John Weaver. Journal of Religion and Popular Culture. Volume 23, Issue 1, April 2011.
Part I: Introduction
Many recent critics have pointed out the fear of homosexuals inherent in evangelical attempts to heal “ex-gays.” Yet relatively little attention has been paid to the label that the religious right has placed on gays and lesbians: the label of “mentally ill.” This is regrettable, as understanding evangelicals’ view of the mentally ill is essential if one is to understand the ant-gay rights discourse currently prevalent in evangelical circles.
Non-evangelicals have heard little about evangelical views concerning the mentally ill; most of their knowledge comes from horror stories of evangelical exorcists commonly known as deliverance ministers. Currently, there are at least 600 known deliverance ministries operating in the United States (the real total may be two or three times as high). These ministries commonly hold to a theory of “demonization,” in which both Christians and non-Christians are physically inhabited by certain demons who cause a variety of physical and mental ailments. As Christianity Today points out, complications arise in such ministries because it is difficult for the “untrained” to differentiate between demonization, psychological disorders, physical illnesses and “sinful” habits. Agnieszka Tennant, a believer in deliverance ministries herself, writes that Christians should pay “special attention to involvement in the occult, generational sins … and sexual molestation or other ways in which one person gets control of another’s body and/or mind.” According to deliverance “theorists,” such habits are more likely to lead one to accept the influence of demons.
Prominent deliverance ministers like Bob Larson can make huge profits off the exploitation of the vulnerable and the mentally ill. Such ministries concern both moderate evangelicals and non-Christians, as they often hint at a viewpoint on the mentally ill that is decidedly antiquated. For instance, one deliverance minister, in an interview with CBC news, argued that sometimes demons can cause chemical imbalances in the brain, which in turn cause mental illnesses. Both the chemical imbalance and the resulting mental illness are the direct result of sin. To make matters even more problematic, most deliverance ministers believe in what are called generational sins. Generational sins are family demonic curses passed down generation after generation, until a deliverance minister intervenes. Thus, when a deliverance minister is confronted with the reality of genetically-inherited mental disorders, the deliverance minister simply claims that what is being inherited is not genes, but demons. Genes, in other words, mimic demons.
Deliverance ministries represent an extreme in evangelical distrust of the mentally ill, an extreme favoured by charismatic and Pentecostal Protestants. To most other evangelicals—and certainly to most fundamentalists—deliverance ministries represent a gaudy, theologically unsound, and quite possibly financially corrupt method of spiritual abuse. Yet among neo-evangelicals, fundamentalists and Reformed Protestants there is a much more widely respected conceptual system regarding the mentally ill—one that has earned both praise and controversy. This system, known as nouthetic or biblical counselling, is not characterized by the kind of anti-intellectualism that dominates deliverance ministries, yet it itself is not totally immune to theological controversy.
Biblical counselling is based on a few simple presuppositions. In the view of the biblical counselling movement (BCM), the term mental illness is a misnomer (in a manner very similar to how anti-gay evangelicals deride the term “gay”). Traditional psychiatry tends not to make a distinction between mind and brain. To the biblical counselling movement, this distinction is crucial. While the brain can be sick, the mind cannot. Therefore, a person cannot truly be mentally ill, and any behaviour deemed “deviant” by the church is condemned as sinful, even if it is caused by mental illness. Interestingly, biblical counsellors condemn homosexuality for the same reason. Ed Welch, a prominent biblical counsellor, contends that biology, including a same-sex sexual orientation, can never cause a human being to sin (homosexual sex being defined as a sin by him). While the biblical counselling movement does acknowledge the existence of certain rare biological mental impairments, the movement believes that the problem with the majority of people who are labeled mentally ill is that they are not sick, but sinful. Thus, mental illness is usually caused by sin, or pride according to the biblical counselling movement.
Like anti-gay rights discourse and the current defenders of legal “personal responsibility” in the face of brain damage, biblical counselling has built itself on the premise of denying the physiological origins of conditions widely regarded to be biological. To most evangelicals, admitting that a personal trait is natural is to admit that a person has no control over expressing that trait. Thus, in the evangelical mind, it is crucial that homosexuality or violent behaviour not be biological in origin; if it isn’t, they reason, how can they continue to oppose a biological condition that God must have created? Thus, opposition to homosexuality and the violence sometimes caused by the mentally ill is not simply about distrusting gays and other perceived social deviants, but also about defending one of the core tenets of evangelical theology. The LGBT community and the mentally ill have becomes a referent, not so much of perversion, but of the collapse of biblically inerrantist thought.
The biblical counselling movement, and other similar anti-psychology evangelical ministries, have based their counselling methodology on the presupposition that practically all mental illness is not the result of organic causes. Just as the ex-gay movement has apologists who continue to argue against the mounting evidence for homosexuality’s biological origins, the biblical counselling movement has developed its own share of such scientific claims. Marshall and Mary Asher, for instance, claim that there is no laboratory test to confirm the diagnosis of OCD. A radical British biblical counsellor claims that schizophrenia and depression are both “non-organic” in origin, and that the former can be cured by simply telling schizophrenics “to take responsibility for their actions”.
Of course, the whole label of “mentally ill” has come under attack over the last forty years. Many psychiatrists and social theorists, most prominently Michel Foucault and Thomas Szasz, have argued that the whole classification system that labels and categorizes the mentally ill is really a covert form of social control. As Szasz perceptively points out, psychiatry can quickly become an excuse not just to “heal the sick, but to control the wicked”. In such a system, Szasz argues, the psychiatrist serves the role of social engineer, punishing deviance and rewarding social compliance.
