might not be able to remember who they are, they are not thereby a different person or, worse still, less a person. At the very least, lucidity, be it brief or prolonged, ought to warn against any philosophical or medical dogma in this emerging field. The truth is we just don’t know what is going on inside the mind of another person, simply because we are not them. For all our brain scans showing the parts that have been damaged, we cannot ask of these scans what existentially we do not know, nor can ever know.

The point I am wanting to make here, as a kind of preamble to the main argument, is that long before I had to deal with the challenge of dementia in my own family, I was already questioning as a pastor (or ‘cure of souls’ to use the old-fashioned term) the received, almost exclusively, medical wisdom surrounding dementia. Nurses and carers working in residential care homes, with floors dedicated to people with dementia, are reporting similar experiences, in particular through the medium of music[2]. Instead of bleakness or blankness that one might suppose in an environment of memory loss, they are enjoying surprisingly rich and deeply moving experiences with the people they care for.

However, as much as these experiences can act as signs of hope, in truth it is not lucidity that forms the basis of my reflections concerning my mother, even if she did respond to my Welsh hymn-singing, but something else that I learned in Christian community, namely the power of relationships in defining and sustaining who I am. Let me state the case in the form of a contrast: if my identity is something I create as an autonomous private individual, and dependent to a large degree on a proper functioning as we might conceive in Western conceptions of personhood, then, of course, once I lose my ability to remember who I am, I become less a person. In such an understanding, all the metaphors of losing a person to dementia, or them disappearing or going on a journey, are entirely apt. If, on the other hand, my identity is not something I self-actualise, as a private individual, nor simply cognitive, but rather something that is held by others, as is the case in many non-Western cultures, and as we might hope to find in Christian community, then the fact that someone forgets who they are need not cause diminishment or defect, but rather be the permission for others to hold their identity for them[3]. Certainly, this is how I would like to describe, and even explain, what happened with my mother. In short, despite the experience of dementia, indeed maybe because of the experience of dementia, she was more my mother, not less, simply because I was holding the identity of both of us. She didn’t know who I was. Nor did she know who she was. But I did. I knew who she was, and I knew who I was. I knew that I was her son, just as I knew that she was my mother. And it seemed that this was enough for both of us.

I appreciate that, in the cultural context of late modernity where dementia, as with dying itself, submits to far more clinical criteria, such an experience of intimacy between a son and a mother sounds fanciful, if not downright deluded. The medical facts are that large sections of her brain had died, and to that extent she was no longer able to function or even be the person that she was. Indeed, in so far as this medicalisation of dementia is held as a definitive statement on personhood, then the well-documented story of Sir Ian Botham not visiting his father in a care home, since for him his father in advanced dementia no longer existed, does have a certain logic to it, even if it sounds brutal.

What living in Christian community had taught me, however, and what living with disabled people in residential care (in a Roman Catholic context where human fragility is arguably more accepted than it is in my own Protestant evangelical tradition) had fostered in me many years previously is that such a clinical, solely cognitive rendering of human personhood is not only depressingly reductionist, but no less a creed than anything I might come up with in terms of a response to the challenge of dementia. Yes, the loss of memory has devastating impact, such that it is not inappropriate to talk about it in terms of bereavement. An inability or refusal to register this loss is indeed a form of denial. But to presume that cognitive dysfunction also means relational dysfunction fails to take into account the many and various other ways – emotional, physical and spiritual – in which human beings foster intimacy with one another. Anyone who has spent any time (the importance of ‘time’ is a notion I want to return to) working in residential care will know that emotional response and physical touch are very much the common currency. So, I walk into a room where my mother is sitting and even though she doesn’t recognise who I am, she has an emotional response that is commensurate with the bond that exists between us. Or I lean over to give her a kiss to say hello and she tugs my beard like she used to, her body memory able to respond even though her actual memory is gone.

For some this might seem like small beer – a clutching at straws. Maybe. For sure, my own experience of dementia did not have to face the challenge of personality change, or violent behaviour, which I imagine to be a different prospect all together. But what these small bodily gestures represent, I believe, and in particular our valuing of them, is the beginning of a protest against an overly cognitive approach to dementia, which, by definition, tends towards a fairly bleak trajectory of care. In fact, if we wanted to be very controversial, we could at this point turn the whole debate on its head and argue that it is precisely for lack of touch and lack of meaningful and healthy relationships that dementia occurs in the first place. To state the matter boldly: dementia is not a cause of isolation, but rather the effect – not so much a neurological problem, though it registers as such, but a sociological problem.

