22 June 2007

Helping people: beware category-confusion

by Dan Phillips

Four propositions:
  1. There is no therapy for sin
  2. Repentance is inappropriate for brokenness
  3. Category-confusion / misdiagnosis can be very harmful
  4. However, the sin and brokenness can work in tandem
Expansion. A wrongheaded, un-Biblical compassion has led to the abandonment, by many, of the categories of sin and repentance. We don't like making people feel guilty — more to the point, people don't like being made to feel guilty! So, rather than speaking of actions as sins, and people as sinners, and urging repentance, many prefer more psychological terms.

So, now, people don't sin; they make mistakes. They aren't sinners; they're broken. They don't need repentance; they need healing, and therapy.

You know what I'm going to say next, don't you? Maybe not.

Truth is, people do make mistakes. People are broken. And people do need healing. But people also sin, are sinners, and need repentance.

Here's where it gets dicey.

The first problem is in correctly diagnosing which is which, so as to point this soul in the right direction. Misdiagnosis can be absolutely disastrous.

Take for instance a woman I met some twenty years ago. She told me she had spent years in a deep, dark depression. She had packed on a lot of weight, and her life had pretty much gone down the toilet.

What do you say, doctor? What is your diagnosis? Sin can cause depression, can't it? Yes, indeed it can (cf. Genesis 4:5-7). So shall we urge this woman to root out the sin in her life, and repent — and, if that doesn't work, tell her she clearly either hasn't confessed all her sin, or hasn't sincerely repented?

In this case, that would have been some serious soul-malpractice. This woman's doctor diagnosed (if I recall correctly) an issue with her thyroid, and prescribed a supplement. The change was dramatic and almost instantaneous. She saw herself in the mirror as for the first time, and completely changed her life. Cause: strictly glandular.

However, suppose someone comes to us with all sorts of physical and emotional symptoms. This person is in physical pain, can't sleep, is plagued with fatigue, free-floating fears and anxieties, and with a sense of impending doom. Physical symptoms... must be physical cause, right? This is clearly a broken person who needs encouragement, medication, affirmation, and assurance. Right?

Except Scripture shows that unconfessed sin can cause symptoms both emotional and physical.
For my life is spent with sorrow, and my years with sighing;
my strength fails because of my iniquity, and my bones waste away.
(Psalm 31:10)

For when I kept silent, my bones wasted away
through my groaning all day long.
4 For day and night your hand was heavy upon me;
my strength was dried up as by the heat of summer. Selah
(Psalm 32:3-4)
What to do?

's counsel is good: "Do not be hasty." If you know there is sin in someone's life, then the loving thing to do is point him to the only remedy for sin: the blood of Jesus Christ (Ephesians 1:7; 1 John 1:9).

Counseling will not alleviate the guilt, power, nor dreadful side-effects of sin; therapy will not, medication will not, self-help will not, self-talk will not, positive thinking will not, possibility thinking will not, living our best life now will not, being purpose-driven will not, Jabez' prayer will not — nothing is a sovereign remedy sin except the blood of Jesus Christ, which is applied to us through repentant faith.

In fact, if any of those "remedies" does succeed in dulling the ache and misery of guilt and its accompaniments, then the person is twice as bad-off as he was before. That he can now stick his hand into the flame without feeling pain is not a good thing.

But at the same time, remember that there can be an interplay in the same person. Elijah was very depressed (1 Kings 19:4). Why? I reason from the cure to the cause. God did four things for Elijah, directly and mediated:
  1. Got him some food (vv. 5-8)
  2. Got him some rest (vv. 5-6)
  3. Gave him some corrective counsel (vv. 9-18)
  4. Got him some assistance (v. 16b)
From this, I reason that Elijah's depression had physical, spiritual, and cognitive elements to it. Dealing with any one aspect, in exclusion to the rest, would not have truly helped him.

What is the practical, perhaps pastoral upshot? Caution, care, and humility are called for. Wisdom is called for. Depression can have any one or five of a dozen causes, easily. Piling guilt on someone who is simply overworked, oppressed, abused, or melancholy, will exacerbate the problem. Equally, affirming and encouraging someone who has rebelled against the Word of God is worse than worthless.

