Executive Director Jim Newheiser speaks about issues related to Christians using psychotropic drugs and how we should approach these situations from a biblical counseling perspective.
- To listen to this episode: 002 Christians, Psychotropic Drugs, and Biblical Counseling
- Subscribe to the podcast
- Medical Issues and Biblical Counseling (SS16)
- Hodges, Charles, Good Mood, Bad Mood (book)
- Newheiser, Jim, “Influences on the Human Heart” chapter in Christ-Centered Biblical Counseing (book)
- Hendricksen, Laura, Will Medicine Stop the Pain? (book)
- Welch, Ed, Blame It on the Brain (book)
Hello and welcome to the IBCD Care and Discipleship podcast. We’re excited to have you with us. I’m Craig Marshall and today we have with us our executive director, Jim Newheiser, and we’re going to be talking a little bit about medical issues and biblical counseling. Jim, one of the things I’ve noticed is when you talk to people about biblical counseling, an issue that often comes up is their stance on the use of medication, particularly psychotropic drugs. What are the concerns that are underlying these questions, and how do they fit into the biblical counseling movement as you understand it?
Well, first there’s the context of the world in which we live and the way in which psychologists and psychiatrists are trying to address people’s personal emotional problems. More than a generation ago talk therapy was popular. A person with a problem would come and they would talk to a licensed counselor or psychologist, and they would interact, and that counselor would use some method like cognitive behavioral therapy or whatever and try to work that person through his problems. Lately there’s a much more biological view of people’s problems that it’s a chemical imbalance that causes depression or anger or addiction, and so the treatments in the secular world tend to be much more in terms of medications.
From the early stages of our movement as biblical counselors there was a recognition that the Bible addresses many of the same issues for which people are taking meds, in the sense the Bible speaks to many cases of depression and how to deal with that spiritual depression through spiritual means, through the gospel, through the truths of the scriptures. Likewise, with problems such as anxiety and worry. Biblical counselors early on recognized that some of the problems for which people were taking medications are problems that the Bible addresses. We’ve actually had many cases in which people who applied the truths of the word of God to their problem were able to do much better without needing medications.
Now that had been carried too far by some in that there were some nouthetic counselors, biblical counselors who almost made it sound like never ever should a Christian take a psychotropic drug, the problem is always merely spiritual and must be addressed simply through spiritual means. In that case I think they carried things beyond what the Bible teaches.
One of the words that’s been thrown around a lot in this conversation is psychotropic meds. What are psychotropic meds? What are we talking about?
What are psychotropic meds? What are we talking about?
When think of medication you can think of the kinds of medication most of us take in the course of our lives, where you have pain and you take an analgesic, you take ibuprofen or Tylenol. You have an infection you might take an antibiotic. The medication is designed either to relieve symptoms or to actually cure the underlying cause of a physical problem.
In the realm of what they would call psychological problems, and we would say a lot of those are spiritual problems, you have medications none of which claim actually to like an antibiotic address the cause of the problem. They might, like an analgesic address, claim to address the symptoms of the problem, and that they would say a person who is prone to be very depressed, if he takes a certain medication, it will cause his moods to level out, to stop going up and down so much. Or they would claim in other areas like a person who deals with anxiety and there are medications that are designed to affect the brain and the brain chemistry in such a way that the feelings, the symptoms would diminish. I guess also they’re among the most widely advertised medications, and that people are watching TV or reading magazines have these bad feelings, and a company promises if you talk to your doctor, he might give you a pill that’ll make you feel better.
I guess if we’re to boil the questions and the issue down it’s what place do medicines that affect our moods or mental activity, what role do those medicines have in the lives of a Christian? Is that at the heart of the question?
What role do these medicines have in the lives of a Christian?
Should Christians ever take psychotropic drugs is a question being raised in our circles. My own thinking on this has evolved over the years in that early on, when I started doing this kind of counseling over 20 years ago, I had cases for example, when someone comes in very depressed and the problems were clearly spiritual. He had unconfessed sin in his life, and when that sin was confessed and repentance took place, he no longer felt depressed. The doctor put him on medications, but when he dealt with the cause of the problem which was spiritual, he didn’t want or need the medications any more. So early in my thinking I thought, “Oh well, maybe everybody is that way.” People came in with other problems that clearly had a spiritual element, and I tended to think things would always work that way. Now more experience and learning about how the body works I’ve had to modify my thoughts in some ways.
As I’m hearing that, you’re saying one factor in thinking through that has been experience. How has that impacted your view of the scriptures? I mean as someone hears that someone’s view has changed, and it’s supposed to be a biblical view, one fear people can have is, “Oh, you’re just starting to read the scriptures through this lens of addressing a view you’d rather take.”
