Image for Neuroscience & the Soul

Interviews

Pornography and Neuroscience: An Interview with William Struthers


Psychologist William Struthers of Wheaton College discusses his research on the intersection of human sexuality and spirituality.

Professor of Psychology, Wheaton College
December 21, 2012

Sometimes churches feel the need to separate sexuality from spirituality: one is good, the other bad. But is this a helpful way of thinking about who we are as people? Psychologist William Struthers doesn’t think so. Read on for a conversation between CCT and Dr. Struthers on the significance of uniting our understandings of sexuality and spirituality.

Evan: Start off by telling something about your work and research.

Dr. Struthers:  My name is Bill Struthers. I’m a professor of psychology at Wheaton College. I teach in the psychology department, although I consider myself a neuroscientist by practice and by trade. I have been doing research in the area of a number of different things.

Part of being a neuroscientist is being interdisciplinary, and being in a psychology department has really given me opportunities to do a lot of different research in a lot of areas. The one area that I think that I’m most interested in, though, are the neurological mechanisms of arousal. When you study this, there’s a whole host of things you can look at.

When I first started off as an undergraduate, I actually started off looking at sexual behavior. That was part of the reason why I think I was given admittance into my graduate program as well, is because I was coming with a set of knowledge and skills about how to study sexual behavior, whether that be from orientation to arousal to specific behaviors.

That’s my first love, if that makes any sense. Studying sexuality has been something that I’ve been really interested in and fascinated with since my early career. When I went a little bit further, what I found is that many of the endogenous systems that underlie arousal, and underlie excitement and reinforcement are the same neurological mechanisms that underlie addiction.

When you look at drugs of addiction, whether that be alcohol, or cocaine, or amphetamines, or heroine, it’s pretty much the same neurological system underneath it all. Tweaked a little bit subtly in different ways.

I also find great fascination with the mechanisms for natural reinforcement and for addiction as well. Not surprisingly, I found myself doing research in the area of sexual addictions and looking at drugs of abuse.

What’s interesting is that, over the years, it’s really moved from the slicing up of rat brains and looking at gene expression in the cortex, to, looking at how it plays out in clinical settings with people, and more recently, with some of the work that I’ve been doing on pornography.

I’ve been looking at what it is that makes pornography so enticing to so many individuals, especially men. How does it really warp their way of thinking about sexuality? How does that play itself out in the way that they behave sexually? How does that influence relationships and their own spiritual development? That’s what I do right now.

Evan: Tell us a bit about your life in the lab versus your work as a clinician. 

Struthers: One of the great things about being a neuroscientist researcher is that I can take some of the things that I do in the lab. Whether it be with a rat’s brain that you are slicing up and looking at the gene expression in these different areas and understanding what steps do you move from when you take a rat, and you moved to a primate, and then you move to a human being?

In many ways, the parts of the brain are still there, but they’re tweaked a little bit. How much do we look at the comparative research and say, “Well, the same systems that underlie, we’ll say, sexual arousal in the rat are present in the primate are also present in the human,” but the rat is not human. They’re different. A rat doesn’t look at pornography.

A rat doesn’t go out and solicit sex from a prostitute, but we find human beings actually do this. To a certain extent, you have an ability to say, “There is some continuity there.” Also, you want to say, “Things get a little richer the further on that you go.”

Being part of the training of clinical psychologists, you do see that sexual dysfunction and problems with respect to sexuality in human beings cause an awful lot of problems. They cause an awful lot of distress.

Because to be a good practicing clinical psychologist, you do have to understand the brain. You do have to understand that there are some similarities, and what you learn from animals can be very helpful in what you can do with human beings and the help that you can offer human beings, but it has a ceiling to it. How far does the animal research bring you up to that ceiling?

Then, the point at which you now need to transition above that ceiling is important to know.

Evan:   What’s the connection between psychology and addiction?

Dr. Struthers:  When it comes to the connection between psychology and addiction, as a brain scientist I look at this and I say, “Well, if the brain is this organ that is really orchestrating what goes on with the organism, taking information in and figuring out what it needs from within itself, it’s got its own needs physiologically.

It needs to eat. It needs to drink. It has a drive to reproduce. It takes this information and it figures out what to do with the bodies, and then acts on the world.If you think about that, as a finite organism, as a creature, you have to eat, you have to drink, and you have to find out where these things are.

You need to know when you’re hungry, you need to know you’re thirsty, and so the body sends these signals to the brain, and the brain figures them out and says, “Oh, OK, guess we need some food. Well, where were we, the last time we had food? Well, I guess we weren’t here, we must have been somewhere else, so let’s go to where the food is.”

What happens if we get to where the food is and there’s no food there? Now what happens is that drive is going to start increasing. The need for food will begin to get more severe. What happens is the brain will experience a good deal of distress as well, so there’s an emotional effect, where a person says, “OK, I’m hungry now.”

It’s not just “I could use something nice to eat,” it’s, “I’m really hungry now, and I need to focus my attention on where the food is, and I need to go find something.” What will happen is, eventually, the more hungry you get, the more frantic you’ll get looking for food, the more emotionally distressed you’ll become.

Then, when you find the food and you eat the food, “Ah,” it’s a glorious experience. There are few things that are as wonderful as when you’re really hungry and you have a great meal, there’s such a great pleasure that comes with that.

