Well, good afternoon, students. This is our public policy class, and we're in the topic of medicine this spring. And I want to look at psychiatry today from a pastoral standpoint. I'm not a psychiatrist. I'm not even a trained counselor or psychologist. And so, I know the Word of God, And I am grateful that God's Word sheds light on a variety of topics. And through personal experience, affliction, driving me to ask questions in the Word of God, and then walking with people as they go through their own valleys, again, driving me to ask questions of the Word of God, driving me to ask questions of those who know the Word of God, and also know of these phenomena of the mind better than I do, I want to just share with you then some things that I have learned. And as Paul would say, I trust that my opinion has some value and is trustworthy. So, may the Lord lead. Whatever is not true according to scripture, may that slough off. And then whatever is true according to scripture and according to reality, And may that stay. And so may you be encouraged by this. It's been interesting as a pastor now in my middle years. I'm 50 years old. I've had the opportunity since age 30 to walk with a variety of people. And one of the things that was most eye-opening to me was to realize how many of my congregation members are actually on a medication. some kind of psychiatric medication. It is so common. I remember when my wife had surgery. In comes, you know, as part of the regiment, she was an inpatient for three days in a hospital. Here comes the local psychiatrist and he wants to say, you know, how are you doing? Do you have any depression? Do you have any anxiety? And he was ready to fill out a script right there to give her some medication. And it's just common practice now. It's almost assumed that this would be the case. And so, in looking at and asking questions, wondering, Lord, what do you think about this? A couple things have come to mind to kind of set it in a larger context. So, I want to mention two contexts and then describe the issue in terms of approach. And so almost like a diagnosis and then a prescription. And so as we look at the context in which we live, let's keep in mind, number one, our society is very, very prone to be pain-free and safe at all costs. That's going to affect this issue in a couple ways. Safe at all costs means if there is any chance that this depression might lead to suicide or that this anxiety might lead to some harmful behavior. Immediately, we're going to go on the route, as a society, of putting this person on a prescription. It is deemed as lesser of two evils, but I'm not even sure it's even seen as an evil or a bad thing. We're going to err on the side of safety. That's number one. There's even posters about depression that you'll see on billboards, and it's danger. I'm not sure society in the past treated these symptoms in the same way. It is known that melancholy, to describe John of the Nezareth's term that we saw last week, it was known that melancholy could lead to suicide. And Edwards, in his book, Faithful Narrative of the Surprising Work of God in Conversions, talks about even one person who became so overcome by anxiety over heaven and hell and their future state that they ended up taking their life. And so, it was known. They didn't have the means, per se, that we do today to prescribe something. And so, maybe that's the reason why they didn't go that route, just it wasn't available. But just know, our society is very, very prone to value safety almost at all costs. And this is a challenge to us. There is a danger here. I am not minimizing that danger at all. And if you know of anybody who is prone to suicide and you have heard of it, you are under obligation to tell somebody who is an authority figure in their life. You cannot hold that in. If somebody says something like that, you need to talk about it. This is a very serious issue. and I've sought counsel myself. What do I do? This person has just told me they are contemplating taking their life. There is protocol in the psychological world on how to handle these things and care can be given and institutional care can be given. In a psychiatric ward, the person can be kept safe and then counseling can be given. So, I am not minimizing the danger at all, but I'm wanting you to be aware that for people that aren't even close to being in that position, like my wife in the hospital, here's the fellow with the prescription ready. If she just said, you know, I'm feeling anxious today, he probably would have given her a prescription. Similarly, out in this idea of being pain-free is also a value. So not just that we want to be safe, but we also want to be pain-free. Recently, we had a family member who had wisdom teeth taken out. And it is standard now that the person be put out, that there be anesthesia, general anesthesia, and you just sleep your way through this oral surgery. Be aware, that was not standard procedure a generation ago, even with the means of general anesthesia. It would be local anesthesia and it would be done right there. You would be conscious or maybe semi-conscious, but it wasn't like complete general anesthesia, which by the way, has its own risks. It's not just a fail safe approach. So that's just a small little vignette of the kind of thing I'm pointing at. We are a culture that is very much valuing safety almost at all costs, which is ironic. At all costs brings with it its own risk, as well as that we don't want to experience pain. And in the long term, what that does is it prohibits us from developing in deeper ways. It reminds me of my corn that I was growing in Louisville, Kentucky. I was a brand new gardener. I'd taken out the lawn and had tried to work the soil. It was horrible. I didn't know what I was doing. It was full of clay. I put no compost in