This is taken from the book "Counseling the Hard Cases" by Stuart Scott and Heath Lambert

CHAPTER 8

“JACKIE” AND DISSOCIATIVE IDENTITY DISORDER

Stuart Scott

An Unexpected Reunion

GOD HAS A WAY OF giving his people lifelong Christian friends who grow as close as family. But these gifts often develop in the least expected ways. Nothing brings lives together more meaningfully than walking together through a storm of sin and suffering toward the peaceful tranquility of God’s grace. Jackie is one such family friend who joined us long ago for one such amazing journey. To this day she is a trophy of God’s grace, whose own personal reflections are sprinkled throughout this chapter; and she has long been a sister fully capable of encouraging our family when we need it most. But our relationship did not begin this way at all.

One Sunday evening in the church where I first pastored as a young man, I saw a new yet familiar face enter the back of the sanctuary as the service began. Jackie slipped in and sat down alone. As I glanced at my wife who normally met the eye of any visitor with a warm smile, I first noticed a surprised expression as she seemed to slump down into her seat. Something was up.

As it turns out, Jackie was as surprised as my wife to find herself providentially sitting in our little church. After the service my wife kindly greeted Jackie and reintroduced me to her college friend, whom I had first met at our wedding. Jackie looked different. The past five years had taken their toll on her. We exchanged brief updates on our lives and commented that we should have her over soon.

Later, with a painful look on her face, my wife asked me to pray for her inner struggle about getting involved in Jackie’s life again. Even though Jackie was dear to her, everything within her said that she was not ready for another difficult journey with her. However, because she recognized God’s patience in her own life and knew that his grace would enable her, there was nothing to do but trust God and exhibit the love of Christ to her old friend.

Days Gone By

I had forgotten all about Jackie. Not long after my marriage to Zondra, she had received an unexpected call from Jackie. They were close friends. Zondra had been the floor leader in Jackie’s dorm and had helped her through a number of troubling situations, including a horrible drug addiction withdrawal. Jackie was calling to ask Zondra’s forgiveness for maintaining a life of habitual, compulsive lying while in college. She communicated that she had recently been saved and wanted to confess that the drug problem and other crises she had shared with Zondra were total fabrications, including her claim of being violently raped. Zondra was shocked. At this point in her life, my young wife had no idea how to trust or help someone with such deep problems. As she reflected on Jackie’s admission of her bizarre deceit, Zondra was secretly relieved that she and Jackie were separated by many miles and that someone else was now involved in Jackie’s life. In reflecting back on this particular time in her life, Jackie wrote:1

I became very legalistic trying to ease my guilt. . . . When I went off to college, I met someone who would eventually be a catalyst for God’s amazing mercy and grace being revealed to me. It was once again an authority figure, and I again used her and lied to her. . . . She left school before I did. . . . God began to work in my heart and bring me to the point of realizing that I did not really know him. Then the guilt was even greater, so I tried confessing to God and others, . . . but I still did not realize that I needed to truly and personally trust the gospel and give my life to Christ. I really didn’t know what either meant.

The next six years were the worst of my life. A failed engagement led me to a life of isolation and despair—even wanting to die. I blamed God for many things and left the Church. . . . For five years I denied the truth of Scripture. . . . I lived life for me! My thinking became futile and my foolish heart darkened. I believe that at this time God gave me up to the lusts of my heart, and I dishonored my body . . . and as Romans 1 says I exchanged natural relations for those that are contrary to nature. I had a three-year relationship with another woman. More guilt! More lies! More double life . . . this dishonoring relationship brought me to even greater despair. I was just miserable.

Coming for Counseling

Zondra wasn’t sure Jackie would return, but once again she was surprised when Jackie began regularly attending our little church and spending time in our home. It was soon obvious that Jackie had many doubts and questions about who God really is and whether she could be forgiven and know him personally. She expressed a desire and a commitment not to make things up about herself anymore, but she continued to be very private, had difficulty relating to people, and still tended to manipulate others in various ways for attention.

As Jackie attended church and heard the Word of God, the Spirit began to work in her life. The gospel became more personal. She would later reflect on this time, after many conversations and sermons which clarified for her the true gospel and the transformative nature of the new birth:

My [faith] professions over the years were just that—professions. They were not true conversion. [When I was] twenty-five however, God literally brought me to my knees and broke my heart and saved me. The first thing I did was end the sinful relationship I was in. And I began a discipleship Bible study with a woman at church, but there was so much garbage in my life from years of living in sin.

We slowly got reacquainted with Jackie, but we were still woefully ignorant of her past as well as all that was going on in her life at present.

