Counseling Process

The Gunshot Victim

Stefan Nitzschke
April 9, 2024
5 minute read
Blog
The Gunshot Victim

A gunshot victim is rushed to the hospital, having sustained a single direct hit to the chest. The EMT’s were able to stabilize the patient, but he’s in need of immediate medical attention. He’s received by an oncologist who quickly subjects the man to a battery of lab tests and scans to determine whether he has cancer. Finding what the doctor believes to be a spot on his lungs, the patient is immediately prepped for surgery to excise the cancer.He dies on the table from the gunshot wound.Given the same startling scenario, the gunshot victim is instead received by an ER doctor who rushes the man into surgery to address the chest wound. Fixated on the task-at-hand, the surgeon misses the presence of lung cancer and discharges the patient once he has recovered from surgery.He dies eight months later from the undetected cancer.As hyperbolic as these scenarios may seem, they paint an illustration of what can happen in the counseling room. Stemming from a desire to help men and women in their struggles, we can often overlook their immediate or extended need. One example may be a married couple who comes to you shortly after an instance of a husband’s adultery. What are the extremes to avoid?

Oncology Counseling

As a biblical counselor, the heart is always the target. “What did you do,” necessarily leads to “why did you do it?” This takes quite a bit of labor; after all, “The purpose in a man's heart is like deep water, but a man of understanding will draw it out” (Proverbs 20:5, ESV). But the battery of questions and time-involved labor to draw out the heart may not be the most appropriate activity at first—especially if you’re dealing with a “gunshot victim.”For the fractured married couple, it’s necessary to concentrate your primary attention on the volatility at-hand. One member of the couple has just committed a dire sin against God and his spouse through his adultery (c.f., Hebrews 13:4)—the “why” can wait. The immediate need of the moment is for you to come alongside the offended party, offering up comfort and counsel as she would require. Additionally, he will need to be addressed according to his disposition. Both will need to know what the path towards restoration looks like, tailored specifically to their need.The “oncologist” counselor may not have the necessary focus on the couple’s immediate need. A quick way to lose them would be to sidestep the occasion and aftermath of adultery in order to address on all the underlying issues that may have led to a broken marriage. Like the cancerous gunshot victim, they may succumb to the injuries of the immediate crisis during your medley of examinations.

Surgery Counseling

That’s not to say we ought to lose the forest for the trees. As counselors, we can get so fixated on the need of the moment that we neglect root causes or important matters that are unrelated to their presenting problems. Like the ER surgeon in our illustration, you can be looking for cancer while mending the gunshot wound. Or, to carry the illustration even further, if your counselees are coming in every week with a different bullet hole, it may be a good indicator that you haven’t been looking for the shooter…A good “surgeon” counselor will address the need of the married couple as it pertains to the instance of adultery. He’ll care for the wife in her grief, he’ll address the husband in his sin, and he’ll seek to bring the couple towards reconciliation and healing. But he may then graduate the couple, unaware of her intense bitterness and his enslavement to pornography that will lead them to divorce a short eight months down the road.

All Things

God created each of us differently. If you disciple or formally counsel long enough, you’ll see your area of “specialization” or giftedness. Some counselors are oncologists, able to ask all the right questions to get at root causes. Others are surgeons, gifted in patching up wounds and addressing the need of the moment. And while I recognize the simplicity and absurdity of the medical illustration—each of us are called to be multidisciplinary disciplers.Looking to Paul’s theology, he expected Timothy to utilize God’s Word to serve the full spectrum of those he would have the privilege to shepherd (2 Timothy 4:1-2). He commanded the Christians at Thessalonica to address one another according to the objective disposition of the hearer rather than the subjective gifting of the speaker (2 Thessalonians 5:14). Paul himself sought to be “all things” to all men that he might win some (1 Corinthians 9:19-23).Each of us must joyfully practice the area of gifting given by the Lord—but always with a keen awareness of our weaknesses. When the “gunshot victim” is rushed into our office, we must be the surgeon that mends the wound and the oncologist that roots out the cancer, all the while serving under the Great Physician (Mark 2:17).Photo by Natanael Melchor on Unsplash

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