Before launching into a critique of The Christian’s Guide to Psychological Terms, Second Edition, hereafter referred to as The Christian’s Guide, some disclosure on our part is necessary. Importantly, we believe and have taught for over 40 years that the Word of God and the work of the Holy Spirit in the fellowship of the saints are sufficient to deal with the nonorganic issues of life without sending Christians out of the church to psychotherapists. Additionally those who suffer from the biological trials and tribulations of life can profit greatly from biblical ministry in addition to whatever medical help they are receiving.
We have taught and practiced from the beginning that all the personal, relational issues of life that are now popularly referred to licensed psychological counselors for “cure” through conversation can best be done through those in the church ministering to one another. Building up the church spiritually is far more important than erecting biblical counseling offices, which in many ways are often just knock-offs of psychological counseling offices and practices.
The back cover of The Christian’s Guide describes the authors:
Marshall and Mary Asher are graduates of the Master’s College with Master of Arts degrees in biblical counseling. They are both certified by the Association of Certified Biblical Counselors. Mary also holds a degree in psychology. Together they serve Christ as biblical counselors at Redeemer Community Church of San Antonio, Texas, where Marshall is anelder.1
Dr. Wayne Mack wrote the Foreword to The Christian’s Guide and several leaders in the biblical counseling movement (BCM) endorsed it. Therefore many pastors and counselors have or will purchase it. However, we advise those who desire to minister biblically not to waste their time using this book. Contrarily Mack says in the Foreword: “Again and again, I had to say, ‘A book like that needs to be written, but right now I don’t know of one.’ Now I’m glad I can say such a book is available” (p. viii). Prior to the Ashers’ book there was no book in Christian circles that gave such Psychological Descriptions for the hoped-for purpose of illuminating Christians with their Biblical Descriptions of the same problems, because none was necessary. None of the Psychological Descriptions are needed in order to suggest Biblical Descriptions with prescriptions of what to do.
Biblical ministry for Christians has existed for two millennia without any necessity for Psychological Descriptions. Biblical ministry thrived even though many of the psychological terms and mental disorders were not known during that period of time. Biblical ministry was not hampered by the lack of the Ashers’ Psychological and Biblical Descriptions. In fact, the Ashers’ guide, instead of clarifying for purposes of biblicizing, confuses the reader with their own opinions about what constitutes a spiritual disorder.
The Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association, contains over 300 mental disorders. Dr. Jeffrey Lieberman, who is chairman of psychiatry at Columbia University and former president of the American Psychiatric Association, says: “With rare exceptions such as narcolepsy, which can be diagnosed by testing cerebrospinal fluid, there are no objective biological measures for mental illness.” 2
A Major Failure
The Ashers provide the reader with 219 psychological and biblical descriptions from Abnormality to Zoophilia. The book is a collection of psychological terms, such as “Boundaries” (p. 31), “Burnout” (p. 34), and “Collective Unconscious” (p. 47), and mental disorders, such as “Depression” (p. 61), “Dissociative Identity Disorder” (p. 70), and “Obsessive Compulsive Personality Disorder” (p. 129). The Ashers point out that mental disorders may include “brain injuries or tumors” (p. 12), “brain damage” (p. 21), “genetic predisposition” (p. 27), “caffeine intoxication” (pp. 35-37), and a number of other biologically and or organically related conditions, including narcolepsy, which is “a physical illness that should be managed by a physician” (p. 123).
However, the Ashers, like too many in the BCM, believe that those mental disorders that lack medical markers are actually spiritual problems that require biblical solutions. The Ashers consider that all mental disorders, with the exception of those that they themselves identify as biological in The Christian’s Guide, are non-medical disorders. Otherwise they would have said so, just as they did for the ones they identified medically. Any mental disorders in The Christian’s Guide that lack such designation are obviously regarded by the Ashers as solely spiritual problems only requiring biblical solutions, which are given under each “Biblical Description.” Otherwise the Ashers would have indicated any organic or biological roots as they did for others.
