October 16, 2017

iMonk 101: The Christian and Mental Illness II: Is There Such A Thing As Mental Illness?

This is the second in a series I did in November of 2005 on Christians and Mental Illness. Looking back at the comments that this post prompted, it’s apparent that many Christians are deeply suspicious of any model of dealing with problems of mental and emotional health other than using the Bible. This is a more mediating view for those who believe we can benefit from some of the scientific approaches used in contemporary psychiatric treatments. There remain large issues between secular psychology/psychiatry and religion. This is one layperson’s view. I am not a trained therapist of any kind. Talk to your doctor and your pastor if you have questions for yourself.

Because the Bible is authoritative in Christianity, it is often difficult to come to terms with forms of knowledge that ignore the Bible, and especially difficult to deal with systems of knowledge that threaten to transcend or neutralize the Bible. In America, this tension did not fully dawn until the fundamentalist-modernist controversies of the early twentieth century. While Darwin continues to get most of the attention, it is more likely Freud who has created the most perplexing tensions for Christian believers.

Psychology does not appear to be an immediate frontal assault on the Christian view of truth. Many Christians, especially in more moderate communions, have been open to psychology as a way of compassionately understanding human beings. More recently, however, psychology has met with sterner opposition from many evangelicals, who have become aware that the discipline was atheistic, even religiously hostile, from the outset, and that its ways of explaining, understanding and helping human beings have potentially dire consequences for the Christian view of truth.

Any student of Freud will realize that the founder of psychology bequeathed a view of religion to the discipline that can quickly begin treating religion itself as an aspect of mental illness, and God as a manifestation of human wishful thinking. While responding to Freud’s critiques of religion isn’t difficult, the basic tension is there, and doesn’t go away by putting the word “Christian” somewhere in the sentence, as in “Christian psychology doesn’t have these tensions.”

Today, many serious Christians often reject any and all reference to psychology. (This varies enormously and is an admitted generalization.) A minister may practice Christian counseling, but let him claim to be a Christian psychologist and fully half or more of the Christian community will refuse his assistance. Christian counseling has developed its own alternative approach to dealing with mental, emotional and behavioral problems, with dependence on scripture at the center and a rejection of psychology as mandatory.

This shift has brought the entire concept of mental illness into question for many Christians. Should we be using the categories, vocabulary, diagnoses and treatments of psychology to describe and treat human beings? Many conservative Christians say “no,” and will refuse to recognize common conclusions and approaches of the psychological disciplines. When psychiatric treatment is recommended, these Christians are even more resistant, and often refuse recognized and accepted treatments for mental, emotional and behavioral disorders. As enamored as our culture is with the authority and insights of psychology, many Christians are unconvinced and even belligerent.

This creates conflicts and tensions in the lives of many Christians. Psychology, in various forms, exists everywhere in our culture. It is part of the cultural imagination of any semi-educated, semi-literate western person. “Pop-psychology” is an entire phenomenon that exists on the casual acceptance of psychology as authoritative in our culture. If a crisis occurs or an answer is needed, our culture brings on the psychologists. They are, in many ways, the secular chaplains of the American religious/cultural mileau.

What is a young Christian in college to do? The courses are required and the concepts are everywhere. Is a graduate education in psychology a betrayal of the Bible? Is a family seeking help for a depressed, acting out or suicidal loved one sinning when they resort to the help of psychology or psychiatry? Is it wrong to take medications if you believe in God? Can a Christian choose psychology or school counseling as a vocation? These are important questions that defy simplistic solutions.

I believe Christians cannot–and should not–entirely reject or escape the “knowledge base” that exists within their culture, including psychology and the concept of mental illness. These concepts and “namings” of human conditions can, if appropriated correctly, be useful and compassionately helpful.

Psychology, as science, is a discipline largely based on conclusions developed from repeated, careful observations. From observing, listening to and treating millions of individuals over time, a descriptive approach is acquired. These various descriptions are what we refer to as mental and emotional illness, and Christians committed to the idea that truth is the greatest friend to a hurting family or person should always embrace truthful observations, even if they come to us from other sources of understanding the world than our own.

For example, my wife and I love the CBS show, “Criminal Minds.” The FBI profilers in the show know the various kinds of mental illness so well that, once a person is diagnosed, they can anticipate his/her thoughts, actions and reactions. This is not mystical or about intelligence or insight particularly. It is statistics. Repeated observations create categories like “paranoia” and “psychosis.” These are described in detail, and over time, treatment options are developed that alter or solve the problems observed.

Imagine that Toyota manufactures a car, a Camry. Over time, the flaws and problems of that particular car become evident. While it may have any and all problems, in actual fact it tends to have a particular set of problems, which are labelled and “treated” based on repeated observation and methods of treatment. The car may develop an unknown problem, but statistically, that’s unlikely. The squeaking noise in the front brake will be the same thing 98% of the time, and the solution will be the same each time, with minimal variation.

The observations of human beings by psychologists are where we get the language of mental and emotional illness. We should be cautious and careful in appropriating this language, but as much as it is descriptively accurate, Christians should have no fear of it. Calling depression “depression” is not surrendering to the worst assumptions of psychology. Depression is a set of observations. They allow a set of responses. They help us build a plan for treatment. And so on with many many kinds of mental illness.

The persons exist, and their problems exist. It is not wise to reject what repeated observation and treatment have yielded in the quest to help people.

At this point, many Christians will point out that the psychological concept of depression does not contain the Biblical content necessary for a true solution. “Depression,” they will say, is not a disease, but simply a manifestation of sin or loss. This may be quite true in many cases. The Christian vocabulary may be the most meaningful way to approach and respond to an individual case, but when we look at the culture as a whole, this is not going to work. If we insist on refusing the diagnostic language of psychology and using the language of faith, we will have to limit our involvement with people to the Christian community and control the problem so that whatever response we make is understandable.

