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Adam Lambdin, author of Schizophrenia, Mental Illness and Pastoral Care (2016) can write from personal experience that “Schizophrenia is diabolical” (52).  Adam is schizophrenic. I hesitate to write that Adam “suffers” from schizophrenia, but because he has not suffered direct and indirect consequences of the disease: he has; but rather because Adam has blessed the church with his account of schizophrenia.

The book has three primary elements: Adam’s personal experience; a brief discussion of physiology of the disease; and a discussion of what has and has not helped in responding to this disease.

Adam’s personal history was quite useful for understanding what it is like to live with schizophrenia. The process by he came to understand his condition is both fascinating and heartbreaking. As the effects of the disease grew, Adam did not suspect the true nature of his difficulties, “After all, I had absolutely no clue that I was schizophrenic.”

His explanation of how there were delusions which covered up the delusions which he suffered — the delusions about the delusions — well demonstrated the tremendous pit into which this disease can drive one — hence, the reason he calls the disease “diabolical” (not demonic, which unfortunately some well-meaning people believed to be the case). The delusions created  a horror movie hall of mirrors within his brain.

Adam then reviews medical evidence that schizophrenia is a real disease. Unfortunately, there has been a deal of confusion on this point, within and without the church. This is the trouble with a disease which is typically diagnosed based upon behavior and affect and self-reported states of mind.

How does one rightly and accurately distinguish between those problems with result from physical disease and those which flow from personal volition? When presented with someone who is depressed, or who refuses to follow instruction, or who behaves in an inappropriate manner, does their outward expression come from a lack of self-control, a damaged brain, drug use, some sinful choice. These can be very difficult questions and the interaction between physical and spiritual causes can be very hard to disentangle.

Adam’s experience and observations on these points need to be carefully considered. His advises (page 53) that one begin with a charitable posture when the underlying cause is doubt; something with which I would agree.

The third topic covered in the book is the response to his schizophrenia. Adam details the many well-intentioned and yet hurtful responses, and the insufficient counsel he received.

A great deal of this discussion concerns the biblical counseling world, which sadly, has had some advocates who were not helpful here. (I write this as a biblical counselor professor at The Masters University, so biblical counseling is something I sincerely advocate.) There have those who have tried to reduce all instances of bad outcome labeled “psychotic” or “schizophrenic” (this label has and been used to describe various persons who may not all have the same underlying physical problems; the famous musician or actor who melts down in public, may be “crazy” or even “psychotic” without suffering from a degenerative brain disease).

There is a physiological brain disease called “schizophrenia” that entails damage to the brain. The precise mechanism by which this disease begins and progresses is not as well understood as I wish it were. Thank God, there is some medication which can alleviate some symptoms of the disease.

Yet, the failure to carefully distinguish between people who have a degenerative brain disease and people who are just degenerates has hurt people like Adam. Insisting that someone “repent” of schizophrenia makes as much sense as telling someone to repent of the flu. (And in both instances, the physical problem can become a basis for temptation. But it is no sin to suffer from a disease. People who are physically ill need compassion and medical treatment).

Adam’s discussion of the sort of counsel, instruction which helps with schizophrenia is discussed as a distinction between “secular” psychology and biblical counseling. This is the one place where I would take the most exception with Adam. Not that I disagree with those sorts of things which have been helpful. But I do not believe the line is drawn in the right place in terms of the positions:

There are people who think they are offering counsel consistent with the Scripture; who are not. There are those who know too little about what the Scripture provides, and thus offer inadequate counsel.

The various forms of counsel which proved most effect for managing the effects of the hallucinations and delusions are not foreign to biblical counseling as a discipline — even though they may little known or practiced by counselors. For instance, a great of what is discussed by Richard Sibbes in the early 17th century in his work The Soul’s Conflict With Itself is in accord with the sort taking one’s thoughts captive (2 Cor. 10:5) taught to Adam by his psychologists. Indeed, I have personally given very similar counsel to a man suffering from auditory hallucinations and know that similar counsel has been given by biblical counselors to those suffering from schizophrenia.

That does not mean that I am not interested to read what these psychologists and psychiatrists have done which they have found effective.

However, it is precisely because Adam has been poorly counseled by well-meaning Christians that I would want counselors to read this book and think and train more carefully than they have done.  But this is not the place to work through that complex issue.

And so, in short, I am very pleased that Adam has written this book. I have had the honor of having Adam as a graduate theology student at The Masters University — and even had some brief discussions with him on this subject. I will be recommending this book to counselors and students — not just for those who are particularly interested in schizophrenia, but for all those who seek to better understand the question of brain disease or injury and counseling issues (that is a particularly difficult question, because it is hard to know precisely what is the cause or this or that). There has been far too little consideration of these questions in the biblical counseling world. Adam’s book is a welcome addition to the discussion.

(I was not paid for this review. I purchased a copy of the book to give this review.)