Repost in Response to John Piper: The Chaplain and Mental Illness


Recently John Piper, through his Desiring God twitter account, sent out the following message: “Stop seeking mental health in the mirror of self-analysis, and start drinking in the remedies of God in nature.” The result was a backlash from many concerned with this apparent disregard for the nature of mental illness. A friend of mine told me afterward that he had recently lost a friend to suicide and that this sentiment was not helpful in the least.

Piper later walked back on his statement a bit, adding the context of the statement for clarification, noting that “mental health” meant something different 40 years ago.

To be quite honest, the suggestions included in the text (“10 Resolutions for Mental Health”) were quite interesting and would be beneficial for anyone. I recommend you read them. However couching this advice for “mental health”, knowing that true mental health is not just an intellectual endeavor but involves the interplay of biology and psychology as well, is still irresponsible.

Many shared their own stories of the battle between faith and true mental illness.

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Christianity today still has much to learn about mental illness. Following is a post I originally wrote in 2015 which speaks to this further.

The issue of how Christians deal with mental illness has been on my mind as of late. One reason is that I’ve been going through my own therapy for anxiety and depression, which rears its head from time to time in my life. Second is that I came across a LinkedIn discussion in a pastor’s network group that had some pretty ugly things to say about mental illness and psychotherapy.

Writer and musician Shaun Groves recently posted his own reflections on depression and faith on his blog, and while I can’t repost the whole article, I would certainly recommend it to you (here’s the link). He had written about his father-in-law’s death as a result of suicide and while many offered their sincere condolences some of the responses were a bit shocking. One wrote, “Did he not believe the words from scripture he read to his church?”. Another wrote, “The Bible tells us not to worry, not to fear, be afraid, etc. 366 times, one for every day of the year including leap year! What can stinkin thinkin do, but make a person sick?”.

Groves went on to site research that found that for those who self-identified as Evangelical or Fundamentalist Christians, people were split evenly when asked if they thought depression, bipolar disorder or schizophrenia could be cured by faith alone (48% yes vs. 47% no). This attitude was quite different than those of Americans in general.

source: shaungroves.com

Dr. Marcia Webb, a clinical psychologist with Seattle Pacific University, found similar results:

Over the years, in my own experience as a Christian, I often heard statements in church settings, from both congregants and religious leaders, associating mental illness with lack of faith. I started to investigate this possibility further by reading research in the psychology of religion literature. I would learn that a significant portion of the Christian community in countries around the world endorses the belief that believers should be immune from mental disorder, and that mental disorder may be evidence of either personal sin or demonic influence (Cinnerella & Loewenthal, 1999; Dain, 1992; Hartog & Gow, 2005).

Part of the problem is that some Christians see psychology and counseling as antithetical to faith. I was once told that “‘Christian Psychology’ is an oxymoron. A Christian should not need Psychology because they have the Prince of Peace.” When I brought up issues around the importance of counseling  it was written off as “psychobabble”. While this individual was certainly in the minority in this particular discussion, it’s certainly not the only time I’ve heard of it.

It’s not hard to find popular Christian books decrying psychology with titles like “The End of Christian Psychology”,
“Why Christians Can’t Trust Psychology”, and “Psychobabble”.  While most of these titles tend to be older, they are still widely available and promoted by churches and religious broadcasters.

What this has to do with Chaplaincy is that we need to be aware that for some their faith, at least from our perspective, will be a hindrance to their healing and development. We will on occasion  come across those who need more help than we can offer, and our mandate is such that we direct them to the help that they need. It’s not uncommon to direct someone to professional counseling to get help with mental illnesses such as depression. Stresses that come from hospital stays, ER visits, long-term illness and starting hospice can exacerbate problems to the point that normal coping strategies fail and mental illness can take hold. Many Chaplains, myself included, take advantage of counseling and psychological support from time to time. I would bargain that most professional Chaplains have a very favorable view of psychology and counseling.

So when we run up against those who are suspicious of psychology, or even outright hostile towards therapy, what are we to do when we feel that they may benefit from it?