Jackie manifested an understandable tension that commonly plagues those who are saved out of years of secret sin. She had a fresh hope based on her secure, eternal, grace-based standing with God, but she also had trouble getting out of long-standing sin patterns and developing new righteous habits. This tension can produce a deeply strained Christian experience, and people like Jackie often find themselves in desperate need of the interpersonal ministry of God’s Word. Jackie needed the light of God’s Word to shine on her daily desires and thoughts. She needed to understand the divine and human dynamics of change. Most of all Jackie needed the glories of Christ and his gospel to explode with fresh relevance for her current challenges.

Still plagued at times with guilt and shame over her past, she regularly struggled with depression and anxiety. She was still experiencing difficulty deciphering reality and telling the truth. Her emotions were unstable, and she was uncomfortable giving or receiving expressions of affection. These serious and legitimate issues were outweighed by a greater concern on Jackie’s part as she came to me for help. She was aware that she could not account for substantial blocks of her time, and she actually thought that she was (in her own words) “catching glimpses of Christ or someone while at home.”

Unfortunately, at this point in my ministry, I had no idea how to help someone like Jackie. In fact, my seminary training had taught me to refer such troubled individuals to a Christian psychologist or psychiatrist. I chose to recommend Jackie to a local Christian psychiatrist, assuming she would receive some secret psychological or medical key from a biblical perspective and be prescribed the medications she likely needed.

Because of Jackie’s arrival and two other difficult counseling cases in our church, I simultaneously began to seek further training that might help me in my counseling ministry as a pastor. A past ministry colleague told me about a biblical counseling program, but I was skeptical. Could it be true that the Word of God was sufficient for handling complex psychological problems?

As I followed the progress of both Jackie and the other two members with their counselors, I grew increasingly concerned. The methods their counselors were using were anything but biblical, and I realized that virtually no biblical truth was being offered. All of them were getting worse, becoming more self-focused and troubled. In fact, Jackie was now having panic attacks. How can this be right? I thought. How could this be reconciled with the sanctification claims of the Bible? As I investigated further, I learned that even with a signed release form it was difficult to obtain any kind of substantial explanation of Jackie’s troubles or a basic summary of the help she was and would be receiving. I eventually received this from her psychiatrist:

I saw “Jackie.” . . . At that time she complained of symptoms of depression and anxiety and also some dissociative episodes. I believe diagnostically Jackie suffers from dysthymic disorder (chronic depression) and possibly from an identity disorder. . . . She has an extreme amount of difficulty integrating her feelings and her thoughts. . . . The memory lapses she experiences probably serve the defensive function protecting her from unacceptable emotions.

Dissociative Identity Disorder

I later learned that Jackie had been diagnosed with multiple personality disorder, or what is now called dissociative identity disorder (DID). Her therapist held to the perspective (common even among Christian psychiatrists) that multiple personalities were responsible for conflicting behaviors and memory loss. A number of factors led Jackie’s psychiatrist to give her the DID label. First, Jackie could have won an acting award for her habitual pattern of lying, which led to a great deal of confusion about the truth and who she actually was. Second, she had a traumatic childhood experience. Third, she was engaging in bizarre behaviors such as walking aimlessly down the middle of the street in a rainstorm at night, not knowing what she was doing or why she was doing it. Fourth, Jackie had great trouble now managing her emotions. Fifth, as mentioned, she was losing blocks of time. A final, critical piece in the diagnosis was her sexual confusion and inability to explain it.

The popular Christian Survivors website states:

The process of healing for people with DID is a long and complex one, with very different outcomes for different people . . . Some systems will come to a place where they are actually able and willing to integrate, [or blend] their alternate personalities into one whole person; whereas others will reach a place of high function, with the alters happy to remain separate, but co-conscious (able to communicate) with one-another.2

These perspectives are built on and follow the presuppositions and theories of secular psychology divorced from biblical truth.3 Such theories are merely derived through human interpretation of the observation of troubled individuals. The Diagnostic and Statistical Manual of Mental Disorders (then the DSM-III-R) encompasses the prevailing psychiatric thought about DID:

The essential feature of Dissociative Identity Disorder is the presence of two or more distinct identities or personality states (criteria A) that recurrently take control of behavior (criteria B). There is an inability to recall important personal information, the extent of which is too great to be explained by ordinary forgetfulness (criteria C). . . . Dissociative Identity Disorder reflects a failure to integrate various aspects of identity, memory and consciousness.4

The Psych Central website states:

Approaches vary widely, but generally take an individual modality (as opposed to family, group or couples therapy) and emphasize the integration of the various personality states into one, cohesive whole personality. It should be noted that while it’s convenient to talk of people who suffer from this disorder as having “multiple personalities,” this is just a theoretical construct. People who suffer from this disorder believe they have multiple personalities which then take on a life of their own within the individual (perhaps reinforced by the belief). The new term for this disorder in the DSM-IV more accurately reflects the problem—the individual suffers from dissociative identities. Their personality is the sum of these identities, which have been split off at some point in the past. The split is usually due to some individual or multiple traumatic events.5

The Mayo Clinic, a resource highly regarded by most, has this to say about dissociative disorders:

Psychotherapy is the primary treatment for dissociative disorders. This form of therapy, also known as talk therapy, counseling or psychosocial therapy, involves talking about your disorder and related issues with a mental health provider. . . . Psychotherapy for dissociative disorders often involves techniques, such as hypnosis, that help you remember and work through the trauma that triggered your dissociative symptoms. The course of your psychotherapy may be long and painful. . . . Although there are no medications that specifically treat dissociative disorders, your doctor may prescribe antidepressants, anti-anxiety medications or tranquilizers to help control the mental health symptoms associated with dissociative disorders.6

Jackie grew concerned that the results of her therapy did not justify the expense. She believed all she was doing was talking about her feelings and was seriously considering discontinuing her sessions. In our conversations I also voiced my own concern about how she was doing. During this period my wife and I received a call from the police in the middle of the night. Jackie was found distraught, in the middle of a busy street, running barefoot in the rain. Clearly she was not improving, and she was now endangering herself.

Eventually Jackie did stop attending therapy. At the urging of my colleague and friend, I began to counsel Jackie. I decided to try the biblical counseling program. Within a relatively short time, I was assured that I could offer Jackie better help with the Word of God, the supernatural work of the Holy Spirit, and the involvement of the church. What Jackie needed was to understand her problems biblically and to apply God’s truth specifically to her life.

Giving Hope and Getting to Know the Real Jackie

As I began my new counseling training, I began meeting with Jackie more consistently (often with Zondra present). My situation allowed me to consult with other biblical counselors regarding her case. Because Zondra and I already had a trusted relationship with Jackie, my first priority was to shine some hope into the situation. I explained to Jackie that we were going to trust God’s promise to sanctify her by his Word (John 17:17). We were going to depend on his faithfulness to provide a way out of her present struggles and lead her to a walk with Christ that would bring him glory (1 Cor 10:13; 1 Pet 1:3–4). Through our discussions we established that her old sin-enslaved self was dead and buried with Christ and that her new nature was invincibly alive with Christ. In certain ways, since her conversion she was a completely new person, never to be the same again (2 Cor 5:17). Jackie was alive from the dead, inhabited by the Holy Spirit, and empowered to love and obey God. Through Christ she had a new heart and new power to appropriate biblical truth in new ways. She had a new relationship with God, and even with all her current struggles, Zondra and I had seen a difference in Jackie’s life and desires.

My second priority was to learn all I could about Jackie’s life. What was her story? Wisdom speaks clearly in Prov 18:13: “The one who gives an answer before he listens—this is foolishness and disgrace for him.” I needed to listen well before I could counsel well. Here is Jackie’s own lengthy personal account of the information I gained through the early data-gathering process and subsequent conversations.

Growing up in a Christian home, I always knew about God and his Son Jesus Christ. There was not a time (that I can remember in my formative years) in which I did not think that Jesus was who the Bible said he was. I believed the basic facts: that Jesus was the only way to heaven, that everyone was a sinner, and that everyone needed a Savior. As a very young child, I lived in a home full of love and security. My mother held weekly Bible clubs for the neighbor kids, we were all involved in the Bible Memory Association, and I memorized quite a lot of Scripture. My life seemed perfect at age four. I had wonderful parents and two brothers, and my mom was expecting another baby. I was so excited.

We had two boys, so I asked my mom for a girl (not realizing there wasn’t a choice). When the baby came, it was not a girl; it was another boy. I remember being very angry and hurt because my mom didn’t listen to me. Resentment settled in my heart over this and was compounded by the fact that when he came home from the hospital I had to share my room and my mother’s attention with him! I did not like him. Sometimes I even wished he were never born. I was confused and upset at my mom for not giving me what I wanted; it seemed only fair to me.

I turned five years old just a few weeks after my baby brother was born. And my near perfect life was about to change again. When my baby brother was about four months old something happened that would play a major role in the development of my emotions for many years to come.

I was staying with my aunt for a little visit. My parents and three brothers were at home. It came time to come and pick me up, so they all piled in the car to come and get me. Not too far from home, they were involved in a traffic accident. A policeman came to my aunt’s house to notify us of the situation. I heard them talking and knew that my family was in real trouble. This is when it began—the guilt, the fear, the detachment from painful emotions. It turned out to be a horrific accident.

Everyone was injured to some degree, but the two people who were hurt the worst were the two people that I had wished were no longer in my life, my mom and my baby brother, Ryan. And oh, the guilt! I was sure it was my fault. I never told anyone this. I was too ashamed and hid the guilt that was always in my heart. This apparently was not something I could cope with on my own at five years old. I suppose I was too young to realize initially I could verbalize my guilt, fears, and confusion to God or anyone else.

My mother and brother almost died. Their injuries were severe. They both still suffer with some of the effects of the accident some 45 years later. We, the children, stayed with my aunt. We weren’t allowed to see my mom and brother, as they were in the hospital for a long time. I missed my mother and was scared I would never see her again. Dad would visit us at my aunt’s.

