"Have a purpose in life, and having it, throw into your work such strength of mind and muscle as God has given you," wrote¹ Scottish essayist, historian, teacher and writer Thomas Carlyle (1795-1881). This highlights the importance of keeping focus on the goal to be attained. Canadian educator and writer Laurence J. Peter (1919-1990), author of The Peter Principle (1968), put it this way: "If you don't know where you are going, you will probably end up somewhere else."² As the Book of Leviticus encourages us, we can have God at our side in our journey of life. "I will walk among you, and will be your God, and you shall be my people." (Leviticus 26:12).

The Buddhist tradition, while eschewing a personal God, nevertheless holds to the view of individual and group responsibility, so much so that one Buddhist scholar wrote: "Thus we are capable of changing ourselves, even to the extent of changing the world.... If we start toward the direction performing wholesome acts from this very moment, then our future will be full of brightness."³

Purpose in life is more complex in Hindu teaching. It involves four features: dharma (paying debts (thanks) for being born, cared for by parents and teachers, respect for guests and other living things; artha, (prosperity) guided by dharma; kama (desire) as is appropriate in terms of dharma and artha, and moksha (enlightenment) self realization, that is to say, liberation and attaining a sense of being one with God and the universe.⁴

The Hebrew sense of the purpose of life stems from Genesis." And he said: Let us make man to our image and likeness: and let him have dominion over the fishes of the sea, and the fowls of the air, and the beasts, and the whole earth, and every creeping creature that moveth upon the earth." (Gn 1: 26). Rabbinical scholars have seen this as meaning that mankind "was to elevate and refine the whole of nature, including the beasts and animals, to the service of true humanity."⁵

A good Christian summary of man's purpose in life is given in the Catechism of the Catholic Church: "God, infinitely perfect and blessed in himself, in a plan of sheer goodness freely created man to make him share in his own blessed life. For this reason, at every time and in every place, God draws close to man. He calls man to seek him, to know him, to love him with all his strength."⁶ That God is to be our guide toward pursuing our purpose in life is poetically expressed thus by the Eastern Church spiritual father, St. Symeon the New Theologian, "So who would draw nearer to Him? .... He gives Himself to me ... And I am filled with His love and beauty (Hymn 16)...That is where paradise is ... (Hymn 19)"⁷

ENDNOTES

1 [http://www.goodreads.com/quotes/310955-have-a-purpose-in-life-and-having-it-throw-into]

2 [http://thinkexist.com/quotation/if_you_don-t_know_where_you_are_going-you_will/214682.html]

3 [http://www.buddhanet.net/cbp1_f2.htm]

4 [http://www.religionfacts.com/meaning-of-life/Hinduism]

5 [http://www.chabad.org/library/article_cdo/aid/108390/jewish/What-is-Lifes-Purpose.htm]

6 [http://www.usccb.org/beliefs-and-teachings/what-we-believe/catechism/catechism-of-the-catholic-church/epub/index.cfm]

7 [St. Symeon the New Theologian, Hymns of Divine Love]

A song that was popular from the start of the Vietnam War in the mid 1960’s and re-recorded in ensuing years, up to the present time, by over a hundred artists was titled: "What the World Needs Now Is Love." A nutshell of the song’s theme is in the lyrics: "What the world needs now is love, sweet love, it's the only thing that there's just too little of…." In some renditions of the song the lyrics are interspersed with sound bites of bigotry, hatred, prejudice, segregation, gunfire and references to the assassination of the Kennedys and Martin Luther King.ⁱ That the world needs love is a truism. The question arises though, how do we bring love about? Setting aside the legal, political and scientific aspects of personhood, we can discern an answer by focusing on the individuality of each person.

Applying understanding and love to groups is more difficult than to individuals. Research psychology gives some insight as to why this is so. Individuals in groups are often de-individuated.ⁱⁱ That is to say, we do not see them as individuals but as group members. They are without individual personhood. By definition, 'groups' are an abstraction. Violent, destructive acts, and surely a lack of love toward them, are, therefore, more easily applied to groups, and by members of groups to each other.

On this matter I am taking a cue from the ending paragraph of science journalist Virginia Hughes’ National Geographic Magazine 2014 series on personhood: “Here’s why I think the personhood notion so valuable. We are people. Our people-centric minds evolved for a reason (namely, our species depends on social interactions) and our people-centric minds dictate how our society works. .. It’s the crux of our reality.”ⁱⁱⁱ

Centering on what various religious traditions have to say about personhood may be a way to increasing love in the world. One line of Hindu thought approaches the issue from an altruistic point of view: “What makes a person different from inanimate objects? Undoubtedly we can come up with many traits: self-consciousness, intelligence, awareness of others as fellow-persons, and many others. But there is a particular trait that is perhaps the most powerful expression of personhood, namely the willingness to forego one’s own advantage for the sake of someone else. When someone sacrifices his own wealth, health, or even his life, we see that he has reached the highest level of what it means to be a real person….”^iv A second line of Hindu tradition is that "According to Vedic literature an eternal individual soul inhabits the body of every living creature….The soul enters the womb at the time of conception, and this makes the fetus a living, individual person."^v On the other hand, “Buddhism defines personhood through psychological facts;” this allows one contemporary Buddhist scholar to write that these consist of: “materiality, feeling, perception, mental formation, and consciousness.”^vi In Judaism, the moment of personhood is equivocal and is informed by legalistic standards. What is agreed upon, based on Exodus 21: 22–23, is that after birth the taking of life is murder, thus indicating that the taking of the life of an individual is murder of a person.^vii

The Christian idea of personhood stems from the Sacred Scripture’s Book of Genesis: (1: 26) “And He [God] said: Let us make man to our image and likeness.” St. Gregory Palamas summarizes the sublime meaning of the understanding personhood in this way: “What I am is an image of God manifest in a spiritual, immortal and intelligent soul, having an intellect that is the father of my consciousness and that is consubstantial with the soul and inseparable from it. That which characterizes me, and is real and sovereign, is the power of intelligence and free will.” (Philokalia IV p. 118).^viii To love we must focus on the personhood of God and the personhood of each one of us. In this context we can see the meaning of Christ’s teaching: “Amen I say to you, as long as you did it to one of these my least brethren, you did it to me.” (Mt 25: 47).

The honoring of personhood does, indeed, seem a sure way to increase the kind of love the world needs – now, and always.

¹ [https://en.wikipedia.org/wiki/What_the_World_Needs_Now_Is_Love]

² [Diener, E., Fraser, S. C., Beaman, A. L. and Kelem, R. T. (1976). Effects of deindividuation variables on stealing among Halloween trick-or-treaters. Journal of Personality and Social Psychology. 33(2), 178- 183.]

³ [http://phenomena.nationalgeographic.com/blog/only-human/]

⁴ [http://www.karma2grace.org/page.asp?pg=72]

⁵ [http://www.hinduismtoday.com/modules/smartsection/item.php?itemid=338]

⁶ [http://www.stc.arts.chula.ac.th/A%20Concept%20of%20Person.pdf]

⁷ [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2582082/]

⁸ [Palmer, G.E.H.; Sherrard, P.; and Ware, K. (Trans.) (1971, 1981, 1988, 1990). Philokalia, I-IV. London: Faber and Faber.]

To borrow the opening lines of the famous 19th English novelist Charles Dickens in his A Tale of Two Cities (1859): "It was the best of times, it was the worst of times, it was the age of wisdom, it was the age of foolishness..." Though Dickens was referencing the pre and post-French Revolution state of political, social and spiritual affairs in London and Paris, we can well apply these words to the state of the contemporary world as we enter the 21st Century.

On one hand, we have the "light" of unsurpassed scientific and technological innovations unimagined a couple generations ago. Here we can think of space travel, medical knowledge and treatment, the humanities and the sciences; smart-phones can especially be singled out as they are more powerful even than the previous generation of computers, allowing for instantaneous social communication and transfer of text and visual information throughout the world. Much of this can be seen as "wisdom." By analogy, we can see it as one edge of a two-edged sword.

On the other hand, we have the "darkness" of the age: the exponential disparity in the standard of living, economically and politically, between 'haves' and 'have nots.' We have a new form of warfare: combatants, disguised as ordinary citizens, carrying out massive terrorism. We see hijacked planes being flown into skyscrapers, brutal public executions of innocents, such as beheadings, and suicide bombings (many of which are motivated by radicalized religious adherents² or militant atheistic dictatorships).

Met. Hilarion

In some cases, such as in the Levant, this has led to the movements of populations fleeing this unprecedented terrorism, and the threatening of the cultures of those being persecuted as well as of the cultures of the countries they are fleeing to for safety. The ethos of this age also includes increasingly militant secularism attacking Christ and His Church.³ Many of these issues have been extensively discussed by Metropolitan Hilarion of Volokolamsk, Chairman of the Department for External Church Relations of the Moscow Patriarchate.

All of this being made worse by failure to care for the earth, God's creation, and the ensuing consequences such as global warming, water pollution and poverty etc. (Morelli, 2015).⁴ Awareness of all of this "foolishness," the underside of the two-edged sword, is made readily available to all by ubiquitous social media devices.

The followers of Christ, who are members of His Body the Church, can, in the spiritual tradition of the Eastern and Western Churches, engage in spiritual combat against the 'darkness' of our age.⁵ Following this counsel, the ethos of our prayers and life should be confidence in God, humility that He is with us, and the acquisition and cultivation of virtue. In combating the evil one, who is known as the separator and divider, we can ponder the words of Christ to His apostles: "This kind can go out by nothing, but by prayer and fasting." (Mk 9:28).

The members of the Society of St. John Chrysostom, [and all who pray for unity in Christ] have a unique spirituality and apostolate in a world wherein Christians are under increasing assault. We may be few in number, we may be the poor, the lowly or the meek, the outcasts and, as in the sense of the Hebrew word, anawim. But, in unity with Christ and His Church, we have strength. Let us continue our apostolate of unity and pray and work to overcome all that divides us.

1 This article is based on the Society of St. John Chrysostom-Western Region (SSJC-WR) President's Message in the Light of the East Newsletter 2015-16 Winter. The Society of St. John Chrysostom is an ecumenical group of clergy and lay people which promotes Eastern Christianity and Ecumenical Dialogue between the Eastern and Western Churches toward the healing of the sin of disunity. It has sponsored the Eastern Churches Journal and the annual Orientale Lumen & Light of the East Conferences. It has been in existence since 1997 in the United States and for over 70 years in England. For more information see the SSJC-WR website: www.lightoftheeast.org.

2 Metropolitan Hilarion: "Radical Islamism, known as Wahhabism or Salafism, is a movement within the Islamic world that has as its goal the establishment of a worldwide Caliphate in which there is no place for Christians." [orientalreview.org/2013/11/11/christian-world-is-facing-challenges-of-militant-secularism-and-radical-islamism] For an comprehensive summary of the history of Wahhabism see: www.huffingtonpost.com/alastair-crooke/isis-aim-saudi-arabia_b_5748744.html

3 Metropolitan Hilarion: "Militant secularism in Europe [and elsewhere] has a long history going back to the period of the French revolution. But it is only in the twentieth century in the countries of the so called socialist bloc that godlessness was elevated to the level of state ideology. As regards the so called capitalist countries, they preserved to a significant degree the Christian traditions which shaped their cultural and moral identity. Today these two worlds appear to have changed roles. ... In Western European countries we can observe the steady decline of the numbers of parishioners, a crisis in vocations, and monasteries and churches are being closed. The anti-Christian rhetoric of many politicians and statesmen becomes all the more open as they call for the total expulsion of religion from public life and the rejection of the basic moral norms common to all religioust raditions." [orientalreview.org/2013/11/11/christian-world-is-facing-challenges-of-militant-secularism-and-radical-islamism]

4 www.orthodoxytoday.org/OT/view/saving-gods-creation-another-east-west-alliance

5 [Lorenzo Scupoli & Theophan the Recluse (1997) Unseen Warfare: The Spiritual Combat and Path to Paradise of Lorenzo Scupoli-as edited by Nicodemus of the Holy Mountain and Theophan the Recluse, Crestwood, NY: St. Vladimir's Seminary Press.]

All have heard the popular aphorism ‘it is more blessed to give than to receive.’ Well, it turns out that the blessing received by giving may be more extensive than previously imagined. For example, a recent survey indicated that those who had a practice of giving reported greater physical health, an elevated level of happiness and well-being as well as a substantial attenuation of feelings of stress.ⁱ Does social connection turn good deeds into good feelings? On the value of putting the `social´ in prosocial spending, the answer is definitively yes.ⁱⁱ Other studies indicate that giving thoughtful, empathic (giving something meaningful to the recipient) gifts brings the gifts gives the gift giver the greatest overall satisfaction.ⁱⁱⁱ This implies that seeing the person you are giving to as a unique person is more efficacious in bringing about the ‘blessings’ in giving, versus contributing to the masses. As St. (Mother) Theresa of Calcutta put it: "If I look at the mass, I will never act. If I look at the one [the single individual], I will."^iv

As any individual in mankind is a unity of body, mind and spirit, a spiritual connection to giving can aid in our understanding of generosity, and even prompt us to be giving thanks by giving. One recent study on philanthropy (gift giving) concluded: “The more important religion is to a person, the more likely that person is to give to a charity of any kind, according to new research released today.”^v

One Buddhist writer tells us: “those who are well-established on the path to emancipation continue to practice giving as it is conducive to wealth, beauty and pleasure...,” which are the four sublime states a human can attain and reach bodhisattva. Bodhisattvas give in this manner whenever the opportunity presents itself, strictly in order to fulfill the danaparami, the "perfection of giving," which is the first of the ten perfections they must cultivate to the highest degree in order to attain Buddhahood (perfect enlightenment).^vi Hindu political and spiritual leader Mahatma Gandhi once said: tells us: “The best way to find yourself is to lose yourself in the service of others.”^vii The Jewish Torah speaks extensively of tzedakah, meaning the act of giving to the needy. It can be considered as charity, although justice would be a more accurate translation as God “selects certain people as agents to disburse His bounty to others.” Such giving is a blessing for the giver because the Torah indicates that “the gifts that we give to others will eventually return to us.”^viii

The Christian theology of giving is profound. The spiritual father of the Church, St. Maximos the Confessor, tells us it is in “imitation of God . . . . He gives equally to all according to their need.” The saint also gives a practical account of how giving can be done: it is a “state of love [that] may be recognized in the giving of money, and still more in the giving of spiritual counsel and in looking after people in their physical needs.”^ix This love is in imitation of God Himself. The lesson for giving is for us to see God in individual persons.

