Mental Illness: A Scriptural Perspective Of Mental Illness & Behavioral Disorders

Connected with sin allowed in our lives is also the matter of alcohol and other substance abuse. We have mentioned it already in connection with physical causes of mental illness, for alcohol and other drugs do have a physical effect on the brain. There are chemical substances (drugs) that, taken properly and under medical supervision, affect the brain in a beneficial way. Others (such as cocaine or heroin) give a temporary pleasurable experience but are accompanied by serious detrimental effects. The ingestion of such substances is almost always done with the full knowledge that there will be both pleasurable and painful consequences. As with other causes of mental disturbances, we recognize that there are those who, because of their mental and physical makeup, find it much easier to become addicted to drugs, especially alcohol. Once he has started to abuse the substance involved, the individual may become addicted, perhaps both physically and psychologically, and find it difficult to stop the habit. Symptoms of mental illness are often produced both in the immediate time frame and in the long term. We have all seen the sad behavior of one inebriated by excess alcohol, but chronic alcohol abuse may result in mental illness due to permanent brain damage (Korsakoff’s psychosis). Scripture warns us about all this, and Solomon tells us in the Proverbs:

“Who hath woe? who hath sorrows? who hath contentions? who hath babbling? who hath wounds without cause? who hath redness of eyes? They that tarry long at the wine. ...

“Look not thou upon the wine when it is red, when it giveth his color in the cup, when it moveth itself aright.

“At the last it biteth like a serpent, and stingeth like an adder.

“Thine eyes shall behold strange women, and thine heart shall utter perverse things” (Proverbs 23:29-33).

Other Addictions

It is beyond the scope of this book to speak in detail about every addiction, but a few comments are in order before we go on. First of all, we must remember that addictions may include many things in our lives. Paul says to the Corinthians, “All things are lawful unto me, but all things are not expedient: all things are lawful for me, but I will not be brought under the power of any” (1 Corinthians 6:12). Scripture specifically mentions such things as sexual immorality, the abuse of alcohol, and overeating, but we can be brought under the power of many other things — sports, physical exercise, gambling, caffeine — even such things as risk taking. We must recognize that the unruly desires that drive addictions are found in every human heart. The Lord Jesus said, “Whosoever committeth sin is the servant of sin” (John 8:34).

Doubtless the tendency to a particular addiction is influenced both by genetics and by various influences in our upbringing, but then our will enters the picture, for we like to sin. Then, when we have indulged in a particular behavior repeatedly, we become enslaved by it so that it controls us. Thus we have purposeful acts of sin combined with the controlling nature of addictions. In fact, all sin acts like this, but addictions make it more apparent.

If we deny the slavery of addictions, we must assume that the individual has power to change himself. This is not true, for man’s will is powerless against sin without the power of the grace of God. On the other hand, if we deny the willful sin involved in addictions, then we allow ourselves to put the blame outside of ourselves, much as did the politician quoted earlier, who excused his drug dealing on the premise that his brain was messed up. The reality is that a tendency in our hearts — “the sin which doth so easily beset us” (Hebrews 12:1) — finds its expression in sinful choices and ends up as controlling behavior that resembles a disease. “When lust hath conceived, it bringeth forth sin: and sin, when it is finished, bringeth forth death” (James 1:15).

We will now consider the third aspect of sin and its consequences, that of circumstances and sin acting on us from without.

Circumstances and Sin Acting on Us

We have already noticed that circumstances and their influence on our mental state are mentioned more than once in the Word of God. The Lord foretold that, as a result of disobedience, Israel would suffer greatly at His hand. One of the sufferings they would experience is mentioned in Deuteronomy 28:34, namely, “Thou shalt be mad for the sight of thine eyes which thou shalt see.” The word here has the thought of raving through insanity, in this case the result of seeing the awful judgments God would bring upon His people. Likewise, we are told in Ecclesiastes 7:7 that “oppression maketh a wise man mad.” Many individuals can manage to cope reasonably well in life if things go smoothly and peacefully. Yet if troubles and difficulties come in, often they are tipped over the brink into abnormal thought patterns and behavior. Such things as chronic physical pain, bereavement, the loss of one’s job, family crises, and other stressful circumstances can all affect our mental state. To this list we would also have to add less common causes like war, torture, and the continuous lack of proper sleep. (In mentioning a lack of sleep, we are referring to sleep deprivation as a result of stressful circumstances.) All of these are the effects of sin from without, sin that has distorted the whole pattern of life in this world.

If one suffers severe, chronic physical pain for more than a month, he will, humanly speaking, begin to be depressed. The loss of one’s source of income or, more seriously, the death of a loved one can also precipitate a bout of depression. Those with more serious mental disorders like schizophrenia can sometimes manage to lead relatively normal lives if most of the stress is removed, but they find that their illness is greatly aggravated by difficult circumstances. Individuals subjected to the horrors of war and/or torture frequently suffer such things as shell-shock and even long-term personality changes. All this is sometimes referred to as post-traumatic stress disorder. The less resilient one is and the more fragile one’s emotional makeup, the less it takes in the way of adverse circumstances to cause obvious abnormal thinking or behavior.

All of this has increased greatly in our modern world. At the time of writing this book, entities like depression and serious anxiety have increased dramatically in Canada during the past twenty years. Disorders with a psychological component, such as fibromyalgia and chronic fatigue syndrome, have seen an even greater increase. Often stress in one’s life leads to disturbed sleep and ultimately chronic sleep deprivation. This results in chronic fatigue, increased anxiety, physical pain, and finally depression. The whole syndrome becomes a vicious circle as the depression and anxiety lead to further stress. As well, we must realize that stress may be due to our own will, where our pride pushes us to have our own way. The frustration that occurs when our will is thwarted can produce stress and ultimately all of the problems we have just mentioned. Another has wisely remarked that “circumstances would not trouble if they did not find something in us contrary to God; they would rustle by as the wind.” Here again we are in an area where different causes of mental illness overlap one another, making the subject very complex.

Appendix

The Nature of Man

In discussing mental illness, it is good to have an understanding of man and his nature, as given to us in the Word of God. It is because man is such a complex being that mental illness is so complicated. Two verses in Scripture that tell us clearly how man is constituted are found in 1 Thessalonians 5:23 and Hebrews 4:12. They read as follows:

“The very God of peace sanctify you wholly; and I pray God your whole spirit and soul and body be preserved blameless unto the coming of our Lord Jesus Christ” (1 Thessalonians 5:23).

“The word of God is quick, and powerful, and sharper than any two-edged sword, piercing even to the dividing asunder of soul and spirit, and of the joints and marrow, and is a discerner of the thoughts and intents of the heart” (Hebrews 4:12).

Body

These verses tell us clearly that man is a tripartite being, composed of spirit, soul and body. The body is the physical or material part of his being, while the soul and spirit are the spiritual or nonphysical part of man. This same truth runs throughout the Word of God and is also found in the Old Testament. Different words are used in both Hebrew and Greek to distinguish “soul” and “spirit.” Creatures in the animal kingdom have bodies, and in one sense they also have souls, for a “living soul” is anything that lives by blood and breath. Thus, in the flood at the time of Noah, Scripture says that “all in whose nostrils was the breath of life ... died” (Genesis 7:22). But while animals are living souls, they were not created by God’s breathing into them the breath of life, as is said of man (Genesis 2:7). This is an immense difference and clearly marks man out from the lower animal creation. Sometimes the soul is called the “inner man,” distinguishing it from the body, or “outer man.” The soul of man is immortal, as is clearly seen in the case of the wicked man in hades after death, in Luke 16. So Scripture speaks of “your mortal bodies” (Romans 8:11) in contrast with the soul, which is immortal.

Scripture tells us in Psalm 139:14 that we are “fearfully and wonderfully made.” The following observations show us something of the magnitude and wonder of the body’s formation:

“Each person at the moment of conception begins life as a single cell. How does that cell know what to do to construct a body composed of trillions of individual cells of different kinds and different functions? Most schoolchildren know the answer: Imprinted in that original cell are instructions for the construction and operation of the human body — instructions which will be followed unerringly. DNA replicates this blueprint onto every cell produced. And every cell, amazingly, will know which part of those directions it is to follow.

“Today’s schoolchild also knows that DNA has an incredible capacity for storing information. The information contained in DNA the size of a pinhead would fill a stack of books 500 times as high as the distance from the earth to the moon! [This would be a stack 120 million miles high!] It would take tens of thousands of desktop computers to store and process that amount of data.

“But the lesson of DNA points far beyond. ... The three billion chemical letters [in the human genome] express information in a language which must be read to be usable! A language necessarily involves ideas framed within grammatical rules and can be created and expressed only by intelligence. ...

“Language expresses thoughts — and thoughts are not physical! They may be articulated in physical form, such as sounds or words or sentences on a page or the coded chemical letters in DNA. Obviously, however, the thoughts being conveyed by the language are independent of the material upon which they are expressed. A sentence may be written on paper, wood, sand, a computer chip, or audio tape, but none of these originated the message. It must have an intelligent, nonphysical source independent of the physical means of storage of communication.”

The human body is extremely complicated, and perhaps nothing in it is as complicated as its brain. Here is the organ where all of the functions of the body are coordinated, whether voluntary or involuntary. In addition, all thought processes must be mediated through the brain, and memory must be stored there. Any injury to the brain may have profound effects, not only on bodily functions and thought processes, but also on one’s personality. Although the brain has been the subject of much study and research, it is still poorly understood.

However, man is not only body, as we have seen, but also soul and spirit. Let us see what Scripture says about them.

Soul and Spirit

Soul and spirit are often used for the same thing, when Scripture speaks of the nonphysical part of man as contrasted with his body. Depending on the emphasis, sometimes the word “soul” may be used, and at other times the word “spirit.” In 2 Peter 2:8 we are told that Lot “vexed his righteous soul,” while in 1 Samuel 30:12, concerning the servant of the Amalekite, Scripture says, “When he had eaten, his spirit came again to him.” Thus, while Scripture distinguishes between them, the soul and spirit are never separated — rather, one is the higher part of the other. As the lower part of man’s immortal being, the soul is connected with his appetites and emotions — that which makes each one an individual, distinct from others in personality. For example, Psalm 107:9 tells us, “He satisfieth the longing soul, and filleth the hungry soul with goodness.” The spirit, on the other hand, is the higher part of man’s being. It has more to do with the active intelligent consciousness and includes the God-conscious part of man. In the believer, the spirit is often connected with the Holy Spirit which dwells in him and which acts on his spirit to produce activities suitable to our new life in Christ. So we find in Romans 8:16 that “the Spirit itself beareth witness with our spirit, that we are the children of God.”

Much more could be said on this subject, and space does not permit us to go into all that Scripture gives us concerning man’s soul and spirit. For a more detailed consideration of the subject, the reader is referred to two excellent pamphlets, “Body, Soul, and Spirit,” by J. R. Gill, and “Man: A Tripartite Being Composed of Spirit, Soul, and Body,” by H. C. A.

“I” and Personality

The subject is far more complicated than even these considerations would indicate, however. We have seen that man is a tripartite being composed of body, soul and spirit. While each is distinct from the other, we know that each communicates with the other, and each affects the other, either positively or negatively. The soul and spirit must work in and express themselves through the body, and the body cannot function without the soul and spirit. Thus Scripture tells us that “the body without the spirit is dead” (James 2:26). Just as the body cannot do anything without the soul and spirit being in it, so the soul and spirit cannot express themselves in this world without a body. The three must work together.

But how do they work together? What is it that orchestrates the union of spirit, soul and body so that they can function in an integrated way? We have already noted the verse that tells us that Lot “vexed his righteous soul” (2 Peter 2:8). In Proverbs, Solomon speaks of one that “ruleth his spirit” (Proverbs 16:32). Paul could tell the believers in Rome, “Let not sin therefore reign in your mortal body” (Romans 6:12). It is evident that there is a conscious “I,” that essence of the individual that influences and directs the spirit, soul and body but is not part of them. All three—spirit, soul and body—are united under one personality, yet the “I” is above them and thus is more than the sum of spirit, soul and body. The following excellent quotation summarizes the subject for us and delineates the difference between the conscious “I” and spirit, soul and body:

“Furthermore, we judge that Scripture distinguishes between ‘personality’ — the conscious ‘I’ — and spirit, soul and body, inasmuch as it does not definitely, and much less exclusively, identify personality with any one of the three. We read that ‘the spirits of the prophets are subject to the prophets’ (1 Corinthians 14:32). We have the verse in the Old Testament which says, ‘He that ruleth his spirit’ (Proverbs 16:32). In connection with the soul, David said, ‘I humbled my soul’ (Psalm 35:13); ‘I lift up my soul’ (Psalm 86:4). Solomon speaks of a man destroying his soul and wronging his soul (Proverbs 6:32; 8:36). In reference to the body, Paul can say, ‘I keep under my body’ (1 Corinthians 9:27). These and many other Scriptures of a like character would show that in man there is the union of the material and spiritual under a single personality, as one has said, ‘Day by day, hour by hour, minute by minute we observe, each within himself, a central authority, directing and controlling, on the one hand, the movements and operations of an animal frame, and, on the other, the faculties and efforts of an intelligent spirit, both of which find in this central authority or person their point of unity. How this can be we know not.’ To this we may add that if death supervenes, the ‘I’ is identified with that which is immaterial — the spirit and the soul — yet when in the body, whether now or in the resurrection state, the ‘I’ is surely identified with spirit, soul and body.”

As the author of the above quotation says, all this is beyond human understanding. It should be noted, however, that in the above quotation, the author uses the word “personality” to describe the essence of the individual himself, not merely the particular traits that distinguish one individual from another. We are reminded of what the Word of God says in Ecclesiastes 11:5: “As thou knowest not what is the way of the spirit, nor how the bones do grow in the womb of her that is with child: even so thou knowest not the works of God who maketh all.” We notice in this verse that both the spirit and body (bones) are mentioned, showing us that we do not really know how the spirit comes into the body, nor even how the body itself is formed. Man may have discovered DNA, but how it all works is still a mystery. As we cannot understand the “way of the spirit” and “how the bones do grow in the womb of her that is with child,” so we cannot understand exactly how the physical and nonphysical parts of man’s being interact with each other.

Many questions arise at this point, some of which cannot be answered. How does that thing we call “will” energize the soul and spirit, and how do the soul and spirit communicate with the brain (the body) so that voluntary acts can be executed? How does the body influence the soul and spirit? What is pain, and why do we feel it? Why do we interpret one odor as being pleasant and another offensive? Such questions may be interesting, but again are ultimately beyond our comprehension.

Because of the complex nature of man, we will find that some aspects of mental illness will likewise be unable to be explained. The disruption that sin has introduced has affected man in every part of his nature and has resulted in disorders that involve all three parts of his being—spirit, soul and body. While we may be able to make some observations and draw conclusions, we are ultimately in a realm that God alone can understand fully.

At the same time, let us not allow what we cannot understand to spoil and perhaps obscure what we can understand. Let us again be reminded that “His divine power hath given unto us all things that pertain unto life and godliness” (2 Peter 1:3). If during this discussion we find things that are beyond our understanding, let us not be discouraged. If God has not told us something, then we may rest assured that it is not necessary for life and godliness. God has not chosen to satisfy all our curiosity, but He has given us what we need to live for His glory in this world.

