In parts one and two we’ve seen how the therapeutic worldview disconnects from reality. People with problems are treated less seriously than they deserve. They are given band-aid therapies for questions that call for an organ transplant. Let’s think carefully through a series of implications.
1. The facts are the facts – but what do they mean?
Notice that nobody disputes the facts. Mental health practitioners, friends and family, you, me, and the God of the Bible agree that Garrett is narcissistic, has a bad temper, drinks too much, and uses porn. He tries to control his world because he thinks it’s his world. All agree that Sarah starves herself, works out relentlessly, and puts in a lot of mirror-time. She demands perfection on her own terms. Nothing I’m saying questions any of these facts. These are facts that call for explanations and call out for help.
The question is how to interpret the facts. What do these problems mean? Why do our five friends live like this? Why are they ruining their lives?
- Does each of them “suffer from” a quasi-medical-sounding disorder that actually explains his or her problems? Do they “have” diseases or conditions that the labels correctly name?
- Or are they “doing” extremely disorderly things for extremely confusing reasons? Are they living out lifestyles that God correctly names?
In other words, is the final explanation for our problems something bad happening to us? Or is it something bad about us? God’s interpretation is the second one, and he gets last say.
A true interpretation sees the problem of sin concretely, right in the details of people’s lives and problems. By the way, it’s crucial to understand sin accurately. Most people think that to identify something as “sin” means saying that the person consciously chose to do some bad action. The person also has the power to Just Say No. But the Bible comes at sin from the opposite direction. We do many wrong, unloving things without even knowing what we’re doing or why. Most sin is not a matter of conscious choice. The “high-handed” sins are conscious. But much of what we do, think, and feel expresses that we are blind, self-deceived, metaphorically drunk or sleepwalking, calloused, acting like brute beasts, walking in the dark. So we do not have the power to Just Say No. That’s why we need a Savior from ourselves. Sin actually tends to make us more unconscious (“blind”) and more compulsive (“enslaved”). I am what I am, and do what I do, even if it’s self-destructive and destroys my relationships.
Furthermore, sin is an interpersonal offense and insult – to God first. He calls us to love him utterly… but we are self-preoccupied in a thousand ways. Most people view “sin” as an item from a select list of heinous behaviors that hurt others. God sees much further. I can’t accurately see myself until God makes me self-aware of what I look like to him.
And, still further, grace targets sin. Jesus comes for sin. Mercy and compassion are given for sin. Forgiveness buries sin. Most people think that the word “sin” only implies judgment, condemnation, self-righteousness, and moral exhortations to try harder. That’s the obvious thing to think. But God is not so obvious. He forgives people who are not righteous, and self-righteousness is a heinous sin. Christ does what none of us can do. Jesus’ blood and righteousness and resurrection set us free from sin’s guilt and punishment. Christ’s Spirit progressively frees us from sin’s power. The Lord’s return will free us from sin’s presence. God directly applies his mercy and power, changing us into the image of his glory.
We’re objecting to the misinterpretations placed on troubled and troublesome lifestyles. We aren’t denying the trouble. Jesus came for the trouble.
2. Quasi-medical labels are mislabels
Think a bit more about those verbs “suffers from,” “has,” “is,” and “has a case of.” We use these passive verbs to describe our experience of a true medical problem. You suffer from cancer or have a broken leg. You are a diabetic or have a case of hives. None of these true medical conditions describes your behavior, your motives, your lifestyle. They describe something bad that’s happening to you.
Of course, your lifestyle and choices can affect whether or not you develop a medical problem. Smoking might cause lung cancer. Dirt-bike racing might cause a broken leg. But smoking cigarettes and riding dirt bikes are things you do – just like drinking too much, or worrying what people think, or obsessing in front of the mirror. I hope we’d never say, “He has a bad case of dirt-bike syndrome, and suffers from a smoking disorder”!
Notice that the descriptions of our five troubled friends consistently portray what they do, how they think, how they react emotionally, how they treat other people. Lise broods relentlessly on her failings, and is so preoccupied that she’s inattentive to her daughter. Matt is a dreamer, and then checks out into his fantasies, leaving his girlfriend in his dust. Chandra worries that she’ll be rejected, and hides from people. And each of them lives as if God were a non-factor. They do their lives; they don’t suffer from their syndromes. By definition, a human being is an “active verb,” not a passive verb. We want and fear, love and believe, do and say, act and react. You don’t “have a case of” the way you do life.
3. What people do affects relationships.
Notice that in each of the five stories, what a person does affects other people. Our five friends do not have private pathologies. Their closest relationships suffer. Other people worry about them, or feel hurt by them, or get angry at them. This is because outbursts of anger, drunkenness, extreme dieting, relentless self-recrimination, escapism, instability, and social anxiety intrinsically threaten relationships. By definition, doing such things isolates you from God and people. You can’t live this way and at the same time trust God and love people. These are five different ways of being devoutly self-absorbed. It’s significant that friends and family sense this. They’re troubled by the distance and relationship breakdown caused by self-preoccupation. They have good reasons for their concern.