Controversial as this sounds, if this were proven – and there is a growing body of evidence that, in some cases, social isolation is very much the precursor of dementia – then it would only strengthen the approach taken here: namely, that the best way to care for someone with dementia is not simply by trying to address the medical situation (worse still, by trying to promote, as some kind of panacea, an early warning system otherwise known as payment by diagnosis) but by seeking to address the societal pressures that cause such debilitating and physically damaging isolation. In much the same way that dying itself needs to be rescued from its medicalisation, so we should charter a similar approach to dementia: not so many visits to the hospital to assess the latest situation, but more visits to those in care, and more time with the individual.

My own impression, and it is a hopeful one, is that one is beginning to discern in the culture at large something of a retrieval of this kind of personalism. It seems that people are growing tired, in some quarters at least, with what Martin Buber calls the ‘I-It’ world of rational objectivity and are reaching out towards something akin to what he describes as an ‘I-Thou’ world: a world of mystery and encounter[4]. Such are the signs of hope that it seems to me the time is ripe to be quite sophisticated in our claims. In short, dementia need not be the tragedy that our culture purports it to be. Nor should it be synonymous with the loss of identity that clinical science insists we see it as, for the simple reason that identity is not ours to lose in the first place. Rather, identity is something that is also held by others. In my life, thus far, I have been a son, a brother, a friend, a colleague, an uncle, a husband, a son-in-law, a father, not to mention the various other familial designations given to me. And in so far as those relationships still hold, then I continue to be that, even when I cease to remember who I am[5].

However, it is at this point in the argument that we need to go beyond questions of identity, even the more relational, communitarian notions of identity that have been proffered here, and begin to explore ultimate theological questions regarding personhood. After all, relationships are fragile to say the least. Being held in love by others is possible only so long as those relationships persist. In the care home that my mother lived in for the last few months of her life, one observed the tragic and all too common reality of relatives who were uncared for, unvisited and living among staff who could not possibly hold their identity for the simple reason that they had never shared it.

Quite apart from the questions this raises about the kind of society we live in, where so many people are discarded when they cease to function well, it exposes something of a problem and an irony in our more relational approach: namely, that such people could still end up depersonalised – regarded as less than a person – precisely at the point at which they lack strong relational networks. And this we can never accept as a Christian response to dementia. Hence, I want to argue that it is precisely at this point that the Christian community has something very unique to offer, not only to the debate surrounding dementia, but also to the many issues relating to disability in general. Central to a Christian understanding of personhood is not simply relational connectedness but ontological rootedness: a definition of personhood as that which is given by God and which therefore cannot be diminished, whether it be physical disability, neurological damage or even family neglect.

One notes in this respect the work of people like Henri Nouwen whose reflections on the sanctity of human personhood has acted in recent years as something of a rear-guard action against the terrifying utilitarianism of so much modern life. Through the experience of living in community (specifically the L’Arche communities), Nouwen alerts us – in much the same way as Leonard Cheshire and Sue Ryder did, just after the Second World War – to the importance of treating people as nothing less than persons created in the image of God. People have a right to be cared for and loved, Cheshire and Ryder argue, simply by virtue of being a member of the human race. Personhood is not something contingent on identity, or even relational health, nor must it be confused with it, but something given to us by God and therefore to be held with reverence and love[6].

In such communities, which for those of us who have read about and experienced them have become something of a microcosm of what a Christian society could be, the underlying basis upon which lives flourish depends not on the effectiveness of medical care, although it can never be less than that, nor even on the professionalisation of social care, for that has the tendency towards impersonality, but rather on the simple notion that to be human is to be loved, and to live humanly is to love.

In promoting this approach to dementia, and even to use the word ‘love’ in the context of neurological challenges, I am deeply aware of how amateurish it all sounds. It feels as useless as some chaplains feel when they turn up on a hospital ward only to be side-lined by consultants and registrars. Yet if we are to be true to our theological traditions, it surely behoves us to say, as those who take the incarnation as central to things believed, that it is precisely in the act of loving, in the actual encounter of another human being, however frail or weak, that something of the mystery of the world is unveiled. A theological approach to dementia is not about whether Scripture is read, prayers spoken, or communion offered (these are indeed sacraments of the Church, and have power in and of themselves in conveying grace) but rather on the simple commitment to honour this person before me in all the particularity of their person be they rich or poor, young or old, healthy or sick. Precisely in the act of loving, paying attention to what the poets call the ‘thisness’ of the actual conditions I encounter (as opposed to an idealised and often abstract version of life that has become increasingly more attractive in our media culture) one discovers intimations of the grand narrative that Christians believe is embodied in the gospel of Jesus.

