Saturday, April 07, 2012

Can Christianity Cure Obsessive-Compulsive Disorder? Review

Ian Osborn, Can Christianity Cure Obsessive-Compulsive Disorder? A Psychiatrist Explores the Role of Faith in Treatment (Grand Rapids: Brazos Press, 2008)

Ian Osborne’s Can Christianity Cure Obsessive-Compulsive Disorder? A Psychiatrist Explores the Role of Faith in Treatment is a mixture of autobiography, biography, history, cultural analysis, secular psychology, and religious therapy. The title’s allusion to exploration reveals the author’s interest in Obsessive-Compulsive Disorder (OCD) is not simply an academic exercise. He relates his own personal struggle with this disorder. This led him to seek not only the personal root or situations causing OCD within individuals, but also the historical and cultural underpinnings that play into the manifestation of the disorder. He assumes that the disorder isn’t simply a modern phenomenon, but has effected previous generations as well. If one scours the records of the past looking for the right clues, OCD can be diagnosed back into the lives of many important historical figures.

Osborn explains OCD using the paradigms of secular psychology. OCD is a narrowly defined psychiatric syndrome (p. 26) characterized by intrusive, recurrent, unwanted, and inappropriate obsessions that torment an individual. To alleviate this obsession, compulsory acts “solely performed to put right a tormenting thought” are performed. “An obsession strikes, anxiety mounts, and a repetitive act provides a temporary way out” (p. 27). Appealing to an “up-to-date psychological model” for the cause of OCD (pp. 112- 115), Osborn states that all individuals have anxiety producing thoughts. Most people though are able to dismiss them. The sufferer of OCD cannot do so, but rather franticly attempts to suppress such thoughts. The brain behind the brain reasons that such hard conscious work to push away a thought must mean that the thought is too important to be rid of, so the thought remains (p. 114). The compulsory act invoked for relief of the repetitive unwanted thought provides only a temporary relief, causing the same repetitive compulsory behavior.

Osborn has a unique historical perspective to add to such a full-sized project. He himself was involved in the psychiatric field while important research into OCD gained momentum. As a psychologist, Osborn appears to have moved with the popular trends of psychological theory and treatment. He initially treated OCD as any psychologist would: with cognitive-behavioral therapy. This method involves teaching people “to purposefully expose themselves to their worst fearful thoughts” (p. 10). He later moved along to the trend of using responsibility transfer therapy. This method involves a sufferer allowing another person to take responsibility for their particular obsession. For instance, if someone is obsessed with making sure the kitchen stove is shut off, the responsibility of checking its status is delegated to a trusted individual. This transference of responsibility often provides relief from the overwhelming feelings generated by OCD. Osborn states, “While obsessive-compulsive disorder sufferers are easily overwhelmed by the responsibility they imagine to rest their own shoulders, they are also very good at giving responsibility to others” (pp. 12-13).

Rather than following secular psychological definitions toward any sort of non-theism, Osborn takes a strong stance against any who would classify religion as a form of OCD. He’s particularly negative toward any sort of Freudian bent that treats “religious beliefs and rituals” as “the pathological vestiges of society’s growing pains” (p. 25). He presents an entire section of argumentation countering Freudian theory (pp. 111-112). Even though “widely discredited” Freudian theory is still “widely influential” (p. 110). He counters such a paradigm by citing studies from secular psychology journals demonstrating “superstitions and religious behaviors are obsessed no more often in young OCD sufferers than in the general population” (p. 25). He insists that today’s psychological experts agree that OCD sufferers can be plagued by any idea that’s threatening to them, religious or not.

Osborn has a much larger goal than simply refuting the notions that OCD is caused by religion. His ultimate goal is curing the disorder with a religious solution. He first covers the various secular techniques used noting their successes and limitations (pp. 130-137). The final secular treatment discussed explores “Responsibility Modification Therapy” which includes responsibility transfer therapy. Transferring responsibility to others “might be the most powerful of all therapeutic approaches to obsessive-compulsive disorder” (p. 143). The shortcoming of such an approach is finding an individual willing or available to play such an integral role in rehabilitating a sufferer. All the argumentation of Osborn’s book has led to the notion of placing God as that ultimate “someone” willing and available to help someone with OCD. Osborn suggests “individuals suffer from obsessions because of an excessive sense of responsibility for harm to self or others” (p. 162). By using transference, a sufferer gives the responsibility for such things to God.” “A person suffering from fire obsessions… turns to God and allows him to take responsibility for the prevention of fire; a Christian tormented by contamination obsessions gives God the responsibility for whether or not he will get a disease; an individual who fears he has offended God leaves responsibility for any offense to God” (p. 162).

But how does one do this? Osborn states that the feeling of responsibility must first be identified. For instance, a woman who was obsessed over a suicidal jump out the window was not ultimately afraid of death, but rather plagued by the devastation it would cause her parents. Once identified, God would be responsible for her parents’ feelings. Second, obsessional fears should still be battled against by the use of positive self talk: “Right now it is more important for me to trust God than to make certain that my fear does not come true” (p. 164). Third, Transferring responsibility to God is a form of prayer: “What the Christian needs to do… is to turn to God in confidence and leave the obsessional fear with him” (p. 165). Fourth, Osborn suggests meditating on scripture passages. Meditating on scripture can cure OCD, in that grasping the meaning of particular passages can change a persons’ perspective (pp. 166-167).

