Mental Health Problem or Sin Problem? Wait—Can’t It Be Both?
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Problems in our behavior can be both mental health problems and “sin problems.” Part of the confusion on the topic of mental health among conservative evangelicals and fundamentalists is the assumption that a life problem has to be one or the other.
Consider a physical health analogy: Suppose I lose a leg in an accident. Because it’s a lot harder to walk now, I lay on the couch excessively, experience a lot of unhealthy weight gain, and neglect important duties.
I started with a health problem and developed a sin problem. The two are interconnected yet have distinct features.
Suppose I start to have financial and relationship problems due to my excessive idleness. I decide to get help. I go to a pastor who says, “You have a sin problem. Repent and change your habits.” That doesn’t sound fun, so I also go to a medical doctor who says, “We can get you a better prosthesis. After some physical therapy, walking will be less painful and this will help you be more active.”
That doesn’t really sound fun either, but hopefully I still take both sets of advice.
It would be tragic if, instead …
- The pastor said, “The prosthesis industry is a sham. They’re all just trying to get people addicted to gadgets to make money for Big Gadget. You just need to deal with your sin.” Then I took that advice.
Or… - The doctor (prosthetist) said “No, your problems are 100% due to your pain. Leave religion and sin out of it.” Then I took that advice.
In light of eternity, one of these bad choices is worse than the other, but they’re both bad choices—because with physical health problems we don’t have to have either a medical problem or a sin problem. We can easily have both.
These are also not the choices with mental health. We can be mentally or emotionally messed up and also have sin problems that are related—related as results, or as causes.
Body, Mind & Sin in All Directions
This is where the dynamic gets more interesting. Let’s alter the analogy. Suppose, rather than losing my leg in an accident and then becoming overly indolent, I’m a lazy couch potato for years, lose my leg partly as a result, then become even more sedentary.
Mental illness might usually be more like that. Setting aside for the moment how my laziness would lose me a leg, let’s just say it did. (It’s a thought experiment, so we can do that!) How does that help us understand how sin and “therapy” work together?
We know from Scripture that sin has negative impacts on physical health, as well as on attitudes and feelings. I think few would dispute this, but here’s a few examples.
Many are the sorrows of the wicked, but steadfast love surrounds the one who trusts in the Lord. (Ps 32:10)
The wicked flee when no one pursues, but the righteous are bold as a lion. (Pr 28:1)
For the love of money is a root of all kinds of evils. It is through this craving that some have wandered away from the faith and pierced themselves with many pangs. (1 Ti 6:10)
A tranquil heart gives life to the flesh, but envy makes the bones rot. (Pr 14:30)
We could also note interesting narrative examples of sin leading to emotional and physical health problems. But the Bible also describes times where things worked in the other direction, emotional or physical states contributing to sin.
- Moses, in anger, strikes the rock (Num 20:10-11).
- Saul, in fear, offers the sacrifice (1 Sam 13:11-13).
- Esau, hungry, swaps the birthright (Gen 25:32-34).
- Hezekiah, sick and sorrowful, neglects (probably) his duties (2 Kings 20:1-3).
Scripture reveals that, as embodied spiritual creatures, our thinking, emotions, spiritual state, and behavior are all intertwined. Probably nobody reading this would take the position that all physical maladies are the result of personal sin. But sometimes they are. For the most part, we can easily see this.
So, with physical ailments in relation to sin, we allow adverbs:
- Partially
- Indirectly
- Sometimes
When we start talking about mental illness, though, many seem to become suddenly adverbless. To them, a problem has to be all one thing or all another thing—and this leads to extreme statements like those uttered by John MacArthur recently, and many before him.
Let’s return to the analogy/thought experiment. Because I have a laziness problem, I lose my leg. My behavior then worsens. I develop even lazier habits, with increasing harms—and also increasing pressure to continue down that path. As I gain weight and my muscles atrophy, physical activity becomes harder and harder. Maybe I develop depression as well.
I decide to get help. A pastor correctly helps me see that I got myself into this mess through my sinful choices. He, again correctly, advises me to repent and start being a better steward of my health.
I do that … but I’ve still only got one good leg and a lot of pain.
Enter the question of the sufficiency of Scripture!
The Sufficiency of Scripture
I deeply appreciate the concern for biblical sufficiency that drives many to take a hostile stance toward mental health. To the degree that concern drives them, they are acting for the best of reasons. And the potential for conflict between the biblical view of the human person vs. the perspective and instructions of a mental health therapist is real. Sometimes they really do come into conflict.
