This Demon Only Comes Out By Prayer and Prozac

Matthew Loftus is a family doctor who lives with his wife Maggie and his daughter Naomi in Baltimore , where they are blessed to be a part of New Song Community Church. He aspires to finish his novel and to teach medicine overseas. You may follow him on Twitter @matthew_loftus if you’d like.

“It’s a chemical imbalance.”

You may have heard or said those words before in reference to mental illness. I have done both myself a number of times in my practice as a primary care doctor. One good example of opening the conversation about them can be found here from Ed Stetzer; one of Stetzer’s explicit goals is to decrease shame and stigma against mental illness by locating the pathology of mental illness in neurobiology and then asserting the need for medication to rectify the dysfunctional biology. As Christians across the world grapple with the modern understanding of mental illness, it is helpful to not only understand what these imbalances are and how medication might address them, but also to challenge a point of view that reduces mental illness to a mere malfunction of biology.

The impetus behind the use of the words “chemical imbalance” is good. After all, confining mental illness solely to the untouchable realm of feelings and thoughts is not only ignorant of biology, but also of orthodox anthropology. Furthermore, such a harsh dichotomy happens to be extraordinarily ineffective in the lives of most sufferers of mental illness. You may or may not have heard of an excellent book that sought to make clear the theological importance of our physical bodies; affirming that deficiencies or excesses of certain chemicals in our brains play a role in mental illness is an important step in the process of rightly treating our bodies as part of the created order. In turn, the judicious use of other chemicals to rein in the torment and harm caused by mental illness is as much a part of using our God-given power to exercise dominion over the earth as is carefully using pesticides on our crops so that more people can eat.

However, saying “you’ve got a chemical imbalance” does not go far enough and, paradoxically, can often take us too far in the wrong direction.

Assigning mental illness solely to such imbalances is inadequate firstly because it underappreciates the complexity of neurobiology. For example, we know very well that people with depression have lower serotonin levels (most potently demonstrated in studying the brains of those who have committed suicide.) Selective serotonin reuptake inhibitors (SSRIs) such as Prozac or Zoloft raise serotonin levels in the brain. However, while many of the measurable effects of SSRIs on neurons can be seen within hours of first taking the drug, the effects of these medications are rarely appreciated until at least 4 to 6 weeks, making it far from clear that raising one’s low serotonin levels is their sole useful effect. Furthermore, the fact that any of these medicines has roughly a 30-40% chance of working in isolation on the first try is evidence that any “imbalances” we discuss are less like our car’s windshield wiper fluid and more like our food’s soil. When dealing with even more complex illnesses like bipolar disorder (which responds to a wide range of medications that are also effective for epilepsy) or schizophrenia (which involves a greater variety of neurochemical pathways), it is clear that the language of “chemical imbalance” is simply a starting point.

Secondly, while it is obvious that there are many aspects of brain biochemistry that we cannot consciously control, there are many others that we can. The choices we make shape our physical bodies– including our brain structure and genes. This is most apparent in the cycle of addiction, wherein an addict’s brain is often demonstrably altered to have a minimal response to normal pleasurable stimuli and to require greater and greater doses of the drug of choice to not feel agonizing withdrawal. However, as we learn more about the bodies that God has given us, we see that chronic stress and traumatic events (often caused by the sin of others) can shape the brains of children with immature decision-making ability in ways that last for a lifetime. Thus, there is a reciprocal relationship between our environment, our bodies, and our feelings. Both our moods and our decision-making abilities are shaped by constant internal decisions and external stimuli.

The most potent example of this principle is the case of a sexually abused child who overeats not only to soothe the excess quantities of stress hormones that may or may not be predisposing them to depression later in life, but also to appear less attractive to their abuser. Even without immediately jumping to the conclusion insisting that the government must do something (as part 3 of the article linked above does), it is clear that we must jettison any simplistic understanding of the complex interaction between brain and body as a matter of individuals choosing to either sinfully wallow in mental illness or righteously embrace freedom in Christ. Similarly, we must also not succumb to a materialistic view that defines people stuck in mental illness solely as victims of circumstance.

We go too far in the wrong direction in this manner when our appreciation for the power of pharmacology to help guide our brain chemistry into a more ordered pattern becomes a helpless veneration of medicine. I have seen this, too, in my practice– patients who have been trained to believe that their own efforts to calm their nerves or pay attention are useless when compared to the power of Xanax or Adderall. The danger of these medications is that they are powerful enough to abrogate our efforts; as prescriptions for these (and similar) medications continue to dominate the market in a way that disquiets many clinicians, a sense of restraint and discipline is necessary for all parties involved.