For example, the Ashers’ “Biblical Description” of “Depression,” one of the most prevalent mental disorders, refers to “wrong thinking” and “spiritual problems” (p. 61) and thereby indicates that the Ashers presume that depression is not biologically caused by any medical condition and thus treat it solely as a spiritual problem requiring a biblical solution. No latitude is given for the possibility of medical involvement, which is the approach the Ashers take with all of their mental disorders with the exception of those for which they specifically list biological involvement. As one can suspect from Lieberman’s statement about Narcolepsy and the DSM, there are no objective medical tests that can confirm the diagnosis of depression. Neither are there objective medical tests that can confirm the diagnosis of “Bipolar 1 Disorder.” Yet the Ashers arbitrarily describe a person with “Bipolar 1 Disorder” as having a “genetic predisposition” (p. 27), even though, as with depression and numerous other mental disorders, there are no objective medical tests that can confirm the diagnosis. This grave inconsistency reveals the Ashers’ personal bias throughout The Christian’s Guide.
It is a mistake to think that one can know whether or not mental symptoms that are not clearly “caused by brain damage, tumors, gene inheritance, glandular or chemical disorders” are actually “nonmedical problems.” One of the most difficult issues to deal with in counseling is the cause and treatment of mental disorders. The sum and substance of Ashers’ assumption, based upon their format, is as follows: Unless there are proven biological diseases that can account for the usual symptoms of mental disorders, the root causes and cures are spiritual and can be resolved biblically, except for those conditions that they themselves believe have a biological involvement, such as “Bipolar 1 Disorder.”
Since we cannot always know whether or not there are bodily generated difficulties, one should not conclude, as the Ashers do, that the mental disorders are spiritually driven, thereby only needing biblical remedies. We quickly add that those with life issues, whether biologically generated or not, can be ministered to biblically as the occasion arises with much humility and without assuming “wrong thinking,” for example, to be the cause.
The blunt truth is that no one, no matter how expert, educated, and experienced in the field of medicine, can say for sure whether or not there are “organically generated difficulties” involved or whether they are “nonmedical problems” behind mental disorders with no medical markers! Thomas R. Insel, MD, former director of the National Institute of Mental Health says:
Mental disorders are among the most complex problems in medicine, with challenges at every level from neurons to neighborhoods. Yet, we know so little about mechanisms at each level. Too often, we have been guided more by religion than science. That is, so much of mental health care is based on faith and intuition, not science and evidence.3
An article in Psychology Today reports that there are “100 billion neurons in the human brain” and that it would take 32 million years “to count each synapse in the human brain at a rate of one synapse per second.”9 An article in the Psychotherapy Networker describes the human brain as “the most complex biological entity known on earth.” The author adds, “The number of possible interconnections among its neurons exceeds the estimated number of atoms in the universe.”10 The brain is obviously central to the mind-body relationship because it controls every organ system in the body. In addition, the brain also responds to every organ system within the body. This interaction of body to brain/mind and brain/mind to body is a complex process, and the enigma of it prevents anyone from knowing much truth about the underlying causes of mental symptoms. Knowledge is limited because the secrets of human behavior are locked up in the brain-mind-body relationship and particularly in the brain.
Most competent practicing medical doctors who see patients regularly and any book written by a capable medical doctor on this subject will debunk the Ashers’ extremely erroneous idea that mental symptoms without biological markers are devoid of any possible biological origin or involvement. For example, Erno Daniel, MD, PhD, an internal medicine doctor who has been at a large medical clinic for 30 years and seen patients on a regular basis, has written a book titled Stealth Germs in Your Body. In his chapter “What Else Could It Be?” he has a section titled “We Found Nothing” versus “There Is Nothing.” Daniel says:
Clearly there is a difference between “we found nothing (abnormal)” and “there is nothing (abnormal).” Ingeneral “we found nothing, so far” means that the screening examinations and tests that were ordered to look for particular conditions yielded negative results at the time they were done. In other words, nothing truly abnormal was found on the examination or on the tests that were chosen to be performed thus far. Clearly, that doesn’t prove conclusively that you are not harboring stealth germs in your body, as there is no foolproof test that can find everything. The absence of a large number of possible conditions does not exclude the presence of some other previously undetected or evolving condition (bold added).4
When Job was covered with boils and pleaded with God to take his life, his counselors basically diagnosed the cause of his problems being spiritual (hypocrisy, sin, and a wrong relationship with God). They misdiagnosed his problem and pushed him into further grief. Christians who follow some of the ideas of the Biblical Counseling Movement, as presented in the Ashers’ book, may be in danger of becoming a 21st century version of Job’s counselors.
