Is Mental Illness Simply Spiritual?

Part 1 of a 2 part series on nouthetic / biblical counselling

Hi friends,

Usually I only send emails here at the end of the month with links to my favourite resources from that month and a personal update. However, I wanted to pop into your inbox today to share something that has been on my heart for a while. I’ve held onto this article for over a year, shared it with many people to receive their feedback and suggestions, and have carefully researched it. I’ve also prayed and sought wisdom from those I respect throughout this year.

I fear that this piece will hurt feelings, but I also know that the truth is too important to hide. I promise my intentions are not to bash, harm, or anger anyone. Rather, I hope to encourage others who have faced the same pain and confusion from the biblical counselling as me and show them another way forward. I write as one who has suffered from and one who was a part of this very movement. Thank you in advance for your kindness.

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Should the term “brokenness” set off alarm bells in our minds for bad theology?

As I washed dishes in a previous house—where the counters boasted bright, fire-engine red and the wallpaper was even louder—I listened to a podcast. The women discussed how to recognize false teachers, and one of them pointed out, “False teachers often use the word ‘brokenness’ excessively. Rather than talk about sin, they talk about brokenness and how we’re all just broken.” 

These women aren’t the only ones who dislike the word “broken.” As I sought to understand mental illness from a biblical perspective, I found many who disliked considering mental illnesses as anything other than sin, not brokenness. For years I lived in and studied under the biblical / nouthetic counselling movement and believed that my anxiety and all its related difficulties were simply sin issues I had to repent of. They taught me that mental illnesses were only spiritual and could be thoroughly dealt with through the Bible. 

I lived under the painful belief that defined my mental illnesses as character flaws. I considered them as sins that could be killed if I had more faith and memorized more Bible verses. I attacked some as idolatries that could be dethroned if I loved God more. Others I labeled as the result of spiritual immaturity. But when all my efforts failed—and God didn’t cure me—I wondered how I could be counted among God’s family.

This kind of teaching boils down to the belief that all mental illnesses are spiritual issues to be admonished and repented of. But is mental illness simply spiritual? I’ve come to see, with much undoing of the bad theology I had absorbed, that it’s not. Mental illness can’t be distilled to spiritual issues of sin and doubt, and brokenness shouldn’t raise red flags.

We Are Sinful

We need a correct theology of sin to clearly understand and respond to the gospel. Adam and Eve sinned against God in the Garden—they rebelled against his command and sought to live life their way. As a result, they passed their sin nature down to all of us. Yet this is why Jesus came. As Athanasius so beautifully wrote, 

It was our sorry case that caused the Word to come down, our transgression that called out his love for us, so that he made haste to help us and to appear among us. It is we who were the cause of his taking human form, and for our salvation that in his great love he was both born and manifested in a human body.¹

When we come with faith in the gospel and trust in Christ’s finished work for our redemption, we likewise repent of our sins out of love and gratitude to him for this great salvation. Jesus himself proclaimed, “Repent and believe the gospel!” (Mark 1:15; cf. Matt. 4:17). We’re saved from our sins, called out of sin, and given the ability to kill sin by the Holy Spirit. 

True, some have tried to soften this message to get rid of sin entirely and claim we are only broken. However, to scratch sin out of the Bible distorts the gospel message itself. We all sin and fall short of the glory of God (Rom. 3:23). Jesus didn’t come to only save us from our brokenness; he came to save us from our sins (Matt. 1:21). 

But We’re Also Broken 

In the Fall, much broke. Our relationship with God fractured. God once walked in the Garden of Eden with Adam and Eve, but after their rebellion, God had to interrupt the intimacy they once enjoyed  due to their sinfulness. God cursed the earth with thorns and thistles, and now the world aches for release from that curse. Our bodies became marred as well with ailments, sickness, and ultimately death. Human relationships splintered; as sin took root in our hearts, that sin caused us to hurt one another. Humanity and this world broke because of sin. God’s design of creation included none of these conditions.

Yet Christ came to heal this brokenness, too. He came to upheave not only sin, but all its devastating consequences. As Jesus healed the sick and ailing during his earthly ministry, he gave us a foreshadowing of how one day he will trample sin and its effects once and for all. He has gone to prepare a new home for us where sin will never again taint, tarnish, or ruin our lives. There, Christ will wipe away every tear with his gentle hand.

What Biblical Counselling Teaches

Biblical counsellors say that most mental illnesses find their roots in further sins of selfishness and pride or spiritual doubt and discouragement. Heath Lambert, former president of The Association of Certified Biblical Counselors (ACBC), wrote a few years ago for ACBC’s blog:

When you pay attention to the problems that our culture identifies as mental illnesses, you’ll notice that they are problems which involve an active human heart in ways that traditional diseases do not: folks diagnosed with clinical depression need hope and encouragement, folks labeled as alcoholics need to learn self-control, children identified with obstinate defiant disorder need to learn to respect their parents. What other diseases have hope, self-control, and submission as elements fundamental to cure?

Do not misunderstand me. I’m not trying to sit in judgment on all people diagnosed with a mental illness … I’m also not saying that there is never anything medically wrong with people labeled with a psychiatric disorder.