it, nothing. But I planted my corn and it shot up four inches tall and then utterly fell over. They all fell over on each other. and I'm glad nobody took a video of this because I will admit it, I was out there propping up my little corn with sticks. The problem was is that I had overwatered it and it didn't have time to develop roots, to dig down into the soil. Now, that's my ignorant gardening even there speaking. Perhaps it was just poor soil to begin with. But it strikes me as a picture of the need to allow some kind of suffering in order to develop roots and to force the issue, almost, or at least to provide the opportunity for faith to dig down deeper, to find more solid footing and firm foundation deep. This is the value that scripture presents to us for suffering in general. Both Romans chapter 5 where Paul actually exalts not just in the hope of glory but the means of the hope of glory. That hope of gaining heaven Experientially, that hope or confidence grows as my character is confirmed through perseverance. Perseverance only comes where there is tribulation or pressure. Therefore Paul says I'm not just gonna rejoice in going to heaven someday and the hope of going to heaven I'm gonna rejoice in what strengthens my hope that I really am a believer and that nothing can shake my foundation Christ is solid enough and Those are the tribulations the trials that come It builds hope and Paul then could rejoice in them. Ironically. He could rejoice and even boast in them Similarly, he says in 2 Corinthians 12, he says, take the thorn of the flesh away, I just want it gone, and we do pray, as in the Lord's Prayer, deliver me from the evil one, lead me not into temptation, but it's all under your will. And so, Paul prayed and Jesus said back to him, my grace is enough for you, Paul. Power, my power, is perfected in your weakness. I want you weak. It's going to keep you humble, because you've seen great things. You need this to help keep you humble. And I'm going to empower you in it. My power is perfected in your weakness. Therefore, Paul said, most gladly, therefore, I rather boast in my weakness that the power of Christ, that the power of Christ may dwell in me. Therefore I am well content, he says, with weaknesses, with distresses, with persecution, with difficulty, with insults for Christ's sake. For when I am weak, then I am strong. That combination of perfect tenses there is really intriguing to me. Because we want to say, if I am weak, then I can't be strong at the same time. Therefore, when I'm done being weak, then I will become strong. And God's purpose often for the Christian is to purposely make them weak and simultaneously strong. To have fellowship in the sufferings of Jesus and simultaneously the power of His resurrection. That's what Paul describes in Philippians 3 as knowing Christ. It's interesting that that thorn in the flesh was also a messenger of Satan. So it was a combination of both spiritual oppression and with physical manifestations. And he had learned to be content. That's encouraging on two sides. One is it takes learning. You don't just get this when you're a new Christian. On the other side, it can be learned. Paul says in Philippians 4, I have learned to be content in all circumstances. And I think it was that experience of asking the Lord to take away that thorn of the flesh three times is when he learned to be content finding that with this problem I can also simultaneously be strong. Well, James has a similar approach to suffering. In James chapter 1, consider it or reckon it pure joy when you encounter various trials, knowing that the testing of your faith produces endurance, and let endurance have its perfect result. that you may be perfect and complete, or mature and complete, lacking in nothing. Let it have its result. We don't want suffering to work its way out. We want to, give me the pill, give me the way out, get me out of here, Lord. Pray it, but if he says no, recognize he has a good design in the suffering for you and for his kingdom. And so we need to trust him on what that may be. Well, that brings up just a follow-up warning on that. We need to be careful, as John Piper said famously, to not waste our life. There's a book that he published. It was entitled, Don't Waste Your Life. And our senior pastor has given that book out just so it could be on people's shelf. Even, he said, if they don't read it, at least it says, don't waste your life. It preaches just sitting there. Well, John Piper got cancer in his mid-60s, and he put out a little booklet afterwards called, Don't Waste Your Cancer. There's opportunities to learn and grow through this. Ask the Lord to open your eyes to see it. Those who desire to get out and grab an artificial way out are in danger of the warning in Isaiah chapter 50, Who among you, who is among you that fears the Lord, that obeys the voice of his servant, that walks in darkness and has no light? And so here's somebody who worships God truly and obediently, and yet walks in darkness and is lacking light. I believe Christians can be depressed, can be oppressed. I think even Paul exhibits that in 2 Corinthians, where he speaks about weakness. Let him, the prophet says, let him trust in the name of the Lord and rely on his God. Now, we're gonna show a little later, this relying on God may be to have a little wine for our stomach's sake. It may be a means that God has provided. We want discernment in this. But let's be aware, some of the ways that the world presents to us as being an out are not truly relying on God. And so the prophet warns, Behold, all of you who kindle a fire, who encircle yourselves with firebrands, so this is a light we make of our own doings, walk in the light of your fire, and among the brands you have set ablaze, this you will have from my hand, God warns, you will lie down in