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Psychotherapy and the spirit-in-process: an integration of process theology, pneumatology, and systems psychology.

Systems psychology and Christian theology provide distinctive theoretical lenses for viewing the richness of human experience expressed through intrapersonal, interpersonal, and contextual phenomena. Psychology and theology have been formed, historically, through different methodologies, each shaped by its own epistemology. Also, historically, they have explored and illuminated vastly different areas of human experience, with psychology focusing on the nature of humanity and theology focusing on the nature of God and God's relationship with humanity. When synthesized to focus on a single facet of experience, however, these seemingly orthogonal lenses offer a fuller, more complex understanding of the human condition. Through the integration of theology and psychology, human experiences become psycho-spiritual experiences, imbued with simultaneous immanence (in the biology of humanness) and transcendence (that which harkens to the divine ebb and flow). Such integration provides a multi-layered series of meanings and congruent metaphors that provide a gestalt of explanatory richness in which to consider the Imago Dei.

The intrapersonal, interpersonal, and contextual systems that define a psychological view of human existence are most fully expressed in and through relationship. God, as the eternal thou, is simultaneously apprehended in and through relationship, where each individual is shaped by the "in between" of I-Thou dialogue. Few human relationships reflect both the confluence of multiple systems and God's presence in the I-Thou dialogue more so than the therapeutic process between clinician and client. The aim of this discussion is to seek a renewed understanding of the therapeutic process through a systemic approach to the integration of theological and psychological insights. A systemic approach not only accounts for intrapersonal, interpersonal, and contextual variables, but also integrates psychological data with theological propositions from the Christian tradition. Two theological sources are of particular interest: process theology, with its articulation of God's perpetual invitation to step from the past into the future, and the pneumatology of Jurgen Moltmann, emphasizing the companionate, indwelling presence of the Holy Spirit. Through the integration of these theological propositions with the epistemology of systems psychology, we identify the activity of the Holy Spirit in the midst of the therapeutic process (the Spirit-in-process) at three levels. The Spirit invites a kenotic meeting of client and clinician to form the working alliance, foments an emotionally rich environment in which the corrective emotional experience takes place, and serves as midwife to the genesis of new synapses and neurons in the brain.

Process Theology

Post-enlightenment tensions between those claiming the preeminence of scientific empiricism and those adhering to religious orthodoxy have given rise to a perception that religion and science are in fundamental conflict (Jeeves & Brown, 2009). The tradition of process theology provides an important counterpoint to that perception. Initiated by the work of physicist, mathematician, and philosopher Alfred North Whitehead, process theology aims to reconcile the theological constructs of christianity with the basic tenants of metaphysics (Griffin, 2003).

Whitehead's theology draws on a foundation of Hegelian dialectic, in which tension between opposing forces or propositions leads to a transcendent synthesis (Thoburn & Sexton, 2015). Whitehead proposed that every occasion of human experience is to be viewed as a synthesis of all previous occasions. This proposal can be applied at the atomic level, as quantum theory suggests that all atoms are comprised of the previous history of their subatomic particles (Whitehead, 1925). Whitehead extrapolated the experience of atomic particles to reality itself, suggesting it has an inherent relational nature. Every moment of reality emerges from the relational tension between its preceding moments. Suchoki (1986) described this premise in relation to two merging molecules, one labeled A and the other B. Both A and B have themselves been formed through the previous interaction of atomic particles. When A and B merge with one another, their synthesis requires a process of adaptation. Some of the particles that have formed each molecule are released while others are maintained. Suchoki described this process as "the loss of the former milieu, the death of a former unit" (p. 18) in the interest of what is becoming. Whitehead referred to these dismissed particles as negative prehensions, and the new molecule that takes shape through a harmonizing of A and B he called concrescence (Whitehead, 1929). The new molecule that is formed by a synthesis of A and B will inevitably come into contact with another molecule (C), incur its own negative prehensions, and move towards a new concrescence. For Whitehead and subsequent generations of process theologians, this iterative dance between concrescence and negative prehension represents a divinely constituted process. At the most macroscopic levels, God is constantly inviting the world out of what has been and into this ongoing process of becoming.

Theologians following in the wake of Whitehead's proposals (Cobb & Griffin, 1976; Keller, 2008; Mesle, 1993) have attempted to more explicitly develop process theology in relation to Christian doctrine. Of particular relevance is a process conceptualization of theodicy, the area of theology attempting to explain the existence of evil. Suchoki (1986) identified sin and suffering as emerging from bondage to the past--the steady repetition of what has already taken place. It is this constant cycling of a closed system that prevents movement toward concrescence. Adherence to the status quo is then the essence of sin. one becomes closed off to the possibility of new data, blocking new relational exchanges that lead to life-giving adaptation, in turn impeding the divinely inspired process of becoming (Cobb & Griffin, 1976).

