Why do people always assume nouthetic counseling is against depression medicine?

Discussion in 'Church Order' started by BayouHuguenot, Jul 9, 2015.

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  1. BayouHuguenot

    BayouHuguenot Puritanboard Amanuensis

    Whenever discussions about nouthetic counseling come up, people always throw the charge that the Jay Adams school is against using medicine to treat depression. Or said another way, "Depression is caused by sin."

    I have been told by students of this school that is a straw man. Perhaps it is, but why is this a recurring criticism? Is there some earlier basis of fact?
  2. Pergamum

    Pergamum Ordinary Guy (TM)

    Here is Jay Adams from his book Competent to Counsel:

  3. Pergamum

    Pergamum Ordinary Guy (TM)

    ...and again:

  4. Pergamum

    Pergamum Ordinary Guy (TM)

    From The Christian Counselor’s Manual…

  5. BayouHuguenot

    BayouHuguenot Puritanboard Amanuensis

    Thanks. Would you happen to have page numbers?
  6. Pergamum

    Pergamum Ordinary Guy (TM)

    Sorry. Not sure.
  7. Ask Mr. Religion

    Ask Mr. Religion Flatly Unflappable

    First and second quotes from pages 93 and 48, respectively.
    Third quote from page 9.
  8. psycheives

    psycheives Puritan Board Freshman

    Excellent question and quotes and page numbers. Good job, guys. This is helpful.

    I understand CCEF and Westminster Theological Seminary Philadelphia's classes to have moved away from such a strict view and they hold a more positive view on medicine. Also see David Murray's views in his Christians Get Depressed Too book. They leave room for physical causes of depression (like issues with the Thyroid) due to the fall, acknowledging that our bodies are broken in may ways that they originally were not.

    I understand Association of Certified Biblical Counselors (formerly NANC) and many of my previous MacArthurite/Baptist churches (who generally endorse/teach and are part of NANC) to take a middle road between Jay Adams' view and CCEF. They require certified counselors to read Adams but take a softer approach in supplementing him with CCEF materials and admitting he was a bit strict.
  9. SolaScriptura

    SolaScriptura Puritan Board Doctor

    I agree that medicines are "mere" relievers of symptoms. I liken it to putting a man in a straight jacket: his ability to flail and harm himself or others is inhibited, but nothing about his heart or mind that led to the situation has been affected. Thus as soon as the straight jacket (medicines) are removed, he's back in the same old mess. This is why treatment of emotional/behavioral problems with medicines is deficient. Please don't read me as saying controlling symptoms is bad. Not at all. But what is bad is the all too common idea that equates symptom management with having fixed the problem.
  10. Pergamum

    Pergamum Ordinary Guy (TM)


    Agreed. But you're not willing to discourage all medication and denounce all of psychology as bunk, right? You see that a temporary back brace may help until the patient builds up the muscles of his back, right? And that psychology may have some usefulness.

    I think Jay Adams saw all the abuses of psychology and reacted very strongly.
  11. BayouHuguenot

    BayouHuguenot Puritanboard Amanuensis

    Right--and few secularists today take Freud seriously. Once medical and chemical diagnoses came onto the scene, Freud's psychoanalysis became laughable.
  12. DMcFadden

    DMcFadden Puritanboard Commissioner

    With the rise of epigenetic science and proof that behavior can change our DNA, I wonder if chemical imbalance is always the cause of the depressive symptom or the depressive symptom is often the cause of the chemical imbalance.
  13. R Harris

    R Harris Puritan Board Sophomore

    What date or edition do you have for the "competent to counsel" book?

    I heard from a nouthetic counselor here in OK a few years ago that Adams had somewhat softened his views - at least to the point that drugs should be a last resort, which I would wholeheartedly agree with.

    It is a fact that sometimes physiological factors - such as hormone imbalance - can lead to depressive symptoms or behaviors. Treatment for this can help, but the vast majority of times it is not the definitive solution for the problems at hand, which is what the nouthetic counselors try and tell people.
  14. Semper Fidelis

    Semper Fidelis 2 Timothy 2:24-25 Staff Member

    Some things worth looking at:



    The Mohler interview is fascinating and the researcher's own conclusion that the mental health community has gone much further than it ought to have. He categorizes most mental illness as the "worried well" while acknowledging the existence of real psychiatric problems.

