a word before we begin

I want to talk with you, My Friend, about the couch. Not the one in your living room, but the one the whole modern world has been taught to lie down on, the therapist’s couch, and the vast culture that has grown up around it, until it has become the water we all swim in and can no longer see. We live now in a therapeutic age. Its language is everywhere: trauma, triggers, boundaries, toxic, self-care, my truth. It has its own priesthood, its own confessionals, its own sacraments, and, increasingly, its own pharmacy. And it has walked, almost entirely unchallenged, straight through the front doors of the church.

So I am going to do a thing that is not done very often, and that will make some people uncomfortable, and I am going to do it anyway, because I believe it needs doing. I am going to hold the whole of modern therapy culture up against the Word of God and ask, plainly, how much of it survives the comparison. I will tell you now that I do not think much of it does. I am going to be hard on this, harder than you may be used to hearing, and I want you to know going in that the hardness is not cruelty. It is that I have come to believe a great deal of what the church has swallowed here is Babylonian to the root, and that saying so gently enough to offend no one would be its own kind of lie.

But I am not going to leave you with nothing, either, because that would be cowardice dressed up as courage. There is a true thing where the false thing stands, a real and biblical way that souls are meant to be helped and healed, and it is older and deeper and far kinder than the counterfeit that replaced it. So we will pull down, and then we will build. Come and sit with me, and we will look at the couch together, and at what the Word of God has to say about it.

chapter one

take a seat

Take a seat. Tell me about your childhood. You know the scene before I finish describing it, because it lives in a thousand films and a million jokes, and because it may well be a scene from your own week. The therapeutic model has become so total, so much the assumed background of modern life, that we have stopped being able to imagine that human beings ever lived, and suffered, and healed, any other way. But they did, for all of human history until about a hundred years ago, and it is worth remembering that this whole apparatus is very new, and very Western, and was built on a particular set of beliefs about what a human being is, beliefs that a Christian has every reason to examine before lying down and making himself comfortable.

And let me put some numbers to how total it has become, because the scale of it is genuinely staggering. In the United States, by recent government figures, more than one in ten adults, some 11%, are taking a prescription medication for depression, and among women the figure is better than one in seven. Over a single recent decade the measured prevalence of depression rose by 60%. Look at a room of ten women in your church and understand that, statistically, one or two of them are medicated for their sadness, and more are in therapy, and nearly all of them have been taught to narrate their inner lives in the vocabulary of the couch. This is not a fringe. It is the sea we are all swimming in.1

We have stopped being able to imagine that human beings ever suffered, and healed, any other way.

Now hear me carefully at the outset, because everything depends on my not being misheard here. I am not saying that sadness is not real, or that suffering is not real, or that the human mind cannot break in genuine and terrible ways. It can. I am not mocking the person in real anguish, and I am not telling anyone to throw away a medication their doctor has given them. That is not my subject and not my place. My subject is the whole vast system of thought that has grown up around human suffering, the therapeutic worldview, and the specific and disastrous thing that happened when the church, instead of testing that worldview against the Word, simply baptized it and welcomed it in. That is the thing I mean to examine, and I mean to examine it without flinching.

Because here is what I have come to believe, and what I want to lay before you and prove from the Scripture across these pages. The therapeutic culture is not a neutral set of tools. It is a rival faith, with a rival account of what you are, what is wrong with you, and what will make you whole. And when you understand that, you understand why it cannot simply be married to Christianity with a few verses sprinkled over the top. You cannot serve two gospels. So take a seat, yes, but not on their couch. Take a seat here, with the Word open, and we will reason it through together.

