by John MacArthur
Contemporary culture is dominated by dangerous assumptions about “mental illness” and psychiatric therapies. God’s people, by contrast, must examine these things in light of the absolute truth of Scripture. In this article, Pastor John calls believers to exercise biblical discernment as they reject the bankruptcy of human wisdom and find their sufficiency wholly in Christ.
I have vivid memories of the days when the Christian integrationist psychology movement was prominent in the 1990s and beyond. We engaged in that battle as the movement was attacking biblical sanctification. I wrote the book Our Sufficiency in Christ to underscore the truth that the only true remedy for suffering and pain in human life is found in Christ and in the transformative work of the Word through the Spirit. While psychology has since receded with the rise of the Biblical Counseling movement, we now confront a more formidable adversary to Scripture: psychiatry.
Psychology clearly lacks transformative answers, but psychiatry introduces a more pernicious danger by fostering a destructive dependency on drugs. This practice grants the medical profession the troubling freedom to damage people’s brains and lives under the guise of treatment. Offering misguided advice is one thing, but turning people into addicts is far more egregious. We work tirelessly to rid our streets of illicit narcotics, yet psychiatry dispenses addictive substances within the sterile environment of clinics, making the problem appear more respectable but no less destructive.
Psychiatric diagnoses like “gender dysphoria” have wreaked havoc in our society by offering destructive surgical solutions to sinful inclinations. This is especially directed towards our children in the name of healthcare. We condemn genital mutilation of children in Islamic countries. But our society commends the practice when performed in our operating rooms. This is no better than Josef Mengele, a medical doctor known as the “angel of death,” an executioner in the German concentration camps and a butcher of children for Adolf Hitler, who conducted medical experiments on children in which he amputated and reattached their genitals to the opposite gender. Transgender surgeries are the modern iteration of Mengele’s abuse of children. This is the most horrific aspect of the current assault on children which I address in my recent book The War on Children. Mental health professionals are destroying a generation of children, young people, and adults with drugs and mutilative surgeries.
In light of this, I recently remarked during a Q&A session that mental illness does not exist, a statement that unsurprisingly sparked a firestorm. To clarify that reality, I preached a sermon that addressed my conviction on this matter, which led to a significant amount of questions and criticism due to psychiatry's deep entrenchment. This has compelled me to articulate a more nuanced statement on psychiatry and drugs to help those who misunderstand the truth of my previous remarks.
In a world where “mental illness” is the overwhelming diagnosis for behaviors that are antisocial and often rooted in sin, and medication is the prescribed remedy, it's crucial to question prevailing assumptions from a biblical perspective. This statement seeks to challenge common misconceptions about issues surrounding “mental health” and offer biblical wisdom on how to think about them.
The term “mental illness” illegitimately assigns the status of a disease to human behavior that may be abnormal but not necessarily “phenomena independent of human motivation or will.”(1) Drawing on research by the famed psychiatrist, Thomas Szasz, we differentiate between physiological brain diseases, which have clear biological markers, and subjective “mental disorders,” which lack objective diagnostic criteria. In his own words, Szasz maintains that:
mental illness is a metaphorical disease: that bodily illness stands in the same relation to mental illness as a defective television set stands to a bad television program. Of course, the word ‘sick’ is often used metaphorically. We call jokes ‘sick,’ economies ‘sick,’ sometimes even the whole world ‘sick’; but only when we call minds ‘sick’ do we systematically mistake and strategically misinterpret metaphor for fact—and send for the doctor to ‘cure’ the ‘illness.’ It is as if a television viewer were to send for a television repairman because he dislikes the program he sees on the screen.(2)
In other words, the problem is not medical but moral. The mind is different from the brain. By scrutinizing the place of psychiatry and psychopharmacology among the sciences, and popular psychiatric diagnoses like ADHD, bipolar disorder, Schizophrenia, depression, and PTSD, we shed light on the danger modern psychiatry has unleashed on our society by confusing the moral for the medical.
A prominent psychiatrist, Dr. Paul Minot, has the following to say about his own profession:
I’ve been practicing psychiatry for 38 years, and I absolutely love my job. I love my patients, my professional colleagues, and my coworkers. I couldn’t be happier with the work that I’ve chosen. But I have come to the conclusion that I am participating in the biggest scientific scam of this era.
