I have been studying pastoral care this semester, and I came across Jay E. Adams’ work on Christian counselling. For the most part, I have really appreciated Adams’ critique of Freudian psychoanalysis and the culturally-accepted “medical model” of mental illness. He argues that depression needs to be understood in biblical categories, in particular, that it is not something that simply seized upon a person from the outside, like catching a stomach bug. Rather, it is often the result of spiralling unbiblical reactions to a circumstance. That circumstance may not have been something under the person’s control, but allowing themselves to wallow in despair is. That is a behavioural response that needs to be addressed biblically.
However, a cautionary word I would add when attempting Adams’ method is that it’s easy to think we’ve understood when we haven’t. If the goal of nouthetic counselling is to lovingly confront the lies people believe with biblical truths, then it is necessary to understand precisely what those lies are that they believe. If we don’t do that, we run the very real risk of further overemphasising truths they are already comfortable with, and as a result de-emphasising truths that they are currently doubting. This has the effect of reinforcing the lie rather than the needed corrective truth! Not a good outcome at all.
Consider the following two conversations with a person who is spiralling into depression (we’ll call them “Dave”). Let’s say that the initial circumstance they are responding to is getting laid off from work.