Harold Kroto, the man who discovered Buckyballs, was giving a lecture once where he asked the class to raise their hands if they think the sun revolves around the earth. The class snickered and no one dared raise their hand. He then asked them to raise their hands if they think the earth revolves around the sun. The entire room raised their hands, hoping they weren’t about to be tricked into something. Then he asked them to keep their hands raised if they knew the evidence for the earth revolving around the sun. Not a single person kept their hand up. He then explained that they took it on faith that the earth revolves around the sun. (Source: Things I Mean to Know)
How many things do you take on faith? How many things have you researched until you fully understood both sides of the debate? Until you could argue the oppositions point better than they could? Today I want to tackled one topic I think many people on both sides take on faith. It’s an issue that gets raised constantly, even cyclically, on social media. The debate over chemical imbalances in the brain versus those that think it’s all a hoax.
Is Brain Chemistry Real?
Some people are posting about how metal illnesses and chemical imbalances are real. You’ve probably seen this cartoon from Robot Hugs that makes a point about the absurdity of not getting help when you’re experience mental health issues:
On the other hand, I’ve seen people posting about how leading psychologist don’t believe that mental illness are just chemical imbalances. Take this article as an example: On the Myth of Chemical Imbalances. The author has been practicing psychotherapy for nearly a decade and he cites another psychologist who claims he’s never heard a psychologist who used the term “chemical imbalances” in any way other than in mockery.
Which of these is more accurate? Are mental health issues the same thing as physical issues? I’ve done some digging into this complex issue and want to show you some relevant quotes and discussions from prominent psychologists and medical doctors.
Depression, anxiety, posttraumatic stress, and schizophrenia are not, have never been, and will never be “just like” cancer or diabetes or heart disease, despite the obfuscations of psychiatrists, mental health professionals, and mental health “advocacy” groups.
~ Mark L. Ruffalo, LCSW in The Great Paradox of Psychiatry
If anything has been gleaned from the origins of these maladies [mental disorders] in two decades of work, it is that the genetics of psychiatric disorders are terribly complex. No individual gene for a psychiatric disorder has been found and none likely ever will be.
~ Charles Barber, MFA, Yale Psychiatry Professor in The Brain: A Mindless Obsession
The more we learn about the workings of the mind, the more we realize that we can never reduce human thought, feeling, or behavior to a biochemical reaction.
~ Armand M. Nikoli, Jr., MD, Harvard Psychiatrist The Harvard Guide to Psychiatry 3rd Edition
Did you catch that? These psychiatry professionals think there is no biologically identifiable reason for mental health issues. Not only that, but they purport that we will never find such a link. The complex mental health issues we experience are far different than physical health issues.
Part of the issue in our common misconception about psychology is that we think of psychologists as doctors who can look at our symptoms and determine our condition and therefore what is truly wrong with us. And no wonder, it makes a lot of sense! If you got to the doctor with the stomach flu, you have tell tale signs that will alert the doctor to your condition and he can prescribe curative medicines. If he’s in doubt he can draw your blood and find the real problem. But this is not true for psychology.
‘Mental illness’ is terribly misleading because the ‘mental disorders’ we diagnose are no more than descriptions of what clinicians observe people do or say, not at all well established diseases.
~ Allen J Frances M.D. (Literally wrote the book on mental health disorders) in What’s in a Name?
There are currently no standard ways of treating or assessing mental illness based on brain images.
~ Charles Barber, MFA, Yale Psychiatry Professor in The Brain: A Mindless Obsession
The fact that we think of extreme emotional issues as being a direct byproduct of brain chemistry is thwarted by the fact that there is no way to assess or test for these alleged brain chemistry issues. There are no tests the doctor can give or scans they can run to determine who has depression, anxiety, or ADHD. All of the experts keep speaking the same theme, that mental issues are not diseases nor are they chemical imbalances. The diagnosis we use are nothing but labels that describe the state someone is in, but there could be a 100 different causes for how they got there.
