Interview with Dr. Jay Adams



Last week I had the opportunity to talk with Dr. Jay Adams and Rev. Donn Arms on the telephone about a range of topics. These included the history and present state of biblical counseling, underlying philosophical and theological principles (such as the unity of truth and sanctification), and a mix of methodological and practical questions (including counseling unbelievers and the role of counseling ministries outside of church oversight).

Part one (30 mins) focuses mainly on the biblical counseling movement and foundational ideas.

Part two (19 mins) delves mostly into methodological and practical matters.

A few random observations

  1. If conducting interviews is anything like preaching, I’ll have to do this about 100 more times before I get half good at it! (Have I lowered your expectations sufficiently?)
  2. Dr. Adams has been involved in this area of ministry (as well as many others) for longer than I’ve been alive. So it’s with reluctance that I say the unity of truth problem doesn’t seem to be adequately answered in the interview. Perhaps explains better what I was unable to grasp during our talk.
  3. I believe Dr. Adams’ approach to counseling has strengths that continue to commend it strongly even though there are many (“non-integrationist”) biblical counselors today with slightly different approaches who are doing excellent work. These strengths include the following:
    • A crystal clear understanding of sanctification that leaves believers with no doubt about what they are responsible to do about sin problems in general (provided they are willing to understand what to do)
    • A high view of Scripture and it’s power to speak to the vast majority of problems we tend to think of as counseling issues today
    • A skepticism toward Freudian and post-Freudian (but equally godless) approaches to human nature and problems
    • A firm conviction that sin problems are best handled in a local church context
    • A passionate belief that regeneration (and the blessings that go with it, such as the indwelling Holy Spirit) form the only basis for deep and abiding solutions to sin problems


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Tim Terpstra's picture


Do you sense there is a significant difference in their understanding and presentation of sanctification between Adams and the CCEF guys? Was the idols of the heart question an example of this?

Aaron Blumer's picture


I actually can't remember where I first encountered the "idols of the heart" emphasis so I can't speak to CCEF's connection with it. But either way, I don't think it has all that much to do with folks' official view of sanctification, though it does impact the practice. I do believe there are such things as idols that are not statues ppl bown down to (and NT is sometimes very broad about the "idol" concept... equating in one place with greed, if I remember right).

My only gripe w/the "idols of the the heart" thing is that some want to attribute every single problem to one particular idol or other... and since, as Jay pointed out, there isn't much Scripture to guide that, it breaks down into speculation and very unclear almost mystical language. Wish I had examples handy, but I don't.
I've promised to do an article on sanctification one of these days and dig into it, but not sure when I'll get to it... it just seems that there are a variety of approaches (as opposed to "views") to sanctification these days that make it very difficult for believers to understand what they are supposed to do (some even say there is nothing to "do"). I don't believe the NT is unclear about that at all... and I think sometimes we are taking something easy-to-understand but hard to do and trying to turn it into something hard-to-understand but easier to do (because you can always say "I'm trying" or "I'm making progress" when the goal is extremely vague and mystical).

Ann B.'s picture

Can I share a neat story? My husband's brother, an MD in a town near where Dr. Adams lived at the time, was thrown a surprise party about a dozen years ago for a "big" birthday. We went early to help, and my husband ended up parking cars for over an hour, hiding them behind a neighbor's house, with a really nice man with a beard. When they returned to the house, I enjoyed a brief conversation with the same very friendly and kindly man. Neither one of us asked his name at the time. It wasn't until about a half hour later that we realized that my husband had parked cars for an hour with Jay Adams. We ended up eating near him and his wife at the party, and they were delightful dinner companions. I had read several of Dr. Adams' books - had used them as college textbooks as well - and it was nice to see that in real life he was the "real thing."

Aaron Blumer's picture


Close encounters of the nouthetic kind. Biggrin
I'm not surprised. I found that he is quite emphatic about what he believes but always gracious.

Bob T.'s picture

Jay E. Adams states the following in the book “The Big Umbrella”:

“In this country, because of a prestigious alliance with the A.M.A., a psychiatrist is required to have an M.D. But you will soon agree that Freud was right if you read the articles written by some psychiatrists complaining about the necessity to take medical training that they never use in their work and soon forget. The point is this: there is nothing a psychiatrist does with his medical training that a physician couldn’t do just as well, or better. And the physician could do it in conjunction with a pastoral counselor. The psychiatrist may write prescriptions for tranquilizers or other pills now and then, but a physician does that all of the time. There is no need for a specialty in order to prescribe pills.”
The Big Umbrella, p.6, Presbyterian and Reformed, 1972.

This statement reveals one of the major problems with the Nouthetic counseling philosophy. Psychiatrist is a medical specialty that involves special and continuous training in those aspects of medicine and research that involve the brain and neurology and the various diseases that affect them. In actual practice they have left Freud far behind. They are specialists who through knowledge and research are able to diagnose a cause and when necessary prescribe proper medication. There are now over 70 anti psychotic drugs available. Only the specialist physician (Psychiatrist) can accurately and safely prescribe them. Most all physicians in general or family practice will not get involved in prescribing anti psychotic drugs or treating mental problems. They may prescribe mood elevation drugs in some cases. If you have a serious medical problem you most likely will be referred to a specialist who understands a specific area of medicine. When it comes to genuine mental illness, the general practice physician or Psychologist will not treat the mentally ill without a psychiatrist being involved. It is a medical problem requiring a medical specialist.

This statement by Jay E. Adams appears to indicate a great deal of prejudice against the psychiatrist and very little knowledge of how they practice. It is a statement of monumental ignorance. This foundation assumption regarding psychiatry continues today in the second generation of Nouthetic counselors. They talk of physician referral but not psychiatric referral. They speak of mental illness but then start talking about depression. Depression alone is not mental illness though it may involve a medical cause.

Those who would be classified as genuinely mentally ill can only be properly cared for with the help of psychiatry. The drug prescription medication is almost always needed. With the mentally ill the proper drug is usually the only answer. The Schizophrenic or Bipolar person will suffer delusions, paranoia, and uncontrolled attitudes and moods without proper medication.

Chemical imbalance is today often diagnosed based on medical testing. Brain scans show the differences in function of a normal brain and a brain with chemical imbalances. This is now well established verifiable medical science.

In the interview, the person with J.E. Adams gives three problems with psychology (psychiatry). They are “agenda, diagnostic, and the chicken and the egg.” His statements are filled with errors and serious ignorance of modern psychiatry.

Most mentally ill people are not in the office of the private psychiatrist or psychologist. They also are not attending church even though they may be a Christian. They are being seen by a psychiatrist at the public health centers and are on SSDI or SSI. They are also on Medicaid. They get about 600 to 800 dollars to live on each month and do not have adequate shelter or care. If they have families that care they may have a place to live. They often do not take their medication and become confused. You see them pushing their shopping carts with their belongings. Those who have help and take their medication can often live fairly normal lives. The difference is the modern medicine available for treatment and getting them to take it regularly.

I would recommend that everyone see the movie “The Soloist.” It is a true story and parts of it are filmed at Christian run shelters in Los Angeles that specialize in sheltering the mentally ill. Those of us who have family members who suffer from mental illness and who are caretakers, understand the reality in this film.