Mental illness, as a descriptive tool and category, does functionally exist for persons in any culture. Becoming conversant with how a culture describes mental illness is far more useful than rejecting the concept, and it allows the resources of truthful observation to come into the picture.

It is also important to note that the concept of “normal” mental health is another tension. Human beings present a wide array of behavior and personalities. Who is empowered to say person A is mentally ill and person B is merely irritating or quirky? Society does “hold the keys,” so to speak, and the “key keepers” have been known to be capricious in what they label or unlabel as mental illness. For instance, homosexuality is no longer listed as a psychiatric disorder. One day homosexuality was mental illness. The next it was not. (BTW–I consider this an appropriate move. Labeling immoral or unpopular behavior as mental illness is something Christians should always oppose.)

There is no doubt that there is a particularly insidious aspect to the ability to label anyone mentally ill. For example, is a person who wants to kill himself mentally ill? Should this be “in his folder” for the rest of his life? I work and teach many people who have had serious suicidal episodes. Many healthy adults have been so unhappy or despondent about an event in their lives that they have verbalized suicidal thoughts. Is this mental illness? Is a person desiring death rather than a year of cancer treatments mentally ill? Is a person who emotes strongly at particular times, but functions normally in all areas of life, mentally ill?

Is depression mental illness? Yes, but at the same time, many healthy people have depressive symptoms. A recent article in The Atlantic recounted how Abraham’s Lincoln’s depressive side probably contributed to his effective presidential leadership. Thousands of gifted people have been “melancholy,” from Paul in Philippians 1 to Charles Spurgeon to presidents like Lyndon Johnson and Richard Nixon. (I wonder what Spurgeon might have written in a journal during his depressive periods? Let’s be glad his modern-day fan club doesn’t have to digest Spurgeon saying he hated the ministry or wished he’d never been born.)

Is Manny Ramierez mentally ill? “Normal” for Manny is a world uniquely his own, but should he be treated? Medicated? Made “normal?” Would you want Manny to be something other than Manny? Is J.D. Salinger mentally ill? Is a person covered with tattos “mental?” Is a young man who quits law school to go live in the woods in need of “help?” Are eccentric artists “crazy?” Do you consider those who take viewpoints strongly different from yours to be “mentally ill?” Would you act on that conviction if you had the chance?

I meet hundreds of students who are diagnosed with disorders such as ADD, ADHD, Oppositional-Defiant and so on. Many are the subjects of counseling, hospitalization and medication. Yet, the “normal” from which they have deviated is defined by public schools and middle-class American suburban values. In these cases, “normal” is a kind of social/behavioral conformity forced upon the young by experts and educators. (See “Girl Interrupted.”) The wonderfully diverse and non-conformist side of human beings is the enemy in this definition of normal.

I will admit that it is not always pleasing or helpful to me as a Christian to be told that Johnny-who-can’t-do-anything-in-school has a syndrome or disorder. This approach seems to shift some of what is needed for Johnny to change into an arena outside of his control. Medication-based treatments have a tendency to minimize responsibility for seeing our emotions, behavior and mental state as part of our own human stewardship. But in the vast majority of cases where mental illness or behavior disorders are diagnosed, these issues do exist, and the diagnosis and the treatment suggested by psychology will most likely be rational and reasonable enough that help can be offered and expected.

Still, even with these observations, I believe the category of mental illness is useful, even essential for Christians in western culture. With a generous allowance for our manifold humanity, we still can look at “collections” of observed behavior revealing to us something that can be called–and treated–as mental illness. My young friend who thought he was God could not function. Psychiatric drugs and counseling gave him back his life and a future. To have ignored this would have been foolish.

Because the Bible’s description of mental/emotional illness comes in the package of its own culture, Christians have to decide if they are going to reject the contemporary language of psychology and resort to the language of ancient culture, or if they are going to “read” contemporary culture with the Gospel at the center. Can the concept of mental/emotional illness be transformed through the Gospel to be of useful service to Christian compassion?

This same question is present for physical illness as well. The Bible is a prescientific book, and most of contemporary understanding of human biology and physiology is absent. Science has given us tremendous tools to use in treating disease, and if we reject these in favor of the understanding of disease in the Bible, there is going to be a lot of suffering and death that could have been prevented.

The entire question of accepting contemporary ways of thinking about studying, labeling, analyzing and treating human beings for their mental/physical and emotional illnesses is a question that calls upon Christians to contemplate their view of the Bible and its proper use. If their view of the Bible’s truthfulness includes the assumption that it is a book providing a specific plan for treating illnesses of body and mind, then that commitment will, I believe, take the Christian down a road that is ultimately less compassionate than the acceptace of some form of accommodating the knowledge and insights of science, medicine and psychology.

The Bible is about Christ, and is not a manual for treating mental and emotional illness. The Biblical presentation of the Christian story stands in judgment over psychology and every other form of knowledge because CHRIST IS LORD AND JUDGE, not because the book of Proverbs is the best manual for dealing with emotional illness.

Now that I have concluded that mental illness does exist, and we can–prudently and cautiously–accept the language and treatments of psychology as potentially helpful, I will move on to “Is mental illness a manifestation of spiritual forces (demons) or the results of personal sin?”