Take depression for an example. You can get depression from the loss of a loved one, abuse in your past, constant reflection on your own mistakes, or any number of other reasons. Would any of those show up in a brain scan? No. But what of the cure? Most doctors prescribe the same drugs regardless of the cause. They usually don’t even ask after the cause!
In researching depression and its cures, I found a study that tested Zoloft, St. John’s Wort, and placebos against each other. The study found 25% of those taking Zoloft received a full reduction in depression. Those that were taking St. John’s Wort had a 24% response. But those on the placebo schooled them both, with a full 32% responding with complete reduction in symptoms. (For more on how chemicals aren’t solving emotional issues, see Good Mood Bad Mood by Charles D. Hodges, M.D.) If a placebo is more effective than drugs, that indicates that most of the issues the drugs appear to be solving would be solved on their own (in time) or through the belief that something can fix them (placebo effect). If you’re interested in seeing the study results for yourself you can find them here.
Drugs Cured Me!
Most of the time when I have participated in conversations about depression or anxiety, I have heard someone say, “I know that chemical imbalances are true, because I took a drug and it cured me.” I don’t doubt that their cure coincided with their taking medication. However, there may be more going on than just popping pills and finding freedom. We cannot reason that solely because some people have found relief from their symptoms that the actual cause was addressed. There are several reasons we should not immediately accept the answer that drugs are the solution to our emotional issues:
1) Ex Juvantibus is the medical term for making a determination about the cause of a disease by what solved it. For instance, if a patient has strep throat and takes aspirin to fix it, they would be wrong to think that the aspirin cured them simply because the strep throat went away. Strep throat is a short lasting illness on its own and will subside without medication.
I’ve seen at least two scholars take up the stance that ex juvantibus should be considered for psychological issues. Steven Rose, emeritus professor of Biology and Neurobiology at the Open University and Greshem College in London and Charles D. Hodges, M.D. both point out that psychotropic drugs do not seem to have an actual effect on reducing depression.
If you’ll allow me a taboo – quoting from Wikipedia:
Steven Rose applies the term [ex juvantibus] to the use of psychoactive drugs to “cure” depression, implying that the underlying cause of depression is not simply low levels of certain chemicals in the brain (such as serotonin) that these drugs treat. ~Wikipedia
I fear in making this point, some people who have struggled with depression, anxiety, or other emotional issues in the past will be upset and say that I’m discounting their experience. I hope I am wrong in believing that, as the truth is far from it. I firmly believe that there are many people that have come through hard times and that they took drugs at some point and the symptoms subsided or went away. Hodges and Rose would say the same. The point is not what happened as a person gets through emotional turmoil; the issue is what really caused the emotion turmoil in the first place. When we focus on the end of an issue instead of the beginning we focus at the wrong part for diagnosis and are sorely tempted to come to the wrong conclusions.
2) The Placebo Effect appears to account for a large portion of those cured of emotional troubles. Earlier I cited a study where the placebo effect was greater than the percentage of people cured of depression by St. John’s Wort and Zoloft. You may be thinking this is a fluke, but Richard A. Griggs PHD wrote in his book Psychology a Concise Introduction that the placebo effect might account for more than 50% of a drug’s effectiveness. In this case he was talking about chronic pain reduction, but the principle holds true. The placebo effect is a large portion of why people are cured from their issues. He goes on to say that the placebo effect of drugs today is greatly increased over that in 1996. He theorizes that this is true because our culture uplifts drugs as a cure all. Other cultures don’t have such a strong placebo reaction and also don’t have such a strong drug culture.
Again this does not mean that people aren’t cured by the drugs. The pain may very well go away, but it isn’t the drug that cause the relief you experience. And just as ex juvantibus doesn’t diminish the reality of the curative experience you might have gone through, neither should this.
If mental health issues are not biological than what are they? What further role to psychologists play? Dr. Armand M. Nicholi said:
The more we develop and use psychopharmacology drugs, the more we realize that these drugs usually must be combined with psychotherapy to be more effective.