We need to ground the question of sufficiency better, though. Let’s give it more context.
(1) The same Bible that claims to be sufficient for life and godliness (2 Pet 1:3) also teaches us that body, mind, and behavior all interact, and contribute help or harm to our pursuits of right or wrong behavior. We are not upholding the sufficiency of Scripture if we take some of what it says and distort it to cancel out something else it says.
(2) Nobody thinks that physical healthcare and repentance are mutually exclusive. Returning to my thought experiment, nobody thinks I have to …
- either repent of my laziness
- or get a better leg prosthesis.
I can do both.
This might be a better example: If I wreck my liver because of drunkenness, I can do both of these things:
- Stop getting drunk.
- Get a liver transplant.
One does not prevent the other.
So, why do so many assume a person can’t receive mental health therapy (maybe even joining the less than 20% who take medication) and also repent of sins that led to the problem or result from the problem? If I’m struggling with clinical depression, I may or may not have sinned my way into that condition. I may or may not sin because of that condition.
But let’s say both are true. I can certainly repent, start obeying God, and also get help from a therapist. I might do the sin-correcting and also acquire the mental health equivalent of a prosthesis.
Arguments applying the sufficiency of Scripture to exclude any kind of help outside the Bible are errors of scope. If the problems we’re talking about are not exclusively spiritual, we should not expect their solutions to be exclusively spiritual.
Two things ought to be clear by now in the mental health vs. sin debate.
- Rejecting all mental health studies and therapies does not flow directly and simply from a high view of the sufficiency of Scripture.
- We cannot assume that repentance and treatment are mutually exclusive responses to problems.
Aaron Blumer 2016 Bio
Aaron Blumer is a Michigan native and graduate of Bob Jones University and Central Baptist Theological Seminary (Plymouth, MN). He and his family live in small-town western Wisconsin, not far from where he pastored for thirteen years. In his full time job, he is content manager for a law-enforcement digital library service. (Views expressed are the author's own and not his employer's, church's, etc.)
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JD,
Great thoughts. Mental health issues are a spectrum of items that impact us. Some are controllable and some are not. Some are sin and some are not. For the first 52 years of my life, I never really understood what mental health issues were. I equated them to sin struggles. I viewed them as things that we can control. Scripture tells us that we need to control our thoughts. Year and a half ago tragedy struck me and I experienced mental health issues, and it changed my entire perspective. In the last 18 months, I have met Christians from all walks of life experiencing similar issues. I have met pastors in our circle and Christian leaders that I went to school with at Christian colleges that are struggling with similar issues. And what I have learned is that I had it all wrong, and much of the teaching I have had, had it all wrong, and most churches have had it all wrong. Mental Health issues is not some sort of thing that people need to get over. It has taught me so much about God. It has drawn me closer to Him like never before. It has also taught me the complexity of the issue and the inadequacy of always trying to deal with it solely as a spiritual issue. There is oftentimes aspects that need to be addressed by competent professionals. I have met people in church dealing with issues and they receive simplistic, often trite direction. And the church could do so much more. There are people suffering every day in our services, there are pastors struggling every second they stand in the pulpit preaching, and there are kids struggling our our church classes just to wake up each day, and we miss the signs, because we view mental health issues as some type of fraud perpetuated on us by the medical community, or we if we do see an issue we tell people to just get over it, or pray harder, or tell them that the reason they are suffering is because of some form of sin. It is sad. Scripture is not silent on it, but we miss it.
Although I understand that the church could "do more," I do not think the answer is for the pastors to get intense training in mental health. There are so many things that pastors could get trained in that would be a benefit to their congregations, but our primary focus should be in the word and prayer. Then we should have the humility to realize that our congregations could also benefit from others as well. I am thankful for the surgeons and chiropractors that have helped the people that I also minister to. I sometimes fear that our focus on training pastors in counseling has made some think that there is no need to refer people to someone who can address it from a different perspective.
A lot of good points a long the way. In some cases, we’re saying the same/very similar things with differences in how we prefer to say it or differences in emphasis.
This is not accurate. The Bible does recognize and describe certain mental illnesses as mental illness. For example, the Bible describes the divinely caused mental illness of King Nebuchadnezzer (Dan. 4:28-37). David faked mental illness in the presence of Achish, and he was described as “insane” and a “madman” (1 Sam. 21:12-15). As I mentioned before, Matt 4:24 is translated “seizures,” but this word is literally “to be moonstruck” or insane. Paul, in his argument, likens himself to a “madman” (2 Cor. 11:23). The word Paul uses here is used in Greek literature to refer to someone who is insane.