This process conceptualization of theodicy is premised on the assertion that God is made manifest in the invitation to concrescence. Whitehead carefully articulated a God of invitation rather than coercion. He described God as both transcendent (equated with the infinite realm of all possible becoming) and imminent (inherently present in each occasion of concrescence). Where many Christian theologians identify God with omnipotence--power over both what is possible and what occurs--Whitehead and the process tradition locate God's power in the offering of opportunity (Mesle, 1993). In the process tradition, this invitation to becoming finds its truest expression in relationship, as God's invitation to love (Whitehead, 1929). The process notion of theodicy would suggest, however, that God's invitations are necessarily met with a subjective response. At times this leads towards God into deeper relational love; at other times it leads away from God and back into isolation and suffering.

As a school of thought that is explicitly Christian, process theology has also provided proposals for viewing the simultaneous divinity and humanity of Christ. Through the incarnation of Christ, God made manifest in human form the invitation to live in love. As the Emmanuel, God among us, Christ is a physical embodiment of the divine offering of opportunity, the fullest expression of what we might become. Gospel stories of the woman at the well, the calling of the disciples, and the meal with Simon the Pharisee are representations of the divine figure inviting people into new ways of being--new concrescences. Because he is also fully human, Jesus is offered the same divine invitation in each moment of his own life. Mesle (1993) suggests that Jesus' ministry exemplified a continual acceptance of God's call to concrescence, evidenced by stories of love, sensitivity, truthfulness, and transformation. The gospels' declamation of the life of Jesus offers a model of human responsiveness to divine invitation.

Pneumatology

Process theology's emphasis on divine invitation is well complemented by a theology of the Holy Spirit. When placed alongside process theology, the pneumatology described by Jurgen Moltmann (1992) provides a description of the Holy Spirit that is particularly suited for integration with systems psychology. Three elements of Moltmann's pneumatology are relevant: (1) the indwelling nature of the Spirit, (2) the Spirit's presence amidst suffering, and (3) the Spirit as midwife.

In describing historical references to the Holy Spirit, Moltmann highlights references to the Spirit as shekinah. Found most frequently in the Hebrew Bible, these references describe the indwelling of the Spirit at a particular place and time. The word is itself derived from Hebrew terminology for the tabernacle, the literal physical enclosure in which the Israelites believed that God dwelled among them. In a more general sense, however, the shekinah is present whenever the worshipping community gathers. Moltmann points to traditions from the period of Babylonian exile, when the shekinah was thought to have travelled with the people into exile. In Jewish tradition, the notion of shekinah is carried forward to suggest that whenever two or more sit down to study the Torah, the Spirit is present with them (Moltmann, 1992).

The second feature of Moltmann's pneumatology is his emphasis on the Spirit's presence amidst suffering. In the shekinah tradition, the Spirit is present amidst the suffering of the people of Israel. In the New Testament, the Spirit accompanies Jesus from the time of his baptism through his death on the cross. Moltmann references Hebrews 9:14 ("Christ, through the Holy Spirit, offered himself without blemish to God") to suggest that the Holy Spirit was intimately present with Jesus in his suffering. That point is reinforced by Paul's words in Romans 9, that the Spirit intercedes in the midst of suffering with "sighs too deep for words," and by Jesus' prayer on the cross ("Father, into your hands I commend my Spirit," Luke 23:46) as an indication of the Spirit giving witness to his pain. It is important to note, as Moltmann does, that the companionate suffering of the Spirit is different from Jesus himself:
   The Spirit does not suffer in the same
   way, for he is Jesus' strength in suffering ... On
   Golgotha, the Spirit suffers
   the suffering and death of the
   Son, without dying with him (p. 64).


The Spirit accompanies Jesus into his moment of deepest suffering and anticipates what is to come after Jesus' death on the cross. As Moltmann suggests, Christ's death and rebirth are two elements of a single moment guided by the Holy Spirit.

Here we find the third feature of Moltmann's pneumatology, his view of the Spirit as midwife to the resurrection. He points to the use in Christian tradition of metaphors describing the death and resurrection as birth-pangs and birthjoys (respectively) of the Spirit (Moltmann, 1992). The Spirit's companionate presence accompanies Jesus onto the cross and into death, and then is there to usher in new life through the resurrection. This notion of Holy Spirit as midwife is echoed by process theologian Catherine Keller (2008), who links the Spirit with the birth pangs and new beginnings of the early church.

