ACBC Counseling - Question 20

20. (Case Study) Tim believes his recent psychiatric diagnosis is a life-long disease and is to blame
for his behavior towards his wife. Write out your word-for-word response to Tim on this matter. In
your response, be sure to address the themes of biblical responsibility and self-control.
 Overview
o Introduction
o Introduction to Psychiatric Diagnosis
o The Importance of Your Worldview
o A Quick Review of Emotions in Biblical Counseling
o Acknowledging Personal Responsibility for Sin
o The Importance of Self-Control
o Summary
I. Introduction
A. Background:
1. Tim and Emily come from a church across town and have asked to meet you because of some
help that you offered their friends several months ago. They are coming because of a persistent
problem they have had in their marriage. They explain that in their six years of marriage Tim
has always had a “short fuse.” He regularly “loses it” when he comes home from work which
fills the evenings with tense communication. Their weeks are filled with arguments about
everything from dinner being ready on time, to whether they should have kids. Tim thinks Emily
is a good wife, admits the problems are his fault, but says he just doesn’t know how to “maintain
control.” About a year ago Tim went berserk screaming at Emily, kicking the kitchen table and
throwing plates on the floor in response to Emily’s complaint that he came home late without
calling. Emily was always uncomfortable with Tim’s previous pattern of outbursts, but this was
different. She was truly scared. Tim was too. In tears she told Tim that something had to
change.

Tim talked to his pastor who told him that he needed to see a professional therapist. Tim
followed the advice and made an appointment with the Christian counselor whom his pastor
recommended. Tim met with the therapist for a few sessions, who ultimately recommended he
see a psychiatrist for medical care. When Tim met with the psychiatrist, he was told that he had
bi-polar disorder and began to take the medications prescribed by the physician.

Tim was initially discouraged to learn that he had a disease that would likely last his entire life,
but he was thankful to have a plan to deal with problem. Emily was also encouraged that there
was now at least something they could do.

Their encouragement quickly gave way, however, when after several months on the medication
Tim had still not really changed. While his temperament seemed milder in general the loss of
control, and screaming were still present. It was at this point that Emily began to regret ever
marrying Tim. All the arguments together with the couple’s lack of children were taking their
toll. She realized she was in a marriage that she did not want to be in, but didn’t think she had
any options.

Then last week Tim “went completely crazy.” Emily suggested on a Saturday morning that Tim
should cut the grass because he had not done it the week before. Tim did more than scream and
throw things this time. As he yelled and became more “worked up” he threw the phone at Emily.
He missed her, knocking a hole in the wall, but they both knew he had crossed a line. Emily said
she couldn’t take it anymore and wanted out of the marriage. She told him that if something
didn’t change very quickly, she was going to leave. That is when he reached out to his friend
who recommended you.

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 ACBC Counseling - Question 20

Tim and Emily both profess faith in Christ and relate their testimonies of conversion in their teen
years. Both are also terribly discouraged. Tim doesn’t know how to treat Emily better since he
is “plagued” by this disease. Emily loves Tim and would like their marriage to work, but she is
worn out with the lack of change. She feels badly about wanting to leave because she knows he
has an illness, but she is increasingly convinced that God is telling her to divorce Tim.