The first thing we need to do is leave space to find out why. Did they or someone they know have a bad experience in the past? Is psychology seen as something contrary to God’s will? Do they feel that they have to handle things on their own without help? Finding out his or her concern about getting help is an obvious but important first step to overcoming those obstacles.

There are many common concerns that people have regarding counseling and treatment which get in the way of getting help. Researchers have identified some of the most common ones as:

  1. Social Stigma & Social Norms: Research has found that when a person’s culture or subculture (religion, social network, family system) sees counseling as a negative event or a “last resort”, than that person is less likely to seek out help. Mental illness tends to have very poor connotations in society, and people may fear being labeled with a disease or diagnosis. The Chaplain can help here by providing positive reinforcement and affirming self-worth regardless of societal “labels”. There may be situations where psychological treatment may actually be seen as a negative in their job or family. In these cases care must be used to support the person to find treatment while at the same time minimizing risks. The Chaplain can also help identify and reinforce new social structures that are more supportive, while at the same time helping the individual cope with any backlash from others.
  2. Treatment Fears: There is very limited understanding of treatment options available and what they may involve. Some may jump to extremes such as scenes of ECT or therapy in films and conclude that all therapy is similar. Providing information on treatments and sharing one’s own experiences will help tremendously here. One can also encourage folks to simply try counseling for a period of time, with the understanding that if things don’t go well with a certain therapist or treatment plan then they can try something else. Reframing professional counseling as education, life coaching, or support groups can also go far to alleviate fears and misconceptions.
  3. Fear of Emotion & Self Disclosure: Some may fear what would happen to themselves emotionally – or spiritually – when long withheld feelings and truths are brought out. It may be that the person may not have much experience opening up, and doing so makes them feel vulnerable or stupid. One may fear judgment or criticism as well. Here, the Chaplain can help by encouraging the person to talk about their feelings and reflect back when they are doing so. Recognizing and reinforcing this will help someone tremendously when entering therapy. Use of positive regard and maintaining a calm demeanor when confronted with difficult subjects are also critical here.
  4. “Risks Outweigh the Benefits”: The negatives associated with therapy (as stated above) may be overemphasized while the potential benefits may be minimized. Researchers have found that the perceived risks and benefits are the two most influential factors in whether or not one seeks treatment. The Chaplain here can help by allowing the person to give full vent to their apprehensions and reflecting them back in a more realistic manner, asking about the probability of that actually happening. The Chaplain can also confront minimized strengths and benefits, which will also minimize the negatives.

While Chaplains may not formally provide therapy and treatment, the support and direction that they provide can be critical to those suffering from mental illness. The Chaplain’s own experience and struggles, especially if they involved personal counseling, can also go far to normalize the experience of needing help, affirming that one is not alone in the healing process.

 

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9 thoughts on “Repost in Response to John Piper: The Chaplain and Mental Illness

  1. I have a BSW and I am working towards my MSW and clinical licensure. I can say with assurety that one must take the DSM with a grain of salt. The elephant in the room is that the DSM is used as a means to diagnose persons for the purpose of medicaid and medicare reimbursements. This is how licensed mental health counselors and psychotherapists get paid unless they charge a flat fee for non insured clients. I believe as Christians we must be wise and recognise the political and monetary ramifications of “diagnosing” people.

    Also, as a Board Certified Chaplain working towards licensure as a mental health counselor in my state, I work with many individuals in our Behavioral Health Unit, and as Hiratio mentioned earlier many of the patients I visit aside from a few specific cases are dealing with spiritual issues not “mental” ones. What is unfortunate is that once a person has been “diagnosed” by a clinician with the DSM that label goes with them and then they are given drugs that do begin to have adverse affects on their mental state. However, by this time it is too late because now that person has been labeled and people/clinicians treat them as such.

    I am also noticing chaplaincy wanting to move into the direction of trying to receive a UNBC like licensed mental health counselors, licensed clinical social works, etc for the purpose of being able to bill medicaid and medicare for services.
    I’m not against helping and treating people with severe cases of mental disease such as dementia, alzheimer’s etc where nuclear test have shown delpetion of brain cells and functions, but most if not all mental “mainstream” diseases can be treated with the power of God.