Eventually Mom came home, and then Ryan, and relatives or people from church came to care for us there. I began to do everything I could for my mom and Ryan to make up for all the bad thoughts and wishes—to try and soothe my guilt. My baby brother became my favorite, and from then on, I was his protector. Sometime during age five I was attending revival meetings at our church and the preacher, who was the “fire and brimstone” type, scared me half to death. I just about ran down the aisle to profess Christ and obtain my fire insurance (a pass to get into heaven and most importantly to stay out of hell!). Soon after this I was baptized, and life went on as I knew it before; except now, I was “saved from hell,” so I thought.

The traffic accident changed our entire family. From my perspective nothing was ever the same again. I continued on the path of resentment and private guilt, rather than being honest with anyone. Not too long after my mother’s recovery, my parents felt the Lord was leading them into full-time missionary work. So by age seven there was yet another huge change. We relocated and began our missionary training. I clearly recall that during this time I was fantasizing, making up stories and pretending for relief. It seemed to me that in my pretend world, I was getting the attention I once had, and my "new world" was much more fun than my real one. I had no idea where this would lead me.

The next three years we moved every year to further our training, but we finally ended up where I lived from age nine and for many years. At this time we were very involved in the work of the mission, church, and youth groups. It was then that I really began to make things up. I would lie to myself about who I was or what was going on around me.

Most of the time there was a great dichotomy between what was going on in the inside of me and what I was portraying. On the outside I was the good girl who never got into trouble, the dutiful Christian daughter. On the inside I was afraid, miserable, and pretending. Then my life of nonreality and deceit took the next step down. I don’t know all the reasons why, but a huge one was for attention. I began to lie to others (mostly those in positions of authority) and make up things that would cause them to have sympathy for me and want to spend time with me—to counsel me and “help the poor child.” I was for the most part doing great (I had a good and stable life and was doing what was right). But with these people I pretended to be a rebellious, wayward teen. I fabricated that I was fooling around with guys, into drugs, enveloped by sadness, and having confusion about spiritual things that I really understood. I thrived on the attention I gained while being “taught,” when I really understood all along.

This life of lying went on for years. When I exhausted one person’s help, I would move on to another and another, draining them of their time and love for very unnecessary reasons. My life of deceit and guilt and confusion led to turning inward and clamming up. I was a very “shy” person. I stayed in the background mostly. I really lived life in my head. Well, I lived two lives: the real one (in a sense) where I acted the part of a model Christian girl, going to Bible clubs and being the award winner; I was the missionary kid who never did anything wrong. And a false one about which I lied to select people and regularly lived in a fantasy world in my head. Whom I was around would dictate the life that was presented. I knew that I was deceiving others but felt compelled to do so. I was a slave to my sin and addicted to attention. This lust would breed manipulation and jealousy in any relationship of significance.

I did gain a lot of attention and loved it for the moment. But it was never real, never enough, never lasting. So I had to continue to use people, to go to the next person I could exhaust. I was looking for satisfaction. It never came in people or the attention I gained. I was still a miserable person.

As far as my spiritual life went, I believed I was a Christian on the basis of my profession and baptism at age five. I strove to perform like the Christian of the Bible in many respects. But I knew I miserably failed. I was always feeling I couldn’t follow “the rules.” Of course, the guilt of my double life and all the sin that was there were playing a more major role than I realized.

My “life with Christ” was pretty much duty, nothing personal for sure. I was simply growing in my knowledge of Scripture, and my days were either good or bad according to what kind of deeds I had or had not done. As time went on, I became more and more legalistic in my dutiful life, trying to ease my guilt. I believed I could sometimes talk to God and ask him for things, depending on my performance.

My life was about to take another turn. When I was 19, I went off to college. I continued my fabrications and my use of people, but, as mentioned, I met someone there that would eventually be an instrument in God’s hand toward my true conversion. . . . [But first,] after two more years of lying and another empty profession of faith to appease my guilt, I left school over my first serious relationship with a guy . . .

When my failed engagement led to isolation, despair, and even wanting to die, I turned my back on God and spiraled into all kinds of degradation, just like what is pictured in Romans 1. From early childhood I knew God existed, but I did not honor him as God, nor did I give thanks to him. My thinking became futile, and my foolish heart was indeed darkened. I exchanged the truth about God for a lie, and I did not worship God. During this time I saw so much evil coming from my life [including the earlier mentioned sexual relationship with another woman]. The things that came out of my mouth and life showed that there was more sin in my heart than I ever thought possible. This time brought me to new levels of low. Finally, I knew God was far from me and inaccessible. Then God began to work in my heart, drawing me to himself.