That negative emotion that comes when you feel like you’re distressed is counterbalanced when the need is actually met, that there’s great pleasure that’s found in that. That’s the body’s way that it goes about motivating you and pushing you out into the world. It has a great neurological system that’s set up and designed to do just that.

Of course, this plays a role in eating, in drinking, and in reproduction. Those are the basic primary reinforcers.

Evan:  What do you mean by “primary reinforcer”? 

Dr. Struthers:  A primary reinforcer is anything that meets a basic primal need:  eating, drinking, sex. Those are the big three. When you look at other species as well, animals love to eat, they love to drink, and they love to mate, but they eat when they’re hungry. They drink when they’re thirsty. They mate when they have not had a mating experience recently.

It’s not as if an animal would just sit and gorge, and gorge, and gorge, and gorge itself, or drink, and drink, and drink or mate, and mate, and mate until it passes out. What’ll happen is there’s a need. The animal will meet that need, and then it will go on to doing something else. You’re going to be eating, and eventually you’ll need more food, or you’re going to need more to drink. With sexuality, it gets a little more interesting, because technically you don’t need to mate in order to survive. You do need to eat and drink, but you don’t need to mate. You don’t die from virginity. You don’t die from celibacy. You don’t die from abstinence, but there’s a drive there.

I think with sexuality there’s something more going on that is really interesting to unpack, because I think it gets more to this issue of connection. Getting back to the question of addictions, the thing that make addictions addictions is that, usually, they are drugs, or they’re some kind of compound that comes in and hijacks the system.

For example, cocaine, amphetamine. It’s not like you have a drive for cocaine, or you have a drive for amphetamines. Those are not things that we’re built to want. They’re chemicals that exploit the way, neurologically, we are built to want. We’re built to want food. We’re built to want water.

We’re built to want a kind of intimate connection that expresses itself in sexuality and the having of offspring. When a drug comes into the system, it’s now hijacking the system and, also, in somewhat of a violent way, taking the system that has been working pretty nicely for the most part, and now narrowing it so that the only that’s really interesting anymore is not the food, not the drink, not the social connection, the sex or anything like that. It’s the drug. That becomes the sole focus.

When you don’t have the drug, that’s where all that negative energy comes from. That’s where the pleasure comes from, is when you get the drug but in a cruel way, a very sinister way. Because it has so violently acted on the system, the system now is adjusting to try to make sure that doesn’t happen again.

When you take the drug the same dose the second time, usually it’s not going to produce the same kind of euphoria. You’re going to be a little bit disappointed, but because you’ve taken it the second time, you’re now trying to make it that much harder the next time, the third time.

This is the problem with addictions, is that they begin to spiral out of control. You keep searching for that first high that you got, but you can’t really get that first high again because the drug has prevented you, because of the neurological response that you’ve had to it, from ever getting that high again.

You have to take up much larger dose of that drug, which then makes it harder to get the next high. It begins to spiral out of control. That’s the cruelty of addictions. Here is what’s going on in the animal brain about why it wants food, why it wants water, why it wants sex and just follows through into adulthood.

We’re built to want a kind of intimate connection that expresses itself in sexuality

Evan:  What are the tools that the neuropsychologist gets to use from within neuroscience to treat addiction?

Dr. Struthers:   It’s interesting because, if you think about the different tools that a neuroscientist would use versus the tools that a psychologist would use, a neuroscientist would probably want to say, “Well, we don’t really have much to offer you other than probably some medication. We can give you a drug.

We can maybe stick an electrode in your brain and induce some deep brain stimulation. That’s something that we could do, or we could do surgery. We could go in and cut that part of your brain out so that that’s not a problem anymore.”

All of those, I think, are problematic because, unless we want to get into the neuroengineering of people, I think you’re limited in what you can really do.

What I think is a better way of thinking about it is let’s look at, as a psychologist, what are some of the tools that we know already exist to help people who are struggling with addictions. Let’s see what’s going on neurologically with them.

For example, if it’s a group that you’re meeting with, or if you are going to be doing some therapeutic intervention with them, or giving them specific tasks to do, what we can do is we can stop, and look, and see what effect is this having on at psychological level and at the behavioral level.

If there is anything going on, if there are changes, we can probably safely assume that there’s something going on at a neurological level. I think what you want to be mindful of is that some people, let’s say a psychiatrist, will say, “Well, you’ve got a problem with addiction.

” What we’re going to do is we’re going to give you a drug that blocks the release of dopamine in the nucleus accumbens, which is what many of these drugs do that you become addicted to. Take cocaine, dopamine’s released in the nucleus accumbens. We’re going to give you a dopamine blocker to prevent that from happening.” That’s actually not an uncommon approach to take with these things.

Specifically, the drug Antabuse is given to people who are alcoholics. What it does is it blocks the alcohol so that when you take the alcohol in, it changes the way the alcohol is processed and actually makes you sick, with the hope that you get sick from drinking the alcohol. Then what will happen is that you’ll stop drinking alcohol.

In truth, what happens is people stop taking the Antabuse. They stop taking the drug that makes them sick when they drink the alcohol so that they can just drink the alcohol and get rid of their withdrawal syndromes. The pharmacological approach is one that is tricky.

You could do the deep brain stimulation thing, put on an electrode in their brains, but I think people get a little uncomfortable with that. If we can avoid that, that would be preferable, but sometimes things are sufficiently severe that you’re willing to take that risk. The neuroengineering approach is one that is perhaps on the horizon, but I think there may be other ways of going about doing it. Once again, think about the brain as connected in this fully integrated organism.