II. Introduction to Psychiatric Diagnosis

A. Welch “Psychiatric problems . . . are in a different class from traditional medical
diseases. With most medical diseases, you can actually see what is wrong. For example,
you can see a brain tumor on a CT scan, you can see the tangled neurons of Alzheimer's
disease, and you can see the damage to the brain caused by a violent accident. Each of
these conditions is clearly distinguishable from normal brains. But brain function in
psychiatric problems shows no consistent differences when compared with normal brain
function. Further research may reveal differences in the future, but at this time, there is no
such thing as a consistent, verifiable chemical imbalance or neuroanatomical abnormality
among the psychiatric diagnoses. Blood tests and brain scans are not even used in making
a psychiatric diagnosis.”1
1. A 2018 study, entitled “Epidemiology and risk factors for bipolar disorder,”
begins by stating, “Bipolar disorder is a multifactorial illness with uncertain
aetiology.” Aetiology means the cause, set of causes, or manner of causation of
a disease or condition. They go on to say, “. . . while some genetic and
environmental factors have strong evidence supporting their association with
2. The criteria typically used to make this diagnosis is “. . . episodes of severe
mood disturbances . . . and disturbances in functioning.”2
B. Welch “The myth is that psychiatric problems are strictly medical. Yet the reality is that
many psychiatric problems are both physical and spiritual problems, others are
thoroughly spiritual, and all of them point to difficult and sometimes painful experiences
that need biblical ministry.”3
C. What about psychiatric medications?
1. Welch “. . . medication can alleviate some symptoms in some people. On this
there is no doubt.” He goes on to say, “What exactly does medication help?
Medication cannot change the heart: it cannot remove our tendency toward sin,
it cannot revive our faith, and it cannot make us obedient to Christ. It can,
however, alleviate some of the physical symptoms associated with some
psychiatric problems.”4

1
Edward Welch, Blame It on the Brain? Distinguishing Chemical Imbalances, Brain Disorders, and Disobedience,
105-106.
2
Tobias Rowland & Steven Marwaha, (2018). Epidemiology and risk factors for bipolar disorder. Therapeutic
advances in psychopharmacology, 8(9), 251–269. https://doi.org/10.1177/2045125318769235
3
Edward Welch, Blame It on the Brain? Distinguishing Chemical Imbalances, Brain Disorders, and Disobedience,
107.
4
Edward Welch, Blame It on the Brain? Distinguishing Chemical Imbalances, Brain Disorders, and Disobedience,
108-109.

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 ACBC Counseling - Question 20

2. Welch “Psychiatric medication is not treating a verifiable chemical imbalance

in the brain. Contrary to public perception, psychiatric medications are not
chemical bullets that target one particular brain chemical. They are more like
chemical blitzkriegs, strafing chemical sites in the brain and hoping for the
best.”5
3. Welch “If you poll people in the church, you will find a spectrum of opinions
on psychiatric medications. Some will say it is from the Devil, some will say it
is the answer, and some don’t care. A more moderate opinion is that, although
it is not wrong to take these medications, they are rarely our first line of attack
against personal suffering. Instead, we should first consider that God can bless
us through our suffering, and we might also weigh the possibility that
psychiatric medications could numb us to the refining benefits of suffering.”6
III. The Importance of Your Worldview
A. A worldview is just that, the way someone views the world. It is essentially a scaffolding-
type framework consisting of your morals, beliefs, and values that is used to view
anything and everything you see in the world. It’s a sort of lens that you view everything
through, allowing you to see everything in a certain light. It will include biases and
personal preferences. It can be modified and adapted overtime or if new information is
presented.
1. As born-again believers, and especially as biblical counselors, we should work
to develop a biblical worldview built upon the framework of ideas, beliefs,
morals, and principles that are found within the Scriptures. The Scriptures
should be the ultimate authority over our worldview. Whenever we look at an
issue or problem in counseling, it should be from the biblical worldview.
2. Higbee “A large part of good counseling is helping counselees see that at the
root of all psychological problems are theological errors. No one can have a
proper view of self without a proper view of God.”7
3. Adams “There is another evil which stems from the Medical Model. Disease
and sickness are often mysterious, especially to the layman. Disease comes
from without and serious illness must be cured from without-by another-the
expert. The sick person feels helpless, and so turns to the physician. The
physician, like the disease which invaded the patient, solves the problem from
without. Thus again, personal helplessness, hopelessness and irresponsibility
are the natural results of the Medical Model. If a person’s problems in living
are basically problems of disease and sickness rather than problems of
behavior, he has no hope unless there is medicine or therapy which can be
applied in such trouble, they move from despair to deeper despair.”8

5
Edward Welch, Blame It on the Brain? Distinguishing Chemical Imbalances, Brain Disorders, and Disobedience,
109-110.
6
Edward Welch, Blame It on the Brain? Distinguishing Chemical Imbalances, Brain Disorders, and Disobedience,
110.
7
Garrett Higbee, “‘Tony’ and Bipolar Disorder,” Counseling the Hard Cases: True Stories Illustrating the
Sufficiency of God’s Resources in Scripture, 179.
8
Jay Adams, Competent to Counsel: Introduction to Nouthetic Counseling, 7.

