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Core Christianity: Tough Questions Answered

6 Things You Should Know About Faith and Mental Illness

by Michael Horton posted August 5, 2019

Many of us were raised in an era when "it's all in your head" meant that mental illnesses weren't real at least not as real as a broken arm. This tendency reflects not only a lack of appreciation for the rapid growth in medical diagnosis and treatment of such disorders but a cluster of theological misunderstandings. So here are a few introductory theses to consider.

1. We are body-soul creatures. 

Contemporary brain science has shown the remarkable extent to which our thoughts, feelings, attitudes, and actions are connected to our bodies specifically, our brain and chemical interactions. "Mind over matter" betrays a pagan rather than biblical view of human beings. According to Scripture, reality is not divided between spirit/mind and matter, but between God and everything else. Angels and human souls are no more divine than antelopes or fingernails. We are not God and yet we are like God: created in his image that is, in true holiness and righteousness.

Because we are body-soul unities, physical and spiritual issues intersect in ways that can't be easily pulled apart. It is, therefore, a biblical view of the human person that cautions us against dismissing physical trauma as an illusion or spiritual and moral responsibility. The "real you" is not just your soul but you as a body-soul unity: distinction without separation. The biblical view of human beings as body-soul unities should already prepare us to accept that every spiritual problem has a physical component and vice versa. 

2. Sin is a condition, not just actions.

According to a 2008 Baylor study, 36 percent of church attendees with mental illness said that they were told by their leaders that it was the result of sin; 34 percent said they were told it was a demon; 41 percent were told they didn't have a mental illness; and 28 percent were even told to stop taking medication.[1] "Deliverance ministries" make a lot of this second point. Many believe that demons bring "generational curses," passed down from generation to generation. There is simply no appreciation for the biblical gravity of the sinful condition in such a view.

In a biblical perspective, sin isn't just something we do or don't do. It arises out of a sinful condition. Just as the whole self is created in God's image, the whole self is fallen. Consequently, we are sinners and sinned against, victimizers and victims. That is not to say that we are not personally responsible for our sin, but that the sinful condition is far greater in its extensiveness than that.

We can be like Job's counselors, assuming that he had done something to deserve his calamities. If he would only ferret out the sin and come clean with it, then God would restore his fortunes. But neither Job nor his friends had access to the first chapter, where God permitted Satan to test Job so that something greater than physical health, wealth, and happiness would appear. Satan meant it for evil, but God intended it for good. Job's suffering brought him to the confidence he expressed in chapter 19: "As for me, I know that my Redeemer lives, And at the last He will take His stand on the earth. Even after my skin is destroyed, Yet from my flesh I shall see God; Whom I myself shall behold, And whom my eyes will see and not another. My heart faints within me!" (vv. 25-27). 

Neither his friends nor a modern naturalism would be able to explain the ultimate purpose for Job's suffering from the available data. And in our own suffering, we do not have access to "chapter 1" either. All we see are the natural causes and the divine revelation that God works all things together for our good, because he has already triumphed over sin and death in Jesus Christ.

3. Science is a gift of God when it recognizes its own limits.

We never tell people with cancer, "Just pray more and read your Bible more." Ordinarily, God does not act immediately and directly, but indirectly through secondary causes. It's interesting that in Genesis 1 and 2, we have not only the direct command, "Let there be…!" followed by the report, "And there was…," but also the command, "Let the earth bring forth…!" with the report, "And the earth brought forth…." Even in this mighty act, God created the world out of nothing (ex nihilo), and he worked through the physical elements and processes he himself had created to bring about their fruitfulness. Both are God's acts. 

My wife and I prayed for God to heal our triplets when they were born prematurely with various complications. We didn't care whether it was a miracle or God's providential work through excellent physicians and nurses. As it turned out, it was the latter. Either way, God answers prayer. Among the means through which God brings his plans to pass is prayer. And yet prayer isn't magic. Just as Christ himself in Gethsemane did not "turn His eyes to the divine plan but rested His desire, that burned within Him, upon His Father's knees," we too "in pouring out prayers do not always rise to speculate upon the secret things of God."[2] Instead of trying to decode God's hidden purposes, our prayers should focus on the good he has published concerning us. We should be as bold in our prayers as the biblical examples repeatedly encourage. 

4. Christ came to heal the sick, not those who are well (or who think they are).

Here's the key point: Prayer and Bible reading aren't therapies at all, much fewer replacements of medical prescriptions. Prayer is simply talking to God the Father, in the Son, by the indwelling Holy Spirit. Reading the Bible may be "therapeutic," but only because we're looking for something more: namely, the truth about God, ourselves, our world, our hopes and fears, and reconciliation with God in his Son. 

When the focus is on Christ, who is proclaimed to us in the gospel, we can pray with honesty, casting ourselves on God's mercy. We aren't coming to a judge, or even to a therapist, but to our heavenly Father who has accepted us in his Son. We're not rubbing a lamp and making a wish, but we are children crying out to the sovereign God who cares for us and answers our feeble, half-hearted, and even intemperate rants with love, wisdom, and compassion.

5. Christ saves the whole person, but sanctification is a process that is never finished in this life.

Just as the whole person is created in God's image neither divine nor demonic, and wholly fallen in body and soul the whole person is justified and is being renewed daily in Christ's image. This renewal at present is evident spiritually. While the body wastes away toward the grave, the "inner self" is being renewed day by day (2 Cor. 4:16).

We would all like to reach a safe haven, a plateau of health, where we no longer struggle with sin or the physical and emotional pains of daily dying. But we don't find this safe landing place in our experience either physically or spiritually. The only safe haven is Christ himself, who has objectively conquered sin and death, and who intercedes for us at the Father's right hand until he raises us bodily for the everlasting Sabbath.

6. The theology of the cross and the resurrection give us faith, hope, and love.

We are baptized into Christ. What was the pattern of his life? Instead of taking the easy way out Satan's offer of glory now he embraced the cross, not out of Stoic resolve, but out of "the joy set before him": namely, our salvation (Phil. 2:5-8). By his suffering, the sting of death (the curse of the law) has been removed (1 Cor. 15:56-57). But we still follow him from death to victory, but that victory over the pain of sin and death does not lie on this side of glory (Rom. 8:18-25). 

A robustly biblical theology of the cross and resurrection fixes our hope on Christ, who knows our suffering more than we do and who has overcome it objectively. We live in our Christian families and in our churches in that in-between time, awaiting the day when we share fully, in body and in soul, in Christ's glory. Our churches have to be a place where we "wait for it with patience" together. In the process, we need better soul care that appreciates the extent to which physical and mental suffering can be relieved in the meantime. Christians should welcome these advances as signs of God's orderly providence and compassionate care for his creatures. There will always be a central place for spiritual care especially the faithful ministry of preaching, teaching, sacraments, prayer, and discipline. But, like a kid with a broken leg, getting people to the emergency room may be the first order of business.

Adapted from Michael S. Horton,"Faith and Mental Illness" Modern Reformation, Jul/Aug 2014. Used by permission. 


  1. ^ See http://www.baylorisr.org/wp-content/uploads/stanford_perceptions.pdf. 
  2. ^ John Calvin, Commentary on the Psalms 1:353.
Photo of Michael Horton

Michael Horton

Michael Horton (@MichaelHorton_) is the Professor of Systematic Theology and Apologetics at Westminster Seminary California. The author of many books, including Core Christianity. He lives with his wife Lisa and four children in Escondido, California.

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