Sunday, October 23, 2011

Renewing of the Mind (Part 1) Phil 4:5-7

I've recently been more and more interested in Psychiatry and specifically in Cognitive Behavioral Therapy (CBT). I’ve had several intriguing conversations with Jeffrey Schwarz (who showed the brain changes that occur with CBT) and I’ve studied under David Burns (most famously of Feeling Good) and his TEAM therapy. CBT as I understand it, essentially focuses on intentionally practicing certain thoughts. The idea is that many mental illnesses are at their core an irrational belief which leads to a habit of bad thinking. If this irrational belief can be identified, confronted with rationality, and then finally ousted through practice of right thinking, there will be some healing. Essentially, the theory asserts that you can choose your thoughts, and so by indirect consequence, you can choose your moods. If you think depressing thoughts, you will wind up depressed. If you think pleasant thoughts, you won’t. The role of the therapist is to help teach a person to identify the irrational thoughts and practice rational ones.

[Now please note: this is what I have learned from two specific thinkers in CBT. CBT doesn’t strike me as a standardized orthodoxy, so these observations might not be true elsewhere, and as I am only a neophyte, it might not even be true here.]

I was reading in Philippians yesterday and chapter 4 really jumped out at me because it seemed that Paul in the First Century had figured out CBT. This will begin a long-running series on Psychotherapy in the Bible. I’ve had the thought before, but decided “here” was as good a place as any to start. If you have other passages that speak to this question, please let me know and I’ll (eventually) write about them. I’d be interested to collect these from other traditions, literature and philosophy. So if you’re a Shakespeare scholar, send some passages my way. Or if you know about parallel passages in the Koran, please let me know.
5 Let your reasonableness be known to everyone. The Lord is at hand; 6 do not be anxious about anything, but in everything by prayer and supplication with thanksgiving let your requests be made known to God. 7 And the peace of God, which surpasses all understanding, will guard your hearts and your minds in Christ Jesus. (Philippians 4, ESV)
The sections starts off with “reasonableness,” and moves immediately to anxiety. The alternative to anxiety is prayer with thanksgiving. The immediate consequence of this thankful prayer is the peace of God. And this peace itself becomes a defense of both the heart and the mind.

One of the major ‘irrationalities’ that cause anxiety is the desire to control. What if I fail that test? It’s Friday night and I’m out of town; what is she doing right now? I don’t know everyone at the party; what if they don’t like me? I’m speaking in five minutes; what if I say something stupid? What if the plane crashes? Everyone has the temptation to fall into these anxious thoughts. What does Paul advise? Pray. Give it to God.

What does that do? It helps you realize that it’s in God’s hands, anyways (everything is, after all). Kneeling before the Throne Room of the Universe, one feels humble; not the big shot who has something to prove. And then when one rises from prayer, and walks out of the Throne Room, one realizes that one was just in the THRONE ROOM OF THE UNIVERSE. What problem could possibly concern Heaven? And what problem could possibly concern one of its citizens?

Also, we can’t forget the thankfulness. No matter how bad things get, every Christian can open his prayer with: “Thank you Father, for life and breath and salvation.” Though every once in a while you get a man like Job, most can go a lot further than that prayer. Most can be thankful for family, health and even wealth. Most have some hint of nature (sun or stars or sky if nothing else) that they can be thankful for.

Paul tells us to pray a lot. He tells us to practice this set of thoughts and attitudes. And when we do this, we’ll be armored from further assault to both heart (emotions) and mind. Exactly in agreement with CBT, Paul says that something you practice by conscious effort (prayer) will be a guard against future perturbation of mood (“heart”) and thought (“mind”).

So let’s imagine our first character, overwhelmed with feelings of anxiety for an upcoming exam. He is anxious probably because he’s grasping onto his pride and playing out the worst case-scenario in his mind, over and over again. He’s imagining getting the test back, with a big “F” on it, and his having to take the course again, and lose his scholarships, and be ridiculed by friends, and have to go home and tell his parents, and not get into medical school, and, and, and… Now let’s let him pray:
Father, I thank you for life and breath and salvation. I thank you that you have given me the opportunity to study at this wonderful school, that you’ve given me friends that believe in me and a family that loves me. Thank you for this beautiful day, the warm sun and calm green trees. I lift up this exam to you. I have been diligent in my preparation; I have studied what I have studied and done all that I can. And so now I pray that you give me success. Passing this exam will ultimately help me serve your children by entering medical school. Nevertheless, not my will but yours be done: I trust that you will be with me and will do what’s best for me, be it to fail this exam or to pass. Amen.
 If our young friend prays this prayer (or others like it) for 15 minutes a day, he’ll have a lot harder time stressing out about the exam. It’s in God’s hands. He’s accepted the possibility that he might fail, but he’s not worried about that either. On top of it all, he began with gratitude; even this alone will put him in a better mood than when he started.

The pattern of Philippians 4:5-7 is brilliant and powerful:
1. Begin with being reasonable.
2. Don’t worry.
3. Instead, pray and be thankful.
4. This will guard your heart and mind.


  1. Great thoughts David!

    I always love to tell classes that when it comes to "renewing the mind" (Rom 12:2; Eph 4:23), that is exactly what CBT gets right!

    But, of course, we are not to stop there. I see classic (even Christianized) CBT as Col 3:1-4, just without Col 3:5-14. I'd love to know your thoughts!