Those of us who are caretakers of mentally ill persons view J.E. Adams as a seriously ignorant and dangerous person and training in Nouthetic counseling as a joke. The whole field of Nouthetic counseling as a false intellectual discipline built on contrived reality and selective biblical truth. A degree, usually a D.Min., in Nouthetic counseling is a degree in a made up field that pretends to have answers by ignoring the real problems.

Nouthetic counseling is as integrationist as other approaches to Psychology and counseling. They will use many of the statistics and findings of studies done in clinical Psychology. It seeks to derive a system of truth for counseling from scripture and the impose this system on scripture.

Biblical counseling recognizes the priority of truth is established by scripture and will endeavor to screen all principles and methods that ar expressly contrary to scripture. However, it will recognize and accept that if something is discovered and known from sources other than scripture and is reasonably verifiable as true. All truth is God's truth. No truth can conflict with the truth of scripture that is clear and properly applied.

One truth that is improperly applied here is the concept of the sufficiency of the scriptures. The scriptures are sufficient for the purposes intended. To use both scripture and other disciplines together in gaining an answer to a specific problem does not diminish the scriptures. The scriptures give answers for the soul. They give no instructions in human anatomy or diseases of the body. Man is a living soul and has a body. His soul works with and through the body. If we have a problem with the brain our soul will be effected in the way we express ourselves and behave. Integration of truth is essential to have a proper understanding and arrive at a proper spiritual interpretation of cause and effect.

Nouthetic counseling is a recently derived and invented system that diminshes real bibilical counseling. It was invented out of thin air. It was not part of historic approaches to sanctification or part of historic Fundamentalism. True Fundamentalism seeks to protect the church from dangerous movements. and trends. Nouthetic counseling should be looked upon as being in the same intellectual catagory as the KJVO movement.. It has an improper view of the the application and intent of scripture and has created a dangerous cultic mindset which has an improper view of the relation of Revelatory truth and non revalatory truth. Six day creationism is a clear on the face scriptural teaching. Nouthetic counseling has no such clear scriptures for its foundation principles. Its name and many of the scriptures used are misapplied from the original intent. It was improper to compare this non acceptance of Nouthetic counseling with acceptance and non acceptance of evolution. However, that statement reveals the cultic false epistemology that this system rests upon.

Donn R Arms's picture

I do not believe I have ever met Bob T so I have no way of gauging whether or not his comments about Dr. Adams are intended to be tongue in cheek or not. Either way, he has given SI readers a good example of the kind of vitriol Dr. Adams has attracted for over 40 years. For Bob T, a man who I gather from his posting is somehow invested in the mental health industry, Jay Adams is not a fellow believer and follower of Christ whose views are to be debated and evaluated. Instead, he is “dangerous,” “ignorant,” and “cultic.” His views are “a joke,” “invented out of thin air,” “in the same category as the KJV only movement,” “prejudiced,” “misapplications of Scripture,” and (amazingly) “integrationist.” I am not sure how the ad hominim pejoratives contribute to the discussion.

I thought I had heard all the criticisms of Dr. Adams that could be raised but Bob T presents one that is new to me. He is quite correct that today most psychiatrists “have left Freud far behind.” The quote he posts is from a book Dr. Adams wrote in 1972, a time when Freud was still revered in the psychological world. But for Bob T, Dr. Adams is to be faulted for not being prescient enough to know what the secular psychological landscape would look like 37 years later in 2009. Still, the point Adams made in 1972 is even more true today. Most psychiatrists do not do truly medical work. They prescribe drugs philosophically, not medically.

The term “mental illness” is at best, a metaphor. It is not a reality. The mind is not a biological organ and therefore cannot be “ill.” The brain (a biological organ that can be treated medically) is not the same thing as the mind. In the Scriptures, the terms “mind,” “heart,” and “soul” are used interchangeably to describe the inner person where one thinks and lives before God. We will continue to think long after our brain is buried and decayed.

Donn R Arms

Joseph's picture


A quick philosophical point; you are fallacious in your reasoning about the mind.

Besides the fact that there are Christian non-reductive physicalists (a view I do not support or think well of, but it exists and is cogent), one can be a dualist and still think "mental illness" is a reality. Besides the fact that your point about metaphor is of dubious relevance and meaning (almost everything can be shown to be metaphorical; this is major issue in studies of "metaphor" and the "literal" sense), and the fact that your idea of "illness" is rather reductive, one can still argue that the mind is numerically distinct from the brain yet claim, as any responsible dualist that I know of would (e.g. Alvin Plantinga), that the proper functioning of the brain is a necessary condition for the proper functioning of the mind. Thus, brain functioning corrolates, quite obviously (hence the otherwise inexplicable attraction of reductive physicalism/materialism in neuro-science), with mental functioning.

This point alone indicates the fallaciousness of your reasoning, but beyond this point, one can note the fact that one of the dominant strands of dualism, one based on Aristotelian/Thomistic hylomporphism (the body is the matter that is informed by the mind, which is the form), would also support the idea of mental illness, because this tradition, quite influential in Christianity, argues that though mind and matter are distinct, they are inseparable, at least in this life, and therefore they function together.

It's simply basic ignorance of neuro-science to not acknowledge what everyone knows: that brain states corrolate with incredible precision to "mental states," and even if this erroneously leads some to reduce the latter to the former, it should lead no one to deny the corrolation and inseparability of the two.

Bob T.'s picture

Donn R Arms wrote:
I do not believe I have ever met Bob T so I have no way of gauging whether or not his comments about Dr. Adams are intended to be tongue in cheek or not. Either way, he has given SI readers a good example of the kind of vitriol Dr. Adams has attracted for over 40 years. For Bob T, a man who I gather from his posting is somehow invested in the mental health industry, Jay Adams is not a fellow believer and follower of Christ whose views are to be debated and evaluated. Instead, he is “dangerous,” “ignorant,” and “cultic.” His views are “a joke,” “invented out of thin air,” “in the same category as the KJV only movement,” “prejudiced,” “misapplications of Scripture,” and (amazingly) “integrationist.” I am not sure how the ad hominem pejoratives contribute to the discussion.

I thought I had heard all the criticisms of Dr. Adams that could be raised but Bob T presents one that is new to me. He is quite correct that today most psychiatrists “have left Freud far behind.” The quote he posts is from a book Dr. Adams wrote in 1972, a time when Freud was still revered in the psychological world. But for Bob T, Dr. Adams is to be faulted for not being prescient enough to know what the secular psychological landscape would look like 37 years later in 2009. Still, the point Adams made in 1972 is even more true today. Most psychiatrists do not do truly medical work. They prescribe drugs philosophically, not medically.

The term “mental illness” is at best, a metaphor. It is not a reality. The mind is not a biological organ and therefore cannot be “ill.” The brain (a biological organ that can be treated medically) is not the same thing as the mind. In the Scriptures, the terms “mind,” “heart,” and “soul” are used interchangeably to describe the inner person where one thinks and lives before God. We will continue to think long after our brain is buried and decayed.

First, please note that there are no ad hominum attacks of Jay E. Adams. The attacks are of his ideas and outlook and that of Nouthetic counseling. However your post does involve an ad hominem attack.

