William P. Wilson, M. D.
Professor Emeritus of Psychiatry
Duke University Medical Center
Durham, N. C. 

Director, Institute of Christian Growth
Box 2357 Burlington, N. C.
27216-2347

Most scientists in the world today are trained in a natural philosophy that has become increasingly deterministic during the last century. As the body of scientific knowledge taught in our educational systems is saturated with determinism the supernatural is denied. Society has, therefore, developed increasing skepticism when it confronts the continuing claims of religious authorities that a supernatural realm really exists. Our way of thinking, or "scientific habit of mind" (Lewis, 1947, p. 43) does not allow us to consider the supernatural for more than a fleeting moment before we must dismiss it as an imponderable subject.

But there are those of us who have encountered the supernatural early in our lives. This may have occurred before we seriously embarked on a scientific career. If it did we have conflict when we discover that our belief in the supernatural is anachronistic. If, on the other hand, we have never encountered the supernatural and have accepted scientific determinism as the philosophy we live by, conflict is engendered if we encounter the supernatural. Conflict elicits unpleasant emotions such as fear, anger, or confusion, emotions that call for action to rid ourselves of the stimulus. As we do not like these painful emotions, we search for relief. In our search we may find that one of four solutions will ease our pain (Carter, 1977). The first is to compartmentalize our beliefs, creating two worlds in which we live, not allowing any intercourse between the two. The second is to reject the supernatural. The third is to attempt to make some integration if we feel free to do so. The fourth is to decide that all problems are spiritual. This is called spiritual reductionism. Reductionists reject any biological or psychological genesis of disease.

It is a sad but true fact that in a hostile world we scientists, who are Christians, most often choose to compartmentalize our faith even though we are warned not to make that choice (Deut. 30:19, Matt. 10:33). Instead we are ordered to integrate it, i.e. to live it. But how can we do this if we do not know how? Where can we learn how to achieve a usable integration? The answer to these questions are not readily available. There are few teachers and role models. Even those that exist generally tend to be inaccessible to us. Therefore, we are left with the alternative of trying to make our own integrations, if they are to be made at all.

Seventeen years ago the author had a radical encounter with God. After that encounter he soon learned that one could not separate the biological, psychological, social and spiritual aspects of a person’s being from one another. As God revealed his wisdom and knowledge, I found that the various components of human nature are a unity and have to be treated as such. As I was aware of my myopic view of human nature, I felt that it was imperative that I expand that view by trying to understand its spiritual component. As I struggled to achieve this, I found that I could not understand it until I developed a better understanding of the structure of the mind.

Desiring to be obedient, I searched the literature to find out if others had a broader view of human nature and mind, but I found little that was of use to me. This is not to say that much had been written, but it was too theological (DeGraaf, 1977) or too complicatedly scientific (Scher, 1962) to be of real use. Undiscouraged I sought to think it through on my own, but I needed a starting point. As I was theologically naive, I believed that the Bible was truth and that it led to all wisdom, so I began my search for understanding there. As I read, I discovered that I did not know that the human mind was driven by a supernatural animating force called a spirit, so that it was impossible for me to know how to integrate such a concept into the biopsychosocial model of the mind that had been presented to me during the years I spent in medical school and in psychiatric and neurological training. But there is more to learning than formal education; there is experience. I had experienced God, so I knew that He had communicated with me, and that he did it through my mind. As one of my patients later put it, "I knew things that I had not been taught." Since I was not scientifically naive, I knew that I was either insane or that God was real, so I had to determine which was the case. I found no evidence to prove that I was insane, therefore, He must be real. Convinced of his reality, it was absolutely imperative that I open lines of communication with Him. I needed to access his wisdom and to find out what he wanted me to learn and to do.

I began by trying to reformulate my understanding of the mind. Since I knew that the scientific view of man’s nature was incomplete, I again turned to the Bible. When I did, I found that I had a different problem. Because the Bible had come into existence over several thousand years, and had been composed in several different languages, the words used to describe the mind and its components often had different meanings. It was necessary, then, that I try to untangle these language problems. I did, therefore, choose one statement about our whole being that seemed to me to be most complete and use it as my starting point for clarification. The statement is in I Thessalonians 5:23. It describes the whole man as consisting of body, soul and spirit. It is true that this tripartite division of the whole man could have had its origin in Greek natural philosophy, a subject with which Paul was quite familiar. But when I looked for corroborating evidence, it seemed that even in the Old Testament (1 Sam. 30:12, 1 Kings 21:5, Job 26:4, etc.) this same division is found. It is just not as succinctly started.

