Sane Faith by David Powlison

 This article was originally taken from the Boundless Webzine website.

Sane Faith

By

David Powlison

Sane Faith, Part 1
by David Powlison

We've invited Dr. David Powlison to begin a discussion on counseling from a biblical perspective by writing a series of articles for Boundless. This is a conversation starter: We believe that thoughtful discussion of significant issues is crucial to the flourishing of the body of Christ.

Focus on the Family does not promote one particular model of Christian counseling, but earnestly seeks that we all grow in wisdom together. As with any article on Boundless, publication is not meant to be taken as an endorsement of its content. It is our hope that you are challenged to consider the relevance of Scripture, the importance of balance in the counseling process, and to better understand the Lord's concern and power when it comes to understanding the real life problems that we all struggle with.

* * *

Garrett, 23, is a recent college grad. When some little thing frustrates him or he doesn't get his way, he explodes in anger. It goes way over the top. In college he was an episodic binge drinker, but he's started to drink regularly and heavily over the past year. The effects of alcohol in him are unpredictable. Sometimes booze mellows Garrett out, but most times it lowers his threshold for volatile hostility. In addition to his growing drinking problem, he routinely turns to online pornography for a "fix." His friends don't know about that, but they fear for his future, wondering if he will self-destruct with his drinking and violent temper.

Official diagnosis and current street wisdom? "Garrett suffers from intermittent explosive disorder (IED) and is an addictive personality — and Garrett is all about Garrett, and has control issues, big-time."

Sarah, a 29-year-old single woman, has become increasingly preoccupied with her looks, her calorie intake, and her exercise regime. She often "feels fat," at 5'9" tall and weighing only 103 pounds, She's relentless in her activities and self-care, competitive, always trying to prove herself. Her roommates and family have become more and more concerned. Sarah seems joyless, and has been detaching herself from normal social interactions. She seems nervously self-preoccupied most of the time, so she has little time, energy, or attention for anything or anyone besides herself.

Diagnosis and current wisdom? "Sarah has anorexia — and she's a perfectionist with low self-esteem."

Lise, 32 and married, with a toddler, has felt down ever since she had the baby. Lise has had a tendency to wallow in self-reproach ever since childhood, but lately it's gotten worse. She's mired in loops of self-condemning thoughts, endlessly rehearsing and bemoaning her faults, both real and imaginary. She has developed elaborate "quiet time" rituals that help her feel some sense that her life is OK. She never feels like God loves her. Her husband worries that Lise's ritualistic habits and "sticky thoughts" about personal failings interfere with her ability to raise their child. Her brooding casts a pall over their relationship, too. The simplest question — "How was your day?" — often turns into a dark spiral of complaint and despair. He walks on eggshells: "What can I do? What can I say?"

Diagnosis and current wisdom? "Lise has a case of clinical depression and obsessive-compulsive disorder (OCD) — and she sets impossible standards for herself."

Chandra, 21, a senior in college, has battled intense anxiety feelings ever since adolescence. She gets tongue-tied if she's put on the spot in a social interaction. She increasingly avoids social situations, and only goes to gatherings or events if she has a friend with her to run interference and carry the ball conversationally. She hasn't been out on a date since a couple of ill-fated attempts in high school when she "almost had a panic attack" trying to figure out what to talk about. Chandra medicates her anxiety with daytime TV, Netflix and chocolate ice cream.

Diagnosis and current wisdom? "Chandra suffers from social anxiety disorder — and she's shy, gets glued to the tube, and needs her chocolate fix."

Do you recognize any of your friends in these people? I do. Do you recognize something of yourself in any of their problems? I do, too.

And do you also notice how each diagnostic label simply takes what we already know and then restates it in quasi-medical-sounding language? The actual experiences of life-lived get turned into a depersonalized "condition." Problems get viewed exclusively as something a person "has," rather than the array of things a person feels, thinks and does.

It's curious. The labels don't actually add any information to what we already know. Yet they somehow alter the entire way we perceive a person. They even alter how people perceive themselves. The story and the struggle get lost in translation.

Hold onto that thought, and we'll come back to it later. First we're going to climb into the story and the struggle.

