Healing and the Scriptures (Nashville: Oliver-Nelson, 1988), by Dr. Martyn Lloyd-Jones, contains transcripts of several talks he gave at various assemblies of Christian medical doctors. Next to Preaching and Preachers, this book may lay bare the pastoral heart, and pastoral wisdom, of Lloyd-Jones better than any other (at least any other that I have read). He speaks as a medical man to medical men, yet he always retains that pastoral heart and perspective. Because of this, I think the book is as much a help to pastors as it is to doctors.

There is so much to be gleaned from the book, but in this post I will focus on what is perhaps the greatest contribution of the book specifically for pastors. In the last chapter – Mind, Body, and Spirit – the Doctor describes in some detail his own personal method for pastoral counseling. He takes you through his thought process of diagnosing problems and treating them from a pastoral perspective. This is the nitty gritty wisdom of a man who, at the point he gave this talk, had 40 years or so of pastoral experience in handling the Scriptures and dealing with real people with real problems. In this post, I have simply condensed the talk down to its salient points.

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I. Dangers in pastoral counseling

A. Over Involvement

• “One is that the minister may get too involved…The minister is apt to become too emotionally involved in his efforts to sympathize. I have known a number of instances where ministers have really been brought almost to a breakdown themselves in their efforts to identify themselves with the difficulties of members of their congregations” (pp. 144-145).

B. Using Spiritual Methods for All Problems

• “Another danger for a minister is to regard each case as spiritual and to approach it wholly on spiritual lines” (p. 145). He notes a case in which Christians had tried to offer spiritual counsel to a manic depressive and had exhausted themselves.

C. Breaching Trust

• “A further difficulty for ministers…is that some patients feel that they cannot trust the minister, because they are afraid that they may be used as illustrations from the pulpit” (p. 145).

II. Lloyd-Jones goes on to describe his own method for pastoral counseling: Differentiating between four categories of problems: physical, spiritual, psychological (mental illness), and demonic issues

• The first task is always diagnosis…Let me say at once, it is something that is extremely difficult. I find that differential diagnosis in this realm [i.e. as a pastor] is usually much more difficult than in clinical medicine – difficult as that may be at times (p. 147).

He uses the order – physical, spiritual, psychological, demonic – intentionally, noting that this is the order that he followed in his attempted diagnoses throughout most of his ministry.

A. Physical Problems

1) Diagnosis

• “The first question I always ask myself is, ‘Is it physical?’ I wish to emphasize this, because there are some to whom it never occurs that the whole cause may be physical” (p. 148).

He goes on to cite several examples in which nervous conditions and spiritual crises have been caused by physical ailments.

2) Treatment

His way of dealing with physical issues is to have the ailing person seek good medical treatment (p. 167).

B. Spiritual Problems

1) Diagnosis

• “The second question I ask myself is this: ‘If it is not physical, is it spiritual?’…What do I mean by a spiritual problem? It is one which can be dealt with entirely in spiritual terms. For example, the commonest problem is lack of assurance. Many are troubled about this. Others are concerned about some particular sin and how they can be rid of it. Or it may be the memory of a particular sin, or of an incident of blasphemy, or sin against the Holy Spirit, or some serious lapse in conduct” (p. 151).

• “I have always found that with persons in this spiritual category there is a clear diagnostic point. They always show a readiness to listen and they almost jump at any of the verses quoted which give them relief. They hold on to what will really bring comfort and release. One must not be put off by their appearing at first to demur a little, with a, ‘Yes, but…’ They are really doing this in hope that you can go on to make your case still stronger. They want you to make your case and in my experience it is a diagnostic pointer to those in this group” (pp. 152-153).

2) Treatment

Patient, repetitive, Scriptural, pastoral counseling using the Bible and Christian wisdom derived from the Bible:

• “…There is need for detailed proof. What I mean here is, that one must be precise and detailed in bringing to bear the scriptural arguments. The impression that one can just pat them on the back and tell them ‘Don’t worry’ is not only wrong, it can be real cruelty. We need to be very patient. We may need to go over the same arguments more than once. There may need to be a number of visits, but you must keep on and on” (p. 168).

C. Psychological Problems

• “The third category…is the psychological. I use that general term, but if you prefer it, it could be ‘mental illness'” (p. 153).

• “It is necessary for us to work with those in this field who have to establish the reality of mental illness, otherwise we are going to be guilty of great cruelty to some of those who come to consult us” (p. 155).

