The Christian response to mental illness is one of the great tragedies to ravage the church today. This tragedy began with the rise of the medical model of mental illness. The medical model used in the world of medicine has been hopelessly hijacked by those in the field of mental illness. The implications threaten the very foundations of psychiatry, as they depend on the medical model for diagnosing and treating mental disorders. These implications also threaten the foundations of psychotherapy and the biblical counseling movement as they follow the psychological counseling format. The very terms mental illness, mental disorder, and mental disease have become a blight to society, as they have been misunderstood, misapplied, misconstrued, and misused by many in both society and the church.
The purpose in writing Christian Response to Mental Illness: Mutual Care in the Body of Christ is to encourage believers to minister to all who seek biblical, spiritual care, including individuals who are suffering from mental illness or who are suffering from other mental-emotional-behavioral issues, known in Scripture as trials and tribulations, without throwing them into an either/or category (biological or spiritual). Therefore, we scientifically discredit the prolific, promiscuous, and popular use of the metaphor mental illness and later reveal that one does not always need to know the answer to the following question: Do those individuals who suffer from mental-emotional-behavioral symptoms or who have been diagnosed with a mental illness without objective biological markers have a true disease needing medical treatment, a psychological problem calling for the worldly system of psychotherapy, or a spiritual problem needing a biblical solution?
To help those who would give mutual care in the Body of Christ, we describe the origins of the medical model of mental illness and its numerous ramifications. However, we reveal that, in most cases of personal ministry, it is both not possible and not necessary to know for sure whether or not such disorders or challenges are the result of an objective biological illness.2 In this perilous, peculiar, and puzzling area of not truly knowing whether or not a mental-emotional-behavioral issue is biological or spiritual, one can nevertheless assume that people are responsible for their behavior and can benefit from biblical ministry.
We recommend that Christians who minister to others begin with the understanding that individuals, regardless of their mental-emotional-behavioral symptoms or designations, can be ministered to, as long as a rational conversation can take place and that the content of the conversation is undergirded by love and biblically-based.
In our past writings we have revealed the sinful nature of both the psychological and the biblical counseling that follows the conversational format of psychological counseling. Over the years we have exposed counseling conversations of both psychological and biblical counselors that violate biblical admonitions.
As we have said many times: The best way to recognize the unbiblical nature of psychological and biblical counseling that explores personal relationships is to read or hear and evaluate available literal, live (not simply playacted) counseling by using biblical standards. There one can see and hear how the counseling problems are discussed and what sinful conversations are actually involved….
In contrast to the expectation and practice of the usual counseling sessions with sinful conversations, we encourage what the church has provided through the years—mutual care, in which believers minister care for one another and encourage fellow believers to know the Lord, believe His Word, and learn to walk according to their new nature in Christ, rather than according to the old Adamic nature. Such ministry is for all believers to give and receive within the Body of Christ.
History of the Medical Model
As we describe the history of the medical model of deviant human thinking and behaving from its beginnings to its present, be aware that there is, in most cases, a lack of objective biological markers for almost all the diagnoses. Research psychiatrist Dr. E. Fuller Torrey describes the earlier predecessors of the medical model as similar to, but not as sophisticated as the contemporary idea that “for every distorted thought there is a distorted molecule.”3
All the medical models of mental illness from the beginning are theoretical ideas that are not directly supported by objective biological markers. The early predecessors of the medical model of irrational thinking and behaving were based upon speculation and conjecture. In other words, they were hypothetical ideas that lacked scientific proof.
The origins of the medical model date back at least to the Greek theories of humors and their derivative personalities. From ancient times through the Middle Ages, physicians and philosophers used their understanding of the four humors (bodily fluids), the four temperaments, and signs of the zodiac to treat diseases and understand individual differences among people. Torrey says that in the Greek theory of humors, “Irrational behavior of various kinds was attributed to an imbalance of the humors—depression, for instance, was due to excessive bile.”4 However, the “imbalance of the four humors” as an explanation for irrational behavior is a hypothetical idea that is not scientifically provable.
(Circa 500 AD to 1500 AD)
During the Middle Ages the medical model declined and religion was used to explain deviant thinking and behaving. It was conjectured that the mental-emotional-behavioral deviancy of mankind was attributable to demons or evil spirits. Many symptoms of irrational thinking and behavior were described during this period of time, but no objective biological markers were needed as the speculation was that the symptoms were due to the spiritual world.
Renaissance (Circa the 14th through the 17th Centuries)
During the Renaissance, religious explanations for deviant thinking and behaving ebbed and medical treatment began for those individuals suffering from irrational behavior. The thinking and behaving symptoms were considered medical illnesses, though usually no objective biological markers were named.
Franz Anton Mesmer (1733-1815) was another contributor to the medical model. Mesmer believed that he had discovered the great universal cure of both physical and emotional problems. In 1779 he announced, “There is only one illness and one healing.”5 Unlike the bodily humors, Mesmer presented a hypothetical idea that an invisible fluid was distributed throughout the body. He called the fluid “animal magnetism” and believed that it influenced illness or health in both the mental-emotional and the physical aspects of life. He considered this fluid to be an energy existing throughout nature. He taught that proper health and mental well-being came from the proper distribution and balance of the animal magnetism throughout the body. All of this was based upon Mesmer’s say-so.