We're all in these stories

Let's start with the common ground we feel with other people's stories. These problems are garden-variety human struggles ... amped up to very destructive levels. They beset each one of us to a greater or lesser degree. Of course, for the four people described, these tendencies have taken on life-dominating power.

Perhaps you can't identify with just how badly another person flounders. But can you identify with worry? Getting angry? Overindulging in food or drink? Immoral thoughts? Self-preoccupation? Feeling guilty and despondent? Breeding unrealistic hopes? Escape into TV or music or web surfing? Bickering and gossip? Feeling anxious around people? Blanking out on God? All the different ways of being loveless, and joyless, and restless? We can each identify with aspects of what these people do.

Each of these four stories describes a person who needs help in order to face up, to deal, to change. But these people aren't in a completely different category from the rest of us. They aren't weird, as if the rest of us were normal. Think about it this way. They dial up the volume, but we all play the same kinds of music. These are our friends ... and ourselves.

It's no surprise, then, that the Bible engages the varieties of chaos, confusion and trouble that mere humans experience. Our stories interweave with God's story at every point. God intends that we understand what exactly goes wrong — and how exactly he goes about making it right.

In his letter to people who know Jesus, James alerted us to something about personal and interpersonal chaos. Wherever you find "confusion and bad stuff" (James 3:16 paraphrase), you'll find two underlying problems. First, "bad zeal" wants the wrong things too much. Second, "selfish ambition" organizes life around all-about-Me.

James is unblinking about what's wrong, but he never gives the mess last say: "God gives more grace" (4:6). More than what? His goodness is more than all that goes wrong inside us. Confusion and bad stuff is exactly what he goes to work on.

Of course, the particular details of our four friends' stories have a 21st century flavor. But once you scratch the surface, they simply give new spin to old problems. These struggles are variants on the typical confusion and bad stuff of people everywhere. Almost 2000 years ago, Paul said "the works of the flesh are obvious." He gave fifteen examples: "sexual immorality, impurity, sensuality, idolatry, sorcery, enmity, strife, jealousy, fits of anger, rivalries, dissensions, divisions, envy, drunkenness, orgies, and things like these" (Galatians 5:19-21). Anyone can see that this is not the way life is meant to be. All forms of self-preoccupation are the opposite of love, joy, and peace. Paul rounded off his list by pointing far beyond the examples he chose to mention. "Things like these" include the 21st century problems of our four friends and people like us.

So our friends' chaotic ways of living fit the category "works of the flesh." These lifestyles show up on the MRI of Scripture. God sees them for what they are, and he teaches us how to see through his eyes.

God also looks behind the externals into the inner reasons. Galatians 5:16-17 names the motor for a destructive lifestyle: the "desires of the flesh." That's Paul's phrase for bad zeal and selfish ambition. The things people want seem so instinctive and plausible. But our desires become monsters and dictators. We want the wrong things too much, and approach life as if it's all-about-Me.

Garrett's way of life is "my way or the highway." No wonder he gets so angry. Sarah worships an ideal of thinness that even supermodels can't attain. No wonder she's so unhappy. Lise lives by a principle of self-attained standards of performance, and goes snow-blind to the mercies of God towards her. No surprise, she has no sense of peace. Chandra craves approval (and panics about possible rejection). She's so worried about how other people treat her that she has no thoughtful kindness to give to them.

God sees what's operating on the inside, as well as what's oozing out for all to see. He sizes it up for what it is, and then helps us to understand life the same way he does.

These patterns of inner motivation are what the Bible calls your "heart." We generate substitutes for God. The false masters are "little gods" that become I GOTTA HAVE THAT! Our blind, misplaced devotion enslaves us. We express our submission to little gods by destructive lifestyles, by our emotions, thoughts, words, and choices that the Bible calls foolish. God wants us to see our hearts the way he sees us. Inside and out, this is exactly what Jesus came to forgive and aims to transform.

• Jesus died to overthrow the dictatorship of the flesh
• Jesus died so that you won't die clinging tight to your idols
• Jesus died so you won't waste your life massaging and refining self-preoccupation
• Jesus lives to become your true Master

Here's the whole message in a sound bite: "He died for all, that those who live might no longer live for themselves but for Him who for their sake died and was raised" (2 Corinthians 5:15). Jesus can liberate Garrett from the stranglehold of self-will, so he actually begins to care about other people. Jesus can bring Sarah to her senses, so that she comes to love the beauty of Jesus rather than obsessing over an impossible and empty ideal. Lise can rebuild her life on a new foundation. Chandra can find safe refuge and the courage to reach out.