Many billions of dollars are spent each year in an industry built on a corrupt body of pseudoscience, that has been maintained and exploited by monied interests for decades. This audacious scientific fraud has been more successful than any other of our day.
The assumptions of the general public are that we psychiatrists have a good understanding of how the brain works; that we can diagnose distinct disease states, of which we have some pathophysiological knowledge; and that we can prescribe treatments, usually medications, with full awareness of how it is that they benefit us. But every one of these assumptions is unequivocally and demonstrably false.(3)
Simply put, psychiatry is not a hard science, measured by quantifiable and objective data. It operates in the realm of the immaterial mind which is not subject to scientific analysis. In fact, modern psychiatry and its dependence on pharmaceuticals can be traced back to the mid-twentieth century when there was much success in fighting infectious diseases with medicine. The same process of fighting disease with pharmaceuticals was imposed upon the world of psychiatry, which originally had its roots in the bizarre and reprehensible treatments of the insane asylums of the 19th century(4) and intensified in the 20th century with Josef Mengele’s mutilation of children. However, a notable distinction emerges in the treatment approaches between conventional medicine addressing physical ailments and psychiatry's reliance on chemical interventions for the range of human suffering. Robert Whitaker’s account of this is worth noting:
The ‘magic bullet’ model of medicine that had led to the discovery of the sulfa drugs and antibiotics was very simple in kind. First, identify the cause or nature of the disorder. Second, develop a treatment to counteract it. Antibiotics killed known bacterial invaders. Eli Lilly's insulin therapy was a variation on the same theme. The company developed this treatment after researchers came to understand that diabetes was due to an insulin deficiency. In each instance, knowledge of the disease came first—that was the magic formula for progress. However, if we look at how the first generation of psychiatric drugs was discovered and look too at how they came to be called antipsychotics, anti-anxiety agents, and antidepressants—words that indicate they were antidotes to specific disorders—we see a very different process at work. The psychopharmacology revolution was born from one part science and two parts wishful thinking.(5)
Whitaker goes on to document how psychopharmacology began creating drugs with no objective data on their efficacy, dulling the senses without curing the problem. In fact, it tended to do the very thing it purported to cure. This reality is echoed by Daniel Carlat, an acclaimed psychiatrist, who in his astonishingly candid book on the field states, “Such is modern psychopharmacology. Guided purely by symptoms, we try different drugs, with no real conception of what we are trying to fix, or of how the drugs are working. I am perpetually astonished that we are so effective for so many patients.”(6) And even when these drugs seem to work, as Irving Kirsch has discovered, their efficacy is not better than a placebo.(7) If anything, they harm the patient with side effects, brain damage, and worse.(8) And what could be worse? Trying to come off them without serious damage.
This may be the reason why there exists what some scientists have called the treatment-prevalence paradox when it comes to “mental illness.” The basic concept is that the advances in diagnosis and treatment of disease should mitigate against the spread and severity of the disease over time. Abigail Shrier helpfully notes, “As early detection and treatment for breast cancer improved since 1989, rates of death from breast cancer plummeted. Or maternal mortality: as antibiotics became more readily available, rates of maternal death in childbirth collapsed. Better and more widely available dental care has meant fewer toothless Americans…And yet as treatments for anxiety and depression have become more sophisticated and more readily available, adolescent anxiety and depression have ballooned.”(9)
The Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association (APA), serves as the standard for diagnosing “mental illnesses.” However, progressive editions of the DSM have become increasingly inclusive, broadening the criteria for various disorders.(10) This has led to situations where normal human emotions or behaviors fall within the diagnostic categories.
