Pathology is disease and sickness. With disease and sickness is the result of suffering and death. These concepts are all intimately tied to the human condition which begs the question “why must we suffer”? Different philosophies have different explanations throughout time. Secular sources recognize pathology as the natural order of evolution. Psychopathology and any pathology is part of life as organisms live and die within the cosmic struggle of existence. Pathology is treated in the present moment and its etiology is categorized according to an empirical process of elimination based upon categories of biological causes, psycho-social causes and cultural causes. Religious traditions also vary. Buddhism and Hinduism recognize suffering as central to the human condition. Buddhism seeks to escape the pathologies and resulting suffering of this world through Nirvana or the becoming into nothingness, while Hinduism recognizes this world as a great illusion and suffering as a result of karma. Monotheistic creeds consider suffering to be a result of deviance from God’s moral law. Christianity, in particular, recognizes suffering not merely as deviation from God, but also a broken human condition as a result of that deviation. Individuals are born into this world subject to suffering. Hence, as a result of sin, humanity experiences a traumatic condition, its consequences and also the continuance of sin itself in actuality (Boerger, et. al., 2023). Sin, according to St. Thomas Aquinas, is thus a disordered action from God which leads to disastrous consequences that naturally include pathology.
In this blog, we will examine these concepts, but look deeper from a Christian Counseling perspective of an etiology that encompasses sin as the core root of pathology and how integration of modern psychology and pastoral care can emerge to a more holistic and complete care of not just mind and body, but also soul. Please also review AIHCP’s Christian Counseling Certification, as well as its Christian Grief Program and also its Christian Spiritual Direction Certification.
Theodicy
Since pathology is part of life, humanity experiences suffering and death. At the core root and etiology of it is sin, yet this suffering and pain seems so unfair. The death and gross genocide of a population at the hands of a ruthless regime, the death of an young child to cancer, or the devastation of a storm to a community all point to a horrific world marred by sorrow. When individuals refuse to acknowledge sin and its corruption of the natural design, it leads to anger towards God. The question within Christian theodicy is how can a good and all powerful God permit evil? Kelly, 2002) Either God is not all powerful to prevent the evil, or He is not all good to permit it. This classical attempt to limit one to either/or confuses the reality of human and angelic free will and its part in the cosmic story of temporal reality. Free will is what guarantees sentience. God has given sentient creation made in His image the choice to love or hate Him. When disordered response emerge in free willed creatures, horrible consequences occur. God was willing in His foresight to permit these evils at the expense of free will. One can only include that the price of free will is essential to being made in the image and likeness of God.
Unlike other faiths or philosophical explanations of evil in the world, the Christian worldview believes in a God who through Jesus Christ, both God and man, died for His creation to repair the spiritual damage of sin with promise of eternal life free of suffering. God, through Jesus, did not allow His creation to suffer alone but came as an example to expose the temporal world for its folly, and to suffer with humanity and ultimately die for it. This is the ultimate act of mercy and justice grounded in infinite love.
Soul Care and Modern Psychology
Psychology before the advent of Sigmund Freud was more likened to pastoral care for the mind. Within it existed not only age old wisdom collected from Scripture, patristic fathers, and medical knowledge of the times, but also an element that acknowledged that beyond the mind existed the soul. With this metaphysical prerequisite, care of the soul equated to treating many pathologies from a religious and spiritual perspective (McRay, et al., 2016). This allowed certain conditions of the mind to be seen in correlation with states of the soul. Concepts of sin, its consequences, the habitual growth of vice in the soul, and the forces of the demonic were all considered when tying things to depression, anxiety, sexual deviations, or even anti-social disorders. Of course, the primary issue was that pre-scientific minds were limited in the study of pathology. This led to an over emphasis of explaining everything as a result of the unseen and in some cases superstitious understandings of mental defect. Modern psychology corrected this but went a step even farther that eliminated any emphasis of soul care. Empiricism and the scientific method over corrected the imbalance, removing any concepts of metaphysical causes or the need of care of the soul. Instead, modern science attempted to eradicate metaphysics all together since metaphysics is a non-observable study.
The modern scientific method corrected many superstitious ideals and labeled unknown pathologies to their proper etiologies but in its clean sweep of all metaphysical explanations, it reduced itself to a sterile tool only capable of abstracting data from observable phenomenon. Concepts of sin or its correlation with mental defect were removed and the idea of the soul was attempted to be completely explained within the physiology of the brain. Modern and secular science boasted it had mapped the “soul” to the brain and reduced it to a physical origin. This led to a new imbalance. Instead of a pre-scientific mindset which over attributed all pathology to the unseen, the post-scientific mindset attributed all pathology only to the observable and natural.