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 ACBC Counseling - Question 20

B. The ‘Secular’ worldview vs. the ‘Biblical’ worldview

1. In this case study, Tim’s position is consistent with a secular worldview. Tim
has accepted that he has a disease that is causing all his outbursts of anger and
loss of control. He has been on medication, hoping that it would address these
behaviors, but was discouraged, like Emily, when the medications failed to
affect his behaviors. His behaviors have even gotten worse.
a. From the ‘secular’ worldview, he suffers from bipolar disorder. He has a
disease that is causing him to exhibit extreme behaviors that are
damaging to him and his relationship with his wife. This is a life-long
disease that can hopefully be treated with medication, but total
restoration or recovery from this psychiatric disorder is not likely, as it is
a life-long disease. Managing the symptoms with pharmaceuticals and
therapy is the only realistic course of action.
2. Let’s look at these same behaviors from a biblical worldview. Tim regularly
loses it and has arguments with his wife that result in screaming, kicking, and
throwing items. His behaviors have escalated recently, and he has even tried to
hurt Emily in this last incident. This situation seems to be trending in the
wrong direction, in a downward spiral bent on the destruction of their marriage.
a. Based on the background data, we can make the following statements
about this counseling case from a biblical worldview.
1) It appears that Tim is not living for the Lord as evidenced by his
works (Matt 7:16).
2) His regular sinful behaviors indicate that he lacks several fruits
of the Spirit, namely, peace, patience, kindness, gentleness, and
self-control (Gal 5:22-23).
3) The sinful anger that he regularly exhibits shows that he is
selfish (Phil 2:4), lacks self-control and discipline, and foolishly
exhibits outbursts of anger (Prov 14:29; 29:11).
4) There is a significant amount of work to be done regarding self-
denial and putting off sinful actions and putting on righteous
ones (Eph 4:17-32).
5) But before any of this can be accomplished, he must sincerely
put his faith in Christ for salvation, acknowledge his wrongdoing
and responsibility for his sinful actions, confess his sins against
God and his wife, repent of them, and put on the righteousness of
Christ.
b. Tim certainly does have a lifelong ‘disease’ that he is struggling with,
and that ‘disease’ is the enemy within, his sinful nature, his sinful flesh.

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ACBC Counseling - Question 20

1) Romans 7:15-24 For I do not understand my own actions. For I

do not do what I want, but I do the very thing I hate. Now if I do
what I do not want, I agree with the law, that it is good. So now
it is no longer I who do it, but sin that dwells within me. For I
know that nothing good dwells in me, that is, in my flesh. For I
have the desire to do what is right, but not the ability to carry it
out. For I do not do the good I want, but the evil I do not want is
what I keep on doing. Now if I do what I do not want, it is no
longer I who do it, but sin that dwells within me. So I find it to be
a law that when I want to do right, evil lies close at hand. For I
delight in the law of God, in my inner being, but I see in my
members another law waging war against the law of my mind
and making me captive to the law of sin that dwells in my
members. Wretched man that I am! Who will deliver me from
this body of death?
i. Lundgaard “We can also think of law in the way we
speak of ‘laws of nature.’ Gravity, for example, is a law
that bends things in its direction. It perfectly conforms us
to its ‘commands.’ Gravity is not a law as an idea or an
outward precept, but a force that can make objects
‘obey’ its ‘will.’ In this sense every urge and inclination
in us is a law. Hunger is a law, thirst, sexual drive,
fear—each impels us to fulfill its demands, and each
brings a force to bear on us to bow us into submission.
Indwelling sin works like this—enticing, threatening,
even bullying. So Paul calls it a law to get us to see that
it is powerful even in the lives of believers and that it
constantly works to press us into its evil mold.”
2) Christians and biblical counselors sometimes tend to deny or
minimize psychiatric disorders, instead, focusing solely on their
sinful nature as a cause of their problems. Conversely, the
secular world typically ignores the sinful flesh, solely focusing
on a psychiatric disorder. As biblical counselors, we must be
careful not to fall into either ditch. Since we believe in the
dichotomy of man, that he is made up of both body and soul, it
seems consistent with Scripture that sin affects both body and
soul.
i. As Christians, we can see how sin has dramatically
affected the spiritual life of mankind, enslaving it and
ushering in spiritual death. As we look around, we can
also see how sin has dramatically affected the physical
life of man, bringing sickness, disease, and physical
death.
ii. Romans 5:12 Therefore, just as sin came into the world
through one man, and death through sin, and so death
spread to all men because all sinned.