Second, as noted by the remarks, and those of his assistant in the interview, his views regarding psychiatry are essentially the same today. Also, this view can also be seen in some of the recent books by second generation Nouthetic counselors. Edward T. Welch and others will talk of physiological causes but then go no further than depression and the over prescribing of drugs. They will mention Schizophrenia or bipolar but never deal with them or other mental illness. Their acquaintance appears to indicate almost no understanding of psychiatric illness (the latest PC label).

Third, I am familiar with the Biblical terms for the soul and would differ that Soul, mind, and spirit are exact synonyms. Man is a living soul. That immaterial soul has a spirit aspect and a mind aspect. However, the term used is not "mind illness" referring to the immaterial aspect of the soul but "mental illness" which refers to the process and result of thinking. It refers to the mental process which involves the mind and the brain and the result. The mind is not able to function properly through the Brain when the organ of the Brain is not functioning properly. The result is "mental illness". It is "mental" and it is "illness" as there is physiological disease involved. The aversion of Nouthetic counseling to this term is most likely due to their agenda. This agenda involves false concepts of the sufficiency of scripture and of epistemology or how we know truth. All truth is God’s truth. However, non revelatory truth can be wrong and therefore non truth. This does not preclude the reasonable verification and acceptance of non revelatory truth. We do this every day of our lives. We repair our automobiles, repair our electronics, and are healed through medical science. All such truth is God's truth. This does not diminish scripture as th priority truth source to which all truth must be compared and that no truth can contradict.

Fourth, my characterization of Nouthetic counseling may seem overly harsh but expresses the true feelings and opinions of many Christians who are caretakers for the mentally ill. Once one is critically confronted with those mentally ill, the ideas and literature of the Nouthetic counseling movement appear as a cruel joke. There is a Christian care center in Grand Rapids, Michigan that focuses on the mentally handicapped or ill. They do not allow Charismatic or Nouthetic oriented Christians to be involved in their ministry. The charismatics cannot differentiate between physiological illness and Demonization. They also want miracle healing on demand. The Nouthetic Counselors have insufficient appreciation of the psychiatric diagnosis and necessity of prescription drugs. They often diminish the need for drugs and this can be dangerous for the mentally ill who are hard to deal with in this matter. Both are extremely dangerous to the well being of the genuinely mentally ill. The Christian care centers in L.A. County are of the same opinion. I heard a Nouthetic counselor who has a regular Radio progrem speak many time overly harshly of anti psychotic drugs and their use. On one occasion he advised a caller who by admission had been under hospital care several times and who did not like taking hes medication to "stop immediatly because this may be your problem. " He was advised to seek Biblical counseling and to "get off drugs." To the care taker, of this person this was dangerous advice. When off of medicine some mentally illness can become dangerous, especially to those close to them.

Fifth, your accusation that psychiatrists do not do medical work, and prescribe drugs philosophically rather than medically, is not what is occurring today. This is the kind of opinion that makes Nouthetic counseling dangerous. This is why most Nouthetic counselors do not refer to Psychiatrists. Only the psychiatrist can deal with the reality of the medical problem that is mental illness. It is the general practitioner Physician who is likely to prescribe a mood drug without proper medical consideration. The psychiatrist gains vast experience in dealing with the mentally ill. The local psychiatrists in the L.A. county mental health dept. see from 8 to 10 seriously mentally ill a day. They can recognize symptoms with little problem. However, they will also order all necessary and pertinent testing. Everyone they see is on disability due to mental illness. These are not just depression or behavior cases. It is estimated that 1% of the adult population has such serious mental illness. This has nothing to do with the kind of problems the Psychologist or Christian counselor deals with.

Sixth, there are many Fundamentalists who are able to fully honor scripture by rejecting that which is contrary but recognize the blessings of truth gained from different intellectual disciplines. Such disciplines as Psychology have a history of many theories that were, and are, contrary to biblical truth. However, the progress of knowledge has still been blessed by many of the findings in this field. Christian counselors with insufficient theological discernment and Biblical commitment can be a problem. True Biblical based counseling is based upon the foundation of a good theological knowledge, practical experience, a willingness to learn from many sources, and a willingness to recognize limitations. Humility should make us thankful for established truth and increased affectiveness in psychiatric medicine. Nouthetic counseling theory and methodology have presumptions that interfere with true biblical counseling and dealing fairly and affectively with genuine mental illness.

Aaron Blumer's picture


I do think Jay sometimes paints with an overly broad brush. But, Bob, you're doing the same sort of thing in dismissing nouthetic counseling entirely and in such over heated terms. Let's look for a few things we agree on.
1. People do sin
2. Many of their problems are due to their sin
3. The Bible specializes in dealing with sin
4. Many of the problems in item 2 are seen today as "belonging" to the fields of psychology and psychiatry and their methods rather than the Bible's

So what's going to happen? Sometimes sin problems will end up medicated or "talk therapied" when what they really require are new birth, knowledge, faith and repentance. For sake of argument, let's suppose that sometimes biblical counselors incorrectly identify items as belonging in #2 when they really have subtle "organic" causes (or at least major contributing factors).
Each of these is going to tread on the others' turf sometimes. And opinions will vary widely has to how often each of these scenarios occurs.
But all who believe the Bible should be able to recognize the truth of 1-3, and anyone paying attention should be able to recognize the truth of #4.
So.. maybe these would form a good place to being a conversation rather than a rant?

rogercarlson's picture

Very Good post Aaron. To add to it, there are many within the psychatric community that are unwilling to deal with the short falls. On more than one occassion, I have referred someone who needed to be hospitalized (they were a danger to themselves or someone else or both). It was clear to everyone (police, EMTs, me) that they were going to hurt themselves or others. They were home withing two hours b/c they talked a good game. In my area that happens often, but I still refer.

Roger Carlson, Pastor
Berean Baptist Church

Bob T.'s picture


My opinions regarding Nouthetic counseling are expressed in terms giving reasons why it is not considered a valid counseling philosophy. I do not believe these would normally be characterized as a rant.

Before Nouthetic counseling was proposed out of thin air, all Biblical counseling recognized your items 1 through 3. Most recognized your item no. 4 in various degrees.

A very serious problem exists within the Nouthetic counseling philosophy. This problem is that all true and genuine mental illness is physiologically based and can only be treated by Psychiatrists. The accepted, and medically effective treatment, is with anti psychotic drugs. Nouthetic counseling simply cannot accept this and in various ways seek to diminish this need of such treatment. In their scenario of the "Chicken and the egg" they even seek to propose that there may be some responsibility upon the mentally ill because they choose their thinking and behavior and this then changes Brain chemistry. This has been the subject of much research and is thoroughly discredited by all legitimately recognized studies. After the fact change does occur in some cases because such conditions as Schizophrenia often continue to deteriorate, especially if medication is not taken regularly. Yet this middle ages philosophy was stated in the interview with you. Nouthetic counseling is based upon defective research, pooled ignorance of those wishing to uphold some sort of Biblical accountability for all behavior, and a paranoid attitude toward culture and society that includes an aversion to science that involves the mind and human behavior. In this respect the anti intellectual tendency toward knowledge by Fundamentalists has produced the embracing of a counseling theory that is dangerous. It is like the mentality of some groups that advocate faith only healing and are against the intervention of medical treatment. In the same way, Nouthetic counseling presents a false anthropological view of man and mental problems. It is defective both philosophically and theologically.