In our culture, too many rely on formula's and quick-fixes. Beware the pastor with 5 "P's" to banish depression. Don't be that pastor. People aren't reducible to snappy formula's. We were created complex, and then sin made us complicated.

"Flee fornication" is not complicated. "Why do I always feel so sad?" can be very complicated. You like being treated as an individual, and not as if you're mass-produced widget? Then do unto others.

Dan Phillips's signature


~Mark said...

Thanks for a great and important post. This is one of the most abused areas I see on a daily basis in almost every church I deal with.

You really hit the nail on the head with th emost important key: don't rush. Take the time to investigate the life of the person coming for help. If you know that person is involved in some great sin, you know where the major part of the problem lies, but you can still, in love, start with a conversation over a meal.

Unless of course, you're close to this person already and you've earned a level of personal intimacy which allows you a more blunt approach.

One of my biggest problems turned out to be a chemical imbalance which God brought to light through a friend, and after getting treatment I was much more able to tackle the issues of sin in my life.

There were also times when loving friends had to tell me I was just coddling a sin, and when they pointed it out, I realized that I sometimes had blind spots which they helped me overcome just by speaking up.

Daniel said...

This is stunningly timely and specific> for my ministry at the moment DJP. I don't know who else the Lord intended to read it, but I was definitely supposed to.

Thanks again.

CalvDispy said...

Diagnosing people's problems is tricky and difficult. It requires a lot of wisdom and discernment. And at that rate you wonder whether you've accurately understood the problem. It is perhaps the most difficult part of pastoral ministry. Thanks for the insights.

Tom Chantry said...

I would title this post: Why Every Counseling Formula Is Flawed. Formulas tend to presume and address a single issue. Life is too complex to work that way. This is why elders are to be men of wisdom and maturity, and why they require constant prayer. A weekend seminar can prepare you to counsel, but much more is required to be a shepherd of souls.

DJP said...

Good title, Tom. Or, "Helping people is HARRRRD"?

DJP said...

Or, "If helping people isn't being hard, you're probably not doing it right."

Kinda long, though.

Tom Chantry said...

I like it, though. It says a lot!

mark pierson said...

I was glad to read this today. There are no quick fixes. Spurgeon points this out in his Lectures To My Students. What can be dealt with today with a hug, may have to be dealt with with a frown tomorrow, even while dealing with the same person. Sometimes medication, sometimes confession and repentance.

Jon Nunley said...

This is such an excellent post.

Another aspect of depression that I have found when in counseling situations is not so much a sin issue per say, as it is a self-pity issue.

That is why I love your encouragement to take time and not rush into some diagnosis.

As soon as you feel too old to do a thing, go out and do it. As soon as you feel critical, say something kind in a kindly way. As soon as you feel neglected, send a cheerful note to a friend.
~ Oliver Wilson

Jon's wife, Lisa

Matthew Henry said...


Good post. I found a book that was of great help the more fully develops much of what you just posted here. It is "Blame It On The Brain" by Ed Welch. Highly recommend it.

Jon Nunley said...

I know... self-pity is a sin issue... but... You know what I mean.

jsb said...

Dan, I'm making my way through Lloyd-Jones's "Spiritual Depression" (yucky title), and finding it deep and uplifting. Totally biblical, too.

So often these days, uplifting sermons are like so much foam on the top of a Cap; and then they throw away the Cap.

David said...

To quote the Simpsons;

"I've found that there's more to ministry than not caring about people."

To quote James;

"Is anyone among you suffering? Let him pray. Is anyone cheerful? Let him sing praise. Is anyone among you sick? Let him call for the elders of the church, and let them pray over him, anointing him with oil in the name of the Lord. And the prayer of faith will save the one who is sick, and the Lord will raise him up. And if he has committed sins, he will be forgiven. Therefore, confess your sins to one another and pray for one another, that you may be healed. The prayer of a righteous person has great power as it is working."