Comments

  1. L. Winthrop says:

    “…many evangelicals…have become aware that the discipline was atheistic, even religiously hostile, from the outset…”

    Well yes, Freud was atheistic, but that hardly defines psychotherapy today–many of Freud’s ideas (including most of his writings on religion, which are very strange) would now be generally rejected. Psychologists etc. belong to various religions, though for various reasons evangelical Protestantism is underrepresented (and atheism / Judaism / Buddhism overrepresented).

    For clients who have happily integrated religion into their lives, I doubt that very many therapists would advise them to make any changes. Rather than atheist “evangelism” on the part of the shrink, a more typical situation would be one in which the client’s religion has been associated with difficulties of some sort. Perhaps the client is gay, and his church opposes homosexuality. Perhaps arguments about religion have caused marital difficulties. Perhaps the client is vulnerable to losing touch with reality, and the religion emphasizes things like demonic possession, or the end of the world.

    The question then becomes, how important is it that a particular religious affiliation be maintained? Is it better to be a happy, well-adjusted defector, or a melancholy member of the faithful? Many religions find it difficult to accept that anything could possibly be more important than themselves, but a psychotherapist is understandably not going to go along with this.

    • Robert Cragg says:

      I have been battleing with Bipolar Depression for many years now, I just don’t think some christians even care and to me thats a big problem it is and illness like anything else, people need to be in someone elses shoes for awhile before they comment.
      This world was corrupted when sin entered the world, so why can’t people have Depression as well as any other illness.
      This subject is very sensitive to me and I would also like to write and article about it, starting with my testimony and working through problems solving with God’s help, If anyone would be interested, I would love to be a help to others.

    • answer: if those are the only two choices… the answer is ‘melancholy member of the faithful’. no Bible-believing Christian would choose otherwise… life without Christ means death without Christ.

  2. “The Bible is about Christ, and is not a manual for treating mental and emotional illness.”

    Bingo! This is why I love the iMonk!

    I am working on a book with someone who has dealt with mental illness issues for their son his entire life. Thank you for your balanced and thoughtful perspective. Trust me…this is much needed in our churches.

    dm

    • The Bible is about Christ, and is not a manual for treating mental and emotional illness.

      The bible is instructive on how we should deal with people who have mental illness, as it teaches us to deal with all people.

      • Exactly where does the Bible specifically tell us how to deal with schizophrenia or bi-polar disorder? I have studied the Bible for a little while now and have yet to find that treatment plan. Seeing the Bible like the ‘Chilton’s Auto Repair Manual’ for life does a great disservice to the Bible and to the message of the Bible (not to mention the people God has entrusted us to care for).

        One can always reduce all our problems to a ‘sin’ problem, which ultimately is true (given the Fall and depravity), and the ultimate answer to the sin problem is Christ’s atonement and the new creation that is coming. However, between now and then, telling someone their emotional problems are because of sin (therefore they need to repent of something – and they usually have no idea of what) will usually only add guilt to the mix, making their problems even more serious.

  3. I sent you an email. Thanks.

  4. Michael, totally agree — great post. I can attest from personal experience that there is great value in secular psychology, even for Christians.

    4 years ago, I started having panic attacks. I was a pretty normal person until one day I woke up with chest pain, thought I was dying, and rushed off to the emergency room. Many months later, I was stil having intermittent panic attacks and I thought I was going crazy. (Diagnosis: panic disorder — a label that accurately described what I was experiencing, and I can assure you it was very real to me and felt very much out of my control.)

    In the end, it was a combination of many things that helped me get better — medicine, counseling (both from a pastor and from a psychologist), reading books on the subject, relaxation techniques, better nutrition, and getting more sleep/exercise. There were physical factors, mental/emotional factors, and, yes, spiritual factors that needed to be addressed. It took over a year before I felt 100% back to normal.

    The human person is complex. It’s a huge mistake to rely exclusively on medication. But I still think Christians should consider medication as part of a comprehensive treatment plan. For example, medication often helps “stabilize” someone (as it did in my case). But it MUST be combined with other treatments, including spiritual healing and growth — with the goal of addressing the complex array of things that might have contributed — even things as simple as getting enough sleep and eating healthier.

    I believe that many people who are on medications for mental disorders could eventually become medication-free, if they (and their friends/family) summon the courage to address the issue comprehensively … especially including issues of physical health, spiritual health, emotional environment, etc.

  5. An important post. This is a great discussion every year when I teach The Brothers Karamazov.

  6. I actually went up for prayer in a church. “Why do you want prayer?” I was asked. “I’m depressed”, I responded. “Depression is a sin”, was the response. He prayed for me. I’ll give him credit for that. Wouldn’t let him pray for my dog though now.

    IMO, many sensitive people who are under Law centered preaching are more likely to have stress in their life that can exacerbate the symptoms of mental illness. So while the Bible itself is not the answer for mental illness proper application of the Gospel and Law can stabilize some people’s souls that can help treatment be more effective.

    When I finally started realizing that if I didn’t get out of bed it would not effect one thing about God’s Covenant in Christ toward me then I began the slow process of some sort of healing. Of course not getting out of bed may mean I can’t pay the bills. But AT&T being upset with me is a whole differnt matter than God being upset with me.

    • Steve, you’re preaching to my choir.

      Depression runs in my family (from genes or learned behavior. Both? Probably) At any rate, I grew up Southern Baptist with all sorts of law thrown at me. It was like they didn’t read the second half of Romans…or at least I didn’t. Needless to say, it didn’t help. It wasn’t until I quit worrying about whether I was sinning or not, but to focus on God’s love and the grace provided that I, too, began healing. I still deal with depression. Especially when life gets challenging. Yup, meds and the whole bit. I’ll spare you the details. However, where the Bible use to harm, now it heals. It is because now I view each page with the knowledge of a God that loves us and wants to redeem us, not an empirical tyrant that doesn’t allow for mistakes.. God the Merciful Father and His Loving Obedient Son Jesus be praised!