There is no denying the force of Szasz’s analysis of the psychiatric system. Psychiatrists, like most representatives of ideological state apparatuses, can serve as normalizing agents. For instance, under the Nazis, psychiatrists served as the eugenic hygiene arm of the state. Germany’s T4 program, which euthanized the mentally ill, “involved virtually the entire German psychiatric community and related portions of the general medical community.” The job of psychiatrists, when they serve ISAs, is not so much to make the individual content with his or her lot, as to normalize the individual to comply with accepted societal standards. In contemporary American society, that normalizing standard is happiness. Any deviation from this standard marks the suffering individual as “dysfunctional,” or “ill,” or “psychologically incompetent.” In many cases, of course, the individual may want to get rid of these feelings regardless of whether they feel any social normalizing force being imposed on them. But other individuals feel perfectly content within themselves, and resent the authoritarian impulses of the psychiatric health system.
Biblical counsellors are enthusiastic supporters of Szasz, and much of their critique of the psychiatric establishment echoes Szasz’s more nuanced criticisms. Evangelical critiques of psychiatry often argue (as do Martin and Deidre Bobgan), that psychiatry ends up limiting personal autonomy and individual freedom, in favour of a kind of professionalized dictatorship. To these counsellors, such a dictatorship is extremely problematic because it creates a kind of “Jehovah effect,” in which therapists take on the role of a professional priesthood whose role is to speak for God. But the biblical counselling movement also departs from Szasz at crucial points. Szasz offers a general objection to all forms of social normalizing. He repudiates the “tacit assumption inherent in designating patients as deviants: that because such persons differ, or are alleged to differ, from the majority, they are ipso facto sick, bad, stupid, or wrong, whereas the majority are healthy, good, wise, or right”. Szasz feared that allowing such classificatory systems to survive would allow social majorities to categorize persons or groups as “deviant” in order to legitimize seeing these human beings in a “lesser” light. But while the biblical counselling movement also rejected the normalizing influence of the whole “illness” categorization, it accepted God as a normalizing agent in place of psychiatry. God was the standard from which no depressed, compulsive, or suicidal person could deviate. As Jay Adams, founder of the biblical counselling movement, states “Jesus Christ is at the center of all true Christian counseling. Any counseling which moves Christ from that position of centrality has to the extent that it has done so ceased to be Christian”. The same, of course, applies to any counselee who deviates from Christ’s holy words.
The use of God as a normalizing agent to control mentally deviant behaviour may seem unusual to secular readers, but the legal community is being faced with the same issue today. For the legal community, the normalizing agent controlling society is the law. It is an agent that is supposedly blind, treating each individual with equal justice (though one must be morally blind to actually believe the system operates that way). But the law assumes that almost all human beings are capable of acting as independent agents, who voluntarily submit themselves to the laws under which they live. Modern neuroscience and psychiatry are turning this concept on its head. If a human being is just a collection of neurochemical impulses, with no free will, how can any human being be held for actions that are biologically predetermined? In recent decades, movies and books (i.e. Gattaca is a prominent and excellent example) have glorified the primacy of human will over genetics. What is missed in all these lovely paeans to the human spirit is that that will may merely be a product of our genes as well. Most human beings have a profound urge to reject their deterministic nature, yet this belief has more to do with personal psychological predilections and discomforts than it has to do with science.
The supporters of the biblical counselling movement have built their movement on normalization. They have set up their own classificatory systems, from which they deem what behaviours are considered spiritually normal and which are not. For instance, Robert D. Smith, a leading biblical counselling advocate and medical doctor claims the manic phase of bipolar is “a faulty, sinful attempt to overcome the depression one feels, fears, and unsuccessfully seeks to alleviate.” A tic exhibited by a Tourette’s syndrome patient is “sinful if it is a response to life, if it turns the one with it away from pleasing God, or if it is disruptive to others.” Marshall and Mary Asher’s Christian’s Guide to Psychological Terms presents an extensive catalogue of this kind of normalizing rhetoric. Anorexia is considered a sin, because anorexics are “dominated by the fear of man”. Children with Asperger’s syndrome sin when they fail to develop “mutually supportive interpersonal relationships”. The volatile mood swings caused by disorders like bipolar 1 are the result of “bitterness and despair”. Obsessive compulsive disorder is a manifestation of “ungodly fear”. Perhaps most disturbing is the Ashers’ tendency to doubt the salvation of certain groups that they deem mentally ill. A schizophrenic, for instance, should be considered an unbeliever “… until proven otherwise (even if he has a history of effective Christian ministry)”. Like much anti-gay rhetoric, the Ashers’ view of salvation divides the world into the normalized evangelical “Us” and the abnormal homosexual/mentally ill “Other.”
