Monday, August 19, 2013

Foundational Concepts Towards a Christian View of Mental Health (Part I of II): Theories on Convergence of Spirit, Soul and Body

As stated in many previous posts on this subject, I believe that if a person suffers emotional problems because they're struggling with a sin issue and won't repent, I suspect that Biblical counseling is likely helpful. My concern is piqued, however, when sins are assumed to be the cause of symptoms that might be due to physiologic cause or due to syndromes that have strong physical elements (e.g., diabetes, nutritional deficiencies, thyroid disorders, brain dysfunction, etc.). 

Challenges like grief and forgiveness also involve a journey of growth that may take many years, during which a depression or anger phase may be very healthy and appropriate – and are not sins. Often, they are part of the healing process that result from sins committed against them. When mental health issues present themselves and are not the sequelae of problems with sin on behalf of the person experiencing them, I believe that Biblical counseling only approaches (that reject physical or clinical/functional causes or perspectives) can often do more harm than good and serve to condemn the person in distress.

Before presenting Dr. John Weaver's guest post about problems with Biblical counseling, I wanted to explore some of the reasons why certain Christian groups may prefer a Biblical counseling only approach to mental health, ideas that may help put his upcoming post into perspective. I will attempt simplify some helpful related concepts, distilling them down to the basics to broaden the understanding of why nouthetic counseling in particular makes certain assumptions about the nature of man.

More specifically, some traditions of Biblical counseling maintain that there cannot be such a thing as “mental health” because a well mind can only be realized through spiritual life which comes only through saving faith in Jesus. I believe that it is important to understand why, particularly when this has become an interest of concern for groups like the Southern Baptist Convention who now seek to develop a doctrinal position statement on mental health.

We do not have any clearly laid out conceptual frameworks in the Bible for understanding that which we cannot see in terms of this intersection of mind, emotion, will, thought, soul, and spirit. We know that we have physical bodies that can be separated from our consciousness, and we know that we have spirits that can be reborn into eternal life, but we are not told specifically how those elements intersect or come together. Much has been written by philosophers and theologians alike, and while I'd love to discuss these matters, I wish only to help the reader understand some considerations that will help with understanding some of the nuances in Weaver's post. For brevity's sake, I will also state all too simply that these discussions and ideas, for better and for worse, have had a profound impact on how the mind/consciousness has been understood, the Christian concept of thought, but also on the practice of traditional medicine (which includes disorders of the mind).

Please also note that I don't intend these definitions to be authoritative but as something of a jumping off point to better understand the discussion, primarily that which has influenced the development of “Biblical counseling” which is seen my many as an alternative system to contemporary mental health care. Also note that some of these points may seem a bit tedious, but in so doing, I hope to do reasonably fair justice to particular doctrinal Protestant viewpoints that differ.

Views of the Spirit, Soul and Body

Trichotomist View. The Trichotomist view sees man as comprised of three essences that manifest in three realms: spirit, soul, and body. The deepest level of existence is that of spirit, and in a diagram is placed in the center, often flowing outward to affect change in the mind, and then body. The next layer would be the soul, the aspect of man that generally is thought to encompass the mind, the will, and the emotions of the person. These are soulish elements where consciousness dwells, understanding that all who live have consciousness. This layer of being of the soul is housed physically within the brain, though the soul is thought of as separate from the body. Problems with the physical brain can create problems for the soul, if that brain doesn't function properly. Ill health can also affect the function of the soul. Both would present problems that one would have to overcome as a matter of character development.

I've seen it diagrammed as a bullseye, with the spirit in the center, the soul in the middle, and the spirit in the outer layer.

The Dichotomist View. The Dichotomist perceives of mankind as having only two facets: that of
the body and the combination of soul and spirit together as one and the same thing. This combination of soul/spirit can be depicted with the same kind of bullseye diagram, but it only has two layers with the body represented by the outside layer. Certain Protestant theologies maintain that there is not enough evidence to argue for a separation between the soul/mind and a separate spirit.

I suspect that for the spiritually dead, those who have not placed saving faith in Jesus, that these people are only partially alive because they have consciousness, existing with an unenlightened mind that has not been quickened by the Holy Spirit.

The Monist View. There is also an idea that these facets of man are either indistinguishable or are functionally inseparable while the body lives. In some variations of this view, the spirit and/or mind as a consciousness continue to exist after the body expires.

Christian and Protestant Implications

The Trichotomist View. If correct, in terms of Scripture from which good arguments can be mounted, all living individuals have souls, but if they are not yet Christians, the spirit aspect of the individual is not yet alive. By grace and through faith, the spirit is “born again,” giving the person a degree of spiritual discernment that those who are still “dead in their sins” do not possess. Over time, this spiritual life permeates and transforms the other elements of the person as a sovereign act of God, but Scripture also suggests that the person has the duty to care for their mind/soul and conforming it to what God desires. The spiritual awakening gives the person the desire and power to overcome setbacks of the soul, and it also states that this has a health and life-imparting affect on the body as well.

For the person who is dead in their sins, by appealing to their soul through thought and emotion and ethics, one can introduce them to the idea of spiritual life in Christ. Those who don't put their faith in Jesus have minds, wills, and emotions, but they are not informed with spiritual wisdom and guidance. Evangelism targets this very aspect of the soul. Some denominations believe that faith unto salvation comes through an act of the soul by choosing to receive Jesus first or perhaps simultaneously with God's work in them, and the Holy Spirit then instills life in them.

