As we said in Part One: Our prime reason for writing this review of Christ or Therapy? For Depression & Life’s Troubles by Dr. E. S. Williams1 is to confront a false conclusion that many Christians have reached regarding mental disorders. Because mental disorders often have no biological markers to reveal their cause, these Christians, including Williams, conclude that both the cause and cure of such disorders must be spiritual.
The Linchpin
We are concerned about the way Williams and others bifurcate as they do and are rigidly set in their spiritual/biological dichotomy, contending that most mental illness is either the result of a spiritual problem or a detectable biological brain disorder. The following contrast is a major theme of Williams’ book and reinforces his idea that believers and unbelievers suffer differently:
Scripture draws a contrast between the many sorrows of the wicked and the joy of the upright in heart…. Unbelievers are by nature children of wrath, “having no hope and without God in the world” (Ephesians 2.12). In their hopeless state they frequently suffer despair, unhappiness and depression under the weight of their sin and unbelief.
Believers have been made spiritually alive in Christ and have been saved from the wrath to come through the mercy and grace of God. Having been justified by faith we have peace with God through our Lord Jesus Christ (54-55).
This is true. However, Williams ignores the possibility of undetected biological issues and therefore uses the above as evidence that believers do not ever suffer depression like unbelievers.
Here and elsewhere Williams totally disregards the possibility that believers may indeed suffer depression in the same way (same symptoms) as unbelievers because of undetected biological causes. Instead of including this as a real possibility to consider, he simply tacks on his undefined “small group” (see Part One).
Williams also appears to be oblivious to the obvious possibility that, while Christians have spiritual resources for dealing with depression and life’s troubles, some nonetheless do suffer in the same way and with the same horrendous symptoms as nonChristians, from biological disorders that have no detectable markers. In such cases the only difference would be the way a Christian may respond to any biological disease differently from a nonChristian.
After discussing the arbitrary nature of diagnosing depression, Williams says:
What all this means is that the diagnosis of depression is highly arbitrary and totally subjective. We must underline the fact that there are no clear, objective or truly measurable diagnostic criteria. There is no physical sign, blood test or X-Ray that can confirm the diagnosis. All depends on what the patient says and how the psychiatrist or counselor interprets it (22).
Williams later states, “…there is no objective test to confirm the diagnosis of clinical depression” (42).
The linchpin for Williams and others for the belief that Christians do not suffer depression as others do (symptoms and signs) is the simple fact that, except for a small number of cases where biologically causative factors are found (and he is not clear about this), there are no biological markers for mental disorders. Therefore Williams and others like him conclude that such mental disorders must not be biologically based. We conclude from reading his original manuscript and Christ or Therapy? that, except for severe symptoms, no discernible biological markers for Williams equals a spiritual cause and necessitates a biblical cure. He is unclear as to whether the individuals with severe symptoms are spiritual cases. In other words, for Williams, aside from his “small group,” only the medically detectable brain disorders are valid; all others are matters of the soul (nonphysical). This either/or approach of Williams is a simplistic and dangerous conclusion.
There is a whole class of diseases called “idiopathic.” According to the dictionary, “Idiopathic is an adjective used primarily in medicine meaning arising spontaneously or from an obscure or unknown cause.”2 In other words, there are no biological markers for such diseases; there are only symptoms. There are many such diseases of the body and brain that occur, and we assume that Williams would agree that there are idiopathic diseases of the body that are known only by their symptoms. If logic prevailed, Williams would also say, “No discernible biological, bodily markers means no biological, bodily problems.” We mention this because there are individuals and ministries that carry Williams’ not “like everybody else” conclusion to bodily diseases as well.3 Williams admits to only a small number of individuals who suffer diseases of the brain, but it appears that he is assigning these only to a small number with severe symptoms and to those biologically and not symptomatically diagnosable ones, rather than including brain disorders that are indeed idiopathic, i.e., of unknown cause. It does appear from what Williams says and alludes to that, aside from severe symptoms, he has only two classes of mental disorders, i.e., spiritually related and biologically detectable. (This is more clearly his position in his original manuscript mentioned earlier.)
Just as diagnosing idiopathic bodily diseases that lack biological markers must rely upon symptoms, diagnosing idiopathic brain diseases that lack biological markers must also rely upon symptoms. In regard to spiritual markers, all of them are symptomatic, e.g., church membership, personal testimony, words, actions, financial giving, teaching, Christian family, Bible college or seminary degree, being a pastor, etc., none of which can be said to be a certain sign that one is a believer.
Williams refers to hallucinations, delusions, and paranoia as “alarming symptoms” that “require medical attention” (42). He admits that these are all symptoms and obviously without biological markers. While Williams admits that “alarming symptoms…require medical attention,” he does not admit that less than “alarming symptoms” could be equally valid to consider for major depression and other mental disorders as being possible brain disorders with biological root causes.
