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This book has been brewing in my mind for over a decade.

The ideas were forming as I counseled, traveled and spoke to churches across the globe. My primary goal was to find a way to encourage people that change was possible and what they needed was a way of connecting the lines between their daily struggles and their relationship with God.

In the fall or 2016, I was invited to teach a class on worry at Carriage Lane Presbyterian Church. Near the middle of the class, I had been mulling over Pilgrim’s Progress by John Bunyan and the thought occurred to give the class “steps” they could take to grow in grace. Soon after that class, a series of blogs began to take form that eventually shaped this book.

In late 2017, the final stage came as I reconnected with The Good Book Company and pitched the idea of a book on change that was short, accessible yet nuanced enough to capture more complex struggles. They accepted and provided an excellent editor, Rachel Jones, who gave wise feedback through every iteration of each chapter.

My hope is that this short book would be read by individuals, couples, families and churches. But I would also love to see it used in one-on-one discipleship relationships, as well as a foundational supplement for counselors as you seek to help others grow in grace.

Thank you to each and every person who had a shaping influence on this book.

Tim Lane

Comment

Tim Lane

Dr. Timothy S. Lane is the President of the Institute for Pastoral Care and has a counseling practice in Fayetteville, GA. He is a minister in the Presbyterian Church in America (PCA), having been ordained in 1991 and a member of Metro-Atlanta Presbytery. Tim has authored Living Without Worry: How to Replace Anxiety with Peace, and co-authored How People Change and Relationships: A Mess Worth Making. He has written several mini-books including PTSD, Forgiving Others, Sex Before Marriage, Family Feuds, Conflict, and Freedom From Guilt.

He has experience in both campus ministry (University of Georgia, 1984-1987) and pastoral ministry where he served as a pastor in Clemson, SC from 1991 until 2001. Beginning in 2001 until 2013, he served as a counselor and faculty at a counseling organization  in Philadelphia, PA. Beginning in 2007, he served as its Executive Director until 2013.

In 2014, Tim and his family re-located to his home state, Georgia, where he formed the non profit ministry the Institute for Pastoral Care. His primary desire and commitment is to help pastors and leaders create or improve their ability to care for the people who attend their churches. For more information about this aspect of Tim's work, please visit the section of this site for the Institute for Pastoral Care. He continues to write, speak and travel both nationally and internationally. Tim is adjunct professor of practical theology at several seminaries where he teaches about pastoral care in the local church.

What Exactly Is Anxiety?

Anxiety and Modern Research

What is worry? In the first blog we discussed the experience of worry and in the second we addressed the multi-layered potential shaping influences that impact the degree to which we may struggle with anxiety. But what exactly is anxiety/worry? How do you begin to define it?

Let’s begin with the advent of modern psychology and psychiatry. A great deal of empirical research has been done over the past century. While these disciplines are quite young in many ways, they have proven to generate a wealth of observable data. When Christians stop and listen to the research, they are able to wisely engage rather than dismiss it out of hand. The following definition is an excerpt taken from the DSM Psychiatry Online Website:

Anxiety disorders include disorders that share features of excessive fear and anxiety and related behavioral disturbances. Fear is the emotional response to real or perceived imminent threat, whereas anxiety is anticipation of future threat. Obviously, these two states overlap, but they also differ, with fear more often associated with surges of autonomic arousal necessary for fight or flight, thoughts of immediate danger, and escape behaviors, and anxiety more often associated with muscle tension and vigilance in preparation for future danger and cautious or avoidant behaviors. Sometimes the level of fear or anxiety is reduced by pervasive avoidance behaviors. Panic attacks feature prominently within the anxiety disorders as a particular type of fear response. Panic attacks are not limited to anxiety disorders but rather can be seen in other mental disorders as well.

