We both love how Matthew has taken the concept of sin and given a breath of fresh air to the topic. You must read this book because in its pages you will finally gain a biblical perspective on sin and what it takes to free yourself from the bonds that so easily entangle!

Gary and Michael Smalley
Smalley Relationship Center
When mental illness afflicts a loved one, how can we understand what is happening and respond appropriately? This biblically-literate and scientifically-informed book offers helpful insight, encouragement, and practical advice. For pastors and for those who hurt for those who hurt, Matthew Stanford offers sensitive and welcome guidance.

David G. Myers, Ph.D.
Professor of Psychology, Hope College and author of Psychology Through the Eyes of Faith.

Monday, December 14, 2009

AD/HD Interview

For all those interested I will be on Midday Connect (www.middayconnection.org) with Melinda Schmidt discussing Attention-Deficit/Hyperactivity Disorder, Monday, Dec. 28th at noon CST.

Tuesday, December 8, 2009

Stories

Personal stories are powerful. When we really get to know someone and begin to understand the events that have preceded their present circumstances it becomes harder to judge them and easier to show compassion. From time to time I will be posting the stories of the hurting people that I work with so that we all might begin to see suffering with the eyes of Christ.

Joanna was born in Germany where her father was stationed in the military. While appearing happy on the outside the family hid a dark secret and was in constant conflict. Joanna’s father was an alcoholic who physically abused both her and her mother. After the birth of her brother when she was five, Joanna adopted the role of mother/protector and worked hard to make the home environment safe and happy for him. To dull the pain from years of abuse she began drinking and smoking marijuana at 15. “I wanted freedom” she told me, “I was unhappy with my parents trying to control me”. While she would experiment with different drugs (marijuana, crack cocaine, prescription pain killers) through the years, much like her father alcohol was always her main addiction. Despite her heavy drinking she was able to graduate from high school and completed three years of college.

After 25 years of heavy drinking the longest period of sobriety she can remember is 30 months. She has attended seven different alcohol treatment programs but relapsed soon after completing each. Never married she has been involved in a number of unhealthy and abusive relationships with men. She has also been unable to hold a job for more than a few months at a time due to her addiction. “If I’m unhappy, I want to drink and because I drink I’m always unhappy”. When I met Joanna she had just completed her third week in a local inpatient, faith-based drug treatment program that I work with.

At 35 Joanna has no relationship with her father and hasn’t for some time. As I listened to her story I was struck by the amazing parallels between the life of a daughter left empty by the lack of a father’s love and the life of a father who never appreciated the blessing he had been given. She likely began drinking both because of a genetic predisposition passed down to her from her father and the severe abuse that he inflicted on her. As an adult she continued to try and heal her pain with alcohol as she moved from one abuser to another recreating the father-daughter relationship that had so damaged her as a child. In 1997 Joanna’s father was convicted of intoxication manslaughter and sentenced to prison for deaths he caused while driving drunk. Joanna herself has two convictions for driving while intoxicated. The legacy of this family, passed from generation to generation, is alcoholism and abuse. Joanna received it from her father much like he, as Joanna reported, had received it from his alcoholic father (Joanna’s grandfather).

Tuesday, December 1, 2009

The Bible and Madness

What we call mental illness was not always treated as a medical problem. In the not too distant past the abnormal thoughts, feelings and behaviors often associated with these disorders were suggested to be signs of personal weakness and something to be ashamed of. Unfortunately, this is still a far too common perception in the Church today and has resulted in the alienation of thousands who desperately need the spiritual support that only the body of Christ can provide.