Christ overthrows dictatorial desires. The fruit of His Holy Spirit — Galatians 5:22-23 — makes for a life worth living.

Of course, the freedom is never all-at-once, one-and-done. But Jesus creates new conditions for life. In our lives now, He begins to make right all that goes so wrong. He sets about the long, hard answering of the complex questions. He begins a lifelong freeing process.

Two ways of doing life

From Jesus' point of view, there are two fundamentally different ways of doing life. One way, you're connected to a God who's involved in your life. Psalm 23 is all about this: "The Lord is my shepherd ... and his goodness and mercy surely follow me all the days of my life." The other way, you're pretty much on your own and disconnected. Let's call this the antipsalm 23: "I'm on my own ... and disappointment follows me all the days of my life." We'll look first at the antipsalm way of doing life.

Antipsalm 23

I'm on my own.
No one looks out for me or protects me.
I experience a continual sense of need. Nothing's quite right.
I'm always restless. I'm easily frustrated and often disappointed.
It's a jungle — I feel overwhelmed. It's a desert — I'm thirsty.
My soul feels broken, twisted, and stuck. I can't fix myself.
I stumble down some dark paths.
Still, I insist: I want to do what I want, when I want, how I want.
But life's confusing. Why don't things ever really work out?
I'm haunted by emptiness and futility — shadows of death.
I fear the big hurt and final loss.
Death is waiting for me at the end of every road,
         but I'd rather not think about that.
I spend my life protecting myself. Bad things can happen.
I find no lasting comfort.
I'm alone ... facing everything that could hurt me.
Are my friends really friends?
Other people use me for their own ends.
I can't really trust anyone. No one has my back.
No one is really for me — except me.
And I'm so much all about ME, sometimes it's sickening.
I belong to no one except myself.
My cup is never quite full enough. I'm left empty.
Disappointment follows me all the days of my life.
Will I just be obliterated into nothingness?
Will I be alone forever, homeless, free-falling into void?
Sartre said, "Hell is other people."
I have to add, "Hell is also myself."
It's a living death,
         and then I die.

The antipsalm tells what life feels like and looks like whenever God vanishes from sight. As we hear about Garrett and the others, each story lives too much inside the antipsalm. The "I'm-all-alone-in-the-universe" experience maps onto each one of them. The antipsalm captures the driven-ness and pointlessness of life-purposes that are petty and self-defeating. It expresses the fears and silent despair that cannot find a voice because there's no one to really talk to.

Our four friends are spinning out of control. They might implode. Something bad gets last say when whatever you live for is not God.

And when you're caught up in the antipsalm, it doesn't help when you're labeled a "disorder," a "syndrome" or a "case." The problem is much more serious: The disorder is "my life." The syndrome is "I'm on my own." The case is "Who am I and what am I living for?" when too clearly I am the center of my story.

But the antipsalm doesn't need to tell the final story. It only becomes your reality when you construct your reality from a lie. In reality, someone else is the center of the story. Nobody can make Jesus go away. The I AM was, is and will be, whether or not people acknowledge that.

When you awaken, when you see who Jesus actually is, everything changes. You see the Person whose care and ability you can trust. You experience His care. You see the Person whose glory you are meant to worship. You love Him who loves you. The real Psalm 23 captures what life feels like and looks like when Jesus Christ puts his hand on your shoulder.

Psalm 23

The Lord is my shepherd, I shall not be in want.
He makes me lie down in green pastures.
He leads me beside quiet waters.
He restores my soul.
He leads me in paths of righteousness for his name's sake.
Even though I walk through the valley of the shadow of death,
I will fear no evil, for you are with me.
Your rod and your staff, they comfort me.
You prepare a table before me in the presence of my enemies.
You anoint my head with oil.
My cup overflows.
Surely goodness and mercy will follow me all the days of my life,
and I will dwell in the house of the Lord forever.

Can you taste the difference?