Since spirit was the missing ingredient in my view of the nature of man, I first investigated that concept. In my search of the accumulated knowledge of the past on this subject (Come, 1959), I found that the concept of spirit had been around since man’s inquiries into his nature were first recorded. Even the most primitive of humans recognize that there are powerful and dangerous forces in their world. The life journey that they have to make is hazardous because the world is grounded in order and held intact by an inner irresistible logic, by laws that encompass the universe and give it order. At the same time these laws make living a dramatic risk for any particular unit of life (Thurman 1963, p. 64). Since early humans believed these forces or this force to be like the wind or breath, an unseen force, it is not surprising that they chose to use the word which means wind or breath to denominate the animating force or vital principle in living beings. To animate means to inspire into action, therefore, spirit is better defined as a vital force that activates living beings. Activation implies that there is movement, and movement has direction. In our three dimensional world this movement is toward or away from some one or some thing and it will have as its purpose the nourishment and recreation of life (Smith, 1955).

In the Bible, the word spirit (pneuma) is most often used with the meaning of animating force. It is always distinguished from soul (psyche), flesh (sarx), and body (corpus). St. Paul was quite clear in his use of the term as animating force (Eph. 4:23). Less often spirit is used as a synonym for mind, but none of the New Testament writers make this a primary usage. Occasionally spirit describes a state of heightened emotion (Eccl. 7:9). In this sense, it is still an animating force but has been given the added quality of a specific emotion. Finally, spirit is used to describe non-corporeal or transcendental personalities such as Satan and his minions, (Acts 17:16, II Cor. 11:4, etc.) As well as the non-corporeal personages of persons who had at one time been alive (I Sam 28:12, Matt. 14:26, Luke 24:30, 37). After I had completed my survey I chose to view man’s spirit as animating force.

To my dismay I found that such a definition was not congruent with the theological literature. Only two authors, Watchman Nee (1968) and Arnold Come (1959) confronted the necessity of trying to clarify the concept of man’s spirit. In Come’s book, man’s spirit is defined as personality or mind. As I examined his views I realized that his definition arose out of an existential bias in his thinking, but the thing that seemed to have influenced him most is the biblical description of the Holy Spirit as total being. It is only logical that he should believe that our spirit, like God’s, is mind (John 4:24).

But our thoughts are not God’s thoughts. We cannot ignore the fact that the Bible primarily uses the word spirit as the animating force in man and considers it the innermost part of man’s mind--the force that animates his body, soul and flesh. I believe, as does Watchman Nee (1968), that it is not only exegetically permissible and correct, but also psychologically preferable, to view man’s spirit as an animating force.

Not surprisingly, psychology has said little about man’s spirit in recent years. The last person to discuss the subject with any authority was Joseph Jastrow (Reymert, 1928). He described the presence of a force that had been given names such as Elan Vitale, Horme, or Life Force by other writers. He was vague in his definition of this force and did not discuss its role in the function of the mind. Deterministic psychology since that time has ignored it and has believed that the mind is driven by the "Id" which, until recently, has been considered the sexual drive. This concept, proposed by Sigmund Freud (1927), has been accepted as the most basic functional unit of man’s nature or mind. It has created a serious problem for Christians and many non-Christians since it deprives humans of their uniqueness and equates them with all other animals. If Freud’s hypothesis is correct, humans have no raison d’etre.

As a Christian I found it necessary to reject such a view of man’s nature because I believe, after experiencing the joining of God’s Spirit with my spirit, that He has directed me toward a higher good. I no longer accept the humanistic psychology that I had acquired in my education and feel so I have developed a new one based on a view of the nature of man that includes the spirit. With this I am able to see wellness as harmony between God, man, and the world. I now define disease holistically because I include the spiritual dimension of his nature.