ADHD
For example, childhood diagnoses of Attention Deficit Hyperactivity Disorder (ADHD) have risen radically in recent decades.(11) This increase reflects an over-reliance on diagnoses and a clinical rebranding that narrows the spectrum of normal behavior. As Aldous Huxley once said, “Medical research has made such enormous advances that there are hardly any healthy people left.” Peter Breggin’s findings on this matter are alarming:
ADHD is not a valid diagnostic category that meets the criteria for a medical syndrome (Baughman and Hovey, 2006; Breggin, 2008a; Whitely, 2010). Like all other psychiatric disorders, there is no evidence that it is has a biological cause (Moncrieff, 2007a). With regard to the three ADHD behavioural categories of hyperactivity, impulsivity and inattention, sometimes these behaviours may be part of typical childhood behaviours. Other times, they may result from boring and poorly disciplined classrooms, lack of grade level educational skills, emotional problems generated from problems at home or in school, issues relating to poverty such as hunger or poor nutrition, or insomnia and fatigue and a variety of chronic illnesses, including diabetes and head injury (e.g. sports concussions) (Breggin and Breggin, 1998). In my clinical practice, all these causes have been evident.(12)
Breggin is not alone in his conclusions about ADHD. Thomas Armstrong has written on this subject in his book, The Myth of the ADHD Child.(13) Supporting this research is the work of an Israeli doctor, Ophir Yaakov, ADHD is Not an Illness and Ritalin Is Not a Cure: A Comprehensive Rebuttal of the (Alleged) Scientific Consensus.(14) The title of his work says it all. Structured routines and discipline, rather than pharmaceutical interventions, are sufficient for hyperactive children to navigate life successfully.
Bipolar disorder
The experience of the highs and lows of life in a condensed period of time is labelled “bipolar disorder.” Before lithium and other medical interventions, those who suffered from this condition were few in number and largely recovered on their own, going on to lead normal lives. But today, the diagnosis has increased exponentially partly due to the expansion of “mental illness” diagnoses and the destructive drugs that are used to treat the condition.(15) Moreover, the use of illegal substances like marijuana and other stimulants has been proven to induce mania and melancholy.
Initially, lithium was used to treat bipolar disorder. But it left the patients worse than it had found them: “there is inadequate evidence that lithium has a beneficial effect, that there are indications that it is ineffective in the long-term outlook of bipolar disorder, and that it is known to be associated with various forms of harm.”(16) Use of antidepressants followed. But study after study shows that these drugs only make things worse.(17)
Schizophrenia
Schizophrenia means “split mind,” signifying a schism in a person’s mode of thinking which renders him unable to distinguish between reality and fantasy. Coined in the early 20th century, schizophrenia was believed to be primarily rooted in genetics. This belief led to tragic consequences, such as the sterilization of individuals with the condition in Nazi Germany. However, no biological connection can be established for this condition: “Yet for all the intense research in universities and the gigantic pharmaceutical companies (Big Pharma), and despite the huge advances in genetics, the genes and biochemistry believed to cause schizophrenia and depression remain elusive.”(18) In other words, there is no medicine to treat this “mental condition.” This assertion is backed up by the fact that most “schizophrenic” patients had recovered without medical intervention before the arrival of Thorazine, the popular drug used to “treat” schizophrenia. If anything, Thorazine and other neuroleptic drugs make the patients worse, addicted, and prone to recurring episodes of uncontrollable behavior.(19) These drugs are the classic case of when the cure is worse than the disease. As Whitaker concludes, “Since the arrival of Thorazine, the disability rate due to psychotic illness has increased fourfold in our society.”(20)
Even if these drugs might alleviate some acute symptoms in the short term just as Tylenol would help a cancer patient deal with a headache, the long-term data on the efficacy of drugs in treating schizophrenia is non-existent. As the professor of psychiatry at the University of Montreal, Emmanuel Stip notes regarding the treatment of schizophrenia with neuroleptics, “It cannot be denied that there is currently no compelling evidence on the matter, where ‘long-term’ is concerned.”(21)
Depression
Depression is a prolonged and intense feeling of sadness and melancholy. Although people have experienced these feelings throughout history, it wasn't until the 1960s that depression was linked to a chemical imbalance in the brain. This theory suggests that low levels of serotonin contribute to depression, and that antidepressants can help alleviate symptoms by boosting serotonin levels in the brain. Pharmaceutical companies took advantage of this highly speculative theory and advertised it as a medical fact for financial gain. However, in a recent meta-analysis of evidence for the chemical imbalance theory, scientists have made the following unsurprising discovery: “This review suggests that the huge research effort based on the serotonin hypothesis has not produced convincing evidence of a biochemical basis to depression. This is consistent with research on many other biological markers. We suggest it is time to acknowledge that the serotonin theory of depression is not empirically substantiated.”(22) The noble lie of chemical imbalance has been discredited. The death of the theory should also spell the death of antidepressants.