Other Terms

There are several other terms that will be used when we are dealing with the nonphysical part of man in the light of the Word of God. Scripture uses the words “heart,” “mind,” “conscience,” “flesh” and “will” to describe various aspects of our being. We will also define the word “intellect,” although the word itself is not found in the Bible. However, in better translations of the Bible (such as the JND translation), the word “intelligence” is used a number of times. These terms all describe that which is nonmaterial, except for the word “flesh” which can refer to both that which is material and what is nonmaterial. These terms are not synonymous and have different meanings that need to be understood. It is important to understand what these words mean within the context of Scripture, for if we use these words in this book, we will attempt to use them with the meaning that Scripture attaches to them, unless otherwise stated.

Heart

The “heart” is a very general expression for all the inner man. Sometimes it is spoken of as the seat of the affections and will, while at other times as the sinful self with its evil desires. When Scriptures says, “If our heart condemn us” (1 John 3:20), then it encompasses the conscience. When we read, “My son, give Me thine heart” (Proverbs 23:26), it is our affections. In Jeremiah 17:9 we find that “the heart is deceitful above all things, and desperately wicked; who can know it?” Here it is man in all his sinfulness as a result of his fall. When we read, “The veil is upon their heart” (2 Corinthians 3:15), it is spiritual perception or lack of it. Thus, the heart refers to all moral exercise within us, but the word must be interpreted to some extent by the context in which it is used.

Mind

The mind is that which thinks, perceives and reasons. According to Scripture, we have some control over it, for we are told to “have your mind on the things that are above, not on the things that are on the earth” (Colossians 3:2 JnD). My heart (as the seat of affection) goes to what is important to me, but I have the ability to set my mind on something as an act of my will. Thus my will, while in one sense being part of my mind, also controls it and directs it in different ways. So the man in Romans 7:25 says, “So then with the mind I myself serve the law of God; but with the flesh the law of sin.” Here his mind wants to do what is right, but his flesh, his old sinful self, can only sin. In the unbeliever his mind is influenced and is ultimately under the control of his flesh, his sinful self, and Satan uses this to manipulate his mind in an evil way. So we read of Nebuchadnezzar that “his heart was lifted up, and his mind hardened in pride” (Daniel 5:20). Romans 12:2 speaks of the “renewing of your mind” as a result of the mind’s being under the control of the Spirit of God instead of Satan and the flesh.

Intellect

The intellect may also be said to be part of the mind, as being that which man uses to reason and which enables him to use acquired knowledge to make deductions. In another sense, it is also part of the brain, in that it is connected to the ability to learn, and then to use what has been learned. Thus, an intellect may have ability in one direction or another, as one may be clever in mathematics while another’s intellect excels in creative writing. It is important to recognize that the intellect can never discover anything in divine things: It may deduce correct conclusions, but it can never go above itself. Man, as to his mind and intellect, is always a discoverer, never a creator. He can use his intellect to reason with knowledge and thus reach right conclusions, but the knowledge itself is always the product either of testimony or experience.

Conscience

Conscience is that which man acquired at the time of his fall in Genesis 3 and which gives him the knowledge of good and evil. It is an innate sense in us that a thing is right or wrong. Before his fall, man was innocent and was not conscious of the difference between good and evil, but after eating of the tree of the knowledge of good and evil, he acquired a conscience that reminds him of right and wrong. Not that conscience by itself is always a reliable guide, for like the eye, the conscience needs light to operate properly. When man gives up the moral light that God has given him in His Word, his conscience may mislead him and allow him to do wrong things. Scripture speaks of this as having a “seared” conscience (1 Timothy 4:2). But man always has some sense of right and wrong, and it is his conscience that gives him this. The animal kingdom does not have a conscience, just as it does not possess a spirit.

The Flesh

Another term that we need to define is what Scripture calls the “flesh.” The word is used in several ways in the Word of God. Sometimes it is used simply to mean the body as distinguished from the soul and spirit, as, for example, in 1 Corinthians 15:50 where we are told, “Flesh and blood cannot inherit the kingdom of God.” The word can also be used to describe man’s nature in general—man in his whole being. Referring to the incarnation, we read that “God has been manifested in flesh” (1 Timothy 3:16 JND), and surely this implies more than simply that the Lord Jesus took a body. He had a human soul and spirit (without sin), for He was a man in every sense of the word. In the same way, when Peter and the others fell asleep in the garden of Gethsemane, the Lord could say, “The spirit indeed is willing, but the flesh is weak” (Matthew 26:41). Peter’s conscious “I” wanted to follow the Lord, but he did not realize the weakness of his natural flesh. His whole natural being was involved in this weakness, not merely his body. But the word is also used to describe that sinful self that man acquired when he fell — that sinful nature of man which can do nothing but commit sin. So we read in Romans 7:18, “I know that in me (that is, in my flesh,) dwelleth no good thing.” Paul could say to the Galatians, “He that soweth to his flesh shall of the flesh reap corruption” (Galatians 6:8). William Kelly makes the following comments concerning the term “the flesh”:

“I employ the expression ‘human nature’ ... abstractly for humanity, without a question of the state in which it was created originally or into which it quickly fell. Just so the word ‘flesh’ is used sometimes in Scripture for man’s nature simply, as in ‘the Word was made flesh’ (John 1:14), God ‘was manifest in the flesh’ (1 Timothy 3:16), Jesus was ‘put to death in the flesh’ (1 Peter 3:18), ‘Jesus Christ come in the flesh’ (¤ John 4:23). The special doctrinal sense of the term, as characterizing the moral condition of the race, particularly in the epistles of Paul, looks at the principle of self-will in the heart.”

The Will

We have already seen that the will is connected with the conscious “I”—that part of us that is above spirit, soul and body and which ultimately is able to influence and control all three. The will has been affected by sin, in that fallen man now wills to do evil. So God could say concerning mankind at the time of Noah, “Every imagination of the thoughts of his heart was only evil continually” (Genesis 6:5). In fact, every exercise of man’s will is itself wrong, for as a creature, man’s responsibility is to obey. The word used for sin and iniquity in Scripture could really be translated as “lawlessness,” simply meaning the exercise of an independent will. An independent will is always wrong, even when doing things that may not be wrong in themselves. But this will also wants to do positive evil, because of man’s sinful nature. The believer possesses a new life in Christ, a new nature that wants to please God. It cannot sin, for its will delights in that which is pleasing to God. So in 1 Peter 4:2 we find the “lusts of men” contrasted with the “will of God.”

Because the will is affected by our sinful self, “the flesh,” as Scripture calls it, we find that the mind is affected too. Colossians 2:18 speaks of one who is “vainly puffed up by his fleshly mind,” while Romans 8:7 reminds us that “the carnal mind is enmity against God.” Paul could speak of the Ephesians before they were saved as “fulfilling the desires of the flesh and of the mind” (Ephesians 2:3). The mind has been made the servant of our sinful nature, and Satan uses man’s evil lusts to induce him to commit sin.

Demon Possession

It was Satan (in the disguise of a serpent) who first lied to Eve and tempted her to disobey God by eating of the tree of the knowledge of good and evil. We learn from other scriptures that Satan was once one of God’s angels, but that he rebelled against God, wanting to have a place that did not belong to Him. Other angels evidently rebelled with him, so that now there are thousands of demons who constitute Satan’s hosts. They are constantly seeking to thwart God’s purposes and often do so by living in men and women, influencing their minds and bodies in a wrong way. Sometimes this bad influence involves taking control of the human soul and spirit (and ultimately the body) and producing symptoms of mental illness. There are several examples of this in Scripture.

In Matthew 17:14-21, we have the story of a boy who was possessed with a demon and who, as a result, was described by his father as “lunatic, and sore vexed: for ofttimes he falleth into the fire, and oft into the water.” When the Lord Jesus cast out the demon, the child was cured. In Mark 5:1-20 we read the story of a man who was possessed with demons and who lived among the tombs, naked, crying, and cutting himself with stones. When Jesus had cast out the demons, he was “clothed, and in his right mind” (Mark 5:15).

There have been many other accounts from eyewitnesses who tell of those who have acted in very abnormal ways, evidently because of the influence of demons who possessed or harassed them. Often the hallucinations and bizarre behavior exhibited by these people is attributed to other causes, until the true nature of the problem is recognized. People in African and Asian countries know well how that bewitchments and the casting of spells can affect not only the bodies but also the minds of people. An American psychiatrist working in Zimbabwe for a year recounts the following, concerning a patient he was called to treat. (The term “sister” simply refers to a nurse.)

“‘Can you make out what she is saying, Sister?’

“‘Yes, some of it,’ answered Sister Chimhenga. ‘Amai is saying that her great grandmother, Ambuya Zezuru, is speaking to her and possessing her. She is called by Ambuya to suffer for her sins.’

“I knew what the Shona word ‘ambuya’ meant and that ‘amai’ meant ‘mother’ or ‘missus,’ but I did not catch all of the cultural significance of Sister’s interpretation. ‘Sister, I’m sorry, but what does all that mean?’

“‘It means that Amai believes that she is being bewitched by her great grandmother, who may have been a prophet in her time. An important ancestral spirit.’

“‘A bewitchment?’

“‘It could be,’ she said, pausing. ‘Her family must have thought so.’”

Sadly, while much of the world languishes in captivity to such evil forces, many people in Western countries deny that Satan exists. Satan’s power is increasing in previously Christian countries, as God and His claims are being more and more set aside. Consider the following incident that occurred in the practice of a Christian physician whom I know well:

“About six years ago, I was interviewing a woman in her hospital room. She was severely depressed and was not responding to medications. As I was asking her questions about her thoughts, she suddenly developed a ‘glazed’ look, and I knew that she was no longer able to hear me. She seemed to be frozen in her own thoughts while staring into the distance. Moments later she spoke in a mechanical, unnatural voice and said, ‘Leave her alone; she’s ours!’

“It did not take much discernment to realize that I was no longer speaking to my patient and that an evil, supernatural force had pushed her aside to directly intimidate me.”

As the doctor had already noticed in this case, the usual medications used to treat depression were not effective in this woman. A power greater than she had taken hold of her, and only by the casting out of the demon could she be healed. Sometimes those under demonic power will hear voices or see unreal things, and occasionally it is difficult to know, at least in the beginning, whether the individual is suffering from a psychotic illness or is experiencing a demonic attack. Sometimes professionals who are not believers will not recognize what is happening and put the patient on medication at first, only to find out that it does not work predictably.

Since the time that the world rejected the Lord Jesus Christ, Scripture calls Satan both the god and prince of this world. (See 2 Corinthians 4:4 and John 14:30.) He is the god of this world religiously and its prince politically. He knows that he is a defeated foe, but in this time of God’s grace, he continues to be “the prince of the power of the air” (Ephesians 2:2), going about his evil work. He may indwell an unbeliever, taking over his person and forcing him to do whatever the evil spirit commands. Although he cannot indwell true believers (because they are indwelt with the Spirit of God), he can and does harass them, especially those who may have been involved in occult practices before they were saved. Reading sinful (such as pornographic) or occult books or watching entertainment that contains evil themes may open the door to these demonic attacks. As well, deliberately dabbling in occult practices (such as using Ouija boards, chanting a call to the spirit world, or becoming involved with fortune-tellers) may invite these evil spirits into our lives.

The only remedy for demon possession is the authority of the Lord Jesus that can command the demon to depart from the person. The Lord Jesus did this many times during His earthly ministry, and certainly the apostles did it too. The Lord Jesus has made this power available to believers, through His name. Before He ascended back up into heaven, the Lord Jesus said, “These signs shall follow them that believe; in My name shall they cast out devils” (Mark 16:17). Now it is possible for demons to be cast out of those afflicted by them, because of the power in the name of the Lord Jesus. The following true story shows how this happened in the case of a demon-possessed woman:

“Mrs. K. ... came to see me about a long-standing depression. She was very vague and nervous during the early part of the interview. After a few minutes of superficial small talk and preliminary questions, she said to me, ‘I’m having trouble listening to you since there are three people talking to me continuously in my mind.’ Well, this was a new experience for me. She was clearly not schizophrenic, so I knew that this was not a psychotic illness causing her to hear voices. She was totally sane, though depressed.

“I wasn’t sure what to do, but I wondered if she was having one of those occult experiences that I had spent so many hours inquiring about. This interference was going to make the interview very difficult, so I paused and made some simple notes in my chart to buy time. In my heart I said to God, ‘I don’t know what’s going on here. If this woman is hearing from evil spirits, in the name of Jesus could you please shut them up so I can finish this interview?’

“When I then looked up from my notes, she looked at me with an intensity that I had not seen in her before and said, ‘What did you just do?’ I explained that I had just noted her last statement in my chart. She would not be put off by that answer and persisted, ‘No, you did something else.’ I was confused by this time and again stated that I had only been writing in her chart and asked what made her think that I had done anything else. Her answer changed the course of my spiritual and professional lives when she stated, ‘You did something, since the voices stopped for the first time in twenty years. They are now hiding, and they are afraid of you. What did you do?’ ...

“My mind was suddenly opened to the fact that yes, indeed, she was sane and she was being tormented by the voices of demons. They stopped speaking to her because when I prayed the authority of Christ filled the room and they were afraid.”

It is important to recognize demonic power as a very real cause of mental illness, not only in such obvious cases as the one just cited, but also in other manifestations such as evilly distorted thought patterns, insomnia, nightmares, and panic attacks. As the Word of God is given up and Christian values and principles are more and more ignored, I believe we are seeing increased activity of Satan in countries where his power was formerly restrained to a large extent by the light of Christianity.

For the believer, the best antidote to such attacks of Satan is a life lived in communion with the Lord. The Ephesians had been heavily involved in occult practices before they heard the gospel, but after they were saved it is recorded in Acts 19:19 that “many of them also which used curious arts brought their books together, and burned them before all men.” In his epistle to these same believers some years later, Paul could say to them, “Have no fellowship with the unfruitful works of darkness, but rather reprove them” (Ephesians 5:11). To the Colossians he could say, “The Father ... who hath delivered us from the power of darkness, and hath translated us into the kingdom of His dear Son” (Colossians 1:12-13). The believer has been delivered from Satan’s power, but if he persists in living a worldly life and engaging in sinful behavior, he again places himself in a position where Satan can harass him. Let us remember that we have been delivered from Satan’s evil kingdom and that we are now called to “walk as children of light” (Ephesians 5:8). If we obey this exhortation, we will not give Satan an opportunity to gain an influence over us.

Criminal Behavior

The believer recognizes that all criminal behavior is the result of the activity of what Scripture calls “the flesh” — that old sinful self that is part of us as children of a fallen race. Again, it is all a matter of degree, for what distinguishes criminal activity from other sin is the transgression of a known law. As we saw previously, Scripture uses the word “iniquity” to describe sin, and this word really means “lawlessness,” or the action of an independent will. As such, sin is that which is done without reference to God, and thus Scripture tells us that “the plowing of the wicked is sin” (Proverbs 21:4). It is not that the act of plowing is in itself sin, but rather the fact that man does so independent of any consideration of his responsibility toward God. However, God has instituted and does recognize government in the earth, and governments do set up laws in order to regulate society and curb bad behavior.

In some individuals with severe mental illness, criminal activity occurs—that which is not only abnormal but which causes serious harm. In serious personality disorders, particularly the so-called antisocial personality, there are those who are sometimes termed “psychopaths.” These individuals have both severe abnormal personality traits and marked deviant behavior, yet often appear very normal and totally in control of the situation. They are usually clever, charming and able to manipulate others well, while underneath they remain totally self-centered, ruthless and seemingly lacking in feelings or remorse. They are also characterized by impulsiveness, a need for excitement, a lack of responsibility, and frequent deceit and lying. Left to themselves, such individuals often end up living a life of crime of one sort or another, covering the whole spectrum from such things as fraud and embezzlement to violence, robbery and cold-blooded murder.

