[MARTIN CAREY]
“The LORD is my shepherd; I shall not want. He makes me lie down in green pastures. He leads me beside still waters. He restores my soul” (Psalm 23:1–3).
These words of David the shepherd-king are so familiar, so easy to gloss over and to move on. Recent events in our lives have driven me back to this passage, and I have a new appreciation of its power. Psalm 23 speaks eternal truth and good medicine into troubled souls. When our lives seem undirected, when we look in vain for rest and comfort, we can flee to the Shepherd. No matter what we are suffering, or for how long, He will lead us to places of comfort and goodness for His name’s sake.
Many Christians, however, walk a more difficult path, suffering from afflictions of the mind that never seem to resolve. Comfort and confidence in God’s goodness seem to elude them. I am not speaking here of severe mental disorders, such as schizophrenia or bipolar disorder. I want to address the special difficulties of those with personality disorders. All of us are broken and sinful human beings that need salvation, but many Christians suffer from deep dysfunction in their core areas of functioning. They tend to suffer from conflicted relationships, problems with emotional regulation, irrational thinking, problems with work. They often have rigid life habits, experience strong negative emotions they cannot control, and struggle with poor impulse control.
The Mayo Clinic website defines personality disorders this way:
A personality disorder is a type of mental disorder in which you have a rigid and unhealthy pattern of thinking, functioning and behaving. A person with a personality disorder has trouble perceiving and relating to situations and people. This causes significant problems and limitations in relationships, social activities, work and school (https://www.mayoclinic.org/diseases-conditions/personality-disorders/symptoms-causes/syc-20354463 ).
These dysfunctional patterns do not describe the more serious mental diagnoses that lead to hospitalization, but they are very troubling to those afflicted and to others near them. In addition to their emotional and behavior difficulties, sufferers of PDs often misperceive others, misunderstand God, and misinterpret their own impact on others. Their impaired perceptive abilities get them into conflicts with loved ones and colleagues. Their personalities were often shaped in families with damaging conflicts and distortions. The traits that helped them survive childhood became liabilities as adults. The sins of the fathers are passed to the children, in ways hard to understand or change.
As Christians we have good reason to be suspicious of psychological theories and categories. We should question the validity of psychiatric diagnoses, given the secular history of psychology. Many prominent theorists of psychology, such as Sigmund Freud and B.F. Skinner, were openly opposed to God and the Bible, and formed their ideas as alternatives to traditional religion. As a licensed therapist with 40 years experience in mental health, I had to question the ideas that shape my professional life when I became a Christian. This involved rethinking and discarding much, and holding fast only to what is good. I write this blog as someone who is repeatedly humbled by God’s word, and I continue to question my assumptions in conversations with wise Christians.
Are Diagnoses Valid?
The question remains, how can diagnoses from secular psychiatry be helpful to Christians? As biblical counselors will point out, psychological diagnoses can be used as excuses for patterns of sin. The labeled patient can simply say, “That’s the way I am; deal with it.” Additionally, the number of psychological diagnoses have been growing, along with the number of people being diagnosed. Where does all this diagnosing and labeling end up? These are valid concerns, and the Christian counselor is rightly skeptical of psychiatric claims of authority.
Some Christians take a strong moralistic stance towards those who suffer from emotional or personality disorders, interpreting those problems as the results of sin. As sinners saved by grace, we know that all human problems have a spiritual component, entangled with our original and continuing sin. As Christians, though, we follow Jesus, the great physician who heals the broken hearted, the poor in spirit, and those who are bound (Isaiah 61:1-3). When we “encourage the fainthearted, help the weak” (1 Thessalonians 5:14), we are loving our neighbors, and pointing them to One who saves from sin.
God’s word and valid science are not necessarily in conflict. Foremost, Christians have confidence in the God of all truth, who reveals Himself in His word. That forms our worldview and provides “truth-filters” to evaluate everything else. He also told us that He extended his general creation grace to all men. That grace can include scientists who seek to provide relief from all forms of suffering. There are medications that provide imperfect but genuine help to psychiatric sufferers, and I have witnessed this personally many times. We can be thankful for good science, while recognizing and avoiding the abuses. God is sovereign over the work of unbelieving scientists, as He causes his grace to fall on both the just and the unjust.
Despite the larger problems with secular psychology, I have learned that good clinical descriptions of patterns of suffering are helpful in understanding certain common varieties of suffering. The 10 personality disorders (PDs) are a good example of helpful descriptions of real-life mental difficulties, and are not dependent on the erroneous ideas of Freud, Skinner, or other theorists of pseudoscience. Writing this blog article, I was especially helped by an article written by two Christian professors at Houston Baptist University, Eric Johnson and Warren Watson, titled Still Saints: Caring for Christians with Personality Disorders (https://www.desiringgod.org/articles/still-saints ). Their overview of personality disorders is not only clinically helpful, but comes from a strongly biblical worldview and genuine pastoral sensitivity.
