Thursday, May 8, 2014

Warning: Nouthetic Alert

Nouthetics is driving me crazy!

Which wouldn't be so bad, I suppose, if I wasn't already crazy.

"Nouthetics" is the term used by a brand of Christian counselors in describing their Bible-based approach to dealing with mental illnesses, such as depression and addiction.  These Christian counselors call themselves "Biblical counselors," to differentiate themselves from other Christian counselors who incorporate science in their therapeutic approach.

Nouthetics might sound like a wholesome and authentic evangelical response to secular psychiatry, yet, right off the bat, these "Biblical" counselors are practicing a deceptive form of advertising.  Their very name insinuates that theirs is the only Bible-approved method to dealing with mental illnesses, kinda like the Good Housekeeping seal.  So I call "Biblical" counselors "noutheticists" instead, so I'm not enabling any holier-than-thou image, while pointing out that another valid alternative exists.

That valid alternative is called simply Christian counseling, and it combines basic psychiatry with Christ-honoring methods of interacting with mentally ill people.  Some people call it Christian clinical psychology, or Christian psychotherapy.  And in the interest of full disclosure, I'm particularly biased against nouthetics, and towards Christian counseling, since I'm living proof of its benefits.

Confused already?  It's easy to be, since mental illness itself isn't well-understood.  And for evangelicals who have a mental illness, or want to help those who do, overcoming the secular stigmas surrounding mental illnesses is only one part of the battle.  Within the Christian church, there is additional spiritual shame that is heaped upon people with mental illnesses, all tied into the presumption that one's personal sin is the cause of their problem.  Having a group of theologians try to sanctify such misconceptions further exacerbates things.

That's where nouthetics comes in.  According to the website for the Association of Certified Biblical Counselors (ACBC), "nouthetic counseling is biblical counseling that uses Scripture to confront people about their sin with the goal of helping to restore them to usefulness."  Which, frankly, is something all pastors and preachers should be doing, right?  Confronting everyone about their sin.  After all, we all sin.  We're all struggling with patterns of sin and sinful behaviors.  But when it comes to people who exhibit what science says are mental problems, some Christians feel compelled to recoil in sanctimonious dismay.  You mean somebody is suicidal?  Somebody gets their feelings hurt easily?  Somebody is lazy?  Those are all sin issues in disguise!

Or, at least, that's the theme of nouthetics.  Some noutheticists will allow that a few particularly profound cases of mental illness may respond to certain types of medicine, but biology is not seriously regarded by nouthetics as a common component of mental illness.  To validate their dubiousness of science, Noutheticists tend to rely on dated and controversial theories about homosexuality, for example, which once was considered a mental illness by secular psychologists.  However, today, even the most atheistic therapist would disavow such a notion.

Part of the nouthetic aversion to science stems from the fact that there's nothing medical about its proponents, such as the ACBC.  The group's founder, Dr. Jay Edward Adams, has a doctorate in preaching, not medicine.  All of the training ACBC provides is in doctrine and theology, which while not bad topics to know when dealing with mental illnesses, are themselves interpretations that mere mortals have created about the truths revealed in the Word of God.  Just as most medical theories have their critics, so do most religious doctrines and theological views.

Being skeptical of parts of science is healthy; throwing the baby out with the bathwater rarely is.

Of course, with nouthetics, believing that God can cure mental illnesses is orthodox theology, and represents a Biblically-based hope.  However, it's easy to get the sense that noutheticists believe God will cure mental illnesses, if we really want to be cured.  After all, if one believes mental illnesses are de-facto sin issues, and that Christ came to save us from our sin, then if we let God free us from mental sins, He will.  If we don't get healed, it would be because of our stubborn, sinful pride.

Meanwhile, nouthetics ignores those parts of the Bible in which Christ reprimands His followers for assuming a person with physical problems has those problems because of their personal sin.  Not everybody gets healed from their physical illnesses, do they?  Shucks, not everybody who's saved will necessarily conquer their other sin issues, such as obesity, adulterous thoughts, jealousies, and idol worship.  Even if nouthetics was right about sin being the main problem with mental illness, sanctification is a process that will only reach its fulfillment in Heaven.

Would noutheticists say it's wrong to give gluttons medical help to curb their eating habits?