You might want to read both antipsalm and psalm again, slowly. Maybe even read out loud. The psalm is sweet, not bitter. It's full, not empty. You aren't trying to grab the wind with your bare hands. Someone else takes you in His hands. You are not alone.

Jesus Christ actually plays two roles in this most tender psalm. First, He walked this Himself. He is a man who looked to the Lord. He said these very words, and means what He says. He entered our predicament. He walked the valley of the shadow of death. He faced every evil. He felt the threat of the antipsalm, of our soul's need to be restored. He looked to his Father's care when He was cast down — for us — into the darkest shadow of death. And God's goodness and mercy followed Him and carried Him. Life won.

Second, Jesus is also this Lord to whom we look. He is the living shepherd to whom we call. He restores your soul. He leads you in paths of righteousness. Why? Because of who He is: "for His name's sake."

You, too, can walk Psalm 23. You can say these words and mean what you say. God's goodness and mercy is true, and all He promises will come true. The King is at home in his universe.

Jesus puts it this way, "It is your Father's good pleasure to give you the kingdom" (Luke 12:32). He delights to walk with you.

Part 2
We've invited Dr. David Powlison to begin a discussion on counseling from a biblical perspective by writing a series of articles for Boundless. This is a conversation starter: We believe that thoughtful discussion of significant issues is crucial to the flourishing of the body of Christ.

Focus on the Family does not promote one particular model of Christian counseling, but earnestly seeks that we all grow in wisdom together. As with any article on Boundless, publication is not meant to be taken as an endorsement of its content. It is our hope that you are challenged to consider the relevance of Scripture, the importance of balance in the counseling process, and to better understand the Lord's concern and power when it comes to understanding the real life problems that we all struggle with.

This is the second article in a 3-part series. We encourage you to read part 1 if you haven't done so already.

* * *

In the first article of this series, I introduced you to four people who struggle with typical "problems." If you haven't read that article, do go back and start there. This article builds on what was said earlier.

Each of the four lifestyles earned a label for a person: addictive personality, eating disorder, OCD, and so forth. But we saw how each one of us can identify with the things they do, think and feel. You and I might be different in degree from Garrett and Sarah, but we aren't different in kind. Lise and Chandra are fellow strugglers, not bizarre aliens. We noticed how the Bible "normalizes" the seemingly abnormal, reinforcing awareness of our common humanity.

And, finally, we took Psalm 23 and turned it upside down. The "antipsalm" mapped into the four lifestyles – and captured the madness in each of us. But the real Psalm takes us by the hand and walks with us into sanity.

The Awkward Problem of Evil

If you've followed me so far, you might feel a question nagging at the back of your mind. Why don't we hear more of this refreshing and realistic way to think about people? What's the purpose of tagging people with diagnostic labels, of piling on the heavy freight of "disease" and "syndrome"?

Why doesn't the therapeutic establishment use human and humane terms to describe Garrett and the rest of our friends? Their stories describe things we can all understand and identify with. Why does God explain behavior, emotion and the human heart in such a different way from the labels? And why do the therapeutic answers never offer anything remotely like the intimacy of Psalm 23?

The answer to these questions is complicated. But it boils down to two things.

First, if you face our problems for what they actually are, then you have to acknowledge the problem of evil. What's wrong is much more serious than a sickness or syndrome. Evil operates on the inside – bad zeal and selfish ambition. And evils come at us from the outside: betrayal, false values, poor role models, shallow relationships, a body going out of sync, injury, aging, death. Both sin and suffering characterize the problem of evil.

But the diagnostic labels (and street wisdom, and even our four friends) never mention the E-word: evil. What distorts our lives? Evil. What breaks our lives. Evils, both inside and out. Something very dark and very complex is going on. Bad stuff comes at you, and bad stuff is an operating system inside you.

No one can fail to see evidence of evil. You feel it. You participate. But people don't want to name it for what it is. We might admit the evil of a Hitler or a suicide bomber killing innocent children. We fail to see the evils operating in normal problems.

Second, if you acknowledge the scope of the problem of evil, then you realize you need a Savior. If evil infects us all, then someone not under the power of evil must bring light and life from outside the system of darkness and death. That person is Jesus Christ.

