Inner Man and Outer Man
In biblical counseling, addressing both the inner and outer man is essential. Humans are composed of both physical bodies, the outer man, and immaterial aspects, the inner man. By taking into account both dimensions, biblical counseling aims to provide comprehensive and effective care for individuals.
The interplay between the inner and outer man can significantly impact our lives. The inner man refers to our minds, hearts, thoughts, emotions, beliefs, and self-perception, while the outer man pertains to our physical bodies, our health, and the damage we cause to our bodies. If the inner man is not healthy, it can cause the outer man to suffer. And as we do damage to our outer man, this makes us more insecure in our inner man. And the cycle continues.
Anxiety and fear, for example, can manifest themselves in both the inner and outer man. The inner man may experience a heavy heart, where feelings can be overwhelming and all-consuming. Additionally, anxiety and fear can lead to a shift in focus, values, and delights, often prioritizing earthly concerns. On the other hand, the outer man can show physiological responses, such as a nervous stomach, ulcers, increased heart rate, fatigue, and sleeplessness. Anxiety and fear may also preoccupy an individual with securing earthly pleasures and safety. In extreme cases, anxiety and fear may immobilize an individual.
In another example, manifestations of depression in the inner man can include feelings of hopelessness, sadness, despair, guilt, shame, and worthlessness. These feelings can lead to a lack of motivation, difficulty concentrating, and a loss of interest in activities that were once enjoyed. Outwardly, depression can manifest as social withdrawal, isolation, lack of energy or motivation, difficulty sleeping or concentrating, irritability and a lack of communication with others. Inner man and outer man influence each other—prolonged sickness can lead to depression; prolonged depression can lead to illness.
One final example, substance abuse, is a complex issue that involves both physical and spiritual dimensions of a person's life. Substance abuse can greatly affects the outer man, the physical body, in the areas of organ damage, impaired thinking and reasoning, and increased risk of accidents and injury, to themselves or to others. Biblical counseling recognizes that substance abuse can both stem from and cause inner struggles, such as emotional pain, unresolved trauma, low self-esteem, guilt, shame, or a sense of purposelessness. Addressing the inner man entails delving into these deeper issues and helping counselees find hope and healing through the Word of God and the power of the Holy Spirit working in their lives.
By integrating a focus on both the inner and outer man, biblical counseling seeks to provide guidance and support that aligns with the Word of God and promotes holistic well-being. It recognizes the complexity of human nature and acknowledges the importance of considering all aspects of an individual's life to facilitate lasting and meaningful change.
As you are going through an exploratory session with a counselee, and in future sessions, look for ways the inner man and outer man correspond. There are certain situations where it is appropriate for a counselor to recommend that a counselee get a physical examination from their doctor. Here are some scenarios where a physical examination might be recommended:
Physical Symptoms: If the counselee presents with physical symptoms or complaints that may be related to their emotional or psychological struggles, you may want to suggest a medical evaluation. Certain medical conditions can manifest as emotional or behavioral issues, and ruling out any underlying physical health problems is essential.
Medication Review: If the counselee is taking medications for physical health conditions, you should be aware of these medications to better understand their overall well-being and potential interactions with counseling interventions. It may be necessary to collaborate with the prescribing physician to ensure coordinated care (see article below for more on this).
Substance Abuse: When a counselee is struggling with substance abuse, a medical evaluation can assess the extent of physical harm caused by the substance use and help determine the appropriate level of care needed, including possible detoxification or medical treatment.
Chronic Health Conditions: If the counselee has chronic physical health conditions, these may have a significant impact on their mental and emotional well-being. Understanding the challenges posed by these conditions can help the counselor tailor the counseling approach accordingly.
Nutrition and Lifestyle: A physical examination can provide insights into the counselee's overall lifestyle and health practices, including diet and exercise, which can influence emotional well-being.
Safety Concerns: If you suspects that the counselee's physical health is at risk due to self-harming behaviors or other reasons, you should prioritize the individual's safety and encourage seeking medical attention if necessary.
As biblical counselors, we should approach the recommendation for a physical examination with sensitivity and communicate its purpose clearly to the counselee. The primary goal is to ensure that all aspects of the individual's well-being are considered and addressed appropriately throughout the counseling process.
Article: The Dichotomist View of Mankind by Bryan Carlson
“Dichotomy refers to man being made up of two parts—a material part and an immaterial part” (Faith notes 102).
The dichotomist view of mankind is a doctrine that views humanity as consisting of two distinct parts: the body and the soul—or spirit—used interchangeably (John 12:27, 13:21; Hebrews 12:23; 1 Peter 3:19; Revelation 6:9, 20:4). “Scripture does not seem to support a distinction between soul and spirit. There does not seem to be a satisfactory answer to the questions…’What can the spirit do that the soul cannot do? What can the soul do that the spirit cannot do’” (Grudem, Systematic Theology, 477, notes p. 103). “Then the Lord God formed man of the dust of the ground and breathed into his nostrils the breath of life; and man became a living being” (Genesis 2:7). “Although there were two steps to the act of creating, the result was a single, unitary living person. To be sure, the particles of earth provided the material, while God’s breath effected life. Material and immaterial combined to produce a single entity” (Ryrie 103). The body is the physical aspect of humanity and is subject to corruption, decay, and death. The soul or spirit, on the other hand, is the non-physical aspect of humanity and is immortal and incorruptible. 1 Corinthians 4:16 encourages us to “not lose heart. Though our outer self is wasting away, our inner self is being renewed day by day.”
