Mark Pickett has written this helpful review of “The pastor with a thorn in his side.” In his review, Mark picks up on a number of things that he would have liked further analysis and discussion of in the book. I agree with Mark that these are crucial areas that we need some further discussion on. We were of course constrained by the nature and purpose of this book which was simply to start sharing stories but we hoped and are encouraged to see it prompting further conversation.
I’ve tried to take time in some of my articles and online videos/audio to take the conversation further and hopefully those articles and talks will cover some of the territory that Mark has identified. So here, I wanted to pick up on two of the issues he has highlighted.
“By theological reflection, I mean, for example, on the mystery of providence and the dimension of spiritual warfare in mental health issues. The use of the Bible in counselling is merely touched on and little is said about prayer. Should they have called their elders to pray for them and anoint them with oil (James 5:13-16)? In many parts of the world, churches would find the silence of these matters puzzling. Is it a cultural blindspot for us in the West?”
On the use of the Bible in counselling, Steve Kneale picks up on how Biblical content can have a transformative effect on the use of CBT. Meanwhile I write here about the challenges with introducing the specific concept of “Biblical Counselling” to a conversation with someone who is depressed. That article dovetails neatly into the conversation about spiritual warfare and prayer.
You see, these conversations are rooted in the question of “what exactly is depression and what is/are its root cause(s). That question itself needs to be asked in the context of another question
“What does it mean for us to be justified members of God’s covenant people, still works of progress in terms of sanctification and inhabiting frail bodies in a fallen world?”
Sorry if that is a bit of a mouthful but let me explain further. As I explained in the article on Biblical Counselling, some offers of help and advice seem to come with an assumption that the person has identified the problem, like Job’s comforters, they mean well but their stating point seems to be that if someone is depressed then that must reflect a moral and/or constitutional failing on the part of the sufferer. Of course, depression can be caused by sin, however there can be a whole variety of causes and many people simply will never identify a specific trigger for their depression.
Therefore, whilst I agree with Mark that the place of calling the elders for prayer and of identifying spiritual warfare can be a blind-spot here in the West, I think we’ve got to handle these carefully. I write as a pastor who has frequently prayed with people who have experienced either severe and acute or chronic and debilitating health conditions. Before leaping into the theological stuff, very practically, we need to be alert to how the person is feeling. A gathering of a group of people to pray over the person may itself be a cause of further anxiety, especially if the person is struggling to engage in groups. However, prayer with them, naturally when visiting and for them in their absence is certainly welcome.
Theologically, it is worth observing what scripture says about “calling the elders.” The relevant passage is James 5:13-16.
13 Is anyone among you suffering? Let him pray. Is anyone cheerful? Let him sing praise. 14 Is anyone among you sick? Let him call for the elders of the church, and let them pray over him, anointing him with oil in the name of the Lord. 15 And the prayer of faith will save the one who is sick, and the Lord will raise him up. And if he has committed sins, he will be forgiven. 16 Therefore, confess your sins to one another and pray for one another, that you may be healed. The prayer of a righteous person has great power as it is working.”
Notice that James says that the elders should pray and anoint and the prayer will heal/save the one who is sick. It then immediately goes on to say that the person who is sick will be forgiven their sin. Whilst I don’t think that a visit and prayer from the elders should be limited to contexts where there is sin, James does seem in this situation to link sin and the call for healing prayer closely together. And this means that the person who is told to call the elders may well hear that message.
Now, if sin is either a cause or an irritant, then praying through those things with the person and encouraging reconciliation where needed and where possible is going to play a significant part in their healing. However, if it isn’t the person’s sin but rather depression arising from the sin of others against them, circumstances, physical/medical causes then we need to be exactly clear about the motives, purpose and expected outcomes of prayer.
Similarly, I think that we don’t talk often enough about spiritual warfare as western-conservative evangelicals. This I think is in part an over-reaction to some confused views of what spiritual warfare means that have tended to dominate much of the theological conversation. So, as soon as we mention spiritual warfare, people often think in terms of demonic possession and oppression. And we all know horror stories of people with depression, PTSD, Bi-polar disorder and schizophrenia who have been subjected to exorcisms.
So again, we need to handle that one extremely carefully and sensitively. You see whilst demonic oppression and possession does happen, normal spiritual warfare is concerned with day to day life. Look at Ephesians 6 and Paul’s teaching about the armour we need. It’s set in the context of every day life, how to be good husbands, wives, parents, children, employers and employees. So, in a sense, yes depression is to do with spiritual warfare. It’s to do with spiritual warfare because sometimes it arises out of circumstances and the challenges and conflicts we face in everyday church and everyday life. It’s also to do with spiritual warfare because how we respond to sickness is part of it. When I am ill, my first desire is to escape out of my suffering but I might realise that God does not always take us out of our trials so instead I seek to survive through. Yet God does not just want me to survive my suffering, he wants me to be holy in it. That’s true whatever my role in church life as member, elder, deacon, ministry leader or pastor.
So, when we talk about spiritual warfare, again we need to be clear about what we mean by this. Properly understood, it is obvious to me that many people who are suffering depression are either because they have been deeply wounded in the battle or they are in the heat of the battle right now as Satan seeks to tempt and to harm them causing them to fall in the midst of suffering and God uses the suffering to test and refine them for their good and his glory.
There’s much more to be said on these subjects but I hope this article helps push our thinking and the conversation forward still further.
 Not just for pastors and elders but for anyone in the congregation suffering from mental health issues.
 Note that where they are not the cause of a break down in relationships and/or where other parties are not interested in seeking reconciliation then actually pushing for that may be extremely dangerous and destructive.