By now, much digital ink has been spilled on social media and in the blogosphere concerning inflammatory, if not unsurprising comments made by Pastor John MacArthur on the socially dynamic issue of mental health and illness. Speaking at a church conference in California on April 20, MacArthur went on record as saying that common mental health diagnoses such as OCD, ADHD, and PTSD do not actually exist, but are instead “noble lies” created by the fields of psychology and psychiatry to “medicate people.”1MacArthur went on to assert that “Big Pharma” is to blame for much of the mental health crisis, and that its production and delivery of psychotropic medications is one of the most deadly circ*mstances ever unleashed on our children.
Beyond these comments, MacArthur continued to opine that diagnoses such as ADHD—or more appropriately, the cluster of symptoms surrounding the diagnosis—can all be attributed to poor (sinful) choices on the part of the child and bad parenting. MacArthur then warned that parents who choose to medicate their children in response to an ADHD diagnosis are setting them up to become “drug addicts and criminals.”
Here is where full disclosure in research hits for the purposes of this essay:
My wife and I are the parents of four kids. Three of the four are domestic adoptees. Each of the three were drug exposed in-utero. And two of the three have ADHD diagnoses; one with anxiety and the other with “inattentive type with impulsivity.” Common comorbidities in ADHD kids, such as learning disabilities and short-term memory issues, are present in both. I share their stories only after much reflection. The facts belong to them. But, given the gross misunderstandings which exist within the church, I cannot advocate for them and others as effectively by maintaining silence.
So, not only are my wife and I biblical counselors by vocation with a natural interest in these and related topics, but we are invested in these concerns at the highest of levels personally. I have to own my biases. That said, my desire is to engage these issues with biblical faithfulness and a fair-minded relationship to secular data and research. My own kids and the people to whom we minister depend on it. Contrary to what another biblical counseling pastor has asserted, our efforts are not about fascination with secular sophistication; it is all about family.
A Concern for Truth
When my wife and I listened to MacArthur’s comments, we both knew right away that the man was speaking out of turn, and in a way that could be a legitimate threat, spiritually and physically, to any who would hear him and be motivated to follow his counsel. Frankly, I found MacArthur’s comments to be rooted in a fear of what he does not well understand—by choice. MacArthur does not lack the ability to relate properly to these issues—he lacks the will.
To bring more clarity, it is important to understand that MacArthur does not deny that people experience troubling thoughts, emotions, and behaviors—those clusters of symptoms to which the secular mental health world has attached names like OCD, PTSD, and ADHD. What he denies is that they have any biological origin. He and others appear to take up this position because, to date, none of these diagnoses have been assigned an agreed upon pathology. The etiologies (origins) of these disorders are not fully and finally understood and identified. This is an unfortunate position to take; among other things, the lack of an established pathology is not equivalent to the conclusion, “ADHD does not exist.” In order to take up MacArthur’s position, one must willfully deny the mountain of well-researched evidence pointing to biological origins and interactions. The fact is, medical science could be just around the corner from discovering an identifiable pathology for any of these diagnoses; living as if that is not true does not help anyone.
Considering ADHD specifically, there is valuable and intriguing research evidence pointing to a lack of “white matter” in the brains of young boys who have been diagnosed with ADHD. White matter is that stuff which makes up or contains the neurological tissue wherein information is properly transmitted in the brain. The lack of white matter, it is reasonably hypothesized, is a physical condition of the brain wherein ADHD may well be the result, among other negative health outcomes.
The good news is that there is a growing body of research suggesting strongly that young ADHD boys who receive appropriate stimulant medication (specifically with a drug called methylphenidate) will see an increase in white matter over time.2 This is all, by the researchers’ own admissions, correlative. They cannot and do not claim causation. But the correlations are significant. To dismiss them out of hand and prohibit sufferers the opportunity to potentially benefit from the findings with appropriate caution while simultaneously receiving biblical counseling is foolish. This runs afoul, in my estimation, of a Reformed understanding of common grace.
