Psychiatry and Christianity

Why write about Psychiatry and Christianity? Psychiatry is becoming increasingly relevant for all doctors. The importance of understanding the psychology of patients in all areas of medicine and surgery is being recognised. In the past, often the mind (or 'psyche') and body have been seen as separate, unrelated entities. Plato said 'This is the greatest error of our day in the treatment of the human body, that physicians separate the soul (=psyche) from the body'. What was true in Plato's time is still true today.

Traditionally Psychiatry is one area Christians shy away from. There are several issues which give rise to genuine concern. Montagu Barker, in a CMF publication[1] discusses some of these issues: for example, the relativistic views of many psychiatrists are incompatible with Christian views of right and wrong.

This article, however, is to be concerned with another important issue, the Supernatural and mental illness. Along the way we hope to begin to see that the Bible has much to say on the subject of the sickness of the mind.

The mind in the Bible

The mind features prominently in the Bible. The mind and heart are described as being cunning[2]. God has given mankind over to a depraved mind[3] which leads to death. We could perhaps all be described as being mentally sick. God gives new life to our minds[4], and our lives are to change by the renewing of our minds[5]. We are told to think on good things[6], which is strangely similar to 'modern' ideas of cognitive therapy.

Also, some people are described by others as being 'out of their minds'[7]. The writer of Proverbs makes an astute observation that men with warped minds are despised[8]. Anxiety and despair are also described[9]. Minds can have doubts[10], be troubled[11], and have delusions[12].

Demons or delusions?

In the last reference there seems to be a distinction made between delusions and the direct work of the occult, visions, divinations and idolatry. The two are however grouped in the same list. This may indicate that although distinct, the work of the occult and the delusions of men's minds are hard to separate fully. Can we identify what is mental illness, and what is spiritual?

The definition of delusions according to the Oxford Textbook of Psychiatry, is very specific. A delusion is an unshakeable belief, not based on reason which is incongruent with an individual's culture and background. When dealing with the subject of religious delusions, one has to consider what an average Christian believes. So the truth or falsehood of the belief is not the issue, but its 'normality'.

The belief in the demonic, or indeed our belief in God is therefore not delusional. It is possible that some symptoms of mental illness are actually demonic in origin. Voices heard in the head commenting on the sufferer in a hostile way, could perhaps be demons. That is not to say that such people are necessarily possessed. The devil's legions are all around us. It could well be that a biochemical problem in the brain causes an individual to be sensitive to a dimension we are not. This is speculation, and the alternative view that such phenomena are the product of a sick mind is certainly possible from this verse.

All this talk of the occult and supernatural may sound very unfamiliar. We like to think such things are just superstition, and from the past. This very obvious work of Satan is still prominent today, however.

It is said that 250,000 Britons describe themselves as witches or pagans today[13]. This could well be an underestimate, since such groups are clandestine by their very nature. Groups often involve important people, and in spite of highly illegal activity, are rarely brought to justice. The CMF quarterly Newsletter of July 1989 reported on a conference held by the Association of Christian Psychiatrists at the Royal Society of Medicine. This conference examined the controversial issue of child satanic sexual abuse. 'All of the speakers were able to talk from first hand experience with cases of ritual child abuse in which multiple physical and sexual assaults, the use of drugs, brainwashing and inverting of normal values (psychological abuse) and child and animal sacrifice featured consistently.'

Such obvious works of Satan are often associated with possession states. Sargant's famous work[14] attributes the similarity of possession states world-wide to their being caused by purely physiological phenomena. He argues that despite world-wide belief in gods that control natural events and can possess men, it is man that has invented gods and not vice versa. He argues we need to believe in a god, and yet there are no real gods. He also believes that man is the most approachable of the so-called gods.

As a Bible-believing Christian it is hard to accept these theories. In the 50s such arguments raged within the church. It has been pointed out that Jesus is the one from whom we learn most about demons. He clearly believed in them. To argue that he was a child of his time, due to the limitations of his flesh, insults not only him, but the Holy Spirit who could surely have revealed to him (if necessary) such a basIc fact as the non-existence of demons. To claim Jesus knew better but adapted himself to make it easier for others to understand makes him a liar. The only conclusion must be that demons were very much alive and active in Jesus day, and if they were then, there seems no reason why they shouldn't be today[15].

In a symposium published in the Journal of the Royal Society of Medicine it is refreshing to note that Sydney Crown (of The London of course!) points out that people who practise the rite of exorcism believe not only in its efficacy but in the reality of the spirits[16]. There must be none of this Western superiority which claims we have outgrown 'primitive' beliefs in demons whilst saying they are real for the tribesman. If such beliefs are primitive, then let us join the very Son of God himself in being right but 'out of date'.