Health is a discipline. The bodies that God has given us require care and attention to maintain in a way that fits the pattern he established for our being; while our appetites can sometimes be helpful guides to our needs, they are often magnified or minimized by sin in such a way to lead us astray. Whether we are choosing certain foods, actively exercising, or avoiding other substances, our health requires active management and control.

These individual choices are also clearly shaped by our environment, from the simple unavailability of fresh vegetables in certain neighborhoods to the more complex changes caused by chronic stress described above. Disciplines, while individually practiced, are shaped by the communities that we live in and the values we collectively affirm. Wendell Berry points out that “autonomy” is a false cure for our modern ills, saying, “Healing is impossible in loneliness; it is the opposite of loneliness.” When we do not pay heed to the disciplines– either individual or environmental– that shape our health, the breakdown of our bodies is attended by the breakdown of our minds and spirits.

In regards to mental health, it is often said that “food is the most overused antidepressant and exercise is the most underused antianxiety medication.” A variety of well-designed studies have borne out the efficacy of behavioral interventions for a variety of mental illnesses, demonstrating that our power over mental illness is not limited to pharmacology. That said, anyone who has ever seen a loved one struggle to take medication for mental illness can see that even the act of using pharmacology’s power (and bearing its side effects) is itself a discipline. Even more telling are the studies that show that some of the sickest people who burden emergency rooms with repeated visits see great improvements in their physical and mental health when they are brought into closer personal contact with caring people and housed.

Talk of health as a discipline or health choices as being shaped by culture brings to mind the issue of personal responsibility, which is a useful rallying cry for helping oneself feel less perturbed about the suffering of others, but by definition cannot be embraced as a corporate policy. Personal responsibility is clearly a component of discipline, but it is not the only one. For those who are struggling with mental illness, it is imperative they are approached first as persons with dignity whose ability to make rational decisions and take responsibility has been impaired– whether by themselves, by another, or by the happenstance of neurobiolog. Once this relationship of trust and respect is established, we can walk with them through both the personal and professional interventions necessary to learn or rediscover the skills that attend to personal responsibility.

Similarly, shame can be useful; the things that people with mental illness say and do when swayed by the winds of their depression or mania are often a powerful motivator to change their behavior when they feel ashamed of them. While we want to rightly eradicate the effects of shame that keep people from seeking help and being honest, it is possible to strain out a gnat and swallow a camel if we take the language of “chemical imbalances” too far and put personal responsibility out of reach for those who suffer from mental illness.

In the end, both the people who wish to eradicate shame from mental illness and those who wish to use it as a hammer for every health-related nail they see will find themselves in conflict with a holistic worldview that embraces the continuity between physical existence, knowledge, indiscernably complex emotions, and meaningful spirituality. The bodies that God created us with are prone to the corruption of sin in ways that science can both illuminate, abet, or help to heal– but only if we can appreciate the full complement of healing means that He has given us.

Mere Fidelity: What Adoption Is and Isn’t

Today, the folks of Mere Fidelity tackle adoption. We’re drawing on the following text from Oliver O’Donovan’s Begotten or Made:

Adoption is not procreation, and does not fulfil the procreative good of marriage. It is a charitable vocation indicated to childless copules by the personal tragedy of their deprivation in this area. And although it may richly compensate for the sorrow and satisfy the desire to nurture and educate children, it is still a substitute for procreation rather than a form of procreation. This is not to belittle or demean the adoptive relationship. Indeed, it might be said to praise it on altogether a higher level, inasmuch as it points beyond the natural goods of marriage to the supernatural good of charity. But adoption cannot be taken as a precedent for interpreting procreation as a simple enterprise of the will. (page 40)

The iTunes feed is here, if you’d like to subscribe (thanks to everyone who has reviewed us so kindly) and an RSS feed for the show lives here.

Special thanks to MK Creative Arts for the audio editing.

Finally, as always, follow Derek and Alastair for more tweet-sized thoughts.

“Glitter Grenade: a review of Aaron Belz’s Glitter Bomb”

(Reviewer’s note: I don’t know much about Aaron or about poetry. You can click here for samples and a quick check on Aaron’s background. Or you could go to Costco, then hire a licensed private investigator. Just depends on what kind of samples and background check you want.)

 

One book of poetry, two days of pleasure (mixed with confusion) for the reader.

The author rarely swings and misses at that third strike. Never metaphor at a five-‘n’-dime

he couldn’t flip to readers and leave ‘em at sixes and sevens.

 

Does

blank verse shoot lead or

blanks? Does this poetry earn

blank stares?