torment. Self-reliance will always lead to self-destruction in the end and the punishment of God. And so we must rely on God. We must wait on him. We must look to him. And it may be after three earnest prayer sessions, like Paul, God says, no, I want you to be weak, but I also want you to be strong. and I want to teach you to be content. So this is first premise. Society really values safety, really wants to be pain free, and so we need to be careful as Christians not to buy into that safety at all cost, pain free at all cost, because the at all cost is actually a danger in itself. Second premise, if we're talking about mental health and psychiatric stuff, let's just be aware a Christian can go crazy. There is no promise in scripture that says, I will always have my mental faculties. There is nothing like that in scripture. In fact, it has been testimony that there have been many Christians, and we know of some probably personally, who have gone crazy at the end of their lives through Alzheimer's, a disease in the very flesh of what enables them to think. And so I do believe that with 1 Corinthians 14, there is a mystery between my thinking and my spirit. Paul says that he could pray in tongues, and his spirit would be praying, but his mind would be inactive. I have a good friend of mine who has a closed-head injury, and he has short-term mental loss, memory loss, and yet quotes scripture profusely and beautifully and powerfully. And I've seen that as a picture of the ability, the difference between spiritual power and mental power. So, if the disconnect is so strong, whether in a coma or whether in Alzheimer's, that all we're seeing is just body or flesh and the person is behaving irrationally, even meanly, the flesh has never been promised to be redeemed. It must die or at the rapture be changed. That's not the real person according to Romans 7. A Christian is a combination of spirit and flesh. And the flesh is ugly till the day we die. It is thoroughly sinful. And as Paul says in Romans 7, I know that nothing good dwells in me that is in my flesh. And he's not speaking just metaphorically. He's speaking of the law of sin in the members of his body. And he cries out, O wretched man that I am, who will deliver me from this body of death? I think, Christians, we need to recognize the reality of our body. It will tempt us till the day we die. It is to be treated with respect, because God will redeem it in the resurrection. We are not to be like the Greeks and trash it. or the early Christians that were very Greek, dualistically oriented, the ascetics who took no care of their body. No, the body is to be valued because it is part of who we are as humans and Jesus will redeem it. A human is a body-soul-spirit combination. But, let us be recognized, the redemption happens in stages. Just as right now we have the spirit of adoption in us, we do not have the adoption yet. This is Romans 8 language. We have the spirit of adoption that cries out, Abba Father, but we don't yet have the redemption of our body, which is called the adoption. And so, theologians call this the already not yet. and recognizing the already not yet is thinking biblically, thinking realistically. They call it an over-realized eschatology when Christians assume they can act like they're in heaven already. They can act like I'm only a spirit being and even my body is spiritualized. No, you have a soulish body. You will get a spiritual body, 1 Corinthians 15, a body oriented to the spirit someday. But right now, you have a soulish body. It is a natural body. And Paul calls what we deal with in that realm flesh. And it is always a temptation to sin. We'll talk more about this next week when we deal with the question of genetics and behavior and the interplay between spirituality and body and the mystery there. Let's just recognize right now the charismatic community and the Pentecostals Though I respect their faith, and I even asked once in my life, I want to know some Charismatics, and God gave me the privilege to teach for a while at a Charismatic Christian school. because I wanted to see that side of Christianity, and I respect their big view of God and their faith. They pray. Sometimes I think it's a zeal not according to knowledge. Because of what we saw earlier with Paul and his thorn in the flesh, God does not promise that all my problems will go away. He doesn't give healing to everything in this life. He has promised me resurrection and He has promised me now suffering. And so sometimes I'll overcome it and He'll get glory. I believe He can miraculously heal me. Praise God. But He may not. He may instead keep me weak and simultaneously make me strong. Just remember historically, the Pentecostal movement grew out of the Wesleyan movement. And the Wesleyan movement grew out of a logic that said, if it's a duty, I must have the ability. That same kind of logic said, if God is able, it must happen. He is able to cleanse me of all sin and perfect me. Therefore, and he commands me, perfect love and entire sanctification. Therefore, it must be possible in this life. Well, he is able to do it, but he has chosen not to do it. Romans 7 speaks of a believer's life. We continue to sin. Romans 8, we make progress. Romans 7, we continue to sin. And so, a perfectionistic mindset coming out of Wesleyan holiness then projected upon the physical problems of life, I believe, gave birth to the kind of charismatic mindset that though it has a faith in God, I think it lacks the basis of knowledge that says suffering is still a part of what we must experience. So, recognizing an all or nothing approach to Christianity is not going to be what we need. We need an already not yet, a both and. It's interesting, one of the books I give to young couples when they're going to get married is called, A Promise Kept, The Story of an