by Nicholas J. Mattei
Blame it on the Brain is a book that seeks to give a Christian perspective on the modern renaissance of brain science. Author Ed Welch lays out the contrasting worldviews of secularism and Christianity and their implications on the understanding mental health. This topic is multifaceted and complex and this due partly to the fact that the interplay between soul and body is so mysterious and at times very difficult to comprehended. Yet, Welch seeks to bring biblical clarity and lay out biblical principles in our examination of the different mental and behavioral problems that are exhibited in human beings. While not being simplistic, Welch lays out biblically simplified answers to what the root causes are and who or what is responsible for many of the problems that we see in society that are said to be connected to mental health.
Part one of the book begins by discussing the relation of the brain to the soul. Welch refers to the historical debate that has gone on concerning this topic. Philosophers and physicians have tried to give many explanations. Some say that the soul is located in a certain part of the brain, others like Aristotle have suggested it is located in the heart. But, over the last two centuries there has been much development in the field of neuroscience which has led many to claim that there is not in fact any soul but only the brain. Before moving any further Welch reminds us that when we come to this topic there is no neutral party and everyone brings their preconceived worldviews to the discussion and that as Christians we need to remember the authority of Scripture over this field of study because the foundation and beginning of all true wisdom and knowledge is the fear of the Lord. Welch comments concerning what biblical principles should guide us before we go any further: “The problem in establishing a biblical oversight of the brain sciences is that, at first glance, there seem to be very few biblical principles available to guide us. Here are three: God created all things. Therefore, God created the brain. God has called us to be students of creation. Therefore, creation, including the brain can be studied and partially understood. Students of God’s world should be people of integrity of truthtellers. Therefore, scientist should be careful in their investigations and truthful in their reporting of results. They should not fabricate or skew results to suit their private agendas.”  The church has failed in the past to engage in a nuanced and meaningful way in the realm of biological sciences and therefore the Bible has been losing its functional authority in this area. So what is needed is a more in-depth biblical interaction with the issues of mental health and the field of biological sciences and as Welch states, “We want to listen to what people are saying about the brain, develop clear and powerful biblical categories and bless both the sciences and the church in the process.” 
Welch goes on to discuss the different secular views on the mind or soul in relation to the body. There is monism and dualism. Monism says there is no immaterial element and the mind emerges out of matter and dualism says there is an immaterial element and the body is influenced by this immaterial mind or soul. Over against this, the biblical perspective is that we are composite beings, body and soul and that we are essentially one person. The Scriptures define the soul in such terms as heart, mind, spirit etc. What differentiates this view from the secular view the most is as Welch says “The biblical perspective includes that idea of mind-as-self-aware and mind-as-purposeful, but it is much more. With our minds we are responsible before God and we are responsible to him, either for or against. Our minds are the initiators of all moral action.” 
The body is then referred to in the Bible as the flesh and is not inherently evil but is the mediator of all moral actions stemming from the heart. The implications of these definitions are two-fold and will be the axioms from which Welch will build on for the rest of the book. These implications are “Any behavior that does not conform to biblical commands or any behavior that transgresses biblical prohibitions proceeds from the heart and is sin.”  And “Any behavior that is more accurately called a weakness proceeds from the body and is sickness or suffering. Sickness or suffering can also be caused by specific sin, but we must be very careful to have ample justification before we make such a link.” 