    I think the things that have been added into mental health categories make it very difficult to sort out what, precisely, is mental illness.
  15. Pergamum

    Pergamum Ordinary Guy (TM)

    Here is a typical article on depression by those who follow Adams:

    Note that the author denies that depression is a disease or illness because a disease or sickness involves damage to some part of the body, whereas depression is merely a mood. Also, notice how the author is suspicious of any theory of depression which involves an imbalance of chemicals in the brain. His type of argumentation also usually includes studies showing the over-medication of antidepressants and studies which seem to disprove the current monoamine theory of depression.

    The author goes further and states:
    and also (in a step that some authors stop shy of) states:

    In general, I think articles like this are both helpful and unhelpful. They are helpful in that they challenge the accepted notions of psychology, many of which cannot be proved through empirical research. But I also find articles such as this unhelpful in that they overstate their own case and go too far in the other direction, equate depression with sin, poo-poo all medications for depression, are overly suspicious of theories which factor in chemical influences over our mood, and often treat Christian counselors and psychologists who find merit in the secular field as if they were compromisers or inherently sub-biblical (i.e. there is only biblical way of practicing psychology).

    I believe that the bible shows us cases of depression that are not sinful and that chemical/physical/biological factors play a large role in our tendency towards depression (depression running in families, occurrence of depression in identical twin studies, post-partum depression or episodes where large health or hormonal changes coincide and seem to cause depression, etc), and I also believe that the verdict is still out on the monoamine theory of depression and that it seems like chemical deficiencies might play a role in mood.
  16. Pergamum

    Pergamum Ordinary Guy (TM)

    Here are also two relevant articles that seem to cover several perspectives:


    In that article is an AMA study, and it is interesting the conflicting ways in which both sides read that study:

    Here is another article: http://www.psmag.com/health-and-behavior/evangelical-prayer-bible-religion-born-again-christianity-rise-biblical-counseling-89464
  17. BayouHuguenot

    BayouHuguenot Puritanboard Amanuensis

    While I disagree with the earlier Adams School (assuming that they changed their views), it is true that there is a tendency to always prescribe something in terms of medicine. And there is such a way where Adams' Disciples and the medical community can be off. Sometimes depression is triggered by lack of sleep et al (my own case when my newborn was ill). Contra the hyper-nouthetics, I wasn't in carnal rebellion, but contra Big Pharma, I didn't need 200mg of Prozac. I just needed a week of sleep.
  18. Pergamum

    Pergamum Ordinary Guy (TM)

    You needed a physical change, albeit not meds. Not merely "take two Scriptures and call me in the morning" and "repent of your depression." Exercise, diet, outside walking, mental change and variety, good smells, and good health are all physical components which effect a mood change. Poor diet, poor surroundings, poor rest, and poor exercise patterns seem largely at the heart of many peoples' bad moods. I might even say that these things impact the chemicals in your body.
  19. BayouHuguenot

    BayouHuguenot Puritanboard Amanuensis

    That's exactly what I did. I invested in kettlebells. I started systematically doing hand stand push ups, bent presses, one leg squats, back bridges, and the like. I literally felt new life coming into me. I might start a ministry and call it Judges14:5 Ministries.
  20. Pergamum

    Pergamum Ordinary Guy (TM)

    Ha. Yes. Sign me up for your ministry newsletters then. I prefer long hikes....I'll start a competing ministry and denounce yours as sub-biblical. I just need a bible verse for mine...
  21. Ask Mr. Religion

    Ask Mr. Religion Flatly Unflappable

    The quoted page numbers I provided are from the Logos versions of the book.
  22. MW

    MW Puritanboard Amanuensis

    Why is it assumed that counselling is therapeutic? The disobedient chooses death over life. It is a part of the perfection and righteousness of the providential order when people bear the consequences of their choices and actions. How else will they learn? How else will God's ways be vindicated. The counsellor must beware that he is not telling lies for God or working contrary to the providential order.

