Faith in Focus

COUNSELLING THE MENTALLY ILL



Ours is a painful world!

One cannot help but feel helpless when observing the ravaging effect of sin in human lives. Some conditions of suffering, no doubt, are the result of one's personal sin or possibly that of the near or extended family. And certainly, there are also conditions beyond any observable immediate connections. Some diseases and malfunctions have no apparent connection with our own personal sinful condition. We do well often to ponder the words of the Saviour about the surrounding circumstances of the man born blind (John 9). Jesus' disciples show a typical trait of "lumping together" things that do not have any immediate connection.

I am writing about these things with much trepidation. In counselling others in the area of mental illness I must confess, that "… I know in part …" (1 Cor 13:12). As Christians we do not swallow all the findings of so-called psychoanalysis hook, line, and sinker, but there may be some findings worth our attention. Nor should we, as Christians, follow the mere clinical, cold, theological analysis which Job's friends applied to Job's case.

Or, to put it another way, we believe that by God's common grace not everything secular is valueless, just as not everything in the area of special grace gives us perfection in our understanding in dealing with mental illness.

We can learn a great deal from the approach of our Saviour. Those who are counselling others need to go back to the gospels time and time again. Listen to what the evangelist says about Jesus in John 2:23-25, "… He knew all men, and … He did not need anyone to bear witness concerning man (i.e. human nature), for He, Himself, knew what was in man" (what made him tick).

Here is the Master psychologist and psychiatrist. He understood man's psyche perfectly, and he could heal man's psyche (ie soul). John's gospel abounds with examples as to how Jesus deals with the various characters He meets, e.g. Simon Peter, Nathaniel, Nicodemus, the Samaritan woman at the well, the crippled man at the pool, the woman caught in adultery, etc.

Jesus understood people like no one else. We cannot possibly presume to know all the ins and outs of human mental deviations.

We can go to extremes in making secular, man-centred judgments, leaving the spiritual side of man out of consideration. On the other hand, we can so concentrate on the spiritual that we leave the psychological and physical out (e.g. God bless you, brother!) meanwhile overlooking actual physical needs (see James 2:15-16).

It seems to me (in my limited experience) that in understanding people so as to counsel them wisely, warmly, and biblically, we must bear in mind at least these two facts of reality, viz.:

  1. The biblical notion of mankind generally, i.e. how the Bible sees man as a sinful, fallen creature, created indeed by God in His wonderful image, but made miserable by sin and salvable in Christ (see e.g. Psalm 8).
  2. The actual condition (situation) of a specific person, e.g. Job, in his miserable condition, made even more miserable when his friends began to analyse his wrong-doings.

The complex nature of mental illness is disguised by the very description "mental". What role does the spiritual play? What physical damage to the brain is responsible for the present condition? What psychological causes lie behind the behaviour changes?

The Christian counsellor is to be aware of Jeremiah's classical statement of truth, "Deceitful is the heart …who can know it?" (Jer 17:9), and he is to apply this truth both to himself and to his client/counsellee. There is a tendency in secular counselling today to blame almost everything on one's past, and ignore a person's own sinfulness and accountability. We should not react to that by totally ignoring the background to someone's condition.

There is a wide range of mental illnesses which affect a great variety of people. Depression in a "mild" form is experienced by many people. Generally the cause can be pin-pointed. It is a different case with manic-depression (or bipolar disorder). This illness is characterised by two opposite sets of symptoms: abnormal elation and excessive depression. Counselling in such cases is particularly difficult. Medication is often given to curb the excessive build-up of energetic involvement in order to prevent subsequent fatigue in the depression stage.

It is important to be brief in dealing with such folk. On the one hand a listening ear is necessary, and on the other hand it is wise to stress that we may reach out to God through Christ, to confess our need of Him in the areas of sinful failure and weakness, and cling to the forward-looking hope. A few appropriate Bible verses will be helpful.

Another area of mental disorder is schizophrenia, sometimes explained as "split-personality", but actually much more complex to describe. Some symptoms are: reactions which are out of place (inappropriate), even to the point of being dangerously aggressive; another symptom is hearing voices which terrorise the sufferer; and further, a progressive withdrawal from life.

Again, it is important to listen and size up the experience of suffering and encourage the person to draw near to God in Christ who conquered all the powers of darkness. (Christ's victory is real and so are the powers of darkness, although what the schizophrenic sees are great delusions.) Point also to God's grace and forgiveness (as above). Never forget that Christ can bring about change, and when direct counselling is impossible, prayer is not.

There are a number of other illnesses affecting disorders of the brain or damage to the nervous system: Dementia, or in its more severe form, Alzheimer's Disease; Multiple Sclerosis (MS); Parkinson's Disease; Motor Neurone Disease; Epilepsy, etc. There is much research going on world-wide and the NZ Neurological Foundation publishes regular updates.

Even though we know comparatively little about the various mental illnesses and the best way to counsel those who suffer from them, we have a great and merciful High Priest, who is able to sympathise with our weaknesses, and counsels us in His Word to "draw near to His throne of grace boldly" (Heb 4:14-16).

Besides the people who suffer from these and other illness, we may also have to counsel those who care for them, whether at home or in an institution. That also includes that we pray for doctors and specialists.

And, best of all, we await with eagerness a new heaven and a new earth in which righteousness dwells where there will be no more pain, nor death …! (2 Peter 3:12 and Rev 21:4).

Rev. John Goris (Nelson)

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Faith in Focus /NZ Reformed Church / gmilne@ihug.co.nz / revised November 97 / Copyright 1997