It’s an organ within the organism. That’s what makes it an organism. It’s got all these different organs. What is interesting, though, is there’s been some really interesting research that’s been looking at what happens if we think of addiction as something that we can immunize you against, using the body’s natural immune system.

What happens if we give just a little bit of cocaine to someone and their body develops an immune reaction to it so that the next time they’re exposed to it, it doesn’t have that same effect on them. It won’t have that sort of euphoria that it would be if you never had been immune to it, similar to giving a person a vaccination.

You give them a little bit of that, whatever the virus is, so that later on when they are exposed to it, their body recognizes it because it’s got a history with it, and so you don’t fall prey to that virus.

I think there’s some interesting things that are not just neuroscience, but full organismic ways of thinking about addiction that may be more beneficial than just overly focusing on the brain when it comes to addiction.

Evan:   What do you think about taking that conversation to a religious and a spiritual perspective? How should a Christian think about those neuroscientific potential treatments for addiction? What explains addiction and what explains the treatment of if? Is it a physiological thing, is it a spiritual thing, or some combination of the two?

Dr. Struthers: I love that question because it, gets at some of the important issues of our day that we are thinking about when it comes to science and religion. Too often I think we frame them as, “Is it this or is it this?” when often times I think that it’s a both/and situation. It is a spiritual thing, but it might not be spiritual in the way that we think about spiritual.

Is it a neurological thing? Yes, but it might not be in the way that we think about it as a neurologic thing. Addictions have many different levels to them.

 When you’re thinking about how it develops and how you recover from it, I think the goal should always be about how we get a person to a place of health where they can exercise their agency in a way to be able to make the decisions that they’re free to make. the hallmark of an addiction is the person really is not able to make those decisions.

The drug makes the decision for them, so there’s something that has power over them. The drug has power over them and that’s what make an addiction so problematic, is that the person tries to stop but they can’t stop. Just by sheer force of will it’s very uncommon and rare for the a person who is in the severe place of, say, heroin addiction for them to just say, “I’m going to do this cold turkey,” and they succeed. That’s a rare occurrence.

Evan: What do people mean when they say, “I’m just going to do this cold turkey, I’m going to do this by the power of my will”? Or  sometimes people would say, “It’s not by the power of my will. It’s by the power of the Holy Spirit.” Have you found religious people to be more resistant to pharmacological treatment because of their belief in some kind of divine agency? 

Dr. Struthers:   A lot of it has to do with the way we think about our experience. That’s why we have  these questions of science, and religion, and faith, and, “Was it God who did it? Was it the drugs that did it? Was it the therapist who did it?” Really, human beings are singular things, and we’re completely integrated.

Oftentimes we see the world in categories, and we like boxes, and so the language that we use helps us make sense of our world because we have to have categories. We have to have language in order to make sense of the world because it makes the a lot easier to deal with.

What happens is, I think, is that we get comfortable using the language of theology. We’ll explain everything as a result of the Holy Spirit, or God’s power, or my personal soulish will, the agency that I’m going to exercise, and this is really the result of sin or X, Y, and Z using that religious language.

Others may be more comfortable saying, “No, this is a biochemical imbalance. It’s the drug that’s doing it,” that it’s all of these things. At the end of the day, I think there is something. There’s a right answer for what exactly is going on, but I don’t think that using any one of these languages on their own really accurately describes what’s going on.

I consider myself a Christian who has a strong belief in the power of God and in the importance of the decisions that we make.   I’m also a neuroscientist, someone who says, “Yeah, we do know, kind of, what’s going on in the brain when these things are happening.”

I think it’s nice to be able to use both of those languages and to be bilingual, so to speak. Also, as someone who is a psychologist, who understands what’s going on in the clinical realm, the therapeutic realm, I feel very much like someone who’s trilingual. I think there’s a richness that there’s some things that you just can’t explain using only the psychologist or the neuroscientist’s language.

You do need the religious language, and there are some things that you really could explain better using this language as a neuroscientist or using this language as a therapist than you would if you were only using the language of scripture. My hope is that we get a richer understanding of how these different languages address the issue of addictions and address the issue of spirituality.

Even if spirituality seems to only fit over here, it actually is something that’s a human experience that fits in all of those dimensions. There is something that you can only get at using the language of theology when it comes to spirituality.

Maybe, as you go over to neuroscience, it just looks and sounds very, very different, almost as if it’s incompatible with this other language, with this language of spirituality. Psychology sits in the middle able to dabble in both of them as a bridge between these two. That’s why I like being there, but I think that, in and of itself, it has its own vocabulary that has a richness to it.

Oftentimes you can see the neuroscientist over here basically says, “These other two languages. They’re moronic. They don’t make any sense, and, really, my language is the only language,” so there’s this neuroscientist triumphalism, that says: “This is the one right way to talk about these things.”

Then you’ve got theologians over here saying, “No, this is the one right way to talk about it.” Then you’ve got psychologists who say, “No, this is the one right way.”I think that rather than allowing any one of these perspectives to say, “This is the one right way to think about” addiction, or spirituality, or whatever it is that you’re talking about, I think there’s something to be gained by listening to all of them recognizing that there may be some times that You might want to listen to one voice a little bit more closely.

