63 Comments

As a neurologist and someone who is also trained in psychiatry, I believe that attributing mental illness solely to sin, and worse, teaching this perspective, is itself a form of sin. This notion has caused significant harm and is fundamentally untrue. Mental illness is highly complex and has roots in genetics, neurochemistry, neuroplasticity, life experiences, and countless other factors. I cannot help but wonder about the anthropological and theological framework someone must have to hold this position. In my experience, ideas like total depravity and a Cartesian anthropology play into this. Mental health is erroneously viewed as some kind of immaterial entity and therefore cannot be considered physical. While a stroke affects the brain, mental illness is perceived as affecting only the immaterial mind, and therefore cannot be thought of as biological. This misconception is very harmful and is contrary to reason.

Remember, God is not just the God of the Bible; He is also the God of reason.

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Great points. Yes! Incomplete and inaccurate theologies enable this. It also carries hints of gnosticism with the emphasis on the spiritual over embodied realities or seeing embodied responses as sinful or to be "put off."

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he is also the creator of our bodies.

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Yes, he sure is.

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>>>Mental health is erroneously viewed as some kind of immaterial entity and therefore cannot be considered physical. While a stroke affects the brain, mental illness is perceived as affecting only the immaterial mind, and therefore cannot be thought of as biological. This misconception is very harmful and is contrary to reason.<<<

THIS. Maybe we should thank JM for his timing and how it has brought up this important discussion during Mental Health Awareness Month. So many people need to hear this.

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💯

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I’ve had OCD since I was a kid and I’m still fighting some religious compulsions that formed because of teachings like this. But I’ll never forget the first time a pastor shared that Jesus’ grace alone was enough. Because that changed everything. And I’m thankful for counselors who know Jesus and also study psychology. Sometimes we need Jesus and Prozac.

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YES. Wise, holistic counselors to such important ministry. So very thankful you found a different way forward.

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This stuff makes me crazy. I think the thing that is so frustrating, is that if some of these things were given proper care, they might not need medication. There’s so many tools you can use before you get to pharmaceuticals. But you need someone who understands the brain function and trauma and the actual psychology (and — SHOCKING— but this can be done without being heretical because it turns out sound therapy is much more “biblical” than whatever this is).

That verse about, “they tie up heavy burdens, hard to bear, and lay them on people’s shoulders” comes to mind.

I understand that in some ways this might be a reaction to the over diagnosis and over identification happening on social media. It’s not helpful to identify as a mental health diagnosis. But to deny suffering that can be proved with brain imaging to have altered the brain? It just blows my mind, and makes me so angry and sad for the people who are already suffering so much and have things like this heaped on them.

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Yes, exactly! Heavy, heavy burdens that compound injury. The framework of total depravity and suspicion of any external sources of authority really enables this. ESPECIALLY with prooftexted verses b/c people can excuse willful ignorance with "God's ways are higher," etc. And you're right - there are conversations to be had about overmedication and things like that but denying the reality of conditions is not the starting place.

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I am so sorry to hear that you dealt with PP OCD, and I am so proud of you for seeking medical help. It’s absolutely ridiculous the way that people spiritualize physical/neurological conditions, while they claim that others are “medicalizing” spirituality. It’s hardly distant from calling in a witch doctor to figure out why there’s a “curse” causing your child’s epilepsy. . .

Medicine, neuropsychoimmunology, and spirituality are intricately linked….AND Jesus never ignored the physical aspects of illness. I love the verse where people are asking “who sinned, this man or his parents?” And Jesus says . . .”Neither!”

That’s a verse that should be required reflection for every so-called Christian.

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Than you and 💯 YES! I think of that verse often, especially when I'm reading all the Christian parenting books focusing in on sin.

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Oh my goodness. Just all, all, ALL of this.

Thank you so much for the work you do putting this kind of response together.

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You are so very welcome. ❤️‍🩹 Thank you for reading!

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Thank you, thank you, thank you. You concisely argued exactly what my thoughts and experiences have encircled for months. I’m hoping to thoroughly and constructively articulate my concerns about the scrupulous language baked in to many moats of evangelical thought, word, rhetoric, and ministry. You’ve emboldened me to this end; thank you for this necessary commentary.

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You are so very welcome! I'm glad it was a help to you!

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May 11
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Yes! I appreciate Jay's writing as well.

The constant introspection and self-evaluation is just a lot.

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You mention Bill Gothard. As a former student of his homeschooling curriculum, ATI, I can attest that Gothard attributed mental illness to spiritual causes/failures in much the same way as MacArthur. In fact, parts of MacArthur's wider statement - he mentioned a book published in 1951? - sounded eerily familiar to Basic Seminar statements from Bill Gothard.

I developed symptoms of religious scrupulosity during my adolescent years and ATI made it all so much worse. I never got a definite diagnosis because, of course, I was too afraid to ask for such help. About five years of my teens is fragmented in my memory because I spent most of the time in such terrible mental and emotional darkness. I survived, but the scars remain.

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Oh, Holly, I am so very sorry. I believe you and can only imagine what that was like in a community that demanded performance in every area of life. Thankful you found a way out of that and are healing.