Because we have been concerned about how some biblical counselors view schizophrenia, we turned to that page in Ashers’ The Christian’s Guide. Under the “Biblical Description” for schizophrenia, the Ashers say: “Schizophrenia is an exaggerated response to fear, guilt, and hopelessness. He has unmitigated guilt and much to fear. For this reason, a schizophrenic should be considered an unbeliever until proven otherwise (even if he has a history of effective Christian ministry)” (p. 180, bold added).
We first encountered this false presumption when we examined teachings at The Master’s College and Seminary and wrote “A Critical Review of The Master’s College and Seminary Biblical Counseling Program.” Dr. John Street chairs the graduate program in Biblical Counseling (MABC), which is the largest program of its kind in America.
We include here the section on schizophrenia,5 which we call “a second grievous teaching given by Street”:
A second egregious teaching given by Street at the Fall 2011 Training Conference is in a talk in which he discusses thirteen psychological labels and avoiding the use of them. One of the labels he discusses is that of “schizophrenia.”6 He begins by saying, “schizophrenia is just a nice Greek word for people who believe that they have personalities talking in the back of their head.” To begin with, Street has over-simplified a complex and not completely understood condition that comes in a variety of forms. It might surprise Street to know that there are some schizophrenics who do not “believe that they have personalities talking in the back of their head.” His overly simplistic statement is medically appalling as any neuropsychiatric expert would tell him.
Street then compounds his grievous error by saying, “Actually working with schizophrenia’s not hard at all.” (Bold added.) To demonstrate how simple it is to work with schizophrenics, Street begins by saying, “If this represented all the schizophrenics in the world [at this point he stretches his arms out wide], only this many [he holds his thumb and forefinger almost together] are really genuine true Christians.” In other words, there are almost no “genuine true Christians” who suffer from schizophrenia. Since only the Holy Spirit would know how many are and are not Christians, Street has obviously usurped the place of the Holy Spirit as he presumes to have knowledge that there is only a small number of schizophrenics who are believers, and he does so on the flimsiest and false biblical standard as will be seen shortly. Such certain knowledge belongs only to God.
Street proceeds to tell how one can cure schizophrenics by saying:
And of those people [schizophrenics] you have to settle one thing early. Who’s going to define your reality for you? The voices in the back of your head or the Bible? What’s God’s Word say? If you can settle that issue early with this: you can’t work with all these other people. All these schizophrenics think that they’re Christian; they’re not. But you’d only work with a Christian. Remember all counseling is pre-counseling until a person comes to Christ. Right? Well, if you can settle that issue early: Who defines your reality for you? Is it what’s God’s Word says or is it that voice in the back of your head that says hurt yourself or hurt that other person.
So all one needs to do is to make sure the schizophrenic is a Christian because, according to Street, “you’d only work with a Christian” and “if you can settle that issue early” and “who defines reality for you…God’s Word” or “that voice in the back of your head,” then and only then a possible easy cure. While teaching people to base their reality on God’s Word is sound advice, Street overlooks the complexity of schizophrenia and its range of symptoms.
Schizophrenia is one of the most enigmatic of the mental disorders and its cure has been elusive to this day. For Street to casually set aside the billions-plus dollars spent and the multitudinous hours labored on research on schizophrenia by brilliant minds in his promotion of his personal opinion based on his proposed schizophrenia cure restricted to only an extremely small group of Christians that one is able to identify is reprehensible!
Harvard Medical School reports: “One in a hundred persons will at some time suffer from schizophrenia. Its causes are obscure, and no way is known to prevent or cure it.”7 (Bold added.) In his book Surviving Schizophrenia, E. Fuller Torrey, MD, refers to schizophrenia as “today’s most misunderstood illness” and says:
Contrary to the popular stereotype, schizophrenia is an eminently treatable disease. That is not to say it is a curable disease, and the two should not be confused. Successful treatment means the control of symptoms, whereas cure means the permanent removal of their causes. Curing schizophrenia will not become possible until we understand its causes; in the meantime we must continue improving its treatment.8
Street’s “cure” for “Christian” schizophrenics is based upon his say-so and could never be put to the scientific test; how could it be? To begin with, who or what establishes a person as a Christian, when Street says, “All these schizophrenics think that they’re Christian; they’re not”? Consider the amount of confusion and guilt that Street’s blundering opinion will cause Christians who already suffer from schizophrenia.