What I am saying is that in almost every single mental illness diagnosis, spiritual issues of right and wrong, good and bad, obedience and disobedience are on the table in ways that they are not with traditional diseases. This means that people diagnosed with mental illness need the gospel in ways that are different than those with an actual disease.²

Heath Lambert does well to acknowledge a medical reason behind psychiatric disorders. He goes wrong in assuming that every mental illness begins as mostly a spiritual problem to resolve through biblical counselling (and apparently changing the gospel from person to person).

Lambert isn’t the only leader in the biblical counselling movement who believes and teaches this troubling theology. In a biblical counselling training session in 2011, Dr. John Street (a professor of biblical counselling at The Master’s University) stated that mental illnesses are not real. According to Dr. Street, people either have physical issues that can be proven with medical testing or a spiritual issue that can be diagnosed and treated with the Bible.³ The leaders and trainers in the biblical counselling movement define the majority of mental illnesses as spiritual issues of sin and discouragement.

Consider the outworking of such teachings. A friend of mine who struggled with depression saw a biblical counsellor. At every session, the counsellor blamed my friend’s depression on the sin of pride. The counsellor taught them that if they would work harder to forget themselves, think less about themselves, and become more selfless, the depression would disappear and joy would return. Instead, the depression only grew, to the point of suicidal thoughts.

Though there are many people within the biblical counselling movement with many different opinions, these examples repeat with discouraging frequency, indicating a pattern of mishandling the tender souls of God’s children. Leaders of the movement teach biblical counselling trainees this underlying philosophy at training events, books, podcasts, and articles from key leaders within the movement. While some biblical counsellors exist who see these teachings at odds with their beliefs and practices, we can’t ignore these dominant philosophies taught at the higher levels and which found the movement as a whole.

What If It’s Brokenness and Sin? 

Sometimes brokenness and sin muddle together. In mental illness, we suffer under the brokenness of our minds from the curse of sin. Anxiety, depression, bipolar, OCD, burnout, PTSD, and other ailments frazzle our brains and cause them to misfire. In trauma, when someone else has sinned against us or we go through a scarring experience due to the effects of the Fall, our bodies and minds likewise feel the reverberations of sins. And at times these broken parts of us may produce sin as a symptom (but not always). As Brad Hambrick writes, 

“advanced brokenness” are matters of aptitude, physical pain/limitation, or emotional regulation challenges rooted in one’s physical condition or traumatic history. Our goal, as ambassadors of Christ, in these matters is to grieve with the individual facing these challenges (Romans 12:15 as a way of embodying Matthew 5:4), and destigmatize the condition or experience so that the individual will be willing to engage the common grace remedies God has provided to alleviate such suffering.⁴

Counsellors like Lambert fail to see that in some situations our brokenness, caused by sin’s fracturing effects around us, produce sin. They fail to perceive that the root to all mental illness isn’t sin or a spiritual problem that a Bible verse can and gospel message can fix. Mental illness is a medical disorder. While the symptoms may appear as moral issues, they’re caused by a disorder or illness within our brains that requires tending. At times, obedience may be hindered by a mental illness that requires professional care first. Science, studies, and research show that issues such as trauma and specific phobias affect specific areas of the brain and cause them to react.⁵ Unfortunately, many biblical counsellors ignore this kind of psychological research because they claim no set of blood work or medical scans can prove the existence of mental illnesses.

When sin becomes muddled with mental illness and trauma, we need to recognize that a sinful heart isn’t always the primary cause. Here, brokenness is the cause, and brokenness doesn’t need lectures of repentance but careful mending. We need someone to see our brokenness and come alongside to help carry us towards healing. We’re still responsible for our sins and are called to repent, but we may need professional help reworking our brain to enable us to do so. Alongside qualified mental care, we also need helpers who are understanding and show us the love of Jesus, which is gentle and compassionate. Christ doesn’t wag a finger in our face or sigh with frustration that we still haven’t killed this sin. He bends low. He comforts us. He reminds us of his love and grace for all of his children that never runs dry. 

Is mental illness simply spiritual? No, the answer is much more complex and complicated. At times our brains are simply broken, and with a proper understanding of sin and the effects of the Fall, we realize this truth and can stop viewing our mental illnesses as only sins to be conquered. We can view them as true illnesses that need God’s common grace of provision in qualified and licensed professional help.

1. Athanasius, On the Incarnation, trans. Penelope Lawson (Wantage, England, n.d.).

2. Heath Lambert, “The Spiritual Nature of Mental Illness, Part 1: The Gospel and Mental Illness,” Association of Biblical Counselors, November 13, 2013, https://biblicalcounseling.com/resource-library/articles/the-spiritual-nature-of-mental-illness-part-1/.

3. Session 4 - Gathering Data: Discerning the Problems Biblically, BCDASoCal Basic Counselor Training (Biblical Counseling and Discipleship Association of Southern California, 2014), https://www. youtube.com/watch?v=VvtvMMs3_Jk

4. Brad Hambrick, “We Are Equally Sinful. We Are Not All Equally Broken or Toxic.,” Brad Hambrick, October 13, 2017, http://bradhambrick.com/we-are-equally-sinful-we-are-not-all-equally-broken-or-toxic/.

5. Yvette Brazier, “Everything You Need to Know about Phobias,” ed. Timothy J. Legg, Medical News Today, November 27, 2020, https://www.medicalnewstoday.com/articles/249347/.