    • I was lucky in that depression was not generally considered a sin in my church and at the Christian College I attended, but my real breakthrough was when I started studying some of Catholic Monasticism and reading about the gift of tears, which is considered one of the greatest of gifts in Monastic traditions. That helped me make the jump from depression being just “not a sin” to actually being something that God can use! It’s certainly inaccurate to equate depression to the gift of tears, but it was still a very useful insight for me.

      Somewhat Ironically this helped me realize that there was some sin involved in my depression because I was mostly depressed for selfish reasons. I was able to move from “Woe is ME” to “Woe is THE WORLD”. I was still depressed, but it took some of the sting away and now whenever I get depressed I search for something that’s worth being depressed about. That sounds pretty silly I suppose, but it helps me significantly. I’d still get pretty upset with someone who states that all depression is from sin though.

    • BTW,

      Anyone hear of “Recovery Incorporated”?
      I would highly recommend googling them and checking out their stuff.

  7. Is it possible for you to go to a mental health clinic that offers family therapy and accepts payments on a sliding scale according to your income?

    • Thanks, Christiane. I appreciate your suggestion. That’s what my husband and I do weekly. We also have once a month family appointments which helps address the issues our Littles struggle with. Unfortunately for our daughter, true rehabilitation facilities do not have sliding scale options.

  8. I’ve grown up with parents in the behavioral health field and have my own very serious diagnosisi to take care of. My psychatrist went to Duke Divinity for a year before he decided his ministry was to be a psychatrist. My husband is training to be a chaplain and is taking counseling courses. I have never been around Christians that denied the usefulness of psychology and psychiatry. That makes me very very sad to know that there could be such a large group out there who think my almost weekly, sometimes daiily, thoughts of death are due to me not loving Jesus hard enough or…well I don’t know what they would think it’s from.

  9. When I went to my pastor to ask her to help me pray away the thoughts of suicide that just wouldn’t stop, she told me she’d be glad to pray with me, but that God invented therapy and medication for a reason. She had me making an appointment to see a therapist that day, and then behind the scenes got some of my church brothers and sisters assembled to watch me.

    When I broke down one night and was looking into the abyss, they were calling my house, asking if I were OK. I can remember a lady, an angel really, crying on the phone because she wanted to help me so badly. Truly my church saved my life. But it wasn’t scripture and theology and parables and Christian theory; it was nothing more than simple love, and the church was the place in which that love grew, facilitated by a pastor who preached it from the pulpit.

    This sounds wacky, but you want to know what else helped? Online prayer websites. There is something very powerful in having total strangers living who-knows-where lifting you up to God. I swear I could feel it.

    • Bless you for your courage to bare your frailty to others, and bless your church for responding appropriately. I’m very sorry that Debbie’s church didn’t respond the same way.

      From Mark 12:

      28 One of the teachers of the law came and heard them debating. Noticing that Jesus had given them a good answer, he asked him, “Of all the commandments, which is the most important?”

      29 “The most important one,” answered Jesus, “is this: ‘Hear, O Israel, the Lord our God, the Lord is one.[e] 30 Love the Lord your God with all your heart and with all your soul and with all your mind and with all your strength.'[f] 31 The second is this: ‘Love your neighbor as yourself.'[g]There is no commandment greater than these.”

      32″ Well said, teacher,” the man replied. “You are right in saying that God is one and there is no other but him. 33To love him with all your heart, with all your understanding and with all your strength, and to love your neighbor as yourself is more important than all burnt offerings and sacrifices.”

      34 When Jesus saw that he had answered wisely, he said to him, “You are not far from the kingdom of God.” And from then on no one dared ask him any more questions.

    • That’s beautiful, Jjoe. Thank you for sharing what it looks like when it’s done right. 🙂

    • Wow. That is an excellent example of the Body of Christ.

  10. Good beginning, Michael. This is a complex but important issue to address. There are usually no simple solutions on either side (“take two pills and call me next month”, or ” read two chapters, pray more and call me when everything is better”) but God can use both to bring healing and wholeness into the lives of those who are suffering. It is naive, really, to think that thinking, feeling, embodied spiritual beings, living in a fallen world, who were made to relate to God, self and others in some form of integrated way would always be able identify and solve anything very easily. Thankfully, God is greater, good and loving. He is with us and for us – even when he feels a million miles away.

  11. What do you mean when you say the Bible is pre-scieintific? The Bible pre-dates most of our current scientific knowledge such as (most relevant to this discussion) psychology. However science is defined as “ability to produce solutions in some problem domain”. There were weapons used in the bible, cities built, various types of medicine and even the crucifixion was the result of Roman knowledge learning to effectively torture and kill. All of these require science, the accumulation of knowldege. I hope I am not just splitting hairs here, but the bible is not pre-scientfic. It is simply set in the knowledge base and science of the days of it’s writers.

    • RP,

      I would define science as having an understanding of how things work, rather than what works. From my standpoint, you are more describing engineering and/or technology vs science.

      A simple example: Technology (or even pre-science) knowing the limestone and vinegar forms bubbles. Science- knowing that calcium carbonate reacts with the acetic acid in vinegar to form carbon dioxide and calcium acetate.

    • i agree. the bible is not pre-scientific. God, who designed and created every facet from the unseen to the seen existing in the universe today hardly requires mere man to offer speculated theories about how things work. it’s laughable.