An example I like to use is that the human experience is like an orchestra. You need all of the different pieces of the orchestra. Sometimes one instrument will rise and carry the melody. The other instruments are playing something that seems like it’s discordant but actually harmonizes with the melody very well.

It’s not that everyone’s playing the same melody because drums don’t play the notes in the way that a violin does. Violins don’t make the same kind of noises that the cymbals make. The cymbals don’t make the type of noises that a trumpet might make.

Maybe at different points and times, those different instruments will carry the melodies, but there will be times when it sound like they are discordant, and we say, “No, this is the right notes to play.” “No, this is the right note to play.” But, when you step back and you listen to the larger piece, you understand that they actually fit together very nicely.

Evan: In light of that analogy, how would you characterize the relationship between science and religion more generally? 

Dr. Struthers:  When it comes to questions of science and religion, oftentimes the warfare metaphor is used, is that one has to be right. One’s got to dominate and destroy the other. I think that oftentimes it’s because people just want a simple explanation and sometimes the explanation just isn’t very simple.

The human condition is not simple. Some people will say, “Well, science and religion are  asking different types of questions.” Sometimes they are and sometimes they are not. It’s not as if they’re in completely different arenas and never the two are allowed to overlap or, if one does, it’s encroaching on the other.

I think that’s a wrongheaded way to be thinking about it. I think many times they are asking the same questions, but they are asking the questions in different ways using different motives. Also, I think that there are times when it’s good to think about theology as a game. There are some rules that govern the way that you play Monopoly, for example.

Everyone has to take a turn and this is how the game goes. If you step outside of those rules, the game falls apart. You become very dedicated to thinking that this is the right way to play the game. Whereas, for example, football, it has a different set of rules. It’s played in a different set of arena.

All the pieces and all the bodies are moving at once and they have breaks in between the plays. Then soccer’s got a different set of rules Neuroscientists, psychologists, theologians play their game, which is an epistemological game of trying to figure out what’s really going on in the world, these bigger worldview questions.

It’s not that one set of rules is better than the other. They’re just a set of rules that we’ve agreed upon in these different disciplines that help us advance what we’re trying to advance towards, which is getting to some understanding the way things really are.

Evan: Why should a Christian play these games? What’s at stake for an individual Christian who’s trying to make sense of what looks like a completely conflicting magisteria?

Dr. Struthers: You’re playing the game whether you want to or not. The game’s a lot easier if you know what the rules are. For many Christians, we’re used to playing this kind of game. We have a good idea of what those rules are. Many Christians don’t have a good understanding of the game that the scientists are playing.

The scientists have a pretty good idea of what the rules are of their game. They maybe don’t know what the rules of the Christians, those people who are answering questions in this way. Part of it is our responsibility to just explain the rules of our game to people who are playing the game, but they are not following the right rules.

For example, being a football player trying to play Monopoly, to tackle your opponent when they are moving their person to Boardwalk doesn’t advance the game, and doesn’t really advance their game either because I’m not playing football, I’m playing Monopoly.

Paul writes about this. How do we try to be open, to be all things to all people? How can we at least be able to explain what it is we’re trying to do in such a way that we’re not saying “this is the only one right way to do it,” or, “What you’re doing doesn’t really matter,” or, “You don’t have the ability to play my game”?

I think that, as a person of faith, understand these are all just different games. They’re all part of the unique experience that is what it means to be a human being. We’re all, I think, we all just want to have some basic questions answered.

Is there a God? What does it mean to be human? What’s of value in this world? What’s right? What’s wrong? What’s the nature of reality? There’s some basic worldview questions we’re trying to ask. Historically, when you look at it, the way that we advance those questions is by agreeing, “Here’s some of the rules of how we’re going to try answering these questions and let’s do that.”

You see that happen wonderfully for philosophers. They’re great at figuring out what the rules are and for scientists. You look at the enlightenment, you look at the development of science in the western world, and you see that it wasn’t until the coming of the scientific revolution that people said, “These are the new rules. These are some new rules we’re going to use.”

Scientific advances and these medical advances blossoming out of it. No matter how many antidepressants we come up with, no matter how many vaccines we come up with, we’re not going to solve some of the problems that are these big questions like who is God. Does he love me?

These are deep questions that science, because of the way they made their rules, can’t really answer. They can’t because of the way that the rules are restricted. They’re limited now in the way that they even think about how those other questions should be asked.

Evan:  Let’s talk a little bit about neuroethics. At a few points, in thinking about the application of neuroscience to addiction therapies, you mentioned things like neuroengineering or enhancement, use of pharmacology to fix your addiction. Comment on some of the ethical questions surrounding that. Should we be concerned about our own agency when it comes to solving these problems? 

Dr. Struthers: When asking the question, “What is an agent?” usually we think of it as a person who is making a decision and that decision is freely made that they decide, “I want to do X and I don’t want to do Y,” and that they’re freed from any other things that may influence them from being forced into doing Y or forced into doing X.

We think of agency as this kind of notion of, “I’m free to do whatever I want.” I’m not quite sure I like that way of thinking about agency because, when we think about it in the context of addiction, we would say, “Oh. Well, clearly here’s a person who isn’t able Anything that diminishes your agency is a bad thing. But, if we actually were to take that to its logical extreme and we would say, “Well, perhaps a person who is loaded with vice, a person who is an addict, they make a bad decision.”

