Pills, therapy and sin

US pastor Gabriel Hughes tweeted the following to his 15k followers this week.

I want to spend a little bit of time responding here as quite a few people reacted strongly to what came across as an insensitive comment.  Among Hughes’ followers will be people who struggle with depression, other forms of mental illness and a battle with suicidal thoughts.  I agree with those who considered his comment to be reckless and thoughtless. We should weigh our words carefully as pastors.

Now it is important in responding to acknowledge that there has been debate over the benefits of medication and therapy with certain types of mental illness. For example, in 2014, James Davies wrote a book investigating approaches to psychiatry where he questioned the benefits of medication for mental health issues and argued that a lot of treatment was driven by a powerful pharmaceutical lobby.[1] There have also been questions raised too about the benefits of Talk Therapy in some cultural contexts and particularly with reference to PTSD.[2] Thirdly, as Christians we will also want to recognise the unhelpful philosophical presuppositions behind some approaches to psychology especially with reference to Freud and Jung. 

However, we also need to remember that it is not unusual for there to be ongoing debate and discussion academically about therapeutic approaches as well as practically about whether or not specific treatments are helpful. This is expected in other medical disciplines not just in mental health matters. Over the years different drugs and therapies have been tested and tried for asthma, some more effective than others. There have even been provocative books and articles arguing that asthma treatment is driven by the major pharmaceuticals and that asthma can be treated without medication. Personally, I have found some of the suggested techniques to manage breathing without drugs helpful and that has no doubt played a part in reducing my dependence on the drugs. However, the reality is that my inhalers remain helpful and necessary so I won’t be throwing them out anytime soon.

So, as with any other medical field, I can recognise that there are differences of opinion. However, I also need to remember that I don’t have expertise on this side of things and so I do well to sta in lane, focus on the spiritual aspect of things and follow/encourage others to follow the best medical advice available at the time.

The other thing that it is important to capture at this stage is that whilst Gabriel Hughes may well have been clumsy and insensitive when trying to use a tweet to comment on a sensitive subject, there is a point about sin.  Sin can and often does have an affect on mental health.  This is for three reasons.  First of all, because sinful decisions may lead to me finding myself in unhealthy environments and relationships that prove destructive, secondly because sin brings guilt and shame that effects mental health, thirdly because holding onto bitterness is both sinful and emotionally unhealthy.

Jay Adams, considered by most to be the father of the modern Biblical Counselling movement argued strongly in his writings that the primary responsibility of the Christian counsellor was to challenge about sin and encourage repentance. He was suspicious of drug and talk therapies.  It is worth remembering that he was responding in strident terms to a dominant culture of his time and expressing concern at a perceived drugs epidemic.[3]

At times, Adams approach came across as harsh and legalistic. Indeed critics have suggested that despite his protestations against secular methods and philosophy that his approach is as much shaped by Behaviourism as it is by the Bible.

More recent members of the Biblical Counselling movement offer a more nuanced approach recognising that there are physical and environmental factors as well as the fact that the mental health sufferer is both sinner and sinned against.

I believe that our minds and bodies are complex. Therefore, when approaching mental health, it is important to recognise that all or some of a number of factors may be present. Yes, the person may be affected by the consequences of their sin, we should not ignore that. However, remember that often the cause of mental distress is abuse by another. To tell the victim that they are suffering because of their sin is to mind a continuation of that abuse. At the same time, there will be physical/organic factors.

For those reasons, I would stick with an approach that is careful to investigate what exactly is needed for the specific person. Mental health issues should be medically diagnosed. If medicine proves effective it should be used, specialised counselling should be considered and alongside that spiritual counsel from pastors should be available too.


[1] James Davies, Cracked. WSee hy Psychiatry is doing more harm than good, 2014.

[2] See e.g. https://www.theguardian.com/global-development-professionals-network/2015/feb/05/mental-health-aid-western-talking-cure-harm-good-humanitarian-anthropologist and also https://www.theguardian.com/society/2014/may/26/misjudged-counselling-psychological-therapy-harmful-study-reveals 

[3] See The Big Umbrella, Competent to Counsel and Ready to Restore.

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