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3) Our physical bodies are so depraved that it is reasonable to

assume that we can suffer from physical ailments that can
dramatically impact our thoughts, words, and deeds.
C. Summary
1. Tim believes his recent psychiatric diagnosis is a life-long disease and is to
blame for his behavior towards his wife. Is he right?
a. Tim may be suffering from a disease process, but the evidence is simply
unclear. The behaviors that have led to Tim’s diagnosis of bipolar
disorder are also consistent with someone who has allowed his sinful
flesh to run his decision-making process. He appears to lack self-control,
a fruit of the Spirit (Gal 5:22-23), and lacks a renewal of the spirit of the
mind (Eph 4:22-24).
b. Tim has a sinful flesh that continually and persistently urges him to sin.
Whether he is saved or not, he will suffer from that “condition” for the
entirety of his life.
2. Can Tim blame his sinful flesh for his sinful behavior toward his wife?
a. Adams “The idea of sickness as the cause of personal problems vitiates
all notions of human responsibility. This is the crux of the matter. People
no longer consider themselves responsible for what they do wrong. The
claim that their problems are allogenic (other-engendered) rather than
autogenic (self-engendered). Instead of assuming personal responsibility
for their behavior, they blame society.”9
1) Ezekiel 18:20 The soul who sins shall die. The son shall not
suffer from the iniquity of the father, nor the father suffers for the
iniquity of the son. The righteousness of the righteous shall be
upon himself, and the wickedness of the wicked shall be upon
himself.
2) Job 1:22 In all this Job did not sin or charge God with wrong.
3) Job 2:10b In all this Job did not sin with his lips.
b. From the biblical worldview, we must conclude that there is no
foundation to blame our circumstances, diseases, illnesses, suffering, or
anything else for our sinful actions. Instead, we must conclude that we
are totally and completely responsible for our sinful actions. The blame
lies squarely on us, the sinner.
1) James 1:2-4 Count it all joy, my brothers, when you meet trials
of various kinds, for you know that the testing of your faith
produces steadfastness. And let steadfastness have its full effect,
that you may be perfect and complete, lacking in nothing.
2) Proverbs 28:13 Whoever conceals his transgressions will not
prosper, but he who confesses and forsakes them will obtain
mercy.

9
Jay Adams, Competent to Counsel: Introduction to Nouthetic Counseling, 6 – 7.

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IV. A Quick Review of Emotions in Biblical Counseling