Now if we reject the standard view of human nature and add a new dimension, it becomes clear that we must reshape our views of personality development. Time will not allow us to discuss personality development here, but it is important to realize that if one adds a spiritual dimension to human nature, then those theories of personality development that have their origin in biology, those that attribute the development of personality to sexual drives, and those that insist that all personality attributes are learned are unacceptable. The radical restructuring of the process of personality development must assign appropriate significance to the biological, cognitive, emotional, behavioral, and spiritual factors that influence its formation. This we have attempted to do.

Since I cannot discourse on the subject of personality development here, I ask you to believe that I have formulated a theory that does ascribe a significant role to the various factors mentioned above. This allows me, then, to go on to a brief discussion of the subject of mind; a discussion that is more closely related to the remainder of this presentation.

Before we turn to the structure of the mind, I must mention a major problem that has to be faced before we can consider the structure of the mind. This problem is whether the brain and the mind are a unity, or whether the mind exists above the brain and interacts with it. Sir John Eccles (1980, pp. 17-26) has recently reviewed the subject and enumerated the various theories that are extant. These he divided into two groups, the materialist and the interactions. The materialist theories state that the mind and brain are a unity and one cannot exist without the other. The interactions theories assert that the mind determines and controls the function of the brain. There are, however, two of these theories. The first called dualist-interactionism is the only one that is compatible with the biblical view of the mind because it asserts that the mind can exist independent of the brain. Emergent-interactionism, the second theory, asserts that the two are inseparable. If we examine these theories in the light of our biblical understanding of man’s existence it is clear that there is only one acceptable theory and it is dualist-interactionism. There can be no afterlife if the brain and mind are not separable.

Having examined the mind-brain problem, we can turn our attention to the structure of the mind. We have already commented that it has certain functions. These, once again, are biological, cognitive, emotional, behavioral, and spiritual. In the accompanying diagram (Fig. 1) I have attempted to show how the mind "lives" in the environment that is called the "world". At the top we see the interaction of the organism with the world through its sensory system. This information is routed into many different parts of the system. It is my belief that once it gets into the brain it is distributed to the various subsystems over parallel routes that are controlled by a central system. This synthesizes the output of these subsystems through the process that we call thinking, into some form of response that either ignores the input, stores it for future reference, or acts on it with a response that we called "behavior output". As you view the diagram you will note that I have accounted for all of the various functions mentioned above, but have detailed the functions of the soul. In the diagram we used the term affective tonus, a concept developed by Sir Charles Sherrington (1963), to denominate the spirit.

SPIRITUAL DEVELOPMENT

If we believe that man possesses a spirit that is an integral part of his mind, and that it influences the development of his personality, it is necessary to move on to a better understanding of how, when and under what circumstances man’s spirit and God’s spirit join (Rom. 8:16). Then we will determine what effect this has on the further development of the person.

At birth a child has a manifest spirit that is vigorous and diffuse in its expression. His spirit animates his cries, his search for food and his movements. As his body matures, his spirit becomes channelized and he begins to crawl and then to walk. As he acquires mobility, he aggressively explores more distant areas of his environment, seeking greater freedom. If restrained, he protests and seeks release from restraint.

When, in time, he develops speech, his willful desire to control his activity is immediately verbalized. The toddler says, "Let me go! I want it! No!"

From his birth to his death, man’s spirit seeks to determine its own direction. During childhood this self-direction needs to be guided by significant others into channels of constructive activity. The soul is then, to some extent, a blank page that must be filled with appropriate ideas and emotional expressions. This is the nurturing job of both parents and culture. After puberty, the spirit strives to be more unfettered so that it can seek its own destiny. If there has been appropriate training the individual will have self discipline. Usually separation and individuation takes place as self discipline develops. Even so, the adolescent’s inherently rebellious spirit drives him to do things that are in conflict with the values that he has learned. He does this because he encounters others with contrary values. This knowledge drives him to test his own values. As he tests them, he learns that the behaviors in which he is indulging elicit pain in his own life and in the lives of others. Since he wants to avoid pain himself, and does not desire to inflict pain on others, he will control his behavior and live by the values that he has been taught, or has learned out of necessity. The term values, as used here, are those things that make a favorable difference in a person’s life (Baier, 1973).