Garrett's consuming "I insist on my way" is a sin of the heart against God, who alone is King, whose will is that we love Him utterly. Garrett needs what only Jesus can give, comprehensive forgiveness and a complete turnaround. Sarah's endless striving up the ladder of idolatrous slenderness is a sin of the heart against God, who calls her to love Him with all her heart. She needs powerful mercy. And so it is with Lise and Chandra, each putting their own spin on our need for God.

Like all human beings, they are by nature lost in the antipsalm. We need Him to save us from the inner logic of our hearts. We need Him to save us from suffering and death.

If Garrett manages his temper a little better, if Sarah eats a bit more healthily, they've barely dented the surface of their problems and their need. They need mercies. They need a change of heart, a different Savior, a different Lord. They need Psalm 23. We all do.

But if you don't want to need Jesus Christ, then you must deny the depth and scope of the problem of evil.

The Relevance of Christ

We sought to make sense of these four stories through God's eyes. We approached people with troubles in the light of God's mercies and power in Christ. His love is candid, patient, and effective. He intends that we each know our need, and find Him true. Then we, too, grow more candid, patient and effective in our love for other strugglers.

The persuasive voices in modern culture look through different eyes. The diagnostic system now in vogue makes problems seem smaller and solutions seem easier. It explains problems as genetics plus the social environment, with a nod in the direction of how you talk to yourself: "nature + nurture + self-talk." It sounds so appealing. With just the right medication, the right kind of friends and the right affirmations to boost your self-confidence, you can fix your kind of syndrome. The Savior of the world plays no part in the solution, because alienation from God plays no part in the problem.

There's a wide gap between medical-sounding labels and the Bible's straightforward teaching. There's a wide gap between therapeutic solutions and self-sacrificing love. Why the gap?

It's hard to face reality.

In T.S. Eliot's words, "Human kind cannot bear very much reality." Here's a longer answer, again in T. S. Eliot's words. When the Church tells of Jesus, she tells people

... of Life and Death, and of all that they would forget.
She is tender where they would be hard, and hard where they like to be soft.
She tells them of Evil and Sin, and other unpleasant facts.
They constantly try to escape
From the darkness outside and within
By dreaming of systems so perfect that no one will need to be good.
But the man that is will shadow
The man that pretends to be.
         – "Choruses from 'The Rock,'" part VI

The man that is shadows every pretense. Goodness is our greatest need. There is darkness both outside and within. There is tender mercy where we least expect it. And there is the hard reality that without such mercy, you die. Jesus calls for change of heart.

How much the perfect systems would like to forget all that.

Part 3

We've invited Dr. David Powlison to begin a discussion on counseling from a biblical perspective by writing a series of articles for Boundless. This is a conversation starter: We believe that thoughtful discussion of significant issues is crucial to the flourishing of the body of Christ.

Focus on the Family does not promote one particular model of Christian counseling, but earnestly seeks that we all grow in wisdom together. As with any article on Boundless, publication is not meant to be taken as an endorsement of its content. It is our hope that you are challenged to consider the relevance of Scripture, the importance of balance in the counseling process, and to better understand the Lord's concern and power when it comes to understanding the real life problems that we all struggle with.

This is the final article in a 3-part series. We encourage you to read part 1 and part 2 if you haven't done so already.

* * *

We've seen how the therapeutic worldview disconnects from reality. People with problems are treated less seriously than they deserve. They are given Band-Aid therapies for questions that call for an organ transplant. Let's think carefully through a series of implications.

1. The facts are the facts — but what do they mean?

Notice that nobody disputes the facts. Mental health practitioners, friends and family, you, me, and the God of the Bible agree that Garrett (see part 1 of this series) is narcissistic, has a bad temper, drinks too much and uses porn. He tries to control his world because he thinks it's his world. All agree that Sarah starves herself, works out relentlessly, and puts in a lot of mirror-time. She demands perfection on her own terms.

Nothing I'm saying questions any of these facts. These are facts that call for explanations and call out for help.

The question is how to interpret the facts. What do these problems mean? Why do our four friends live like this? Whyare they ruining their lives?

• Does each of them "suffer from" a quasi-medical-sounding disorder that actually explains his or her problems? Do they "have" diseases or conditions that the labels correctly name?
• Or are they "doing" extremely disorderly things for extremely confusing reasons? Are they living out lifestyles that God correctly names?

