Fifty years ago there was no comprehensive model of counseling within believing Protestantism. How things have changed! Yet this counseling revolution has raised many questions that are still being debated concerning epistemology, human motivation and how counseling should be “delivered” to those who need it.
I will speak of two fundamentally different tendencies, two incompatible organizing centers, using the acronyms VITEX and COMPIN…
VITEX believes that secular psychologies must make a VITal EXternal contribution in the construction of a Christian model of personality, change, and counseling. While biblical faith gives us certain controls to evaluate outside input, it does not give enough detail to enable us to constitute and develop a model. The operating premise of VITEX, whether explicit or implicit, is that Christian truths must be “integrated” with the observations, personality theories, psychotherapies, and professional roles of the mental health world. Modern psychologies are the engine producing insights, theories, and practices. In an essential way, the counseling that Christians do will orient to and take its cues from outside sources. The fascinating, exciting, relevant, and important developments are taking place external to Christian faith and practice. Biblical truth is static in comparison.
In contrast, COMPIN believes that the Christian faith contains COMPrehensive INternal resources to enable us to construct a Christian model of personality, change, and counseling. While the modern psychologies will stimulate and inform, they do not play a constitutive role in building a robust model. The operating premise of COMPIN is that the Faith’s psychology offers a take on the human condition essentially different from any of the other contemporary psychologies. The living Christ working in his people through his Word is the engine producing depth of insight, accurate theory, and effective practice. The counseling that Christians do must orient to and take its cues from our own source. Practical theological development is the cutting edge. The modern psychologies and psychotherapies are relatively dull, shallow, and misleading in comparison.
Powlison spends the rest of the essay defending COMPIN (biblical counseling) and critiquing VITEX (integrated counseling). He notes:
To answer the question of how do we determine what is true in psychology, Powlison offers a hierarchy of priorities:
His concern is that VITEX (secular integrated) inverts these priorities, causing great harm to “Christian” counseling:
In response to this inverted approach, Powlison demonstrates that the Bible rejects the idea that we must learn from unbelieving mental health professionals in order to care for souls, and instead teaches we must look to Scripture to understand how to care for souls:
Biblical confirmation of this first priority is unmistakable… From the outset, Scripture redefines how we tend to define “counseling.” Counseling is not fundamentally a professional helping activity, where an identifiably competent party intentionally offers aid to an identifiably distressed party in a formalized structure (such as weekly one-hour sessions on a fee-for-service basis). Given the culture’s professionalized definition, the Bible seems relatively insufficient—even utterly silent—on the subject of counseling. But if counseling is about the tongue, and wise or foolish companions, and master-disciple relationships, and one-anothering influences for good or bad, and the truth or lie that speaks in the heart, and ministry of the Word of life… then the Bible brims. Relatively formal, private counseling ought only to apply and extend the practical truth and knowledgeable love that ought to characterize both informal relationships and public ministry. Counseling, whatever its formal or informal status, is either foolish (reorienting us away from God and toward our own self-trust) or wise (reorienting us to God). We need, first and foremost, to learn our own paradigm for understanding and transforming human nature, and that is exactly the Bible’s major focus in revealing God on the stage of human life.
Sin exerts a systematic distorting effect on thought and practice. The Bible teaches us how to see and expose sin and error. Most ungodliness is not unusually vile. It is so utterly commonplace that we miss it. In our day, it includes the deep assumptions every secular psychology makes about what transpires in the human heart. Secular psychologists can’t help the godlessness of their view of the psyche and relationships. A secular psychology is the cultural product of a God-less person and will reflect and express that. Theories systematize and rationalize the unbelief of those who create and embrace those theories. Because the wisdom of the world has always been foolishness with God, the Bible always conducts a secondary polemic in order to defend and clarify the truth and to protect people from plausible falsehoods. This running argument arises from redemptive intention, not paranoid irascibility. The Redeemer is conducting an invasion, and he critiques other theories in order to convert people to his indestructible truth. The Bible’s demonstrated second priority, criticizing untruths, is one logical implication of the demonstrated first priority, revealing truth.