Does Glitter Bomb? Answer left

blank. (For an atom-split second, just wait.)

Was the bomb dropped? Diffused? Answer right

now: all the Belz, most of the whistles. Almost all flowers, just a few thistles.

Do not ask for whom the Belz beguiles. His toll fare is fair, for his free verse brings smiles.

 

In some, low overhead, genius-saturated. In 1/2 of 1/2, my crazy culture much-exegeted.

In sum: 1/2 genius, 1/2 cultural saturation craziness that’s over my lowly head. (Epexegetical much?)

 

The first poem feels like a second chance, rising on the third day, sallying forth, a ship’s captain—my captain—and a fifth of gin.

Can intoxicated poems deep-six the seven seas of reader’s regret for my overly prosaic sins? Spoiler alert: yes.

Do the lines lumber, like a rusty Olds eighty-eight?

Spoiler alert: nein

Behold, young poems that glitter. Light and shiny as tin,

ever-new, wise like an elf,

riffing—even rhyming—until the clock Belz strikes twelve.

 

I’m Cinderella, these poems are glass slippers. They once were Lost, these 4 8 15 16 23 42 61 poems and now I am found. Amazingly gracious, and glittery ever after.

 

At least until I return to the Inhumanities to read, idk, Collected Essays or Assays into Collectivism.

 

But while you watch me careening back down my academic cliff,

Spent like a beer at Cheers falling from the cleft chin of Cliff

Note:

some will want CliffsNotes, a treble clef on which to transpose

Belz’s ringing, confusing,

pleasing notes.

But they’re not so much

de-noted as detonated. Not so much

composed as decomposed like fertilizer that fuels the

bomb, man. Just try transposing that.

 

I did, and I’m all blown up, not at all composed.

It’s totes my faults the Glitter earthquake exposed.

 

Jason volleys great riffs from the Great Rift Valley in East Africa. Follow him on Twitter and on Facebook if you dig lepidoptera. His latest book is Imitating God in Christ.

Mere Fidelity: On Divine Accommodation

How does God accommodate himself to us? How do we know when he has accommodated himself to us, or when we are projecting ourselves back on him?  In this episode, we take up what has traditionally been called the doctrine of ‘divine accommodation,’ and consider its limits and its abuses.

Other details worth noting:  the iTunes feed is here (thanks to everyone who has reviewed us so kindly) and an RSS feed for the show lives here.

Finally, as always, follow DerekAlastair, and Andrew for smart thoughts about theology and the world.

3 Thoughts on Kindle Unlimited

Kindle_Paperwhite_3GI have a roundup on Amazon’s latest innovation over at Mere O Notes so if you’re wanting to learn more about Kindle Unlimited, start there.

I. Our Technocratic Libertarianism

While Mark Lilla is basically correct in saying that we live in a libertarian era, that term is not without its problems. (Ross Douthat made this point quite well in a recent blog post.) Despite our libertarian tendencies, we are still creatures bearing the image of God and living in a world as creatures made by that God. So both the essence of our humanity and the nature of our creaturely existence constrains our ability to function as completely autonomous beings. But when you have a society dedicated to such stark libertarianism to the cost of all non-coercive forms of community, this necessarily leaves only the coercive forces of big business and big government as the coherent social bodies able to shape communal life.

Thus we have services like Netflix and now Kindle Unlimited, both of which are premised on giving the user a seemingly infinite amount of choice, yet all of the choices available are defined by the business providing the service. So our experience of the service might seem libertarian because there are so many choices and there’s nothing stopping us from choosing anything on offer.

Yet the choices available to our libertarian will are themselves defined and handed down by the only viable social bodies left to us. We just don’t notice them as much these days because Amazon and Netflix have so completely blended into the fabric of our lives that we seldom look beyond them when looking for a movie or book. This is particularly troubling with Amazon given their current spat with Hachette and their history of questionable behavior regarding Kindle books.  Continue reading

Mere Fidelity: On Marriage and Donated Gametes

This week’s conversation continues through our reading of Oliver O’Donovan’s Begotten or Made? with a conversation about the ways in which the possibility of gamete-donation by third parties to married couples has reshaped our understanding of marriage and its goods.

We take as our launching point this meaty bit from O’Donovan:

“For such a thesis forces the sharpest of dividing lines between the procreative and the relational goods of marriage.  It invites us to think that if the relational good is fulfilled in an exclusive communion of sexual love, then the procreative good may be fulfilled in any way at all, not necessarily by an exclusive communion of procreational power. 

