Law, Grace and Nouthetic Counselling of Depression

· 18 min read

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.

Counsellor: Hi Dave. Sarah tells me that you two were chatting earlier, and that she’s concerned about some of the things you were saying. She thinks you might be feeling a little depressed? How have you been going lately?
Dave: [chuckles], yeah, I guess I’ve been feeling pretty rough since I got laid off. I just don’t know what to do. I feel like I’ll never get back on my feet and I’m just ashamed at having been let go.
Counsellor: do you mind me asking why you were let go? You said you’re feeling a bit ashamed of it. Is there a reason for that? Was there something you did wrong at work?
Dave: you mean like stealing or something? No, nothing like that. I guess I just wasn’t good enough at my job. They were making some cuts and they just laid off about a third of the people in my division. They just didn’t have as much work any more, and I didn’t make the cut of people who got to stay.
Counsellor: I see. So, it sounds like you’re pretty confident that they weren’t unhappy with your performance. It sounds like this wasn’t a disciplinary matter. It sounds like they would have happily kept you on if there had been enough work for everyone. Is that right?
Dave: yeah, that’s right.
Counsellor: then I guess I’m wondering why you feel ashamed about being let go? It’s not that you’ve done something wrong or unethical to feel guilty about. So where’s this feeling shame coming from?
Dave: I dunno. I guess it’s just so public. It means that all these people I used to work with, I was friends with a bunch of them, they all know I was in the bottom third that didn’t make the cut. They know I wasn’t one of the better workers there. I guess I’m worried that they’ll look down on me for not being as good as they were, the ones that are still there.
Counsellor: what this sounds like to me is wounded pride. It sounds like you’ve had your identity a bit wrapped up in your job. Now that it’s gone, you’re worried about what people think of you. I think the problem is that you’re fearing men and not God. Have a look at John 12:43 with me. John condemns the Jewish authorities here, because although they believed in Jesus, they refused to confess it because “they loved the glory that comes from man more than the glory that comes from God.” If your sense of self-worth is coming from what your former workmates think of you, that’s actually an ungodly attitude that you need to repent of. You need to let your identity come from God. How about we pray about that together?
Dave: … okay sure, it’s always good to pray I guess.
Counsellor: Okay I’ll pray. Lord God, thank you for my brother Dave, thank you that you love him and that you give him his true identity. We pray that you would fill him with your Holy Spirit, that you would transform his heart and mind, that you would grant him repentance from this fear of man and lead him to instead trust in you for his worth and dignity. We pray that in your timing you would provide a new job, that it would be a blessing to Dave, and that you would continue working in his life to make him more like Christ. We pray these things in Jesus’ name, Amen.

The above type of scenario is not an uncommon one. Some of you reading this may even have been counselled along similar lines. But there is a real and serious problem with the fictional interaction above. The counsellor hasn’t really understood yet why Dave is feeling ashamed. As my wonderful lecturer Dr. Russell might have said, this counsellor hasn’t been sufficiently “curious”.

In reality, Dave’s fear of man is only the surface-level issue, not what’s really going on underneath. Dave is actually spiralling downward because he believes that he deserved to be laid off. Dave recently read a devotional book that was big on the importance of self-discipline in the Christian life. He’s been feeling guilty since then about the fact that he doesn’t get up at 5am each day to pray for an hour before starting the day, like some Christian leaders from the past whom he’s read about. He feels that his spiritual life is lacking, and that God isn’t happy with his performance. He feels that the Holy Spirit has been using this book to convict him of laziness. When he got laid off, he reasoned that it was because he was just as lazy at work as he was in his spiritual life. He started thinking: “I could hide my sinful laziness when it was just about my private prayer life, but now that it’s led to me being laid off, it’s on view for everyone to see. They will all think less of me, but they’re right to do so. After all, God thinks I’ve been lazy lately, that’s why he led me to read that book and be convicted by it. I haven’t made the Lord’s work my priority. Sure, I’ve had a quiet time most days, but it’s not long, and then I go to work and think about non-spiritual things most of the day. I’m not focussed on God, I’m focussed on so many worldly things. I’ve been lazy because I’m just a selfish person. And now everyone else will see me the same way God sees me.”

