Nouthetic Biblical Counseling Nearly Cost Me My Life

Nouthetic biblical counseling nearly cost me my life. What is nouthetic biblical counseling and how can it be dangerous for people like me?

A Brief History

The biblical counseling movement was founded by Jay E. Adams. Adams referred to his approach to counseling as nouthetic, from the Greek verb noutheteō meaning to warn, admonish, exhort found in verses like Colossians 3:16 and 1 Thessalonians 5:14. In 1976 Adams founded the National Association of Nouthetic Counselors (NANC). On October 8, 2013, a week after Heath Lambert stepped into his new role as director, NANC was renamed ACBC (Association of Certified Biblical Counselors). This is the sect of biblical counseling that I received and was trained in from 2006 through 2015, and continued to be exposed to through 2019.

In his book The Biblical Counseling Movement: History and Context, David Powlison explains the “biblical counseling movement sought to reclaim counseling for the church and provide a Christian alternative to mainstream psychiatry and psychotherapy.” Jay E. Adams is credited with starting this movement. Adams also wrote,

“To put the issue simply: the Scriptures plainly speak of both organically based problems as well as those problems that stem from sinful action and behavior; but where, in all of God’s Word, is there so much as a trace of any third source of problems which might approximate the modern concept of mental illness. …What then, is wrong with the “mentally ill”? Their problem is autogenic; it is in themselves. …and will therefore naturally (by nature) attempt various sinful dodges in an attempt to avoid facing up to his sin. …Apart from organically generated difficulties, the mentally ill are really people with unsolved personal problems.”

In his book, The Biblical Counseling Movement After Adams, Lambert writes, “The assertive tone so frequently employed by Adams was less an inherent character flaw than a strategy to drive hearers toward making a decision. … For Adams, bombast [high-sounding, language with little meaning, used to impress people] was a conscious tactic.”

Powlison described his experience with Adams’s approach as, “a populist strategy for engaging in turf warfare, it pushed people to decide either for or against. He then criticized scholarly understatement as ineffective strategically, and frequently pusillanimous [showing a lack of courage or determination; timid].”

Many of you may be less familiar with Adams and the effects of his approach, but you are likely familiar with Mark Driscoll and his effect on Mars Hill Church and the Acts 29 Network. Leaders who employ bombast tactics will likely build a foundation stricken with mold that will spread and grow upon whatever good they produce. Anyone who stands upon this foundation (whether fully aware or not) will be affected in one way or another. The strong who wholeheartedly embrace the teachings and tactics will likely rise to adopt some variation of the behaviors themselves carrying on the legacy. Some who embrace the teachings may question and reject the overtly caustic behaviors but miss the less obvious harmful behaviors, and ideologies. It is likely that the people brought up in this theology and ideology will be so confident that their way is correct, that they will disregard the first-hand experiences of suffering saints. And it is likely that those who do not fit the non-disabled, neurotypical mold will be slowly suffocated under the weight of nouthetic care.

My Experience

I had trouble describing it at first. I was [content warning] blacking out and coming to with sharp objects in my hands, sometimes bleeding. I saw and heard things that weren’t there. I experienced horrific and violent intrusive thoughts and compulsions. I had outbursts of rage that I could not control. I experienced extreme ups and downs. Yet, the parts of this people witnessed or the bits I had the courage to share, were labeled as spiritual issues with full knowledge that I was chronically ill yet without consideration that my behavior could possibly be affected by illness.

Though at the time my only diagnoses were Complex Post Traumatic Stress Disorder and Fibromyalgia, it was both suggested and insisted upon that I had agency, that I could have self-control over my thoughts and behaviors. It was suggested that if I once was able to practice self-control that, with the practice of spiritual practices, I should get better at it. It was suggested I had a contentment issue. It was suggested that my struggles with my thought life were temptations. When I attempted to explain that I thought there was more going on, I received pushback by a dear friend who was not only twice my size, a man I had previously witnessed yelling at counselees, a man who had previously shut down my concerns of female safety, and subtly communicated his control over my ministering, but also my pastor with a P.h.D. in nouthetic biblical counseling who had spiritual authority over me. Although he did not raise his voice, his tone and posture were intense, urging and unyielding. I had no power to push back. I felt intimidated. The only option presented was to believe what he thought to be true of my experience. Under such duress, my system shut down.

I was losing agency and I could have died by my own hand against my will countless times. I had sought help from those considered to be wise. Either all these wise people were right and I was wrong, or I was right and all these wise people were wrong. Naturally, I chose to believe that I was wrong, that they knew something that I didn’t. So when confession didn’t help and the issues only worsened, I could only assume it was my failure and that I was forsaken. This counsel was having a prosperity gospel affect on my faith leading me to self-hatred, believing these symptoms were my desires, believing God had forsaken me of sanctification, and dangerous hopelessness.

Between the general teachings in this faith community and the assertions and suggestions I personally received, I was taught to believe that my thoughts and compulsions revealed my desires. There was not, to my recollection, a caveat for mental illness. No mention of central nervous system overload. No mention of trauma responses. No mention of the litany of infections, illnesses, or syndromes that are scientifically proven to cause irritability at best and psychosis antithetical to one’s desires at worst. Because there was no room made for mental illness or neurodiversity, I was inadvertently taught that my symptoms were a reflection of my desires or depravity. I was taught that my trauma responses were habitual worry. I thought myself a monster. I broke my spiritual back attempting to sanctify symptoms. When my symptoms only grew worse, this caused seasons of dangerous hopelessness.