Just as Street erroneously justifies his use of the Bible to support his unbiblical problem-centered counseling,9 he also erroneously uses the Bible to support his corrupt medical understanding of schizophrenia and his supposed cure. Consider the person with schizophrenia being counseled by Street or by someone he has trained who tries unsuccessfully to follow Street’s plan, is not “biblically cured,” and ends up concluding that he is willfully hearing “voices in the back of [his] head” and/or that he is eternally lost and rejected by God.
Think of what might happen to one who not only continues to be plagued by voices, but enters into deep despair. Hopefully Street’s counseling and that of those who follow his teachings will not increase the suicide rate among those who suffer from schizophrenia.
Imagine all those MABC students and those world-wide who see or hear Street’s presentation on schizophrenia believing this egregiously false teaching and then counseling their counselees accordingly. These counselors will erroneously assume that all schizophrenics “have personalities talking in the back of their head[s]” and that the counselor merely needs to determine whether the counselee is a Christian and proceed to lead the counselee to listen to God instead—and then: “abracadabra,” a cure! And, imagine the potential lawsuits that may occur because of this teaching carried out by Street and all these biblical counselors who follow him. This is one more tragedy of Street’s false teaching that is available at TMC&S and the BCDASoCal web site for anyone in the world to see and hear and erroneously believe and follow. Because of Street’s position and background and because Dr. John MacArthur, who heads TMC&S, is so highly regarded world-wide, many will embrace these teachings.
Torrey versus Street: E. Fuller Torrey, M.D, quoted earlier, is a research psychiatrist specializing in depressive illness and schizophrenia. Torrey is the executive director of the Stanley Medical Research Institute and has written several best-selling books on mental illness. Torrey is an eminent research authority, who has over many years seen numerous patients suffering from depressive illness and schizophrenia, which are his specialties. Therefore, we were interested in Torrey’s response to Street’s teaching on depression and schizophrenia.
We were also interested in Torrey’s medical response to Street’s belief that bodily diseases are “easily discernible” with “a good thorough physical” and to Street’s conclusion that in Julie’s case “there is no sign of any organic abnormalities.” In addition, we were curious as to what Torrey would say about Street’s views on schizophrenia. Torrey responded to us as follows:
Dr. Street’s advice betrays a woeful lack of knowledge. Depression and many other psychiatric disorders are physical diseases of the brain which are not detectable by “a good, thorough physical,” including blood tests. Psychiatric disorders can be caused by genetic, infectious, metabolic, and other organic etiologies, some of which are detectable by a physical exam and blood tests, but many cannot be.
His [Street’s] statement about schizophrenia is simply ignorant. I have known many “true Christians” who have schizophrenia. The fact that Dr. Street is in a teaching position is scandalous.10 (Bold added.)
This ends the section on Street’s teachings as included from “A Critical Review of The Master’s College and Seminary Biblical Counseling Program.” Although the Ashers do not make the same comments as Street, we include the entire section as it is likely they share the same prejudices regarding schizophrenics, since they are both “graduates of The Master’s College with Master of Arts Degrees in biblical counseling,” the program headed by Street (back cover of The Christian’s Guide).
Note the difference between Street’s view of “Schizophrenics as Christians.” For Street, “there are almost no ‘genuine true Christians’ who suffer from schizophrenia.” For the Ashers, “a schizophrenic should be considered an unbeliever until proven otherwise (even if he has a history of effective Christian ministry).” Instead of “almost no” (Street), it is absolutely “no” for the Ashers.
Compare Street’s cure, stated earlier, for the schizophrenic, which is the answer to his question, “Who’s going to define your reality for you?” with the Ashers’ cure from their brief response: “Teach the Gospel…. Confront them with their sin and point them to the Savior…. Regeneration will transform them” (p. 180). In other words, once they are regenerated, they will no longer be schizophrenic, according to the Ashers.
Torrey’s remarks about schizophrenics as Christians apply to the Ashers only more so because of their extreme position. Torrey would be clearly disappointed with the Ashers and doubly condemn their ignorant view of schizophrenics as “unbelievers.”
Where’s the Warning?
