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Pastor's Prattle
Psychiatry does not appear to be concerned that Christianity has abdicated far too much responsibility to professionals for the care of the severely mentally ill. Christianity does not appear concerned that psychiatry has relegated human nature and conduct, including the spiritual, to brain biology.
—Dan Blazer, M.D.
“What do you think the purpose of the medicine is?”
“It’s supposed to drug me...make me change my behavior.”
This brief exchange explained a lot. Compliance is difficult when you believe that the medicine is harming you, making you into something you don’t want to be. The teen deserved an explanation.
“No. Actually it is supposed to act a bit like a filter. It should help you pay better attention that way. It will block some of the extra noise, the stimuli that make it hard for you to concentrate. But your behavior is still up to you...”
What also proved to be a helpful analogy was to compare the teen’s mind with the inside of a home, with all its pieces of furniture: chairs, table, sofa, beds, paintings, whatever makes it comfortable and lived in. “Who decides what kind of furniture goes into your house? Do the neighbors? Can they tell you what kind of bed you have to have? Is it their job to decide what color the walls are inside your house, or what room is your bedroom? Who decides that stuff?”
“I guess I do.”
“Anyone else? What would happen if your neighbor came in and started poking around trying to rearrange your furniture to suit her choices, not yours?”
“I’d tell her to get lost.”
Exactly. There are only two people who ultimately can decide where, what and how the furniture of my interior life is arranged for good—me, and my Creator, God. Other people can make all sorts of suggestions—“Maybe you ought to put the table over there. Beds work better in the bedroom... Doesn’t having a skeleton rattling from the ceiling there make you feel guilty all the time? Lighter colors in here might lift your mood....” This is the role of the counselor.
The good therapist, the good counselor, the good psychologist and the good psychiatrist are skilled in recognizing the various pieces of someone’s interior “furniture” and in studying the arrangement. She/he can assist a troubled soul in determining that one of the reasons she feels constantly down is that she keeps stumbling over the “chair” left in the hallway of her life. Put directly, the good therapist is a good diagnostician. She/he has become familiar with the ordinary workings of people’s minds to recognize various symptoms and their likely origin. For example, mid-night wakenings, irritability, feeling down, significant weight gain, recent traumatic loss—these suggest depression. Experience and education, wisdom begets insight.
At the same time, the good therapist knows what sorts of furniture and what furniture arrangements work well and what not so well. Rarely is it advantageous to situate the easy chair astride the kitchen table. Just so, someone whose vivid memory of tragedy while on vacation should be encouraged mentally to separate the two items—not every vacation will involve a drowning. But this is where the therapist’s power ends. She/he cannot step inside another’s soul and make those changes.
It is up to me to act on the advice I receive. I have to take the stumbling blocks out of the hall. I have to arrange the interior furniture of my life in a way that is livable. I have to make the exchanges and renovations. Which is why so often secular counseling fails: I am just too weak. Far too often therapy progresses without an end in view because either the therapist is incompetent or the counselee is helpless to effect significant change, or both.
The good news is that it doesn’t have to be that way. In the Bible God outlines the pattern of life he envisions for us his creatures. He tells us he has given us everything we need for life and godliness—that’s all the “furniture” required for a life that accomplishes the purposes God intended. But it’s not done on our own—it’s through knowing him, inviting him into our lives (2 Peter 1.3). He alone can make the needed renovations for a life fit to house the King. God has promised to do within us what no amount of external structure was ever able to accomplish, by sending his Spirit to take up residence in the homes of our lives (Rm 8.3,11). Secular therapy that takes no account of God, his ways and requirements, that does not request the assistance of the Creator in mending broken hearts and lives condemns itself to armchair quarterbacking.
What of medication?
Correctly prescribed and monitored, psychiatric medication has the same function as insulin for a diabetic. What the body cannot do for itself—for whatever reasons—the medication supplies. It gives the soul space to evaluate the condition and direction of one’s life, a chance consciously to decide instead of simply reacting to stimuli.
Stated simply, psychotherapy does help in describing the soul’s condition, suggesting some useful patterns of behavior, and pointing a path toward better functioning. It doesn’t supply the interior power to renovate, cleanse, or effect permanent change. On her/his own the individual does have some means to take a different perspective and reorient. But it takes the power of God to effect true renovations and lasting change. He alone can make the spiritually dead live.
“It is easier to write books and hold seminars where the encounter is brief and upbeat than it is to work day in and day out with someone suffering a chronic and serious mental illness” (Dan Blazer, M.D.). This stuff is very hard work.
How we need the power and grace of God!
1Rev. Alan R. Wolcott is also a disability claims examiner for the state program funded by Social Security. He has read and analyzed hundreds of claims involving diagnosis, prognosis and treatment of mental illness.