The Ashers’ beliefs are quite widespread in the biblical counselling movement, though admittedly others in the movement are much less likely to express their views so bluntly. John MacArthur, a prominent Reformed pastor within the evangelical movement, argues that psychotherapy is embraced by the spiritually weak—those who are not stoical enough to accept that life’s pain leads to a better relationship with God. David Powlison, the most prominent second generation biblical counsellor, proclaims that: “Galatians 5:19-21 says that the manifest lifestyle of sin is ‘obvious’…. Those ‘works of the flesh’ are sinful; they arise casually from various ‘lusts of the flesh.’ … What about problems like those labeled ‘eating disorders’ or ‘obsessive-compulsive disorders’ that do not appear on the representative list in Galatians 5? ‘Obvious’ (and close study will unpack the details to show the how and why of those works of the flesh).” OCD and anorexia, in Powlison’s estimation are sinful “lusts” rather than diseases or psychological aberrations. Michael Emlet, another second generation biblical counsellor, writes that “It is that very sacrifice [of Christ] that can embolden you to step into the light to forsake the real sin: the self-absorption in which an OCD sufferer is caught.” Emlet is relatively understanding by biblical counselling standards, but he apparently does not recognize that calling OCD “self-absorption” and a “sin” may make the counsellee feel worse. Winston Smith, in the Journal of Biblical Counseling, asks “Why is the obsessive compulsive person so prone to adopt the standards of the world rather than God’s standards?” OAIM, an online ministry influenced by the biblical counselling movement, argues that depression, suicidal tendencies, schizophrenia, panic disorders and eating disorders are all the result of an unbiblical response to our personal sinful behaviour. Perhaps the cruellest comments are reserved for bulimics. Elyse Fitzpatrick, commenting on this group, mournfully asks “What precipitates these {bulimic} binges? You may discover lusts both of the body and the mind.” Fitzpatrick goes on to state that bulimia is influenced by “greed” and “idolatry”. Still, others argue that the root of all our problems is sin and that insanity is often a judgment for pride and sin.
I do not know what sociologists would make of evangelical attitudes towards the mentally ill. In many ways, evangelical attitudes towards mental illness bear a similarity to the way Americans view Prozac. For the truly depressed, of course, such a medication is absolutely necessary. But often, Prozac becomes a palliative cure for individuals who are being forced to buy into a socially constructed definition of what happiness should consist of. The same kind of “joyocentric” viewpoint forces those who mourn their departed to quickly recover from their feelings of remorse and regret. Americans, perennially happy, insist that happiness be mandatory for all, even for those who have quite understandable reasons for wishing to flee the Joy Patrol. Evangelicalism, with its focus on inner serenity, is particularly vulnerable to this kind of group-joy conformism. Personally, I believe that the pressure within the evangelical subculture to define oneself as filled with the “joy of the Lord” plays a large part in evangelicalism’s aversion towards those who are classified as mentally ill. The mentally ill, evangelicals notice, are often unhappy. Since they are unhappy, they can’t be filled with the joy of the Lord—and if they aren’t filled with that joy, they must be sinning against God. In their search to save those deemed mentally ill from psychiatric enslavement, biblical counsellors may have inadvertently created a new classificatory system every bit as restrictive as the one it sought so nobly to replace.
Part II: Theological Underpinnings of the Biblical Counselling Movement
Anti-gay rights discourse is rooted in a commitment to literalist interpretations of scripture. While in recent years non-literalists have been open to the idea that the Bible’s comments on homosexuality may need to be reinterpreted, most evangelicals remain ardently committed to the idea that the Bible speaks to this issue, and all other issues with which modern people are confronted. Those who specialize in anti-gay rights discourse believe that if the church condones homosexuality, then any respect for biblical inerrancy will be lost, and evangelical culture will disappear. For instance, Ed Welch, in Blame it on the Brain, writes that “The homosexual hermeneutic disagrees with a plan reading of Scripture, goes contrary to the history of biblical interpretation and is reminiscent of the Pharisaic narrowing of the law so condemned in the New Testament.” Evangelical discourse about the mentally ill is based on a similar presuppositional strategy. Reformed evangelicals and fundamentalists believe they are engaged in a life-and-death struggle against the “psychologizers of the gospel” for the soul of the church.
Biblical counselling began to develop in the late 1960s and early 1970s as a reaction to both the increasing prevalence of psychological practices within the evangelical church and to the deinstitutionalization of the mentally ill that was occurring during that period. The founder of the movement, Jay Adams, was heavily influenced by the works of non-evangelical psychologists like O. Hobart Mowrer and William Glasser. Glasser pioneered what has come to be known as reality therapy. Reality therapy revolves around confronting counsellees with the maladaptivity of their own misbehaviour, and then forcing them to change that behaviour. Glasser’s reality therapy relied heavily on the idea that the mentally ill suffered from a basic inadequacy, their inability to meet their own basic needs and acknowledge “reality.” Thus a good therapist would help lead his or her counsellee to reality. Glasser’s system, on which—along with Mowrer’s integrity therapy—Jay Adams obviously heavily relied, was thus primarily a confrontational system. What made it philosophically problematic, however, was its conceptualization of reality as the “ideal” to which all human beings must aspire. In Glasser’s manifesto, Reality Therapy, he never mentions the possibility that mental health may be found by other roads than the “real.” Why illusion, or myth, or delusion, should not be seen as “real” is a question that Glasser never acknowledges, let alone addresses. Furthermore, by focusing on the patient’s perceived lack of ability to fulfill basic needs, Glasser inadvertently portrays those deemed mentally ill as being some sort of parasitic population, whose fangs need to be withdrawn from “healthy” society. Mowrer’s contribution to biblical counselling was to focus the movement’s attention on “admitting” and “divesting” oneself of one’s “weaknesses.” Mowrer argued that we should “recognize the self-condemning and self-punishing nature of his [the patient’s] condition and … respect him for holding himself thus accountable.” He also maintained that he had “repeatedly seen persons who have wallowed in neurotic ‘illness’ for years recover with astonishing swiftness when they are given a little encouragement in admitting the reality of their guilt.” Mowrer’s therapy thus assumed the guilt of the client, regardless of the motivation behind that guilt.