In the unregenerate state man has to struggle to control his behavior. He lacks the power to control his human nature, so it is no wonder that he sometimes gives up the struggle and "drops out", or ends his life when he realizes that he cannot live life without hurting others and himself. What is more tragic is that he realizes that he is trapped and cannot free himself of the problems of morality, the lack of meaning in his life and the unreasonableness of death. Most tragic is that he does not know that he has a way out of his state of despair. God has provided it. He has promised to give him control over those behaviors that give rise to pain in his life and in the lives of others. He has promised to provide meaning in his life, and he has promised him victory over death.

We have noted that man’s mind, which includes his spirit is uncontrolled in the unregenerate state. Its activity gives rise to many negative emotions. But what about positive emotions such as love? Does the unregenerate person experience positive emotions? The answer is yes. From birth to death a radical neediness that is generated in his spirit will drive him to seek love. Man begins his love life with his parents, whose own spirits cause them to love him. They nurture him in love until he is capable of managing his own life. Then they free him to become an autonomous person. Because of this loving relationship the developing child learns how to love not only himself, but also others.

At puberty the child develops a neediness for the opposite sex. Marias (1971, p. 181) has described this neediness as a "radical" neediness. If not inhibited its natural fruition is in marriage. Love moves men and women to installation (or becoming one) in each other and provides a spiritual union. Here it is important to note, that just as there is a oneness with one’s parents that is never totally dissolved, so should the oneness with one’s spouse never be dissolved. A further fruit of the installation of a person in someone of the opposite sex is marriage, and ultimately the procreation of children who are installed in the oneness of the parent’s relationship.

All of mankind has one more radical need and this is for the numinous. Everyone was created to live in union with God even though that union was broken. Without God we are incomplete, and to become whole we must install God at the deepest level of our being. We can only do this, though, by an act of our will. We do not tolerate readily the imposition of another’s will above our own (Smith, 1955, 23-38), even God’s. We can, though, voluntarily submit ourselves to God, ask him into our life and accept him as Lord and Master to install him. Since Jesus Christ is the way to God, we ask him into our lives and the installation is accomplished (John 14:6).

With this act we are regenerated and unusual things happen. We enter, what was called by William James ( 1961, p. 202), the assurance state. Because God has joined his Spirit to our spirit (Rom. 8:16) and we know his love, we are assured of his existence, something that we have not known before. Another thing that occurs is the healing of the despairs of our lives. We have found out that we have something and someone to live for, therefore, our lives have meaning. We can control our desires, so we do not despair of morality. And because we know that we will have eternal life, our despair of death is healed. Next because our moral transgressions called sin have been forgiven, we develop a new sense of cleanliness within. Released from the emotional burdens that we had we now see the world differently. Suddenly there is sunshine, blue sky, green grass, bubbling water in the streams, and a world full of beauty. This is God’s creation and its beauty is remarkably illuminated.

But there is more, for we perceive truths that we have not know before. First we begin to understand the reality of the Trinity. God is the Father who revealed himself in the Son, and the Son is revealed in the Holy Spirit--the Spirit of Christ and the Spirit of God. This occurs because the Spirit reveals the truth about God (John 14:17, 16:13). This revelation further strengthens our faith and increases our certainty as to the trustworthiness of God. The Gospel doesn’t make sense to a person without faith. To him it is one more comparative religion, perhaps of slightly more importance than those of Buddha and Mohammed. For a real Christian, the Gospel is a reality.

Another truth revealed to us is that God’s commandments are absolute. All men know God’s truths, for they are written on our hearts, and if we have a Bible available to us we can find them in his Word. But even more importantly we find that they have been illuminated and their value becomes a reality. We know that they make a favorable difference in our lives if we live by them, and that we will ultimately suffer pain if we do not. Thus we seek to be obedient, and with the power that we have acquired through God’s presence in our lives we are able to begin to live by these values.

Along with the perception of truth we will notice changes in our behavior. The first is that we find that the world we lived in is not as desirable as it had been. We no longer seem to have anything in common with the persons with whom we formerly associated. We do, then, seek new friends, people who will talk to us about the things that we now find more interesting and whose behavior is more congruent with what we consider to be appropriate to our new beliefs. When we associate with them we find that our knowledge and understanding of the Christian lifestyle increases. Among these people we are rewarded with affirmation when we successfully live as the Lord would have us live. But even when we are unsuccessful and have been chastised, there is forgiveness and reconciliation available to us and we are immediately restored to fellowship with God and man.

