Mental Illness and Responsibility – Part 1
I remember that back in Grade 6, my twin daughters came home chatting about that day’s lesson in their Health class. They has been learning about something called “the blame game.”
The blame game
Probably we all know how to play the blame game. We are criticised by our supervisor at work, and we’re quick to point to the circumstances that led to our poor performance. Or I’m in a tough conversation with my wife, and she’s making some accusations, but I’m throwing them back with some of my own.
Sometimes the blame game is played in the church too. A person blames his lazy attitude on the way that he was raised as a child. Someone blames his lack of church contributions on his high load of debt. I suspect that we don’t usually have patience with this kind of blame-shifting, and we want to hold people to account.
But what about some other scenarios? Can we excuse certain sinful behaviours because of the presence of a mental illness? Should we make allowances and exceptions because of how a person is afflicted in his or her mind? What is the balance of a person’s responsibility and their illness? As fellow members in Christ, how can we respond in a way that will not only help the person, but also honour the holy God?
Ponder a couple of scenarios so that you can appreciate the challenge of sorting out a fitting response.
1) There is a sister in your congregation who is only very rarely in church on Sundays – maybe once per month, sometimes less. It comes to light that she has an intense anxiety about coming to church. She fears almost everything about it: being surrounded by other people, having to speak with other people, being in an enclosed space for more than an hour. She agrees that God wants her to gather with his people, and that it’s important for her faith, but she can’t do it. Is she is breaking the fourth commandment, and should she be under discipline? Or does her illness – this extreme phobia – excuse her lack of attendance?
2) There is a brother who is struggling with addiction to pornography. He has admitted that for the last five years he has had viewed pornography on an almost daily basis. Some accountability has helped, but the brother admits that he still finds ways to access sexually explicit material. As the months go by, he seems to be growing more entrenched in his sin, and he is less open to the guidance of fellow members. He recently said that the fault for his sin is in his brain, that his addiction to sex means that he is incapable of resisting. Is this a clear cut case of unrepentant sin against the seventh commandment?
More scenarios can be described. But the critical question is this: Are there times when, because of my brain, I am not responsible for my behaviour before the Lord?
Encountering mental illness
We’re speaking about mental illness, but it’s good to back up and offer a definition and then list a few examples. First, a loose definition: A mental illness is a clinically significant health problem that affects how a person feels, thinks, behaves, and interacts with other people.
Second, in our life together as believers, what mental illnesses are we likely to encounter? There is depression, dementia, obsessive compulsive disorder, anxiety, bi-polar disorder, panic disorder, attention deficit disorder, anorexia, bulimia, post-traumatic stress disorder, and various extreme phobias. We might also encounter mental health difficulties that arise because of addictions to drugs and alcohol.
Blame the brain?
So here’s the question: How much can we blame the brain? Now, if you’re hoping for a binary approach, you won’t read it here. If you’re looking for a formula or equation that you can use in these kind of situations, you’ll have to look elsewhere. And there surely isn’t one!
As already noted, this is a complex area to navigate. No two situations are the same because of the individuals involved, their predispositions to developing mental illness, the particular illness, and the history and context of each situation. Still, we can take into account some important considerations. I want to acknowledge that I’m relying on insights from the book called Blame it on the Brain? by Ed Welch.
Welch explains that there is a view today that almost everything begins in the brain. All our behaviours are caused by brain chemistry and physics: “My brain made me do it.” As a consequence of viewing the problem as strictly physical, the answer is often strictly physical too, as in: “I have a chemical imbalance in my brain, so how can I level that out?” Or, “My child is being hyperactive at school and disrupting the class, so what medication can he take to help him behave?”
Solutions in science?
Sometimes it’s tempting to conclude that it is “all upstairs,” a matter of the brain. For example, when someone is in the darkness of depression, we can talk to them at length; we pray with them; we read Scripture to them. There are months of intensive spiritual effort, and nothing seems to work. Despite our best efforts, the person’s faith is struggling mightily. They say that they feel “dead” inside, and miles away from God.
