Christian Counseling and the Problem of Empiricism

RodinAs I have mentioned before on this blog, if there is any theologian in the past hundred years that has rightly earned the title “Most Misunderstood,” Cornelius Van Til is at the top of the list. Van Til himself was incredibly consistent where the implications of his theology and philosophy were concerned, as Dr. K. Scott Oliphint has more than adequately proven. Unfortunately, not all of those who have followed in Van Til’s wake have been as consistent as he was.

Dr. Jay Adams was deeply influenced by Dr. Van Til and sought to apply Van Til’s insights in apologetics to the field of counseling. In his seminal work Competent to Counsel, Adams excoriates the psychiatric field of his day for being blindly indebted to the deeply anti-biblical insights of Freud and Jung. Allow me to say that his criticism of the psychiatric field on this point was spot on, but only insofar as one remembers when the book was written. Much of his criticism is no longer accurate now, as much (though not all) of psychiatry has roundly criticized Freud and no longer depends upon him to the degree that they once did.

Adams went on to found the National Association of Nouthetic Counselors, which has become a thorn in the side of many a Reformed and Presbyterian church member who suffers from mental illness.

The field of biblical counseling (whether we’re speaking of the CCEF side of the coin or the NANC side of the coin) has rightly pointed out that far too often Christians flee to the use of psychiatry without considering the underlying worldview that psychiatry involves—namely, one that is wildly opposed to Christian theism. Coupled with their belief that Scripture is a sufficient guide to counseling, this leads nouthetic counselors to take positions that are actually at variance with their own biblical worldview.

Here’s an example, drawn from a biblical counseling training conference given in southern California in 2011. Speaking of his interaction with one of his patients, Dr. John Street makes this statement:

Now, we know that there are certain types of diseases and circumstances that can bring on feelings of depression, symptoms of depression. But all of those types of problems are easily discernible with a good, thorough physical.

Dr. Street concludes by saying that, “there’s no sign of any organic abnormalities.”

Note that nouthetic counseling is based on the belief that bodily diseases are “easily discernible” with “a good, thorough physical.” In reading the works of other nouthetic counselors, you find this sort of statement fairly regularly. (cf. Counseling: How to Counsel Biblically by John MacArthur for further examples.)  Since depression, bipolar disorder, and schizophrenia cannot be found in a “good, thorough physical,” then they are without any organic cause. Thus, apart from any indication of a physical cause, one can infer that the cause is spiritual (i.e., sin) and can be cured by repentance.

The first issue is that it seems that Dr. Street either is ignorant of idiopathic diseases or chooses to ignore them. There are a whole host of diseases that cannot be tested for and can only be diagnosed by exlusion, such as SIDS, Bechet’s disease, Bell’s palsy, Sarcoidosis, and Tolosa-Hunt syndrome.

Another problem is that such a position is itself based on a secular form of empiricism that is irreconcilable with a Christian worldview (Van Til, Introduction to Systematic Theology, 115). Since the consistent empiricist holds that all knowledge is derived from sense experience (a statement which can’t be proved empirically, I’ll have you note), by taking the position that diseases are easily discernible via a thorough physical exam, the nouthetic counselor has fallen into the very unbelieving epistemology that he was trying to avoid! One must wonder how the nouthetic counselor avoids descending in to Hume’s skepticism given their empirical bias. It’s also worth pointing out that there seems to be an a priori judgement that mental illnesses simply can’t be idiopathic, which doesn’t comport at all with the underlying empiricism in Street’s formulation of nouthetic counseling.

The simple reality is that it’s much easier to simply say, “Repent!” than it is to admit that there’s a lot that we simply don’t know regarding mental illness. This pushes us back to the issue of pride, as ministering to those who are suffering in the throes of mental illness requires a great deal of humility.

A humility, I might add, that too many so-called biblical counselors seem to lack…


"I appeal to you, brothers, to watch out for those who cause divisions and create obstacles contrary to the doctrine that you have been taught; avoid them. For such persons do not serve our Lord Christ, but their own appetites, and by smooth talk and flattery they deceive the hearts of the naïve." (Romans 16:17-18) Please read "The Comments Policy."

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