Here’s the second installment in our current series, Sin, Mental Illness and the Church. Today, we look at the work of Jay Adams and his conceptualizations that are foundational to the development of the Biblical Counseling movement.
If Sigmund Freud had an outsized role in the growth of modern psychiatry, Jay Adams has had a similarly outsized role in the growth and influence of the Biblical Counseling movement.
It’s important for our readers to understand how central Adams has been in impacting how pastors from evangelical and reformed traditions think about mental illness and pastoral counseling. Now in his mid 80s, Adams continues to teach and to write. Other leaders of influence within Biblical or Christian counseling circles have either written in response to Adams’ foundational work or sought to build upon his work. We’ll look at this phenomena in a subsequent post in which we’ll examine the perspectives of the leaders following in Adams’ footsteps.
As a young pastor fresh out of seminary in the early ’60s, Adams felt ill-prepared to respond to the needs of those who approached him for counseling. He was critical of the practice of referring out to secular professionals who would impart “non-Christian counsel.” Ironically, Adams was to be influenced in his thinking by O. Hobart Mowrer, a prominent psychologist and behavior therapy researcher from the University of Illinois (a former President of the American Psychological Association, and a non-Christian) who was a vicious critic of the field of psychiatry and the medical model of understanding mental illness. Adams served a summer internship with Mowrer at two state-run psychiatric hospitals in Illinois in 1965…paid for by a foundation established by Eli Lilly!
In Adams’ landmark book, Competent to Counsel he established the foundation for the Biblical Counseling movement.
The thesis of this book is that qualified Christian counselors properly trained in the Scriptures are competent to counsel-more competent than psychiatrists or anyone else.
In the book, Adams lays out his construct of mental illness. In reading what he has to say, I have to remind myself that the book was written in 1970, that it’s one of approximately 100 books that he has written, and much of his subsequent writing has served to modify, expand upon or tone down criticisms (a little bit) issued in Competent to Counsel. Heath Lambert, a modern leader in the Biblical Counseling movement, wrote that “for Adams, bombast was a conscious tactic.” With that said, Adams (as the founder of the Biblical Counseling movement) rejected the modern concept of mental illness…
To put the issue simply: the Scriptures plainly speak of both organically based problems as well as those problems that stem from sinful action and behavior; but where, in all of God’s Word, is there so much as a trace of any third source of problems which might approximate the modern concept of mental illness.”
Adams was also very blunt in his assessment of persons with mental illness…
What then, is wrong with the “mentally ill”? Their problem is autogenic; it is in themselves. The fundamental bent of human nature is away from God. Man is born in sin, goes astray “from his mother’s womb speaking lies” (Psalm 58:3) and will therefore naturally (by nature) attempt various sinful dodges in an attempt to avoid facing up to his sin. He will fall into varying styles of sin according to the short-term successes and failures of the particular sinful responses he makes to life’s problems. Apart from organically generated difficulties, the mentally ill are really people with unsolved personal problems.
“I do not wish to disregard science, but rather I welcome it as a useful adjunct for the purposes of illustrating, filling in generalizations with specifics, and challenging wrong human interpretations of Scripture, thereby forcing the student to restudy the Scriptures. However, in the field of psychiatry, science largely has given way to humanistic philosophy and gross speculation.”
Sometimes, instead of speaking of mental illness, people talk about “emotional problems.” But this language is as confusing as the former. When a client is depressed or high, or anxious or hostile, there really is no problem with his emotions. His emotions are working only too well. It is true that his emotions are not pleasant, but the real problem is not emotional, it is behavioral. Solutions aimed at relieving the emotions directly (as, e.g., chemical methods like pills or alcohol), therefore, must be considered to be nothing more than relief of symptoms.
Adams was resolute in his initial insistence that sin is the cause of the problems that lead people to seek counseling…
“In nouthetic counseling, the stress falls upon the “what” as opposed to the “why” because the “why” is already known before counseling begins. The reason why is already known before counseling begins. The reason why people get into trouble in their relationships to God and others is because of their sinful natures. Men are born sinners.”