Here is a list of classifications of worry that can be found in the most current version of the Diagnostic and Statistical Manual of Mental Disorders V (DSM V). Where possible, screening questions from Allen Frances’ book, Essentials of Psychiatric Diagnosis, are included in italics:

  • Separation Anxiety Disorder: Is your child inordinately scared of separations?
  • Selective Mutism: the voluntary refusal to speak (typically occurring outside the home or immediate family).
  • Specific Phobia: Do you have a particular fear that causes you special trouble, like flying, heights, closed places, animals, seeing blood, or getting an injection?
  • Social Anxiety Disorder (Social Phobia): Do you frequently avoid social situations because you are afraid of doing something stupid or looking silly?
  • Panic Disorder: Have you ever had a panic attack?
  • Panic Attack Specifier: A panic attack associated with a certain trigger (social anxiety, etc.).
  • Agoraphobia: Are there many things you’re afraid to do and many places you’re afraid to go?
  • Generalized Anxiety Disorder: Are you a ‘worry-wart,’ unnecessarily anxious all the time about a lot of different things?
  • Substance/Medication-Induced Anxiety Disorder: Have you had a lot of anxiety symptoms associated with using drugs, drinking alcohol or coffee, taking medication, or withdrawing from drugs or medication?
  • Anxiety Disorder Due to Another Medical Condition: Have you had symptoms of anxiety in association with a medical condition, like and overactive thyroid?
  • Obsessive-Compulsive Disorder: Do you ever have weird thoughts that you can’t get out of your mind? Are there rituals you can’t resist doing over and over and over and over again?
  • Post-traumatic Stress Disorder: Have you experienced a traumatic event that keeps haunting you in terrible memories, flashbacks, or nightmares?

Below is a helpful chart that compares “normal” anxiety and “abnormal” anxiety.

Everyday anxiety or an anxiety disorder?

What are we to make of this information?

While this is a very brief representation of the data, it still begs the question, "How can we engage this information and learn from it?" Here are some initial thoughts:

  1. We can certainly learn a great deal from this descriptive material. When someone tells you that they are struggling with anxiety, it is not uncommon to assume you know what they mean. You often extrapolate from your own experience of anxiety or others whom you have helped in the past. But that would be a mistake. These various descriptions help you to see how complex each and every person’s struggle with anxiety can be. The data teaches us to be more curious and to ask more questions as we get to know the particular contours of a person's struggle.
     
  2. If you are not careful, it may seem like the person who is high-functioning with “everyday” anxiety is normal and okay. Yet, biblically, every person is in need of God’s help no matter how seemingly small or big the problem. In the chart above, the person in the left column needs to be as vigilant about their low-grade anxiety as the person with a more intense struggle. No matter where you fall on the worry continuum, each and every person should be asking these questions on a daily basis. We will see why this is so important when we begin to see how Scripture defines worry.
  • “How can I love God and neighbor more fully regardless of my level of struggle with anxiety?"
  • “How can I be more and more conformed into the likeness of Jesus?”
Living without worry
By Timothy Lane

3. It might be tempting to think that the person who is high-functioning has a deeper faith than the person who struggles more intensely. But that is not necessarily so. Someone who struggles more intensely with anxiety may actually have a more robust faith than the person whose struggle is less. The Scriptures remind us again and again that the weak know their need of God’s grace while the “strong” may be falsely self-confident and self-reliant.

4. Finally, you may conclude that these diagnoses are similar to a medical diagnosis. You might conclude that the person “has” a psychopathology in the same way a person has a medical pathology or disease. While there may be an organic aspect to the person’s struggle, the DSM V categories are largely, if not only, descriptive. They are describing thoughts and behaviors that are observable. The cause may be largely unknown.

Please share your thoughts in the comment section below. In the next post, we will begin to see how Scripture defines anxiety.

Copyright © 2016 Timothy S. Lane

2 Comments

Tim Lane

Dr. Timothy S. Lane is the President of the Institute for Pastoral Care and has a counseling practice in Fayetteville, GA. He is a minister in the Presbyterian Church in America (PCA), having been ordained in 1991 and a member of Metro-Atlanta Presbytery. Tim has authored Living Without Worry: How to Replace Anxiety with Peace, and co-authored How People Change and Relationships: A Mess Worth Making. He has written several mini-books including PTSD, Forgiving Others, Sex Before Marriage, Family Feuds, Conflict, and Freedom From Guilt.

He has experience in both campus ministry (University of Georgia, 1984-1987) and pastoral ministry where he served as a pastor in Clemson, SC from 1991 until 2001. Beginning in 2001 until 2013, he served as a counselor and faculty at a counseling organization  in Philadelphia, PA. Beginning in 2007, he served as its Executive Director until 2013.

