By Tim Bryant
How do we best help someone experiencing debilitating emotional symptoms? I am a 25-plus-year sufferer of malabsorption syndrome, extreme food allergies, and chronic fatigue. My wife and four children can testify that there have been times through the years that I felt so depressed that lifting my body out of bed each morning to fulfill even the smallest daily responsibility was a major battle. There have also been times in my life that I could not slow down my racing heart, anxious thoughts, insomnia, and even panic attacks. My emotional struggles for stability has taught me an approach to relieving troubling emotions through the use of prayerful biblical meditation and humility. Because of this I am often able to help people who are where I have been. As I listen to their struggle I am prayerfully asking myself the following question, “What does this person truly need most?” I want to know what true needs are not being met in their life based on a biblical view of what mankind’s true needs actually are (Luke 10:42; Job 23:12; Mat 4:4; Duet 8:3; 1 Tim 6:8). This is essential.
Here is a biblical perspective based on three areas of true need that we all have: 1) We have spiritual needs because we were created by God and for God. We function best when our choices, thoughts and lifestyles are in fellowship with God and in harmony with His Word. Only then do we reflect his character and image. 2) We have physical needs because we were created with a body that has basic needs of good nutrition, adequate sleep, and appropriate exercise. 3) We have medical needs because, in spite of proper care, our bodies can malfunction and become damaged or diseased. This a result of the curse introduced through the Fall of Adam, putting us all under the effects of sin and death. Each of these areas of true needs directly and significantly affect our emotions. We are a needy people–we always need more of God and His Word nourishing us or we suffer spiritually; we always need more nutrition, exercise and sleep or we get sick; we sometimes need medical help to restore our bodies to physical health.
There are two other “needs” that modern society would want to add to the three true needs. Some believe that if these two needs are not met, they can likewise cause debilitating emotions. The psychological needs theory is based on the belief that we need love, acceptance, significance, self-esteem, positive nurture, etc., or else we have little choice but to become dysfunctional in various ways, including emotional. They promote the emotional needs theory that too much past negative experiences will inevitably cause present negative and debilitating emotions. The psychiatric needs theory is based on the belief that the brain is the seat of our personhood, including the emotions. Thus, the psychiatric approach to helping the person with debilitating emotions uses mood-altering drugs to control the parts of the brain that process emotional status, believing this is a medical need. There are several widely used types of psychotropic drugs available today. A biblical view would neither discount the help that psychotropics can bring nor discourage their wise use in certain cases, but a biblical view rejects the belief that psychotropic drugs is needed to deal with troubling emotions.
Psychotropics drugs can be a secondary helper at best, but it may become a cover that prevents finding real solutions at worse. It may be necessary to medicate a person if there is a high risk of danger to self or others, and if there is no alternative available to offer protection or to bring quick relief from severe emotional torment. Psychotropics may be deemed necessary to help ameliorate the emotional symptoms while the spiritual, physical or medical needs continue to be investigated. The troubled person may have undetected spiritual or hidden physical problems at the root of the emotional problem. Unfortunately, what often happens is that psychiatric medications are overused, prematurely used, or only used, halting further investigative work on the true needs at the root level of troubling emotions.
The overuse and premature use of mood altering drugs has led to masking real problems such as lack of self control, wrong thinking, deviant behavior, poor sleep habits or poor dietary choices. Additionally, psychotropic drugs can mask adverse medication or food reactions or even the diagnosis of true medical diseases such as hypothyroidism or endocrine disturbances like decreased testosterone. Therefore, it seems prudent to use mood altering drugs as a secondary solution and to prioritize assessing what we know are three true needs of emotional health: the spiritual, the physical and the medical.
This is contrary to much of the current culture that often places prescribing drugs as the initial, and sometimes the only, treatment paradigm. However, for the biblical counselor, these three areas must be sufficiently assessed and a remedy clarified and pursued for any problems that are discovered. If the person is still in significant emotional distress, or a danger to self or others, drugs may be a necessary, temporary solution. We have often seen at the Lowcountry Biblical Counseling Center that as the spiritual, physical and medical needs are assessed and met, and as the person begins to grow in faith, establishing an obedient walk with the Lord, then the emotional state and control improves. At that point a reduction or suspension of the drug under the careful supervision of a medical professional should be considered.
I have listed here some basic questions to help you or someone you are counseling to assess true needs. This is only a starting point for the assessment. Pursue this prayerfully, carefully and humbly. Do not hesitate to reach out for leaders in your life and to those knowledgeable in dealing with the spiritual, physical and medical needs.
Assessment 1: Spiritual Needs
What is the person’s relationship with the Lord? What do they know and believe about God and is that being developed into a healthy fear of the Lord through a confident trust in and growing love for the Lord? Is there character growth? Are they in appropriate environments that help them to grow through their struggles? Are changes needed (i.e. parenting styles, communication issues, school, church, friendships, use of time, counseling, etc.)? Is there guilt or shame that has not been addressed?
Assessment 2: Physical Needs
Are the basic needs for nutrition, sleep and exercise regularly met? Are significant dietary changes warranted? Is help needed to aid in sleeping better from a medical, cognitive, or structured routine perspective? Is a specific routine of exercise needed? Is the body healthy and active?
Assessment 3: Medical Needs
Do tests reveal a true physical malady or deficiency in the body that needs medical treatment? Is more research, testing and treatment needed? Is a medical specialist warranted that can look into a specific area that seems suspect? Are the medicines and treatments that are currently being used effective, or are some medical changes warranted?
Assessment 4: Psychotropic Drugs
Has sufficient effort been attempted in the above areas to discover and remedy negative contributions, but without significant change on the emotions? Are the emotional symptoms dangerous or debilitating enough to warrant psychotropic medications, knowing emotional symptoms are often signposts to real problems on other levels (spiritual, physical, medical) that have yet been revealed?
Many times there are answers for those struggling with troubling emotions on the spiritual, nutritional and medical level that, if pursued and applied, would powerfully and positively affect the troubling emotions. But many times hurting people do not get to the deeper spiritual or physical root issues due to a variety of reasons: 1) our diagnostic ability to assess the spiritual and physical condition is limited; 2) the person struggling is not willing to discuss and discover the real issues on the spiritual or physical level; 3) the person struggling does not consistently apply the advice the counselor or doctor has prescribed.
AVOID THE OVERUSED, PREMATURELY USED OR ONLY-USED APPROACH
In closing, remember, medicating emotional symptoms is not wrong, but is not always wise. Be careful not to let the use of psychotropics be overused, prematurely used, or only used. When dealing with troubling emotions, especially when there is no clear nutritional or medical diagnosis, learn how to let prayerful meditations on God and His Word be the main means of bringing spiritual peace and joy, and let psychotropics, when deemed wise, assist in this means – not the other way around. When psychotropic drugs do seem warranted, biblical counseling and meditation should continue. Many times if a person who is on psychotropic medications also continues to pursue biblical thoughts and behavior change, then in time that person’s change allows them to back off the medications in part or entirely, under a doctor’s care. We have seen this many times at Lowcountry Biblical Counseling Center.
May the Lord give us wisdom as we seek to biblically care for souls who live in earthen vessels.
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