With regard to biblical counseling, the dichotomist view of mankind has several implications for understanding the inner and outer man:
First, it is important to understand and address both physical and spiritual needs. Since human beings consist of both a physical and a spiritual component, biblical counseling must address both aspects of a person's being. This means that counseling should not focus primarily on behavioral changes but address underlying heart issues that may be contributing to the problem. Matthew 10:28 says, "And do not fear those who kill the body but are unable to kill the soul; but rather fear Him who is able to destroy both soul and body in hell.” There are serious consequences to not addressing the heart with my counselee.
Second, we must focus with our counselees on the value of cultivating the inner man—their spiritual nature. In 2 Corinthians 4:16, Paul writes, "though our outward man perish, yet the inward man is renewed day by day." Biblical counseling should encourage people to focus on developing their spiritual life through prayer, studying the Bible, and participating in fellowship with other Believers. When a person's inner man is strengthened, they are better able to withstand the challenges of life.
Third, the dichotomist view of mankind highlights the need for ultimate restoration, which involves the complete healing of both the physical and spiritual aspects of a person's being. This restoration will be fully realized in the future when Christ returns and believers are given new, glorified bodies (1 Corinthians 15:42-44). Until that time, biblical counseling should encourage people to seek both physical and spiritual healing, with the understanding that ultimate restoration is only possible through faith in Christ.
Fourth, it provides a framework for understanding the nature of the human condition and the root causes of many psychological and emotional struggles. For example, recognizing that the soul is the inner man and that it is immortal and incorruptible can help individuals understand that their ultimate hope and peace lies in their relationship with God, rather than in temporal or external factors. 1 Thessalonians 5:23 says, "may your whole spirit and soul and body be kept blameless at the coming of our Lord Jesus Christ."
Fifth, it provides a framework for addressing spiritual issues in counseling. Recognizing that the soul or spirit is the non-physical aspect of humanity can help individuals understand the importance of spiritual growth, encouraging us to work to address issues such as sin, guilt, and shame. Romans 8:10, “But if Christ is in you, although the body is dead because of sin, the Spirit is life because of righteousness.”
The heart is desperately wicked (Jeremiah 17:9) and must be redeemed. This can and should be resolved biblically. The counselee does not need to see a pastor for the spirit and a psychologist for the soul. "For the word of God is living and active and sharper than any two-edged sword, and piercing as far as the division of soul and spirit, of both joints and marrow, and able to judge the thoughts and intentions of the heart” (Hebrews 4:12-16).
Faith Biblical Counseling, ACBC Exam Track 5, 102.
Wayne Grudem, Systematic Theology, 477.
Charles Ryrie, Basic Theology, 223.
Article: Working with a Counselee’s Physician by Bryan Carlson
In cases like the young woman struggling with whether or not to take medication for her depression, it would be a good idea to suggest that she get a physical exam to rule out any physical issues that may be contributing to her depression. If necessary and appropriate, you may want to offer to accompany her to the doctor's office to provide support and help answer any questions. To work with a physician, I would obtain the counselee’s consent for the physician to share information about her condition and treatment plan and for you to share what you have learned about her and have been working through with her. This collaboration would involve regular communication and updates between the physician and yourself to ensure that she receives the best possible care.
As a biblical counselor, it's important to work collaboratively with other healthcare professionals when appropriate and necessary, including physicians, to provide the best possible care for our clients. The counselee would have to specifically request this collaboration because of HIPAA laws and the fact that we are not licensed healthcare providers. When working with physicians, it is important to recognize their expertise and not be adversarial. It is good to find out their view on anti-depressants and counseling at the very start of the relationship. While they may be quick to prescribe medication, it is important to inform them that we would like to try counseling first. It may be helpful to ask if the doctor has any other suggestions, such as lifestyle changes. If the doctor does recommend medication, we should respect their decision but also continue counseling and potentially encourage the client to get a second opinion if necessary. This would be an excellent time to refer to a doctor who is a Believer or who endorses biblical counseling. We should be open to collaborating with them in order to provide the best possible care for our clients.
Working with a counselee’s physician can be helpful to rule out any medical problems that could be contributing to her depression or if her condition has become severe enough that she requires stabilizing help. However, there are situations where it is not advisable to work with her doctor—for example, if either she or her doctor are resistant to moving toward change, think that biblical counseling is not a legitimate solution, or continue to call something biological that is actually sin. Additionally, if the doctor's care is actually making things worse for her and she won’t listen to you as her counselor, this would be a time to stop working with both her and her doctor.
Ultimately, the decision to work with the doctor should be based on what is best for the counselee and her overall well-being. As a biblical counselor, it is important to prioritize her needs and work collaboratively with other professionals when and if necessary, while also being mindful of any potential ethical or theological concerns. (Faith notes 63-65; Roy 28-29)
Faith Biblical Counseling, ACBC Exam Track 5, 63-65.
Don Roy, IBCD, ACBC Theology Exam Study Guide, 28-29.
