Let me use an obvious example to illustrate my point. Scripture is not designed to counsel Christians out of cancer. Cancer’s root cause must be addressed by surgery, chemotherapy, etc. But the Bible is sufficient to counsel Christians through cancer. The only way we know that cancer should be placed in this category, however, is that science has discovered cancer. We are, to some degree, dependent on science to determine that a problem is not spiritual at its root.

I am so thankful for the dialog with Dr. Lambert on the sufficiency of Scripture in counseling. I pray that God will bring more light to His people as a result. It seems to me the issue boils down to how we know which problems have physical causes and which have spiritual causes. When Dr. Lambert says “autism is not, properly speaking, a counseling problem,” presumably this means it has a physical cause. But how do we know that? The Bible doesn’t tell us about autism.  It seems to me we know it’s “not, properly speaking, a counseling problem” because of general revelation. So it should be safe to say that God did not intend for the Bible to reveal autism. Nor was it designed to counsel Christians out of autism. It certainly was designed to counsel them through autism. I think everyone agrees on these points.

Physical or Spiritual?
The issue is, how do we determine if certain kinds of depression and anxiety have a physical or spiritual cause? How do we know if these are, properly speaking, counseling problems?  We all agree that if all depression is primarily caused by personal sin, then the Bible is sufficient to counsel us out of depression. The bigger questions will always be, do certain kinds of depression have a physical cause and was the Bible designed to reveal those causes without looking to science?

When I talk to people committed to Nouthetic Counseling they either haven’t thought about this or they say, “we don’t have enough conclusive scientific evidence to be sure,” or, “there’s no test that can be done to determine a chemical imbalance in the brain that causes depression.” But isn’t that admitting in some way that science must be involved in the process of determining this? Presumably, if the science was conclusive, we would say of certain kinds of depression and anxiety that they are not, properly speaking, counseling problems. That would then lead us to the conclusion that we can’t counsel Christians out of these kinds of depression. The ultimate cause must be addressed another way.  Yet Scripture is completely sufficient to counsel people through this difficult time as they work with doctors to address the ultimate cause.

Counseling Through Cancer
Let me use an obvious example to illustrate my point. Scripture is not designed to counsel Christians out of cancer. Cancer’s root cause must be addressed by surgery, chemotherapy, etc. But the Bible is sufficient to counsel Christians through cancer. The only way we know that cancer should be placed in this category, however, is that science has discovered cancer. We are, to some degree, dependent on science to determine that a problem is not spiritual at its root.

Let’s apply this to a slightly less obvious example. I doubt anyone would disagree that lack of sleep can cause all kinds of mental problems like depression, anxiety, even suicidal thoughts. Sleep directly effects the brain. And there are many physical problems that can cause sleep deprivation. For instance, take a person who has severe sleep apnea that eventually leads to sleep deprivation and then to severe depression. Is the Bible sufficient to counsel that person out of depression if it is ultimately caused by sleep apnea? Sixty years ago we might have said yes because we didn’t know about sleep apnea. Once it was discovered, however, we would all agree (I hope) that the best counseling in the world would not make the depression go away until the person was treated for the apnea and got some sleep.

None of this suggests that the Bible is not sufficient to counsel people through this kind of depression. And it is sufficient to counsel people out of the sins that often accompany these experiences (unbelief, self pity, bitterness, anger). But if we are going to get to the root of the depression, we must address the sleep deprivation. There are many more examples like this one.

Again, I don’t think anyone would disagree at this point.  The disagreement seems to be over what science has not revealed conclusively.  But even if we grant that there is no test that can determine a chemical imbalance in the brain (I’m not sure this is the case), we have a great deal of conclusive scientific evidence that the brain is extremely complex and there is much we still do not know. We also know that the brain is subject to physical problems just like any other organ in the body and that these physical problems can have a huge impact on our mental state. Isn’t it probable that there are still plenty of brain problems that we don’t know about? Isn’t it also probable that some of the experiences of depression and anxiety could be caused by these problems? If we understand the pervasive effects of the Fall, would we not expect this?

High Stakes
I know those who are eager to guard the sufficiency of Scripture believe the stakes are high. But the stakes are very high the other way as well. If we treat problems that are ultimately physical (like autism) as though they are ultimately spiritual, we can really hurt God’s people. And we are more dependent on science to reveal this than many care to admit.

I understand that conservative Christians are afraid this will open the door to excusing all kinds of sins. I know I was.  It was my own depression and anxiety that pushed me to consider that this issue might be a little more complex than I realized.  It was scary because I thought I was abandoning the sufficiency of Scripture. But I wasn’t. I was merely coming closer to what what God designed Scripture to do and not to do. And I was coming closer to understanding the real world I live in.

John Belden is Pastor of Pilgrim OPC. This article first appeared on Head, Heart, Hand blog and is used with permission.