In part two of the book Welch deals with three main categories. One being specific brain diseases, two being psychiatric problems, and three being behaviors once called sins but are now considered a sickness. Some examples of the first category being Alzheimer’s and head injuries, the second category being Depression and A.D.D, and the third category being homosexuality and alcoholism. As he mentioned in part one of the book, many times the behaviors that come from these issues in the three different categories can be sometimes simply the occasions for concealed sins of the heart to be revealed and not the reasons for the sinful behavior itself. Welch then lays out four basic steps for family and friends to consider in helping their loved ones. These steps are to get information on the disease or issue, distinguish between spiritual and physical symptoms, address heart issues and maximize remaining strengths: correct or minimize weaknesses. In dealing with the first category of brain issues, Welch comes to the conclusion that these are mostly physical problems that need to be addressed medically but that does not mean that we should ignore the spiritual life of the person but rather seek to minister faithfully to them in hope that the Lord will work in there lives despite their physical handicap. When addressing the second category of mental issues Welch states that there really isn’t much evidence to support the notion that these issues are purely physical in origin or that there are verifiable chemical imbalances. Welch does however refer to them as a hybrid between physical and spiritual and he gives this qualification, “Depression… and every other human behavior is represented on a neurochemical level. This doesn’t mean that the brain causes all these behaviors, but that the brain expresses differences in behavior at a chemical level.”  Welch then ends his book with a lengthy discussion on the last category of mental problems encompassing homosexuality and alcoholism. Welch concludes that these are not mental dieses or natural orientations but sin that is expressed in our body because of our sinful nature and that ultimately the glorious Gospel of God’s grace in Jesus Christ is the answer for true and lasting transformation.
I find Welch’s book to be refreshing and helpful. He does not pull any punches but yet he approaches many of these very complex and sensitive topics with pastoral wisdom and graciousness. This book is both theoretical and practical. When it comes to his treatment of the first category of issues like Alzheimer’s and brain injuries, Welch provides needed insight and hopeful yet sobering stories of real-life interactions he has had with people and their families who have suffered from these things. In the midst of all this he applies the biblical worldview faithfully, for instance, when dealing with post injury problems in those who have suffered head injury Welch says “Thus, it is not surprising that one of the best predications of post injury problems is pre-injury character. The cognitive impairments of those who were previously committed to biblical living will rarely lead to the same frustrating changes that are obviously in those who were not. Secular research and case studies even support this conclusion, although, of course, they don’t talk about obedience or righteousness.”  This is such an amazing insight, it speaks volumes of this truth found in the Scriptures, “Watch over your heart with all diligence, for from it flow the springs of life.” Prov. 4:23. This supports Welch’s thesis of the heart or soul of the person being the determinative factor of their whole being, not the brain.
The second category of issues that Welch deals with as stated above are the psychiatric problems. This section hits close to home for me as I have dealt with these types of issues in my past and have taken medication for them. His three propositions he gives are; psychiatric problems are always spiritual problems and sometimes physical problems, psychiatric disorders sometimes respond to medication and psychiatric labels are descriptions, not explanations. I find these propositions to be spot on. In my own experience my issues where fundamentally spiritual in nature, their symptoms where slightly alleviated by medication and their labels were just describing outward manifestations of a troubled soul.
I find Welch’s comments on medication to be very relevant and needed. His assessment is that psychiatric medications are over prescribed and that too often people end up taking more than one medication to offset the side effects of another medication. I find this to be absolutely true and the problem has only grown worse since the writing of his book. Ultimately these medications are band aids and are far from being a cure. In saying that however, I do agree with Welch’s moderate position on medications. As he says “A more moderate opinion is that, although it is not wrong to take these medications, they are rarely our first line of attack against personal suffering. Instead, we should first consider that God can bless us through our suffering, and we might also weight the possibility that psychiatric medications could numb us to the refining benefits of suffering.”  This rings true for what happened to me and going forward my approach would be to access and address the spiritual issues in a person first with pastoral counseling and the ordinary means of grace and then try and address any physical issues that accompany the psychiatric problem with a holistic health approach addressing diet, sleep and exercise and then, and only then if the person is still manifesting debilitating symptoms, seek the temporary use of medications as a last resort while still going through the regiment previously stated.