ⁱ[Aknin, L.B., Dunn, E.W., Sandstrom, G.M. and Norton, M.I. (2013).

ⁱⁱInternational Journal of Happiness and Development, 1(2), pp. 155-171.

ⁱⁱⁱ[http://blogs.scientificamerican.com/literally-psyched/the-psychology-behind-gift-giving-and-generosity/]

^iv[http://www.huffingtonpost.com/wray-herbert/the-power-of-one-the-psyc_b_2670533.html]

^v[https://philanthropy.com/article/Religious-Americans-Give-More/153973]

^vi[http://www.accesstoinsight.org/lib/authors/various/wheel367.html]

^vii[http://psychcentral.com/blog/archives/2013/12/22/how-giving-makes-us-happy/]

^viii[http://www.chabad.org/library/article_cdo/aid/256321/jewish/Eight-Degrees-of-Giving.htm]

^ix[Palmer, G.E.H.; Sherrard, P.; and Ware, K. (Trans.) (1971, 1981, 1988, 1990). Philokalia, I-IV. (IV p. 55). London: Faber and Faber.]

One of the most frequently questions I am asked as Chairman of the Chaplain and Pastoral Counseling Department of the Antiochian Archdiocese is for a referral to an Orthodox mental health practitioner. Sadly Orthodoxy is not a majority spiritual tradition in North America and Orthodox practitioners are few. So careful questioning by potential patients, family and clergy of a potential practitioner regarding the practitioner's understanding and respect for the spiritual values of their patients is very important. This course is meant to aid in this inquiry.

It also should be noted that this course is an updating and reworking of a recently published chapter: Psychotherapy with members of Eastern Orthodox Churches, (Morelli, 2014).]

St. Paisios

by Fr. George Morelli

You doctors, must take good care of your patients in order to avoid unpleasant situations. You should have a practical mind. Generally speaking, every one of us must take advantage of his mind which is a gift from God.
(Saint Paisios of the Holy Mountain)¹

In the last segment of this online course, I presented a Case Study integrating scientific evidenced based Cognitive Behavior Therapy within an ethos of spiritual healing that makes up the Eastern Orthodox healing tradition. In the Orthodox Church, healing of the soul ranks higher than the healing of the body and mind. The primacy of spiritual to physical healing is derived from the Epistle of James. St. James tells us:

St. James

Is there any one among you suffering? Let him pray ... Is any among you sick? Let him call for the presbyters of the Church, and let them pray over him, anointing him with oil in the name of the Lord; and the prayer of faith will save the sick man, and the Lord will raise him up; and if he has committed sins, he will be forgiven (James 4.13 - 15).

However physical-mental healing is not to be ignored. As mentioned earlier in the course it behooves us to use God's gift to mankind of reasoning, (Gen 1:26) to understand His creation and use it to heal disease. This is in emulation of Christ Himself, who as St. Luke (5: 15) informs us that as He preached: "great multitudes came together to hear, and to be healed by Him of their infirmities." We are morally and ethically required to use the most advanced reasoning currently known to mankind in our current age. In the present day evidence based clinical psychotherapeutic science indicates that the Cognitive Behavior Therapy (CBT) and its related models (e.g. Rational Emotive Behavior Therapy (REBT), Dialectical Cognitive Behavior Therapy (DCBT), Interpersonal Cognitive Therapy (ICT) etc.) have been shown to be most efficacious in the psychotherapeutic treatment of various mental disorders. Recently questions have arisen about publication bias in favor of CBT. This is to say that scientific journal editors may have chosen to publish articles that promote favorable CBT findings. Researchers such as Cuijpers, Berking, Andersson, Quigley, Kleiboer, & Dobson. (2013) have addressed this issue doing a meta-analysis of studies derived from a comprehensive database including: PubMed, PsycINFO, Embase, and the Cochrane library. A summary of their findings indicate that while the effects of CBT "may have been overestimated until now," it nevertheless "has the greatest weight of evidence."

Thus this next segment of the course gives a brief outline of the CBT model.

Cognitive Distortions

Keeping in mind the caveats above, and as noted in the Case Study, the cognitive-behavioral model of emotional dysfunction (Beck, Rush, Shaw and Emery, 1979; Ellis, 1962) has been shown to be effective in dealing with dysfunctional emotions, decreasing inappropriate behavior and increasing appropriate behavior. According to this model, basic dysfunctional emotions such as anger, anxiety, depression and mania, as well as more complex emotions such as anticipation, awe, jealousy and remorse (Plutchik, (2002) are produced by automatic distorted or irrational appraisals, attitudes, beliefs and/or cognitions. Situations (something that someone has said or done or events that have happened) do not produce or cause the emotional reaction. Rather, we upset ourselves over people and events by our cognitive processing of these situations. If our thinking is clear, rational and non-distorted we have normal feelings like annoyance, concern and disappointment. Even opening this model to a less strict position, (allowing for subcortical activation of emotion) it would be maintained that some control over emotions initiated by these subcortical centers could be had by cognitive (cortical) methods.

In Beck’s model, individuals have automatic thoughts (similar to primed cognitions investigated by Loftus, 1980) about activating events, including: selective abstraction (drawing conclusions unwarranted by the facts), personalization (attributing neutral events as referred to oneself), polarization (viewing events in all-or-nothing terms), generalization (the tendency to conclude events will never change or always remain the same), demanding expectations (Ellis, 1962) (the belief that there are laws or rules that must or should be obeyed) and catastrophizing (Ellis, 1962), (the perception that something is more than 100% bad, awful or terrible). 

A theoretical cognitive model with clinical-pastoral utility from an Orthodox perspective is attribution theory (Weiner, 1974; Abramson, Seligman & Teasdale, 1978). In this model, explanations of events as due to combinations of internal or external and unstable (temporary) or stable (permanent) factors influence felt emotion and subsequent behavior. After rapport and diagnosis and treatment goals have been established, the Cognitive-behavioral treatment strategies usually involve some form of didactic presentation of the cognitive model.

Bibliotherapy is often used adjunctively. Some recommended books include: Beck, A.T. (1988), Love is Never Enough; Burns, D. (1980), Feeling Good; Ellis, A. (Ellis and Harper, 1975) A Guide to Rational Living, Knaus w.J. (2014) The Cognitive Behavioral Workbook for Anxiety (2nd edition).

In the therapeutic sessions, the patient is then helped to recognize, pinpoint and identify his/her cognitive distortions and learns to challenge and restructure the irrational distorted cognitions that are initiating or sustaining the dysfunctional emotions and to change to more accurate non-distorted cognitions. Use of notes and charts in the treatment session and outside the office (homework) is encouraged to facilitate the patient's integration of these concepts.
Three guiding questions are used in the restructuring process:

1. Where is the evidence?
2. Is there any other way of looking at it?
3. Is it as bad as it seems?

With repetition, the new functional undistorted belief system becomes habitual (automatic) and credible.

ENDNOTES

1 Former Elder, now Saint Paisios of the Holy Mountain was officially canonized a saint by Patriarch Bartholomew of Constantinople and the Holy Synod on 13 January 2015. (www.omhksea.org/2015/01/ecumenical-patriarchate-officially-entered-elder-paisios-among-the-list-of-saints/) Among the Orthodox, the pathway to sainthood is usually started by the popular acclamation that someone is worthy (Axios!) of sainthood. This was the certainly the case of saintly Elder Paisios. His Feast Day will be on 12 July. My readers may want to pray the Apolytikion and Kontakion of the new saint:

Apolytikion in Tone 1

The offspring of Farasa, and the adornment of Athos, and the imitator of the former righteous, equal in honor, O Paisios let us honor O faithful, the vessel full of graces, who hastens speedily to those who cry out: glory to Him Who gave you strength, glory to Him Who crowned you, glory to Him Who grants through you healings for all.

Kontakion in Plagal Tone 4

The most-famed ascetic of the Holy Mountain, and the newly-enlightened light of the Church, let us praise him with hymns with all our heart, for he leads the faithful towards a perfect life, filling them with rivers of gifts, therefore we cry out: Hail, O Father Paisios.

REFERENCES

(These references are for the entire course, only a portion are for Part 9)

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Novaco, R.W. (1975). Anger Control: The Development of an Experimental Treatment. Lexington, KY: Lexington.

Novaco, R.W. (1977). Stress inoculation: A cognitive therapy for anger. Journal of Consulting and Clinical Psychology, 45. 600-608.

Palmer, G.E.H.; Sherrard, P.; and Ware, K. (Trans.) (1971, 1981, 1988, 1990). Philokalia, I IV. London: Faber and Faber.

Posner, M.I., & Snyder, C.R.R. (1975). Attention and Cognitive Control. In Solso, R.L. (Ed.), Information Processing and Cognition: The Loyola Symposium. Hillsdale, NJ: Erlbaum.

Powers C., Nam, R.K., Rowatt, W.C. & Hill, P.C. (2007). Association between humility, spiritual transcendence, and forgiveness. Research in the Social Scientific Study of Religion, 18, 75-94.

Rathus, S. A. (1973). A 30-item schedule for assessing assertive behavior. Behavior Therapy, 4, 398-406

Sakharov, Archimandrite Sophrony, (1999). St Silouan the Athonite. Crestwood, New York: St. Vladimir's Seminary Press.

Shiffren, R.H. (1988). Attention. In Atkinson, R.C., Herrnstein, R.J., Lindzey, G., & Luce, R.D. (Eds.), Stevens' Handbook of Experimental Psychology. (Vol.2). NY: Wiley.

Spiegler, M.D. & Guevremont, D.C. (2010). Contemporary Behavior Therapy. Belmont, CA: Wadsworth.

Staniloae, D. (2003). Orthodox Spirituality: A Practical Guide for the Faithful and a Definitive Manual for the Scholar. South Canaan, PA: St. Tikhon's Seminary Press.

Tavris, C. (1984), Anger: The misunderstood emotion. NY: Simon & Schuster

Vlachos, Archimandrite Hierotheos (1993). The Illness and Cure of the Soul in the Orthodox Tradition. (Translated by Effie Mavromichali). Levadia, Greece: Birth of the Theotokos Monastery.

Vlachos, Archimandrite Hierotheos (1994a). Orthodox Psychotherapy: The Science of the Fathers. (Translated by Esther Williams) Levadia, Greece: Birth of the Theotokos Monastery.

Vlachos, Archimandrite Hierotheos (1994b). Orthodox Spirituality: A Brief Introduction. (Translated by Effie Mavromichali). Levadia, Greece: Birth of the Theotokos Monastery.

Ware, Bishop Kallistos (1979). The Orthodox Way. Crestwood, NY: St. Vladimir's Seminary Press.

Ware, Bishop Kallistos (1963). The Orthodox Church. London: Penguin Books.

Weiner, B. (Ed.). (1974). Achievement Motivation and Attribution Theory. Morristown: General Learning Press.

Wheeler, E. P. (ed., trans.) (1977). Dorotheos of Gaza: Discourses and Sayings. Kalamazoo, MI: Cistercian Publications

The issue of bystander intervention in crisis situations became a major media and social frenzy as well as a topic of extensive behavioral science investigation after the early morning stabbing murder of a 28 year old woman, Catherine Susan ("Kitty") Genovese, in Queens, NY, on March 13th, 1964. Typical of Initial media reports of the incident was a New York Times front page headline on March 27:: “37 WHO SAW MURDER DIDN’T CALL THE POLICE- Apathy at Stabbing of Queens Woman Shocks Inspector.” Subsequent investigations did reveal that a couple of individuals did respond, albeit ineffectually.ⁱ However, this incident and reports about it did highlight the general apathy among individuals when confronted with critical incident events. This is what makes those who do act courageously in moments of danger more heroically notable.

Recently, news media worldwide told of the Moroccan alleged terrorist with an AK-47 and 300 rounds of ammunition traveling from Amsterdam to Paris on a high speed train. After hearing the first shot he fired, USAF Airman 1st Class Spencer Stone (receiving a severe hand wound in the engagement), Alek Skarlatos, Oregon National Guard specialist, accompanied by their friend Anthony Sadler, and joined by British citizen Chris Norman, tackled and subdued the gunman. It was reported that a couple of others also were involved in overcoming the gunman. As the encounter happened on French soil, they were awarded the French Legion of Honor. In giving the award, President François Hollande said, “Your heroism must be an example for many and a source of inspiration...Faced with the evil of terrorism, there is a good, that of humanity. You are the incarnation of that.”ⁱⁱ

Good religion should inspire us to act heroically to the best of our ability. In Hindu Vedic literature, the Sanskrit term virya literally means “state of a strong man” or “manliness” and is often associated with heroism and virility.ⁱⁱⁱ In Buddhism the term virya is broadened to include the components of heroism: "energy", "diligence", "enthusiasm", or "effort". It impels wholesome or virtuous actions.^iv A United Synagogue Leader’s Guide discusses the Jewish concept of a hero by asking: “Who is a hero?” Answering: “One who overcomes his urges.”^v In the Christian tradition, heroism is related to deep love. St. John in his Gospel tells us: “Greater love than this no man hath, that a man lay down his life for his friends.” (15:13)

An heroic act, especially one which puts us in danger of losing our life, actually brings us closer to Godliness. In this matter we can consider the answer of Jesus to the question about the greatest commandment. “Master, which is the greatest commandment in the law? Jesus said to him: Thou shalt love the Lord thy God with thy whole heart . . . And the second is like to this: Thou shalt love thy neighbor as thyself.” (Mt 22: 37, 39) To help us apply this to our lives we can consider the wisdom of St. Paisios of the Holy Mountain who tells us: “When someone goes beyond himself, he goes beyond the earth…As long as he remains self, he cannot become a heavenly person. There is no spiritual life without sacrifice.”^vi

ENDNOTES

i. http://www.newyorker.com/magazine/2014/03/10/a-call-for-help
ii. http://www.nytimes.com/2015/08/25/world/europe/france-train-attack-legion-of-honor.html?_r=0
iii. https://en.wikipedia.org/wiki/V%C4%ABrya_(Hinduism) iv. https://en.wikipedia.org/wiki/V%C4%ABrya
v. Mishna, Pirkei Avot 4:1; www.usy.org/wp.../heroes-Jewish-concepts.doc
vi. Elder Paisios of Mount Athos, (2008). Spiritual Counsels II, Thessaloniki, Greece: Holy Monastery “Evangelist John the Theologian”

Patriarch Bartholomew I and
Metropolitan John of Pergamum

An exciting convergence of agreement between major Eastern and Western Churches has recently taken place on a critical contemporary moral issue: care for the environment. Orthodox Metropolitan John Zizioulas of Pergamum has labeled the issue in question existential ecumenism,ⁱ because it deals with the problem of living out our lives on earth and cosmos, the creation God has given us dominion over. (Gn 1: 28)

One of the first modern-day alerts of the current environmental crisis occurred in the message on the Day of Prayer for Creation in September 1993 by Patriarch Bartholomew I, Ecumenical Patriarch of Constantinople, who wrote, "During this time, brothers and children in the Lord, when international organizations, inter-state legislation and scientific research programs are united in jeremiads and lamentations to toll the bell of danger so that man might sober up in time before the coming of mass chaos, which would threaten universal order and balance in the various so-called "eco-systems," not only of our planet, but of the entire cosmos. . . .ⁱⁱ

The words of Pope Francis I of Rome in his encyclical Laudato Si now add to this. The theological connection to God's creative act recorded in Genesis can be immediately seen in the Holy Father's words: "This sister [our earth] now cries out to us because of the harm we have inflicted on her by our irresponsible use and abuse of the goods with which God has endowed her."ⁱⁱⁱ

St. Paisios

The papal encyclical is not a scientific treatise, but a moral challenge to be aware of our past sins and repent for them by reversing the ills we have inflicted. In this regard, the Holy Father references Patriarch Bartholomew who informs us: "For human beings. . .to destroy the biological diversity of God's creation; for human beings to degrade the integrity of the earth by causing changes in its climate, by stripping the earth of its natural forests or destroying its wetlands; for human beings to contaminate the earth's waters, its land, its air, and its life – these are sins". For "to commit a crime against the natural world is a sin against ourselves and a sin against God." It is clear that consumerism, greed and power have to be replaced by a spiritual respect for creation, what Metropolitan John calls ecological asceticism, "restraint in the consumption of natural resources [and] immense waste of natural materials."

