Serious mental illness and Christianity: Questions about responsibility

Today marks the end of the semester and the end of Counseling & Physiology. At the end of this course I ask students to talk amongst themselves regarding what they have learned in the course and what questions remain. The most frequent questions have to do with this:

What of a person’s struggles can be viewed as physiological; what is spiritual? What is the client responsible for?

[I should explain. We looked at problematic behaviors (e.g., cursing, aggression, etc.) after brain injury and the physiology of bipolar disorder. The class took bodily weaknesses quite seriously and recognized that sometimes our expectations of individuals exceeds capacity.]

At the end of this post I’m going to give you what I think are some better questions to ask. But first: Simultaneously, a couple of my old blog posts are getting a lot of attention these days–both having to do with the problem of serious mental illness, faith, and the response of the church. I highly recommend you skim the posts (both are incredibly short) but hang out with the comments.

These two posts are some of the most viewed and most commented on. Each and every comment reveals a world of heartache, alienation, and confusion about how one should think about mental illness, healing, responsibility, and the Christian faith. Clearly, we have not talked about this problem enough in the church–either to those with chronic mental illness or to their loved ones. Far too many are suffering alone.

Does it matter what of your problems are physical and what are spiritual?

Let’s say that you are a parent of a 3-year-old. Due to no fault of your own, your child misses their afternoon nap. It is now 6 pm and your child is both hungry and tired. She sees some candy and begins to whine for it. You know that you will feed the child in 15 minutes. You decline to give the candy and your child now has a temper tantrum. What do you do? Or, what SHOULD you do? You most likely provide mercy and kindness as you try to calm the child down. If the child screams, cries, and maybe even strikes you…has she sinned? Yes. Does it matter at the moment? Probably not so much as you acknowledge the child is limited by her lack of sleep.

Now, let’s extend the analogy. Would you treat your 40-year-old spouse in a different manner if they also had a tantrum because they were tired and they wanted dinner NOW? Of course, you would determine their moral capacity to be greater than the 3-year-old.

Back to our question…is it necessary to consider the division between spiritual and physical problems? Here’s why I think not. Problems are problems. Physical problems are spiritual problems in that we don’t do things only with our body and leave out our spirit. And spiritual problems always include the body. We don’t have spiritual experiences outside our neurons. Further, I still have to respond to the 3 or 40-year-old now (illustration above). Yes, I need to discern how to respond. Do I teach, comfort, discipline, rebuke, encourage? Am I responding with grace and mercy? Less important (though highly desirable) is my efforts in trying to keep the problem from happening again. Isn’t that really what is behind the physical/spiritual question: Who is going to make sure that x problem is taken care of?

Here are some better questions:

1. What can I do to help bring increasing comfort, hope, and encouragement–right now?

2. What response is my client capable of–right now (post hoc)?

3. What spiritual or physical interventions might be of help–right now?

4. How can I encourage my client to accept/respect their body (and its limits)–right now?

5. How can I encourage my client to see the hand of God in their life–right now?

6. What community resources and/or involvement can be made available–right now?

Notice the emphasis is on practical/mercy ministry, increasing insight, and commitment to seeing self from God’s point of view (rather than “normal”, “acceptable” as defined by church or larger community).


Filed under biblical counseling, christian counseling, christian psychology, Christianity, Psychiatric Medications, Psychology, Uncategorized

7 responses to “Serious mental illness and Christianity: Questions about responsibility

  1. 1. In the case of child, discipline and order of habit. If she is put down for a nap, then she wont be tired…& hungry, just hungry. A healthy snack and early to bed in the meanwhile.
    2. 40 y.o. if brain damaged would have less expectations than a bipolar disordered spouse. Can’t enable the tantrum.
    3. If husband Bible says wife can appeal. With wife the tantrum thrower, with respect, expect they are able to wasit for dinner, unlike a 3y.o.
    4. Ask the client to verbalize their own limitations. This acts as feedback and insight into their recognition of and acceptance of same. If skewed, you have some work to do; behaviour modification therapy?
    5. Their role as Christian spouse transcends all disorders.
    6. I can’t go past The Lords Prayer. Every one needs this one. They are not exceptions. The Almighty judges us all-perfectly!
    Author of ‘A Butterfly Landed An Eagle’..

