The problem with “mental illness”

I wish there was a word or phrase to cover the mental and emotional disorders (e.g. depression, anxiety, schizophrenia) that result from both personal sin (for which we are responsible), and personal suffering (for which we are not – or not wholly –  responsible).

For example, when I sometimes write about “mental illness,” some Christians hear such “disease” terminology as denying sin, minimizing personal responsibility, undermining the sufficiency of Scripture, and ignoring the divine provisions of repentance toward God, faith in Jesus Christ, and the indwelling of the Holy Spirit. That’s not my intention.

On the other hand, I and others react against the way some Christians reject all (or most) “mental illness” categories. We see this as a serious denial of biblical anthropology, a denial of the extensive damaging effects of the fall upon humanity. Our reasoning for believing in such damage is rooted in Scripture and goes something like this:

Step 1: As a result of the fall, my body’s chemistry, physics, and electricity are damaged.

Step 2: My brain uses physical structure, chemistry, and electricity to process my thoughts and emotions

Step 3: My brain’s ability to process my thoughts and emotions will be damaged to the extent that my brain is affected by the fall.

Step 1 is a biblical fact. Step 2 is a scientific fact. Step 3 is the logical result of Steps 1 and 2.

There are three additional complications to contend with here. The first is that the brain acts as a bridge between our spiritual and physical worlds (our soul and our body) in a way that no other body part does, making it difficult to achieve clear distinctions between what is spiritual and what is physical. Second, the brain is the most complex organ in our body, with so much still to be explored, discovered, and understood that some scientists call it “the last frontier.” Third, just as with all areas of my body, the “natural” damage to my brain in Step 1 can be increased by three aggravating factors:

Factor A: Damage outside my control (e.g. genes, brain injury, aging, abuse**, shock, Parkinson’s, Alzheimer’s, etc.)

Factor B: Personal sin which is my responsibility (e.g. substance abuse, the deliberate choice to think sinful thoughts/feel sinful emotions, the refusal to trust/obey God, rejection of the means of grace, etc.).

Factor C: Direct divine intervention (i.e. God, in His sovereignty, may impact my brain processes: as a chastisement to correct my faith, or as a test to display my faith – as physical suffering did in the case of Job).

As the damage under Step 1 is increased by these three factors, so the disabling suffering in Step 3 will also be increased. But what should we call the mental and emotional disorders/effects in Step 3?

Misleading and harmful
Given that sometimes the disorders in Step 3 are the result of personal choices (Factor B), to use only “mental illness” terminology can be misleading and harmful.

But given that sometimes the disorders in Step 3 are the result of a fallen brain, or damage outside of my control (Factor A), or the direct intervention of God (Factor C), to use only “personal sin” terminology can be equally misleading and harmful.

So what do we call the disorders? “Sin” is too narrow in many cases. “Illness” is too narrow in other cases. Use of either category exclusively is inaccurate, provoking suspicion and often hostile reaction.

In the ongoing absence of mutually acceptable terminology that would allow us to speak more accurately and comprehensively, I have a number of suggestions that I hope might help to bring Christians a bit closer together as we discuss these vital matters that impact millions of suffering people. Tune in tomorrow for more details.

UPDATE: Here’s a link to that follow up post Maximizing and Minimizing Mental Illness

** See Eric Johnson’s book, Foundations for Soul Care for a review of the scientific evidence of the physical changes that take place in the brain due to sexual and verbal abuse in childhood.