In other words, is the final explanation for our problems something bad happening to us? Or is it something bad about us? God's interpretation is the second one, and He gets last say. A true interpretation sees the problem of sin concretely, right in the details of people's lives and problems.

It's crucial, by the way, to understand sin accurately. Most people think that to identify something as "sin" means saying that the person consciously chose to do some bad action. The person also has the power to Just Say No.

But the Bible comes at sin from the opposite direction. We do many wrong, unloving things without even knowing what we're doing or why. Most sin is not a matter of conscious choice. The "high-handed" sins are conscious. But much of what we do, think and feel expresses that we are blind, self-deceived, metaphorically drunk or sleepwalking, calloused, acting like brute beasts, walking in the dark. So we do not have the power to Just Say No.

That's why we need a Savior from ourselves. Sin actually tends to make us more unconscious ("blind") and more compulsive ("enslaved"). I am what I am, and do what I do, even if it's self-destructive and destroys my relationships.

Furthermore, sin is an interpersonal offense and insult — to God first. He calls us to love him utterly ... but we are self-preoccupied in a thousand ways. Most people view "sin" as an item from a select list of heinous behaviors that hurt others. God sees much further. I can't accurately see myself until God makes me self-aware of what I look like to Him.

And, still further, grace targets sin. Jesus comes for sin. Mercy and compassion are given for sin. Forgiveness buries sin.

Most people think that the word "sin" only implies judgment, condemnation, self-righteousness and moral exhortations to try harder. That's the obvious thing to think. But God is not so obvious. He forgives people who are not righteous, and self-righteousness is a heinous sin. Christ does what none of us can do. Jesus' blood and righteousness and resurrection set us free from sin's guilt and punishment. Christ's Spirit progressively frees us from sin's power. The Lord's return will free us from sin's presence. God directly applies His mercy and power, changing us into the image of His glory.

We're objecting to the misinterpretations placed on troubled and troublesome lifestyles. We aren't denying the trouble. Jesus came for the trouble.

2. Quasi-medical labels are mislabels

Think a bit more about those verbs "suffers from," "has," "is" and "has a case of." We use these passive verbs to describe our experience of a true medical problem. You suffer from cancer or have a broken leg. You are a diabetic or have a case of hives. None of these true medical conditions describes your behavior, your motives, your lifestyle. They describe something bad that's happening to you.

Of course, your lifestyle and choices can affect whether or not you develop a medical problem. Smoking might cause lung cancer. Dirt-bike racing might cause a broken leg. But smoking cigarettes and riding dirt bikes are things you do — just like drinking too much, or worrying what people think, or obsessing in front of the mirror. I hope we'd never say, "He has a bad case of dirt-bike syndrome, and suffers from a smoking disorder"!

Notice that the descriptions of our four troubled friends consistently portray what they do, how they think, how they react emotionally, how they treat other people. Lise broods relentlessly on her failings, and is so preoccupied that she's inattentive to her daughter. Chandra worries that she'll be rejected, and hides from people. And each of them lives as if God were a non-factor.

The truth is that they do their lives; they don't suffer from their syndromes. By definition, a human being is an "active verb," not a passive verb. We want and fear, love and believe, do and say, act and react. You don't "have a case of" the way you do life.

3. What people do affects relationships.

Notice that in each of the four stories, what a person does affects other people. Our four friends do not have private pathologies. They are not the only ones suffering; their closest relationships suffer as well. Other people worry about them, or feel hurt by them, or get angry at them.

This is because outbursts of anger, drunkenness, extreme dieting, relentless self-recrimination, escapism, instability, and social anxiety intrinsically threaten relationships. By definition, doing such things isolates you from God and people. You can't live this way and at the same time trust God and love people. These are four different ways of being devoutly self-absorbed. It's significant that friends and family sense this. They're troubled by the distance and relationship breakdown caused by self-preoccupation. They have good reasons for their concern.

Consider the contrast between this and a purely medical problem. Friends and family will be deeply concerned for you if you have a broken leg or suffer from cancer. But trauma or illness don't automatically separate people and jeopardize relationships. In fact, usually sickness provides a context in which people come together and feel closer. Friends and family rally to support you. You appreciate the love and concern they show. Medical problems often draw people together in love and appreciation.