A. Emotions are defined as the stirring up of someone to a particular action, whether
positive or negative. It’s an “. . . inter-experience that stems from attitudes that stirs you
to a particular action or response.”10
1. “. . . it’s really important to define emotions this way because . . . there’s
almost a mystical approach to emotions. Most people think about emotions as
something that happens to them . . . (but) as we understand this topic biblically,
it’s actually quite the opposite . . . It’s something coming from the inside.”11
B. Unchecked emotions make a terrible engine, but they make a great caboose.
1. When an individual allows their decision-making process to be controlled by
their emotions, serious calamity lies ahead. The idea of listening to the heart for
the answers or doing what is right in your own eyes is strongly discouraged in
Scripture (Jer 17:9; Prov 12:15).
2. Mankind is repeatedly told to exercise self-control, not allowing themselves to
be overwhelmed with emotions (Prov 15:18; 29:11; 25:28; 2 Tim 1:7).
Therefore, we must view our, and our counselees, emotions in the proper
context, as warning lights on the dashboard showing you that something is
wrong, it’s not going well, or it needs attention.
3. Then, after sincerely seeking the Scriptures for guidance, we can make a
decision, develop a plan, or renew our thinking with biblical principles, and our
feelings will have been the catalyst that affected biblical change in our life
(Prov 1:2-7; Prov 3:5-6). Once you’ve allowed biblical principles to run your
decision-making process, revisit your emotions. Like a caboose, they follow
the engine, and like a warning light, they indicate how things are going.
a. Proverbs 12:15 The way of a fool is right in his own eyes, but a wise
man listens to advice.
b. Proverbs 29:11 A fool gives full vent to his spirit, but a wise man quietly
holds it back.
c. Proverbs 15:18 A hot-tempered man stirs up strife, but he who is slow to
anger quiets contention.
d. 2 Timothy 1:7 For God gave us a spirit not of fear but of power and
love and self-control.
e. Proverbs 25:28 A man without self-control is like a city broken into and
left without walls.

10
Samuel Stephens & Nicolas Ellen, Emotions as Vital Indicators, from the Podcast "Truth in Love 301" delivered
on March 8, 2021. Available at: https://biblicalcounseling.com/resource-library/podcast-episodes/emotions-as-vital-
indicators/
11
Samuel Stephens & Nicolas Ellen, Emotions as Vital Indicators, from the Podcast "Truth in Love 301" delivered
on March 8, 2021. Available at: https://biblicalcounseling.com/resource-library/podcast-episodes/emotions-as-vital-
indicators/

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 ACBC Counseling - Question 20

V. Acknowledging Personal Responsibility for Sin

A. When we look at the issue of sin with regard to an individual from a biblical perspective,
we must conclude that sinfulness or a sin nature entered the human race through Adam,
and has affected everyone of natural birth since the fall of man.
1. 1689 Baptist Confession of Faith “All actual transgressions arise from this first
corruption. By it we are thoroughly biased against, and disabled and
antagonistic toward all that is good, and we are completely inclined toward all
that is evil.”12
2. Romans 5:12 Therefore, just as sin came into the world through one man, and
death through sin, and so death spread to all men because all men sinned—
B. Although we are all descendants of Adam, and have inherited a sin nature, we have also
personally sinned. Therefore, even if we were somehow not responsible for the sin nature
that we inherited, which we are, we are still responsible for the sins that we have
personally committed. Our sinfulness will continue even after being regenerated and last
until we receive our glorified bodies.
1. 1689 Baptist Confession of Faith “During this life, this corruption of nature
remains in those who are regenerated. Even though it is pardoned and put to
death through Christ, yet both this corruption of nature and all actions arising
from it are truly and actually sin.”13
2. Romans 3:23 for all have sinned and fall short of the glory of God,
3. Romans 3:10-18 as it is written: “None is righteous, no, not one; no one
understands; no one seeks for God. All have turned aside; together they have
become worthless; no one does good, not even one. Their throat is an open
grave; they use their tongues to deceive. The venom of asps is under their lips.
Their mouth is full of curses and bitterness. Their feet are swift to shed blood;
in their paths are ruin and misery, and the way of peace they have not known.
There is no fear of God before their eyes.”
C. What’s the problem with blame shifting your responsibility over your sin?
1. It robs any hope of having victory of that sin issue. If you are not responsible
for your own actions, what hope do you have for overcoming them?
2. It denies your ability to confess and repent from your sin.
3. It goes against the Scriptures, effectively declaring that God is a liar.
a. 1 John 1:8-10 If we say we have no sin, we deceive ourselves, and the
truth is not in us. If we confess our sins, he is faithful and just to forgive
us our sins and to cleanse us from all unrighteousness. If we say we have
not sinned, we make him a liar, and his word is not in us.
D. The truth is that we are absolutely responsible for our own sins and our sinfulness.
Regardless of the situation or the people around us, we are ultimately responsible for the
sins we commit. We are responsible for the way we respond to any given situation.