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As a Catholic who has wrestled with scrupulosity, I deeply appreciate your thorough sharing and reflection here. I know the courage this vulnerability requires; thank you for writing and publishing this anyway. That's an enormous sign of your healing journey. Grace is such a weird concept for those of us with OCD tendencies. It's a mystery we will never understand... but, thankfully, we don't have to understand it.

I'm comforted that Substack directed me to your reflection, since I also wrote about my scrupulosity and published it this weekend. I feel now less alone. 💙

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Thank you for reading. I’m glad to have connected here though sorry we share this in common ❤️‍🩹

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I just read a wonderful new book called A Quiet Mind to Suffer With by John Andrew Bryant. it is brilliant! He describes his personal prayer journey through hospitalization for OCD to a renewed relationship with Jesus, that is integrated and leads to healing and holiness. Highly recommended.

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I've had my eye on that one for a while! So looking forward to reading it!

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I cannot wait to read your book (and Kelsey’s)! (I cannot figure out the grammar of that sentence.) what’s so appalling to me is that comment about becoming pastorally detached. Attunement is probably the one key thing that transforms us as humans…God’s attunement to us, our attunement to one another, a parent’s attunement to a child. By detaching, these leaders are robbing their people and themselves the one reliable way to see people transformed which is one of the most glorious things I get to do as a mother, a teacher, a spiritual director. Absolutely BONKERS.

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Thank you!

YES. It leaves everyone so bereft, because the methods themselves train people to continually detach and kind of have an almost robotic response to themselves and others...so then even when, say, an adult child or a parishioner later names injury or pain...the response will be stunted. It's so heartbreaking, because it kind of becomes an exponential betrayal. This kind of teaching steals, kills, and destroys.

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This laid out the background and gave an explanation of what i experienced! I don’t ever remember hearing the term “nouthetic” but I definitely grew up hearing “biblical counseling” was what is needed. I followed that path of scrupulosity and it took me a direction that was harmful. You wrote something that could have been written to describe my experience. You wrote, “When you have lists and systems and formulas for victorious living, the person in front of you doesn’t matter. Their mental health, their physical presence, their unique circumstances are *all* irrelevant, because rooting out the sin and “putting on” the right behavior and thoughts becomes all that matters. Listening to someone’s story and circumstances becomes only a tool to parse out their sin.”

Yes!! I experienced that from multiple pastors and a counselor after I was vulnerable about struggling with the effects of abuse in my past. It heaped shame upon shame!

And once the carefully constructed framework of their interpretations set forth as 100% Bible starts coming down, it’s messy! And it’s freeing and grace can grow!

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Shame upon shame - really names so much. Because if it doesn't "work" for you, well, then, you are the problem. 💔 I'm so sorry you experienced this and am thankful you found a different way forward.

It really is messy - I often think of it as a house of cards - which is why I suspect any challenge or critique is met with defensiveness and fragility and accusations of backsliding or heresy or you were not of us, etc.

Not many people refer to it as "nouthetic" anymore, because of the negative connotations - "nouthetic" was taken from the Greek work that carries the connotation of confrontation, so "biblical counselors" kind of attempted a rebrand to suggest they are softer in confrontation, but the roots are all the same.

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So good. But we must also remember that back in the 70's psychoanalysis really was toxic. It told women and children that abuse never happened...it was all in their dreams or imagination. Mental hospitals were abysmal abusive places, electric shock and even lobotomies were still being done. One Flew Over the Cuckoo's Nest came out. Etc. And medication really is usually more damaging than not. (I really do know what I am talking about and I follow Harvard trained psychiatrists who are still criticizing all these abuses.

HOWEVER, MacArthur sounds like a Scientologist here. It's not the criticism of psychiatry per se that is the problem. It's the forbidding of any kind of therapy at all (except what your cult offers) when we have progressed over 50 years and have wonderful therapists now, tons more research to inform us. It's not like it was in 1970. But they are pretending that THEY have a magic cure, (like scientology), it works for everything, all else is evil. And it's just as toxic, manipulative, and used as ammunition for abusing victims just like in scientology. And him saying that PTSD isn't real. He has his head in the sand.

Christians don't do this about regular medical care even though there are serious issues of over-medication and bad ideas there as well. MacArthur would probably seriously criticize a family who will only pray for healing and never take their kids to the doctor. I'm so glad most believers are much smarter about this. But with his personal seminary, I'm very concerned about these guys raising up another generation of people like them. 😪

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Thanks for drawing attention to this. Yes! So often various movements were reactionary to things in the moment. It is difficult to, in a sense, read teaching from eighty years ago and remember that we are (in a sense) time travelers.

MacArthur seems frozen in time, however, and this is a stance he has intentionally chosen and propagated over the years - in spite of it having tragic results even within his own community.

That's an interesting comparison to scientology. And, yes, the reach just multiplies because his educational institutions and conferences are designed to train up leaders.