It must follow from this, firstly, that the procreative good of marriage ceases to be the natural fulfillment of the relational good. As I argued in Chapter 2, when procreation is divorced from its context in man-woman relationship, it becomes a project of marriage rather than its intrinsic good; the means to procreation becomes the instrumental means chosen by the will, rather than themselves being of the goods of marriage. 

Correspondingly, sexual union itself is deprived of the features that give it its importance in human affairs. It can no longer be the case that the mingling of life in sexual union is a mingling that has both relational and procreative implications. It is no longer the case that the gift of self in sexual communion is at the same time a gift to the other of the possibility of parenthood. The divine blessing of children is no longer a blessing conferred upon this relational union of bodies with its promise of permanent affection and affinity. Children are now to be given (if the verb is still appropriate) by quite a different route.

It would seem to me that those who insist that [artificial insemination by a donor] should be available only to married couples, do not value the direct contribution of sexual communion to procreation, but only the indirect contribution which it makes by establishing a secure and stable domestic context for a child to grow up in. That is what gives this insistence its slightly ‘moralistic’ flavour. It defends the link between married love and procreation only at the level of social order, while abandoning the underlying conception of that link as part of the ontology of marriage, the conception which originally made that form of social order seem necessary and right.”

Other details worth noting:  the iTunes feed is here (thanks to everyone who has reviewed us so kindly) and an RSS feed for the show lives here.

Finally, as always, follow DerekAlastair, and Andrew for smart thoughts about theology and the world.

Special thanks to Christopher Hutton editing the audio. 

NT Wright and his Reformed Critics

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This week’s show follows up on the conversation about NT Wright and locates him among his Reformed critics.  Who’s right, who’s wrong, and are there paths between that can learn from both?

Various links from topics that came up during the show.

1. N.T. Wright on Penal substitution.
2. Wright’s most recent stand-alone summary article on justification.
3. D.A. Carson’s The Vindication of Imputation on the difference between exegetical and theological levels of discourse.
4. Michael Horton’s Review of Wright’s Justification.
5. Michael Bird’s comparison of John Piper and N.T. Wright.

Other details worth noting:  the iTunes feed is here (thanks to everyone who has reviewed us so kindly) and an RSS feed for the show lives here.

Finally, as always, follow DerekAlastair, and Andrew for smart thoughts about theology and the world.

Special thanks to Christopher Hutton editing the audio. 

 

Mere Fidelity: The Transgender Question

This week’s conversation continues through our reading of Oliver O’Donovan’s Begotten or Made? with a discussion of the questions that have come to the fore in recent weeks about transgender people.

We take the following excerpt from O’Donovan as our way in to the subject.

The sex into which we have been born (assuming that it is physiologically unambiguous) is given to us to be welcomed as a gift of God. The task of psychological maturity–for it is a moral task, and not merely an event which may or may not transpire–involves accepting this gift and learning to love it, even though we may have to acknowledge that it does not come to us without problems.  Our task is to discern the possibilities for personal relationship which are given to us with this biological sex, and to seek to develop them in accordance with our individual vocations.  

Those for whom this task has been comparatively unproblematic (though I suppose that no human being alive has been without some sexual problems) are in no position to pronounce any judgment on those for whom accepting their sex has been a task so difficult that they have fled from it into denial.  No one can say with any confidence what factors have made these pressures so severe.  

Nevertheless, we cannot and must not conceive of physical sexuality as a mere raw material with which we can construct a form of psychosexual self-expression which is determined only by the free impulse of our spirits.  Responsibility in sexual development implies a responsibility to nature–to the ordered good of the bodily form which we have been given. And that implies that we must make the necessary distinction between the good of the bodily form as such and the various problems that it poses to us personally in our individual experience.  This is a comment that applies not only to this very striking and unusually distressing problem, but to a whole range of other sexual problems too. 

My personal apologies for cutting out during part of this quote, and for the clicks during my talking.  That’s totally my fault.

Other details worth noting:  the iTunes feed is here (thanks to everyone who has reviewed us so kindly) and an RSS feed for the show lives here.

Finally, as always, follow DerekAlastair, and Andrew for smart thoughts about theology and the world.

Special thanks to Christopher Hutton editing the audio. 

 

33 Under 33 at Christianity Today: A few quick thoughts

Christianity Today’s new cover story is a list of 33 “young believers who [they] think are leading today’s church in key ways—and who embody what it will look like in the years to come.”  Or, as my good friend Eric Teetsel humorously put it on Twitter, a list of 32 “incredible folks”….and me.