Further, research from a variety of sources bears significant data suggesting that children who receive proper medical care for ADHD experience better outcomes as they age in comparison to their peers who receive no medical care. The categories of concern include overall mortality and risk for drug abuse. MacArthur specifically warned parents that to medicate their children for ADHD would raise the risk of them becoming drug addicts. Unfortunately for MacArthur, the evidence is the exact opposite. Children who are properly treated for legitimate ADHD diagnoses (read: no, to over diagnosing and improperly medicating) experience lower levels of impulsivity, and as a result, see a significant percentage decrease in drug abuse.3
The circ*mstances I just summarized in brief remind me that MacArthur described ADHD kids as being “unable to sit still or pay attention.” This is a gross mischaracterization or simplification of what ADHD kids and their families actually experience on a daily basis. It is disappointing to know that some in the biblical counseling movement share this negligent understanding and take up ministry to these children and families as if these were the two main symptoms. In fact, the actual panoply of symptoms is quite diverse. If a biblical counselor intends to bring hope to those suffering from the effects of diagnoses such as ADHD, OCD, or PTSD, they owe it to their counselees and their families to be properly familiar with the actual experience and relevant data, and not settle for mere pop-level, colloquial definitions. Anything less is an inexcusable disservice to those we serve and a blight on the credibility of the biblical counselor’s work.
Trust Christ and All His Benefits
After MacArthur’s initial statements lit the internet on fire, he appeared on a podcast with social media personality, Allie Beth Stuckey. In the interview, MacArthur attempted to defend and clarify his previous statements. At the conclusion of the interview, MacArthur made what I considered to be the most disastrous of pastoral comments: “Trust Christ, not chemicals.”4
Of all the comments MacArthur offered in this saga, this was the most insensitive and nonsensical. Nonsensical, because no one in the Christian community with whom I am familiar is advocating otherwise; quite the opposite. Insensitive, because the inference is that those who choose medication after prayer and deliberation have chosen to be disloyal to Christ. Such an assertion is highly offensive and unwarranted. To weaponize the complicated and nuanced decisions that families and struggling individuals are making under difficult circ*mstances is spiritually manipulative. Is it possible that someone out there somewhere is doing just that? Sure. But one ought not shame the majority because of the poor choices of a few—particularly when lives hang in the balance.
Instead of subscribing to MacArthur’s view of mental health care—which rejects out of hand the impressive body of observational evidence available to us in the secular realm as the direct result of God’s common grace to all mankind, and without appealing to the problematic use of cobelligerent research (a common problem within particular corners of biblical counseling)—I suggest, along with many other biblical counselors, that we make meaningful use of common grace truth, while holding fast to our biblical worldview.
The irony is that the God who gave us his special revelation in Scripture is the same God who provides that common grace truth found outside of Scripture. The artificial bifurcation of these two bodies of truth, where the common is labeled as wicked and of no use to the Christian, is an unfortunate circ*mstance driven by a variety of unnecessary factors. I suspect that fear, suspicion, rationalism, and biblicism are among them, but those are not topics for this post.
In the end, I will commend MacArthur and others for their strong commitment to and desire for a church wholly submitted to God and his Word. I would commend them for their great desire to see people everywhere anchored in the hope of Jesus Christ for all of life’s dominating circ*mstances. I and those who stand with me hold the same desires; we even share many of the same biblical strategies in our helping ministries. The rub comes where we hold some divergent ethical conclusions that we each consider to be valid and important.
The church needs us to work hard at reconciling those differences, because as we bicker in public, real people suffer in silence.
As we lean into the future of mental health care and biblical counseling, we must pursue what it means to enjoy Christ and all of his benefits, and to hold out to sinners and sufferers alike the full breadth and scope of all the help and hope that is contained therein.
Notes
- “Is Mental Health a Myth? Guest: Dr. John MacArthur,” Relatable with Allie Beth Stuckey, Episode 1008, April 20, 2024.
- Helen Dwork, “Methylphenidate May Affect Brain Development of Children with ADHD,” Additude, April 1, 2024, footnote 1.
- Nicole Kear, Melanie Wolkoff Wachsman, “ADHD Medication Use Lowers the Risk of Death, Hospitalization: Study,” Additude, April 5, 2024.
- Allie Beth Stuckie, “Is Mental Health a Myth? Guest: Dr. John MacArthur,” Relatable, May 24, 2024, podcast.
©Joshua Waulk. All Rights Reserved.
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Joshua Waulk
Joshua Waulk is the founder and executive director at Baylight Counseling, Inc. in Clearwater, Fl. He is married to Christy, and has four children, three of whom are adopted. Josh earned his MA in Biblical Counseling at Southeastern Baptist Theological Seminary, and is completing his final project toward the Doctor of Ministry, also in biblical counseling at SEBTS. His project focuses on attachment issues in Christian adoptive parenting.
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