BIOPSYCHIATRY Psychiatry is back or is it? That’s the question I responded to in a letter to a friend who has been influenced by relatively recent ideas about why behave badly.
I’m writing this letter to share a few of my thoughts and concerns about understanding the causes of and solutions to what the Bible would call ungodly, sinful behavior. In a recent class which you attended I made a strong point about the importance for Christian counselors put ting biblical labels on the problems of people. I warned against the danger of being reductionistic. I wanted students to know that the broad spectrum of what the world may call schizophrenia or other so called serious psychological problems may have many causes with one of them being something physiological or organic.
In my own counseling experience over the last thirty or more years, I have encountered in counseling a number of people who have been labeled schizophrenic who have never had any serious physical tests to determine the presence of physiological factors. These people were labeled that way because the physician or psychologist saw the symptoms mentioned in the DSM 4r and concluded without any physiological evidence that the person was suffering fro m a disease called schizophrenia. My point in saying what I said to my students was that they should not let the bizarre stuff frighten them. I encouraged my students to send counselees with bizarre behavior to get a thorough check up but I also wanted them to look for garden variety biblically identified problems. In my judgment, doing otherwise destroys hope in the counselee and the person who may be trying to help. It is my conviction based on clear biblical teaching that wrong, unbiblical thinking and behavior messes people up in many ways and sometimes results in weird and bizarre conduct. I believe that if we buy into the world’s definition of the nature and causes of all schizophrenic behavior we have locked a person into hopelessness. And I simply will not do that.
I agree with you that some (? much) bizarre behavior may be manipulative or learned patterns of response and behavior and other bizarre behavior may be connected to something with an organic basis. But since I’m not omniscient and since I can’t quickly distinguish between the non-organic and the organic when I encounter in counseling a person with bizarre behavior I begin to counsel the person looking for the things the Bible indicates may be connected to strange behavior and then go on to present the biblical solution.
To this point in history there have been at least three periods of history where the pendulum has swung to biopsychiatry for diagnosis and solution to human problems. One followed the Civil war where the rage was “neurasthenia”; a second was during the 1940’s and 1950’s where the solution to serious problems was electro shock therapy or having a lobotomy and now since the early 1990’s the emphasis is has been on genetic structures and brain chemistry. In biopsychiatry, the solution for problems that involve clearly unbiblical behavior and ways of living is directed toward localizing brain function, greasing the neuroelectrical system and buoying up our chemistry.
I simply have problems believing that the solution to what the Bible would identify as sin is found in any of these things. I have a theological presuppositional problem as well as a historical problem with that kind of approach. I do not believe because of my biblical anthropology and hamartiology that the main cause of or solution to severe or less severe problems with anger, fear, pride, selfishness, sexual promiscuity of any kind or violence can be relegated to the realm of the organic or genetic. I do not believe that in reference to behavior that the Bible calls sinful behavior (I John 3:4; James 4:17) that we are helpless pawns of our physiology.
And one more thing, as I’ve stated previously, it’s true because we are sinners that some bizarre behavior may be manipulative behavior and, in some cases, it’s probably true that some organic difficulties may make it difficult for a person to concentrate or think constructively or process information, but how do I know which it is? How can I distinguish between a problem involving an physical inability to think and a problem involving a person that is practicing manipulative behavior or that is trying to avoid responsibility or that just doesn’t want to hear what is being said (biblically the old stick your fingers in your ears trick – Acts 7:57)?
In counseling a real person, when I see bizarre behavior, do I assume that the person with bizarre behavior has an organic difficulty or do I realize that the person may have developed a pattern of tuning out, of running away in his mind and that that person may have become very skillful at spacing out? How do I distinguish between someone who has through practice of unbiblical thinking and ways of handling life withdrawn more and more from reality and the person who is manifesting psychotic symptoms related to genetic issues?
Another question – did the genetic difference suddenly appear or was it there all the time? If so, why wasn’t the person behaving weirdly previously? If it was there previously, can the person’s bizarre behavior be totally connected to the genetic issue or is there more involved? It seems to me that to prove that any one genetic difference is the cause of what is called schizophrenia or any other so called psychological problem you would have to prove that no one who is not schizophrenic had that genetic difference. What is the proof that a genetic malfunction is the cause of schizophrenia? Could that genetic difference be true of a person, but not necessarily the cause – perhaps it is one of many things.
I find it very interesting that research seems to indicate that often the time of life when the weird stuff seems to manifest itself is when a young person leaves home (one family systems therapist observed this and wrote a book which I think was called Leaving Home; others have observed the same phenomena). Research also seems to indicate that the person who manifests this bizarre behavior often comes from a seriously disturbed family. Then too, another time when bizarre behavior often manifests itself is when a person is old and seems to be experiencing senility or Alzheimer’s disease. Some studies have seemed to indicate that there are times when schizophrenic behavior in older people is also related to a lack of meaning and purpose in life. They have nothing to live for, nothing really to occupy their minds. Giving them something to live for and helping them to understand that they can make important contributions has helped some of them to get rid of their bizarre behavior and begin to live meaningfully and in touch with reality lives again. I saw that very thing happening very recently in a counseling case with an 85 year old person in the last few weeks. I’m not suggesting that all bizarre behavior with older people is related to a lack of meaning and purpose for life, but I do believe that it is sometimes the case. I fully believe that if we don’t fill our minds and lives with the right stuff all kinds of weird stuff can happen.
Anyway, these are some of the things I’ve been thinking and struggling with recently. I pass them on to you for your consideration. Thanks for listening or reading.