Some have said that mental illness did not exist in biblical times and is just a modern invention to legitimize sinful behavior. I once read an author that based his argument on the fact that you cannot find the terms mental illness or mental disorder in the Scriptures. He is correct of course, you cannot find those terms in the Bible but you do see the related terms madness and insanity used often. These terms are used to describe a set of thoughts and behaviors recognized to be extreme, debilitating and abnormal in nature. The existence of madness and insanity in biblical times is clear:

Some References to Madness and Insanity in the Bible

Old Testament
A punishment for violating the covenant (Deuteronomy 28:28)
Feigned by David to escape capture (1 Samuel 21:13-15)
Prophet’s servant is thought mad (2 Kings 9:11)
Madness compared to foolish behavior (Proverbs 26:18)
Madness is the opposite of wisdom (Ecclesiastes 1:17; 7:7)
Nebuchadnezzar’s punishment (Daniel 4:32-34)

New Testament
Jesus is thought to be insane by His family (Mark 3:21; John 10:20)
Jesus heals a lunatic (Matthew 17:15)
Festus suggests that Paul is mad (Acts 26:24-25)
Believers could be thought to be mad (1 Corinthians 14:23)
Paul’s ideas so extreme as to be thought insane (2 Corinthians 11:23)

So individuals displaying abnormal thoughts and behaviors, the mentally ill, were clearly known throughout biblical history. Today those same abnormal thoughts and behaviors have been categorized into a set of specific mental disorders for which many effective interventions and treatments have been developed. Mental health research and practice have made significant strides in relieving the mental and physical suffering of those afflicted with mental illness. Yet there continues to be a high level of suspicion, distrust and even fear in the Church when it comes to psychology and psychiatry. The simple fact is that Christians develop mental illness at the same rates seen in the general population and suggestions such as “you need to pray more” or “this is just the result of weak faith” are ineffective in dealing with these serious medical conditions.

Monday, November 23, 2009

B.A.B.S.

Several years ago my wife and I attended a fund raising dinner for an international ministry with which we are involved. I was excited to go to the dinner for two reasons. First, I am very supportive of this ministry’s work in advancing the gospel message around the world and second, I wanted to hear the invited presenter. The guest speaker, a retired professor of psychiatry, was to talk about his involvement with the ministry’s efforts in several foreign countries. But that isn’t why I was so interested, what peaked my curiosity was the qualifying label that had been printed under his name on the flier for the dinner, “Born Again Brain Scientist”. When I first read that I kind of laughed. I thought isn’t it obvious that anyone invited to speak by the ministry would themselves be a Christian. Or is there something inherent in the title “scientist” that would lead people, especially people of faith, to think that such an individual is not a believer. Unfortunately, I think the latter may be true.

The fact that many in the Christian community equate the title “scientist” with atheist is troubling to me, because much like the invited speaker I am also a “brain scientist” more specifically a neuroscientist and a follower of Jesus Christ. To this day my friend Dave (who was also at the dinner that night) begins his emails to me, “Hey B.A.B.S.”. A second misinformed association comes from within the scientific community itself and is just as troubling, faith is little more than a set of superstitions and myths held by unenlightened individuals.

It seems that you can’t pick up a magazine or turn on the television these days without seeing a story on the conflict between science and religious belief. The disagreement tends to focus around three main issues: the sanctity of life, the origin of life and sinful behavior. Sanctity of life includes topics such as the use of embryonic stem cells, abortion, euthanasia (e.g., physician assisted suicide) and cloning. The second point of contention, the origin of life, is seen in the on-going dispute between the proponents of naturalistic evolution and those that believe the universe shows signs of intelligent design. The third point of conflict has to do with biblically defined sinful behavior for which science has shown some biological predisposition or basis. Some of the most emotionally debated behaviors include homosexuality, addiction and criminality.

As a Christian and a neuroscientist, I stand at the boundary point of what appears, at least on the surface, to be two very different worlds, or perhaps it is more precise to say worldviews. From my unique vantage point, I have unfortunately seen scientific knowledge distorted to justify sinful behavior and perhaps more disturbingly, I have seen Christians misuse the scriptures to demonize and alienate the very ones that they should be reaching out to. The underlying cause of this problem in the church is a lack of knowledge, both of basic science and scriptural teaching. The relevance of the Gospel in our present scientific age goes without question but if we, as followers of Christ, are going to successfully engage the culture we must stop reacting out of fear of science and start leading the discussion.