12
The 1689 Baptist Confession of Faith, Chapter 6: The Fall of Mankind, and Sin and Its Punishment, Paragraph 4.
13
The 1689 Baptist Confession of Faith, Chapter 6: The Fall of Mankind, and Sin and Its Punishment, Paragraph 5.

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 ACBC Counseling - Question 20

1. 1 Corinthians 10:13 No temptation has overtaken you that is not common to

man. God is faithful, and he will not let you be tempted beyond your ability, but
with the temptation he will provide the way of escape, that you may be able to
endure it.
E. Taking personal responsibility for your personal sins and sinfulness is essential for
repentance, but it is also a sign of a true believer. A lack of repentance and a denial of
personal responsibility indicates an immature and ignorant believer. We are continually
reminded in the Scriptures to acknowledge our sinfulness, repent and reject that manner
of life, and to put on righteousness.
1. Matthew 7:3-5 Why do you see the speck that is in your brother’s eye, but do
not notice the log that is in your own eye? Or how can you say to your brother,
‘Let me take the speck out of your eye,’ when there is the log in your own eye?
You hypocrite, first take the log out of your own eye, and then you will see
clearly to take the speck out of your brother’s eye.
2. 2 Corinthians 5:9-10 So whether we are at home or away, we make it our aim
to please him. For we must all appear before the judgement seat of Christ, so
that each one may receive what is due for what he has done in the body,
whether good or evil.
3. Galatians 6:7-8 Do not be deceived: God is not mocked, for whatever one
sows, that will he also reap. For the one who sows to his own flesh will from
the flesh reap corruption, but the one who sows to the Spirit will from the Spirit
reap eternal life.
VI. The Importance of Self-Control
A. The relationship between personal responsibility and self-control is not difficult to see. If
someone is able to deny or blame shift the responsibility for his own actions, then there is
no need for self-control. What exactly would he be controlling himself from? He didn’t
do anything wrong, right? The truth is that we must objectively look at ourselves through
the biblical worldview, acknowledge our personal responsibility for our own actions, and
accept our desperate need for self-control.
1. Galatians 5:16-25 But I say, walk by the Spirit, and you will not gratify the
desires of the flesh. For the desires of the flesh are against the Spirit, and the
desires of the Spirit are against the flesh, for these are opposed to each other,
to keep you from doing the things you want to do. But if you are led by the
Spirit, you are not under the law. Now the works of the flesh are evident:
sexual immorality, impurity, sensuality, idolatry, sorcery, enmity, strife,
jealousy, fits of anger, rivalries, dissensions, divisions, envy, drunkenness,
orgies, and things like these. I warn you, as I warned you before, that those
who do such things will not inherit the kingdom of God. But the fruit of the
Spirit is love, joy, peace, patience, kindness, goodness, faithfulness, gentleness,
self-control; against such things there is no law. And those who belong to
Christ Jesus have crucified the flesh with its passions and desires. If we live by
the Spirit, let us also keep in step with the Spirit.

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 ACBC Counseling - Question 20

