Exposing the Myth that Christians Should Not Have Emotional Problems
By, Dwight L. Carlson

"The only army that shoots its wounded is the Christian army," said the speaker, a
psychologist who had just returned from an overseas ministry trip among missionaries.
He summed up the philosophy of the group he worked with as:

1. We don't have emotional problems. If any emotional difficulties appear to arise,
simply deny having them.
2. If we fail to achieve this first ideal and can't ignore a problem, strive to keep it from
family members and never breathe a word of it outside the family.
3. If both of the first two steps fail, still don't seek professional help.

I have been a Christian for 50 years, a physician for 29, and a psychiatrist for 15. Over
this time I have observed these same attitudes throughout the church—among lay leaders,
pastors, priests, charismatics, fundamentalists, and evangelicals alike. I have also found
that many not only deny their problems but are intolerant of those with emotional
difficulties. Many judge that others' emotional problems are the direct result of personal
sin. This is a harmful view.

At any one time, up to 15 percent of our population is experiencing significant emotional
problems. For them our churches need to be sanctuaries of healing, not places where they
must hide their wounds.

THE EMOTIONAL-HEALTH GOSPEL

Several years ago my daughter was battling leukemia. While lying in bed in the hospital,
she received a letter, which read in part:

Dear Susan,
You do not know me personally, but I have seen you in church many times…. I
have interceded on your behalf and I know the Lord is going to heal you if you just
let Him. Do not let Satan steal your life—do not let religious tradition rob you of
what Jesus did on the cross—by His stripes we were healed.

The theology behind this letter reminded me of a bumper sticker I once saw: "Health and
Prosperity: Your Divine Right." The letter writer had bought into a "healing in the
Atonement" theology that most mainstream evangelicals reject. According to this
traditional faith-healing perspective, Christ's atonement provides healing for the body and
mind just as it offers forgiveness of sins for the soul. The writer meant well, but the letter
created tremendous turmoil for my daughter.

While evangelicals have largely rejected "health and wealth" preaching—that faithful
Christians will always prosper physically and financially—many hold to an insidious
variation of that prosperity gospel. I call it the "emotional-health gospel." The emotional health
gospel assumes that if you have repented of your sins, prayed correctly, and spent
adequate time in God's Word, you will have a sound mind and be free of emotional
problems. Usually the theology behind the emotional-health gospel does not go so far as
to locate emotional healing in the Atonement (though some do) but rather to redefine
mental illnesses as "spiritual" or as character problems, which the church or the process
of sanctification can handle on its own. The problem is, this is a false gospel, one that
needlessly adds to the suffering of those already in turmoil.

This prejudice against those with emotional problems can be seen in churches across the
nation on any Sunday morning. We pray publicly for the parishioner with cancer or a
heart attack or pneumonia. But rarely will we pray publicly for Mary with severe
depression, Charles with incapacitating panic attacks, or the minister's son with
schizophrenia. Our silence subtly conveys that these are not acceptable illnesses for
Christians to have.

The emotional-health gospel is also communicated by some of our most listened-to
leaders. I heard one national speaker make the point that "At the cross you can be made
whole. Isaiah said that 'through his stripes we are healed' … not of physical suffering,
which one day we will experience; we are healed of emotional and spiritual suffering at
the cross of Jesus Christ." In other words, a victorious Christian will be emotionally
healthy. This so-called full gospel, which proclaims that healing of the body and mind is
provided for all in the Atonement, casts a cruel judgment on the mentally ill.

Two authors widely read in evangelical circles, John MacArthur and Dave Hunt, also
propagate views that, while sincerely held, I fear lead us to shoot our wounded. In his
book Beyond Seduction, Hunt writes, "The average Christian is not even aware that to
consult a psychotherapist is much the same as turning oneself over to the priest of any
other rival religion," and, "There is no such thing as a mental illness; it is either a
physical problem in the brain (such as a chemical imbalance or nutritional deficiency) or
it is a moral or spiritual problem."