A different picture right?

Now consider the effect of the counsellor’s words above on Dave. What has the counsellor communicated to Dave?

Dave already believes all these things (or at least, he believes things so close to what the counsellor is saying that he will naturally interpret the counsellor’s words through that lens). But he also believes that he is on a cycle of failing to do the things the counsellor is telling him he ought to be doing. This “counsel” is just going to reinforce the problematic half-truths that led Dave to be depressed in the first place. This is going to do more harm, not bring healing!

What Dave needs is not more encouragement to beat himself up for having a sinful attitude! What Dave needs is to be reminded that GRACE is enough for him, that God IS pleased with him in Christ. That God does not hold Dave’s sins against him. That Dave doesn’t have to pray for an hour before dawn each day for God to be happy with him. That God rejoices because Dave has turned and trusted in Christ, that He looks on Dave with love and that He has good things planned for Dave to do in His service. How much hope would it give Dave if he was able to internalise those truths? How much liberty could he know if he was broken out of the performance trap by trusting in the simple truth that God loves him unconditionally, and isn’t shaking His head wearily at Dave for not praying more. How much more empowered would Dave be to simply ask God each day “okay, I’m truly loved, what would You have me do?”

So what could the counsellor have done differently to get at what’s really going on with Dave? Be curious, ask good questions, and don’t assume you understand.

Counsellor: Hi Dave. Sarah tells me that you two were chatting earlier, and that she’s concerned about some of the things you were saying. She thinks you might be feeling a little depressed? How have you been going lately?
Dave: [chuckles], yeah, I guess I’ve been feeling pretty rough since I got laid off. I just don’t know what to do. I feel like I’ll never get back on my feet and I’m just ashamed at having been let go.
Counsellor: do you mind me asking why you were let go? You said you’re feeling a bit ashamed of it. Is there a reason for that? Was there something you did wrong at work?
Dave: you mean like stealing or something? No, nothing like that. I guess I just wasn’t good enough at my job. They were making some cuts and they just laid off about a third of the people in my division. They just didn’t have as much work any more, and I didn’t make the cut of people who got to stay.
Counsellor: I see. So, it sounds like you’re pretty confident that they weren’t unhappy with your performance. It sounds like this wasn’t a disciplinary matter. It sounds like they would have happily kept you on if there had been enough work for everyone. Is that right?
Dave: yeah, that’s right.
Counsellor: then I guess I’m wondering why you feel ashamed about being let go? It’s not that you’ve done something wrong or unethical to feel guilty about. So where’s this feeling shame coming from?
Dave: I dunno. I guess it’s just so public. It means that all these people I used to work with, I was friends with a bunch of them, they all know I was in the bottom third that didn’t make the cut. They know I wasn’t one of the better workers there. I guess I’m worried that they’ll look down on me for not being as good as they were, the ones that are still there.

