We generally do not engage others who are blogging as there is no end to the controversies in which we could involve ourselves. We also rarely post guest bloggers. Today we make an exception to both general policies to bring you an important article from our friend “Ab” Abercrombie.
In recent weeks, an article appearing on the Internet has caused great stir in the biblical counseling community, and in the Body of Christ at large. There has been much debate through the years regarding psychology, psychiatry, and medication, as they relate to and interface with biblical truth. This latest addition is no different except it advances opinion and position without biblical consideration.
The article “Listening to Prozac…and to the Scriptures: A Primer on Psychoactive Medications” is written by Dr. Michael Emlet (M.Div., M.D.), a faculty member of the Christian Counseling & Education Foundation (CCEF). As a medical doctor and theologian, Dr. Emlet should be considered an expert in this matter. However, a thorough review of the article reveals a position, which is unbiblical in its foundation.
The article begins with reference to two different case studies; one benefiting from medication; another showing no gain and feeling a conviction to live medication free. The author speaks to the conundrum of these diverse situations and suggests, rightfully, that medication has become commonplace in the Christian community and counselors must increase our knowledge of pharmacology. But Dr. Emlet also states “we need a biblically-based philosophy to guide the use or non-use of medications” (Emlet, p 1).
Amen…I thought. Then I read the rest of the article.
Over the next few pages Emlet provides useful information regarding the classes and categories of psychoactive medications, their applied usage, drug names for identification, and possible side effects. This is helpful information for any counselor unfamiliar with such drugs and is useful in understanding how the counselee views him/herself, and how he/she has been “diagnosed” and treated by the medical community.
From here the veracity of the article gets muddy. Dr. Emlet goes forward with a lengthy discussion of how these drugs are supposed to affect the brain and eventual life of the patient. He asks the questions we all want answered: “How do they work?” and “Are they treating ‘chemical imbalances’”? (Emlet, p 14).
Unfortunately the answers never come. Instead the reader is provided a treatise on how the brain works and speculation to the possible effects of psychoactive drugs on the brain. Based upon his research, Dr. Emlet’s conclusions are less than inspiring:
Are we treating true chemical imbalances?
“We don’t really know—maybe” (Emlet, p 15).
Are psychoactive drugs effective?
“…we do not know exactly how these medications work in humans” (Emlet p 14).
Thirty-five percent (35%) of individuals who are given a “placebo” drug, report improvement (Emlet p 15).
“So, at the end of the day, of those 100 patients who got the active drug, 30% did not respond, 35% may have responded by virtue of a standard placebo effect, and 35% may have responded due to the actual effects of the drug itself” (Emlet p 15).
“At this point there is no way to predict who will respond best to which treatment” (Emlet p 15).
Are drugs more effective than counseling?
“Individual studies have revealed that even in moderate to severe depression…counseling was equal to medication at four months of treatment” (Emlet pp 15-16).
In an earlier article entitled “Are Psychology and Psychiatry Medicine”, this author provided a review of other studies, which leaves the biblical counselor with even less confidence in the usefulness of such medications. Dr. Kenneth Kendler (2005), a psychiatrist and co-editor in chief of the journal Psychological Medicine said: “We have hunted for big simple neurochemical explanations for psychiatric disorders and have not found them” (p. 433).
In his book, Blaming the Brain (1988), Elliot Valenstein, professor emeritus of neuroscience wrote: “Although it is often stated with great confidence that depressed people have a serotonin or norepinephrine deficiency, the evidence actually contradicts these claims” (p. 292).
Stanford psychiatrist and researcher David Burns is quoted as saying: “I spent the first several years of my career doing full-time research on brain serotonin metabolism, but I never saw any convincing evidence that any psychiatric disorder, even depression, results from a deficiency of brain serotonin. In fact we cannot measure brain serotonin levels in living human beings so there is no way to test this theory” (as cited in Lacasse & Gomory, 2003, p. 385).