Right. Well, the Bible is infallible, unchanging, and fully sufficient to address our spiritual issues, our spiritual problems. Sometimes we can be guilty of putting an interpretation on the Bible that the Bible doesn’t demand. The bible does not explicitly teach that Christians are not allowed to take psychotropic drugs. That’s an inference that some people make. In my case, several things have influenced me to realize that there are cases in which Christians may have the freedom or may be appropriate for them to take psychotropic drugs.
One is, I’ve been shown, and this is we’re getting to know a psychiatrist, a medical doctor who deals with diseases of the brain, who is really helpful to me, is she showed me how brains are literally, you can see in brain scans that people with certain kinds of schizophrenia, other diseases, the brain is literally deteriorating. So when the person whose brain is deteriorating hears literal voices, they think they’re being told to do things, that medication can in some cases offset the deterioration, the malfunction, the disease of the brain, at least to relieve some of those very undesirable symptoms, and if there’s a medical solution, that’s something a Christian has the freedom to take advantage of and it would be very wrong to judge that Christian for making that decision.
So in the examples you used there, there’s a closer link probably to a medical problem and a medical solution as in deterioration of the brain. What about in situations where it could be heavily influenced by sin, there’s no direct correlation to helping something medically? How do you think about those things?
I appreciate when Ed Welch says, “There may be a physical problem, but there’s always a spiritual problem.” This also gives me hope as a biblical counselor. If someone’s coming in with whatever their problem is, there’s a spiritual element to worry, to fear, to depression. Even someone who has their brain deteriorating in terms of Alzheimer’s, and memory loss, and dementia, the word of God addresses the spiritual struggle they’re enduring and I can bring that word to this person to give him spiritual health, but that person is also free to seek medical help.
Now, the question you raise is, how do I know what is physical and what is spiritual? Part of how my view has changed is that I realize there are cases in which I will not know, there are cases that are clearly major physical element. There’s been a brain injury. There’s clear brain disease, brain deterioration. There are some cases that seem clearly spiritual like David in Psalm 32. He seems depressed. Well he committed murder and adultery. And God is chastising him. That wasn’t just there wasn’t a physical cause for his bad feelings. It was a spiritual cause that led to the physical bad feelings.
But there will be cases in which someone, I’ve had people who without any explanation I can figure out who just had overwhelming feelings of sadness, no big sin, no big worry. Is there, could there be something going along with them physiologically? Maybe. I’m not sure. I have to admit my uncertainty. I can’t say from the bible with complete certainty, “This is merely spiritual.” I can say, “Yes, there’s a big spiritual element. I want to address that.” I might even encourage somebody don’t run after the medications ‘til we have addressed the spiritual problem, but I can’t judge with certainty that there is not a physical issue in some cases.
So that’s how you view the situation with meds. A lot of times people are already coming in on medications or with views already formed about these things. How do you approach a person who’s already using or interested in psychotropic meds?
On our intake form for new counselees we ask what medications they’re on. Some of those we’re familiar with. Sometime I’ll look them up online so I can understand what is it meant to treat and what are some of the side effects that are possible. I’ll sometimes ask the counselee about that. But I’m going to ask in a non-judgmental way like, “Why are you taking that and how is it affecting you,” rather than coming across as hostile to the meds.
At that point typically we’ll just focus on the spiritual problem. “Okay, you’ve been feeling very depressed. What are some potential spiritual causes that could be leading to these symptoms?” In the back of my mind I’m thinking, “Well, if we can address the causes, the symptoms will go away.” Quite frankly, most people who are on these drugs, don’t like them. A lot of people go off of them because they’re tired of just feeling, sometimes it makes them feel like they have no emotions or no feelings, no highs, no lows.
My approach would be first to just let me help you from the bible. That’s what I’m equipped to do. I can use the bible to help you with your spiritual struggles. Then often it’ll be the counselees saying, “You know, maybe I don’t need these anymore.” I would say, “Well, tell your doctor that, ask your doctor if it’d be possible for you to cut back or to go on a process of getting off of the med under his supervision, and do that as a test case to see if you’re okay without it.” I’ve had people who have done that and have gotten off of the meds. The doctors aren’t always thrilled, but it’s not my decision, it’s the counselees decision. Then sometimes they may be afraid to get off of the med, and while in my opinion maybe I wish they’d try, I view that as a matter of their liberty to make that decision.
I just had someone that I was working with the other day who there are lots of marriage struggles that we’d been wrestling with, and kind of having worked through some of those. Then the question came up of, “Hey, I’m on these meds, and they help me with this, but the side effects are this.” Realizing he and his wife kind of never had really talked through that. So it seemed like my role was a lot just to help them think through wisely the pros and cons of using those and the hard issues behind it. Do you think does that seem like a reasonable approach or …?
