Recently, a friend of mine from church e-mailed me the following question:
Hey Marie,I thought it was a good question, and quite possibly one which some of you readers are wondering about, as well, so I am posting my entire answer to her below. Anti-depressant medications are routinely prescribed in the treatment of eating disorders, so this is an ethical question related to my ministry. Since writing this reply, I've gotten much deeper into my current course of "Medical Issues in Counseling" and find that I've portrayed the position accurately.
I was wondering if in your NANC training you ever get to the point when you have to encourage someone to stop taking drugs. How do you do that? I know it is probably a long answer but I would love to know!
"Well, first I should clarify that I am not under NANC, but rather INS (Institute for Nouthetic Studies). It's the same exact position, theology & theory, though...but the difference is if you want to get the NANC certification (after completing the INS' 185 hours of coursework), you still have to then take the NANC exam and do your 50 hours of supervised counseling under your local church. I would expect that question then becomes a big one, because so many peeps are on so many meds. (Interestingly, my next course, which should arrive any day now, is Medical Issues - and I am SURE that question will be covered in much more depth!)
From what I understand, a NANC counselor does not/cannot advise a counselee to stop taking her physician prescribed meds. They have to qualify counsel with "I am not a physician", and if you think about it, it would be a HUGE liability risk to come out and tell a counselee to stop taking them. Some actions are described as "painting a big bulls-eye on the door of the church" (lawsuits). Also, as you know yourself, going off psychotropics and SSRI meds cold-turkey can be dangerous; the body grows physically dependent on them. I am honestly not sure if a NANC counselor can even encourage the counselee to "wean" herself off of them, and while it's great if they do, that MUST always be done under a doctor's supervision.
Now, that said, suppose a person were asking the NANC counselor hypothetically about the usefullness of drugs for what is assumed to be a "chemical imbalance". Depression is the usual issue....did you know, that after marriage problems, depression is the biggest thing you see in nouthetic counseling? It's also the hardest to counsel - because peeps come in armed to the teeth with "information" they've "learned" about depression. When working on my book, I discovered that now top-flight psychiatrists and researchers are admitting the chemical imbalance theory is unproven. It was a myth all along.
If asked, I imagine a NANC counselor could certainly point these facts out (having the research info right there in front of you doesn't hurt - "The Christian Counselor's Medical Desk Reference" is required reading for my course, and I also recommend Tyler & Grady's "When Sin is Called Sickness"). But making the argument that depresion etc. is not an organic disease (and therefore meds don't work; they ONLY TREAT THE SYMPTOMS) is one thing; telling someone they should stop a Rx they are already on is quite another.
As you know, the "counseling" I do is infomal - generally women seek me out after finding me online. I have never shied away from telling them straight-up that drugs are totally ineffective at treating eating disorders; that's a pretty easy one to prove. If they've contacted me, they've already read at leasts ome of my writing and know where I stand on that issue, anyway. However, what I have found is that (in the case of eating disorders), women prefer to take meds because they want to convince themselves it is still a "disease". If they realize the drugs don't help, on some level they are admitting it's not a physical disease that they have...but a spiritual one (sin). Many Christians just don't want to go there. (Which is probably most of the attacks I've gotten on my blog are from professing Christians -- NOT atheists).
It's a hard thing to face that you are in sin, and as long as you hang on to the meds and the illusion that you are "suffering from a 'mental illness'", you can deny to yourself that bulimia (or whatever) is a sin against a holy God. It takes time for the Holy Spirit to gently lead someone to that realization. Once they get there, though, NOW real change can begin. I have never seen a truly repentant women want to keep on claiming it's a "mental illness" card - so the drugs become a non-issue (although withdrawal may be another story).
So basically, my approach would not be first and foremost to focus on "stopping the drugs". It would be to help the person understand what God's Word says, and what it implies about her behavior (or depression). Once she is open to let God work in her heart and she is renewing her mind, the drugs can be seen for what they are -- a chemical answer to a spiritual solution. Then it's up to her. But to directly tell a counselee she should stop whatever she's on would be dangerous - for the counselor; for the church; and possibly for the counselee. I would not hesitate to advise against STARTING them, though. And from what I've seen just in my work as a medical interpreter, doctors push antidepressants like lemon drops. It's crazy!!! An elderly woman having a melancholy day? "I'm going to recommmend a psych consult...I think you should take something." An immigrant with an unemployed husband and health problems? "I'm going to increase your Celexa dosage." I could go on all day....but the point is, doctors will deliberately put patients on antidepressants to make them dependent; now the healthcare system is getting $$ for the rest of his/her life. (Nearly half of the $$ supporting the pharmecuetical industry is from antidepressants, according to one instructor). So there is a definite agenda there...and while I wouldn't think twice about explaining this to a counselee, you can't overstep your bounds by advising them against what their doctor is doing. Although I don't think a NANC counselor would agree to counsel someone who's also seeing a psychiatrist."