Christian Worldview
A Christian worldview is a religious and metaphysical worldview. Uniquely different than other religious and metaphysical views, it considers the physical world to be broken with death and suffering. It considers the temporal world to be a flawed design that was not originally intended by the Creator but marred because of sin or deviation from God. First, the disobedience the demonic and then followed by the sin of Adam created a disturbance in creation that led to discord. For humanity in particular, the sin of Adam thrust humanity into the temporal reality. Genesis states that due to Adam and Eve’s sin, death entered into their world. St. Augustine coined the term for this as “Original Sin” (Lamoureux & Wadell, 2010). Original sin corrupted the nature of humanity. Before, Adam contained great knowledge, control of his passions, and an inclination towards good that was not clouded to disorder, but after his fall, humanity’s nature, albeit not totally corrupted, was disorientated away from God. With this traumatic state, grace was cut off from the soul and humanity’s body was subject to suffering, pathology and death. Hence, a new condition, its consequences and continued deviance resulted in the fall of Adam.
Redemption came through Christ who paid the price of sin. Through Christ’s death as the perfect priest and perfect victim, the infinite debt and injustice was paid and God’s mercy and reconciliation was granted to humanity. Through grace earned by Christ and dispensed through the Holy Spirit, the spiritual consequences of sin and its metaphysical wounds were healed, but the the physical broken condition and consequences of Original sin remained. So while the debt of sin was paid, its lingering consequences of a disordered nature, pathology and death still remained in the temporal reality.
A Christian world view accepts the brokenness of human nature and the role sin has played in marring the world, but also maintains a hopeful future with God since the spiritual death has been paid in full by Christ for those willing to accept it.
The Importance of Recognizing the Metaphysical In Pathology
As pointed out, when everything in psychopathology is reduced to demons or sin, or the opposite, when everything in pathology is reduced to the observable, there exists an imbalance. A good balance recognizes that not every illness or mental defect is a direct result of sin, or a devil, but within the norms of the modern psychology has its source in natural and explainable phenomenon. This balance also acknowledges, however, that many defects are more than physical but also tie directly to the soul and deeper metaphysical realties, such as demonic influence or vice. When metaphysical realities are neglected or dismissed, then a more complete care of the total person is lost.
For instance consider these mental disorders.
Depression and anxiety are unsettled emotional states. Modern science and the DSM-V-TR has given insightful diagnosis to their symptoms and etiologies. At a biological level, they are tied to imbalance of serotonin for depression and GABA in anxiety. While there are other neurotransmitters that play key roles, for brevity, just consider these elements tied with multiple psycho-social implications of trauma, abuse, low self-esteem, and behavioral practices. All of this paints a picture of why melancholy exists within the person but what if there are deeper issues afflicting the person that are beyond the temporal? What if at a deeper state, the low self-esteem is tied spiritual disorder? What if despair and rejection of God’s mercy is at play, or even worst, demonic oppressive thoughts tormenting the person (Amorth, 2016). Many times, resistant depression has deeper issues that SSRI’s cannot rebalance because they are not temporal but metaphysical in origin. The original source is the brokenness and until that original source is recognized, the person may experience physical symptoms or relate to a particular event, but the nature of the underlying issue is not exposed until spiritual issues are addressed. Whether these issues are self imposed through sinful and destructive habit or encouraged through demonic influence. It is no wonder that in many cases exorcisms reveal the names of demons by their vice or pain inflicted upon the person (Amorth, 2016).
Another example includes paraphilias or sexual deviations. Modern psychology identifies disorders as things that cause impairment not based on objective reality of right or wrong but upon cultural and social norms, as well as mental functioning. Deviations are only considered wrong when impairment occurs or harm to self or others exists. This differential treatment of morality avoids a particular religious bias but also ignores the source of the disorder which is primarily a rejection of God’s moral law and the natural purpose of the conjugal act. It ignores the lustful mutation of the sexual act, as well as the underlying demonic sources surrounding this distortion. How can one truly find healing with these disorders when the actions themselves are not condemned.
Finally, for brevity, one last example includes anti-social personality disorders. While modern psychology attempts to understand the brain of sociopaths, narcissists and psychopaths, their behavior includes numerous conditions that lack empathy, compassion, and love for others. Instead, their malignant will chooses themselves over others. These actions become imposed upon their very character and nature as to be as natural as breathing. This attempt to explain evil behavior based solely on biological factors, as well as psycho-social and traumatic early childhood events is lacking. These types of individuals are not just programmed wrong, but their soul is also sick. They chose at one point actions tied to vice that eventually became habitual to form a sinful character. Tying together the new neuro processes of their mind with a sick spirituality is a far more complete explanation.
