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Mental Illness and Medicine

I. Mental Disorders and Biblical Counseling

We live in a broken world full of people suffering with profound trouble and intense pain. One manifestation of that brokenness is the problem that our culture recognizes as mental disorder. Increasing numbers of people are diagnosed with these complex difficulties, which require wisdom and multi-faceted care. We confess that, too often, the church of Jesus Christ has not been recognized as a source for profound hope and meaningful help for such difficult problems. We further acknowledge that many Christians have contributed to a negative stigma attached to such diagnoses through simplistic understandings of these problems, and have offered solutions grounded in ignorance.

As an organization committed to pursuing excellence in biblical counseling the Association of Certified Biblical Counselors has, for decades, been calling upon faithful Christians to grow in the twin tasks of understanding complex problems and learning skills to address them in the context of counseling. As an organization committed to the sufficiency of Scripture for counseling we believe that the Bible provides profound wisdom to guide us in caring for people diagnosed with mental disorders.

One example of this wisdom is the biblical teaching on dichotomy. The Bible is clear that God created human beings to consist of both a body and soul. To be a human being is to exist in these two constituent parts, which are separable only at death. Even after death, Christians confess that the bodies and souls of human beings will be restored at the Last Day. This biblical truth points to the high honor and regard that God gives to both the physical and spiritual realities of humanity. (Genesis 2:7; Matthew 10:28; 1 Corinthians 7:34; 2 Corinthians 5:1; 1 Timothy 4:8)

A theological reality like this one requires Christians to honor both body and soul as crucial to human existence. Christians, therefore, should respect medical interventions as a fully legitimate form of care for those struggling in this fallen world. Examinations by medical professionals are crucial adjuncts to a biblical counseling ministry as they discover and treat, or rule out physical problems, which lead many to seek counseling help.

Another example of this biblical wisdom is the teaching in Scripture on the dynamic nature of problems that we experience in a fallen world. Human beings have difficulties, which always carry physical and spiritual implications. Both aspects need to be addressed in an appropriate fashion. Human beings experience problems with spiritual implications for which they are morally culpable and must repent. Human beings experience other physical and spiritual problems, which are not a consequence of their sins, are not their fault, but which are painful realities that attend life in a fallen world. (Matthew 5:8; 26:38; 2 Corinthians 7:9-11; 1 Thessalonians 5:14)

This theological reality requires Christians to approach problems in a complex way, rather than a simplistic one. Christians understand that some spiritual realities will require a rebuke, but others will require encouragement in the midst of pain. Still others will require help in the midst of weakness.

II. Mental Disorders in Contemporary Culture

Christians today live in a secular and therapeutic culture, which lacks the sophistication of the Scriptures in understanding these matters. This culture attributes physical causation to many problems ignoring their spiritual roots and implications. This practice is confusing and unhelpful since the Bible teaches that not all serious problems are medical problems. The Bible’s teaching on humanity leads us to conclude that many problems are physical in nature, many others are spiritual in nature, and each of these affects the other. God’s Revelation in the Scriptures about the complexity of humanity forbids the secular reductionism that makes all problems merely physical.

The contemporary language of mental illness is one example of this reductionism. The compendium for mental illnesses that our culture recognizes as authoritative is The Diagnostic and Statistical Manual for Mental Disorders (DSM). This manual makes many accurate observations about the manifold problems that afflict people. For biblical counselors, the DSM paints an inadequate and misleading picture. It fails to express, recognize, or understand the spiritual aspect of problems that afflict people. Because of that failing it cannot offer clear help and hope for people diagnosed with its labels. While some of the disorders listed in DSM are medical in nature, many others are not. Even when the problems in DSM have a physical component the spiritual and Godward elements of humanity are not addressed by the DSM, which biblical counseling must take into account. Christians must be committed to a way of understanding and speaking about complex problems that is more likely to lead to real and lasting change than that recorded in the various editions of DSM.

III. Counseling Practice

In light of these realities, ACBC endorses the following standards of belief and practice for its certified counselors and counseling centers that would care for people diagnosed with the complicated problems identified as mental disorders.

1. Biblical Counselors must acknowledge that human beings struggle with physical and spiritual problems.

2. Biblical counselors shall encourage the use of physical examinations and testing by physicians for diagnosis of medical problems, the treatment of these problems, and the relief  of symptoms, which might cause, contribute to, or complicate counseling issues.

3. Biblical counselors shall help their counselees respond biblically to physical problems, but deny that spiritual interventions are the only proper response to problems with a medical element. They reject any teaching, which excludes the importance of the body and the goodness of God, which leads to the blessing of medical care.

4. Biblical counselors reject the notion that medical interventions solve spiritual problems. They embrace the use of medicine for cure and symptom relief, but deny that medical care is sufficient for spiritual problems, which require Christ and his gospel for ultimate relief and lasting change.

5. Biblical counselors shall be committed to counseling those with medical problems, but should not attempt to practice medicine without the formal qualifications and licensing to do so. When they have questions or concerns of a medical nature they should refer their counselee to a competent medical professional for diagnosis and treatment.

6. Biblical counselors shall nurture a spirit of humility, understanding many issues at the nexus of body and soul defy simplicity. They recognize that many problems are combinations of physical and spiritual issues. Others are problems, which are not easily identified as one, the other, or both.

7. Biblical counselors do not reject the true observations found in The Diagnostic and Statistical Manual of Mental Disorders, but do reject that DSM is an authoritative guide for understanding the cause and treatment of complex problems of human behavior, thinking, and emotions. They affirm that God’s Word in Scripture serves as this authoritative guide. Biblical counselors move toward using biblical language to refer to the counseling problems that people face. They are committed to applying the Bible to an understanding of the causes of and treatments for these problems.

8. Biblical counselors are committed to biblical discernment in understanding the nature of spiritual issues, and to dealing with sin through gentle, Christ-centered correction.

9. Biblical counselors are committed to biblical discernment in understanding the nature of spiritual issues, and to dealing with suffering through Christ-centered encouragement.

10. Biblical counselors are committed to biblical discernment in understanding the nature of spiritual issues, and to dealing with weakness through loving care in the context of the body of Christ.

For particular Standards of Doctrine relating to this topic, see Doctrine of Scripture.

For particular Standards of Conduct relating to this topic, see Commitment to Care, Commitment to Scripture, Commitment to Humanity, Commitment to Competency, Commitment to Authority, and Commitment to Reconciliation.