• “Why would I affirm the reality of such illness? I suggest that the familiar (hereditary) element in the case histories alone is sufficient to establish it. Another fact is the periodicity so characteristic of many cases…Not only that, but there are many cases of mental illness which do not respond at all to spiritual, scriptural treatment, and indeed, are even made worse by this” (p. 156).

He cites specific cases for proof, and references Richard Baxter’s book, The Cure of Melancholy and Overmuch Sorrow (click the link for the full text), extensively (you can see my thoughts on that book HERE).

1) Diagnosis

• “I think that you will find almost invariably that those who are mentally ill do not really listen to you. You quote Scripture, they do not listen. They keep repeating the same statements and give the impression that they are waiting for you to finish so that they can say their piece over again. This is almost invariable. You notice the difference as compared with those in spiritual trouble. The latter are anxious to have help. The others are not. I always feel with them that I am a kind of tangent to a circle. One never penetrates, they are almost impatient and go on repeating the same thing” (p 158).

2) Treatment

First, do not try to be a psychologist, especially of the Freudian kind (p. 168). They may need to see a physician/specialist. An appropriate prescription medication may be precisely what they need (but we are not able to decide that). Lloyd-Jones goes on to make a strong case for medical treatment for psychological cases. He relates brain chemistry to other physical ailments:

• “If it is right to use insulin in replacement therapy for the pancreas, why is it wrong to take tablets which influence the good chemistry of the brain? I think we must get hold of the concept that mental illness is really something that has an ‘organic’ basis. It is something that can be explained chemically” (p. 169)

After making his argument, his conclusion is:

• “We can, therefore, reassure those who believe that it is sinful to take drugs which relate to brain function that, where clinical trial and proper use have shown them to be valuable, they should be received with thanksgiving. All things in nature and scientific knowledge are the gifts of God and should be used to his glory” (p. 172).

*Note: Remember that Lloyd-Jones is not calling for the mass medicating of the masses – he is talking specifically about those who are clearly mentally ill according to the diagnostic pattern that he has set forth. ADHD, childhood manic depressive disorder, and the like were not even a blip on his radar screen when he gave this talk in 1974. He is specifically speaking of adults showing clear signs of mania or major depression.

D. Demonic Problems

• “This brings us to my last category which is ‘the demonic.’ Am I confronted in this case with the physical or the spiritual or the psychological or the truly ‘demonic’?” (p. 158).

The Doctor goes on to make his case for the present reality of demonic activity in this world. He then distinguishes between ‘demonic oppression’ and ‘demonic possession.’

1) Demonic Oppression

a) Diagnosis

He argues that demonic oppression usually consists of attacks on believers, and he gives his diagnostic points:

• “What are they? First, the sudden onset of the condition; second, it was something unexpected in this type of person, and something that they had never had before. Suddenly…excellent people are changed and become more or less useless. There is always a suggestion of an occult opposition to the work of God which they are doing, as if an enemy is out to spoil or stop it (pp. 162-163). Another diagnostic element is extreme weakness…Then the last diagnostic point is that they, of course, make no response to any medical treatment, no matter what it is. They also baffle all those who treat them medically or psychiatrically” (pp. 164-165).

b) Treatment

• “…I do not hesitate to say this – you will always be able to deliver them by reasoning with them out of the Scriptures. I do not mean by just quoting Scripture but deploying the whole basic arguments of Scripture concerning salvation, calling and service” (p. 168).

2) Demonic Possession

a) Diagnosis

• “Then there are cases which can only be regarded as demon possession…What are the diagnostic points in these cases? You generally find a history of dabbling with spiritualism or the occult in some form. It may have been back in their childhood, or during teenage [years], that they have been introduced to the occult and experimented with occult phenomena. They may also have experimented with drugs” (p. 165).

• “One clear diagnostic point is that one becomes aware of a dual personality” (p. 165).

• “A still more significant pointer is their reaction to the name of our Lord. I always tell ministers who are confronted by the duty of treating such cases to use the phrase – ‘Jesus Christ is come in the flesh’ and to note the reaction. Talk to them of ‘the blood of Christ’ and you will generally find that they will react quite violently to this” (p. 166).

b) Treatment

• “If it is demonic the choice of the correct treatment is not difficult. There is nothing that one [can] do but to seek…divine aid for the exorcism of the evil spirit. There is, as you know, a Church of England service of exorcism. The late Bishop of Exeter has produced a booklet which, in my opinion, explains this all very well indeed. It teaches clearly what should be done and not done” (p. 167).

