Blame It on the Brain: Distinguishing Chemical Imbalances, Brain Disorders, and Disobedience, by Edward T. Welch. Phillipsburg, New Jersey: Presbyterian and Reformed Publishing Company, 1998. 204 pp.$12.99, (paper). [Reviewed by Prof. Robert D. Decker.]

This is a good book on a difficult subject, a subject which continues to occupy the attention of practical theologians, pastors, Christian psychologists, psychiatrists, social workers, and educators. The difficult subject is this: Is what we call mental illness sin or sickness, or does it partake of both? Our ministers and Christian school teachers ought to read the book carefully. They will find help in dealing with God’s people, adults, children, and youth, who experience depression, anxiety, and other like problems.

Welch, a counselor at the Christian Counseling and Educational Foundation in Glenside, Pennsylvania and a Lecturer in Practical Theology at Westminster Theological Seminary in Philadelphia, states his goal with the book in these terms, “As Christians today, we want to avoid the ecclesiastical mistakes of the 1880s. This time, we want to listen to what people are saying about the brain, develop clear and powerful biblical categories, and bless both the sciences and the church in the process” (p. 26). While not agreeing with every detail of Welch’s conclusions, this reviewer is convinced that Welch successfully achieved his goal.

The author offers two key definitions when he writes, “Any behavior that does not conform to biblical commands or any behavior that transgresses biblical prohibitions proceeds from the heart and is sin,” and, “Any behavior that is more accurately called a weakness proceeds from the body and is sickness or suffering. Sickness or suffering can also be caused by specific sin, but we must be very careful to have ample justification before we make such a link” (pp. 43, 44). The list of symptoms which can be categorized as physical or spiritual on the basis of the above two definitions is helpful (p. 45). Among the physical symptoms Welch lists: mental retardation, feelings of depression, feelings of panic, hallucinations, problems with attention and concentration, and mental confusion. Among the symptoms proceeding from the heart and which are, therefore, sinful Welch lists: sexual immorality, lust, evil desires, filthy language, malice, greed, anger, rage, murder, strife, arrogance, boasting, disobedience to parents, unbelief, et. al.

In the third chapter, “Mind – Body: Practical Applications,” (pp. 49-61), Welch considers, “… four practical principles that emerge from the mind-body discussion.” These are:

1)The brain cannot make a person sin or keep a person from following Jesus in faith and obedience.

2)Each person’s abilities—brain strengths and weaknesses—are unique and worthy of careful study.

3)Brain problems can expose heart (spiritual, RDD) problems.

4)Sinful hearts can lead to physical illness, and upright hearts can lead to heath.

The reader will find very helpful the chapters on Alzheimer’s Disease and Dementia and Head Injury in Part Two, chapters 4 and 5, of the book (pp. 63-102). In these chapters we’re told how to recognize the symptoms of these illnesses and injuries. The author offers as well a number of helpful suggestions on how to deal with the affected person and his/her family members.

Chapter 6 is a good, brief introduction to psychiatric problems. In this chapter Welch offers three important propositions:

1) “Psychiatric problems are always spiritual problems and sometimes physical problems.” Surely no Reformed, Christian pastor or counselor would disagree with this.

2) “Psychiatric disorders sometimes respond to medication.” In this helpful section the author points out that medications help some people and not others. He reminds us that these medications have side effects, some of which are long-term. In this connection Welch makes these points, “First, since we don’t fully know thedepth of someone else’s suffering, we should be careful when offering our opinion about medication. It is easy to underestimate the extent of a person’s pain. Second, we should remember that, in general, the alleviation of suffering is a good thing. And third, since the Bible does not clearly prohibit these medications, the issue is not whether medication is biblically lawful or unlawful; rather, the issue is how to make wise, informed decisions…. Whether a person takes psychiatric medication or not is not the most important issue. Scripture is especially interested in why someone is taking medication. And it is clear that medication is never the source of our hope. With these guidelines in mind, there is biblical freedom to try, or not to try, psychiatric medication” (pp. 111, 112).

3) “Psychiatric labels are descriptions, not explanation.”

Chapter 7 is an excellent discussion of depression. In this chapter the author argues convincingly that “the basic steps of a biblical approach to helping them (depressed people, RDD) are similar to those you would follow to help people with physical problems…. First, you understand the experience of depression. Second, you make tentative distinctions between physical and spiritual symptoms. Third, this distinction will allow you to focus on heart issues” (p. 115). Welch, while stressing the spiritual dimensions involved with depression, recognizes that “depression does have physical symptoms.” And medical treatments of these physical symptoms can be helpful in easing or erasing these symptoms (p. 125).

A sane approach to this terrible problem, thinks this reviewer.

In chapter 8 the author deals with Attention Deficit Disorder (ADD). He offers many helpful suggestions for parents and educators who must deal with ADD children. Welch’s comments on the “need for structure” are well taken (pp. 141, 142). The section on “Applying These Steps to Other Psychiatric Problems” (pp. 147, 148) is too brief to be of value and really begs the question, i.e., assumes what needs to be demonstrated.

In chapters 9 and 10 the author discusses biblically the sins of homosexuality and alcoholism.

There are a couple of weaknesses apparent in this book. One is that the author relies too much on secondary sources, and another is that these sources are often not the latest works. Some, in fact, date back to the forties, fifties, and sixties. A good index and bibliography would have added to the value of an otherwise very good book.