Alcohol Abuse Advice

Case Management: Implementing a New Kind of Talk Therapy

Norma (name changed) was a 72-year-old, gray-haired lady who could have easily been mistaken as a an All-American grandmother. As she entered the therapy room, she was obviously expending a tremendous amount of energy to look calm and poised. As we began to get acquainted, Norma began to share a very deep hurt that precipitated her insomnia and anguish.

As she began to share her story, it was obvious by her profuse crying that Norma had been unable to find comfort in her Norma had been married for 53 years to Joe. It wasnt long ago that they had celebrated their 50th wedding anniversary with their 5 children, 12 grand-children and numerous friends and relatives. To all of their friends and family, they appeared to have a perfect and happy life. They attended church regularly, served communion to the sick, and visited the nursing homes.

Unfortunately, Joe had suffered a heart attack and had died suddenly. As is often the case with couples who live long lives, the husband died first, leaving Norma feeling lonely and depressed. Had depression and loneliness been Normas only symptoms, she may have been able to rely on

her friends and family to make it through. Unfortunately, Norma had been suffering from nightmares that would often wake her in the middle of the night. When Joe and Norma were first married, they had made two wedding

vows that they promised to keepuntil death do us part.â The first was that they would not let the sun go down on their anger (Eph. 4:26), and the second was a willful decision not to use the word divorce as it pertained to their marriage. During therapy, it was discovered that Norma and Joe had experienced some frustration over an alcoholic son who had recently lost his job. Norma was a person who felt a lot of compassion and couldnt stand the thought of her son hurting, whereas Joe had a core belief that their sonhad gotten himself into this mess

and he can get himself out of it.â That night, instead of turning toward each other to address the problem, Norma and Joe laid in bed, feeling frustrated and angry. Joe was in the habit of getting out of bed when he was angry, sitting in the living room, watching TV as he thought about the situation. Normally, he would then return to bed and talk with Norma after hecooled off.â Together, they would share their concerns and make a united front. This particular night, Joe did not return. About an hour after Joe left the bedroom, Norma went in to see what Joe was doing and she found him lying unresponsive on the couch. In a frantic response, she had called 911 and attempted CPR but was unable to revive him. She recalled not hearing anything from the room where she found Joe. It was later determined that Joe had suffered a massive heart

attack, which took his life. Norma, devastated over the loss of her husband, has suffered with insomnia and exhaustion. She was in the habit of crying herself to sleep, only to be awakened with the reoccurring

nightmare that Joe had died, she had gone to bed angry, and she was now unable to say goodbye to him. Norma approached counseling with a desire to eliminate her nightmares and to find closure.

Norma stated that even during the funeral she had not been able to find

any comfort regarding closure. She wanted to talk about what to do with

their son, especially since she was now the only surviving parent. She

also wanted to tell Joe she loved him one last time but felt it was too late. Norma felt hopeless as she was overwhelmed by these impossibilities. As a Christian counselor, this issue brings to light some very difficult questions. Is there a way for Norma to have closure? What form of closure should we take since the funeral was notsuccessful?â Since Norma wanted to tell Joe she loved him, was there any way that this could happen? After spending six years as a Hospice Chaplain, I had seen the devastation caused by lack of closure, so I decided to implement a different type oftalk therapy.â Instead of

only Norma and me talking about the situation, I asked her how she would feel if she were able to talk to Joe and tell him how she was feeling.

Norma looked at me as if to say,Are you crazy? Hes dead!â My questions to her went like this:Do you believe that Joe is in heaven?â to which she repliedYes.â I then asked her,Do you believe that God cares about what you are going through?â With tears in her eyes, she quivered and replied,Yes.â I then asked her to give some thought to what I was about to propose. Since God is omnipotent I encouraged