On this, I just wanted to clarify that when I said “mental health disorder” is a modern category, I meant that exact term is a modern term… but also there is unique content in the term. It is not the precise equivalent of the Bible’s words for madness.
(Edit: Also the catalog of disorders is quite new… as in, less than a century.)
So, yes, madness exists in the Bible and people described in that language in Hebrew and Greek would very likely be described as having a “mental health disorder” in today’s lingo.
But “disorder” is relatively new language. It looks like probably 20th century (https://bcmj.org/mds-be/historical-perspectives-theories-diagnosis-and-…).
Increasingly, though, I’m seeing the term “mental health conditions,” which I take to be an intentionally more vague category. In my not-exhaustively-informed opinion, “more vague” is good with these things. It’s more honest. There is usually more that we don’t know than that we do know.
Fortunately, you can love and help people without having them all figured out!
Edit to add: I think that touches on what is really the worst aspect of both the “anti-‘mental illness’ ” camp and the mental health sector: When we think we have someone all figured out, we’re often rushing to judgment and not really staying attentive and focused on helping with what’s happening right now. And that’s bad regardless of which point of the ‘attitudes toward mental health’ spectrum you’re on.
Views expressed are always my own and not my employer's, my church's, my family's, my neighbors', or my pets'. The house plants have authorized me to speak for them, however, and they always agree with me.
Condition vs disorder is a good point. I just found this article at the Gospel Coalition today that fits well with our discussion. It may be worth listing it as a separate filing.
The FAQs: Thinking Biblically About Neurodivergence (thegospelcoalition.org)
But “disorder” is relatively new language. It looks like probably 20th century (https://bcmj.org/mds-be/historical-perspectives-theories-diagnosis-and-…).
Increasingly, though, I’m seeing the term “mental health conditions,” which I take to be an intentionally more vague category. In my not-exhaustively-informed opinion, “more vague” is good with these things. It’s more honest. There is usually more that we don’t know than that we do know.
In my not-exhaustively-informed opinion, we have more "mental health conditions" today because we as a society are softer and more fragile than previous generations and past cultures. Today, people are easily traumatized and are emotionally weak. If someone yells at them at work, they sue because of emotional distress and a hostile work environment.
When I study history, particularly the history of ancient Greece and Rome, I come away shaking my head when I then read about people today who claim to be victims of micro-aggressions, oppression, emotional abuse, etc. They would not last long in ancient Sparta or Rome. In fact, they wouldn't last long on the 19th-Century American frontier.
"What?!?! The chuck wagon doesn't serve latte?"
I've listened to various interviews of student protestors at the different college campuses. These students are claiming mental health conditions because of their treatment by the school administration and the police. I'm left with this observation: Our culture is growing weaker and more fragile with every passing generation.
In my not-exhaustively-informed opinion, we have more “mental health conditions” today because we as a society are softer and more fragile than previous generations and past cultures. Today, people are easily traumatized and are emotionally weak.
I see a mix of being weaker and being more caring. You can look at the old days of “being a man = being John Wayne” and definitely see tradeoffs. Jesus openly cried on multiple occasions. He was not what we used to identify as being “emotionally tough.”
As for workplaces, I’ve worked in plenty of uncaring, “you are just a cog in the machine, so turn on time” environments. Some of them had emotionally abusive leaders. If it’s not OK for me to be emotionally hurt why is OK for someone in power to be emotionally injurious? They are both weakness of a sort. One is less ethical than the other.
There is a difficulty balance between being people who care about others, join them in their struggles, try to be supportive, vs. being coddling and encouraging weakness.
I don’t have any solution, but I think it’s not obvious that a colder and tougher culture is better than a warmer and softer one.
Maybe if we have to go to war we find out colder and tougher would have been better. In the mean time, there are worse things than an excess of gentleness toward each other’s pains.
If we have the luxury of being a more sensitive and supportive people, why not go ahead and be more sensitive?
The fact that we have cars makes us all weaker at walking, but I’m not sure we should give up cars to solve that problem. So, again… tradeoffs.
I’m biased, I’ll admit. I’ve never been anybody’s idea of tough, so I’ve never valued that.
Views expressed are always my own and not my employer's, my church's, my family's, my neighbors', or my pets'. The house plants have authorized me to speak for them, however, and they always agree with me.