All of this has its roots in sin which has affected the individual in a very severe way, aggravated in many cases by an upbringing and a society that now fails to control the outward manifestations of it. In the past, the effects of stable family life, firm discipline and Christian principles in society tended to control such behavior, at least to a large extent, but the past two decades have witnessed such a moral declension in Western countries that there has been a marked increase in serious crime. More than this, such crimes are being committed by children at an ever younger age, and we are seeing children under the age of ten who seem capable of the sort of mindless violence that once was seen only in hardened adult criminals. We are saddened by all this but should not be surprised, for when man gives up God, God may give up man to experience the full effect of what he has chosen.

Adding to the problem is the public’s fascination with such behavior, for evil is naturally alluring to our old, sinful self. A newspaper article described it as follows:

“From mild naughtiness to vicious criminality, the performance of bad deeds is something the rest of the population evidently wants to know about. This is one way to explain why the psychopath, that personification of remorseless evildoing, has such an established place in the public consciousness. We’re all psychopaths under the skin.”

Such an individual and our response to him/her bring out both the effect of the fall on us as creatures of Adam, and willful sin. Doubtless the psychopath is genetically predisposed to his bad personality structure, but then his will takes that tendency and allows it to act in open sin. Some would say that these individuals have been born without a conscience, since they seem to feel no regret or remorse for their terrible acts. This is not true, for man acquired a conscience (the knowledge of good and evil) when Adam and Eve ate of the tree of the knowledge of good and evil. The real root of the problem is found in Psalm 53:1: “The fool hath said in his heart, There is no God.” Man’s conscience needs light to function properly, and if God and His claims are rejected, then man behaves as if there were no God. Another has remarked most aptly concerning this verse:

“The secret of this course is old too. ... All the path of the wicked comes from this. For him God is not. Faith does not exist, and God is not seen. This is the secret of all error in practice and in human reasoning. The more we examine the whole course of human action, the faults of us Christians, the various wanderings of philosophy, the more we shall find that no God is at the root of all. Here it is the case that the conscience takes no notice of God. The heart has no desire after Him, and the will works as if there were none. Man says so (that there is no God) in his heart. Why should he say it? Because his conscience tells him there is one. His will would not have one, and, as God is not seen in His workings, will sees only what it will. God is set aside, and the whole conduct is under the will’s influence, as if no God existed.”

The increasing tolerance and even admiration by others of some of these traits has serious implications indeed, if the Lord should leave us here a little longer. While the personality and behavior of the so-called psychopath may be extreme, we must remember the solemn words of Scripture, “As in water face answereth to face, so the heart of man to man” (Proverbs 27:19). The newspaper article expressed it well when it commented that we are all psychopaths under the skin. The “perilous times” spoken of in 2 Timothy 3 and in which we are now living will, no doubt, see an increasing prevalence of such sinful behavior and will culminate in complete anarchy after the church has been called home.

While we may deplore such awful exhibitions of man’s sinful self as we are witnessing today, let us remember that, as the writer quoted above says, the secret of all error in us, even as believers, is that we think and act independently of God. May we be kept close to Him who not only made us, but has sent His Son “who gave Himself for our sins, that He might deliver us from this present evil world” (Galatians 1:4). We have been morally delivered from it now; soon we will be bodily delivered from it, at the Lord’s coming. “Even so, come, Lord Jesus” (Revelation 22:20)!

W. J. Prost

December 2006

Conclusions

In the light of all that we have been considering, it becomes obvious that mental illness, whether mild or seriously disabling, is very complicated. There are almost always multiple causes, such as physical, spiritual and circumstantial. It is the presence of these multiple causes together with our limited understanding of mental illness which is, no doubt, responsible for much of the misunderstanding and unbalanced thinking on the subject.

There are those who would reduce every abnormal mental or emotional response to a spiritual problem, while others would say that it is all physical, to do with malfunctioning neurotransmitters and bad chemistry in the brain. We have seen that neither of these is totally wrong, but neither is totally right either. Some would try and relate everything to experiences we had at some earlier time in our lives, while others would say that original sin is the cause of all of these problems. Again, both may be factors in mental illness, but neither explains the whole picture. Rather, in any given situation, multiple factors are likely involved and thus need to be addressed. Genetic, environmental and spiritual factors may all be present, in greater or lesser degrees. The assessment of the different factors in an individual case together with the choice of appropriate therapy presents the greatest challenge for those who treat mental illness.

For the believer, the whole subject should foster humility, when we realize the complexity of man as the highest being in creation — the one who was created in the image and likeness of God! Surely the likeness was lost as a result of the fall of man, but the image remains — he is still the head of creation and thus represents God in this world. We should be humbled, too, when we consider that “by one man sin entered into the world, and death by sin” (Romans 5:12). It was man’s sin that introduced into this world not only disorders of the body, but also of the soul and spirit, and all are involved in mental illness. May we always approach the subject with that holy reverence that realizes that “we know in part” (1 Corinthians 13:9), whether in spiritual or natural things. Let us talk a little now about treatment.

Final Conclusions

In making some concluding remarks, let us remind ourselves of several things. First of all, let us emphasize again that God has allowed mental illness in the lives of believers, just as He has allowed physical illness. Often His grace is shown more in overcoming such problems than if we had never experienced such a difficulty. The words of a poem come to mind:

“Full many a rapturous minstrel

Amid those courts of light

Will say of his sweetest music,

‘I learned it in the night!’

“And many a rolling anthem

That fills the Father’s home

Sobbed out its first rehearsal

In the shade of a darkened room.”

How many have enjoyed the hymns of those like William Cowper, whose name we have already mentioned. Yet such hymns were written with the background of manic-depressive illness. How many saints of God have suffered under serious difficulties, yet have found the grace of God sufficient to help them overcome them and have borne a bright testimony in spite of them!

Second, let us remember that “the things which are seen are temporal” (2 Corinthians 4:18) and that “our light affliction, which is but for a moment, worketh for us a far more exceeding and eternal weight of glory” (2 Corinthians 4:17). The difficulties of this life may seem overwhelming at times, but the believer can view them all in the light of eternity. Such things are not only temporal, but, as our verse tells us, work for us a far more exceeding and eternal weight of glory. No doubt such difficulties are most trying at times, but if they are accepted from the Lord and gone through with Him, they can produce an eternal weight of glory. Only in this life can we learn God as the God of all comfort, the God of all encouragement, and the God who can give us the grace to go through the hardest circumstances. We cannot learn such things in heaven, for there will be nothing there for which we need comfort or encouragement. We can have such experiences only down here, yet the weight of glory thus worked for us is eternal.

Let us close with a quotation from C. H. Mackintosh:

“Look at yonder bent and withered frame — that body racked with pain and worn out with years of acute suffering. It is the body of a saint. How humiliating to see it like that! Yes, but wait a little. Let but the trumpet sound, and in one moment that poor crushed and withered frame shall be changed and made like to the glorified body of the descending Lord.

“And there, in yonder mental hospital, is a poor patient. He has been there for years. He is a saint of God. How mysterious! True; we cannot fathom the mystery; it lies beyond our present narrow range. But so it is; that poor patient is a saint of God, an heir of glory. He too shall hear the voice of the archangel and the trump of God and leave his illness behind him forever while he mounts into the heavens in his glorified body to meet his descending Lord.

“Oh, what a brilliant moment! How many sick chambers and beds of languishing shall be vacated then! What marvelous changes shall then take place! How the heart bounds at the thought and longs to sing, in full chorus, that lovely hymn:

“Christ the Lord will come again;

None shall wait for Him in vain;

We shall then His glory see —

His who died to set us free.

“Then when the archangel’s voice

Calls the sleeping saints to rise,

Rising millions shall proclaim

Blessings on the Saviour’s name.

“‘This is our redeeming God!’

Ransomed hosts will shout aloud:

‘Praise, eternal praise be given

To the Lord of earth and heaven!’”

(Little Flock Hymnbook, #266)

Introduction

Mental illness is a controversial subject, but an important one, because it affects all of us, either directly or indirectly. At some point in our lives probably all of us will have occasion to have contact with mental illness, and, of course, any of us may occasionally experience some of the symptoms of it, even if we do not exhibit full-blown manifestations. During the past fifty years or so there have been many changes in the way mental illness is viewed, especially in the Western world. The proliferation of psychotropic drugs has made a vast difference in the treatment of serious mental disorders. These advances in treatment have brought the matter more and more into public focus and made people more willing to talk about the subject. In the modern world, there has definitely been a marked increase in the stresses and strains in our lives, and as a result such things as psychology, various types of counseling, self-help groups, and other forms of mental therapy have mushroomed. All of this raises questions in the minds of many believers. On the one hand, they find themselves, at least to some extent, victims of the same forces and the same disorders as are seen in the world at large, but on the other hand, they see themselves differently from unbelievers. Many are bewildered and confused, even frightened, by the tremendous number of options in treatment, and many fear (quite justifiably) that some of these treatments may not only be useless, but positively harmful.

Does God Himself, through His Word, offer us insight into and guidelines for this difficult subject? I believe that He does. He delights to be a light for our path.

The Lord Jesus and Depression

It is in this area that we must make some comments about the Lord Jesus Christ. He, as a sinless Man, came into a world of sin and thus experienced all the awful effects of sin from without. He went through every kind of suffering that a sinless man could go through. We read in Hebrews 4:15, “We have not an high priest which cannot be touched with the feeling of our infirmities; but was in all points tempted like as we are, yet without sin.” All of this rose to an unparalleled height when He went to the cross, for there He experienced not only all that man’s wicked heart could devise, but also the wrath of a holy God against sin. As a sinless man He felt it all, and felt it perfectly. In contemplating all of this in the garden of Gethsemane, His holy soul was overwhelmed by what lay ahead. Matthew’s Gospel records the scene as follows:

“Then Jesus comes with them to a place called Gethsemane, and says to the disciples, Sit here until I go away and pray yonder. And taking with Him Peter and the two sons of Zebedee, He began to be sorrowful and deeply depressed” (Matthew 26:36-37 JND).

Here we find sinless perfection in the presence of evil, and such evil as no other was ever called upon to experience, yet meeting it in that perfection which accepted it all from the Father. As we have seen, evil tends to depress the soul, and our Lord felt the evil personally, yet perfectly, because of His holiness. As a result, since Satan had nothing in Him, the consequence of this depression was only communion with God. Another has most aptly remarked concerning Christ’s work on the cross, “Scorn, enmity, perfect depression (He was crucified in weakness; see Psalm 22:14) and Jehovah’s face hidden from Him, these marked His state really there but [He was] faithful, saying, ‘Thou art holy’” (italics mine).

We will have more to say on this when we speak about the treatment of mental illness, but it is humbling and at the same time encouraging to see our blessed Master experiencing all the effect of sin from without and feeling what can be called depression on that account. We walk on holy ground here, however, and would make it completely clear that, while our blessed Lord had human nature, He did not have fallen nature. As a perfect man, He could feel as any other man might feel, and because of His sinlessness He felt the awfulness of sin in a way that none other could. When all of this was brought to bear upon Him in Gethsemane’s garden, it did indeed depress Him and resulted in prayer to His Father.

Many Questions

In traveling to various parts of the world and interacting with believers of different cultures, I find that the subject of mental illness comes up frequently. Many have relatives and loved ones who clearly need help in this area and are perplexed as to where to seek treatment. Many questions arise, such as:

Should they seek help from psychiatrists and other types of counselors, or is the matter always a spiritual issue?

Is there sometimes a chemical imbalance that can be corrected by proper medication, or is this an unproven idea?

Do we know how drugs that affect the brain really work, and is there a place for their use among Christians?

How responsible is the individual for his behavior in cases of mental disturbance?

The answers to such questions as these are not always readily available. It is hoped that we will be able to take up the subject realizing that, as in physical illness, so also in mental illness, there are things that we do not fully understand. However, we count on God and His Word for answers to our questions, for on any moral and spiritual subject, God has given us in His Word the light we need.

We are told in 2 Peter 1:3 that “His divine power hath given unto us all things that pertain unto life and godliness.” Our hearts need to get hold of this most important principle. We may not know or understand everything about mental illness, or about many other subjects, for that matter, but God has assured us that, “through the knowledge of Him that has called us by glory and virtue” (2 Peter 1:3 JnD), we have all the light we need in order to live a godly life in this world. In view of these and other scriptures, we are confident in looking into the matter of mental illness in the light of the Word of God, and we will seek to find the answers to some of the questions that inevitably come up when the subject presents itself. We may not find the answers to all of our questions, but we know that God has given us all we need to know in order to live for His glory in this world.

Illness and Healing in the Bible

What then is mental illness? I believe there is a scriptural basis for using the term.

In Matthew 4:23-24 (JND), we read as follows:

“Jesus went round the whole of Galilee, teaching in their synagogues, and preaching the glad tidings of the kingdom, and healing every disease and every bodily weakness among the people. And His fame went out into the whole of Syria, and they brought to Him all that were ill, suffering under various diseases and pains, and those possessed by demons, and lunatics, and paralytics; and He healed them.”

Here we find that the Lord Jesus healed every disease and every bodily weakness. When Scripture begins to refer to those that were ill, they are grouped under five different categories:

There were those who had various diseases, and surely these would include such things as infections, cancer, inflammations of various kinds, and diseases that result from aging.

Coupled with disease, there were those suffering from pains, which, of course, would include the pain resulting from such illnesses as arthritis, headaches or cancer, but would also include pains inflicted from outside the body. The thought of torment or torture is included in the word.

People were also ill when they were possessed by a demon, and, of course, this could affect both the body and the mind.

Paralytics are mentioned, as those who had lost the ability to use some part of their body, and thus were unable to function normally.

The word “lunatics” is also included in the list, as indicating those who had a disordered state of mind. The word in the Greek has the thought of being “moonstruck” or crazy, and it is a general word used for those not in their right mind. The same word is used in Matthew 17:15 to describe the boy who threw himself into the fire or into the water. In this case, the lunatic behavior was caused by a demon. Such individuals are placed along with others who had diseases and pains, and they are categorized as being ill. The state of being a lunatic was an illness which the Lord Jesus healed along with other diseases.

Mental Illness

How then do we define mental illness? There is really no definition that will encompass every aspect of the subject, for we are dealing with a matter that does not have well demarcated boundaries. To some extent, our view of mental illness is affected by the culture and society in which we live. Also, as there is a variation in what is generally considered to be normal physical health, so there is a variation in what is considered to be a normal pattern of thought and behavior. All of us at some point in our lives may experience some of the symptoms of disordered thinking, but only if the symptoms go beyond a certain point will we be said to be mentally ill. Accordingly, we will define mental illness simply as being any abnormal pattern of thought and feeling that results in disturbed behavior, and which thus affects the individual’s ability to function in his relationships with others and/or in his work.

Here it is important to clarify our definition relative to what Scripture has to say, as the definition I have suggested is very broad. The Word of God uses the word “lunatic” to describe those with disordered thinking and behavior, and as we have seen, such individuals are also included among those whom the Lord Jesus healed. It is difficult to know how far this word extends in describing those whose behavior is abnormal and what degree of disturbance is encompassed by it. I quote the scripture only to show that the Lord Jesus recognized at least some abnormal behavior as a disease and healed it, as He did other diseases. We might well hesitate to place every individual with some abnormality of thought or feeling in this category and call him/her a lunatic. In this book we will discuss a wide variety of disorders that have at least some component of disturbed thought and/or feeling. The reader may not see all of them as manifesting mental illness, but rather simply the display of what Scripture calls “the flesh”—our sinful nature. As we will see, there is often a mixture of the two. Whatever the cause, I suggest that a consideration of all of these entities before the Lord is appropriate to our subject.

