Three Truths to Help Christians Think Biblically About Psychiatric Disorders
While I was, perhaps obviously, immediately put off by the opinion that my daughter with Schizoaffective Disorder is likely being oppressed by demons, it did stoke the fire in me to return with passion to the often neglected responsibility we have as Christians to think Biblically about the issues of life. This is not always easy, as the Bible doesn’t explicitly mention a lot of the issues of our day in the terms that we use. This does not, however, cancel out the truth that in God’s Word we have “everything we need for life and godliness” (2 Peter 1:3). Nor does it absolve us of our responsibility to “not be just hearers of the Word, but doers also” (James 1:22), which requires diligent study and application in every area of life. In the first article of this series, Foundations for Thinking Biblically About Psychiatric Disorders, I explored the way brain science and Scripture are both from mind of God Himself, as the Creator of all things. I proposed that the Biblical approach to psychiatric disorders is not in choosing between brain science and the Bible, but rather to embrace both, with Scripture as the authoritative lens through which to interpret brain science. If you haven’t read that article yet, I recommend starting there! If you have, welcome back! Let’s dig into three Biblical truths that help Christians think Biblically about psychiatric disorders, shall we?
You Are an Embodied Soul, Made Good by God
It’s no secret that when God finished creating man and woman, He declared them both to be very good. What may be a little less immediately apparent is that human beings were not created as souls with unfortunate but necessary earth suits. No, God created man as beautifully and inextricably linked body and soul, as a “spiritual being with an earthly tent” (2 Corinthians 5:1). So, when God declared man to be very good, that declaration applied to both man’s body and soul. Both body and spirit existed in a state of perfection, albeit for a short amount of time.
Your body wasn’t an accident of the fall, but a divine decision rooted in eternity. God made man’s body, then joined the immaterial soul with his material body: the LORD God 1) formed the man of dust from the ground and 2) breathed into his nostrils the breath of life, and the man became a living creature (Gen. 2:7, numeration added to make a point). The material body was not an afterthought, it was an essential part of God’s design. In fact the physicality of Adam’s nostrils was the explicit point of introduction for his soul. In union of body and soul, man became a living creature.
If that’s not enough to convince you, consider the fact that your body won’t be thrown away in glory either. Your soul will continue with Jesus in eternity, embodied. It will be a glorified body for sure, but a body nonetheless. In fact, Jesus Himself is still embodied. Your body isn’t an unfortunate appendage to the real star of the show, but rather an essential part of what it means to be human. Psalm 139 considers the way in which God thoughtfully and carefully designed your unique body, and He has sovereignly planned for it’s perfect, glorified destiny in the new heavens and new earth.
These biblical truths demand that we take the body and all its intricacies seriously as God’s very own good idea. I am no brain scientist, so I turned to Johns Hopkins Medicine to learn God’s truth about the complex organ He created with care and intention. What I found is complex and beautiful, and again, it’s all God’s very good idea. For example, the frontal lobe, which is involved in personality characteristics and decision-making, was God’s idea. The amygdala, which regulates emotion and memory and is associated with the brain’s reward system, stress, and the “fight or flight” response when someone perceives a threat, was God’s idea.
You are an embodied soul. To be sure, the interplay of body and soul is mysterious, but the reality is that God created both to exist in unison. Just because we can’t understand how they come together doesn’t mean it isn’t true. Blaise Pascal admitted that “man cannot conceive what his body is, even less what his spirit is, and least of all how body can be united with spirit. That is the peak of his difficulty and yet it is his very being.” The union is a mystery, the reality is irrefutable.
You Are an Embodied Soul, Corrupted by the Fall
The fall broke everything.
The fall broke our hearts and minds, bending us away from God without the regenerating power of the gospel.
The fall also broke our bodies. All of creation, including our bodies, groans in anticipation as we await liberation from bodily futility, decay, and corruption (Romans 8:19-23). From stomach bugs to cancer, from stubbed toes to third degree burns, from vitaligo to cleft pallets– our bodies have experienced the brokenness that sin has brought into our human existence. From pain in childbirth, to final breaths, our bodies come into this world experiencing the fall and they leave this world experiencing the fall.
Understanding the duality of our being, and the duality of our brokenness, so to speak, has significant implications for the way we think about disorders of the brain. It would be unbiblical to blame all broken thinking and behavior on the brain, because we know that the fall bent our hearts away from God, and therefore away from Truth and toward sin. It would be equally unbiblical to blame all broken thinking and behavior on the heart, because the brain, as a created bodily organ– with sophisticated processes that control emotions, decision making, and impulse control– is subject to futility, decay, and corruption. The goldilocks principle, outlined in Mike Emlet’s book (references in Foundations for Thinking Biblically About Psychiatric Disorders), is instructive here, encouraging us not to put all of our problems in one basket.
Just as your heart can have a murmur, so your brain can experience misfire. Our brains, intricately and brilliantly designed by God, keep our hearts beating, keep our memories intact, regulate our emotions, and tell our feet to take a step. It is unbiblical to assume that the brain, as an organ of the body, has been excused from the brokenness our bodies experience as a result of the fall.