There are two dangers to the historic Fundamentalist ideas. One is the KJVO movement. The other is the Nouthetic counseling movement. Both are built upon pseudo intellectualism and extra biblical dogmatism.

We certainly can agree on items 1 to3 and with some of item 4. However, it is the extra baggage of the Nouthetic counseling movement that is the problem. They have philosophical assumptions that are not only extra biblical, but in the case of their view of th constitution of man, are contrary to scripture. A big step would be their at least being aware of what medical science now knows with regard to the human brain and behavior. It would also be good for them to acknowledge the need to treat mental illness with anti psychotic drugs and being thankful that such drugs are now available. Just 30 years ago the drug treatment picture was severely limited. 50 years ago we had to lock up the mentally ill as the only way of keeping them safe. Nouthetic counselors continually misrepresent the drug prescription treatment picture and the methodology of Psychiatrists. Until they can present knowledgeable and truthful picture of this necessary and effective aspect of medicine they are guilty of negligence based on ignorance and being a stumbling block to the treatment of the mentally ill. We are not talking here about the thousands who receive counseling for various problems. They can be handled by knowledgeable laymen and trained biblical counselors. We are talking about the "mentally ill." Such have physiologically based problems.

I have not painted with broad strokes. I am not giving a rant. I am telling you that thousands of people, many Christians included, deal with mental illness daily. Nouthetic counseling is an enemy to them. Many Christian families with loved ones who are mentally ill look at Nouthetic counseling advocates like those advocating a flat earth. Their Fundamentalist mentality is seen as prjudice based on ignorance.

Nouthetic counseling does not adequately display the love of God and the compassion of the Lord Jesus Christ. This has been stated to me in various ways by both mentally ill Christians and their care takers. How right they are. This is seen even in your interview with Jay E. Adams. They appear to receive those who criticize as persecutors of their stand for biblical truth. In reality they bring turmoil and misunderstanding based on false biblical views to many who suffer and are in need of a truly biblical and Christ like approach to their problems.

Aaron Blumer's picture


Let's try again.
Can we agree that...
1. People are sinners
2. A lot of their problems are the result of their sins
3. The Bible specializes in dealing with the sin problem
I'll skip the fourth point for now since it might muck up the possibility of finding some common ground. Finding the common ground is important here because I think we need to be clear about we disagree with and why... and try to get away from vast sweeping generalities (mostly negative).

I'm pretty sure we agree that everything that is a sin problem should be dealt with as a sin problem and the Bible is the best tool for that... wouldn't we?

Tim Terpstra's picture

Aaron & Bob

Your list (1-3) is where it seems the church lost its way at one point, and the "nouthetic" world is seeking to reclaim to the good of the church. I do think many "Bible believing" churches still chalk most aberant and even sinful behaviors to imbalances and emotional sicknesses, that are simply the long term affects of sin.

Your experiences reflect two things. One is just like the term fundamentalism, those claiming "nouthetic" represent a wide spectrum of beliefs and practices. Sometimes a good idea is practiced imperfectly, thus to some impugning the idea. Your experience is/was real, but my experience with the nouthetic world has been far different, particularly on the compassion side and the medication approach. Most instruction I have been given has emphasized that since we are not doctors, refer any counselee to a doctor and don't attempt to play doctor. Focus on the spiritual issues that are present and leave the physical to those who are trained.

Secondly, the question you have raised seems to deal with severe situations that do bring both medical professionals and the Church to a place of humility and some uncertainty. Obviously, you have experience with a situation that has greatly affected you and those close to you. Even the work of medical professionals in these case does not bring "healing", but may allow someone to exist and live. These drugs may indeed be needed mercies, but to everyone's sorrow they do not result in a return to lasting health.

In my experience, these cases are not the majority of people that are being ministered to in churches. Most who are needing help in the church today do struggle with clear issues of obedience and trust. Some have been under the care of psychiatry and have not received the "therapy" to address the heart struggles that are present. They feel like they have "stabalized" emotionally, but they lack the knowledge and hope to really change their relationships, attitudes, affections, and actions. That is where the nouthetic world is aimed, returning care of the immaterial man to the Church.

Bob T.'s picture


I do not know what your point is? What I have posted has nothing to do with counseling regarding problems that may involve sin. However, it would appear to me that Nouthetic counseling is wrong in many instances in this sphere of counseling. The well taught biblical pastor may be more effective than the trained Nouthetic counselor in dealing with normal counseling problems. Many so called Nouthetic counselors are merely part of a new pseudo profession that has little legitimacy. It is like Chiropractic or Naturopathy is to medicine. We have people running around with doctor degrees that represent questionable course content and philosophy of healing. In this case the healing of the soul.

Mental illness is not a sin caused problem other than being part of the physical curse of the fall as was my two time bout with Cancer. It is a medical problem with necessary medical treatment.

Of course we agree on items 1 through 3 as do all the Evangelical Psychologists that I know of. The Charismatics would also agree as would Wesleyans and Dispensationalists. However, these groups all have a differing view of the sanctification process. Nouthetic counseling is built upon the theology of the Reformed view of sanctification plus other additional concepts.

Aaron Blumer's picture


Well, now we're getting somewhere because now I know what you accept and what you don't... and thus where the beef mostly is: the "Reformed view of sanctification."

The spirit of nouthetic, though, doesn't depend on these things. The spirit of it is "Let's not leave to social scientists and medical doctors what belongs to the Spirit and the Word" coupled with a pretty expansive view of what that includes.
We all have different opinions about where the lines should be drawn in that area, but the using the Bible for all it's worth was the driving force behind the movement. Of course, along that scale of "just how much is the Bible worth in dealing with these things," there are extremes and the differences become major. But anyone passionate about not short-changing the Bible is closer to nouthetic than to most of the alternatives.
But I don't know anybody (besides Jay himself and probably Donn) who agrees with all the details of "nouthetic." Certainly Welch doesn't (I don't think he claims to be "nouthetic" at all, though I could be wrong).

Larry's picture


Mental illness is not a sin caused problem other than being part of the physical curse of the fall as was my two time bout with Cancer.
This is a very overly simplistic and dangerous approach. To pretend to know the cause of mental illness in any case, much less in all cases, is way too high an opinion of one's knowledge. You simply cannot know what causes mental illness in all cases. To say that it is not a "sin caused problem" is the height of naivete. It may not be, but it may be. Just because you have a little knowledge about something doesn't mean you know enough to make these kinds of pontifications. A little knowledge is a dangerous thing, precisely because it is little.

Your view is dangerous in that it ignores the relationship between material and immaterial. There are physical illnesses that are sin-caused and physical illnesses that are not. And sometimes, it isn't even a true physical illness. Sometimes physical symptoms are the result of sinful thought patterns as well as thought patterns that turn into actions.

Your view that mental illness is not sin caused does a great disservice to those who desperately need to be confronted about their sin but instead are given a free pass because it is "mental illness." This type of oversimplification is as dangerous as the kind of oversimplification on the other side.