Mesmer’s ideas may sound rather foolish from a scientific point of view. However, they were well received by many at the time. Furthermore, as they were modified, they formed much of the basis for present-day psychotherapy. The most important modification of mesmerism was getting rid of the magnets. Through a series of progressions, the animal magnetism theory moved from the place of the physical effect of magnets to the psychological effects of mind over matter. Thus the awkward passing of magnets across the body of a person sitting in a tub of water was eliminated and all that was needed to cure the irrational disturbance was a conversation.
Mesmer’s far reaching influence gave an early impetus to scientific-sounding religious alternatives to Christianity. He also started the trend of medicalizing religion into treatment and therapy. Nevertheless, he only gave the world a false religion and a false hope. Distinguished Professor of Psychiatry Thomas Szasz describes Mesmer’s influence this way:
Insofar as psychotherapy as a modern “medical technique” can be said to have a discoverer, Mesmer was that person.… Mesmer stumbled onto the literalized use of the leading scientific metaphor of his age for explaining and exorcising all manner of human problems and passions, a rhetorical device that the founders of modern depth psychology subsequently transformed into the pseudomedical entity known as psychotherapy.6
This was a pseudomedical entity because Mesmer still maintained his idea of “one illness, one healing” and the “animal magnetism” that flowed through the body, even when the magnets were no longer necessary for cure. Only the words between the counselor and client were needed. Mesmer created a mechanistic medical model built on symptoms, but absent objective biological markers, which produced the counseling movement that followed. The counseling that followed and continues right up to the present day deals with symptoms through a hypothetical framework for cure without the necessary objective biological markers to qualify as a disease.
19th and 20th Centuries
It was not until the 19th Century when rationalism and positivism promoted the belief that man was governed by natural laws and that these laws could be discovered and clarified through science.
Hypothetical versus Symptomatic
In medicine there were major advances in the discovery of bacterial reasons for diseases, such as syphilis, tuberculosis, and typhoid, which sometimes resulted in deviant thinking or behaving. It was reasoned that other such thinking or behaving must be caused by other diseases or for other bodily reasons. Up until the mid-nineteenth century the rationalization behind irrational thinking and behaving was speculative and hypothetical.
The first of two significant changes occurred, which initiated a different medical model profile for such irrational thinking and behaving. The first significant change in the medicalization of deviant thinking and behaving resulted from the work of Emil Kraeplin (1856-1926). Kraeplin was a German psychiatrist who believed that the psychiatric diseases had physical causes and established a classification system of mental disorders. The classification system involved symptoms that are subjective evidences of disease. Kraeplin considered psychiatry to be a branch of medical science and should be treated as such. Kraeplin’s classification system preceded the Diagnostic and Statistical Manual of Mental Disorders (DSM) and the International Classification of Diseases (ICD) and certainly influenced them. The DSM and ICD are predicated on the idea that deviant thinking and behaving are medical issues, i.e., diseases, even though there are no objective biological markers for the disorders listed.
The second significant change was brought about by Sigmund Freud (1856-1939), who is responsible for rapidly advancing the medical model. Instead of moral treatment by means of religion and philosophy, Freud advanced the medical model with its psychological underpinnings. Freud molded his hypothetical psychological themes into a pseudo-scientific framework that propelled them further into medicine. Yet even prior to Freud, deviant thinking and behaving had been quite firmly established as diseases.
Under Freud deviant thinking and/or behaving constituted a “disease” and curing such was “medicine.” In short, Freud devised a psychotherapy (psychoanalysis) that he represented as a scientific theory and as medical therapy.This was the second significant change in the use of the medical model for mental and behavioral disorders and a significant, unique, and historical precedence-setting act on the part of Freud. This set the standard for future psychotherapies to function without the need for objective biological markers to qualify behaviors as diseases.
Freud is the most prominent name in psychotherapy and is considered the father of the psychotherapy movement. Freud invented psychoanalysis as a method for treating mental-emotional disorders and particularly for investigating what he considered to be the unconscious mind. Psychoanalysis is known as the fountainhead of Western psychotherapy. As such, it has influenced most of contemporary psychotherapy. With Freud’s doctrine of the unconscious and its related theories, his work set a standard and framework for others to follow and modify. His ideas permeate later theories and therapies and have significantly influenced the thinking and writing of the twentieth century and beyond. E.M. Thornton says in her book The Freudian Fallacy:
Probably no single individual has had a more profound effect on twentieth-century thought than Sigmund Freud. His works have influenced psychiatry, anthropology, social work, penology, and education and provided a seemingly limitless source of material for novelists and dramatists. Freud has created a “whole new climate of opinion”; for better or worse he has changed the face of society.7
Indeed, Freud’s constellation of theories about the human psyche is merely a set of one man’s fantasies. Regrettably his theories have been elevated from fantasy to fact, accepted as gospel truth, and applied to almost every area of human endeavor. Therefore, it is essential to remember that Freud’s ideas and theories are simply unproved opinions, not facts; his own notions, not reality.
