Does my Loved One Lose Their Personhood and Do They Diminish in Value If They Develop a Severe Mental Illness (SMI)?

When a loved one's mental symptoms reach the point where they are severe, and mental functioning is greatly reduced, or the personality of the person is so starkly changed that they are hardly recognizable, it can feel like the loss of the person. This can lead family members to ponder questions about personhood. How does God really see my family member in this state? What does the Bible say about what makes someone a person...could they have actually lost their personhood to this illness? It causes a shudder to pulse down one's spine to consider this possibility, and most people don't really think it could be true that their loved one could have lost personhood, but they don't have a firm knowledge of what the scriptures say either, so there is little certainty and clarity.

Questions about whether their loved one can serve God arise. We covered in a previous chapter the question of whether those who are mentally disabled can glorify God, and the answer is yes if they use the little they have in the service of God He will be equally glorified by them as He is by those who give their all and possess more. But what about those who seem to have nothing left to give, those in comas or late stage dementia, or those who are chronically psychotic and trapped in a world of delusion and aren't coming out of this state with medical treatments. Can these people still glorify God?

The Blessing of Marley Jewel
Last year my mom found a baby robin on the side of the walkway in a dangerous area where dogs and people walked by. She picked it up and we fed it and took care of it until we could take it to a bird sanctuary. That little bird had a quiet, noble dignity to her. I learned from that experience that there really isn't such a thing as a common bird. She had a majesty to her. She taught me many things about God in the short time we had her. Each morning, she woke us with biophonic sounds that felt like medicine for the brain—natural tones that seemed to travel straight to the hippocampus, gently rousing us from sleep. They pressed some hidden “delight” button in our minds, and my mom and I would find ourselves smiling before we even opened our eyes.

Marley Jewel -- as we started calling her -- had no shame in asking for food. She knew how to be powerfully assertive without being rude or sacrificing her dignity along the way. The same bird that could perch there majestically, could also shove her mouth wide open and demand worms and wolf them down, and somehow lose no ounce of dignity in doing so. She knew it was eat or die, and she had determined with all the zeal in her little body that she was going to live.

At every milestone of her development she did not ever give up or accept defeat as an outcome. She tried tirelessly to fledge, until on the very last day we had her, she finally succeeded. I can still see her little majestic form perched on the edge of the plastic container we kept her in. Her silhouette looked so proud, and I felt pride swell up in my own heart for her that was stronger than it made sense for me to feel over a bird.

Why was Marley so special? Because she revealed aspects of God in her nature. It is God who has a quiet dignity to Him, and who has character traits of perseverance and commitment. Marley was not the source of those "invisible qualities" as the Bible calls them; God is, and God incorporated them into her design.

The Bible tells us all created things passively reflect God and His attributes. I say passively because Marley was actuated by instinct, not moral will. She was going to fledge. Unlike people, it wasn't possible for her to get discouraged, and lose faith or become rebellious and decide not to fledge. True something like a faulty gene in her "breeding" could result in a Robin being too timid or reserved to learn how to fledge, and this kind of thing does happen sometimes, but if it does happen it's not by choice. The bird, not possessing will and agency involving moral choice, wouldn't be rebelling if it had such a gene that caused it to back down from fledging.

Man Categorically Unique From Animals
While animals can to some extent reveal God's attributes to the world, man does in the highest way possible, to the point where there is no comparison. Man is categorically different from animals. The Bible shows this when it says man is to have dominion over the animals and rule over them, as God does with us. God is in a category distinctly higher than us, and this is why He rules us, so the reference to man ruling the birds is a similar idea that shows superiority in nature. Just as God is not equal in nature with man, so man is not equal in nature with animals.

"And God said, Let us make man in our image, after our likeness: and let them have dominion over the fish of the sea, and over the fowl of the air, and over the cattle, and over all the earth, and over every creeping thing that creepeth upon the earth."
Genesis 1:26

This is why it is not a sin to kill and eat an animal, but it is one of the worst sins to kill a person. This is why it is not called murder when one kills an animal, but it is murder to kill a person intentionally.