According to Adams’s counselling manifesto, Competent to Counsel, he was greatly impressed by the supposed success Mowrer had treating patients. However, Adams had theological qualms about both Mowrer’s and Glasser’s therapy, because their therapeutic regimes were not based on Christian precepts. In response, Adams developed biblical counselling, a therapeutic methodology that focuses on confronting counsellees with their “sins,” in order to bring them closer to God. Adams, seeing God as the ultimate reality, merely substituted union with God, rather than union with reality, as his central therapeutic goal. Since then, the biblical counselling movement has boomed. Type “biblical counselling” (or “counseling”) into Google and one will find over a million hits, among which include counselling centres, biblical counselling online journals, online ministries and blogs.
Why did Adams feel the need to create a distinctly evangelical counselling methodology? Why did he target both the mentally ill and the psychological profession with his anti-psychiatric rhetoric? These are harder questions to answer, but I will argue that a combination of historical and cultural circumstances united to create Adams’s now massive movement. Adams and his fellow biblical counsellors strongly emphasize what they call the “sufficiency” of Scripture. This is the concept that the Bible holds answers to all life’s problems. As one pro-biblical counselling website puts it, “The Bible contains the only pure truth of God. All else is distorted by the limitations of human perception.” In the minds of biblical counsellors, the soul and the mind are functionally equivalent. Ed Welch puts it bluntly when he says that “The brain cannot make a person sin or keep a person from following Jesus.” Welch equates the mind with the terms “spirit (spiritual), heart, and inner person or inner self”. Owing to this equation, the proper care of the mind can only come through the proper care of the soul. Biblical counsellors strongly object to the idea that psychology can be used to cure what they see as spiritual problems (“problems of living,” in biblical counselling parlance). David Powlison, a leading biblical counselling advocate, claimed in 2007 that “Psychotherapeutic professionalism is a defective institutional structure for cure of souls…. Those who claim expertise to teach and counsel others will still not be significantly accountable to the church and to orthodoxy for their faith and practice.” Psychology, in their minds, is violating the sphere of influence of the church, just as current legal professionals feel that neuropsychiatry is trampling on their precious and arbitrary definitions of legal right and legal wrong.
There are some obvious flaws in this line of reasoning. Biblical counsellors proclaim the sufficiency of the scriptures when dealing with the human mind, but not when it comes to any other area of human endeavour. Biblical counsellors routinely seek medical advice, both for themselves and their counsellees (indeed, a whole biblical counselling medical reference text, The Christian Counselor’s Medical Desk Reference, was written to help biblical counsellors discern between “true” brain abnormalities and sin). They acknowledge the power of human reasoning in medicine, engineering and architecture. They reject only that knowledge that threatens their view of scriptural self-sufficiency, namely evolutionary biology and psychology. They also reject these two fields precisely because of what they have to say about the nature of humanity.
For evangelicals, it is crucial that human beings be divorced from anything fleshly, anything that could potentially divide them from the divine side of Jesus’s dualistic deity/ man nature. For Catholics, Jesus is made flesh in the real world: relics heal, transubstantiation really happens, stigmata appear on hands. While the idea of a fleshly Jesus may still seem uncomfortable to Catholics, they are also reassured by this same Jesus, as they have never denied his material existence in the real world. But for evangelicals, despite their doctrinal emphasis on the humanity of Christ, the practical reality of evangelical theology is that for Jesus to be divine, both mind and body must be of divine quality. A Christ who lusts, defecates, and evolves from lower forms of life, is a Jesus that is dangerously similar to man—a man whose mind must therefore be carnal. For evangelicals, to be human means to imitate the divine. And for people to imitate the divine, the divine must really be divine. A sexualized, evolved Jesus, a Jesus whose brain suffers from schizophrenia and obsession, is, for evangelicals, a fundamentally flawed incarnation of deity. Witness the rabid evangelical reaction to any hint of Jesus’s sexual nature in Martin Scorcese’s Last Temptation of Christ or the frequent use of C.S. Lewis’s trilemma in evangelical churches (“Liar, Lunatic or Lord”) to see how fundamentally evangelicals separate the sexualized and the diseased from Christ.
