Dr. Welch has a Ph.D. in psychology as well as theology degrees, and has been a counselor for years. His doctoral work was on brain physiology, so Blame it on the Brain is the fruit of 20 years of reflection on the subject.
Welch wonders if the brain "has been given too much credit" (p. 12). Many have held the brain responsible for some bad behavior: "My disease did it!" (p. 13). While the observations of the rapidly expanding field of brain sciences can be very helpful, when interpreted through a biblical lens they can be put in a more modest and helpful perspective. How do these discoveries illustrate biblical truths that can be applied to people's lives? Instead, too often sin problems are mislabeled as solely brain problems, and thus the true cause is left unaddressed (p. 25).
Four very practical principles emerge from this approach to mind-body issues: 1. The brain cannot by itself `make' a person sin (pp.49f.). 2. Each person's abilities (brain strengths and weaknesses) are unique (pp.53f.). 3. Brain problems can expose heart problems (pp.56f.). 4. Sinful hearts can lead to physical illness; upright hearts can contribute to good health (pp.58f.).
In part two of the book these principles are then concisely but thoughtfully applied to a series of examples. First are apparently physical issues: Alzheimer's disease (pp. 67f.) and head injury (pp.85f.). Next are more psychiatric issues: depression (pp.115f.), "A.D.D." (pp. 131f.), homosexuality (pp.151f.), and alcoholism (pp. 183f.).
Welch's treatments of these problems abound with practical, sensitive insight. In the process he clearly defines the deeper issues at stake: what is the soul?; what is the body?; what is sin?
For me, a crucial component of the book is the section on the mind-body relationships, especially pp. 43-48. Welch is careful to distinguish the heart from the body, but without separating them. Drawing upon rich Trinitarian analogies, he is careful to outline a model that seeks not to over-emphasize either the duality or the unity. This understanding enables us to try to distinguish between sin and sickness. As Welch ably define sit: "any behavior that does not conform to biblical commands or any behavior that transgresses biblical prohibitions proceeds form the heart and is sin" (p. 43). Conversely, "any behavior that is more accurately called a weakness proceeds form the body and is sickness or suffering" (p. 44). We are to repent of sin. But things that reflect only our creaturely limitations are not immoral, but proceed from our fallen bodies.
The example Welch uses of hallucinations is illustrative. The Bible does not prohibit them, so we can not admonish someone for experiencing them. We are called to compassion for them. The hallucination may have been caused by a prior sinful choice, and the hallucinatory may respond to them with sin, but the hallucination itself is not sinful. A helpful chart on p. 45 lists out some examples of body problems (broken bones, mental retardation, feelings of depression, hallucinations) and heart (mind) problems (anger, pride, drunkenness). Of course, many problems involve both the body and the heart or mind, and in unequal and obscured proportions. How do we separate out the differences? And why is it helpful to try?
Each summer during high school and college I worked in a nursing home. The changes I witnessed in particular residents after being away from them for almost a year were often shocking and tragic. I think of a seemingly kind and affable man named D., who in a few months seemed to transform into an unrecognizably profane and lewd bore. Welch demonstrates convincingly that such brain or body problems as D.'s Alzheimer's can expose what is in the heart. The brain appears to have led the person into bad behavior, when it is more accurate to say that the brain problem allowed certain otherwise hidden parts of their heart to be uncovered. Welch contends, "In some case brain problems function like truth serum for the heart" (p. 58).
Welch's treatment of the subject is fairly comprehensive but far from exhaustive. Questions of application remain. If meds can only, at their best, address the body issues and not the heart, how do we know which needs addressing? Welch addresses this in a wise, but frustratingly brief section in pp. 125-127. Adopting Welch's guidelines is easy enough, but applying them to real life situations, I know from experience, is another matter. What about the person who meets some but not all of the criteria listed on p. 127 (they are over forty; have had no prior history of problems with depression; are taking prescription drugs, etc.)? This is not a flaw in Welch's treatment of the topic, just a limitation of its brief explication here.
I have known a person, for example, who had his first bout with depression at age 62. But it was extremely serious. He became despondent and delusional and was checked into a residential treatment facility. His case meets the first of the two criteria listed by Welch, but not the last two. Clearly, his depression was triggered by some circumstances in his life (some the direct result of some horrible choices, others not). Yet, just as clearly it seems that the depression, while largely originating from his sinful behavior, now had a physical component. His medications, while wrought with multiple serious side effects, did seem to successfully contribute to his ability to function. Yet, if I were given a decision making role in his `treatment,' I would want to somehow know: were the drugs really helpful, or was it their placebo effect? And if they did reduce his anxiety, is that all necessarily good? Did he not need discomfort to drive him to make changes in his absolutely horrendous behavior? And if so, how much and what type of discomfort?
Anyway, Welch's book wrestles with some deep issues and presents them in a lucid and readable format.