For such communities to form, and more specifically for a way through the overwhelming negativity surrounding dementia, Nouwen is right to adduce that we must renegotiate everything, from the way we understand what we have achieved in our lives, to the way we experience time, all the way through to the way we understand salvation. For example, in the care home that my mother lived in for the last few months of her life, there was a whole corridor of people whose lives spanned everything from a former headmaster to a secretary at the same laboratory in Bridgend where my mother worked as a young woman. I came to know them as Hugh, Mary, Carol, and Mark. As a result of getting to know them, as well as the staff who were dedicated to their care, the long, magnolia-coloured corridor, which for any first-time visiting relative is something of an ordeal, became for me the corridor of memories. Hugh, next door to my mother, was clearly living out his years as the headmaster of a grammar school in nearby Port Talbot, and on one occasion convinced me that he was about to take the morning assembly and therefore I needed to give him time to prepare his notes. To the extent that one could understand what was going on and enter the period of life that Hugh clearly thought he was living in, one could play along with the ruse. As anyone who has cared for people with dementia will know, not only is there a poignancy about these scenarios, but there are times when it all becomes delightfully humorous. On another occasion, Hugh thought I was one of his prefects come to accompany him on to the stage at the assembly hall. In order to reach Hugh, however, not only in those moments of high drama, but more importantly in the rather more mundane moments when nothing is happening, or in the times when he was struggling to eat, time had to become less chronological and more sacramental. In order to fully encounter Hugh as the human being he truly was, including the condition of dementia that he now had, one had to renounce the tyranny of the clock, the need to get on, and simply learn to embrace the present tense of whatever Hugh was dealing with at that time[7].

Fortunately, Hugh lived in a care home where the staff had the conviction and, of course, the time concerning such leisureliness. Like the early hospice movement, which in many ways was a protest against the medicalisation of palliative care, many of the staff were able to transcend contractual notions of employment, as well as purely clinical notions of dementia, and offer instead high class, professional, medical care, as well as the personal touch. For Theresa Ahmad, who founded the home with her husband in the late nineties, there was simply no question that her staff would not engage personally and emotionally with the patients they served. Professionalism and love were not the mutually exclusive categories that they have so often become in our highly managerial, continual assessment world, but rather an essential convergence of the highest standards of nursing care with the highest regard for individual honouring and respect. Two of the staff, in fact, came to my mother’s funeral, even though technically it was their day off. To them she was not a statistic, but Linda. And together with us, friends and family, they grieved her passing.

Incidentally, or maybe not so incidentally, my mother was not a Christian nor, despite being located in a Welsh valley, was I conscious of any religious sentiment in the people I met. Hence, it is not surprising that there was a tension right at the heart of my own experience of trying to care. As a result of my experience, with my mother and through my own experience of working with people with cerebral palsy, I can now understand better the strains that many evangelicals feel who enter into the caring professions; tensions that require them at times to suspend their convictions, if that doesn’t sound too liberal, in order to offer care that honours the physical, cognitive and emotional challenges that these illnesses bring. This is not an argument for universalism, as attractive as that might be as an option, but rather a recognition that the vocation to care for people with dementia is about reverencing the vulnerability of each and every person, trusting that through these simple and faithful gestures of love something of the presence of Jesus is made known.

Even so, for all the sensitivities around this particular question of faith in a pluralistic and increasingly secular society, what I do want to highlight, as we come towards the end of this paper, is the way that wrestling theologically with dementia can yield surprisingly helpful and hopeful ways of responding to the questions we all face regarding faith and the loss of memory. After all, who has not been disturbed in their own Christian faith by seeing a respected minister, for example, or a renowned theologian, contract dementia, and not be able to even recollect the basic creeds. For all the astonishing stories that I referred to earlier, where suddenly in a prayer or a hymn the person we once knew seems to re-emerge, nevertheless we are more often than not left with profound existential questions about what would happen to our own faith if we too ended up with dementia. For instance, would I still be saved? Would I be able to maintain virtues that are distinctively Christian? Which person would I be before God?

To many of us, these questions sound preposterous, almost comical. And maybe in some sense they are. But they are important questions nonetheless and ones that can cause a great deal of anxiety among the faithful. However, as someone whose pastoral ministry is located at the interface of these existential questions of faith, doubt, suffering and morality, it occurs to me now that the very root of the fear surrounding dementia, namely loss of memory and the ramifications for faith, also provides possible clues as to the way out of the dark labyrinth of loss, because central to the biblical revelation is remembrance: not our remembrance of God, which can be erratic to say the least, but God’s remembrance of us, both now and in the future.