A specific example of a psychiatric problem that Welch goes on to deal with is depression. This chapter also hits close to home for me in that I have dealt with depression in the past and I have recently been counseling a young man who deals with extreme levels of anxiety and worry that basically leave him in a depressed state, or at least in the unfunctional state that depression leads to. Many of the root spiritual causes of depression that Welch lists cross over into anxiety such as guilt, shame, fear and unbelief. Guilt is one specific aspect that has really hampered this young man that I have been counseling, especially false guilt as Welch so succinctly puts it “Guilt from the violation of false human standards comes when we interpret the world according to our rules rather than God’s. As such, false guilt, at a deeper level, is against God’s Word, and it can be addressed through Gods Word.”  This has been where I have tried to hon in on with this young man. Biblically addressing issues of the heart is the key, as Welch has said throughout this book. Welch also gives wisdom on how to deal with depressed (and I would add anxious) people when he says “Compassion cannot ignore unbelief or sin. Too often, family and friends think the depressed person is very fragile and cannot handle any frank discussion about sin or hard-heartedness. But to ignore these issues when they are obvious in someone’s life is to treat that person without love and compassion.”  This is most certainly true. We cannot beat around the bush; we have to engage these people head on in a gracious yet firm way. I have seen fruit in this approach.
Welch ends his chapter on depression with a case study of a depressed woman named Susan who suffered for ten years with depression ultimately because of the guilt of an abortion. In counseling with a faithful friend, the point was brought up that Susan really wasn’t accepting God’s grace and forgiveness because of her pride in wanting to meet God halfway in doing penance for her sins. This insight caused a breakthrough and the depression almost immediately lifted. I have seen a similar issue with the young man I have counseled in that there is sin and guilt from the past and then there is ongoing sin to try and rectify or make up for his former sins. This is a point I will want to bring up again to him, though I do see in his case that there may need to be a temporary period of anti-anxiety/antidepressant use to quell some, at times, extreme symptoms.
In the last section of his book Welch takes up the last category of mental issues being homosexuality and alcoholism. His section on homosexuality was excellent and very prophetic as he, writing over twenty years ago, states that “Political sanctions will be imposed on institutions that refuse to hire homosexuals. Homosexuals will probably have their ‘place at the table’ with civil recognition of same sex marriages. Under the heading of ‘pluralism,’ all forms of sexual expression will be considered equally valid…More denominations will revise their exegesis of biblical passages to allow for homosexual relationships. And people who otherwise take the Bible seriously will leave churches that call homosexuality ‘sin.’”  Almost all of this has come true here in America.
Welch takes a commendable stand against the idea of “homosexual orientation.” This is where the church must engage our culture. Welch says of homosexual orientation “It relies on neither biblical date nor medical research. Instead, it is a political premise for gaining homosexual rights and is rooted in personal experience.”  Even twenty years since the writing of this book this is still the case. Even within the church we now see the forming of “Side A” and “Side B” viewpoints on homosexuality. Side A, being the most ridiculous, says that homosexual orientation is real and that committed and loving homosexual couples should be admitted into the church. Side B, being a bit more moderate, says homosexual orientation is real but homosexual activity is sinful, and the same sex attracted person should seek a life of celibacy. Welch again in a prophetic manner actually addresses this Side B mindset when he writes “A second result of accepting a homosexual orientation…is that the best counsel we can give someone with that orientation is, ‘Look but don’t touch. You will always think it and want it, but don’t actually do homosexual behavior.’ The victims of such counsel will never have the privilege of battling and rooting out sin at the level of the imagination.”  It's astonishing to note that this is exactly what has happened. Side B is growing within the church and that is exactly the same counsel that is being given to them. I know Christians who struggle with same sex attraction who have taken this Side B viewpoint and the result is not good and the trajectory is even worse. I also know Christians who struggle with same sex attraction who have rejected Side A and B and stuck with the biblical view that homosexual orientation is not true and through the process of as Welch says “juggling two themes: the knowledge of ourselves and the knowledge of God” , they have found lasting transformation and are happily married to godly women. At the base of this is “the confident faith that his or her sins really have been pardoned by God at their deepest root.” 
Blame It on the Brain is an excellent book that provides a great starting point for Christians as they seek to engage the mental and spiritual issues of our day. Welch says his work is “but a bare outline of what I think the Bible says about addictions.”  Only an outline it may be, but a helpful, faithful and prophetic one at that. I would recommend this book to pastors and lay brethren alike. May God use this work as a great tool for Christians to be repairers of the breach.
Edward T. Welch Blame It on the Brain (Phillipsburg, NJ: P&R Publishing, 1998) 22-23.