Adams’ approach is described as nouthetic counseling. Nouthesis and nouthesio are the Greek noun and verb forms of the word translated as “admonishing” in the ESV translation of Colossians 3:16…
Let the word of Christ dwell in you richly, teaching and admonishing one another in all wisdom, singing psalms and hymns and spiritual songs, with thankfulness in your hearts to God.
Adams describes nouthetic counseling as a strategy that seeks to correct sinful behavior patterns by personal confrontation and repentance. The three basic elements involve teaching by God’s Word, solving problems by verbal means through confrontation and the motivation of love and deep concern to help the counselee for their own good (an element that some may overlook in employing Adams’ techniques). Nouthetic counseling is a very directive, authoritative and confrontational approach.
He described the qualifications for nouthetic counselors…
Preeminently, a nouthetic counselor must be conversant with Scriptures. This is one reason why properly equipped ministers may make excellent counselors. A good seminary education rather than medical school or a degree in clinical psychology, is the most fitting background for a counselor.
Adams was also extremely critical of the secular professions that had commandeered the domain of counseling. From The Christian Counselor’s Manual…
Biblically, there is no warrant for acknowledging the existence of a separate and distinct discipline called psychiatry. There are, in the Scriptures, only three specified sources of personal problems in living: demonic activity (principally possession), personal sin and organic illness. These three are interrelated. All options are covered under these heads, leaving no room for a fourth: non-organic mental illness. There is, therefore, no place in a biblical scheme for the psychiatrist as a separate practitioner. This self-appointed caste came into existence with the broadening of the medical umbrella to exclude inorganic illness (whatever that means). A new practitioner, part-physician (a very small part) and part secular priest (a very large part), came into being to serve the host of persons who previously were counseled by ministers but now had been snatched away from them and placed beneath the broad umbrella of “mental illness.”
If I were to summarize the essentials of Jay Adams’ teaching that remain foundational to what we know today as Biblical or Christian Counseling, they would be as follows…
- Everything we need to be able to counsel people for emotional or behavioral problems that aren’t clearly organic in nature can be found in Scripture. The Bible is sufficient for counseling.
- Often, the underlying cause of the problems that lead people to seek help is sin, absent a clearly identified medical condition.
- If the underlying problem is sin, the solution is found in the person of Jesus Christ and his saving work of redemption as revealed through God’s Word. Positive change flows from the power of Christ through the transformative power of the Holy Spirit.
- Psychiatry and psychology all too frequently dissuade people from taking responsibility for their emotional states and patterns of behavior.
Dr. Adams is the founder of the Institute for Nouthetic Studies (INS), the National Association of Nouthetic Counselors (NANC), and the Christian Counseling and Educational Foundation (CCEF). INS offers training and a certificate program in Nouthetic Counseling. He maintains a current blog and has a page on the INS website featuring his answers to frequently asked questions.
Editor’s note: I presented Jay Adams’ work for the purpose of helping those within our growing movement of Christians seeking to welcome and include kids and families impacted by the full range of disabilities into the local church to understand how many leaders serving in churches most committed to evangelism and outreach gained their practical understanding of mental illness. While many of our readers will find Jay’s teaching “provocative” to say the least, you will find no criticism of his work here.
We need to keep in mind that if we’re going to change the perceptions that cause a majority of those who do not regularly attend church to disagree with the statement that those with mental health issues are welcome at church and engage church leaders from evangelical and reformed congregations to pursue intentional outreach to families impacted by mental illness, we’re going to need to find common ground with those in positions of influence within the Biblical Counseling movement and we’ll need to find a few courageous leaders in the field to take up the cause of inclusion.
Next, we’ll examine some unintended consequences of the movement Jay Adams launched.
Revised January 29, 2015.
Consider joining us this winter for Key Ministry’s online group study that will accompany our blog series…Sin, Mental Illness and the Church. This study will be a combination of Bible reading/study and supplemental readings/material to enlighten participants as we examine the following questions…
- How has the understanding of mental illness evolved in the evangelical movement in America over the past half-century?
- How do past and current attitudes in the church influence outreach efforts to families of children and teens impacted by mental illness?
- What can we learn from Scripture of God’s purposes in the lives of those impacted by mental illness?
- How can we help more kids and families impacted by mental illness to experience the love of Christ through involvement in a local church?
Anyone can join us, but a Facebook account is required. Click here to register!