Stetzer: "Mental illness is not a subject Christians should run from."

"In our churches today, we often feel like we can’t talk about our problems." Infographic: The Christian Struggle with Mental Illness

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Aaron Blumer's picture

EditorAdmin

Part of the struggle is discerning the extent of the spiritual issue with mental health. How much is physiological and how much is spiritual ? Is mental illness a punishment for sin or a natural illness?

The first question is a very very good one. The second one is simultaneously a false choice and a false disjunction. There are many other ways for sin to be involved other than "a punishment"... but on that point, there is no reason why a particular case couldn't be both "natural illness" and some sort of punishment.

Some subtle strawmanning there? He doesn't mention the biblical counseling movement, but it seems to be in the crosshairs. While not agreeing entirely, I can sympathize. I have encountered a fair amount unhelpful oversimplification in the movement... but the alternatives I've seen are certainly not reliably better!

The kernel of truth is that there is generally not a culture of openness about problems in churches, in what I've been able to observe directly and indirectly. How to fix that I really don't know . . . though I have been blessed to be in congregations where it does not seem to be a problem. I'm just not sure how that was achieved.

Bert Perry's picture

I've got multiple relatives who've been on various drugs from Lithium to Prozac, and we've seen quite a bit.  The brother in law who was basically in a vegetative state while his mania was controlled, but always gave a clear sign he was going manic that the counselors always missed.  Millions in care for him and nobody figured out his cue was buying and selling cars.  The sister in law (his wife) who was also bipolar and the best the same basic group of helpers could do was to keep things in check.  The helper from her church whose help managed to get him into divorce court, and others who "helped" themselves to her possessions.  The counselor who did destroy my stepdad's first marriage and nearly destroyed his relationship with his daughter.  The counselor who, while counseling both my brother and I and our parents, missed the fact that what was bugging my brother and I was the state of our parents' marriage at the time and tried to tell me that I was guilty over "self-pleasuring"--something I wasn't aware of at the time, nor did I know the meaning of that big word.  

Let's just say that as far as I'm concerned, all parties have a LOT of improvement available, since my family's experience parallels the treatment Santa got in "Miracle on 34th St."  And the article?  Well, he's obviously taken sides already and made some assumptions that he's not totally open about, as Aaron notes.

Aspiring to be a stick in the mud.

Mark_Smith's picture

Let's say you wanted to preach a sermon on mental illness as the article suggests. What verse of Scripture would you start out with as a clear example of mental illness in the Bible?

 

What does that tell us?

Bert Perry's picture

Remember when David goes before Achish with drool in his beard?  He wasn't insane, but he knew how to play the part.  Then you've got Acts 26:24, where Festus tells Paul his great learning has made him mad.  

You could also make a case for Romans 1, where refusal to acknowledge God leads people to believe all kinds of things are normal and healthy.    Probably a bunch more of that type--oh, and remember Nebuchadnezzar in the book of Daniel?

Aspiring to be a stick in the mud.

Mark_Smith's picture

I don't consider Festus' comment having anything to do with mental illness.

David--- he pretended to be insane. OK. How do take that and preach about mental illness?

As for Nebuchadnessar, that was spiritual, not mental. At least in my opinion.

 

So, nuts.

Bert Perry's picture

Mark--agreed fully that neither Paul nor David were actually mad.  However, the way Festus and Achish talked does indicate that they were familiar with cases where the mind just wasn't working right, just as Paul refers to in Romans 1, and just as is described in Daniel--and a bunch of other places.

Moreover, I'd suggest that you hit it right on the money when you comment that Nebuchadnezzar's insanity was spiritual.  Closer to today, a psychiatrist named Miriam Grossman became famous (or infamous if you're on the left) by noting that most of the young ladies she was treating for depression at her employer--UCLA I believe--were ones who had not that long ago decided to become promiscuous.  Now did these young ladies have a mental problem, or a sin/spiritual problem?  My answer is "yes".  Remember that the root word of "psychology" is "psyche", or...."soul".  So did Nebuchadnezzar have a mental problem or a spiritual problem?  Again, yes.  God in His goodness allowed Nebuchadnezzar's sin of pride to be manifested as infirmity of mind.  

Which is a long way of saying that you are entirely correct that it is not easy to figure out anything about mental illness from the Scriptures, but if we're willing to do a little more work than just prooftexting, we're likely to figure some things out.

Aspiring to be a stick in the mud.

jimcarwest's picture

We could start by correctly defining this term "mental illness."  It is a misnomer that has  been created by psychologists and counselors who do not ascribe to the biblical viewpoint of man.  So-called "mental illness" does not exist, unless one is referring to some physical anomaly in the central nervous system. If this is the correct definition, then as other illnesses, it should be treated as a medical pathology.   The biblical view would be more aligned with the term "emotional problems or disturbances."  These find their explanation as spiritual problems, and to be healed, they respond primarily to spiritual therapies.  Biblical counselors understand this and therefore provide the best treatment for long-term care and healing.  Sorry to bust the bubble of those who may trace their roots to Sigmund Freud.

 

Aaron Blumer's picture

EditorAdmin

There have been a couple of unhelpful reactions to the Freudian revolution. 