In dealing with this subject, we will look at what is clearly mental illness—those individuals with so-called “psychotic” behavior. Those who exhibit such behavior are not in control of themselves and, to a large extent, are out of touch with reality. They would definitely fit into the category of “lunatics,” as mentioned in Scripture.

Also, we will discuss abnormal behavior where the individual is still in touch with reality and not out of control. These behavioral disorders are often called “neuroses,” as opposed to “psychoses.” As we will see, there is often an overlap between the two. More than this, in both cases there are aspects of his behavior that the individual cannot help, but also part for which he must take some responsibility.

At the beginning of this book, I mentioned that I was going to approach the subject in the light of the Word of God. I trust this will be the case and that the conclusions arrived at, especially in the moral and spiritual realm, will be in keeping with the mind of God as revealed in His Word. However, since the author is a medical doctor and has sought the assistance of other Christian medical doctors, there will be occasional comments based on that training and background. I hope these will be helpful in “rounding out” the discussion of the subject, but in saying this, I realize that medical knowledge is constantly changing. Some of the comments made in this area may be superseded by better knowledge at some point in the future. Also, I will make other comments from time to time that are based on my own observation and experience as an individual, not so much as a medical doctor, but as a Christian. Such comments will be obvious to the reader, and, of course, must be taken as a personal judgment, rather than having the authority of Scripture.

Mental disturbances may have multiple causes. Some may be primarily organic (caused by physical changes in the brain), while others may have their origins in the soul and spirit. Frequently both are involved, and often such causes are interconnected in a way that may be difficult to sort out. There is a great variation of opinion on the subject, not only among believers, but also in the world at large. Since the subject does not lend itself to scientific research in the same way as do other medical disciplines, some of the ideas about the nature and cause of mental illness tend to be based on theories and concepts rather than on solid scientific evidence. Much that is done in the way of treatment tends to be empirical (based on observation and experience) and is, perhaps, framed and determined, to some extent, by the culture in which we live. Also, the realm of the mind is very interrelated with the spiritual, and here we are definitely in an area where Scripture and not science must be the final authority. This principle will have to be kept in mind as we deal with our subject and will surely throw us back on the Word of God, which “liveth and abideth forever.” It is very comforting and assuring to know that God has given us all that we need to live a godly life in this world, while recognizing that there are aspects of mental illness that are beyond our understanding.

It is not the purpose of this book to discuss in detail all the various types of mental illness that have been recognized, or to approach the subject through the classification used by the psychiatric profession. However, since mental illness expresses itself in a wide variety of ways, it will be good for us to have some idea of the scope of the subject. Thus, some consideration of these different manifestations is necessary before we can proceed. The terms we will use will be the same ones used by those who treat mental illness, as these terms are commonly recognized and understood. Let us look at some examples of mental illness and behavioral disorders.

Mental Illness in the Bible

Madness or insanity is mentioned a number of times in Scripture, showing us that such things were present and well recognized in both the Old and New Testaments. We have already seen how the word “lunatic” is used in the New Testament to describe those who were afflicted with disordered thinking and behavior. There are many other references, however, in the Word of God. In the following verses, the word “mad” means a pattern of thinking or acting without reason or judgment.

In Deuteronomy 28:34, Israel was told that they would be “mad for the sight of thine eyes” when they would see the awful judgments God would bring upon them for their disobedience. The word here has the thought of raving through insanity, clearly brought on by adverse circumstances.

Then in 1 Samuel 21:13-15, David pretended to be mad so that Achish, king of Gath, would think that he was insane and not kill him. Obviously the ruse worked, for Achish clearly regarded David as being mad and out of his mind.

In Ecclesiastes 7:7, we are told that “oppression maketh a wise man mad,” while in Hosea 9:7 we are told, “The prophet is a fool, the spiritual man is mad, for the multitude of thine iniquity.”

In Daniel 4:1-37, Nebuchadnezzar tells his nation how God humbled him with a severe mental illness for seven years until he learned a most important lesson, namely, that “the most High ruleth in the kingdom of men, and giveth it to whomsoever He will, and setteth up over it the basest of men” (Daniel 4:17).

In Acts 26:24, Festus accused Paul of being mad. The word here has the thought of “mania,” or craziness. Paul replied that he was not mad, but rather was speaking the words of truth and soberness. Again, in 1 Corinthians 14:23, Paul says that if unbelievers came into the assembly when the believers were speaking in tongues, they would think that they were mad, or raving like maniacs.

These references show us that insanity was clearly recognized for thousands of years. Sometimes it was brought on by circumstances, sometimes by demon possession, and sometimes by God Himself. The word “lunatic” is used once in the New Testament (Matthew 17:15) to describe the state of one who was demon possessed, but in Matthew 4:24 a distinction is made between those possessed by demons and those who were lunatics. A disordered mental state might be caused by demon possession, but such a condition could occur in the absence of a demon. Thus we see that mental illness of various kinds and from different causes is recognized in the Word of God.

The Nature of Man

In considering mental illness, it is helpful to have an understanding of man and his nature, as given to us in the Word of God. However, since man is a complex being, some readers may find the subject complicated and the concepts difficult to grasp. For this reason, this section will be found in the Appendix. However, it may be turned to and read at this point, if desired.

Moral Responsibility and Mental Illness

We must remember a most important principle, namely, that God always holds us responsible for the motives of our behavior. A small child may be more prone to misbehave because it did not get a proper afternoon nap, but wise parents will not totally excuse such bad behavior, although making an allowance for the lack of a nap. In the same way, we cannot altogether blame a physical disease for bad behavior, although the disease may make it more difficult for us to do what is right. Scripture tells us “the Spirit also helpeth our infirmities” (Romans 8:26), and this includes such things as bipolar disorder or post head injury emotional problems. Furthermore, a physical disease, whether affecting the brain or some other part of the body, cannot prevent us from following the Lord and looking to Him for help in the situation. Paul could say to the Corinthians, “Though our outward man perish, yet the inward man is renewed day by day” (2 Corinthians 4:16). Likewise, the Lord Himself could say to Paul, “My grace is sufficient for thee: for My strength is made perfect in weakness” (2 Corinthians 12:9). While it is certainly not easy to find one’s natural abilities distorted, reduced or even taken away, yet it is an opportunity for us to recognize our weakness and look to the Lord for strength and help. Many dear believers have found this to be true and have been overcomers and bright testimonies for Christ, even with such disabilities.

In making these statements, we must, of course, distinguish between abnormal and sinful behavior. As a result of mental deficiency or mental illness, an individual may exhibit abnormal behavior which is characteristic of that particular illness. For example, the manic and depressive phases of bipolar disorder are largely beyond the individual’s control and will cause certain types of behavior that he cannot help. The lack of memory and inability to reason that go with Alzheimer’s disease are characteristic of that disease and cannot be helped. However, sinful behavior (that which is morally wrong) is something over which we have control, at least as to motive, although the distortions of our spirit, soul and body because of man’s fall may make it harder for us to control such tendencies. No doubt there is sometimes a fine line between what is abnormal because of mental illness and what is sinful because our will and wrong motives are involved.

The subject of willful sin and our responsibility before God brings up the question of addictions, which we will now look at.

The Nature of Mental Illness

How then does mental illness develop? Is it a physical thing, brought on because of chemical imbalance or other changes in the brain which do not allow the soul and spirit to express themselves properly? Or is it mainly in the nonphysical realm — the soul and spirit? Is it sometimes a combination of the two? Or does the origin go even beyond this and involve the conscious “I” that is controlling the spirit, soul and body? Is the origin always the same, or do different forms of mental illness have different causes?

In seeking to answer such questions from a scriptural point of view, we must start with the root cause—sin. All of the disorder and confusion in this world stems from that awful thing that was introduced into the world in the Garden of Eden. In considering the effect of sin and its consequences in this world, we must take up the question in at least three different ways. First of all, we must consider sin in each one of us as creatures of Adam and who thus feel the effects of sin in our being because we have been born into a fallen race. Second, we must consider sin that may be willfully allowed in our lives and which can also have an effect on us. Finally, we must consider sin as being in the world and thus affecting each one of us from without, as in adverse circumstances or something that may be done to us.

Neurotic or Behavioral Disorders

Personality Disorders

In this category we recognize, first of all, a range of problems that can be called personality disorders. We all have behavioral traits which are enduring patterns of perceiving, relating to, and reacting to ourselves and others in a wide range of contexts. These traits make us distinct individuals and are spoken of as our personality. In some individuals, certain traits become exaggerated to such an extent that they have serious inflexible and limited patterns of behavior. Often the inflexibility of the personality and its vulnerability to particular stresses results in real difficulties in social adaptation, leading to significant distress in the individual’s life. Some have a dependent personality, where the individual has difficulty making decisions, initiating projects on his own, or expressing disagreement. Such people go overboard to obtain the approval of others and are urgent in seeking relationships. Others have an avoidant type of personality, where they are unwilling to get involved in anything unless certain of being liked. Such people are preoccupied with being criticized and are inhibited in new situations because of feeling inadequate. The antisocial personality lacks the capacity to form proper relationships with others. They appear callous and self-centered, devoid of a sense of responsibility, and are given to immediate pleasures. They often lack social judgment, yet they are intelligent enough to devise rationalizations to convince themselves that their actions are reasonable and warranted. The obsessive-compulsive personality is preoccupied with orderliness, perfectionism and interpersonal control, at the expense of flexibility, openness and efficiency. The following description gives us an example of an obsessive-compulsive personality:

“Mrs. C., a 41year-old grocery store manager, comes for an evaluation at the insistence of the regional manager of the chain for which she works. She has failed to turn in the last four periodic reports on time, and her store has one of the lowest productivity ratings in the chain, even though she usually comes in earlier and stays later than any of the other managers and appears to be busy every minute of the day. Mrs. C. has frequent battles with her employees and has the highest turnover rate of employees in the chain. When confronted with these problems, she insists that her store is being run ‘properly’ and by the book — unlike the others in the chain, which are maintaining ‘shoddy’ standards.

“It is easy to identify the source of difficulty in the store. Mrs. C. insists that her employees shelve and arrange goods in exquisitely straight lines. She checks, double-checks, triple-checks, and quadruple-checks all her figures, which is why her periodic reports never get in on time. She micromanages every aspect of the store’s operation and, consequently, her meat and produce managers are always transferring to other stores. Instead of appreciating Mrs. C.’s constant supervision, her managers find it annoying and time-consuming. She is constantly drawing up charts, tables, graphs and employee directives. She spends much of her time each morning constructing an elaborate to-do list that she never finds time to complete.

“Mrs. C. has been married for fifteen years and has two children in their early teens. Her husband is a postal worker. Mr. C. reported to the therapist that until Mrs. C. began working at the store six years ago, they had lots of marital struggles because of Mrs. C.’s need to oversee and direct every aspect of his life. She had insisted on knowing where he was at every moment and had tried to plan all his leisure-time activities. He said that it was a great relief to him when she began to work at the store and became too busy to pay so much attention to his life. Mr. C. says that he and the children have a hard time persuading his wife to take a vacation and that it generally does not turn out to be much fun when she does agree to go. Mrs. C. plans their itinerary and activities minutely and insists that everyone must participate in what she has scheduled. Nothing is allowed to be spontaneous or unplanned, and everyone is expected to spend their time ‘productively’ even when on vacation.”

Anxiety Disorders

Another well-recognized manifestation of behavioral disturbance is that of anxiety disorders. This is one of the most frequently encountered forms of mental illness. In this category are such entities as phobias, stress disorders, and disorders causing panic attacks. Some people have a generalized anxiety disorder, where they worry all the time about almost everything. As may be expected, such individuals have (for various reasons) a high degree of anxiety, often accompanied by irrational fears. In addition to the intense and often disabling anxiety, they may experience physical symptoms such as pounding of their heart, sweating, trembling, shortness of breath, and lightheadedness. Anxiety disorders can affect children as well as adults, as the following example shows:

“Anne-Marie (not her real name) was a 10year-old girl from an intact, supportive family who was described as ‘anxious from birth.’ She had been a cautious, shy preschooler, but she adapted well to grade 1 and began making friends and succeeding academically. She presented several times with chronic, diffuse abdominal pain that was worst in the morning and never present at night. She had missed about twenty days of school during the previous year because of the pain. She also avoided school field trips, fearing the bus would crash. Her parents reported she had difficulty falling asleep and frequently asked for their reassurance.

“She was worried that she and members of her family might die. She was unable to sleep at all when anticipating a test. She could not tolerate having her parents on a different floor of the house from herself, and she checked the doors and windows in the evenings, fearing intruders.

“Her clinging, need for constant reassurance, and school attendance problems were both frustrating and upsetting to her parents.

“She had not experienced any traumatic events, although she reacted very strongly to the television images of September 11, 2001. One of her grandparents had died the previous year. A maternal aunt had recently been treated with fluoxetine [an antidepressant drug] for depression and was described as ‘a nervous person.’

“Anne-Marie has symptoms typical of a childhood anxiety disorder.”

Mood Disorders

Another very frequent manifestation of mental illness is that of mood disorders. In this category are the well-known entities of depression and manic-depressive illness. Depression is characterized by continuous feelings of sadness and emptiness, a markedly diminished interest in all activities, an inability to concentrate, insomnia, constant tiredness, and a feeling of worthlessness. Manic-depressive (or bipolar) disorder is characterized by periods of depression alternating with periods of elation, racing thoughts, tremendous energy, a decreased need for sleep, and extreme talkativeness. Kay Redfield Jamison, a professor at Johns Hopkins University and an international authority on manic-depressive illness, recounts her own experience with the disorder. Here is her description of how she felt:

“There is a particular kind of pain, elation, loneliness, and terror involved in this kind of madness. When you’re high, it’s tremendous. The ideas and feelings are fast and frequent like shooting stars, and you follow them until you find better and brighter ones. Shyness goes, the right words and gestures are suddenly there, the power to captivate others a felt certainty. There are interests found in uninteresting people. ... Feelings of ease, intensity, power, well-being, financial omnipotence, and euphoria pervade one’s marrow. But, somewhere, this changes. The fast ideas are far too fast, and there are far too many; overwhelming confusion replaces clarity. Memory goes. Humor and absorption on friend’s faces are replaced by fear and concern. Everything previously moving with the grain is now against — you are irritable, angry, frightened, uncontrollable, and enmeshed totally in the blackest caves of the mind. You never knew those caves were there. It will never end, for madness carves its own reality.

“It goes on and on. ... What then, after the medications, psychiatrist, despair, depression, and overdose? All those incredible feelings to sort through. ... What did I do? Why? And most hauntingly, when will it happen again? Which of my feelings are real? Which of the me’s is me? The wild, impulsive, chaotic, energetic, and crazy one? Or the shy, withdrawn, desperate, suicidal, doomed, and tired one? Probably a bit of both, hopefully much that is neither.”

Here we have seen a case where neurotic behavior can be coupled with occasional bouts of psychotic behavior, so that the line between “lunatic” conditions and behavioral disorders is sometimes blurred.

