Medical Problems that Present as Counseling Issues

April 27, 2016

Charles Hodges

More From

Charles Hodges

One of the most important things we can do in biblical counseling is to make certain that we are not counseling people for emotional, behavior, and thinking struggles when they have a medical cause for the problem. As we counsel, one of the first homework assignments we ought to give is to see a physician for a thorough physical exam and appropriate laboratory tests. By doing this we hope to exclude physical explanations for troublesome thinking, emotions, and behavior.

There are many examples of medical diseases that could result in people seeing a biblical counselor for help when they ought to be seeing a doctor. There are also situations when the problem can have aspects which are both medical and spiritual. And there are times when behavior is incorrectly labeled as a disease when the solution is found neither in medicine or counseling. Let’s look at a few.

Odd Eating Habits

Pica is a medical disorder in which children and adults eat unusual things or eat them in unusual amounts. Children will eat dirt. I’ve seen adult patients eat and crunch on ice until they crack teeth. Other nonnutritive substances that might be eaten include pencil erasers, string, fingernails, mucus, and small stones.

Parents who struggle with children eating dirt could view this as a medical issue, or they might think it is simply a matter of training and obedience.  When the child continues to “rebel” against them and disobey them, they might make their way into a counselor’s office hoping to find help in their struggle. This brings us back to the importance of making sure every counselee has seen or will see a physician for full work up.

Most doctors would check blood work that would likely reveal that the child has iron deficiency anemia. The same diagnosis would apply to the adults.  The doctor would prescribe iron for the child and in a short time the child would not be eating dirt anymore or need counseling. And, the adults would not be eating ice either!

Hormonal Challenges

There are many other diseases that might present as a counseling issue.  Cancer of the pancreas and hypothyroidism can present as depression. Hyperthyroidism and abnormal heart rhythms can present as anxiety, fear, and worry. Some forms of dementia and Cushing’s disease can produce disagreeable behavior.


ADHD is an example of a medical diagnosis where a solution may not be found in either a doctor’s examination room or a counselor’s office. Current research indicates that individuals with ADHD need to move in order to learn.[i] The movement and distractibility represents a difference in an individual instead of a disease.[ii] Thus, it becomes more of an educational problem rather than a medical or counseling problem.

In all of the above examples, the advice of a physician can be very valuable to the counseling process. Finding a physician in the community and establishing a working relationship will be a benefit to you and to those you counsel. None of us wants to be in the unhappy position of counseling a child for rebellion against parental authority, when all the child needs is a little iron. Sending those you counsel to see their doctors for a good exam will help keep that from happening.

[i] University of Central Florida. “Kids with ADHD must squirm to learn, study says.” ScienceDaily. ScienceDaily, 17 April 2015. <>.

[ii] Florida State University. “Squirm with purpose: Fidgeting is helpful for ADHD patients, study shows.” ScienceDaily. ScienceDaily, 22 February 2016. <>