1 PHYSICAL AND SPIRITUAL ASPECTS OF COUNSELING GEORGE SANDERS, M.D. A. Reasons for Sickness - All sickness is due to sin - because of the Fall, there is a curse on man, which can manifest itself as illness. 1. General Reason for Illness a) The Fall - Genesis 3 b) Romans 5:12 c) 2 Corinthians 4:16 d) 2 Corinthians 5:1 e) Hebrews 9:27 2. Specific Reasons for Illness a) Personal sin can cause or influence illness. (1) James 5:15-16 (2) 1 Corinthians 11:27 (3) Natural consequences of sin (4) Unbiblical responses to life s trials b) Divine purposes may lead to illness. There are divine purposes at work in a person's illness. (1) 2 Corinthians 12:7 (2) Ultimately: The glory of God - John 9:1-3 (3) The Story of Job 1
2 3. How should a believer respond to an illness? a) 1 Corinthians 10:31 Do all to the glory of God. b) Fulfilling God's purposes in your illness is more important than getting well! B. The Mind-Body or Spiritual-Physical Interaction 1. Definitions: mind = spirit = soul = heart 1 Thessalonians 5:23 2. The body affects the mind a) Cancer diagnosis may lead to depression b) Plastic surgery c) Psych meds like Valium that affect the brain -> mental changes 3. The mind also affects the body - Emotional upset -> loss of appetite, diarrhea 4. The mechanism for the mind-body interaction? Via the brain and its connections to the body Peripheral Nervous system and Hormones a) Peripheral Nervous System - Autonomic Nervous System b) Hormones 5. How important is this mind-body interaction? Consider the role of stress in disease. a) Produces physical symptoms b) The body's response to stress may aggravate diseases already present. c) Terminology 2
3 (1) Psychosomatic - mind/body connection (2) Biblical - spiritual/physical interaction o Psalm 32:1-4 - Body wasted away, suffered pain, chronic fatigue o Psalm 38 Physical distress d) Treatment of physical problems with a spiritual/mental cause? (1) Medication (2) Assertiveness Training (3) Stress Management (4) Placebos (5) Biblical Counseling 6. Biblical Counseling would deal with the underlying spiritual issue = A Trial Deal with the trial biblically. C. The Correct Response to Illness 1. Evaluate reasons for the illness a) Just due to living in a fallen world? b) Spiritual cause? c) Sin the cause? d) Divine Purpose? Glorify God 2. Ask the right question: How can this illness be used to glorify God? a) Recognize the truth of John 9:3 - What glorifies God is what is best for the sick person and it may not be getting well! 3
4 b) Evaluate personal goals c) 2 Corinthians 12:9-10 d) James 1:2-4 e) Romans 8:28-29 f) Genesis 50:20 g) Job 2:10 h) 1 Cor. 10:13 - God always promises victory not necessarily deliverance 3. You are responsible for glorifying God regardless of how you feel. 4. What if I have a disease for which medical science hasn't discovered a cure? D. Medical Issues in Counseling Depression - Is Drug therapy Effective? 1. A bit of neuroscience S NE D S = Serotonin NE = Norepinephrine D = Dopamine MAO = Mono Amine Oxidase Re-uptake Synapse MAO MAO inhibitors slow degradation of S & NE ( S & NE) Tricyclics block re-uptake of S & NE ( S & NE) Prozac blocks re-uptake of Serotonin 4
5 a) Synapses & Neurotransmitters b) Removal of neurotransmitters occurs by either their breakdown via monoamine oxidase or reuptake c) The most commonly used antidepressants block the reuptake of neurotransmitters, typically SSRI s = Selective Serotonin Reuptake Inhibitors 2. The Theory of Chemical Imbalance: "Mental illness is a result of a chemical imbalance in the neurotransmitter levels in the synapses in the brain." - Scientific evidence does not support it! 3. Problems with the theory a) Take a normal person and deplete them of serotonin, they won t become depressed b) Give someone a drug that increases the level of serotonin any effect on depression takes much longer to develop c) There are antidepressant drugs that decrease the serotonin level that are as effective as those that increase it d) Placebos are as effective in the treatment of depression as antidepressant meds 4. Why do so many people still believe it? a) Their health care providers tell them it s true b) Allows people to take a drug to treat their problem c) Allows people to come out of the closet about their problem d) There is a great deal of $ at stake 1 in 10 Americans takes an antidepressant at an annual cost of $10 billion! 5
6 e) There is not a good alternative theory 5. Even if The Theory of Chemical of Imbalance is not true, do antidepressant drugs have a role in the treatment of depression? There is no good evidence for a chemical imbalance in the brain other than the imbalance caused by antidepressant drugs! Peter Breggin, M.D. 6. What does scripture say about depression? a) Proverbs 17:22 b) Proverbs 14:30 c) Scripture gives hope! Antidote for depression!! 7. Treatment of Depression by health care professionals SOME FINAL WORDS OF ADVICE 1. Don't practice medicine. Don't ever take someone off medication or recommend that they stop. Leave this to their doctors. 2. Deal with spiritual issues and consult with a physician in the treatment of medical issues. 3. Don't be intimidated by medical science that is not an "exact" science. Doctors are there to help, but they don't have all the answers. You have scripture, which is exact and is all-sufficient for the spiritual needs of your counselees. Although some doctors today treat mental issues with drugs, you are able to treat these issues with biblical counseling that reigns supreme when it comes to changing the mind and heart of your Christian counselee. 6