In 2014, Tim and his family re-located to his home state, Georgia, where he formed the non profit ministry the Institute for Pastoral Care. His primary desire and commitment is to help pastors and leaders create or improve their ability to care for the people who attend their churches. For more information about this aspect of Tim's work, please visit the section of this site for the Institute for Pastoral Care. He continues to write, speak and travel both nationally and internationally. Tim is adjunct professor of practical theology at several seminaries where he teaches about pastoral care in the local church.

What Causes Us To Worry?

Everyone worries. Some of us more than others. Reports show that nearly 20% of people living in the US struggle with anxiety. That means that approximately 65 million people experience worry that impacts their daily lives and relationships in profound ways.

In 2008, American physicians wrote more than 50 million prescriptions for specifically anti-anxiety medications and more than 150 million for antidepressants, many of which were used for anxiety-related conditions.

Causes for Worry

So why do so many of us struggle with anxiety? That question has been at the center of much debate. The pendulum has swung from one extreme to the other throughout history. Some have thought that worry is purely a physiological issue while others have concluded that it is purely spiritual. Alan Horwitz states this in his book, Anxiety: A Short History:

Between the fourth and sixteenth centuries, religious, magical, and folkloric views of anxiety and other mental conditions largely displaced empirically-based Hippocratic and Galenic conceptions in Western societies. While the latter beliefs persisted within medicine through the medieval period, medical knowledge itself was overridden by ecclesiastical structures. Over the course of the seventeenth century, however, anxiety was once again increasingly likely to be viewed within a medical, as opposed to spiritual, framework. Within medicine, the influences of humoral pathology, which had dominated medical thinking since Hippocratic times, gradually waned. By the end of the eighteenth century, while humoral conceptions remained popular theories of temperaments in the general culture, medicine preferred physiological accounts to explain how mental disturbances resulted from malfunctioning nervous systems (p. 54).

While Horowitz’s view of the church may be oversimplified, we still must ask: what causes anxiety? Does the Bible provide categories that enable us to avoid the swinging pendulum between faith and science? I believe it does.

The historic Christian categories of World, Flesh and Devil are entirely capable of providing a robust understanding of people and their problems, allowing us to avoid simplistic reductionism on either end of the spectrum. We don’t have to engage in either/or thinking and conclude that anxiety is either purely physiological or only spiritual. This means that we can learn from the best insights that modern science has to offer along with the rich truths of Scripture which remind us that God is able to meet us in our struggles with worry.

Below is a simple diagram that captures the many shaping influences that may be relevant to any particular person’s struggle with worry.

World

The category of “world” is everything outside of the heart. These are the external shaping influences that we experience as human beings made in God’s image. It is the person’s situation; their context. To minimize the impact someone’s circumstances has on a person is to be sub-biblical. The God of Scripture takes our situation seriously. This is a place where we can learn most from modern scientific research:

  • Brain: we all have brains that determine our personalities and pre-dispose us to a host of struggles. All of us are constitutionally wired differently. Our brains are also impacted by the fall of humanity. We are all broken at some level and exhibit various mental strengths and frailties.
  • Body: we have bodies that have strengths and weaknesses. They too are broken in different ways and impact how we respond to difficulty.
  • Event and Relational History: we have good and bad things that have happened to us along with people who have blessed us or hurt us.
  • Political/Cultural/Socio-economic Context: we exist in a context that impacts the degree to which we may struggle with worry.
  • Gender: our gender plays a role in how we struggle with worry.
  • Religious Upbringing: the beliefs that shaped us growing up influence our struggle with worry.
  • Age: the longer we live, the more grief and loss we experience. This can make us wiser or more prone to anxiety.
  • Race/Ethnicity: whether we are the majority or minority culture in a given context will also shape the way we experience anxiety.

This list is not exhaustive. You may be able to think of other external shaping influences. Each one can be nuanced to fit every person who has ever lived. No two people are alike.

While we take all of this seriously, it is important to note something interesting about the struggle with anxiety. While appreciating one’s context, changing one’s context does not guarantee that you will live a worry free life.