This talk of 'gods' sounds very primitive, and Christianity is supposed to be a monotheistic religion. It is very interesting that in the context of a culture that had complicated rituals for exorcism there is no Old Testament description of exorcism. From being centre stage the gods are relegated to obscurity. Their worship is to cease[17] and they are mocked and ridiculed[18]. Theologians discuss how the spirit world is stripped of all its meaning and fearfulness in the Old Testament. It is only God who is to be feared, since He created the entire spirit world[19], and 'its role and domain are determined by His sovereignty.'[20] Demons are fallen angels who have rebelled against God, and yet are still very much subject to limitations put on them. No-one has a totally free will, God restrains and prevents much evil both in this world, and in the spiritual realm.

The reality of this world is not denied, its importance is merely minimised. This veil surrounding the demonic is dramatically lifted around Jesus. It is as though God only allows the demonic to be seen when his Son is present. This may well be to counter the unhealthy fascination men feel for evil.

The aetiology of demon possession

There are many ways of contact with the demonic realm. In addition to Satanic rituals, more subtle methods exist. Biblical scholars are agreed that God does not normally allow the spirits of the dead to be contacted. There is neither any suggestion that spirits of the dead can hover, and haunt places. Mediums who call up these spirits are inspired by demons if not purely by their own imagination. Demons would of course know enough information about deceased individuals to impersonate them. The case of Samuel[21] is often cited by the so-called Christian Spiritualists. It is thought that this was an exception, possibly the only one. The witch of Endor was surprised to see the real Samuel come up, it may well be that she was expecting a familiar demonic spirit who gave her her powers.

It is important to realise as Christians that such activity, and even the so-called harmless fun of ouija boards, fortune-telling, horoscopes and hypnotism, as well as certain types of meditation and alternative medicine can all be dangerous. Not everyone who dabbles in these things will become possessed, it seems some are more vulnerable than others. It is, however, playing with fire. Ouija in particular has led to severe depression, fear of the future, and on occasion even suicide to fulfil a 'prediction' of death. It is true that some of all this is due to purely sychological effects, but the devil can and does use even psychological effects to destroy people's lives. What is more, God makes clear in the Bible his hatred for all such practices, and they are clearly forbidden[22].

Any Christian who has had contact with such things needs to repent, and renounce his links with the evil involved. This may take help from a skilled leader in the church. It is often wise to follow the example of the Ephesians and destroy all items in any way associated with suspected demonic activity.[23]

The purpose of describing here a list of things which have been seen to be related to demon possession is not to create a sense of fear. Rather, we are called to root out of our lives all that is idolatry. That includes the modern gods of money and selfishness as well. The key here is to realise that God gives us a spirit of self-discipline[24]. Anything which causes us to lower our mental defences and become uncontrolled should be avoided. Our minds are naturally active, even whilst asleep and passivity should be avoided[25] A passive empty mind is an invitation to spirits to take control[26] This is why certain types of meditation and hypnosis are to be avoided. The surrender of control to a powerful hypnotist is submitting to a form of domination. Christians are told not to lord it over others[27], but rather serve. The picture of biblical leadership is that of the chief servant washing other's feet[28].

Today, even in the church, there is the feeling that such things don't really matter, due to the increasing acceptance of New Age philosophy Even the so-called harmless pursuits can lead to more serious involvement, as well as being dangerous in themselves. it is almost like a drug; our fascination with 'the dark side' once aroused is addictive. It is interesting that mild drug abuse is also often seen in people who become possessed. Indeed one psychiatrist, who felt he had never seen or at least recognised demon possession in a patient of his. felt that the closest he had come to recognising possession was in his work with drug abusers. The self-destructive urge of patients seemed almost to come from outside of them.[29]

We must avoid an unhealthy desire to know the future beyond what God promises to reveal to us. Any desire to control others is also wrong, and the very foundation of witchcraft. Unnecessary secrecy or separatism, such as found in Freemasonry and other cult groups, can also be a sign of demonic activity. In short, anything which is not of the character of the Kingdom of God should be avoided.

Demon possession the cure

Once again it must be stressed that demon possession is not the inevitable result of all this. It is possible to be influenced by demonic activity without being possessed. In some ways it would almost be better not to deal with possession in an article like this. An adequate treatment cannot be given here. It is not to be recommended that those reading this article go racing into 'deliverance ministry'. Without the proper authority and experience this can become just as much a preoccupation with the demonic as anything else we have mentioned.

It should also be stressed that exorcism is a potentially dangerous occupation. Emotional and physical damage could be done to the subjects. Those practising it have also (at times) been known to be in physical danger due to the almost super-human strength seen at times.[30] This is not intended to frighten, but we must recognise these spirits are far more powerful than we are. It is only in Christ who has destroyed their power through his death that we can stand, and see his victory. A wise, mature and experienced leader should be involved in any deliverance attempts.

