Normalizing Psychiatric Problems: Pro and Con


One of the hallmarks of the Biblical Counseling movement has been the clear articulation that psychiatric problems are not different in kind from any other set of problems. This assertion is made by some for a couple of reasons:

  1. To make sure everyone knows that the bible speaks to every kind of experience. if one draws lines between “regular” anxiety and pathological anxiety, those who meet the criteria for a DSM diagnosis might think that biblical material cannot speak to their situation–that they need to go elsewhere for help. God cares for and addresses every concern.
  2. To level the playing field between professionally trained counselors and biblical counselors. If the roots of human problems are common no matter the outer expression of them, then pastors and lay counselors can understand the issues (pride, suffering, fear, despair, etc.) and walk alongside anyone. One may not need special training to help another.
  3. To communicate to the healthy that they are not different from the more obviously unhealthy. The point is to reduce stigma and promote unity.

Consider the pros and cons of this viewpoint.

Pro:

  • Reduction of stigma and ghettoization
  • Increase normalization (“so, I’m not so different from others) and similarity with the rest of humanity
  • Increase the confidence and courage of leaders to address and dialogue about all forms of suffering

Con:

  • Decrease in interest in the specific experiences of suffering thus narrowing problems down to a simplistic cause (sin?)
  • Possible over-confidence of some leaders leading to a reduction of empathy and listening to the experiences of other; failure to consider body/mind issues not specifically elaborated on in the Bible.
  • Failure to recommend outside helpers with specific expertise and training; dismissal of the need to have professional counselors who may have greater practice with certain kinds of interventions\

When I teach my Psychopathology course I want my students to see just a bit of themselves in descriptions of people with thought disorders, addictions, eating disorders and the like. I want to normalize these kinds of problems so that students don’t think of clients with the problem as somehow different from their own experiences. While I may not binge, I may be able to empathize with those who do. However, I do not want them to think their brief binge as exactly the same as someone else’s experience. Otherwise, they might assume it would be easy to “just say no” to the binge.

When I teach my Physiology course, I want my student so to see the complexity of the brain and body and thus recognize the unique forms of suffering some go through. I want them to realize just how little we understand how much the body influences our experience of the world and of self. However, I do not want them to medicalize psychiatric problems. If they did that they might believe that counseling has little influence on psychiatric disorders. They might think that biblical reflections on anxiety and depression have no place in the healing of serious problems in living.

What is your experience regarding christian leaders handling of psychiatric problems? Do you see too little normalization? Too much? Do you see minimization of psychiatric suffering?

7 Comments

Filed under biblical counseling, christian counseling, christian psychology, Christianity, counseling, counseling science, Psychology

7 responses to “Normalizing Psychiatric Problems: Pro and Con

  1. Phil, As always, interesting post. As for your cons, I imagine that the first two are possible, but they certainly are not necessarily logically associated with the “normalizing” you dicuss.

    It is thoroughly possible and biblical to respond compassionately to suffering, detect robust causes for suffering (and sin), and “normalize.”

    Related to the second possible con, I’m sure you and I have each seen those who are experts in DSM diagnosis become over-confidenct and under-empathetic. In fact, I’ve seen more of that on the “psychiatric” side than I ever have on the BC side.

    Related to the third, again, possible, but not necessary, nor is it true to the historic modern BC movement or to the current “generation” of BC folks. For example, BC has always maintain a high level of connection with medical doctors. And I believe many BCers today have great respect for the expertise of others, especially those doing good descriptive research.

  2. Bob,

    Well, I agree with you and disagree. I agree that the cons are not necessarily logical. However, they are not only possible but actual. I have many instances. And true, I have seen many an arrogant psychiatrist too. But this post isn’t about that problem. It is about the tendency–which is real–of some to overly simplify problems. I have seen individuals with standing in the BC community refuse to address psychiatric disability because they were too afraid of encouraging victimization. Is it epidemic? I don’t know…I just think we need to admit this is one of our problems. And some medical problems get more attention than others.

    Here’s an example. I read two recent short publications about trauma and ADHD. Neither gave any significant description to the actual neurological aspects of these problems while focusing almost completely on good spiritual advice on how to think about suffering. One particular sufferer read between the lines–the absence of any discussion of my body’s impact on me must mean that I can choose not to be this way. I don’t think the author intended that but it may be a natural consequence of overfocusing on one aspect to the exclusion of another.