Thus, let us, inspired by "existential ecumenism," heed the words of newly canonized St. Paisios of the Holy Mountain: "This grass is an icon; this stone is an icon; and I can kiss it, venerate it, because it is filled with God's grace. The world is not for us to take things from, but a place where we cast off our passions and desires."^iv 

FOOTNOTES

i https://www.patriarchate.org/the-green-patriarch

ii http://www.goarch.org/ourfaith/ourfaith8047

iii http://w2.vatican.va/content/francesco/en/encyclicals/documents/papa-francesco_20150524_enciclica-laudato-si.html

iv http://www.goarch.org/ourfaith/ourfaith8047

There is a deep chasm between genuine and sincere concern for the problems that beset others versus undue personal disturbance. One of the major disaffirmative consequences of an undue concern for others problems is that we are not able focus on fostering our own healthy physical, psychological or spiritual functioning and wellbeing. This is often accompanied by our own emotional distress. Furthermore, this then leads to being ineffective in giving others the help they may deservedly need and that we might want to give to them. Irish author, poet and playwright, Oscar Wilde (1854-1900), put it this way: “Selfishness is not living as one wishes to live, it is asking others to live as one wishes to live.” ¹

Sometimes there are situations in which others’ problems do affect us. We may personalize the idea that others are not acting the way we want, taking it as a personal insult or slight. However, as cognitive clinical psychologist, Albert Ellis (1962)² points out, it is our own “injustice-collecting ideas,” or what I would label as our demanding expectations that we be ‘justly treated,’ that inflates our own feelings of annoyance. For example, if someone acts ill-manneredly towards us, it is our own ‘self talk’ about it that triggers our untoward feelings: “What rudeness he/she has! How dare he/she do that to me.” We insist that others follow our own set of rules. We fail to perceive the reality that people are going to act the way they want, not the way we want them too. A psychological alternative is to stop focusing on our own irrational reaction to what others are doing or not doing so that we are able to focus on calmly and caringly help others in overcoming their impediments and challenges.

Psychological research has shown that individuals intrinsically committed to their religious tradition can are more focused on affirmative care for others, such as giving financial charity and doing voluntary work.³

Many religious traditions urge us along the path of letting go of self in caring for others. One contemporary guide to Buddhism tells us: “love, generosity, having common values, appreciation of others, being sensitive to their needs and not always demanding one’s own way.⁴ This is seen in the Buddhist concept of tanha, often translated as ‘blind demandingness’ which is to ask of the universe [in this case, others] more than it is ready or able to give.

Hebrew tradition marries wisdom and helpfulness. The Jewish Talmud has two relevant passages: “Examine the contents, not the bottle.” This spiritual counsel would prompt us to discern the real, deserving needs of others and thus to enhance our ability to provide effective help. The Talmud goes on to say: “The highest form of wisdom is kindness.” This is to say, the calm and caring help we can render.⁵

The Christian tradition is reflected in the counsels of St. Paisios of the Holy Mountain when he asks: “How are we to brighten up our love [helping] others?” He answers: “The less I consider myself, the more I remove myself.” By withdrawing consideration of self from our encounters with others we can put into practice the saint’s other counsel:” Through kindness and patience [we] should try to help.”⁶

ENDNOTES

¹[http://www.worldofquotes.com/topic/Selfishness/1/index.html]

²Ellis, A. (1962). Reason and Emotion in Psychotherapy. Secaucus NJ: Lyle Stuart.

³[http://www.davidmyers.org/Brix?pageID=13]

⁴[http://www.buddhisma2z.com/content.php?id=166#sthash.8ZONV7Cm.dpuf]

⁵Pies, R.W. (2000). The Ethics of the Sages: An Interfaith Commentary on Pirkei Avot. Northvale, NJ:

⁶Elder Paisios of Mount Athos, (2008-2012). Spiritual Counsels II,IV. Thessaloniki, Greece: Holy Monastery “Evangelist John the Theologian”

One of the most frequently questions I am asked as Chairman of the Chaplain and Pastoral Counseling Department of the Antiochian Archdiocese is for a referral to an Orthodox mental health practitioner. Sadly Orthodoxy is not a majority spiritual tradition in North America and Orthodox practitioners are few. So careful questioning by potential patients, family and clergy of a potential practitioner regarding the practitioner's understanding and respect for the spiritual values of their patients is very important. This course is meant to aid in this inquiry.

It also should be noted that this course is an updating and reworking of a recently published chapter: Psychotherapy with members of Eastern Orthodox Churches, (Morelli, 2014).]

by Fr. George Morelli

You doctors, must take good care of your patients in order to avoid unpleasant situations. You should have a practical mind. Generally speaking, every one of us must take advantage of his mind which is a gift from God.
(Saint Paisios of the Holy Mountain)¹

The last segment of this online course ended with “the advice of McGoldrick et.al. (1996), that it behooves the clinician to interweave the patient's spiritual value system into treatment.” In this regard a recent review by David Elkind (2015)² of the Handbook of Psychotherapy and Religious Diversity (2nd ed.) points out: “If it turns out that the [patient’s] religion is to be an important contributor to his or her problem, then the therapist can either refer the [patient] to a more appropriate clinician or seek consultation with a member of the clergy in question.”

Studious immersion in case studies is critical in learning about and understanding psychological processes and the application of psychotherapy to the treatment of individual, family and social disorders. In terms of research it is important to emphasize that case studies are not scientific proof of any theory. At best they serve as groundwork to formulate hypotheses that can be scientifically investigated. (Morelli, 2006b). Hypothesis are assumptions or guesses as to how observations are related to each other to predict observable and measurable outcomes. However case studies or case example also have a didactic function. They can serve to illustrate how treatment can be applied to various disorders. In this regard, it must be further emphasized that it behooves the researcher and clinician to use the best of scientifically evidence based intervention processes in the treatment of any disorder. The case example given below is an outline, a nutshell, of clinical intervention with scientific evidence based psychology treatment, Cognitive-Behavior Therapy (CBT), integrated with Eastern Orthodox spirituality. A contemporary, more detailed of overview of CBT can be found in Beck (2011).

CASE EXAMPLE:

I Case History

Identifying Information: Sophia is a 45-year-old Greek Orthodox Christian female born in Greece. She is married 21 years with two girls ages 20 and 18. She is deeply committed to the Orthodox Church. Her husband and daughters are nominally committed to the Church.

Chief Complaints: She sought counseling for symptoms of anxiety, depression and marital and family conflict over differences in religious commitment.

Psychiatric History: Unremarkable

Personal and Social History: She was born in a small village in Greece. She immigrated to the United States at 10 years of age. She is an only child due to pregnancy and birth complications her mother underwent. She had a very religious upbringing. She reported her parents were very strict. Her mother died when she was 15 years of age. Her father passed away two years later and she lived with her aunt until her marriage.

Medical History: Unremarkable; Mental Status Check: Unremarkable

DSM-IV-TR Diagnoses:

• Axis I: 300.4 Dysthymic Disorder; 300.02 Generalized Anxiety Disorder; V61.20 Parent-Child Relational Problems; V61.1 Partner Relational Problems; V62.89 Religion or Spiritual Problem.
• Axis II: None; Axis III: None
• Axis IV: Psychosocial and environmental factors: Mild (Problems with primary support group-value discord).
• Axis V: Global Assessment of Functioning: 70 (Some Mild Symptoms)

II Case Formulation: Several predominant automatic thoughts accompanied her anxiety and dysphoric emotions. She had a tendency to have demanding expectations. She would complain that her daughters did not do the things she wanted them to do. She had the underlying belief that there is a universal law that children should always do what their mothers ask. If they don't obey, she has the right to get upset. She would also generalize to see things in 'always or never' categories. Her husband had different interests than she did; she would tell herself, he "will never change" and "will always be the same". She would criticize her husband's choices, thereby weakening the marriage even more. She also had Catastrophizing thoughts: the perception that something is worse than it actually is. She erroneously reacted to her daughter's and husband's choices as if they were grave and catastrophic events and she thus reacted with even more anxiety and dejection. She also had erroneous spiritual beliefs incompatible with the mind of Christ and His Church. E.g., she did not understand or apply the principle that God asks and never coerces obedience.

III Treatment Plan: Initial intervention focused on ensuring a trusting, caring, therapeutic and spiritual relationship. She was comfortable to know her feelings and thoughts were listened to and understood. The principles of cognitive-behavioral therapy were reviewed in sessions and in bibliotherapy assignments. David Burns' (1980) book, Feeling Good, was used. Standard tools of examining and restructuring automatic thoughts and consequent emotions were aimed at attenuating her anxiety and dysphoric symptoms. Behavioral practice (role playing) both in the office and as "homework assignments" was integral to the treatment. The depth of her religious commitment allowed for a significant spiritual component to her treatment. Her demanding expectations led her to impose her personal set of rules on her family, often coercively. She assumed that the inviolability of physical laws (gravity, for example) applies to moral laws and social norms as well. This was rooted in her faulty understanding of human nature and God. God gave mankind free will. Obedience, while a requirement, always remains a choice and cannot be coerced. A person cannot violate the law of gravity, for example, but remains free to disobey God's commandments (as well as social rules and norms). Disobedience to the moral law of God certainly causes different degrees of consequences, some major like the loss of eternal life, and others more minor. Nevertheless, God does not force obedience.; it can be offered only in freedom. So the understanding and practice of Orthodox spirituality was integrated into her treatment.

Clinical Outcome: Sophia's anxiety and depression symptoms significantly decreased over the course of a year. The relationship with her husband and daughters also was much improved; she was no longer distressed over choices they would make that differed from hers. For example, not only was she less controlling but participated more in her husband's hobbies.

Clinical Postscript: Some years after termination of therapy I was contacted that Sophia had terminal brain cancer. She was admitted into a leading cancer hospital. Her initial presenting problems and treatment focus involved on her anxiety, dysphoria and family problems. Because she was a deeply religious woman, I made clinical-pastoral visits (as a priest-psychologist) to her during and up to her death in the hospital. The nature of her new 'treatment' shifted from family issues to the acceptance of her impending death. Because of her deep commitment to Orthodox Christian teaching, the concept of her spirituality was integrated into exploring and addressing the "meaning of her life." It comforted to her to know that she had brought Christ to her family, and that He would continue to care for them spiritually after she would be dwelling with Jesus after her physical death. By addressing her cultural value of being a devout Orthodox Christian and integrating this into her therapy, she became fulfilled spiritually and could die in peace.

ENDNOTES

1 Former Elder, now Saint Paisios of the Holy Mountain was officially canonized a saint by Patriarch Bartholomew of Constantinople and the Holy Synod on 13 January 2015. (www.omhksea.org/2015/01/ecumenical-patriarchate-officially-entered-elder-paisios-among-the-list-of-saints/) Among the Orthodox, the pathway to sainthood is usually started by the popular acclamation that someone is worthy (Axios!) of sainthood. This was the certainly the case of saintly Elder Paisios. His Feast Day will be on 12 July. My readers may want to pray the Apolytikion and Kontakion of the new saint:

Apolytikion in Tone 1

The offspring of Farasa, and the adornment of Athos, and the imitator of the former righteous, equal in honor, O Paisios let us honor O faithful, the vessel full of graces, who hastens speedily to those who cry out: glory to Him Who gave you strength, glory to Him Who crowned you, glory to Him Who grants through you healings for all.

Kontakion in Plagal Tone 4

The most-famed ascetic of the Holy Mountain, and the newly-enlightened light of the Church, let us praise him with hymns with all our heart, for he leads the faithful towards a perfect life, filling them with rivers of gifts, therefore we cry out: Hail, O Father Paisios.

2 Elkind, D. (2014) PsycCRITIQUES .Vol. 59, No. 45, Article 4

REFERENCES

(These references are for the entire course, only a portion are for Part 7)

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Athanasius, St. (1975). On the Incarnation of Our Lord. Crestwood, NY: St. Vladimir's Seminary Press.

Bandura, A. (1986). Social Foundations of Thought and Action: A Social Cognitive Theory. Englewood Cliffs, NJ: Prentice Hall.

Beck, A.T., Rush, A.J., Shaw, B.F., & Emery, G. (1979). Cognitive Therapy of Depression. NY: Guilford Press.

Beck, A.T. (1988). Love is Never Enough: how couples can overcome misunderstandings, resolve conflicts and solve relationship problems through cognitive therapy. NY: Harper-Collins

Beck, A.T. (1999). Prisoners of Hate: The cognitive basis of anger, hostility and violence. New York: HarperCollins.

Beck, J.S. (1995). Cognitive Therapy: Basics and Beyond. NY: The Guilford Press.

Beck, J.S. (2011). Cognitive Therapy: Basics and Beyond. (2nd ed.). NY: The Guilford Press.