Biblical counsellors’ reasoning rests on the false relationship they set up between brain and mind. Most evangelicals are insistent that the mind is more than just a part of the brain. One of the most extreme biblical counselling amateur online articles, “Psychiatry is Bogus,” argues that humans are physical bodies controlled by non-physical souls. David Powlison adds that “Contemporary victim theories abound, whether operating under psychological, medical, sociological, or Christian aegis. All such theories rob people of moral responsibility and insert some determinism at the foundation of human life. Biblical counselling has resisted seeing people as determined—whether by heredity, the sins of others, organic imbalances, poor models, unmet needs, mental forces imposing on us as ‘illness’ or demonic inhabitants.” Biblical counsellors feel threatened by the idea that the mind could be part of the body or could be something socially or biologically predetermined, because to them it implies that the soul, too, is just a physical construct. Perhaps the most extreme manifestation of this tendency comes in Elyse Fitzpatrick and Laura Henderson’s Will Medicine Stop the Pain?, in which the two authors criticize materialists because they believe that “the physical brain is the part of us that thinks, feels, and makes choices.” Fitzpatrick and Henderson then make the illogical leap (even further than most biblical counsellors would go) that “The Bible clearly teaches that our invisible inner person (not our brain) is the source of our thoughts and intentions … our emotions … and our choices…. We want to remember that our thoughts, choices, and feelings originate from the inner person, not in the physical matter of the brain.” The brain, in this extreme version of biblical counselling, does not think. The soul does. A soul that was purely organically based sounds suspiciously like evolutionary biology to biblical counsellors, and throws into question the biblical doctrine of the immortality of the soul. If the soul is attached to the body, does it not die when the body dies? The biblical counselling movement, like certain elements of the legal profession, seems to be quite oblivious to the possibility that the mind itself is merely a construct of the brain. With good reason, for this idea collapses the whole epistemological framework on which both biblical counselling and modern evangelical anti-gay discourse are based. If the mind is just part of the brain, then it is immaterial whether the mind or brain is sick/”abnormal.” Even if one’s thoughts, in this hyper-literalist sense, are not symptomatic of mental illness and/or homosexuality, the organic processes that create these thoughts are. In either case, this would force biblical counsellors and anti-gay individuals to see the individual as not responsible for his or her mental malfunctions (evangelicals defining homosexuality as a mental malfunction), forcing both groups to redefine what they consider “personally responsible.”
This lack of responsibility troubles biblical counsellors. At the most basic of levels, evangelicals object to what they consider psychiatry’s practice of “excusing the guilt of sin”. To evangelicals, sin is sin. It is not relative, no matter whether one is schizophrenic, manic-depressive, obsessive compulsive, or “normal.” Jay Adams believes that the “idea of sickness as the cause of personal problems vitiates all notions of human responsibility…. People no longer consider themselves responsible for what they do wrong”. In Adams’s mind, the concept of mental illness obscures what humanity’s real problem is: our sin natures. In anti-gay discourse, those who oppose homosexuality are often not so much concerned about persecuting gays, as they are at protecting heterosexual men from any hint of homoerotic behaviour. A similarly troubling relationship exists between the mentally ill and non-mentally ill in Adams’s mind. Adams clearly is not so much concerned about the truly insane as he is with those who he believes mask their sin natures behind an outer exterior of erratic behaviour. Like gays, the mentally ill represent a perfect target for the projection of evangelical fears. They are a minority group, they are unpopular, and most of all, they are invisible. Like communists and gays, mentally ill people are not easily distinguishable from the average every-day citizen. They can remain hidden, just beneath the surface of every-day life. They are the hidden fifth column within the church. Yet, is this evangelical societal disapproval so different from what secular culture does with its own insane members? In 2007, after the Virginia Tech shooting, there was widespread discussion of how Seung-Hui Cho was evil, corrupt, psychopathic, a serial killer, etc.,—yet there was precious little effort to understand the massive psychological problems that prompted Cho to commit his deadly act. Instead, schools enacted a wide-variety of paranoid protective measures, practices that in many ways mirrored the fearmongering about a mentally ill fifth column that biblical counsellors so delight in. My own school handed out a pamphlet to all teachers, encouraging them to report “abnormal” behaviour to the counselling centre. For non-evangelicals, too, the mentally ill serve as an ideal fifth column, at which anger can be directed, rather than deal with the real societal problems that cause such tragedies (such as poor gun control laws and inadequate health care).
Biblical counselling is based on a fundamentally Cartesian view of human nature. Cartesian dualism holds that an immaterial soul is trapped within a physical body. Because of this view, Cartesians held that the human body is but “a machine that the rational mind can manipulate in mysterious ways”. Crucial to Cartesian thought is that the mind, as an entity, “can never be shown to be derived from, or a form of, or a function of, or reducible to matter”. In other words, Cartesian dualism, at least in its primitive form, separates brain from mind, arguing that the brain is distinct from the mind. The Cartesian system is the foundation for modern concepts of guilt and innocence, since if the mind really is part of the brain, criminals can always blame their actions on a sick brain. Cartesian separation of mind and brain allowed the West to avoid this confrontation over rivalling concepts of guilt for several centuries, but slowly neuropsychiatry is advancing on the frightened ranks of legal prosecutors whose conceptualization of moral guilt is now endangered.
But if prosecutors are frightened, biblical counsellors are absolutely terrified of the prospect of diseased, rather than sinful, minds. Biblical counsellors have to be committed to such a conceptualization of the mind. If people do not have free will to commit sins, it means they are predestined to sin by someone else … and the only candidate for that someone else is God Himself. Biblical counsellors are left in a double-bind situation. Either they admit God can’t predestine events and thus betray their beloved Calvinism, or they argue that God can predestine sin and thus question the benevolence of God. Biblical counsellors choose to accept limited human free will—the concept that people can choose to sin—in order to avoid the bigger theological error of arguing that God causes sin. The mentally ill, therefore, must have free will to commit sin, since if they had an illness, their illness could not have been chosen by them, but caused by God. God would have predestined their illness, and thus predestined all the “sinful behaviour” mentally ill people commit.