There are, indeed, some fantastic people on the list.  Eric himself has done incredible work taking up the mantle of a new social conservatism and Peter Blair has made Fare Forward  one of the best places in the conservative intellectual pantheon.  I had the good fortune of meeting Brannon McAllister recently, and walked away awed by both his work and his character. Trevin Wax is well known to readers of Mere-O, and Wesley Hill’s unquestionably one of the best writers and most astute theological minds of the younger crop of thinkers.

And those are just the people that I know. The rest seem to be similarly impressive.  You can read the whole thing here today for free.  After that, it goes behind the paywall.

Since I am (somehow) on the list, let me offer a few further thoughts about it.

IMG_2401c

My photo:  Yes, that photo is taken in Oxford.  Yes, I am very lucky.  But what you can’t see on the website is that my shirt is untucked.

Like, one side is sticking out.  I’m serious.  I noticed it when I got home and uploaded the pictures and, frankly, find this particular detail amusing.  And maybe a metaphor for something.  I feel like you, the internets, need to know these things, especially when I show up on a list like this.

My heading:  Just to clarify things, I am not a historian by profession. I just happen to think that history matters and that a core part of my vocation is to function as something of a pointer toward those who not only came before me, but have more depths to offer than I do.  Like Oliver O’Donovan, who is thankfully still living but who models far better than I what a mind saturated in Scripture and tradition looks like.

Gratitude:  It’s neat to have my (mostly underserving) work recognized for this sort of thing.  I try not to put too much weight on these sorts of things, as youth is a fickle thing and the real meaning of my life will not be known until the end of it (and even then, it will only be known to those like my wife who know whether this kind of attention is truly deserved).  But it would be a disservice to those who have formed me if I did not extend the commendation where it properly belongs:  to my parents and family, to the Torrey Honors Institute at Biola who gave me such a great education and who continues to support me, to my many friends and interlocutors who I have learned so much from, and to all of you readers here at Mere-O for sharpening my thoughts along the way.  There’s a “we” that stands behind the “I,” which is never to blame but which invariably sets the conditions for success and so necessarily shares in the reward.

Other thoughts:  Is it too self-serving to commend my two books to you?  I still like ‘em.  I hope you do too.

Also, I got asked a few questions in preparation for the piece about Mere-O and my take on “millennials.”  So for the sake of posterity, here are the answers to those questions.

What’s the inspiration behind Mere Orthodoxy? What do you hope readers take away from the site?

I set up the site a decade ago to carry on in my own way the kind of cheerful, thoughtful, culturally astute observations that made both C.S. Lewis and G.K. Chesterton such important figures in 20th century Christianity.  But I can’t escape a strong self-consciousness about the gap between us and them, which is why one of my main hopes is to always function as something of a signpost for other readers.  There aren’t many people among the living who can think and write with the depth that previous generations of Christians had, so if my only legacy is introducing a few people into that tradition then I’ll be a relatively happy man.

As a writer and a student of Christian ethics, you’re aware of the unique cultural setting today’s Christians find themselves in. What gives you hope about this generation and the future of our faith? 

The ground for hope that I have been able to stand on without hesitation is the promise that Christ will not depart from his church and that the gates of hell shall never prevail against it.  If we step beyond this to evaluate whether we should have hope based on a particular generation’s or society’s qualities, and stay there for too long, we will be prone to overinflate both our virtues and our vices.  If I am cheerful about the future of Christianity, it is only because I am aware that Christianity has been dying in every age….and being reborn in the same, even if not in the same spot.  We have a faith that takes the same shape as our Savior’s life:  It is new in every generation, yet still (and must be) the “same old thing.”  If I am hopeful for my own generation, I am so because the whole business is true–really, deeply, down-to-the-molecules-true, and whether in this lifetime or five hence the truth will always win out.  Many of my peers have demonstrated a heightened desire to inquire into that truth and understand it, and as long as we do so from within the community that has been authorized to proclaim it then our future will be secure.

 

 

 

Mere Fidelity: Surprised by NT Wright

This week, we take up the subject of…N.T. Wright.  Widely regarded as one of the most influential and best New Testament theologians of our day, we consider how best to read him and his impact on Christianity in the English speaking world.

The NT Wright Page is the single best place online for more of his work. You might also consider looking at one of his many books (we mentioned a few in the show).

Mere FidelityAdditionally, this NT Wright interview came up, as did Sarah Over the Moon’s dismayed response to it.  Consider as well Alastair’s examination of Wright’s views on marriage for more.

Other details worth noting:  the iTunes feed is here (thanks to everyone who has reviewed us so kindly) and an RSS feed for the show lives here.

Finally, as always, follow DerekAlastair, and Andrew for smart thoughts about theology and the world.

Special thanks to Christopher Hutton editing the audio.