09 Oct

Understanding ADD/ADHD Using This Biblical/Theological Lens

  The biblical counselor must honestly inform the parents that one cannot find ADD in the Bible. That said he must also inform the parent that the label, like the names of all psychological disorders, refers to a collection of observable behaviors known as criteria or symptoms. Psychology views the whole collection of behaviors as one by giving the collection a label that we call a diagnosis. That diagnosis becomes greater in psychology than its behavioral parts.[1] While some claim that ADD results solely from a biological source, since diagnosis depends on behavioral abnormalities, it seems consistent to view ADD as something very loosely connected, if at all to a medical problem.[2]

Even in the most recent fact sheet about ADHD published by the DSM-5, they still state that the disorder exhibits a pattern of behavior, not biological test results, which includes no less than six behaviors of inattention and hyperactivity or impulsivity.[3] Most importantly even ADD experts admit that all children display ADD behaviors at one time or another.[4] Thus a biblical counselor can reassure parents that their child does not have a problem that biblical parenting cannot address. The parents may rightfully respond that if the issue simply results from bad behavior, then they will just discipline the child more consistently. At this point the biblical counselor must balance his comments and make sure the parents understand exactly what biological problems could exist and exactly what biblical counseling offers.

Research, while inconclusive does show some connection between certain states in the brain and the behaviors associated with ADD/ADHD. Drugs like “Ritalin [do] not treat any known chemical deficiency in a child’s brain…” but act instead like aspirin to temporarily suppress symptoms.[5] Children with alleviated symptoms do have greater control over their behavior. None of this research has yielded conclusive enough results to even develop the most rudimentary biological test for the disorder. Experts utilize subjective behavioral and aptitude assessments to corroborate criteria in order to diagnose a child with ADD.[6] Parents need for the biblical counselor to indicate that even though medications do help symptoms, God created their child with a unique makeup that they can address with something no medicine or method can, a personal relationship.[7]

Some parents may ask, “What characteristics caused others to think my child has ADD?” Without knowing it, the parent most likely recognizes the major unifying factor among the ADD criteria; namely that “the ADD child is plagued with poor regulatory ability.”[8] Attention wanders and fixates, the child cannot filter out distractions and impulsivity marks the child’s activities, responses, and variable moods; which apart from the intensity and frequency appear like those of all other children.[9] This may appear a daunting collection of behaviors to address, however the biblical counselor can refer to Deuteronomy 4:9. This verse tells parents to keep their souls diligently, remembering what God can do as they diligently make Him known to children and grandchildren. Diligent care to regulate one’s soul and that of children has always characterized biblical parenting.

Parents may reasonably assess the criteria a psychiatrist uses to diagnose ADD as “simply [characterizing] fallen human beings, who need God’s grace to become more attentive, considerate, diligent, loving, and faithful.”[10] Even so, a biblical counselor helps the parent and child to recognize that ADD, may actually may occur due to admixture of genetic and biological makeup as well as the individual’s desires, choices and prior actions. Thus the real question a biblical counselor should help the family ask addresses whether or not “there are times when, because of my brain, I am not responsible for my behavior?”[11] This question delves into areas which this paper cannot explore however, to sum up briefly, whatever the heart desires the brain and body do. Even so, a weakened body can influence the heart by demanding a response from the heart concerning its areas of weaknesses.[12]

If this stands true, the person affected by the unique temptations of ADD still stands responsible for choices in the heart to pursue known wickedness issued by his weakened body This sort of responsibility, the Bible calls sin. To that one may also add another category of biblical responsibility, called weakness. Weakness in this sense represents suffering resulting from giving in to temptations issued by the body not known in the heart as wicked.[13] To illustrate, the person who willfully disrupts the church service stands guilty of a more serious offense to God than an ADD child who inadvertently disrupts the congregation by loudly humming the last hymn during the sermon. The same behavior of disrupting the congregation does not receive the same discipline due to the inward intent of the heart.