  1. A generation of pastors (with exceptions of course) pretty much surrendered all the persistent personal problems/anything labled "mental illness" to the mental health professionals
  2. A later generation decided that Freud and everyone associated with him must be wrong about absolutely everything

So I would agree that "mental illness" needs defining. This is the whole problem really. The biblical counseling movement, since early Jay Adams days, has upheld an "organic" escape clause, to avoid completely rejecting the mental illness concept. More recent iterations seem to be a bit more accommodating in tone, but last I knew, there was not really strong work out there on the boundary between sin issues/spiritual issues vs. what is in a more mental health professionals' sort of category.

Of course, the ever broadening definition of "mental illness" from that direction (DSM IV, DSM V) hasn't helped the situation. But not all the professionals buy into that--by a long shot.

The fact of the matter is that we don't really have a clear idea of how the spirit and body and brain and chemical physiology of the body interact. The mind-body question is a very, very old one. Scripture clearly indicates that they are linked in both directions. Body influences attitude/"emotions," thoughts, and actions (e.g. Ps. 104:14-15, 1 Kings 19:3-7). And actions/thoughts/emotions influence the body (e.g. Prov. 16:24, 17:22, 15:30).

What we really need is a new collaboration between people with a high view of Scripture who will not surrender to the perceived authority of the social sciences but who will also not dismiss the social sciences from the equation. On the other end of the collaboration, we need a generation of Christian mental health professionals with a high view of Scripture who are determined to do everything possible spiritually to help clients and submit the findings of the social sciences to the authority of Scripture, but making use of what may be helpful.

It's far to easy to be dismissive either of spiritual concerns or of the social sciences. But the right road in this matter is not an easy one.

By the way, Scripture does indicate that the heart can be "sick" and this is not a reference to an "organic" condition.

e.g.

Pr 13:12 NKJV 12 Hope deferred makes the heart sick, But when the desire comes, it is a tree of life.

Nonphysical illness of the mind is a biblical category and any anthropology that rejects this is defective.

Joel Shaffer's picture

So Jim, do you believe that schizophrenia or Bipolar disorder are physical anomalies in the central nervous system?  In your opinion, is it ok for these people who have been diagnosed with mental illness  to take psychotropic drugs to deal with these problems?   I ask these questions because for several years I used to work for a Christian ministry called Servants Center that ministered to the mentally ill homeless.  In my many encounters with this population of people, I met a guy that used to wash his hands with his own urine, another man who believed he received secret messages from the CIA through a cup that he would place against walls, another man who wore about 20 hats (even in the summer) because he felt that his brain would fall out of his head, another person who thought he could communicate telapathically with little people who lived in computers, and the list goes on.  In most of these cases, once he were able to get them to trust us, provide some housing and get them on their proper medications for their mental illnesses, they stopped having these hallucinations and became much more stable.  We were also dealing with other issues as well.  A few of them were alcoholics and some had other sin issues in their lives, but the combination of discipleship and counseling along with connecting them to psychiatrist for their meds, and connecting them with housing was the best way to help them.  

Aaron Blumer's picture

EditorAdmin

I think we who already have a high view of Scripture and a healthy skepticism for the social sciences have to start out with a presumptive respect for mental health professionals.

So how I see that working is case by case, but I think pastors can work more with these professionals than is often assumed. Navigating the privacy issues is a significant barrier, and I'm not a HIPAA expert. But there are ways for patients to authorize their "spiritual leaders/clergy/etc." to have information about their cases and interact w/the professionals they're working with to coordinate.

Your question makes some assumptions: that the categories represented by these diagnoses are valid. I'm not prepared to say they are or say they are not. But the DSM is a slowly evolving document, and not everybody thinks all that highly of it even in the professional world. So... I can't answer the question because (a) I don't have enough info about the specific cases and (b) I'm not sure the criteria for these diagnoses is entirely compatible with a biblical view of human nature.... and a few other reasons I'm sure I'll think of later. Smile

My attitude/experience though is that DSM & related perspectives don't generally try to account for spiritual realities one way or the other. They just don't go there. They are not actively denying them, but recognize that they have no tools for dealing with them or figuring out how they relate to where the observable stuff begins. The social sciences work with controlled studies, collected data, precedent, hypothesis and so on. And try to generalize from that.

I'm sure some of the pro's are rabidly anti-Christian and anti-religion in general. I have talked with several (and read several others) who are not of that mindset at all. They want to help people, and usually welcome the participation of other leaders in the lives of "patients" to some degree.

I believe that in many cases medication is helpful. But even the pros, contrary to common stereotypes/strawmen, acknowledge that the efficacy of meds is widely disparate. Some seem to improve quite a bit, many only a little, many not all, and some get worse. This is all documented in the studies they publish. There may be some vocal (and ignorant ...or extremely optimistic) zealots here and there who talk like the social sciences are going to fix everything, but this attitude is far more common among those outside the profession (media types and movie stars and pop lit. writers). The people who do research... well, making grandiose promises is not their style.

Also, the well informed acknowledge that success rates are .... not stellar.

jimcarwest's picture

So would anyone like to provide a proper definition of "mental illness"?  Is the term intended to define a pathology of the central nervous system?  Or does it intend to refer to the multitudes of emotional problems that people have developed as a result of poor parenting, enslaving habits, deviant behavior, drug abuse, sexual abuse, and a host of other expressions of the sin nature and its consequences?  If the brain is injured, undeveloped from birth, or damaged by accident or through repeated mal-nutrition, then we are dealing with a real physical malady.  In such cases, medication and surgery and diet may offer some promise of treatment to alleviate the resulting suffering.  If we are applying the term "mental illness" to the multitudes of bad behaviors that are the result of sin against God and against others, it is mal-practice to attempt to remedy these character flaws and deficiencies in a way that does not deal with the divine/human relationship.  The early tendency among Christian psychologists was to defer to the medical model, but experience showed that real healing of spiritual problems was not actually possible in this way.  It was like applying a skin salve to an internal illness.  This is not to deny that there is a spiritual/physical interaction that is going on in all of us.  Attitudes affect physical responses, and physical illnesses may influence spiritual attitudes.  It is essential to delineate, however, between the two.  The secular social sciences and medicine have generally discounted the role of the spiritual.  The field of biblical counseling has brought some balance to this study.