2. 2 Peter 1:3-10 His divine power has granted to us all things that pertain to life
and godliness, through the knowledge of him who called us to his own glory
and excellence, by which he has granted to us his precious and very great
promises, so that through them you may become partakers of the divine nature,
having escaped from the corruption that is in the world because of sinful
desire. For this very reason, make every effort to supplement your faith with
virtue, and virtue with knowledge, and knowledge with self-control, and self-
control with steadfastness, and steadfastness with godliness, and godliness
with brotherly affection, and brotherly affection with love. For if these qualities
are yours and are increasing, they keep you from being ineffective or unfruitful
in the knowledge of our Lord Jesus Christ. For whoever lacks these qualities is
so nearsighted that he is blind, having forgotten that he was cleansed from his
former sins. Therefore, brothers, be all the more diligent to confirm your
calling and election, for if you practice these qualities you will never fall.
3. Brad Hambrick “This side of heaven, the desires of the self, if left unrestrained
and prioritized, lead to destruction instead of flourishing. If we say ‘yes’ to
everything that we want, life does not go well. The ability to tell oneself ‘no’ is
a virtue that leads to flourishing.”14
4. Hambrick “. . . we cannot abdicate our role in self-control. Self-control is not
heavenly mind-control, as if our will were absent from the equation. What is
being empowered is the ‘new self’ to rule over the ‘old self’ (Eph 4:22-24).
The Spirit empowers the redeemed self to defeat the fallen self, but the Spirit
does not allow the redeemed self to be passive in the fight.”15
a. Proverbs 25:28 A man without self-control is like a city broken into and
left without walls.
b. 1 Corinthians 9:24-27 Do you not know that in a race all the runners
run, but only one receives the prize? So run that you may obtain it. Every
athlete exercises self-control in all things. They do it to receive a
perishable wreath, but we an imperishable. So I do not run aimlessly; I
do not box as one beating the air. But I discipline my body and keep it
under control, lest after preaching to others I myself should be
disqualified.

14
Brad Hambrick, SELF-Control as a Fruit of the SPIRIT and Implications, Biblical Counseling Coalition (17 Dec
2018). Available at: https://www.biblicalcounselingcoalition.org/2018/12/17/self-control-as-a-fruit-of-the-spirit-and-
implications/
15
Brad Hambrick, SELF-Control as a Fruit of the SPIRIT and Implications, Biblical Counseling Coalition (17 Dec
2018). Available at: https://www.biblicalcounselingcoalition.org/2018/12/17/self-control-as-a-fruit-of-the-spirit-and-
implications/

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 ACBC Counseling - Question 20

VII. Summary
A. How do you write this question?
1. ACBC is asking for a word-for-word response Tim’s comment that he believes
his diagnosis of bi-polar disorder is (1) a life-long disease and (2) to blame for
his sinful behavior toward his wife. We are to include the themes of biblical
responsibility and self-control in our response.
2. The majority of psychiatric diagnosis, such as bi-polar, are established on the
subjective analysis of a provider and not on empirical objective data. It’s quite
likely that a diagnosis of bi-polar disorder may actually be established on
habitual sinful behaviors, and not on an organic cause.
a. As Biblical Counselors, we must remember the dichotomy of man, that
man is made of both body and soul, and that sin has affected both. Do
not underestimate the depravity of the flesh. Just because we do not have
an empirical test for bi-polar disorder, we must respect the fact that it
may be possible that it does have an organic cause.
b. Since we cannot confirm an organic cause, nor rule one out, we must
focus our efforts on the spiritual side of our counselee and be willing to
work alongside a physician on the physical side.
3. In love and a spirit of gentleness, we must confront the fact that Tim is denying
his personal responsibility for his sinfulness toward his wife, and blaming his
sinful behaviors on his bi-polar diagnosis. We need to remind Tim that until he
is willing and able to acknowledge his sinfulness, he will not be able to have
victory this issue.
a. Once Tim is able to acknowledge his sinfulness, he can confess his sins it
to God and to his wife, repent, seek forgiveness, and be reconciled.
b. Through the Spirit and by a renewal of the Spirit of his mind, Tim can
begin denying his sinful flesh, exercising self-control, and begin putting
on righteousness. The goal is to bring Tim to a place in which he says
earnestly, from his heart, “So whether I are at home or away, I make it
my aim to please him” (2 Cor 5:9).
VIII. Suggested Reading
A. Edward Welch, Blame It on the Brain? Distinguishing Chemical Imbalances, Brain
Disorders, and Disobedience.
B. Jay Adams, Competent to Counsel: Introduction to Nouthetic Counseling.
C. Garrett Higbee, “‘Tony’ and Bipolar Disorder,” Counseling the Hard Cases: True
Stories Illustrating the Sufficiency of God’s Resources in Scripture.

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