That bad decision, we would say, “They’re responsible for that bad decision.” But, as there’s a consequence to that bad decision where they now have to keep taking that drug over and over and over again, the fact that they are on their 15th time or 16th time of getting high, in some way they don’t have control.

 Their moral accountability for that 15th, 16th time isn’t as severe as those first, or second, or third times that they’ve made that bad decision. In some ways, I would want to say they’re more accountable for the bad decision that they made.

Knowing the consequences or the potential consequences and they said, “I want the high, the pleasure over the possibility of falling down this road to addiction.” I would say, morally, they’re more accountable for those first few times because, at the point where they’ve lost agency, talking about accountability and moralities, they can’t do anything.

To use some Christian language, they’re a slave to the flesh. To expect them to do anything otherwise is ridiculous. I would say now we look at that and, with addiction, we say, “Oh yeah, that’s a bad thing.” Maybe the entry point they were morally accountable, but addiction, now I have more compassion on the person who’s an addict because they have no agency.

Dr. Struthers: What happens if a person makes a decision and it’s a good decision, and, as a result, something happens that makes the next time making that same decision a little easier, and a little easier, and a little easier?

As you go further on down, it’s not addiction in the way that we think of as addiction to a drug, but let’s say it’s the honing of a way of thinking so that you are so free from even entertaining doing the bad thing that it’s not on the table. There’s no agency. All agency is gone. I think we’d call that sanctification.

It’s the same process. It’s just going in a very different direction. When we talk about a human being and we say a human being’s moving towards depravity or moving towards sanctification, the more sanctified you become, the more moral you become, the more virtuous you become, the less likely it is for you to do something that is immoral.

I’m still losing my agency, though, as I go because now what’s happening is that I’m becoming not a slave to the flesh, but a slave to Christ, a slave to those things that are God. I’d argue that in many ways you’re losing your freedom in that sanctification process.

You’re losing your agency in that process, but we value so much this notion of agency that if we really step back, it’s not about having the freedom to do whatever we want whenever we want, but in many ways the Christian walk is about losing the ability to sin and losing that desire to make some of those choices so that we’re actually pruning some choices along the way.

That, I think, is the virtuous life. It’s not still having all those options open. It’s just the virtuous life is actually about losing the bad options and the depraved life is about losing the good options.

Now, The question of neuroethics should be about how we maintain the integrity of giving people free choice in the decisions that they make, recognizing that they’re going to make some decisions that are going to be good, some that are going to be bad.

But, are there things going on inside them neurologically that are inhibiting them from doing that? Things that are not healthy? When you look at the normal course of development, we have a good idea of what’s healthy and what’s not healthy.

For example, a person who has Alzheimer’s disease. We would not look at them and hold them to the same moral standards, I would hope, as we would A person who is 30 years old, physically fit, for whom everything is going on great. we would expect that person to make good decisions.

Whereas a person who is much later on in life, who’s lost a lot of their faculties, neurologically their brain’s beginning to die, we would hold them to a different standard and we would expect things differently from them.

With neuroethics, what we want to be thinking about is:How do we help people get to a place of robust health? In the absence of the ability to do that, can we augment them pharmacologically with other types of technological things that give them that greater freedom to make the kinds of decisions that they want?

So much of neuroethics is about how we help people out who are severely impaired. I would say that’s very much a therapeutic approach. Now, that’s contrasted with what I’d say is the neuro-enhancement…Much of that is about the therapeutic side of things.

I think the problem that we have in our culture is that now we’re moving from a therapeutic approach to an enhancement approach. How do we now give people who should be able to make good decisions on their own, how do we give them shortcuts to getting to places?

How do we enhance them or get them to a place where they now have greater capacities or capabilities than other people do? That’s a very different type of question. We’re going down a very different road. Rather than trying to bring a person to a place of health, how do we now give people opportunities to go beyond what it means to be a normal, healthy, functioning human?

Evan:  So is the goal to make people better than simply “well”?

Dr. Struthers: Better than well is probably a good way of thinking about it, but I think much of what we need to be better than well is already found in scripture and does not require technology. It gets to our question of, what is well? What is healthy? What is better? What is the goal of humanity, of an individual?

What is the goal that they have? Is it flourishing? What does that look like? I think we, as Christians, will say it’s very much tied to the unique ways that we’re gifted as individuals, but is also tied to being a human being. What is the picture that we, as Christians, look to as the model for a healthy human being? I think that’s Christ.

Evan: How could you repackage this into advice for a Christian who is struggling with mental health issues? 

Dr. Struthers:  That’s a great question and one that we talk about quite a bit in my class, actually. Thinking about the way that we conceptualize issues of mental health, I think, is very unique in our culture. Even the language that we talk about, we talk about as mental health as if there’s some kind of a healthy point that you want to get to.

When you look at the spectrum of human experience, we would look at a person and say, “You’re bipolar and we need to fix you.” The reality is that, for a lot of people, their bipolar nature is incredibly distressing.

If you give them the lithium, they’ll take it, but then they’ll stop taking it because there are some things that they experience in those highs or in those lows that is an important part of their human experience for them.

The art that is done when people are in the depths of despair or the insight that comes at the points of being sub manic. There are important things that have been discovered in those places that have helped the larger community.

To look at a person who  has bipolar disorder as fundamentally broken, involves a certain level of hubris.  It also involves looking at health as really nothing more than the avoidance of suffering.