Thanks for the post. Is good.

Sewing said...

This is a very insightful post. There's a lot here to ponder and think about, and I have no doubt I'll have reason to call upon the advice you provided here at some point in the future. Thank you, Dan.

But can I also say the graphics for this post are superb in their simplicity and expressiveness? The broken logo, the reintegrated (made right) Rubik's cube. Who does all the graphics, anyhow? All of you? Phil?

DJP said...

Most of the Pyro logo graphics, specifically, are Phil. Lately, Frank's been doing some. My count stands at... let's see... carry the zero... hmm....



Sewing said...

Doesn't matter. You all contribute in your own particular ways. Praise the Lord for your work.

DJP said...

~mark — This is late, but to add to your story, I knew another lady, who had a doctor almost tangentially discover a B12 deficiency. Another marked improvement in overall mood and outlook, no psychotropic drugs, a physical issue.

Even So... said...

(stand back, hearing aids down, please)

Praise God Almighty!

Seriously, DJP, you've hit it on the head...there is no such thing as Cookie Cutter Christianity©...and those deliverance ministries that want to do it in a flash are just a flash in the pan of the flesh...

brentjthomas said...

It is always fun to read a good sermon with Biblical quotations and a quotation from an Ent sage.
I have been told that my name "Brent" was chosen for me because it has "Ent" in it.
Thank you for your post. I'd thank you in Entish, but such an expression of gratitude would be very lengthy.

Matt said...

Superb, Dan.

KristineT said...

"Helping people is HARRRRD"

Love it *chuckle* but, it's SOOOO true!

I have to completely agree with Daniel's comment on this post, concerning the timeliness and appropriateness of it's message. Indeed.

Wonderful, Dan. Thanks.

Brian said...

Thanks for the post. It helps me solidify many of my own thoughts.

Anonymous said...

Well said Dan. I just know that you are prepping yourself for some kind of ministry. I seems too obvious. May God continue to work in and through you brother. Also, great sermon last week brother. I didn't get to hear the evening one. But the morning one was awesome. Those are the kind of tear jerkers I don't mind. Unlike the three jokes and a sad story kind.

I am reminded that the Puritans were called "Physicians of the soul". And that, for good reason. They really got down to the heart of the matter that ailed people. I think you hit the nail on the head here.

JulieMom said...

This was a great post. I have read several of your previous posts, but this one caused me to blog about it. Thanks for your insight and challenge. God bless you!

Vicki said...

Oh this is SO good. I'm glad somebody finally addressed the complexities of the matter. All too often, we've been hasty to judge or offer counsel. Having suffered through more than one major depression in my adult life, I found everything you shared to be true, only it took me nearly 30 years to gain some wisdom about it...

God bless you!

~Mark said...

"~mark — This is late, but to add to your story, I knew another lady, who had a doctor almost tangentially discover a B12 deficiency. Another marked improvement in overall mood and outlook, no psychotropic drugs, a physical issue."

Yup! B complex vitamins are being discovered to be vital in everyday body functioning, and probably not coincidentally the clinic that treats my ADHD was founded by and run by Christians! (Not a necessity, butanice surprise.)

Having said that, I DO believe that once sin is found to be the primary problem, it does become a "quick-fix" issue: go and sin no more. ;)

Sparrowhawk said...

Dan, how does this post best apply to Nouthetic Counseling?

DJP said...

What I remember and understand about nouthetic counseling doesn't conflict with anything I've said, I think. Adams left room for issues rooted in truly physical causes and, as I recall, advocated working in conjunction with a good physician. Plus, I think that the image of nouthetic counseling as saying that every problem is directly rooted in a particular sin is a caricature, and not accurate.

Emily Gaskin said...
This comment has been removed by the author.
EG said...

Great post... encouraging. I went to my pastor recently for counseling on depression. Does anyone think that taking medication (for anxiety or depression) is a sin? (Or simply not trusting God?) I'm really struggling with this one...! I've read the word translated "sorcery" in the Bible is the Greek word pharmakeia, where we get the English word "pharmacy."