This line of sin-in-a-box thinking appeals to many conservative evangelicals.  Perhaps that's because it absolves them of so much mental heavy-lifting concerning the idea that God allows some of His people to be a little bit "crazy."  Many conservative evangelicals need everything to fit into spiritual compartments so they can make sense out of life.  And granted, it makes no sense for God to use mental illnesses to help teach us about His sovereignty, His grace, and His peace.  If Christ-followers could still struggle with depression, or severe anxiety, or something else we really don't understand, and kinda spooks us out, then maybe noutheticists themselves could be similarly afflicted at some point in their life!

Physician, why can't thou heal thyself?

How much easier to make the whole thing a problem with sin, and simply hammer enough doctrine and theology into "patients" so they snap out of it.

Not that there aren't a bunch of silly Freudian psychotherapists and Durkheimian sociologists running around out there, wooing churchgoers with hedonistic theories about mental illnesses that absolve patients of personal responsibility.  Blame anybody but yourself!  Don't judge, don't condemn, don't believe in absolutes.  And to be sure, bad science, bad psychology, bad theology, and irresponsibility are all rampant.  Both inside and outside the counseling offices of Christ-following therapists!  Indeed, there is so much going on regarding the numbers of people being diagnosed with mental maladies, the amount of money people are spending on antidepressants, and the resources being created to propel the mental treatment industry, it's easy to get scared by it all.

And in addition to their patients, I wonder if noutheticists themselves might be a bit scared.  Scared by what they see as unbridled pandering to neurotics.  Scared by our society's wholesale abdication of conventional morality and respect for Biblical sin.  Scared by personal problems that put a drag on our country's economy.  Scared by all the weak Christians out there only too eager to let their brains - what's left of them - be coddled by worldly psychobabble.

It's an epidemic!  And you know what?  Maybe it really is.  But is it an epidemic of sin?  Sin, after all, has been around since the Garden of Eden.  However, a lot of the chemicals we've created within the past century or so haven't.  All of the additives we're now putting into our foods, the pollution we've created, and even the post-industrial lifestyles we pursue:  they're all relatively new.  Along with this perceived epidemic of mental illness.


Yes, some mental patients are taking advantage of science and the good intentions of their therapists.  So, what else is new?  Mental hypochondriacs outed by noutheticists deserve to be.  Nevertheless, we all know that some of us deal with stressors better than others.  Some people enjoy personalities that help them acclimate to pressure - and even sometimes enjoy pressure!  We're also able to embrace a wide variety of commodities - everything from consumable goods to social status - that only grows broader and deeper in its selection as humanity's existence on this planet plods along.  How we engage with those commodities varies between people, based on our gender, age, education, faith, health, and other factors.

Oh - you caught me!  I included "health" in that list of factors that influence how we engage with the everyday elements of our lives.  But health indeed plays a role in how we function in society, doesn't it?  And not just whether we have cancer, or sleep-apnea, or a broken arm.  Our brain isn't some contraption that wheezes and ticks along outside of our body, is it?  Our emotions aren't stored in some lockbox down at a portable nerve center, are they?  Our brain, our emotions, and our nervous system are integral parts of our body.  And nouthetics wants to compartmentalize them for the sake of addressing mental problems theologically?

To the extent that everybody who suffers from a mental health issue is a sinner, then yes, we all need theological discipline, accountability, and exhortations regarding Christ's sufficiency in all things.  But should we let what's wrong with secular mental health treatments dictate our condemnation of it in its entirety?

Instead, I would encourage noutheticists to look at their heart.  Are you hating the sin, as well as the patient?  What is your deepest motivation when it comes to counseling Christ-followers who struggle, for example, with depression?  Is it mostly skepticism that depression exists?  Is it mostly your own personal struggle with narcissism that you're projecting onto the patient?  Is it a prideful assumption that you're more spiritual than the patient, and you need to help them "see the light?"  Do you pity your patients, as Christ did when He walked this planet and interacted with sinners, or do you disdain them?

Technically speaking, sin is anything that keeps us from God.  So in a sense, since chronic clinical depression (my diagnosis) could keep me from God, the things that contribute to my depression can be considered sins.  But in some weird way that I'm only now beginning to appreciate, I'm not sure my chronic clinical depression is keeping me from God.  In fact, I'd say that at times, I think my walk with Him is deeper than its ever been.  Despite - or even because of - my depression.

If you really want to help Christ-followers who are struggling with mental issues, don't stop reminding your patients about sin that might be affecting their situation.  But please don't deny them the medical care they may need.

In my experience, a lot of clinical depression involves interpersonal relationships - or the lack of them.  If you're not careful, nouthetics could be part of the problem.  Not the solution.

To read more about my own struggles with chronic clinical depression, click here.

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