MacArthur, in Our Sufficiency in Christ, presents the thesis that "As Christians, we find
complete sufficiency in Christ and his provisions for our needs." While I agree with his
abstract principle, I disagree with how he narrows what are the proper "provisions." A
large portion of the book strongly criticizes psychotherapy as one of the "deadly
influences that undermine your spiritual life." He denounces "so-called Christian
psychologists and psychiatrists who testified that the Bible alone does not contain
sufficient help to meet people's deepest personal and emotional needs," and he asserts,
"There is no such thing as a 'psychological problem' unrelated to spiritual or physical
causes. God supplies divine resources sufficient to meet all those needs completely."
Physically caused emotional problems, he adds, are rare, and referring to those who seek
psychological help, he concludes: "Scripture hasn't failed them—they've failed
Scripture."

A PLACE FOR PROFESSIONALS

When adherents of the emotional-health gospel say that every human problem is spiritual
at root, they are undeniably right. Just as Adam's fall in the garden was spiritual in nature,
so in a very true sense the answer to every human problem—whether a broken leg or a
burdened heart—is to be found in the redeeming work of Christ on the cross. The disease
and corruption process set into motion by the Fall affected not only our physical bodies
but our emotions as well, and we are just beginning to comprehend the many ways our
bodies and minds have been affected by original sin and our fallen nature. Yet the issue is
not whether our emotional problems are spiritual or not—all are, at some level—but how
best to treat people experiencing these problems.

Many followers of the emotional-health gospel make the point that the church is, or at
least should be, the expert in spiritual counseling, and I agree. Appropriate spiritual
counseling will resolve issues such as salvation, forgiveness, personal morality, God's
will, the scriptural perspective on divorce, and more. It can also help some emotional
difficulties. But many emotional or mental illnesses require more than a church support
network can offer.

I know it sounds unscriptural to say that some individuals need more than the church can
offer—but if my car needs the transmission replaced, do I expect the church to do it? Or
if I break my leg, do I consult my pastor about it? For some reason, when it comes to
emotional needs, we think the church should be able to meet them all. It can't, and it isn't
supposed to. This is why the emotional-health gospel can do so much harm. People who
need help are prevented from seeking it and often made to feel shame for having the
problem.

Thankfully, more and more people in the Christian community are beginning to realize
that some people need this extra help. If professionals and church leaders can recognize
the value of each other's roles, we will make progress in helping the wounded. Forty
percent of all individuals who need emotional help seek it first from the church, and some
of these will need to be referred to mental-health professionals. Church leaders should get
to know Christian therapists in their communities so they can knowledgeably refer people
with persistent emotional problems.

DEPRESSED SAINTS

Lurking beneath the stigma that many Christians with mental and emotional problems
face is a simple question: Can a Spirit-filled Christian have emotional problems? The
emotional-health gospel overlooks the record of the Bible itself and church history, just
as health-and-wealth gospels must ignore the history of not-so-rich saints (not to speak of
Jesus himself).

The Reformer who penned "A Mighty Fortress Is Our God," Martin Luther, in 1527
wrote: "For more than a week I was close to the gates of death and hell. I trembled in all
my members. Christ was wholly lost." According to Luther's famous biographer, Roland
Bainton, Luther found himself "subject to recurrent periods of exaltation and depression
of spirit." Luther himself had written that "the content of the depressions was always the
same, the loss of faith that God is good and that he is good to me."

The famous preacher Charles Spurgeon, who lit the fires of the nineteenth-century revival
movement, struggled so severely with depression that he was forced to be absent from his
pulpit for two to three months a year. In 1866 he told his congregation of his struggle: "I
am the subject of depressions of spirit so fearful that I hope none of you ever get to such
extremes of wretchedness as I go [through]." He explained that during these depressions,
"Every mental and spiritual labor…had to be carried on under protest of spirit."

In the Bible we find that Moses, Elijah, Job, and Jeremiah suffered from depression, often
to the point of being suicidal. Elijah's miraculous victory over the prophets of Baal in 1
Kings 18 is followed in the next chapter with Elijah despondent and trembling with fear:
"And he was afraid and arose and ran for his life…and sat down under a juniper tree; and
he requested for himself that he might die" (1 Kings 19:3-4; all verses quoted from the
NASB unless otherwise noted).