Breck, J. (2001). Scripture in Tradition: The bible and its interpretation in the Orthodox Church. Crestwood, NY: St. Vladimir's Seminary Press

Burns, D. (1980). Feeling Good. New York: William Morrow.

Demakis J. (2004). Historical precedents for synergia: Combining Medicine, diakonia and sacrament in byzantine times. In S. Muse (Ed.), Raising Lazarus: Integral healing in Orthodox Christianity. Brookline, MA: Holy Cross Orthodox Press.

Ellis, A. (1962). Reason and Emotion in Psychotherapy. Secaucus NJ: Lyle Stuart.

Ellis, A. & Harper, R. (1975). A Guide to Rational Living. NY: Wilshire

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Morelli, G. (2004) Sex is Holy: The responsibility of Christian parenting. The Word. 48. 6, 7-8.

Morelli, G. (2006a, March 6). Asceticism and Psychology in the Modern World. http://www.orthodoxytoday....

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Morelli, G. (2006c, July 29). Dealing with Brokenness in the World. Available: www.orthodoxytoday.org/OT....).

Morelli, G. (2006d, December 21). The Ethos of Orthodox Christian Healing. Available: http://www.orthodoxytoday....

Morelli, G. (2009, September 26). Secularism and the Mind of Christ and the Church: Some Psycho-Spiritual Reflections. Available: http://www.orthodoxytoday....

Morelli, G. (2014). Psychotherapy with members of Eastern Orthodox Churches. In P. Scott Richards & Allen E. Bergin (Eds.) Handbook of Psychotherapy and Religious Diversity (2nd ed. pp. 77-102). Washington DC: American Psychological Association.

Novaco, R.W. (1975). Anger Control: The Development of an Experimental Treatment. Lexington, KY: Lexington.

Novaco, R.W. (1977). Stress inoculation: A cognitive therapy for anger. Journal of Consulting and Clinical Psychology, 45. 600-608.

Palmer, G.E.H.; Sherrard, P.; and Ware, K. (Trans.) (1971, 1981, 1988, 1990). Philokalia, I IV. London: Faber and Faber.

Posner, M.I., & Snyder, C.R.R. (1975). Attention and Cognitive Control. In Solso, R.L. (Ed.), Information Processing and Cognition: The Loyola Symposium. Hillsdale, NJ: Erlbaum.

Powers C., Nam, R.K., Rowatt, W.C. & Hill, P.C. (2007). Association between humility, spiritual transcendence, and forgiveness. Research in the Social Scientific Study of Religion, 18, 75-94.

Rathus, S. A. (1973). A 30-item schedule for assessing assertive behavior. Behavior Therapy, 4, 398-406

Sakharov, Archimandrite Sophrony, (1999). St Silouan the Athonite. Crestwood, New York: St. Vladimir's Seminary Press.

Shiffren, R.H. (1988). Attention. In Atkinson, R.C., Herrnstein, R.J., Lindzey, G., & Luce, R.D. (Eds.), Stevens' Handbook of Experimental Psychology. (Vol.2). NY: Wiley.

Spiegler, M.D. & Guevremont, D.C. (2010). Contemporary Behavior Therapy. Belmont, CA: Wadsworth.

Staniloae, D. (2003). Orthodox Spirituality: A Practical Guide for the Faithful and a Definitive Manual for the Scholar. South Canaan, PA: St. Tikhon's Seminary Press.

Tavris, C. (1984), Anger: The misunderstood emotion. NY: Simon & Schuster

Vlachos, Archimandrite Hierotheos (1993). The Illness and Cure of the Soul in the Orthodox Tradition. (Translated by Effie Mavromichali). Levadia, Greece: Birth of the Theotokos Monastery.

Vlachos, Archimandrite Hierotheos (1994a). Orthodox Psychotherapy: The Science of the Fathers. (Translated by Esther Williams) Levadia, Greece: Birth of the Theotokos Monastery.

Vlachos, Archimandrite Hierotheos (1994b). Orthodox Spirituality: A Brief Introduction. (Translated by Effie Mavromichali). Levadia, Greece: Birth of the Theotokos Monastery.

Ware, Bishop Kallistos (1979). The Orthodox Way. Crestwood, NY: St. Vladimir's Seminary Press.

Ware, Bishop Kallistos (1963). The Orthodox Church. London: Penguin Books.

Weiner, B. (Ed.). (1974). Achievement Motivation and Attribution Theory. Morristown: General Learning Press.

Wheeler, E. P. (ed., trans.) (1977). Dorotheos of Gaza: Discourses and Sayings. Kalamazoo, MI: Cistercian Publications

Sometimes we carry around the idea that what we have done in the past is a determiner of what we will do now and in the future. We become, so to speak, captives, prisoners or slaves of our past. A variation of this attitude is that if we have felt strongly about something that has occurred to us in the past, then we are bound to feel the same in the future. Cognitive clinical psychologist Albert Ellis (1962)¹ considers such attitudes 'irrational beliefs.' Such attitudes can be subset under a superordinate automatic thought of generalization. (Burns, 1980², Morelli, 2006³). That is to say, the thought that events and the way I respond to them will always be the same way and never change.

Such attitudes propel a cascade of thought-behavioral scenarios that lead to inaction. For example, a person may focus on failing or performing poorly at a past endeavor, think that they will fail on a new task, and never even try to begin the new task. A functional approach to the difficulty would be to attempt to find a new, that is to say, alternate solution toward accomplishing the task or solving the problem. Many times individuals will simply repeat ineffectual ways of approaching the problem that have proved inadequate in the past and have led to failure. Previous failure becomes a vicious excuse to avoid real, effective problem solving.

Cognitive psychological therapeutic alternatives for those combating this irrational belief will include help to acknowledge that previous failure has occurred, and an emphasis on working on changing the 'present.' In this way, their future can have a different past, that is to say, through the changes in thinking and action planning that they have made 'today.' And, in the process, they will have developed a new cognitive skill and gained self-control.

The virtue of hope, a component of various religious traditions, can nurture and support both the overcoming of fixedness on past failure and the developing of new functional cognitive-behavioral skills. Generally speaking, hope is the expectation of affirmative outcomes for one's activities and the events and circumstances of one's life. In a recent article in The Hindu, hope is described as "the essence of human life."⁴ The essay goes on to say: "The tendency in a man usually is to bemoan his fate. Often he may be heard to mutter, "I am tired of living". Even day-to-day (small) problems snowball into major crises. This outlook should be changed and hope is the essence of life and a man should use it for good."

In a similar manner, a contemporary Buddhist monk, Thanissaro Bhikkhu, shares this wisdom: "Insight into change teaches us hope. Because change is built into the nature of things, nothing is inherently fixed, not even our own identity. No matter how bad the situation, anything is possible. We can do whatever we want to do, create whatever world we want to live in, and become whatever we want to be."⁵ Common to Judaism and Islam is that it is trust in God that engenders hope. Rabbi Allen S. Maller points out that "A person who believes in God cannot become a pessimist, sinking into negativism, cynicism, depression or despair."⁶ Toward this end, we may ponder the words of Eastern Church spiritual father St. Maximus the Confessor (Philokalia II, p. 53) who tells us: "...hope in God engenders [objectivity], and patience and forbearance engender hope in God; these in turn are the product of complete self control...."⁷

ENDNOTES

1 Ellis, A. (1962). Reason and Emotion in Psychotherapy. Secaucus NJ: Lyle Stuart.

2 Burns, D. (1980). Feeling Good. New York: William Morrow.

3 Morelli, G. (2006, March 6). Asceticism and Psychology in the Modern World. http://www.orthodoxytoday.org/articles6/MorelliMonasticism.php.

4 [http://www.indiadivine.org/content/topic/1055577-the-hindu-article-hope-is-the-essence-of-human-life/]

5 [http://www.dhammawheel.com/viewtopic.php?t=5658]

6 [http://www.rabbimaller.com/judaism-and-islam/faithful-hope-in-qur-an-and-judaism]

7 Palmer, G.E.H.; Sherrard, P.; and Ware, K. (Trans.) (1971, 1981, 1988, 1990). Philokalia, I-IV. London: Faber and Faber.

A recent Google Alert on Psychology referenced an article addressing the effects of exposure to tobacco smoke titled - I pray facetiously as a question - "Is Secondhand Smoke Child Abuse?"¹ The answer is obviously: "Yes!" Even those who would argue contra-wise would at the very least maintain that exposing children to secondhand smoke is a "moral failure" that needs addressing by mental health practitioners. I would be remiss if I did not add a couple of increasingly occurring unhealthy, and thus abusive, habits related to smoking: vaping, a recently emerging health hazard, and even some culturally sanctioned perilous practices such as 'hookah' smoking.

The Theology of the Custody of One's Body

Man's dominion over Creation

In Old Testament Sacred Scripture we read God's words regarding our ancestral parents and from them to all of mankind: "And He said: Let Us make man to Our image and likeness: and let him have dominion over the fishes of the sea, and the fowls of the air, and the beasts, and the whole earth, and every creeping creature that moveth upon the earth." (Gn 1: 26). In the scriptural account of creation, the bringing forth of living creatures and mankind specifically occurs in the latter "days," or epochs of creation. St. Basil (329–379 AD) in his Homilies on the Six Days (epochs) of Creation [The Hexaemeron]ⁱⁱ reflects on the value and dignity of the living creatures, (cattle ox wolf, dog etc.) "Let the earth bring forth the living creature. Thus when the soul of brutes ... was born by the command of God. ... But each animal is distinguished by peculiar qualities." This being so, the dignity and worth of man is so much higher.

St. Basil tells us "Man, a celestial growth, rises superior to them as much by the mould of his bodily conformation as by the dignity of his soul." The dignity and worth of mankind has profound moral implications and responsibilities. Once again St. Basil informs us: "When we consider the natural and innate care that these creatures without reason take of their lives we shall be induced to watch over ourselves and to think of the salvation of our souls; or rather we shall be the more condemned when we are found falling short even of the imitation of brutes."

The deleterious health effects of second and third hand smoke

The Center for Disease Control notes that the smoke in tobacco is composed of more than 7,000 chemicals; over hundreds of them are toxic.ⁱⁱⁱ In a recent article in the Annals of Family Medicine, Goldstein (2015)^iv summarized the scientific findings on the health effects of secondhand smoke. Among the consequences of the pernicious smoking habit is the exposing of others to multiple smoke-related diseases, including asthma and pneumonia. Secondhand smoke (SHS) is also associated with sudden infant death syndrome, lung cancer and heart disease. It should also be noted that adults exposed to secondhand smoke have a higher risk for cerebrovascular accident (Stroke).^v

Previously, little social, public health or ethical-moral attention has been given to the victims of Third Hand Smoke (THS). What is especially egregious about exposing others to THS, especially children, is the involuntary nature of the exposure. In this regard the National Institute of Health indicates:

THS exposure results from the involuntary inhalation, ingestion, or dermal uptake of THS pollutants in the air, in dust, and on surfaces. Such exposure includes inhalation exposure to compounds re-emitted into the air from indoor surfaces and particles resuspended from deposits, and dermal and ingestion exposure to compounds partially derived from cigarette smoke and resulting particles that have settled, deposited, and accumulated on surfaces.^vi

The special case of electronic cigarettes (vaping)

Electronic cigarettes (e-cigarettes) are personal nicotine delivery systems (ENDS). A battery powers a heating element that atomizes an aerosol - vaporizes aerosols - usually containing glycerin, glycol, nicotine, propylene and various flavorings, which are then inhaled.

One concern of researchers is that of the delivery and exposure to particulate matter. The nicotine in vaping is delivered "by creating an aerosol of ultrafine particles".^vii A study conducted by Williams et al (1958) found that through both smoking e cigarettes and exposure to secondhand vapor the "metal nanoparticles can deposit into alveolar sacs in the lungs, potentially causing local respiratory toxicity and entering the bloodstream."^viii

One of the marketing strategies used by e-cigarette manufacturers is to promote their health benefit over conventional cigarettes. Unfortunately, this does not take into consideration that nicotine is highly addictive and that it has adverse effects on human brain development, especially in children and adolescents.^ix

The special case of Hookahs

Hookahs are implements to vaporize and smoke various substances such as flavored tobaccos (e.g., apple, cherry chocolate, mint). The Center for Disease Control (CDC) notes there is a wide misconception that hookah smoking is less unhealthy than cigarette smoking.^x Contrarily, this is far afield from the truth. Cigarette smoking and hookah smoking share the same health risks and the subsequent secondhand and thirdhand effects. In fact, the World Health Organization (WHO) has labeled Hookah smoking "a serious potential health hazard."^xi

In heavy and long term use of hookahs Sajid, Chaouachi & Mahmoud (2008) found elevated levels of carcinoembryonic antigen (CEA), which is associated with various health conditions including colorectal carcinoma, gastric carcinoma, pancreatic carcinoma, lung carcinoma, breast carcinoma, and medullary thyroid carcinoma, and various non-neoplastic conditions such as ulcerative colitis, pancreatitis, cirrhosis, COPD, Crohn's disease, and hypothyroidism.^xii

Moral Implications of these findings

This article started with the spiritual reflection that we are made in God's image and called to be like Him. Furthermore, we are to care for all creation. Mankind, being created in God's image, is the summit of His creation of the material cosmos. If we are to care for the earth and its creatures, how much more, therefore, are we required to care for ourselves and all around us. To be blind to the ill effects of our unhealthy actions to ourselves and to those around us is to be blind indeed.

We can apply Our Lord's words on sin to our sinful effects of any kind of smoking: firsthand cigarette smoking, the effects of second and thirdhand smoke and the proliferation of e-cigarettes and hookah delivery systems. "Or how canst thou say to thy brother: Brother, let me pull the mote out of thy eye, when thou thyself seest not the beam in thy own eye? Hypocrite, cast first the beam out of thy own eye; and then shalt thou see clearly to take out the mote from thy brother' s eye." (Lk 6:42).