babylonian wisdom

is waiting for you

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sources & notes

  1. U.S. figures on medication for depression: the CDC’s National Center for Health Statistics reports that in 2023, 11.4% of adults age 18 and over took prescription medication for depression, women (15.3%) more than twice as likely as men (7.4%); the rate rose from 9.8% in 2019 to 11.4% in 2023 (NCHS Data Brief no. 528, April 2025; NHIS data). Over the 30-day window, NHANES 2015–2018 found 13.2% of adults on antidepressants, rising to 24.3% among women aged 60 and over (NCHS Data Brief no. 377, 2020). The CDC further reported (April 2025) that measured depression prevalence in U.S. adolescents and adults rose roughly 60% over the preceding decade.
  2. The argument that worldview is incidental to a worldview-neutral discipline (engineering, orthopedics) but constitutive of psychology, because psychology answers the inherently religious questions of anthropology (what man is), hamartiology (what is wrong with him), and soteriology (what heals him), is the central contention of the biblical-counseling movement. See Jay E. Adams, Competent to Counsel (1970); and, more recently, the writings of David Powlison and Heath Lambert for the Christian Counseling and Educational Foundation (CCEF) and the Association of Certified Biblical Counselors (ACBC).
  3. The contrasting anthropologies are stark. Sigmund Freud (e.g. The Future of an Illusion, 1927) treated religion as illusion and located human motivation in unconscious drives; Carl Jung developed a mystical and occult-tinged psychology; Carl Rogers grounded his client-centered therapy in an assumption of innate human goodness; Abraham Maslow placed “self-actualization” at the apex of his hierarchy of needs. Set against the biblical account of man as fallen (Romans 3:10–23), whose central problem is sin (Isaiah 59:2) and whose cure is repentance, faith, and conformity to Christ (Romans 8:29; 2 Corinthians 5:17), these constitute a rival anthropology and soteriology, not a neutral toolkit.
  4. Hebrew yaʿats (יָעַץ, Strong’s H3289), “to advise, counsel, purpose,” with the noun ʿetsah (עֵצָה, H6098), “counsel, advice, purpose.” Proverbs 19:21 sets human plans against the Lord’s ʿetsah, which alone “shall stand.” Isaiah 9:6 names the Messiah Pele Yoetz, “Wonderful Counselor,” and Isaiah 28:29 calls the Lord Himself “wonderful in counsel, and excellent in working.” See W. E. Vine and the standard Hebrew lexicons (BDB).
  5. Greek noutheteo (νουθετέω), “to admonish, warn, instruct, put in mind,” appears eight times (Acts 20:31; Romans 15:14; 1 Corinthians 4:14; Colossians 1:28; 3:16; 1 Thessalonians 5:12, 14; 2 Thessalonians 3:15); the noun nouthesia three times (1 Corinthians 10:11; Ephesians 6:4; Titus 3:10). In every case it denotes the Word-saturated, concerned, personal admonition of believers toward one another for Christlikeness. W. E. Vine, An Expository Dictionary of New Testament Words, s.v. “Admonish, Admonition.”
  6. Romans 15:14, where Paul tells an ordinary congregation it is “able also to admonish [noutheteo] one another,” is the seed text of the modern biblical-counseling recovery. Jay E. Adams, Competent to Counsel (Presbyterian & Reformed, 1970), took its title from this verse and argued for the sufficiency of Scripture in the cure of souls, against the integration of Freudian, Rogerian, and Skinnerian systems.
  7. On the historic embeddedness of soul-care and marital help in family, kinship, and the local congregation, rather than in a professional class: this is the ordinary pattern assumed throughout Scripture, e.g. the counsel of elders and the aged (Titus 2:3–5, older women teaching younger; Job 12:12), the role of parents and extended family (Proverbs 1:8; 6:20), and the mutual admonition of the whole body (Romans 15:14; Galatians 6:1–2). The professionalized, individualized model is a modern departure from this.
  8. Matthew 18:15, “If thy brother shall trespass against thee, go and tell him his fault between thee and him alone,” establishing the order: direct address first, wider involvement only afterward. With Ephesians 4:29 (speech “for edifying”) and Proverbs 16:28; 17:9 on how talebearing and the airing of grievances divide rather than reconcile. The point: bringing in others to reconcile differs entirely from recruiting them as a sympathetic audience against one’s spouse.
