Tag: mental health

Desiring God and Mental Health: Name It Claim It for Your Brain (UPDATED)

Update at the end of the post…
Last week, I wrote about Kenneth and Gloria Copeland who think you can speak cures for PTSD and the flu. Today, I present a different form of name it claim it – John Piper’s Desiring God and anti-mirror therapy for mental health. Earlier today, Desiring God tweeted:


Repeat after me: Mental health is health. Mental illness is illness. Brain is body.
I suspect John Piper would cringe to think he has something in common with the Copelands but turning mental health into a spiritual fruit is in that ballpark.
Copeland says soldiers can get rid of their PTSD with a dose of Scripture. Desiring God prescribes a spiritual refocus as if those who are mentally healthy are spiritually sound.
Perhaps I am sensitive to this message due to my clinical experience with Christians. I have seen the damaging effects of messages like this and know how Christians with mental health diagnoses hear this.
Tweets like the one from Desiring God reinforce the misconception that mental health conditions can be overcome by willpower or positive thinking. Those who struggle have to deal with their illness and the stigma from those in the church who spiritualize their illness. Although beyond the scope of this post, an important issue is that, generally speaking, evangelicals have not grappled with the reality of brain as body. Consciousness arises from brain and does not reside in a spiritual substance independent of body. Like it or not, if you don’t deal with this, I don’t think you understand who we are as human beings. Knock out certain parts of our brain and we become different people. I don’t think I have ever heard a sermon or Sunday school series on the religious significance of our brains.
Some people using the Tweet advice will find comfort because they have positive associations in their brains to images of God which might take their minds off a negative personal preoccupation. However, someone else with different brain chemistry and history may not make the same associations. They may try to work their brains in the same way, but due to something out of their conscious control, their feelings do not respond in the same way. They do not and cannot find mental health no matter how long they stop staring in the mirror.
When those who don’t succeed with anti-mirror therapy go to church, they feel even worse because their faith is questioned. They are told, even if subtly or indirectly, that they don’t have enough faith. If they just believed harder or put God first, or dealt with the sin in their lives, then the advice would work.
Last year, a friend of mine wrote about the frustration of depression:

Occasionally, bouts of depression are triggered by obvious catalysts, like losing a job or loved one or some kind of overt trauma. Often, though, nothing is “wrong”. We’re not upset or sad or angry or stressed about anything particular, but our body is deploying hormones as though we’re being attacked.
It is these episodes that are most frustrating to the friends and family of people who have depression; they don’t know what to do to help because there’s seemingly nothing wrong. The victims of those moments find it doubly frustrating, as a silent, crushing dread slowly bears down on our souls, challenging us to find a name for it.

This frustration is compounded by Christians conflating mental health with spiritual status. If the Desiring God tweet had said enlightenment or satisfaction or something other than mental health would come from staring at God’s beauty, that would be fine. I hope John Piper and his crew will pull that tweet and clarify that they are not the Copelands.
 
UPDATE (2/6/18): Not long after I published this article, Desiring God posted the following Tweet:


The link is to a 2007 tribute by John Piper to Clyde Kilby. This follow up tweet is confusing because the original tweet which aroused so much reaction isn’t found in the 2007 article. The closest statement to it is this statement attributed to Kilby by Piper:

Stop seeking mental health in the mirror of self-analysis, and start drinking in the remedies of God in nature.

This isn’t at all what Desiring God originally tweeted. The “remedies of God in nature” could easily refer to medication or therapy or an experience in nature. Since Piper quoted it approvingly I don’t really know what Kilby meant. In any case, I am less concerned with the Kilby article and more concerned with the spin engaged in by whoever is running the Twitter account at Desiring God.

How Would a Biblical Counselor Handle This Case?

photo-1473508476344-269a87b502ee_optOn Monday, I wrote about the conflict between adherents of biblical counseling and Christian psychology. Biblical counseling denies the role of psychology in counseling while Christian psychology (as proposed by former Southern Baptist Theological Seminary professor Eric Johnson) uses the research and insights of psychologists to enhance counseling.
In the recent post, I mentioned a document titled 95 Theses for an Authentically Christian Commitment to Counseling. The document was written by Heath Lambert, a SBTS professor and executive director of the Association of Certified Biblical Counselors. Lambert said that the theses were written to stimulate debate. This post and future posts on the topic are written as a response to the theses.
I want to start by discussing the following statements and present a case study. I intend to send this post to Dr. Lambert and will post any response he sends.