The booklet he references (Exorcism: The Report of a Commission Convened by the Bishop of Exeter (1972)) is available for free online HERE.

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The book, Healing and the Scriptures, is available HERE (used copies are cheap at the moment). Plus, the actual talk on which the chapter is based is available (for free) at the MLJ Trust website in two parts: Part 1, Part 2. If this post piqued your interest at all, I encourage you to listen to the talks, and, better yet, get the book.

Quotations are used as summaries for instructional purposes.

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APPENDIX: IAIN MURRAY ON LLOYD-JONES AS A PASTORAL COUNSELOR

A. On Diagnosis

• “In interviewing a person who had come for help ML-J followed some basic procedures, beginning with diagnosis. There were certain broad questions which he always asked himself such as: Was the person a Christian or a non-Christian? Was the problem spiritual or were there indications that the individual had physical or mental problems requiring medical advice or treatment?” (Iain Marry, D. Martyn Lloyd-Jones, The Fight of Faith: 1939-1981, p. 406).
• In the footnote here, Murray writes that Lloyd-Jones considered the category of mental problems to be “a minority” (Ibid).

• “Preliminary diagnosis of this kind ML-J regarded as far from easy and he often emphasized to fellow ministers the harm that could be done by wrong evaluations: ‘We are dealing with souls, with persons.’ His method was to listen, at length if necessary, and with occasional questions which might, at times, cut at right angles across the speaker’s own line of thought” (Ibid).

B. On Spiritual Counseling

• “Where the problem of those who sought help was not psychological and they professed to be Christians, perhaps considering that they need sanctification or assurance, he set no great store [on] self-assessments. The first thing was to make certain of their foundation. He therefore looked for the features of a regenerate mind, such as concern to be God-centered instead of self-centered and where this was missing the starting point had to be conviction of sin. A defective understanding of sin he regarded as the main hindrance in stopping people [from] depending on Christ alone for justification. ‘If you talk to a man about sanctification only, when his great need is to be shown the way of justification, you will aggravate his troubles” (p. 407).

C. On Distinguishing a Christian from a Non-Christian

• “If he believed he was speaking to a non-Christian he would simply repeat the same truths he preached, looking to the Holy Spirit to give the necessary light for a saving response…Whether or not an individual was a Christian made a fundamental different to Dr. Lloyd-Jones’ whole approach to their particular problem. The Christian and the non-Christian may, of course, experience the same kind of problem, but while the latter is spiritually helpless, the Christian is in possession of a strength which is not his own. He has ‘died to sin.’ He has the ability to resist sin and must do so…Christians are to look not at themselves and their problems but at what God has done for them” (pp. 407-408).

D. On His Personal Style

• “A number who were in very evident moral trouble when they first saw ML-J to confess their need, observed how he never reacted with shock or disapproval. Speaking on this point to Christian doctors, he once said: ‘We must always be careful to avoid condemnation – especially in the case of a sick or agitated person. If the plain truth of the situation comes home to the patient that is one thing; but is not our place to condemn.’ ‘For people in difficulties of their own making,’ writes Geoffrey Thomas, ‘his tolerance was inexhaustible…He was the very antithesis of the unworldly “churchy” person destitute of knowledge of wordly problems” (pp. 412-413).

• “It would give a misleading impression, however, to imply that ML-J in private was nothing but charm and affability. He could be otherwise. His patience had limits in the case of those who caused difficulties for themselves or for others when, he considered, they ought to have known better. At such times he could speak very plainly and, as some of us close to him found, with a touch of anger” (p. 413).

• “It was observed by one of the medical members at Westminster Chapel…that ML-J ran his vestry interviews as a specialist runs his consulting rooms…Few people succeeded in taking much of his time unnecessarily. Those who came simply to meet him and exchange pleasantries were always welcome, but after a few minutes they were liable to be propelled gently backwards to the door with a warm handshake. As this procedure was obviously unworkable if a visitor was seated, ML-J had to make an instant decision as each person was shown into his room. He was always standing as someone entered and would move at once towards them to greet them. If he judged that a short conversation was all that was needed…he would remain standing with them. On the other hand, if the individual was a stranger who had come with a spiritual concern, he or she would be asked to sit down on the leather couch while ML-J would sit opposite, either in a favourite leather armchair beside the electric fire or on a swivel chair beside his desk. He never spoke to anyone from behind a desk” (p. 405).

For further details see Murray, The Fight of Faith, pp. 403-423.