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Christian Suffering and Therapeutic Narcissism: Simon Jooste on a Biblical Approach to Prozac, Part 2

4 June, 2008

Suffering and spiritual flourishing

Suffering in general and depression in particular are not things to be glamorized or sought out as good things. Yet, “[s]uffering is an evil out of which the God revealed in the crucified and risen Jesus can bring good.” (1) Thus, we should always be in two minds about it. Suffering can neither be eliminated from human life nor written off as having no purpose. Jesus should be our model here. In Gethsemane Jesus shrank from the suffering that was to some, yet accepted it as part of his calling and obedience (Matt. 26:36-42). (2) Like Jesus, Christians are called to suffer for the sake of the kingdom (Lk. 9:23; Rom. 8:17; 1 Peter 1; James 1). “The suffering that comes is an evil, but the God who in Jesus has not abandoned us in that suffering can bring good from it for us as for Jesus.” (3)

By virtue of his union with Christ, the Christian’s life is inextricably tied up with various forms of suffering (Rom. 8:17; 1 Peter 1:16). He follows in the footsteps of his Savior who drank the bitter cup to its dregs so that we might have life. The insignia of the cross is upon every Christian and suffering is a key ingredient to spiritual flourishing (Job; Ps. 119:67; 1 Peter 1:6-7). Only a regenerate Christian understands the ‘foolishness’ of a suffering Messiah and the according weakness and despised nature of the Christian life (1 Cor. 1:18ff). The following are some more specific ways in which Scripture reveals the benefits of suffering, which includes depression. (4)

First, suffering strips the Christian of self-sufficiency and self-exaltation, and casts him upon the righteousness of Christ. In other words, suffering forces the Christian to live by faith (2 Cor. 12:9; 2 Cor. 1:6; Heb 11). Jesus entrusted himself perfectly to the Father as he faced his coming passion ordeal (Matt. 26:42). Furthermore, for the Christian, suffering tenderizes the conscience towards sin and fuels a life of repentance (Rom. 7-8:1).

Secondly, suffering becomes, in the hand of God, a tool by which virtue and good works are fashioned in the believer (Js. 1:2-4; Rom. 5:3-5). Jesus learned obedience through what he suffered (Heb. 5:8). This is no less true for the Christian. Speaking more concretely, suffering drives the Christian out of himself to love his neighbor, to empathize with others, and to be a part of the life of Christ’s church (2 Cor. 1:4; Rom. 12). Suffering not only fashions the fruit of the Spirit individually, but benefits the local church at large: opportunities to love and be loved. (5)

Thirdly, suffering teaches the Christian of the distinctiveness of the Christian life. The Christian life is one of a groaning pilgrimage through the desert of this age, yet simultaneously caught up in the age to come (Eph. 2:6; Col. 3:1). Suffering sensitizes the Christian to the already-not-yet tension of this life, thus guarding against the extremes of despair and triumphalism (under and over realized eschatology) (Heb. 11:1).

Fourthly, and drawing upon the first three, suffering orients Christian living toward the glory of God and his enjoyment (WCF 1; 2 Tim. 2:10; 1 Pet. 1:7). Not only does suffering teach that Christ alone is the way of salvation, unto the glory of the Father, but also that God ultimately dictates happiness and the limits thereof in this life. God’s revelation is ultimate authority for giving understanding to this life. Suffering presses the patient on to glory in God and his providential care.