Your kith and kin will be concerned for you when you're sick. They want your body to get well. But they'll be concerned about you when you're devoutly self-absorbed. They want you to become a different kind of person. That's one more evidence that the deepest problem for all four is some form of sin.

Again, remember some things we mentioned earlier. "Sin" doesn't always mean consciously chosen badness. Most sins express how what I love has become disordered and dictatorial. When my core love turns away from God, I blindly attach myself to something else — anything else. I then live out the implications by making selfish choices.

And to name your problem as "sin" does not mean that others should scold, moralize or condemn you, or that you should beat yourself up with self-recrimination and trying harder. Jesus Christ comes "so that we may receive mercy and grace to help in time of need" (Hebrews 4:16). Mercy and helpfulness specifically target sin. So identifying how sin operates opens a wide door to God's mercy, patience and power. God's mercy restores all the relationships that sin threatens, reconciling us to God and equipping us to reconcile with people.

4. Quasi-medical labels artificially separate people

As we've seen, lifestyle problems harm relationships. But harm can come from the other direction, too. To put a diagnostic label on a person harms your relationship with that person. It creates artificial distance. We should be able to identify with each other, but if I think that you are sick and I am well, I artificially divide us.

A true medical problem creates an objective experiential distance between people. Let's say I get in a car accident and suffer a broken leg. My doctor and my friends do not have broken legs. I hurt a lot and need crutches. They feel perfectly fine and walk normally. Their experience and mine are fundamentally different. I am not well. They are well. I definitely need their help. They can help me precisely because they are not all laid up with broken legs!

But if you use quasi-medical labels for what I do, think and feel, it creates artificial distance between us. If I struggle with anxiety or irritation or escapism ... well, so do you. So does everybody. But if you label my struggle as a "disorder," then that means you are normal, but I am sick. That's an artificial distance, because none of us gets anger, fear and pleasure-seeking exactly right.

I might be having a much bigger problem than you. But our actual differences are matters of degree. I may be stuck and blind, while you've grown wise in an area of life. That matters for your ability to help me. But at the most basic level of human experience, you know that you and I have the same general tendencies and temptations. We come in very different flavors and intensities, but we are more alike than different. Our underlying commonality is fundamental. That's why you see so much of yourself in Garrett and Lise and the others.

You can help people precisely because you do have first-hand understanding of the basic human struggles: "There is no temptation that overtakes you that is not common to all" (1 Corinthians 10:13). You can help people precisely because you do know the grace of God at work in you, and that's exactly what others need: "God comforts us in all our affliction, so that we may be able to comfort those who are in any affliction" (2 Corinthians 1:4). Because we are in it together we can help each other.

Medical doctors don't ever need to have the same problems as their patients. But brothers and sisters always have the same kinds of problems as their fellow strugglers. Therefore we share the same essential cure, which always involves some form of faith working through love, by the grace of God in Christ. There's no artificial distance, because we have a real commonality.

5. How do we weigh the various contributory "factors"?

I've focused on the heart, the gospel and our identification with each other. But how should we weigh all the other variables that affect us? No one disagrees that genetics might contribute a "tendency," and that the social environment abounds with "triggers." Countless factors "influence" us.

But what is the final cause of how you live? Of course, you are your final cause. That said, let's look briefly at the many contributing factors.

What goes on in your body has an influence. When you experience allergies or sleepless nights, premenstrual hormones or chronic pain, Asperger's or Alzheimer's, your mood, thinking and actions are affected. You're tempted in different ways than when you feel fine.

Similarly, it's obvious that each of us comes wired from birth with a different temperament. Some people are more prone to anger, others to anxiety, others to getting discouraged, others to pleasure-addictions, and so forth. Our bodies affect us in many ways. It's likely that Lise's post-partum hormones color her moods.

But does the body give the decisive, underlying explanation for their personal problems? No; no more than it gives the decisive explanation for their good and loving choices. The body is a contributory factor, an influence. It's not the final cause of either your faith or your idolatry, your kindness or your selfishness.

What the people around you do also has an influence on you. Like "nature," "nurture" plays a role. Every one of us lives in a world filled with competing values, a variety of hardships and many enticements. You implicitly absorb the categories of thought provided by your native language, and the values of your native culture.