Norma to ask God if he would give Joe a message. In a sense, I was calling for something radical,Message Therapyâ (MT). Message Therapy is when a person on earth asks God to give a message to a person already in heaven. As a form of therapy and theology, one must wonder if this is even possible? Biblically, we are told of a parable whereby the rich man, who was in Hades, was able to see Lazarus in Abrahams bosom (Luke 16:19- 31). Abraham also dialogued with the rich man (vv. 27, 30), indicating two-way communication. Be advised that: (1) this is a parable; (2) this parable occurs prior to Christs visit to paradise; (3) that the rich man was in Hades, not on earth; and (4) the purpose of the parable was to illustrate the importance of pre-death decisions, not necessarily communication. However, we have hope that it might be possible. Based on this text and silence on the topic throughout Scripture, it us unclear whether people on earth can communicate with people in heaven through God. After receiving supervision and talking with some pastoral counselors, we concluded that Scripture simply does not adequately address this question. However, God, in my opinion, is the only one who would have the power to honor such a request. God is not bound by our request but certainly is capable, if willing, of honoring it. Also, Message Therapy encourages people to talk with God directly about their concerns. That day, with tears overflowing, Norma and I held hands and prayed that God would give Joe a message. I started the prayer and Norma finished by sharing her thoughts, fears, concerns, and mostly how much that she loved Joe. Neither of us know if God fulfilled our request, but Norma felt relief. As a follow-up, Norma now talks regularly with God and asks him to relay messages to Joe. Her nightmares have ceased and the depression and loneliness have been

reduced. David Tharp is an ordained American Baptist Minister currently finishing his Doctorate in Clinical Psychology at the Department of Corrections, Ethan Allen School in Wales, Wisconsin.

Response to David Tharp

David Tharp utilizes a creative and relational view of God and supplicative prayer as an effective, brief therapeutic intervention. Philippians 4:6-7 grounds this use of prayer in Scripture. Its effectiveness gives evidence to the interventions clinical and spiritual worthiness. Tharp focuses on Normas need for closure without

getting sidetracked by other issues. This illustrates a fine example of a Christian approach to brief therapy. He uses supervision well by seeking counsel on the use of his strategy. Regardless of our confidence in a new, creative biblical intervention, keen judgment and clinical humility seek out the counsel of wise colleagues. Norma presents with

situations where she has no control. A collaborative, therapeutic relationship utilizes her faith to resolve her desire to say good-bye to Joe. She discovers choices and options in how she responds to being elderly and a widow. How we can stay connected with our loved ones through God is presented with a reasonable perspective on afterlife. This provides hope and can ease the despair of death. Before utilizing this technique, assess the clients reality orientation. Using this intervention if ones client is delusional or has limited cognitive ability could be confusing or add to ones delusional system. Norma views her heavenly Father as caring and helpful. Some clients views of God may need to be worked on before they trust God to care enough to send their messages. Assess for other losses, the need for support,

and other problems that may emerge after resolving the presenting issues. As Norma gains closure on her goodbye to Joe, other therapy work may begin as she moves through the stages of accepting his death. There are other interventions for consideration. One effective strategy is letter writing. Although sending a letter to heaven is not the intention

here, being able to identify and communicate feelings can be achieved.

This technique allows clients to discover some issues or feelings that

can be used in supplicative prayer. The letter serves as a form of such

prayer for clients who may communicate better through writing. Clients

tap into deeper understandings and realizations through writing that

sometimes do not occur with spoken prayers. Other techniques include

role-playing, psychodrama, art therapy or the Gestalt technique of the empty chair that allow for similar results. Some combination of these

and Message Therapy can develop a strong intervention. Focus was on

how Norma experienced the loss with having no chance for good-bye.

One might explore her beliefs and feelings for any guilt or responsibility for Joes anger and heart attack. Her approach to her son might imply some codependancy that would influence her thoughts and feelings about the tragedy. As Norma deals with the loss of companionship, copes with an alcoholic son as a lone parent, handles the various details of widowhood, lives alone, and adjusts in general,

she will probably will develop other emotional needs. A referral to some

sort of support group or grief therapist who can help with the sudden

loss of her husband and ensuing issues is important. Online counselor is always available to help you out.

J. Mark Shadoan, M.S.W., LCSW, recently moved from Richmond, Virginia, where he practiced for 16 years and helped establish Resource Guidance

Services, a Christian family services center. Mark is now with Light Counseling, Inc,. in Lynchburg, Virginia, and is also the Director of Student Chapter Development for AACC.

Related Coping With An Alcoholic Articles