Biblical counselling theorists thus worry that the concept of mental illness will make the classification of sin increasingly more difficult. Ed Bulkley states that “If one accepts the logical conclusions of psychology, sin must be reduced to medical dysfunctions and a person can no longer be held responsible for his behavior, his ethical conduct, his thought life, or his morality”. The Bobgans echo Bulkley’s fears, arguing that “If we really believe that a person with a mental-emotional-behavioral problem is sick, then we have admitted that he is no longer responsible for his behavior and if he is not responsible for his behavior who is? Where does one draw the line?” These theorists express concern at the possibility that “sin” may be treated biochemically, that it may in fact be biochemical in origin. Ed Welch, for instance, comments that “brain function in psychiatric problems shows no consistent differences when compared with normal brain function.” Welch, a more moderate biblical counsellor, admits that psychiatric medication is sometimes necessary but then lists several qualifiers about medication that focus on its potential side effects. Welch concludes: “What exactly does medication help? Medication cannot change the heart: it cannot remove our tendency toward sin, it cannot revive our faith, and it cannot make us more obedient to Christ. It can, however, alleviate some of the physical symptoms associated with some psychiatric problems.” Therefore, even if a medication prevents one from lusting after someone, as medications with sex-dampening effects occasionally do, those medications are not actually preventing one from sinning, but merely physically affecting the body. Biblical counsellors do believe in the Fall, the Christian doctrine that all mankind suffers from original sin. Thus, physical illnesses can safely be classified as a “result” of the Fall. Similarly, mental illnesses that are clearly caused by diseases of the brain, such as those illnesses that are induced by tumours, can be also classified as consequences of the Fall. But evangelicals do not believe a mind, as opposed to a brain, can be diseased. They reason that the mind, being non-organic, is spiritual, and therefore is in essence the soul. The soul is not a product of original sin, since it was perfect. The soul/mind, therefore, can only become diseased by the result of an individual choice to sin, not from any predestined fall. Without this mind/body split, pro-biblical counselling evangelicals would have to contend that God predestined some people to be gay, to be schizophrenic or to be obsessive. If these biochemical imbalances are sin, does that not mean then, that God predestined sin? Such a conclusion is unthinkable to biblical counsellors, so they are forced to blame these bio chemical imbalances on the mentally ill themselves, rather than the God who ostensibly created them. In a very real sense, this is as much an anti-gay move as a shot taken at the mentally ill. Adams, more adept theologically than the practitioners of reparative therapy (who see homosexuality as a mental illness), realizes the theological implications of the concept of mental illness when dealing with homosexuality. If homosexuality is truly an irreversible mental or physical condition, then to offer gays and lesbians a medical cure is to admit that the LGBT community really has no control over its behaviour. In Adams’s mind, this assertion is tantamount to admitting that homosexuality is not a sin, but a sickness. And if this is the case, how can the Bible condemn someone for something over which he or she has no control? Adams is left in an ideological dead-end—homosexuality can be neither natural nor sickness. It must be a sin.
It is not just homosexuality, but practically every other form of socially-constructed deviancy/sin that biblical counsellors feel will collapse if psychological theory is accepted. How can something be a sin if a person can’t be held morally responsible for the deed committed? Swearing will no longer be wrong, so long as one has certain cases of Tourette’s syndrome. Murder, while punishable, can’t be considered a sign of evil, when committed by a mother with post-partum depression. Premarital sex is not sinful when someone in a manic phase has it. The mentally ill, like gays and lesbians, would not be responsible for their violation of established evangelical social norms, because they have “sicknesses,” not sins. Yet, for biblical counsellors, this is tantamount to admitting that the Bible is not inerrant, or is only inerrant for certain people. Those who have sicknesses are especially exempt from biblical prohibitions. Each person has a different gospel, as each person suffers from a different mental affliction or physical “abnormality.” Even mainstream evangelicals, with their powerful devotion to universalizing schemas, would find this psychologizing of sin problematic. For biblical counsellors, however, it amounts to little short of heresy. Not only are people being allowed to sin, but the very concept of sin is being made irrelevant by what they consider the encroachment of sin to be within the church.
Unfortunately for those evangelicals who are mentally ill, the rise of the biblical counselling movement has coincided with the rise of the church growth movement. The church growth movement, led by Rick Warren, is a group of rapidly growing evangelical churches. While the reason for the rise of these churches is complex, many evangelicals believe that these churches have succeeded because they have “psychologized the gospel.” John MacArthur, who is the most prominent critic of the “psychological gospel” movement, has argued that evangelicalism is being over-run by talk show hosts, pop psychologists, and Christian radio counsellors. Macarthur argues that psychology is “no more a science than the atheistic evolutionary theory upon which it is based. Like theistic evolution, Christian psychology is an attempt to harmonize two inherently contradictory systems of thought”. David Powlison, in tracing the roots of the new psychologically-flavoured churches points out Robert Schuller and James Dobson as significant influences on the “mass psychological movement” of the 1970s and 1980s, both men leaders of mega-church/para-church organizations. Macarthur fears that this new psychological gospel will usher in a wave of liberalism, arguing that “Sin is called sickness, so people think it requires therapy, not repentance. Habitual sin is called addictive or compulsive behavior, and many surmise its solution is medical care, rather than moral correction”. This spiritual corruption allows therapists and therapist-like pastors to infect the church with the psychological gospel. As the Bobgans put it, the biblical counselling movement believes that psychologists and psychiatrists have “supplanted spiritual ministers in matters that have more to do with religion and values than with science and medicine”. The church growth movement and its psychological allies are seen as poachers, taking members from the older churches and infecting them with a new, psychological gospel.