The Diagnostic and Statistical Manual for Mental Disorders, 5th Edition, divides 10 personality disorders into three clusters, A, B, and C. These disorders of the personality do not describe what we call “insanity” or “craziness.” Their thoughts, emotions, and relationships are disordered, even though they can generally function in their daily lives. Many can hide their problems quite well.
For example, consider the narcissistic personality disorder, is a condition which
“…manifests as excessive self-importance, a lack of empathy, and the pursuit of admiration, often resulting in disappointment, exacerbated by a sense of fraudulence and unworthiness” (Johnson and Watson).
Persons with narcissistic personalities often occupy positions of leadership, becoming prominent actors, performers, and pastors. If they are Christ-followers, God can use them mightily, even in their weaknesses. While all of us have met people exhibiting disordered personalities, we must admit that we have behaved in disordered ways ourselves. Or consider the traits of obsessive-compulsive personality disorder, which can include perfectionism, rigid behaviors, hoarding, a critical nature, and being controlling towards others.
Adventism and Personality Disorders
Some personality disorders reveal deep and significant spiritual problems. Many of us who grew up in an Adventist family can either identify with this personality style, or relate to someone who does. Our belief system contributed to certain anxieties and emotional pain. Taking Ellen White seriously, we were conscious of her many restrictions and warnings that made us uneasy in many social situations, especially around non-Adventists. We learned to distrust emotions, so that our feelings were strictly controlled, so that strong feelings of spontaneous of love, enjoyment, or sadness were difficult to express.
The Adventist theology of end times, such as the investigative judgment, taught us to fear when our names will come up in judgment. We believed that those living in the last days must achieve moral perfection, that we must remember and confess every sin, and that Jesus will stop his intercession for us, and these beliefs fed a powerful undercurrent of worry. These theological anxieties led to a kind of spiritualized obsessive-compulsive disorder on a grand cosmic scale! Obviously, family religion and backgrounds can contribute mightily to personality disorders.
All of us display some of the traits of personality disorders at some time or another. We all come from sin and brokenness. To borrow from our Lord’s words (Matthew 7:1), when we sit in the seat of psychological judgment over others, we can be sure the same harsh standards will be used against us! While we’re analyzing the problems of other people, let’s take a good look at ourselves. Most, if not all of us, have elements of these personalities, not necessarily at the level of disorders, but as “styles” of thinking, feeling, and relating to others. All of us can be difficult and have things to repent of.
As Christians, we have a world view with a once-for-all cosmic solution that secular sufferers don’t have. Only through the gospel of Jesus Christ can we find ultimate answers to our mental health problems. Our spiritual sickness must be dealt with first before our psyches can find rest. Spiritual healing begins by solving our perilous position before God. We’re not just damaged people; we were all living our lives as doomed people:
“We all once lived in the passions of our flesh, carrying out the desires of the body and the mind, and were by nature children of wrath, like the rest of mankind. But God, being rich in mercy…” (Ephesians 2:3).
The sin that damns us isn’t just how we think or behave. It’s not a psychological problem. We can never understand our problems studying the reductionistic categories of psychology. Our disordered souls reveal a profound lostness residing in our very natures, the original sin we received from Adam. “But God…” intervened long before we had any inkling about God’s wrath towards us. He acted to save us,
“…even when we were dead in our trespasses, made us alive together with Christ—by grace you have been saved—and raised us up with him and seated us with him in the heavenly places in Christ Jesus” (Ephesians 2:5).
Having made us alive in Christ, God has dealt with the root problem. Christ has reconciled us and purchased our healing at the cross. Our brokenness and bankruptcy of soul are qualifications for blessing. He can say to those of us with disordered minds, “Blessed are the poor in spirit, for theirs is the kingdom of heaven” (Matthew 5:3).
The Pharisees and scribes grumbled to the disciples about Jesus accepting sinners, welcoming the disordered and badly behaving people, and eating with them. Jesus replied,
“Those who are well have no need of a physician, but those who are sick. I have not come to call the righteous but sinners to repentance” (Luke 5:31-32).
Admitting our own sin and weaknesses is a sign of our spiritual maturity. It makes us welcome into the loving fellowship of Jesus and His difficult friends. It is so easy for us to be like those Pharisees, separating ourselves from damaged and difficult people. Oh, how we all need to come, humbled and repentant, to Jesus the physician! He can grant us the miracle of forbearance for one another.
We can bring our disorders and weaknesses to our Maker and ask for healing. He is our faithful Shepherd who will guide us to still waters and restore our souls. He will heal us in His timing. We may get the answer that Paul received when he asked three times for his “thorn in the flesh” to be removed. The Lord’s answer was, “my grace is sufficient for you” (2Cor. 12:9). Your weakness of a disordered personality may be the painful thorn placed in you to display the glory of God’s grace. Boast then about your damage, for His power shines its brightest in our weaknesses. †
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