No longer drink only water, but use a little wine for the sake of your stomach and your frequent ailments. (1 Tim. 5:23)
Is there no balm in Gilead? Is there no physician there? Why then has the health of the daughter of my people not been restored? (Jer. 8:22)
For thus says the LORD: Your hurt is incurable, and your wound is grievous. There is none to uphold your cause, no medicine for your wound, no healing for you. (Jer. 30:12-13)
We live in a psychologized culture. It is difficult to turn on our TVs, or listen to the radio without coming across some psychologist or self-help guru preaching their wares and philosophies about how we should live and why. In our day-to-day lives, we meet many people who have bought into the lie that counseling psychology has the answers to all of our problems. I am not against all psychology, only that which leads us away from God, away from true psychology, and away from lasting help and healing. Like the woman in Mark 5 who had been bleeding for the past twelve years, who had seen every doctor of every kind but to no avail, and who finally sought out Jesus for help, so others come to us with their pain and suffering, needing to hear a word from Jesus. How do we help people who are taking medication as a means of living with their situation?
What We Should Know About Diagnoses
There are two popular methodologies, or schools of thought, concerning how to diagnose a person who is ill, either physically or mentally: the medical and psychological. In the world of medicine, a body has a disease if something has been introduced to it from an outside source. There are organic causes resulting in some behavioral problems, but these organic causes are found through medical testing. These tests show physical evidence and describe a disease within the body, rather than reports about body functions or feelings from the patient alone. To qualify as an illness, the condition in question must show damage to the body’s physical tissue.
In the world of psychology, the diagnoses are made on the basis of the reported behavior, feelings, and thought processes of the counselee, and are not testable or verifiable reasons for the behavior. Various theories are proposed to account for the behavior, but there are no scientific tests given to justify conclusions.
To contrast the two schools of thought, in physical medicine, a disease produces physical and testable symptoms. Also, in medicine there are no moral implications directly related to the disease or illness. In psychology, verbal reports of symptoms reveal “illnesses, diseases, etc., and virtually all mental illnesses include a moral component. In other words, when a person has polio, diabetes, or cancer, the disease does not cause the person to sin. He may sin because his self-control is influenced by the disease, but the sin is not tied to the disease. But if a person has been diagnosed with ADHD, OCD, or any other “mental illness” it is precisely because he is exhibiting moral/sinful or unusual behavior. His thoughts, motives, feelings and behavior is responsible for the diagnosis in the first place. (For more information on his go to The Biblical Counseling Coalition web site and type in “mental illness” in their search engine.)
Reasons Folks Give for the Use of Drugs
From our perspective Man A is living according to his feelings rather than according to Biblical principles. He does not see God in his circumstances (Rom 8:28). He believes that if he could only change his feelings, his life would change. He has been told that he has a chemical imbalance. This may be, but there has been no measurable or testable proof to verify this diagnosis. Dopamine and Serotonin are the most recent culprits in the chemical imbalance game.
Eric Kandel, MD, a Nobel Prize laureate and professor of brain science at Columbia University, believes it’s all about biology. “All mental processes are brain processes, and therefore all disorders of mental functioning are biological diseases,” he says. “The brain is the organ of the mind. Where else could [mental illness] be if not in the brain?”
Kandel adds, social and environmental factors are undeniably important to understanding mental health. “But they do not act in a vacuum,” he says. “They act in the brain.” (http://www.apa.org/monitor/2012/06/roots.aspx)
The theory is that the brain is filled with chemicals interacting with one another, and when our behavior goes awry it is due to too much or too little of the various chemicals. But again, this is theory, not fact. The introduction of medication may improve a person’s mood, feelings, and by extension behavior, but this does not mean that the problem was chemical in the first place. It could be a placebo effect, a change of heart, or choice about mood, or it could be that the person’s behavior changed his chemical situation.
The obvious question arises, “but what if it is proven that chemicals do cause symptoms to change?” That would mean that we are able to test for chemicals in the brain and we would give the disease a name and have a specific medical treatment. We don’t have any of that now.
Questions You Might Ask Someone Taking Meds
When you encounter someone on meds you might pay attention to how they talk about the medication. Ask the following questions:
- What tests were run to prove a physical problem is present? How did the test prove the diagnosis?
- How was it shown to you that the physical condition has caused your emotional or behavioral state?
- How does the medication help your condition?
- Does the medication change your relationship to God? Or How does the medication change your relationship with God?
- When will you be able to come off the medication?
These questions will most likely not help your friend in the counseling context, but their answers will be good for understanding what your friend is hoping and trusting in, regarding their life and situation. And, the answers will also help you know how to pray for them. However, I would be very careful as you ask these questions because the person may become defensive or distraught depending on the answers they are able to give. Most people assume the meds are what is needed and to ask these questions indicates a possibility that they have placed their trust in the wrong god. Knowing this can either help you in your ministry to them, or get in the way. You’ll need a lot of wisdom in this area.
What the Bible Teaches About Feelings and Behavior
The Bible teaches that feelings exist, but the emphasis throughout is that what is important is to think and act first (Jn. 13:17; Jas. 1:25; Prov. 29:18). The assumption is that feelings come after the doing, not before. With this in mind we can go on to say that when a person feels sad, lonely, depressed, angry, anxious, etc. it is a result of prior situations, circumstances, and choices. The Bible teaches that everything is about worship, and right worship leads to lovely emotions: love, joy, peace, etc., thus we can conclude that negative feelings are the result of faulty worship and unbiblical thinking.