The Nature of Counseling and the Content of Scripture
6. When people experience difficulties as they live in a fallen world, they require wisdom about life to help them face these problems (Prov 19:20).
7. The wisdom to confront life’s difficulties is most often communicated in conversations our culture refers to as counseling.
8. The issues of concern in counseling pertain to problems people face as they relate the difficulties in their life to the faith and practice described in Scripture.
9. Because counseling problems concern the very same issues that God writes about in his Word, it is essential to have a conversation about the contents of the Bible to solve counseling problems.
10. The subject matter of counseling conversations is the wisdom needed to deal with life’s problems, and so counseling is not a discipline that is fundamentally informed by science, but by the teaching found in God’s Word.
11. When the Bible claims to address all the issues concerning life and godliness, it declares itself to be a sufficient and an authoritative resource to address everything essential for counseling conversations (2 Pet 1:3-4).
12. Christians must not separate the authority of Scripture for counseling from the sufficiency of Scripture for counseling because, if Scripture is to be a relevant authority, then it must be sufficient for the struggles people face as they live life in a fallen world (2 Pet 1:3-21).
13. The authority and sufficiency of Scripture for counseling means that counselors must counsel out of the conviction that the theological content of Scripture defines and directs the conversational content of counseling.
14. The Bible teaches that the person and work of Jesus Christ provide God’s sufficient power to solve every problem of humanity so, according to Scripture, he is the ultimate subject of every counseling conversation (Col 2:2-3).

According to the statements above, a Christian approach to counseling should address life’s difficulties, and involve the Bible and Jesus Christ alone as the solutions to all problems. At the outset, we might have a disagreement about the proper subject matter for counseling. I accept the reality of mental and emotional disorders and believe that counseling conversations may also involve techniques and information which do not come directly from the Bible. But I am getting ahead of myself. Let me first present the case (some identifying details have been changed).

A mother and her second grade son attended the first session together. The father was at work. A meeting with them revealed that the youngster was afraid to remain in his school classroom. The boy attended a local public school and had never been afraid to go to school before. However, within the first month of school, his pattern was to enter school and remain in his classroom. After just a few minutes, he bolted from the room to the school office seemingly in terror and asked for his parents. This had been going on for about a month nearly every day. He remained in school on days his class attended field trips or out of class activities (e.g., library days). The parents had tried alternating morning rides to school and his father had carried him back into the classroom on multiple occasions only to have the same result. He bolted from the class looking for his parents.
On examination, the boy had male typical interests, played rough and tumble sports, was tall for his age, and was socially popular. He had never displayed separation anxiety beyond the norm prior to this year. In all respects except the fear of remaining in his classroom, the boy and his family (one older female sibling) seemed entirely normal and unremarkable from a mental health standpoint. The parents were leaders in their Christian church and the boy happily attended Sunday School and had professed a belief in Jesus as his Savior.

I realize this puts any respondent at a disadvantage. I have the details and know how the case turned out. However, I am curious to know if this kind of situation would be taken on by a biblical counselor. Given the statements concerning the sufficiency of the Bible to handle all problems, I wonder how a biblical counselor would begin and what kind of interventions would be considered.
If I don’t hear from ACBC, then I will give my best guess about how a biblical counselor would respond based on the 95 theses, and then explain how I responded, and why I think this case is relevant to the discussion about biblical counseling and Christians in psychology.
To read all posts in this series, click here.

Fallout from the Arizona shooting

Most people commenting on the Arizona shooting are speculating about motive, the role of public discourse on the shooter, and the shooter’s mental health.  I confess my bias from the start – from what I have read, the shooter Jared Loughner sounds like he is paranoid schizophrenic. Of course, I am not engaging in a formal diagnosis since I have no direct data. However, the signs are certainly suggestive.

What is bound to happen for some time to come is the blaming of the event on ideology. The left seems to be pulling out Sarah Palin’s use of bullseyes on Giffords district and the right is doing the same – apparently some disgruntled far left people also know how to use bullseyes. For some reason, The Daily Kos removed a post which had some very disturbing things to say about Rep. Giffords.