  2. Lou

    I agree hat we need an approach to problem solving that involves the spiritual/physical person. But in response to your comment that “we do ot have a spiritual experience outside our neurons” I have three questions:

    1. Does God have a “mind” without a body? Is 18.1a; Jn 4.24
    2. When our body is dust does our mind cease to function? Jas. 26.6
    3. Does this have any impact on how we deal with life? Ep. 6.12

  3. Penny

    I have been reading Bruce Perry lately who (agreed he IS an evolutionist it seems, although I don’t know for sure since I haven’t talked to him directly) discusses the interaction between body & mind.
    I am finding more often than not,that a explanation of the complex body/mind interactions to my clients (often using crude drawings on white board) helps them have compassion/mercy for themselves (yes sometimes our amgydala does hijack our bodies and initiate a ‘chemical dump’ that often keeps us from reacting/responding as well as we’d like until our bodies process those chemicals) and for their loved ones. The truth is we “….are fearfully and wonderfully made”….and the presence of neglect, abuse, trauma, & stress do impact our central nervous systems.

    Mental health is a complex interplay of behavior, genetics, moral responses, chemicals,hormones, neurons, emotions, motives, passions, desires, vows made, core beliefs about reality and memories, social support, physical health, faith, resiliency, and locus of control. Simplistic/reductionist explanations that attempt to explain mental health as formulas are not helpful.

    If an adult has a temper tantrum in response to no dinner it may be “immaturity” or “narcissism” or “self-centeredness” or being a bully: it could also be an adult who is triggered by old memories of neglect that his body responds to inappropriately. Is he responsible for his behavior? YES. Has his body/mind just surged him with chemicals that remind him of being deprived? Maybe. Might he be simply Axis 2: possibly…’s just not simple is it?

  4. Scott Knapp

    Newsflash to the secular psychological/counseling world: Man is a) fearfully, b) wonderfully, and c) mysteriously/confidentially*** made!

    *** No matter how many double-blind studies you do, no matter how many theories you come up with and grand unifying theories you attempt to craft, you’ll never put enough data together that enables you to manipulate all the variables, and I (God) have no intention of giving you permission to do so! You can’t fix your world! (Thanks, Penny)

  5. [is it necessary to consider the division between spiritual and physical problems?] I have been struggling with this very question with regards to my 18 year old daughter. She has fetal alcohol syndrome. While her IQ is normal, she has deficits in executive functioning, judgment and impulse control. And, here’s why I think not — she is no longer the size of a 3 year old. When she rages or has a tantrum, she is dangerous. I can’t pick her up, put her to bed and be assured that she will rest and return to a previous level of functioning that will assure the safety of the rest of the family.

    Yet, my daughter is being released from jail in 3 days. We are approaching the coldest part of a Minnesota winter and she has no where to go. She lost her placement in her adult foster home because she ran away. Another home recently denied her a bed because they felt that she was a danger to the other vulnerable adults.

    1. I can give her a bed. But, how will this affect the 5- and 7-year old child who live in our home? What risk are we assuming? If she rages and my husband attempts to restrain her to keep the rest of the family safe, will the police see that as an appropriate use of force? She has stolen from us, started a fire in our home and uses drugs and alcohol. Are we enabling her or helping her?
    2. My daughter will always need an external brain. She is capable of supported employment. She doesn’t qualify for this service because she has a felony.
    3. I have attempted to keep her connected to the church. I have failed. It is difficult for people in the church to understand organic brain disorder in the face of a “normal” looking young adult.
    4. She came into my home as a foster child when she was 7. I have tried to teach her about FAS and how to advocate for herself. She prefers to pass as normal.
    5. I can love on her. I just don’t know what that looks like.
    6. NONE! The response of Christians is always, I will pray for you. But, I don’t really need prayer. I need real, tangible, measurable assistance from the community of God, the church. My daughter needs shelter in a home without young kids. I need someone from the community to give her a job so that her entire day isn’t unstructured, unsupervised “hanging out.” I need her to stay connected to the community rather than hidden in a taxpayer supported home somewhere.

  6. This is an interesting post. I agree with you for the most part. You do need to take into account how to you respond to certain people if they perform certain actions. I’ve bookmarked this post to read over again later. Thanks!

  7. Carissa

    So if you just fix the BODY, and the chemical imbalances of someone with Serious Mental Illness, will the spiritual follow????

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