The Christian Mental Health Problem
Does the Bible specifically address mental health issues? No. No, it does not. Just like the Bible is not a science book, but is correct and accurate when it addresses scientific matters; the Bible is not a handbook on mental health issues, but mental health issues do exist in Scripture.A fair and honest examination of the men and women of Scripture reveal the presence of mental health issues. Several key examples are present.
- Job became anti-social due to his depressive state (Book of Job)
- King Saul fought battles of depression and anxiety (1 Sam. 16:14-23)
- King David was routinely given to extreme emotional distress and depression (Psa. Psalms 6, 13, 18, 23, 25, 27, 31, 32, 34, 37-40, 42-43, 46, 51, 55, 62-63, 69, 71, 73, 77, 84, 86, 90-91, 94-95, 103-104, 107, 110, 116, 118, 121, 123-124, 130, 138, 139, 141-143, 146-147)
- Elijah was stuck in self-pity and became suicidal (1 Kings 19:3-18)
Every human being is comprised of a body, soul, and spirit. These three cannot be neatly separated and examined. They intertwine to form a cohesive whole; a person. Thus, the physical, psychological, and spiritual all come to bear in the mental health realm. Because of the Fall of Adam humanity is totally depraved. Our complete sinfulness effects every portion of our humanity – body, soul, and spirit. Sin, with its effects, is increasingly getting worse (2 Tim. 3:13), therefore, it is understandable that mental health issues would be on the rise.
The prevalence of mental health issues among Americans is staggering. The statistics published by the National Alliance on Mental Illness (NAMI) bring to light the severity of the mental health issues we face as a society.[1]
The prevalence of mental health issues among Americans is staggering. The statistics published by the National Alliance on Mental Illness (NAMI) bring to light the severity of the mental health issues we face as a society.[1]
- Approximately 1 in 5 adults in the U.S.—43.8 million, or 18.5%—experiences mental illness in a given year.
- Approximately 1 in 25 adults in the U.S.—9.8 million, or 4.0%—experiences a serious mental illness in a given year that substantially interferes with or limits one or more major life activities.
- Approximately 1 in 5 youth aged 13–18 (21.4%) experiences a severe mental disorder at some point during their life. For children aged 8–15, the estimate is 13%.
- 1.1% of adults in the U.S. live with schizophrenia.
- 2.6% of adults in the U.S. live with bipolar disorder.
- 6.9% of adults in the U.S.—16 million—had at least one major depressive episode in the past year.
- 18.1% of adults in the U.S. experienced an anxiety disorder such as posttraumatic stress disorder, obsessive-compulsive disorder and specific phobias.
- Among the 20.2 million adults in the U.S. who experienced a substance use disorder, 50.5%—10.2 million adults—had a co-occurring mental illness.
Sadly, the American evangelical community has largely ignored or excused mental health issues. The ignorance within many American churches has typically polarized around three prevalent responses from pastors and churches.
The first, and most naïve, is that mental health issues are a result of Satanic or demonic attack or possession. The treatment of such issues is to exercise the demonic possession and/or withstand the demonic influence. While the New Testament does say that believers are in a spiritual battle (Eph. 6:11ff), there is no link of the Satanic/demonic with mental health issues; let alone any command to do spiritual battle in such arenas. It is simplistic, irresponsible, and naïve to attribute all mental health issues solely to the realm of the demonic.
Secondly, there is the position that every mental health issue is a sin issue. Pastors are largely the most guilty in this realm. They have attempted to tackle mental health issues themselves; claiming that every problem is a sin problem that can be addressed through biblical counseling alone. Many of these pastors are poorly equipped at best, and most are totally ill-equipped to help someone with a genuine mental health concern. Too often, however, pastors suffer from a genuine heart to help people and an ardent adherence to the truth of Scripture. This heart can bleed over into a Messiah complex that causes pastors to believe they are the only ones qualified to help people. Their ardent adherence to the truth of Scripture can breed a skeptical distrust of anything secular; particularly something that can tread on their spiritual turf. Sadly, the ineptitude and jealousy some pastor exhibit in the mental health realm does more harm than good to those in their care who genuinely suffer from mental illness. This does not mean that sin may not be an issue at play in someone who is depressed or anxious, for example. However, there are so many other factors at play that can be contributing to a person’s mental health issue that nullifies this approach as overly simplistic.
