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  • Writer's pictureAdam O'Neill

Standing in the gap through Christian Psychiatry

Updated: Aug 3, 2023


Standing in the gap through Christian Psychiatry

“I just think medicine should be medicine and if I have questions on spirituality I’ll go to my rabbi or priest.” My friend posed the question casually but I knew it was coming and I should have been more prepared. But here, over dinner, I struggled to come up with an answer. When I began work in Christian Psychiatry I had grown accustomed to confused looks or follow up questions but had not yet encountered outright opposition to my practice.


The argument was this: that medicine is a secular field that uses our natural senses to treat chemical imbalance; it isn’t the place to discuss faith. To be fair, my friend isn’t the only one who feels this way. Medicine has come a long way from spiritual healers and shamans. In ancient times, sickness was not a sign of a physical disordering but a spiritual one and it required a spiritual healer. Today enlightenment and the age of reason hold honored positions within the medical community. Medicine has adopted naturalism as its champion. There are, however, winds of change. Illness is beginning to be explored from a holistic perspective; and it is to our benefit. Our problems do not exist in boxes, separated from the other aspects that make us human and neither should our treatments. I fear, though, that the spiritual perspective we have added is just another box to check off on an intake form.


Very few who have sought my care have understood what they were experiencing as a purely chemical phenomenon. Those of us who have experienced mental illness know that above all other types of pain, psychological anguish leads to questions of meaning and purpose, of a sense or something greater than ourselves and our relation to it. These questions often remain, even after the disease is treated. In my experience, those with faith feel the strain of believing God is good and those without faith find themselves asking if there might not be some purpose or meaning behind their suffering. Nihilism does very little for the sufferer. So who is the proper “clinician” to handle the existential crisis: the philosopher, the priest, the counselor, the psychiatrist? Many have been incorrectly medicated by, albeit well-intentioned, providers.


The age of naturalism has resulted in an epidemic of over-prescription of psychoactive medications. There are pills to make you feel calm, pills to help sleep, there’s one to help you stay up, one to quiet voices among many others, and as a clinician to be fair, it’s much easier to write the script than listen to the stories. A 15-minute appointment at a family doctor provides very little time for philosophical lines of questioning. The result has been a clear predominance to prescribe. The Journal of the American Medical Association published an article in 2013 which found that 1 in 6 adults had taken a psychiatric medication in the prior year. That number has likely increased. The over-prescription of medication has led to a response by certain members of the faith community to decry their use altogether. To quote from one article from CBN titled “Prozac Jesus: Has Jesus Been Replaced With a Substitute”, “It is not Christ’s design that Christians be dependent on anything but him for physical, emotional and spiritual stability. We teach that Jesus is enough; we say that he has changed our lives that the old has gone away and that we have been born into new life. But if this is the case, then why is the church full of people suppressing secret struggles with depression?” To make my point clear I do not espouse or agree with the assessment of this article.


Instead, I believe, the answer must exist somewhere in the middle. Surely a chemical problem can have a chemical solution, a spiritual problem a spiritual solution. But what of those concerns that exist somewhere in between. What if depression begins to ask questions of existence and the presence of suffering that an antidepressant can’t answer? What if prayers offered in faith yield the name of a clinician or a prescription instead of miraculous healing? It seems to me that this situation requires a bit more nuance, someone trained to stand in the gap and feel the tension of this uncertainty with their patients. I’m not claiming to be that person, at least not perfectly, but I’m learning to be. All I ask is for the space to do so.


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