I've heard Elijah here described as being a coward or accused of having a grand old pity
party. Such interpretations fail to see God's compassionate response to his cry: "And the
angel of the Lord came again a second time and touched him and said, 'Arise, eat,
because the journey is too great for you' " (19:7). Far from criticizing him, the Lord
allows him to rest and twice sends an angel to feed him.

Job cried out in the midst of his suffering, "I cannot eat for sighing; my groans pour out
like water…. My life flies by—day after hopeless day…. I hate my life…. For God has
ground me down, and taken away my family…. But I search in vain. I seek him here, I
seek him there, and cannot find him…. My heart is broken. Depression haunts my days.
My weary nights are filled with pain…. I cry to you, O God, but you don't answer me'"
(3:23-24; 7:6, 16; 16:7; 23:8; 30:16-17, 20, LB). Notice that even with his depression, the
Bible says, "In all this Job did not sin" (1:22). Moreover, God reproves Job's friends for
accusing Job of sin and for their "failure to speak rightly concerning my servant Job"
(42:7-8).

So the answer to our question is a definite yes: Spirit-filled Christians can experience
emotional problems.

Those who adhere to the emotional-health gospel often believe that negative emotions are
in themselves sinful. We need to ask them how they account for the displays of Christ's
emotions. In the Garden of Gethsemane, he "began to be very distressed and troubled.
And He said to them, 'My soul is deeply grieved to the point of death' " (Mark 14:33-34).
Jesus, in coming to earth, took upon himself the form of a human with all its frailties, yet
he did not sin.

Paul writes with affirmation, "And I was with you in weakness and in fear and in much
trembling" (1 Cor. 2:3). Later he wrote, "We were afflicted on every side; conflicts
without, fears within. But God, who comforts the depressed, comforted us by the coming
of Titus" (2 Cor. 7:5-6).

Consider this thought experiment. Give me the most saintly person you know. If I were to
administer certain medications of the right dosage, such as amphetamine, thyroid
hormone, or insulin, I could virtually guarantee that I could make this saint anxious with
at least one of these agents. Would such chemically induced anxiety be explained as a
spiritual sin? What if the person's own body had an abnormal amount of thyroid hormone
or insulin and produced nervousness? I have seen patients in this precise predicament.
While the church should never condone willful sin, it must learn to accept that people
within it may suffer from emotional symptoms that are not the result of personal
unconfessed sin, as many proponents of the emotional-health gospel suggest. We must
take seriously Paul's injunction to "encourage the fainthearted, help the weak, be patient
with all men" (1 Thess. 5:14).

CALLING WOUNDS SCRATCHES

Which brings us to the heart of the problem with the emotional-health gospel. Followers
of the emotional-health gospel often have a naive understanding of the nature and cause
of mental illness. Is mental illness always due to sin? Can people cure themselves by
doing or thinking the right things? What role do chemicals and genetics play? What part
can good, biblical counsel have in restoring people? How we answer these questions will
dramatically skew how we deal with those suffering emotional problems.

It is tempting for people experiencing everyday stress and its accompanying anxiety or
depression to think that those with severe emotional problems feel much the same as they
do—only a little worse. After all, isn't depression merely feeling blue or down, and
anxiety just plain worry or nervousness?

One minister writing on depression stated that he was "depressed" for several days after a
property contract had failed. He wrote, "As a basic rule I never sympathize with
depressed people…. These people have already pitied themselves excessively, thus
generating their depression. What they need is help, which comes by gently getting them
to see that they are indulging in self-pity." From the experiences of the many patients I
have observed, I strongly doubt this author has experienced or understood clinical
depression.

Recent studies of more than 11,000 individuals found depression to be more physically
and socially disabling than arthritis, diabetes, lung disease, chronic back problems,
hypertension, and gastrointestinal illnesses. The only more disabling medical problem
was advanced coronary heart disease. And the U.S. Department of Health and Human
Services reports that individuals who have suffered both emotional illness and cancer
report that their emotional illness caused them the greater pain.