In any case, my personal view is that efforts to locate this horrible act in ideology is a mistake. As with other shootings, I think mental illness is underestimated by policy makers. Apparently there were warning signs which were “handled” but were not addressed in any meaningful way. The curent laws do not allow for a long term response to signs of instability, but rather on short term detention for people who might seem to be a danger to themselves or others.

The right and left will blame each side for the tragedy, but I hope at some point we will come together and look at the need for a more comprehensive policy relating to the treatment of severe mental illness and the long term treatment needs of those afflicted.

North Jersey magazine says “Don’t blame mom”

I am quoted often in this article by Kathryn Davis on parenting, primarily mothering and various adult outcomes, including homosexuality and eating disorders. Her initial focus is autism:

In his book, Teaching Individuals with Developmental Delays, author O. Ivar Lovaas notes, “The number of proposed causes was limitless because professionals found it easy to be inventive, considering their ignorance of the etiology of behavioral delays. These delays already tend to be amplified by the parents’ guilt and anxiety over the possibility of having contributed to the problem (a characteristic of most parents regardless of the child’s problem).”

Lovaas was a behaviorist who taught George Rekers. Rekers adapted the behaviorism into his treatment of GID but did not follow his teacher’s skepticism of parental cause for childhood issues.

Today Show on PANDAS

Back in the spring, I wrote an article on Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcus (PANDAS). The disorder has opened my eyes to the potential role of bacteria in mental illness. Recently, the Today Show did a segment on PANDAS with a remarkable case of a boy attending school at nearby Carnegie-Mellon University. Watch and learn.


 

I also blogged at length about this condition. Part one dealt with the condition and part two with a potential paradigm shift in mental health and part three developed an interactionist perspective.

New Zealand study examines abortion and mental health link

Joining the Coleman et al study is a study reported by this Medical News Today news release:

Women who have an abortion face a small increase in the risk of developing common mental health problems such as depression and anxiety, according to a new study from New Zealand.
But the researchers, writing in the December issue of the British Journal of Psychiatry, say their findings point to a “middle-of-the-road” position on abortion – and do not support either the strong pro-life or pro-choice arguments.
Researchers from the University of Otago studied the pregnancy and mental health history of over 500 women born in Christchurch, a city in South Island.
The women were interviewed six times between the ages of 15 and 30. At each assessment, the women were asked whether they had been pregnant and, if so, what the outcome of that pregnancy had been. The women were asked whether the pregnancy was wanted or unwanted, and if this had caused them to be upset or distressed.
The women were also given a mental health assessment during each interview, to see if they met the diagnostic criteria for major depression, anxiety disorders, alcohol dependence and illicit drug dependence. The researchers took other confounding factors which might be associated with increased risks of various pregnancy or mental health outcomes into account.
Overall, 284 women reported a total of 686 pregnancies before the age of 30. These included: 153 abortions (occurring to 117 women), 138 pregnancy losses (including miscarriage, stillbirth and termination of ectopic pregnancy), 66 live births that resulted from an unwanted pregnancy (or one that provoked an adverse reaction), and 329 live births resulting from a wanted pregnancy (where there was no reported adverse reaction).
The study found that women who had had abortions had rates of mental health problems that were about 30% higher than other women. The conditions most associated with abortion included anxiety disorders and substance use disorders. In contrast, none of the other pregnancy outcomes were consistently related to significantly increased risks of mental health problems.
However, the overall affects of abortion on mental health were found to be small. The researchers estimated that exposure to abortion accounted for between 1.5% and 5.5% of the overall rate of mental disorders in this group of women.
Professor David Fergusson, John Horwood and Dr Joseph Boden said their study had “important implications for the ongoing debates between pro-life and pro-choice advocates about the mental health effects of abortion”.
Writing in the British Journal of Psychiatry they said: “Specifically, the results do not support strong pro-life positions that claim that abortion has large and devastating effects on the mental health of women. Neither do the results support any strong pro-choice positions that imply that abortion is without any mental health effects.
“In general, the results lead to a middle-of-the-road position that, for some women, abortion is likely to be a stressful and traumatic life event which places those exposed to it at a modestly increased risk of a range of common mental health problems.”
Reference:
“Abortion and mental health disorders: evidence from a 30-year longitudinal study.” Fergusson D, Horwood LJ and Boden JM (2008). British Journal of Psychiatry, 193: 444-451

I am still reviewing the study but it looks like the APA should have waited to bring out their report on abortion and mental health.