  12. Religious issues are far from the biggest problem with psychology/psychiatry.
    1) You alluded to a tendency to “medicalization of normal”, the creation of ever more “illnesses”, such that, eventually, no one is normal. This is dangerous and creates anxiety where none should be. The category of personality disorders, for example, once upon a time was mostly subsumed under “jerk”.
    2) Simple ineffectiveness that is stunning in a discipline that purports to be a science. For example, lying completely negates much of psychiatry. How many people are declared no risk to themselves, then commit suicide? How many are declared no risk to others, then murder or rape?
    3) Psych depends on the patient as informant, but the patient is, by definition, not a reliable perceiver of reality. My daughter saw a psychologist for a year, and all sorts of behaviors went unaddressed, because she didn’t think there was an issue and thus didn’t mention them.
    In sum, there are real mental illnesses, and effective therapies for many, especially the most obvious forms, but there is also a lot of pseudoscience and politics in it all.
    FYI: I am a physician – and not a Scientologist 🙂

    • Jonathan Hunnicutt says:

      My wife is a psychologist, and her favorite joke is this: “How many psychologists does it take to change a light bulb? One, but the light has to want to change.”

      I guess I would only ask you as a physician how difficult your profession would be if you had to rely almost entirely on self-report from your patients, instead of having things like cultures, CTs, and other tests and measures.

      So I guess my question is: how would you address these issues? What more could psychologists do?

  13. Rob Grayson says:

    Thanks for an interesting and relevant read, as usual.

    While I agree that there is great value in understanding and applying principles of psychology, there is also a very real danger of such principles being abused by well-meaning but incompetent Christians. I’m not saying that Christians are the only ones who do this, but I’ve met a fair few in recent years who have done. I have in mind one particular person in a position of spiritual oversight who tends to apply “pop psychology” to any given issue. The first solution to any person’s problems lies not in the gospel but in understanding and interpreting that person’s psychological make-up, usually followed by fishing for emotional “wounds” and baggage that need to be “healed”. I’ve rarely seen good come of this kind of approach.

    As usual, balance is required.

  14. I am pretty firmly entrenched in the nouthetic camp and am wary of psychology as a “religion of self” as the focus tends to be on the person and not on Christ. However, I also recognize the value that it has had in many Christians’ lives and, as with spiritual gifts, it is very difficult to discount experiences.

    I just wanted to chime in with one observation that I learned from my Systematic Theology class. One’s approach to treating strange behavior has much to do with whether you are a dichotomist or a trichotomist when you consider how man is assembled. If man is two parts “body and soul,” then you are likely to spurn psychology. If man has three, “body, mind, and soul,” then psychology becomes a viable option.

    I think that is a fundamental question that everyone needs to wrestle with before deciding where he or she lands on this issue.

    • This sounds like work for the vivisectionist. 🙂 And we usually find what we’re looking for.

    • Jonathan Hunnicutt says:

      I think you make an interesting point about dichotmist or trichotomist, but what if humans are wholes?

      What if we don’t have souls in the Cartesian sense?

      BTW, as a pastor who’s wife is a psychologist, I get pretty defensive about alternative Christian therapies, but I appreciated your spirit of humility about how psychology has helped people. Could you recommend a good book on nouthetics?

      • Jonathan,

        I would say that Competent to Counsel by Jay Adams is the seminal work on the matter. The book Psychology Debunked by Lisa Bazler offers an insider’s view of the world of psychology as she was a practicing psychologist. If I had to recommend one book it would be Adams.

  15. Intersting take, iMonk, as always.

    I appreciate the dichotomist/trichotomist concept, and think it may explain a lot. I am both a trichotomist and one who sees the value in much that psychology has to offer, so it resonates with me. Thanks for giving me that to chew on, Jason.

  16. I don’t believe Christianity, or any religion, is in conflict with psychaitry. I believe RELIGION is. It is religious edicts and doctrinces which cause conflict. For example, a Christian believer’s depression can be made worse by the rejection of it by Christian leaders/counselors as demonic/satanic influence, i.e., ‘you’re depressed because you’re allowing satan to control your thoughts’.

    • God and psychiatry are not in conflict. God and science are not in conflict. If the spiritual part of ourselves is in conflict with the rational part of ourselves, then we are not whole. To make our consciousness a simple chemical reaction is anti-psychiatry, actually.

  17. iMonk,
    Before you start hacking away at that next topic, “Is mental illness a manifestation of spiritual forces (demons) or the results of personal sin?” may I offer that there could be more than these two options? What of sins that aren’t ours personally? What of spiritual generational effects (sins of the fathers and all that)? What of biological generational (genetic) elements, environmental toxins, learned habits, stress, etc? Something to consider.

  18. Headless Unicorn Guy says:

    In America, this tension did not fully dawn until the fundamentalist-modernist controversies of the early twentieth century. While Darwin continues to get most of the attention, it is more likely Freud who has created the most perplexing tensions for Christian believers.

    I remember some Christian bestseller of the Eighties (maybe by Hal Lindsay, but definitely not Late Great Planet Earth) that named Darwin, Marx, and Freud as “Satan’s three main attacks to make Christians fall away” or some such. All I remember for sure is that it had Darwin, Marx, and Freud and all their works as puppets and deceptions of SATAN (TM).

  19. If one replaced the references to psychology/psychiatry with references to “regular” medicine, would this post still make sense? I don’t believe so, unless you are a Christian Scientist. Mental illness *is* illness, plain and simple. It has a biological basis, and a hereditary component. Mere depression is chronic and insidious. It tears apart minds, lives, and families. It infuriates me when any group of people, especially Christians who should be displaying more not less compassion than the world, deny these facts based on superstition or half-understood theological or philosophical concepts. Telling someone they are depressed because they are sinful or possessed by demons is as reasonable and spiritually helpful as telling them they have diabetes or cancer for those reasons.