 

jimcarwest's picture

There is reason to believe that the disorders of Bipolar and schizophrenia may have a root in deficiencies in the central nervous system.  Certain nutrients may be lacking that throw things into disarray.  Sometimes a better diet may affect behavior.  Eg. a study was done in prisons which divided the population between those who ate the normal diet, which was high in sugar, and a corresponding group that had sugar content reduced considerably.  Definite behavioral and attitudinal differences were noticeable.  In the same study, it was determined that criminal behavior was related to hypoglycemia -- low blood sugar.  In extreme cases, where returning the body to physical homeostasis, drugs have proven helpful.  The tendency, however, is simply to prescribe drugs universally.  My own experience stems from a family member who was diagnosed as Bipolar.  Psychiatrists in different cities put him on a variety of psychotropic medications, some of which had suicide as a side effect.  What was never addressed was the deep sorrow and shock that came from his mother's suicide (who was also on the same drugs), and the sad result was his taking his own life after four or five years of these drugs.  The problem he was dealing with was beyond the reach of medications.

 

jimcarwest's picture

Aaron Blumer wrote:

I think we who already have a high view of Scripture and a healthy skepticism for the social sciences have to start out with a presumptive respect for mental health professionals.

So how I see that working is case by case, but I think pastors can work more with these professionals than is often assumed. Navigating the privacy issues is a significant barrier, and I'm not a HIPAA expert. But there are ways for patients to authorize their "spiritual leaders/clergy/etc." to have information about their cases and interact w/the professionals they're working with to coordinate.

Your question makes some assumptions: that the categories represented by these diagnoses are valid. I'm not prepared to say they are or say they are not. But the DSM is a slowly evolving document, and not everybody thinks all that highly of it even in the professional world. So... I can't answer the question because (a) I don't have enough info about the specific cases and (b) I'm not sure the criteria for these diagnoses is entirely compatible with a biblical view of human nature.... and a few other reasons I'm sure I'll think of later. Smile

 

Wouldn't it be nice if some of those secular health professionals at least acknowledged the spiritual role in counseling also?

 

My attitude/experience though is that DSM & related perspectives don't generally try to account for spiritual realities one way or the other. They just don't go there. They are not actively denying them, but recognize that they have no tools for dealing with them or figuring out how they relate to where the observable stuff begins. The social sciences work with controlled studies, collected data, precedent, hypothesis and so on. And try to generalize from that.

I'm sure some of the pro's are rabidly anti-Christian and anti-religion in general. I have talked with several (and read several others) who are not of that mindset at all. They want to help people, and usually welcome the participation of other leaders in the lives of "patients" to some degree.

I believe that in many cases medication is helpful. But even the pros, contrary to common stereotypes/strawmen, acknowledge that the efficacy of meds is widely disparate. Some seem to improve quite a bit, many only a little, many not all, and some get worse. This is all documented in the studies they publish. There may be some vocal (and ignorant ...or extremely optimistic) zealots here and there who talk like the social sciences are going to fix everything, but this attitude is far more common among those outside the profession (media types and movie stars and pop lit. writers). The people who do research... well, making grandiose promises is not their style.

Also, the well informed acknowledge that success rates are .... not stellar.

Aaron Blumer's picture

EditorAdmin

jimcarwest wrote:

So would anyone like to provide a proper definition of "mental illness"?  Is the term intended to define a pathology of the central nervous system?  Or does it intend to refer to the multitudes of emotional problems that people have developed as a result of poor parenting, enslaving habits, deviant behavior, drug abuse, sexual abuse, and a host of other expressions of the sin nature and its consequences?  If the brain is injured, undeveloped from birth, or damaged by accident or through repeated mal-nutrition, then we are dealing with a real physical malady.  In such cases, medication and surgery and diet may offer some promise of treatment to alleviate the resulting suffering.  If we are applying the term "mental illness" to the multitudes of bad behaviors that are the result of sin against God and against others, it is mal-practice to attempt to remedy these character flaws and deficiencies in a way that does not deal with the divine/human relationship.  The early tendency among Christian psychologists was to defer to the medical model, but experience showed that real healing of spiritual problems was not actually possible in this way.  It was like applying a skin salve to an internal illness.  This is not to deny that there is a spiritual/physical interaction that is going on in all of us.  Attitudes affect physical responses, and physical illnesses may influence spiritual attitudes.  It is essential to delineate, however, between the two.  The secular social sciences and medicine have generally discounted the role of the spiritual.  The field of biblical counseling has brought some balance to this study.

I don't have a good answer for that.

I was thinking I probably need to qualify or contradict something I said earlier on the definition of mental illness. I described it as 'ever expanding' but I'm not sure that's fair. What the Diagnostic and Statistical Manual of Mental Disorders (DSM) has increasingly done is expand the number of named "disorders." But it's probably popular misunderstanding that equates these with "mental illness." It might be fairer to say it's a capitulation to their inability to define mental illness. Rather than classifying these as "illnesses" they prefer to term them "disorders."

