The God Squad: Deciding between pastoral and professional counseling is hard

Question: My 19-year-old niece appears to be struggling with deep anxiety. She’s decided not to return to college and only appears comfortable in her parents’ home. Although she works and has friends, she needs to feel that her parents are always close by.

This was a minor problem in her younger years, which has worsened with age. I feel she needs to consult with her medical doctor and/or a mental health counselor, but my brother seems convinced that the counsel of their minister is sufficient. Clearly it isn’t, evidenced by her quitting college at a school less than an hour away.

When do you feel counsel by clergy is sufficient and when should a person move on to other professionals? I worry that my brother is doing a grave injustice to his daughter, as is the minister. — B., via the internet.

Answer: All the clergy I know and love face this difficult question often in their counseling. Many people feel there’s a stigma attached to consulting a psychologist or psychiatrist that doesn’t exist when seeking advice from clergy.

Pastoral counseling enables troubled people to at least receive some help rather than suffering alone. Some also feel that many mental health professionals harbor a negative view of religion, and therefore won’t respect the religious commitments of their patients.

My view is that for spiritual questions, clergy are just the right people to consult. However, when the problem is more than a spiritual crisis. and when medication or long-term therapy is required, the troubled person and his or her family should seek out trained medical help.

Most sensitive clergy are aware of their limitations in this regard and will, on their own, suggest a referral to a therapist sensitive toward religious patients. Your niece does seem to have a problem a clergy person is unlikely to be able to address.

As the aunt and not the parent, I encourage you to speak to your brother and strongly suggest at least a preliminary visit to a trained professional therapist, perhaps using a therapist’s ability to prescribe medications as your main argument. If he won’t hear you, sadly, there’s nothing more you can do.

When I was struggling with health issues and with my despair over Fr. Tom Hartman’s illness, a friend made and paid for an appointment for me with an excellent psychiatrist. I didn’t want to insult my friend or waste his money, so I went to see the doctor and he helped me greatly to begin my crawl out of the pit. Perhaps such an intervention might be received in the same way by your niece and her parents. I pray for her and them and thank God that she is blessed with an aunt who cares for her so deeply.

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