Looking for heaven on earth: Navigating a culture of therapeutic narcissism

While the Christian lives simultaneously as a member of two kingdoms, wholesale consumption of culture is deadly. A suffering Savior and his cross-bearing followers are folly to the world. Generally speaking, western culture gravitates towards a theology of glory. (6) Whether atheist or not, most forms of modern western spirituality exalts human autonomy, excuses sin, and shuns suffering. Accordingly, there is an attraction to a medical model that reduces emotional experience and well-being to mere biology: the a-moral firing of neurons or secretions of serotonin. In this view, man is just another animal in a morally indifferent universe, having power to re-create, the ability to write his own script. (7) With moral straps loosened, the sky is the limit for experiencing ‘happiness’ in this life. This has led some to describe the ethic of the age as one of pragmatic narcissism (longing for a state of bliss): the triumph of the therapeutic. (8 ) Practical success is a suffering-free and pleasure-filled individual experience. (9) Prozac becomes yet another form of therapy for tangible existential results. Neither practitioner nor patient remains unaffected by the spirit of the age. (10)

Redefining Illness

With a priori proclivities towards locating mental/emotional malfunctions in the body alone, coupled with a narcissistic push for pleasurable well-being, the diagnostic pool for illness invariably widens. Accordingly, health and wholeness looks and feels something like “a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity.” (11) Indicative of this trend is Dr. Peter D. Kramer, who has argued categorically that depression is an illness rooted in the physiology of the brain alone. In his latest book, Against Depression, he campaigns to eradicate depression altogether, just as medicine once eradicated smallpox. (12) While some forms of depression may have physical roots, Kramer is illustrative of a trend toward labeling every form of sadness as sickness (and thus eligible for Prozac). Accordingly, appropriate grief over the passing of a loved one is now considered a form of illness that must be medicated. (13) Likewise, healthy mourning over sin is considered questionable. (14) The medical community and its view of self are threatening to redefine normal emotions and temperament. But for the limits of medical advance, every effort is made to reshape and reform all those who fall short of complete well-being – if not make them better than well. (15)

The Happy and Triumphant Self

Organically related to the redefinition of illness and drawing upon the same a priori assumptions, is the leveraging of Prozac for re-creating the happy and triumphant self, for better personal performance. With drugs like Prozac and more powerful ones on the horizon, comes the possibility of designer personalities through cosmetic psychopharmacology. (16) As supposed ‘masters and possessors of nature,’ man is able to refashion parts of his psyche that don’t suit him. (17) Thus, the under-endowed melancholy personality gets a sanguine boost from Prozac.

A close cousin to the above trend is something socially akin to steroid use in the athletic arena. Like athletes who soar above their natural abilities through the use of anabolic steroids, Prozac is being used to enhance individual performance in society. Society defines optimal performance as emotionally upbeat resilience and pressures its members to conform accordingly (for a happy and pleasurable existence). (18 ) As a result, the accounting clerk looks to Prozac to avoid emotional dips on the job and better position himself for making manager one day. The mother of three turns to Prozac because society has no place for an anxious and frazzled, let alone depressed, individual. Prozac becomes the magic pill to meet the peer pressure of society: the collective drive for establishing heaven on earth. (19)

