In the ongoing, and important, discussion of the nature of mental illness it seems to me that it would be incredibly helpful if we could be more deliberate in our distinction between “mental illness,” as a very large societal umbrella covering multitudes of non-organically-related behaviors, and “mental illness” as an organic, physiological disorder backed up by legitimate scientific research. For the latter category, it seems that we would be much better off if we used a term like “brain malfunction.” I submit this recommendation to the discussion for a number of reasons, which I hope to elaborate on more fully later in the week, as well as provide a resource page on this very challenging topic.
One reason I think we need a term other than “illness” is that this word often automatically generates in our minds unqualified confidence that a problem is indeed proven, lock-tight, as physiological and, therefore, medically solvable. However, that is not the case with at least some disorders that fall under the umbrella of mental illness. Even some secular psychiatrists resist the DSM IV’s, and soon-to-be V’s, propagation of an ever-growing number of behavioral problems as “illnesses” for which persons may be treated by professionals who may then be compensated by insurance companies. The word “illness” too easily produces a victim-mindset in persons who might no longer be held responsible and, therefore, require medication. Since this is how our society has been trained to think we must work extra hard to make clear distinctions of definition, as we strive to apply a biblical worldview to all of life, lest we unintentionally contribute to the world’s tragic hijack of hope.
There are legitimate mental illnesses. The curse of sin has affected every part of our being, including our bodies, which includes our brains. But the difference between a “brain malfunction” and most of what is popularly called “mental illness” is that the former has an organic cause, i.e. something is truly wrong with the brain itself. This is not to say, then, that it can always be “fixed.” Knowledge of the problem is not equal to understanding the solution. The brain is the most complex part of our physical being and much is beyond our current understanding and, I believe, always will be. But it is to say that we need to do a better job distinguishing between that which is physiological in nature and that which is behavioral—acknowledging all along that the line between will certainly be blurry, if not indistinguishable, at times.
Allow me to illustrate my point. One of our daughters has severe cognitive delays. Although she is an 8-year-old in her body, she is a 3-year-old in her mind. It is unlikely that her mental, i.e. thinking and reasoning capacity, which does indeed affect her behavior in some ways, will develop much beyond an early elementary level. The secondary cause of her disabilities are unknown, but is probably a genetic abnormality affecting her neurological system. That is, her brain and its related processes are malfunctioning—according to the human standard of what is “normal.” On the other hand, the primary cause of her disabilities is more sure. Her Creator made her as a very unique image-bearer who brings Him glory and blesses our lives in ways that only she can (Psalm 139). We may legitimately say that her brain malfunctions (again, by man’s standard of measurement, not by her sovereign Creator’s plan), but she does not have a “mental illness,” as it is defined by society in general. To confuse these two categories would not only do her a disservice by adding more labels that diminish the reality that God actually intended her to be this way, but it would do a disservice to others whose problem does not have a discernible physiological cause by diminishing the glorious hope of change found in the complete renovation of the heart, mind, and soul by Jesus Christ and His Word.
By virtue of the indwelling Spirit of God, according to the apostle Paul, believers have the mind of Christ (1 Cor 2:16). The challenge for each and every one of us is to diligently apply that mind, which is revealed to us in the Scriptures (v. 13), to every other kind of knowledge that God has richly given to man. Later in the week, I will attempt to explain how other biblical counselors, both older and younger, continue to strive to work through these complex matters with humility, respect, and great appreciation for medical science, while also maintaining their allegiance to God’s Word.