I think in the mental health world we use distress and suffering as a key element in thinking about whether something is pathological and needs to be treated or not. I think, as a Christian, suffering plays a very critical role in the way that we understand our faith, in the way that we understand the human experience.

Life is not about avoiding suffering. Life is not about saying that there is nothing good to be found in suffering, but I do think God meets people in those places, and he can reveal himself and he can meet them in those place of needs that oftentimes, by trying to medicate people out of their depression, we might be actually depriving them of some opportunities to meet God in those places.

Now I don’t want that to get out and be misunderstood as I think people should be depressed and stay depressed. It’s not what I’m saying at all. I’m saying that we’re medicating people towards a singular type of experience.

Perhaps there have been things that God has done in the past that have not just been to help individuals, but to help communities in revealing himself and pointing people in ways towards sanctification and towards any number of things that have been good for them.

Let’s use the example of Ezekiel. It may very well have been that Ezekiel had temporal lobe epilepsy and that a lot of his visions accompanied his epilepsy. Now was that from God? Was that an affliction from God? Was that a way that God revealed himself through affliction?

As Christians, I think that we don’t necessarily even need to find the right answer to those questions, but we need to find better ways of asking those questions and being open to the reality that some things may be gleaned from these other types of ways of understanding that, that we may lose if we don’t give them the freedom to.

For example, maybe God, maybe the Holy Spirit is using a medication to help a person. We need to move away from thinking of the Holy Spirit as this invisible ghost that waves a magic wand and bops people on the head and fixes them.

I think that way of thinking about the Holy Spirit is a wrong headed way of thinking about the Holy Spirit. Maybe we need to move away from thinking about scripture as just a bunch of words, but as revealed truth that is divinely revealed.

Revealed in a very special, unique way that’s different from what we get from science, which is general revelation. Maybe there’s things that are discovered through scripture that, when it imposes itself on the brain, it provides insight in the way we understand the world.

Maybe the spirit of God is moving through what we would say are naturalistic means to do things in ways that, if you were properly fed, if you had proper nutrition growing up, and all of the genetics were aligned in your favor, you probably would not have this problem, but there was trauma that was introduced. There was, maybe, malnutrition that was introduced.

You didn’t have the best compliment of genes because of the epigenetics, the things that your father did changed his genome and it was passed on to you. Not in a eugenics like fashion, but all of these things play into an understanding of why you are in the place that you are in.

Some problems may be better met via some routes than others. I don’t think there’s a problem with taking antibiotic. I don’t think that that is me denying the power of God, but I think if I took antibiotics way too much it would compromise my immune system.

We do that with children. We don’t give children too many antibiotics because they need to come through those illnesses. Their immune system needs to be exposed to those things so that when they’re adults, they can respond to the minor infections that they get without needing medication. There’s a time and a place for those things.

Evan: Are you drawing an analog between these? Allowing a child’s body to learn to cope with its physical ailments with this analog of allowing individuals to learn to cope with some of their mental ailments?

Dr. Struthers:   Yes. Let me use the example of the immune system and how the common cold maybe is a little bit like normal problems that you will run into in life. If you have a child and every time the child gets sick you take the child to the doctor at the first sign of an illness and you pump antibiotics into their system, you’ll probably deal with the infection that the child has.

What will happen, though, is that the child, as they continue to grow up and get developed, their immune system will never really learn how to respond to infections because they’ll always be relying on these outside medications coming in to help them.

If the child gets a cold, we would not want to throw as much medication at them as possible, but we want to kind of give their body the opportunity to learn from the cold, to adjust to the cold so that when they’re adults and they get a little bit of a cold, it doesn’t debilitate them.

With a child who’s overmedicated, you can compromise their immune system. There’s actually a whole host of other things that you can do with giving children too many antibiotics, which is why many doctors are reluctant to do it too much.

What happens is that when the child now meets a massive infection, that’s the time for medication. It’s not that you never want to give children antibiotics, it’s just that there’s an appropriate time and an appropriate place for the antibiotics.

When their immune system just can’t keep up with the infection, that’s when you need to give them the antibiotics, but not every time they get a small infection. What happens is, over time, if the child gets the antibiotics when they really need them, when they can’t cope with their problems, that’s when you get the antibiotic.

When they can cope with it, you give them the opportunity to cope with it. They will develop into a person who’s probably pretty healthy, that, as an adult, won’t need antibiotics very frequently. If they’re medicated their whole life, they’re going to get to be an adult and they need medication all the time. That’s not good for them.

If we think now about the things that might be problematic, let’s move that into a mental health arena. A child, when they’re distressed, needs to learn how to manage their distress. They need to learn how to manage disappointment, because you’re not always going to be the fastest kid in your class.

You will be upset when you don’t win the race, and that will be disappointing. You don’t give them an antidepressant because they didn’t win the race. You don’t try to medicate every minor disappointment that they have. Now, there may be times, let’s say the child loses both of their parents, and they’re teenager, and they fall into this pit of despair.

There may be an appropriate use for medication to help them in those places. That may be the time, like with the antibiotic. That may be a time to maybe come alongside them and help them to regulate, to meet them in that need, but it’s not designed for them to carry with them the rest of their life.

I think too often we think of especially antidepressants as things that people need to take for the rest of their lives. I don’t think they need to be like that. I’d say there are other ways that people can be met in that place of despair.