Thirdly, the evangelical community often demonizes any secular psychiatry and psychology as purely humanistic and ungodly, and therefore not appropriate for Christians. Some within the evangelical community devolve into straw man and ad hominem criticisms of anything secular that touches the human psyche. Pastors and believers believe that every battle is a spiritual battle in the soul of man and that the best cure for mental health issues is to have more faith and spend more time in Bible reading and prayer. Let’s be honest. Humanity at large has a very real spiritual problem; separation from life in God due to sin and the total depravity it brings. As was stated above, sin is debilitating and God’s curse on the physical universe and humanity in particular as a result of the Fall is the ultimate underlying cause for mental health issues – along with relational issues, physical sickness, death, difficulty in work, etc. (Gen. 3:14-19). The biblical cure for this base issue is the new life that is found in Jesus Christ alone for salvation, but that does not mean that becoming a Christian instantaneously and automatically solves the very real mental health issues faced by so many – even in the community of believers. The effects of the curse on sin as a result of the Fall continue to be felt and addressed by all mankind, including Christians, until God restores the universe to His original design pattern and removes the presence of sin altogether (Rom. 8:16-23). It is, therefore, naïve to turn a blind eye to the root causes of certain mental health issues; lumping them all together as spiritual issues. It is equally naïve to ignore the spiritual aspects at play when treating mental health issues among Christians.
The Viability of Secular Mental Health Models
The question for many within the evangelical community has been how to handle secular treatment of mental health issues. By and large, secular treatment philosophies and protocols have been viewed with distrust within the evangelical community. Dr. Sarah Rainer points out that this need not be the case. She states, Secular psychologists operate on a biopsychosocial model of human development and behavior. This model proposes humans develop and operate according to biological, psychological, and social influences. Accordingly, we are products of our biology and environment, both bearing equal importance.
In more recent years, psychologists have begun recognizing that our spirituality impacts our lives, but have yet to say it is imperative for life. While the traditional psychological theories and models that are based upon naturalism are insufficient from a Christian worldview, not all secular psychology is wrong. Indeed, there are many helpful and positive aspects of psychology to consider, which is why there is a need for integration.[2]Rainer goes on to rightly point out that, for the Christian psychologist or psychiatrist, their worldview must be determined by Scripture, but that does not mean that secular methodologies and treatment protocols are not viable. Rainer calls for the integration of a distinctly Christian worldview with certain aspects of secular treatments. Rainer makes several salient points in this regard.[3]
Allow me to reiterate and expand on some of them.
What Dr. Rainer is saying is that the evangelical world need not throw out the proverbial baby with the bath water.
The Christian and Mental Health Treatment
The remaining question is whether or not it is permissible or advisable for a Christian to seek secular help for mental health issues. It’s a perplexing question to be sure. On the one hand, we who follow Jesus should have an unshakable fidelity to the Bible and its sufficiency for our problems. On the other hand, the Bible was not designed to be a handbook of mental health treatment protocols. As Sarah Rainer advocates, a synthesis of the best secular psychology and psychiatry offers, filtered through the truth of biblical revelation, is the best avenue for the believer.
It is good to distinguish here pastoral/biblical counseling and psychological counseling. While there may be some overlap, pastoral counseling focuses on man’s deepest issue – his broken relationship with his Creator-God. It reminds us that we are more sinful than we could have ever imagined, but equally loved more than we can comprehend. It addresses our sin problem which runs deeper and is more pervasive than we thought. It reminds us that as believers we have died to sin and need not be bound any longer by its grip. We have been set free in Christ and are free now to live as saints within the Body of Christ. Pastoral counseling confronts man with his brokenness, need of the Savior, and opportunity to be redeemed by God’s grace. Once that occurs, it seeks to help the believer live according to the revealed truth of God as he is transformed by God’s sanctifying grace into a person who accurately reflects Jesus Christ.
Secular psychological counseling accepts that men are broken and seeks to help them find strategies to cope in a difficult world. It approaches the human predicament from a bio-psycho-social model. It challenges negative thought patterns and behaviors that make things worse for us as we live in a complicated world. It addresses inter-relational patterns of human interaction and often tries to create a safe space where we can share life’s difficulties.
For the Christian, a synthesis of pastoral counseling and secular psychology in a bio-psycho-social-spiritual model, as advocated by Rainer, is often the best treatment protocol for mental health issues. This is where pastoral counseling can work in tandem with a Christian psychologist or psychiatrist who approaches life and practice from a Christian worldview to address the individual holistically. There are times when individuals are not going to be responsive to the Gospel or be able to address their spiritual needs until their present symptoms have been addressed. Secular techniques can be very helpful in treating mental health symptoms and helping individuals gain a level of health that allows them to address spiritual matters cogently.
What is a believer to do when a Christian psychologist, psychiatrist, or counselor is unavailable and a mental health crisis occurs? It is foolish to ignore mental health issues, especially when the underlying cause is unknown. Secular psychologists and psychiatrists are perfectly capable of diagnosing and treating mental health issues and mental illness. No pastor is qualified to diagnose a mental health issue, let alone any biological mitigating factors which may accompany it. There is really no biblical reason not to engage the services of a secular medical professional when it is needed; even Jesus recognized that those who are unhealthy need a doctor (Luke 5:31).