Lastly, in the assurance state the Holy Spirit leads us to continue to desire to know God better. We want to communicate with him through prayer, Bible study and the Eucharist so that we better know his will and do it to achieve our chief end, His glorification. His will for us is that we be loving. That we love Him, our spouses, our children and our fellow men. In loving we put the best interest and welfare of everyone above our own. We give water to the thirsty, food to the hungry, clothes to the naked, and visit the sick and the imprisoned. We are changed from selfish to selfless persons.

The emotional changes that take place in our new state are many. First our despair is relieved and replaced by joy (Ps. 30:11). Second our love is amplified and we are able to show it in our relationships (Gal. 5:22). Thirdly, when we contemplate God’s love and power we are filled with awe (Rev. 4:11). Fourthly, fear is gone because we know that God, Creator and Controller of the universe, cares for us and will guide and protect us (I John 4:18). Fifthly, we do not have to be ashamed because our inadequacy and wrongdoing has been forgiven (I John 1:9). Sixthly, our anger and hate can be decathected because we know that we have both the desire and the power to forgive those who wronged us (I John 1:7). Lastly, because we know that we will have eternal life we do not have to dread death (Rev. 21:4). In this new state of existence we have hope.

The changes described above dramatically alter our will, a compound function of the mind made up of the spirit channelized through the soul. Since power is increased and God’s values have primacy over those of the world, we observe a redirection of will. Usually, God dramatically changes our direction in some areas, but others require nurturance in the faith. In more severe cases, counseling is required.

In the above I have described the changes that occur when a person experiences conversion. In the following, I will describe the changes that take place in the process called sanctification. If you remember, I observed that spiritual conflict develops in the mind of the unregenerate person before he or she is finally forced to surrender his or her life and accept the lordship of Christ. Figure 2 is a flow chart that details the paths that may be taken by a person from the time that the Holy Spirit begins to woo the lost person to Christ.

We begin our movement through the Christian life with a sinful person that is oriented to self. At some time in their life this person develops an existential despair of meaning, morality or death. This despair is made up of the cognition that there is no hope in worldly things, as well as the painful emotions of sorrow, anger, fear, emptiness, confusion or pain. Because of them they suffer. At some time, the Holy Spirit reaches out to them. This occurs because of God’s unfailing love (Rom. 10:21). The love that draws the sinner to God is called prevenient grace. By this grace they are guided to God’s message. Then their ears are opened, or the veil taken from their eyes, and the truth about God is revealed to them. This truth is illuminated by the Holy Spirit in the message that they hear. They now understand and know the steps that are necessary to achieve salvation. These are confession, repentance and the receipt of forgiveness. When they make Christ Lord of their life, salvation is achieved and the Holy Spirit dwells in them.

Here it is necessary that all those who receive Him realize their forgiveness and accept it! Only with acceptance of forgiveness is their salvation complete.

But salvation is not enough. Almost every person brings into their Christian life the accumulated garbage of hurt, anger, fear, confusion, shame, pain, and emptiness accumulated when they were unregenerate. Most of them do not know how to be a Christian. Most lack a firmly established set of values to guide their life. They do, therefore, need a complete change of their mind to transform them into the new person that God wants them to be (Rom. 12:2, II Cor. 5:17). This transformation only takes place when they are discipled.

Unfortunately, few people in the church know what this entails. If one searches the theological literature, they find that little has been written about this subject. Even one of our largest protestant denominations has neglected this need. When I was a member of the Curriculum Resources Committee of the Board of Discipleship of the United Methodist Church, I learned that there was not a single piece of literature that could provide a new believer an in depth understanding of how to live their newly acquired faith, or how to apply it to the transformation of their mind. To be sure there were a few isolated pieces in different series, but it had not been brought together to make it readily available to the average church member. A search of the theological library in my university and local bookstore shelves also failed to reveal any single piece of literature that I considered adequate. Appalled I realized that most persons in the church did not know that discipleship is learning how to be a Christian.