Sure. There are cons. We’ve already mentioned the side effects. Many of them are undesirable, and some of them go beyond the emotional side effects, the physical side effects. But I would do it in a way where it’s interactive, not, “Get off of this,” but, “How do you feel about this? What do you think about this? How does it affect you?” I would try to point them more also to, “As you grow in learning to trust God more, as you grow spiritually, do you think that some of what you may be causing you to use this may diminish so that you could consider trying without it?”
I know that in some people’s lives they go on the meds temporarily. There are psychiatrists who favor this as well, where the doctor puts them on a med to get them through that time. Again, the choice to use the med rests between that person and their doctor. I would even warn people in general that doctors tend to be too quick to give too many meds so I’d be cautious there.
But if someone is losing it, and I’ve had cases where people through anxiety, through a manic phase as they may call it gone days without sleep, I would want them to take the med so they can sleep or they’re going to damage themselves. I think in the same way that if a person, their emotions are just totally out of whack, that’s a freedom they would have, you’ve been trying to pray with them and bring the word of God to them, but it’s a freedom to temporarily try the meds to get some stability.
Are the use of psychotropic drugs a matter of Christian Liberty?
You mentioned the word freedom a lot in regards to Christians taking medication. What’s led you to that view, and did you use to view it as a freedom that Christians had?
I think that using that term came from something I heard Dr. Charles Hodges who’s going to be speaking for us soon use where he made the statement. At first I found it kind of objectionable. He said that the use of psychotropic medications is a matter of Christian liberty. But as I heard him speak and as I thought more about it, I realized there’s nothing in the Bible explicitly commanding us not to take these medication. There are commands against being inebriated, being drunk, but I can’t prove from the Bible that someone can’t take these drugs. I can’t prove medically that this person doesn’t have some kind of physical thing going on. In many cases I don’t know.
So you can definitely see this is a hot button issue and there a lot of factors that are at play, Christian liberty, what the person’s true needs are, really trying to work with them and make the issue the issue. As you were talking about that it just makes me think that when we approach this issue as a litmus test, we could be setting ourselves up for some problems. Is there a better way to think about this?
Well, I think there have been in Christian counseling circles 2 unpleasant extremes, neither of which I think reflects a biblical position. One extreme has been to go along with the world, which sees our problems as being merely biological and chemical, and therefore they can be addressed with medications. That neglects the spiritual element which is always present and is usually predominant.
But there’s also a danger of an overreaction in the other direction where you would make a litmus test of someone’s orthodoxy as a counselor that they would always forbid the use of medications or forbid the use of medications except for in a clear cut diagnosed proven physical malady of the brain. As I said earlier, because we can’t always diagnose the brain maladies that are there, I can’t say with certainty there’s not one. I’ve had cases where I’ve wondered if that could be the problem in someone whose thinking is so unclear. We can’t go judging people who choose to take these medications or even give others that freedom.
Our focus as biblical counselors is regardless of the choices the counselee is making, the bible has the answer to the spiritual questions they raise that the scriptures rightly applied are going when it deals with the causes we’ll then deal with the symptoms, which will make the pills in many if most cases unnecessary. But we cannot tell people that they’re not allowed to take the pills.
I think the word of God can work in spite of someone taking the pills to help them through the gospel have a right walk with God, and as I said, maybe in time they’ll realize they don’t need those anymore, but it’s not like they’re in my bad books if they think that’s something they want to continue to do. That is a freedom they have. We need to be careful not to go beyond the scriptures, as we would be tempted to judge others who don’t see these things exactly as we do.
So it brands out from just the medical perspective, but how well are we as Christians learning to live graciously with those who may have different views than we do on issues of Christian liberty?
I would say adamantly we should not judge our fellow Christians who choose to take these medications. I would still say I would like to help them in many cases to thrive spiritually such that not as many would turn to those medications. But I don’t want us to be at all judgmental of people for using these psychotropic drugs. I’m not saying they’re some kinds of second class Christians or even second class counselees. They like we need the grace of God.
These are complicated and nuanced issues, but thanks for agreeing to talk through them with us and give us some helpful categories as we think through them, and then also seek to help others where these issue abound.
We’re looking forward to continuing this conversation March 4th and 5th when Dr. Charlie Hodges will be with us for our spring seminar here in Escondido, California. He’ll be presenting on what’s medical about mental illness, counseling people with psychological diagnosis, thinking biblically about OCD, and paying attention to ADHD. Seminar registrants are also invited to a live podcast recording the night before with Jim and Charlie, as well as a time for interactive Q&A. All of the details can be found at our website, at ibcd.org/events, and you can follow us on Facebook, Twitter, and Instagram. Thanks for joining us.