Which is fair enough.

They may be on the right track. Through a biblical lens, we know everybody is messed up spiritually due to sinful nature, the Fall, etc. We also know that being sinners and living among sinners results in all sorts of collateral damage, so to speak. Or, shall we say, collateral "disorder."

The social/psychological/psychiatric world is limited by its nature to categories like healthy vs. unhealthy, constructive vs. destructive, and the like. As Christians we are more interested in the category of right vs. wrong and true vs. false. But these categories overlap a good bit more than we often seem to recognize. Shouldn't we expect, given what is revealed in Scripture, that people who do wrong or have a lot of wrong done to them (and deal with it as sinners do), also behave in ways that correlate strongly with the categories of "unhealthy" and "destructive"?

The twist is that a social science world that is mostly godless and lacking any transcendent moral authority will frequently err in its view of what is "healthy" and "constructive." But not always, by a long shot. Because they are committed to observation and fact gathering, reality has a way of often butting in on faulty views of what's healthy/constructive. The data, though ultimately not enough to penetrate fallen minds and force truth on those hostile to it, does provide checks and balances on the whole system.

I mean, you don't have to be a Bible believing Christian to understand that behavior that gets you rejected by everybody you try to make friends with is unhealthy.... or behavior that makes you unemployable, unable to sustain a marriage, unable to raise stable and independent children, etc.... We would expect that the kinds of thought processes and behaviors that are destructive/unhealthy in these ways also correlate strongly with what the Bible reveals to be sinful attitudes and actions.

So, no, the social sciences are not going to start talking about sin (LOL). But they know a lot about what doesn't work and it's no coincidence that sinful patterns also don't work too well. A good bit of the time, a person who learn to relate to people in "more healthy" ways, would also, if born again, be relating to people in ways that are less sinful.

Back to the definition question: Maybe we should give up on that entirely. I mean, as a thought experiment, what if we just imagine that everybody is "disordered" in varying degrees and ways and people need help to deal with it in morally right as well as "healthy" and "constructive" ways?

So maybe I agree with the "mental illness is a myth" folks more than I thought, but for entirely different reasons.

All I know for sure at this point is that I'm (1) not equipped to precisely define mental illness and (2) I can't really see any way it would help if I could.

Aaron Blumer's picture

EditorAdmin

I'll just throw this out there as an admittedly not-even-half baked idea....

If we suppose that we are generally not going to know if folks we're helping are afflicted with chemical/brain or other sorts of damage, what if we strive to help with them with an assumption of damage/disease?

What I mean is, what does that really change? If so and so can't seem to get along with his spouse or hold a job or stay away from drugs etc., how do I help him if he is "sick" vs. not?

What if I assume that he is damaged in various ways, maybe some of them physical and hereditary, maybe some of them "psychic" or whatever, and take it as biblically as possible from there?

It's really not an extreme assumption, given what we know biblically: we live in a cursed world, body affects spirit and spirit affects body, tendencies toward particular failures can be multigenerational... and probably other truths that are relevant.

  1. Where we run into trouble is with trying to think about how much blame/responsibility belongs to the individual and how much repentance is called for. I'm assuming a believer here, to simplify the issue for the time being.
  2. The second issue we run into is ability: how capable is he of thinking and behaving differently?

Now I'll hazard to say this much for the social sciences: they are not really interested in intentionally lifting responsibility from people for how they behave. The reason they're not is that this has practical consequences: a person who blames his choices on incapacity or on other people is powerless to behave any better. He has put the solutions beyond his own grasp. To put it another way, responsibility and ability tend to correlate. (With exceptions.)

So, while the social sciences would tend to place less responsibility on people in general than a biblical view does, it's not inherently anti-responsibility. It's just pretty disadvantaged by not accepting revealed information as a starting point. But get this: to an extent, they have the same dilemma we do as biblical disciplers: they want to figure out what a person is capable of changing and make the most of that, while not really knowing what is unalterable or not their fault.

But back to my "what if"

What if we assume our counselees/friends/whatever are damaged in various ways, had alot of help getting as messed up as they are, and have at least some limitations that they cannot overcome? Where does that lead in how we biblically help them?

As an analogy, if a guy can't run well because he has only one leg, all the counsel in the world won't make him run better. What if he has an invisible emotional/mental missing limb? This is not as far fetched as some seem to suggest. We all know people have widely varying cognitive abilities/intelligence. We know some folks can't ever in a million years learn to spell well--their brains are not wired that way. Some can't see colors--or can't perceive the differences between them. Some can't remember the meaning of a multisyllabic word, no matter how motivated they are. In dealing with children who have not fully developed, we know they can't abstract very well, no matter how hard they might try (though they really have no idea what abstracting even is). And we know that some never grow out of that.

People are damaged. And they are sinners. They are not one or the other. We have to deal with that reality in how we approach helping them.