No Biological Markers;
No Spiritual Markers
Just as there may be no biological markers that clearly reveal the etiology of various mental disorders there are also no spiritual markers for them. It is as serious an error to assume that those with mental disorders without biological markers are suffering exclusively for spiritual reasons as it is to assume that those with mental disorders without biological markers are suffering exclusively for biological reasons. Williams says that “the exact cause of depression is unknown” (21) and admits that “the diagnosis of depression is highly arbitrary and totally subjective” (22). This subjectivity will be there whether the diagnosis is psychological or spiritual. Williams makes it sound as though only those in the psycho-secular camp make wrong diagnoses regarding depression. How sad it is when a Christian diagnoses a fellow believer’s depression as spiritually caused when, indeed, there may be hidden biological reasons for the symptoms.
To be fair-minded one needs to avoid categorically placing individuals who are without biological markers into either a spiritual or a medical box because only God knows the nature and extent of each. Beyond the obvious cases, such as brain tumors, etc., the ones who are biologically afflicted but do not have biological markers are known only by God. Only God knows for sure when biological markers are absent whether there is a spiritual or biological cause and whether a spiritual or medical solution is all that is necessary. Williams’ teaching encroaches on God’s territory.
Sydney Walker III, a neuropsychiatrist, says:
Each year, hundreds of thousands of Americans who are actually suffering from common medical conditions such as hyperthyroidism, Lyme disease, and even poor nutrition are misdiagnosed with psychiatric disorders. Studies show that the rate of misdiagnosis is more than 4 in 10.4
They can also be misdiagnosed as having spiritual roots as Williams does.
There is a whole range of bodily disorders that have mental-emotional, behavioral symptoms. Some of these biological disorders are in their embryonic stages—not yet detectable. These symptoms can result in personal discomfort and interpersonal problems.
In the Scientific American Mind, an article titled “Ruled by the Mind” says, “Many common ailments and physical conditions can influence the brain, leaving you depressed, anxious or slow-witted.” The article discusses some somatopsychic disorders in which “the root of the problem [mental disorder] lies in the body—and in particular the immune system.” 5 There are many bodily disorders that doctors do not relate to the mental disorders that result from them.
An article in the Wall Street Journal titled “Confusing Medical Ailments With Mental Illness” refers to “more than 100 medical disorders” that “can masquerade as psychological conditions or contribute to them, complicating treatment decisions.” The article states, “Recognizing an underlying medical condition can be particularly difficult when there is also a psychological explanation for a patient’s dark moods.”6 Think about the personal harm that can result from assuming a spiritual cause and cure for such disorders!
We agree with Williams’ concern about “treating normal emotional states as illness” (23). However, to conclude that all are spiritual unless there are clear biological markers is to err in the other direction. The line between major depression and normal states may be unclear, but to assume that all is due to spiritual causes when there are no clear biological markers leaves an entire group in an undefined no man’s land. As mentioned earlier, the early history of psychiatry is filled with diagnosing people as having mental problems when no biological causes were found, which later turned out to be biological diseases with mental symptoms.
In the absence of biological markers, spiritualizing a mental disorder and prescribing a biblical regimen alone can be as serious a mistake as biologizing a mental disorder and prescribing a drug, the reason being that following Williams’ conclusion about depression of Christians would surely induce guilt and greater suffering in even the most godly individuals. Wouldn’t it be much better to admit that one may not know what underlies an individual’s depression and yet provide spiritual helps that could alleviate the suffering and promote spiritual growth?
Everything in life has spiritual overtones. However, everything in life is not the result of our spiritual choices and that includes depression, which can be the result of genetics, hormones, illnesses, diseases, injuries, and circumstances, all of which can affect one’s state of mind. And, of course one will respond to the issues of life biblically more and more as one grows in the spirit and matures in the faith. Therefore, one should seek to minister the things of the Spirit and build individuals up in the Word. Whether the problem is biological, spiritual, or both, believers may minister God’s mercy, grace, and truth to fellow believers, because every occasion of suffering can be used for comfort and spiritual growth unless the one who ministers thinks he can diagnose another person’s heart attitude. There must be much humility in personally ministering to those who are suffering, even if they have brought this suffering upon themselves.
A Fundamental Disagreement
The heart of our disagreement with Williams is that he teaches that believers experience depression differently from unbelievers and he is critical of those who infer “that when it comes to depression there is no difference in the experiences of believers and unbelievers” (54). In addition Williams teaches that faith in Christ affects “our tendency to become depressed” and is critical of those who believe that “faith in Christ does not affect our tendency to become depressed” (p. 54). He is in error by inferring that what is sometimes true of SOME believers is true of ALL believers ALL the time. We give one simple example regarding the use of SOME and ALL.
Let’s say a woman who is suffering from depression is not a believer. Let’s say by the mercy and grace of God she is converted, but her depression remains. In such cases, SOME may be delivered from depression. However, others, because of biological impairment, will continue to suffer depression “like everybody else” as long as the brain is affected. Yet, during that time a believer who continues in depression may draw close to the Lord and find comfort and encouragement in time of need. This is why Williams needs another category, namely, possible biologically caused mental disorders without markers.
Finally, a major omission on the part of Williams is this. Since there are so many people on psychotropic medications and because reading his book could lead them to question or change the use of them, Williams should have included a warning, such as the following: “Please consult your medical doctor before changing, stopping or starting any psychotropic medication, such as an antidepressant.” This warning should be placed somewhere on the front pages of Christ or Therapy? even if it is pasted on the current, already printed copies.