Alex Guggenheim's picture

Aaron Blumer wrote:
Well, now we're getting somewhere because now I know what you accept and what you don't... and thus where the beef mostly is: the "Reformed view of sanctification."

Wow, after reading rather comprehensively Bob T's comments where the significant portion of his objection and argument (where the beef mostly is) he presented is based in Adam's rejection of true psychiatry and noting that the comment you cited is a singular one of Bob's, it is a bit of a head shaker to read that someone comes away from it believing the somewhat anecdotal reference to the Reformed view of sanctification is where his beef mostly is with Bob. I could be wrong but it appears his beef is mostly with the former (the psychiatric denial by Adams), first and foremost.

Bob T.'s picture

Larry, your post does not deserve a long answer. You need to get beyond your Fundamentalist Bible College education before you accuse someone who is a care taker for a mentally ill person and involved with research on the subject for over 10 years as being naive. I have been involved with this subject in teaching law and in court. Your arrogance is only exceeded by your appearant ignorance. Opinions like yours are exactly why Fundamentalism looks so bad to educated Christians. Why has Fundamentalism lost the younger generation? Look in the mirror.

If you properly define what and who is genuinly mentally ill, then you have a medically based cause. All Schizophrenia and Bipolar and adult autism has been so classified based in many studies. So have other catagories. You can probably still get the Canadian dept. of health study on Schizophrenia online. I do not have the time to find the address for you. Read and learn before you offer opinions!!

Larry's picture



My post deserves more interaction than you are willing to give it. But I understand it is easier just to accuse me of ignorance. First, I don't even have "fundamentalist Bible college education." Second, knowing some things about the issues is enough to offer a contribution. Third, I have dealt with these issues in ministry for a number of years. So I am not sure why you are calling me arrogant.

If you truly are a care taker for a mentally ill person, and if you have truly been involved with research for ten years, then your comments are even more inexcusable. How does someone with that kind of background possibly make the charges you have made? It is inconceivable to anyone with even a cursory knowledge of both mental illness and the Bible. I am not familiar with your caretaking responsibilities, so I won't pretend to pass judgment on that. You, in return, not being familiar with my experience should not pretend to pass judgment on it either. If you want to quit making personal attacks and read what I actually said, then you can offer a congent and coherent response.

I will sum it up for you again.

1. Some mental illness is physiological. No one should dispute that.

2. Not all mental illness has been shown to be physiological or caused by physiology. No one should dispute that.

3. Physiological mental illness has not been shown to be completely disconnected from sin. We know for a fact that much of what is diagnosed as mental illness can be traced to sin based on the diagnostic standards used by psychiatrists. No one should dispute that. Sometimes, sinful habits can bring on physiological changes.

4. It is naive and simplistic to say that all mental illness is physiological. We simply do not know that. Even a cursory reading of the relevant material will bear out the fact that we simply do not always know what causes things like clinical depression. If you read the DSM and compare it to Scripture, you will see very quickly that many of the things they consider as mental illness can in fact be traced directly to spiritual issues. That doesn't mean they all are. But it means that a psychiatrist who does not explore that realm is not dealing with the whole realm of possible contributing factors. He is doing a disservice to his patient not to consider what else might be contributing to the problem.

You don't seem to admit any other possibilities, even though the Bible and human experience gives us plenty of reason to I think your biggest problem revealed here is that you do not show any interaction at all with the interaction of the body and the spirit. The fact is that the human is complex. Spiritual matters, such as sin, do affect the body, and our response to the world around us. You are ignoring that fact.

Take, for instance, clinical depression. Let's assume there are physiological indicators (which, as you know, generally are not tested for). Are those physiological indicators the cause of depression? Or are they the result of depression? You see, that is what psychiatry does not fully interact with. If a person is involved in habitual sin, and they exhibit "clinical depression," we should immediately suspect that the sin habits may be the cause of the clinical depression. Surely even you admit that, don't you?

So, Bob, you may know more than you are saying here, but based on what you have said here (and said previously) you do not demonstrate a good handle on the complexity of these issues.

You have some valid concerns with the nouthetic counseling movement. But you also have some severe problems with your position, at least as you have laid it out here.

Bob T.'s picture


my problem is not with Reformed sanctification here. This is with Nouthetic counseling and is not my problem alone. As J. Adams admits, he has received harsh criticism from many. Much of it has been very specific and has handled the issues better than I have here. It must be understood that most Evangelicals reject Nouthetic counseling. I know several who are very conservative and reject many of the concepts from secular Psychology but also reject Nouthetic counseling. It is a shame that many in Fundamentalism have accepted it. When at a Fundamentalist seminary in the early 1970s we had a class on counseling. However, it was not oriented toward Nouthetic counseling as that was not yet popular. As a "True Grace Dispensationalist" I would not agree completely with the Reformed view of sanctification. However, that is not the focus here at all.

I know you are seeking a common ground on the issues. I appreciate that.

Bob T.'s picture

your reference to the DSM indicates where you stand on these issues. The DSM is used for billing purposes for insurance and government. It provides broad category information and description. It is not a primary or secondary source for information and knowledge as to the state of Psychiatric medicine.

Today we actually have mental illness studies indicating that it is physiologically based. Clinical depression is not part of that classification. It seems like every time Nouthetic counselors talk about mental illness they digress to using depression or clinical depression as some sort of example or excuse. You say that "we simply do not know that all mental illness is physiological." Who is we? Only physiological or medically based mental illness is so classified. You are possibly confusing the fact that Psychologists do not consider all psychological problems, including depression (which some loosely call clinical depression) as physiological. They will endeavor to use "therapy." Some will refer to a Psychiatrist for a prescription. These are usually not classified as "mental illness." The use of Brain scans is now wide spread. Physiological problems are the essence of mental illness within the mental health system.

Your claim for ministry acquaintance with the issues is very interesting to me. Pastors and church staff usually have almost no interaction with real mental illness. All I can say to you is to get the DVD for the movie "The Soloist." You will quickly understand what I am talking about. The subject in this film is typical of mental illness problems. It is a true story. Many caretakers have been through what the reporter in the movie goes through. You do not spend time trying to figure out what sins you can find. You try to keep them on medication and just care and help them move forward and alleviate symptoms. Some will improve if kept on the proper path of medication and later improve their executive functions and possibly work. Some will have symptoms subside in their forties. A Psychiatric nurse at a local hospital was in the mental health system from age 21. She went back to school in her forties and finally obtained her Phd. at age 70. She is still working in the behavioral medicine unit. Schizophrenia shows itself in males in the late teens and early twenties. In females it shows up in the twenties and even starts in the thirties in some. This is when the last 5% of the frontal lobe develops. If a person had the knowledge and experience to diagnose they could often see some odd symptoms in childhood years even though the child functioned mostly normal. When the onset does occur the first symptoms are usually word salad (mixing word order in sentences) and obsession with journaling which may be done with very small writing. The journaling will become increasingly nonsensense sentences. Eventually they may start hearing voices and may reply when alone. These and other onset symptoms are common in all schizophrenia onset. If diagnosed early, progression to more serious problems may be alleviated. However, because of parental and public ignorance most early symptoms are not understood and are over looked. Bipolar has its own set of onset symptoms. Some overlap with Schizophrenia. Studies indicate the causes to be genetic or birth or pregnancy trauma, such as an automobile accident. Studies indicate that twins separated at birth and brought up separately but one becomes Schizophrenic, the other has a 50% chance of also becoming Schizophrenic. These studies, and countless other studies, have given us a vast new resource of understanding regarding the different classifications of mental illness. The Brain is a mystery but we have made progress in understanding and treatment of mental illness. This includes the fact that all that is classified as mental illness has a medical etiology.