Then they go to a psychiatrist... he prescribes some medication, and in weeks the depression starts to lift! The person begins to talk about church in a more positive way, and to read the Bible again, even enthusiastically. So was it all in the brain? Did a dose of medication really solve it? Does the brain really have so much influence on our spiritual life?
The same thinking is applied to other areas of behaviour. Some people argue for a biological basis of homosexuality. They also argue for a biological basis for anger, and disobedience to parents, and worry, drug abuse, and stealing. These are all brain problems, they say, not sin problems. Sometimes they point to evidence which suggests, for example, that the brains of pathological liars are physically different from the brains of “normal people,” people who are wired to (usually) tell the truth.
As Christians, we have to sort through this. We acknowledge that science can help by teaching us something about how the brain works. Yet science presents data that has been interpreted by fallible humans, people who have their own worldviews and weaknesses. Science too must be made subject to the Bible.
Who we are
So to help us, we need to consider what the Bible says about who we are. The LORD created us as complex beings, as a natural organism that is at the same time being indwelled by a supernatural spirit. In 2 Corinthians 5:21, for instance, Paul describes us as spiritual beings who are clothed in an earthly tent. This two-fold composition is seen throughout the Bible, and we notice it particularly at death, when the soul or spirit goes to the Lord and the body stays behind and is buried in the ground.
Despite the separation that happens at death, when we’re living we are one person, an intimate unity of spirit and body. So how do spirit and body relate and function together? At minimum, we can say that they are mutually interdependent. We know this from experience: the way that your body feels very much affects your spirit; the activities that your spirit chooses are worked out in the body, both good and bad. Ultimately, though, the spirit or the heart is the moral captain, the “wellspring” of our life (Prov 4:23). It’s the heart that empowers, initiates and directs. And the problem is that our heart is inclined to evil.
Directed by the Doctrine of Sin
So when it comes to questions of responsibility and response, the Bible’s teaching about sin is essential. I understand that mentioning sin in the context of mental illness can make people uneasy. You’ve probably heard the horror stories about people telling those who are struggling with depression, “You just have to pray more. Try to read the Bible more.” That’s a response which essentially says, “You’re feeling so miserable because you haven’t done something that you need to – it’s because you’ve sinned.” I certainly don’t advocate that approach.
Yet it’s true that sin is a reality, and it’s our deepest problem, one that affects absolutely every aspect of our life. The Scriptures teach that all human beings are born as sons and daughters of Adam. Without the Holy Spirit’s intervention, we are dead in trespasses and sins, without any inclination to seek God or do what is good.
So if sin is a deeply rooted problem, if it’s as deep as our very nature as human beings, we need to conclude that the brain itself is unable to make a person sin or to prevent a person from following Christ. The Scriptures teach us to say that any behaviour which does not conform to God’s commands or any thought which transgresses his prohibitions, is something that proceeds from the sinful heart. And it is sin.
Created as responsible
That’s not how God made us, of course. When God created us in the beginning, He made us in his image. Part of that means that we were created with the ability to make moral decisions and that we are responsible for our behaviour.
This idea of our responsibility before the LORD is seen, for example, in the laws of Leviticus. There it says that even if a person sinned unintentionally, without meaning to, they needed to present a sacrifice of atonement (Lev 5:17). They weren’t excused because of a lack of intent, but they were held to account.
Upholding this sense of responsibility actually shows respect for a person. As an example, say you have a son who continually breaks your household rules. Because you’re so nice, you always excuse him and not to punish him: he’s young, he’s immature, he has a lot of pressures at school. It feels like you’re being merciful. But ultimately, you’re not treating your son with respect for his dignity as one created in God’s image. You’re implying that he’s too weak to handle the consequences, or too dumb to figure out a better alternative. You’re not helping him to grow in his sense of responsibility, while the loving thing would be to let him experience consequences.
In the same way, we are responsible before God our Father. He doesn’t give us a free pass for any sin, because He made us to serve and obey him in all things.
In the next article, we’ll see how this truth relates to the way that we try to help our brothers and sisters who are struggling with mental illness.