I see a mix of being weaker and being more caring. You can look at the old days of “being a man = being John Wayne” and definitely see tradeoffs. Jesus openly cried on multiple occasions. He was not what we used to identify as being “emotionally tough.”
You can be both caring and "emotionally tough." The things that Jesus experienced and saw during his earthly ministry would cause most people today to crawl up in the fetal position and suck their thumb.
Think about what the apostle Paul experienced during his ministry (2 Cor. 11:23-29). Yet, he was still caring and affectionate toward others.
I think it comes down to expectations about life. Those who are brought up expecting hardship, suffering, and struggle are better able to cope with the unfairness, trauma, loss, pain, and hurt that life brings. Those who are brought up expecting people to value them, praise them, appreciate them, and listen to them turn into emotional trainwrecks when things don't go their way. This leads to greater stress, emotional trauma, depression, suicidal ideation, etc. They also view those who do see the world more harshly and respond accordingly as "toxic."
It's not about air conditioning or driving cars; it's about one's life expectations and experiences. I think there is something helpful in embracing aspects of stoicism.
case in point: A retired hog farmer in my church told me that growing up on the farm he used to butcher hogs every year. When he and his wife had daughters, they had them involved in the process as well. However, today, they would never have their grandchildren participate in butchering hogs because the grandchildren couldn't handle it emotionally.
Good points.
I got to thinking more on it later and there is definitely “good tough” and “bad tough.” We often think of the cold leader who dishes out harsh criticism as “tough,” but he’s actually weak. He can’t govern his emotions strategically or use wisdom on how to motivate subordinates.
Maybe “good tough” relates to “What does it take to stop me?” You can be ‘sensitive,’ even ‘emotional,’ but absolutely refuse to be thwarted by that in achieving what you know you should achieve. That’s “tough,” though it might not look like it to some.
I’m not prepared to make generalizations about whole generations on good vs bad toughness, though. Isn’t an excess of caving in to adversity kind of inherent in being young? It’s immaturity and can persist with age, but immaturity is appropriate when you’re young.
But is there an excess use of mental health by youth who have been pampered and think every little pain is a mental health crisis? There’s some evidence for that. Ironically, though, sometimes the mental health provider is helping them realize that every little thing is, in fact, not a mental health crisis, so… I’m sure sometimes it compensating for bad parenting.
But who parents well in every way and all the time?
Views expressed are always my own and not my employer's, my church's, my family's, my neighbors', or my pets'. The house plants have authorized me to speak for them, however, and they always agree with me.
Was doing some thinking about Tom's comments about whether it's helpful if one expects things to be a struggle at times, and the comment "it's not about air conditioning..." got to me.
Now certainly he's correct that it's not primarily about air conditioning, or really about any one factor, but at the same time, what's being said when we say "if you think it's going to be a struggle, you'll be better off" is that one is developing the ability to cope.
And this goes both ways. At one level, those little struggles--trying to figure out how to survive at 100F without AC, algebra class, whatever--both teach coping strategies and reinforce the lesson "this life is going to be a struggle at times." If you never have a reason to struggle, the lesson "this life is going to be a struggle" is going to be ignored. If you never learn to cope, obviously your coping skills are going to be less.
There is a portion of this that can be taught in a classroom or from the pulpit, and there is a much bigger portion, IMO, that is taught by doing difficult things and learning those life lessons. So while I don't advocate giving up air conditioning altogether--especially if you're driving through Death Valley--I do think there's a great case to be made for strategic use of difficulty to create robustness.
(side note; I did drive through Death Valley without AC once, 114 in the shade at 10pm....let's just say it involved a lot of water to drink and no bathroom breaks needed!)
Aspiring to be a stick in the mud.
There is a portion of this that can be taught in a classroom or from the pulpit, and there is a much bigger portion, IMO, that is taught by doing difficult things and learning those life lessons. So while I don't advocate giving up air conditioning altogether--especially if you're driving through Death Valley--I do think there's a great case to be made for strategic use of difficulty to create robustness.
I've read my share of "how to be a man" blogs in the past several years. Some are garbage. Some are helpful. But, one of the recurring themes I've noticed is that men need to reject passivity, accept responsibility, lead courageously, and serve humbly in the face of adversity and setback. Teddy Roosevelt is often cited and admired in this regard.
Today, many children are taught just the opposite. In fact, most adversity, challenge, and setback are purposely removed from a child's upbringing. Children become adults unprepared to face real and significant adversity and setback. They are emotionally unable to cope with it because they never learned how. Instead, they find comfort and consolation in becoming victims and in finding communities who will support their victimhood.
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