The word nouthetic comes from the Greek noun nouthesia and verb noutheteø. The word, used primarily by the apostle Paul, is translated “admonish, correct or instruct” (e.g., in Rom. 15:14). It is a focused bringing to bear of Scripture on a counselee’s life. It is a refined, intentional approach to what pastors have always done. Nouthetic counseling is overwhelmingly the counseling philosophy of fundamentalist nondenominational churches, conservative Baptists, and other conservative Christians. The movement seems especially strong in suburban churches.
A growing National Association of Nouthetic Counseling and numerous other organizations for nouthetic counselors have tried to establish a bedrock foundation for counseling in conservative churches. This foundation was first laid in the writings of Jay Adams, particularly his book Competent to Counsel.
Dr. Adams based his watershed book in part in what he experienced as a counselor in two psychiatric institutions. He refined his theological base when he became a professor of practical theology at Westminster Theological Seminary and developed a course on the theory of pastoral counseling. His interpretation of Scripture and observations led him to a central conclusion:
Apart from those who had organic problems like brain damage, the people I met in the two institutions in Illinois were there because of their own failure to meet life’s problems.4
Adams states, in his Christian counselor’s manual, “The hope for the depressed persons, as elsewhere lies in this: the depression is the result of the counselee’s sin.5
It may seem that such a view places Adams in complete opposition to psychology, but this is not the case. From the early 1970s, he primarily attacked one dominant psychological view—psychoanalysis. Psychoanalysis arose out of Freudian theory and permeated the psychiatry of the 1950s through at least the 1980s. It had influenced pastoral counselors, who may have attended psychology classes in college without ever hearing a Christian critique of the Freudian worldview.
Preacher-educator John MacArthur has been quite involved in this movement. Several pastor training institutions strongly base counseling instruction on nouthetic principles. Nouthetic counselors are solidly Bible-believing Christians who love the Lord and adhere to the Bible as God-breathed, infallible, and inerrant.
Nouthetics: Schizophrenia and Mania
The problem is that Nouthetics was designed with everyday problems and mood swings in mind. It seldom concerns itself with the difference between feeling “down” and clinical depression. Nouthetics doesn’t accept that there are differences between the two levels of depression, for it recognizes no physical causes for clinical depression or most other illnesses.8
Nouthetic counselors surely do run into persons who have made a break with reality, but the nature of the counseling seldom brings counselors face-to-face with schizophrenics so conceptually disorganized and paranoid that they can’t function.
With Bible in hand, counselors would not get very far with persons whose auditory hallucinations make it impossible to concentrate. Bringing spiritual reality into a severely psychotic or manic person’s world is like standing at a fixed point and talking to someone who is riding a high-speed merry-go-round. The person counseled might be able to comprehend a simple verse or biblical concept, but there is little ability to focus, and the merry-go-round never slows. I’ve listened to the nonstop monologue of someone in a manic state without getting in a single word.
The rationality needed to hear Nouthetic counsel and meditate on Scripture simply does not exist for such a person. Such lack of rationality and inability to concentrate indicate that there might be a flaw in the theory that mental illness relates strictly to spiritual need and will go away as Christians grow in biblical concepts.
Laboratory Evidence? The Litmus Test of Nouthetics?
As science continues to learn more about neurology, nouthetic counseling will no doubt have to make concessions. So far, however, proponents of nouthetics have resisted much consideration of developments. Nouthetic counselors rest on a belief that there is no biological basis for mental illness on the same rationalistic basis by which evolutionists reject consideration of a Creator. The argument of proponents is that biological connections to mental illness have never been proven in a laboratory. An unbiased look at the study results makes this argument sound weak.
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