Consider the contrast between this and a purely medical problem. Friends and family will be deeply concerned for you if you have a broken leg or suffer from cancer. But trauma or illness don’t automatically separate people and jeopardize relationships. In fact, usually sickness provides a context in which people come together and feel closer. Friends and family rally to support you. You appreciate the love and concern they show. Medical problems often draw people together in love and appreciation.
Your kith and kin will be concerned for you when you’re sick. They want your body to get well. But they’ll be concerned about you when you’re devoutly self-absorbed. They want you to become a different kind of person. That’s one more evidence that the deepest problem for all five is some form of sin.
Again, remember some things we mentioned earlier. “Sin” doesn’t always mean consciously chosen badness. Most sins express how what I love has become disordered and dictatorial. When my core love turns away from God, I blindly attach myself to something else – anything else. I then live out the implications by making selfish choices. And to name your problem as “sin” does not mean that others should scold, moralize, or condemn you, or that you should beat yourself up with self-recrimination and trying harder. Jesus Christ comes “so that we may receive mercy and grace to help in time of need” (Hebrews 4:16). Mercy and helpfulness specifically target sin. So identifying how sin operates opens a wide door to God’s mercy, patience, and power. God’s mercy restores all the relationships that sin threatens, reconciling us to God and equipping us to reconcile with people.
4. Quasi-medical labels artificially separate people
As we’ve seen, lifestyle problems harm relationships. But harm can come from the other direction, too. To put a diagnostic label on a person harms your relationship with that person. It creates artificial distance. We should be able to identify with each other, but if I think that you are sick and I am well, I artificially divide us.
A true medical problem creates an objective experiential distance between people. Let’s say I get in a car accident and suffer a broken leg. My doctor and my friends do not have broken legs. I hurt a lot and need crutches. They feel perfectly fine and walk normally. Their experience and mine are fundamentally different. I am not well. They are well. I definitely need their help. They can help me precisely because they are not all laid up with broken legs!
But if you use quasi-medical labels for what I do, think, and feel, it creates artificial distance between us. If I struggle with anxiety or irritation or escapism … well, so do you. So does everybody. But if you label my struggle as a “disorder,” then that means you are normal, but I am sick. That’s an artificial distance, because none of us gets anger, fear, and pleasure-seeking exactly right. I might be having a much bigger problem than you. But our actual differences are matters of degree. I may be stuck and blind, while you’ve grown wise in an area of life. That matters for your ability to help me. But at the most basic level of human experience, you know that you and I have the same general tendencies and temptations. We come in very different flavors and intensities, but we are more alike than different. Our underlying commonality is fundamental. That’s why you see so much of yourself in Garrett and Lise and the others.
You can help people precisely because you do have first-hand understanding of the basic human struggles: “There is no temptation that overtakes you that is not common to all” (1 Corinthians 10:13). You can help people precisely because you do know the grace of God at work in you, and that’s exactly what others need: “God comforts us in all our affliction, so that we may be able to comfort those who are in any affliction” (2 Corinthians 1:4). Because we are in it together we can help each other. Medical doctors don’t ever need to have the same problems as their patients. But brothers and sisters always have the same kinds of problems as their fellow strugglers. Therefore we share the same essential cure, which always involves some form of faith working through love, by the grace of God in Christ. There’s no artificial distance, because we have a real commonality.
5. How do we weigh the various contributory “factors”?
I’ve focused on the heart, the gospel, and our identification with each other. But how should we weigh all the other variables that affect us? No one disagrees that genetics might contribute a “tendency,” and that the social environment abounds with “triggers.” Countless factors “influence” us.
But what is the final cause of how you live? You are your final cause. That said, let’s look briefly at the many contributing factors.
What goes on in your body has an influence. When you experience allergies or sleepless nights, premenstrual hormones or chronic pain, Asperger’s or Alzheimer’s, your mood, thinking and actions are affected. You’re tempted in different ways than when you feel fine. Similarly, it’s obvious that each of us comes wired from birth with a different temperament. Some people are more prone to anger, others to anxiety, others to getting discouraged, others to pleasure-addictions, and so forth. Our bodies affect us in many ways. For example, Matt may have been born more restless and distractible than you or I. It’s likely that Lise’s post-partum hormones color her moods. But does the body give the decisive, underlying explanation for their personal problems? No, no more than it gives the decisive explanation for their good and loving choices. The body is a contributory factor, an influence. It’s not the final cause of either your faith or your idolatry, your kindness or your selfishness.