~ Armand M. Nikoli, Jr., MD, Harvard Psychiatrist The Harvard Guide to Psychiatry 3rd Edition
I saw this same sentiment echoed in other psychologists. The issue we must worry about at this point is that the science suggests that the drugs aren’t the cure. The main thing that seems to be working here is therapy/counseling.
Counselors everywhere will tell you that there are no easy fixes to complex mental states and emotional issues. And they are correct. The brokenness that is felt and experienced by so many people that are suffering and have been labeled as Anxious, Depressed, ADHD, OCD, Bipolar, et cetera are very real, intricate problems that create complex issues on both personal and interpersonal levels. If the issues we face as individuals are not biological or chemical, then the solution to our problems must be sought out in counseling.
This truth is born out in the the psychological realm. Not only do the psychologists who advocate drugs also advocate for counseling, the scientific studies have proven the effectiveness of counsel. Speaking about patients that went to receive therapy/counseling Griggs had this to say:
The average psychotherapy client was better off than 80% of the people not receiving therapy. (Source: Psychology: A Concise Introduction)
What’s amazing about this, is the type of counseling didn’t matter. Whether good or bad counsel – counsel is better than none at all.
The point here is that therapy is effective, and drugs have not been proven to solve complex emotional issues. This is the role psychologists should fulfill. Their aim should be to help you take view of your life (where you’ve made good and bad decisions and where you’ve been hurt by the actions of others) and help you find a way to move forward in good conscience. These complex issues are best resolved through intentional counseling.
This can best be summed up in a quote allegedly* from Steven Hyman:
We psychiatrists have been given an impossible task. Our medications are sometimes able to alleviate symptoms, though they often come with side effects. But we cannot give people what they really need. People need meaning and relationship.
~ Steven E. Hyman, MD, Former Director of the National Institute of Mental Health (NIMH). This quote is supposedly taken from a National Public Radio (NPR) show entitled “The State of Psychiatry in America Today.”
*This quote is originally cited by the Christian Counseling & Education Foundation (CCEF) in a DVD series called “Psychiatric Disorders.”. I reached out to the Broad Institute, where Steven Hyman now works. A spokesperson says he never said it. I reached out to CCEF for clarity, and a spokesperson there said they also couldn’t find the source material but that it was a summary not a quote from a talk on NPR in the late 90’s. This caused me to go on a multi week long search to find the original airings of NPR broadcasts in the 90’s. I eventually was able to get my hands on all three of Hyman’s segments from the 90’s (plus one from 2000) and none of them come close to this summary. I leave it here for two reasons: First because I think it’s a good summary of the argument I’m presenting. And second, because I want to show that I did not take any of these quotes at face value. I pursued them until I could hand over hard evidence.
Disclaimer: For any unbelievers reading this, I have only referenced medical and mental health professionals up to this point. It is my hope that in referencing experts and laying out the some of their quotes that are in conflict with that we see in the average debate/conversation about mental health issues, that you’ve been given something to think about. I hope that some of your assumptions have been challenged and that you are able to begin to reform your beliefs and foundations for your view of mental health. At this point you may want to stop reading, because I am about to move from the hard facts of how many leading psychologists think about these issues to the way Christians think about these issues. If you’re curious to know about the Christian view of psychology and counseling, please read on, but where you wish to interact with the facts as presented by scientific experts, please consider this the end.
Counseling As Cure
Disclaimer 2: For those who are choosing to read on, know that I am about to present three views on Christian counseling and point to the one I think is most Biblical. There are actually more like five views on Christian Counseling. I will review them all when I review the book Psychology & Christianity Five Views by Eric L Johnson in a couple months. For this section, I will be a bit more simplistic.