This parallel between Moltmann and Keller suggests the place at which pneumatology might be integrated into process theology. Moltmann's view of the Holy Spirit as indwelling, witness to suffering and loss, and ushering in new life fits well with process theology. Moltmann's pneumatology, when integrated with process theology, allows for an articulation of the functions of the Spirit-in-process. First, the companionate, indwelling presence of the Spirit-in-process invites relationality and synthesis. Through the shekinah, Whitehead's two poles are brought together, and there is an opportunity for concrescence. Second, the Spirit-in-process bears witness to negative prehensions, the suffering and isolation of a closed system, while simultaneously pointing towards resurrection in the form of God's invitation to concrescence. Finally, the Spirit-in-process serves as midwife to the synthesis, facilitating the birth of what becomes new.

The Therapeutic Process

The relationship between client and clinician is inevitably multifactorial and has inspired its own extensive body of research on both process and outcomes (Horvath, Del Re, Fluckiger, & Symonds, 2011). Setting aside for a moment the differences between treatment modalities and variables related to the efficacy of clinical treatment, our focus here is on the relational phenomenology that unfolds between two individuals. To that end, we will integrate the three functions of the Spirit-in-process with three constructs from a systems view of psychotherapy: the working alliance, the corrective emotional experience, and the genesis of new synapses and neurons in the brain.

The Working Alliance

The development of a collaborative relationship between client and clinician is considered vital to the therapeutic process. Because there is strong empirical support to affirm this point (Horvath, et al., 2011), it has been generally accepted across different theoretical models. A systems psychology approach goes a step further to suggest that collaboration hinges on the capacity of both client and clinician to be fully present to the here-and-now relational space (Yalom, 2002).

Carl Roger's construct of congruence further articulates the role of the clinician in shaping the relationship. He described congruence as the clinician's secure sense of self and transparent embodiment of that self, coupled with a willingness to fully encounter the selfhood of the client (Rogers, 1989). Studies operationalizing Roger's construct of congruence indicate at least a medium effect size on therapeutic outcome (Kolden, Klien, Wang, & Austin, 2011). The development of a successful working alliance is premised on an authentic meeting of clinician and client. Buber (1937) articulates a similar view of the relational space in his discussion of the I-Thou relationship. Buber's I-Thou relating is a mutual affirmation of the self and the other, and the relationship itself represents both means and ends. Buber goes so far as to say that one's sense of self emerges out of relationship (Buber, 1937).

For Buber, this relational space is also a sacred space. The meeting of two individuals occasions their meeting with God; it is an invocation of the shekinah, the indwelling of God among us. In the context of psychotherapy, the meeting of clinician and client enacts the presence of the Spirit-in-process. By approaching one another with authenticity and openness, the client and clinician are drawn together into communion with the Holy Spirit. From the standpoint of process theology, the presence of the Spirit also signals the convergence of two occasions, the precondition for concrescence. That an attuned, genuine, and affirming relational context prefigures the divine process of becoming (God's concrescence) is reinforced by Buber's suggestion in his published dialogue with Rogers (Anderson & Cissna, 1997):
   Confirming means ... accepting the
   whole potentiality of the other ... I can
   recognize in him, know in him, the
   person he has been ... created to
   become. I can confirm him in
   myself, and then in him, in relation
   to this potentiality that ... can now be
   developed, can evolve (p. 124).


His words parallel the assertion of process theologians that transformation is made possible through God's foreknowledge of what has been and the divine invitation to become (Whitehead, 1929). Through development of the working alliance, the client and clinician thus invite the Spirit-in-process, and in turn, establish the contextual basis for a process of becoming.

Corrective Emotional Experience once the therapeutic alliance and presence of the Spirit-in-process have established a contextual basis, opportunities emerge for the corrective emotional experience as an interpersonal mechanism for therapeutic change. Through the corrective emotional experience, the clinician provides "a new, more satisfying way of responding to the client's old relationship patterns" (Teyber and McClure, 2011, p. 27).

During psychotherapy, the therapist intently observes for maladaptive behavior patterns and cognitive schemas being used by the client. These patterns of thinking and acting are often developed earlier in life and represented adaptive responses at the time of their genesis (Lamb & Lewis, 2011). As suggested by psychoanalytic literature on parataxic distortion, these previously adaptive patterns become maladaptive when they continue to shape expectations for interpersonal relationships (Shubs, 2008).

