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JBC 29:3 (2015): 4258

Spiritual Growth in the Face of

Psychiatric Disorders
by EDWARD T. WELCH

No one likes physical weakness. It is, at least, a nuisance. At worst, it is a chronic

and intrusive pain that leaves people imagining how death is better than life. But
it is a frequent accompaniment to spiritual growth. When you generate a list of
wise people, most of them are familiar with physical weaknessJoni Eareckson
Tada, for example.
It makes sense. Sanctificationspiritual growthis for the needy, and
physical disabilities certainly remind us that we are needy. Notice how much
more we pray and ask for prayer when we have a physical weakness. That alone
shows how the Spirit uses weakness in our sanctification. As a general rule we
expect that among Gods people, the more broken the vessel, the more obvious
the sanctification.
When we consider examples of physical weakness, the normal suspects
come to mind: cancer, surgeries, disabilities from accidents, headaches and
other chronic pains. These and many other physical struggles are too common
among us. There is another category of weakness, however, that is especially
relevant in our modern era. These weaknesses are particularly confusing and
sometimes marginalized in our churches. They are the ones identified by
psychiatric diagnoses.
Edward Welch (MDiv, PhD) counsels and teaches at CCEF. He is the author of When People Are Big and God
Is Small.
An earlier version of this article appeared as Sinners Learning to Act the Miracle in Acting the Miracle,
edited by John Piper and David Mathis (Wheaton, IL: Crossway, 2013). Used with permission.
www.crossway.org

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Psychiatric diagnoses can be hard to understand, and ministry to those

who have been labeled with a diagnosis tends to be either too cautious or too
confident at a time when wise pastoral care is most needed. With the need for
wise pastoral care in mind, this article will identify the basic theological tools
to help those who identify themselves in psychiatric terms, and then illustrate
what sanctification can look like for three individuals who live with a physically
based weakness.
Psychiatric Diagnoses and Scripture
In only a few decades, psychiatrists have gone from the stewards of asylums
to our hope for emotional peace. The word on the street is that they have
pharmacological answers for everything from the blitzkriegs of mania to the
weariness of boredom. Then there are the rumors we hear about new designer
drugs that might make us all just a little better.
These hopes have led to a bifurcated world. In one, Scripture speaks about the
eternal condition of our soul. In the other, psychiatry oers answers to some of
our most pressing day-to-day struggles. Given this perceived division, psychiatry
has become the de facto expert to the church as well as the world.
Psychiatry, of course, is not at fault for intruding into matters that
were once the purview of Scripture. The problem is that we are unskilled at
turning Scriptures gaze onto these diagnoses in such a way that it continues
to meaningfully interpret all things. When you hear, I am bipolar or I am
ADD, you hear people who feel more understood by a label than by Scripture.
A goal, therefore, is to biblically interpret psychiatric diagnoses so that those who
identify with these diagnoses know that Scripture does speak to them, that they
can be wisely loved by the church community, and grow in Christ.
And the need is great. Psychiatry has gradually expanded its girth to
include most things in life that are hard: the emotional lows of depression and
highs of mania, addictions, fears and anxieties, disordered or chaotic thoughts,
learning disabilities, autism and Aspergers disorder, anorexia and bulimia,
cutting and self-injurious behaviors, and post-traumatic stress disorder, to
name a few. Descriptions of these experiences appear in the Diagnostic and
Statistical Manual (DSM-5) of the American Psychiatric Association (APA).1
These descriptions aim to demarcate problems from each other and identify
them rather than provide explanations. The DSM-5 does not focus on alleged
causes, in part because there are no clearly understood biological markers for
most psychiatric problems. Even so, most people usually assume that there
are biological causes to psychiatric issues and, as a result, medicines are the
1

These are available in print or on the APA website.

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SPIRITUAL GROWTH IN THE FACE OF PSYCHIATRIC DISORDERS | WELCH

premiere treatments. Given that assumption, we can understand even more why
psychiatric diagnoses have become partitioned from Scripture.
Yet, even if there is a medical contribution to psychiatric diagnosesand
many diagnoses have such a contributionthat is not the end of the oversight
of Scripture or the church. The church must be more active when someone has
a physical aiction, including a psychiatric one. In the face of any potentially
life-dominating chronic disease, aicted people need a bounty of service, prayer,
encouragement and spiritual clarity. The church moves toward people who are
struggling. We never simply leave them to the experts. If someone is taking
psychiatric medication, that person is struggling and hurting, and the church
should come alongside and help. Pastoral care should automatically accompany
medication, whether that medication is chemotherapy or Prozac.
The First Steps of Pastoral Care
A simple way to bring psychiatric diagnoses back under Scriptures purview is to
move toward those who identify with a diagnosis and ask, How can I pray for you?
I know that this [diagnosis and its symptoms] is probably hard for you, and
you have been on my heart. How can I pray for you?
This simple step is ordinary, but revolutionary. With it, you break the
partition between Scripture and psychiatry. Scripture is now brought close to
these problems, and new questions suddenly appear.
How do we pray for this?
What does Scripture say that is relevant?
What promises of God speak directly to the person?
Symptom relief is usually the first thought. Pray that I wouldnt be depressed.
That is a fine way to pray, but, with any problem that might be physical, we want
to add, may your inner person be renewed day by day (see 2 Cor 4:16).
You or the aicted person may be tempted to think that a psychiatric
diagnosis can stand in the way of sanctification. But sanctification is possible
assured evenamong all who profess faith in Jesus Christ.
His divine power has granted to us all things that pertain to
life and godliness, through the knowledge of him who called
us to his own glory and excellence, by which he has granted to
us his precious and very great promises, so that through them
you may become partakers of the divine nature. (2 Peter 1:34)
Given this promise, we expect that spiritual growth would be even more obvious
in the midst of these trials.
Remember Two Basic Theological Tools
Scripture is relatively easy to access for common struggles such as fear and

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