So even before the consideration of Scripture, which is an inverted approach, science has little to offer in support of its own theories. Yet, Dr. Emlet uses this frail information to move toward his eventual endorsement of psychotropic drugs in spite of the following glaring facts:
- The usage of these drugs is a product of unproven theory.
- We do not know how or if these drugs truly affect brain chemistry.
- There are no medical tests available for assessing the need or measuring the effectiveness of these medications.
- Only in testing “dead” tissue, can any projections be made about their “potential” benefit.
- Prescription and use of these drugs are unlike any other medical process wherein a true ailment and remedy are discerned via definitive testing.
- There is no true protocol…use is largely a process of trial and error.
- There is no consistent response to these medications.
- Benefit is irregular at best and highly influenced by a “placebo effect”…expecting the drug to help.
Thus far, this author is unconvinced. But for the “itching ears” (2 Tim 4:3), the prospect of relief is a sufficient theology.
Providing a Biblical Context…
Far worse than Dr. Emlet’s reliance upon faulty science, is his biblical justification for medication’s use. Rather than build his theology regarding medication from Scripture, Dr. Emlet seems to use Scripture (taken out of context) to support his theology.
His first position reads as follows: “It is a kingdom agenda to relieve our suffering; it is a kingdom agenda to redeem us through suffering” (Emlet p 16). In support of the first position, Emlet references Acts 10:38 as the “kingdom agenda to relieve our suffering.” But is this truly the meaning of the passage when read in correct context? Peter said:
“You know of Jesus of Nazareth, how God anointed Him with the Holy Spirit and with power, and how He went about doing good and healing all who were oppressed by the devil, for God was with Him” (Acts 10:38).
To extrapolate from this passage a “kingdom agenda” to relieve suffering is an interesting reach. In truth, this verse is embedded within the presentation of the Gospel to the Gentiles. Verse 38 is an historical truth, describing the works and wonders of Jesus Christ, sent from Heaven as the Messiah. In examining the context, the Word renders a very different conclusion:
Opening his mouth, Peter said: “I most certainly understand now that God is not one to show partiality, but in every nation the man who fears Him and does what is right is welcome to Him. The word which He sent to the sons of Israel, preaching peace through Jesus Christ (He is Lord of all)- you yourselves know the thing which took place throughout all Judea, starting from Galilee, after the baptism which John proclaimed. You know of Jesus of Nazareth, how God anointed Him with the Holy Spirit and with power, and how He went about doing good and healing all who were oppressed by the devil, for God was with Him. We are witnesses of all the things He did both in the land of the Jews and in Jerusalem. They also put Him to death by hanging Him on a cross. God raised Him up on the third day and granted that He become visible, not to all the people, but to witnesses who were chosen beforehand by God, that is, to us who ate and drank with Him after He arose from the dead. And He ordered us to preach to the people, and solemnly to testify that this is the One who has been appointed by God as Judge of the living and the dead. Of Him all the prophets bear witness that through His name everyone who believes in Him receives forgiveness of sins” (Acts 10:34-43).
Clearly the intent of Peter’s entire sermon, is to bring the listener to salvation through faith in the Lord Jesus Christ, with whom, rests the “kingdom agenda” of redemption through forgiveness of sins.
While it is true that Jesus healed many throughout His ministry as Dr. Emlet references, the agenda of Heaven was never about earthly comfort but eternal life. A contextual understanding of Scripture illuminates God’s great draw and calling unto salvation. In each and every healing recorded in the Bible, there is a spiritual intent that overrides the physical outcome.
Remember the healing of the paralytic (Mark 2) and the Lord’s first proclamation: “Son, your sins are forgiven”(v 5). Then in order to counter the mumbling of the scribes: “…who can forgive sins but God alone” (v 7), Jesus told the paralyzed man to “…get up, pick up your pallet and go home” (v 11).
