Three Competing Realities around Mental Health
by Dan Tsouloufis (Guest Post)
As a certified biblical counselor, I have been observing three competing realities in our society around the issue of mental health, as well as the purported solutions being offered by the clinical mental health industry.
In my observation of these three competing realities, my goal isn’t to explain the causes or influences of the mental health crisis in our society, but rather to establish that our current mental health industry seems to be missing the boat in its diagnosis, while also being ineffective in its purported solutions.
The first reality is that in the past couple of decades, there are more resources than ever for people dealing with some sort of mental health issue, whether it’s for anxiety, depression, attention-deficit disorders, eating disorders, obsessive-compulsive disorders, substance-abuse disorders, gender dysphoria, and many other disorders. In attempting to deal with these myriad mental health issues, there is an abundance of licensed clinical social workers in most schools across the country; there is an abundance of licensed clinical mental health therapists in various counseling centers across the country; and there is an abundance of psychologists and psychiatrists in most hospitals and in-patient/out-patient mental health centers across the country. In addition, there is an abundance of pharmaceutical drugs that are purportedly designed to remediate, or at least lessen, the severity of various mental health issues.
The second reality is that we live in a day and age of unprecedented creature comforts as well as an unprecedented standard of living in comparison to the history of civilization before 1950. Moreover, we have access to advanced medical care that is unprecedented in comparison to what was available in 1950. In addition, there are more educational opportunities than ever for people who are seeking community college, or university, or various trades. There are student loan programs available, as well as many scholarship and grant opportunities. In addition, while living in America is not perfect, its citizens enjoy political and religious freedoms that are unprecedented in comparison to the history of civilizations that came before ours. Yet in spite of these facts, many young people not only believe they are victims of an oppressive society that is out to get them, but they are being taught by other adults to believe this way, leaving them unable to recognize the vast opportunities and advantages of living in the twenty-first century in a free and prosperous country like America.
The third reality is that in light of the aforementioned abundance of licensed clinical social workers, licensed clinical mental health therapists, psychologists, psychiatrists, and pharmaceutical drugs of all kinds, why do we continue to see more and more people struggle with anxiety, depression, attention-deficit disorders, eating disorders, obsessive-compulsive disorders, substance-abuse disorders, gender dysphoria, and suicidal ideation? In spite of a massive and ubiquitous mental health industry, and in spite of a massive pharmaceutical industry that is purported to treat various mental health issues, the reality is that we are not observing more mentally healthy and stable people, but less. There doesn’t appear to be any tangible, measurable progress being made as a societal whole with regard to mental health (just the opposite). It seems like more people, not less, are stuck in patterns of anxiety, or depression, or dysfunction, or gender confusion, or substance abuse, or suicidal ideation.
Thus, I think it’s fair to ask: Why is our society not getting happier or healthier from a mental health standpoint? Should our response be to keep prescribing more psychotropic medications and finding more disorders to diagnose? Or, perhaps the three realities that I described are revealing that we’re not seeing the whole picture. Perhaps some of the approaches toward mental health as well as the solutions are pointing in a different direction. As biblical counselors, I think a proper response is to recognize that many (but not all) mental health issues are circumstantial in nature (due to grief, loss, trauma, etc.), plus they are heart issues and therefore spiritual in nature. This of course doesn’t negate the possibility of physiological causes for some mental health issues. Nonetheless, it is not helpful to categorize all mental health issues as having solely a physiological cause.
God created human beings with a body and a soul. As such, humans are endowed with both a material nature and a spiritual nature. Moreover, the heart is the root of our desires and motives (Proverbs 4:23; Jeremiah 17:9; Mark 7:21-23; Luke 6:45; James 1:14-15; James 4:1-2). Sin is the result of a heart that is oriented away from God and does not find its satisfaction in Him. Whereas, righteousness is the result of a heart that is oriented to God and finds its satisfaction in Him.
