I can remember sitting in church as a young teenager as my pastor posed a question about the possible links between demon possession and mental illness. His brother-in-law was a board certified psychiatrist and a professing Christian, which lead him to pose the following question: “What if I told you I was counseling someone who spoke in multiple different voices, was violent, prone to hurting others, and disposed to harming others? How would you diagnose such a person?” His brother-in-law responded along the following lines: “Not being able to examine the patient first hand, my arm-chair diagnosis would lead me to believe that he was perhaps suffering from dissociative identity order or perhaps some sort of psychosis.” My pastor asked him a probing and legitimate question, namely, “Why not demon possession? After all, I just described the behavior of the demoniac at the tomb of the Gerasenes and the text clearly states that he was demon possessed” (Luke 8:26-39). My pastor’s question raised some important issues vis-à-vis how we diagnose and therefore treat certain ailments. Do we treat all mental health issues as matters pertaining to sin or is there a legitimate place for medical science? I desire to address these questions as a pastor, not as an expert in either demon possession or psychiatric medicine. What does the Bible have to say on these issues?
We live in the wake of modern assumptions about the Bible and after the famous “demythologizing” program of biblical scholars such as Rudolf Bultmann. Bultmann once asked how people who use electricity, drive cars, and know of the wonders of modern medicine still believe in a three-tiered world (heaven, earth, and hell) inhabited by demons and angels? He sought, therefore, to remove the “mythical” elements in the New Testament and boil its message to its purest form—a message that would could be embraced by moderns. On the other hand, there are God-fearing, Bible-believing, well-intended Christians who approach psychiatry with a degree of skepticism given the propensity for doctors to take common moral problems, provide a fancy label, and then excuse immoral conduct as a disease. Criminals are no longer guilty of their crimes but can provide exculpatory reasons for their immoral actions. Recall the recent case where a teenager was placed on ten years of probation for four counts of vehicular manslaughter even though his blood-alcohol count was three times the legal limit. “Expert” testimony for the defense claimed that the boy suffered from affluenza, a psychological state where a person is unable to possess a sense of right or wrong because of profound wealth. Both extremes fail to approach the question of the possible relationship between demon possession and mental illness with care, nuance, and especially wisdom. Liberal theologians too quickly dismisses the reality of the demonic on the basis of preconceived prejudices about the Bible’s claims (down on the farm it’s called, disbelief), and the well-intended Christian fails to recognize that all physical problems are not immediately related to sin.
We must first recognize the reality of the demonic. The Bible is clear about this. All you have to do is read the gospel accounts of Christ’s numerous encounters with demons (e.g., Matt. 4:22, 24; 7:22; 8:16, 31; 9:33-34; 10:8; 12:24ff; 15:22; 17:18). Moreover, a cursory survey of these passages reveals that demon-possession is real. But on the other hand, these same passages inform us that Jesus not only cast out demons from those who were possessed, but that he healed “the sick, those afflicted with various diseases and pains, those oppressed by demons, epileptics, and paralytics” (Matt. 4:24). In other words, there were those with numerous afflictions, both spiritual and physical. Take for instance the fact that Matthew records that Christ healed epileptics but in addition healed those who were demon possessed. These were, according to Matthew’s account, two different classes of people in need of healing. By way of contrast, there were those who were demon-possessed who were gripped by epileptic-like seizures (e.g., Mark 9:18). This is to say, not all epileptics were demon-possessed and not all demon-possessed people were epileptics. The Scriptures appear to recognize the fact that some epileptics suffered from a medical condition (Matt. 4:24), while others suffered from a spiritual malady (i.e., demon possession, Matt. 17:14-18). This distinction has important pastoral implications.
First, like a good doctor, a pastor must properly diagnose his counselee. Are there any indicators, for example, that reveal that the person dabbles in the occult? Do they spend great amounts of time engaged in immorality of any sort? That is, do they imbibe from evil practices that might expose them to the demonic? Are they engaged in idolatry of any sort? This might be an indicator that demon-possession is a factor.
Second, is the person a Christian? I do not believe that a Christian can be demon-possessed because the “house,” so to speak, of the person can only have one of three conditions: inhabited by demons, uninhabited, or inhabited by the Spirit of the living God. If a person is a genuine believer inhabited by the Spirit of God, they might dabble with the demonic, but demon possession is not possible. Paul rebuked the Corinthians, for example, for partaking of food sacrificed to idols, which was a form of demon-worship (1 Cor. 10:21). But these Christians were not demon-possessed. One of the points the gospels make is that with the arrival of the king, namely Jesus, comes the arrival of the kingdom. And if the king and his kingdom are here, then he casts out every offending thing, especially the unwelcome demons. Believers are indwelled by the Holy Spirit and constitute the new Holy of holies—a sanctified place unsuited for demons.
Third, is it possible that the person you are counseling is suffering from a medical ailment? While we are all sinners and therefore subject to the effects of the fall, guilt, spiritual pollution, and even death itself, not all medical ailments, even those of the mind, are connected to demon possession. I once suffered from migraines, insomnia, fatigue, irritability, and aching joints, among other symptoms. I was firmly convinced that I was suffering from a spiritual malady—that I failed to trust Christ in the midst of some trying circumstances. I thought my mouth was saying I trusted Christ in the midst of the trial but my body was calling me a liar. My wife, on the other hand, was not equally convinced and encouraged me to see my doctor. Long story short—I needed surgery because of a medical issue. I had the surgery and my symptoms disappeared virtually over night. Not all physical problems are related to sin.
These three questions are by no means exhaustive but they do touch upon chief points that you should explore as you seek to determine the source of a person’s problem. We need to have a high regard for the Scriptures and not be afraid to identify sin when we see it, whether in ourselves or in others. But we should also have a high regard for the good gifts that God has given in the creation of humanity, such as mathematics, science, literature, and even medicine. Psychiatry is a medical science, one devoted to the study, diagnosis, and treatment of the human mind, one of the most fascinating organs in the human body. We should not be too quick to dismiss the diagnosis of a medical physician, especially if we are not trained in medicine ourselves
In the end, we must look to Christ to give us wisdom when to dispense medicine from a pharmacy and when to dispense the medicine of the gospel. Pray that Christ would give you this much needed wisdom until we will all be delivered from every form of suffering and sin when on the last day we behold the face of God in the face of Christ and he wipes away every tear.