The good person out of the good treasure of his heart produces good, and the evil person out of his evil treasure produces evil, for out of the abundance of the heart his mouth speaks. (Luke 6:45, 46)
For the word of God is living and active, sharper than any two-edged sword, piercing to the division of soul and of spirit, of joints and of marrow, and discerning the thoughts and intentions of the heart. (Hebrews 4:12)
When we speak of shepherding, and especially in the biblical counseling world, we focus mainly on the heart. “The heart is the real you. It is the essential core of who you are. The Bible uses heart to describe the inner person. The synonym the Bible most often uses for the inner being is the heart. It encompasses all the other terms and functions used to describe the inner person (spirit, soul, mind, emotions, will, etc.). These other terms to not describe something different from the heart. Rather they are aspects of it, parts or functions of the inner person.”
And while the heart is the basic focus of our counsel, we can never forget other aspects of life that contribute to the behavior and understanding of our counselee.
We are human (physical) beings. So we do not lose heart. Though our outer self is wasting away, our inner self is being renewed day by day. (2 Corinthians 4:16). As I grow older my hearing is not as good as it used to be. As I grow older my eyesight is not as good as it used to be. As I grow older I cannot think quickly on my feet in the ways that I am accustomed to. I used to be athletic. A runner, tennis player, and a volleyball player. But that was only until my knees failed me. As we counsel those in our care, we must remember that there is a physical aspect to our counselee that may be contributing to their issues. It may be as simple as lack of sleep, yet it may be more serious conditions, some chronic, that these dear saints are dealing with.
I have friends who are married and yet quite different than one another. He is from a country outside the United States and she is an American. The way that he was raised in his country is completely different than the way that we raise children here in the US. And so, there is a societal aspect to our thoughts and behavior. I was raised in Southwest Ohio. The culture in Southwest Ohio has no resemblance at all to the culture in Southern California. And so I must help my counselees understand the differences that social and societal traditions play in their thinking and their understanding of problems, issues, and each other.
And then there are the noetic effects of sin. And in addition to the noetic effects of sin, are my personal sin struggles and my battle with sin. I must understand from Romans 5, that my counselee now has peace with God, access to God, assurance from God, is indwelt by God, and is preserved in God. All the while also understanding from Romans 6 that we must know, reckon, and yield our bodies to righteousness and not just present our bodies as instruments for unrighteousness. How does the sin of the fall affect my counselee? How does the sin of others in their lives affect my counselee? And does my counselee even realize that sin makes them stupid?
All of these aspects of life contribute to the thoughts and intentions of the heart, and of a counselee’s thought process and justification of their behavior.
And certainly not least of all, is the fact that all this is taking place under God’s sovereign, providential care.
So, while we certainly understand the importance of defining and revealing themes, idols and issues of the heart, we can never forget other contributing circumstances in the lives of our counselees. This is what makes counseling more than a cookie-cutter ”take two Scriptures and call me in the morning.” This is what makes biblical counseling exciting. It is watching God transform lives in the midst of all these things.
 Paul David Tripp, Instruments in the Redeemer’s Hands, p 59.