This post is part of a series. Go here for Part 1, Part 2 and Part 3

Content Note: Discussion of mental illness deniers and their philosophy.

With this post, I want to address some of the confusing and, sometimes, conflicting messages put out by the leaders of the Biblical Counseling Movement (BCM). I call this the “bait and switch” because I think it is being done on purpose with intent to mislead.

Make no mistake: Many of the leaders involved in this movement are outright mental illness deniers. First, they are operating from a 40-year-old biased understanding of psychiatry and mental health, so they are not fully aware (if at all) of modern advances in psychological understanding. (The movement actually discourages counselors from obtaining a comprehensive education in modern psychological theory and practice, lest they become ‘corrupted’ and unconsciously integrate that knowledge into their counseling practice.) Second, the BCM was founded on the idea that mental illness (classified in the BCM’s literature as “problems in living”) is the result of sin. This is the core of the movement’s theology.

But being forthright about that core belief in this day and age makes one look like an ignorant arse and doesn’t get many people in the door. So when addressing the public on blogs or in interviews, BCM leaders throw out some statements to make themselves appear more open-minded than they really are. However, their true beliefs and methods of counseling stay exactly the same.

Let me show you what I mean.

One of the biggest controversies surrounding the BCM has been the issue of psychiatric medication. Many people have claimed that a biblical counselor instructed or encouraged themselves or a family member to stop taking medication that was prescribed by a psychiatrist, or discouraged them from seeking such treatment when it was obviously needed – with disastrous consequences. Heath Lambert, Executive Director of ACBC and a board member for the Biblical Counseling Coalition (BCC), has responded to these claims in a series of blog posts and statements:

“Counselors may have opinions about such things [psychiatric medication].  These opinions may even be well-informed, and backed-up with excellent scientific research.  At the end of the day, however, they are just opinions.  Any counselor who does not have a medical degree is simply not equipped, by law or professional training, to add behavior to their belief. […]

“The reason we teach our counselors [sic] to handle the issue of medication this way does not only have to do with their lack of a medical degree.  The reasons also have to do with loving others well.  When someone comes off these medications it can have a very serious effect on the body.  A person’s life can be threatened.  These kinds of medical decisions where the health and safety of a human being are at stake must be left to medical professionals. […]

“I hope you can appreciate that the same is true at NANC.  When a few of our counselors do things that we tell them not to do I want you to understand that they are working out of accord with their training, not in keeping with it.  I also want you to know that when they do that they are doing things for which they will be held accountable by our organization.”

However, that position contradicts what appears in the ACBC’s Standards of Conduct section for biblical counselors:

Remember, Heath Lambert is the Executive Director of ACBC. It is his job to know what is presented on his organization’s website. Executive directors approve an organization’s communications.

Also remember that the BCM is an extreme anti-psychiatry movement. True, the BCM’s leaders say that mental problems can have organic causes. But what they mean by “organic” is a disease that can be concretely diagnosed by a medical doctor, such as a brain tumor or hypothyroidism. In their view, these are the only valid causes of “non-spiritual mental problems.” Not only do they reject emotional trauma or chemical imbalance as organic causes, they outright deny that such causes exist. If a medical doctor cannot test for it or document some kind of physical tissue damage, it falls into the category of speculative psychobabble. (That’s why biblical counselors often say they will only refer counselees to physicians, not psychiatrists. Per the BCM, psychiatrists are not qualified to diagnose “problems in living.”)

True, Lambert and other leaders are careful to stress in their training materials that counselors should not tell people to stop taking medications. But they draw a clear line between psychiatric meds and medical drugs:

“Psychiatric medications are pressed from a different mold than other kinds of medications like the Claritin I just swallowed.

“This is not an obscure observation. The Journal of the American Medical Association, to cite just one source, released a study showing that the actual pharmacological benefit of antidepressant medications for most people is basically non-existent and often worse than a placebo. This means that what happens when you take psychiatric medication to help with sorrow is very different than what happens when you take insulin to help with diabetes. Whereas insulin conveys a physical and medical benefit, psychiatric meds typically work—when they work at all—because we want them to work.”

