Biblical Counseling and the Medical Model
by Joe Leavell
Photo by Anna Shvets from Pexels
Like many people I know, for many years I have suffered from periodic migraine headaches. These headaches often come on strong when I am very tired, overly stressed, slightly dehydrated, or even if I am exposed for a long period of time to bright light. Usually they begin when my eyes start to pulsate, and I’ll see spots to the point that I can barely see out of my eyes. After 20 minutes or more the symptoms will subside and then I know I have about ½ hour until a very intense pain on either one or both sides of my head will torment me. These headaches can last between 4-6 hours and can sometimes be strong enough to make me lose my dinner.
When the migraines start, I immediately seek fast acting migraine medication. Do these meds prevent my head from throbbing? Unfortunately, they do not. They merely mask and dull the pain so that I can make it through the headache.
Several years back, my wife insisted that I see a chiropractor to see if they could help in some way. The chiropractor discovered that because of significant reading for my students and the way I was using my laptop, my neck was curving incorrectly, completely inflamed, and even small neck rubs were met with sharp pain. The chiropractor was able to explain with me how the problem came about. You know how your mom always told you not to slouch? Yeah, the chiropractor said I should have listened to her. He then showed me how to better care for my neck through posture and exercises.
Did I follow his advice? By and large I did, and the migraines began to fade. I still had to take medication when I got an occasional migraine. Rather than getting a migraine almost every week, now my bottle of migraine medication expired because I no longer needed it. Because someone was dedicated to thoroughly fixing the problem rather than just giving me medication, I went over a year without getting one migraine!
Of course, in my case, I’m a dude and a pretty hardheaded one. I haven’t been to a chiropractor in a very long time, have mostly stopped the neck exercises, and guess what, the migraines still come and go when my neck gets stiff and the other combinations of fatigue, stress, etc. hit me at once. At least now I know why and what to do about it when that happens.
Looking for Meaningful Solutions
Why do I tell you about my neck? Well, it is not so that we can have a debate on whether chiropractors are a sham or the solution to many medical problems. That’s a discussion for another place. I bring up that story because I want to illustrate how our biblical counseling model is different from the medical model by using my experience of someone seeking to find the underlying problem rather than perpetually masking the pain.
The secular medical approach to abnormal behavior sees a biological source behind all mental disorders. In this way, disorders are treated in the same way a doctor would treat a broken bone: with medication and perhaps therapy for the pain while the body heals itself. Does this model obtain some measures of success in changing behavior and alleviating symptoms? Absolutely! However, as was the case with my migraines, the medication model was never intended to solve the underlying issues that led to the problem but was merely meant to mask and dull the manifestations of symptoms.
This is vital importance to the conversation. If we merely have a biological disorder in the brain free from an interwoven eternal spirit, then we are merely victims trapped in a dysfunctional body. As such, we are no longer responsible for our body and we cannot find meaningful value beyond our diagnosis. Our disorder inevitably will become our identity because it is not something you have, it’s something that you are. This tragically takes away any hope of true joy amidst our dysfunction. We inevitably become passive and use our medication to mask the physical symptoms because we see nothing deeper in the cause or effects that our dysfunction has with the soul.
The Interwoven Body and Spirit
At BCA, we believe that the Bible teaches that God created us with two parts: body and spirit (Genesis 2:7). These two parts to our being are extremely complex and both greatly affect the other. For example, when Naboth refused to give up his family’s vineyard to King Ahab in 1 Kings 21. The physical symptoms of depression and even lack of appetite in Ahab were caused by his sinful unsatisfied desires of the heart. Ahab’s greed affected his body’s appetite and he sunk into depression to where he would not even get out of bed. Medication could certainly have masked his symptoms and maybe even provided him with energy but it never would have touched his heart of self-worship.
Yet is depression always the result of sin? No. In the case of the prophet Elijah, we find him in 1 Kings 19 in a time of exhaustion, begging God to take his life. God’s solution for Elijah was not an immediate lesson or reprimand. His solution was to give Elijah a good night’s sleep and nutritious meals that restored his physical strength. It wasn’t until after his body was refreshed that God began to speak to Elijah about his situation. In Elijah’s case, his body’s physical weaknesses affected his spiritual perspective of his circumstances and physical recovery was the primary need even before addressing his despondent heart.
This is critical for our understanding of how to treat clients with mental disorders. The medical model seeks to merely resign the human soul to mere chemical brain activity rather than a spiritual being that God interwove with a physical brain for the function of the body. This is why science has not been able to genetically find biological reasons and solutions for all our behavioral issues, such as anger, obsessive selfishness, pride, sexual addictions, etc.
These character issues stem not from biology but from a sinful heart/soul that manifest themselves in physical behavior. Those who are exhibiting an envious heart desperately need a spiritual change that can only be accomplished by surrendering our will to God’s. Others have genuine physical struggles, and sometimes their minds have ceased functioning as they were designed. These often find great spiritual pressure as did Job when he experienced tremendous loss and physical suffering. These are those who are in need companionship to encourage them in God’s faithfulness, love, and goodness to support them while they get the physical care their bodies need.
Does Medication Have a Place?
At BCA, we are not opposed to medical professionals giving appropriate medication. We are not doctors, and we will not give medical advice to clients on whether they should take or abstain from medication. As was the case of my migraines, my symptoms were not a spiritual struggle and medication was helpful. I used it to mask my pain as was intended until I could find the underlying solution.
We understand that the body can affect how we perceive things spiritually and vice versa. As such, we often encourage our clients to get a thorough physical exam (Prov. 18:13) or if there is evidence of dysfunction to see a good psychiatrist or neurologist. However, while medication can sometimes help dull the physical symptoms, medication alone cannot solve the complex spiritual nature of humanity. The good news? We serve a God who can! This is why we are “Biblical Counseling of Arizona.” While a doctor or a psychiatrist can be of value in helping physical symptoms, God alone is able to sufficiently both change and comfort the hearts and lives of His people.
For further study:
http://www.biblicalcounseling.com/blog/nanc-myth-2-nanc-counselors-are-against-medical-science
Blame it on the Brain - by Ed Welch
Counseling the Hard Cases - by Stuart Scott and Heath Lambert
