In Defense of My Opposition to Nouthetic Counseling

As I expected, proponents of biblical counseling are leaving comments suggesting that what I’m writing simply is not true. They believe I am taking a harsh stance against biblical counseling and unfairly representing them. I have carefully looked over the statements I made concerning nouthetic counseling. I do not want to unintentionally write something that has no basis in truth. Perhaps my statements need explanation.

First, let me explain that the biblical counseling movement is wide-ranging. I am going to defend the statements made in my posts about nouthetic counseling as ascribed to by Jay Adams. I do have major concerns about biblical counseling as a movement; however, I fully acknowledge there are definitely biblical counselors who are more liberal in their views of “mental illness” and psychiatric medications.

In defense of my statements, I am drawing mostly from the writings of Jay Adams. My statements are in bold. The defense of these statements comes directly below.

I

The nouthetic method of counseling is vehemently opposed to psychiatric medication. They generally believe that depression and other mental illnesses are a result of sin.

(Nouthetic counselors) disregard modern psychiatric medicine, including antidepressants and anti-psychotics.

Jay Adams most popular book is entitled Competent to Counsel. He does acknowledge that some mental illness stems from “organic” problems. Adams throws around the term “so-called” a lot. (He often says “so-called mentally ill," or "so-called chemical imbalances.”) His definition for the “truly mentally ill” is found in a footnote in Chapter 3 of Competent to Counsel.

I.e. with the exception of organically-based problems such as brain damage, toxic problems, hardening of the arteries, and insanity by gene transmission, which may affect the brain directly. In each case, as well as in adrenachrome deficiencies, to the extent that it is possible to do so, the patient is still responsible to handle his handicap in accordance with the revealed will of God.

These organic causes of mental illness cannot be treated by drugs, with the exception of “adrenachrome deficiencies.” “Adrenachrome deficiencies” relates to Adams admission that schizophrenia MIGHT be a result of a perceptual malfunction of the brain, and therefore, an actual organic problem.

There is a possibility that some of the bizarre behavior which one meets in so-called schizophrenic persons, stems from organic roots. (Adams, Competent to Counsel 37)

However, this is a highly debatable theory that has been all but rejected by the medical community. The following is from Wikipedia (which I realize may not be the most reliable source. However, Hoffer’s scientific inquiries into this theory have long since been abandoned, and finding relevant information about it has proved difficult. The Wikipedia article is well cited):

Hoffer's claims regarding schizophrenia and his theories of orthomolecular medicine have been rejected by the medical community.[15] In 1973, the American Psychiatric Association reported methodological flaws in Hoffer's work on niacin as a schizophrenia treatment and referred to follow-up studies that did not confirm any benefits of the treatment.[16] Later studies similarly failed to find benefits in the use of megavitamin therapy to treat schizophrenia.[17]

In fact, schizophrenics most readily respond to the use of anti-psychotics, which often have extreme side-effects, which is why so many choose to go off their medication. An extremely large percentage of homeless peoples are schizophrenics who are un-medicated.

Adams’ other explanation for the confounding problem of schizophrenia is that it is a condition that stems from a sinful nature. In Competent to Counsel, he uses an example of a woman faking a catatonic state to avoid life’s responsibilities:

Don't accept the claim that a person is "out of touch with reality" unless some organic cause for "catatonic" behavior has been detected. Counsel the individual as if he is in touch with reality. If what you say is threatening enough, he will respond. Try to learn what it is he is attempting to avoid. Investigate each case to discover what is behind it, and counsel accordingly. (Adams on nouthetic.org)

(This theory doesn't really work for those who have been in catatonic states for, well, years. I don't think anyone's good at faking it for that long.)

Adams often states that what we perceive as "mental illness" is actually what he refers to as "camoflauge." I.e., the person is faking mental disease in order to get out of having to change sinful habits.

Adams also believes the following:

Problems may be solved, not by ventilation of feelings, but rather by confession of sin. (Adams, Competent to Counsel xvii)

On his website, he answers as to whether or not nouthetic counselors are opposed to medication:

What we do deplore is the use of medicine to deal with problems that have no organic cause. We are adverse to masking those difficulties with medicine. For instance, if one’s conscience is troubling him by triggering unpleasant feelings, we think that the solution to the problem is not found in drugs but in dealing with whatever it is that activated the conscience in the first place. In such cases the counselor deals with sin, not with the feelings. That is the bottom line. For help on so-called “chemical imbalances,” for instance, see The Christian Counselor’s Medical Desk Reference. (Adams on nouthetic.org.)

