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Diagnosis Determines Treatment Plan

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Ten years ago my mother became very ill. A persistent cough and difficulty breathing sent her to her doctor for help. Bronchitis was the diagnosis, antibiotics the cure. “Don’t worry,” he said. “You’ll be much better soon.”

My mother didn’t feel better, she got worse. She wheezed. She couldn’t sleep. Her breathing became labored. Her doctor now added asthma to her diagnosis and prescribed an inhaler plus new antibiotics.

 But my mother’s symptoms didn’t subside and eventually she required an ambulance ride to the hospital. There she received the bad news that she didn’t have bronchitis or asthma after all. She had lung cancer.

If you’re working with a couple that despite your best treatment plan is getting sicker and sicker, perhaps it’s time you reevaluate your diagnosis.  Last month I blogged about David’s sin against Bathsheba and her husband, Uriah, and diagnosed it as an abuse of power. David came from humble origins but for some time after he became king, he felt entitled to use his position to get whatever he wanted.  He commanded Bathsheba to his bed because he could and then sent Uriah to the front lines of battle when an unplanned pregnancy resulted.

Whether or not we ever write an official diagnosis on an insurance form, when we counsel someone, we have particular ideas about what is going on in his or her life and heart that shape the direction we take in counseling. For example, if King David had come to you or to me over this situation in his family life and ministry, how different would his treatment protocol have been if we had diagnosed his problem as an adulterous affair, an inappropriate sexual relationship, or sexual addiction? What would have been the outcome if we had focused on treating David’s depression or guilt rather than confronting his abuse of power as Nathan did?

How would Bathsheba have felt if instead of seeing her as a victim of King David’s abuse of power, we told her she was the one who tempted David?  In addition, if we see Bathsheba as a mutual sinner instead of a victim of a horrible injustice, we will also fail to notice what impact David’s sin against her and her husband has made in her ability to trust David or be his wife.  

How we define “what’s wrong” impacts not only our understanding of a couple and their problem(s), but the kind of treatment plan we implement. An antibiotic is great medicine for someone sick with bronchitis, but it is impotent against cancer.  In the same way, when we diagnosis serious marital sin incorrectly, our treatment plan, although biblical, will also be ineffective to bring about true healing.

October is Domestic Violence awareness month.  I think it’s crucial as biblical counselors that we get very clear on what God says about this devastating cancer lurking within the hearts and homes of people we know. Every week I receive frantic calls and e-mails from Christian women who feel scared, trapped, hopeless, and helpless because their most intimate relationship is abusive; verbally, physically, sexually, economically and/or spiritually.   

Church leaders and biblical counselors often lack the awareness as well as the skills necessary to see and address this problem in a wise and competent manner.

In my next few blogs I want to build a competent, biblical treatment plan for this kind of problem but for now, I want to look at four (4) specific ways we can begin see domestic abuse biblically.

1.      It is always sin.The scriptures are clear. Abuse of one’s authority or power, even legitimate, God given authority is always sin.  Abusive speech and/or behavior is never an acceptable way to communicate with someone, even when we’re angry.   Malachi 2:16-17; Psalm 10:11;  Psalm 11:5; Colossians 3:19; Colossians 3:8. 

2.      Violence is never an appropriate response to being provoked. Most people blame others for their sinful response.  Typically we hear, “If only you wouldn’t have done that (or said that), then I wouldn’t have acted that way.”  The truth is people provoke us all the time, from the poky driver who is slowing us down to the teenager with a smart mouth.  But God says we are still responsible for our response. When Moses sinned in his angry outbursts to the Israelites sinfulness, God held him accountable.

When we allow others to justify their sinfulness because of someone else’s sin we are not only blaming the victim, we are enabling someone to excuse their own sinfulness. That does not help them to take responsibility for their own actions or attitudes. Jesus says “Out of the overflow of the heart, the mouth speaks.”  What comes up and out of our mouths during these times of provocation, exposes our own heart (Ephesians 4:26;  Luke 6:45). That can give a counselor plenty to talk about and work on.

3.      Domestic abuse is not about headship or a lack of submission.  Biblical headship does not grant a husband unlimited power over his wife, the right to remove her choices from her, or the right to have his own way all the time.  Headship is always described as sacrificial service, not as a license to get one’s own way (Mark 10:42-45; Ephesians 5:1,2; Ephesians 6:21-29). 

In addition, biblical submission is always something someone who is doing the submitting chooses to do. It is a voluntary position an individual takes out of his/her love for Christ, and desire to please and obey Him. Even God does not force people to submit.

When a husband forces a wife into giving into something she does not want to submit to it is not called biblical submission. It’s called coercion, manipulation, intimidation and sometimes rape.

4.      God's purpose is to deliver the abused. God cares deeply for victims of violence. The sin of injustice is the abuse of power whether it is in a nation, a community, a church or a home.  Throughout the psalms David cries out for deliverance from the hand of his oppressor. God has a tender heart toward those who have been victimized by the cruelty of others.  (Psalm 5,7,10, 140, Acts 14:5)

Let me close with a ditty Daniel Goleman wrote in his book, Vital Lies, Simple Truths. He writes,

The range of what we think and do

    is limited by what we fail to notice.

And because we fail to notice that we fail to notice

   there is little we can do to change.

Until we notice how our failing to notice

   shapes our thoughts and deeds.

How long has it taken the church to notice that David’s sin with Bathsheba was not adultery?  My NIV study bible still describes it as a mutual adulterous affair. Yet the prophet Nathan clearly does not indicate this in his confrontation of David.  My prayer is that as biblical counselors we will begin to notice how we have failed to notice abuse of power in a relationship and ask God to open our eyes to see more clearly.


Posted on March 30, 2012