At this time I began to desire returning to church—to try and somehow clean up my life and seek God again. I was still in a relationship with a woman, which continued to bring guilt and shame; but I began to seek out a church. I did find a church, and by God’s providence the wife of the pastor (Zondra) was the college friend I had lied and confessed to years earlier. The relationship needed much repair. But I was willing to overlook Zondra’s disappearance from my life, and God gave her grace to open her life to me again.

Under the ministry of Stuart and Zondra, I finally and personally recognized my great sin, my need for a personal Savior, and God’s genuine offer of grace to me. And for the first time I received his forgiveness. Although I was no longer purposefully making things up about who I was, I did still lie a lot about things that really didn’t matter. I had gotten into such a habit of lying that I lied without even thinking about it. And the guilt and shame still engulfed my heart at times.

Several months after my salvation, I went to Stuart (my pastor) for help for the problems I was still having. . . . He sent me to see a psychiatrist but eventually began to counsel me himself.

In our early sessions together, Jackie and I discussed most of the dynamics surrounding her life story. I investigated her family relationships more deeply. I explored her interaction with the trials in her life, including how the tragic car accident changed her life so dramatically. We talked about her understanding of God and the spiritual steps she tried to take along her path. I looked for evidence of her goals in life and took note of the sins in which she was currently engaged. I questioned her more carefully about exactly how she related to others in her life, and I began to ask myself what God says about each of the key discoveries learned.

Where Do We Go with Jackie?

During my time gathering information about Jackie, I also learned that she had not been sleeping much at all. It was important for me to minister to her as a whole person since spiritual and physical components do affect each other (1 Kgs 9:1–18; 2 Cor 4:16–18). One of my first steps was sending Jackie for a physical checkup, and her physician prescribed a few nights of sleeping pills. It was crucial that Jackie get some good sleep to stabilize her overall physical and emotional state, to increase her ability to concentrate, and to help her benefit from counseling.7

Over time we dealt with the issues in Jackie’s life one by one. Following the initial promise of hope in Christ, we started with (and often returned to) her recent conversion and its implications for her daily life. We unpacked 1 Cor 6:11 and 2 Cor 5:17 as we discussed the gospel and especially her identity in Christ. Whether Jackie’s old identity was viewed as multiple confused personalities or a singular enslaved personality, her past identity as a whole was just that—old and dead. “Such were some of you,” Paul wrote to the converted sinners of Corinth (1 Cor 6:11 NASB, emphasis added). Now, along with these redeemed saints, Jackie was, in a real sense, a new creation (2 Cor 5:17). We also pondered Phil 2:12–13 as we examined her role and God’s role in the process of change. God desired Jackie to work hard at growth and tend the garden of her own thought life. He also promised that her labors would be fueled and fertilized by his own energizing and cultivating work within her. This blend of serious responsibility and energizing power was designed by God to amplify Jackie’s commitment to apply God’s truth personally to her life (Jas 1:22) for the right reasons (Rom 12:1–2). Even in the face of great difficulty, it was wonderful to watch Jackie work at the assignments I gave her with prayer and zeal. Ultimately she had a true desire to honor the Lord and submit to Scripture. This commitment went a long way in facilitating the Spirit’s supernatural work in her life (Eph 4:30).

Idolatrous and Destructive Life Agendas

Jackie’s heart was genuinely arrested by God’s grace. Therefore, she was ready and eager to consider the practical issue of what her heart was worshipping in her everyday living. After talking through certain Scriptures that deal with one’s heart (Romans 1; Ezekiel 14; Jas 1:12–15; 4:1–4), Jackie was motivated to contemplate some questions I gave her: “What am I willing to sin to get, or sin if I don’t get?” “For me, to really live is what?” (see Phil 1:21). “What have I habitually sought and set my heart on in this life?”

With compassion for what Jackie had been through as a child, we traced patterns of sinful worship which she had been pursuing throughout her life. Her eyes were opened to certain lusts she had developed—for attention; for a personal, all-satisfying relationship; for the approval of others; and for control over her situations. It was essential for Jackie to understand that every human heart always fixates on some object of worship because we are created to worship (Deut 11:16; John 4:23; Rom 1:18–32; Col 1:16).

She learned that prior to salvation her heart was enslaved to false worship and engaged in it constantly. It also made sense to her that while life’s circumstances may have influenced the direction of her affections and her false worship, such external factors were not the ultimate cause of her idolatry. Rather, her sinful idolatry must be attributed to her fallen condition and the lustful bent of her own heart (Jer 17:9; Titus 3:3). It was helpful for her to understand that because she did not know God she would have found something to worship instead of him—even if her family’s car accident had never happened. Without Christ, Jackie became increasingly convinced that other things would bring her meaning and happiness. Her pursuits, choices, and responses had all flowed from the true objects of her affections and her hope or loss of hope in them.