PTSD
When we confront life-threatening events, it's only natural to avoid reliving those traumatic memories. These experiences profoundly reshape our responses to future challenges, a phenomenon labeled as Post-Traumatic Stress Disorder (PTSD). Yet, calling it a disorder is absurd, akin to labeling grief or guilt as pathological. It's perfectly normal to steer clear of painful memories—it's a fundamental aspect of human resilience, not a medical condition. Even the chair of the DSM-IV task force, Dr. Allen Frances, admits that “the diagnosis of PTSD is imprecise because it is based exclusively on the person’s own self-report—there is no laboratory test or objective measure.”(23)
And medication for this “illness” is not very effective as Frances goes on to say “PTSD is one fad that has not been much instigated by drug companies. They shy away from advertising for it because medicines are not very effective and they fear the risk of bad publicity when things don’t go well in patients with such high visibility.”(24) If anything, antidepressants have been linked to a higher rate of suicides.(25)
A recent study found that the majority of veterans who commit suicide were not diagnosed with a “mental illness,” but rather exhibited externalizing behaviors like aggression, impulsivity, and rule-breaking actions, and substance abuse.(26) Many of them experience survivor’s guilt, a profound feeling of regret and shame for having survived a casualty which many others did not.(27) These are issues that cannot be medicalized but are better addressed through biblical counseling and support within the normal course of life.
Several factors contribute to overdiagnosis. Pharmaceutical companies play a role by marketing medications directly to consumers and influencing diagnostic practices. Additionally, financial incentives in healthcare systems can incentivize diagnoses that lead to higher reimbursement rates. Marcia Angell of Harvard Medical School has found that in Minnesota and Vermont, “psychiatrists were found to receive more money [from drug companies] than physicians in any other specialty.”(28) It is hard not to imagine the same to be true in other parts of the country.
Advocating medical treatment for moral behaviors is as harmful as condemning medical conditions as moral failings. This blurs the lines between different realms of reality, leading to societal dysfunction. Psychiatry steps on the toes of ministers, pastors, counselors, and congregants. As Szasz observed, “Psychiatric activity is medical in name only. For the most part, psychiatrists are engaged in attempts to change the behavior and values of individuals, groups, institutions and sometimes even of nations. Hence, psychiatry is a form of social engineering. It should be recognized as such.”(29)
Life is replete with challenges—fear, grief, disappointment—all part of the human condition. And navigating life is difficult. The fracturing of families in our society has set our children up for failure to overcome these challenges. We need moms and dads, brothers and sisters, grandmas and grandpas, and friends and mentors and teachers and counselors, and everybody who can teach us how to develop skills to live life. But with society collapsing all around us, is there hope still? Can Christians face life without psychopharmaceuticals?
Jesus offers profound insights into navigating the complexities of human suffering. In John 13-16, we witness Jesus preparing His disciples for the worst night of trauma and fear that anyone has ever experienced. Nothing could be as traumatic as losing Christ. This was the night of His betrayal before the day He was crucified. The disciples were engulfed in disappointment, sorrow, uncertainty, and dread, confronted with the devastating reality of losing their Lord. He was their everything. They had forsaken all—family, friends, careers, and personal ambitions—to follow Him. They abandoned their own plans and comfort, even when He said, “The foxes have holes and the birds of the air have nests, but the Son of Man has nowhere to lay His head” (Matthew 8:20). They followed Him even when it cost them their families (Luke 14:26). They followed One who was rejected by the elite of their nation: religious educators, politicians, and more. He was despised and rejected, and they became social pariahs. They were left with only Him. They had but one Teacher who provided for everything, interpreting the world and life for them. He revealed God to them, teaching profound theological lessons daily from the simplest illustrations. He unveiled the condition of the human heart, showcasing grace, goodness, mercy, kindness, righteousness, justice, and holiness. He provided food when needed, protected, and sheltered them. They had no other. They embodied what Paul said, “For to me, to live is Christ” (Philippians 1:21).