I was given the solution to my problems but my problems only increased. What was I to do? I was stuck between a rock and a hard place which only aggravated my symptoms. Daily I faced the danger of dying to either accidental death or hopelessness under extreme duress.

It wasn’t until my husband spoke up (years after I had begun) that I felt, to some degree, believed. Previously, my concerns that I was a danger to myself and others had been dismissed. Once my husband understood we sought inpatient care. Once my husband spoke up, then my concerns were taken seriously.

In January of 2020, a year after I theorized to my pastor that my struggles with my thought life and behaviors had something to do with my health, I received a list of additional diagnoses from my DO that affirmed my theory.

• Lyme Disease: a spiral shaped bacteria that drills into the tissues, organs, bones and had crossed my blood-brain barrier causing chronic meningitis. Case studies suggest that Lyme Disease can be associated with symptoms common to schizophrenia and bipolar disorder, including paranoia, delusions, olfactory (ability to distinguish scents), auditory and visual hallucinations, catatonia, and mania as well as other neurological complications.¹ I can affirm these experiences.

• Babesia: (a common co-infection with Lyme) a blood parasite similar to malaria that can cause a host of symptoms including anemia, malaise, depression, air hunger and even acute respiratory failure, heart failure, liver failure, renal failure and coma.

• Relapsing Fever: (a common co-infection with Lyme) a bacterial infection characterized by repeated episodes of fever.

• hormonal deficiency: my testosterone in particular was dangerously low which my doctor tells me can cause symptoms of anxiety, depression, irritability, moodiness, and fatigue as well as intense intrusive thoughts and compulsions. Within weeks of treatment the intensity of violent intrusive thoughts and compulsions drastically reduced.

• severe vitamin and mineral deficiencies: some were also dangerously low and can not only cause issues with memory but can affect mood as well.

• limbic dysfunction: the limbic system processes and regulates emotion. Dysfunction can lead to anxiety, depression, mood swings, memory problems, emotional dysregulation, and difficulty with social interactions.

• Mast Cell Activation Syndrome: an auto immune condition that causes allergic reactions and inflammation.

• chronic mold infection: mold often colonizes in the gut disrupting the brain-gut connection.

• Autism and sensory processing disorder meaning I struggle to understand social interactions and my brain has trouble processing multi-sensory information.

• ADHD: better described as attention variability with executive dysfunction and low dopamine levels.

These were in addition to my previous diagnoses of C-PTSD from childhood trauma and Fibromyalgia with hypoglycemia, all of which included symptoms of mood change. After over a decade of attempting to sanctify these symptoms (and a lifetime of being expected to act “normal”) I finally received proper diagnoses and treatment. I began to explore the difference between temptations/sin and psychiatric symptoms of illness as well as characteristics of neurodiversity. With medical intervention and becoming trauma informed, the symptoms noticeably improved as did my faith. Upon sharing my findings and diagnoses with my counseling pastor, he did lament with us but did not acknowledge his failures to notice symptoms of psychiatric disability nor did he acknowledge the negative affects his nouthetic approach had on my faith or mental health over the course of a decade.

In nouthetic counseling, admonishment of sin is prioritized and mental illness or diversity (Autism, ADHD, etc.) is not an option. Soul care is prioritized and there seems to be little wonder or curiosity as to how our physical body (affected by the fall) interacts with our mind. As previously mentioned, the word nouthetic is found in 1 Thessalonians 5:14 which in the ESV says,

“And we urge you, brothers, admonish the idle (and disruptive, NIV), encourage the fainthearted, help the weak, be patient with them all.”

If nouthetic counseling focusses on admonishment, what then happens to those who are experiencing weakness or faintheartedness? What if that weakness has to do with (potentially undiagnosed) medical issues that pastors and biblical counselors are not equipped to recognize? What if behaviors determined by pastors and biblical counselors to be disruptive are actually symptoms of illness, a trauma response or characteristics of a neurodiverse person? What if what we are trained to label as sin is actually suffering? As Dr. Stephen Grcevich, child psychiatrist and founder of Key Disability Ministry, writes,

“lots of biblical counselors went overboard on the “sin” and “truth” components of Adams’ model and forgot about the “grace.””

Grcevich goes on to cite a research study in 2012 that found, 30% of attendees seeking help from their church for themselves or a family member because of a mental health condition reported negative interactions counterproductive to treatment. Women (37%) are significantly more likely than men to report being told by their church that they don’t have a mental health disorder, 23% were discouraged from their church about the use of medication for mental disorders , and 41% report negative interactions with their church.

If pastoral care and biblical counseling are not approached with humble curiosity and if these ministers are not trauma and clinically informed, it is not only negligent but potentially deadly to people with disabilities and severe mental illness. I am not saying pastors and biblical counselors ought to be able to provide psychiatric care, but that they ought to accept the complex nature of the embodiment of image bearers and be educated to recognize when an individual’s struggles are not primarily spiritual in nature. In fact, if we were to air on the side of grace, we would assume suffering before assuming sin.

* If you are seeking clinical Christian counseling check out Fieldstone Counseling.

* To hear from various doctors about Lyme Disease related psychosis as well as the affects of Lyme Disease on Autism, check out, The Monster Inside Me documentary (a Christian directed film).

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