Once again, Alan Horwitz states this in his book, Anxiety: A Short History:

Modern developed societies are the safest, healthiest, and most prosperous that have ever existed so we might expect that their citizens would have low levels of anxiousness….
Nevertheless, surveys inform us that the public reports more anxiety disorders now than in the past. These studies indicate that anxiety is the single most common class of mental illness; almost one in five people has had an anxiety disorder during the past year and more than a quarter of the population experienced one at some point in their lives (p. 143).

Certainly there is nothing wrong with changing your circumstances if you are in danger, but situational change does not mean you will be anxiety free. There is a need for more.

Flesh/Heart

This category factors in the reality that we were created by God to worship and trust in him in the midst of our circumstances, no matter what they are. This is where the Bible focuses most of its attention. It does so, not because it is simplistic, but because it offers something that no other theory of change offers; a personal, loving, redeeming God who becomes a human being, lives, dies and is raised from the dead to give us new life, wisdom and power to live in relationship with him! The Bible does not minimize the category of “world” at all. Yet it does call us to depend upon and trust in God in the midst of our joys and sorrows.

Devil

This category is factored into the Biblical worldview because it recognizes that evil is real and personal. While most attention is focused on the other two categories, the Bible does clearly state that we have one who is opposed to God’s people and he seeks to tempt and accuse those who follow Christ. In Ephesians 6:10-20, the apostle Paul gives clear instruction on how to fight the schemes of the Evil One. When this category is improperly over-emphasized, it can lead people to look for demons in every pathology. When it is improperly under-emphasized, it can lead people to miss the real battle that is part and parcel of the Christian life.

Modern psychology and psychiatry attempt to capture the multi-layeredness of people and their problems by talking about the bio/psycho/socio/cultural aspects of causation. The Biblical worldview allows us to take those categories seriously along with painting an even fuller, more nuanced picture. Whether the church has always represented this level of nuance is something to debate, but the Scriptures are clear.

Patience and Compassion

One of the most relevant aspects of understanding these three categories is to fully appreciate the multi-layered nature of anxiety. When we do this, we can understand why some people may struggle more than others. The more layers that are involved, the greater the struggle and the harder it may be to change.

If you struggle with severe anxiety, this can help you calibrate your expectations and not live under a cloud of shame because of your struggle.

If you are someone who is helping someone who struggles deeply, these categories can move you to greater empathy and compassion. They can also help you see that, even in the midst of a struggle with anxiety, the living, redeeming God wants to meet you in your troubles and comfort you and walk with you.

Copyright © 2016 Timothy S. Lane

Comment

Tim Lane

Dr. Timothy S. Lane is the President of the Institute for Pastoral Care and has a counseling practice in Fayetteville, GA. He is a minister in the Presbyterian Church in America (PCA), having been ordained in 1991 and a member of Metro-Atlanta Presbytery. Tim has authored Living Without Worry: How to Replace Anxiety with Peace, and co-authored How People Change and Relationships: A Mess Worth Making. He has written several mini-books including PTSD, Forgiving Others, Sex Before Marriage, Family Feuds, Conflict, and Freedom From Guilt.

He has experience in both campus ministry (University of Georgia, 1984-1987) and pastoral ministry where he served as a pastor in Clemson, SC from 1991 until 2001. Beginning in 2001 until 2013, he served as a counselor and faculty at a counseling organization  in Philadelphia, PA. Beginning in 2007, he served as its Executive Director until 2013.

In 2014, Tim and his family re-located to his home state, Georgia, where he formed the non profit ministry the Institute for Pastoral Care. His primary desire and commitment is to help pastors and leaders create or improve their ability to care for the people who attend their churches. For more information about this aspect of Tim's work, please visit the section of this site for the Institute for Pastoral Care. He continues to write, speak and travel both nationally and internationally. Tim is adjunct professor of practical theology at several seminaries where he teaches about pastoral care in the local church.

When Culture Feels Scary

When you reflect on the past month in the U.S. -- the recent SCOTUS rulings, racial tension and debates over immigration policy, to name a few -- do you find yourself pessimistic and fearful or optimistic and hopeful? Depending upon where you stand on particular issues, a wide variety of responses can be seen. For some, it may evoke celebration. For others, deep sadness. Some, anger, and for many, a great deal of fear. Yet, looking at our particular zeitgeist in comparison to what believers in the Old Testament and the New Testament faced has a way of providing helpful clarity as well as deep optimism. Yes, I said optimism! I am talking about deep biblical optimism, not pollyannish optimism.