Monday, November 16, 2009

AD/HD

Attention-Deficit / Hyperactivity Disorder (AD/HD) is a controversial topic. Within Christian circles some have gone as far to suggest that AD/HD is nothing more than rebellion resulting from bad parenting or society’s attempt to turn sin into sickness. There are troubling statistics that may make one doubt the legitimacy of AD/HD as a diagnosis. For instance, why has the incidence rate for AD/HD increased significantly in the United States in recent years but remained relatively stable in Great Britain? How do we explain the 700% increase in psychostimulant use during the 1990s? Are we having an AD/HD epidemic? And if so what has happened to cause so many of our children to be damaged? Although answers to these questions are complex, overdiagnosis and the overuse of medications are legitimate concerns that trouble many parents whose children are affected by this problem. I suggest three explanations for the recent and dramatic increase in the diagnosis of AD/HD. It is likely that there are many other factors that have contributed to this increase, but I would like to focus on the three I see as most influential.

The first is the problem of misdiagnosis (overdiagnosis). Clearly some children are misdiagnosed with AD/HD and wrongly given psychostimulants. Misdiagnosis can happen with any illness whether it is mental or physical in nature (an accurate diagnosis is always the product of quality professional training and an efficient evaluation). Parents must search out qualified professionals who will take the time to rule out all other possibilities before making a final diagnosis. Misdiagnosis and the overuse of medications in children are not unique to AD/HD. We can look no further than antibiotics to find another example. Throughout the 1980s and 1990s pediatricians wrongly, but knowingly, prescribed antibiotics for non-bacterial infections. This was done in many cases to pacify the parent who demanded something be done for their sick child. Because these children had viral infections the antibiotics were useless in their treatment. Ultimately this overuse of antibiotics has led to antibiotic resistant strains of bacteria and infections that are now more difficult to treat. Is it a far leap to imagine that the same scenario may occur with AD/HD; a troubled child, a weary teacher, a struggling parent, and a pediatrician trying to better the situation? It is imperative that a child showing AD/HD-like problems and behaviors receive a full medical and psychological assessment prior to diagnosis. While I believe that misdiagnosis definitely occurs and may have contributed to the increase in AD/HD diagnosis and treatment, I do not believe that to be the only reason.

A second factor contributing to the increase in AD/HD is that a better defined set of criteria and greater acceptance of the diagnosis has lead to more children who actually display AD/HD problem behaviors being diagnosed and treated. This is not a bad thing! We all know that children are each unique. They develop and mature at different rates. Some will acquire physical skills quickly, others more slowly. Still others will never acquire certain physical abilities. Is it so difficult to imagine that the same can be said of cognitive abilities? Some children will struggle cognitively, regardless of their environment and parents. Appropriate diagnosis and treatment gives these children a chance at a normal and productive life that they would not have had otherwise.

A third factor that I believe has contributed to the dramatic increase in the prevalence of AD/HD is related to societal changes that have placed greater demands and expectations on children. Anxiety levels in children and college students have increased significantly since 1950. This increase has been associated with a lack of social connection and a sense of a more threatening environment. Our fast paced, high stress society is damaging our children. Just think for a moment about some of the things that younger and younger children are exposed to everyday: divorce, fear of violence, drug use, unlimited materialism, unrealistic academic expectations and absentee parents. Dr. Sam Goldstein, a prominent AD/HD researcher, says it this way, “…a review of all sources of childhood data suggests that children are finding it increasingly more difficult to meet the expectations and demands of our culture. In response, more and more are experiencing problems…Thus, increased cultural demands upon children increases the number struggling to meet the expectations of the culture. This acts as but one more force leading children to the doorsteps of physicians and psychologists… Even if it is one out of twenty, that is five percent of the population. That is five percent of all children who simply struggle to sustain effort, and require more time, patience and support to develop the self-discipline necessary to deal with life’s daily requirements.”