    I think this is what Jay Adams was originally driving at. While the issue is understood to be moral it must be dealt with in terms of scriptural imperatives. If it is conceded that the issue is not moral, it really has nothing to do with the counsellor, and it falls to the sphere of the physician.
  23. Pergamum

    Pergamum Ordinary Guy (TM)

    Not sure I understand your point?

    What does this mean?

    There are a great many issues where a physician may not be needed, but neither is the issue directly moral or spiritual. Weight loss strategies, sleeping problems, improving social skills, etc. A pastor may help somewhat, yet these areas being not always directly moral, there seems nothing amiss in getting advice from others as well.
  24. MW

    MW Puritanboard Amanuensis

    The pastor is not a guru. Distinctively "Christian" counselling has nothing to do with these things. Consider what our Lord said to the man who asked Him to tell his brother to divide the inheritance with him.
  25. OPC'n

    OPC'n Puritan Board Doctor

    Low levels of serotonin is real and causes a multitude of illnesses not just depression. Levels of serotonin can be obtained via blood draws. Some of the effects of low serotonin are:

    "Serotonin exerts its major effects on the parts of the brain responsible for controlling mood, appetite, sexual desire and performance, sleep, memory, learning, social interactions and temperature regulation.

    However, outside the brain, serotonin also affects the cardiovascular system, the endocrine system and muscles. It has even been found to contribute to the regulation of milk production in the breast." Here is a link about low serotonin its effects and ways to increase the levels.

    There are a number of ways to increase your levels of serotonin which include diet and exercise, being in the sun, and medication. To ignore any symptoms of low levels of serotonin, is unwise. I say all this bc many times depression isn't a sign of a "bad" relationship with God. It's the least understood organ in the body. It's also the least testable. I've seen some of my patients who have had an injury to their brain become completely different people both in mood and behavior. The brain uses chemicals and electricity to function and help other organs function. We shouldn't treat it any differently than we would any other major organ.
  26. Pergamum

    Pergamum Ordinary Guy (TM)

    I think we might agree. I never said the pastor should necessarily be involved in these issues. There are psychologists and other gurus who might help people with such problems, and such help is perfectly legit (i.e. all psychology and forms of counseling that are not pastoring/discipling is not bunk, but there are certain areas of help and benefit they can perform, even if from a non-religious perspective). Some coaches are great for increasing strength, losing weight, and some counselors are good at motivating people to eat right or sleep well or reducing fear of flying, etc. We need not discredit their legitimacy or claim that one must necessarily do all of these things in a "Christian way" for us to acknowledge some benefit from their services.

    Your statement seems to prove my own dismay that so many pastors spend so much time in "Biblical Counseling" and that so many seek out their NANC certifications and focus so highly on this area. It seems an area of overmuch focus in some circles. They are spending hours and hours in intimate counseling with fragile women and many fall, and some count this time counseling as "an evangelistic opportunity" such that they seem to equate biblical counseling with evangelism such that evangelism decreases. Pastors should preach, evangelize and disciple and i don't see counseling as synonymous with any of these key areas of focus pastors are charged with doing. Therefore, I remain very ambivalent about Jay Adams and the movement he started. Much of it was needed, but some of it became out-of-balance.
  27. MW

    MW Puritanboard Amanuensis

    The minister has the charge to feed souls with Word and sacraments. He doesn't study for the ministry so that he can do brain surgery. He must leave these things to those who know what they are doing.

    Dr. Adams' first concern was for the pastoral ministry. Psychology was negating moral norms and psychiatry was overtaking the roll of pastoral care. In this situation he carefully defined the sphere of service which the pastoral charge must defend if it is to remain effective. Without a knowledge of this sphere the minister will end up becoming a therapist without any moral authority. His clarifications were much needed, and well stated in the book on shepherding. I think once it extended beyond the pastor's office it started to move in on the territory of other professionals, and that is where it became problematic.
  28. Reformed Covenanter

    Reformed Covenanter Puritanboard Commissioner

  29. Pergamum

    Pergamum Ordinary Guy (TM)

    Thanks. Yes, I agree.
  30. R Harris

    R Harris Puritan Board Sophomore

    I think what you have said here, combined with Matthew's comments, is the proper approach. The danger is swinging too far in either direction. It really takes a lot of experience and discernment to really be a strong, competent counselor to know what the proper remedy is in some complex situations.
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