It should be noted that there are three levels of falling short, missing the mark, also known as sinfulness, in this regard. First is the physical exposure to the teratogens in smoke, second is the psychological modeling that prompts others to sinful behaviors (Morelli, 2009)^xiii, and third is the spiritual scandal of having others observe our breaking God's commandment. Did not Our Lord tell us: "Woe to the world because of scandals. For it must needs be that scandals come: but nevertheless woe to that man by whom the scandal cometh." (Mt 18:7" In this regard it behooves us to follow the counsel of St. Paul: "But judge this rather, that you put not a stumblingblock or a scandal in your brother' s way." (Rm 14: 13)

ENDNOTES

i [http://learningenglish.voanews.com/content/is-secondhand-smoke-child-abuse/2700010.html]

ii [https://www.fisheaters.com/hexaemeron9.html]

iii [http://www.cdc.gov/tobacco/data_statistics/sgr/50th-anniversary/index.htm]

iv [Goldstein, A.O. (2015) Is exposure to second hand smoke child abuse? Yes. Annals of Family Medicine. 13 (2)103-104.]

v [http://www.cdc.gov/tobacco/data_statistics/sgr/50th-anniversary/index.htm]'

vi [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3230406/]

vii [Ostro, B., Feng, W.Y., Broadwin, R., Green S., Lipsett, M. (2007). The effects of components of fine particulate air pollution on mortality in California: results from CALFINE. Environ Health Perspect. 115:13–19.]

viii [Williams M, Villarreal A, Bozhilov K, Lin S, Talbot P. Metal and silicate particles including nanoparticles are present in electronic cigarette cartomizer fluid and aerosol. PLoS One. 2013;8:e57987.]

ix [Liao C-Y, Chen Y-J, Lee J-F, Lu C-L, Chen C-H. Cigarettes and the developing brain: picturing nicotine as a neuroteratogen in clinical and preclinical studies. Tzu Chi Med J. 2012;24:157–161.] It may be noted that a teratogen refers to any agent that interferes with normal embryonic development. A neuroteratogen specifically targets neural-brain development.

x [http://www.cdc.gov/tobacco/data_statistics/fact_sheets/tobacco_industry/hookahs/]

xi ["WHO Study Group on Tobacco Product Regulation (TobReg) an advisory note Waterpipe tobacco smoking: dangerous health effects include risk to public safety if used by multiple users, research needs and recommended actions by regulators, 2005" (PDF).]

xii [Sajid, Khan; Chaouachi, Kamal; Mahmood, Rubaida (24 May 2008). "Hookah smoking and cancer: carcinoembryonic antigen (CEA) levels in exclusive/ever hookah smokers". Harm Reduction Journal (Harm Reduction Journal) 5 (1): 19. doi:10.1186/1477-7517-5-19. PMC 2438352. PMID 18501010.]

xiii [http://www.orthodoxytoday.org/OT/view/smart-parenting-xvii-love-and-worship-in-the-domestic-church-of-god][http://www.orthodoxytoday.org/OT/view/morelli-overcoming-anxiety-christ-the-church-fathers-and-cognitive-scientif]

An irrational belief: that is what cognitive clinical psychologists consider an attitude of desperate need to depend on others (Ellis, 1962). However, they distinguish between unhealthy dependence and psychologically and spiritually healthy dependence. The characteristic signs of unhealthy dependence are the high intensity of the emotional need, a sense of self worthlessness, and a lack of confidence and ensuing helplessness and hopelessness when not dependent on others. To discern between them in and for oneself, a good beginning would be a realistic assessment of one's strengths (talents) and weaknesses. It is important to know one's God-given strengths in the various domains of life, academic, cognitive, creative, social skill and sport. Then one can build on those gifts of strength, often by enhancing them with the aid of others who can guide because of their more advanced skills. If our weaknesses can be compensated for, then others may help us in this regard as well. Another way of looking at this is to say that we attain independence by recognizing our strengths and weaknesses while remaining open to guidance from others to attain even greater competence. Thus, we develop a healthy dependence. Many of those engaged in the most demanding professions, who demonstrate what we consider great personal acts of bravery and skill, may initially appear 'independent.' However, such individuals would be first to acknowledge their reliance on others around them. Frequently heard among those in the military and among emergency first-responders are: "I got your back," and "it was a team effort."

We can look to various spiritual traditions to discover a symbiosis between independence and dependence. A Buddhist spiritual writing contains these poetic verses: "My hut is roofed, comfortable, free of drafts; my mind, well-centered, set free. I remain ardent. So, rain-deva. Go ahead & rain." (Thag 1.1) A contemporary Buddhist scholar's interpretation of these poetries elucidates it. "The monk doesn't need anything from anyone. He is free and determined. He is ardent. Along with these traits, one might characterize him as independent. The very writing of this poem, however, implies dependence on the part of the monk. Without dependence, he could not have written, "So, rain-deva, Go ahead and rain." His mind's freeness depends on the comfortableness of his hut, which depends on the hut's roof."¹ The mutual interaction between dependence and independence is also noted in a recent Hindu commentary. "When the mind is focused on the Lord, there are no insurmountable problems."² In this matter we can think of the counsel of an anonymous writer: "Believe in yourself the way God believes in you."³

In the Judeo-Christian tradition, in the Book of Psalms, David, the king and warrior, says of God: "His truth shall compass thee with a shield: thou shalt not be afraid of the terror of the night. Of the arrow that flieth in the day, of the business that walketh about in the dark: of invasion, or of the noonday devil. A thousand shall fall at thy side, and ten thousand at thy right hand: but it shall not come nigh thee." (Ps 90 5-7). An Eastern Christian Church spiritual father, St. Nikiphoros the Monk, quite explicitly tells us of the crucial importance of having an enlightened guide in life "so that under his [her] instruction we may learn how to deal with the shortcomings and exaggerations [that beset us]" (Philokalia IV, 205)⁴ Thus we are able to live a life of 'healthy dependence.'

1 [http://sophia.smith.edu/blog/buddhistthought15/2015/02/22/dependence-and-attachment-in-buddhism/]

2 [http://www.thehindu.com/2004/03/31/stories/2004033100060800.htm]

3 [http://www.goodreads.com/author/show/13850032.yel]

4 Palmer, G.E.H.; Sherrard, P.; and Ware, K. (Trans.) (1971, 1981, 1988, 1990). Philokalia, I IV. London: Faber and Faber.

One of the most frequently questions I am asked as Chairman of the Chaplain and Pastoral Counseling Department of the Antiochian Archdiocese is for a referral to an Orthodox mental health practitioner. Sadly Orthodoxy is not a majority spiritual tradition in North America and Orthodox practitioners are few. So careful questioning by potential patients, family and clergy of a potential practitioner regarding the practitioner's understanding and respect for the spiritual values of their patients is very important. This course is meant to aid in this inquiry.

It also should be noted that this course is an updating and reworking of a recently published chapter: Psychotherapy with members of Eastern Orthodox Churches, (Morelli, 2014).]

You doctors, must take good care of your patients in order to avoid unpleasant situations. You should have a practical mind. Generally speaking, every one of us must take advantage of his mind which is a gift from God.
(Saint Paisios of the Holy Mountain)¹

The last segment of this online course ended with  “the advice of McGoldrick et.al. (1996), that  it behooves the clinician to interweave the patient's spiritual value system into treatment.”  In this regard a recent review by David Elkind (2015)² of the Handbook of Psychotherapy and Religious Diversity (2nd ed.)  points out: “If it turns out that the [patient’s] religion is to be an important contributor to his or her problem, then the therapist can either refer the [patient] to a more appropriate clinician or seek consultation with a member of the clergy in question.”

Studious immersion in case studies is critical in learning about and understanding psychological processes and the application of psychotherapy to the treatment of individual, family and social disorders. In terms of research it is important to emphasize that case studies are not scientific proof of any theory. At best they serve as groundwork to formulate hypotheses that can be scientifically investigated. (Morelli, 2006b). Hypothesis are assumptions or guesses as to how observations are related to each other to predict observable and measurable outcomes. However case studies or case example also have a didactic function. They can serve to illustrate how treatment can be applied to various disorders. In this regard, it must be further emphasized that it behooves the researcher and clinician to use the best of scientifically evidence based intervention processes in the treatment of any disorder. The case example given below is an outline, a nutshell, of clinical intervention with scientific evidence based psychology treatment, Cognitive-Behavior Therapy (CBT), integrated with Eastern Orthodox spirituality. A contemporary, more detailed of overview of CBT can be found in Beck (2011).

CASE EXAMPLE:

I Case History

Identifying Information: Sophia is a 45-year-old Greek Orthodox Christian female born in Greece. She is married 21 years with two girls ages 20 and 18. She is deeply committed to the Orthodox Church. Her husband and daughters are nominally committed to the Church.

Chief Complaints: She sought counseling for symptoms of anxiety, depression and marital and family conflict over differences in religious commitment.

Psychiatric History: Unremarkable

Personal and Social History: She was born in a small village in Greece. She immigrated to the United States at 10 years of age. She is an only child due to pregnancy and birth complications her mother underwent. She had a very religious upbringing. She reported her parents were very strict. Her mother died when she was 15 years of age. Her father passed away two years later and she lived with her aunt until her marriage.

Medical History: Unremarkable; Mental Status Check: Unremarkable

DSM-IV-TR Diagnoses:

• Axis I: 300.4 Dysthymic Disorder; 300.02 Generalized Anxiety Disorder; V61.20 Parent-Child Relational Problems; V61.1 Partner Relational Problems; V62.89 Religion or Spiritual Problem.
• Axis II: None; Axis III: None
• Axis IV: Psychosocial and environmental factors: Mild (Problems with primary support group-value discord).
• Axis V: Global Assessment of Functioning: 70 (Some Mild Symptoms)

II Case Formulation: Several predominant automatic thoughts accompanied her anxiety and dysphoric emotions. She had a tendency to have demanding expectations. She would complain that her daughters did not do the things she wanted them to do. She had the underlying belief that there is a universal law that children should always do what their mothers ask. If they don't obey, she has the right to get upset. She would also generalize to see things in 'always or never' categories. Her husband had different interests than she did; she would tell herself, he "will never change" and "will always be the same". She would criticize her husband's choices, thereby weakening the marriage even more. She also had Catastrophizing thoughts: the perception that something is worse than it actually is. She erroneously reacted to her daughter's and husband's choices as if they were grave and catastrophic events and she thus reacted with even more anxiety and dejection. She also had erroneous spiritual beliefs incompatible with the mind of Christ and His Church. E.g., she did not understand or apply the principle that God asks and never coerces obedience.

III Treatment Plan: Initial intervention focused on ensuring a trusting, caring, therapeutic and spiritual relationship. She was comfortable to know her feelings and thoughts were listened to and understood. The principles of cognitive-behavioral therapy were reviewed in sessions and in bibliotherapy assignments. David Burns' (1980) book, Feeling Good, was used. Standard tools of examining and restructuring automatic thoughts and consequent emotions were aimed at attenuating her anxiety and dysphoric symptoms. Behavioral practice (role playing) both in the office and as "homework assignments" was integral to the treatment. The depth of her religious commitment allowed for a significant spiritual component to her treatment. Her demanding expectations led her to impose her personal set of rules on her family, often coercively. She assumed that the inviolability of physical laws (gravity, for example) applies to moral laws and social norms as well. This was rooted in her faulty understanding of human nature and God. God gave mankind free will. Obedience, while a requirement, always remains a choice and cannot be coerced. A person cannot violate the law of gravity, for example, but remains free to disobey God's commandments (as well as social rules and norms). Disobedience to the moral law of God certainly causes different degrees of consequences, some major like the loss of eternal life, and others more minor. Nevertheless, God does not force obedience.; it can be offered only in freedom. So the understanding and practice of Orthodox spirituality was integrated into her treatment.

Clinical Outcome: Sophia's anxiety and depression symptoms significantly decreased over the course of a year. The relationship with her husband and daughters also was much improved; she was no longer distressed over choices they would make that differed from hers. For example, not only was she less controlling but participated more in her husband's hobbies.

Clinical Postscript: Some years after termination of therapy I was contacted that Sophia had terminal brain cancer. She was admitted into a leading cancer hospital. Her initial presenting problems and treatment focus involved on her anxiety, dysphoria and family problems. Because she was a deeply religious woman, I made clinical-pastoral visits (as a priest-psychologist) to her during and up to her death in the hospital. The nature of her new 'treatment' shifted from family issues to the acceptance of her impending death. Because of her deep commitment to Orthodox Christian teaching, the concept of her spirituality was integrated into exploring and addressing the "meaning of her life." It comforted to her to know that she had brought Christ to her family, and that He would continue to care for them spiritually after she would be dwelling with Jesus after her physical death. By addressing her cultural value of being a devout Orthodox Christian and integrating this into her therapy, she became fulfilled spiritually and could die in peace.

ENDNOTES

1 Former Elder, now Saint Paisios of the Holy Mountain was officially canonized a saint by Patriarch Bartholomew of Constantinople and the Holy Synod on 13 January 2015. (www.omhksea.org/2015/01/ecumenical-patriarchate-officially-entered-elder-paisios-among-the-list-of-saints/) Among the Orthodox, the pathway to sainthood is usually started by the popular acclamation that someone is worthy (Axios!) of sainthood. This was the certainly the case of saintly Elder Paisios. His Feast Day will be on 12 July. My readers may want to pray the Apolytikion and Kontakion of the new saint:

Apolytikion in Tone 1

The offspring of Farasa, and the adornment of Athos, and the imitator of the former righteous, equal in honor, O Paisios let us honor O faithful, the vessel full of graces, who hastens speedily to those who cry out: glory to Him Who gave you strength, glory to Him Who crowned you, glory to Him Who grants through you healings for all.

Kontakion in Plagal Tone 4

The most-famed ascetic of the Holy Mountain, and the newly-enlightened light of the Church, let us praise him with hymns with all our heart, for he leads the faithful towards a perfect life, filling them with rivers of gifts, therefore we cry out: Hail, O Father Paisios.

2 Elkind, D. (2014) PsycCRITIQUES .Vol. 59, No. 45, Article 4

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Morelli, G. (2014). Psychotherapy with members of Eastern Orthodox Churches. In P. Scott Richards & Allen E. Bergin (Eds.) Handbook of Psychotherapy and Religious Diversity (2nd ed. pp. 77-102). Washington DC: American Psychological Association.

Novaco, R.W. (1975). Anger Control: The Development of an Experimental Treatment. Lexington, KY: Lexington.

Novaco, R.W. (1977). Stress inoculation: A cognitive therapy for anger. Journal of Consulting and Clinical Psychology, 45. 600-608.

Palmer, G.E.H.; Sherrard, P.; and Ware, K. (Trans.) (1971, 1981, 1988, 1990). Philokalia, I IV. London: Faber and Faber.

Posner, M.I., & Snyder, C.R.R. (1975). Attention and Cognitive Control. In Solso, R.L. (Ed.), Information Processing and Cognition: The Loyola Symposium. Hillsdale, NJ: Erlbaum.