Biblically, these observable behaviors represent choices that may derive from sinful and righteous desires upon which the child has acted.[16] In other words, no matter which weakened state the brain or body suffers from, only the heart can choose to sin.[17] With that in mind, the biblical counselor can explain that the help he offers this family counsels them to encourage and train their child to make repeated choices which please God, in spite of the body’s temptations.[18]

The parents and children affected by ADD do not have the expertise to have much effect upon the child’s biology; however they can certainly take responsibility for the child’s environment, routines, and relationships so as to help the child make consistently God-pleasing decisions.[19] To do this the parents must diligently seek to distinguish between what appears as physical weakness and that which appears as spiritual sinfulness. With an ADD child the parent should ask himself if the defiance stems from a conscious decision or an inconsistent understanding.[20] For instance, the child leaves a mess in the room he just left. If the parent told him before his departure to clean the room, then he consciously decided not to clean his room. If the parent did not remind him assuming he would remember the house rule, then the parent can assume he did not consistently remember the standing rule. Conscious decisions to defy a parent warrant direct redemptive discipline. Parents must also address inconsistent understanding, with formative discipline. They do so by reminding the child of the rule and offering him a “second chance” to get things right. Further, the parent can begin forming a better discipline structure, by getting to know the type of reminders, like posted charts and lists or non-verbal signals, which help the child to manage his behavior. In all these, the parent avoids reacting to problems by planning ahead to address them.[21] The biblical counselor should perhaps even have the parents memorize verses like Proverbs 15:1. This verse tells them that a soft word turns away wrath, a key reminder that parents need as they discipline their child in ways that please God.

If no efforts like these improve the child’s ability to function, someone may mention medication. Just like any other adjustment to the child’s environment, parents must take responsibility both to consider the medication as well as continue to help the child to make the right decisions. As with any medication, wise advice relates the truth that “just because a drug has an effect does not mean it is appropriate – or biblical.”[22] The parent must diligently train up a child. The parent has the freedom to decide that medications such as Ritalin offer enough positives to warrant use. That said, the parent must always remember that “the question is more ‘is it wise?’ than ‘is it wrong?” Parents should seek the wisdom of Scripture which the apostle Paul offers when he says “All things are lawful for me, but not all things are helpful. All things are lawful for me, but I will not be enslaved by anything.”[23]  Believers when dealing with the use of a lawful substance must gauge its biblical appropriateness based upon its helpfulness for Christian ministry as well as whether it enslaves the person who uses it. For some Ritalin and other medications may pass this test. For others, no psychotherapeutic drug will pass this test. For either, the parents must seek to raise the child in a way they believe pleases Christ.

Parental involvement towards establishing formative and redemptive discipline may seem daunting, but crucial to the growth of the child towards pleasing God. Far from having a crippling disorder which forces the child to always choose sin, the times when the child gives into his body’s weaknesses expose the desires of his heart.[24] The biblical counselor should help the family to think of 1 Peter 2:21-22 which says that “Christ also suffered for you, leaving you an example so that you might follow in his steps. He committed no sin, neither was deceit found in his mouth.” Christ left a sinless example for the child in those areas in which a child finds difficulty behaving acceptably or profitably. Those areas become the proving grounds that the parent must diligently seek to train him to become more like Christ, not more manageable.  Even though one cannot find ADD in the Bible, one can find biblical wisdom which will guide him towards a God-pleasing solution for each of the observable behaviors which come underneath the category heading ADD.

[1] John Babler, “A Biblical Critique of the DSM-IV.” The Journal of Biblical Counseling 18, no. 1 [Fall 1999]: 25.

[2] Robert Smith, “ADHD” (lecture notes, Redeemer Biblical Counseling Training Institute,  Duncan, SC Spring 2013)  pg 74.

[3] DSM-5 Attention Deficit Hyperactivity Disorder Fact Sheet (American Psychiatric Association, 2013)

[4] Warren, 3.

[5] Edward T. Welch, Blame It on the Brain? Distinguishing Chemical Imbalances, Brain Disorders, and Disobedience (Phillipsburg: P&R Publishing, 1998), 142-143.

[6] Warren, 21

                [7] Warren, 150

[8] Warren, 10.

[9] Warren, 10-14.

[10] Babler, 27

[11] Welch, 27.

[12] Welch, 40-41

[13] Welch, 44.

[14] Warren, 14.

[15] Babler, 27

[16] Babler, 29

[17] Welch, 49.

[18] Babler, 25.

                [19] Warren, 78-91.

[20] The concepts developed by Welch, 136-139 for the purposes of this paper have been reworded.

[21] Welch, 141.

[22] Babler, 27

[23] 1 Corinthians 6:12-13.

[24] Welch, 57.

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Posted by on October 9, 2013 in Shepherding


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