In order to get some perspective, let’s consider one example from the life of the Apostle Paul. In Acts 18, we learn that he is near the end of his second missionary journey. He is leaving Athens and heading to Corinth. That, in and of itself, is worth considering. Paul’s time in Athens bore little fruit as far as we can tell. There was no successful church plant there that we are aware of. As Paul leaves Athens and arrives in Corinth, he says this,

I came to you with great fear and trembling (I Corinthians 2:3).

Prior to his time in Athens, Paul had experienced significant persecution for his work of spreading the gospel. The bottom line is this; Paul is struggling with fear as he faces opposition. He is a minority in the cities where he moves and preaches the gospel. He is outnumbered. People think he is crazy and narrow-minded. He is an outcast. His values are at odds with the culture he is moving and living in. Corinth, itself, was a challenging city. Not unlike many of our modern cities in the world.

It is within this context that Jesus speaks to Paul in Acts 18. Listen to what Jesus says and how it is very relevant for believers today.

9 One night the Lord spoke to Paul in a vision: “Do not be afraid; keep on speaking, do not be silent. 10 For I am with you, and no one is going to attack and harm you, because I have many people in this city.” 11 So Paul stayed in Corinth for a year and a half, teaching them the word of God.

The last phrase in verse 10 is a game changer as we ponder how we relate to our culture as Christians. Paul certainly hears words of encouragement that bring new strength and resolve to his efforts. Jesus promises to protect him and be with him in the midst of his work in Corinth. But Jesus goes another step. It is a positive statement that changes Paul’s perception of those he will encounter as he goes about his gospel work.

Jesus says that many of Paul’s present adversaries will be his future brothers and sisters in Christ. Not all of them will. Paul will experience ongoing persecution and rejection. That comes with the territory as we follow the King of a very different kingdom. Yet, as Paul relates to his current enemies with a tone and posture of grace, conviction, humility and tenacity, people will find hope and grace in the One whom Paul knows and proclaims.

How are we doing as a church in the 21st century within the context of our culture? Are we pessimistic or optimistic? Do we live in fear or in hope of the advancing kingdom of God; a kingdom of grace, mercy, forgiveness and joyful repentance?

What about your particular church? Do we see the cultural challenges of the day as opportunities for pastoral apologetics; a winsome and persuasive display of God’s kindness and call to a changed life?

What about you? Do your family members, co-workers and neighbors enjoy your company or hope you don’t show up due to your strongly held opinions and the way you express your convictions? Are you fearful and self-righteous?

Paul’s tone and demeanor shifted radically upon receiving Jesus’ counsel. It is the same counsel that you are receiving today. The King is on the move rescuing folks just like you and me. In fact, he wants to use folks just like you and me. We have an opportunity to be the church and represent our gracious King. This starts by building bridges and connecting with people; especially with those whom we may disagree.

Sound scary? If so, know that you have the same promises and encouragement from Jesus as Paul did as he moved to Corinth.

Copyright © 2015 Timothy S. Lane

Comment

Tim Lane

Dr. Timothy S. Lane is the President of the Institute for Pastoral Care and has a counseling practice in Fayetteville, GA. He is a minister in the Presbyterian Church in America (PCA), having been ordained in 1991 and a member of Metro-Atlanta Presbytery. Tim has authored Living Without Worry: How to Replace Anxiety with Peace, and co-authored How People Change and Relationships: A Mess Worth Making. He has written several mini-books including PTSD, Forgiving Others, Sex Before Marriage, Family Feuds, Conflict, and Freedom From Guilt.

He has experience in both campus ministry (University of Georgia, 1984-1987) and pastoral ministry where he served as a pastor in Clemson, SC from 1991 until 2001. Beginning in 2001 until 2013, he served as a counselor and faculty at a counseling organization  in Philadelphia, PA. Beginning in 2007, he served as its Executive Director until 2013.