Counsellor: tell me a bit about your workmates. What was your relationship with them like? Was it very competitive or something?
Dave: No, not really. We were all one team, we got along well.
Counsellor: Do you think you’ll stay in touch with some of them?
Dave: Oh yeah, definitely. Tom and Jim are still there, we hang out on the weekends sometimes.
Counsellor: So you’re not worried they’re going to break off the relationship or anything like that?
Dave: Nah, we’re fairly good mates.
Counsellor: So if they’re good friends, why is there this sense of being ashamed? Usually it’s our friends who we feel safest around.
Dave: Yeah, I guess. I think it’s because they’re my friends that I don’t want them to think less of me.
Counsellor: why would they think less of you?
Dave: … because I’m the one who got laid off?
Counsellor: no, I mean, specifically. What do you think will change in their opinion about you because you got laid off?
Dave: that I’m not a hard worker. I worry that they’ll think I’ve been lazy and that’s why I got fired.
Counsellor: well, you said before that it wasn’t disciplinary, that there were just a chunk of lay-offs. That sounds like no one at work was really unhappy with your work ethic, or were they?
Dave: well, I guess they thought it wasn’t as good as everyone else’s who stayed.
Counsellor: tell me a bit about that. How do you feel about your work ethic in general? Do you think of yourself as a hard worker, or as a bit lazy?
Dave: well… I mean, I try to work hard… but I’m probably a bit on the lazy side.
Counsellor: what makes you say that?
Dave: well, getting fired for one thing!
Counsellor: let’s put that to one side for a second. I want to know if losing this job is related to your overall pattern of life, or if it’s a bit of an isolated incident. So we’re not going to count this job for the moment. It’s not part of the question. Outside of your last job, do you feel like you were a hard worker, or fairly lazy?
Dave: Umm… gee. I guess I thought I was a relatively hard worker, but God’s kind of been showing me my laziness lately, and then I got fired on top of that, and it’s like “okay God, I get it, I’m lazy, I badly need to change.”
Counsellor: how has God been showing you your laziness?
Dave: I read this book about Christian self-discipline. It was a tough read, but I think there were some things in there I really needed to hear. It was kind of about how the modern world is so distracted all the time, and Christians should really be sacrificial in order to focus themselves on God’s work.
Counsellor: what did you feel you needed to hear in it?
Dave: well, my prayer life kind of sucks. In the book there were some stories about Christian leaders who used to get up at like 5 or even 4 every morning while it was still dark and pray for hours. I’ve never done that. I have these crappy little 15-minute quiet times, I don’t even do them every day. I just needed the kick in the pants to push me to really put God at the centre, not just tack him on.
Counsellor: a kick in the pants, huh?
Dave: yeah.
Counsellor: what if you didn’t ever get up that early to pray?
Dave: what do you mean?
Counsellor: I mean, what would happen if you didn’t do it? While we’re at it, what would happen if you stopped having those quiet times? What if you just read the Bible at church each week?
Dave: umm, I guess I’d be letting myself be lazy and my spiritual life would suffer?
Counsellor: what does it mean to have a healthy spiritual life?
Dave: I guess that you pray and read the Bible a lot?
Counsellor: anything else?
Dave: umm, not really? Like, maybe you should get baptised at some point?
Counsellor: nothing else?
Dave: nothing immediately springing to mind.
Counsellor: have you thought about how Jesus fits into your spiritual life?
Dave: what do you mean? I’m praying to Jesus, I’m reading about Jesus, isn’t it kind of all about him?
Counsellor: Nope, it’s about you praying and reading.
Dave: yeah, but about Jesus, right?
Counsellor: is God happy with your relationship with Him right now?
Dave: probably not, it’s a bit strained after all.
Counsellor: strained how?
Dave: well, I haven’t been praying as much as I probably should.
Counsellor: did Jesus pray enough for God to be happy with him?
Dave: ha ha, I assume so.
Counsellor: do you trust in Jesus to make you right with God?
Dave: … yes.
Counsellor: then praise Jesus, because God is happy with you, regardless of your current prayer life.
Dave: what do you mean?
Counsellor: God isn’t happy with any of us because of what we do, remember? He’s only happy with any of us because of what Christ has done for us.
Dave: I get that, but he still commands me to read the Bible and pray, and I don’t always do it.
Counsellor: So God’s going to be unhappy with what Jesus has done for you unless you do your bit too? Sounds a lot like salvation by works to me! That’s heresy my friend.
Dave: Ha ha, seriously though.