On the other hand, the Diagnostic and Statistical Manual of Mental Disorders (DSM), contains descriptions, symptoms, and other criteria that health care professionals use to diagnose mental disorders. Notably, the DSM describes characteristics and symptom clusters inherent to psychiatric diagnoses, but it does not explain the causes. This means that while it may characterize a person’s brokenness well, it does not, from a Biblical standpoint, explain the locale of that person’s brokenness (and to be fair, it does not claim to do so). The DSM-5 does not distinguish between physiological, relational, cultural, spiritual, and situational causes. While there is room in a Biblical approach for physiological causation due to our theology of sin and the fall, as outlined above, this does not exclude the possibility that disordered thoughts and behavior (i.e. diagnosable psychiatric conditions) could be a broken heart response to a broken world. Disordered thinking and behavior can result from being sinned against, such as Job experiencing what could be characterized as major depression after the loss of his health, wealth, and family and the subsequent judgement and mishandling of Scripture by his friends. Disordered thinking and behavior can result from the simple fact that sin has messed up our thoughts, desires, and emotions, as is the case with Judah, Jesus’ betrayer. After his grievous sin, being devoured by guilt and shame, he changed his mind and brought back the thirty pieces of silver to the chief priests and the elders, saying, “I have sinned by betraying innocent blood.” They said, “What is that to us? See to it yourself.” And throwing down the pieces of silver into the temple, he departed, and he went and hanged himself (Matthew 37:3-5).
When it comes to disordered thoughts and behaviors Christians need to consider the whole person, both in terms of his being very good and very broken. It is only with this complete view that we can think rightly about disordered thinking and behavior, commonly known as psychiatric disorders. This requires both compassion and wisdom. It requires us to be students of the Word, science, and the person, as each individual is presenting with different circumstances, different genes, different life experiences, and different heart postures before the living God. Often it will require the humble task of consulting with appropriate medical and psychotherapeutic professionals to understand what part the brain might be playing. And it will always require us to keep our Biblical worldview as the filter for our learning, refusing any conclusion that falls outside the purview of God’s Word.
You are an Embodied Soul, Destined for Complete Restoration by Christ’s Redemptive Work
2 Corinthians 5:1 teaches us that we are spiritual beings clothed in an earthly tent that will be made new. It goes on in verse 4 to say that while we are still in this tent, we groan, being burdened—not that we would be unclothed, but that we would be further clothed, so that what is mortal may be swallowed up by life. In other words, our earthly bodies are currently a burden- they are broken, and hurting, and the cause of much suffering. But Paul says our groaning is not from the desire to be ridof these physical bodies, but rather from a deep longing to be further clothed, so that what is currently mortal, under the curse of sin, may be swallowed up completely in eternal life.
Both our bodies and our souls have been redeemed by Christ, and are awaiting His glorious return, at which point both body and soul will be completely made new. Jesus began His restorative work with His life and death 2,000 years ago, and He continues to work by His Spirit and through His church to continue that work until the ultimate restoration when He returns. This has major implications for the way that we respond to psychiatric disorders now.
Jesus modeled to us just how pervasive that restoration is and will be. He engaged in healing both physical and spiritual maladies. He gave sight to the blind and bestowed grace and honor on the shamed. He restored the leper and included the marginalized. He made the paralytic walk and forgave his sin. He exorcised demons and raised the dead. Jesus came, lived, died, and will come again with the express purpose of making all things new (Revelation 21:5). It is our call and privilege to participate in the restorative work that Christ began and promises to complete– both in body and soul. This means educating ourselves and coming alongside sufferers, showing genuine compassion and practical care for their troubles. This could take a myriad of forms (we will explore some examples in the next article!), but for now consider the way our compassionate love and practical care should be amplified for suffering image bearers as a result of our Christian faith.
The late David Powlison, of The Christians Counseling and Education Foundation, had been working in a psychiatric hospital for three years when he came to faith. In a podcast produced by CCEF, he talks about how his work with psychiatric patients did not change or become irrelevant when he came to Christ, but rather completely expanded:
“It is characteristic of men and women who work in a psychiatric hospitals that they really care about people. They really care. These are troubled people, and your work is defined by caring for them. That [is not something] that becoming a Christian changes. It is [something that is] amplified by it. One of the ways that care tends to be shut off at a certain point in a secular setting is the way that a label interferes and the well start to see the sick as defined through a label. One of the things that actually even contributed to my coming to faith is seeing the points of contact and similarity between both very troubled people and supposedly ‘normal’ people, like me, and the rest of us on the step. We were certainly different in degree. There was a reason we got to go home and had keys. And the people there didn’t get to go home and didn’t have keys. But they struggled with all the same human stuff. So a kind of care that isn’t top-down, but is actually side-by-side is one of the unique strengths of our Christian faith. And it is a far deeper kind of care that doesn’t presume my health and your pathology but presumes that however troubled you are, though you may struggle in much more extreme ways than I do, there are points of contact in what people struggle with. So genuine care got amplified.”