Responders to Lambert’s post pointed out that he misconstrued the actual findings of the study. The study says that antidepressants are generally ineffective for people with only mild depression. For people with serious depression, however, antidepressants “represent the best established treatment for major depressive disorder.” Lambert also draws conclusions that are not expressed in the study – conclusions that are not backed by any cited medical evidence or research.

In a training PowerPoint used by NANC (Part 13 – Medical Issues and Drugs), the trainer asks, “Are drugs needed in biblical counseling?” The response:

5. Concluding that medication is needed for counseling success denies the sufficiency of Scripture (2 Pet. 1:3, 2 Tim. 3:16-17)

6. Bad feelings are often God’s warning system that something is wrong in the heart. Medication can mask that warning system so that heart issues are not addressed

7. When no proven medical issue exists, no medication is truly needed

The training encourages counselors to gather information as to when the “bad feelings” began, and then approach the issue from a spiritual standpoint. “Eventually, the counselee will see that they do not need medication because they have learned to respond to problems biblically.” So while counselors are discouraged from telling people to stop taking their meds, they will have succeeded in counseling when the counselee decides he no longer needs them.

No conflict of interest there. *Sputter, cough, sputter.*

And while Lambert claims that ACBC counselors who violate their training by advising counselees to quit their meds will be held accountable by the organization, he never outlines how. Remember, the ACBC and other biblical counseling organizations, as far as I can tell, have no code of professional ethics that counselors are required to sign. The few accountability standards that exist refer almost solely to adhering to biblical behavior and the organization’s statement of faith.

Second, the BCM as a whole relies on Matthew 18 as the discipline model for out-of-line counselors:

If a member is reported as failing to comply with the Standards of Conduct, and the Executive Committee establishes that the principles of Matthew 18 have been followed, in regard to private matters and there proves to be reasonable grounds for the report then two members appointed by the Board shall speak with him and others involved, in private consultation and in a spirit of gentleness, to determine if there has been failure to comply.

If the matter is not resolved satisfactorily, a written statement of the findings shall be made to the Executive Committee and a copy provided to the member in question.

The Executive Committee shall meet with the member in question and seek to restore him in accordance with Scriptural procedure. If this procedure fails, the Executive Committee shall make written recommendations to the Board with a copy to the member in question.

The Board of Trustees shall make the final decision. If the matter is not resolved in accord with Scriptural precept, the membership of the member in question shall be terminated.

Discipline may be administered by admonishment, reproof, reprimand or termination of membership.

(This was taken directly from the ACBC website, under the Failure to Comply article of the Standards of Conduct.)

So before the ACBC will even investigate a charge of wrongdoing against one of its counselors, it will first determine whether those lodging the complaint have followed the procedure outlined in Matthew 18. Which is (1) confronting the counselor in private, (2) confronting him with two or more witnesses, and (3) bringing him before the church. Then the ACBC will repeat that process with their own people “to determine if there has been failure to comply.” If the Executive Committee agrees that wrongdoing occurred and can get the counselor to admit it and promise not to do it again, he will be considered “restored” and allowed to continue practicing.

Let me be clear: Nowhere in these materials is there a list of zero-tolerance offenses that would lead to automatic termination of a counselor’s certification. Not misrepresentation of qualifications. Not giving misleading or dangerous medical advice. Not violating a counselee’s confidentiality. Not even sexual abuse of a minor. And nowhere does the ACBC or similar organizations indicate that they would involve the police if they did, in fact, determine that one of their counselors had engaged in criminal activity.

And this is just one example of the BCM’s bait and switch technique. It is all over the IABC’s website with statements like the following:

“While recognizing that many problems of thinking and behavior are physically caused, Biblical counselors recognize that many physical symptoms are generated by wrong patterns of thinking and action.”

So how do counselors tell the difference? It is a question that the BCM’s leaders have yet to answer clearly. When you begin with the premise that all suffering has its roots in sin, that’s where you eventually conclude. The reality is that the majority of the BCM’s leaders don’t really recognize physical ailment as divorced from sin or an adequate explanation of mental or emotional struggle. They have one hammer, and everything is a nail.