(so I guess I don't really think it's half baked, as you can see!)

jimcarwest's picture

Aaron Blumer wrote:

 

jimcarwest wrote:

 

So would anyone like to provide a proper definition of "mental illness"?  Is the term intended to define a pathology of the central nervous system?  Or does it intend to refer to the multitudes of emotional problems that people have developed as a result of poor parenting, enslaving habits, deviant behavior, drug abuse, sexual abuse, and a host of other expressions of the sin nature and its consequences?  If the brain is injured, undeveloped from birth, or damaged by accident or through repeated mal-nutrition, then we are dealing with a real physical malady.  In such cases, medication and surgery and diet may offer some promise of treatment to alleviate the resulting suffering.  If we are applying the term "mental illness" to the multitudes of bad behaviors that are the result of sin against God and against others, it is mal-practice to attempt to remedy these character flaws and deficiencies in a way that does not deal with the divine/human relationship.  The early tendency among Christian psychologists was to defer to the medical model, but experience showed that real healing of spiritual problems was not actually possible in this way.  It was like applying a skin salve to an internal illness.  This is not to deny that there is a spiritual/physical interaction that is going on in all of us.  Attitudes affect physical responses, and physical illnesses may influence spiritual attitudes.  It is essential to delineate, however, between the two.  The secular social sciences and medicine have generally discounted the role of the spiritual.  The field of biblical counseling has brought some balance to this study.

 

 

I don't have a good answer for that.

I was thinking I probably need to qualify or contradict something I said earlier on the definition of mental illness. I described it as 'ever expanding' but I'm not sure that's fair. What the Diagnostic and Statistical Manual of Mental Disorders (DSM) has increasingly done is expand the number of named "disorders." But it's probably popular misunderstanding that equates these with "mental illness." It might be fairer to say it's a capitulation to their inability to define mental illness. Rather than classifying these as "illnesses" they prefer to term them "disorders."

Which is fair enough.

They may be on the right track. Through a biblical lens, we know everybody is messed up spiritually due to sinful nature, the Fall, etc. We also know that being sinners and living among sinners results in all sorts of collateral damage, so to speak. Or, shall we say, collateral "disorder."

The social/psychological/psychiatric world is limited by its nature to categories like healthy vs. unhealthy, constructive vs. destructive, and the like. As Christians we are more interested in the category of right vs. wrong and true vs. false. But these categories overlap a good bit more than we often seem to recognize. Shouldn't we expect, given what is revealed in Scripture, that people who do wrong or have a lot of wrong done to them (and deal with it as sinners do), also behave in ways that correlate strongly with the categories of "unhealthy" and "destructive"?

The twist is that a social science world that is mostly godless and lacking any transcendent moral authority will frequently err in its view of what is "healthy" and "constructive." But not always, by a long shot. Because they are committed to observation and fact gathering, reality has a way of often butting in on faulty views of what's healthy/constructive. The data, though ultimately not enough to penetrate fallen minds and force truth on those hostile to it, does provide checks and balances on the whole system.

I mean, you don't have to be a Bible believing Christian to understand that behavior that gets you rejected by everybody you try to make friends with is unhealthy.... or behavior that makes you unemployable, unable to sustain a marriage, unable to raise stable and independent children, etc.... We would expect that the kinds of thought processes and behaviors that are destructive/unhealthy in these ways also correlate strongly with what the Bible reveals to be sinful attitudes and actions.

So, no, the social sciences are not going to start talking about sin (LOL). But they know a lot about what doesn't work and it's no coincidence that sinful patterns also don't work too well. A good bit of the time, a person who learn to relate to people in "more healthy" ways, would also, if born again, be relating to people in ways that are less sinful.

Back to the definition question: Maybe we should give up on that entirely. I mean, as a thought experiment, what if we just imagine that everybody is "disordered" in varying degrees and ways and people need help to deal with it in morally right as well as "healthy" and "constructive" ways?

So maybe I agree with the "mental illness is a myth" folks more than I thought, but for entirely different reasons.

All I know for sure at this point is that I'm (1) not equipped to precisely define mental illness and (2) I can't really see any way it would help if I could.

 

I think the main point of this series of posts stemmed from the subject of "mental illness" and how to address it.  If we move to the larger sphere of "the social sciences," we include counseling, sociology, psychology, and psychiatric therapy.  Generally, for quite some time now these modalities have pursued a philosophy that ignored God, diminished personal responsibility and denied guilt, practiced blame-shifting, and rejected the biblical view of man.  

It has always been the practice of wise, spiritual counselors to rule out physical causes for aberrant behavior.  Every good counselor addresses the possible physiological causes that might explain these behaviors or disorders, often requiring a medical examination to inform the counselor of the current state of health of the counselee.  These physiological causes fall within the term "mental health" in a constructive manner.  It is when no physiological reason for wrong behavior can be found that biblical counselors examine the individual with regard to wrong, sinful, and/or misguided conduct, i.e. a sin issue.  The counselee may be suffering from the hurt/damage caused by the sinful behavior of others, but it may also include sinful responses found in the counselee that, when addressed, hold promise for healing and restoration.  It is wrong to denominate such sinful behavior with the term "mental illness."  If that is the case, then all of use are a little bit sick.  In reality, we are all sinful, and that is a different thing.

The so-called social sciences tend to discount the spiritual element in behavioral disorders because they do not accept the biblical view of man.  For them, disorders have primarily a physiological or a sociological cause which therapy and medical treatment (psycho-tropic drugs, shock treatment, hospital internment, and other therapies/modalities offer the best hope of treatment.  

