Thursday, May 21, 2020

A Concise Christian Appraisal of Psychology and Psychiatry

Fifty years ago Jay E. Adams, the father of the modern biblical counseling movement, concluded that psychology and its “illegitimate child” (i.e., psychiatry) are in serious trouble.[1] The basis for Adam’s assertion was that despite its grandiose claims to the contrary, the interventions offered by psychology and psychiatry didn’t work. Today, the conclusions Adam’s drew in the 1970s have been validated ad infinitum by the crises in psychology and psychiatry. This essay seeks to provide a concise articulation of a few of the problems within these disciplines, demonstrating that the evaluation issued by Adams in the 1970s has continued to find validation.

The Unscientific Science

In 2012, Ed Yong, a science journalist, published an article in Nature which outlined a few of the significant methodological problems inherent in research psychology. According to Yong, the vast majority of research results published in major psychology journals are actually incapable of being reproduced.[2] Yong cited Chris Chambers, Professor of Cognitive Neuroscience at Cardiff University, who noted that “High impact journals often regard psychology as a sort of parlour-trick…When we review papers, we’re often making authors prove that their findings are novel or interesting.”[3] Chambers continued, “We’re not often making them prove that their findings are true.”[4] Similarly, Scott Lilienfeld and Irwin Waldman have recognized the scandalous nature of this crisis:
Indeed, in the pages of our field’s most prestigious journals…scholars across diverse subdisciplines have maintained that the standard approaches adopted in published psychological investigations tend to yield a disconcertingly large number of false positive findings.[5]
How significant is this problem? In 2015, the Open Science Collaboration (OSC) published an assessment of the replications of one hundred studies published in three of the most prestigious psychological journals. OSC found that “A large portion of replications produced weaker evidence for the original findings despite using materials provided by the original authors, review in advance for methodological fidelity, and high statistical power to detect the original effect size.”[6] Further, OSC found that only one-third of the replications attested to the findings of the original studies.

Trust Us, We’re the Experts…

Despite being repeatedly outed as about as scientific as alchemy, research psychology and its resultant therapies still find considerable support within both the church and the general public. This is partially due to psychology’s continual effort to market itself as a necessary and effective means unto human flourishing. Articles frequently emerge touting the effectiveness of psychotherapy, reinforcing psychology’s place as a bona fide science. One such article, published by the American Psychological Association (APA), claimed, “Psychotherapy is effective, helps reduce the overall need for health services and produces long-term health improvements.”  To substantiate its claim, the APA cited “more than 50 peer-reviewed studies.”[7] That is, the same psychological establishment whose studies have been shown to be legitimate only one-third of the time has also claimed upon the basis of “more than 50 peer-reviewed studies,” that its therapies work. Moreover, several bombshell studies have emerged that suggest psychology’s confidence is vastly misplaced. For instance, one study published in 2015 concluded that the efficacy of psychology’s interventions for depression have been significantly overstated.[8] Purveyors of cognitive-behavioral therapy (CBT), the current “gold standard”[9] in psychotherapy, have been shown to massively exaggerate the effectiveness of CBT. One meta-data study indicated that only seventeen percent of trials of CBT for depression and anxiety were shown to be effective.[10]

One might imagine, given this sordid state of affairs, that psychology would dampen its enthusiasm for itself. Hardly. Brian Hughes, Professor of Psychology at the National University (Ireland), has observed that even though psychology “considers itself agile at producing authentic insights about the human psyche,”[11] it actually suffers from “excessive self-esteem:”[12]