The recounting of such works in Acts 10 was to bear witness of the Kingdom’s presentation of the awaited Messiah. Jesus is come and salvation is near. Believe in Him and be saved…not relieved.
Do not forget Jesus’ first sermon: “Repent for the kingdom of Heaven is at hand” (Matt 4:17). The “kingdom” is present, the Messiah has come, and salvation is within reach this is the Lord’s agenda.
Surely we recall the woman with the issue of blood who was healed by Jesus:
A woman who had had a hemorrhage for twelve years, and had endured much at the hands of many physicians, and had spent all that she had and was not helped at all, but rather had grown worse – after hearing about Jesus, she came up in the crowd behind Him and touched His cloak. For she thought, “If I just touch His garments, I will get well.” Immediately the flow of her blood was dried up; and she felt in her body that she was healed of her affliction (Mark 5:25-29).
For twelve years she suffered “at the hands of many physicians” and was “not helped at all.” But in her faith in the Messiah, she was “healed of her affliction” immediately. Jesus responded:
“Daughter, your faith has made you well; go in peace and be healed of your affliction” (Mark 5:34).
Her faith, her belief in Jesus, made her well. But Christ spoke not only of her physical healing but her eternal salvation. Failure to acknowledge this truth is tantamount to biblical malpractice. Peter wrote:
“…and He Himself bore our sins in His body on the cross, so that we might die to sin and live to righteousness; for by His wounds you were healed” (1 Pet 2:24).
Clearly the healing is one of spiritual redemption not physical comfort. This is not to say that physical healing is never a part of God’s design, but more than not, it is used as an aspect of spiritual realignment.
Dr. Emlet’s second position is that it is a “kingdom agenda” to redeem us through suffering. In this point he references numerous passages, which speak to the fellowship of sharing in the sufferings of Christ. Primary is the following:
“…that I may know Him and the power of His resurrection and the fellowship of His sufferings, being conformed to His death” (Phil 3:10).
Again the extraction of Scripture from full context conveys an incomplete message. After speaking of his heritage and position as a Jewish leader and his previous confidence in the flesh and the advantages of his position, Paul conveys his fuller message is as follows:
“But whatever things were gain to me, those things I have counted as loss for the sake of Christ. More than that, I count all things to be loss in view of the surpassing value of knowing Christ Jesus my Lord, for whom I have suffered the loss of all things, and count them but rubbish so that I may gain Christ, and may be found in Him, not having a righteousness of my own derived from the Law, but that which is through faith in Christ, the righteousness which comes from God on the basis of faith, that I may know Him and the power of His resurrection and the fellowship of His sufferings, being conformed to His death; in order that I may attain to the resurrection from the dead” (Phil 3:7-11).
The suffering Paul addresses is the surrender of earthly status, comfort, and false assurance for the sustaining truth and benefit of the Lord Jesus Christ. It is about being conformed to His likeness. In death of self there is eternal life; the resurrection from the dead.
Suffering is part of a fallen world. Suffering can be a product of the Christian walk. The endurance of suffering that is “unjust” brings the “favor of God” (1 Peter 2:19). And Scripture states:
“And not only this, but we also exult in our tribulations, knowing that tribulation brings about perseverance; and perseverance, proven character; and proven character, hope; and hope does not disappoint, because the love of God has been poured out within our hearts through the Holy Spirit who was given to us” (Rom 5:3-5).
Again the reference to suffering (tribulation) has to do with the sanctification of the believer, growing in perseverance, character, and hope. It is a tribulation, which grows out of godly living that hones and shapes the follower of Christ so our hearts remain ever hopeful. But according to Dr. Emlet, we perhaps should interrupt the Kingdom’s training by seeking the relief of the world.
Dr. Emlet ends his article with the following conclusion: “Medications are a gift of God’s grace…” Yet he warns they can “used idolatously.” In other words…”drugs good, humans bad.” God has given a gift of mercy and relief…if only we can receive and utilize the gift without sinning.