    I’m glad that when Jesus encountered the man in the Gerasenes he did not refer him to a mental health counselor.

  2. Thank you for your kind and thoughtful words brother. Please do not see this as adversarial

    I’m not a fan of The Copeland’s, nor would I call them mainstream. Yes, I can see where stating faith alone may be an issue. However, it seems fair to say you need faith to get through it. However, the statement at the bottom of that link shows counseling (biblical and secular), as well as drugs under medical supervision may be options they/he agree with.

    NIMH states: “PTSD is defined as a someone who have experienced a shocking, scary, or dangerous event”. Any event can be a rape, beating, scared by a relative, roller-coaster, losing a limb due to gun shot, workplace accident, or natural disasters. Any event. In the case of this article – war.

    Symptoms include:
    Living through dangerous events and traumas, Getting hurt, Seeing another person hurt, or seeing a dead body, Childhood trauma, Feeling horror, helplessness, or extreme fear, Having little or no social support after the event, Dealing with extra stress after the event, such as loss of a loved one, pain and injury, job loss or home, Having a history of mental illness or substance abuse

    NIMH further states: “The main treatments for people with PTSD are medications, psychotherapy (“talk” therapy), or both. Everyone is different, and PTSD affects people differently so a treatment that works for one person may not work for another. It is important for anyone with PTSD to be treated by a mental health provider who is experienced with PTSD. Some people with PTSD need to try different treatments to find what works for their symptoms.”

    https://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml

    Most go through one or more of these issues in life, and sometimes more than one at one time. Not all deal with it the same, but universally understood in and outside of Christianity.

    The main thrust of treatment in the NIMH article states maybe drugs, but absolutely talking through, asking questions, listening, empathy, and giving ‘homework’ to cope before, during and after triggered. This is taught first day of the first weekend of biblical counseling class.

    Bible Characters who have been held up as PTSD survivors are; Job who lost his entire family and all his goods to those we’d call war lords today. David – chased by Saul and his band of men as well as reprimanded by God for Bathseba, and murder. The bible speaks to, but is not called PTSD. It also shows how to, and not too give advice. If we are scared, a biblical counselor should provide ‘talk therapy’ just as a psychologist would do. A biblical counselor would also state that they believe a person may use a drug to quell PTSD.

    A biblical counselor could certainly be trained in the soul therapy portion of treatment. Maybe not specifically for war trauma. There are some who are, and more resources will be forthcoming from biblical counselors. Here’s one.

    http://biblicalcounselingcoalition.org/tag/ptsd/
    https://pastordaveonline.org/2017/11/27/a-review-of-helping-your-family-through-ptsd-by-greg-gifford/

    Where the biblical counselor may disagree is:
    1. Does the issue truly warrant the drug?
    2. If they do need it, for how long? Especially in light of today’s opoiod crisis?
    3. The CLOSENESS of the relationship between the counselor and counsellee.
    4. Is the person dealing or not dealing with underlying issues?

    Just one example of many I’m intimate with:
    I have the opportunity to counsel a person deemed to have PTSD due to losing a limb. They also lost their marriage and meaningful relationships with family and former friends. While admitting to some of the problem, they’ve never faced changing the issues that brought the underlying issue. The person had a SUD’s issue which seems to have played into the limb loss. They were then given drugs to alleviate pain, which lead to the abuse of the drug. Then, mixing of the drug with alcohol, then rehab. Now deems themselves ‘clean and sober’, while continuing to use the original drugs, and adding weed. The person does not sleep, eats very little, and is back on a dosage of original drugs which is too high leading to extreme hyper activity, and lends to non-sleep.

    What does psychology and the bible say that would be dramatically different in dealing with this person? Or, is the question which one is better at dealing with the underlying issue? Unfortunately, it may be that the person will never deal with the issue. So, I continue to pray and reach out to the person. The bible doesn’t speak specific to limb loss, but it does speak to hiding our underlying problems, soaking in drugs, sober-mindedness, repentance, forgiveness, (problem for the person), and giving ‘wine’ for a period of time to hurting souls.