As attempts to replicate their research produce a mounting series of damp squibs, you might expect that by now psychologists will have become quite cautious. Psychologists should be nervous about the way their popular paradigms contradict each other: they should surely realize that one theoretical explanation is difficult to defend alongside another that is its exact opposite. Psychologists should be equally apprehensive about their vague and imprecise approaches to measurement. They should be obsessed with equivocation: after all, those margins of error must mean something. Their statistical struggles…should breed additional trepidation. Psychologists should surely react by limiting the ambition of their inferences. And each time they remember that their research captures just a thin snippet of the world’s population, psychologists must feel the torrents of collective embarrassment running down their spines.[13] 
Psychiatry similarly suffers from a self-esteem problem. Electroconvulsive therapy (ECT) or what is more popularly known as “Shock Therapy,” is a well-hyped intervention designed to aid people with either severe or persistent emotional disorders.[14] In ECT, epileptic seizures are introduced to the brain while a person is under general anesthesia through the use of a device.[15] Eighty-five percent of those who undergo ECT are seeking relief from depression.[16] This, in itself, is curious since there is no known pathology that causes depression.[17] Thus, introducing seizures into someone’s brain in order to “cure” depression is obviously misguided.

Like biogenic theory, ECT also relies upon a reductionistic view of the human person that rejects the existence of the immaterial soul. What the anxious or depressed person needs is the wisdom of God’s Word, sound teaching, compassion for their suffering, and prayer—and not a brain seizure.[18] Moreover, the terrible side effects of ECT are numerous and well documented.[19] Scientifically, ECT and its supporting studies have been shown to have grave problems. In 2010, Drs. John Read and Richard Bentall conducted a meta-data study that analyzed all scholarly literature published on ECT with particular emphasis on depression. In this study, Read and Bentall noted that the vast majority of ECT studies neglected to include a placebo.[20] Further, Read and Bentall found several other methodological problems with almost all of the other ECT studies. After their comprehensive review of the literature, Read and Bentall concluded with another scientist who wrote, “There is no evidence at all that the treatment has any benefit for anyone lasting beyond a few days…The short-term benefit that is gained by some simply does not warrant the risks involved.”[21]


Marketing Illnesses

We might ask, “Hasn’t the world benefited from psychology’s identification of mental illnesses?” The innumerable disorders present in the Diagnostic and Statistical Manual, 5th Ed. (DSM-V), have been well observed to be, shall we say, over the top.[22] Do you really need that cup of coffee in the morning? You likely have “Caffeine Use Disorder.”[23] Obsessed with that new video game? You’ve got “Internet Gaming Disorder.”[24] Or, are you nervous in situations where you might be embarrassed? According to the DSM-V, you may have “Social Anxiety Disorder." Given the DSM-V’s range of “disorders,” it is no wonder why one in four to five adults in the U.S. are said to have a mental illness.[25]  

Psychology and psychiatry have effectively marketed the existence and even causality of certain major DSM-V disorders to the general public and this without basis or warrant. Bipolar disorder, in its various iterations, is a case in point. Bipolar is something of a catchall diagnosis that is dependent upon a perceived set of symptoms.[26] There is currently no known pathological cause for bipolar, and subsequently, there is no treatment known to the medical community “that provide[s] sustained, symptomatic, and functional recovery.”[27] Indeed, the scholarly assessment of bipolar has concluded, “From a neurobiological perspective there is no such thing as bipolar disorder.”[28] Yet, bipolar is routinely characterized as a “brain disease” by the psychiatric and psychological communities. While the symptoms experienced by those who are said to have either bipolar I or II are entirely genuine, misidentifying these symptoms as a “brain disease” is antithetical to providing genuine help.

Psychotherapy’s Moral Vacuum

Steming from Freud’s insistence that psychotherapy lands within the realm of the scientific[29] (i.e., as a clinical expression of psychological science), psychotherapy has sought to portray its practice as an objective and “value-free” discipline. However, it is undeniable that there exists a set of moral presuppositions that underly psychotherapy. One cannot give a word of counsel without presupposing what is right and wrong. One cannot quantify therapeutic effectiveness or even “mental health” without first rooting these concepts in a system of moral truths. The question is, therefore, from whence do these morals come? What is the moral grounding for the psychotherapist’s counsel? Are the relevant moral commitments of therapists divulged to their counselees prior to the giving of counsel? More likely, psychotherapists merely impose their personal moral commitments upon their clients under the pretense of “science.”