    I wholeheartedly recommend Peter D. Kramer’s book “Against Depression” as a readable and beautifully written explanation of the science behind depression. I also recommend “Losing God: Clinging to Faith through Doubt and Depression” by Matt Rogers, a description of a Christian’s experience with depression.

    I apologize for posting a rant on your site as a complete newbie, but I consider this issue extremely important. It’s about time for Christians and society in general to catch up with forty or fifty year-old science, and exercise compassion instead of misplaced judgementalism.

  20. When I was suffering from depression, the result of pouring my soul into trying to save a marriage in which I was the one being verbally, mentally, and emotionally abused, my pastor assured me that I’d hear a lot of people telling me that getting therapy and being on antidepressants was un-Christian. I should ignore them.

    He said that the Christian Church is the only army in the world that makes a habit out of shooting its own wounded. Rather than reaching out and helping our hurting brethren, a lot of Christians take the opportunity to kick those who are down.

  21. A related thought to some comments here: Christian treatment of people with mental problems seems to say a lot about how we view God and the Christian life. We seem to assume that a person who is saved and living a holy life should basically be healthy and happy. So if you’re basically cheerful, that’s good. If you love praise-and-worship choruses and can achieve elation while singing them, you’re spiritual. You’re also spiritual if you can arrive at a Bible study and say, “I was praying this week, and God spoke to me! I had such a sense of confidence!”

    We seriously need to begin recognizing that it may be just as “spiritual” for a person in mental or physical pain just to trust in God and survive the week. Or to believe God’s promises and not feel anything. We need a way to recognize that sometimes suffering is inevitable and that it can be redemptive or open paths to ministry a “happy” person cannot access. The Christian walk seems to me to be less about becoming a stereotypically whole person as becoming a person who can learn to “see” themselves with some honesty, then love God and others and somehow “move forward” from wherever it was they started mentally and spiritually. I am not sure it has much to do, ultimately, with subjective feelings of happiness … although love of God and others probably does promote these feelings for most people.

    • Look at Jeremiah. He wasn’t the stereotypical “whole” person – he was one moody dude! Neither really, when you get right down to it, were King David, Job, King Solomon (read Ecclesiastes), Elijah or Joseph.

      Christ himself was a truly gritty, loving, honor-built, strong individual with almost nothing in common with “Mr. Spiritual.” Indeed, Christ said, “If anyone comes to me and does not hate his father and mother, his wife and children, his brothers and sisters—yes, even his own life—he cannot be my disciple. And anyone who does not carry his cross and follow me cannot be my disciple. ” (Luke 14: 26-27) Now that don’t sound like Mr. Spiritual do it?

      • Amen to that!

      • jeremy – i believe you misunderstand the scripture you quoted. Christ was comparing love for Him to love for anything else… in that you must love Me so much that “by comparison” it will look like you hate everything else.

  22. Prayers for you, Debbie.

  23. The mindset of many evangelicals regarding psychology and mental illness, I believe reflects a self imposed naivete regarding the deep pain, suffering, disfunction and illness in the world. Many Christians have become so insulated from the world that they have no real experience with people who are severely mentally ill. When all we see is the results of “pop psychology” on TV and in our suburban communities, it is no wonder that we react against it. I believe the evangelical response to this issue (and other issues related to education, poverty, homelessness, healthcare, crime, justice, etc.) would be much different if we lived in communities where violence, injustice, suffering, disfunction, etc. were all around and if we were in close relationship with people for whom these are day-to-day realities. It’s time we took the great commission seriously, leave the comfort of our safe, homogeneous communities and begin to bring healing to the broken places in our country.

  24. I struggle with some of the horrific mis-steps medicine and psychology has made in its history of understanding mental illness. Walter Freeman and frontal-lobe labotomies comes to mind, along with shock treatments, thorazine, etc. Even today, medical treatments seem like a lot of trial and error. If science looks at the brain and sees nothing but tissue, nerves, and electric impulses and fails to see the soul, the “ghost inside the machine”, then they may never truly understand mental illness.

    • Christiane says:

      Sometimes the ‘doctors’ (psychologists and psychiatrists) are also ministers, priests, or rabbis.
      In the case of a psychiatrist, you have a medical doctor with the training of a psychologist, and someone who is very knowledgable about brain chemistry, neurology, medications, and so forth.
      If the psychiatrist is also a member of the clergy, you have the best of both worlds.

      These people do exist.

      • Ah, but is the “science” of the brain really proven? I mean, do we know with certainty about the chemistry of depression like we do with diabetes? I think dumb ox has a really good point here.

        • Just to play devil’s advocate … A scientist would readily admit that scientists have made huge and horrific mistakes in the course of making and testing out various hypothesis and theories about the brain. She would then point out that scientists have the ability to test and ultimately to discard these notions, while religion and philosophy are not inherently self-correcting. Thus today’s science is is probably still quite crude, particularly since we know less about the brain than any other organ. But it is also the best guide we have — certainly the second best guide, if you wish to place Scripture in the first position.

    • Part of the problem with treating mental illness is the complexity of the brain, not to mention how each person reacts to various drugs. Example, some people find skunk odor to be extremely obnoxious and others only mildly bothered by it.

      Another factor is that the brain can adapt to physical insults. If you read the book, “My Lobotomy”, the man at the end had a brain scan done. The physicans, if they had just looked at the scan, would have expected a very low functioning, if at all person, not one who had a near normal life.