Past Circumstances

In addition to present circumstances, we must mention experiences that one may have had previously in his/her life. We bring up this subject with caution, not because the phenomenon does not exist, but because there has been so much controversy and misunderstanding about this aspect of human behavior. It is unfortunate that Sigmund Freud championed much of this approach to human behavior, for because of his atheistic views and anti-Christian ideas, believers have quite rightly given him and his theories a wide berth. Nevertheless, it is true that past experiences do mold our thinking and outlook, and painful experiences may cause us to develop certain coping strategies or defense mechanisms. As long as these coping strategies are good (such as seeking help from someone or avoiding the cause of the problem), they make it possible for us to reduce the impact of stressful events and maintain normal behavior. However, if they degenerate into defense mechanisms that are destructive, they may well provoke mental disturbances instead of avoiding them. Those who repress a painful memory or deny that something unpleasant really happened may experience some short-term relief, but they will eventually find that they must face reality. We may leave a splinter in our finger to avoid the pain associated with removing it, but the resulting infection and inflammation will create a much greater problem than if we had taken the trouble to remove it. So hurts and bad experiences that happened in the past may cast a shadow over our lives, causing us to think and act in ways that are abnormal.

Demon Possession

This cause of mental illness is a most important one, and one which is mentioned a number of times in Scripture. Because it is a factor in mental illness that is frequently neglected and perhaps not even recognized, it is important that we consider it carefully. However, because it is in a class by itself and because it is so important, we will consider demon possession as a separate entity later in the Appendix.

Criminal Actions

We have seen how willful sin can cause mental illness and how sin allowed in our lives can aggravate a tendency that is already present in our beings as the result of sin. If this is carried beyond a certain point, the individual may be guilty of criminal activity. This is another case where willful sin combines with sin as a result of man’s fall. Again, because this is a special type of willful sin, we will leave it for consideration in the Appendix.

The Psychiatrist

The mere mention of the word “psychiatrist” evokes varied and sometimes very emotional reactions on the part of believers. Some believers, especially those who have had a loved one or good friend who benefited from psychiatric treatment, respond very positively. Others who associate the profession with the theories of those like Sigmund Freud and Carl Jung and with all other anti-Christian ideas recoil in horror that any believer would even consider being treated by one. Of course, there is every position between these two polarized views.

Recognizing Symptoms

As with many things in the Christian life, balance is needed in our thinking, and wisdom that comes ultimately from having the mind of the Lord. We have seen that the human spirit, soul and brain can be deranged by factors beyond our control and that some people have a constitutional tendency to develop mental illness. Abnormal thought patterns and behavior can be studied, categorized, and then recognized in the individual by the particular symptoms that he presents. Such entities as schizophrenia, anxiety disorders, bipolar disorder, and personality disorders can be recognized and labeled when the appropriate symptoms present themselves. The names applied to such disorders may vary from culture to culture and the cause attributed to different things, but the general pattern of mental illness is very similar in various parts of the world.

In the matter of diagnosis, psychiatry and psychology cannot go beyond the observation and classification of such patterns of behavior, other than perhaps to associate them, in some cases, with factors in the individual’s environment, or to recognize that a particular chemical imbalance in the brain may be a contributing cause. Nevertheless, it is good to be able to put a label on the patient’s problem, to be able to recognize the pattern of that particular disease, and to have some idea of the severity of it. The psychiatrist can be helpful in all this.

Psychotropic Drugs

Also, there have been great strides made during the past fifty years in the research and development of psychotropic drugs. Beginning with the discovery of lithium and chlorpromazine back in the 1950s, the last fifty years have witnessed the development of a myriad of new drugs that have revolutionized the treatment of mental disorders. Prior to the 1950s, most severely disturbed individuals had to be managed in institutions, often with locked doors, barred windows, and sometime physical restraints. (The treatment of the paranoid schizophrenic under the subheading “Schizophrenia and Other Psychotic Conditions” is an example of this.) Today most psychiatric admissions are brief, with a rapid return to life in the community. Much of this change is the result of better drugs to treat mental illness, and here the psychiatrist is necessary, for only he knows how to prescribe and supervise the use of these drugs. It is easy to see that such drugs should be prescribed and managed by a medical doctor who can appreciate the indications for them, the proper dosage, the side effects, and their interaction with other drugs. Likewise, someone who is trained to recognize and classify mental disorders can better diagnose a particular problem and initiate treatment.

As a medical doctor, the psychiatrist is trained to probe for various causes of the symptoms he sees and, after putting the information together, to decide what forms of treatment are likely to be helpful in the particular case. He is trained to recognize various forces in the individual’s life and to integrate these with the person’s heredity, personality, background and beliefs. Then he tries to map out a treatment regimen that may include supportive therapy and drugs, as well as helping to give the patient insight as to what he may do to help alleviate his problems.

Administering Drugs

There are many earnest Christians who have been greatly helped by seeing a psychiatrist and who find themselves able to lead relatively normal lives as a result of a carefully monitored treatment program that may include psychotropic medication. Even the visits made to the doctor from time to time can provide support from someone who knows and understands, who is able to discuss and advise, and, if necessary, manipulate medication to achieve the proper effect. Just as, for example, the diabetic needs his insulin or oral medication monitored and adjusted periodically, so the individual with long-term mental illness needs someone who can perform this role. The psychiatrist is necessary in many cases, at least to initiate all this. Sometimes a family doctor can do some of this diagnosing and prescribing, and he can certainly monitor a patient when a treatment regimen has been set up.

Drugs and Morals

Perhaps some will ask, “Why, then, do some believers have such negative feelings about the psychiatrist and feel so strongly against his role in the lives of Christians?” First of all, we must remember what has been said previously, namely, that psychotropic drugs have no moral effect. They make the brain able to function more normally, but they cannot improve anything beyond the physical (the brain). We will deal with this subject more in a subsequent section. Second, while the psychiatrist can certainly give supportive care and psychotherapy, he cannot deal with the spiritual aspect of the illness unless he is himself a believer in the Lord Jesus Christ.

While medication and man-made psychotherapy may provide some temporary relief, they will not usually provide a permanent solution to the problem, because there are spiritual issues that need to be addressed. Behavior may be explained and perhaps excused as being the manifestation of the disease. (While psychiatrists seldom refer to a certain behavior as sin, they often say, “That’s just behavior,” meaning that it is voluntary action as opposed to a manifestation of the particular mental illness.) Certain behavior may be acknowledged to be harmful, but the reference point will tend to be man. Thus, behavior may be considered harmful to one’s self or others, but often is not viewed as a sin against God. Finally, it must be recognized that the relationship between the patient and the psychiatrist is, of necessity, a very intimate one. The most private information and delicate details of one’s life may have to be aired, and as such, the psychiatrist is in a position to direct the therapy and perhaps mold the patient’s thinking in a way that few others have the opportunity to do. Most psychiatrists, recognizing the importance of a patient’s religious convictions, would not normally give advice contrary to these unless they perceived that such beliefs stood in the way of a resolution of the problem. It is easy to see, however, that such an opinion would be based on the psychiatrist’s own perception of the situation, and if based on man’s wisdom instead of God’s, might well be contrary to Scripture. We must remember that “the fear of the Lord is the beginning of knowledge” (Proverbs 1:7), and that on every moral and spiritual subject, our thinking is wrong unless founded on the Word of God. May we always remember the statement in Isaiah 8:20: “If they speak not according to this word, it is because there is no light in them.” If man is to have a true understanding of himself, he must begin with respect for and the acknowledgment of the Lord who made him and to whom he is responsible.

Thus, we must not rely on man’s wisdom, whether drugs or psychotherapy, to cure spiritual problems. Rather, they must be faced in the Lord’s presence. Even ungodly men have recognized this. Consider the following observations by Dr. Carl Jung, a contemporary of Sigmund Freud:

“I should like to call attention to the following facts. During the past thirty years, people from all the civilized countries of the earth have consulted me. I have treated many hundreds of patients. ... Among all my patients in the second half of life — that is to say, over thirty-five — there has not been one whose problem in the last resort was not that of finding a religious outlook on life. ...

“It seems to me that, side by side with the decline of religious life, the neuroses grow noticeably more frequent. ...

“The patient is looking for something that will take possession of him and give meaning and form to the confusion of his neurotic mind. Is the doctor equal to the task? To begin with, he will probably hand over his patient to the clergyman or the philosopher, or abandon him to the perplexity which is the special note of our day. ... Human thought cannot conceive any system or final truth that could give the patient what he needs in order to live: that is faith, hope, love, and insight” (emphasis mine).

Carl Jung clearly recognized the religious need of many of his patients, and indeed within the mature age bracket he mentions, all of them evidently suffered from a lack that no ungodly man could supply. It is possible that the psychiatrist may be a worldly man with no understanding of the believer’s new life in Christ, or worse still, he may even harbor atheistic and anti-Christian sentiments, like Sigmund Freud whom we have mentioned. In such cases, the psychiatrist (perhaps with good intentions) may give advice and make suggestions that are contrary to the Word of God, and which, if followed, may do positive harm to the Christian. Humanistic thinking that places self at the center of our thoughts has pervaded our world in the past forty years, and we need to be on guard against it. May we be more familiar with the Word of God, which places Christ at the center of all things!

Psychotic Disorders

Schizophrenia and Other Psychotic Conditions

First of all, we come to the more serious types of mental illness, encompassing schizophrenia and other psychotic conditions. In these cases the individuals are not in contact with reality, in that they have lost the ability to tell the difference between what is real and what is imaginary. Psychotic illnesses are characterized by severely disordered behavior and speech, with delusions and hallucinations (such as hearing voices and seeing nonexistent things). Occasionally psychotic episodes can occur in other mental disturbances such as mood disorders. Similar symptoms can also be caused by substance abuse, side effects of medication, and general medical conditions. Autism probably should also be included in this category, a disorder characterized by language problems, repetitive behaviors, and difficulty with social interaction. Schizophrenia, however, is always characterized by psychosis. These people are often so disturbed in their ability to think and judge clearly that they may not realize that they are mentally ill. The following is a description of a typical paranoid schizophrenic:

“A. B., a physician, 38 years of age, was admitted in 1937 to a public hospital for mental disease following his arrest for disturbing the peace. Specifically, he had frightened his neighbors by hurling objects at imaginary people who, he said, were tormenting him, by beating the air with ropes, and by breaking glass in the apartment that he and his wife occupied.

“Upon his commitment to the hospital, his wife described his personality traits as follows: ‘He has always been a deep thinker. Lately, however, he cannot concentrate. He is rather aggressive and is the type who insists upon imposing his own ideas on everyone else. He thinks that people have to agree with him. He is stubborn and argumentative. This trait was even referred to in his college yearbook. He is an independent thinker and is very bright. He had big plans for the future. He was formerly quite extrovertive until the last few years, when he refused to go out and mingle with people.’

“As the patient’s mental disorder progressed, he developed a great wealth of delusions. He stated that he was ‘the link between the living and dead,’ that he was a ‘universal medium,’ that a certain physician called on him by mental telepathy for added strength and skill in surgical operations. He believed that someone was hiding in a trunk in his house and so he fired several bullets into the trunk. He accused his brother of spraying him with chloral hydrate from the third floor of his house. He therefore sat behind a closed door waiting for his brother, and upon hearing a noise, shot through the door. He grew a beard because his face, he said, was being changed in subtle ways by outside influences, adding that if he wore a beard, his true identity would be known. Following his admission to the hospital, he often spent long hours in his room where he could be heard pacing the floor, moaning, or making a noise like a dog, striking his head with his fist, or pounding the wall. When asked the reason for his behavior, he explained that he was suffering tortures because people abused their powers of mental telepathy and were directing those powers toward him. He spent nearly all the day in his room where, during the fourth and fifth years of his hospital residence, he would frequently be heard shouting, screaming, and uttering noises that the attendants described as resembling the howling of a wolf.”

Sin Allowed in Our Lives-Willful Sin

We have already seen that we have all been born as members of a fallen race, and as such we are subject to the effects of sin in our spirit, soul and body. In addition, because sin has entered this world, we also have a sinful nature that Scripture often calls “the flesh.” Scripture uses this expression to describe man’s sinful self that cannot please God. (This is also explained more fully in the section on “The Nature of Man.”) In the New Testament, especially in Paul’s epistles, it refers to man’s moral condition without God and the principle of self-will that governs the actions of the natural man. When our sinful nature, “the flesh,” is allowed to act, it can certainly contribute to and sometimes be the main factor in mental illness.

When sin is allowed in our lives, it is at once more serious, for it brings our responsibility before God into the picture. This is clearly seen in the case of Nebuchadnezzar in Daniel 4, whose mental illness was allowed of God because of his pride. Such sin is obviously different from a tendency to mental illness that is inherited, for it involves what Scripture calls “the sin which doth so easily beset us” (Hebrews 12:1). While there is no doubt that the tendency to these besetting sins is often passed on in families, yet we must draw a distinction between that which is the result of sin and that which is sin itself. The tendency to a particular type of behavior is clearly an infirmity, the result of sin, but bad behavior is sin itself. Sinful thought patterns and bad behavior can precipitate mental illness, and here it is definitely a spiritual problem. There is, however, encouragement in dealing with it, for as believers we can know deliverance from sin because the Lord Jesus has died to sin. We will say more on this subject when we discuss treatment.

For example, suppressed anger which is kept in the heart can bring on depression, and the depression will not lift until this is recognized and dealt with. Many stories about this could be told. A man walked into the room of a friend who had fallen into depression again and again, so as to need hospitalization, and bluntly asked, “Okay, what are you angry about this time?” It worked. The patient blurted it out and began to recover. Another example is given by E. C. Hadley in his book, You Can Have a Happy Life. He comments:

“We may not be fully conscious of the fact that sin and self-will are the cause of our anxious fears. It is so easy to deceive ourselves and make ourselves believe that someone or something else is responsible. However, we will never get rid of our fears or have any real peace until we admit the truth and get things right with God.

“A young lady, brought up in a Christian home, began to do things that her conscience condemned. Unwilling to admit them and confess them to God, she began to persuade herself first that God didn’t care, and then that there was no God. For several years she claimed to be an atheist. But the sin in her life gradually developed into anxiety and fear.

“She finally felt as if she were losing her mind and ended up in a mental hospital. Many remedies were tried, but no relief came until she faced the fact that she was trying to rule God out of her life. Once she confessed her sins and surrendered to God, she was able to leave the hospital with her anxieties and fears gone, and her mind clear.”

Sometimes we try to blame bad behavior on some physical cause, such as an abnormality of the brain. One such case involved a prominent politician who was holding a press conference. Here is the account of what happened, written by someone who heard him:

“This anti-drug politician had been a Teflon man through his two terms of office. Although he had faced constant legal charges, none of them stuck. Embezzlement, selling political favors, drug use — he was always accused but never found guilty. Now he had been caught in the act of buying and using illegal drugs. It was all on tape. How was he going to get out of it this time?

“As he was moving toward the podium, a reporter called out, ‘Why did you do it? Why did you lie to us all these years?’

“His response was immediate. ‘I didn’t do it,’ he said. ‘My brain was messed up. It was my brain that did it. My disease did it!’ There wasn’t a hint of remorse — only indignation that someone would ask such a question.”

This man was assuredly not mentally ill in the real sense of the word, but rather he was excusing his sinful behavior by saying that he was not responsible because his brain was supposedly messed up!

We are all familiar with the well-known case of Judas Iscariot, a disciple of the Lord Jesus who betrayed Him for the money involved. When the Lord Jesus did not use His divine power to escape but rather allowed Himself to be arrested, it is recorded that Judas returned the money and then committed suicide. No doubt he was sorry for what he had done, but his sorrow was rather for the consequences of his sin than for the sin itself. Scripture tells us that “godly sorrow worketh repentance ... but the sorrow of the world worketh death” (2 Corinthians 7:10). Poor Judas felt such remorse that he “went and hanged himself” (Matthew 27:5). Such was the awful result of sin allowed in his life!