    Blessings brother...keep up the excellent work!

  2. Hey Scott! I'll definitely add these to the docket!

    There are certainly similarities in approach between CBT and Christianity, but they are not the same thing. One of the two does discuss Jesus at some point. But it will be intriguing to see what can be gleaned for secular practice, and what can be added to Christian practice. Or is that even the right question? Maybe more generally: how can iatros (doctors) heal the psyche (soul)?

  3. I realize that you are attempting to cover many things with this blog, but I would like to discuss your post in terms of the mental illness of depression.
    I agree with you, the pattern of Philippians 4:5-7 is brilliant and powerful, however, I believe that to some degree you may be simplifying things a bit. If someone is suffering from depression, or is the throes of a depressive episode, they cannot make it out alone.

    1. Begin with being reasonable.
    Depression is not reasonable. A person who is depressed is does not only believe the worst of him or herself, but they believe it with such conviction that it is no longer a belief; it is a truth, reinforced every day.

    2. Don’t worry.

    Worrying is a depressed person’s bread and butter – if they don’t worry about themselves, who on this earth will? You might as well tell a river to flow upstream. A depressed person is often plagued with the fear that if they disappear, no one will notice, and worse, no one will care. They are afraid that they will disappear into the blackness and their voice will not only be unheard, but its loss will not matter.

    3. Instead, pray and be thankful.

    Thankfulness is difficult to argue for or against. A depressed person is thankful for a respite, a brief period of utter joy and life. They are sometimes thankful to be alive, however, it can be hard to be thankful when depression pushes in, and numbness and apathy take hold. Your example prayer, everything you are thankful for is external – how are you supposed to be thankful for depression? I agree that “not my will but yours be done: I trust that you will be with me and do what’s best for me…” but how is depression what is best? Though I believe that God does have a purpose for everything, it is hard to argue with someone who is suffering. It is the age-old argument, why does a good God let bad things happen?

    4. This will guard your heart and mind.

    I agree with you that if you truly release all of your worries, emotions, trials, and suffering to God, you heart and mind will be at rest, but what then of suicidal thoughts? Where do they come from? Some depressed people desire a physical pain that will match their emotional pain, which is difficult to comprehend. However, not everyone who suffers suicidal thoughts is in extreme emotional pain. It could be a learned thought pattern, but where did this pattern initiate, and how can a person repeat this pattern of suicidal thoughts enough so that it becomes a learned habit that is completely unconscious?

    So back to my original point, a person who is suffering from depression cannot make it out alone. There must be something that teaches them to follow this pattern, something that teaches them what is reasonable and what is not. The help that leads a person out of depression can be God, it can also be people, or it could be a combination of these two.

  4. If I could take a stab at your question, "How can doctors heal the soul?" My initial thought is that doctors cannot heal the soul. Not really. If the soul is dead like Paul says in Ephesians 2, then a doctor could no more heal a soul than he could make a corpse partly alive. The best a doctor can do without the work of the Holy Spirit is to maximize common grace. The growing quest for mental health as not just the absence of mental illness but the presence of positive mental wellness is a brilliant understanding of all that is available in common grace, but nothing more. It is certainly not in any way saving grace and neither is the fruit of CBT the same as the fruit of the Spirit.

    Here is what I mean. CBT, as I understand it, uses science essentially to figure out the best way that our body and mind function through changing harmful beliefs or thought patterns. The problem is that the soul is not observable, only the body (including the mind) is. So you can jury-rig your idolatrous heart to function like a newly created heart and it will look much the same in the mind. But all you have done is replace horizontally harmful idolatries with predominantly vertically harmful idolatries. Anxiety is directly harmful to the worrier and those close to him, but self-righteousness benefits everyone except the self-righted man himself on judgement day. The fear of man, the fear of consequences, the love of self-glorification and other such idolatries that bring about moralistic behavior are both condemnable offenses and a mechanism of common grace that God allows to keep mankind from self-destruction.

    Basically the best Pharisees were similar to the best CBT'ers. They've done a brilliant job of manipulating their idolatries to bring about the closest thing to true human flourishing. But without the love of God in their hearts that only the Spirit can incubate they have only made it more difficult to see Jesus as their savior. Those who are forgiven much, love much. CBT without Gospel-preaching is pharisee training. CBT slapped on with Christianese but without Gospel-preaching is grace-empowered justification with man-powered sanctification which isn't really sanctification. Telling people to thank, pray to, and trust in God is not bad but likely they will apply it moralistically. Unless you show that they will only be able to apply Phil 4:5-7 as much as they see that Jesus lost everything to be thankful for on the cross, got his prayers to take the cup away turned down, and was forsaken by the God he trusted perfectly his whole life--all of which we deserve and all so that we could truly have something to be thankful for, an audience for our prayers, and a perfectly faithful God who always works everything for our good. It comes down to faith. It comes down to how real the truth of the Gospel is to your heart. Thoughts?

  5. Some additional thoughts... You have to include verse 4, "Rejoice." In order to rejoice, the Gospel has to be real to you, it has to touch your heart. Also, you have to include verse 1, "stand firm in the Lord" which is fighting for the faith and the anecdotal example of verse 3, "laboring side by side with [Paul] in the gospel."

  6. Thank you two; I think this is the most thoughtful and substantive critique that I've yet gotten. My week is quite busy, so it will take me some time to respond. BRB :)