For example, Sarah lives in a society that glamorizes unreally thin women. Garrett's father was a poor role-model for how to handle frustration, and his bad example "discipled" his son into temper and drinking. We live in a world where betrayals of trust occur. Chandra lives among a group of peers who might (and have) hurt her.

But do those experiences provide the decisive explanation for their struggles? No. These are significant and impacting, but not determinative. Your surrounding environment influences you in countless ways, but it never determines whether your life orients in the direction of Christ or twists in on yourself.

In fact, countless factors "influence" you. Weather and seasons? You may feel gloomier during three cloudy weeks in January than you do during three bright weeks in July. The project due next week in school or on your job? The current state of your personal finances? World politics before and after 9/11? Immediate traffic conditions and whether you'll be late? What's on TV tonight? Whether your football team is winning or losing?

Any of these can affect you. But does any one decisively determine how you will react?

No. You are always in the mix.

In fact, the Bible teaches that God actually arranges the stage on which you live. He is the Lord of history, including your local time and place, and your personal history. Your particular matrix of influences provides the context in which your faith (or your self-will) plays out, in which He meets you (or you shirk Him).

This awareness frees you. You can seek to understand any contributory influence as just that, as a factor and not the cause. You won't grant them too much credit, morphing them into root causes and excuses for your sins. But you also won't dismiss them as irrelevant, ignoring the actual situations and difficulties in which you need practical wisdom and practical mercies.

How you live comes out of your heart. "Keep your heart with all vigilance, for from it flow the springs of life" (Proverbs 4:23). The heart is you, not something that happens to you. Jesus says that when wrong actions appear, that wrong comes "from within, out of the heart of man" (Mark 7:21). Something about who you are and what you live for sets your trajectory in life and shapes every choice.

Deep down, everyone knows this is true.

That's why every sort of treatment or therapy involves taking some responsibility for your life. It's odd, when you think about it. According to the therapeutic outlook, you have no real responsibility for causing your problems. Your syndrome, disorder or disease was caused by genetics, hormones or how people treated you. But you are given final responsibility for solving what's wrong. You can get a grip; you can make better choices; you can choose to heal; you can change your self-talk.

Here's the logic: "You are definitely NOT a sinner. But you definitely ARE your savior."

God sees things the other way around. You definitely ARE a sinner, and you are definitely NOT your Savior.

When this merciful Father gets a grip on you, you take hold of Him. As the patient Spirit changes you, He enables you to make more loving choices. Because the good Shepherd restores your soul, you flourish. This most personal God teaches you how to talk with Him, so you stop talking to yourself so much.

We're tangled up, and we also live in tangled bodies amid a tangled world. C. S. Lewis vividly captured the profoundly humbling self-awareness this reality creates:

Man's love for God must always be very largely, and must often be entirely, a Need-love. This is obvious where we implore forgiveness for our sins or support in our tribulations. But in the long run it is perhaps even more apparent in our growing — for it ought to be growing — awareness that our whole being by its very nature is one vast need; incomplete, preparatory, empty yet cluttered, crying out for Him who can untie things that are now knotted together and tie up things that are still dangling loose. (The Four Loves, chapter 1)

Many things will influence you. The whole world is knotted up and dangling loose. But you are still your biggest problem. You need what God alone can give. It's no accident that Jesus begins here: "The poor in spirit are blessed" (Matt. 5:3). It's no accident that Paul heard God address his fundamental human weakness: "My grace is sufficient for you, because power is made perfect in weakness" (2 Cor. 12:9). It's no accident that most of the psalms cry for help. It's no accident that Jesus is who He is, and does what he does. It's no accident that God freely gives what you most need — the mercy to change your relationship with Him, and the power to change you.

Coming home to sanity

When we see how deeply the "madness in our hearts" (Ecclesiastes 9:3) infects us and our friends, then we see how deeply the love of God in Christ applies to our deepest problems. The real Psalm 23 and all the rest of God's wisdom lead us home.

Jesus Christ actually lived and died to rescue us. He now lives specifically to rewire our core insanity and to overcome our inevitable isolation. Best of all, His answer to self-absorption is not just a bunch of great ideas. The Lamb of God is a real person. The Shepherd calls you into a talking, listening, long-term, committed relationship. He's good, and good for you.