"Whoso sheddeth man's blood, by man shall his blood be shed: for in the image of God made he man."
Genesis 9:6

While acknowledging that the Father cares for the sparrows and that when one of them dies the Father doesn't fail to notice, highlighting the value of animals and putting a spotlight on animals rights, the Bible says "you are more valuable than many sparrows." Matthew 10:31. What it really means here is that a person is worth more than any number of sparrows. There is no comparison between a person and a sparrow, for people are made in the likeness of God. (Genesis 1:26-27)

It is Being in God's Image That Gives Us Value and Personhood
But what does it mean to have a nature that is in God's image; what does this entail? Is our nature our brain, or are body, or both? Or...is our nature our level of development or functioning? Do we achieve this nature after developing for some time in the womb, at the point when a brain develops, or do we have this nature from the very onset?

While Christians do refer to our reason and our ability to tell right from wrong as being the attributes that set us apart from the animals and make us in the image of God, this doesn't mean someone who has lost this functioning isn't in the image of God or that they have lost that image. The reference to these abilities is really a reference to our nature, not the abilities themselves. Someone who makes the argument people are superior to animals because we can reason and understand language, isn't saying someone in full psychosis who has lost their ability to reason is on part with the animals. It's a reference to our higher nature, and some functions are highlighted in order to show the contrast in natures between us and animals.

When do we get our nature? At conception! That's right, a nature isn't something that is acquired after long stages of development, and a person doesn't gain a nature in degrees (or lose it in degrees). Our nature is there from the moment of conception. And I'm sure if the science were precise enough we would see marvels in the human organism that do not exist in that of animal fetuses. However. science is very limited in this world, and we don't always catch these views. And the brain is so complex it's very hard to understand the science of what is happening as it develops from a single-celled organism. It is beyond us, that is for sure.

A 10 week old baby in the womb is not less in the image of God than a full grown person.

The baby bears the image of God from the moment of conception when it is a single-celled organism, a zygote, all the way till it is a 90 year old in the nursing home.

The Point at Which We Gain Personhood According to the Bible
And this is where the genius of the divine mind of God is seen, in the fact that the single-celled zygote is as much a person as the fully formed 9 month old baby. At every stage there is a person there. The zygote is not something that is developing into a person, it is rather a person who is developing and gaining new functions and capabilities and complexity. It is already a person from the very moment of conception.

Wonder is inspired by watching God develop a person, one that is already alive, from the ground up. He doesn't form the baby as we might expect Him to in our human wisdom, as an artist does when they form a clay figurine, where the hands and head and limbs are formed first and then if you need to make changes to the size or shape you add on more clay and expand your original figure. No, instead He forms the person focusing on systems, and builds the baby from the ground up like one might build a house starting with a foundation and ending with the roof, only much more complex and interwoven, using layers of develop that encompass multiple systems at once and threads together, more how an advanced AI system might design something, showing His mind is not limited to human ways of processing information, and He is beyond human.

It is the worldly ideologies that draw an arbitrary line in the sand and separate our physical form from our personhood. And every time we have done this in history disastrous results have followed. Every time we've looked at a living human, and determined that human being is not a person, and other living humans are persons, based on something other than being a living being, things like race, or level of mental functioning, or level of education, or anything else other than being alive, people have been devalued, mistreated, and even killed.

Dehumanization is not safe and it is not humane.

The world says some people can be human and yet not be persons. For many people in the world the zygote formed at conception when a sperm meets an egg, is seen as just a blob of tissue, and they don't think it's wrong to take the morning after pill and flush the zygote out of their body to its death, if they suspect a pregnancy in the very early stages.

But what does God's Word say?

The Our-Brain-is-What-Makes-Us-in-God's-Image-Not-Our-Body Argument
I’ve heard people give the argument that our body isn’t in God’s image just our brain and our capacity to reason. This is really what it means to be in God’s image, to have a mind that functions like God’s mind and can understand the deep truths in His Word. What this argument does is it divides a person into parts. Part of you is one thing, and part of you is something else –- not sure what. But personhood in the Bible is our whole organism, or being. It is the organism that bears the image of God, not the brain only.