Counsellor: Seriously. I’m not kidding around at all. Let’s look at Galatians 5:4 – “You are severed from Christ, you who would be justified by the law; you have fallen away from grace.” Think about that carefully Dave, “severed from Christ”. The road you’re going down now, where you try to earn God’s happiness with you, that is a road that leads to being cut off from Christ. This is dead serious.
Dave: So what are you saying, I just shouldn’t have a quiet time at all? Jesus had all my quiet times already?
Counsellor: Why do you have a quiet time?
Dave: to be closer to God?
Counsellor: do you like being closer to God? Is that a good desire that the Holy Spirit has given you?
Dave: yes, I guess.
Counsellor: then a quiet time sounds like a good idea.
Dave: ha ha. But I don’t have to, that’s what you’re saying?
Counsellor: you don’t have to do anything. Jesus has done it all. Let’s go back to basics. Ephesians 2:8-10, do you remember it?
Dave: not off the top of my head!
Counsellor: Oh Dave, it’s a good one. I recommend memorising it. Let’s read it. “For by grace you have been saved through faith. And this is not your own doing; it is the gift of God, not a result of works, so that no one may boast. For we are his workmanship, created in Christ Jesus for good works, which God prepared beforehand, that we should walk in them.”
Okay, let’s answer some questions from these verses. How are we saved?
Dave: … by grace through faith?
Counsellor: what did we do to get that grace?
Dave: umm…
Counsellor: Did we do anything? Look at verse 8.
Dave: Ha ha “not your own doing”, no I guess we didn’t.
Counsellor: so why did we get it?
Dave: it was a gift.
Counsellor: what does it mean that it’s a gift?
Dave: it’s “not a result of works”.
Counsellor: right. So now what do we do, if we already have this gift?
Dave: good works?
Counsellor: yep, good works. Like praying and reading the Bible, among other things. Why do we do them?
Dave: because God prepared them for us to do?
Counsellor: do we have to do them?
Dave: I guess so, if God put them there for us!
Counsellor: but hasn’t God already given us the gift? How can we need to do them for the gift if we already have the gift? And didn’t we say that it was “not by works”?
Dave: Yeah. I guess we don’t have to, but we get to?
Counsellor: yes, absolutely. Dave, your quiet times are a gift to enjoy, not a burden to bear.
Dave: wow.
Counsellor: I know.
Dave: So I guess, I can do them, because I want to do them, but I don’t have to do them?
Counsellor: totally.
Dave: that’s great. It’s kind of a relief.
Counsellor: it’s an amazing relief. You could tie yourself in knots forever if you kept beating yourself up for not having a perfect devotional life. It will never be perfect. You’re still a sinner, and your devotions won’t get you to heaven. Instead, pray for God to put the desire in you to enjoy taking time for devotions. And then let Him guide your heart. Don’t sit around worrying that you’re not good enough. Jesus has already taken care of the “good enough” part. It’s time to enjoy what he’s won for you. Enjoy the Holy Spirit giving you joy in pursuing God.
Dave: that’s amazing. I think I’m actually going to enjoy my quiet time tomorrow.
Counsellor: I bet you will, now you know God’s not looking over your shoulder upset at you! Geez, that sounds terrible. How much better to know God loves you.
Dave: can we pray?
Counsellor: of course we can. Father, thank you for saving Dave by the blood of Jesus. Thank you for raising Jesus from the dead so that Dave could also have new life. We pray that you would bless him in his devotional life, that he would truly enjoy knowing you deeper and deeper each day. We pray that you would give him strength and energy for his search for a new job. We pray that you would provide the right job at the right time. We thank you that you have already planned out good things for Dave to do, we pray that you would guide him toward them, and give him the courage to take them on. Thank you that Jesus has made our peace. Thank you that there is joy for us in your presence. Amen. {{ closespan }}

How do you think Dave’s depression looks now? Do you think he’s maybe in a better position to respond in a godly way to his situation? I do. It’s important in the process of nouthetic counselling to be compassionate with people. See when they’re living in licentiousness and need to be called to repentance, but don’t see nouthetic counselling as a game of whack-a-mole where your job is find all the “sin gophers” in someone’s life and smack them down. Your job is to prune the vine so it can grow. If the vine is being strangled by something, you’ve got to untie that something so the vine can move freely again. The law informs love, and a Christian living and sleeping with their girlfriend needs to be told to cut it out, because it is a sin. But a Christian who stops attending church because they think they’re unworthy to receive communion needs to have the gospel of free grace preached to them with all might and vigour, for the honour of Christ who sacrificed so much that we might take it without paying. Don’t forget that nouthetic counselling is not just about calling to repentance from sin. It’s also about calling to repentance from living as though grace had not come.