AFTERWORD:
I have not addressed ministry within the realm of disability, whether emotional, psychological, or physical. I highly recommend the work being done by Dr. Stephen Grcevich at Key Ministry - http://www.keyministry.org/ Key seeks to build the Body of Christ by empowering churches to minister to families of children with hidden disabilities.
- Scripture and the Gospel must be prominent. The belief in and use of Scripture and the Gospel should permeate the Christian treatment of mental health issues. This is a recognition that there is a spiritual aspect in play in mental health issues. This is true perhaps more so than any other medical field because mental health issues and mental illness stems so much so from the human psyche; the human soul.
- Operate on a middle ground. The biopsychosocial model of the human nature can be appreciated. As Christians, we can learn about the complexities of humanity, the intricacies of the human brain, environmental influences on human personality, and the social and cultural impacts on behavior and mental health. Such middle ground removes the naïve simplicity of reducing all mental health issues to morality or sin issues, while simultaneously recognizing that all humanity is plagued by the curse of sin and separation from God apart from Christ. Operating from a middle ground seeks to learn from the secular model without abandoning the spiritual aspect of humanity as beings created in God’s image. It is a philosophy of viewing mental health that considers both the depravity and dignity of humanity.
- Secular techniques can be helpful. The use of certain secular therapy techniques is not inherently wrong for the believer. The conflict arises when secular techniques contradict Biblical truth. The issue here is one of dependence. Because God’s provision of the ultimate cure for the base human issue of sin lies exclusively in Jesus Christ, simply relying on secular techniques which abate symptoms undercuts the individual’s need for the Savior. That does not mean, however, that secular methodologies are not viable.
- Secular research can be appreciated. Ultimately, all truth is God’s truth. Christians cannot ignore secular research simply because it is not being conducted from within a Christian worldview. However, secular research must be filtered through the biblical grid.
What Dr. Rainer is saying is that the evangelical world need not throw out the proverbial baby with the bath water.
The Christian and Mental Health Treatment
The remaining question is whether or not it is permissible or advisable for a Christian to seek secular help for mental health issues. It’s a perplexing question to be sure. On the one hand, we who follow Jesus should have an unshakable fidelity to the Bible and its sufficiency for our problems. On the other hand, the Bible was not designed to be a handbook of mental health treatment protocols. As Sarah Rainer advocates, a synthesis of the best secular psychology and psychiatry offers, filtered through the truth of biblical revelation, is the best avenue for the believer.It is good to distinguish here pastoral/biblical counseling and psychological counseling. While there may be some overlap, pastoral counseling focuses on man’s deepest issue – his broken relationship with his Creator-God. It reminds us that we are more sinful than we could have ever imagined, but equally loved more than we can comprehend. It addresses our sin problem which runs deeper and is more pervasive than we thought. It reminds us that as believers we have died to sin and need not be bound any longer by its grip. We have been set free in Christ and are free now to live as saints within the Body of Christ. Pastoral counseling confronts man with his brokenness, need of the Savior, and opportunity to be redeemed by God’s grace. Once that occurs, it seeks to help the believer live according to the revealed truth of God as he is transformed by God’s sanctifying grace into a person who accurately reflects Jesus Christ.
Secular psychological counseling accepts that men are broken and seeks to help them find strategies to cope in a difficult world. It approaches the human predicament from a bio-psycho-social model. It challenges negative thought patterns and behaviors that make things worse for us as we live in a complicated world. It addresses inter-relational patterns of human interaction and often tries to create a safe space where we can share life’s difficulties.
For the Christian, a synthesis of pastoral counseling and secular psychology in a bio-psycho-social-spiritual model, as advocated by Rainer, is often the best treatment protocol for mental health issues. This is where pastoral counseling can work in tandem with a Christian psychologist or psychiatrist who approaches life and practice from a Christian worldview to address the individual holistically. There are times when individuals are not going to be responsive to the Gospel or be able to address their spiritual needs until their present symptoms have been addressed. Secular techniques can be very helpful in treating mental health symptoms and helping individuals gain a level of health that allows them to address spiritual matters cogently.
What is a believer to do when a Christian psychologist, psychiatrist, or counselor is unavailable and a mental health crisis occurs? It is foolish to ignore mental health issues, especially when the underlying cause is unknown. Secular psychologists and psychiatrists are perfectly capable of diagnosing and treating mental health issues and mental illness. No pastor is qualified to diagnose a mental health issue, let alone any biological mitigating factors which may accompany it. There is really no biblical reason not to engage the services of a secular medical professional when it is needed; even Jesus recognized that those who are unhealthy need a doctor (Luke 5:31).
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