Counseling is an essential part of life. We all seek advice from friends and family when life gets hard or our emotions are overwhelming us. And that’s all that counseling is, seeking advice from someone who has training or experience to give us answers. Sometimes we think the only training that is necessary is being alive. That’s why we ask our friends how we should go about getting someone to fancy us. Other times, the counselor must have extensive training and experience in order to be useful. Which is often why we seek out professionals to help us through depression or anxiety.
Unfortunately, not all training is created equal. And how can it be? If the goal is good advice that frees us from our trauma, the counselor has to base that advice on some worldview. If it’s based on humanism, the advice will come out self serving, if it’s based on views that are more pantheistic, the advice will be more about accepting the current suffering to prepare you and grow you for the next life. Each worldview directly feeds into the type of advice we give each other; psychologists are not exempt from this statement.
Even in theistic (specifically Christian) circles the kind of advice you get can vary widely. There are at least three views in Christian Counseling.
1) That the Bible doesn’t address mental health and thus we should embrace secular psychology. This view must be rejected outright for we see counseling happen all throughout the Bible (Job 2:11-13, 4-42; Jon. 4; Mat. 5-7; et cetera) and the Bible specifically commands counseling (1 Thes. 4:18, 5:11 & 14,;Heb. 3:13; Col. 1:28; and Rom. 15:14)
2) There are those that attempt to merge (integrate) secular and theistic views on counseling, reasoning that while the Bible is fully true, not all truths are in the Bible (the Bible doesn’t teach math, it just assumes it).
3) Lastly, there are others that argue that the vast majority mental issues are sin issues – whether caused by them or as a reaction to things done to a person by others. Most issues that come up in the counseling office deal more with things done to someone and not the sin they themselves have committed. (Some well known diseases would be exempt here: hypothyroidism, hyperthyroidism, Cushing’s disease, Huntington’s disease, brain tumors, and pancreatic cancer are a few examples)
I went to a college that taught integrationist counseling (the second option in the list above). They sought a merging of secular ideas and biblical truth to get to a more perfect counsel. They took the works of prominent secular psychologists and distilled their lessons down and took the ones they thought didn’t contradict the Bible and began using them along with the Bible to try and solve the issues of our day.
On the surface, this may not sound that bad, but the integrationist has a problem. They have to decide for every issue that arises: does the Bible talk about this and provide a solution? And often times, they will decide that the Bible doesn’t talk about it and take whatever secular approach seems most beneficial. The issue here is the subjective nature of the method. One counselor might find that drugs are the solution to the problem, while another might elect for therapy. One counselor might see that someone is struggling with Impulse Control Disorder, while another might call him out as a thief.
In school I found this subjectivity incredibly disturbing. For instance, how can Christians say that there is never anything wrong with anxiety when Jesus clearly calls believers to “not be anxious” (Matt. 6:25-34). If Jesus tells us not to be anxious, then he’s telling us it’s possible to not be anxious. Which means anxiousness is usually a sin. Taking drugs to relax your anxiety may make you feel better, but it doesn’t relieve the underlying issue. If the Bible calls something out as a sin, you can be assured it gives a method for dealing with it (for this example see Matt. 6 and Phil. 4). If you are properly responding to the emotions you have, drugs may be able help you get through these hard moments… but the most important thing is that you are actively taking the right steps in response to God. (However, as pointed to above the drugs don’t seem to actually work. Charles Hodges recommends that the best approach when experiencing emotional issues it to get a physical with your primary care physician to make sure there are no health issues and see a good counselor at the same time.)
I do not wish to make lite of anxiety or any other issue, unfortunately a full treatment on the Biblical answer to this issue is outside the scope of this article. All of our emotions serve a purpose at different times in our lives (Eccles. 3:1-8), but some of our emotions are more known for leading us down a sinful path. If you are struggling with anxiety, both of these books have been highly recommended to me: Elyse Fitzpatrick’s book Overcoming Fear, Worry, and Anxiety and Ed Welch’s book Running Scared. Please know too that reading a book will not be an instant solution. You can’t microwave change. Change is a slow process; you’re making a bouillabaisse here. (Traditionally, bouillabaisse takes 72 hours to make, making it one of the most time intensive meals to prepare.)
