One of the accusations leveled against conservative believers is the common charge that our pastors are not professionally trained or certified, and consequently, when it comes to counseling parishioners, are in way over their heads. Whether the issue is clinical depression, or dealing with childhood abuse, or fighting addiction, or any other number of serious but common afflictions, the charge is that however exegetically adept a man may be at exposition of the book of Romans, when it comes to issues like these, he is necessarily out of his depth.
There are a number of observations in response to this, which really need to be taken together as a whole. Any one response, however cogent in itself, will not help us understand what is actually going down.
When it comes to the heart of man, which is, like the rest of him, fearfully and wonderfully made, the mystery of sin can do a lot of mysterious damage, and the impact of the fall can show up in lots of places, including in our physiology. The body is not simply a carrying case for the soul, which in its turn can be easily fixed with spiritual platitudes and nostrums. It ain’t that easy. But neither is the spirit of man helplessly carried along on a river of chemicals, helpfully supplemented by tributaries flowing into it from the local pharmacies. The proper conclusion should be that everyone is in over their heads. The proper demeanor is humility, and OCD ought not to be treated as though it were a busted transmission. In helping people with such issues, we are always dealing with moral agents, and never with a simple mechanism.
Having restricted the likelihood that anyone can just waltz in and “fix things,” it has to be recognized and acknowledged that there are many counselors who do make things worse. This is the case for counselors inside the church, and it also true with secular counselors. The difference is that incompetent pastors will make things worse for free, while secular incompetence charges by the hour. So to resist the therapeutic imperative does not require us to say in response that every conservative pastor knows what he is doing.
At the same time, a pastor can confess himself to be medically untrained, and yet remain a competent (and confident) pastor. This is because the Scripture teaches us how to deal with all sorts of issues that really are spiritual in nature, but which have been medicalized in a society that has become radically therapeutic in its default assumptions.
The fact that one country is clearly here and the other country clearly there does not eliminate the possibility of disputed territory between them. And when the dispute arises, the Canadians do not get to say something like “don’t tell us what the Canadian countryside looks like. We have lived here all our lives.” Yes, quite, but Saskatchewan over there looks an awful lot like North Dakota over here. In either place, as the joke goes, when your dog runs away, you can see his tail for three days.
So I quite grant that we ought not to treat a radical chemical imbalance in the brain with lively exhortations to “pray more” — but it also needs to be said that folks on the other side of the border ought not to treat true gnawing guilt with Zoloft.
So a believing and competent medical doctor and a competent pastor can work together, recognizing that their mutual competencies and areas of expertise do overlap. (Incidentally, granting this does not require us to also assume the expertise of hostile observers from two thousand miles away, provided they also have an Internet connection, a CAPS LOCK on their keyboard, and a spittle-flecked monitor.)
Wise pastors are involved in the cure of souls. Many of the psychological traps our generation is struggling with are caused by (or exacerbated by) true guilt, lack of real forgiveness, and cancerous bitterness. Remove those, deal with those effectively, and a lot of medicine cabinets would be a lot less crowded. “I myself am satisfied about you, my brothers, that you yourselves are full of goodness, filled with all knowledge and able to instruct one another” (Rom. 15:14, ESV).
So in saying these things, I do not at all deny the effectiveness of some medical treatments in helping deal with some “spiritual” problems. What I am denying is the deity of the certified classes. And in affirming the sufficiency of Scripture, as I do, I am not affirming the sufficiency of pat answers that are festooned with Bible verses. “Brethren, be not children in understanding: howbeit in malice be ye children, but in understanding be men” (1 Cor. 14:20).