So far we have mentioned some examples of mental illness where willful sin was the primary cause of the problem. However, willful sin can be a serious factor in mental illness that has its primary origin in sin as the effect of the fall of man. The predisposition to mental illness may be inherited, but the outward manifestations of such tendencies may be the result of sin allowed in one’s life. A propensity toward mental illness that would otherwise remain dormant can be brought out by willful sin. Episodes of mental illness are sometimes a specific reaction to severe anxiety arising from inability to meet the demands of adult adjustment. Such a difficulty may have its roots in a permissive upbringing, where there was a lack of the necessary discipline to shape the individual properly. A medical doctor (a believer) who treated a large number of college students made this observation:

“Children who have never been conditioned by some frustrations during the first fifteen years of life will not be very fit to meet the demands of adult living without experiencing unusual stress.”

Dr. Douglas Kelly, the chief psychiatrist at the Nuremberg trials, made the statement that we have raised “a generation of children who have not been taught the discipline required for getting along with the world. ... We have been overenthusiastic in our refusal to teach control lest we traumatize.” If he made this statement more than fifty years ago, what would he say today? Children who have been disciplined mentally and physically to work, to accept restrictions on their behavior, and to direct their emotions and energies outward instead of inward will not be nearly as likely to develop mental illness, even if they have been predisposed to it by heredity. We will say more about this subject when we consider circumstances and the effect of sin from without.

In our discussion of the scope of mental illness, we have mentioned personality disorders and how sin has sometimes distorted the “makeup” of the individual so that his patterns of behavior deviate markedly from others. Sad to say, this effect of sin on one’s personality sometimes leads to willful sin, where the individual becomes angry at not being accepted as normal. Instead of admitting the problem and seeking help in dealing with it, he lashes out at others. He may deny that he has a problem, choosing rather to regard himself as normal and others as abnormal. Such people are doomed to lead most unhappy lives until they face the problem, admit it, and seek the Lord’s help. In other cases, the individual is genetically predisposed to his bad personality structure, but then his will takes that tendency and allows it to act in open sin. This is particularly true in the serious disorder sometimes called the antisocial or “psychopathic” personality. Left to themselves, such individuals often end up living a life of crime, unless the grace of God reaches them and saves them.

Addictions, too, are part of this aspect of mental illness, in that they are connected with an inherited tendency which is then allowed to flourish to the point where it becomes sin. Because this is such a large subject, we will reserve it for a more thorough discussion later in this book.

The question of willful sin also brings us to a discussion of our moral responsibility in mental illness.

Sin as a Result of the Fall of Man

Physical Effects

First of all, we know that our bodies are affected by sin, sin that was introduced into the world in the Garden of Eden. God had said to Adam, “Of the tree of the knowledge of good and evil, thou shalt not eat of it: for in the day that thou eatest thereof thou shalt surely die” (Genesis 2:17). The words “thou shalt surely die” in the Hebrew original could be read, “Dying thou shalt die.” Throughout human history man has been made brutally aware of the truth of this statement as he has experienced the disordered function and gradual deterioration of his body. The brain is part of the body and thus has been affected by all this. Since the soul and spirit (and ultimately the conscious “I”) must express themselves through the brain, they may find themselves unable to do so properly because of disordered function of the brain. The imperfect physical organization of man since the fall has rendered the mind (used in the general sense), through its connection with the body (in this case the brain), liable to false perceptions and abnormal expressions.

Such things as Alzheimer’s disease, Parkinson’s disease, brain tumors, head injuries, and brain infections can all cause disturbances of behavior. The lack of proper sleep might also be included here. We can place alcohol and other substance abuse in this category, as they affect the brain in a physical way. Here we are already dealing with a combination of causes, for alcohol and substance abuse involve willful sin, while head injuries and a lack of proper sleep involve adverse circumstances and the effect of sin from without.

Most of us have had contact with someone who has developed Alzheimer’s disease and, as a result, no longer thinks or acts in a normal way. The individual often has poor concentration, poor memory for recent events, difficulty in planning and organizing his life, and impaired reasoning abilities. More serious are the resulting emotional and psychological problems such as changes in personality, inappropriate behavior in social situations, agitation, irritability, and even paranoia (an irrational suspiciousness or distrust of others).

In serious head injuries or after a stroke, the individual’s ability to function intellectually is usually damaged, but there are often other changes such as increased anxiety, emotional lability, and even aggression. In some cases there is an exaggeration of certain traits (such as stubbornness or impulsiveness) that the individual may have had before the accident and a lack of control over tendencies which may have been present already.

In addition to these somewhat obvious physical causes of mental illness, we know that the brain is involved in mental disorders such as depression and schizophrenia. It is not our purpose to enlarge on what medical science may have discovered in this realm, but suffice it to say that research has been able to demonstrate a biological component of some mental disorders. For example, various chemical substances are involved in the proper action of neurotransmitters in the brain, and when these are not present in the right amounts (either an excess or a deficit), symptoms of mental illness may result. This is certainly an important contributing factor in some forms of mental illness and predisposes the individual to a particular disorder. However, it is a mistake to categorize someone having a mental illness as simply having a “chemical imbalance.” The matter is far more involved than this, taking on a complexity in which multiple genes act in concert with nongenetic factors to produce a risk of mental disorder.

We will leave the matter of alcohol and substance abuse for now, as these are more in the category of a spiritual problem rather than a naturally occurring one. But the others that we have mentioned are things that occur because we have been born into a sinful creation. Although believers have had their sins forgiven, they are still part of a creation that “groaneth and travaileth in pain together until now” (Romans 8:22). The next verse tells us that “ourselves also, which have the firstfruits of the Spirit, even we ourselves groan within ourselves, waiting for the adoption, to wit, the redemption of our body.” Only when the believer has his glorified body will he function in the way that God intended. But again, the problem of mental illness is more complicated than simply a disorder of the brain.

Soul and Spirit

So far, we have considered only how sin has affected the physical side of man and how a diseased or damaged brain may not respond in the right way. But do we realize that sin has reached into every part of our being, moral and spiritual as well as physical? We would readily agree that the tendency to lie, steal or murder is definite evidence of sin which is in us because of the fall of man. We must recognize, however, that the soul and spirit are affected by the fall of man, not only in our having a tendency to commit sin, but also in manifesting abnormalities that sin has caused. We are all born into this world as lost sinners, and while the essential evil is neither in the body itself nor in human nature and its faculties, yet all of these are spoiled by it. While the body itself is not sinful, it suffers from the effects of sin, as we have seen. Also, it is through his body that man commits sin. David could say in Psalm 51:5 (JND), “Behold, in iniquity was I brought forth, and in sin did my mother conceive me.” Paul says in Romans 7:18 (JND), “I know that in me, that is, in my flesh, good does not dwell.” The term “the flesh” as used in Scripture sometimes refers to man’s whole natural being—body, soul and spirit. (This is developed more fully in the section on “The Nature of Man.”) Scripture also tells us that naturally we were “sons of disobedience: among whom we also all once had our conversation in the lusts of our flesh, doing what the flesh and the thoughts willed to do” (Ephesians 2:23 JnD). I would suggest that all of man’s being is included in these verses. Thus, the body (including the brain) feels the effect of sin in its disordered function and deterioration, and the soul and spirit, with all our faculties, have been affected by sin.

In his booklet Self-Esteem, the author states:

“Many of you are aware that there are different personality types, and in a general way we can all be fitted into one (or a combination) of these different types. For example, some people are hard workers, well disciplined, and good organizers. These are the people who can manage anything and who generally accomplish a lot in this world. No doubt this ability was given to them of God, and it is fair to say that they would have had this ability even if man had not fallen. But these people usually have a negative side to them, for they are often arrogant and intolerant of others. They may be sarcastic and often do not work well with others. They may rise to the top in the business world and be in managerial positions, but they are sometimes not liked by their subordinates.

“On the other hand, there are those who are far more open and friendly and are what we would call ‘people persons.’ They are intuitive, can sense other people’s feelings, and react appropriately. They usually have many friends and are well liked by others. Again, this is a God-given trait and would have been part of them without the fall. On the negative side, these people often have a problem with self-discipline and find it difficult to discipline others. They find it more difficult to keep an appointment on time, to manage their affairs in an orderly way, and to take responsibility seriously.

“What we see in the personalities of men, including ourselves, is partly what God in His wisdom created and partly what sin has brought in. We see beauty in nature and recognize God’s handiwork, but then we see the ruin that sin has brought in.”

Some of what is called mental illness or disordered behavior is really an exaggerated expression of what are normal mental and emotional responses, but without the proper integration with and balance of other traits that would enable the individual to react normally. Just as each personality type has a downside which is, no doubt, the result of sin, so the effect of the fall on the human soul and spirit contributes to abnormal behavior which may result in mental illness. The effect of imbalances in our makeup results in what is conventionally called personality—that combination of qualities that makes the individual unique. However, if these imbalances go beyond a certain point, the exaggeration of one or more tendencies results in abnormal behavior which we may call mental illness. For example, the imagination is an important, useful and interesting part of human personality, but an overactive imagination which does not distinguish between fantasy and reality may result in delusions and even hallucinations.

Let us consider a well-known mental illness such as manic-depressive (or bipolar) disorder. Is it merely a physical condition, or is there more involved? Is it caused simply by a brain that is “wired” to go off occasionally in a frantic flight, to be followed by a corresponding crash into depression? No doubt a distortion in brain function is part of it, and this is the reason that psychotropic drugs can effect some relief of the symptoms. However, I believe that Scripture would lead us to believe that sin affecting the soul, spirit and the conscious “I” is also involved. As we have already noted, the soul and spirit interact with the body (the brain) in a way that only God can fully understand, and since sin has pervaded every part of man’s being, the effect of it is felt in body, soul and spirit.

Many believers have suffered from mental disorders, and continue to do so. In some cases, these were largely due to factors beyond their control, as in the case of William Cowper, the well-known hymnwriter who lived in the eighteenth century. When he felt well, he could write beautiful hymns, such as “Ere God had built the mountains” and “God moves in a mysterious way,” and even lighter poems like “The Ride of John Gilpin.” But when depression overtook him, he was haunted by the blackness of despair, and several times he attempted suicide. All his life he was subject to the “highs and lows” of his illness, although he saw clearly the fullness of the work of Christ for his salvation.

I have known more than one earnest believer who struggled with schizophrenia, with its delusions and hallucinations. Others have to cope with anxiety disorders, being subject to such things as panic attacks and phobias, with the mental and physical anguish that these entities involve. Having known some of these individuals for more than twenty-five years, I am persuaded that the problem is neither purely physical nor purely in the soul and spirit. Rather, we must understand that, just as the body is subject to disorder and disease through sin, so the soul and spirit are also affected by it. Beyond even all this, sin has affected the conscious “I”—the essence of the individual himself that ultimately controls the spirit, soul and body. While this may sometimes be a spiritual problem and may always have a spiritual dimension, the tendency itself is the result of sin distorting the soul and spirit as well as distorting the body. Often sin distorts both the physical and the nonphysical at the same time, resulting in a complex origin for the particular mental illness. This brings us to a consideration of the second aspect of sin and its consequences, namely, sin allowed in our lives.

Treatment

General Principles

We are all aware that the treatment of disease can be complicated, even if we are considering mainly physical disease. It is not enough to treat only the body, for we know that the spirit, soul and body interact in well-recognized, if poorly understood, ways. Scripture tells us that “a joyful heart promoteth healing; but a broken spirit drieth up the bones” (Proverbs 17:22 JnD). Likewise, we read, “The spirit of a man sustaineth his infirmity; but a broken spirit who can bear?” (Proverbs 18:14 JND). So the nonphysical and physical influence each other, either for good or bad. This principle is well-known in medical circles and in the world at large. Even in simple illnesses like the common cold, studies have shown that happy, well-adjusted people have fewer colds and of shorter duration than those who are unhappy or under stress.

It is the same for mental illness, for we have seen that, in most cases, spirit, soul and body are all involved. All the various factors responsible must be considered and identified, and treatment will not be effective without this. Most mental illnesses have some physical component, and thus it is a mistake to view all mental disorders as spiritual problems. On the other hand, it is an even greater mistake to view the whole problem as physical, for while medication can treat what is physical, it has no moral effect and can never reach into the soul or spirit.

A most important point must be made here, namely, that there is a spiritual dimension to every case of mental illness. There are several reasons for this. In the first place, we must recognize that God allowed it, just as He allows physical illnesses. The acceptance of it and the recognition of God’s hand in allowing it is the first step in dealing with the problem. Second, because man is a moral being with a responsibility toward God, there are moral and spiritual issues that affect mental illness. The spirit, soul and body interact with one another, and when abnormal behavior occurs, sometimes sinful behavior is involved (or potentially involved) too. Finally, there is the need to recognize the problem of mental illness, and not deny it. As with all sin in the flesh, man has a tendency to excuse, to deny, to blame others, and perhaps even to blame God. An individual afflicted with mental illness may have the tendency to view himself as normal and others as abnormal. Such a denial of the problem makes for a most unhappy life, as no treatment can have any long-term effect in these people. Of course, these spiritual dimensions can all be present with physical illness too, but we would suggest that they are often present to a greater degree in mental illness and are thus more important.

In considering treatment, we will frequently refer to Scripture. While the comments made will be generally applicable to all who experience mental illness, we wish to make it clear that we are going to use the Word of God freely, as writing for the benefit of those who know the Lord and who have trusted Him as their Saviour. For those that read this who may not know the Lord Jesus as their Saviour, we would point out that the only remedy for sin is to be found in the Lord Jesus Christ. At Calvary’s cross He satisfied God as to the whole matter of sin, and now we read that “the blood of Jesus Christ His Son cleanseth us from all sin” (1 John 1:7). On this basis we read that God “now commandeth all men everywhere to repent” (Acts 17:30). He wants you to know the Lord Jesus as your Saviour today and know that your sins are forgiven!

The Lord, the Great Physician

“We have not a high priest not able to sympathize with our infirmities, but tempted in all things in like manner, sin apart. Let us approach therefore with boldness to the throne of grace, that we may receive mercy, and find grace for seasonable help” (Hebrews 4:15-16 JND).

“Whatever your state, come to Jesus, and you will find that He is always gracious, that He has always grace. ...

“He was despised for it — faithful in love going through all the scene of man, because He was the faithful Witness, that grace may come to me where I am ashamed to be seen of men: there Christ comes to seek me out, determined to be the faithful Witness of God, who is rich in mercy.

“You cannot be in any condition that Christ did not come into. He plunged into the very sea of men’s misery to help you out. It is a comfort to get man’s sympathy, but he often cannot help us. What is it to get God’s sympathy, which has power in it?”

Our Sympathizing High Priest

We have already referred to the Lord Jesus as having passed through every kind of suffering and difficult circumstance that a sinless man could go through, even that perfect depression that came from contemplating and eventually going through His sufferings on the cross. We saw how He accepted it all from His Father and thus, in perfection, continued in communion with His Father in it all. As a result of going through all this, He is now able to be a “merciful and faithful High Priest” to those who are also experiencing the difficulties of the Christian path. Of course, it would be blasphemous to suggest that our blessed Lord Jesus ever suffered from any illness from within, whether physical or mental, but in passing through all the circumstances we may be called upon to pass through, He experienced from without all the evil that was in the world. Because of His holy nature and because of His love, He felt it all as no other could. It was common for men to lose their reason as the result of a Roman scourging, yet the Lord Jesus endured it all and “witnessed a good confession” before Pilate afterward. We have already noted that in Matthew 26:37 (JND), it says that the Lord Jesus became “sorrowful and deeply depressed” in the garden of Gethsemane, showing that He felt very much the prospect of being made sin for us. Yet He could, at the same time, think of the spiritual welfare of others, telling His disciples to pray that they should not enter into temptation. So our blessed Lord is there for us, not as One who has not experienced any of our trials, but who was tested in all that we are passing through, although without sin. He wants us to come to Him with our infirmities and weaknesses, in order to obtain mercy and grace to help us when we need them.