Why did they embrace such a costly path? Why did they put all their eggs in one basket? Because they believed Jesus was the Messiah, the long-awaited King who would inaugurate His kingdom and fulfill all the Old Testament promises to Israel and the world. They were following the true King, anticipating the glory of His kingdom. No sacrifice was too great for such a reward—until He announced his departure. And He said it repeatedly:
“From that time Jesus began to show His disciples that He must go to Jerusalem, and suffer many things from the elders and chief priests and scribes, and be killed, and be raised up on the third day. And Peter took Him aside and began to rebuke Him, saying, “God forbid it, Lord! This shall never happen to You.” But He turned and said to Peter, “Get behind Me, Satan! You are a stumbling block to Me; for you are not setting your mind on God’s interests, but man’s.” (Matthew 16:21-23)
And while they were gathering together in Galilee, Jesus said to them, “The Son of Man is going to be delivered into the hands of men; and they will kill Him, and He will be raised on the third day.” And they were deeply grieved. (Matthew 17:22-23)
And as Jesus was about to go up to Jerusalem, He took the twelve disciples aside by themselves, and on the way He said to them, “Behold, we are going up to Jerusalem; and the Son of Man will be betrayed to the chief priests and scribes, and they will condemn Him to death, and will deliver Him over to the Gentiles to mock and flog and crucify Him, and on the third day He will be raised up.” (Matthew 20:17-19).
This shocking revelation left them shattered, plunging them into profound mental anguish. Jesus, whom Isaiah called the “Wonderful Counselor” (Isa 9:6), who as God knows what is in every person’s mind (John 2:25), urged them to stop being troubled (John 14:27). The Greek verb for troubled is tarasso, which means to be agitated, afflicted with grief, terror, fear or anxiety. Jesus issued a command: “Stop being troubled.” How? By believing in God and in Him: “Believe in God, believe also in Me” (John 14:1). Jesus reiterated this imperative: “Stop letting your hearts be troubled” (John 14:27) and concluded His discourse in the upper room with the assurance, "In this world you will have trouble, but take heart! I have overcome the world" (John 16:33). To believe in Him is to trust in His promises, promises that permeate His discourse that evening. He is sufficient for every grief, disappointment, and fear, all of which are overcome by the strength of His promises. And what are those promises?
1. Jesus Affirms His Love
As the feast of Passover approached, Jesus, fully aware that His hour to depart from this world had come, demonstrated the depth of His unwavering love for His disciples. He loved them "to the end," signifying the ultimate expression of His commitment and affection (John 13:1).
2. Promise of Heaven
Jesus offered profound reassurance to His troubled disciples, promising them an eternal dwelling in His Father’s house. He declared, "In My Father’s house are many dwelling places... I go to prepare a place for you." By this promise, Jesus addressed and dispelled the ultimate fear of death, affirming the disciples' secure place in the heavenly abode (John 14:1-3).3.
3. Greater Works Through Believers
Jesus conveyed a staggering promise to His disciples, assuring them that those who believe in Him would perform even greater works. This promise, fulfilled through the miraculous spread of the gospel and the mighty acts performed by the apostles post-Pentecost, underscores the expansive and enduring impact of their ministry (John 14:12).
4. Assurance of Answered Prayers
Jesus promised the efficacy of prayers offered in His name, ensuring that such petitions would glorify the Father. He declared, "Whatever you ask in My name, that will I do, so that the Father may be glorified in the Son" (John 14:13-14). This assurance is bolstered by the apostle Paul’s affirmation in Philippians 4:19, where he speaks of God supplying every need according to His riches in glory.
5. Gift of the Holy Spirit
Jesus promised the advent of another Helper, the Spirit of truth, who would dwell with believers forever. This divine Paraclete would not only accompany but also indwell the faithful, providing perpetual guidance and support (John 14:16-17).
6. Knowledge of the Truth
The Holy Spirit, identified as the Spirit of truth, would reside within believers, teaching them all things and reminding them of Jesus' teachings. Additionally, the Spirit would disclose future events, glorifying Jesus by revealing His profound truths and guiding believers into all truth (John 14:17, 26; 16:13).
7. Peace of Christ
Jesus bequeathed His unique peace to His disciples, a peace distinct from the fleeting peace of the world. He urged them not to be troubled or fearful, even amidst tribulation, for He had overcome the world (John 14:27; 16:33). This peace is a profound tranquility rooted in trust in the Father.
8. Fruitfulness in Christ
Jesus is the true vine, with believers as the branches. Those who remain in Him would bear much fruit, signifying a life of eternal significance and divine productivity (John 15:5).
9. Refining of Persecution
Jesus forewarned His disciples about the inevitable hatred and persecution from the world, as they are not of the world. He emphasized that such trials serve a refining and sanctifying purpose, purifying the faith of believers (John 15:18-20; cf. James 1:2-4).