CBT, for example, operates upon the basis of a great variety of undefined moral concepts (e.g., “meaning,” “dysfunction,” “good/bad thoughts,” “improved behavior”):
In a nutshell, the cognitive model proposes that dysfunctional thinking (which influences the patient’s mood and behavior) is common to all psychological disturbances. When people learn to evaluate their thinking in a more realistic and adaptive way, they experience improvement in their emotional state and in their behavior.[30]
Never are these moral concepts fleshed out in the literature and are instead merely assumed in practice by the therapist or counselee. Tellingly, some researchers in the field have proposed ethical training for therapists in order to fill the moral vacuum.[31] Others have proposed the equivalent of a married bachelor: moral neutrality.[32]

Conclusion

In many ways, psychology and psychiatry are akin to those chained within the confines of Plato’s cave: Both are disciplines which confidently assert their ability to understand and aid the public while failing to apprehend basic truths. The findings of these disciplines are often both contradictory and dubious, and many of the therapies purported to help hurting people are, in reality, ineffective and detrimental.



[1]
Jay E. Adams, Competent to Counsel (Grand Rapids, MI: Zondervan, 1970), 1.

[2]
Ed Yong, 5/16/2012, “Replication Studies: Bad Copy,” Nature, 485.7398, 299.
[3]
ibid.
[4] 
ibid.
[5]
Scott O. Lilienfeld, Irwin D. Waldman eds., Psychological Science Under Scrutiny: Recent Challenges and Proposed Solutions (Hoboken, NJ: Wiley-Blackwell, 2017), xxi.
[6]
Open Science Collaboration, 08/28/2015, “Estimating the reproducibility of psychological science,” Science, 349.6251.
[7]
2012, “Research Shows Psychotherapy Is Effective But Underutilized,” American Psychological Association, https://www.apa.org/news/press/releases/2012/08/psychotherapy-effective.
[8]
Ellen Driessen, Steven D. Hollon, Claudi L. H. Bockting, Pim Cuijpers, Erick H. Turner, 09/30/2015, “Does Publication Bias Inflate the Apparent Efficacy of Psychological Treatment for Major Depressive Disorder? A Systematic Review and Meta-Analysis of US National Institutes of Health-Funded Trials,” PLoS One, 10.9, https://doi.org/10.1371/journal.pone.0137864.
[9]
Daniel David, Ioana Cristea, Stefan G. Hofmann, 01/29/2018, “Why Cognitive Behavioral Therapy Is the Current Gold Standard of Psychotherapy,” Frontiers in Psychiatry, 9.4, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5797481/.
[10]
Falk Leichsenring, Christiane Steinert, 2017, “Is Cognitive Behavioral Therapy the Gold Standard for Psychotherapy? The Need for Plurality in Treatment and Research,” Journal of the American Medical Association, 318.14, 1323-4.
[11]
Brian M. Hughes, Psychology in Crisis (London, UK: Palgrave, 2018), 119.
[12]
ibid., 120.
[13]
ibid., 119.
[14]
Max Fink, Electroshock: Healing Mental Illness, (New York: Oxford Univ. Press, 1999), 1.[15] ibid.[16] A. Rajendran, V. S. Grewal, Jyoti Prakash, 04/2015, “Does Criticism of Electroconvulsive Therapy undermines its benefits: A Critical Review of its Cognitive Adverse Effects,” Delphi Psychiatry Journal, 18.1, 160.
[17]
Gregor Hasler, 10/09/2010, “Pathophysiology of Depression: Do We Have Any Solid Evidence of Interest to Clinicians?,” World Psychiatry, 9.3, 155-61.
[18]
Psa. 23:4; Prov. 12:25; Matt. 11:28; 1 Pet. 5:7.
[19]
ibid., 160-3, John Read, Richard Bentall, 2010, “The effectiveness of electroconvulsive therapy: A literature review,” Epidemiologia e Psichiatria Sociale, 19.4, 342-4.
[20]
ibid., 334.
[21]
ibid., 344.
[22]
Allen Frances, Saving Normal: An Insider's Revolt Against Out-Of-Control Psychiatric Diagnosis DSM-5 Big Pharma and the Medicalization of Ordinary (New York: William Morrow & Company, 2014).
[23]
Diagnostic Statistical Manual, 5th Ed. [DSM-V] (Washington, DC: American Psychiatric Publishing, 2013), 792-3.
[24]
ibid., 795.
[25]
Kathleen Ries Merikangas, Marcy Burstein et al.,  2010, “Lifetime prevalence of mental disorders in U.S. adolescents: results from the National Comorbidity Survey Replication--Adolescent Supplement (NCS-A),” Journal of the American Academy Child Adolescent Psychiatry, 49.10, 980‐9.
[26]
DSM-V, 121-39.
[27]
Vladimir Maletic, Charles Raison, 08/25/2014, “Integrated Neurobiology of Bipolar Disorder,” Frontiers in Psychology, 5.98, 1.
[28]
 ibid.
[29]
Jeremy Holmes, 1996, “Values in Psychotherapy,” American Journal of Psychotherapy, 50.3, 259-60.
[30]
Judith S. Beck, Cognitive Behavioral Therapy: Basics and Beyond, 2nd Ed. (New York: The Guilford Press, 2011), 3.
[31]
E.g., in her study, Popescu has noted that, “Ethical questions and moral dilemmas are an important part of the therapeutic or philosophical counseling process that cannot be neglected…Existential issues are of utmost importance in both types of practices, since issues like meaning, scope, death, freedom and isolation are intrinsic to the human conditions…” Beatrice A. Popescu, 2015, “Moral Dilemmas and Existential Issues Encountered Both in Psychotherapy and Philosophical Counseling Practices,” Europe’s Journal of Psychology, 11.3, 520. Cf. Michelle J. Pearce, Harold G. Koenig et al., 03/2015, “Religiously Integrated Cognitive Behavioral Therapy: A New Method of Treatment for Major Depression in Patients With Chronic Medical Illness,” Psychotherapy, 52.1, 56-66.
[32]
Richard C. Springer, 1994, “Morality and the Practice of Psychotherapy,” Pastoral Psychology, 43, 81-91.