By calling sadness “depression” or restlessness “attention deficit disorder” it secretly imputes biological causes for which there is no evidence.
~ Eric R Maisel Ph.D in The Great DSM Hoax
The unpleasant emotions we feel (anxiety, guilt, dejectedness, anger, et cetera) are warning signs for us to change our behavior. Just like the feeling of physical pain tells us to remove our hand from the stove before severe damage is done, negative emotions tell us to change our actions before our spirit is harmed. We need to listen to our emotions and react appropriately.
There’s a story I heard recently about a woman who had a particularly hard pregnancy and she went into postpartum depression. She went to the doctor not knowing what was wrong, and the doctor prescribed her antidepressants. Which led her into a cycle of trying to find the best drug, but none of them were working. After a long series of attempts and failures to fix the problem, she went to see a Christian Counselor (who also happened to be a gynecologist). She explained to him how her trip through antidepressants began and that they weren’t working, and he exclaimed “they’re not working because there’s nothing wrong with you. It’s perfectly natural for you to be feeling those feelings given what you’ve been through.”
When tough emotions hit, one of the most important things we can do is work through them.
The idea that metal health issues are all chemical imbalances of the brain is not a view held by many psychiatric experts, and it ought to be abandoned by the world at large. Science does not support a biological cause to most mental health issues. Given that, when we are feeling negative emotions, we should keep in mind that this is part of life. We all have highs and lows, so the best thing to do is seek out godly counsel to help us through the toughest lows in our lives.
Of the three Christian views on counseling outlined above, I side most closely with the third (Scripture has an answer for our negative emotions). I think it lines up most accurately with what the Bible has to say and with real life experiences. However, I do think there are some physical ailments that can lead to mental health issues. For instance, if your thyroid has been damaged, you are more prone to feelings of depression and lethargy. It will take a medical doctor to help fix that damage, and not a counselor. During that medical treatment, both kinds of professionals can work together to help you through your toughest spots. That said, physically caused mental health issues are pretty rare, most people experiencing these emotionally driven mental health issues will find that they are caused by some kind of loss or hurt done to them.
Christian Counseling isn’t so concerned with the emotions you’re feeling as it is with how you respond to them. If the Bible lays out a method for solving an issue you are facing and you believe in God, you have a clear path for what you must do. Follow the path God has laid out before you! If you don’t believe in God, you still have hope; hope found in relationship with Jesus Christ and the redeeming work of his life, death, and resurrection. If you’d like to know more about what having a relationship with Jesus means, please contact me, I’d love to talk to you about it.
Additional Resources (besides those linked above):
12 Shocking Facts About the Dangers of Psychiatric Drugs by Dr. Edward Group DC, NP, DACBN, DCBCN, DABFM
A Theology of Christian Counseling by Jay E. Adams
Christian Counseling from PBS (Not a fan of this source, I don’t think the counseling here is presented in a way consistent with Scripture)
Christians, Psychotropic Drugs, and Biblical Counseling by the podcast Care & Discipleship
Dangers Related to Psychotropic Drugs from Dr. Josh Axe DNM, DC, CNS
Good Mood Bad Mood by Charles D. Hodges, M.D.
New Clue to How Lithium Works in the Brain from MIT News
Psychedelic Mushrooms Help Your Brain by Stephanie Larsen
Psychiatric Disorders: A biblical approach to understanding complex problems from CCEF
Psychology & Christianity Five Views edited by Eric L. Johnson
Review: The 21st Century Brain 2005 by John McCrone
Stereothreat by the podcast Radiolab
The Fix by the podcast Radiolab (I’ve listened to the last 2-3 years of their podcasts over the last few months, but this one is relevant to this conversation.)
The 21st Century Brain by Chris Nunn
The Work Required to have an Opinion by Charles Munger, Psychologist