Our Only Hope in Life and Death
I’ve spent the majority of this series so far emphasizing God’s design, sin’s impact, and the promised glory of both body and soul, both the brain and the heart. Before moving into some practical take aways in the next post, I’d like to bring some nuance to this truth: God does in fact care for both body and soul, and Jesus did bring healing to both body and heart. But it is undeniable that Scripture places an emphasis on the heart in this life, because without its redemption, both the body and soul are lost in the next. You may have a healthy body and brain in this life, but if your spirit has not be regenerated, you will lose it in the next. You may have a diseased body and brain in this life, but if your spirit has been regenerated, you will gain it in the next. So while God created both body and soul equally good, and sin rendered body and soul equally broken, the priority of health this side of eternity is not equally distributed.
I alluded to the story of Jesus healing the paralytic above, and I think it sheds light on this nuance. We all know the story: four friends, determined to get their paralyzed friend to Jesus for healing but blocked from entering the house in which Jesus spoke, manage to get their paralyzed friend onto the roof, break through the roof, and safely lower the paralytic through the hole in the roof all the way down to Jesus. Mark 2 picks up with this story this way: And when Jesus saw their faith, he said to the paralytic, “Son, your sins are forgiven.” To be honest, the friends were probably standing there scratching their heads. “Uhm, thanks Jesus? We were kinda hoping you’d, ya know, heal his body?” In the meantime, the Pharisees are all riled up, accusing Jesus of blasphemy. And immediately Jesus, perceiving in his spirit that they thus questioned within themselves, said to them, “Why do you question these things in your hearts? 9 Which is easier, to say to the paralytic, ‘Your sins are forgiven,’ or to say, ‘Rise, take up your bed and walk’? 10 But that you may know that the Son of Man has authority on earth to forgive sins”—he said to the paralytic—11 “I say to you, rise, pick up your bed, and go home“. Jesus used the miracle of physical healing to prove His power and authority to save the man from his biggest problem: sin and eternal separation from God. Sin that would not only exclude him from the restoration of the brokenness of his body, but that would plunge him into eternal torment. Jesus clearly cared for the physical suffering of the people He ministered to, and so should we. But Jesus also clearly prioritized spiritual salvation over physical because by it the whole person would one day be restored– to right relationships, to perfectly working bodies, to union with their Creator, to the true glory of what it means to be an image bearer.
I absolutely love the way Ed Welch puts it: “The good news about this distinction between heart and [body] is that the heart can be renewed and so can reflect the light of Christ even when the brain is weak or wasting away (2 Cor. 4:16). Those whose brains are still immature, such as children, can know Christ and follow him in obedience. Those with brain diseases can respond to God. Those who are mentally delayed can be wiser than scholars. Spirit-given faith, not IQ, is the power behind true knowledge and understanding, and faith is an expression of the heart… This truth contains a profound blessing. It means that we can reflect the light of Christ even when our brains and other body organs are unhealthy and diseased”. And thismeans that we have the promise of no more tears, no more pain, no more death to hold onto in faith. It means that our current afflictions pale in comparison to the eternal weight of glory being prepared for us. It means if we too prioritize the spiritual salvation of our loved ones who suffer from psychiatric disorders, we will some day know them with out the burden of obsession, compulsion, delusion, or depression. We will enjoy them truly, without the veil of their affliction. We will know them in regulated bodies, in minds that have full access to their potential, and in spirits that have been lifted out of the pit of shame, loneliness, and angst of living with a body and brains that they cannot trust. We will know them. For this reason, following the example of my Jesus, I will certainly fight, day in and day out for Evie’s mental health and physical well being. But even more than that I will point her to Jesus, the one who promises to make her new.
When we recieved Evie’s first psychiatric diagnosis, Obsessive Compulsive Disorder, we consulted both a Biblical Counselor and a secular psychologist trained in diagnosing and treating anxiety disorders. I remember very clearly understanding that my baby was suffering from a physiological illness, brokenness in her body. The presence of a strong genetic history, the early age of onset, and the intensity of her symptoms made this clear. We acknowledged a broken body. We thanked God for common grace, and the brilliance of professionals who understood the brokenness of her body and had tools, both medication and ERP therapy, to offer us to bring her back to health. We also recognized that our only hope in life and death, in OCD and Schizoaffective disorder, is that:
she is not mine, but belongs, body and soul, both in life and in death, to our faithful Saviour Jesus Christ. He has fully paid for all her sins with his precious blood, and has set her free from all the power of the devil. He also preserves her in such a way that without the will of her heavenly Father not a hair can fall from my head; indeed, all things must work together for my salvation [which the Lord accomplished in her in 2023]. Therefore, by his Holy Spirit he also assures me of her eternal life [where her bodily brokenness will be no more] and makes her heartily willing and ready from now on to live for him” (Heidelberg Catechism, Question and Answer 1, pronouns modified).
Stay Tuned
All theology is practical theology. From here we will consider some practical take aways from all the Biblical truth we have dug through in order to conceptualize psychiatric disorders through a Biblical lens. Until then, stay radiant, my friends.