Powers C., Nam, R.K., Rowatt, W.C. & Hill, P.C. (2007). Association between humility, spiritual transcendence, and forgiveness. Research in the Social Scientific Study of Religion, 18, 75-94.

Rathus, S. A. (1973). A 30-item schedule for assessing assertive behavior. Behavior Therapy, 4, 398-406

Sakharov, Archimandrite Sophrony, (1999). St Silouan the Athonite. Crestwood, New York: St. Vladimir's Seminary Press.

Shiffren, R.H. (1988). Attention. In Atkinson, R.C., Herrnstein, R.J., Lindzey, G., & Luce, R.D. (Eds.), Stevens' Handbook of Experimental Psychology. (Vol.2). NY: Wiley.

Spiegler, M.D. & Guevremont, D.C. (2010). Contemporary Behavior Therapy. Belmont, CA: Wadsworth.

Staniloae, D. (2003). Orthodox Spirituality: A Practical Guide for the Faithful and a Definitive Manual for the Scholar. South Canaan, PA: St. Tikhon's Seminary Press.

Tavris, C. (1984), Anger: The misunderstood emotion. NY: Simon & Schuster

Vlachos, Archimandrite Hierotheos (1993). The Illness and Cure of the Soul in the Orthodox Tradition. (Translated by Effie Mavromichali). Levadia, Greece: Birth of the Theotokos Monastery.

Vlachos, Archimandrite Hierotheos (1994a). Orthodox Psychotherapy: The Science of the Fathers. (Translated by Esther Williams) Levadia, Greece: Birth of the Theotokos Monastery.

Vlachos, Archimandrite Hierotheos (1994b). Orthodox Spirituality: A Brief Introduction. (Translated by Effie Mavromichali). Levadia, Greece: Birth of the Theotokos Monastery.

Ware, Bishop Kallistos (1979). The Orthodox Way. Crestwood, NY: St. Vladimir's Seminary Press.

Ware, Bishop Kallistos (1963). The Orthodox Church. London: Penguin Books.

Weiner, B. (Ed.). (1974). Achievement Motivation and Attribution Theory. Morristown: General Learning Press.

Wheeler, E. P. (ed., trans.) (1977). Dorotheos of Gaza: Discourses and Sayings. Kalamazoo, MI: Cistercian Publications

Basically, people prefer not to face discomfort. The consequence of their feeling anxious about possible impending discomfort is that they avoid "life's difficulties and self responsibilities." (Ellis, 1962)¹. The comfortable route is to do what is easy, natural or intrinsically enjoyable. Avoiding responsibilities, and their ensuing untoward consequences, can be exacerbated by the imagery we create of scenarios, that is to say, the imagined sequence of possible efforts in actually doing these tasks. Often we create an image of how awful we would feel doing the most difficult part of the task. A cognitive therapeutic alternative is to transform the image into an affirmative one.Imagine yourself performing the simplest part of the task and then re-evaluating how uncomfortable it would be to do that. Then imagine yourself starting at that simple point.

Adherence to a spiritual tradition may help us to avoid overcoming avoidance of responsibilities, by motivating us to act responsibly. A contemporary commentary on Buddhism states "Buddhism is in essence a practice, a method of mental training by which we cultivate morality, concentration and wisdom. It is meant to be lived, not just discussed or believed in." It then goes on to say: "The idea of personal responsibility is central to the Buddhist teachings. The course of an individual's life, including the degree of happiness and peace he experiences, is ultimately determined by his own present and past actions..."² In the Judaic tradition we read from the prophet Jeremiah (31:29-30): "In those days they shall say no more: The fathers have eaten a sour grape, and the teeth of the children are set on edge. But every one shall die for his own iniquity:every man that shall eat the sour grape, his teeth shall be set on edge." The common meaning of this passage is that we are to be responsible for our own deeds and not be accountable for the deeds of others.

Using cognition (thinking) in acting responsibly was not lost on a contemporary spiritual father of the Eastern Church, St. Paisios of the Holy Mountain (1924-1993). He noted:"The excuse of irresponsibility applies only to those who do not think." (p. 74)³. The spiritual elder counseled breaking tasks down into doable parts. Although originally given as advice to parents, his guidance can be applied to all. He said that "parents must also help their children from a young age to assume responsibility for themselves.They should be given opportunities in the family to do small chores suitable for their age..." (p. 121)⁴ In treating patients with procrastination-avoiding responsibility issues, I frequently would advise that they start with the first and simplest part of the task, which frequently would be to get an item or tool necessary to begin a chore. For example, to set out a pencil and pad to start a school assignment, or to set out a hammer and nail to hang a picture. After perceiving that the level of discomfort felt was minimal, it is now easier for the patient to move on to the next step and repeat the process. Also acquired is a sense of self-mastery or what Bandura (1997)⁵ terms self-efficacy. That is to say,acquire an attitude. or belief in competence that can motivate confidence and completion of tasks. Our life's journey toward emotional, psychological and spiritual accomplishment is thus enhanced.

When encountering fearsome situations some people have an automatic appraisal that they must flee from them at all costs and that they should continue to keep such dangers in mind - and even "keep dwelling on the possibility of such events occurring" again. This is described by clinical cognitive psychologist Albert Ellis, (1962)¹ as being "terribly concerned about" them. Another possible common reaction is to 'freeze in place.' Granted, there are some dangerous events in which it may, in fact, be appropriate to flee or freeze. To run and call attention from someone threatening harm would be functional in some situations; naturalists, however, would advise that when coming upon a harmful animal in the wild many times it is best to immediately stop, and not move to prevent calling attention to yourself. Most common everyday situations are not this extreme, and for our well-being it behooves us to deal with them.

When I was in post-graduate clinical training under Ellis, I was instructed in the technique of performing a public "shame exercise' and then teaching the technique and encourage its use by patients who were adversely affected with fear in their daily lives. One example suggested (and that I practiced) was to go into a large department store and shout out the time of day every 10 seconds while riding up and down the escalator for a few minutes. I quickly learned that I could get through such shameful and potentially fearsome situations. The "shame exercises" given to patients as psychotherapy 'homework' are related to their particular feared circumstances. To this day, I tell patients that they are capable of carrying fears with them as they journey through their various life activities.

Such counsel was not lost on some of our brave military individuals. Former U.S. Navy aviator, POW and Silver Star recipient John McCain has said: "We are taught to understand, correctly, that courage is not the absence of fear, but the capacity for action despite our fears. Courage is fear holding on a minute longer."² World War II General George S Patton, commented: "If we take the generally accepted definition of bravery as a quality which knows no fear, I have never seen a brave man. All men are frightened." He further went on to say: "The time to take counsel of your fears is before you make an important battle decision. That's the time to listen to every fear you can imagine. When you have collected all the facts and fears and made your decision, turn off all your fears and go ahead!"³

A spiritual perception when confronting life's vicissitudes can aid us in persevering in fearsome situations. The Buddhist tradition would have us focus on detaching ourselves from our attachments: "From what is dear, grief is born, from what is dear, fear is born. For someone freed from what is dear there is no grief— so why fear? (Dhammapada 212). Judeo-Christian teachings would encourage us to see God accompanying us in frightening times. As we read in Psalm 90 1-5, "He that dwelleth in the aid of the most High, shall abide under the protection of the God of Jacob. He shall say to the Lord: Thou art my protector, and my refuge: my God, in him will I trust. For he hath delivered me from the snare of the hunters: and from the sharp word. He will overshadow thee with his shoulders: and under his wings thou shalt trust. His truth shall compass thee with a shield: thou shalt not be afraid of the terror of the night." Thus, as Eastern Church Father, St. John Karpathos summarizes, "With our whole soul we must trust in God: as one of our Fathers said, 'Entrust yourself to the Lord, and all will be entrusted to you.'" (Philokalia I, p. 308)⁴. While carrying our fears with us we can be assured that God is accompanying us as well, as our buckler, our shield, our protector.

1 Ellis, A. (1962). Reason and Emotion in Psychotherapy. Secaucus NJ: Lyle Stuart.

2 [http://www.transcendingfear.com/quotes.php]

3 [http://www.transcendingfear.com/quotes.php]

4 Palmer, G.E.H.; Sherrard, P.; and Ware, K. (Trans.) (1971, 1981, 1988, 1990). Philokalia, IIV. London: Faber and Faber.

One of the most frequently questions I am asked as Chairman of the Chaplain and Pastoral Counseling Department of the Antiochian Archdiocese is for a referral to an Orthodox mental health practitioner. Sadly Orthodoxy is not a majority spiritual tradition in North America and Orthodox practitioners are few. So careful questioning by potential patients, family and clergy of a potential practitioner regarding the practitioner's understanding and respect for the spiritual values of their patients is very important. This course is meant to aid in this inquiry.

It also should be noted that this course is an updating and reworking of a recently published chapter: Psychotherapy with members of Eastern Orthodox Churches, (Morelli, 2014).

You doctors, must take good care of your patients in order to avoid unpleasant situations. You should have a practical mind. Generally speaking, every one of us must take advantage of his mind which is a gift from God.
(Saint Paisios of the Holy Mountain)¹

Factors Affecting Human Behavior

Icon of Ladder of Divine Ascent based on the
spiritual treatise written by St. John of the Ladder

Such Church Fathers as St. John of the Ladder and St. Gregory Palamas indicate that continual sin becomes habitual. [Thereby making behavioral patterns less voluntary.] Habits can make the spirit dark. They work by blackening our minds, which guides and inclines people to do things they would not normally think of. (Palmer, 1984-93) The Church Fathers suggest reducing the strength of habits by removing sensory factors and stopping memories [thoughts] as they begin. With repetition, these new techniques become stronger. This is not unlike the 'thought stopping' techniques proposed by Cognitive-behavioral therapists. For the Christian, putting these techniques in a spiritual perspective, as suggested by the Church Fathers, provides added motivation and rationale for the treatment.

Cultural Values in Psychospiritual Therapy

Cultural (and to a lesser extent, spiritual) factors have received increased emphasis in understanding mental disorders and psychological treatment (DSM IV, American Psychiatric Association, 1994; McGoldrick, et. al., 1996). It would be unthinkable for Orthodox Christians not to include spiritual factors in the understanding and treatment (healing) of mental disorders. The Christian spiritual tradition, including the prayers and practice the church, Scripture and the writings of the spiritual Fathers, lends itself to an elegant integration with the Cognitive therapy methods noted above.

While non-religious clinicians will not, of course, employ prayer for and/or with their patients, ethically they are required to include patients' religious values, even merely as a tool for understanding and treatment, as suggested by McGoldrick, et. al. (1996). Christians are committed to do all in Christ's name. Jesus told His followers: "For whoever is ashamed of me and of my words, of him will the Son of man be ashamed when he comes in his glory and the glory of the Father and of the holy angels." (Lk 9: 26) St Paul reminds: ". . . knowing that in the Lord your labor is not in vain." (1 Cor 15: 58) Thus, following the advice of McGoldrick et.al., it behooves the clinician to interweave the patient's spiritual value system into treatment.

A clinical caveat for orthodox Christian mental health clinicians

Evidence (science) based clinicians are trained to realize that others are going to follow their set of rules, not the personal set of rules the mental health practitioner may have. As long as the laws of society are not broken and professional ethics are followed it behooves the clinician to respect the patient's values. In emulation of Christ, who for example was asked by the rich young man "Good master, what good shall I do that I may have life everlasting? (Mt 19:16), an orthodox mental health clinician can answer straightforwardly what the inquirer must do in accordance with Christ's teachings and His Church's Holy Spirit inspired understanding of His teachings. However, if not related to patient-inquirer psychotherapeutic treatment, such instruction is better done outside of treatment and by an orthodox spiritually oriented person other than the therapist. It should be recalled the young man rejected Christ's counsel and as St. Matthew records: "And when the young man had heard this word, he went away sad: for he had great possessions." (Mt 19: 22) In today's post-Christian secular world, we can extend 'great possessions' to include not only material things, but attachment to alternative lifestyles (LGBT), right to choose (abortion-murder) and multi and same sex marriage, etc. The Christian psychotherapist must always be guided by St. Paul's counsel to the Ephesians (4: 32): "And be ye kind [emphasis mine]one to another; merciful, forgiving one another, even as God hath forgiven you in Christ."

ENDNOTES

1 Former Elder, now Saint Paisios of the Holy Mountain was officially canonized a saint by Patriarch Bartholomew of Constantinople and the Holy Synod on 13 January 2015. (www.omhksea.org/2015/01/ecumenical-patriarchate-officially-entered-elder-paisios-among-the-list-of-saints/) Among the Orthodox, the pathway to sainthood is usually started by the popular acclamation that someone is worthy (Axios!) of sainthood. This was the certainly the case of saintly Elder Paisios. His Feast Day will be on 12 July. My readers may want to pray the Apolytikion and Kontakion of the new saint:

Apolytikion in Tone 1

The offspring of Farasa, and the adornment of Athos, and the imitator of the former righteous, equal in honor, O Paisios let us honor O faithful, the vessel full of graces, who hastens speedily to those who cry out: glory to Him Who gave you strength, glory to Him Who crowned you, glory to Him Who grants through you healings for all.

Kontakion in Plagal Tone 4

The most-famed ascetic of the Holy Mountain, and the newly-enlightened light of the Church, let us praise him with hymns with all our heart, for he leads the faithful towards a perfect life, filling them with rivers of gifts, therefore we cry out: Hail, O Father Paisios.

REFERENCES

(These references are for the entire course, only a portion are for Part 6)

Abramson, L. Y., Seligman, M. E. P., & Teasdale, J. (1978). Learned helplessness in humans: Critique and reformulation. Journal of Abnormal Psychology, 87, 49-74.

Alfeyev, Bishop Hilarion, (2002). The Mystery of Faith. London, England: Darton, Longman and Todd.

Alfeyev, Archbishop Hilarion. (2009). Christ the Conqueror of Hell: The descent into Hades from an Orthodox perspective. Crestwood, NY: St. Vladimir's Seminary Press.

Athanasius, St. (1975). On the Incarnation of Our Lord. Crestwood, NY: St. Vladimir's Seminary Press.

Bandura, A. (1986). Social Foundations of Thought and Action: A Social Cognitive Theory. Englewood Cliffs, NJ: Prentice Hall.

Beck, A.T., Rush, A.J., Shaw, B.F., & Emery, G. (1979). Cognitive Therapy of Depression. NY: Guilford Press.

Beck, A.T. (1988). Love is Never Enough: how couples can overcome misunderstandings, resolve conflicts and solve relationship problems through cognitive therapy. NY: Harper-Collins

Beck, A.T. (1999). Prisoners of Hate: The cognitive basis of anger, hostility and violence. New York: HarperCollins.