I took the time to give the above information so you will understand that much is known about mental illness causes and etiology. If someone wishes to allege that sin may be the cause of the presence of such illness then please show the study information. As you should realize no such studies can really be done. It is after the fact speculation. Also, in light of studies indicating a physical onset such speculation is simply avoiding what we do know.

The genuinely mentally ill deserve our love and care. It is sin to seek to make them accountable based on theories. Some medical experts have indicated that man's attitude and behavior may effect their physiology. However, none indicates that such could have such a severe effect as to initiate, contribute to, or cause actual mental illness. Nouthetic counselors like to use any such statements beyond their context and intent to construct a theory of sin causation. This is soundly rebuked by both secular and Christian behavioral science.

Your statements about mental illness are not accurate, old information of the 1950s to 1970s theories, and not in accordance with sound medical science of today. It is information found in books advocating Nouthetic counseling. Such books are not written by qualified medical science researchers and practitioners.

I have now interacted with you more than I should have . Larry, you need not do the somewhat extensive research I have done in this area as you do not have the motivation I have. Most Pastors do not have the time or necessity to do so. However, you should refrain from giving your opinions which are not based on accurate information and valid sources. I am going to give another post tomorrow in which i will give the ten best and latest books that can be a real help in understanding this subject today.

Larry's picture


Thanks Bob. That’s a start.

First, your title to your post is part of the problem and it indicates that you are not interacting with what I have actually said. I never said anything that could remotely be implied as saying that it was sin or the devil that makes people do things. You need to get past what you think other people are saying and deal with what I am saying. I have intentionally not been dogmatic because I don't know. But you don't either.

With respect to DSM, it is not used only for billing purposes for insurance and government. The APA disagrees with you, according to their website. The DSM is routinely used in legal cases to assert mental illness. It is also used as a diagnostic tool to increase the likelihood that two psychiatrists will diagnose the same person in the same way. So your explanation was simplistic and inaccurate.

With respect to depression, clinical depression or major depressive disorder is a recognized mental illness, and is frequently attributed to physiology. I am sure you know that. But I am sure you know a lot of this and it makes your statements very confusing.

With respect to physiology, as I have said several times, there is no doubt that at least some mental illness is physiological. However, you are failing to interact with the cause/effect relationship. Does the mental illness cause the physiological symptoms or the other way around?

With respect to dealing with mental illness, I can’t speak for other pastors. And I certainly don’t need a movie about it. I have, for the better part of seven years, dealt with it. I have been through the episodes. The whole hearing voices thing, going through strange behavior, major mood swings, etc is all familiar. I could tell some incredible stories. And yes, bipolar people still sin and you have to try to find the sin issues and deal with them. They do need to stay on their meds. But they still have a heart and will still stand before God and give account, and we will stand before God for how we discipled them. The one thing I have been very careful to do is stay out of the medical end of it. I tell him to stay on his meds. He has no choice about that.

With respect to love and care, you cannot biblically love and care for someone without ministering to them in their sin. Ignoring their sin is not “love and care.” It is helping them along the road to damnation. Even mentally ill people still make choices.

Finally, I don’t advocate nouthetic counseling as you speak of it here. Furthermore, you haven’t actually shown anyplace that I have been wrong. You disagree with me, which is fine, but that doesn’t establish who is right and who is wrong.

So Bob, I appreciate the attempt you made here. I find it inadequate to support the charges you have made. I will look forward to seeing further interaction of substance that will help to clarify the issues.

Greg Long's picture

Bob, I understand this is subject that is close to your heart. I agree that sometimes the nouthetic viewpoint goes too far, and that mental illness is a very complicated subject.

But let me make sure I understand you...after decades and decades of theories first being championed and rejected in the areas of psychiatry and psychology, you are 100% sure that NOW they have it right?

I'm looking forward to your reading list. Let me suggest a book for you to read: American Therapy: The Rise of Psychotherapy in the United States by Jonathan Engel. It is not written by a nouthetic counselor but from a completely secular perspective. He shows the complete failure of psychotherapy. He does advocate the use of drugs to a greater or lesser degree in current therapy of mental illness, but his history should be a warning to be so dogmatic about the causes of or solutions to mental illness.

Greg Long, Ed.D. (SBTS)

Pastor of Adult Ministries
Grace Church, Des Moines, IA

Adjunct Instructor
School of Divinity
Liberty University

rogercarlson's picture


You are right that real mental illness can only be taken care of by psychatrists. But, by your own admission that is less than 5% of the population. For the other 95% there are Biblical alternatives (I have had alot of NANC training, but I don't follow the whole model either).

You also said that in some cases they prescribe drugs for depression. I don't know what it is like in Southern California, but here in rural illinois, it is the other way around. In my small church of 40, i have had as many as 10 on a script for depression at a given time. Like I said earlier, that is the common thing to do here.

I refer and I never tell someone to stop taking their meds. I think those who tell people to stop taking there meds are nuts and I would venture that that is a very small minority who would do that. I have dealt with real mental illness before. But not with a family member as you have (I greatly sympathize and have prayed for your family often). I do have a son with regressive autism, but he is getting better. We have been fortunate that he has not had to be on meds, but if it were needed he would have been on medication.

Let me give you a real life story of my other son. When he was in first grade, he started twitching. His teacher noticed it and so did we. It got worse and we took him to the pediatrition. His Dr.'s response was to automatically refer him to a psychiatrist for medication for terets (medication that at the time was not FDA approved for kids, BTW). Before we did that, I took him to a Biblical Counseling Center. Before we went, I had talked to him and knowing him well, I knew he had some mild fear issues. The counselor at the center asked if he had scene a neurologist.

We made an appt with a pediatric neurologist in Chicago. After he examined him, he asked if he had problems with sore throats. We told him that he had strep twice that year. He told us that he needed his tonsils out. There was cutting edge research that showed there was a connection between the chemicals in infected tonsils and mimicking teret like symptoms.

We made an appt with a local ENT DR. We told him what the neurologist said and he agreed and also told us that children who need their tonsils out will often twitch because they are not sleeping well even when they appear healthy.

Within weeks of having his tonsils out, the "tick" disappeared. We were willing to put our son on teret medication if it were necessary. But how many children out there are on psychotropic drugs that are not even approved for minors because they have "terets" when all they need is there tonsils out? I am not saying there are people who have don' terets. What I am saying and what you would agree with is that whenever a recommendation for medication is necessary is that investigation needs to be done.