“Christian Counselling Movement”
Before stating this next concern regarding Williams’ book Christ or Therapy? we need to say that we are critical of both the psychological and biblical counseling movements (BCM) because they are both problem-centered. The conversations carried on between the counselors and their counselees violate Scriptural admonitions to the contrary. However, while we are critical of the BCM for their problem-centeredness, beyond that commonality with the psychological counseling movement, we have not lumped all those in the BCM together with all those who claim to be doing “Christian counselling” as Williams does.
In Chapter 1 of Christ or Therapy? Williams addresses Christian counseling and throughout the book makes accusations of the “Christian counselling movement in the US and UK” without excluding the BCM. This is either an oversight on Williams’ part or he intended to include them. Either way his accusations when applied to the BCM are egregious, outrageous, and offensive because they are totally false. Those in the BCM, including Jay Adams, the father of the biblical counseling movement, will be offended by Williams’ failure to exclude them from the term “Christian counselling” as he uses it in Christ or Therapy?. In addition those higher education institutions that train biblical counselors, such as the Master’s College and Seminary and the Southern Baptist Theological Seminary, will likewise be offended. Jay Adams, John Broger (BCF), Ed Bulkley (IABC), Randy Patten (exec. director of NANC), John MacArthur, Al Mohler, and many others in the BCM are not guilty of Williams’ accusations.
The following are just a few of the many false accusations throughout Christ or Therapy? made by Williams of those in the BCM as he defined them in his earlier book as being in the “Christian counselling movement” but did not exclude them from his use of the term “Christian counselling” in this current book. Each one of the following statements by Williams is totally false when applied to the BCM:
The Christian counselling movement has accepted without reservation the psycho-secular model of depression constructed by the DSM, and has propagated it widely throughout the Christian church in books, magazines, seminars, conferences and schools of theology (italics his, 26).
Clearly the concept of unconditional love is held in common by the emerging church movement, the Christian counselling movement, New Age thinking, Eastern religions and Luciferians (69).
Behind Christian counselling is a mindset that longs for more than is found in the Gospel of Christ (145).
In effect, Christian counsellors are fermenting a rebellion against sound biblical doctrine, for they have brought the teachings of psychotherapy, built on the foundations of Sigmund Freud, Alfred Adler, Abraham Maslow, Carl Rogers and Aaron Beck, into the sanctifying processes of Christ (146).
Because Williams has not excluded the BCM from the above false accusations, his failure to publicly correct this serious error will leave the impression that he meant to include them. Williams has done a great disservice to those in the Biblical Counseling Movement because he did not exclude them from his scathing criticism of those in the “Christian counselling movement.” Those in the BCM, because they are truly undeserving of his harsh criticisms, will be rightfully offended by his wrongfully directed criticism.
Conclusion
While there is much of which to be critical in the DSM, Williams’ criticisms are ill thought out and result in a false accusation for his second essential characteristic of “Christian counselors” following the psychological “giants of psychotherapy.” While Williams wonderfully brings forth the use of Scripture For Depression & Life’s Issues, he woefully leaves his readers in danger of suffering from depression and life’s issues believing that their current spiritual life is causing the depression and is responsible for their current state of mind and that, as soon as they straighten out spiritually, their depression will be over. This will surely cause many depressed believers to feel guilty about their own “spiritual lack” when they may be as spiritually sound as Williams himself. Williams’ book is a great discredit to those godly individuals and a great disservice to the church.
Williams makes accusations without documentation; he provides absolutely no footnotes for his serious allegations against psychiatry and the DSM; declares the cause and cure of depression and other mental distress as being primarily spiritual; and he fails to exclude the Biblical Counseling Movement from his category “Christian counselling movement.” While Williams’ book Christ or Therapy? has some excellent material, the above faults are such that they eclipse the value of reading the book and are a spiritual danger to those believers who take it as truth. We conclude that Williams’ main problem is that he has an extreme view with respect to mental disorders, which is biblically, medically, and logically insupportable, to which he retrofits his either/or fallacy.
Endnotes
1 E.S. Williams. Christ or Therapy? For Depression & Life’s Troubles. London: The Wakeman Trust & Belmont House Publishing, 2010. Hereafter references will be indicated with page numbers in parentheses.
2 “Idiopathic” in Wikipedia, www.en.widipedia.org/wiki/Idiopathic.
3 Henry W. Wright. A More Excellent Way: Be In Health. Thomaston, GA: Pleasant Valley Publications, 2003.
4 Sidney Walker III. A Dose of Sanity: Mind, Medicine, and Misdiagnosis. New York: John Wiley & Sons, Inc., 1996, back cover.
5 Erich Kasten, “Ruled by the Body,” Scientific American Mind, Vol. 22, No. 1, p. 53, 54.
6 Melinda Beck, “Confusing Medical Ailments With Mental Illness,” Wall Street Journal, August 9, 2011, p. D-1.
(PsychoHeresy Awareness Letter, November-December 2011, Vol. 19, No. 6)