While we would not want to suggest that mental illness is allowed of God simply to make us more dependent on the Lord, yet it is true that the unique nature of a mental disorder casts us on the Lord in a way that perhaps mere physical disease does not. Someone has remarked that He reserves His richest cordials (stimulants) for our deepest needs. Thus we would suggest that the Lord wants us to approach Him first with our difficulties, first of all in submission and acceptance of the problem from Him, and then in a spirit of asking for His help in the matter. Ultimately only He can heal, and only He can direct as to what additional forms of treatment we should seek out. We cannot emphasize this too strongly, for while man can often give relief from the symptoms of both physical and mental illness, ultimately the only remedy for sin is found at the cross. All other forms of treatment must be viewed in this light.

He Gives Grace

If the problem stems mainly from a hereditary tendency to a particular behavioral disorder, He can give us the grace to take it from Him and to live for His glory in spite of it. He can show us what kinds of treatment might be helpful and can help us order our lives so as to be able to cope with the problem.

If the matter involves difficult circumstances, perhaps from stress in the family or the workplace, He wants us to roll the burden over on Him. He has said, “Casting all your care upon Him; for He careth for you” (1 Peter 5:7). He will give us the grace to bear the difficult circumstances, for He has experienced the same. Just as He glorified the Father in the most trying of circumstances, so He wants to give us the grace to do so too. If some change in our circumstances would be helpful in alleviating the stress, He will show us how to do it. This is not to say that He will necessarily take away the source of the problem, but in bringing the matter before Him we can look for and expect His sympathy and guidance. He can help us not to “break” under the weight of the circumstances, but rather give us the strength to be overcomers.

Suffering as a Result of Willful Sin

Even if we have caused some of the problem by our own willfulness and sin, let us remember that if we come to the Lord about it, He will always meet us in love. I knew a man (now with the Lord) who had wasted his early life and who suffered from permanent brain damage as a result of the long-term abuse of alcohol. He was obliged to spend the rest of his life in an institution, and his attitude and behavior initially made it most difficult for the staff there to manage him. But then he accepted the Lord Jesus as his Saviour, and although his mental capacities were still very limited and his behavior not totally normal, the change in him was remarkable. He was easy to manage, always wore a smile, loved to talk about the Lord, and took a prominent part in hymn sings that were occasionally held at the place where he lived. He eventually passed away at a relatively young age, but he was surely a case where “though our outward man perish, yet the inward man is renewed day by day” (2 Corinthians 4:16).

If there is sin in our life that is contributing to the problem, we can bring it before the Lord and deal with it. Much of the stress in our lives stems from this, and perhaps we do not even realize it. Again, we would place strong emphasis on this point. Many dear believers are indeed trying to walk as children of light. As we fail to produce the fruit of that light, we may become disillusioned because we are driven from deep within by that of which we have been unaware. Perhaps we have rightly understood salvation as a free gift, but have not understood that we are to work it out with fear and trembling (Philippians 2:12). We have not understood properly that sanctification (being set apart for Christ) is a process as well as a position. Thus we tend to press on in terms of managing behavior rather than by the renewing of the mind (Romans 12:2). Instead of really changed behavior, the result is rather repression of the flesh instead of death to it. We control evil tendencies while allowing them to remain in a storehouse of the heart. Then, when behavior erupts which is not Christlike, we strive all the more to control the behavior or rebuke the devil (who had to have raw material to work with even if he did trigger the behavior), instead of dealing with the real root of the problem.

Dealing With Sin—the Root

There are many verses in the Bible that show us clearly that the blood of Christ has put the believer’s sins away. In scriptures like Romans 6, the question of sin is dealt with, in its root and principle. There we get the further truth that in the death of Christ, God saw the moral end of the natural man. “Knowing this, that our old man is crucified with Him, that the body of sin might be destroyed, that henceforth we should not serve sin” (Romans 6:6). God never forgives the old nature — death is the only remedy for it. Because of the death of Christ, we are now able to obey the command to “reckon ye also yourselves to be dead indeed unto sin, but alive unto God through Jesus Christ our Lord” (Romans 6:11). Since the believer who is “in Christ” has died to sin too, he is entitled to take this position practically, for he has been placed there positionally through the death of Christ. As we have mentioned, the practical realization of this is a progressive thing in the believer’s life. We must be ready to give up on ourselves as to our sinful nature, if Christ is to live in us. When we were saved, we had to come to the end of ourselves, realizing our complete inability to get rid of our sins by ourselves. In the Christian life we must also realize the total ruin of the “old man” (what we are as members of a fallen race) if we are to walk as Christians in the right way. As long as we focus on merely controlling bad behavior, we will never realize any permanent relief from willful sin.

In saying all these things, we would reiterate what was mentioned previously, namely, that sin allowed in our lives is only one contributing cause of mental illness. We dwell on it a little here because it is a major contributing factor that is probably more widespread than we realize, and it is not always appreciated for what it really is. On the other hand, we would not want the reader to deduce from these comments that we are implying that all mental illness is due to willful sin. Rather, we are saying that it is a factor that must be considered and, if present, must be dealt with.

Moral Responsibility

Connected with this truth is the important principle that we have mentioned earlier, namely, that we are always morally responsible for the motives of our behavior. We cannot blame sinful behavior on some biological disturbance in the brain. Likewise, we cannot blame it on difficult circumstances or some bad experience in the past, as if we were not responsible for what we do. (Unhappily, there is much of this excusing of bad behavior in the world today.) Nor can we excuse our failure to be Christlike by taking refuge in our bodily aches and pains, as if we could not help it. As we have said earlier, surely mental and physical illnesses can make us more vulnerable to an attack of Satan and thus make it easier to sin, but we cannot use this as an excuse for wrong behavior.

Our behavior may be simply abnormal and thus somewhat objectionable to ourselves and to other people, and sometimes it may be clearly sinful. As we have already noted, sometimes the line between the two is a fine one. Ultimately, only the Lord knows perfectly all the factors that have contributed to our altered mental state and perhaps abnormal behavior. In the Lord’s presence we can open up our hearts to Him who knows all things and who cares for us as a shepherd cares for His sheep. We read in Isaiah 53:4, “Surely He hath borne our griefs, and carried our sorrows,” and surely this includes the sorrows of mental illness as well as the grief that we may have experienced. William Kelly comments on this verse in a helpful way:

“He was here below in grace, passing through a ruined, needy, sorrow-stricken world, ready to help any that came, all that were brought, demonized or sick; and a word was enough for the worst. Thus was fulfilled Isaiah 53:4 (not yet the vicarious work of verse 5, et seq.). Certainly that was not sacrificial. ... It was the power that dispelled sickness from every patient in contact with Himself; and this withal as One not in unfeeling distance, but who (in love as deep as His power) took all, bore all, upon His spirit with God.”

The Grace of God

Our blessed Lord wants us to confide in Him, as the One who knows and loves us. In keeping with this, we would suggest that what is needed by the believer suffering from mental illness, more than anything else, is a deep understanding in the soul of the grace of God. We must see that God’s grace is His undeserved favor and that this was extended to us when there was nothing in us to love. When we see that He loves us in spite of our sin (sin which we brought upon ourselves by disobedience) and that He sent His Son to die for us, we realize how much love is in His heart toward us. We see more and more the truth of Romans 8:32: “He that spared not His own Son, but delivered Him up for us all, how shall He not with Him also freely give us all things?” This does not imply that God’s grace will simply remove all the pain of mental illness, any more than He removes all our physical illnesses. Rather, it shows us that the One who sent His Son to die for us that we might spend eternity with Him is surely able to help us deal with matters that have to do with our lives down here.

When we really appreciate the grace of God, we will not wallow in self-pity, become angry, or give up in despair. Rather, we will accept it from God, and as the Lord Jesus did in the garden of Gethsemane, we will use the opportunity to draw closer to the Lord in communion with Him. We will seek His strength instead of meeting the difficulty in our own strength. Another has expressed it well:

“If I hear bad news ... it will make me sorrowful and cast me down, as it did Paul, who had fightings without and fears within. But though thus sorrowful, if Satan has nothing in us, the consequence of this depression will be communion with God, instead of having allowed our affections to wander; we are in the presence of God; we watch with Him in order to speak to Him; but if this is not the case, Satan will take us unawares in moments of carelessness.”

We have mentioned earlier the matter of bad experiences or hurts from the past that may warp our thinking and alter our behavior. While it may be desirable to address these things with those responsible for them, this is not always possible. I believe that we can have them out in the presence of God, and in His understanding and sympathy we can experience healing and blessing. The psalmist could say, “Because Thy loving-kindness is better than life, my lips shall praise Thee” (Psalm 63:3). Surely to know and experience His loving-kindness is better than anything man can supply in the way of healing. We do not have to live under the awful shadow of past hurts all our lives. We need to be brought back to the cross where we see our blessed Saviour having dealt with all of this for us and where He bore the judgment of God alone so that we might be healed. In the garden of Gethsemane, the Lord Jesus went through all the agony of the cross in contemplating it, yet did so only with His Father. No one else really understood, yet the Father’s heart was sufficient for Him. Coming from that place, He could calmly face whatever the Father’s will placed before Him.

Furthermore, we need to count on the grace of God and ask Him for more of it, if we feel the need of it. Paul was given a thorn in the flesh, probably something physical, although the Spirit of God has not told us exactly what it was. At any rate, it bothered him so much that he asked the Lord three times to take it away. The Lord’s response to him was, “My grace is sufficient for thee: for My strength is made perfect in weakness” (2 Corinthians 12:9). Another has remarked, “Wisdom and philosophy never found out God: He makes Himself known to us through our needs; necessity finds Him out.” No doubt Paul came to know the Lord in a way that he might not have otherwise, in the grace that was given to him in connection with that thorn in the flesh. While we would hesitate to suggest that mental illness is allowed in the lives of some in order to allow them to come to know the Lord better, yet we know that in our needs, whether physical, spiritual, mental or material, God makes Himself more precious to us if we take them to Him. Paul found, as have many other believers, that God could use him more in weakness than in his own strength, for then he had to rely more on the Lord and walk in His strength. Just as many saints of God have had to rely on the Lord’s strength because of physical illness, so the believer can go to the Lord with his mental weaknesses and disabilities, asking Him for strength to help him go on. We would suggest that many have come to know the Lord in a richer and fuller way in seeing how He can give the grace for every infirmity, even mental illness.

We conclude this section with a quotation from Romans 8. In this chapter Paul asks the question, “Who shall separate us from the love of Christ?” (Romans 8:35). He then goes on to show us that nothing can separate us, whether things in this life, such as tribulation, peril or sword, or whether things beyond human control, such as angels, death or things to come. I would suggest that mental illness is included in these categories.

Help From Other Believers

“Blessed be God, even the Father of our Lord Jesus Christ, the Father of mercies, and the God of all comfort;

“Who comforteth us in all our tribulation, that we may be able to comfort them which are in any trouble, by the comfort wherewith we ourselves are comforted of God.

“For as the sufferings of Christ abound in us, so our consolation also aboundeth by Christ” (2 Corinthians 1:36).

It is the happy privilege of many of us who are believers in the Lord Jesus Christ to be a help to other believers from time to time, and perhaps this is most needed and appreciated in the realm of mental illness. This is true whether the disturbance is milder, as in a time of grief or stress, or whether we are dealing with a full-blown case of severe psychosis, where the individual is out of touch with reality. The verses quoted above show us clearly that God our Father is the source of all true mercies and comfort, yet He gives us the privilege of showing the same love and care for others as He has shown to us. Thus we are told in Galatians 6:2, “Bear ye one another’s burdens, and so fulfill the law of Christ.”

Physical Versus Spiritual

We have shown that mental illness commonly involves multiple factors, including the body (the brain) and the soul and spirit, as well as circumstances that may act on these. Medication and other modalities (such as electroshock treatment) may sometimes be needed to help the brain to function better, while therapy in the form of listening, interpretation and counseling are needed to help the soul and spirit. There is an important point to be made here. The physical aspects of treatment (such as the use of drugs) will need professional supervision, but for the believer, matters of the soul and spirit are best handled by other spiritual believers. Professional people (like the psychiatrist) may, of course, be helpful in diagnosing a particular illness, based on a constellation of symptoms that points to a specific disorder. He may also be most helpful in recognizing factors that may have contributed to this. But while science has discovered many things to treat malfunctions in the body (in this case the brain), it cannot address the moral behavior that is affected by a distorted soul and spirit and a disordered brain. When the illness involves the spiritual, we are out of the realm of science and into an area that needs a revelation from God.

Scripture, Psychology and Psychiatry

In this area of the spiritual, Scripture and psychology (and psychiatry) may be in conflict with one another. Scripture is a revelation from God to man and, as such, does many things beyond man’s capabilities. It gives life through the Spirit, it judges (but is not judged by man), and it communicates with man, giving to him all things which pertain unto life and godliness. Thus it feeds his soul. It explains to man his nature and his behavior, what animates him, and what controls him. Further, it tells him what his moral relationships are and what his responsibilities are in those relationships. Psychology, on the other hand, is the study of human nature without reference to God or revelation, and thus it cannot, in itself, rise above man’s observation. It cannot discover “laws” which explain the nature of the things as God has designed them: It can discover only “patterns” which have been observed to be generally true, but which do not explain the nature of the thing itself.

The Gift of a Pastor

Here is where the gift of a pastor comes in, a gift that is much needed but perhaps most rare. It is a gift that is often not appreciated as it should be. Because of the nature of pastoral work, little human glory is associated with it, for it is exercised, for the most part, behind the scenes. It is time-consuming and sometimes not appreciated even by the one for whom it is being used. Yet such a gift, properly used before the Lord, can be of inestimable value in cases of mental illness among believers. The value of such a gift is expressed as follows:

“I believe a pastor is a rare gift. ... A pastor must be like a doctor; he must know the right food, and the right medicine, and the right diagnosis, and all the pharmacopoeia, and must know how to apply it too. In one sense, it is a rare gift, and very precious.

Another has commented in a similar way:

“It seems to us that a pastor is to the soul what a doctor is to the body. He must be able to feel the spiritual pulse. He must understand disease and medicine. He must be able to tell what is the matter, and what remedies to apply. Alas! How few proper doctors there are. Perhaps they are as rare as proper pastors. It is one thing to take the title, and another thing to do the work.”

There are two difficulties in connection with the work of a pastor. We have already stated one of them, namely, the rarity of the gift. How often does one long for the heart of a true shepherd, to whom difficulties could be poured out! Even if one does have the gift of a pastor, the pressure and hurry of the days in which we live sometimes make it difficult to take the time for the real work that is needed in this way. Public teaching and ministry may be most helpful, but often miss the mark because they go over the head of the one who needs it most. It is in pastoral work that the true nature of difficulties can be found out and the right word given.

