Mental health is a major concern in the United States, and Christian books concerning depression, anxiety and other mental health issues are common bestsellers. Yet the majority of pastors rarely or never discuss it on Sunday mornings.

A 2018 study by Lifeway research brought the issue of how mental health is addressed in churches to light. The study found that although 66% of pastors rarely discussed mental health issues from the pulpit, over half have counseled someone with an acute mental illness, and ¾ of those surveyed knew someone personally who suffered from clinical depression. The study found that almost a quarter of pastors surveyed struggled with mental illness themselves. If this is the case, why aren’t pastors speaking about this more often?

A major misconception that exists among Christians regarding mental health concerns is that issues such as depression and anxiety are the result of a lack of faith or a lack of Biblical knowledge. John Piper for example wrote, “Jesus says that the root of anxiety is lack of faith in our heavenly Father” and cited Matthew 6:25-34 to make his point. While there is certainly wisdom to be gained about the relationship of trust and anxiety in everyday life, those who suffer from chronic anxiety and panic are often made to feel worse rather than better from this thinking. Often leaders such who promote this view point to the sufficiency of scripture “to meet every need of the human soul”.

“Churches have looked to psychology to fill the gap, but that is not going to work. Professional psychologists are no substitute for spiritually gifted people, and the counsel psychology offers can not replace biblical wisdom and divine power. Moreover, psychology tends to make people dependent on a therapist, whereas those exercising true spiritual gifts always turn people back to an all-sufficient Savior and His all-sufficient Word.” John MacArthur

Even if not put forth explicitly from the pulpit, congregants often feel that their anxiety and depression symptoms get in the way of their relationship with God and may feel that they are ultimately responsible for their symptoms. Some feel that their faith should make them immune to depression or addiction, or that they will be delivered from it through prayer and fasting. When dealing with mental health issues then, counseling and medication are seen as “last resorts” when all else has failed. Some pastors may even scold those who go to counselors for not giving God a chance to work or having a lack of faith. All of this leads to a great deal of confusion, pain and heartbreak among Christians dealing with mental illness, either their own or in their family.

One major reason is simply that clergy are not trained in seminary to discuss or even recognize mental illness. Many seminaries such as Fuller Theological Seminary offer degree programs in psychology and ministry, however these tend to be designed for those seeking to become professional counselors and therapists.

Another reason for this has been the sometimes-rocky relationship between psychology and Christianity. Several months ago I received a response to a post I had put up on a discussion board concerning psychology and faith that posed an interesting question: “show me where the bible approves of psychology”. My first thought was to respond “show me where the bible approves of plumbing” but instead I tried to engage in a discussion with this person about how psychology and faith interact. It didn’t go very well. We had differing interpretations of scripture as well as vastly different concepts of what psychology was.

The Warfare Model

This person’s perception of psychology is part of one particular worldview concerning the relationship of Christianity and the rest of the world, although “relationship” may not be the best term as the two only relate through conflict. You can call it the “warfare” view, as it sees Christianity and psychology to be not only in separate spheres but opposed to each other. I’ve seen proponents of this view call psychology “heretical” and further state that if people “receive the truths of God’s Word, they don’t need any other help.”

Mental illness in this view is seen primarily as a sin problem or spiritual problem, and terms like “spiritual warfare” are used to describe the situation of those dealing with mental health issues like depression or addiction. Going to a psychologist or even a Christian counselor could be regarded as counter to one’s faith or may even lead to loss of one’s salvation.

In a similar way some psychologists and counselors may see the theological convictions of some as damaging or even a sign of mental illness themselves. A person who claims to hear directly from God or to speak in tongues may be seen as having a mental illness, or a woman who believes men are biblical heads of the household may be chastised for not being more independent.

In both cases, each side sees the other as being wrong, dangerous or immoral. This model is not as prevalent as others, but it tends to draw the most attention due to the polarizing arguments made on both sides.

The “Two Kingdoms” Model

A second way of looking at the relationship of psychology and Christianity could be called the “two kingdoms” view. Here the relationship is not viewed by conflict with one another, rather the two are understood as two completely separate spheres of influence. While the two spheres don’t compete, neither do they interact or inform the other. While this view has the benefit of not relying on conflict and has a more positive view of psychology than the warfare view, it suffers in that it fails to see connections between faith and other aspects of life including mental health.

A Christian in this view is free to use psychology as a tool towards health and well-being, but by keeping faith compartmentalized she or he fails to see the connections between their thoughts, feelings, emotional difficulties and faith. Psychologists in this model may not even ask questions about a person’s faith because he or she may see religion as mostly irrelevant to the problem they are having.

This view may also lead to conflict and confusion in areas where the church may see something as a sin issue (pornography for example) while the psychologist may not see it as harmful.

The “Supercessionist” Model

A third model could be called the “supercessionist” worldview. In this view psychology is accepted but only within the bounds of theology. Proponents of “Biblical counseling” and nouthetic counseling for example practice counseling but do so only within the bounds of scripture and theology. Psychological knowledge and practice are accepted only if clearly within the bounds of scripture, and the Bible is considered the primary source for counseling and therapy. Psychology is viewed with suspicion, but not in all-out spiritual conflict with Christianity. This view, while it holds the other as valuable, also tends to see it either implicitly or explicitly as inferior.

Counselors may also operate within a supercessionist model where religious beliefs are considered acceptable if they fall within the boundaries of what is acceptable and normal according to their particular theoretical base.

The Integrative Model

The fourth and final model for this discussion could be called the “integrative” model. This model recognizes that Christianity and psychology have areas where they both interact, overlap and influence each other, but that they also have areas where they are independent from each other. Each could be considered authoritative and helpful within the spheres of influence. Psychology for example does not broadly speak to issues related to salvation or the life and work of Jesus, and Christianity does not speak to neuropsychology or brain function. However there is a great deal of overlap where both psychology and Christianity inform, support and challenge each other. Secular therapeutic techniques such as EMDR can be paired with spiritual direction and prayer to help treat post traumatic stress disorder for example. Psychology and Christianity are not in total conflict as in the “warfare” model, nor are they completely detached from each other as in the “two kingdoms” model. While it has the most in common with the “supercessionist” model in that it recognizes that Christianity is authoritative in matters of faith, it is more willing to accept secular psychological research and treatment paradigms as valid even if they are not explicitly “Biblical”.

A main benefit of the integrative model is that it recognizes that our selves are not made up of separate spheres of influence. Our biology, genetics, environment, faith, emotions, cognition and relationships all operate as a system, each influencing the other in a dynamic way. To leave any part of our life out of the overall equation in discussion of mental health and mental illness weakens our understanding of it and is incomplete at best. There will certainly be conflict though between psychology and Christianity, and where those boundaries are drawn can be ill-defined.

Avoiding discussion or preaching on mental health issues is not really an option. Every congregation has been touched in some way by traumas such as suicide and unexpected loss. Every congregation has members struggling every day with hopelessness, anxiety, and addiction, even if everyone looks the same with hands raised in praise. Pastors can lead and shepherd those in their flocks that are dealing with emotional struggles and mental illness best by not attacking their pain as spiritual failure. Neither can clergy simply ignore the issue because it’s not part of proclaiming the gospel.

Clergy can help dramatically by talking openly about mental health concerns, even the difficult ones such as suicide. There is tremendous evidence that talking about issues like suicide helps to defuse those feelings in others even though the fear is often that it will bring them around. Talking about mental health as part of the whole person – spiritual, physical, emotional, social – will help those suffering directly and indirectly by showing them that they are not alone.

We’ll pick up in this discussion later and see about ways in which pastors and leaders can do that.