My first foray into the world of “Biblical Counseling”, which, back then, was called “Nouthetic Counseling”, began in 1990, when I volunteered at a crisis pregnancy center. The director, Janet, was a big supporter of Jay Adams, and our supplemental training often involved studying and discussing chapters from one of his books. I still have the book The Christian Counselor’s Manual.
At the time, there was a huge countercultural backlash, among many conservative Christians, against traditional understandings of mental illness. Everything–and that’s the key word here–from depression to bipolar disorder to schizophrenia was, in many circles, ascribed to unresolved baggage due to one’s own sin.
Whereas the psychiatric world would contend that these issues were chemical imbalances or matters that had an undetermined organic cause–for which the cure was medication–the “Biblical Counseling” proponents would insist that this was all about confronting sin and guiding a person in repentance.
Compounding matters, the “Biblical Counseling” crowd would promote the idea that pretty much any Christian could be a “Biblical” counselor.
Having seen both approaches in the lives of various folks in the Christian world over the last three decades, and having been a student of the Scriptures–we’re talking Berean-style–for most of the last 4 decades–and having served my share of time as a teacher for most of those years, and having provided my share of counsel and having seen others provide it, here is my assessment….
(1) Biblical counseling is a tool in the toolbox.
(2) There are many times when Biblical counseling is helpful, as–irrespective of one’s mental health needs–we all need to be exhorted and admonished and pointed to the redeeming work of the Gospel and the work of the Holy Spirit.
(3) Not just anyone can do it.
(4) There are many times when a person–even with the best of counsel–will still need psychotropic medications. Whether this is the result of that person’s sins, or whether sin has exacerbated an existing mental illness, or whether the mental illness is a completely separate animal, is irrelevant.
Over the years, I have had the opportunity to know many people who are bipolar. Some of them are not Christian, some of them are Christian. But here’s the thing: there are two types of bipolar people I know: (a) those who take their medications and (b) those who do not. Those who DO take their meds tend to live otherwise responsible lives, even as their mood swings are hell at times. Those who do NOT? Their lives, down to the person, are total train wrecks: sexual excesses, financial irrationality, manic meltdowns, even suicide attempts. Sometimes, sadly, those suicide attempts are successful.
“Biblical counseling” alone never worked with them; for those who are Christian, what works is Biblical counseling combined with diligent and vigilant use of appropriate medications.
Yes, we must address sin issues; that goes for everyone, including you and me. As we do this, we must address that with respect to the Gospel, which includes the work of the Holy Spirit. I would also add that, in our broken world, in our broken bodies, sometimes that brokenness requires psychotropic medications.
Can sin be a cause of mental illness? I think it is possible. I believe that people can have bipolar or schizophrenic issues that sin may exacerbate. Over time, that may take enough of a toll on a person’s brain chemistry that such a one, irrespective of the quality of counsel they may receive, may have to take medications for the rest of his or her life.
Depression is also a fickle issue. I know of a fair number of mothers who suffered post-partem depression. Some of them toughed it out without meds–and their lives were miserable–and others took an anti-depressant for a season, which took some of the edge off their depression.
Fact is, when someone is in a spiral like that–depression, anxiety, manic stage, etc.–they are not in a capacity to reason with you. I’ve tried to counsel folks who were in that position, and it would not have mattered if you could prove to them that the sky is blue, they wouldn’t believe it. I’ve seen very excellent counselors fall short. Why? The issue in those cases wasn’t the quality of counsel: the client absolutely needed medications.
But once the clients took their prescribed meds, they were easy to reason with: Biblical counseling worked just fine with them, once they had the faculties to reason.
My point here: it’s not a question of either/or, as this is a both/and. Biblical counseling works, and sometimes that requires that the client take psychotropic meds in order to be able to receive the counsel.
I would never, ever, tell a client to ditch his or her meds. In fact, I would advise the client to take their meds as directed.
Now I’m going to explain why I have a problem with the idea that “anyone can do Biblical counseling”….
First off, I’ve been a teacher of the Scriptures–spanning children, teens, and adults–for many years. I am not the greatest teacher ever, nor am I the worst. I AM a stickler for sound doctrine, I DO relate the dynamics about which we read in Scripture to our lives today, I interpret the Old Testament with respect to the New Testament, I am a serious student of Scripture, I am observant of the various trends that emerge in evangelical circles, and I am an ardent observer of the fruits of those various trends, sometimes for better, other times for worse. I am a student of Church history and theology. I once had a pastor call me a “blue-collar scholar.”
For me, rightly dividing the word of truth is a very big deal, an imperative if you are going to teach.
And Biblical counseling is a form of teaching!
Would you accept financial counseling from someone who just filed Chapter 7? Of course not.
Would you take a math course from a teacher who failed algebra? Of course not.
Would you accept marital counseling from someone who had an affair?
Then no…it takes more than just being among the Redeemed to be qualified to counsel. You may give someone advice from time to time–even then, wisdom means knowing the value of shutting the heck up–but what I am talking about is farther-reaching than that.
To provide Biblical counsel, you have to know a lot about sin. You also have to know a lot about how the Gospel works in the life of the Believer.
You don’t learn that in a day. And you don’t just learn that by taking a few courses and getting a certificate. You have to wrestle with the Scriptures; you have to wrestle with your own sin, which everyone has; you have to know what it is like to fall down and get back up, over and over; you have to have lots of experience going to the throne of grace, knowing that you stepped in it. If you are married, you have to deal with your own baggage as well as that of your spouse. If you have children, you must succeed where some of the best people in the Bible failed.
But make no mistake: this isn’t something that any Tom, Dick, or Harry can do.
Having said that, I’ll stand by my point: Biblical counseling is a tool in the toolbox. And sometimes, in order to receive such counsel, one may need meds. Some may need meds for a small season (think post-partum), and others may need them for longer periods (think bipolar, schizophrenia).
But to say that it’s a question of either/or is a false dichotomy.