Powlison’s concern is that VITEX psychologists fail to interpret secular psychology through God’s redemptive grid. Instead, they wholly adopt deviant substitutes and then merely sprinkle the Bible into a sub-section of their psychological categories called “spiritual”. Thus only a small minority of our problems are really “spiritual” and only a small minority can be addressed by the Bible. The rest must be addressed by “professionals”.
An example of this kind of thinking is found in the book New Light on Depression. The book is endorsed by the Christian Medical Association and boasts that it is “Medically Reliable” and “Biblically Sound”. The authors explain that
There are four basic types of depression: situational depression, developmental depression, spiritual depression, and biological depression. 
They then severely limit what may be considered “spiritual”.
Spiritual depression is an uncommon diagnosis, at least in most medical settings, but we believe that depression can originate with spiritual causes and have spiritual effects… Spiritual depression is the primary classification when the main issues are those for which faith, reconciliation with God, and the experience of his grace and forgiveness are the most effective treatments. 
The problem is that the VITEX definition of “spiritual” is much narrower than what the Bible considers to be spiritual. The Bible views man in two parts: physical and spiritual – not 4, 8, or 17 parts. Everything about our thoughts and actions is considered spiritual. Rather than reinterpret the secular categories of situational, developmental, etc to fit into the Biblical system underneath the overarching category “spiritual”, these VITEX psychologists simply adopt the “deviant substitutes” as-is and add a “spiritual” category alongside and separate from them. Powlison comments:
One sees in the Bible the normatively wise human psychology; it is so radically God-centered that we can barely see it as a psychology and as the true psychology. It sounds like theology, not psychology. But the Bible portrays the nitty-gritty of human psychology as pervasively theological… There is no “religious” sector of life. Such sectoring is one of the commonplace machinations of sin’s logic that flies in the face of reality… Some still attempt to sector off “spiritual” problems from “psychological, emotional, relational, mental” problems, attempting to validate their professional existence and activity as something qualitatively different from cure of souls. But many at the leading edge of the profession see that the divide between “spiritual” and “psychological” problems is artificial and problematic. Advocates have been won to John Calvin’s foundational insight that true self-knowledge and knowledge of the true God are interchangeable perspectives.
Powlison’s point is that when you have a proper understanding of the Bible, you will recognize that no one can truly understand themselves apart from understanding and knowing God. Because unbelievers do not know God, they cannot know themselves (Jer 17:9-10). Therefore any psychological system they develop is foolishness. “The wisdom of the world has always been foolishness with God”.
What the Bible communicates to us about God’s gaze on the psyche and relationships is so “odd” that even to glimpse it turns our whole notion of psychology and counseling inside out, upside down, and backward. God gives a radically “other” explanation and agenda. Contemporary counseling models—including “Christianized” models—do an extremely poor job of reflecting and communicating what life is really about. They are weakest where they claim to be strongest. We are immersed in decidedly bad psychologies, in gross misinterpretations of human existence.
Rather than than narrowly limiting the scope of “spiritual”, Powlison asks
So what is the problem [we all face and that psychologists want to solve]? The three-word description that Christians have harvested from the Bible is “sin and misery.” The remedy for our disorientation and suffering? The two-word solution that Scripture sows into our lives is “Jesus Christ.” The seven-word version of the solution, encompassing our response, is “Christ’s grace enabling repentance, faith, and obedience.” God is in the business of turning folly and misery into wisdom and felicity. How is such theological shorthand relevant to the problems that counselors of all stripes address daily? How do basic Christian diagnostic categories map onto the details of such things as interpersonal conflicts, unpleasant emotions, misdirected lives, twisted cognitions, chaotic cravings, compulsively escapist behaviors, sufferings at the hands of others, somatic afflictions, devilish temptations, sociocultural lies? That last sentence simply offers a twenty-five-word elaboration of “sin and misery.” One could further elaborate any topic or subtopic into book length without ever needing to slip into another set of categories. Similarly, the wise felicity of grace—God’s solution—can, must, and will be elaborated, tailored, and nuanced as it is worked into our lives.