If I had your opinion of assumming medication was always the answer my son would be on medication for 4 years now and still would have the underlying problem. You accuse Larry of being simplistic and misguided. Bob you seem to be as well. There are MANY who need to be on medication. But there are MANY who do not. People need to investigate before they are put on meds. People need advocates that are seeking the best thing to be done for someone who cannot do it for themselves. Sometimes are needed, sometimes they are not necessary, and other times (like in the case of my son) meds will make the situation worse.

Roger Carlson, Pastor
Berean Baptist Church

Aaron Blumer's picture


There are two major difficulties to discussing these subjects...
1. Personal investment in one view or another
2. Use of terms

As for the first, when someone we are close has had needs that have required us to arrive at some answers and act on them, it's very uncomfortable to consider the possibility that we might not be handling things in the best possible way. This is true regardless if which side of a question you're on. Having had to make some tough choices in that area myself to a degree, I can sympathize. But the more we have personally invested in an idea the less objective we can be about its weaknesses.

As for the second, for many "mental illness" means illness based on brain chemicals. So sometimes the sides of the issue talk past each other because of the lack of shared terminology. So one says "mental illness can be caused by sin" and another says "no way" while simultaneously granting that "many of the problems people have in life are due to sin."
So most of the conflict is--in a way--over what "mental illness" is. And that's very hard to boil down to an essence folks will agree on even in the secular arena. But those who define "mental illness" very broadly in terms of thought and behavior and also define it narrowly in the area of cause (always chemical), are furthest removed from the "nouthetic" approach and--I believe--short changing Scripture (and not helping people as well they might otherwise).
And when "illness" is defined broadly in ref. to behavior, it invariably includes alot of stuff that has not been proven to have chemical causes (though there is much more evidence of chemical correlations) or even really be an "illness" at all.
So it really is necessary to be as precise as possible in defining terms. But not easy.

Larry's picture


So one says "mental illness can be caused by sin" and another says "no way" while simultaneously granting that "many of the problems people have in life are due to sin."
I think we are often presented with false options. The two options are not 'mental illness is be caused by sin" (which I know is not what you said, but it is what some say) and "no way." The options are Mental illness may be caused by sin and mental illness may not be caused by sin. Someone who says, "No way" is (as you say) shortchanging the Bible, and talking well past the limits of medical knowledge. Psychiatry simply cannot identify the causes of mental illness in all cases. The truth is that they cannot even consistently identify mental illness with a given set of physiological symptoms or indicators. They are generally dealing with symptoms, not causes.

So we need to be more cautious about the topic. The dogmatic statements from either side are not helpful, and I think that is what is most frustrating to many. Bob T makes some good points, but in doing so he ignores some other issues, and he makes those points with dogmatism that is not warranted. That is why I say that is simplistic, naive, and dangerous.

Any dealing with the issues of life must include a rigorous spiritual and biblical evaluation. We may find that there are no spiritual issues that we can determmine and thus proceed onto other ways of dealing with things. We may find that there are spiritual issues which must be addressed in conjunction with physical matters. And we may find that addressing spiritual matters is all that is necessary. But we must not rule out an option.

It reminds me of the congressional debate about social security. I remember one democrat saying, "All options are on the table, but we will not allow privatization." Well, that particular Senator is not the brightest bulb because if you take one option off the table (privatization), then all the options are not the table.

In this case, once you deny the possibility of anything spiritual, then you have illegitimate taken one possible explanation off the table. If the situation is truly connected to the spiritual, you have done the patient a gross disservice, and one that has eternal consequences. So let's take this matter more seriously.

Dr. Laura's picture

I practiced psychiatry until my son was diagnosed with autism 18 years ago. I left my practice to direct his treatment program and never returned, because in the interim I discovered biblical counseling. My current ministry includes psychiatrically informed biblical counseling. I've kept up with the psychiatric field and still subscribe to the journals. I like the term "brain disease" better than "mental illness" because today's psychology/psychiatry has muddied the distinction between painful emotional states and real physical illness of the brain. I counsel people with severe brain diseases like Alzheimer's, schizophrenia, autism, psychotic bipolar, and traumatic brain injury, I'm supportive of the use of meds in a variety of circumstances, and I consult with pastors and biblical counselors on their difficult cases. I'm not able to engage in a dialog, and I'm not willing to address every issue that's been brought up in this forum, for reasons of time, but I would like to respond to a few of the assertions that have been made here.

Jay Adams is a brilliant man whose books have done much good, but he is, like all of us, a product of his times. When he first began writing in the late 1960s, psychiatrists were exclusively psychoanalytic. They held to an unbiblical model of personality development, and believed that they could cure everything, including schizophrenia, through talking. His books were directed at this worldview, and he initially spoke more approvingly of psychologists because he received some training in psychology by a university research psychologist (O. Hobart Mowrer). But this was before psychologists in large numbers abandoned university research for clinical practice and took over the same psychotherapeutic ground that psychiatrists later abandoned for the current biomedical model. When he taught biblical counselors to send their counselees to their family doctors instead of psychiatrists for medical screening he was attempting to keep Christians away from psychotherapists espousing unbiblical views, not demonizing psychiatrists. He later had the same problem with psychologists. It was primarily an issue of worldview, not medication use.

Adams left open the possibility that proof of organic causation for some problems could be discovered in the future, and spoke about how we would understand such a development biblically if it should happen--which, of course, it has for brain diseases like schizophrenia. On this subject, I think that he was amazingly prescient, and it's to his credit that his biblical theology was inclusive enough to leave room for this possibility. Overzealous followers asserted that he taught that there was no such thing as schizophrenia and therefore serious brain disease did not really exist, but he never actually said that. His argument was with the label "schizophrenia," not with the potential for existence of conditions that could impair the ability to accurately perceive reality, but many biblical counselors have in the past believed that to be biblical they have to take a "no such thing as schizophrenia and no meds ever" approach.

The biblical counseling movement has been swinging away from this view in recent years. I've had a public ministry for some years now on this subject, and have found unfailingly that biblical counselors are quick to correct their misperceptions about brain diseases when they understand the issues involved more clearly. I encourage biblical counselors to refer those with brain diseases to psychiatrists for medicine, and agree that they are the most competent physicians to prescribe these potentially dangerous medicines. But I also encourage biblical counselors that they can counsel even those who have serious impairments with reality, because even those who are seriously ill also have a sin problem. We can't escape this, since every human being ever born except our Savior is a sinner, and all sinners sin (Romans 3:23). I've found that even very seriously impaired people's function improves when they are in an environment where they are encouraged to take their meds, surrounded by a church community that loves them and holds them accountable, and helped to structure their lives to minimize the kinds of things that work against stability (substance abuse, chaotic living situations, wrong friends, not keeping regular hours, etc). In fact, I'd love to see the church take seriously the deep needs of people who are currently in the community mental health system--not to get them out of it, for many need the free care and practical support it provides, but to supplement it with a much-needed biblical worldview, personal, loving Christian charity and real relationship.