  9. Marriage counseling as a profession is a twentieth-century invention: the first U.S. marriage-counseling centers opened around 1929–1932, and the field grew substantially out of the eugenics movement (Paul Popenoe opened a Los Angeles center in 1930; earlier German “marriage counseling” centers of the 1920s were tied to racial hygiene). The American Association of Marriage Counselors was founded in 1942. Field histories acknowledge that couples increasingly sought professional help “rather than relying solely on family and community guidance” (see A. S. Gurman and P. Fraenkel’s history of couple therapy, Family Process, 2002; and standard reference accounts). The professionalized program thus arose as a replacement for community and kin networks that had previously served the function.
  10. Allen Frances, M.D., chair of the DSM-IV Task Force and former chair of psychiatry at Duke University School of Medicine, Saving Normal: An Insider’s Revolt Against Out-of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life (William Morrow, 2013). Frances warns that “diagnostic inflation” is “converting millions of ‘normal’ people into ‘mental patients,’” that normal grief has been reclassified as Major Depressive Disorder, and that ordinary childhood behavior is pathologized as disorder.
  11. Frances, Saving Normal, notes that roughly 6% of Americans are addicted to prescription drugs and that legal prescription drugs now account for more emergency-room visits and deaths than illegal street drugs; and that “we have far too much faith in pills, far too little trust in resilience, time, and homeostasis.” Scriptural counterpoint: Ecclesiastes 3:1–4 (a time to weep and to mourn); Psalm 30:5 (“weeping may endure for a night, but joy cometh in the morning”).
  12. Elijah’s collapse and death-wish under the juniper tree, 1 Kings 19:3–18 (following the triumph of 1 Kings 18); David’s disquieted soul, Psalm 42:5, 11 and Psalm 88; Job’s anguish (Job 3); Jeremiah, “the weeping prophet” (Jeremiah 9:1; Lamentations 3); Hannah’s “bitterness of soul,” 1 Samuel 1:10; the Lord in Gethsemane, “exceeding sorrowful unto death,” Matthew 26:38 and Luke 22:44.
  13. Jonah’s despair as the fruit of flight from God, Jonah 1–4, especially 4:3, 8–9; the disciples’ fear rebuked as failure of faith in the storm, Mark 4:40 (“Why are ye so fearful? how is it that ye have no faith?”). On distinguishing suffering inflicted from without, endured (as with Job and the hunted David), from anguish flowing from one’s own sin or unbelief: the cure differs with the cause, and Scripture models both comfort and correction.
  14. The demonic and spiritual warfare as pervasive in the Gospels and Epistles: e.g. Mark 1:23–27, 34; 5:1–20; Matthew 8:16; 12:22–28; Luke 10:17–20; and Ephesians 6:12 (“we wrestle not against flesh and blood, but against principalities, against powers…”). Scripture distinguishes the demonized from the merely sick (e.g. Matthew 4:24), warranting careful discernment rather than either denial or sensationalism.
  15. The “tree falling in a forest” puzzle traces to George Berkeley’s idealism (A Treatise Concerning the Principles of Human Knowledge, 1710) and its later popular form. Physically, a falling tree generates pressure waves in the air irrespective of any perceiver; the philosophical trick lies only in defining “sound” as a subjective auditory experience rather than as the objective wave. The point here is the confusion of objective reality with subjective perception.
  16. 1 Corinthians 13:12 (“now we see through a glass, darkly… now I know in part”), on the real but partial and mediated character of human knowledge; with Isaiah 55:8–9 (“my thoughts are not your thoughts…”), Deuteronomy 29:29 (the secret things belong to God), and Jeremiah 17:9 (the deceitful heart). A. W. Tozer, The Knowledge of the Holy, on God’s self-existence and omniscience as the ground of all objective truth.
  17. Pilate’s “What is truth?”, asked of the incarnate Truth and left unanswered, John 18:38 (with John 14:6, “I am the way, the truth, and the life”). The argument that objective truth requires a transcendent ground, absent which only competing perceptions remain, is a standard theistic and presuppositional point; cf. Colossians 2:3 (“in whom are hid all the treasures of wisdom and knowledge”) and Colossians 2:8 (“beware lest any man spoil you through philosophy and vain deceit… after the rudiments of the world, and not after Christ”).
  18. Daniel’s pattern in Babylon: taught “the learning and the tongue of the Chaldeans” (Daniel 1:4) and serving faithfully within the pagan court, yet refusing the king’s defiling provision (Daniel 1:8) and never bowing to Babylon’s gods (Daniel 3; 6). On testing all things and holding fast the good, 1 Thessalonians 5:21; on Christ as the Wonderful Counselor in whom wisdom is hidden, Isaiah 9:6 and Colossians 2:3. The posture commended: discerning use of common-grace observation under the final authority of Scripture, never integration of a rival system as foundation.
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