Exchanging the worship of God for the worship of her idols, Jackie spiraled down into new sins. A lesbian relationship followed her complete and decisive rejection of God’s truth and a full pursuit of what she desired most. She was given over to her lust for a personal, all-satisfying relationship and was willing to fulfill it any way she could. Unlike some, Jackie did not struggle with a desire for women throughout her life, nor did she have a problem with it following her salvation.8 It was driven by her false worship and by her outright rejection of God. With the embracing of God’s grace came also a decisive rejection of this particular sexual sin. Still, while Jackie was no longer a full-time idol worshipper and didn’t fulfill her basic relational lust in that way, it showed up in other ways at various times until it was recognized, repented of, and replaced with a deeper and more united pursuit of Christ.

In contrast to Jackie’s idolatrous lusts, we discussed the supreme worth and value of Christ along with the saints’ profound experience of knowing and worshipping him alone (Ps 73:25–28; Phil 1:21). Jackie was deeply affected by this revelation about her daily heart’s desires and passions. She confessed her sin to God and asked him to remind her of his value and his call to undivided worship if and when she began to resurrect these idolatrous lusts. In the coming months she would have many opportunities to practice this repentance. Over the next few weeks, we continued to paint a picture of undivided worship in her daily life while emphasizing the possibility and importance of being satisfied in God alone. Honing in on the heart (her affections, beliefs, and thoughts) was vital for her growth.

In order to give God the worship he deserved, Jackie would need to pursue several significant new mind-sets: appropriating the gospel daily and embracing God’s love for her (Eph 3:17–19), learning to give love rather than seek it from others (Acts 20:35; Phil 2:3–4), and cultivating a trusting and submissive spirit, yielded to a good God’s control rather than trying to control her own life and the lives of others (Ps 138:8; Prov 16:9, Jas 4:13–15). In the coming months and years, several of these passages would become precious to Jackie.

Practically Working at Change

God’s Word teaches that in the disordered soul, it is natural for sin to flow from the affections, to the thoughts, to the emotions, and to the behavior. The flow of righteousness within even a new and changed heart, however, faces active and powerful obstacles—the flesh, the world, and Satan (Gal 5:16–17; Rom 12:2; 1 Pet 5:8–9). Therefore, I needed to help Jackie work on both the heart and behavioral aspects of her life. It was vital that thankfulness and worship of God remain her motivations and that she learn to depend on Christ’s power so that her new pursuits would actually please God. She also needed to learn the principle of exercising herself toward godliness in tangible and specific ways (1 Tim 4:7–8). Her application of the put-off/put-on principle from Eph 4:22–32 needed to differ entirely from her past efforts to staple good fruit onto a dead tree (her dead heart) and from the toxic legalism that once reigned in her life.9 As expected, learning these lessons was not a one-time event but rather came in successive seasons of life in which she grew by increasing degrees.

Addressing Her Guilt and Shame

A significant theme and substantial problem throughout Jackie’s life was her pronounced guilt and shame over her sins, including her bitterness as a child. The guilt of her sin was still playing a central role in her depression and anxiety, and it often hindered her relationship with God. It was obvious that even as a five-year-old, Jackie had been aware that her angry, simmering thoughts toward her mother and brother were wrong. At such a young age, she was naturally confused about her seeming responsibility for their accident and about what to do with her guilt. Her guilt, stemming from both the violation of God’s Word and her own rules, needed to be confessed and/or forsaken.

We discussed the extent of God’s forgiveness through Christ, how to deal biblically with all of her past sins, and how to clear her conscience.10 On the basis of John’s merciful promise that God responds to sincere confession with full forgiveness (1 John 1:9), I gave Jackie the opportunity to confess to the Lord anything she had not already confessed. Emphasizing Christ’s work for her again (2 Cor 5:21), I pointed out her lack of genuine trust in his atonement at times and encouraged her to confess this as well. Jackie then returned often to the shadow of the cross. This particular session and her continued application of its truth to her familiar patterns of thinking brought a level of peace and freedom to Jackie she had never known before. She learned to bask in God’s forgiveness and its implications declared by the apostle Paul: “Therefore, no condemnation now exists for those in Christ Jesus” (Rom 8:1).

Confronting Dissociation and False Refuges

From an early age Jackie had found ways to dissociate herself from feelings of guilt and pain, escape into nonreality, and dichotomize her “spiritual” life and speech from her personal practice and inner thoughts. There were significant ramifications of this repeated choice. Her ability to relate personally to God’s truth or to relate meaningfully to others was severely hindered. She possessed little emotional capacity to face her own thoughts and feelings honestly. Over time she grew largely out of touch even with good emotions and became fearful or devastated when negative ones emerged. The false refuge of her mental fantasies cornered her into isolation, and she began to voice her fantasies to others as though such ideas were real. She would sometimes get confused about certain aspects of her two lives (made-up versus real), wondering which one was real. Jackie was so personally detached that parts of her memory were affected more than what is typical for those sharing her struggle. She was a small step away from completely compartmentalizing aspects of her person, fully retreating into other “realities,” and being subject to the suggestion of multiple personalities.11 Thankfully, the Spirit of God broke through with the gospel and led her to discontinue her secular-based therapy.12

