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BOOK REVIEWS
Saunders, Stephen M. Martin Luther on Mental Health: Practical Advice for Christians Today. Saint Louis: Concordia Publishing House, 2023.
As anyone in pastoral ministry can attest, mental illness is a significant problem in today’s society. It is so common in fact that “about one in five adults between ages 18-65 will have a mental illness during any given year,” and “the chance of having a mental illness at some point in adulthood is about 46 percent” (pp. 18-19). The statistics for children are, sadly, not much better (p. 24). Dr. Stephen Saunders, a clinical psychologist and psychology professor at Marquette University in Milwaukee, Wisconsin, with decades of experience both in the field and in the academy, has written this book to offer “guidance to pastors, teachers, and laypersons alike in understanding and helping persons with mental health problems” (p. 8).
From the outset, Saunders states that “this book primarily focuses on Luther’s kind, compassionate, prescient advice to those experiencing emotional distress” (p. 7). He then makes the bold assertion that based on Luther’s writings and letters, it could be argued that Luther was utilizing a proto-version of what modern psychotherapists call “cognitive therapy” and “behaviour therapy” (pp. 7-8). Cognitive therapy, as its name suggests, relates to human thought; and behavior therapy deals with tackling patterns of human behavior. According to Saunders, through therapy contemporary “mental health professionals utilize the strategies Luther utilized: normalization and depersonalization” (p. 80). The process of normalizing a mental health issue requires empathy for those in distress, whereas the process of “depersonalization is making foreign something afflicting” the person experiencing a mental health problem (p. 80). Saunders offers solid evidence that Luther was engaging in both practices in his pastoral care letters.
Saunders emphasizes emphatically that “Luther openly acknowledged struggles with emotional turmoil, including that he experienced depression…
Saunders believes, like Luther, that it is crucially important that Christians, especially pastors and other church leaders, do their best to address the issue of mental illness and reduce the stigma surrounding it (p. 39). This is because even the most faithful Christians are not immune to mental health issues (p. 59). Saunders then goes on to detail a common misconception among Christians “that mental health problems are due to sin, lack of faith, or punishment from God,” beliefs he identifies as “scurrilous falsehoods and outright heresies” which are the product of theologies of glory (p. 39). Saunders emphasizes emphatically that “Luther openly acknowledged struggles with emotional turmoil, including that he experienced depression,” and that Luther’s decades of personal experiences with mental health problems helped him to advise others (pp. 49, 51). Beyond this, Saunders even goes as far as claiming that Luther’s “psychological insights closely paralleled his theological insight. In other words, Luther’s theology was his psychology” (p. 52). This is a contentious claim; regardless, Saunders rightly states earlier in the text that “you and your church can offer comfort and consolation to those with mental illness and their loved ones. The church does not flinch from sickness and sorrow…. The Church preaches Christ crucified for all” (p. 40).
Having set the stage, Saunders gets to what in my estimation is the core of his book and the most salient portion for pastors engaging in pastoral care, that is, the phenomenon of Anfechtung—a German word, with no true English equivalent, which encapsulates a profound psycho-spiritual experience of “doubt, turmoil, pang, tremor, panic, despair, desolation, and desperation” (p. 57). According to Saunders, “because they are so closely connected, many authors make a mistake in not distinguishing Luther’s mental health problems from his Anfechtung. But they are distinct, in him and in us. In the same way that physical and mental health are mutually influenced, contributing to each other, Anfechtung and mental health problems greatly influence each other” (pp. 51-52). This is especially true considering our created tripartite ontology body, mind, and soul—as humans (cf. 1 Thessalonians 5:23).
Saunders spills much ink trying to emphasize the difference between a mental health issue and Anfechtung, parsing out the fact that one requires a psychotherapist and the other a pastor (pp. 59-60). He then laments that there has been a shift from pastoral care (focused on the soul) to pastoral counseling (focused on the mind) an evolution he, rightly in my opinion, sees as a degradation (pp. 53-54). As Saunders puts it, “instead of pointing the way to salvation, today’s pastoral training tends to focus on the pastor’s role as a companion on one’s spiritual journey rather than as a caretaker of souls…. pastoral care has increasingly attempted to mimic secular counseling and help persons in emotional distress” (p. 56). Having also witnessed this phenomenon, I must agree with Saunders here: pastoral care is a species of proclamation, not another mystical/metaphysical form of psychotherapy.
Instead of pointing the way to salvation, today’s pastoral training tends to focus on the pastor’s role as a companion on one’s spiritual journey rather than as a caretaker of souls
I have only two critiques of Saunders’ book. First, some of his claims about Luther’s approach to mental health err on the side of anachronism. Although there are similarities between Luther’s approach and many modern psychotherapeutic theories, conflating them in the way Saunders does makes the historian in me uncomfortable. Second, the book is light on practical pastoral care. As noted above, Saunders rightly goes to great lengths to highlight the difference between mental health issues and spiritual issues, particularly in the case of Anfechtung (p. 61). Despite this, however, he offers only a few short words about the pastoral care of persons with Anfechtung and then spends the rest of the book explaining how the various psychological aspects of Anfechtung can be treated with modern psychotherapy (pp. 64-66). Yes, this book is about mental health, not pastoral care, but I would have liked to see Saunders point to some solid pastoral care resources for dealing with Anfechtung, rather than seemingly muddling the distinction between pastoral care and clinical counseling he worked so hard to differentiate. This likely stems from Saunders’ sometimes blurry distinction between thought and belief, exhibited most clearly when he claims that “what people think has big implications in matters of life and death, both temporal and eternal” (p. 76 ). Here I must disagree on a technicality: although thought is a part of belief, it is not ultimately our thoughts which save us, but our faith in Christ. Overall, I think what Saunders offers in this book is an excellent introduction to the very pertinent topic of mental health. This book is accessible for readers of various educational levels and is full of very practical explanations and suggestions for interacting with persons with mental health problems, particularly the content of the last four chapters. I therefore heartily recommend this book as an introductory resource for clergy and laypersons alike.