From a counseling standpoint, I would say that most people, whether believer or nonbeliever, desire guidance on how to make tangible changes in their lives to help them from repeating the same mistakes over and over. In addition, they desire guidance on how to have real hope in their lives (e.g. hope for change, hope for healing, hope for restoration, etc.).
However, for believers specifically: 1) they desire guidance on how to apply God’s truth and His Word to their real-life circumstances; 2) they desire guidance on how to walk with the Lord and trust Him in their everyday lives; and 3) they desire guidance on how to discern God’s plan and purpose for their lives.
Regarding my own counseling philosophy, I believe that counseling should aim at the heart. Below I have outlined four components which I believe are necessary to help the counselee develop a biblical perspective for lasting change.
First, we must uncompromisingly hold to the authority and sufficiency of Scripture and assert that the Bible is the foundation of the counseling process (2 Timothy 3:16; Hebrews 4:12). A counselor’s authority is derived ultimately from Scripture under the guidance of the Holy Spirit.
Second, it is the gospel that unites us to God, therefore the gospel should be a critical component of the counseling process. The cross of Christ is the centerpiece of the universal story of the Bible, and it gives meaning to the rest of the story. Since the gospel is the root of both justification and sanctification, our counseling should seek to point others to Christ, either for their redemption (for the nonbeliever) or their growth in sanctification (for the believer).
Third, we should counsel the gospel of grace, not moralism. Since unregenerate people cannot obey the law on their own power nor please God with their own righteousness, counseling moralism will not lead anyone to justification before a holy God. And for regenerate believers, counseling moralism will not lead to their growth in sanctification, since they need God’s Word as well as the guidance of the Holy Spirit (John 14:15-17; Romans 8:5-6; Galatians 5:16-17).
Fourth, our counseling should aim at the heart, since the heart is the root of our desires and motives (Proverbs 4:23; Jeremiah 17:9; Luke 6:45; James 1:14-15, James 4:1-2). The heart is also the root of our idols and addictions. John Calvin said that our hearts are like idol factories. Thus, real change (i.e. biblical change that results in growth in holiness and sanctification) must be cultivated in the heart, in contrast to mere outward behavior modification, which is temporary and superficial. Lasting change is realized when our heart is motivated by love for God and love for our neighbor (Matthew 22:37-40; Romans 12:10-13; 1 John 4:7-11).
From a biblical standpoint, God wants to rule in our hearts, for our good and His glory. When we experience anxiety in our lives, it is an opportunity to worship and trust God despite our fears. As such, there are three helpful questions we can contemplate in the midst of our anxiety: 1) How does God want me to view my current circumstance in light of Scripture? In other words, what perspective does God want me to have? 2) What might God be trying to teach me through my fear? And 3) How might God use my fear and anxiety to comfort and serve others in a way that would glorify Him?
In this effort, we should seek to be less self-focused and more God-focused, even in the midst of our anxiety. We are to count it all joy when we meet various trials (James 1:2). We know that suffering produces perseverance, and perseverance leads to hope. This is why we are to glory in tribulation (Romans 5:3). We are to grow in character, diligence, and patience (2 Peter 1:5-8). We do this in the face of trials and temptations, facing them with clarity and boldness. God wants us to trust Him and not be a slave to fear (Romans 8:15). The apostle Peter gives believers this encouragement: “Humble yourselves, therefore, under God’s mighty hand, that he may lift you up in due time. Cast all your anxiety on him because he cares for you” (1 Peter 5:6-7).
Lastly, as a Christian and a biblical counselor, I want to help cultivate in my counselees a Christian worldview and a biblical mindset. As such, I want to come alongside them in the midst of their sin or their suffering (or both), and I want to point them to their hope in Christ and their individual need to pursue sanctification in Christ. Their desire should be to trust the Lord and be motivated by their faith in God’s Word, His promises, and His faithfulness. That is where true peace and freedom comes from. “For the Word of the Lord is right and true; He is faithful in all He does (Psalm 33:4).
