A Brief Response to Dr. John MacArthur’s Comments on Mental Disorders

Remember a couple weeks ago when I posted about being “A Hairs Breadth from Nouthetic Counseling”? A Good reason why has become quite relevant as a clip has become popular of Dr. John MacArthur making the following comment:

There’s no such thing as PTSD. There’s no such thing as OCD. Theres no such thing as ADHD. Those are lies…take PTSD for example…what that really is, is grief. You were fighting a war. You lost your buddy. You have a certain amount of survivor guilt cause you made it back, and they didn’t. How do you deal with the grief? Grief is a real thing. But grief is a part of life and if you can’t navigate grief, you can’t live life. But if you clinically define that you can give them a pill, a series of medications, and they wil wind up homeless in LA on a sidewalk. This is, in regard to children, the most deadly thing that’s been unleashed on children: medication. We’re trying to make clear to parents that behavior is essentially the result of choices kids make and if you parent them properly they will make right choices, but if you blame it on something other than their choices you identify them as having something they can’t do something about.

I want to preface my short response with two comments. First, I love and respect Dr. John MacArthur. He has been a great example for so many in the church, and has stood up for what is right when very few, especially in his home state have. I greatly love and respect him, and I hope to shake his hand someday. Secondly, I truly don’t understand why this clip has blown up recently. None of his comments are new. He has held to this position for years upon years. If you want to read more of his position to hear where he is coming from, read his book published in 2005, Counseling: How to Counsel Biblically. I read it a couple months ago. It is pretty much just Jay Adams Nouthetic viewpoint in MacArthur’s words.

As I touched upon in my former post, there are many great qualities to Nouthetic counseling that ought to be championed, although I think ultimately the position falls short. In summary, although there is commonplace in holding to sin (whether as a fallen personal state, fallen condition of the world, or fallen habit currently adopted) as the ultimate diagnosis, Scripture as the ultimate Authority in giving the remedy, and submission to the Holy Spirits work of sanctification as the remedy rightly administered, the Nouthetic method falls short by trying to make Scripture what it never intends to be: a psychology textbook. Again, I talk about this in more detail in that blog so I would recommend reading that either before or after this one. https://www.isaacsparsonage.com/brief-thoughts/a-hairs-breadth-from-nouthetic-counseling

This is a great example because it does well to illustrate the strengths of the Nouthetic view, as well as the weaknesses that I didn’t have time to touch upon very much. It’s true, one cannot verify as a fact that someone has post-traumatic stress, or obsessive-compulsive disorders. This doesn’t mean its guess work though. There are a lot of signs and even brain scans like a NEBA system (Neuropsychiatric EEG Based assessment) that can show higher brain wave ratios between certain specific common brain waves for people who have ADHD compared to those who don’t[1]. There are scans that show excessive activity in the amygdala (the part of the brain associated with fear, emotions, and motivations) for those where PTSD is likely[2]. Again, its not verifiable, but if enough of the commonalities are present it’s a solid assertion to make. There are problems with this still of course. Most people who are diagnosed with these things don’t seem to go through much testing like this. It is expensive and not readily available. What happens instead in many cases is in fact guesswork. I’m in full agreement that this should be frowned upon. That doesn’t mean the real thing doesn’t exist.

I would go as far as to say I that I believe most of the diagnosis of ADHD that are predominately given to young boys, are not accurate, but rather a symptom of our day which hates young men, and sees their average activity as hyper-activity. If I was the counselor, I would recommend a team sport or a hands-on hobby. I would recommend physical exertion before medicine even into adulthood because of how growingly suited our context has become to being sedentary. So, when someone sits to work and they are everywhere but at work, fiddling, fidgeting, and moving about, that’s not indicative of something wrong, to me it is indicative that your body knows best. Go on a jog. Play pickleball. Do something. How much caffeine is in your system right now? Consider all of these things, adjust appropriately, and if it’s still the case anyway than I might as the counseling Pastor then say, “Okay let’s see about setting up an appointment with a psychologist. Let’s hear their opinion on if you need to take something. Then they can refer you to a psychiatrist who can prescribe it”. Is it the case that the majority of therapists and psychologists of our day are lazy and awful? Yes. But is this the case with pastors as well? Also, yes. That’s why the good batch from each ought to be working closely together. One of the very first things a minister should do when he moves to a new church is seek out a Christian psychologist that is decent enough to be able to refer for such cases.

PTSD, OCD, and ADHD, are all real. Believers should not be made to feel like they cannot go to their Pastor about these things for spiritual advisement or prayer. Nor should they feel guilty for taking medicine for such things. It a matter of Christian liberty and personal discernment. Yes, it is the case that these things are far too liberally diagnosed. Not everyone who feels depressed has depression. Not everyone who has been through something traumatic has post traumatic stress. Not every boy who misbehaves at school has ADHD. Not everyone who alphabetizes their bookshelves has OCD. However, some have experienced things beyond their natural tolerance to experience, in a manner either too soon for them to properly gather themselves, or too shattering to find all the pieces. Some truly wrestle with the chaotic never-ending movement of things, always changing, seemingly never for the better, and just need to put their things in order, in order to feel that they themselves are in order. These matters are very real and these people need our benefit of the doubt before our skepticism. Sometimes its obvious, but sometimes it takes real work and time to see which matters are the genuine case. Even for the one’s that aren’t, although their feelings may not be a reality, it doesn’t mean their feelings aren’t real in any sense at all. So, what if they don’t have an anxiety disorder? They are experiencing anxiety. Its real enough then for them to be sick to their stomach in the morning, so its real enough for me to pray for them and dearly wish them cared for as my Lord cares for me when I am in such fits.

Finally, I do want to acknowledge that last point MacArthur makes:

We’re trying to make clear to parents that behavior is essentially the result of choices kids make and if you parent them properly they will make right choices, but if you blame it on something other than their choices you identify them as having something they can’t do something about.

This is a fair point to make because it is so often the case with a lot of people. Although there are many people who clamor for a diagnosed disorder in desperate search for the attention and appeal of victimhood. Others are relieved to hear that they don’t have a disorder because of the very notion Dr. MacArthur mentions where its like, “Great, this isn’t an issue with my brain or some genetic proclivity that runs in my family, I can actually take initiative to do something about this”. That’s a much more noble posture than the prior for sure, but its still based on a misconception. This is why Christian counseling begins at the pulpit. Congregants need to know that a mental disorder doesn’t make them exempt from the call to be holy. Instead of the mindset being, “I have an anxiety disorder, therefore ‘be anxious for nothing’ is an out of reach command for me”, it is dire that they pay even more attention to the given thorn in their flesh, rather than less. Lest they think they have no mark there to miss, ensuring they miss it daily.

[1]  Stephanie Watson, Can a Brain with ADHD Look Different?, healthline.com, September 29, 2017, https://www.healthline.com/health/adhd/brain-scans

[2]   J. Douglas Bremner. Neuroimaging in Posttraumatic Stress Disorder and Other Stress-related Disorders. Neuroimaging Clinics of North America, Volume 17, Issue 4 (November 2007): 523-538. https://www.sciencedirect.com/science/article/abs/pii/S1052514907000664?via%3Dihub