The Bible doesn't divide a human person into parts. It doesn't say our body is in another image from our brain.

God didn’t specify and say “man’s brain has been made in my image but not the other parts of him”. The statement

"So God created mankind in his own image,
in the image of God he created them;
male and female he created them."
Genesis 1:27

Is a reference to our whole organism being in the image of God. That is what that statement means.

Sometimes people will get weird ideas when I say this and ask if a man loses an arm does that mean he's lost the image of God, since it's the whole body that makes him in the image of God.

The answer is no! Such a person still fully bears God's image. Because the person is still a living organism. If they lose key parts needed to be a living organism, then they die, and it's then they lose the image of God and cease to be a person.

But it's not hands or eyes that make us a living organism. The single-celled zygote that is only 5 days old does not have hands or eyes, and because it is a human organism it bears the image of God.

It is merely less-developed, but it is not less human nor less of a person.

Where the Bible Draws the Distinction

Where the Bible draws the line, as we talked about in chapter one, is at life. The Bible calls Adam a 'soul' when he is alive.

"And 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 soul."

Genesis 2:7

In the garden God formed clay and breathed into it the breath of life and the man became a living soul, or being. This shows us that what makes someone a soul, or a being, or a person, is their physical body infused with God’s life-giving power. If one has a physical body, and that body is alive by God’s power (and isn’t dead) then that person is a living soul, they possess personhood.

Notice that having a body isn't where God draws the line. God formed Adam first into a clay body, but did not call him a person until Adam was alive. It is a living body that is a person.

Also notice that death is when the breath of life leaves a person, and they still have a body lying there, but it is devoid of life. They are no longer a person when this happens...and the distinction is because they no longer have the breath of life, a poetic way of saying they are no longer living, and God's Spirit is no longer infusing them with life.

"When You hide Your face, they are terrified; when You take away their breath, they die and return to dust. / When You send Your Spirit, they are created, and You renew the face of the earth."

Psalm 104:29

In the Bible a soul is a person. As we discussed in chapter one, when Paul was shipwrecked and prayed for everyone to live, and God kept everyone alive, the Bible references these persons as souls, saying every soul was saved.

A body becomes a person if they have the breath of God in them, and they lose their personhood if they die and the breath of God leaves them. And this breath is not the first breath a baby takes at birth once it exits the womb. It is the breath of God, not the baby's own breath. The Bible is using a poetic way to reference the creative, life-giving power of God. When God breathed into Adam's nostrils He wasn't just puffing air into Adam's body. God was using His divine power, not mere air, to give Adam life.

This is the same divine power that holds up the universe, and which gives life to animals, and plants and every other living thing.

"This is what God the LORD says— the Creator of the heavens, who stretches them out, who spreads out the earth with all that springs from it, who gives breath to its people, and life to those who walk on it:"
Isaiah 42:5

We can know the zygote in the womb has the breath of God in it because it is alive. It is growing and developing and the cells are dividing and body systems springing into being. The breath of God is clearly in the developing child.

"For you created my inmost being; you knit me together in my mother’s womb."
Psalm 139:13

Just as the dying elderly person retains their value and personhood as long as there is a spark of life left in their body, so the developing baby in the womb holds personhood and value as soon as the spark of life begins for that baby, which is at conception.

Brain Death
The world has a concept they call 'brain death' that is actually based on ideologies that go contrary to scripture. If someone in a coma does not have brain activity that shows up on an electroencephalogram (EEG) they are pronounced medically dead.

But their body is still living! We know this because if someone is truly dead then even the machines their body is hooked up to cannot keep them from biodegrading and smelling and decomposing. If someone who is hooked up to an oxygen machine for instance, dies, the oxygen machine will pump oxygen into a dead pair of lungs which are decomposing and biodegrading.

But with 'brain death' the person is not always dead. It is true that every dead person will fail an EEG, but it is not true that everyone who fails an EEG is dead. If they were then we would not have people who could be kept alive on machines for days or weeks after failing their EEG.

They are still alive and their brain is still alive too. The physical organ of the brain is not yet biodegrading and its cells are still alive. It's the higher functions of the brain that are inactivated and no longer processing.