Jackie needed to know God as her sufficient refuge in reality (Ps 46:1–3). Obviously, focusing on God’s character and his faithfulness to her was foundational for her reliance on him. For this purpose, I asked her to read Psalms and see how the psalmist related to God. She recognized how he experienced difficult emotions at times yet poured out his heart to God (Pss 62:8; 142:1–2), returned to God’s character and truth (Pss 31:9–24; 40:1–5), and trusted God for the grace to get through his painful situation and emotions (Ps 73:23–28). My wife remembers clearly how Jackie pushed through her fears and began imitating this mind-set. Once she began to be honest with God about her thoughts and emotions, the floodgates seemed to open. During this time her emotions were more heightened than she would have liked, but the process was essential.

It was extremely helpful at this time for Jackie to learn how renewing beliefs (embedded ideas of thought) and specific thoughts could affect and help manage her emotions. She needed to confront her anxiety with truth in a personal way. I encouraged her to ask God for the help she needed to face her thoughts and feelings honestly. She found him faithful to give her the help she needed. She was able to learn to take her thoughts captive regarding some long-standing beliefs, her fearful and anxious episodes, and her memories about her past (Rom 12:2; 2 Cor 10:5; Col 2:8).13 This was another huge step in her walk with Christ and her overall growth.

God’s Control Verses Her Control

In addition to the guilt over her sin, not trusting God’s good control over her life had contributed to Jackie’s anxieties and panic attacks. As we continued talking about the love of God for her through Christ, we also began pinpointing evidences of God’s common grace, ways he had worked in her life, and what he had been doing in times of trouble (Ps 145:9; Lam 3:19–28,31–33; Rom 8:28–29). Seeing his love demonstrated in this way was an important motivation for embracing the sovereignty of God and viewing her past differently. It also encouraged her to trust God’s control in both the present and the future. Seeing afresh God’s sovereign love and learning to repent of the false control she had learned to practice concerning her own life and the lives of others helped her lingering anxiety to subside. Reading Trusting God by Jerry Bridges led to even greater strides in trust.14

Untangling the Web of Deceit

Jackie had practiced the sin of lying for so long and in so many ways that dishonesty had become second nature for her. From the time she began hiding her guilt and shame as a child, deceit had become a way of life. It helped Jackie to know that deceit is a natural, sinful outflow from any unredeemed heart (Jer 17:9). Many years of false worship and turning to other refuges had developed this strong habit that would not be easily broken. It would take a full offensive and relentless accountability. We spent time going over deceit from a biblical perspective (Prov 12:22), examining the various forms of deceit illustrated in Scripture—from purposefully giving wrong impressions to telling a complete untruth.15 Jackie was learning to value and worship Christ above all else. She was committed to confession and repentance any time she was deceitful, no matter how painful. I had her track specific instances of deceit in a weekly calendar so that we could gain insight into any patterns, facilitators, or motivators.16 Evaluating this information while continuing to examine Jackie’s tendencies toward idolatry helped her make regular progress. Though her temptation to deceive seemed to linger the longest, she did eventually become a truth-teller. Jackie later wrote: “There came a day when I HATED to lie about ANYTHING, and I would go back and correct so many little ‘white’ lies. Truth is now a very precious thing to me. Knowing God’s truth (his Word) is the most precious of all.”

Learning to Love

One of Jackie’s greatest needs was to learn to love others in a Christlike way. Rather than work on her self-esteem, self-image, or self-confidence, she needed to consider and revel in the love of God and forsake her inordinate focus on herself in her thoughts and relationships. Because of her inward focus, isolation, and preoccupation with fantasies and attention, she did not know the first thing about typical relationships, much less biblical ones. Learning to give unselfishly and sacrificially—rather than using, manipulating, and desperately needing others—would bring glory to God, which was her new goal in life. Doing this would also liberate her from the bottomless pit of self (Phil 2:3–4). Only as she sought to love others just as Christ loves her would Jackie find joy in relationships.

We studied pride and humility and how these opposing mind-sets related to her preoccupation with self or her desire to be approved by God and others based on her own merit. I had Jackie study 1 Corinthians 13 and envision how she could specifically apply love’s various characteristics to her own life. She was then to make concrete plans for loving and serving others. As Christlike love for others became a driving motivation, behaviors like responding to others, communicating more, expressing emotion, and displaying appropriate affection were much easier to work through. I helped her formulate thoughts on how to develop godly relationships from a biblical perspective and to outline practical plans for growth. With Christ’s help Jackie began to experience joy and liberty in relationships in addition to the greater joy she was finding in Christ’s love and her increasingly undivided devotion to him. Her own reflections reveal how pivotal it was for her to learn to love like Christ:

I discovered the joy of loving others and being expressive in that love was one of the highlights! When I gave my life away to others, my heart was filled with a peace and joy like I had never known. . . . Many deep and long-lasting relationships were opened up to me, and I wasn’t seeking them or trying to manipulate them into existence! . . . I went from someone who hid from others and held back my feelings to someone who opened their home and filled it with people to love.