Beck, J.S. (1995). Cognitive Therapy: Basics and Beyond. NY: The Guilford Press.

Beck, J.S. (2011). Cognitive Therapy: Basics and Beyond. (2nd ed.). NY: The Guilford Press.

Breck, J. (2001). Scripture in Tradition: The bible and its interpretation in the Orthodox Church. Crestwood, NY: St. Vladimir's Seminary Press

Burns, D. (1980). Feeling Good. New York: William Morrow.

Demakis J. (2004). Historical precedents for synergia: Combining Medicine, diakonia and sacrament in byzantine times. In S. Muse (Ed.), Raising Lazarus: Integral healing in Orthodox Christianity. Brookline, MA: Holy Cross Orthodox Press.

Ellis, A. (1962). Reason and Emotion in Psychotherapy. Secaucus NJ: Lyle Stuart.

Ellis, A. & Harper, R. (1975). A Guide to Rational Living. NY: Wilshire

Enright, R.D. (2012). The Forgiving Life: A Pathway to Overcoming Resentment and Creating a legacy of love. Washington, DC: American Psychological Association

Erwin, E. (1980). Psychoanalysis: How firm is the evidence? Nous, 14, 443-456

Exline, J.J., Baumeister, R.F. Zell, A.L., Kraft, A.J., & Witvliet, C.V.O., (2008) Not so innocent: Does seeing one's own capability for wrongdoing predict forgiveness. Journal of Personality and Social Psychology, 94, 495-515.

French, R. A. (1991)(trans). The Way of a Pilgrim; and The Pilgrim Continues His Way. San Francisco, CA: Harper

Galanter, E. (1962). Contemporary psychophysics. In Brown, R. (Ed.), New Directions in Psychology. NY: Holt, Rinehart & Winston.

Gassin, E.A. (2001). Interpersonal forgiveness from an Eastern Orthodox perspective. Journal of Psychology and Theology, 29, 187-200.

Hausherr, I. (1990). Spiritual Direction in the Early Christian East. Kalamazoo, MI: Cistercian Publications.

Howe, R. (2005) The Disease Manager's Handbook. Sudbury MA: Jones and Bartlett Publishers.

Hronas, G. (1999). The Holy Unmercenary Doctors: The Saints Anargyroi, physicians and healers of the Orthodox Church. Minneapolis, MN: Light and Life.

Izard, C. (1993). Four systems for emotion activation: cognitive and noncognitive processes. American Psychologist. 100, 1, 68-90.

Izard, C. E. (2001). Emotional intelligence or adaptive emotions? Emotion, 1, 249-257.

Izard, C.E. (2002). Translating emotion theory and research into preventative interventions. Psychological Bulletin, 128, 796-824.

Kadloubovsky, E., & Palmer, G.E.H. (1954). Early Fathers from the Philokalia. London: Faber and Faber.

Kahneman, D. (1973). Attention and Effort. Englewood Cliffs, NJ: Prentice Hall.

Krindatch, A. (2011),(Ed.). Atlas of American Orthodox Christian Churches. Brookline, MA: Holy Cross Press

Langes, M. (Ed.) (1977). The Evergetinos. Athens, Greece: Monastery of the Transfiguration.

Lazarus, R.S. (1991) Emotion and Adaptation. NY: Oxford University Press

Loftus, E. F. (1980). Memory, Surprising New Insights Into How We Remember and Why We Forget. Reading, MA: Addison-Wesley

Marmor, J. (1962). Psychoanalytic Therapy as an Educational Process: Common Denominators in the Therapeutic Approaches of Different Psychoanalytic Schools. In Masserman, J.H. (Ed.). Science and psychoanalysis. (Vol. 5). Psychoanalytic education. Pp. 286-299. New York: Grune & Stratton.

McGoldrick, M., Giordano, J. & Garcia-Preto, N. (Eds.). (2005). Ethnicity & Family Therapy. (3rd ed.). NY: Guilford Press.

McGuckin, J. A. (2004). The Westminster Handbook to Patristic Theology. Louisville, KT: Westminster John Knox Press.

Morelli, G. (2004) Sex is Holy: The responsibility of Christian parenting. The Word. 48. 6, 7-8.

Morelli, G. (2006a, March 6). Asceticism and Psychology in the Modern World. http://www.orthodoxytoday....

Morelli, G. (2006b, May 08). Orthodoxy and the Science of Psychology. Available: http://www.orthodoxytoday....

Morelli, G. (2006c, July 29). Dealing with Brokenness in the World. Available: www.orthodoxytoday.org/OT....).

Morelli, G. (2006d, December 21). The Ethos of Orthodox Christian Healing. Available: http://www.orthodoxytoday....

Morelli, G. (2009, September 26). Secularism and the Mind of Christ and the Church: Some Psycho-Spiritual Reflections. Available: http://www.orthodoxytoday....

Morelli, G. (2014). Psychotherapy with members of Eastern Orthodox Churches. In P. Scott Richards & Allen E. Bergin (Eds.) Handbook of Psychotherapy and Religious Diversity (2nd ed. pp. 77-102). Washington DC: American Psychological Association.

Novaco, R.W. (1975). Anger Control: The Development of an Experimental Treatment. Lexington, KY: Lexington.

Novaco, R.W. (1977). Stress inoculation: A cognitive therapy for anger. Journal of Consulting and Clinical Psychology, 45. 600-608.

Palmer, G.E.H.; Sherrard, P.; and Ware, K. (Trans.) (1971, 1981, 1988, 1990). Philokalia, I IV. London: Faber and Faber.

Posner, M.I., & Snyder, C.R.R. (1975). Attention and Cognitive Control. In Solso, R.L. (Ed.), Information Processing and Cognition: The Loyola Symposium. Hillsdale, NJ: Erlbaum.

Powers C., Nam, R.K., Rowatt, W.C. & Hill, P.C. (2007). Association between humility, spiritual transcendence, and forgiveness. Research in the Social Scientific Study of Religion, 18, 75-94.

Rathus, S. A. (1973). A 30-item schedule for assessing assertive behavior. Behavior Therapy, 4, 398-406

Sakharov, Archimandrite Sophrony, (1999). St Silouan the Athonite. Crestwood, New York: St. Vladimir's Seminary Press.

Shiffren, R.H. (1988). Attention. In Atkinson, R.C., Herrnstein, R.J., Lindzey, G., & Luce, R.D. (Eds.), Stevens' Handbook of Experimental Psychology. (Vol.2). NY: Wiley.

Spiegler, M.D. & Guevremont, D.C. (2010). Contemporary Behavior Therapy. Belmont, CA: Wadsworth.

Staniloae, D. (2003). Orthodox Spirituality: A Practical Guide for the Faithful and a Definitive Manual for the Scholar. South Canaan, PA: St. Tikhon's Seminary Press.

Tavris, C. (1984), Anger: The misunderstood emotion. NY: Simon & Schuster

Vlachos, Archimandrite Hierotheos (1993). The Illness and Cure of the Soul in the Orthodox Tradition. (Translated by Effie Mavromichali). Levadia, Greece: Birth of the Theotokos Monastery.

Vlachos, Archimandrite Hierotheos (1994a). Orthodox Psychotherapy: The Science of the Fathers. (Translated by Esther Williams) Levadia, Greece: Birth of the Theotokos Monastery.

Vlachos, Archimandrite Hierotheos (1994b). Orthodox Spirituality: A Brief Introduction. (Translated by Effie Mavromichali). Levadia, Greece: Birth of the Theotokos Monastery.

Ware, Bishop Kallistos (1979). The Orthodox Way. Crestwood, NY: St. Vladimir's Seminary Press.

Ware, Bishop Kallistos (1963). The Orthodox Church. London: Penguin Books.

Weiner, B. (Ed.). (1974). Achievement Motivation and Attribution Theory. Morristown: General Learning Press.

Wheeler, E. P. (ed., trans.) (1977). Dorotheos of Gaza: Discourses and Sayings. Kalamazoo, MI: Cistercian Publications

There is a tendency in our society to point to outside events in and of themselves as the cause of our happiness or unhappiness. This is followed by the idea that individuals have limited power to control their emotional responses to such happenings. While it is true that physical assaults, depending on their gravity, could certainly harm us, psychological assaults are a different matter. Emotional responses, such as demanding expectations and overevaluations are often triggered by irrational beliefs specific to each individual. These irrational beliefs have been noted by the observations of clinical cognitive psychologists, such as Albert Ellis (1962, p.72)¹ and others.

Especially in this day of instantaneous social media, I want to make clear that in no way am I condoning or excusing the proliferation of socially deviant egregious behaviors, such as bullying, harassment or sexting. However, understanding that we can develop control over our emotional reactions to such untoward events can aid us in walking a path leading to true happiness. Failure to do so leads to a cascading scenario of untoward events. A particularly nasty situation may in reality be quite unpleasant. However, a strong emotional reaction to it, which is also unpleasant, just adds to the problem.

Furthermore, the more strongly emotionally reactive we are to such events, the less effectively competent we are at coping with them or in solving unpleasant events that can be changed.² Thus, though we are now undergoing another bitter event, it is one which we can do something about.

Two mental health cognitive strategies are aimed toward reducing unhappiness. One is realizing that others are going to follow their set of rules, not ours. What helps us understand the reality of this situation is seeing the frame of reference of others, even if we do not agree with their words and actions. That is to say, we see them as wrongdoing, but we still ‘move on.’ Another strategy is to understand that though many of life’s events may be quite disagreeable, few deeds and words are the “end of the world” or catastrophic.Once again, we can focus on ‘moving on.’

There is also a spiritual path pointing us to true happiness. As a recent N.Y. Times article pointed out: “It turns out that choosing to pursue four basic values of faith, family, community and work is the surest path to happiness, given that a certain percentage is… not under our control in any way.”³ Such an idea is central to the truths of the world’s great spiritual traditions. However, to attain this will entail commitment and effort. One writer noted, while reviewing various religious traditions, that they “…demonstrated to me the depths of Judaism, Buddhism and Taoism [and] that I would find similar depths in Islam and Hinduism as well. I certainly have developed a far greater appreciation for Christianity, the tradition with which I’m most familiar.”⁴

With these ending words on working toward achieving true happiness I cannot help reflecting on the words of St. Paisios of Holy Mountain (2011, p. 174): “… the farther they [those trying to attain happiness] go from God, the less comfort and rest they can find in anything they do.”⁵

1 [Ellis, A. (1962). Reason and Emotion in Psychotherapy. Secaucus NJ: Lyle Stuart.]

2 [Morelli, G. (2006, March 25). Smart Parenting III: Developing Emotional Control. http://www.orthodoxytoday.org/articles6/MorelliParenting3.php.]

3 [http://www.nytimes.com/2013/12/15/opinion/sunday/a-formula-for-happiness.html].

4 [http://www.wsj.com/news/articles/SB10001424052702304418404579465244191453008]

5 [Elder Paisios of Mount Athos. (2011). Spiritual Counsels, Vol.1, With Pain and Love for Contemporary Man. Thessaloniki, Greece: Holy Monastery, Evangelist John the Theologian.]

And God created man to his own image: to the image of God he created him: male and female he created them. (Gn 1: 27)

And the Lord God formed man of the slime of the earth: and breathed into his face the breath of life, and man became a living soul. (Gn 2:7)

One would hope that the basis of union among those who acknowledge the transcendent personal God of Abraham, Isaac and Jacob would be that of the worth and sanctity of personhood. It would appear, however, that rather than a reestablishment of cordial relations among those who acknowledge the sacredness of Scripture, and the Book of Genesis in particular, there is an ever growing divide.  Understanding how the differing religious traditions view the genesis and development of the concept of personhood gives an insight of what fuels this ‘great divide.’ Spiritual and moral values differ among those who all consider themselves followers of Christ, and the difference in the understanding of personhood is not only a good reflection of the chasm, but may be in part what is fueling the widening of it. The Apostolic Churches view is that persons are known by God outside of created space and time. The Prophet Jeremiah (1: 5) tells us: “Before I formed thee in the bowels of thy mother, I knew thee: and before thou camest forth out of the womb, I sanctified thee, and made thee a prophet unto the nations.” The traditional Christian Churches understand that God created body and soul, fused together at the moment of conception. This is based on the Virgin Mary’s response to the invitation from God delivered by the Archangel Gabriel: “The Holy Spirit shall come upon thee, and the power of the most High shall overshadow thee.” (Lk 1: 35) The ‘to be’ Mother of God (Theotokos) responded her fiat (“let it be done”): “Behold the handmaid of the Lord; be it done to me according to thy word. And the angel departed from her.” (Lk 1:38).

Dissident Christian Communities

Some Christian communities not in communion with the Apostolic Churches have not dealt directly with the issue of personhood. However, their understanding of personhood can be inferred by their stance on, for example, the issue of abortion. The view of such communities on this issue, placed under the guise of a ‘human right,’ is euphemized as a “right to choose” or a “reproductive rights,” instead of an act of murder, which, of course, it is. One ethicist put it this way: “…most Christian denominations center their support for reproductive rights on the grounds of a woman’s personal responsibility to make moral decisions in accordance with her faith.”[ii] This exemplifies the unfortunate and scandalous desecration of the human person by individuals identifying themselves as Christians.

Division in Islam

The critical importance of understanding the worth of personhood can be seen in the various interpretations or perspectives on personhood in Islam. Islamic scholar Peter Riddell points out that there are various interpretations or perspectives on personhood in Islam. One view is that “Islam holds that Man consists of two essential elements, one material which is the body, the other spiritual which is the soul.” This interpretation would respect the free will of the individual in following Allah’s (God’s) guidance. On the other hand, “non-formally trained” radical fundamental Islamists would say that “Islamic scripture allows for some humans to change from 'person' to 'non-person'.. . . . because they turn away from the guidance God has given them, and corrupt His word and thus their execution is justified.”[iii] The brutal barbaric killings of ISIS, at this writing now including the beheading of the 21 Coptic Egyptian martyr-saints so widely publicized in the media, would be justified in that they consider that their victims are ‘non-persons.’ In this regard, our duty as Christians, (and certainly as committed members and friends of the SSJC), is to despise the evil deed but maintain our love of the person. Consider the words of the angel of the Apocalypse who transmits Christ’s words to St. John the Evangelist: “But this thou hast, that thou hatest the deeds of the Nicolaites, which I also hate.”  (Revelation 2:6).[iv] Thus we can strongly disapprove of the nefarious works or actions of others while still maintaining their worth or personhood. 