Monday, May 18, 2020

Yehoshu'a and Yeshu'a: Christ in the Book of Numbers


I. Introduction: Joshua and the New Generation of Israelites

In the book of Numbers, there are numerous types of Christ that shadow forth his person and work. As with all types of Christ, some are more elaborate than others. Under the heading of more elaborate types of Christ, we find the interrelated events recorded in Numbers 27:12-23. There we read –
The Lord said to Moses, “Go up into this mountain of Abarim and see the land that I have given to the people of Israel. When you have seen it, you also shall be gathered to your people, as your brother Aaron was, because you rebelled against my word in the wilderness of Zin when the congregation quarreled, failing to uphold me as holy at the waters before their eyes.” (These are the waters of Meribah of Kadesh in the wilderness of Zin.) Moses spoke to the Lord, saying, “Let the Lord, the God of the spirits of all flesh, appoint a man over the congregation who shall go out before them and come in before them, who shall lead them out and bring them in, that the congregation of the Lord may not be as sheep that have no shepherd.”  So the Lord said to Moses, “Take Joshua the son of Nun, a man in whom is the Spirit, and lay your hand on him. Make him stand before Eleazar the priest and all the congregation, and you shall commission him in their sight. You shall invest him with some of your authority, that all the congregation of the people of Israel may obey. And he shall stand before Eleazar the priest, who shall inquire for him by the judgment of the Urim before the Lord. At his word they shall go out, and at his word they shall come in, both he and all the people of Israel with him, the whole congregation.” And Moses did as the Lord commanded him. He took Joshua and made him stand before Eleazar the priest and the whole congregation, and he laid his hands on him and commissioned him as the Lord directed through Moses.
Broadly speaking, what we see in this passage are the following –
I. Moses fails to uphold the Lord as holy in the eyes of the first generation of Israelites. 
II. The first generation of Israelites, due to their lack of faith, are rejected from entering the promised land. 
III. Moses is succeded by Joshua/Yehoshu’a whose leadership, it is implied, is like that of a Shepherd. 
IV. Joshua is equipped with the Spirit for the task of bringing the second generation of Israelites into the promised land.
To summarize, we see that the first generation of God’s people were under the leadership of Moses, the one through whom came the Law of God, but neither could enter the promised land. Instead of Moses, it would be the Spirit-empowered successor of Moses named Joshua/Yehoshu'a who would lead God’s people into the promised land by means of his Spirit-empowered words/directions, not by means of the Law. Moreover, it is the new Israel, i.e. the second generation of Israelites, who would enter the promised land with Joshua, and not the first generation of Israelites. By separating the unbelieving first generation from the second generation, God was beginning again with the descendants of Abraham, Isaac, and Jacob. Moses guided the second generation of Israelites, i.e. the children of the first generation, only up until it was time for him to be succeeded by Joshua/Yehoshu'a.