10. Joy in Christ
Jesus expressed His desire for His disciples to experience complete joy, a joy that is rooted in His promises and presence. This fullness of joy is a hallmark of the Christian life, reinforced by Paul's exhortation to rejoice in the Lord always (John 15:11; 16:24; cf. Phil 4:4).
The Apostle Paul's life stands as a profound testament to the power of embracing Christ's promises. From the dark, oppressive depths of the Roman prison where Paul was confined for the cause of Christ, he writes, “I have learned to be content in whatever circumstance I am” (Phil 4:11). This remarkable contentment, expressed amidst such dire conditions, stands as the clearest form of faith and worship. Paul’s serenity was not born of his circumstances but of his steadfast hope in Christ and His promises. It appears Paul drew deeply from the promises Jesus made to His disciples in the upper room (John 13-16). For Paul, the most critical truth was his assurance of being loved by his Lord (Gal 2:20)—a reality underscored by the staggering promises given by Jesus.
Paul serves as an exemplary model for Christians facing the challenges and trauma of life. He endured personal enmities, slander, and gossip by false church leaders. He even faced life-threatening physical torture by others. Recounting his trials he says, “Are they ministers of Christ?—I speak as if insane—I more so; in far more labors, in far more imprisonments, in beatings without number, in frequent danger of death. Five times I received from the Jews forty lashes less one. Three times I was beaten with rods, once I was stoned, three times I was shipwrecked—a night and a day I have spent in the deep. I have been on frequent journeys, in dangers from rivers, dangers from robbers, dangers from my countrymen, dangers from the Gentiles, dangers in the city, dangers in the desolate places, dangers on the sea, dangers among false brothers. I have been in labor and hardship, in many sleepless nights, in starvation and thirst, often hungry, in cold and without enough clothing. Apart from such external things, there is the daily pressure on me of concern for all the churches. Who is weak without my being weak? Who is made to stumble without my burning concern?” (2 Cor 11:23-29).
Clearly, Paul’s suffering was extraordinary, so much so that it drives him to speak as though he is insane in verse 23. The Greek term there is paraphroneō, which literally means “to be beside one’s mind,” a word compound similar to schizophrenia. Modern psychiatrists would diagnose Paul with a myriad of “mental illnesses” for all the things he endured. But how did he make it through life? Did he wallow in his sadness? Did he turn to pharmakeia?
Paul learns that God’s grace is sufficient for him, for power is perfected in weakness (2 Cor 12:9). He even boasts in his weakness so that the power of Christ may dwell in him. Not only that, but he also learns to be content with weaknesses, “with insults, with distresses, with persecutions and hardships, for the sake of Christ, for when I am weak, then I am strong” (2 Cor 12:10). And as we have already seen, Paul can say from the darkest dungeon that he can do all things through Christ who strengthens him (Phil 4:13). Contentment in Christ and His promises enabled Paul to face immeasurable suffering and weakness. We can have the same confidence in the sufficiency of Christ and His promises in Scripture.
By following the example of the Apostle Paul and embracing these promises of Christ, we find the solace and strength necessary to endure life on earth. This is the way for all believers to face life’s hardships. Paul endured unimaginable suffering and yet found contentment and strength in Christ, demonstrating that the power of God is perfected in our weakness. Furthermore, Jesus offers heaven on earth for believers to persevere through life’s hardships. These assurances guide us through fear, sorrow, grief, guilt, and uncertainty, reminding us of our eternal home and the power of prayer.
We must reject the reliance on psychiatric diagnoses and medications that seek to numb our minds rather than transform our hearts. Instead, we should cultivate a deep reliance on Scripture and the sufficiency of Christ, who alone provides the true remedy for human suffering. By taking our thoughts captive for Christ and embracing His promises, we can navigate life's challenges with resilience and hope, free from the captivity of chemicals.
In contemporary evangelical circles, the role of the pastor has shifted dramatically. Motivational speakers in sneakers have taken the place of dedicated shepherds, often reducing the pastoral role to that of an entertainer, a media personality, or a corporate leader. This trend is a grave departure from the biblical mandate for pastors, who are called to be God’s shepherds, not showmen. As 1 Peter 5:2 reminds us, we are Christ’s undershepherds, tasked with the care and nurture of His flock.