Take the example of one who becomes continually closed off and wary of others after suffering through a broken relationship. After ending that relationship, it would have been protective for the person to be more careful about entering into future relationships. Another example can be found in children who become independent and emotionally closed-off after being repeatedly ignored or rejected by caregivers. Their independence represents a protective adaptation to prevent further rejection.

As a person's context changes with time, however, these once-adaptive patterns become maladaptive and begin causing problems. To use the language of process theology, the person becomes imprisoned in a closed system. He or she is unable to make the adaptations necessary to let go of negative prehensions and move towards a new concrescence. The inertia generated by the tendency to recreate the maladaptive emotional climate of childhood obscures God's invitation to become in the present.

The role of the clinician is to work with the client to identify these maladaptive cognitions and behaviors, and when confronted by them, to respond in ways that are more loving and affirming. The clinician must transcend counter-transferences that pull him or her toward a re-enactment of the closed system. Rogers (1989) suggests that if the clinician accepts "the other person as something fixed ... already shaped by his past" (p. 55), then psychotherapy will only serve to confirm that hypothesis. on the other hand, if the clinician meets this other individual as a person who is in the process of becoming, then the suffering of the past is likely to be transcended.

It is important to note that these corrective experiences are necessarily emotional in nature. The clinician invites the client to move beyond self-protective adaptations and into the emotionally painful experiences that lay behind them. Returning to our example of one who has survived a broken relationship, the clinician invites this client to experience what is for them a painful process of opening up to another person. To do so requires becoming vulnerable, reliving the same vulnerability that caused them harm in the past.

Both client and clinician are joined in this interpersonal task by the Spirit-in-process. Moltmann (1992) reminds us that it was the Holy Spirit that accompanied Jesus to Golgotha, joining with him in the suffering of the crucifixion, but not dying with him on the cross. Instead, the Spirit-in-process facilitated the birth of a new concresence--a resurrected Christ. The Spirit-in-process mourns with us what has been and what is lost, while simultaneously urging us toward God's invitation of transformation.

It is the Spirit-in-process that serves to foment these moments of vulnerability and transformation. The Spirit accompanies both client and clinician into these experiences and honors the suffering that is present there, then guides them out of the pain and into new ways of thinking and being. Just as the Spirit was present during the exile of the Jews and the suffering of Christ on the cross, so too is the Spirit present in the Golgotha of psychotherapy. When the clinician, guided by the Spirit, responds to the client's suffering with love and affirmation, a path is laid for the formation of new, more adaptive relational expectations (Teyber & McClure, 2011).

Genesis of New Neurons and Synapses

As a final point of integration, the co-mingling of client, clinician, and Spirit leads to an intrapersonal process within the client. This process is characterized not only by metaphor, but also by literal life, death, and rebirth. Siegel (1999) has suggested that emotion is the gateway to the brain, and at the neuronal level, corrective emotional experiences promote a distinct biological process. In the midst of the therapeutic relationship, a client is brought face to face with her or his affective dysregulation. The vulnerability made possible through the incarnational relational enactment of Christ allows the client to experience affective states that he or she has traditionally repressed because of fears formed by previous experience. Schore (1994) and Siegel (1999) have suggested that these early maladaptive schemas are likely the result of the formation of specific neural networks that store implicit memory. The neuroscience of classical conditioning suggests that these pathways are created when a neutral stimulus (e.g., being emotionally vulnerable with another person) is paired with an aversive stimulus (e.g., rejection) frequently enough to strengthen the synaptic connections between neural circuits that process those stimuli (Lissek, 2012). The phenomenon is summarized by Hebb's axiom that neurons that fire in sequence are structurally linked (Siegel, 1999), and is explained by the neurobiological process of conditioned fear-learning (Lissek, 2012; Liu, et al., 2015). These more theoretical assertions are supported by neuroimaging studies with fear conditioning protocols, demonstrating the strengthening of activated networks through repeated exposure (for a review, see Fullana et al., 2015 or Greco & Liberzon, 2016).

These insights from the field of cognitive neuroscience can be applied, from a theoretical standpoint, to the process of psychotherapy. When a familiar stimulus associated with fear (e.g., emotional vulnerability) is paired with a new environmental response (a more loving and affirming behavior from the clinician), a biological change occurs in the previous pathways. New synaptic connections begin to form between neurons activated by exposure to the familiar stimulus and those activated by positive or satisfying emotional experiences. This phenomenon has been demonstrated in recent neuroimaging studies with PTSD patients (Aupperle et al., 2013; Cisler et al., 2014; Cisler et al., 2016). Changes in neural activation patterns were demonstrated when participants repeatedly re-experienced previously feared stimuli in the safe and supportive context of psychotherapy. over time, these changes in neural activation were associated with diminished fear responses and reduced distress symptomology. Changes in neural circuitry are likely accompanied by a concurrent process of long-term depression, whereby the former synaptic links between the neutral stimulus and the aversive stimulus begin to deteriorate (i.e., extinction; Li, Nair, & Quirk, 2009).