With these things in mind, let us look a little more closely at how these things point forward to the person and work of Christ.

II. The Elder Rejected, and the Younger Accepted

As early as the book of Genesis, we see that God often chooses the younger over and against the elder. God rejected Cain, but accepted Abel. God did not make his covenant with Ishmael, but he did with Isaac. God loved Jacob, but he hated Esau. Indeed, he chose the nation of Israel over and against the rest of the nations who were more numerous than them (see Deut 7:6-8). And we see this pattern in the New Testament as well. There, Christ teaches us that the last will be first and the first will be last (see Luke 13:22-30). The kingdom of God, he later teaches, will be taken from the natural descendants of Abraham and Isaac and Jacob, and “given to a people producing its fruits” (see Matt 21:33-46), i.e. the Gentiles.

In Numbers 27:12-23, we see that the first generation of Israelites is rejected by God for their unbelief, whereas the younger generation is not. The initial body of those who received the Law of God, the Word of God, would not inherit the land promised to Abraham’s seed. Rather, the land was taken from them by God and given to the younger generation of Israelites. The first became the last; and the last became the first.

III. Moses’ Inability, and Joshua’s Ability to Bring Israel to Canaan

The first generation and Moses are rejected by God, and in their place we see the second generation and Joshua. Moses played a limited role in the leading of God’s people, giving them the Law, guiding them to the very edge of the promised land, and proclaiming the one who would come to bring God’s people into Canaan. Moses literally pointed to Joshua/Yehoshu'a, the servant of the Lord who was born under the Law, lived empowered by the Holy Spirit, lived a life of faith, saw the land of Canaan as good, and did not doubt that God’s promises would materialize.

Because of Moses’ sin, he was unable to lead the people into Canaan. The only one who was capable of doing this was Joshua/Yehoshu'a.