This line of thinking may sound foreign to those unfamiliar with reformed Christianity. Many are not used to seeing sin as all-pervasive and have a knee-jerk reaction against the idea that sin could be playing a role in their problems because they fail to see the cognitive (thinking) effects of sin in our lives – they see sin merely as immoral actions. Powlison explains:
Sin is the problem, but people find it difficult to make the core of Jesus’ gaze useful in developing a counseling model. Several common distortions in the working definition of sin make us unable to trace the psychological logic of sin.
First, people tend to think of sins in the plural as consciously willed acts where one was aware of and chose not to do the righteous alternative. Sin, in this popular understanding, refers to matters of conscious volitional awareness of wrongdoing and the ability to do otherwise. This instinctive view of sin infects many Christians and almost all non-Christians. It has a long legacy in the church under the label Pelagianism, one of the oldest and most instinctive heresies. The Bible’s view of sin certainly includes the high-handed sins where evil approaches full volitional awareness. But sin also includes what we simply are and the perverse ways we think, want, remember, and react.
Most sin is invisible to the sinner because it is simply how the sinner works, how the sinner perceives, wants, and interprets things. Once we see sin for what it really is—madness and evil intentions in our hearts, absence of any fear of God, slavery to various passions (Gen. 6:5; Ps. 36:1; Eccles. 9:3; Titus 3:3)—then it becomes easier to see how sin is the immediate and specific problem all counseling deals with at every moment, not a general and remote problem. The core insanity of the human heart is that we violate the first great commandment. We will love anything, except God, unless our madness is checked by grace.
The tendency to only see sin as behavioral and fully volitional carries enormous implications for counseling. When people see sin only as willed actions, then they must invent other categories to cover the blind chaos, insanity, confusion, compulsion, impulsivity, bondage, and fog that beset the struggling human soul. A few people, the consciously bad people, can then be usefully described as sinners. Everybody else might commit a few sins: “Of course, we’re all sinners.” But that is a weightless comment. The weighty action typically occurs elsewhere in the person, going on beneath or beside those occasional, undefined, generic sins. If sin is only conscious badness, then the person grappling with the chaos of the human condition must suffer something else: emotional or psychological problems, demons, mental illness, addiction, inner wounding, unmet needs and longings, adjustment reactions, or some other DSM-IV syndrome.
If a certain problem happens on occasion, and presumably under conscious control, then it might be sin. But if the problem happens a lot, and is driven by blind compulsion, then it is presumably something else and only remotely sin. When the deacon gets drunk and sleeps with his secretary, he sins. But when the drunkard and pornography habitué succumbs, he suffers alcoholism and sexual addiction. When a normal mother feels some anxiety about her children and pressures them, she ought to repent of her worry and domineering and learn to trust God. But when someone is a walking nervous breakdown, feels wracking anxiety about everything and manipulates everyone, then she suffers neurosis or codependency or border line personality or an adjustment reaction. Such thinking swings a wrecking ball into the church’s ability to think about counseling the way Jesus thinks about it. A psychologically astute gaze will discern how sin plays out in people’s problems— and in the things they do not think are problems. False psychologies obscure what the true psychology sees.
The Bible is crystal clear about all these things. This is Theology 101 applied remedially to contemporary bad psychologies in the interests of forming a sound psychology. These are the ABCs of a biblical theory of why we do what we do and what we should do about it. These concepts appear nowhere in any secular model and rarely with any profundity in Christian counseling models. Instead, one finds counterfeits, abstractions of human existence ripped out of their true theistic context.