Given the historic development of psycho-therapy and the social sciences in the secular world, it appears that never the twain shall meet between biblical counseling and the social sciences.  

jimcarwest's picture

 

God never asks us to do what we are wholly incapable of doing.  But for anyone to assume that a normally functioning individual cannot deal with his own responsibility for wrongdoing or for sinful responses to wrongdoing would be to let a person "off the hook" spiritually.  It would exempt him from the need for repentance, for forgiving, for trusting God for strength to overcome hurts, etc. A person who has received damage to his central nervous system that produces a corresponding physical impairment could not be held responsible to take the biblical actions for healing.  These examples, however, are rare.  In most cases of counseling, the individual possesses the ability to follow counsel if he so chooses.  In these cases, it is his own sinful heart that refuses to accept God's remedy for healing.

Aaron Blumer's picture

EditorAdmin

I think I would agree that we can't assume specifics like "This person is incapable of overcoming this specific problem." I wouldn't take the assumption of damage that direction. Rather, my inclination has been to assume that everybody is broken in some ways that are not going to be fixed this side of glory, and I don't really know what those ways are.

So the assumption is that a person can change/adapt/ajdust/grow, but also that we don't know what barriers are insurmountable and what ones aren't. So assume each barrier is a conquerable one until it proves otherwise... and even then, we only shift our efforts in a direction that seems more fruitful.

To me, it's just like raising kids. I don't know much of what I see is a hard wired limitation vs. how much is "just haven't grown yet" in that area. We often (usually? always?) can't really tell. So what do you do as a parent? You prioritize a bit, and you encourage progress where you can and when you run into something seemingly unmovable, you redirect efforts in some other direction and maybe try again later.

Maybe that helps a bit with the spirit of what I'm trying to say.

But I do think that we who want to be as biblical as we possibly can in helping people do also need to get over our aversion to solving practical life problems. I have more thinking to do about this topic and then maybe put something organized together, but many in the Biblical Counseling movement have taken up a manner of speaking about problems that suggests we should all just be sort of sanctification generalists. That is, just generally help people move forward in their walk with God but not specifically try to help them fix their marriage or have more friends or perform better at work, etc.

Why are we so determined not to be practical? I'm generalizing and maybe not fairly, but I've sure seen a boatload of it. Maybe it's an overreaction to the practical focus of the social sciences. My take on that is that practical is really all they can do (to the extent they can do that much) and there is a good bit of useful stuff there. I am just not in the tribe of lofty minded folks who think there is something wrong with useful, practical, duct tape type truth.

Bert Perry's picture

As I understand DSM--a meager understanding at best--it more or less refers to cases where the mind is incapable of understanding reality as we see it, where the mind does understand reality but the person does not care (especially in a way that wants to hurt others), where the mind is less than able to perform certain tasks (e.g. ADHD), or where the mental state leads to undesireable outcomes--e.g. depression, etc..  

Anyone out there who might streamline/correct that?  I was thinking of trying to offer an alternative, but I'd figure that someone more skilled in DSM/etc.. than I might be able to refine this.

 

Aspiring to be a stick in the mud.

jimcarwest's picture

I really can't say with any level of expertise what is behind the DSM, but with its inclusion of many new "disorders" each time a revision takes place, one might wonder if the health professionals aren't attempting to include us all eventually so as to guarantee sufficient income in the future.  I say this rather facetiously.  However, according to statistical studies, fully 46% of all Americans now suffer from one of the disorders listed in the DSM, and the percentage rises with each new edition.   http://www.slate.com/articles/health_and_science/medical_examiner/2013/0...

Given enough time, we'll all be deemed "crazy" or "abnormal" and in need of help, but since this number probably includes health professionals, we wonder who will be "sane" enough to treat us.  Seriously, the field of Christian psychological ministry is burgeoning.  The Bible gives us most everything we need to know about how to heal most psychological disorders.  In tandem with a balanced health focus, the Church has what it needs to address the spiritual/emotional needs of everyone.  

Aaron Blumer's picture

EditorAdmin

I think you should read the DSM a bit (I don't recommend the whole thing. It's a behemoth... and who has that much time?). I would think it wise to hesitate to make generalizations about it if you aren't actually familiar with it.

As for what's behind it...  lots and lots and lots of research, clinical trials, peer reviewed journal articles, case studies... and on and on. And it's not like the professionals all agree with eachother. If you dig a bit you'll find that while there are fads that come and go and often a consensus forms for a while, there is lots of debate.

Also, as I've already noted, the trend is actually away from calling everybody crazy. Rather, the "disorders" language moves away from trying to make two big categories of "crazy" and "normal." So the approach is to focus on observable patterns, catalog them, and study various ways of mitigating them. That's really all it is.

It also doesn't follow that only perfectly whole people can help partially broken people. If that were true, how could anybody ever help anybody?

"The Bible gives us most everything we need to know about how to heal most psychological disorders.  In tandem with a balanced health focus, the Church has what it needs to address the spiritual/emotional needs of everyone."

This is an interesting statement. "Most"? I can certainly accept that but, how do we determine which ones it can heal and which ones it can't? And are "spiritual" and "emotional" the same thing? If not, how do we tell them apart?

But I'm mostly indulging my curiosity at this point.

Isn't it really pretty obvious that we never know what is changeable and what is not in people, or what has to change first before something else can change, etc.? When something seems to not be responding to counseling/discipling/teaching/parenting/etc. efforts, you shift to something that seems to yield better progress. This is the case whether someone has a mental illness or disorder or whatever or not. Whatever damage a person has doesn't alter whether they are responsible and capable of change, it just altars the way in which they are responsible and must change. But these vary a great deal from person to person whether some kind of illness/disorder is part of the mix or not.