It is my hope that you will recognize AD/HD as a real disorder that affects the lives of real children and their families. These children wrestle daily with debilitating physical, psychological and spiritual issues. While mistakes may have been made in relation to diagnosis it does not change the fact that children who struggle with this disorder can be effectively treated and the church has a significant role to play in that healing.

Monday, November 9, 2009

Speaking the Truth

If you are like me, there have been times in your life in which you have allowed your circumstances to define the character of God for you. When times are good, He is a great and loving God. During difficult times, He is distant and uncaring. Stress, guilt, fear, grief, anger and suffering can all cause us to lose sight of the true nature and character of God. The Bible gives us several examples of this: overcome by shame and guilt as a result of their sin, Adam and Eve try to physically hide from God (Genesis 3:8); in his overwhelming pain and suffering, Job begins to believe that God is punishing him unjustly (Job 9:2); driven by anger, Jonah believes he can alter God’s plan by physically running away (Jonah 1:3); fearing for his own life, Peter denies Christ three times (Matthew 26:69-75). These are all examples of misunderstanding the true nature of God.

In my own life, this circumstance-altered view of God became most apparent after my wife had a miscarriage during our second pregnancy. Julie was overcome by grief, and she was angry at God. How could He allow such a thing to happen? For my part, the person who I looked to most as an example of living a life submitted to God was now questioning God’s sovereignty. Where did that leave me? I wanted to understand what had happened. Was the fetus truly a child? Was he or she now with God? What about my wife, was she losing her faith? I was drawn into the Word, and God dramatically changed me. More than ever, I began to recognize His providence in all things and see His faithfulness and love for those He has called His children. God was also faithful to Julie. He ministered to her through cards and notes from friends, through meals brought out of compassion and through a simple red rose. She saw His faithfulness daily and over time she began to see Him again for who He truly is, the sovereign God of the universe who loves her.

Even under normal conditions, we far too often fall into this trap. But imagine for a moment that your mind has been altered by a mental disorder. You question your own thoughts and feelings as to whether they are true. You behave in ways that seem contrary to who you are. Why would God allow this? Does He hear me? Does He care? Does He even exist? Those suffering with a mental illness, like all of us, need to be reminded of the truth. We must be there to lift up Christ, and He will draw them to Himself (John 12:32). While every person struggling with a mental illness is different, I have found that generally, people who are suffering have one main spiritual issues for which they are seeking an answer, Where is God in my suffering?

The Bible records a powerful example of how not to minister to a person who is suffering. We find it in the book of Job, and our bad examples are Job’s friends Eliphaz, Bildad and Zophar. These three men traveled a great distance to comfort their suffering friend (Job 2:11). When they first see him, they are overcome with grief (Job 2:12) and are silently present with him in his suffering for seven days. These men were truly Job’s friends, and they wanted the best for him. They wanted to see their friend healed and restored. Unfortunately, their own misguided views of God lead them to verbally assault Job. Their words did not help Job’s situation, but only brought him pain and confusion. Eliphaz, Bildad and Zophar wanted to fix Job. In one sense they wanted their friend to be healed, in another, his prolonged suffering made them question the very nature of God. Even though Job suffered greatly he had prepared himself for the trail long before it ever happened by building an intimate relationship with the Father (Job 29:4). The scriptures tell us he was blameless and upright (Job 1:1), a man who feared God and shunned evil (Job 1:1). His friends were not as well prepared, their view of God was limited and their relationship with Him was superficial. In the end, God was angered at the three for not speaking the truth about Him to Job (Job 42:7). I believe that we have the same call in situations in which we minister to those who are suffering with mental illness, speak the truth about Him.

