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.
God Change 
3 comments
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September 4, 2006 at 1:34 pm
Joshua Mack
Interesting stuff Dad.
I’ve been thinking about this alot lately.
One example that’s been on my mind. The other night, I couldn’t sleep.
I was basically awake looking at the clock all night long. I felt a tightness in my chest. My heart was pounding a little faster than normal.
A physical issue. A real physical issue.
Also completely tied to a spiritual one. Something had come up, a problem a couple hours before I wanted to go to sleep. I spent the night wrestling with it.
If you had given me a tranquilizer, I guarantee I would have gone to sleep. It would have dealt with the physical issue. And to a certain extent, it would have looked like it solved the problem. After all, I wasn’t able to sleep but then I was.
The thing is it didn’t deal with the entire problem. In this case, it really wouldn’t even have dealt with the cause.
September 4, 2006 at 7:15 pm
David Roeder
I love reading your thoughts on these important issues, Dr Mack. There’s no way you can discuss them all in a classroom, and I count this as “continueing education” as I seek to help counselee’s sort through behavioral issues from a biblical perspective. I meet with so many people that are on med’s for symptomatic treatment (depression, anxiety, etc). Your courses laid the foundation to help these people and give them true hope through the Word of God. Press on, faithful steward.
Your partner in prayer,
David
September 15, 2006 at 12:30 pm
Anonymous
I absolutely loved this article on Biopsychiatry/psychiatry. I have been told by one Pschiatrist and two Pshycologists ( all three Christan) that if there is a pt. w/ paranoid/schizophrenia this could indicate other family members displaying some of these same behaviors. In fact the Psychiatrist spoke to me extensively on this subject due to his patient being my sister -in-law. I was the first voice he had heard from the family that could separate themselves from the situation an un-biased way. He asked me if I had observed tendencies in other family members relating to these two disorders. I had observed many of these same tendencies in several of the family members but @ the time I just thought they were strange behaviors. He explained a lot to me. I have since then (and this has been at least ten years now) observed that many of these dysfunctions seem to be related to learned behaviors but some are not.It seems to me that some family members have more control of these behaviors than others and they recognize them. They are able to exhibit self control while others can not. Oh, I believe they can and do as much as is possible for them, but they just aren’t aware of the change that comes over them. When their “normal” behavior returns they believe they were just and sound in their judgement. I am confused by some of this, but observing this behavior in a family with seven children has been quite a study. There are only two family members that display very little paranoia and no schizophenic tendencies. They all grew up in the same house. The father was an alcoholic, the mother was verbally as well as emotionally abused by him. The mother shows these tendencies very much. In fact at this time she has had a stroke and is institutionalized. She is physically doing quite well but mentally she is pretty much not “all there”. The tendencies she had before the stroke (very paranoid and severe mood swings) have been magnified tenfold so she is totally incompetent and unaware of her lack of judgment. I never met the Father but the children all seem to worship him on the surface but when their guard is down it is obvious from their talk that they feared him and the respect they show him to this day is based on fear. He was not a Christian and the children all talk about how they never knew what kind of a “mood” dad would be in. He could be nice as pie one moment and furious the next for no apparent reason. He’s been dead for twenty two years now. It is a sad situation and admittedly has been extremely hard to deal with over the years. My own children see the dysfunction and we try to be loving and kind about it all. Sometimes it has been very hard for me as their mother to explain a lot of things. We have been very close to all of them and thus I have had a lot of situations while raising my children that I’ve had to protect them from the abuses that tend to happen in families like this. At the same time when “all is well” the family is very nice to have around. You just never know what’s going to happen. It is very disturbing to litle children. My children are all in their late teens and early twenties except one who is just eleven. She has been more sheltered from all of the rest of the family than the other three but she is also dealing with the fact that her dad is going to a psychiatrist now for the first time in his life to try to deal with some of these issues. It has been very difficult for all of us, this therapy, but I believe the Lord will see us through it all. My husband refuses any kind of medication and maybe he should. His therapist has recommended he take some anti-depressants to help him while he is going through the behavior modification part of his therapy just to make it so he can think clearly through it all. I sure do wish he would listen to him because our lives were always a roller coaster ride but now that he’s having to face his demons he’s even more unpredictable and a lot more paranoid. He refuses. He believes Christians don’t need that. So I am on anti-anxiety medication instead because this has caused me to have panic attacks. It is very frustrating and extremely sad. The best part of this wole story is that my husband is into the Word as never before. That can’t hurt!
There really is no peace in a home where this goes on though. One of my sons has embraced homosexuality (Oh the pain to this mother’s heart), my oldest daughter is a bright and shining star but I know she holds things in and some day she will just pop I’m afraid. As far as our youngest goes, court is still out on that one as she is in that horrible part of adolecence that nothing seems to make sense and she can’t have her mommy because daddy is taking all of mommy’s time up making sure his paranoid fears are not based on anything but his paranoia. My oldest son was raised by his other grandmother because of how bad things were when we first got married. I was afraid for him. He’s a very well adjusted and intelligent young man with one more year of college and he will be a high school techer.
I guess the reason I wrote this whole thing was to give you a little piece of the heart of someone who is living this life with these illnesses (for lack of a better way of putting it). I agree with you wholeheartedly that a lot of these behaviors are learned responses to our environment but I also know from first-hand experience that there really are chemical/organic reasons to this madness. It is affecting the lives of many people and it is not an easy thing to live with to say the least. I would love to see some more studies on the topics I have mentioned and am glad to see Christains getting involved with this. Way too often the Christian community just wants to blame everything on our lack of spirituality. They condemn those of us who are dealing with this and those who actually have these dysfunctions. People can be very cruel. Just another sin we deal with on a daily basis. The Christan community needs to realize these are real issues and not just sin in our lives. I was accused by our pastor and his wife of being unforgiving of my husband for these things when I went to them for help in dealing with this problem in our lives. I was accused of letting Satan into out home because I didn’t give up. They just didn’t truly understand the scope of the problem. My husband and I are now in Christian counseling. He for his problems and I for my enabling him to continue these behaviors. We are getting somewhere but it has been a long hard road and at this time I don’t see any light at the end of the tunnel but I know my God is bigger than this problem. I rest in Him.
Thank you for your work and for taking the time to read this. I hope it helps.
Sincerely,
Anonymous