    • Phil,

      You asked your readers, “What is your experience regarding Christian leaders handling of psychiatric problems?” I shared mine. My experience apparently is different than yours, which is one reason we don’t base final answers on experience.

      I understand the focus of your post–where you see potential short-comings in some BCers who “normalize.” Your response talked about reading between the lines because of what was not said. Of course, it would also be possible for folks to read between the lines of your original post, based upon the emphasis of what was said and based upon what was not said. They could easily surmise that, as a rule, those who “normalize,” end up with the three “cons,” while those who do not normalize do not end up with those “cons.” My response was 1.) to answer your question about my experience, and 2.) to provide some possible balancing.

      I don’t think that balancing entails denial of the fact that some within a given “movement” may practice some “cons.” Surely, we all do. Rather, the point is to highlight that the “some” do not necessarily represent the “whole.” And also that others in other “movements” also may practice the identical “cons.”

      Thanks for the opportunity to interact on your blog.

      • Thank YOU for being willing to interact with me. To continue…I’m not one to throw the baby out with the bathwater. I do not think that normalization necessarily leads to the cons. In fact, I think my post reflects that I want students to normalize. The pros are essential. They are not throw-aways. And at the same time we can admit and express that sometimes our good intentions lead us in a direction that also has some cons. If I, as a teacher, have “disciples” who are tending to move in a direction that I myself do not think I am supporting, I think I need to ask myself if there is anything I am doing that might be mis-interpreted. My goal with this post is to try to sort that out. Do we, in our right encouragement of normalization, unwittingly encourage some towards some of the cons.

        Bob, I may be mis-interpreting you but I sense hurt or defensiveness here. Did I cross some line in my post or comment? Happy to take that off-line if you wish. I am certainly not disrespecting BC but wanting to refine and improve it all the more.

        Phil

  3. Phil, I don’t feel any hurt or sense any defensiveness as far as I can read my heart. Like you, I’m glad to go “offline” if you prefer and you are free to delete any of the comments if you sense they are not helpful to the discussion. I simply was/am wanting to advance the conversation. I tend to see things in a both/and way, and while your pros and cons is both/and, I thought a little additional perspective could add some more both/and insights. I appreciate you, your ministry, and your blog. Earlier today I highlighted one of your posts from this week as one of my This Week’s Top 5: The Best of the Best on the Christian Net.

  4. Ryan

    I think this is a very confusing area. I came to Christ 6 years ago in a great church that could not focus more on the Bible if they tried. At the same time I was being discipled and discipling others, I went to graduate school in social work and became very interested in addictions (primarily because of Ed Welch’s book and an addictions class I was taking). Then I found 2 Peter 1:3, and my life has been ever more confusing.

    How do I bring the Bible to bear on peoples’ problems-in-living (Yes, I’ve read every CCEF book I can get my hands one)? How do I make sense of the really great descriptive psychological research? I feel a real struggle in utilizing the good descriptive aspects of psychology while remaining solidly grounded in and guided by what the Bible has to say all the while being both thoroughly practical and God-centered.

    I’d love to get my PsyD. and take classes from CCEF so if anyone knows of anyone who wants to help fund me, please let me know.

    As it is I think this will just be an area of ongoing struggle, but it is a struggle I enjoy.

  5. Ryan Edlind

    Thanks for a great posting. As a pastor in a counseling role with a hx in psychiatry it is rare to see such considerations made on this kind of issue. I think practice bias plays a major role in how psych issues are addressed. We tend to peg issues based on our expertise and resources- not grounding in scripture. Sad but a pragmatic challenge- to remain clear headed, repentance driven, and yet always open to various options with people who are suffering. I am tempted daily to use what is easily and freely available as opposed to what costs me dearly when doing ministry. Psychiatry is more expensive than prayer and Bible study. Yet for some psych treatment is necessary for effective comprehension of Scriptures. Can a pastor really help with providing psych services? Not typically. Can a psychiatrist typically utilize a pastor for a discharge plan? Not typically. We are a lazy people to care for hurting souls aren’t we?

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