Various Christians have put forth suggestions about the exorcism ministry that is seen as the treatment for states of possession. It is seen that false diagnosis can lead to problems for the patient. States of possession should not be looked for, it should be assumed someone is not possessed until there is evidence that they are[31]. D M Lloyd-Jones gives an indication of how to identify demon possession[32]. At the top of the list he places intuition. Experience is the key thing here, but more importantly, the gift of discernment of spirits which God gives[33]. The presence of another personality in the room is sensed. Talking in a strange voice, especially if in another unknown foreign language, can at times occur in possessed individuals. Most dramatically and conclusive is the explosive reaction to the name of Jesus or spiritual matters. If it is clear that there is a spirit present it should be commanded to go. Resistance can occur, and even the disciples did not always succeed on all occasions[34].

In common with others, Lloyd-Jones distinguishes between mental illness and possession. Possessed people are generally ready to listen, and want a way out, he says. On the other hand in certain severe cases of mental illness there is no feeling of contact with the patient. Also prayer will tend to calm those who are mentally ill, whereas those possessed will be excited by prayer and may even only exhibit any signs of abnormality when prayed for.

Such clear distinctions are not necessarily easy to make in practice, nor are they necessarily valid. Some Christian psychiatrists maintain that the symptoms of possession can be found in certain other mental disorders[35]. Some patients who may think they are possessed will recover with physical drug treatment. It is argued that over 90% of suspected possession is purely medical[36]. Sensationalism can occur and many think they are possessed as an easy explanation. A two-handed approach is called for. Even if possession is really there, healing may be possible on a physical or emotional level if it is vulnerability that is causing the possession. It should be noted that even in Jesus' ministry there seems to be a distinction made between those who need exorcism, but also those 'troubled by evil spints' who are healed, not delivered.[37]

It is well known that depression, for example, can be treated with drugs, with listening and social support, with modifying thought habits and with changing circumstances. If we take a wholistic view of man it is clear that another, spiritual dimension can be seen as being just as intimately related to the others. We must also realise that a natural healing is just as much God working as a supernatural one.

It is thought wise to avoid mentioning spirits or demons to people we are trying to help, unless it is absolutely necessary, and to obtain medical consultation if possible. Good follow-up is always required and emotional healing may well be needed[38]. Exorcism should perhaps be reserved for situations in which a clear response to prayer strongly suggests the demonic. Jesus didn't go looking for demons, they trembled when he came around. Having his authority is necessary for effectiveness.

The very dramatic nature of some possession states has led some to believethat such people, and maybe in a more minor way, us as well, are not responsible for our actions. lt is clear that such talk is unbiblical. Demons can only tempt and entice us by our 'own evil desire'[39]. We can resist, but choose not to. Each action may not be self-willed in a possessed individual, but the choice to abandon himself to the devil must have been made. Even the most extremely possessed individual is responsible before God[40]. The Gadarene demoniac came and fell at Jesus' feet. Legion would surely have made him run the other way[41].

Can Christians be possessed?

There has been a long-running controversy in the church about whether a Christian can be demon-possessed. Lloyd-Jones tried to clarify this point by explaining that it is not just a physical analogy. Being full of a demon at any stage in the future is not prevented by the fullness of the Holy Spirit at one point in time. If a person gives himself consistently to evil he will become full of it, in the same way a lover is 'full of' the beloved.

The attempt to sanitise our inner lives as Christians and say that it is impossible for any influence of Satan to act internally is viewed very seriously by one author He suggests that 'a significant degree of emotional immaturity distress, and even nervous breakdowns among evangelicals could be traced to this Utopian error'. To him it is this belief that leads the evangelical to believe he must keep up a front of 'happiness' which contradicts his real experience. This leads at best to hypocrisy and at worst to psychic collapse.[42]

Modern Christian counsellors often do not like to talk of possession as such, since it is an all or none phenomenon and implies ownership. It is preferred to talk about degrees of 'demonisation', and it is felt we all suffer from the work of the enemy in this way to a greater or lesser extent.

Let us not give too much attention to demons, on the other hand let us remember we are all in a battle which is not against flesh and blood[43]. The principalities and powers talked of here are perhaps best seen as powers which hover over areas of sin. It could be seen that the corporate sin of nations leads to bondage to powers which are the idols of that time. This can lead to certain culturally accepted sins, and it is the job of the Christians to identify these, and counter them in their own lives. This will of course go against the grain of what is 'normal'. It is important not to overpersonalise these powers, and so, with Paul, we shall leave them as slightly mysterious ruling 'principles'[44] which affect the lives of people.

The pervasive nature of the work of Satan means that in a sense everything we do as Christians, and as doctors, is to frustrate his works. We should see our battle as guerrilla warfare, however, when it is perhaps rare that the enemy shows his face. We do not need to practise exorcism to attack the influence of Satan in people's lives. The havoc he causes in individual lives is seen everywhere, and fills clinics in GP surgeries, hospitals and psychiatric departments.