Deep depression is not just self-pity. The level of anxiety of those with generalized
anxiety and panic attacks is significant even during sleep. If you can imagine the anxiety
of being on a hijacked airplane and seeing several copassengers shot, you can begin to
grasp the level of anxiety some people suffer for days at a time. Even people with
moderate clinical depression (dysthymia) feel pain on their best days.

From a research perspective, the emerging answer to what causes emotional illness
involves three components: nature (one's biological, chemical, and genetic makeup),
nurture (environment, circumstances, teachings), and personal choice (which can but
does not necessarily include sinful choices). Not uncommonly, the cause is a combination
of all three of these.

While research into these matters is still in its infancy, some conclusions are already
clear. Any paradigm that judges all mental illnesses to have the same cause (whether it be
"sinful choices" or chemical imbalances) is too simplistic. We are a complicated and
dynamic amalgam of body and spirit, nurture and nature. Any attempt to reduce our
holism dishonors the Craftsman who made us.

Let me provide some examples of how these factors interact. More than a decade ago I
experienced a severe depression caused by an external event: a patient for whom I cared
very much committed suicide. For over three months a devastating sense of doom kept
me feeling desperate and hopeless. I forced myself to socialize, exercise, and think on
positive things. I spent additional time in the Word and in prayer. But I couldn't shake the
depression until I asked for the help of a colleague. A circumstance in life (nurture) had
thrown me into a tailspin I couldn't handle any more than I could a car out of control. At
the height of my depression, I am sure my brain chemistry was affected. Still, God chose
to preserve me through talking with a colleague, which had the effect of restoring me
emotionally and, theoretically, chemically.

While my depression had been triggered by an outside circumstance, Marty's* was the
result of a physical cause. A popular Big Ten athlete and a committed Christian, he
encountered his first major depression the year after college. While at times he
experienced tremendous highs, other times it took incredible effort for Marty to get up in
the mornings, go to work, play with his young children, or go to church.

He was afraid of discussing his problem with friends because he believed it was a
symptom of sin. He prayed, struggled, asked God to forgive him, and looked for what
God might be teaching him. The only answers he heard from conference speakers and
church leaders were prayer and confession. He wondered if demons caused his affliction.
When his problem was diagnosed as a physical one—bipolar disorder—I started him on
lithium. The results produced an emotional stability that has lasted to this day—12 years
so far. He is very active in his church and is involved in discipling a number of young
men. But because of the stigma, only his wife and I know of his condition or that he is
taking medication.

A number of studies point to a genetic origin of bipolar disorder. They show that while
close relatives and the second fraternal twin have a 15 percent probability of acquiring
the disease, the second identical twin has a 75 percent chance of acquiring it.
While Marty's illness had an internal cause, it resulted in external behaviors. The same is
true for the cure. Does the physical cause of his illness mean that he was not responsible
for his behaviors? No. We all have to stand before God for what we have done. Yet
independent of what one does, we know that a person with a bipolar disorder is helped by
chemical therapy.

Pat* provides an example of the inadequacy of a rigid physical/spiritual distinction and of
the interplay between nature, nurture, and personal choice. A vivacious 23-year-old
secretary, she had been extremely healthy until her car blew a tire on a busy but
unfamiliar Los Angeles street. When she noticed the graffiti on the walls and people of
another ethnic group who seemed to be watching her every move, she grew frightened.
Subsequently, whenever she drove more than a few miles from home, dreadful panic
attacks ensued. She feared, she said, she would "go Loony Tunes" or die. These attacks
soon began to control her life, even when she was in "places that were perfectly safe."
She also began to withdraw socially.

Her agoraphobia, as this kind of fear is called, had occurred in her family before. Her
maternal grandmother and an aunt had experienced panic attacks, and her mother was
afraid to ride elevators. As Pat sat in my office for her first appointment, she asked,
"What is the cause of these attacks—physical or mental?"