But it's essential to see clearly the distinction between real brain disease and what is referred to as "chemical imbalance." There is much functional brain scanning research linking the brain's chemical status to the thoughts and feelings of experimental subjects. Nobody is arguing with the fact that functional scanning demonstrates the brain's activity when a subject is having thoughts and feelings. But there is not, and cannot be, any research proving that the brain's chemical status arises de novo and produces thoughts and feelings on its own. The belief that it does has to be considered to be religious/philosophical in nature, because it's not possible to determine causation where the immaterial mind is involved. It is possible to experiment on the brain, but it's not possible to delineate via experiments the precise relationship between activity in the immaterial mind and corresponding brain activity. This is not a problem for the many secular psychiatrists who are also materialists, denying the existence of an immaterial mind. But for those of us who want to be biblical, we have to go beyond what the brain is doing to seek to understand how the mind (whose existence the Bible clearly teaches) is involved in cases where physical brain disease is not the primary issue. We also have to insist that even those whose relationship with reality is seriously disordered have thoughts and emotions that are tainted by their sinful nature, and can learn to respond biblically to areas of sin in their lives (as well as learn not to listen to their voices!). But as we do this we need to step very tentatively, understanding that there is much we don't know about the relationship between the physical brain and the nonphysical mind.

Biblical counselors look to biblical anthropology and insist that the mind (soul, spirit, heart) is the source of our thoughts, feelings, and choices. This means that bad feelings, by themselves, do not constitute brain diseases, even though the brain's chemical balance is involved in the expression of those feelings. I don't believe that this means that it's wrong to take medicines for overwhelming feelings. But when people do, they should be aware that what they are doing is suppressing those feelings, not curing them. This is somewhat analogous to what morphine does for the pain of appendicitis--it decreases the pain but does not solve the underlying problem. I've been practicing psychiatry or biblical counseling for about 25 years now, and have not found medicines to be curative in any case by themselves, although they can be a useful adjunct for those who are struggling with very overwhelming emotions, and are essential for those who have true brain diseases, since all we can do for manifestations like voices is to suppress them using medicines.

Biblical counseling is a biblically consistent intervention that gets to the heart of the painful emotions. When I counsel those with brain diseases, I work to get them to understand that they will need to continue to take their medicines to remain stable, as well as teach them how to deal with temptations and struggles in their lives that rise from their sin nature. As they walk in increasing stability, they also begin to understand themselves and their problems better and are able to lead a more normal life. As for those who are not suffering from these devastating diseases, but are struggling with painful emotions, many who begin seeing me while already on medicines over time find them to be no longer necessary because they get to the heart of their struggles. I've also had counselees who don't respond to counseling alone, because they're already in a deep emotional hole by the time they come for counseling. I refer such counselees to a psychiatrist for medicine, and usually find that they do well in counseling with this additional physical support, and later are able to stop the medicines. It should go without saying that when a counselee is considering harm to self or others, I always recommend a trip to the emergency room and hospitalization with medicines, to protect a sufferer when he is too vulnerable to do so for himself.

This is not the only way to slice this pie, and I don't think that you have to see it the way I do to be biblical. This is just the way that I do it. I respect very much the passion that Bob T. brings to this discussion. I am passionate about this topic too, as I have a close relationship with a dear one who has had a very severe case of schizophrenia for almost 20 years, as well as a son who was born with severe autism. But I believe that it's possible to be biomedically informed and biblically consistent at the same time.

I've written books, including one that has a chapter on brain diseases. I want to respect this site's position on advertising my own books, but if you are interested in reading more of my work, you can find me at I'm not available to dialog on this issue because my ministry schedule is busy, but perhaps you'll find my written work helpful in your quest to find your own understanding of the truth on this difficult subject.

Aaron Blumer's picture


Thanks for the post... and it's OK to link to your stuff when it's relevant to a discussion, which it clearly is here.
Your perspective is very interesting on a lot of levels. You don't meet psychiatrists with nouthetic training every day.

rogercarlson's picture

Dr. Hendrickson,
Thank you for posting. I have benefited from your work. When you were in San Antonio a while back, my wife and I wanted to be there. It was right after our son was diagnosed with autism. Your post brings some excellent points and I agree with you comepletely.

Roger Carlson, Pastor
Berean Baptist Church

Bob T.'s picture

Roger, you stated the following concerning my expressed viewpoint:

"If I had your opinion of assumming medication was always the answer my son would be on medication for 4 years now and still would have the underlying problem. You accuse Larry of being simplistic and misguided. Bob you seem to be as well. There are MANY who need to be on medication. But there are MANY who do not. People need to investigate before they are put on meds. People need advocates that are seeking the best thing to be done for someone who cannot do it for themselves. Sometimes are needed, sometimes they are not necessary, and other times (like in the case of my son) meds will make the situation worse."

I do not appear to have made any statements that indicated we should "assume medication is always the answer." I stated that medication was needed for "mental illness." Your son was misdiagnosed by by a pediatrician. But actually it appears he may not have been. He was referred to a psychiatrist for diagnosis but was not taken to one. Another specialist gave a diagnosis which was evidently correct. At any rate, the incidence is not pertinent to the subject of mental illness or medication. No one had yet given a diagnosis or prescribed medication. My posts never indicate we assume medication. I do state that the only remedy for genuine mental illness is medication. But correct diagnosis is necessary.

To others:

Dr. Laura uses the term "Brain disease." I have used the term mental illness as that is the term most common to several venues such as SSDI, SSI, Medicaid, and such groups such as NAMI (National Association of Mental health). However, I appreciate her professional expertise and using the term "Brain disease"probably does away with some confusion. I appreciate Dr. Laura's insight and her perspective on Nouthetic counseling.

I would add that as a pastor, and involved in the Christian community and institutions, I do believe that the J. Adams 1972 perspective on Mental Illness (Brain Disease) is alive and well and still expressed in today's literature from those involved in Nouthetic counseling. The interview on here alludes to this. In the Book "Introduction to Biblical Counseling" edited by John MacArthur, the chapter by John indicates that there may not be such a thing as Schizophrenia and refers to a 23 yr. old Times magazine article. In other chapters the book is still referring to Freud and other prior figures for the purpose of discrediting psychology and psychiatry. It appears to admit to some usefulness but not much. This is a text book currently used at Central Baptist Seminary, Detroit Baptist Seminary, Calvary Baptist Seminary, and Masters College and Seminary. To me this is a very serious problem and discredits those schools.

Let me be clear, I believe in the priority and necessity of Biblical Counseling. However, I view Nouthetic counseling as being a deficient and dangerous form of counseling that is less than biblical. It is also called Biblical Counseling. There are forms of Biblical counseling that give the proper place to scripture but have a more friendly view of the behavior sciences. Dr. Laura appears to be within that framework of Biblical counseling.

The problem within Fundamentalism is that some go to Bible College, Seminary, then to a Doctor of ministry course in Nouthetic counseling. They have never taken the necessary courses in Psychology to be exposed to and gain an understanding of the behavioral sciences. It is like getting a degree in "Creation science" and having never taken the normal courses in Biology and life sciences. We would never accept a Ph. D. degree in Creationism but will accept a PhD in Biology from a person who believes creationism. If you believe and teach nouthetic counseling you should have at least a Masters in Psychology. What is happening is that we are perpetuating ignorance and teaching a form of bi biblical counseling that lacking in needed substance.

It is helpful to have Dr. Laura post on here and give us her perspective. It is certainly helpful.


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