Monday, November 2, 2009

Biology is not Destiny

It is clear that the ancient Hebrews and first century Christians were na├»ve in their understanding of how the brain and nervous system function. However, they were not unaware that this biological system played a significant role in behavior. They understood that disease or injury to the nervous system resulted in dramatic behavioral changes and physical manifestations, many of which are mentioned both in the Biblical text and other ancient writings such as the Talmud (an ancient record of Jewish laws and traditions). It is also clear that the Biblical writers understood that we struggle to control deeply ingrained, biologically related sinful impulses. The scriptures make several references to these inborn sinful patterns and our attempts to bring them under control. Peter suggests that those who indulge in such “fleshly lusts” and “corrupt desires” behave like unreasoning animals driven by instinct (1 Peter 2:11; 2 Peter 2:10-18). Jesus, when challenged by the Pharisees in relation to ceremonial cleanliness and the food laws, taught that defilement comes “from within, out of the heart of men” where sinful thoughts and behaviors originate (Matthew 15:19; Mark 7:21). John teaches us that the “lust of the flesh” is not of God and should not be pursued (1 John 2:16), while James instructs that the source of temptation is the innate lusts within each of us (James 1:14-15). Paul mentions these same fleshly patterns of lust and desire throughout his epistles (Romans 7:17-18, 23; 1 Corinthians 7:9; Galatians 5:16; Ephesians 2:3; 1 Thessalonians 4:5) describing them as overpowering and difficult to control (Romans 7:18-19; Galatians 5:17). However, biology is not destiny. When we fully understand the effects of original sin on our physical bodies it becomes clear that broken biology can never be used as an excuse for sinful behavior. Biblical scholar Dr. Robert Gagnon says it this way, “A biology-equals-morality rationale has no place in a worldview that talks of denying oneself, losing one’s life, taking up one’s cross, dying with Christ, new creation, and living for God.” The fact that we have sinful DNA is simply another example of why we so desperately need a Savior with the power to completely re-create us. We have been made new spiritually (2 Corinthians 5:17), and ultimately, we will be transformed physically (1 Corinthians 15:53; Philippians 3:20-21).

Monday, October 26, 2009

Anxiety

Heightened anxiety is not just a product of our fast-paced, modern society but has been a common problem throughout human history. We find it discussed in the wisdom literature (Job, Psalms, Proverbs, Ecclesiastes), by Jesus in the gospels (Matthew, Luke) and in the epistles of Paul (Philippians) and Peter (1 Peter). We also see it manifested in the lives of many Old and New Testament biblical characters (e.g., Adam, Job, Saul, David, Elijah, Martha, Paul and Peter). Anxiety at normal levels is healthy. Concern for the well being of others (2 Corinthians 11:28; Philippians 2:28) or a physiological response that rouses us to action in a threatening or dangerous situation is a God given part of our being. But excessive worry or worse an anxiety disorder is not healthy but destructive both physically and spiritually. Anxiety is mentally divisive and a result of that confusion of thought is often a misperception of the character of God. God is seen as punitive, perfectionistic and authoritative, someone who can never be satisfied no matter how hard you try. When ministering to those struggling with anxiety our emphasis should be on God’s unconditional love and faithful provision for us. We must remind them that we do not have to perform for God’s love and acceptance. By grace we already have it if we are in Christ. When my anxious thoughts multiply within me, Thy consolations delight my soul (Psalm 94:19).

