God and Mental Illness: Part 4, Dualism and Medication

In the last post we discussed how a Cartesian dualism--a presumed division between body and soul--sits behind much of the stigma associated with mental illness. Given an assumption that the soul is independent the body, we assume that we have (some) control over our thoughts, feelings, and behaviors. This presumed control creates responsibility which creates blame which creates stigma.

A related stigma created by these dualistic assumptions concerns taking medications to deal with mental health issues. 

Specifically, because we assume that we have some "mental control" over thoughts, feelings, and behaviors, many people believe that we must first avail ourselves of psychological remedies and treatments before opting for a prescription. Taking "a pill" immediately to address your mental health symptoms is perceived, by many, to be a sort of moral failure, the easy way out. You should try therapy first, and meds only as a last resort. 

Again, the assumption driving these attitudes concerns the degree of mental "control" we are believed to possess over our thoughts, feelings, and behaviors. If this control exists you should use it, and not "artificially" manage your symptoms with medication. However, if your mental illness is judged to be more neurological, as is biological, pharmacological interventions are deemed more legitimate. If the issue is clearly "brain chemistry" meds are appropriate. So we do, generally, assume medication is okay for things like dementia, schizophrenia, bipolar disorder, or chronic depression. 

But things quickly get murky when we consider other disorders, where symptoms present as more "psychological" than "biological." For example, should you take medication for mild anxiety or depression? Or should you try therapy first, before opting for medication?

Consider, as another example, the treatment of opioid addiction. Is methadone a legitimate treatment? The controversies surrounding methadone and similar treatments concern if you're really treating the addiction by replacing one opioid for a different opioid. Isn't methadone leaving the underlying addiction intact? Proper treatment is considered to be going off opioids altogether through recovery programs, like Twelve Step programs. Recovery, in this view, must be achieved through wholly social-psychological and spiritual means. Proponents of methadone, however, disagree, seeing methadone as a legitimate medical intervention for what they take to be a properly biological condition. Many medical conditions require that you take medication for the rest of your life. Why can't that be the case for opioid addiction?

The point to be observed here is that, beyond the stigma of mental illness, there are also stigmas associated with taking medication. And these stigmas also flow out of a Cartesian picture of the human person, where the soul/mind is able to "control" thoughts, feelings, and behaviors making medication unnecessary. Consequently, if you too quickly opt for medication, that is perceived as a moral failure, as laziness, a copout, as refusing to "do the work" necessary to get better. 

And, as I noted in the last post, in Christians contexts these stigmas surrounding medication are exacerbated. Taking pills is seen as refusing the help and power of God, as a failure of faith.

Summarizing these last two posts, one of the first things we have to face when talking about faith and mental illness are the dualistic assumptions at work, often strongly Gnostic and Platonic assumptions, in how Christians view the relationship between body and soul. We'll turn to issues of embodiment in the next post.

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