Are All Illnesses the Real Deal? PDF Print E-mail
Presbyterion: On Church Government
Written by Douglas Wilson   
Thursday, 17 September 2009 11:14

One of the more delicate tasks facing a pastor is the situation that may be created in his congregation by ailing and sick parishioners who are perhaps not sick in the way they think they are. It is delicate for all the obvious reasons, and writing about it here is also somewhat delicate. If a pastor indicates that he believes that in some cases, some illnesses might not be what they appear to be on the surface, some people are going to think that he believes this all the time, for every case. And that will have a chilling effect on the willingness of some who really are sick to “call for the elders” (Jas. 5:14), as they ought to be able to do.

So it should be said at the outset that there are plenty of mystery illnesses that are genuine stumpers, and that it is not the case that every illness that baffles the medical professionals is a case of hypochondria. In addition, as I have argued before, the established profession of conventional medicine—when it comes to widespread distrust of that profession found among many conservative Christians—has only itself to blame for this. A profession of healing that has signed off on abortion has no right to complain when people start avoiding its experts. This tragedy has naturally opened a door to various forms of self-diagnosis among Christians, some who do it quite well, and some who do not. But either way, it can create pastoral problems.

If the problem stays at the level of aches, pains, and prayer requests, the obvious thing to do is simply pray. The Lord knows the situation perfectly, and committing the whole thing to Him will never cause additional problems. But if the person who is sick requires a great deal of additional practical help (meals, help getting around, child care, etc.), and the pastor strongly suspects that the cause is not physical, what should he do?

The first thing he should do is sort out the possibilities in his mind. It is false to say that there are only two options—true sickness with an identifiable germ at the bottom of it or something fake in the “it’s all in your head” category. Consider the range of possibilities. First is the true malingerer and faker. He is not sick and he knows it, and he is pretending to be sick for reasons of his own, perhaps related to the avoidance of work. Then there is the person who is not sick, but who for very tangled emotional reasons, needs the reassurance that comes to him when he is injured or sick. This is not necessarily self-conscious or self-aware, but it can be pretty obvious from the outside. For example, take the really insecure kid in junior high who gets hurt in P.E., but who wears the knee brace on alternate knees for the next week. Then there is the person who is absolutely convinced there is something wrong with him, or that he needs to head off something because he read an article that said he was in the high risk category, and so he begins to treat himself with high levels of all-natural toxicity. His problems are very real, but they are being caused by the medicine he is giving himself. Then there is the person who has a number of genuine, presenting symptoms, and the pain or discomfort is very real. He believes that the problem is caused by something objective and external, but the pastor (for various reasons) has begun to suspect that the cause is (for example) the result of a great deal of internalized stress or guilt. The effects are real, but the cause is not something that conventional medicine (or alternative medicine, for that matter), can really get at. There are variations on this, but you get the picture. It is important to note that a person in this kind of circumstance is not necessarily lying. We are fearfully and wonderfully made, and just because it is happening in our own bodies doesn’t mean we know what is going on.

The second thing a minister should do is treat every situation that comes to him with sympathy and respect. We cannot see into hearts, and we ought not to act dogmatically as though we can. If any of the above possibilities are occurring, the pastor will have to win an audience with the person he is ministering to, and that cannot be done by viewing every report of an illness with a jaundiced eye right at the outset. “Sick, eh? Prove it.” Take the reports at face value until you start to have objective reasons not to. And when you start to have those reasons, pray for an opportunity to address it with the person—in a way where the subject comes up naturally. And when it is raised, it does not need to be raised as a statement of fact from you. It can be raised as a possibility. “Have you considered . . .?”

The third thing is that the pastor should work to create an understanding within the church (and particularly on the session) that this is the kind of thing that happens from time to time, often in churches. It does not happen all the time, but it does happen. If this simple truth (that it happens sometimes) is reacted to defensively by someone, and they want the church to assume that no illness can ever be in this category, then that defensiveness is a danger, one which cannot be allowed to become a cultural assumption of the congregation.

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Last Updated on Saturday, 03 October 2009 00:18