The church growth movement has been criticized for its focus on self-esteem. Within most traditional Reformed and fundamentalist Protestant churches, the concept of self-esteem or self-love is seen as heretical, because Christianity seeks to deny the self. Asher and Asher define self-esteem as a “manifestation of pride”. The Bobgans, even more radical than the biblical counselling movement from which they have divorced themselves, bluntly state that “Christians should not use such terms as self-esteem, self-worth, or self-image because these terms originate from a secular humanistic society”. According to the Bobgans, self-love is just part of the “desire to be like God”. The Ashers suggest that rather than teaching pride by promoting self-esteem, parents should “take every opportunity to help their children understand their sinfulness and their need for the Savior”. In short, children are taught to hate the self, not love it. Again, much of the fear directed towards those deemed mentally ill has little actually to do with the mentally ill. Those deemed mentally ill usually need little encouragement to hate the self. The self-love gospel is not aimed at the mentally ill, but is promulgated and disseminated by pop psychologist preachers, whose words are meant to solve the simple life problems of materialistic evangelical yuppies, not the terrible suffering of the mentally ill. I have found myself more than once amused by the fact that I disagree with both the biblical counselling movement and the shallow pop psychological gospel that it critiques. But the psychological effects of this anti-self-esteem movement are problematic. Frequently, in my experience, believers in biblical counselling confront the mentally ill with the “sin” of their self-love, not realizing that this is the last thing that a mentally ill person needs to hear.
Part III: Treatment and Cure
So far I have given the reader the biblical counselling movement’s diagnosis of mental illness. But how do biblical counsellors actually treat the mentally ill? Adams believes that Christ must be the centre of all counselling. Adams believes in a process of counselling called “nouthetic confrontation,” in which a counsellor/preacher both publicly and privately confronts individuals in an attempt to change their behaviour (in practice, most modern nouthetic confrontation is private). Biblical counselling assumes that there is something “wrong, some sin, some obstruction, some problem, some difficulty, some need, that has to be acknowledged and dealt with. … In short, nouthetic confrontation arises out of a condition in the counselee that God wants changed. The fundamental purpose of nouthetic confrontation, then, is to affect personality and behavioral change”. In short, Adams assumes that there is something internally wrong, usually sinful, in the person being confronted. This trait, too, mirrors ex-gay therapy. As Michael Bussee points out about ex-gay groups like Exodus International, the problem is always something the matter with oneself—the person is not trying hard enough, or loving God enough. The problem, by definition, cannot be the counselling methodology being used. Biblical counselling, therefore, is a hermetically sealed, self-protecting system. It cannot be attacked, because the problem is always the counsellee or the counsellor, never the counselling methodology itself. Despite Adams’s condemnation of Skinnerian theory, biblical counselling bears a distinct similarity to behaviouralism. Nouthetics presupposes a “counselling type confrontation in which the object is to effect a characterological and behavioural change in the counselee…. Nouthetic confrontation, in its biblical usage, aims at straightening out the individual by changing his patterns of behavior to conform to biblical standards”. The reader should notice the evangelistic impulse of such a therapeutic method. The goal is not to necessarily make the individual patient healthier. This goal is clearly secondary in Adams’s counselling schema. Rather, the goal of biblical counselling is to make the counsellee’s thought life conform to the counsellor’s definition of what “biblical standards” are. If a schizophrenic is acting erratically, but is obeying the counsellor’s version of theological correctness (TC), then the counselling has been successful, regardless of whether the counsellee has been helped or not. Similarly, the goal of most forms of religious gay conversion/ex-gay/reparative therapy programs is to make Christians live in accordance with conservative interpretations of scripture. While “healing” of homosexuality is also a goal, it is not necessarily the primary one.
Scripture is frequently used in nouthetic confrontation, as a method of “reproving, teaching, correcting, and training men in righteousness”. People who have gone through the ex-gay movement often speak of “clobber verses,” a slang term for certain scriptural passages that are used to condemn homosexuality. The most famous of these passages is Romans 1:26-27, which states that “Because of this, God gave them over to shameful lusts. Even their women exchanged natural relations for unnatural ones. In the same way the men also abandoned natural relations with women and were inflamed with lust for one another. Men committed indecent acts with other men, and received in themselves the due penalty for their perversion.” People who have gone through the biblical counselling movement (including myself) have had similar experiences. Repeatedly, biblical counsellors and those influenced by the movement use similar passages to rebuke the mentally ill for not being happy enough, or content enough, or faithful enough. Biblical counsellors particularly like to quote 2 Peter 1:3, which states that “His [God’s] divine power has given us everything we need for life and godliness through our knowledge of him who called us by his own glory and goodness.” Biblical counsellors interpret this verse to mean that the Bible is a sufficient resource to handle any mental health problem, including bipolar disorder, schizophrenia and OCD. Indeed, going off its roots within reality therapy, nouthetic counselling insists that biblical counsellors should not accept “excuse-making or blameshifting,” but rather insist upon the counsellee assuming “responsibility and blame, the admission of guilt, the confession of sin, and the seeking of forgiveness in Christ”. The problem, of course, is that the biblical counsellor has no way of telling whether his counsellee is suffering from guilt and sin, or from a neurochemical imbalance. Indeed, considering the skepticism with which the biblical counselling movement meets such claims, it is highly likely that most biblical counsellors assume the first, with the burden of proof resting on those who wish to prove the latter.