The church community. People coming around that child, to care for that child in those places in many ways is as effective, or maybe even more effective, than giving them an antidepressant. We like the antidepressant because it seems like a quick fix. We like to get rid of those symptoms quickly because it’s distressing for us to see this child in this place of despair.

As parents, we want to say, “My child’s depressed. I don’t want them to be depressed. Let’s medicate them. Like giving them an antibiotic to get rid of the symptoms, let’s get them their antidepressants.”

In reality, what they really need is they need someone to walk alongside them and to say, “OK, there may not be a good explanation for the despair that you’re experiencing, so I’m going to walk with you through that.” That may be what they need rather than the antidepressant.

When my son gets to be 15, 16 years old and has a girl that doesn’t like him, and he falls into the pit of despair, I don’t run for the Prozac. I go to him and I say, “I know what it’s like, and you know what? It’ll fade. Don’t worry.

“It may be a while before you get over her, but don’t worry. It’ll happen,” to walk him through that and to give him different ways of thinking or things that I’ve learned that were helpful in dealing with rejection when I was a teenager. Helping him walk through that, he’ll become a much more stable, emotionally speaking, adult than if I just kept throwing medication at him.

There are ways of dealing with the normal disappointments of human life. I wouldn’t look at his disappointment and say that’s pathological. The fact that a girl didn’t have a crush on him that he had a crush on, and he’s depressed, that’s not mental illness. That’s just normal life.

Much of it is the way we describe and define what’s pathological, I think. In our culture, we’re moving in a direction that I’m very concerned about, not only because of the fact that we are now making some things that are part of the human experience pathologies, but also the approach that we’re taking is medicating them, I think, is problematic.

Thinking about it in the realm of neuroethics, in practical ethical practice, I think is important that, as Christians, we understand really what the issues are and that we can understand why some people who adopt a medical approach, that’s what they do.

They either go and they do a surgical procedure, or they throw a medication at it. That’s their model. As Christians, what’s our model? What’s a different way of thinking about it?

Christ is the picture that we look to for the model of a healthy human being. 

Evan: Plenty of folks in the world of the hard sciences suggest that, with the development of more and more neuroscience in particular, we can attribute much more to the brain than we had before.. For that matter, Christians have traditionally held to the belief in an immaterial soul, something like immaterial heart, even in immaterial substance.

From the dual perspective of a neuroscientist and a Christian, weigh in on that. How do you reconcile those two commitments?

Dr. Struthers:  Traditionally, that’s referred to as the mind/body problem, but what you are saying is that, because of the advances in neuroscience, what we are seeing is it’s becoming contextualized as the mind/brain problem.

I think there’s a neuro-essentialism that we’re moving towards in doing so and I think we’re wrong headed in doing that because, if you really step back, it really is a mind/body problem.  there are things that happen in the body that affect the mind and are rooted in the body.

For example, the thyroid gland. If the thyroid gland gets thrown out of whack and you become hypothyroidal, depression is a very common outcome of that. To think of it as only the brain, I think we need to be very cautious in that, but I understand why. The brain is the seat of consciousness. It’s where we feel ourselves psychologically.

I get that, but to try to take the brain out of the body…we probably should not be doing that. That’s just the first criticism of those who are in the neurosciences saying, “Oh, the mind is just all the brain.” No, the brain is not something that is independent from the body. It’s a part of the body, so we first need to clarify that.

If we think of, then, that the mind/body or mind/brain problem, however you want to think about it within the context of the neurosciences, we have psychological experience. I think even neuroscientists get that, and that we’re not experiencing the firing of synapses. We’re not experiencing the release of glutamate, or serotonin, or dopamine.

We have what seems to be a very qualitatively unique psychological experience. Philosophers will call this qualia. This is the qualia of conscious, the qualia of the mind. It seems to be, in many ways, so very different from the way that we understand the experience of the world as hard objects or that there’s something sort of mechanical and material about the world.

We look at this and, categorically, I think when you look at most religions I would argue from a very dualistic perspective because it makes sense, because, as a neuroscientist, I’d say, “Well, that’s what the brain wants to do. It likes to have categories to make sense of the world.”

It seems like on the inside, there’s this one type of thing, whereas on the outside it seems to be this other type of thing. Desks don’t seem to act in the way that I act, so they don’t have a soul. The dogs kind of act like I do, but not quite, so they have a different kind of soul because something inside them seems to be a little bit different.

I think the issue of the problem of other minds is really inherently a philosophical problem. I think we manage it psychologically by creating these two categories. Now, at the end of the day, I think there are some epistemological and metaphysical questions that get at the question: are there two different types of stuff that are out there? That’s the “Cartesian Conundrum.”

Is there the thinking stuff? Is there the physical stuff? How do they interact with each other? Or, is there only one kind of stuff that’s all physical, and this is just some mental exhaust that plays itself out and it’s not that phenomenal? Does it have any causal influence in the world?

Or, are we all just involved in some weird, psychological, cosmic, ghost, spiritual, common hallucination, which is the material world that we’ve kind of agreed upon just so that we can engage each other well? That’s a great question.

I think, historically, Christians have had some very common ways that they’ve agreed on answering these things. I think it’s very common for people to say, “Well, let’s look back at the history of Christianity. How did Christians deal with this?” You’ve got a body, you’ve got a soul. When you die, the soul is released from the body and it goes to Heaven.