Adams believes that depressive feelings are a result of sinful behaviors like slothfulness, pride, greed, addiction, etc. The book The Christian Counselor's Manual tackles the problem of depression by rooting out the sinful behavior, having the counselee acknowledge their sinfulness, and then working on changing patterns of sinful behaviors. It’s pretty straight-forward and might be helpful to someone who is actually dealing with spiritual depression as a result of chronic sinful lifestyle. (I must emphasize chronic since we all sin on a day to day sometimes hour to hour basis. Chronic sinful behaviors might include drug abuse, cheating, etc. And although I believe behavior modification is an important part of seeking lasting change and restitution, it is folly to pursue it if the counselor has not dealt with possible underlying issues. But I’ll get to that later.)

II

Nouthetic counselors are reactionary: they staunchly refuse to acknowledge any advances made in psychiatry in the past couple of centuries. They hate psychoanalysis and generally refuse recognize a patient’s past experiences as significant to their getting better.

(Nouthetic counselors have a) reactionary and stubborn negative stance against all psychoanalysis ascribed to by “non-Christian” psychologists.


The thesis of this book is that qualified Christian counselors properly trained in the Scriptures are competent to counsel- more competent than psychiatrists or anyone else. (Adams, Competent to Counsel 18)

When pagan approaches are developed to do what God has given the Bible to do, these approaches must be exposed, rejected, and opposed. (Adams, A Theology of Christian Counseling x)

It is my hope that out of the present controversy over the problem of eclectic counseling within Christ’s church (the issue is whether the counseling systems of Freud, Rogers, Skinner, not to speak of scores of others, can be brought legitimately into the church) theological studies will be generated that will lead to clearer definitions of the work of the church and her counseling ministry, so that congregations and their members will better understand the perils involved. In my opinion, advocating, allowing and practicing psychiatric and psychoanalytical dogmas within the church is every bit as pagan and heretical (and therefore perilous) as propagating the teachings of some of the most bizarre cults. (Adams, A Theology of Christian Counseling xi)

The reactionary nature of nouthetic counseling is upsetting. For instance, Adams hates the idea of probing a person’s past in order to confront situations that may be the root of anxieties, depression, or other problems. Here's a theoretical example: perhaps a couple comes in for counseling because their sex life is non-existent. Wouldn’t it behoove the counselor to know that the woman had been sexually abused as a child? Can't past experience, not sin, contribute to a present problem? Here’s what Adams’ says about delving into the past:

Going back into the past is sometimes necessary. There are at least two good reasons, however, for doing so in most cases. First, it is important to review the past thoroughly enough to establish the fact that non-biblical response patterns are at the root of one’s immediate problems…

The purpose for going back into the past is to take a behavioral history.

There is a second reason for going back into the past. The client needs to discover and confess any “perfect-tense” sins… perfect tense sins, sins committed in the past which still have present effects, are sins that have not been settled. Such sins, becase they have never been dealt with adequately, are really present-tense sins as well, because they continue to influence the client’s life and destroy him. (Adams, Competent to Counsel 152)

The nouthetic counselor might give the couple a schedule in order to establish a pattern of healthy marital sexual relations. A Christian psychologist, on the other hand, might explore the reasons the wife does not enjoy sex and deal with the root of the problem. Confronting the past and focusing on God’s comfort is probably a better option than behavioral modification in an instance where someone has been sexually abused.

III

(Nouthetic counselors have an) unsympathetic and legalistic confrontational method of “biblical counsel.”

That’s the trouble with much counseling—it’s merely helping someone get out of a mess. But he’ll get himself back into the mess again unless you counsel otherwise. (Jay Adams blog April 27, 2009)

Adams admits to being unsympathetic to the sinners who come in for counseling. Such is the method of nouthetic counseling: it is blunt and confrontational. Take his example of Millie, a woman who had been “coddled” by her psychiatrist for over a year:

When a nouthetic counselor confronted her strongly on that first day about her lazy, undisciplined, irresponsible behavior and told her to go back to church, to get to work at home, to do her ironing and cleaning, everyone was shocked.