People who are worldly base their lives on their feelings and desires (Eph. 2:1-3). When Christians live this way, they are living according to the world, not according to Christ. Jesus tells us to die to ourselves, to our passions and desires and to live to God. Paul tells us to think on good things, to train our minds to be renewed day by day, and to focus our attention on the glories to come (Phil 4:8; Rom. 12:1ff.; Heb. 12:1ff.). It is when we think rightly that we do rightly and when we do rightly God blesses us with emotions that reflect that right attitude toward God. Right worship produces right thinking and right thinking produces right feelings.
What We Know About Psychotropic (affecting the brain) Medication
There are many instances where medication does help people function with respect to their difficulties in living. However, there are few medications created specifically for the applications for which they are being used; and none that have been proven to do anything for the underlying causes of the symptoms that are being treated. For example, lithium is prescribed for psychosis and manic activity. Nevertheless, lithium does not do anything for whatever is causing the psychotic behavior or the symptoms. It simply numbs the mind in such a way that the person suffering can, in some limited sense, function. We can give praise to God for this result, because in many cases people who are taking lithium could not function at all if they were not taking it. In this case, lithium makes ministry with the person possible. And in this kind of situation, I have no problem with medication. (Originally, lithium was prescribed for gout which was associated with Uric acid. Excess uric acid was linked to depression and manic disorders and was then prescribed for mania. It was abandoned for that purpose in the early 1900’s because the drug companies did not want to produce it because it could not be patented).
But the vast majority of psychotropic medication is given simply because people can’t function at the level they desire or in the way they want. In years past people were even taking Prozac not because they were depressed, but because it gave them new, zippy, outgoing, and aggressive personalities. They were fine before, but the Prozac gave them new lives and this was worth the side effects until people started dying. People tend to blame their low or bad feelings for their inability to function as well as they should or would like to. The medication is used to numb them to the truth of the way they are living, by reducing the level of their bad feelings. In reality they are masking their lives and hiding from the truth. Medication does reduce, even change feelings, but they do not change the heart and so, while the feelings are dampened, the reasons for those feelings in the first place are not dealt with. The person is bound to be the slave of his medications (idol) for the rest of his life.
Counseling Someone Taking Medications
Counseling someone who is taking medication is very much like counseling anyone else. The main difference is that they have been more psychologized than the average person. It is helpful for you to ask all sorts of questions about their experience with psychology and psychiatry, but not helpful to argue with what they think or even to hint that you think it is all a bunch of bad stuff. Continue to build hope in God and in the Biblical process. Teach Biblical principles as normal, working to love the person, shine Jesus on them by being a consistent living example to them. Strive to bring to a deeper knowledge of God and of Jesus Christ by giving Biblical homework and using counseling time productively and redemptively. You need to remember that the medication is not dealing with the source of their problems, God is. Also, keep in mind that as you go through the counseling process the counselee may not need the medication after a while, but he may never get off the meds. The goal of counseling with regard to medication is to render them unnecessary by letting God work in the person’s heart to clear up the reasons they are taking the medication in the first place.
Counseling Someone To Come off Medications
You are not doctors, so what you do with and about medications is not something you should deal with. When I encounter people taking medications, I ask about the side effects. I ask about how they are coping with the side effects and are they taking medications for the side effects. When I think the counselee should ask questions, of their doctor, about their medications or do something with them, I suggest that they talk with their doctor. If you get to the point where you think the changes of heart and behavior have rendered the medications unnecessary, you might suggest to the counselee that she ask her doctor about a) the exit strategy and b) to re-evaluate the need for the meds with the idea of weaning or coming off them.
I am very careful to encourage counselees not come off their meds too soon. If the meds are making it possible for them to function, they should be very careful about not taking them. I would advise you to stay very far away from this kind of counsel. (People who are taking lithium, for example, do not generally want to take it. They are looking for any reason not to take it and your encouragement does not need to be very strong to get them headed in a bad direction. If they need lithium, they need to be under a very careful doctor’s care when they come off the drug). Always remember that you are not a doctor.
If the person is taking depression medication, you may not know if the drug has caused them to not be depressed anymore or if God’s counsel has given them new hope and joy. I would say that generally, if the person has become a new believer or has become a new believer again, there is cause to wonder about the necessity of the meds, but again, have them ask their doctor. Do not tell them they don’t need them anymore. The last thing you need is to cause someone greater distress because you read the situation wrongly.
Finally, if someone you are counseling comes off their meds, make sure that you continue to keep in touch with them for a season afterward. Do not counsel them, have them come off their meds, and then let them go. You might wean them off counseling by having them come in less often and then to call or write and send in reports to you about how they are doing. If you don’t hear from them when you should, go after them and see what is going on.
Smith, Bob. The Christian Counselor’s Medical Desk Reference.
Welch, Edward. Addictions: A Banquet in the Grave.
Welch, Edward. Blame it On the Brain
Powlison, David. How Do You Counsel A Psychologized Counselee? This is an article. You can find it online here: http://www.ccef.org/product-download/how-do-you-help-psychologized-counselee.
How the Psychotropic Industry Works
You might check out Listening to Prozac, by Peter Kramer.