There is some suggestion that one can act to facilitate the work of God in one's life by mediation on the Word of God, and some believe that one's health in mind and body can both be enhanced by the process. For Protestants, this presents a doctrinal problem if the concept also argues that a person is able to mediate their own salvation through the body (through works) or through disciplines of the mind. If the body can affect the soul/mind, then it may seem to suggest that the body/soul/mind can influence the spirit – and the latter is not consistent with a Protestant doctrinal view. 

While the state of the body can affect the soul (by way of emotions or by inhibiting thought), there is nothing that man can do to save his own soul and enhance his spiritual self. What he can do is yield to the process that God begins and governs, and that can facilitate his whole well being. A Dispensationalist pastor that I trust once explained that “you can do it the easy way, or you can do it the hard way,” but the process of sanctification (being made more and more holy through spiritual growth) happens under God's direction as His sovereign work from the inside out, not in the other direction. The idea of “spiritual enhancement” through the body and soul is a gnostic concept.

As this concept is generally embraced by Dispensationalists, they tend to have what I will call a more optimistic opinion about the ability of those who are not yet spiritually reborn to make good and healthy choices, based upon that general witness of truth and the ability to recognize it that all people possess as Paul discusses in the beginning of the Book of Romans. All mankind is given a basic, inherent conscience about right and wrong. Some also see a similar suggestion in the first chapter of the Gospel of John and throughout his epistles. The power of the soul to express faith derives from this glimmer of insight imparted to man as a characteristic imparted to him because he was created in God's image.

Other denominations (including those that are Calvinist) believe that God first awakens the Spirit, and the outward manifestation of this would then be that gift of faith which prompts the person to receive Christ and confess their faith (an act of the will in the soul realm). God then governs all spiritual development through the Spirit alone. If man is given any role in the process through choice or works, this is seen as competing with God. This is important, for if the sovereignty of God is a central focus of the denomination, they see the idea of man's choice as competing with God's will, and this suggests that man is more powerful than God.

Others may agree with this understanding, but they may see it as an issue of perspective: man may appear to have the ability to freely choose, but it is God who orchestrates and directs that free choice before hand, so it just seems like free will from the vantage of the person.

In terms of the body, in addition to benefits like physical healing, that spiritual life flows out into behavior, so that faith becomes not just an idea but is put into action. Worship suggests the use of the body to act in ways that bring honor to God.

I was taught a variant of this model as a Dispensationalist.

The Dichotomist View. Because no very clear and definitive distinction is made between soul and spirit in Scripture, choices of the will and behavior are seen as more directly related to one's spiritual state. The choices made by the person who has not yet placed their faith in Jesus unto salvation are basically dead and unregenerate, and there is no true goodness in them. This view reflects the concept of total depravity of man which defines him as incapable of making choices that will save his own soul/spirit, as this is always and can only be initiated sovereignly by God. We are helpless in our sins and cannot bring life to ourselves because we are dead and dependent on God's sovereign work to initiate that life first. As a consequence, this dichotomist view is generally preferred by Calvinists, and some teach and defend a dichotomist view as the only concept that is strongly supported by Scripture.

The dichotomist holds a more pessimistic view of those who have not been made spiritually alive through faith in Jesus. Because soul and spirit are synonymous and goodness is seen as dependent on a spiritual cause, for many, there can be no such thing as “mental health” (or a healthy mind or thought) because those who are not born of the spirit cannot ever be healthy.
Source of issues of the mind and emotions in many Biblical counseling paradigms

The Dichotomist View has a dramatic impact on how one views issues of emotional, mental or psychological problems, as this view tends to suggest that only spiritual interventions and spiritual awakening through saving faith in Jesus can bring about “mental health.” There can be no real “health” without spiritual birth. The reverse of this idea is also true: if a person suffers spiritual/soul problems, they must be due to a root spiritual cause, either through unhealthy spiritual practices or because of the presence of sin (whether the person willfully chooses it or is unaware that they are sinning).

This also seems to impact evangelistic efforts, as there is less impetus to appeal to a person's soul to receive Christ if that soul must first be made alive by God. The person who has first been made alive in spirit will come looking for and asking about Jesus. Information and ideas that are suggested to those who are spiritually dead will have no impact if God doesn't elect to awaken their spirits. The trouble is, however, that no one can see what is going on in the spirit of another, but for some who hold this view, they may not see great efficacy in a focus on evangelism. Evangelistic efforts are performed because God commanded us to do them, not necessarily because all of such efforts may be effective.

The Monist View. This can vary greatly in its application, and to my knowledge, there has been much less written on this view from a Christian perspective. On the surface of it, it seems to deny the enduring, eternal quality of soul and spirit, and it may be seen as more of a purely rationalist, materialist, or atheist view. If embraced by a Christian, this view may be seen as arguing against salvation by faith alone, if what one does is seen as affecting spiritual life.


Hopefully, these ideas about the nature of man will help the reader more clearly understand why Biblical counseling orders certain things in the way that it does, considering how the people who developed the particular system of counsel conceived of the spirit and the soul.

One more post to come exploring materialism
and other doctrinal considerations
before Dr. John Weaver's guest post

examining nouthetic counseling