On counseling and medication

An interesting discussion on counseling and medication over at another blog raised a good point that I’ve often found is a stumbling block to Christians. David Powlison, quoting the Director of the National Institute on Mental Health, said:

Psychiatric medications can sometimes take the edge off symptoms, but they can't give people what they really need. People need meaning and relationships. Psychiatry can't give that. Medication can't give that.


This is something that is apparently difficult to understand for those who have not had immediate contact with the effects of this kind of medication (known as “psychotropic” medication).

I once had a student whose comment revealed that even those who HAVE had contact sometimes misunderstand. She said in an off-hand manner, “I’ve taken anti-depressants. They make you happy!”

The truth is, they don’t. They might help you to be normal (in a chemical sense), but they don’t make you “happy.” My concern deepened as I counseled this student about this, because she had faced mild-to-moderate depression for so long that she had come to assume that her
depressed state was “normal”-- thus, having that edge of depression taken off was “happy” feeling to her.

Here’s my best analogy of what psychotropic drugs offer: Suppose you love running, and have your heart dead-set on running a marathon in a year. In preparation for a training regimen, you visit your doctor, who informs you that the slight pain in your knee is actually a problem that needs to be addressed surgically; in short, if you don’t have your knee scoped, you won’t be able to train for the marathon, let alone complete it.

Here’s the analogy: if you have your knee scoped, is that going to make you ready for the marathon? No. You’ll still have a lot of work to do to condition your body (and your mind) for running the marathon. But if you don’t have your knee scoped, you are guaranteed that you won’t be able to run the marathon.

So it is with psychotropic medication: they won’t overcome your depression for you, but they might address the physical/physiological obstacles that would keep you from being able to do the work of overcoming depression. (Likewise with anxiety and other clinical mental health issues.)
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The Bible, authority, and interpretation part I

The other day I was with a group of people who were talking about an especially legalistic environment that some of them had been a part of as teenagers-- a place where they were literally told what to believe, and that if they disagreed they would go to Hell. The leaders in this environment were, clearly, abusing their authority and making claims that no one person or group has a right to make.

One person commented on the fact that I should get a lot of sermon illustrations from these stories! (He was right...) That got me to thinking about what the real applications really were. I’d like to reflect on two broad applications here, over two posts.

At one point I asked the question of this group: how did your parents (who were all Christians) continue to believe that it was good for you to be a part of this? After all, I said, you would surely come home and tell them all about it.

Their first response demonstrated how powerful the authoritarian environment was:

No, we were told that if we reported on them we would go to Hell.


[Note, by the way, the similar nature of this environment to a classic abusive relationship-- where the victim is told that THEY (the victim) would get in trouble if they told.]

But as they went on, something else became clear. One of them said:

I was glad to be there. I needed a place where I could belong, and this place felt safe-- partly because of the rules.


And there I saw my first sermon illustration: when it comes down to it, we all gravitate toward legalism. We are all legalists.

When we’re offered an environment where the rules are known, it becomes very easy to settle into that. We know where we stand in the pecking order; we are then able to proclaim with confidence precisely why we have merited the favor of God and men.

I think this is what makes grace so threatening, so terrifying to all of us. If the work that earns us favor isn’t our work (through legalism) but Christ’s work imputed to us (by grace), we are actually dependent on something (grace) and someone (Christ) other than ourselves.

This also illustrates why even communities that are defined by Christ’s grace (namely, churches) quickly return to legalism. Dependence is very uncomfortable. Dependence is often humbling, sometimes awkward, and frequently at odds with pride. Someone who is dependent has just reason to lose some confidence in themselves.

Here’s the irony in it all: we are always dependent. Even when we think we have every reason for confidence (as with the group of teenagers who knew exactly their place in the social order of that legalistic community), we are still dependent on something: for the legalist, it is the rules and laws that we subscribe to, and the authority who creates and enforces them.

Legalism-- that idea that “I can earn merit/favor/righteousness through obedience, and take confidence and pride in myself”-- is a lie.
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