How the notion of remembrance might be a comfort to those facing the prospect of dementia, or even those caring for others with dementia, might not be immediately apparent. In contemporary language, remembrance conveys the idea of reminiscence, or even nostalgia, and it is hard to see how this might have any pastoral resonance beyond simple recollection. However, in biblical terminology, as is well rehearsed in even the most basic primer on Old Testament theology, remembrance is a far more lively concept, conveying not simply data about past events, but more the idea of sustenance: something akin to being held in the heart of God. Indeed, such is the power of remembrance that it can viewed as the reflex to the most basic gift of forgiveness. For as much as it is the gift of God to forgive our sins, and thereby remember them no more, as if they never existed; so conversely, it is in the gift of God to remember us, and thereby sustain us in love, both now and in the future. In the same way as anamnesis in the Lord’s Supper is about bringing past realities into the present, so God’s remembrance of us, makes present tense of our existence, assuring us of His eternal care long after we have remembered how to care for ourselves.

My own view on this, and one that needs developing, is that a restatement of the biblical notion of remembrance addresses not just these pastoral issues surrounding dementia, but some of the clichéd and often unconvincing images that we trade in around the precincts of death. For sure, there will be those who are comforted by our well-worn and hackneyed phrases of ‘going to a better place’ or ‘he’s more alive than he has ever been’ but the question of what happens when a person dies, where do they go, whether we have a soul that survives the body, remain disturbing existential questions, even for those who are in the believing community. Part of the reason for that is the way we make resurrection synonymous with the immortality of the soul. Remembrance on the other hand, God’s remembrance of us, not only circumvents these troubling questions, but also places the stress in the enterprise we call salvation most firmly on God’s activity. In returning specifically to the subject at hand, the anxieties that gather around faith and the loss of memory, this is of huge pastoral significance and resource. In short, for those who worry that they won’t have enough to make it to the end, who find their faith unsettled in the face of others who have lost their memory, who ponders over existential questions such as what part of me is soul, what part is body, and so on, it turns out that the Bible offers us something more credible: that faith is not something one self-generates, only to be dashed at the end by an inability to remember, but something given. The soul is not the invisible part of me but that which denotes the whole and which is both created and kept by God. And finally, long after I cease to remember who I am (and long before my demise into dementia becomes a possibility), I can be sure that God will remember me[8]. As Paul writes, almost as a parenthesis but in what is arguably his most profound theological statement: it is not that ‘we know God’, for that would place an intolerable burden upon our cognitive state, but rather ‘we are known by God’[9].

As paradoxical as it sounds, it is precisely the tragedy of dementia that opens the door, at least for this theologian and practitioner, to such a revelation. In and through the very personal experience of watching my mother lose her memory, I stumbled upon hidden repositories of truth and meaning, which I hope will furnish my ministry for many years to come. But then again, why should we be surprised by such a paradox? Paradox lies right at the heart of Christian worship. Dementia can be the breeding ground for hope, precisely because death is prelude to resurrection.

Footnotes

[1] D. Hansen, A Little Handbook on Having a Soul, Downers Grove: IVP, 1997, 30.

[2] TV Presenter Sally Magnuson explores this in Where Memories Go: Why Dementia Changes Everything, London: Two Roads, 2014.

[3] See J. Swinton, Dementia: Living in the Memories of God, London: SCM, 2012, 153-185 for an expansion of this perspective.

[4] M. Buber, I and Thou, translated by Ronald Gregor Smith, Edinburgh: T &T Clark, 1999.

[5] See G. Stokes, And Still the Music Plays: Stories of People with Dementia, London: Hawker Publications, 2008, for a series of personal and very moving stories of people with dementia.

[6] Nouwen’s most explicit articulation of this is Adam: God’s Beloved, Maryknoll: Orbis, 1997. Adam was someone to whom Nouwen was assigned as carer in the early years of his time at Daybreak, Toronto.

[7] See J. Swinton, Becoming Friends of Time: Disability, Timefullness, and Gentle Discipleship, London, SCM, 2006.

[8] Swinton, Dementia, 186-226.

[9] Galatians 4:9.

About the author

Rev Dr Ian Stackhouse, Senior Pastor, Millmead, Guildford Baptist Church, PhD (LST/Middx); MTh (LST/Middx); BA Hons (Dunelm); PGCE (Dunelm); Accredited Baptist Minister.

Ian Stackhouse has been the senior pastor of Millmead, Guildford Baptist Church, since 2004 and has been in Christian ministry for over 30 years. He is married to Susanna and they have four sons who are at various stages of young adult life. Ian has authored five books (The Gospel Driven Church being his PhD thesis), has edited a book with Dr Oliver Crisp, entitled Text Message, and has contributed various chapters and articles to other publications. Primarily based at Millmead, some of his time is given to teaching at seminaries, churches, conferences and retreats – both in the UK and overseas.

Back to Article List

Close