Scripture is clear about the responsibilities of pastoral ministry.
But we proved to be gentle among you, as a nursing mother tenderly cares for her own children. In this way, having fond affection for you, we were pleased to impart to you not only the gospel of God but also our own lives, because you had become beloved to us. For you remember, brothers, our labor and hardship, how working night and day so as not to be a burden to any of you, we proclaimed to you the gospel of God. You are witnesses, and so is God, of how devoutly and righteously and blamelessly we behaved toward you believers; just as you know how we were exhorting and encouraging and bearing witness to each one of you as a father would his own children, so that you would walk in a manner worthy of the God who calls you into His own kingdom and glory (1 Thess 2:7-12)
And we urge you, brothers, admonish the unruly, encourage the fainthearted, help the weak, be patient with everyone. (1 Thess 5:14)
And when I came to you, brothers, did not come with superiority of word or of wisdom, proclaiming to you the witness of God. For I determined to know nothing among you except Jesus Christ, and Him crucified. And I was with you in weakness and in fear and in much trembling, and my word and my preaching were not in persuasive words of wisdom, but in demonstration of the Spirit and of power, so that your faith would not be in the wisdom of men, but in the power of God. (1 Cor 2:1-5)
Paul’s words in these texts underscore the importance of gentle, nurturing care, grounded in the power and wisdom of God rather than human eloquence or wisdom. Pastors are in the business of soul care, as Paul passionately expressed in Galatians 4:19, “My children, with whom I am again in labor until Christ is formed in you” and Colossians 1:28, “Him we proclaim, admonishing every man and teaching every man with all wisdom, so that we may present every man complete in Christ.” Ephesians 4 further elaborates on the pastoral role in equipping the saints for the work of ministry and building up the body of Christ: “And He Himself gave some as apostles, and some as prophets, and some as evangelists, and some as pastors and teachers, for the equipping of the saints for the work of service, to the building up of the body of Christ, until we all attain to the unity of the faith, and of the full knowledge of the Son of God, to a mature man, to the measure of the stature which belongs to the fullness of Christ” (Eph 4:11-13). Caring for souls is non-negotiable in ministry. As the author of the book of Hebrews states, pastors as those who “watch over your souls” (Hebrews 13:17).
Turning struggling souls to psychiatrists and pharmaceuticals instead of providing pastoral care is a form of pastoral malpractice. By definition, pastors are the shepherds of God’s flock, a role historically rooted in the heart and soul of pastoral ministry—soul care. As Richard Baxter emphasized, “A minister is not to be merely a public preacher, but to be known as a counsellor for their souls, as the physician is for their bodies, and the lawyer for their estates: so that each man who is in doubts and straits, may bring his case to him for resolution.” In today's evangelical world, where pastors often see themselves as corporate heads, this essential aspect of pastoral ministry is increasingly neglected.
The model for pastoral care is found in the great Shepherd, our Lord, as depicted in Psalm 23. Here, we learn the art of shepherding: leading, providing, restoring, guiding, protecting, and comforting the flock. The role of the shepherd is also profoundly illustrated in John 10, where Jesus describes Himself as the good shepherd who lays down His life for the sheep. There is no outsourcing of pastoral ministry to psychiatrists or any other professionals. The great tragedy of turning over the flock of God to psychiatry cannot be overstated.
Pastors must reclaim their God-given role as shepherds of souls, providing the spiritual care and guidance that their congregations desperately need. This is not a task that can be handed off to anyone else. It is the very essence of pastoral ministry, modeled perfectly by our Lord, the great Shepherd as we read in Psalm 23.
Yahweh is my shepherd, I shall not want.
He makes me lie down in green pastures; He leads me beside quiet waters.
He restores my soul; He guides me in the paths of righteousness For His name’s sake.
Even though I walk through the valley of the shadow of death, I fear no evil, for You are with me; Your rod and Your staff, they comfort me.
You prepare a table before me in the presence of my enemies; You have anointed my head with oil; My cup overflows.
Surely goodness and lovingkindness will pursue me all the days of my life, And I will dwell in the house of Yahweh forever.
1 Thomas Szasz, “Mental Illness Is Still a Myth,” Society 31, no. 4 (1994): 36.
2 Thomas S. Szasz, The Myth of Mental Illness: Foundations of a Theory of Personal Conduct, Revised (New York: Harper Perennial, 1974), x–xi.