Edit: I don't want to sound overly rosy about the DSM. It's just the product of a bunch of folks trying hard to help people but using a very limited (but still substantial) toolset. You just can only do so much with the tools of observation and inference, especially if you also don't have your observation and inference process framed in an accurate worldview. Also, they do sometimes (often?) also classify "disorders" as "medical illnesses" and similar language. The APA et. al., are, on the whole, of the mindset that these problems should be dealt with as medical and health issues and funded by health insurance, the government, etc. .... which I personally think is not a helpful direction to go with it other than the extreme cases that are consistently responsive to medication. (It's still true though that the trend is away from classifying people as either mentally ill or not. The trend is toward seeing mental illness as something that can happen to anybody for a while but some people permanently and severely, etc.... like the flu or cancer.)

Bert Perry's picture

....here's an article on mental illness from wiki, where it's defined as "A mental disorder (also called a mental illness or psychiatric disorder) is a diagnosis of a behavioral or mental pattern that can cause suffering or a poor ability to function in ordinary life."

Looks pretty subjective to me, and like Christians have a lot of place to start taking part in the conversation.  

Aspiring to be a stick in the mud.

jimcarwest's picture

I doubt if any of us has read the DSM, and then we have to ask “which edition?” because there are several.  No one “reads” the DSM.  It is an encyclopedia used for reference about what are called “mental disorders.”  Things deemed mental behavior in one may be removed in another, depending upon the differing vote of those who agree to its content.  Christians need to be on guard about the DSM definitions of homosexuality, trangenderism, etc., etc., which are decidedly anti-biblical.  

What is key here is to understand the philosophy that supports DSM.  Is it secular?  Is it anti-biblical?  Is it primarily mechanistic, or does it value the approaches of Biblical counseling?  Does it include as “mental illnesses” what the Bible calls sin? 

I would recommend that readers consider the view expressed in the following article:   https://www.thegospelcoalition.org/article/christian-reflections-on-ment...

The article warns:  “When we look at mental illnesses and only find medical categories, we do not understand the term, and we dishonor Jesus Christ. In doing so we will also keep troubled people from the fullness of help they need. Yes, people with severe problems often need medication. But even when medication is necessary no medical doctor can prescribe what the Great Physician alone can provide.” 

Secular psychology tends to diminish and even despise the role of the biblical counselor in the same manner that modern medicine holds in contempt the role of natural healing. 

Emotional/spiritual healing is a legitimate category of counseling.  The Bible is a legitimate "DSM" when it comes to human problems and their solution.  

I contend that we may have something to learn from each other, but in the present state of psychiatry, the atmosphere is not conducive where mutual respect is lacking.

Joel Shaffer's picture

jimcarwest wrote:

I doubt if any of us has read the DSM, and then we have to ask “which edition?” because there are several.  No one “reads” the DSM.  It is an encyclopedia used for reference about what are called “mental disorders.”  Things deemed mental behavior in one may be removed in another, depending upon the differing vote of those who agree to its content.  Christians need to be on guard about the DSM definitions of homosexuality, trangenderism, etc., etc., which are decidedly anti-biblical.  

What is key here is to understand the philosophy that supports DSM.  Is it secular?  Is it anti-biblical?  Is it primarily mechanistic, or does it value the approaches of Biblical counseling?  Does it include as “mental illnesses” what the Bible calls sin? 

I would recommend that readers consider the view expressed in the following article:   https://www.thegospelcoalition.org/article/christian-reflections-on-ment...

The article warns:  “When we look at mental illnesses and only find medical categories, we do not understand the term, and we dishonor Jesus Christ. In doing so we will also keep troubled people from the fullness of help they need. Yes, people with severe problems often need medication. But even when medication is necessary no medical doctor can prescribe what the Great Physician alone can provide.” 

Secular psychology tends to diminish and even despise the role of the biblical counselor in the same manner that modern medicine holds in contempt the role of natural healing. 

Emotional/spiritual healing is a legitimate category of counseling.  The Bible is a legitimate "DSM" when it comes to human problems and their solution.  

I contend that we may have something to learn from each other, but in the present state of psychiatry, the atmosphere is not conducive where mutual respect is lacking.

 

I am curious with your tendency to dismiss the DSM because of its secular nature, would you classify Autism, or a legitimate brain disease such as Schizophrenia, or Post-Traumatic Stress Disorder as something that only the Bible can heal?   I am much more skeptical of your position to downplay the DSM because I have seen Christians with your worldview counsel mentally ill homeless who are Schizophrenic or Bipolar to stop taking their meds because Jesus and/or the Word of God will bring healing.  In a few cases where there was a misdiagnosis, that actually did happen.  However, the overwhelming majority of situations that I saw where Christians applied amateur counseling to legitimate mental illnesses made things worse.  Several attempted suicides occurred with the homeless population that I worked with due to well-meaning Christians with a truncated Biblical worldview that did not know how to discern the good from the bad within general revelation and told them to stop taking their meds and trust in God.  I understand your concern about mental illnesses and Christian Psychiatry where people ended up managing sin, rather than getting to the root causes of certain problems.  However, just as dangerous is the mindset to dismiss and not take the time to discern the good from the bad within the DSM and attempt to apply the Bible to solve a mental illness like schizophrenia (which is equivalent to a mechanic turning to the proverbs as a guide to figure out how to fix an airplane engine).   

