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A shrink thinks: Is it a sin to be anxious?

November 2019 | by Alan Thomas

Jesus declared ‘Do not be anxious about your life, what you will eat or what you will drink, nor about your body, what you will put on’ (Matthew 6:25) and Paul similarly stated ‘Do not be anxious about anything, but in everything by prayer and supplication with thanksgiving let your request be made known to God’ (Philippians 4:6). So that is clear then. It is a sin to be anxious. Well, not quite. Let us think what we mean by anxiety.

Anxiety is a mild form of fear. It is the normal mental and physical response to a threat. If I’m walking along at night coming home from work and a hooded youth jumps out and threatens me with a knife then I become anxious or even fearful. What does such anxiety involve? My heart races, my muscles tense, I breathe more quickly and experience other physical responses to this threat.

At the same time, emotionally, I feel anxious. All of this is the inbuilt (or better God-built) reaction to any such threat. Such physical and emotional reactions are good because they prepare us for action. But the key point here is how do I think? Do I worry or do I trust God?

The sin in view in Matthew 6:25 and Philippians 4:6 is worrying (anxiously thinking) about our life-situation because this reveals a lack of trust in God. Hence Jesus counsels us to think carefully about how God generously provides even for creatures such as birds who are less important because they are not made in his image. When threatened by a possible lack of food or clothing do we trust God or do we worry that he won’t provide for us?

‘Fretting’ is how Don Carson renders it in Matthew 6:25 and it bears the same negative meaning in Philippians 4:6. To fret is to think anxiously, to ruminate on a perceived problem. The opposite of such sinful worry (anxious thinking) is faith, trusting in God who is fully able to provide.

‘Anxious’ can have the positive meaning of ‘caring about’, or being legitimately concerned for someone. The same Greek word is used like this by Paul in Philippians 2:20 (for Timothy’s anxiety) and in 1 Corinthians 7:32-34 (for anxieties/concerns in relation to marriage).

So a woman learns her brother has been diagnosed with cancer. She knows he has been the family bread-winner. Her response is to be ‘anxious’ about this threat to his family by looking to the Lord to provide and by herself caring and providing help. The key then is how we think and behave in such situations, not how we feel or how our body responds.

Emotional anxiety

In psychiatry we deal with anxiety disorders. These are illnesses due to malfunction in those parts of the brain that underpin our feelings of anxiety. I think we were created with such brain areas so we could experience (the emotion of) the awe and fear of God, an appropriate type of anxiety inspired by appreciation of the greatness of God.

But in a fallen world these same brain areas are also activated by threats, such as in the above examples, and by illness damage. Following the Fall we have become prey to all kinds of diseases which can involve the brain and cause anxiety. Such anxiety illnesses produce the same physical and emotional symptoms as threats do, and so these also are not what Jesus and Paul were dealing with and are not in themselves sinful. However, if someone having such an experience frets that God isn’t in control then that becomes sinful.

When someone is emotionally anxious with such an illness then they also have the well-recognised physical sensations we can all experience from an external threat (like the mugger above): a dry mouth; a peculiar fluttery feeling in the stomach; pins and needles in the arms and legs; breathing too quickly; a racing heart and other symptoms.

In addition to the discomfort of feeling anxious and having their own combination of such physical symptoms they also have anxious thoughts. Such thoughts may simply focus on these physical sensations or on the emotions and be legitimate concerns about what is going on. Or they may be anxious worries that may reflect a failure to trust in the Lord.

Anxiety disorders

Anxiety disorders are very common. They include such diagnoses as: panic disorder; agoraphobia; social phobia; obsessive compulsive disorder; and generalised anxiety disorder. We may quibble about these terms (and I’m not convinced that splitting up the spectrum of anxiety-related illnesses like this is the best approach as they are often mixed). But that they occur and need treatment is clear.

Treatment may involve drugs more commonly used as anti-depressants (like fluoxetine and citalopram). These should be used only in more severe illnesses and/or after non-drug approaches have been tried. Minor tranquillisers, such as benzodiazepine drugs like diazepam are extremely effective anti-anxiety treatments. They can cause problems if used over a long time but can be very helpful for alleviating severe episodes of anxiety.

But in the first instance non-drug approaches should be used. Supportive counselling can be provided effectively by mature Christians who are able to provide emotional support and advice. Formal health service treatments with Cognitive Behavioural Therapy may be used and can be helpful with or without such support from the church. And of course none of these are treatments for sin. They focus on learning how to control the emotion-driven distress and physical symptoms of anxiety disorders.

The person with such an illness may or may not sin in their thinking. Their emotion-driven thoughts may include the kind of sinful worries that Jesus and Paul spoke of. A woman with obsessive compulsive disorder may worry that her long hours of study will still result in humiliating exam failure. A man with generalised anxiety may fret that Brexit will cause him to lose his job. Such worries, even within the context of an anxiety disorder, are sinful. But we understand the context and so show sympathy as we counsel and encourage trust in the Lord.

Or their thinking may not be sinful. It may be legitimate concern about their bodily symptoms or about how to help their family to manage if they become more seriously ill and incapacitated. Often it is difficult to know one way or another. As I’ve noted before we are easily deceived and self-deceived about our thoughts and behaviour.

But what is not sin is the emotion of anxiety and the associated bodily symptoms. These aspects of being anxious are not what Jesus and Paul had in view. They warned against anxious thinking and thus failing to trust God.

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