In truth, Freud’s psychological model and treatment methodology (psychoanalysis) were merely unprovable constructs of his imagination, which became the universal medical model behind all the psychotherapy that followed—absent objective biological proof of disease. Through the malevolent machinations of his mind, Freud brought the psychological into the medical world by giving a scientific-appearing façade to the human mind absent any scientific evidence of disease. And the monstrous acceptance of his scheme, first by the medical community and later by federal funding to universities, became the means of therapizing not only deviant thinking and behaving for veterans at first, but eventually for all problematic thinking and behaving, absent any need to prove that a disease existed. After all, what psychotherapists regard their individual, marital, family clients as having a mental illness? And what psychotherapists show forth objective biological markers for the symptoms of their clients?
Szasz asks an important question:
What is psychotherapy? In the conventional view, it is, generally, the treatment of mental disease—particularly by psychological, social, or environmental, rather than physical or chemical means. In this imagery, psychotherapy is real and objective in the same sense that prescribing penicillin, surgically removing a brain tumor, or setting a fracture are real and objective. Hence we commonly speak of psychiatrists “giving,” and patients “receiving,” psychotherapy. In my opinion, this view is entirely false.8
Szasz later answers that question:
Actually, psychotherapy is a modern, scientific-sounding name for what used to be called the “cure of souls.” The true history of psychiatry thus begins not with the early nineteenth-century psychiatrists, but with the Greek philosophers and the Jewish rabbis of antiquity; and it continues with the Catholic priests and Protestant pastors, over a period of nearly two millennia, before the medical soul-doctors appear on the stage of history.9
Szasz adds: “The spiritual needs of man were thus well understood in Greek antiquity; and they were well articulated in the religious and artistic images and terms appropriate to them.”10
Counseling therapy based upon symptoms absent objective biological proof of disease continued to expand through psychiatry. Freud and other such individuals as Carl Jung and Alfred Adler represented popular psychological approaches. However, because these therapies were very intensive and very expensive and because they required meeting 3-5 times a week with a medical doctor, they involved only a small number of individuals who could afford the time and money.
The field of clinical psychology was developed in colleges and universities circa 1950. This relatively new field later produced degreed individuals who would become licensed and enabled to offer a shorter, therefore less expensive, means of dealing with problems of living in the psychiatric tradition of dealing with symptoms without the objective biological evidence of disease, yet depending on the medical model.
After World War II the federal government invested heavily in universities to produce therapists, primarily for returning veterans, never doubting the questionable medical model connection. These additional monies, along with private foundation grants, were used in universities to expand the clinical psychology departments in order to train individuals to conduct therapy. Clinical psychology, out of which come psychotherapists, was a relatively new profession at that time but is now one of the most popular majors in colleges and universities across America.
Ellen Herman, in her book The Romance of American Psychology, says:
Throughout the entire postwar era, the United States has trained and employed more psychological experts, per capita, than any other country in the world…. Before World War II, professional healers and counselors were few; most individuals allied with psychology did work unrelated to “helping.”11
Herman describes the omnipresence of psychology as having “seeped into virtually every facet of existence,” but she says, “that does not mean that it has always been there or that what experts say has always mattered as much as it matters today.”12
In the last half of the 20th century, the supposed need for psychological counseling and the practice of counseling psychology, rationalized by the medical model, but absent objective biological markers, accelerated rapidly. Instead of having psychoanalysis and its few offshoots, we presently have about 500 different, often conflicting psychological counseling approaches, and thousands of not-compatible techniques with various incompatible underlying psychological theories all dependent upon the psychological medical model of mental illness, absent any necessary objective biological markers.
As the less intensive and less expensive psychotherapies came along, the mental illness/medical model became a façade for counseling problems of living and other mental-emotional-behavioral disorders (absent the needed objective biological markers) instead of or in addition to medicine.
1 Excerpted from Martin and Deidre Bobgan. Christian Response to Mental Illness: Mutual Care in the Body of Christ. Santa Barbara, CA: EastGate Publishers, 2019, Chapter 1, available at amazon.com.
2 Exceptions would be to known illnesses that may affect the thinking and behavior of an individual.
3 E. Fuller Torrey, The Death of Psychiatry. Radnor, PA: Chilton Book Company, 1974, p. 8.
4 Ibid, p. 7.
5 Robert C. Fuller. Mesmerism and the American Cure of Souls. Philadelphia: University of Pennsylvania Press, 1982, p. 1.
6 Thomas Szasz. The Myth of Psychotherapy. Garden City: Doubleday/Anchor Press, 1978, p. 43.
7 E. M. Thornton, The Freudian Fallacy. Garden City: The Dial Press, Doubleday and Company, 1984, p. ix.
8 Szasz, op. cit., p. 3.
9 Ibid., p. 6.
10 Ibid., pp. 104-105.
11 Ellen Herman. The Romance of American Psychology. Berkeley: University of California Press, 1996, p.3.
12 Ibid., p. 5.
PsychoHeresy Awareness Letter, November-December 2019, Vol. 27, No.6