We don’t know if biochemical imbalances exist; we have no measurable evidence of an organic or biochemical process that impedes human function; we don’t know how these medications affect or influence the brain, and they carry severe side effects; some improve, others don’t; but 35% will get better if you give them sugar pills…So we are to conclude:
- God gave us a gift of medication for a condition unknown and unproven.
- The gift works sometimes, but not always.
- The gift rarely produces significant improvement.
- The gift harms some who take it.
- We don’t know how the “gift” works, who should take it, when he/she should take it, or if it will help…but TAKE IT ANYWAY!
- And remember to thank God who provided it for you and remain humble, or your partaking of the drug is sinful.
“Do not be deceived, my beloved brethren. Every good thing given and every perfect gift is from above, coming down from the Father of lights, with whom there is no variation or shifting shadow” (Jas 1:16-17).
Good and perfect…Does this description fit Dr. Emlet’s discussion of psychotropic medication? I think not. These good things and perfect gifts come down from “the Father of lights” in whom all things would be seen with clear discernment and find validation in His Word. Light exposes truth, but where is the truth in Emlet’s discussion of science or Scripture?
The Father of lights is One “…with whom there is no variation or shifting shadow…” There is enough “variation” and “shifting shadow” in this research to choke a horse. In fact it presents the worst of all manipulations; borrowing a truth of Scripture to validate a fabrication of the world. We must remember that a partial truth is in reality a total lie. The similarity between these medications and the description of “God’s gift” is strikingly lacking.
Dr. Emlet is indeed a respected scholar and teacher. His training and background are beyond reproach. These facts make his article especially damaging. One will look to his credentials and ascribe credibility. Those suffering for reasons unknown will potentially embrace his endorsement and loose scriptural validation as permission to pursue the relief of the world over the transformational capacity of Christ.
This author is not wiser than Dr. Emlet, nor do my credentials or resume’ compare. But it has been my attempt to direct the reader away from the conclusions of man toward the unyielding, unblemished, Word of God. Paul said to the church at Ephesus, “For I did not shrink from declaring to you the whole purpose of God” (Acts 20:27).
The believer must build his/her judgment and theology from the entire Bible, not from points and verses that while true, are given in isolation apart from their fuller meaning. The “whole purpose of God” is not conveyed in the alleviation of earthly pain but in the redemption of the eternal soul.
Before we look to medical research; before we adhere to the teachings of preachers and biblical counselors (including this author); we must look to the Redeemer, consume His Word, and listen for His Spirit to teach, discern, lead, and provide. Remember in speaking of the Holy Spirit Jesus said:
“Peace I leave with you; My peace I give to you; not as the world gives do I give to you. Do not let your heart be troubled, nor let it be fearful” (Jn 14:27).
The world does indeed offer a version of peace, but Jesus is clear that His peace is “not as the world gives.” We must be clear regarding which peace we seek.
Abercrombie, W.P., “Are Psychology and Psychiatry Medicine”, The Biblical Counseling Institute, 2007, http://bcinstitute.wordpress.com/
Emlet, M.R., “Listening to Prozac..and to the Scriptures: A Primer on Psychoactive Medications”, The Journal of Biblical Counseling, January 2012, www.ccef.org/jbc/listening-prozac-and-scriptures-primer-psychoactive-medications
Kendler, K.S., “Toward a philosophical structure for psychiatry”, American Journal of Psychiatry 162: 433–440, 2005.
Lacasse, J.R., Gomory, T., “Is graduate social work education promoting a critical approach to mental health practice?” Journal of Social Work Education, 39: 383–408, 2003.
Valenstein, E., Blaming the Brain: The Truth About Drugs and Mental Health, Free Press, New York, 1988.
W.P. “Ab” Abercrombie is the Founder and Director of The Biblical Counseling Institute which offers training in biblical care, counseling, evangelism, and discipleship throughout the U.S. For information regarding his background and ministry, visit the BCI website: www.BCInstitute.com.