The strength’s of Osborn’s book is obviously his desire to help OCD suffering Christians based on Christian principles. The bald truth is that God is ultimately responsible for the lives of his people. Osborn’s main therapy therefore is Biblically sound (Rom. 8:28). Even an OCD suffering Christian should cry out “Abba, Father” (Rom. 8:15), or as Osborn explains (via Saint Therese), OCD sufferers should “expect everything from God as a little child expects everything from its father” (p. 155). Osborn rightly concludes, “Our part [is] to give to God the responsibility for anything that could possibly happen, and to simply trust in him. This is, indeed, a radical a difficult type of faith” (p. 149). The “faith” Osborn is describing though is not a passive Quietism, which “emphasizes complete acceptance of all that happens” (p. 156-157). Rather, Osborn concludes engaging in transference with God is a daily difficult fight. This struggle results in a greater degree of faith (p. 156). It is “a less popular and more difficult therapy, but one that [is] ultimately more powerful and more healing” (p. 157).

There are though difficulties with aspects of this book. Perhaps the most pressing Biblical problem is that more often than not, Scripture is not utilized as that which substantiates Christianity as the cure for obsessive-compulsive disorder. Scriptures are peppered through sparsely, and sometimes grossly out of context (see for instance his citation of Revelation 3:20 on page 162, and his identification of Mary “acting just like an OCD sufferer” in John 2 on page 163).

The reason for the lack of Scripture appears to be that for Osborn, “Christianity” means the Christian tradition, in whatever form it takes. The substantiation of Christianity as the cure for OCD therefore rests, at least in most of the evidence he presented, on a few examples of historically important post-Biblical people from within Christian tradition. The method of determining who represents Christianity isn’t well defined. For instance, he has no problem including both the Protestant reformer Martin Luther along with Roman Catholic counter-reformer Ignatius Loyola. Both men though held to significantly different notions about the church and the Gospel. Including these two men as exemplars of Christianity only one hundred years ago would have met with disapproval from both Protestants and Roman Catholics. I doubt either Loyola or Luther would have considered the other “Christian.” The shortcoming of this definitional ambiguity reaches a deeper level of trouble in that the “cure” posited by Osborn ultimately doesn’t necessarily have to be a “Christian” cure at all. Rather, many other religions could just as easily follow his transference solution. He himself admits this: “What about religious individuals who are not Christian¾ can they make use of these rights? I believe they can… The great monotheistic religions including Judaism and Islam, all share a view of an all-powerful God in whom one can put complete trust” (p. 24).
Another problematic feature of the book is using the model of psychohistory (the idea that history can be understood by applying the science of psychology to a historical figure). This secular method holds that history is more than simply “facts”¾ it is also the result of psychological forces that drive people to do what they do. The basic problem with this approach is that each psychohistorian discovers what one needs in order to validate his particular study.

For example, consider Osborn’s treatment of Luther. Psychohistorical studies of Luther remain unconvincing because each psychohistorian arrives at different and sometimes wildly divergent interpretations (Osborn himself admits this). Osborn never hints at how it’s possible to do psychological studies on a man he’s never met that has been dead for a few hundred years. He does though appear to think his psychohistorical method and conclusions are somehow free from both of these problems. He vaguely explains that “The data” to determine Luther’s mental state is now available (p. 50). One need only “look carefully at the facts of [Luther’s] life” (p. 50). The “data”, according to Osborn, is the advance of understanding and diagnosing mental illness. This though assumes psychology has reached an appropriate teleological end. Such though is an assumption. Upon checking the documentation provided by Osborn for his Luther presentation, he wasn’t entirely consistent with looking carefully at the facts. A few of the Luther citations were footnoted with the disclaimer that they came from either questionable sources or uncertain sources. He also relies heavily on Richard Marius, a man who argues Luther didn’t even believe in God.

These difficulties aside, Osborn has put together a fascinating treatment of OCD. One can at least benefit from the overview of the current ideas surrounding the diagnosis and treatment of OCD. While one may disagree with aspects of his secular based methodology, his attempt to treat this topic religiously is a good first step to show Christians that the need exists to go further and treat this topic spiritually by basing it on a coherent Reformed Christian worldview. Ultimately though, any Christian counselor following in the footsteps of Osborn needs to begin by explaining why it’s only the Christian faith that has a solid basis to help OCD sufferers.


Martin Yee said...

This is interesting. My son is now studying psychology in the National University of Singapore. I will pass this to him to read. From what I read, unlike Karl Barth, Luther is not adverse to learning from science or liberal arts as long as they are not detrimental to a proper understanding or proclamation of the Gospel. Thanks again!

James Swan said...

Thanks Martin.

Keep in mind, from a Christian perspective, overall, I found more problems with this book than helpful answers.