Just so you know, I am also familiar with misdiagnosis by certain health professionals that attempted to use the DSM and/or their experience in a psychiatric hospital to make a diagnosis.  Three months ago, my 13 year old daughter had to be brought into the hospital because she had some physical as well as some emotional (anxiety) issues.   Sadly, an influential pediatric doctor that only saw her for a few minutes was absolutely certain that she had childhood schizophrenia (which is extremely rare) because of her hallucinating and rapid eye-movement behaviors.    However, one can gather from the updated DSM and other books about anxiety, is that the lack of sleep and anxiety will produce the same behaviors as schizophrenia.   Thankfully, because my wife is finishing her degree to become a licensed therapist, she had studied this issue quite extensively  and we were able to prevent a misdiagnosis that the hospital's psychiatrist almost accepted.  

 

 

 

jimcarwest's picture

I think you missed some of my doubts on the DSM, especially with reference to the secular mindset that seems to guide much of it.  I do not necessarily doubt the research that might seem to support it in many cases, but my concerns are rather in the secular philosophy that is behind much of it.  The tendency in secular psychology is to downgrade and berate the role of the Scriptures in spiritual healing.  I would never rush to take medications away from anyone who is using them, but since medication tends to be the "go-to" solution for many of these anomalies, I would seek to use biblical counseling as an adjunct method of dealing with people who sometimes show symptoms of mental "disease," when other issues are also involved.  For your information, some suicides occur due to the use of the medications, which show "suicidal thoughts" as a side-effect on their labels.  We have had two suicides in my family where this was unquestionably the case.  They had no suicidal thoughts until they became dependent on the meds.  A careful biblical counselor will exercise great caution when dealing with a person on psychotic medications.  He will always look for root problems that may have led to dependency.  The literature does recount examples of schizophrenics being "healed" and returned to normalcy through biblical counseling, demonstrating that this "disease" is not always organic in nature and may indeed include a spiritual element.  So, while some avid spiritual counselors may exceed their expertise, and this may lead to other problems, it is only sensible to admit that secular counselors produce some of the same negative results but for other reasons.  The fact is, spiritual-emotional disturbances have a variety of causes, and the fact that there are multitudes of people who have not been "cured" but who have rather become dependent on year after year of therapy, does not speak favorably of the secular approach.  A great deal of the "mental" problems that present themselves today seem to be the result of modern living that creates stresses and strains that our forefathers did not deal with to the same degree.  While being open to all the latest findings, I continue to believe that the Scriptures properly applied and believed go a long ways toward helping people to live sane and balanced lives, no matter the stresses we encounter.  

JKHutch's picture

Dr. Daniel Berger (BJU PhD) has just published Volume One of MENTAL ILLNESS: THE NECESSITY OF FAITH AND AUTHORITY.  Extremely well-documented. Endorsed by Dr. Kevin Hurt, Executive VP of International Association of Biblical Counselors and by Ethan Stanley, Clinical Supervisor, National Counseling Group.   

One of his emphases is that typical medications prescribed for bi-polar and schizophrenic behaviors are now being required by the FDA to list suicide as one of their side effects.    

Available here:  https://www.amazon.com/Mental-Illness-Necessity-Faith-Authority-ebook/dp...

 

John K Hutcheson

Aaron Blumer's picture

EditorAdmin

It is certainly a reference book. There used to be large chunks of DSMiii or iv available online, and I read a good bit.
I would certainly not view it as *authoritative*. Sometimes in the mental illness vs spiritual/sin issues debate we talk as though a source of information has to be either authoritative or utterly useless.
But think of it as a catalog of human behavioral problems from a particular point of view... Sort of like so and so's guide to good restaurants in Seattle... You might not *fully* agree with a single page of it yet still find it useful.
JKH... Thanks for the book info. Exactly the sort of area I need to read in right now.

jimcarwest's picture

I fear that, as Bible believers who derive their approach ot life and its problems from the Scriptures, some may be looking too favorably on the field of psychology and mental disorders  from the secular/atheistic viewpoint.  To ignore that the trend is in that direction, even among believers, would be an error.  I suggest more reading along these lines: "Biblical Counseling" by John MacArthur/Wayne Mack, "Psychobabble" by Richard Ganz, "Psycho-Heresy" by Martin/Deidre Bobgan, and "The Christian Counselor's Manual" by Jay E. Adams.  It's alright to know what is in the DSM, but it's good to recognize that in that manual, some so-called disorders are determined by ballot and not by solid research and experience.  Just saying...

Aaron Blumer's picture

EditorAdmin

Read MacArthur, perused the others. Some good points... Some major problems. In general these sources sidestep the same questions you have sidestepped. Or answer them inadequately. Mostly they just don't go there. But these questions are not going away.

jimcarwest's picture

The Scriptures have been answering all sorts of these problems for thousands of years -- depression, feelings of hopelessness, suicide, criminal behavior, self-pity, fear, anger, envy, drug abuse, sexual deviancy, etc., etc.  It has not suddenly become deficient in dealing with modern man.  It is the secular psychological therapy industry that keeps expanding the definitions and solutions, many of which rest upon blame-shifting, and most of which seek their solution in medications that have in some cases complicated the care of souls.  Rather than finding solutions in many cases, what results is a new form of dependency of the counselee on the counselor.  I'm not sure just what one hopes to gain by this trying to redirect attention towards more confidence in the DSM and secular counseling, but I feel sure someone will try to enlighten me.

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