Tuesday, October 20, 2009

Personality Disorders and the Bible

A personality disorder is a rigid, ingrained pattern of thoughts and behaviors that deviates significantly from the expectations of one’s society. This maladaptive pattern is usually well-established by late adolescence or early adulthood and is serious enough to cause distress or impaired functioning. People with a personality disorder are usually unaware that their thoughts and behaviors are inappropriate, so they tend not to seek help on their own.
Two of the most common and troubling of the personality disorders are borderline personality disorder (BPD) and antisocial personality disorder (ASPD). These personality disorders share a number of overlapping and related symptoms including problems with emotional expression, difficulty forming stable, healthy relationships and impulsive, self-destructive behavior. You may have thought that the Bible would have little to say about personality disorders, but in fact it gives a very clear description of two individuals who shows many of the symptoms associated with BPD and ASPD. I believe that we see an example of ASPD in the description of the “stubborn and rebellious son” found in Deuteronomy 21:18-21 (and possibly Ezekiel 18:10-13) while Gomer in the Old Testament book of Hosea appears to be an example of BPD.
The book of Hosea outlines a five step process of restoration in the life of Gomer that may be effective in ministering to a person diagnosed with BPD or ASPD. Step one is to clearly identify sinful behaviors and describe the associated consequences of such behavior (Hosea 2:1-13). When ministering to the individual with BPD or ASPD, we must be honest with them about the nature of their behavior and its consequences. This must be done in a spirit of love not judgment. Step two is to not become an enabler of the individual’s sinful and extreme behavior (Hosea 2:6). This means that you are not accepting or in denial about the seriousness of the individual’s extreme behaviors. Inconsistency in your response will only make these behaviors more likely to occur. Step three is a difficult one, especially for parents: allow the individual to suffer the full consequences of their behavior (Hosea 2:7). If you or someone else constantly covers for the individual or minimizes the negative consequences of their behavior in some way (e.g., pay off debt, post bail), then the potential for restoration is greatly limited. Step four is to continually make it clear to the person that restoration and forgiveness are possible regardless of what they may have done (Hosea 3:3). In many instances this will require you to humble yourself. It is only through full submission to Christ that you will be able to offer such unconditional acceptance and forgiveness. Finally, step five is to set up appropriate boundaries. Behavior does not change overnight. Once the person has returned to the family or relationship, they will need to be guided towards healing and restoration (Hosea 3:3). Clear and appropriate boundaries will help both you and them as you guide and monitor their progress. This is a long and difficult process for both you and the person with the disorder. Reward successes and point out failures in an environment of acceptance and love.

Thursday, August 20, 2009

Jesus, Sickness and Sin

What would you say to a believer who came to you and said they were clinically depressed or had obsessive-compulsive disorder? What is the appropriate biblical response? The unfortunate truth is that the church has struggled in ministering to those with mental illness. In the Gospel of John we have a 1st century equivalent of that interaction (John 9:1-3): As He passed by, He saw a man blind from birth. And His disciples asked Him, "Rabbi, who sinned, this man or his parents, that he would be born blind?” Jesus’ disciples assumed that sin was the cause of the man’s blindness. In fact, as we can see from their question they believed that the man may have sinned before he was born and brought this punishment upon him. In the Talmud, an ancient record of Jewish laws and traditions, it says that if a pregnant woman sins by bowing to an idol that her unborn child also sins because he also bows. This was a common belief of the day; sin or unrighteousness brought punishment (sickness, poverty, a physical handicap) while righteous living brought health and prosperity. There is a certain sense of self-righteousness in that idea. He’s blind, I’m not. He’s a sinner punished by God but look at me I’m blessed for my good behavior. But what does Jesus say … Jesus answered, "It was neither that this man sinned, nor his parents; but it was so that the works of God might be displayed in him.” This outcast, this “cursed” man, this sinner was blind from birth so that the works of God might be displayed in him. I wonder if he ever thought of himself that way before that day. The works of God that are displayed in this man’s life go far beyond his simple healing. In this section of the text Jesus is emphasizing his messianic authority and power by proclaiming He is the light of the world. This man ultimately defends Christ before the Pharisees and then publicly worships Him. He sees for the first time physically and he sees for the first time spiritually. What about our brothers and sisters with mental illness, do we (like the disciples) see them as less than ourselves? Or do we think of their disorder as an opportunity for the works of God to be manifest in their lives? We need to see them with spiritual eyes, with Christ’s eyes. Every trial, every malady, every weakness is an opportunity for the works of God to be manifest in our lives because God is sovereign over illness, even mental illness.