Faith or Psychosis? A Case Study

Abraham is an elderly male presenting with symptoms of acute psychosis. Physical exam, taken upon admittance, is normal. Psychiatric evaluation shows severe mental and behavioral distortion. Below is a transcript of the evaluation (P= Psychiatrist, A= Abraham).

P. “So what brings you here today?”
A. “The Lord God spoke to me.”
P. “And what did God say?”
A. “He told me to leave Ur.”
P. “And go where?”
A. “I don’t know. God didn’t tell me that part.”
P. “Do you hear God talking to you often?”
A. “Not really. This was the first time I heard Him so clearly.”
P. “Alright. Now after God spoke to you, what happened?”
A. “Well I told Sarah what the Lord God said, and I started to pack up. Told her just what He told me, that the Lord would build us into a great nation.”
P. “I see. And how did Sarah react?”
A. “She was startled, obviously. But when I said we could bring some of our extended family, she seemed better.”
P. “And why do you think that God wanted you to go to a different country?”
A. “Because he told me to. He said he would make me into a great nation, that he would bless me and my descendents, and make my name great.”
P. “Do you have any children?”
A. “No.”
P. “But you said that God would bless your descendents and build you into a great nation. Do you and Sarah plan to have children?”
A. “I don’t understand that part, either. Sarah can’t have children and we’re both too old for that anyway.”
P. “Do you still believe that God was speaking to you?”
A. “Yes.”

Patient exhibits strong signs of psychosis, including delusions of grandeur and reduced capacity to recognize reality. Recommend treatment with antipsychotics, and need for increased patient awareness of disorganized thought processes. Talked with patient’s wife about the condition, explained the dosage of medication and need for increased vigilance toward mental wellbeing. Patient agreed not to make any big decisions until treatment takes effect. Patient will indefinitely postpone moving his family.

Patient also agreed to follow-up with psychiatrist in two weeks to discuss medication and other long-term prevention and self-care methods in the event of a repeat severe psychotic event. Prognosis is good. Patient has sufficient family support and shows initial compliance with treatment plan.

Which is it: FAITH or PSYCHOSIS? Sometimes it can be hard to tell…

“By faith Abraham, when called to go to a place he would later receive as his inheritance, obeyed and went, even though he did not know where he was going” (Hebrews 11:8).

(This post was inspired by Genesis 12 from the Bible, The God Delusion by Richard Dawkins, and The Christian Atheist by Craig Groeschal.)

13 thoughts on “Faith or Psychosis? A Case Study

  1. Would it be fair to say that your premise is that Christians (or any of the Abrahamic faiths) are Psychotic?

    By this premise you would be saying that anything outside the realm of current understanding (ie Abraham speaking to “God”) would be psychotic. Take this a step further to Dawkins who claims that any one who believes in any religions traditions are irrational or perhaps insane or vile (as is stated in the God Delusion). This would mean that anything outside the Philosophy of Naturalism would be considered Psychotic.

    What might we be shutting out of the realm of possibility if we call all that we cannot understand beyond the realm of sanity.

    I believe Galileo may be able to witness to this kind of closed mindedness.


  2. thanks for the comment. Yes, it is fair to say that my premise hinges on the concept that Christians or *anyone of faith* can be called psychotic in the medical community. Psychosis, loosely defined, is a loss of contact with reality and deterioration of normal social functioning. Depending on who observes this “psychotic” behavior, Christianity can be seen as a loss of contact with reality. People who believe in a relational God — and adjust their social funtioning accordingly — can be viewed as psychotic. As a Christian with a science background, I’ve had to accept that faith by its very nature, is often illogical. If it made complete and total sense, it wouldn’t be faith.


  3. Thanks for that answer. You got me thinking then…
    Indeed, I have been happy to throw of the reality of this world (or for the possibility of doing that in the future) and giving up what is foolishness to God.
    I wonder about this faith thing though. Hebrews 11:1 states that “Faith is the assurance of what is hoped for.”
    How can assurance be illogical?


  4. I can relate to this post as I went to see a psychiatrist to please wife #1. She thought I was psychotic. After talking to the psychiatrist, he thought so, too.

    As usual, your posts are different. Great job.


  5. Assurance isn’t illogical in itself, because it speaks to a concrete event. But without evidence? Faith and hope are both based on the anticipation of the unseen. So Hebrews 11:1 is an oxymoron of sorts (to be clear, an oxymoron that I fully believe as a Christian). Someday our faith will become sight. But not yet, at least not fully.

    Do you have a blog on wordpress? The link to your page is down.


  6. No I don’t have a blog anymore. I could not keep up with it, and found I was a bit addicted to writing on it.
    Thank you for your comment.
    While it is illogical, I am most assured.



  7. Let’s be clear, that faith and psychosis have very different definitions and are not mutually exclusive, in fact they can coexist but one does not detract or add to the other. By definition, faith is being certain of hope that is unseen and psychosis is – a derangement on one’s normal personality. A loss of contact with reality and a deterioration of normal social functioning.
    Abram’s family, being decendents of Noah just some 300 years after the flood, were no strangers to God’s calling. They knew the stories of their great-great-great-great-great…grandfather and what God had told him to do when it hadn’t rained and they saw how listening to God saved their ancestors. As a praying man I too feel called at times to go in certain directions that I don’t know why or where they will lead to. I pray for God to direct my path, open the doors he wants me to follow, and close the doors he doesn’t. And by faith I believe that God answers those prayers. But at times I fail to hope and God continues to graciously work on me. It’s not recorded in the Bible that Abram’s family even questioned God’s calling. My selfish interpretation is that Sarai lovingly supported her husband’s spiritual leadership (maybe that’s a psychotic thought). There is no indication that Abram’s personality changed or that he lost the ability to function socially. He simply acted on the belief that God would not lead him into something that was bad for him. That’s hope. The same hope Christians have today. God works for the good of those that love him…if God is for us, who can be against us…what shall seperate us from the love of Christ…no, in all things we are more than conquerors (and nothing can seperate us from God’s love) Romans 8:28-39. That does not conflict with reality, it complements it!


    1. Oops, just realized I made a mistake in my first sentence, but from the rest of the post perhaps you can see what I meant… it should read that “one could detract or add to the other” that’s what I get for trying to use a quadruple negative 🙂


    2. I agree that there are many shades of gray between faith and psychosis, where to some level they may overlap. David would be a good example of this, as he struggled with depression and anger (revenge, even) and we can see his ups and downs in the Psalms. But as you say, it’s the faith and trust in God, that He will work things out according to His will. One thing I like about God is that his people can be unfaithful, sinful, mentally ill, and/or misguided — and he still loves us anyway and uses us to do His will. Thanks for the comment.


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  9. I couldn’t have come up with a better example of how I feel. Thank you so much! It was a funny but not so funny example of what some of us “psychotic” people feel like regularly. I battle with my faith daily now that I am “cured” and I am not in a happy place. I feel spiritually dead and not sure how to overcome it. I have to think that if God wants me to hear something, he can make it happen whether or not I am medicated. But the whole spiritual experience I thought I had has been completely shattered by the diagnosis I have received.


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