Unforgettable Love by Robert McQuilkin. He was a president of a theological school and very involved in missions and conferences and writing. And his wife, an intelligent woman, I think she had her own radio program, engaged in ministry. Can you believe it? In her mid-fifties, started showing signs of Alzheimer's and dementia. Eventually, she became so disturbed, and yet she was happy, but she needed to be around her husband. And if she wasn't, she became very distraught. And this man, in keeping his covenant with his wife, quit his public position and devoted himself to caring for this woman in faithfulness to his marriage vows. And I've sometimes wondered and questioned whether that was the right decision because, you know, obviously the bride of Christ is more important than my bride, but yet Could God use this suffering to open up new doors of different kinds of ministry? And can I trust Him that keeping this faithful covenant, keeping this covenant faithfully, will in His hands actually be a surprising means of furthering? I think so. Otherwise, Paul would have balked at going to prison. and said, well, you're putting me in accessory of prison for two years. How is that going to further the gospel? You're keeping me from getting to Rome. Well, he writes his epistles while he's in prison. And now we have this story of marriage faithfulness, as well as a testimony to God's power perfected in weakness. Christ gets his glory. Well, let me just then move from the background, which took quite a while to explain but I think is important, and just kind of make the application. There's going to be three approaches among Christians when it comes to psychiatric care. Three schools. One is the secular school. And many Christians are trained professionally in our secular schools And so are very comfortable giving prescriptions. And as I found as a pastor, Christians are very comfortable receiving them. And so the secular school assumes that chemical imbalances are basically it. And so let's treat it, establish a chemical balance. In my mind, that's still a debated question, this whole idea of chemical imbalance, but it's a materialistic approach. to the human psyche. This is almost as if we're all body. On the other hand is the purest approach. The purest approach is a reaction. Jay Adams is the start of the New Thetic counseling movement coming out of the late 60s. It's now the biblical counseling movement. I think it's more mature. I appreciate Jay Adams and I appreciate his faith the same way I appreciate a charismatic's faith. But it's another all or nothing approach. It's as if we're all spirit. And so rather than just look at mere counseling and biblical counseling even, or mere medicine and pills, There is also an integrated approach out there that seeks to combine the value of psychology and the value of scripture, and it's called Christian psychology. Much of that, I wonder how biblical it really is. If I had to lean one way in the middle, I would lean towards the biblical counselors, believing that there is still much to be gained by contextualizing the Bible's wisdom, and that many, as I said last week, many of the psychological problems are due to problems in our conscience, and that is exactly where the gospel needs to speak. So, But not all problems are merely thought or even spiritually derived. There is still a body, soul, spirit combination to the human being. And so I think that leaves the door open for possible uses of medicine. So as a general rule of thumb, if we remember the iceberg from last week, how the person presents, and then the three possible sources of body, mind and spirit. I want to treat physically caused disturbances with medicine. For example, if I, if I'm working with a former drug addict who has mentally broken their capacities through drug abuse, Antipsychotic medication may be exactly what is needed to provide some kind of stability until the day the Lord redeems them fully. I want to treat emotionally caused disturbances with life training, not just talking, but training. I think a lot of the disturbances we see among children today are due to the brokenness of our homes, I think there's a lot of ADHD or ADD that is caused by lack of exercise, poor diet, overstimulation with video games, and other undealt with relational issues. I heard testimony from one of our ladies who worked in a school that Some of the young people that gave difficulties in this public school were resolved just by her listening to their story. And then the person felt better and they were able to go back in the classroom and not be disturbing anymore. Because the inner unrest found an outlet. And so there's a host of causes underneath. And so I want to go that route first. Let's explore that first. If we find that, say, there is a physical or psychosomatic dimension to this due to maybe some kind of syndrome, some kind of abuse, some kind of genetic or something, Let's explore medication to stabilize the individual. We may actually find in working with this person that maybe it was caused by thought or even lack of faith or just a traumatic situation that just overwhelmed the system. And it may be, as one pastor in Kentucky, my pastor, counseled an entire congregation that for a season, A medication is helpful to stabilize the person, giving them breath and opportunity to then face their problems, giving them opportunity to have the choice of faith again. Do you want to believe and make strides forward or not? It may be that a medication is helpful to help stabilize I remember one lady that I worked with once had been, I was told, so depressed due to the loss of her husband, she didn't leave her house for over a year or something like that. And then with a little medication, all of a sudden she was able then to come out of the house and deal with life again. Now, As