The Yale Journal for Humanities in Medicine
Spirituality, Religious Wisdom, and the Care of the Patient
Denial in the Context of Illness: An Evangelical Protestant Perspective
Chaplain Barry C. Black
Thank you for this opportunity to address the very important subject of denial in the context of sickness. While serving as a chaplain in Norfolk, Virginia, a few years ago, one of my sailors, a gifted guitarist and wonderful Christian man, was involved in a horrendous motorcycle accident. When I heard about the incident I rushed to the hospital to be with him. The ICU physician told me that the young sailor named, Jason, wasn't going to make it. The doctor told me he'd seen dozens of similar injuries and that there was almost not a chance Jason would recover.
I sat for hours praying by Jason's bedside as he lay in a coma covered in sterile gauze and hooked up to machines. After a lengthy vigil I went home to catch a few hours sleep and returned to the hospital the next morning. When I entered ICU, I greeted the attending physician and Jason's friends who were sitting quietly on the opposite side of the room. Then I sat down next to the bed and held my shipmate's hand as I prayed. A few moments later his mother arrived-an attractive woman, diminutive and prepossessing. She charged into the hospital room declaring, "Praise the Lord, praise the Lord, God has told me that my son will be completely restored to health." She approached the bed and kissed her son, then lifted her hands and worshiped.
The attending physician became agitated and pulled me aside saying, "Chaplain, you really need to do something; this lady's in serious denial. Her son's going to die. She's raising unrealistic expectations for his friends. Speak to her chaplain. Calm her down.would you please talk to her?"
I asked the physician if he understood that I was a Christian chaplain and told him I wouldn't ask a woman of faith to stop praising God for her injured son's recovery because that would be antithetical to the theological principles of evangelical Protestantism.
For a few weeks I visited Jason almost everyday, praying aloud and preaching my sermons to him. Since he was in a coma, I figured he couldn't run away and might even be able to hear what I was saying to him. Eventually Jason was moved from the hospital in Norfolk, VA to one in Richmond, VA, so I said goodbye to him believing I would never see him again.
Two years later I traveled to Atlanta, Georgia, for a preaching engagement. As the worship service started, I heard what seemed to be very familiar sounds of a bass guitar. I lamented Jason's death as I thought how much the music sounded like his gifted tunes. When I turned around to see who was playing, I was stunned to see Jason with a full-faced grin staring at me as he strummed his bass guitar. His mother was also at that worship service to hear me preach. After the service she shook my hand at the door and shook a finger in my face as she asked me why I didn't believe that God was going to heal her son.
I pleaded the fifth amendment that day-but I also learned an important and humbling lesson. When we consider this incredible premise of evangelical Protestantism, we open the door for all kinds of possibilities. And the premise is this: God intervenes supernaturally in the affairs of humankind. Once you accept this premise, denial can then become a constructive force.
Let me now discuss the four distinctive tenants of evangelical Protestantism, how the charismatic movement has impacted evangelical Protestantism, and the ramifications of the premise I've just asserted-God intervenes supernaturally in the affairs of humankind-and what that premise means in terms of denial.
First, denial. Freud tells us that denial is one of our basic defense mechanisms. The defense mechanism, Freud says, is a self-deceptive technique to reduce stress to manageable levels. Freud groups denial along with identification, reaction formation, projection, repression and other defense mechanisms. Freud says denial is usually destructive and rarely a constructive force.
Years later, Anna Freud said essentially the same thing. She said we can judge the maturity of an individual by the infrequency of his or her use of the defense mechanism of denial. The more immature a person is, the more frequently he or she will use denial. Mature people rarely refuse to accept the threatening or tragic aspects of reality.
In 1969 Elizabeth Kubler-Ross did definitive work on death and dying. After interviewing over 200 dying patients, Kubler-Ross developed the five sequential steps of grief. Denial was number one followed by anger, bargaining, depression and acceptance. For Kubler-Ross, denial was an adaptive prelude to the eventual acceptance of the terminal illness. She believes that America is a death denying society as well as an age denying society. We dye our hair or we cut it all off in order to appear younger, and we do our best to maintain physical fitness. We even make our dead appear to be alive. Isn't it incredible that some people actually look more attractive in the casket than when they were alive? Kubler-Ross thinks this is counterproductive, but she does see some constructive aspects to denial.
From an evangelical Protestantism perspective, what would appear to the uninitiated to be denial is actually an exercise in faith. There are four distinctive tenets to evangelical Protestantism. First is a belief in a personal conversion. It is based on Jesus' meeting with Nicodemus chronicled in John 3: "Except a man be born again, he cannot see the kingdom of God."
The second tenant is sola scriptura. It is the belief that the Bible is the sole source of revelatory knowledge. Evangelical Protestants are the children of the 16th Century reformation sparked by Martin Luther's struggle with the Roman Catholic Church. One of Luther's firm beliefs was the Bible and the Bible only. He was fond of quoting Second Timothy 3:16 and 17, "All scripture is given by inspiration and is profitable for doctrine for reproof for correction or instruction in righteousness that people of God may be perfect completely furnished unto all good works." It was the belief that scripture is the sole revelation for the believer that birthed evangelical Protestantism.