Virtue and Vice are parts of life. Individuals who cultivate virtue, lead to behaviors and characters that become naturally virtuous and good while those who cultivate selfish, proudful, lustful, or hateful actions lead to be behaviors and characters that are bad. Modern psychology cannot by itself label these things due to its restricted empirical lens, but when tied with theology and spirituality, one can probe deeper and identify these malignant issues and face them.
An integrated Christian view with modern psychology represents a stronger balance in meeting the etiologies of pathology from both a scientific and metaphysical team that does not look to under or over emphasize each other (Johnson, 2010).
A Psychological and Spiritual Treatment
Healing through proper orientation is key in pastoral care. The vice tied to a mental pathology is identified and the pastoral work involves cultivating the opposing virtue. Individuals dealing with paraphilias receive spiritual direction and moral support in cultivating temperance and the virtue of purity in conjunction with various proven behavioral therapies that help reframe and rewire the neuropathways. Those facing depression, would focus on God’s mercy and love, as well as the virtue of hope and faith to counter the vice of despair, but the psychological and pharmaceutical treatments would concur with them. Or again, individuals facing personality disorders would focus on humility and charity to counter pride and envy and anger but still receive the critical psychological guidance needed to form better habits and curb certain impulses.
These are all examples of uniting psychological and spiritual treatments. There has existed a grave mistrust between mental health professionals who are secular and those who are religious. Many religious communities mistrust empirical methods due to the dismissal of God, while many secular communities doubt the professionalism of many religious due to extremism and excessive superstitious beliefs. There is a place where reason, the scientific method and faith can coexist when properly balanced. This is well seen in the Catholic Church which has thoroughly integrated the process of exorcism. Unlike the Middle Ages, where any mental defect that was misunderstood was considered demonic or a hex, modern science has afforded the faith to utilize its tools to rule out mental defect before proceeding into the rite of exorcism (Amorth, 2016). It is only logical when treating mental pathology to follow the critique of science before assuming the metaphysical to rule out hysteria and superstitious belief. This is not a sin against faith, but a logical narrowing of mental defect from true metaphysical occurances.
The religious professional faces a twofold mission. First to convince their fellow secular colleagues of their qualifications and empirical knowledge, so as not to become ostracized and secondly to convince the local church to understand the importance of the scientific method as a tool that is when used properly is not hostile to the faith (Johnson, 2010).
In addition, the religious professional is sometimes tied to ethical standards. Their role as a counselor in a secular setting demands the creation of a therapeutic atmosphere that encompasses empathy, unconditional regard and safety to speak without judgement or be viewed with bias. Their role in a religious setting changes when it becomes pastoral and the need to guide with moral clarity manifests. This can be conflicting and sometimes difficult but the key is to identify the particular role and function at a particular time and the service being rendered (Johnson, 2010).
Conclusion
It is important to identify a proper etiology of mental psychopathology. This involves balancing spiritual and empirical causes of mental defect without causing an imbalance or extreme in other direction. The Christian worldview presents a view that sin is the ultimate cause of pathology in the world and that care involves pastoral as well as clinical guidance. The care of the person must not just include body and mind, but also soul. Prior times over-emphasized the spiritual causes of mental defect and pathology, but when properly balanced, one can find an effective and integrated way that addresses all the needs of the totality of the person.
Please also review AIHCP’s Christian Counseling Certification, as well as its Spiritual Direction Program.
References
Amorth, G. (2016). An exorcist explains the demonic: The antics of Satan and his army of fallen angels. Sophia Institute Press.
Boerger, J. (2023). The original wound: Considering sin as trauma and psychopathology as the disintegration of human personhood. Journal of Psychology and Christianity. 42(4). 307-321
Collins, G. (2007). Christian counseling: A comprehensive guide (3rd ed). Thomas Nelson.
Johnson, E (ed) (2010). Psychology and Christianity: Five Views (2nd ed). IVP Academic
Kelly, J. (2002). The problem of evil in the western tradition: From the book of Job to modern genetics. The Liturgical Press
Lamoureux, P. & Wadel, P. (2010). The Christian moral life: Faithful discipleship for a global society. Orbis Books
McRay, B, Yarhouse, M. & Butman, R. (2016). Modern psychopathologies: A comprehensive Christian appraisal (2nd ed). IVP Academic
Additional AIHCP Blogs
Diagnosing Psychopathology. Access here
What is Psychopathology. Access here
Additional Resources
Psychology and Christianity: Exploring the Five Views of Integration. (2024). NeuroLaunch. Access here
Abercrombie, W.P. (2013). Psychopathology or Sin? BSI. Access here
Tarrent, J. (2025). “Spiritual Awakening or Psychopathology?”. Psychology Today. Access here