one of my pastors at the church who has training in this says, the big issue is, how are they going to deal with their life problems? Don't fixate on the medication, was his counsel to me as a younger pastor, but focus on their choices with regard to their life problems. Are they facing it in faith? Every drug eventually gets to a stabilizing, equalizing place, and they're back to a normal state again. Now they're dependent on it, but they're back to feeling the raw emotions often. They're back to still facing the difficult life challenges. At some point, the person has to make the choice of faith. And so that's where I, as a pastor and a gospel preacher, want to focus my attention on. Now, with that said, here's a couple thoughts based on scripture that help give a mode of thinking. One is, I think, 1 Timothy 5, where Paul says, keep yourself free from sin to a young pastor who's timid, who even can have some assurance issues of salvation. I believe, Timothy, Paul tells him, After he makes, keep yourself free from sin, he says, oh, oh, use a little wine for your stomach's sake. That may seem out of place, like that's random. It's not in the topic. Oh, it is in the topic. The topic is I'm dealing with a very sensitive soul who wants to keep free from all sin. And in their striving to be super spiritual, actually commendably spiritual, fear is keeping them from using legitimate means, physical means, that would help. We're not just spirit beings. We are body spirit beings. And so some better eating habits, better sleeping habits, and on occasion, a little wine or a little medication is helpful for the spirit. It's helpful, yes, for the spirit because our body influences, not determines, but influences how our spirit is, the circumstances our spirit is facing. We don't want to be addicted. We don't want to be drugged in the sense like we are drunk. That's forbidden. Even Jesus on the cross kept his mind in that sense. We need to be cautious there. But as far as Paul's word of a little, use a little wine for your stomach's sake, if a little medication stabilizes my emotions for a season, enabling me to focus better on my problems and make choices of faith, I personally am not opposed to that option. I think it's part of the realm of conscience, and so I respect those who would differ with me, but I personally find that as an option. Coupled with that, one thing I would then add is this. While that option is there for a season, I think Paul's language when it comes to slavery would apply here. Paul says, were you called as a slave? 1 Corinthians 7, 21. Don't worry about it. It's like, almost like, did you become a Christian while you were on a medication? Don't worry about it. What a neat scriptural phrase. But if you are able to become free, rather do that. And then he says later, you were bought with a price. Do not become slaves of men. I think if we don't have to, we should avoid getting on a medication as a Christian. Let's seek our Lord and see if there's other options, things I've just mentioned. But as far as if I'm on a medication, don't worry about it. If I can become free, rather do it. That vision there of moving from slavery towards freedom, if possible, I think shows the kind of balanced trajectory that the Bible points on this kind of issue, too. If a medication is found necessary due to physical whatevers, then accept it. But if you are able to move from more medication to less medication or from less medication to no medication, rather do that. A Christian should value freedom. Let's move in that direction if we can. And if we can't, we recognize that our body will not be redeemed in this life. It must die or be transformed at the rapture. This requires discernment of thinking. It requires, I think, a graciousness of spirit in handling differences among Christians. And it requires a recognition that God has designed us to endure some measure of suffering in this world, but in his grace has given also some measure of relief as well. And so I am wearing eyeglasses right now because God in his kindness allowed technology. In fact, I believe led technology to develop lenses, corrective lenses, so that my physical ailment, which is continuing to get worse, can still be helped so that I can serve God better and serve people better. I think this also is part of the gifts that God has given. But like all gifts, whether it's money or other measures, we can tend to shift our faith to the measure instead of the God who provided it. And that brings us full circle back to the beginning. Let's be careful that we are not making our own light where this becomes my crutch, my God, as it were. No, God is my God. I depend on Him and am thankful for whatever He has provided, spiritually and physically, and ultimately in the resurrection. So I hope this is helpful. If I had more time, I would even go into how the mindset of all or nothing pertains to money and the issue of debt, or the mindset of all or nothing pertains to homeschooling, the issue of educating children. It's like Christians, in reaction to what the world has said, rely on this, end up, I think, overreacting and becoming absolutists. And I think though that is the trajectory and the means we want to hold on to and embrace those ideals and put them into place, we should not close our eyes to the help that God has given to us by his providence and in his kindness. And so give thanks if we find ourselves like the Apostle Paul. Oh, I'm a Christian, but I'm also a Roman citizen. I don't rely on that, but every once in a while I pull that card out because it's helpful. It's a gift from God. May the Lord give us discernment. Thank you for listening to this. If you have questions, please email me. Let's talk about it. Maybe it's a personal issue. Let me know. It could be somebody you know. Maybe I can help. Thank you.