I remember the day when “Joe” (not his real name) came into the rescue mission. I said, “Hello,” shook his hand, and introduced myself. He responded pleasantly and we began the service. Everything seemed normal. That is, until Joe began talking to the guy next to him. That’s really not uncommon at a rescue mission, but the only trouble was, the “guy” next to Joe was no guy at all. It was a sink. He was only whispering, and I figured to call him out would be a greater distraction than it was worth, so I let it go. As time went on, Joe became increasingly more distant from reality and his “conversations” became increasingly more regular and disruptive. He was schizophrenic.
Believe it or not, schizophrenia is a relatively common diagnosis. In fact, 25% of all those entered into psychiatric hospitals in the US are diagnosed as “schizophrenic” (which is annually around 500,000 people).1 Even since the short time I’ve worked in LA, I’ve had a number or individuals inquiring about schizophrenia because a loved one, friend, or someone they were counseling was diagnosed with it. Of course the primary question is always, “Can the schizophrenic be saved?” and, “Does the Bible have answers for the schizophrenic?” The answer to both is, “YES!” We can come to this conclusion after understanding what schizophrenia actually is.
A lot of people are sort of “spooked” by schizophrenia. It seems like an overwhelming psychological disorder that’s pretty much hopeless, and the actual name “schizophrenic,” along with the Academy Award winner A Beautiful Mind, doesn’t help. It’s a bad term that’s extremely vague and lacks a lot of clarity, describing a wide variety of behavioral issues. That’s why I like Jay Adam’s illustration of the term, comparing it to the diagnosis of a “red nose.”2 There could be a number of reasons why someone might be “diagnosed” with a red nose. They might be “under the sauce,” have a cold, or maybe they were just out skiing too long or had a sunburn. Whichever the case, it’s clear that to refer to the disease by the symptom of all three would be unfair, and to correct the red nose would require an entirely different approach depending on the underlying problem.
The name “schizophrenia” is similar. According to the DSM4, schizophrenia is diagnosed based on the observation of unusual behaviors involving positive symptoms (extremely exaggerated thoughts and behaviors often revealed in hallucinations), negative symptoms (a reduction in normal functions such as unwillingness to converse, inactivity, absence of emotion, etc.), and disorganized thinking. At least one bizarre behavior must be observed for a month, and other less severe symptoms must be observed for at least six months.3 Simply stated, schizophrenia means nothing more than bizarre behavior. The problem? Many are led to believe that schizophrenia is a mental problem and is incurable, when actually, the mind is working perfectly normal. Referring to schizophrenia by what it actually is seems almost too simplistic.
Such was the observation of Carl Gustav Jung, who was an extremely influential writer and has contributed much to what we now refer to as “psychotherapy” in the early twentieth century. But what frustrated Jung was the lack of integrity in the new so-called “psychiatric institutions.” In fact, he worked in one of the most influential institutions in the world at the time, but he observed something shocking. He soon realized that the hospital physicians had no interest in learning the patient’s personal life, even though it was known that this was the key to curing the patient. Most often, this secret life hid some criminal or heinously sinful act, and the burden of keeping such a thing secret would lead to such crippling guilt that they would become “mentally ill.”4 What Jung found was that confrontation and confession were critical steps in curing patients – even those with schizophrenia (which was considered incurable)!
You would think that the discovery of a cure would be met with celebration by the medical staff, but that wasn’t the case. Schizophrenia was a disease declared incurable. It could never be cured, and if it was cured, Jung writes that the schizophrenia was declared as “not a real schizophrenia,” to his understandable frustration. If we remember the actual definition of schizophrenia as “bizarre behavior,” then we would understand the absurdity of this claim. How can it be said that bizarre behavior could never be cured? To me, this itself proves that schizophrenia itself cannot be a real disease as we would understand it. No one would feel the need to defend the legitimacy of a disease to such a degree that they would declare it “incurable,” if it was in fact, a real disease. Imagine if someone had cancer and they were treated for cancer, but when they were cured of cancer, they were told it must not have been real cancer because cancer is incurable. Jung thus concluded that his role at the psychiatric hospital was truly nothing more than a jail-keeper. So the question then becomes, not “How do I help the schizophrenic?” but instead, “How do I help someone with bizarre behavior?”
Bizarre behavior that leads someone to be diagnosed as schizophrenic can be the consequence of a number of issues, but they can be placed under two categories. People can act bizarrely because of an organic issue, and people can act bizarrely because of an inorganic issue. Organic issues would involve something physically occurring within the body. It could be dysperception (chemical), such as when drugs are involved. It could be the consequence of a brain tumor, brain damage, etc, or even something like sleep loss – resulting in massive amounts of adrenaline in the body to keep you awake. Inorganic issues would be something that is not physical, but is the consequence of deception, fear, manipulation, sin, self-deception, etc. It might shock some people therefore, to know that schizophrenia is not a mental problem at all! The problem is actually with faulty data the brain receives for any number of reasons, that the brain then responds to in a normal manner.
For instance, if I was under extreme sleep deprivation, and I saw a bird swooping down at me, when there really was no bird, the natural response for my brain would to send signals making me instinctively duck. The problem wasn’t with my brain. Ducking because I think a bird was striking me would be normal. The problem was with my lack of sleep, which resulted in faulty data being sent to my brain. Likewise, if I was stressed out and terrorized by some secret sin that I committed, I might become extremely and bizarrely reclusive, or maybe even freak out when people came too close. The problem isn’t with my brain, it’s that I’m overwhelmed with fear that my sin will be found out. Either of those situations could lead me to be diagnosed as a schizophrenic.The following chart provided by The Journal of Biblical Counseling is helpful in this regard.5
This is where the biblical counselor needs to practice discernment, since he or she would have to determine the cause of the bizarre behavior. What you can be sure of though, is that you shouldn’t treat the bizarre behavior as a disease.
First of all, the biblical counselor should work hand in hand with a trusted physician to rule out the possibility of things like brain tumors. Physicians can also be helpful in discovering drug abuse through blood tests that might be otherwise unknown, or any other bodily malfunction for that matter. Once this is ruled out, the counselor can then proceed to counsel the schizophrenic as he or she would any other case, addressing the underlying cause of the bizarre behavior. Don’t be misled if you don’t think the “schizophrenic” doesn’t seem to understand you. Continue speaking to them clearly and articulately. Above all, begin with the Gospel and confront sinful behavior as it is. Power is provided in the Scriptures, which are adequate to solve all life’s problems (2 Tim. 3:16-17).
- Maxmen, Jerold S. and Hicholas G. Ward, Essential Psychopathology and Its Treament (New York: W. W. Nortan and Co., 1995), 173. ↩
- Jay Adams, The Christian Counselor’s Manual (Grand Rapids: Zondervan Publishing, 1973), 383. ↩
- Marshall and Mary Asher, The Christian’s Guide to Psychological Terms (Bemidji, MN: Focus Publishing, 2004), 164. ↩
- Thomas Szasz, The Myth of Psychotherapy (Syracuse: Syracuse University Press, 1988), 164. ↩
- Jay Adams, “The Christian Approach to Schizophrenia” The Journal of Biblical Counseling 14, no. 1. (Fall 1995): 30. ↩