The process of becoming a disciple is multi vectored. To begin it, one must learn more about God. Our Lord said that we are "to learn of him" (Matt. 11:29), and we are told by Isaiah (26:3) that we will have perfect peace if our mind is "stayed" on him. To learn about him we must go to our primary source of knowledge, the Bible. "It is inspired by God and is useful for teaching the truth, rebuking error, correcting faults, and giving instruction for right living, so that the person who serves God may be fully qualified and equipped to do every kind of good deed." (II Tim. 3, 16, 17) It teaches us the things that are important for us to know.

The second vector of the process of discipleship is a prayer life. When I first became a Christian I was appalled to learn that I and most other Christians did not know how to pray. That most do not know how to pray, and do not understand the importance of prayer, is manifested in the observation that most Christians pray very little.

But there is more to praying than just spending time, for one must know for what and for whom one must pray. They should know to pray for all persons, for the sick and troubled, for sinful brothers, for neighbors, for the church and its members and for governmental leaders. Then they should know that there are many kinds of prayer. There is intercessory prayer, petitionary prayer, prayer of adoration, prayer of thanksgiving, prayer for healing and prayer of and for forgiveness. I could go on but space does not allow me to give a complete discourse on prayer, therefore, I emphasize the importance of knowing how, where, when, for what and for whom we should pray.

Christian healing is facilitated if the Holy Spirit is active in the process. I described earlier the changes that take place in a person’s life with conversion. These occur because the Holy Spirit comes to dwell in them (John 14:20). Upon His coming He reveals the "truth" about God (John 14:17) and Christ (John 16:14), and imparts power (Acts 1:8). This power energizes the behavioral changes that come when God’s commandments are adopted as our value system. Along with the power come gifts. Some persons receive the gift of healing, a gift that is of great value to the physician or any other person, for that matter. The gifts of wisdom, faith, teaching and discernment are most useful to a psychiatrist or counselor. The healer and the person being healed must discover their spiritual gifts and use them. It is important that both understand the work and person of the Holy Spirit.

Just as important in the process of healing is that the physician and patient know and do God’s will. Average Christians have absolutely no idea about how to ascertain God’s will for their lives. There are a few simple rules but they are rarely taught. They are: (1) What does the Bible say is His will? (2) What does the Holy Spirit speaking through one’s inner being say about it? (3) Is the action to be taken possible or are there seemingly insuperable obstacles? (4) What do mature Christian advisors say about it? (5) What does common sense say about it? (6) Does the action taken and its outcome glorify God? These few questions should be asked about all major or minor decisions that a person makes (I Cor. 10:31).

Discipleship also includes the integration of the person into a warm fellowship where they can grow in their faith. This fellowship should provide the opportunity for the development of friendships, learning and the opportunity for worship that is more that liturgy. True worship provides the opportunity to know the joy of the Lord. In true worship the sacraments are administered in a way that makes them meaningful for all the celebrants. This is especially true of the Eucharist, for along with prayer and Bible study, it is a means of grace.

Obviously there are more facets to discipleship than the subjects mentioned above. There is stewardship, witnessing, service, the exercise of all of the gifts of the spirit and others. But I think I have made my point. We cannot practice Christian healing, and patients cannot take advantage of the healing power of their faith without having been discipled.

Finally in the process of being discipled we learn that we must serve our neighbors. We are to feed the hungry, give water to the thirsty, clothe the naked, take strangers into our homes, and visit the sick and the prisoners. Discipleship is to prepare us for service! God does not expect Christians to be like everyone else in the world. We are to be radically different from the natural man. We have been called to be a nation of priests (Ex. 19:6) and as such are ministers to a lost, sick and dying world.

CONCLUSIONS

In this paper I have endeavored to elucidate the theological and psychological bases for a truly Christian practice of medicine. Since I am a psychiatrist, I focused my comments of my views of human nature and the fact that there is a spiritual component to that nature. Because humans are spiritual it is possible for God to communicate with them and thus draw them to Himself. He then reveals Himself. If they accept His lordship they are converted and become a new person. They do, however, need to be "cleaned up". This can only take place if they are discipled. I concluded my remarks by describing some of the vectors of discipleship. In the next paper, I will discuss how spiritual disease develops and the interventions that are necessary to heal that disease.

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