The third tenant is evangelization-global evangelization. There is almost a spiritual ethnocentrism in this tenant that is taken from what is called the Great Commission of Matthew 28:20, "Go and make disciples of humankind baptizing them in the name of the Father, the Son, and the Holy Spirit, teaching them to observe all things whatsoever I have commanded you and lo I am with you always even until the end of the age." Jesus' final instruction to his disciples was global evangelization. That's why we travel near and far to preach Christ to the unbelieving-it is our commission.
The final distinctive tenet is the belief in the cross-the centrality of Calvary. The passion of the Christ is central to humanity's redemption, but also for our physical healing. In Matthew Chapter 18 the gospel writer chronicles Jesus healing hundreds. He tells us that this was done so that it might be fulfilled what was spoken of by Isaiah the prophet in Isaiah 53:4, "Surely he hath born our grief and carried our sorrows." It is the belief that there is a causal connection between sin and sickness. It is interesting that very often before Jesus healed people He first told them their sins were forgiven. In Mark four we see this when Jesus healed the paralytic.
Let me now address the four distinct tenets of the Pentecostal and charismatic movements. The first tenet is that God the Holy Spirit reveals Himself in three primary phenomena. First, glossolalia-the manifestation of ecstatic utterances or a prayer language. Second, prophecy-what is sometimes referred to as a word of knowledge. And third, physical healing thought the laying on of hands. Hence Jason's Pentecostal mother's walking into his room shouting praises to God, speaking in tongues and speaking words of knowledge claiming her son's recovery was not pathology. In light of her son's total recovering against all odds, who am I to argue with her prognostication. But the point still remains that the Pentecostal and charismatic movements have had an incredible impact upon evangelical Protestantism.
And now back to the premise that God intervenes supernaturally in the affairs of humankind. What does this mean? First, it means that God rewards unwavering faith. One of the verses that is used to prove this point is Hebrews 11:6, "without faith it is impossible to please God." That's an amazing verse. "Without faith it is impossible to please God for those who come to God must believe that he is and that he is a rewarder of those who diligently seek him." The whole notion that importunate prayer can move the arm of God is a critical element in this premise that God moves supernaturally in the affairs of humanity.
The second aspect of the premise is that God can cure terminal illnesses. We read in James 5:13-15a, "Is any one of you in trouble? He should pray. Is anyone happy? Let him sing songs of praise. Is any one of you sick? He should call the elders of the church to pray over him and anoint him with oil in the name of the Lord. And the prayer offered in faith will make the sick person well." James 1:6 says, "and don't waver in your faith when you do this." Hence, when a believing people ask God for healing and claim it in word and deed (evangelical Protestantism teaches that the weak can say I am strong), they are simply asserting their faith in a very powerful way.
The Greek word for faith that is used in the Greek New Testament is pistis - P-I-S-T-I-S. It means God can. It does not mean God will. Prayer for the evangelical Protestant is not saying abracadabra. It is not guaranteeing healing but it is saying that even as a child can reach out his or her hand catch a ball thereby reversing the law of gravity, the omnipotent, omniscient, omnipresent God can reach into human affairs and with equal ease and heal people if he chooses. God can, not God will.
An individual from an evangelical Protestant perspective in denial has a bit of pragmatism to his or her denial. That perspective says that God can heal us and if in His wisdom He chooses to heal, we will praise Him. But if He doesn't, we will still praise Him. That brings me to the final aspect of the premise of God intervening in the affairs of humankind It states that God gives serenity to the believer to face whatever happens. Isaiah 26:3 says, "thou will keep him or her in perfect peace whose mind is stayed on thee." Philippians 4:6-7 says, "Have no anxiety about anything, but pray about everything with thanksgiving and the peace of God that passes understanding will keep your heart and mind in Christ Jesus."
So it is the belief that we can take a Job-like position in the face of the most horrific illnesses. Job suffers and yet he says, "Naked I came forth from my mother's womb and naked I will go. The Lord giveth and the Lord hath taken away. Blessed be the name of the Lord."
I conclude by reading a Bible passage from Second Kings 20 in the Contemporary English Version of the Bible, "About this time, Hezekiah the king got sick and was almost dead. Isaiah the prophet went in and told him, 'The Lord says you won't ever get well. You are going to die, so you had better start doing what needs to be done.' Hezekiah turned toward the wall and prayed, 'Don't forget that I have been faithful to you, Lord. I have obeyed you with all my heart, and I do whatever you say is right.' After this, he cried hard. Before Isaiah got to the middle court of the palace, the Lord sent him back to Hezekiah with this message: Hezekiah, you are the ruler of my people, and I am the Lord God, who was worshiped by your ancestor David. I heard you pray, and I saw you cry. I will heal you, so that three days from now you will be able to worship in my temple. I will let you live fifteen years more, while I protect you and your city from the king of Assyria. I will defend this city as an honor to me and to my servant David."
Evangelical Protestantism says the Bible is our primary source of revelation. This Bible teaches that God continues His involvement in human activities. Once you accept the premise that God intervenes supernaturally in the affairs of humankind all bets are off. And when an individual is claiming a healing and prancing around a hospital room, be careful before you pour water on his or her parade.
Published: February 5, 2005