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but if that lie is based on a true malfunctioning mind, do we still call it sin, while also recognizing the need for a medical fix?
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Sin is sin whether the person realizes it or not and they will have to face facts - bad mind or not. We are deluded, each of us, and that delusion can only be done away with by truth - not just statements of fact but presented to the person in "Spirit and truth."
If the Pastor can wrestle the lie that the person has believed to the ground he is doing his job - that is counseling. If the Psychologist does it the same way - in Spirit and truth - they are then being a pastor.
I am doing a study on "flesh" in the NT. There was no separation of mind and body in the NT. Paul, like in the OT, kept them together.