Obsessive-compulsive disorder (OCD) is a puzzling, well-known mental disorder. Most people are familiar with its common outward symptoms, such as hand washing and stove checking. It bewilders and fascinates us because the beliefs and behaviors of its sufferers don't seem to make sense but nonetheless have a powerful grip on them. As its name implies, the condition manifests in repetitive, unpleasant thoughts that one cannot stop, and a compulsive behavior (e.g., washing, cutting, praying) meant to halt or subdue the thoughts. Then the cycle repeats itself.
There are plenty of books on how to treat OCD's symptoms, but few offer a distinctively Christian framework. So Can Christianity Cure Obsessive-Compulsive Disorder?: A Psychiatrist Explores the Role of Faith in Treatment (Brazos) is special. Authored by Ian Osborn, who himself struggled with and overcame OCD, this book is unique for its three "case studies" of notable Christians. By examining the autobiographical accounts of Martin Luther, John Bunyan, and St. Thérèse of Lisieux, a popular 19th-century Carmelite nun, Osborn presents convincing cases that each struggled with OCD and overcame it through a deepening trust in God. This last point makes the book noteworthy, if not notorious, since the author is suggesting that Christian doctrine held the key to their cures.
Of greatest relevance to the author's argument is a newly developed cognitive treatment for OCD called "responsibility transfer therapy" (RTT). In this model, the OCD sufferer is encouraged to hand responsibility for the problematic behavior over to another person. So, for example, a sufferer may allow someone else to monitor whether the oven is turned off, so they don't have to obsess over whether it is. For reasons unclear, researchers have found RTT to be a successful form of treatment. Osborn conjectures that OCD sufferers may be helped by "transferring responsibility to God," so to speak — a significant, untested shift in the application of RRT, it must be said — and he suggests the three Christian giants found their cure by doing that.
Luther, Bunyan, and St. Thérèse were each deeply troubled at early stages in their lives by dark thoughts and a deepening awareness of their sinfulness, and performed frenzied actions to remedy those thoughts. Luther, for example, dragged his priest into hours-long confession marathons. When he felt he had confessed everything, he would start again from the top. In his slim autobiography, Grace Abounding, Bunyan chronicled his years-long battle with "floods of blasphemies" that would race through his mind and lead him to doubt his salvation. And, as a form of mortification, Thérèse went as far as to wear a scapular that cut into her chest with every movement. All of these actions, it could be said, were vain attempts by the sufferers to "cleanse" or "fix" their undesirable thoughts. But all three experienced profound shifts in their experience by trusting God. They realized they could not themselves address their sins before a holy God, but could "transfer responsibility" to Christ for their salvation and security, which provided rest and relief.
Luther, Bunyan, and St. Thérèse were colorful figures who made a significant impact on their respective worlds, so Osborn's recount of their lives provides an informative and lively read. It would be my first recommendation to Christians (and interested non-Christians) who struggle with OCD. And the value to counselors and pastors should be obvious, particularly to see how Christians have addressed psychological problems in the past, and how we might approach them today. This may be the book's most valuable contribution.
Unfortunately, for a work dealing with church history, Can Christianity Cure OCD? contains some misleading generalizations, such as that Aquinas "set the theological course of the Renaissance" and the Council of Trent "adopted many of Luther's insights." More problematic, though, is Osborn's attempt to interpret Bunyan's, Luther's, and St. Thérèse's stories using a secular model of therapy and its supporting research. The assumptions of contemporary psychiatry and psychology loom large in the book's ideological background; the medical model is assumed. Thus, Osborn never considers what might be the cause of the pressure OCD sufferers experience, or why RTT works. In our day, biological and cognitive approaches to OCD are almost all based in a naturalistic worldview and studiously avoid questions of agency.
According to the Christian story, humans are moral creatures, as well as biological and cognitive ones. Moreover, we are moral failures — what the Bible calls "sinners." As a result, we experience emotions like shame and guilt that are signs of an awareness of that failure. Shame is the nearly universal human sense of some deficit, which Christians believe began when humans first disobeyed God in the Garden. So perhaps the internal pressure of OCD is at least partially due to that sense of shame — certainly influenced by genetics, neurotransmitters, and socialization, but which, in the case of some, gets channeled into obsessions and compulsions as a way of managing it. A theistic and personalistic interpretation of OCD would take into account the biological and cognitive mechanics that are involved, but would go beyond that to consider problems of agency and ultimacy that all humans have to deal with, but which secular psychological theory ignores.
I fear I have focused too much on the book's limitations, for it contains a tremendous rediscovery: There are remedies for the soul's ills in the Christian faith. Both psychiatry and psychotherapy literally mean "soul healing" (psychology literally means "the study of the soul"). Until recently, soul healing was understood to be part of the church's responsibility. However, for the last 125 years, a secular framework has dominated both fields, while much of the church drifted away from its calling to help heal the soul. Today, apart from some popular biblical counseling literature, a vigorous Christian agenda is virtually unheard of. Meanwhile, it has been difficult for believers to imagine how psychiatry and psychology might look were they founded upon a Christian worldview rather than a materialistic one.
So this is a good time to check our bearings. Growing postmodern sensibilities are permitting greater diversity; the example of Christian philosophy over the past 30 years is encouraging. We would do well to follow Osborn's example and comb through Christian literature — beginning with the Bible — to develop a robustly Christian approach to psychiatry and psychology in the 21st century. Perhaps we could develop and test theories that elaborate specifically Christian psychiatric and psychological concepts, models, and practices, e.g., (1) viewing humans not merely as organisms, but also as social persons made in the image of the triune God, dependent and ideally centered on him; (2) understanding sin as the worst kind of psychopathology that afflicts all humans, including Christians; and (3) developing counseling models that focus on Christ's death and resurrection and the edifying benefits he thereby provides his people. We cannot measure the Holy Spirit, but we can measure the Spirit's effects!
Perhaps in coming decades, Christians in psychiatry, psychology, and the human sciences in general can break free of secularism's hold on these fields, and understand human beings Christianly, developing theories, research, and counseling practices that conform to Christian standards of good science and good soul care. To do something so radical requires us to go back to our roots — and rediscover how people like Luther, Bunyan, and Thérèse of Lisieux found their soul healing in Christ.
Eric Johnson is professor of pastoral theology at Southern Baptist Theological Seminary and the director of the Society for Christian Psychology.
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