What the people around you do also has an influence on you. Like “nature,” “nurture” plays a role. Every one of us lives in a world filled with competing values, a variety of hardships, and many enticements. You implicitly absorb the categories of thought provided by your native language, and the values of your native culture. For example, Sarah lives in a society that glamorizes unreally thin women. Garrett’s father was a poor role-model for how to handle frustration, and his bad example “discipled” his son into temper and drinking. We live in a world where betrayals of trust occur. Chandra lives among a group of peers who might (and have) hurt her. But, do those experiences provide the decisive explanation for their struggles? No. These are significant, not determinative. Your surrounding environment influences you in countless ways, but it never determines whether your life orients in the direction of Christ or twists in on yourself.
In fact, countless factors “influence” you. Weather and seasons? You may feel gloomier during three cloudy weeks in January than you do during three bright weeks in July. The project due next week in school or on your job? The current state of your personal finances? World politics before and after 9/11? Immediate traffic conditions and whether you’ll be late? What’s on TV tonight? Whether your baseball team is winning or losing? Any of these can affect you. But does any one decisively determine how you will react? No.
You are always in the mix.
In fact, the Bible teaches that God actually arranges the stage on which you live. He is the Lord of history, including your local time and place, and your personal history. Your particular matrix of influences provides the context in which your faith (or your self-will) plays out, in which he meets you (or you shirk him). This awareness frees you. You can seek to understand any contributory influence as just that, as a factor not the cause. You won’t grant them too much credit, morphing them into root causes and excuses for your sins. But you also won’t dismiss them as irrelevant, ignoring the actual situations and difficulties in which you need practical wisdom and practical mercies.
How you live comes out of your heart. “Keep your heart with all vigilance, for from it flow the springs of life” (Proverbs 4:23). The heart is you, not something that happens to you. Jesus says that when wrong actions appear, that wrong comes “from within, out of the heart of man” (Mark 7:21). Something about who you are and what you live for sets your trajectory in life and shapes every choice.
Deep down, everyone knows this is true.
That’s why every sort of treatment or therapy involves taking some responsibility for your life. It’s odd, when you think about it. According to the therapeutic outlook, you have no real responsibility for causing your problems. Your syndrome, disorder, or disease was caused by genetics, hormones, or how people treated you. But you are given final responsibility for solving what’s wrong. You can get a grip; you can make better choices; you can choose to heal; you can change your self-talk. Here’s the logic: “You are definitely NOT a sinner. But you definitely ARE your savior.”
God sees things the other way around. You definitely ARE a sinner, and you are definitely NOT your Savior. When this merciful Father gets a grip on you, you take hold of him. As the patient Spirit changes you, he enables you to make more loving choices. Because the good Shepherd restores your soul, you flourish. This most personal God teaches you how to talk with him, so you stop talking to yourself so much.
We’re tangled up, and we also live in tangled bodies amid a tangled world. C. S. Lewis vividly captured the profoundly humbling self-awareness this reality creates:
Man’s love for God must always be very largely, and must often be entirely, a Need-love. This is obvious where we implore forgiveness for our sins or support in our tribulations. But in the long run it is perhaps even more apparent in our growing – for it ought to be growing – awareness that our whole being by its very nature is one vast need; incomplete, preparatory, empty yet cluttered, crying out for Him who can untie things that are now knotted together and tie up things that are still dangling loose. (The Four Loves, chapter 1)
Many things will influence you. The whole world is knotted up and dangling loose. But you are still your biggest problem. You need what God alone can give. It’s no accident that Jesus begins here: “The poor in spirit are blessed” (Matt. 5:3). It’s no accident that Paul heard God address his fundamental human weakness: “My grace is sufficient for you, because power is made perfect in weakness” (2 Cor. 12:9). It’s no accident that most of the psalms cry for help. It’s no accident that Jesus is who he is, and does what he does. It’s no accident that God freely gives what you most need – the mercy to change your relationship with him, and the power to change you.
Coming home to sanity
When we see how deeply the “madness in our hearts” (Ecclesiastes 9:3) infects us and our friends, then we see how deeply the love of God in Christ applies to our deepest problems. The real Psalm 23 and all the rest of God’s wisdom lead us home.
Jesus Christ actually lived and died to rescue us. He now lives specifically to rewire our core insanity and to overcome our inevitable isolation. Best of all, his answer to self-absorption is not just a bunch of great ideas. The Lamb of God is a real person. The Shepherd calls you into a talking, listening, long-term, committed relationship. He’s good, and good for you.
This concludes this series.
David Powlison is a counselor and faculty member at CCEF and has been the editor of The Journal of Biblical Counseling. He holds a Ph.D. in History and Science of Medicine from the University of Pennsylvania, as well as a Master of Divinity degree from Westminster Theological Seminary. David has been counseling for over thirty years. He has written many books and articles on biblical counseling and the relationship between faith and psychology.