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The image of God in dementia: Part 1

September 2019 | by Alan Thomas

A lot of ink has been spilled on the subject of the image of God, much of it helpful and some not. What is not helpful is when image has been interpreted to mean ‘mind’. The idea here seems to be that humans have minds but animals don’t.

The problem is this easily comes to be understood as ‘mind’ equals ‘intellect’ and the inference is that people who have ‘lost their mind’ have lost God’s image, with all that that implies for their status and value.

Such a line of thinking has grave implications for people with dementia and mental handicap (and if you tell me the proper term is ‘Learning Difficulty’ then I reply that actually this year it is ‘Intellectual Disability’!).

Image known in action

Image (and likeness, its synonym in this context) is about the whole person and so includes all that man is. As Hermann Bavinck put it: ‘man does not just bear or have the image of God but is the image of God and that … image of God extends to man in his entirety’.

Important also for our focus here is that the Bible does not focus on abstract issues to do with man’s abilities (or attributes). Rather the Scriptures describe man as like God because he imitates God in his behaviour and relationships.

As Michael Horton observes: ‘Just as biblical faith does not speculate on the “whatness” of God’s hidden essence but on the “whoness” (i.e. the character, actions and purposes) revealed in the script, the same may be said of the way in which that faith describes humanity’.

In other words, image is best understood in action, in what we do, rather than in some attempt to define what we are. We show we are like God (in His image) by acting like God. We show this especially by acting as God’s rulers on earth under Him (Genesis 1:26-30) and by relating to other people (Genesis 1:27; 2:18-25).

This relational aspect is the pertinent point here. God Himself has eternally existed in three persons in relationship with one another. God is not a lonely God. God is a relationship-God. Thus when God created man He created us male and female, image-bearers in relationship.

It wasn’t good for Adam to be alone because as a person he needed another person to relate to, so God created Eve to complete him and enable Adam to experience and express God’s image in his relationship with Eve.

Man is not rightly understood and cannot be his true self outside relationships with other humans and especially with God Himself. Our value as God’s image-bearers should be placed in this relational context.

This is especially important to remember when people are ill and most especially when mentally ill. Mental illness by definition damages the mind and thus frequently we experience changes in the person with mental illness.

This is most clearly the case with dementia. We should not view the person with dementia in isolation, rather we should understand them as relational beings and thus in the context of relationships with other people and with God.

Value in relationships

We value people with dementia because of their relationships with us, their family and loved ones. As someone with dementia loses their mental faculties they find it harder to communicate with and to relate fully to others. But their spouse and children are still able to relate to them. They still love them. They still value them. The relationships are still there and can still grow and provide real meaning to all concerned.

The wrecking effects of the disease on the person with dementia do not wreck such relationships. Dementia may damage one side of the relationship as the sufferer increasingly struggles to engage, but they do not damage the input we can give to them from our side. Even when language fails we can communicate our love through emotion and touch which are still experienced and appreciated by people with more severe dementia.

The Scriptures give us other encouragements too. In Romans 8 Paul contrasts the suffering we endure in this fallen world with our glorious future in Christ. Here we are part of a groaning creation. We experience its limitations, especially when we are being damaged by dementia. But as we struggle to pray we are reassured the Spirit is at work within us.

The man with dementia cannot formulate his prayer. He forgets the words and gets muddled. But the Spirit takes hold of them and transforms them into prayers fit for heaven. He knows our desires, he senses our groanings and so intercedes for us and with us at the throne of grace. In such ways he is able to work together with us for our good and his glory. Our brother with dementia may no longer be able to participate in our prayer meetings but he can still by the Spirit’s aid pray and worship his beloved God.

He can also experience comfort and joy from God. When John the Baptist lacked the mental infrastructure to comprehendingly worship his God, the Spirit could still fill him with joy (Luke 1:41), because the Spirit was at work in him from within his mother’s womb (1:15). When God calls us to himself he begins a good work in us and he carries it on to the end, even through the ravages of dementia.

Having called us to know him he is able to relate to us and make his love known to us even when, because of dementia, we may no longer be able to express our love to him. By his Spirit, he ministers to us inwardly to bless us with peace and joy. And there is more. In Part Two we will think about how he is also transforming us into the image of Christ, from one degree of glory to another.

Alan Thomas is a professor and consultant in psychiatry and elder at Newcastle Reformed Evangelical Church.