Siegel (1999) proposed that three additional features may aid the development of these new neural pathways during the psychotherapy process. First is the emotional nature of the corrective experience. Research on memory has long demonstrated that the neurobiology involved in learning is aided by emotional arousal (Ventura-Bort et al., 2016). The facilitation of intense, emotionally charged experiences during psychotherapy may thus increase the likelihood that more adaptive relational patterns will be learned. Second, these corrective emotional experiences occur repeatedly over the course of treatment. While one such experience may have some effect on neurochemistry, research with individuals who suffer from social anxiety suggests that exposure to social interactions in the absence of an aversive response from others is most effective when it occurs repeatedly (Hayes, Hope, & Heimberg, 2008). The corrective emotional experience can thus be understood as a process of repeated, emotionally punctuated interactions between client and therapist. Finally, these new neural pathways are likely aided by a process of neurogenesis in the hippocampus. Entirely new neurons are formed in the hippocampus to aid in the encoding of memories (Carlson, 2013), and diminished hippocampal rates of neurogenesis have been associated with psychopathology, while increased rates have been associated with reductions in distress symptomology (Apple, Fonseca, & Kokovay, 2017). As clients encode their therapeutic interactions into long-term memories, new neurons are likely being generated to become part of the resulting, more adaptive neural pathways.

Returning now to the activity of the Spirit-in-process, we see that the theological concepts we have employed previously play out at a literal, intrapersonal level in the brain of the client. Long-term potentiation and long-term depression are biological representations, respectively, of concrescence and negative prehension. The old milieu degenerates and gives way to a new beginning. Closed circuits formed by the past are opened up and given new life. Amidst this process, we see the Spirit as a companion to the death of old synapses and a midwife to the birth of new neurons and synaptic connections.

Conclusion

It is at this final point that we return to the premise with which we began our discussion. Systems psychology and Christian theology represent distinct lenses through which we examine human experience, yet when integrated, they provide a psycho-spiritual lens that is rich in metaphors and explanatory capacity. In this paper, we have indicated the places at which process theology and Jurgen Moltmann's pneumatology might be integrated with systems psychology to seek a renewed understanding of the therapeutic relationship. Process theology offers its paradigm of divine invitation, negative prehensions, concrescence, and sin as imprisonment in the past. Moltmann's pneumatology indicates the indwelling, companionate, and life-giving nature of the Holy Spirit. Together, these theological insights allow for an understanding of the Spirit-in-process. Turning to the therapeutic relationship, this Spirit-in-process is made present in the working alliance when clinician and client meet one another with genuineness and vulnerability, thus fomenting a context that is fertile for change. The Spirit-in-process accompanies both client and clinician into corrective emotional experiences, whereby old relational patterns give way to new interpersonal experiences. Finally, the theological premises that shape our notion of Spirit-in-process are made manifest at the level of intrapersonal biology via the neural processes that underlie therapeutic change.

Stepping back, we see that this integration of systems psychology and theology allows for a richer analysis of the therapeutic relationship. It offers a view that is simultaneously imminent--exploring mechanisms that underlie individual transformation--and transcendent, linking these transformations to the divine ebb and flow of a universe in process.

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Sam Rennebohm

John Thoburn

Seattle Pacific University

Correspondence regarding this article should be addressed to John Thoburn, Ph.D., ABPP, Professor, Department of Clinical Psychology, Seattle Pacific University, 3307 Third Ave. West, Seattle, WA 98119; thoburn@spu.edu

Samuel B. Rennebohm, M.Div, is a doctoral student in clinical psychology at Seattle Pacific University. His research interests are in the area of family psychology, with a particular focus on stress and well being in dyadic relationships. He holds an M.Div from The Pacific School of Religion and has spent time working as a parish minister and hospital chaplain.

John W. Thoburn, Ph.D., is Professor of Clinical Psychology at Seattle Pacific University. He is a licensed psychologist and licensed marriage and family therapist in the State of Washington and is Board Certified in couple and family psychology by the American Board of Professional Psychology. Dr. Thoburn is co-author of Family Psychology: Theory, Research and Practice published by Praeger Press and co-editor of the book Clergy Sexual Misconduct: A Systems Approach to Prevention, Intervention and oversight.
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