Confiding in Others

Another difficulty arises, particularly with mental illness, because believers are embarrassed and hesitant to confide in someone who knows them well and with whom, perhaps, they live and move on a regular basis. They are ashamed to admit that such a problem as mental illness exists, and perhaps they fear that they may become the subject of gossip. Unhappily, such fears are sometimes justified. As a result, believers may seek help from worldly sources instead of being helped by a true pastor.

We should be willing to confide in one another more, for Scripture tells us to “confess your faults one to another, and pray one for another, that ye may be healed” (James 5:16). I believe that this healing includes mental as well as physical illness. If there were more willingness to recognize such problems, confess them to one another, and pray together, I believe we would see more positive results. Such confession does not mean a kind of “grandstanding,” where we deliberately search our heart and background for as many faults as we can remember, only to broadcast them to our fellow-believers. No, that is not what the Scripture means, for God never occupies us with sin and failure except to get us to deal with it. But if a particular difficulty is present in my life, whether physical or mental, may we have the grace first to bring it before the Lord, and then to be willing to mention it to others, asking them to pray for us. Let us remember, too, that we all feel the effects of sin in our persons, in one way or another. If some have more overt difficulties than others, it is only an opportunity for the grace of God to abound.

Other Ways to Be a Help

In considering the help we can give to others, we should not feel helpless even if we do not have the gift of a pastor. There are many forms that such help can take, and the degree of help that one can offer will be determined not only by the individual’s gift, but also by his maturity and wisdom in spiritual things. This in turn will greatly depend on how closely he is walking with the Lord. Just as “the effectual fervent prayer of a righteous man availeth much” (James 5:16), so a believer who is living close to the Lord will have His mind and be much more help in such situations than one who is merely intelligent in a natural sense. Also, as we have seen from the scriptures already quoted from 2 Corinthians 1:36, it is often the one who has been through difficulties himself who can relate to another who is passing through a similar trial. This is not to say that we need to experience mental illness in order to be able to help another believer who has this problem, but it does make us realize that those who have gone through trials with the Lord are often more equipped to help others than those who may have had an easier pathway.

The help given can take different forms. Sometimes the simple concern and companionship of another, with the knowledge that others are praying for him, can be of immeasurable help to someone who is suffering from mental illness. Probably some of what passes for mental illness in this world is related to the lack (or perceived lack) of love and understanding on the part of others, and the care and expressed concern of others will often go a long way toward relieving the symptoms. We must be willing to be a good listener, to accept the person (not his sin), and pray both with and for him. Of course, wisdom must be used in this, and an understanding of the individual’s particular problem will dictate how help can be given. For example, people who are depressed are generally helped most by short visits from those who are upbeat and positive, while being serious and able to commiserate with the person about how he feels. They are not helped by long visits and lengthy exhortations from Scripture.

If we feel that we know and understand the individual more deeply and can spend more time with him, then we may be able gently to probe the difficulties or background that may be contributing to the problem. This requires much wisdom and dependence on the Lord, for such counseling is a serious thing to undertake and should not be entered into lightly. We have already seen that mental illness is complicated, and treatment must be approached with caution. In seeking to help someone in this situation, we should be careful not to make definite statements about them and their illness unless we are very sure of where we are taking the discussion. Much harm has been done by those who, having only a simplistic and unbalanced view of mental illness, have made quick judgments and rash statements. As a result, sometimes thoughtless and naive counsel is given rather than godly wisdom. Rather, it is better to ask questions, drawing out the person and leading his thoughts so that eventually he will see for himself the point that needs to be made. Knowledge of the Word of God is needed and the spiritual maturity to apply it correctly, but this too comes with guidance from the Lord. Often He can give us a definite scripture and thought to lay before someone that will address the problem and bring them into the Lord’s presence. Our aim should be, not to have dominion over their faith, but rather to be helpers of their joy. (See 2 Corinthians 1:24.)

Often individuals suffering from mental illness will need to be “carried” for some time, as they may seem to improve, then relapse into similar disordered thinking and behavior again. We must not let them go too soon, and we must be ready to help again if the problem returns. Those with more severe illnesses may have to be carried to some extent all their lives.

Bearing Burdens and Being Leeches

In dealing with this bearing of burdens, we must distinguish between bearing one another’s burdens and allowing people to become “leeches.” The word for “burden” in Galatians 6:2 has the thought of a heavy, intolerable stress or weight that requires help in order to be carried, while the word translated “burden” in verse 5 of the same chapter is a different word, having the thought of that which is the normal and proper responsibility of the individual. There are things in life that are properly our own responsibility and should not be pushed over onto others. A leech continually sucks out the strength of another, while never giving anything. Some believers are unwilling to pay the price of personal prayer and spiritual discipline in order to maintain their emotional and spiritual well-being, and thus they end up continually drawing on the strength of others. Such behavior is a taking which prevents giving and ultimately is of the flesh. Occasionally such behavior may have to be rebuked. But for the most part, those with mental illness will be able to function, but they may need help from time to time. It is a privilege to be able to give such help!

We may sum up our observations as follows: On the part of the one suffering from mental illness, he must be willing to admit the problem, just as with physical illness. Those in denial about their illness will not be able to be helped very much. Once the problem is admitted, the individual must be willing to accept help, realizing that God has provided the help for him. It is gratifying to our natural hearts to say, “I can handle it myself; I do not need help.” But if God has provided help for us, let us accept it. Finally, the individual must be willing to help himself. Help may be needed, but it should ultimately be with the objective of being able to manage with as little help as possible. Of course, there are severe mental illnesses where this may not always be possible, but it should always be the objective.

We have spoken about therapy for the soul and spirit; now let us talk a little about therapy for the body — the brain.

Treatment Considerations

Where then does all this leave us? Once again we are thrown back on the Lord Himself, who alone can give wisdom in any given occasion. Just as we sometimes need a doctor for physical illnesses, so we may need a psychiatrist for a mental illness, particularly if medication is needed. We choose a doctor for our physical needs carefully, and we should be even more careful in choosing a psychiatrist. How helpful it is if one can be found who knows the Lord and thus is prepared to treat the patient in every way! But even the best of psychiatrists cannot take the place of a truehearted pastor.

It is striking that Carl Jung would recognize that things such as faith, hope and love were necessary for the healing of persons and that he further recognized that no system of human thinking could impart these. Only in knowing the Lord Jesus as Saviour and in walking with Him can they be a reality in our lives. We must also bear in mind that while others may be helpful in pointing someone in the right direction and perhaps in giving him insight into the nature of the difficulty, ultimately only the individual himself can really deal with his spiritual need in the Lord’s presence.

Now let us consider an allied but quite different discipline, that of psychology.

Psychology

Once again we approach the subject with some hesitation because of the strong opinions held by many believers on the subject. Books like The Seduction of Christianity by Dave Hunt and T. A. McMahon and Psychoheresy by Martin and Deidre Bobgan have been unsparing in their condemnation of psychology as it is practiced today and have warned believers against it in the strongest possible terms. Having read both of these books and others like them, I have to say that these warnings are needed, for some of what they say is true. No doubt, much of their criticism stems from the fact that modern psychology has tended to adopt a humanistic, new age view of man and his behavior and has set aside the Word of God as the only true authority on the moral and spiritual issues that are being addressed. Having said this, it is also my considered opinion that some of this criticism, particularly the viewpoint of the Bobgans in Psychoheresy, is unbalanced and misleading. In seeking to draw attention to a serious tendency toward wrong thinking among believers, they have themselves fallen into error and distorted thinking. In their efforts to expose the flawed thinking behind much of modern psychology, they have assembled an array of negative quotations and opinions that cannot always be supported by Scripture. In their assertion that Christ is the ultimate answer to the problems of life, they are right. In their attempt to reduce most of these problems to willful sin, I believe they have gone too far. When they deny the theory that most of human behavior is the result of what we are thinking unconsciously, they are right. When they deny that there are such things as unconscious thoughts and motives, they are wrong, for the Word of God clearly recognizes that there may be unconscious thoughts and motives that govern my behavior. Elihu could advise Job to pray, “That which I see not teach Thou me” (Job 34:32). Recognizing the possibility of sin working unconsciously in him, David could say to the Lord, “Search me, O God, and know my heart: try me, and know my thoughts” (Psalm 139:23). In another place he could say, “Cleanse Thou me from secret faults” (Psalm 19:12). Again, when they suggest that the believer is called to be occupied with Christ instead of the hurts he has experienced in the past, they are right. When they say that past emotional wounds really have no bearing on our present behavior, they are wrong. In seeking to expose one error, they themselves have fallen into error on the opposite side. Sad to say, man is prone to do this in many areas.

All of this then begs the question, “Is psychology always, all wrong?” By definition psychology is the study of human behavior. It includes such things as I. Q. testing, the evaluation of various personality types, the reactions of individuals to various forces in their environment, and the various ways by which behavior can be modified. The believer can readily see that psychology cannot be viewed as a science in the same way as, for example, the study of chemistry, for it involves a spiritual dimension as well as a natural one. Here again is an area where Scripture must be the final authority. In Scripture God explains the nature of man and his behavior, while in psychology man observes patterns, guesses, and perhaps learns something in a limited way. However, psychology will never get to the whole truth of the matter, for that requires divine revelation. In Scripture God states the relationships He has established and the moral behavior that man is required to have in them; in psychology man tries to explain the behavior without a given basis of morality. In Scripture God reveals what will make a man happy, and why; in psychology man seeks to discover what will make a man happy, and fails. Scripture reveals that the root cause of most of man’s behavioral problems is sin and its consequences; psychology, for the most part, does not have the word “sin” in its vocabulary.

On the other hand, it is sometimes helpful to understand why an individual reacts in a certain way, even from a natural point of view. For example, suppose a teenage girl runs away from home. Many factors can be involved, and we want to make it clear that we are in no way justifying her running away. There may be more than one reason why she chooses to leave home, but we know that in many cases it is because her mother has abdicated her proper role as caregiver and homemaker, thus forcing the girl to undertake a responsibility for which she is not ready and which she thus resents. Call it psychology or what you will, but an understanding of this mode of behavior is sometimes helpful in dealing with the situation and in helping those directly concerned. Many other examples could be given of behavior that is ultimately sinful yet has its roots in various forces that have acted on the individual. This in no way excuses the sin, but does perhaps provide a basis for helping to alleviate the factors that may have influenced the bad behavior.

We would suggest that it is not psychology itself that is so wrong, but rather the basis on which behavior is interpreted and dealt with. It is not wrong to recognize certain patterns of behavior that occur as the result of certain events and relationships that may have shaped the individual, but to suggest that man’s thoughts should replace Scripture as the remedy is a serious mistake. When secular humanism and new age thinking are the basis on which human behavior is approached, man becomes the focus of his own thinking, and God is left out. The result is, on the one hand, a moral irresponsibility and an excusing of sinful conduct, while, on the other hand, the treatment of such behavior tends to be based on self-help and the concept of self-worth. This so-called liberty of thought is not bound by any truth, knows no truth, and doubts all truth. Such an approach puts man at the center of things and is ultimately destructive, for the unbelief produced by confidence in man forces him back into superstition. Unhappily, modern psychology is so riddled with these ideas that it is difficult to separate the two.

Psychologist or Pastor?

In the final essence, if we have difficulties that are not serious enough to need medical help, then it is better to get on our knees with the Word of God open before us and to ask the Lord for His help in overcoming the difficulty. If further help is needed, perhaps a godly believer can be found who will be willing to listen and offer suggestions. Certainly a psychologist who was not a believer would have great difficulty in assessing, for example, a dysfunctional Christian family and giving proper advice. While he might make some good observations, his treatment would always be based on human wisdom rather than on the Word of God. Surely this is an area where we, as believers, have perhaps failed most seriously, for as we have already discussed, there is a great need of pastors in the true sense of the word. How great a need there is for those who can enter into the problems and difficulties of other believers, showing sympathy and compassion, yet being able to give a “word in season”!

In Ephesians 4:11 pastors and teachers are linked together, showing that the characteristics of both are desirable in the same person. One cannot be an effective teacher without a pastor’s heart, and one cannot be an effective pastor unless he knows how to give sound, scriptural counsel. Such individuals are very rare but greatly needed in the church today. If more believers with pastor’s hearts were available to do this often-thankless work, perhaps we would not see so many saints tending to seek out psychologists and other professionals.

Now let us consider one final aspect of mental illness in more detail.

Medication

We have already alluded to the use of medication in our discussion of the psychiatrist. We have noted that there has been a tremendous proliferation of psychotropic drugs during the past fifty years. We have seen that while we do not totally understand the mode of action of most psychotropic drugs, yet they have made a great difference to the treatment of mental illness. Kay Redfield Jamison, an author with bipolar disorder from whose book we have quoted previously, makes the following statement about herself and her condition:

“I have often asked myself whether, given the choice, I would choose to have manic-depressive illness. If lithium were not available to me or didn’t work for me, the answer would be a simple no — and it would be an answer laced with terror. But lithium does work for me, and therefore I suppose I can afford to pose the question.”

We have noted that before the development of psychotropic drugs, most seriously mentally ill patients spent their lives in institutions, virtually prisoners of their condition. The discovery of drugs that can help individuals control their behavior has been a major factor in enabling these people to live and function in the world at large.

We would hasten to add that drugs have not been the only factor in this change. Coupled with the development of psychotropic drugs, there has been a changing attitude toward mental illness. Such things as an appreciation of the regressive effects of institutions, an increased social consciousness, and the growth of community psychiatry have all helped to facilitate the integration of the mentally ill patient back into society. Nevertheless, it remains clear that without the use of psychotropic drugs many of these people would find it impossible to function outside an institution for any length of time.

What then should be the attitude of the believer to such medication? Some feel that since the Lord alone can heal and since God has said, “My grace is sufficient for thee,” we should leave off the use of medication, counting on the Lord and His grace alone. Others may feel that since they have been given medication, they can rely on it and do not need to be concerned about any possible spiritual dimension to their illness. May I suggest once again that both extremes are wrong?

In the Old Testament, when King Hezekiah was seriously ill, God sent the prophet Isaiah to him with the message, “I will heal thee: on the third day thou shalt go up unto the house of the Lord” (2 Kings 20:5). Clearly it was the Lord’s power that did the healing, yet at the same time Isaiah told Hezekiah, “Take a lump of figs. And they took and laid it on the boil, and he recovered” (2 Kings 20:7). Again, in the New Testament, Paul could tell Timothy to “drink no longer water, but use a little wine for thy stomach’s sake and thine often infirmities” (1 Timothy 5:23).

In both of these cases it is definitely the Lord who is in control of our bodies and our illnesses, as evidenced in His words to Hezekiah through the prophet, “I will heal thee.” Likewise, in both cases the instruction was given to use the means at hand to treat the problem. So today we should trust the Lord and look to Him first with our mental as well as our physical illnesses, for ultimately only He can help us sort out the various causes and the reason He has allowed them. However, it is not wrong to use those remedies that God has enabled man to discover, as we see in the examples we have mentioned.

There are some dear believers who need medication to keep them “on an even keel” mentally, just as an epileptic needs medication to keep him from having seizures. If the epileptic neglects to take his medication or the diabetic stops his insulin, the results are serious and can be disastrous. So also those who find themselves in serious difficulties without a regular dose of a psychotropic drug that helps them function normally should accept this and be thankful that it is available to them. It is no more a sign of weakness or lack of spirituality to do so than it is for the one with heart failure to take his digitalis and diuretic (water pill).

On the other hand, wisdom is needed in this, for sometimes we as believers can use medication as a crutch, when what is really needed is for us to deal with the root of the problem. Surely every individual and mental illness is different and must be assessed and dealt with before the Lord, taking every aspect into consideration.