  25. I believe that sin, behavior, thinking patterns, addictions, etc. have a direct bearing on our “mental health”, so to speak. However, I am not on board with movements such as Nouthetic Counseling where it is believed that all we need is found in the Scriptures. God’s Word is not a psychology book. To try and use it as such to the exclusion of other means is, IMO, terribly risky.

  26. New reader. Looking forward to this series as I have pastored for the last 20+ years and currently work in the mental health field.

  27. Part of the problem I think is that we have a tendency to limit creation to our own experience as it relates to the bible. Anything outside of our own religious experience is doubted or outright rejected. We also have a tendency to refuse to believe that unbelievers are created in the image of God just like “we” are, and can still make good observations about God’s creation. To put it into Christianese, pagans can grasp general revelation.

    If anything, Christians should be at the forefront and cutting edge of Psychology, digital technology, and all the other sciences.

    As one who has people with mental illness in my extended family (born-again Christians at that) I understand that mental illness is an area where the church must grow quite a bit. Yes, secular sciences have their own problems, but we should not reject the positive things they contribute just because we claim to read the bible. The descendants of Cain invented musical instruments . Read Genesis 4

    • Headless Unicorn Guy says:

      If anything, Christians should be at the forefront and cutting edge of Psychology, digital technology, and all the other sciences.

      More like they’re where they are with the Arts: Always a day late and a dollar short, denouncing and damning whatever-it-is as Satanic, then coming out with a shoddy sanitized Christian (TM) knockoff around the time whatever-it-is jumps the shark.

  28. Christiane says:

    Medical problems that might be causes of depression and mood disorders?
    Or the results of depression and mood swings?
    Here are some things to think about:

    Thyroid harmone imbalances (hyperthyroidism, hypothyroidism, Grave’s Disease)
    Reactions to medications (especially new medications, where a mood change is noted, or hyper-irritablility, or ‘sadness’
    Heart disease has also been linked to depression, with up to half of heart attack survivors reporting feeling blue and many having significant depression. Depression can spell trouble for heart patients: It’s been linked with slower recovery, future cardiovascular trouble.

    degenerative neurological conditions, such as multiple sclerosis, Parkinson’s disease, Alzheimer’s disease, and Huntington’s disease can set you up for mood disorders.

    stroke

    some nutritional deficiencies, such as a lack of vitamin B12

    other endocrine disorders, such as problems with the parathyroid or adrenal glands that cause them to produce too little or too much of particular hormones

    certain immune system diseases, such as lupus

    some viruses and other infections, such as mononucleosis, hepatitis, and HIV

    cancer

    erectile dysfunction in men.

    When considering the connection between health problems and depression, an important question to address is which came first, the medical condition or the mood changes. There is no doubt that the stress of having certain illnesses can trigger depression. In other cases, depression precedes the medical illness and may even contribute to it. To find out whether the mood changes occurred on their own or as a result of the medical illness, a doctor carefully considers a person’s medical history and the results of a physical exam.

    If depression or mania springs from an underlying medical problem, the mood changes should disappear after the medical condition is treated. If you have hypothyroidism, for example, lethargy and depression often lift once treatment regulates the level of thyroid hormone in your blood. In many cases, however, the depression is an independent problem, which means that in order to be successful, treatment must address depression directly.

    • Stress can cause depression, too. I think this is more than mere psychology; I think prolonged stress can cause chemical imbalances. If stress can cause stomach ulcers and heart attacks, I can just image what it can do to the brain.

  29. Interestingly, depression seems to be the most common example discussed. Of all Mental illnesses, this is the one most directly dealt with in the Bible. Read 1 Kings 19 and Jonah 4. How God deals with Elijah and Jonah are actually consistent with my MFT training.

    I think a therapist who is a discerning Christian can deal well with what is studied for a post-grad degree in most any field of counselling. The more difficult issue is the potential conflict that our Christian faith has with other professionals interpretations of with the profession’s code of ethics.

    • I haven’t seen any angels…

      • funny.
        I mean the provision for necessities (food and rest) that are often neglected by those suffering from depression and series of questions and reasoning. Not all that different from cognative therapy.

        • Headless Unicorn Guy says:

          I remember reading somewhere that at one psych hospital, if they get an emergency admission for depression (such as a suicide attempt), the first thing they do is fill the patient with food (high-protein such as meats preferred), then knock him out for about 12 hours of uninterrupted sleep. The rationale is that someone with depression severe enough to be hospitalized will NOT have been eating or sleeping properly, and getting them fed and rested often eases the depression for further treatment.

          I remember something similar happening back in ’82-83, when someone I knew suffered a complete psych collapse and had to be hospitalized for a while.

      • Headless Unicorn Guy says:

        I haven’t seen any angels…

        Not even at Lakeland? 🙂

        • Haven’t been there. Was in a different hospital – only once. Anice one, but they still lock the doors behind you.

          An angel would be very nice when I’m having a bad ‘down’ day. *smile*

          As for the food & sleep, both were probably good for that person in his situation, but many depressed people (me included) eat *more* when they’re down.

  30. Michael,

    I think the main point in this discussion, which you touched upon, is the ultimate purpose of the Scriptures. Paul highlights three central purposes of Scripture in 1 Tim 3:15-17:

    1) “to make you wise for salvation through faith in Christ Jesus.”
    2) “for teaching, for reproof, for correction, and for training in righteousness”
    3) “equipped for every good work”

    Each of the above are SPIRITUAL in nature – hence I believe the Bible is sufficient for all of our spiritual needs. Nevertheless, it doesn’t promise to meet all of our other needs. Obviously, we have physical needs that Scripture cannot satisfy (even Christ had to eat!). We also have a variety of emotional needs. God acknowledges one of them in creation when He states “It is not good that the man should be alone.” Reading the Scriptures is no cure for loneliness. Lastly, I think the same principle applies to our psychological needs. The problem is that it is easy to demarcate between the physical and the spiritual, but much harder between the psychological and spiritual. There’s admittedly more of an overlap in the latter, but the two spheres are not completely overlapping. That is the issue to me.