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Yes I really agree some of these guys seem frozen in time. Like the ones Sheila Gregoire criticizes about sex, like The Act of Marriage 10th edition or whatever still having the same awful stories and advice. It might have been the best they knew in 1970, but why is it just as ill informed now? Or all the parenting books you guys are critiquing, where the same bad ideas from decades ago are being repackaged and regurgitated.

And I noticed on your live chat you DID bring up the historical factors that influenced him. I really love you guys for knowing so much about and being informed by (an informing others) that all this stuff, good or bad, has a history and a context. It doesn't just get dreamed up one night in a vacuum.

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Wow. “In many ways, I think MacArthur, and those who adopt the biblical counseling worldview, offer a cognitive version of the health and wealth prosperity gospel”

For several years I have termed it “emotional prosperity gospel” in my head, as I think of the teaching I grew up with that made me believe if my relationship with God was right I would feel better. And when I didn’t feel better I assumed it was a spiritual issue. It means so much to read someone else’s description of these experiences.

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Emotional prosperity gospel is a really apt phrase! Makes me think how the ACBC/nouthetic approach requires people to file away their emotions systematically...and, yes, the receipt always comes due.

I'm so thankful this post was a help to you!

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So much of this resonates with my church-based childhood, youth, and college experience. Thank you for offering helpful clarity.

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You are so very welcome.

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Hi Marissa, I really appreciate this article. I struggle with OCD in various forms, one of which is religious scrupulosity. So, I can personally relate (and sometimes I wrongfully apply nouthetic principles to myself...on a journey of grace here!!) I do have a question for you. While I do not want to wrongfully apply the scriptures, I do wonder sometimes about certain Christian tenets becoming lost with the rise of the therapeutic age in the last several decades. Sometimes I get the impression that the call to "take up our cross and follow Christ," for example, is pushed aside, and a prosperity gospel is taken up ("if you follow Jesus, your suffering will be minimal in this life"). I am all for counseling (I have benefitted greatly from it) and for pursuing human flourishing as much as we can, but I wonder sometimes if, in our zeal to pursue wellness in this life, we have forgotten important things like: if we follow Christ we will be hated because people hated him and that suffering in Philippians is framed as "sharing in Christ's sufferings" and in 1 Peter as refining our faith.

With the rise of the therapeutic, I do not often hear Christians talking about these very important principles. Do you have some thoughts on these things?

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Hi Amy! Thanks so much for sharing these thoughts.

I don't necessarily think these things are incompatible. For instance, recognizing or naming something as scrupulosity doesn't remove the associated suffering. Same with anxiety or depression. I'd maybe want to know more specifically what you're seeing - if there are examples of this kind of teaching I'd be happy to take a look - but I sort of think the ability to name mental illness *as* suffering enables these things to be discussed with more depth (vs, say, telling someone their anxiety is a sin to be overcome). But maybe I'd need to know more about what you mean by the rise of the therapeutic.

I also think there's maybe a categorical distinction to be made. Perhaps applying the lens of physical illness to mental illness helps bring this into better focus. I do not think we would say seeking treatment or making choices to live a healthy life is theologically unsound or at odds with the recognition that we may yet suffer and we all will eventually die. And it could be that our faith is refined through suffering chronic illness or something like this, but I do not think we would not tell someone with a chronic illness that desiring healing or pursuing medical treatment is opting out of spiritual suffering.

Maybe part of this comes from reading passages like Hebrews 12 and imagining that suffering is an end good rather than the resurrection reality that the God who raises the dead can bring good out of even the worst kind of suffering. (Which is a different thing than saying God is the author of evil or desires us to suffer as an end).

Anyway, would love to hear your thoughts on this as well!

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Yes, this is really good. I realize that I brought up several things that probably need to be treated as separate issues.

Absolutely - pursuing health and treatment are all good things.

Also, the many passages on suffering in the scriptures have different contexts. Honestly, I think my struggle is a little more personal. I grew up internalizing a bit of a prosperity gospel (e.g. "as a follower of Jesus, you will mostly live a happy life"), which is a very dangerous lie. So, I suppose my thoughts and reading of the scriptures lately have been circling around this false thinking that the Lord is kindly and gently transforming in my life (yay for grace and sanctification!) I suppose I have latched onto the scriptures that speak of the reality of being hated as a Christ-follower because Jesus was hated and of suffering refining our faith. But, it's important for me to parse it out. Because it's not actually comforting to be hated. That is not where the comfort comes from. The comfort comes from union with Christ and the beauty that suffering is actually evidence of loving my Savior.

But, I realize this is actually off-topic. The paragraph above does not really address the category of suffering that is your main treatment. My thoughts here do not address scrupulosity or the way that Christians have, at times, harmfully denied or interpreted suffering. Thanks for bearing with my meandering thoughts.

Agreed - God is not the author of evil, nor does he desire us to suffer as an end.

Thank you!

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Thank you so much for sharing your thoughts! I am so thankful He is kind and knows each of us and our paths so intimately.

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Stumbled on to this article by way of @annelise roberts. Fantastic and horrifying and rage-inducing and so troubling… thank you for this review.

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You are very welcome. Thank you for reading.

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