  1. Gilbert Meilaender, Bioethics : A Primer for Christians, 2nd ed. (Grand Rapids, Mich.: W.B. Eerdmans Pub. Co., 2005), 7.
  2. Ibid., 63.
  3. Ibid.
  4. This is not to say that common sense and natural law do not point, in a limited sense, to the profit of pain. The President’s Council for Bioethics points out that sorrow teaches and discontent provokes living in ways we would not otherwise. See President’s Council on Bioethics (U.S.) and Kass, Beyond Therapy : Biotechnology and the Pursuit of Happiness, 258-60. See also Eric G. Wilson, Against Happiness : In Praise of Melancholy, 1st ed. (New York: Farrar, Straus and Giroux, 2008).
  5. M.D. Joel Shuman and Brian Volck, Reclaiming the Body: Christians and the Faithful Use of Modern Medicine, ed. David S. Cunningham and William T. Cavanaugh, The Christian Practice of Everyday Life (Grand Rapids: Brazos Press, 2006), 41-62.
  6. It is assumed that the theologies of the cross and glory arise as categories from Scripture and every person is an adherent of one or the other (see Walther von Loewenich, Luther’s Theology of the Cross (Minneapolis: Augsburg Pub. House, 1976).; Michael S. Horton, Too Good to Be True: Finding Hope in a World of Hype (Grand Rapids: Zondervan, 2006).)
  7. Algis Valiunas, “Sadness, Gladness-and Serotonin,” Commentary 121, no. 1 (2006): 62. In this view, even if spiritual impulse or issues of the heart are cited as causes for our actions, they can’t surely be the cause of bad behavior, for man is naturally good.
  8. Horton, Too Good to Be True: Finding Hope in a World of Hype, 51. Writing on the therapeutic age in which we live, Philip Reiff described it as having individual well-being as an end in itself, “rather than a by-product of striving after some superior communal end” thus shifting focus “toward a human condition about which there will be nothing further to say in terms of the old style of despair and hope” (Philip Rieff, The Triumph of the Therapeutic: Uses of Faith after Freud, [1st ed. (New York: Harper & Row, 1966). The therapeutic sensibility can be further explicated as that “feeling, the momentary illusion, of personal well-being, health, and psychic security” (Christopher Lasch, The Culture of Narcissism : American Life in an Age of Diminishing Expectations (New York: W.W. Norton & Company, 1991).)
  9. Rieff, The Triumph of the Therapeutic: Uses of Faith after Freud.
  10. Gilbert Meilaender notes that there once was a time when physicians reflected on the moral meaning of their practice. However, the moral meaning of health and medicine has become increasingly secularized, “driven by the view that public concensus must exclude the larger questions about human nature and destiny that religious belief raises” (a minimalist approach). Public policy and medical opinion is shaped as a result (Meilaender, Bioethics : A Primer for Christians, xi.) It has also been observed that the efficacy of antidepressants has also shaped professional thinking (John Stapert, “Curing an Illness or Transforming Self? The Power of Prozac,” Christian Century, no. July 13-20 (1994): 685.) For bibliographic sources on forces shaping the thinking of the medical community (President’s Council on Bioethics (U.S.) and Kass, Beyond Therapy : Biotechnology and the Pursuit of Happiness, 313-28.)
  11. Meilaender, Bioethics : A Primer for Christians, 44.
  12. Valiunas, “Sadness, Gladness-and Serotonin,” 60. See Peter D. Kramer, Against Depression (New York: Viking, 2005). See also —, Listening to Prozac (New York, N.Y., U.S.A.: Viking, 1993). Kramer is too quick to dismiss the spiritual dimension of depression and how the physical and spiritual feed off each other. In addition, he opens the door to Prozac usage by those not mentally ill but looking to improve their quality of life.
  13. I realize that what constitutes ‘appropriate’ grieving is culturally determined and that excessive and prolonged grief is not normal, and might warrant medical intervention.
  14. The danger of the ‘medicalization of self-understanding’ are dissolving the soul into the body and emptying suffering of its spiritual significance (thus stripping the individual of moral responsibility). With the effectiveness of antidepressants, there is a tendency to “redefine, in medical and biological terms, what are currently considered normal emotions, moods, and temperaments.” President’s Council on Bioethics (U.S.) and Kass, Beyond Therapy : Biotechnology and the Pursuit of Happiness, 266-68.
  15. Meilaender, Bioethics : A Primer for Christians, 44.
  16. David Degrazia, “Prozac, Enhancement, and Self-Creation,” in The Hastings Report (2000), 2.
  17. Valiunas, “Sadness, Gladness-and Serotonin,” 62.
  18. Stapert, “Curing an Illness or Transforming Self? The Power of Prozac,” 686. See ‘The Happy Self and the Good Society’ in President’s Council on Bioethics (U.S.) and Kass, Beyond Therapy : Biotechnology and the Pursuit of Happiness, 266-68.
  19. Space does not permit a detailed exploration into the effects that modern western society has on the emotional well-being of an individual. In addition to alienating the emotionally ‘unwholesome’, society makes emotional stability increasingly more difficult as foundational structures of family, work, time/ space, and community become ‘liquified’ (Zygmunt Bauman, Liquid Modernity (Cambridge, Malden, MA: Polity Press; Blackwell, 2000).)

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