  31. This approach seems to shift some of what is needed for Johnny to change into an arena outside of his control. Medication-based treatments have a tendency to minimize responsibility for seeing our emotions, behavior and mental state as part of our own human stewardship.

    As someone who continually struggles with depression, I found that finally entering into therapy and accepting that I might need medication to fuction at times–not even taking the medication, but accepting that I might need it and making a decision to ask my doctor about it–filled me with peace and has made me better able to function.

    I no longer feel as if I am alone in tackling the monster, but that’s just a side benefit–recognizing that it’s not my fault that I am depressed has enabled and freed me to actually work on changing my own behavior and taking responsibility for my wellness, emotions, and mental health in a way that I was flat-out rejecting before I became open to the possibilities of therapy and medication. It has enabled me to enhance, rather than minimize, responsibility toward my own emotions and mental state and how they affect others.

    I think sometimes illness–whether something concrete like cancer or something mental like depression–forces us to rely on forces outside ourselves for healing, and that in itself can be part of the healing process. When our emotions and culture constantly bombard us with messages of “don’t rely on others,” or “sickness is weakness” or “you ought to just get happy,” relying on others and acknowledging that you can’t always be in control is viewed as weakness, but I think it’s a very important and very Christian step toward healing. I know that acknowledging, “God, this problem is outside of my control” through prayer was the first step I needed to make the decision to talk to my doctor and get help.

    I don’t think I know anyone on medication for serious mental or physical problems who isn’t keenly aware of how the medication and other outside help allows them to take responsibility for their own health in ways that they weren’t able to before getting that help.

    Allowing myself to take responsibility for my sickness as something in myself that I need outside help to fix also allows me to take responsibility for the times when I have sinned and blamed it on the untreated depression. Depression? Not my fault. Arguing that I don’t need treatment for my depression? That’s a lot of pride, there, thinking that I and I alone must shoulder my illness. Making life miserable for my roommates with my anger? Making my friends and family worry about me? Performing lazily at work because I can’t be bothered to care about anything besides my own misery? Being resentful of being stopped from committing suicide by my partner? That’s certainly a lot of sin, and it was sin informed by my attitudes toward my illness, but the sin wasn’t caused by the illness–the sin was caused by my decision not to take responsibility for getting care and controlling my illness because I thought that getting outside help meant abdicating responsibility for myself. Nothing, I think, could be farther from the truth.

  32. Thank you for this. As a Christian who suffers from mental illness, I can’t stand to be told to “pray harder” or “let go and let God” or any other of the useless platitudes we use to make ourselves feel better about someone else’s pain.

  33. Have you read the Desert Fathers on acedia?

  34. I’ve seen both sides of this issue.
    We had a guy in our fellowship several years ago who was seriously bipolar, and he kept his condition somewhat in check with meds. But he apparently read something or heard some televangelist on TV that gave him the conviction that he should stop taking his meds and trust God to miraculously heal his condition. After several weeks of this (and some seriously crazy behavior on his part) we in leadership had to put our foot down and tell the guy to take his bloody meds — which he did and leveled back out almost immediately.
    On the other hand, there was this other guy who was in our church’s alcohol and drug recovery ministry. He was a recovering alcoholic and a Vietnam Vet who had frequent flashbacks and psychotic episodes. He was also on a lot of meds prescribed by various doctors, and I highly suspect he was abusing them. In fact, he tried to kill himself by overdosing on one of his medications. Luckily, he failed. But after that, he decided to cut out the medications altogether — and his condition improved greatly. He stopped having psychotic episodes, and he was starting to resemble a functional, rational human being. Unfortunately, he had been ordered by a judge (because of his suicide attempt) to undergo counseling, And that doctor insisted that he start taking a new drug, basically giving him the choice between taking the drug and doing jail time. It wouldn’t suprise me if the doctor was so insistant because he was being offered kickbacks from the company that manufactures that drug. Facing that kind of choice, the guy agreed to take the drug — and (go figure) his mental state started to deteriorate as soon as he started taking them.
    I think situations like this call for some wisdom and discernment on the part of both the mentally ill person and those close to that person. I believe that professional treatments and medications do help a lot of people from slipping over the edge. I also believe that the transforming power of God in a persons life can heal emotional and mental problems. And I don’t think God insists that we abstain from modern medicine or science before He’s willing to do His own healing work in our lives. He’s God, and He can do His thing alongside medical science or without it. And rejecting the help of modern medicine isn’t necessarlily an act of faith. Sometimes, it’s just pure ignorance at work.
    Then again, I don’t think it’s too wise to completely trust everything that comes down the pipe in the world of medical science. There’s a lot of monetary incentive driving some diagnosis and prescriptions — and there are some professionals in the fields of medicine, psychiatry, and pharmacy that would like to keep us all doped up so that they can better line their pockets.

  35. This is a very good post: balanced, thought provoking, informative, and articulate. The subject matter and tone indicate you would find a particular work of literature to be of considerable interest and especially relevant. I refer to my recently released biographical novel, Broken Saint. It is based on my forty-year friendship with a gay, bipolar, Mormon man, and chronicles the intense internal and external struggles of his bizarre and often troubled life as he battles for stability and acceptance (of himself and by others). More information is available at http://www.eloquentbooks.com/BrokenSaint.html or authorautobahn.webs.com/bookpeek.htm.

    Mark Zamen, author