Abortion and mental health disorders: New study finds relationship

A new study published online today finds varying degress of connection between induced abortion and later mental health problems. The article, published by the Journal of Psychiatric Research, used the National Comorbidity Study, a large representative sample of people carried out in the early 1990s. Here is the abstract:

The purpose of this study was to examine associations between abortion history and a wide range of anxiety (panic disorder, panic attacks, PTSD, Agoraphobia), mood (bipolar disorder, mania, major depression), and substance abuse disorders (alcohol and drug abuse and dependence) using a nationally representative US sample, the national comorbidity survey. Abortion was found to be related to an increased risk for a variety of mental health problems (panic attacks, panic disorder, agoraphobia, PTSD, bipolar disorder, major depression with and without hierarchy), and substance abuse disorders after statistical controls were instituted for a wide range of personal, situational, and demographic variables. Calculation of population attributable risks indicated that abortion was implicated in between 4.3% and 16.6% of the incidence of these disorders. Future research is needed to identify mediating mechanisms linking abortion to various disorders and to understand individual difference factors associated with vulnerability to developing a particular mental health problem after abortion.

In the discussion section, the authors believe that abortion contributes to the effect independent of other factors.

What is most notable in this study is that abortion contributed significant independent effects to numerous mental health problems above and beyond a variety of other traumatizing and stressful life experiences. The strongest effects based on the attributable risks indicated that abortion is responsible for more than 10% of the population incidence of alcohol dependence, alcohol abuse, drug dependence, panic disorder, agoraphobia, and bipolar disorder in the population. Lower percentages were identified for 6 additional diagnoses.

Given the multidetermination of mental health disorders, these risks should be taken into account, especially those in double figures.
I believe another significant abortion and mental health study is due out next week as well.
The reference is: Coleman PK et al., Induced abortion and anxiety, mood, and substance abuse disorders: Isolating, Journal of Psychiatric Research (2008), doi:10.1016/j.jpsychires.2008.10.009

Psychiatric Bulletin publishes David Fergusson editorial on mental health and abortion

I posted extensively on the APA Task Force on Mental Health and Abortion in August, including comments from New Zealand researcher David Fergusson. This month, the Psychiatric Bulletin published an editorial by Dr. Fergusson.
The editorial supports the recent Royal College of Psychiatrists’ statement regarding abortion and mental health.
Fergusson’s editorial notes the contrast between a RCP statements in 1994 and 2008. The 1994 view was that no relationship existed between abortion and mental health. Currently, the RCP cautions about the possible effects and suggests post-abortion counseling.
Fergusson notes that such debates are important, especially in the UK since mental health concerns are offered as the major reason a woman is granted an abortion. If mental health status is not improved, or may be worsened, the effects of abortion have major relevance to policy.
He concludes:

It is unlikely that these problems of evidence, uncertainty and the law will be resolved by further medicolegal debates between pro-life and pro-choice advocates. What is required is a well-designed, well-funded and, above all, impartial programme of research into the mental health risks, benefits and consequences of abortion. The recent Royal College of Psychiatrists’ statement makes an important contribution to this process by highlighting the real uncertainties that exist in the current evidence on abortion and mental health.

It is hard for me to read this in any other way but as a critical contrast to the recent APA report.

Wall Street Journal previews APA Mental Health and Abortion task force report

Today’s Wall Street Journal’s Stephanie Simon has an article regarding the APA Mental Health and Abortion Task Force. Titled “New Front on the Abortion Battle,” the article previews the APA committee’s report due to be considered tomorrow (Wed. 8/13/08).
The article begins:

For decades, the cultural battle over abortion has been about what goes on inside a woman’s womb. But more and more, the focus is shifting to what goes on inside her head.
Activists on both sides are awaiting a comprehensive report reviewing two decades of published research on mental health and abortion, to be presented this week at the American Psychological Association’s annual conference in Boston.
The report comes at a pivotal time as some judges and lawmakers have begun to make decisions in part based on peer-reviewed studies suggesting women who have had abortions are at higher risk of anxiety, depression and substance abuse.

The article also refers readers to an annotated list of some studies relevant to mental health and abortion.