Counseling and Medicine

Within Christian counseling circles, one of the most polarizing issues is the use of medicine for controlling the symptoms of various problems.

Some Christians are too slow to seek the help of medicine.  Though they profess that man is both body and soul, their “grit-your-teeth-and-just-pray-harder” approach seems to downplay the crucial role that the body plays in human existence.  Some counselors sadly heap burdens upon people, guilting them out of seeking prescriptions for anti-depressants and the like.

Some Christians, however, seem content to depend exclusively upon medicine.  Just because someone has found a medication that works, that doesn’t mean they should over-do and over-commit themselves.  Prudence and self-discipline combined with medicine can be a truly wise combination that faces squarely the reality of our dichotomous make-up: body and soul.

I’ve been reading through Counseling the Hard Cases: True Stories Illustrating the Sufficiency of God’s Resources in Scripture, edited by Stuart Scott and Heath Lambert and really appreciated Dan Wickert’s comments in chapter 5, “‘Mary’ and Paralyzing Fear”:

As a physician I am always familiar with the details of my counselee’s medications.  I recognize most antidepressants; I know how they work, the common side effects, and the mental and physical dependency that many of these drugs cultivate.  Because of my knowledge in this area, many counselees want my medical advice concerning whether they should continue with their medication.

As a rule, I never advise or require counselees to stop medicating because I am not their physician.  I don’t know their complete medical history, and it would be irresponsible for me to advise them out of ignorance.  In many cases patients who stop taking their medication cold turkey will suffer severe withdrawal symptoms that make it even more challenging to think and act rightly.  Sometimes, however, a counselee with inform me that he is ready to stop taking medication.  In these cases I am always curious to hear his reasons before I advise him to talk to his doctor about stopping.

One question I typically ask is, “Why do you want to stop?”  Often a counselee wants to get off medications because they do not want to be judged by friends or family.  This is not a good reason because the person is often more concerned about his own glory than the glory of God.  A second question I consider is, How are you handling life on the medication?  Are they handling the normal problems of life in a biblical, God-honoring way while they are on the medication?  If not, then taking them off the medication usually will not help the counselee to please God.

Does medicine ultimately solve heart problems?  No.  But is God’s will ultimately going to be hindered by medicine or a lack of medicine?  No.  God will work in a counselee’s heart regardless of whether they are medicated.  My goal and responsibility are to cultivate hope, to help people grow in Christlikeness, and to help them prosper in the freedom of the gospel and in God’s rich purpose for their lives.

Counseling the Hard Cases, pgs. 120-121. (Bold emphasis added.)

Very insightful words.  If Dr. Wickert (an M.D.) isn’t willing to advise those he counsels (in his role as a biblical counselor) either to start or stop taking medicine, pastors and lay-counselors who are not medical doctors should be even more careful in this regard!  While we have a duty to focus our counselee’s attention on the spiritual aspects of their struggles, we should not burden them with pressure to avoid or get off medication, claiming it is somehow more natural or God-honoring.

We do well to rebuke both extremes.  Those who are ashamed of the supposed stigma of medicine should be confronted with their fear of man and helped to focus on God’s glory in place of their own.  Those who are unwilling to discipline their lives spiritually because they are using medicine as a quick and easy answer to their problems should be confronted with their unbiblical assumptions about what causes challenges in the Christian life.

In the end, counselors do best when we lead people to Christ.  When our focus is on helping them see how the gospel relates to their problems, we give them the help we’re best qualified to give.  And when we bring God’s word to bear in the messy places of their lives, we give them hope.  Perhaps if more counselors put the use or non-use of medicine several levels down on their priority list, we would be better able to present biblical and pastoral counseling as the thoughtful and balanced approach it is intended to be.

Rev. Andrew Compton
Christ Reformed Church (URCNA)
Anaheim, CA


11 comments on “Counseling and Medicine

  1. says:

    I agree with some of this,but you should also include in your recommended readings Dr.Jay Adams books …in my opinion he is the Dean of this school,and topic.


  2. Rev Compton, have you read Instrument in a redeemers hand or any other works from CCEF? What method of counseling does this book’s philosophy follow?


    • Hey Nathaniel, CCEF is really my go-to on biblical counseling matters. I haven’t read Tripp’s book (though it is on my wishlist), but I have read a great deal of Powlison and Welch. “How People Change” by Lane and Tripp is next up for me. I’m planning on taking one of the online classes this fall.

      This book is the biblical counseling approach. The editors are from Southern Baptist Theological Seminary and from what I can tell, there has been more and more interaction between CCEF and SBTS over the years since SBTS began their biblical counseling program.

      I appreciate that this book is not simplistic with the hard cases. It eschews naive proof-texty counseling and interacts deeply with the symptoms people are experiencing, and focuses on really listening closely to counselees (solid data gathering) to what the scriptures do and do not say about their problems.


      • Richard says:

        “Instruments in a Redeemer’s Hand” is a terrific resource, Rev. Compton. Really recommend it.


        • I had just skimmed the amazon preview again last night, especially because this book (Scott/Lambert) mentions/recommends it at least once. Ok, ok … I think it’s going in the shopping cart by tonight!!!

          Thanks for the recommendations, brothers!


  3. Dante says:

    Wisdom indeed; he cuts thru issues and gets to the core of the issue. I knew a young woman who was a member at a large church where Stuart Scott eventually became a pastor. She had been made to feel guilty about taking meds so she took herself off of them. After being in a psych ward for a month, she jumped to her death a couple hours after being released.


  4. Great post, Andrew. Having counseled Christians on medicine, I totally agree with the quote and your comments. Thanks!


  5. Steve says:

    You may have heard of the National Association of Nouthetic Counselors (NANC). Historically thy have been quite opposed to medications. I know that they have received a lot of flack on the subject, which is as it should be.
    As of late I have noticed that those who believe that bipolar disorder and depression are not mainly biological (NANC included), grudgingly acknowledge that there may be a place for medications. There are many reasons for this attitude but space does not allow me to put them here.
    These “nothing buttery” approach counselors are not being so dogmatic in regard to telling people to go off their medications. However when you really look at their beliefs they are opposed to medications for depression, bipolar etc. For instance, this is posted on a NANC site:

    We are not opposed to medication, but we have found that it has been over-prescribed in many cases. We prefer to begin addressing issues of the heart with people, even if there may be a need for medication. We often discover that when heart issues are addressed biblically, the need for medication significantly lessens or vanishes altogether. We counsel people who are currently on medication, and also people who are not on medication.

    The key statement above is “We prefer to begin addressing issues of the heart with people, even if there may be a need for medication.” We often discover that when heart issues are addressed biblically, the need for medication significantly lessens or vanishes altogether.” “This is what I am talking about; What issues? Are they depression, hearing voices, mania? How do you deal these issues biblically? I think Lloyd Jones really helps in this area, The Christian Warfare, An Exposition of Ephesians. Medications for clinical diseases (not grief or spiritual depression, etc.) should be at the forefront.
    Steve Bloem
    Co-Author of Broken Minds Hope for Healing When You Feel Like You’re Losing It, Kregel Publications. We address these issues in this book including Sola Scriptura versus Sola Sufficiency.


  6. Thanks for mentioning your book, Steve. It looks very interesting – I’d love to read it!


    • Steve says:

      Thank you, Andrew, Would you like me to send you complimentary copy
      All I need is your mailing address


      • Oh wow – yes, I would be delighted for one! I did some skimming on Amazon and it looked really beneficial! I’ll send you an E-mail.

        Thanks again for your comments and mentioning the book!


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