"The answer is both," I told her, explaining that these factors cannot easily be separated.
Studies show that 7 percent of the population develop panic attacks (with or without
agoraphobia) during their lifetime, and 25 percent among those with close relatives with
the problem. Which raises the question: Does agoraphobia run in families because of
genes or environment?

In 1946, it was observed that patients with panic attacks often have an intolerance to
heavy exercising. Researchers found that during exercise the body normally produces the
chemical sodium lactate, but at higher levels in those who suffered from panic disorders.
In 1967, Ferris Pitts injected sodium lactate intravenously into individuals prone to panic
and found that the injection usually brought on attacks similar to the patient's worst
attacks. The fact that individuals not subject to panic disorders in the first place did not
develop attacks when given the sodium lactate pointed to a chemical difference in the
individuals who experienced the panic attacks.

A later study showed that if patients with panic attacks were given certain medications,
such as an antidepressant or a benzodiazapine tranquilizer, they greatly decreased or
prevented panic attacks from developing when the sodium lactate was later injected.
These are the medications we now use to help individuals such as Pat.
Interestingly, doctors also discovered that telling their patients to relax in order to relieve
their anxiety usually did not work. In fact, for six out of ten patients, trying to relax
actually brought on a panic attack.

With this medical evidence, it is obvious that we cannot attribute such panic attacks to
wrong thinking or choice alone; there are clear underlying biological and chemical
factors. The latest research shows that in anxiety disorders, the nerve endings overfire
and excite the brain with chemicals called catecholamines. Medications we use to treat
anxiety help reduce this overfiring to a normal level.

So what caused Pat's panic disorder? Her history suggests a very strong geneticbiological
vulnerability to develop panic attacks. The fact that her grandmother and
mother often communicated their fears to Pat while she was growing up points to a
developmental influence, as does her learned fear of neighborhoods painted with graffiti
and populated with people of a different ethnicity than her own. The threatening
experience of being stuck on that unfamiliar street provided the environmental trigger
that precipitated her first attack.

Besides nature and nurture, a third part of the equation—personal choice—must be
factored in to understand her attacks fully. Her later avoidance behaviors (such as not
driving far from home) decreased Pat's panic attacks for a time, but they also allowed her
fear to fester and grow. Even after we talked about how avoidance can make panic worse,
and I had encouraged her to take steps to counteract it, she had a hard time following
through on the assignments. She also continued to feed her fears with the notion that she
was going crazy. Such "catastrophizing" often leads to a debilitating fear of having panic
attacks. Since agoraphobia increasingly incapacitated her, I recommended some
medications that often help. To date she has refused them—another choice.
So are Pat's problems caused by sin? If her pastor tells her simply to trust in the Lord, to
pray more, and to meditate more on Scripture (all of which is generally very good
advice), have we really understood or helped Pat with her problems?

WHAT THE WOUNDED NEED

An issue of Moody magazine several years ago addressed the debate over Christian
counseling. A number of writers took a strong stand against it. But Joseph M. Stowell,
president of Moody Bible Institute, offered the balanced view I am arguing for. He said,
in part:

There is often a need for well-trained counselors to lead the broken to healing.
Does that mean the Scripture and the Spirit are not sufficient? No…
While much that is taught and practiced in secular counseling is unbiblical, it is
also true that there are many helpful insights to be gleaned from this field….
We live in a season when life is increasingly complex and the fragility of precious
souls is demonstrated by growing brokenness and complicated conflicts. We dare
not waste their sorrow on the battlefield of careless counsel that violates biblical
parameters or with simplistic, unqualified solutions that plunge them ultimately
into deeper despair.

What the emotionally wounded need is for the body of Christ to be a place of love,
acceptance, encouragement, forgiveness, and compassion. They need a place where
Christ is lifted high and God's Word is never compromised but also where there is
openness to use all available methods of healing that are not contrary to his Word. This
kind of environment will not only foster emotional growth, but it will make this healing
effort a spiritual service pleasing to God.

Dwight L. Carlson, M.D., is the author of several books, including Why Do Christians Shoot
Their Wounded? (IVP), from which this article has been adapted. He lives with his wife in
Torrance, California.