And Argues Not for Either/Or but Both/And
Okay, this is one funny clean sketch, but it does introduce a question...
When it comes to mental illness, compulsion and addiction, why can't a person just "stop it?"
The snarky side of me says, "Well, why don't you just stop sinning?" Stopping it isn't so simple, is it?
Let's be clear what is not under discussion. There is no suggestion that if a person is sick that he must of necessity be a worse sinner than anyone else. That is the bad theology of Job's comforters or those sorts that ask, "Who sinned, this man or his parents, that he was born blind..." We live in a fallen world, and people get all sorts of sicknesses for all sorts of reasons.
What is under the Biblical microscope today are the thorny issues of the mind and innate proclivities, both in terms of mental illness and addictive / compulsive behavior, things like: schizophrenia, bi-polar, depression etc., as well as homosexuality, sex obsession (or addiction), and substance addictions.
I have had some dealings with this, seen some particularly gut-wrenching tragedies up close and personal, and have a heart both for those who struggle with mental illness and addictions. Thus, my thoughts.
I know all these are not of one kind, certainly, and I approach them as the proverbial layman. I think it will be useful to group them together for one part of the consideration and separate them for another.
Some, in the scientific/medical or psychological community, would say that certain disorders of the mind and attendant behaviors are simply illness --the products of conditioning or physiological malfunction, with no moral component at all. An affliction like depression has no element of choice (which would imply some moral dimension and possibility of sin) --it simply is, and it needs to be treated.
Depending on the specialty of the practitioner sometimes is a predictor as to what treatment is viewed to be most effective: primarily medication or talk therapy. Medication may treat the underlying physiological issue, or it may simply suppress the issue. Talk therapy may give some sort of external perspective and tools for addressing the internal and external manifestations of whatever affliction or behavior.
Sometimes Christians, either without thinking or without the best of intention, based upon positive result, will buy this model without any reservation. If a pill makes the depression abate, then a pill must be the right answer; if 12 steps help the alcoholic stay sober, then 12 steps must be the way to sobriety; if talk therapy helps conquer post-traumatic stress disorder, then talk therapy must be the way to cure PTSD.
Some in the church have reacted strongly against this. The Scripture, they say, tells us not to allow ourselves to be mastered by anything --hence in this view addiction, quite simply, is sin. Even if substances are taken by way of self medication --to quell the lasting after-effects of trauma-- it is still a wrong moral choice to take those substances. At any point, the person who is taking those substances can simply choose to stop taking them. Every needle injected and every pill swallowed is a moral choice --simply a choice to sin-- which one could choose not to do, by simple act of will.
Perhaps the clearest picture we get of this is the attitude of many in the church towards homosexuality. It is interesting, as an aside, how quick we are to condemn sins which may hold no particular temptation for us, and how quick we are to excuse sins of which we are guilty. If I leer at a woman, then that is simply natural: men are supposed to be attracted to women; but, if a man leers at another man, then that is gross and disgusting. The truth is --all sin is gross and disgusting. Gossip is gross and disgusting, so is envy, strife, slander and vainglory. Sexual sin is not disgusting because of its physicality (which after all is created and observed by God) and is very good within moral boundaries) but because it is disobedient to him.
Many in the church treat homosexuality as if it were a simple choice --a young man or woman, in a simple act of rebellion, chooses to be sexually attracted to their same sex. This is absurd in the extreme. No choices of that magnitude are simple choices --there are a multitude of conditioning factors, some of which may be genetic predisposition and gender confusion early in life.
It is, however, important to add that genetic predisposition does not remove human sexual attraction from the realm of moral consideration. Human beings are broken by the effects of the fall --we are born with all sorts of baggage and proclivities, some of which we must resist with might and mien.
Understanding those factors helps us to be compassionate to the person struggling with gender identity, who may have given in to that attraction on occasion, or may have adopted it as a lifestyle. Yes, homosexual lust is sin. Yes, homosexual behavior is sin. Yes, a homosexual lifestyle is sin. It is a particularly powerful sin. It is particularly a mark of mankind's rebellion against God's order, even expressed in his general revelation. In that sense, it is a mark of the brokenness of our entire race, as much as it is an indictment on the individual who engages in it.
It also points us to the work of the church, which is not the sort of condemnation that leaves people in despair, but rather rescue. It is not moral people helping the immoral, but rather immoral people saved by grace helping other immoral people find the same grace that both restores them to God and rescues them from the particular manifestation sin has taken in their life, acknowledging that this particular sin does not easily die (and in fact, at the desire level, may not die till glorification). Sin is not a simple choice --it does not simply go away.
Addictions and compulsions are different. Yet, often these are not simple choices, either. It is possible that a young person may simply start using drugs recreationally out of peer pressure, rebellion or to have a good time, and this young person may find himself ensnared. Another person may live through a trauma, and "self-medicate" and be ensnared. Another may have a prescription narcotic and become ensnared. These are not morally equivalent.
Is the addiction disease or sin? Yes. Addiction works physiological changes in the body (at least according to my friends in the medical profession). A body begins to crave substances, and withdrawal itself can be a physically dangerous proposition. Yet, the choice to engage in the addiction or compulsion, even with the physiological "need" factor, involves moral consideration --namely, sin.
We need to say, however, that our idea of sin is flawed. People get very angry when a behavior is labeled "sin," as if that means the person who is engaging in the behavior is worthless, less of a person, or morally inferior to others who do not engage in that sin. That is not the image the Bible gives us of sin. Sin is a want of conformity unto or transgression of God's Law. That is a freeing thing. God is in the business of delivering us from sin, allowing us to repent of sin, and freeing us from the guilt and power of sin. To call something sin is to highlight the beauty of God's willingness to forgive sin, and his help in turning us away from sin (that is, repent).
None of this is easy or a simple choice --this cannot be reiterated enough. Turning away from sin may require years and much help. This is where I argue for a "both / and" approach. Depression has a physiological aspect. I know some of this up close and personal. I also know, however, that self-pity, which seems to be a feature of depression, involves a moral choice. On what battlefield do I fight this? The physiological or the spiritual? Well, why not both? The depressed person can be helped by medication. He may be helped by truth-based therapy. Yet, he can also be helped by hearing the good news that God forgives him of the sin of self-pity, and is willing to help him turn away from it.
Schizophrenia and bi-polar, and the combination thereof are probably the thorniest of these issues. A person loses his grip on reality. He sees and hears things that aren't there. He may see demonic manifestations ordering him to harm himself or others. He may take his own life. There is a physiological defect of a profound nature. Does that mean there is no moral choice involved? It is very difficult to say. I have known a fine, kind, gentle young man who was afflicted with schizo-affective disorder --the worst of both schizophrenia and bi-polar. He took his own life. What killed him --the disease or his own hand? The secrets are locked away in the dark recesses of the tormented mind. Yet, suicide is sin, but God forgives sin. Making a moral judgment on suicide does not mean there is no hope for forgiveness.
We are body-soul unities. These sorts of questions are impossible to separate out --what is sin and what is sickness? In fact, they are both. They are the products of the fall and affected by moral choice. Therefore, we ought to attack them on all fronts. Medication. Talk, Repentance. Grace. Hope. Love. Our weakness in dealing with these things is separating body from soul. One person only looks at the physiology, another only at the psychology, another only at the sin. Someday, we will learn to pull all these together, and maybe then gain more substantial victories over thorny sins, addictions and mental illness than we can today.