Glendon MORIARTY, Pastoral Care of Depression: Helping Clients Heal Their Relationship With God. Binghamton, NY: Haworth Pastoral Press, 2006. pp. 220. paper, $22.95. ISBN 13: 978-0-7890-2383-4.
Reviewed by Jean LANDES & Nathan KOLLAR, St. John Fisher College, Rochester, NY 14618.

This book would help ministers counseling depressed people who have a deep sense of God as an all powerful, omnipresent, all knowing God. Moriarty presents his material in a clear, engaging, and recipe-like manner. If you are a certified/ licensed mental health professional or educated in psychology, much of this is repetitious. If you have theological training, you will find the author concentrating on Christian Evangelical religious presuppositions while, at times, providing reference to more main line types of rituals and theology.

He begins with the standard set of symptoms provided by the Diagnostic and Statistical Manual of Mental Disorders as found in DSM-IV-TR, APA, 2000. But quickly states that he will be dealing with adults and those types of depression resulting from personality development and situational circumstances. This statement is important, because the use of drugs will be avoided throughout the text.

The author claims that depressed adults are people who cognitively but not emotionally understand their faith. The “cognitive” image of God is one of a God who is loving, full of wisdom, and strong. The depressed’s emotional sense of God, however, is of a God who is overly judgmental and demanding perfection in all we do. The result is that the depressed’s emotional understanding of God is causative of continual guilt, shame, worthlessness, fear of rejection, and a demanding desire to be perfect. This emotional sense of God he titles a “God Image.” One’s God image develops early in one’s life and is greatly influenced by one’s parents. The book deals with changing the God image of the depressed adult.

Moriarty carefully reviews most current counseling theories and settles on psychodynamic psychotherapy and cognitive therapy as his chosen methods for helping depressed adults. In settling on them he provides the reader with step by step procedures for their usage in modifying the God image. He also provides “how to chapters” on the therapeutic relationship and assessing the God image.

He reminds the reader of a number of very important things: 1) those counseling the depressed must be aware of their own image of God as well as how it developed in their lives; 2) there is little scientific basis for the theories of God image even though there is sufficient professional experience that witnesses to both its existence and the methods for changing it; 3) professionals must recognize their limits and refer their client when they do not believe in God’s existence or do not have the mental health skills to provide the therapeutic environment to bringing about a healthy God image; and, 4) one must be aware of and strictly adhere to the ethical norms involved in this type of counseling. These are: Do not impose your beliefs on the client; do not offer it as a scientific cure for all of the person’s mental health problems; do not do this if you are not competent; do not offer religious interventions when other medical and/or psychological treatments are needed, and clearly distinguish between the real God and the God image.

Readers will have to make their own decision as to how much trust they place in a non-scientific approach to mental health practices. Perhaps, too, that same decision must be made dealing with the view of God presented here because it presupposes a personal God who acts in one’s life constantly, minutely, sensitive to our every thought, action, and desire.

It is amazing how, with very few modifications in diagnosis, language, and therapy, the entire world view and actions consequent upon a false God image that is presented here is similar to what old Catholic spiritual directors called scrupulosity. For example, an ancient, 1920, manual of Roman Catholic spirituality suggests that feelings of guilt, shame, rejection, and worthlessness before an unmerciful God may easily be destructive of a healthy relationship with God. It suggests, too, that the confessor be sensitive to the penitent and build trust with the individual so that the “cure” of complete obedience (cognitive therapy?) can be applied. It even speaks of depression resulting from misguided scrupulosity.

What the author deals with is not something new. The methods may be helpful within the proper context and with clients adhering to the mental health professional’s theological presuppositions. If you deal with those who experience this type of God and if you have the professional training to help them, this would be a helpful book.

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