The orthodox Church of Christ

Spiritual Church Father Nikitas Stithatos (c. 1005 – c. 1090 AD) provides the patristic, and thus the traditional and orthodox Christian, understanding of the meaning of personhood. An individual “is an image of God manifest in a spiritual, immortal and intelligent soul, an intellect that is the father of . . . consciousness and is consubstantial with the soul. . . and is regal and sovereign.”[v] Vladimir Lossky (1957, p. 201)[vi], a contemporary theologian writing on the mystical theology of the Orthodox Church puts it this way: “The most personal part of man, the principle of his conscience and of his freedom, the spirit in human nature corresponds most nearly to the person; it might be said it is the seat of the person, of the human hypostasis which contains in itself the whole of man’s nature—-spirit, soul and body.”

Let us also consider the moral context in which any ongoing ecumenical efforts should occur. Metropolitan Hilarion Alfeyev, Chairman of the Department for External Church Relations of the Moscow Patriarchate, who recently said: “The task of restoring unity will always be the goal to which Churches and communities ought to strive. At the same time, however, we must remember that the attainment of unity is possible not by rejecting the fundamental norms of Christian morality, not by attempts to accommodate oneself to social currents and an ever changing social establishment, but is possible only on the foundation of [Christ]”[vii] As St. Paul wrote to the Corinthians: “For other foundation no man can lay, but that which is laid; which is Christ Jesus.” (1 Cor. 3: 11).

Without getting into the intricacies of the various patristic writings on the persons of The Holy Trinity, Father, Son and Holy Spirit and the relationship of the Divine persons to human personhood a summary statement, by Archbishop John Zizioulas (1985)[viii] is insightful on this matter. 

Thanks to Christ man can himself “subsist,” can affirm his existence is personal not on the basis of the immutable laws of his nature, but on the basis of a relationship with God which is identified with what Christ in freedom and love possesses as Son of God with the Father. (p. 56).[ix]

This psycho-spiritual reflection provides us with the orthodox Church’s  Christocentric anthropology of the worth of personhood. From this understanding each individual person known by God in eternity and known humanly on earth in space and time existentially-subsistent, has inestimable worth and value. It behooves us to heal society by putting into practice what is implied in the worth of person who is created in God’s image. This means an end to all abortion, capital punishment, euthanasia, murder, torture and any other deed which defiles God’s image in man.

And Jesus looking on them, saith: With men it is impossible; but not with God: for all things are possible with God. (Mk 10: 27)

ENDNOTES

[i] The Society of St. John Chrysostom is an ecumenical group of clergy and lay people which promotes Eastern Christianity and Ecumenical Dialogue between the Eastern and Western Churches toward the healing of the sin of disunity. It has sponsored the Eastern Churches Journal and the annual Orientale Lumen & Light of the East Conferences. It has been in existence since 1997 in the United States and for over 70 years in England. (http://lightoftheeast.org...)

[ii] [http://www.northernplainsethicsjournal.com/NPEJv1n1/janeahlin.pdf]

[iii] [http://www.biblicalstudies.org.uk/pdf/eq/2005-1_047.pdf]

[iv] A 1st Century AD heretical Christian group.

[v] Palmer, G.E.H.; Sherrard, P.; and Ware, K. (Trans.) (1971, 1981, 1988, 1990). Philokalia,  I IV. London: Faber and Faber. (V.4, p.116) 

[vi] Lossky, V. (1957). The Mystical Theology of the Eastern Church. Cambridge & London, England: James Clark & Co.

[vii] https://mospat.ru/en/2015...

[viii] Zizioulas,  J. (1985). Being  As Communion. Crestwood, NY: St. Vladimir’s Seminary Press.

[ix] In a previous paragraph Archbishop John explains  this in more theological terms. “ …the basis of ontology [being] is the person: just as God “is” what He is in His nature, “perfect God,” only as person, so too man in Christ is “perfect man” only as his hypostasis [existence-subsistence], as person, that is, he who subsists who possesses a mode of existence which is constituted as being in precisely the same manner in which God also subsists as being—in the language of human existence this is what a “hypostatic union” signifies (p. 55-56). As St. Paul writes: “For we are made partakers of Christ: yet so, if we hold the beginning of his substance firm unto the end.” (Heb 3:14)

One of the more unfortunate irrational beliefs held by many is that some individuals are intrinsically evil or good. The assumption prompting this deleterious attitude is that the actions that people do define their 'personhood. In practical terms this means that if a person does good, prosocial, kindly and moral things they are a good person. On the other hand, if a person does evil, villainous, immoral and/or wicked things they not only are bad persons but are considered by many to be non-human. Biologically, humans are of the animal kingdom, but people who engage in especially nefarious acts are pejoratively referred to as "animals," - implying they are subhuman and, frequently, not even worthy of life. The implication of this, as cognitive-behavioral clinical psychologist Albert Ellis[1] (1964) puts it, is that, "They did this 'wrong' act, therefore they are perfectly worthless beings who deserve to be severely punished or killed." (p. 66).

Philosophers and philosophical psychologists have considered the basis of humanness to be "a personhood nested within physical, biological, and sociocultural reality, both historically and ontogenetically[ii]." The distinctiveness and worth of the human person, in contrast to others in the animal kingdom, even extends to those spiritual traditions who do not affirm a personal God. For example, The Council for Secular Humanism affirms: "We believe in the fullest realization of the best and noblest that we are capable of as human beings."[iii]

The concept of the person as having worth reaches its peak in various religious traditions. A contemporary Buddhist scholar Somparn Promta writes: "Buddhism believes that all human beings share a set of psychological properties such as self-love, death-hatred, and willing to have a good future."[iv] For Hinduism, the self (atman) is the essence of human life. The definition of personhood in Hinduism is based on this self. "The Vedas teach that all life is sacred. However, human life is the highest level of consciousness. The divine spark, or soul enters at 120 days (Artma). Hindus also perform a pre-birth ceremony at 7 months when personhood is fully achieved."[v]

Common to the understanding of what it means to be a 'person' among the Abrahamic religious traditions of Judaism, Christianity and Islam is the scriptural passage: "And God created man to his own image: to the image of God he created him: male and female he created them." (Gn 1: 27) The Jewish concept of the worth of personhood can be gleaned from a Talmudic discussion on abortion: "if the "greater part" of the fetus has emerged, then its life may not be taken even to save the mother's, "because you cannot choose between one human life and another".[vi] Eastern Church Father Nikitas Stithatos (c. 1005–c. 1090 AD) provides the patristic Christian understanding of the meaning of personhood. An individual "is an image of God manifest in a spiritual, immortal and intelligent soul, an intellect that is the father of . . . consciousness and is consubstantial with the soul. . . and is regal and sovereign."[vii] Islamic scholar Peter Riddell states that there are various interpretations or perspectives on personhood in Islam. One view is that "Islam holds that Man consists of two essential elements, one material which is the body, the other spiritual which is the soul." It would respect the free will of the individual in following Allah's (God's) guidance. On the other hand, "non-formally trained" radical fundamental Islamists would say that "Islamic scripture allows for some humans to change from 'person' to 'non-person'.. . . . because they turn away from the guidance God has given them, and corrupt His word and thus their execution is justified."[viii] The brutal barbaric killings of ISIS so widely publicized in the media would be justified in that they consider that their victims are 'non-persons.'

The closest compatible echo in the secular sphere of the viewpoint of the preponderance of world religions and of clinical psychology is the spirit of the preamble of the United Nations Declaration on Human Rights, which states in part: " . . .whereas disregard and contempt for human rights have resulted in barbarous acts [emphasis mine] which have outraged the conscience of mankind, and the advent of a world in which human beings shall enjoy freedom of speech and belief and freedom from fear and want has been proclaimed as the highest aspiration of the common people."[ix] In this regard, we may consider the words of the angel of the Apocalypse who transmits Christ's words to St. John the Evangelist: "But this thou hast, that thou hatest the deeds of the Nicolaites[x], which I also hate." (Revelation 2:6). Thus we can strongly disapprove of the nefarious works or actions of others while still maintaining their worth or personhood.

ENDNOTES

[i] Ellis, A. (1962). Reason and Emotion in Psychotherapy. Secaucus NJ: Lyle Stuart.

[ii] Ontogenetics is the sequence of an individual organism growing organically; a psycho-biological development of processes involved in an organism changing gradually from a simple to more complex levels.

[iii] https://www.secularhumani...

[iv] http://www.stc.arts.chula...

[v] http://embryo-ethics.smd....

[vi] Rich, Tracey R (1999). "Abortion". Kosher Sex. Judaism 101. Archived from the original on 17 December 2008. Retrieved 2008-12-07. & http://en.wikipedia.org/w...

[vii] Palmer, G.E.H.; Sherrard, P.; and Ware, K. (Trans.) (1971, 1981, 1988, 1990). Philokalia, I IV. London: Faber and Faber. (V.4, p.116)

[viii] http://www.biblicalstudie...

[ix] http://www.un.org/en/docu...

[x] A 1st Century AD heretical Christian group.

[This is a follow up course to Orthodox Christian Spirituality and Cognitive Psychotherapy: An Online Course, that appeared in four parts over the years 2012-2013. This second course is specifically oriented to explain Orthodoxy to mental health practitioners, and serve as a useful resource for Orthodox Clergy and laity as well. Ethically, mental health practitioners should incorporate the spiritual values of their patients in the therapeutic process. The course would serve as an introduction of the Eastern Orthodox ethos and cultural traditions to these professionals.

One of the most frequently questions I am asked as Chairman of the Chaplain and Pastoral Counseling Department of the Antiochian Archdiocese is for a referral to an Orthodox mental health practitioner. Sadly Orthodoxy is not a majority spiritual tradition in North America and Orthodox practitioners are few. So careful questioning by potential patients, family and clergy of a potential practitioner regarding the practitioner's understanding and respect for the spiritual values of their patients is very important. This course is meant to aid in this inquiry.

It also should be noted that this course is an updating and reworking of a recently published chapter: Psychotherapy with members of Eastern Orthodox Churches, (Morelli, 2014).]

You doctors, must take good care of your patients in order to avoid unpleasant situations. You should have a practical mind. Generally speaking, every one of us must take advantage of his mind which is a gift from God (Saint Paisios of the Holy Mountain)[i]

Considerations in the Psychotherapy for Orthodox Christians

Emotion and Neural Processes

Cognition, emotion and behavior interact with each other in complex ways.

There are currently various psychological models to explain this interaction. One model, based on Darwinian evolutionary theory, is that emotion develops as an adaptive value to a stimulus. From the different laboratories of Izard (1993, 2001, 2002), Plutchik (1984) and Tomkins (1991) come remarkably similar findings on the presence of primary emotions shortly after birth.

These researchers agree on six emotions (fear, anger, joy, disgust, interest and surprise) out of about eight or ten primary emotions. Phylogenetically, these emotions occur before the brain structures supporting cognition initiate development. That is, subcortical brain areas such as the hypothalamus and the limbic system develop before the cerebral cortex.

Researchers have shown that emotional responding in lower animals appears to be an innate reaction to certain stimuli. In human brain architecture, the limbic system and hypothalamus are connected by neural structures to these later developing cortical structures, allowing communication between these two areas. Research on neurophysiological processes and psychopharmacological processes summarized by Izard suggests that these areas serve as the possible neural architecture (subcortical and cortical) pathways of emotion. Early Christians knew nothing of the taxonomy and biological substrates that are understood today. They were limited to the understanding of their times. The word ‘passion’ is the term used by the Church Fathers that most closely describes what today’s scientific investigation calls emotions.

Cognition, Emotion, and Psychospiritual Perspectives

The research literature demonstrating the cognitive elicitation of emotion is ubiquitous. Appraisals, anticipations, attributions, beliefs, construals, inferences, judgments and memories of stimulus situations all fall in the cognitive domain. In one early pivotal study out of Richard Lazarus’ laboratory (1991), appraisal strategies of subjects were manipulated before they viewed a film depicting an aboriginal male puberty rite.

Subjects in a neutral or “intellectualized” condition displayed significantly less emotion as measured by self-report and physiological monitoring than subjects in the “sensitized” condition. Other studies in this area use variations of this paradigm. In recent years, a substantial body of information has been collected on cognitive-emotion interaction. (Bandura, 1986; Erwin, 1980; Galanter, E. 1962; Kahneman, D. 1973; Marmor, J. 1962; Posner & Snyder, 1975; Shriffren, 1988).

Cognition research has also been extended to the behavioral processes of parenting (Patterson, 1976).

Cognitive-Behavioral principles in parenting have been outlined in a series of Smart Parenting articles available at www.orthodoxytoday/archive/morelli.

The question arises, in use of psychospiritual intervention to address emotional disorders, as to what extent cognition plays a role in initiating, sustaining and possibly attenuating emotional responding. If one were to maintain that emotions can be triggered even in humans by subcortical processes, would cognitive processes have any role in their modulation?

This is not a trivial question; it is at the foundation of the various Cognitive therapies and goes to the heart of the moral and spiritual teachings of the Church Fathers. Fundamentally: “To what extent can we control our emotions, or what the Church Fathers refer to as our “passions?” Is it true that emotions generated at more basic systems levels, such as subcortical or neural processes, are less cognitively controllable than cortical (cognitive) processes? To what extent do individual differences play a part in such control processes? In other words, are some individuals able to control the various systems of emotional activation over others?

Inasmuch as we have no comprehensive individual difference model of emotion activation, we must proceed with caution and at best heuristically. Each person should be evaluated individually as to what emotion systems are influencing an emotional reaction as well as the person’s ability to have cognitive control of these systems. Some patients with lower levels of cognitive control may benefit from interventions targeting the neural sensori-motor or affective systems directly (i.e., psychotropic treatment, environmental change) as the primary treatment. Patients with higher levels of cognitive control may benefit from more focused cognitive treatment programs (i.e., Beck’s [1995] Cognitive Therapy: Basics and Beyond). It has been my clinical observation, however, that even patients with limited cognitive resources (with the exception of low-functioning cognitively impaired individuals) benefit from some cognitive interventions. This makes neurophysiological sense if it is remembered that in humans the brain’s subcortical (emotion) and cortical (cognitive) pathways are connected. These findings in no way contradict the teachings of the Church Fathers who point out that man, created in God’s image, has “free will.” However, as the Fathers tell us, any number of factors may diminish the capacity of voluntary-involuntary acts.

REFERENCES

(These references are for the entire course, only a portion are for Part V)

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