    Sorry, it’s long. I truly appreciate the opportunity to speak to others about these issues.

  3. I’ve attended probably the largest biblical counseling seminars in the country that believe in biblical sufficiency. There are a number of trained doctors and those who were trained in christian and/or secular psychology. None of those I have spoken to do not believe people should see doctor’s if necessary. It might be ‘when’ they believe.

    This is just my observations from those I have had contact with in counseling/mentoring, family, friends and myself. Most issues I’ve seen of depression are related to inadequate relationships with others were someone has done someone wrong, and you feel bad that you did it, or it was done to you. Yes, that’s a general nutshell statement, but it’s been what I’ve observed. This is also whether they are Christian or not.

    A person who has cheated on their spouse, has remorse, and guilt. THey did it to themselves. That spouse or philanderer may leave, may medicate with drugs of some sort to mask their guilt, or the spouse leaving. The woman goes on drugs as well to mask the hurt of their spouse hurting them. The kids are adversely affected by all of this and are on anti-depressants as well.

    An alcoholic kills someone with their car. THey were already masking their problems, but go deeper. The family is ruined in some cases, and the same as before happens as the above scenario. Drugs mask the underlying issue. One of the kids is so distraught, they start cutting, then attempt suicide. Each person has a mental health issue

    Each is directly related to a biblical principle and very likely resolved with a biblical answer. I’m not poo pooing other means, just stating that biblical counselors are also dealing with the soul, which is what psychology is about.

    Again, just my observations.

    • I think those are valid insights Horatio within the proper context. For many individuals counseling, including Biblical counseling, is sufficient to relieve symptoms and make effective life changes. This is when the problems can be viewed primarily within the context of making poor decisions or confronting sinful behavior. The examples you provide – inadequate relationships, infidelity, and self-medication – would lend themselves to those kinds of solutions. But they would not fall into what I and most others consider to be mental illness. These are things that would be included in the DSM-V and would include things such as major depression, bipolar disorder, and PTSD. While scripture surely has something to say in these diseases and I would certainly argue that the proper positive use of biblical teaching would be beneficial, I would not see it as a primary or sole solution.

      I think also it’s can be too simplistic to say that psychology is solely dealing with the soul. Psychology takes into account not only the emotional and cognitive aspects of the person (perhaps calling this “soul”) but also the biological, genetic, social and familial systems as well. It was well drilled into my head that all behavior has multiple determinants. Therefore we need to look at all of these areas as best we can. Many Christian counselors reflect this, but some – again, I hope I minority – only see faith or sin problems and only treat problems as such. Much of this is due to training. When all you are given is a hammer, everything becomes a nail. Treatment or therapy that goes beyond the Christian in Christian counseling could then be seen as a “last resort” or an inability to address the sin problem, causing some to forego treatment or to be forsaken by the church or minister in question.

      And I say all this right on the heels of a prominent Christian televangelist saying that those with PTSD should seek medical help if their faith is not “fully developed” (http://www.thestate.com/news/local/article197633619.html) with the fairly clear insinuation that faith alone *should* be able to heal PTSD, but only if your faith is strong enough.

  4. This is such a helpful and interesting blog! Thank you for taking the time to write about these things. I’m currently exploring chaplaincy as part of my vocation discernment, and your blog is a wonderful resource.

  5. Strangely, churches have also take up the role of counselor – using noulithic or biblical counseling, the idea being is that if you read the Bible enough, pray about it enough, then with the help of your counselor who exhorts scripture to you, you’ll overcome anything. It’s becoming the Christian alternative to traditional psychology. But it’s also replete with stories of people who weren’t helped by it.

    • Some churches do take the approach that the Bible is sufficient to resolve all issues related to mental health as you say. However I’m hoping that those are becoming a minority. Many pastors and churches either know enough when to refer to trained counselors or psychologists, or else have them in-house through a counseling agency. Theology can certainly be a help and should be brought in to the counseling experience, but it is not always the entire or best solution.

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