The actual cures proposed for individual disorders vary only slightly from individual counsellor to individual counsellor. The Bobgans, for instance, argue that depressives must be confronted biblically, rather than psychologically. Robert Smith warns that “The Bible is the only solution for a depressed person.” Adams too, eschews chemical relief for depression, in favour of “Scriptural” therapy. Asher and Asher provide the most extensive list of biblical counselling treatments. For obsessive compulsives, Asher and Asher suggest their condition will improve as the counselee repents and as the counselee “is willing to endure the fear experience if that is what God has sovereignty and lovingly planned for him”. For Dissociative Disorder, Asher and Asher suggest that the counsellor teach the counsellee with the gospel and confront the counsellee with his or her sin. The bulimic must “repent, confess her sin and study the Scriptures to understand how she can learn to fear God, not man”. An anorexic must “recognize her sins and repent”. Schizophrenics must be confronted with their sins. Lisa and Ryan Bazler, at the edge of the biblical counselling movement, claim that anorexics can “trust God” to get control of their “sinful nature.” People with OCD or OCPD (Obsessive Compulsive Personality Disorder) can gain victory over their illnesses by calling “Jesus the Lord of our lives.” Some in the biblical counselling movement might claim that these approaches do not represent the mainstream of the movement, but the foreword to Asher and Asher’s book was written by Wayne Mack, a former board member of the National Association of Nouthetic Counselors (NANC), the foremost biblical counselling association in the country.
It is crucial for biblical counsellors to view mental illnesses as social constructions, not as literal biochemical realities. Yet the biblical counselling movement does not realize that it itself is a social construction, a social construction based as much on psychology as on biblical thinking. Whatever Adams’s claims, his therapy clearly eclectically combines elements of reality therapy and behaviourism into a religious psychological methodology. Biblical counselling is dangerous, not because it is a religious therapy, but because it masks its clearly psychological goals under a religious trapping. Religious clients come into a biblical counselling session with the expectation that they are getting religious advice about their personal problems. However, what they are actually getting is psychological and medical advice, often by individuals who are not trained in either of these two areas. Moreover, these counsellees may often be unaware of the powerful conditioning tools that biblical counsellors have at their disposal, tools that combine the power of both behavioural conditioning and the patient’s own certain belief in the doctrine of scriptural inerrancy. The combination of conditioning and clobber verses can leave a patient powerfully vulnerable to abuse, even by the most well-meaning biblical counsellor. Thus, even when the biblical counsellor sincerely wishes to “cure” his or her patient, the confusion caused by mixing psychological conditioning practices with anti-psychological selective scriptural interpretation leaves the counsellor’s client with a confused, often self-condemning view of their own psychological and spiritual identity. But what makes such curative methods especially problematic is that it is not clear how the government could even regulate biblical counselling.
Since biblical counsellors do not claim to be psychologists, what they do is technically faith healing, and therefore technically protected under the First Amendment. This means that biblical counsellors, like non-psychologically based ex-gay programs, can offer damaging counselling sessions under the guise of religion, with little or no protection provided for those victimized by such therapeutic methods. Even worse, often psychologists or psychiatrists have little experience dealing with mental illness in an evangelical context. For instance, in combing through psychological journals for articles mentioning evangelicalism’s relationship to mental illness, I found only two, the more important of which is over twenty-five years old (L.R. McLatchie’s November 1984 article “Mental Health Concepts of Evangelical Protestants” in the Journal of Psychology). Combined with evangelicals’ natural aversion towards talking about mental health issues, it is often difficult for evangelical victims of biblical counselling to get the kind of services provided to former clients of the ex-gay movement. The victims of biblical counselling remain silent, as generation after generation of mentally ill evangelicals continue to fall prey to the “help” that the movement so generously offers.
Part IV: Final Thoughts
A woman I knew in college went to a biblical counsellor for help with her obsessive compulsive disorder, as she was dealing with cancer. The counsellor told her that her OCD was the result of the sin of anger. I can still remember seeing her in the hospital, repeating biblical incantations to ward herself from the “sinful thoughts” caused by OCD. Her husband later told me that her religiously-inspired OCD had driven her so mad with emotional pain that she had considered mutilating her own genitals.
My interactions with the biblical counselling community have led me to study the history of evangelicalism’s relationship with psychology. As I have dialogued with biblical counselling supporters, I have noticed the disturbing similarities that unite biblical counselling with the ex-gay movement. This is why I have become especially troubled by the growing tendency of the LGBT community to debate the religious right on its own terms. Both the LGBT community and the religious right have sought to contextualize themselves in terms of normalcy, against the abnormal other. Both groups have eschewed the label of mental illness. While I understand the LGBT community’s desire to avoid this label, it seems unfortunate to me that few within that community have noted the powerful normalizing rhetoric that results from this attempt to avoid the “illness” label. By giving in to the religious right, the LGBT community has back-handily endorsed the religious right’s definition of the mentally ill as marginalized sub-humans. By fighting their oppressors using their oppressor’s rhetoric, the LGBT community has assured the world that of all groups, those deemed mentally ill will continue to be the most “Othered.”
Normalcy, after all, always has a price. The LGBT community has sold its Othered birthright for the questionable benefits of that socially constructed profit. But it is the mentally ill who have been left to pay their tab.
And the price was a lot more than we ever bargained for.