Adams believes that depression is never a cause, but an effect. If this were always the case, the confrontational method of counseling would suffice. But for someone who truly suffers from clinical depression, telling them just to get over it and get back to work is like telling a addict to just stop taking drugs. It isn’t helpful. And it’s cruel.

Nouthetic counselors do not think that clients need to be led along gently over months of years, Instead, they sometimes find that it is necessary to use God’s truth shatteringly to show the person the nevitable hopelessness of his present way of life. They may need to warn him how his present sinful courses of action will lead to nothing but greater discouragement and ultimate defeat. (Adams, Competent to Counsel 173-4)

This sort of “tough love” without exploration of the underlying reasons as to why a person is hurting reminds me of terse radio psychologists who quip ridiculous aphorisms to jolt people into acting the way they want them to.

IV

The refusal to acknowledge emotional and verbal abuse AS ABUSE.

This statement, unfortunately, is a product of my own experiences with counselors trained in nouthetics.

I should not have made it appear that Jay Adams' brand of nouthetic counseling purports this idea… though I can find no evidence one way or the other.

What I find disturbing is that in Jay Adams’ books, especially his books Marriage, Divorce, and Remarriage in the Bible and The Christian Counselor’s Manual, there are no case studies about women who live with unrepentant, abusive husbands, Christian or otherwise.

Here is a review of a book from Founders Ministries, which is an organization that is promoted by the NANC. The book being reviewed is The Wounded Heart by Dan B. Allender:

Believing in the total depravity of the natural man and the remaining sin of the Christian, Allender argues that the victim of sexual abuse typically copes by building a defensive mechanism which is usually sinful. While never ignoring the 100% responsibility of the abuser in the abuse itself, Allender does what most psychology-based counselors will not do. He makes the victim responsible for his/her actions in response to the abuse and in recovery.

…He exhorts the victim to repent of sinful anger (revenge, personal hatred, etc.) toward the abuser while believing in God's righteous anger toward him/her.

Sinful anger is manifested in self-contempt and other-centered contempt as a pattern of life and perpetuates the abuser's control over the life. The Christian must repent of this abuser-centered life and turn to Christ. It is finding our acceptance in Christ, and not in others, which enables us to live without fear of what men can do to us.

This enables the damaged soul to open itself again to feel, to give, and to love those who may hurt them yet again. We are not called naively to trust others unconditionally, but neither are we called to mistrust them. We are called by the Gospel to care, even for our enemy. We are called boldly to love others while finding our completeness and happiness in Christ alone. As the Christian does this, his/her wounded heart is healed and he/she becomes a genuinely unselfish person as was our Lord, overcoming the pains and fears of abuse.

One final word about this book. It is not only for those who have been sexually abused. Most other forms of abuse have the same effect upon the soul. Physical, emotional, verbal, and other forms of abuse cause the victim to respond to betrayal, powerlessness, and ambivalence with self-protective patterns. That is why I believe that this book is so helpful to pastors in ferreting out remaining sins in believers and helping them to recover by the power of the Gospel.

Rooting out "remaining" sins in believers who have suffered abuse and helping them to break their self-protective patterns is the method of many a biblical counselor. This reviewer goes so far as to call the person who has been abused “selfish.”

Conservative Christians should tread lightly upon this subject. Not acknowledging abuse and not treating the abused with the utmost care while condemning the abuser is the real sin here. My friend “Anna” was called selfish. It is a slippery slope we lead here… these “Christian” fundamentalist ideas are not a far cry from fundamentalist Muslim Imams who suggest women who are raped are partly responsible for something they had no control over. Anti-psychiatric rhetoric, I submit, can actually be terribly dangerous.

(For instance, what possible good does it do to call non-Christian approaches to psychology pagan? Is that what we, as Christians are to do? Libel non-Christians as pagans as we walk cloaked in the superiority of "biblical truth?" This is oppressive language that dehumanizes. It is reprehensible.)

So, my comment that nouthetic counselors don’t acknowledge emotional and verbal abuse as abuse may be off base. But their suggestions regarding the counsel of a person who has suffered any type of abuse? Honestly, I find them deplorable.

Conclusion

I stand by most all of the statements and “accusations” I have made. My fundamental disagreement with nouthetics is their reactionary nature, their opposition to science, and their smug insistence that they have the bible on their side. In my next post, I would like to explore other criticisms of nouthetic counseling, including their misuse and blatant abuse of scripture to fit their narrow view of counseling.