3 https://www.paulminotmd.com/
4 Robert Whitaker, Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America (New York: Crown Publishers, 2010), 42–46.
5 Whitaker, 47.
6 Daniel J. Carlat, Unhinged: The Trouble with Psychiatry--a Doctor’s Revelations about a Profession in Crisis (New York: Free Press, 2010).
7 Irving Kirsch, The Emperor’s New Drugs: Exploding the Antidepressant Myth (New York, NY: Basic Books, 2010).
8 Peter R. Breggin, “The Rights of Children and Parents In Regard to Children Receiving Psychiatric Diagnoses and Drugs,” Children & Society 28, no. 3 (2014): 234, https://doi.org/10.1111/chso.12049.
9 Abigail Shrier, Bad Therapy: Why the Kids Aren’t Growing Up (New York: Sentinel, 2024), 20.
10 Allen Frances, Saving Normal: An Insider’s Revolt against out-of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life (New York, NY: William Morrow, 2013).
11 Luise Kazda et al., “Overdiagnosis of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents: A Systematic Scoping Review,” JAMA Network Open 4, no. 4 (April 12, 2021).
12 Breggin, “The Rights of Children and Parents In Regard to Children Receiving Psychiatric Diagnoses and Drugs,” 231.
13 Thomas Armstrong, The Myth of the ADHD Child: 101 Ways to Improve Your Child’s Behavior and Attention Span without Drugs, Labels, or Coercion, Revised Edition (New York: TarcherPerigee, 2017).
14 Yaakov Ophir, ADHD Is Not an Illness and Ritalin Is Not a Cure: A Comprehensive Rebuttal of the (Alleged) Scientific Consensus (Hackensack, NJ: World Scientific, 2022).
15 Whitaker, Anatomy of an Epidemic, 179–80.
16 Joanna Moncrieff, “Lithium: Evidence Reconsidered,” British Journal of Psychiatry 171, no. 2 (August 1997): 117.
17 Whitaker, Anatomy of an Epidemic, 185–88. Also see Joanna Moncrieff, The Myth of the Chemical Cure: A Critique of Psychiatric Drug Treatment (Basingstoke, Hampshire: Palgrave Macmillan, 2009), 174ff.
18 Richard C. Lewontin, Steven P. R. Rose, and Leon J. Kamin, Not in Our Genes: Biology, Ideology, and Human Nature (Chicago, IL: Haymarket Books, 2017), xii–xiii.
19 Whitaker, Anatomy of an Epidemic, 92–108.
20 Whitaker, 120.
21 Emmanuel Stip, “Happy Birthday Neuroleptics! 50 Years Later: La Folie Du Doute,” European Psychiatry 17, no. 3 (May 2002): 117.
22 Joanna Moncrieff et al., “The Serotonin Theory of Depression: A Systematic Umbrella Review of the Evidence,” Molecular Psychiatry 28, no. 8 (August 2023): 3254.
23 Frances, Saving Normal, 159.
24 Frances, 160.
25 Michael P Hengartner et al., “Suicide Risk with Selective Serotonin Reuptake Inhibitors and Other New-Generation Antidepressants in Adults: A Systematic Review and Meta-Analysis of Observational Studies,” Journal of Epidemiology and Community Health 75, no. 6 (June 2021): 523–30.
26 Alan C. Swann et al., “Suicide Risk in a National VA Sample: Roles of Psychiatric Diagnosis, Behavior Regulation, Substance Use, and Smoking,” The Journal of Clinical Psychiatry 83, no. 3 (June 6, 2022).
27 Karlyle Bistas and Ramneet Grewal, “The Intricacies of Survivor’s Guilt: Exploring Its Phenomenon Across Contexts,” Cureus 15, no. 9 (2023).
28 Marcia Angell, “The Illusions of Psychiatry,” The New York Review, 2011, 307.
29 Thomas S. Szasz, Law, Liberty, and Psychiatry: An Inquiry into the Social Uses of Mental Health Practices (Syracuse, NY: Syracuse University Press, 1989), vii.
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———. The Myth of the Chemical Cure: A Critique of Psychiatric Drug Treatment. Basingstoke, Hampshire: Palgrave Macmillan, 2009.
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