The Importance of the Body of Christ

Our small church community was also an integral part of Jackie’s growth and change (see Gal 6:1–3; 2 Corinthians 12; Eph 4:1–13). In many ways it was the catalyst for the public and private ministry of God’s Word to her. It was a spiritual family like she had never known, and it was her training ground where she could apply what she was learning. Through several women who ministered to her, Jackie discovered and began using her own spiritual gifts. In the words of the Christian Counseling and Education Foundation (CCEF), floundering people are “best able to image the triune God as they live and grow in community. Therefore we embed personal change within God’s community—the church, with all its rich resources of corporate and interpersonal means of grace.”17 After all, “change is a community project.”18 Jackie’s transformation brightly illustrated this truth as the church served as the crucial communal environment of truth, care, encouragement, service, and accountability. My work with Jackie was not private by any means.

Reflections

Jackie’s hope grew incrementally from day one. It was small and weak at first, but as she learned about God’s character and commitment to her she began personally and practically interacting with the Word of God. Changes began to take place in her life, and her meager hope blossomed into a strong faith. Through our counseling sessions, family conversations in our home, and Bible study, a biblical understanding of the dynamics of nonorganic depression along with God’s answers for it began to emerge. Her problem of mysticism and subjectivity in her relationship with God and her decision-making as well as how to handle anger, bitterness, and resentment biblically became a focus of work. Jackie began to conquer impure thoughts, developed a proper view of dating, set clear vocational goals, and began to put in place biblical financial principles.19

It was an awesome thing to watch God work in her life. She became one of the greatest servants in our church and one of the most contented single women we have ever known. It wasn’t that Jackie never wanted to marry. She just became more and more focused on loving, serving, and becoming more like the God who had graciously forgiven her and continued to change her. She ministered to our own family in a myriad of ways, particularly to my wife and children in key times of need.

This case is still particularly meaningful to me for many reasons. First, it was my earliest experience of seeing such drastic transformation in a life fraught with difficulties. I saw the personal ministry of the gospel working through God’s revealed truth. Second, it was a personal lesson of trusting God’s wisdom and ability in the face of my own inexperience. Third, it was a major catalyst for the invaluable training I received in how to minister the Word in counseling. Fourth, I have been able to follow God’s continued work of grace in Jackie’s life and to see the ongoing fruit of his Word.

Jackie’s experiences and responses would have led to greater dissociation, more severe emotional upsets, and deeper escapes into nonreality had she stayed her course. To clarify, if Jackie had evidenced stronger expressions when I was counseling her, I would have needed to stay my course of speaking the truth to her in any way possible. It would also have taken more perseverance in the personal application of the gospel and the patient explanation of biblical principles. I likely would have asked for greater accountability and involvement from the church. It may even have taken a stay at a residential biblical counseling facility.20 If Jackie’s problems had been even more amplified and contorted than they already were, God’s Word remains true: “His divine power has given us everything required for life and godliness” (2 Pet 1:3), and “Sanctify them by the truth; Your word is truth” (John 17:17).

Jackie married 10 years later. At just the right time God brought her a godly man whom she loves and supports with joy. Their marriage itself is another story of God’s grace. Today Jackie is a devoted mother of three children and also ministers faithfully to women in her church. Now, 27 years after the fact, Jackie reflected on her time in counseling:

It quickly gave me great hope for “today” and the future ahead. There was a purpose for my life. It was the person of Jesus Christ and all that he wanted to do in me, for me, and through me. Where once I was fearful of other people, unable to even approach someone for a need or question, now I can stand and teach crowds of ladies and just love it! It showed me that as I depend on Christ, the truth of God is definitely all I need for life and godliness. Through his Word, the Lord directs, corrects, encourages, and shows his great love for me, who was once His enemy.

There are many trophies of God’s grace in my life. It is hard to choose one I value most. But if I had to choose, it would be that I understand what it means to be a Christian. It is not about do’s and don’ts, lists to check off, feeling good about myself when I do right, or condemning myself when I do wrong. It is about a personal relationship with the God of the universe. It is about coming to understand how deeply and thoroughly I am undeservedly loved by this amazing God. In one of my favorite books, Because He Loves Me, Elyse Fitzpatrick quotes Tim Keller: “We are, each one, more sinful and flawed than we ever dared believe, but more loved and welcomed than we ever dared hope.”21 What joy that I am seen by the Father through Christ! This means that all glory belongs to him, not me. And that the one who deserves all the focus is Christ—my life, my joy, my all.