The Ashers communicate to those who have mental disorders for which they indicate no medical condition that the Bible is sufficient to deal with their disorders. The Ashers describe the psychological disorders and other psychological terms in such a way as to engender hopeful expectations by presenting a biblical counseling understanding and alternative to those readers who have been diagnosed with one or more of these mental disorders and who may also be taking or considering taking psychotropic medications.11
The Ashers’ book could lead their readers to question or change the use of their medications. Unfortunately the necessary and usual responsible warning about psychotropic medications is entirely absent at the beginning and is a major mistake of this book which may put some readers at risk and leave the authors and publishers open to a potential lawsuit. When describing cases regarding ordinary problems of living for which people seek counseling, such a warning is not necessary. However, when describing mental disorders listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM), a warning is a dire necessity. This warning should be placed somewhere on the front pages, even if it has to be pasted on the current, already printed copies.
The DSM, the psychiatric bible for mental illnesses, has over 300 mental maladies in its latest edition (DSM-5).12 Considering the possible number of different mental disorders for biblical counselors to tackle, as listed in the Ashers’ book, and the fact that psychotropic drugs are available for nearly all of them, one would expect the Ashers to be especially careful to sound the warning that is normally given. However, there is no early warning, and that needs to be corrected, because it is a serious omission and a great disservice to the readers, which could have serious consequences for the counselees.
Dr. Peter R. Breggin, who is probably the best-known psychiatrist in America for his opposition to psychotropic medications, has a full-page warning at the beginning of his best-known book, Toxic Psychiatry.13 His very first words, emphasized by italics, are: “Do not abruptly stop most psychiatric drugs!” 14 Note the exclamation mark!
Although we have ministered to many problemed individuals over the years, we have never referred to such cases by their DSM designation in order to demonstrate that the Bible can indeed be used in such circumstances. However, if we did, knowing that some of those who would read what we write would either be on psychotropic medications or consider using them, we would certainly issue a warning as did Breggin.
We repeat what the Ashers said earlier: “The sufficiency of the Scriptures and the indwelling of the Holy Spirit in every believer endue Christian counseling, with transforming power unknown to psychotherapy.” Because of this lack of warning next to the implied promise of what biblical counselors can do with such disorders, The Christian’s Guide to Psychological Terms is a potential litigious bomb that may be exploded on biblical counselors who naively counsel without caution.
1 Marshall and Mary Asher. The Christian’s Guide to Psychological Terms, 2nd ed. Bemidji, MN: Focus Publishing, 2004, 2014, back cover. Subsequent references to this book will be in parentheses within the text.
2 Jeffrey Lieberman quoted in “DSM-5: Psychiatrists’ ‘Bible’ Finally Unveiled,” Huffington Post, 05/16/2013, www.huffingtonpost.com.
3 Thomas. R. Insel, “Atonement,” www.psychiatrictimes.com.
4 Erno Daniel. Stealth Germs in Your Body. New York: Union Square Press, 2008, p. 195.
5 Martin & Deidre Bobgan, “A Critical Review of The Master’s College & Seminary Biblical Counseling Program,” Part Three, PsychoHeresy Awareness Letter, Volume 20, Number 6, November-December, 2012, https://www.pamweb.org/street_tmc&s_3.html.
6 John Street, “Gathering Data: Discerning Problems Biblically,” Video Session Four, Biblical Counseling & Discipleship Association Southern California (BCDASoCal) Training Conference, Fall 2011, http://bcdasocal.org.
7 Harvard Medical School Mental Health Letter, Vol. 2, No. 12, June, 1986, p. 1.
8 E. Fuller Torrey. Surviving Schizophrenia, 5th Edition. New York: Harper. 2006. p. 156.
9 Martin & Deidre Bobgan, “A Critical Review of The Master’s College & Seminary Biblical Counseling Program,” Part Two, PsychoHeresy Awareness Letter, Volume 20, Number 5, September-October 2012, https://www.pamweb.org/street_tmc&s_2.html.
10 E. Fuller Torrey email 9/13/12.
11 “A psychoactive drug, psychopharmaceutical, or psychotropic is a chemical substance that crosses the blood-brain barrier and acts primarily upon the central nervous system where it affects brain function, resulting in alterations in perception, mood, consciousness, cognition and behavior,” en.wikipedia.org/wiki/Psychoactive_drug.
12 “DSM-5: Psychiatrists’ ‘Bible’ Finally Unveiled,” Huffington Post, 05/16/2013, www.huffingtonpost.com.
13 http://en.wikipedia.org/wiki/Peter_Breggin, 8/24/2014.
14 Peter. R. Breggin. Toxic Psychiatry. New York: St. Martin’s Press, 1991.
(PsychoHeresy Awareness Letter, March-April 2017, Vol. 25, No.2)