Secular Psychology Professionals
Powlison provides a helpful analogy as to why the concept of sin, which is central to all our problems, is found nowhere in any secular psychology:
As far as secular psychologists know themselves, they want to understand and help people. But they are committed to defining the core, causal problem as anything except sin. Imagine a group of detectives examining a murder scene. The criminal has left countless clues. An hour before the crime he had been heard in a restaurant making loud threats. He dropped his business card at the scene of the crime. He stood in front of a surveillance camera that took pictures every three seconds. He left fingerprints everywhere, including the gun, which lay beside the body and which he had purchased three days earlier. He made a credit card call on the victim’s telephone moments after the crime. He was collared running away from the scene wearing blood-spattered clothes. Under questioning he is extremely agitated, alternating between contradictory excuses and sharp cries of remorse. But imagine further that the detectives are committed to find some other culprit, any other culprit, because they themselves are accomplices. All the evidence will be processed through a grid of intentions that forbids the truth. Secularity cannot help noticing the clues screaming out “sin,” even as it cannot help rationalizing away the true interpretation.
State-Licensed Professionals or Elders Called by God?
Does the Holy Spirit intend that we develop a normative social institution for curing souls? The answer is yes. The church—as the Bible defines it—contains an exquisite blending of leadership roles and mutuality, of specialized roles and the general calling. It is the ideal and desirable institution to fix what ails us… In the pages of the Bible we have a social model the secular world can only dream about… To orient face-to-face cure of souls toward the mental health professions is fundamentally, even disastrously, wrong-headed.
The church is in trouble when its designated experts in the cure of souls are mental health professionals who owe their legitimacy to the state. Cure of souls is a decidedly pastoral function, in the broadest and deepest sense of the word. It is deeply problematic to operate as if the Word of God is useful, necessary, and sufficient for public ministry—preaching, teaching, worship, sacraments—but that training and credentialing in secular psychology are necessary for private ministry. In the Bible, the same truths that address crowds address individuals. A preacher no more needs a PhD in public speaking than a counselor needs a PhD or PsyD in clinical psychology. Graduates of psychology programs should not have rights and honors to teach the church about the human condition. Fee-for-service psychotherapeutic professions should not have the rights and honors to practice the cure of souls. They have the wrong knowledge base, the wrong credentials, the wrong financial and professional structure.
Psychotherapists are “ordained” by the state, not by the church. From the church’s standpoint, they are laypersons, not professionals. They attempt exceedingly significant and delicate work in people’s lives in a dangerously autonomous way, without guidance or checks from the church that has responsibility for those people’s lives. If the books and articles are any guide to what is actually done in counseling, then they often mediate falsehoods. But however sincere the beliefs and intentions of individual practitioners and however close particular individuals may be to biblical thinking, the problem is structural. A hugely influential profession is operating by claiming title to the most personally intimate and weighty aspects of the cure of souls: addressing identity confusion, disordered motivation, distortions of functional beliefs, broken relationships, responses to suffering, compulsive sins, and the like. In effect, functional authority over the souls of Christ’s sheep is being granted to a semisecular, unaccountable parapastorate. This invites trouble.
In conclusion, Powlison notes:
Our doctrine must control our study, and our study must flesh out our doctrine. Careful “psychological” study is one direct implication of the sufficiency of Scripture and of getting our first priority straight. We best study human psychology not by submitting ourselves to the world’s deviant psychologies but by looking at the world through the gaze of our own systematic biblical understanding.
Here are some related videos:
How Does Biblical Counseling View Psychiatric Drugs (Powlison)
What Are the Strengths and Weaknesses of Biblical Counseling (Powlison)
Help! I’m Always Sad (Powlison)
Can My Body Make Me Sin? (Welch)
A young man explains how reading “Christian” psychology (VITEX) paved the way for his “deconversion” to agnosticism.
Psychology and the Church
(from Berean Call / Dave Hunt, so take the video with a grain of salt)