That, I think, actually sounds very Greek to me. It sounds very much like it’s heavily influenced by Greek philosophy that was going along in parallel around the time of Christ. When you look at Jewish writings and Jewish thinking, Hebraic thinking, even among the Hebrews there were some differing opinions.

I’d say there were maybe some Hebrews who were sort of dualistic. Some Hebrews which were dualistically, “We’re made of these two parts.” I think there were also some Hebrews who said, “No we’re sort of a singular thing,” who were monistic in the way that they think about it.

That sort of monism/dualism sort of language existed in Hebrew thought. I think it existed in Greek thought. It certainly exists in Christian thought. I think you’re also seeing it exists in secular thinking, non Christian thinking, among philosophers who have no theological anchors or no theological convictions.

They’re just asking those questions, dealing specifically, once again, with those human questions. What does it mean to be a human being? What’s the nature of reality? I think there’s disagreement within many philosophical circles. You’re not going to see it in the scientific circles, because the scientists have said, “These are the rules of our game.

“You’re only allowed to talk about things in this way.” Inherently, you sort of get rid of a lot of those potentials for non material explanations for things, because we’re only looking at the material. Is there neuroscientific evidence for the soul?

Dr. Struthers:  There will be neuroscientific evidence for the soul if the soul is defined in neuroscientific terms. If you’re OK with that, then we can explain the soul.

We can give you a great little definition, if the soul is defined as agency, as the ability to make decisions, or as the place where sensory information comes together and is unified together as the binding problem of consciousness.

If we can find out how to ask that binding psychological experience question, and find neurologically where that is shattered in the brain, if we go and we find, for example, a person has damage to the anterior cingulate cortex, and, as a result, they don’t make decisions real well, they seem to show a very fragmented form of consciousness, there’s your soul.

It’s not the pineal gland like Descartes said. It’s the anterior cingulate on the right side. There’s your soul. There’s the neuroscientific explanation for the soul.

If you don’t want to find the soul that way, if you don’t want to say that it is a decision maker, if you don’t want to say that it is the binding place where consciousness comes together and you have your psychological agency experience, well then what is it?

If you’re defining nonphysical terms, and neuroscience is committed to only talking about things in physical terms, then you’re out of luck. No, you’re never going to find it.

I think you can take a different approach, you can take an interdisciplinary approach and say, “Well, let’s talk about the different ways that we can define the soul, and let’s talk about the different epistemological approaches that we can take.”

Now, rather than trying to play that game over there, or that game over there, or that game over here, let’s make a new game. The neuroscientist can glean things from the theologian, and the theologian can glean things from the neuroscientist and maybe get us to think a little bit more differently in our theology about, “Wow, we didn’t really think about the soul that way before. That’s kind of interesting. Let’s go back to our scriptures, let’s go back to our tradition. Let’s dig a little deeper there.”

Now, that’s an exciting thing for me. Or psychologists who have different perspectives in developing different psychology theories aking their cue from theologians and saying, “There may be some things from theology that we can take and bring into what we’re doing, positive psychology.”

For example, forgiveness research is a great example of that. Then, even for neuroscientists to say, “Well, what happens when you forgive someone? What kind of hormones would be released? What sort of mental health changes? Does the stem cells get a little bit kicked up into high gear in the brain when a person forgives?

” Do you see that the cells actually don’t atrophy, but they actually do expand? Perhaps that’s the result of, maybe, some of these hormones being released, but those hormones are only released when you make that decision to forgive a person.” When you make that decision to forgive a person that’s rooted in, “This is who God is, and what God requires of us.”

To me, we’re talking about different things in different ways, but they’re totally networked together. They’re totally synthetic. They’re totally integrated with one another. They’re not just in categories in different boxes, “Never the twain shall meet.” That’s what gets me excited.

Thinking as the mind/body question, let’s talk about it in all of these different areas, following all of those rules, but let’s now step out of those boxes and appreciate what each of these different groups have to say about it and then say, “Well, that’s interesting.

“Maybe I should reconsider a little bit,” with the goal that we’re actually all working towards getting a better approximation of    What is the true human condition? What is the soul? I think scripture clearly teaches us that we are made in the image of God. What does that mean? Theologians have understood it to mean one thing, and they’re not even in complete agreement about it either.

They have a lot of different views on it. Some say it’s a substance. Some say it’s a function. Some say it’s relational. Maybe it’s all of those things. Psychologists think about it in a different way. The way that we think about what it means to be a human being. We look at apes and we say, “OK, you’re kind of like me, but you’re not me.”

We look at, maybe, even some apes that look very much like humans and say, “You’re not me.” Then we look at a baby, or we look at an ultrasound of our child in the womb, which doesn’t really look like a human being at that point, but we say, “You are a human being. You’re who I am. We are the same.”

When it doesn’t quite look like us, but we’re willing to go that route, psychologically, what’s behind that? Neuropsychologically, what is it about the human brain which, in many ways, looks so much like every other mammalian brain?

Yes, we’ve got a bigger cortex, but there are organisms with bigger brains than us. Why do we have such a unique ability to do the things that we do? Are there unique rules that govern the way that our cortex is networked together? Are there different cells in our brains that other species don’t have?

I think there is some interesting research going on in neurosciencing. What is it about us neurologically that makes us so different from even our closest genetic and neurological primate cousins,?

That image of God. What is it there, neuroscientifically, psychologically, theologically? It’s much more fun when you play well with others. Listening to a solo is nice, but I’d much rather listen to an orchestra.

About the Author