IV. Joshua the Shepherd

Joshua is represented as one who will shepherd God’s second generation of Israelites into the promised land. God provides Joshua in response to Moses’ prayer, in which he says –
“Let the Lord, the God of the spirits of all flesh, appoint a man over the congregation who shall go out before them and come in before them, who shall lead them out and bring them in, that the congregation of the Lord may not be as sheep that have no shepherd.[Num 27:16-17 (emphasis added)]
The language here points forward to Israel’s plight under king Ahab. In 1 Kings 22:17, the prophet Micaiah, speaking for the Lord, declares – 
“I saw all Israel scattered on the mountains, as sheep that have no shepherd.” (emphasis added)
Whereas the Lord provided the second generation of Israelites with Joshua/Yehoshu'a, he did not do so with the southern kingdom. The people were scattered like sheep without a shepherd, a situation that would remain constant over time, as we learn from the prophet Ezekiel, writing during the Babylonian exile. Ezekiel later declares –
The word of the Lord came to me: “Son of man, prophesy against the shepherds of Israel; prophesy, and say to them, even to the shepherds, Thus says the Lord God: Ah, shepherds of Israel who have been feeding yourselves! Should not shepherds feed the sheep? You eat the fat, you clothe yourselves with the wool, you slaughter the fat ones, but you do not feed the sheep. The weak you have not strengthened, the sick you have not healed, the injured you have not bound up, the strayed you have not brought back, the lost you have not sought, and with force and harshness you have ruled them. So they were scattered, because there was no shepherd, and they became food for all the wild beasts. My sheep were scattered; they wandered over all the mountains and on every high hill. My sheep were scattered over all the face of the earth, with none to search or seek for them.
“Therefore, you shepherds, hear the word of the Lord: As I live, declares the Lord God, surely because my sheep have become a prey, and my sheep have become food for all the wild beasts, since there was no shepherd, and because my shepherds have not searched for my sheep, but the shepherds have fed themselves, and have not fed my sheep, therefore, you shepherds, hear the word of the Lord: Thus says the Lord God, Behold, I am against the shepherds, and I will require my sheep at their hand and put a stop to their feeding the sheep. No longer shall the shepherds feed themselves. I will rescue my sheep from their mouths, that they may not be food for them. 
“For thus says the Lord God: Behold, I, I myself will search for my sheep and will seek them out.”
[Ezek 34:1-11 (emphasis added)] 
Whereas the Lord had provided Israel with Joshua after Moses prayed for them, and raised up other leaders who shepherded Israel according to God’s commandments, in Ezekiel we are told by the Lord that he will come and shepherd his people, those Israelites who were like sheep without a shepherd.

V. Jesus the Greater Shepherd

Thus, we clearly see the significance of Mark’s description of the Lord Jesus Christ. Jesus, Mark declares,
...saw a great crowd, and he had compassion on them, because they were like sheep without a shepherd.[Mark 6:34 (emphasis added)]
Seeing that the people were “harassed and helpless” (Mat 9:36), Christ exercised compassion on them. Like Joshua, Jesus is a Shepherd. However, he is the Greater Shepherd, as he explains in John 10:14-18 & 10:27-30 –
“I am the good shepherd. I know my own and my own know me,  just as the Father knows me and I know the Father; and I lay down my life for the sheep. And I have other sheep that are not of this fold. I must bring them also, and they will listen to my voice. So there will be one flock, one shepherd. For this reason the Father loves me, because I lay down my life that I may take it up again.  No one takes it from me, but I lay it down of my own accord. I have authority to lay it down, and I have authority to take it up again. This charge I have received from my Father. 
[…] 
My sheep hear my voice, and I know them, and they follow me.  I give them eternal life, and they will never perish, and no one will snatch them out of my hand. My Father, who has given them to me, is greater than all, and no one is able to snatch them out of the Father's hand.  I and the Father are one.” 
(emphasis added)
Whereas Joshua (Yehoshu’a) could only lead the people externally, Jesus (Yeshu’a) shepherds his people internally as well. Whereas Joshua could not ensure that the people would follow him, Christ clearly declares that his people will hear him and follow him. Whereas Joshua could not say that he and God are one, Christ openly declares himself to be one with the Father.

In Christ, Moses’ prayer for a man to lead Israel finds its ultimate answer. In Christ, Yahweh’s promise to personally come gather his sheep and lead them becomes flesh and blood.

VI. Conclusion

Without denying the historicity of the narrative found in Numbers 27:12-23, we can make out the rough lineaments of the historical events of the New Testament, as well as the person and work of Christ. We see that the Law (Moses) would only function as a tutor up until the time when God would send his shepherd (Joshua) to lead his people into the promised land. We see that those who enter the promised land under the leadership of the shepherd do so by God’s mercy and grace, not by obedience to the Law. And when we take the entirety of the OT into consideration on this matter, we see that Yahweh himself is the Greater Shepherd, the Greater Joshua who would be born under the Law, made like his brethren, and become our salvation, the one who brings us all who have been shown mercy and grace, apart from works, into the greater promised land – the new heavens and new earth in which righteousness dwells.