In 2014, Tim and his family re-located to his home state, Georgia, where he formed the non profit ministry the Institute for Pastoral Care. His primary desire and commitment is to help pastors and leaders create or improve their ability to care for the people who attend their churches. For more information about this aspect of Tim's work, please visit the section of this site for the Institute for Pastoral Care. He continues to write, speak and travel both nationally and internationally. Tim is adjunct professor of practical theology at several seminaries where he teaches about pastoral care in the local church.

Fighting to Believe

Are Evangelism and Discipleship Different?

Jesus’ words in Matthew 28:19 are clear. We are to “go and make disciples.”  We typically think of this command in two phases and use two terms; evangelism and discipleship. Evangelism involves sharing the good news of Jesus to the unbeliever. Discipleship involves obedience once one has believed. When we are not careful, though, this bifurcation can lead to a truncated understanding of the Christian life.

Most professing Christians are aware of the discipline called apologetics.  The word means to “speak in defense” of some belief. In the early church, those who defended the faith to outsiders were called apologists.

As you can see, this term has largely been used by Christians to describe evangelism; the discipline of defending the Christian faith over against non-Christian unbelief. This is wholly appropriate and right. It is the first half of the great commission in Matthew 28:19 “Go.”

Who Are We Trying to Persuade?

I want to broaden the audience of the Christian apologist, though. Not only is the Christian apologist to convince the unbeliever concerning the claims of Christ; but the believer, as well! That is discipleship. It is what I call “pastoral apologetics.” There is a desperate and daily need to make a case for the truth, relevance and power of the Gospel for the believer as he or she faces the daily challenges of living the Christian life.

Notice how the apostle Paul warned the Colossians from being duped into thinking that there was something more they needed in addition to Christ to face the problems of living. Paul says this to believing Christians in Colossians 2:6-8;

6 So then, just as you received Christ Jesus as Lord, continue to live your lives in him, 7 rooted and built up in him, strengthened in the faith as you were taught, and overflowing with thankfulness. 8 See to it that no one takes you captive through hollow and deceptive philosophy, which depends on human tradition and the elemental spiritual forces[a] of this world rather than on Christ.

In other words, while Paul found himself on many occasions defending the faith against the unbelief of those who rejected the message of Jesus’ life, death and resurrection; he found as many opportunities to make a case for the claims of Christ for the benefit and sake of those who already believed. He does not want the believer to be taken captive by any other “false gospel.”

Are You Fighting to Believe?

Every time we gather with other Christians in fellowship and worship, pick up our Bibles to read or take a moment to pray, we are asking this question, “Is this really true?” Why? Because we are so easily duped. We need convincing on a daily basis.

Today, what are you struggling with? What temptation are you facing? Where are you tempted to find meaning and the resources to live another day? If you are honest with yourself, you are always fighting to believe what you profess. May your heart’s cry today be the same as another believer in Scripture who made his doubts and struggles known to God with these words,

I do believe, help me overcome my unbelief (Mark 9:24).

Copyright © 2015 Timothy S. Lane

Comment

Tim Lane

Dr. Timothy S. Lane is the President of the Institute for Pastoral Care and has a counseling practice in Fayetteville, GA. He is a minister in the Presbyterian Church in America (PCA), having been ordained in 1991 and a member of Metro-Atlanta Presbytery. Tim has authored Living Without Worry: How to Replace Anxiety with Peace, and co-authored How People Change and Relationships: A Mess Worth Making. He has written several mini-books including PTSD, Forgiving Others, Sex Before Marriage, Family Feuds, Conflict, and Freedom From Guilt.

He has experience in both campus ministry (University of Georgia, 1984-1987) and pastoral ministry where he served as a pastor in Clemson, SC from 1991 until 2001. Beginning in 2001 until 2013, he served as a counselor and faculty at a counseling organization  in Philadelphia, PA. Beginning in 2007, he served as its Executive Director until 2013.

In 2014, Tim and his family re-located to his home state, Georgia, where he formed the non profit ministry the Institute for Pastoral Care. His primary desire and commitment is to help pastors and leaders create or improve their ability to care for the people who attend their churches. For more information about this aspect of Tim's work, please visit the section of this site for the Institute for Pastoral Care. He continues to write, speak and travel both nationally and internationally. Tim is adjunct professor of practical theology at several seminaries where he teaches about pastoral care in the local church.