Such a person still has the breath of life in them.

So this concept of brain death is really coming from faulty ideas about personhood. It stems from the idea that our brain activity is what makes us a person, and that if we lose all higher brain functions we are no longer a person.

There is no brain death according to the Bible. There is only death. When the person on life support reaches the place where their cells are no longer alive, it is then that they are truly dead.

'Brain dead' is really just someone whose brain has lost higher functioning, and who will die in a matter of days or weeks. But they are not dead yet.

And while it may not be impossible to provide the funds needed to keep them alive on machines, and the best option may be to disconnect them and allow them to die a natural death, and this is not murder if this is done as no active killing is taking place...I don't believe we should be calling them dead before they actually are. This contributes to confusion about personhood and can cause a person to form faulty ideas in other areas of life as well as this one.

According to the Bible, there are living souls or persons, and then there are dead bodies. A dead body is not a person. This is the only point the Bible recognizes as when personhood is lost, at death. And personhood is gained when life begins.


The Conclusion
And so as long as someone is alive they bear the image of God, have full personhood, and full value. Just as the dying elderly person retains their value and personhood as long as there is a spark of life left in their body, so the developing baby in the womb holds personhood and value as soon as the spark of life begins for that baby, which is at conception. Neither our personhood nor our value is on a gradient scale where if your brain is functioning at 100% you are a full person, and if you have a mental illness or brain damage from a stroke so that your brain is functioning at 50% then you are only half of a person, and someone in a sustained coma is just barely a person.

The same principle that determines the single-cell zygote is just as much of a person as the 9 month old baby being born into the world, also applies here and ensures that the person with severe brain damage and limited mental functioning is just as much a person as the highly intelligent scientific researcher.

Hugs of A Severely Mentally Compromised Person Still Greatly Valuable
Just ask anyone who has a severally mentally challenged child, and they will tell you their child's unique personality still comes out, just as the baby in the womb though underdeveloped still displays a personality that is known to the mother. They will tell you their child's hugs mean the world to them.

Or ask someone who has worked in a psychiatric hospital and they will tell you that the artwork created by patients with the most severe cases of schizophrenia is some of the best they have ever seen, very vibrant and visual and full of life.

The person still displays the image of God, even with severe mental handicaps.

They Can Lose the Ability to Glorify God by Their Good Works

But such a person can lose the ability to understand right and wrong, and glorify God in their heart and by their actions. And when this happens it is a very serious reality indeed. Their record stops in heaven.

Normally when we sin or when we do an act of faith and goodness, those actions are recorded in heaven. God is the Moral Lawgiver so He must keep a perfect record, and man is a moral agent under that wonderful law, and he is held accountable by God for his choices.

And when we sin God wants us to appeal to our Advocate in heaven for forgiveness, at which point Christ washes our record clean. We are then to pray for power to do better next time and resist the sin in His power, which he provides.

But when someone is in full psychosis or has another mental condition that destroys their brain's ability to understand right and wrong, the record of that person stops in heaven.

This is like a death, and it feels like one. When I experienced this it felt like attending my own funeral yet I was still technically alive. I had a profound sense of loss, yet because I was psychotic I could not pinpoint what it was exactly that I had lost -- my mind -- and I thought I'd sold myself to Satan and was going to hell. This is how my brain interpreted the experience, as a loss of my eternal life, rather than as a loss of my brain and my moral agency and sense of self.

While such a person can never lose their value, they can lose their ability to do good works.

Without higher reasoning, I could not keep God's commandments. I didn't understand the principles that underlined them. My actions during that time were a mix of trying to comfort myself and others, which I did by going online and encouraging people not to commit suicide who were struggling with depression, and which every day I struggled through as well, disrespectful things, unhinged out-of-control behavior like when I hired taxis and ran all around town because my "voices" told me to go to various places to get signs from God, and following nonsensical ideas about morality like yelling at my father and challenging his authority because I believed I was a prophet who's job was to correct my father on how we was using his authority in our home.

The reason I could be so encouraging and comforting to those with suicidal depression, and also be so disrespectful to my father, is because my actions weren't stemming from sound principles. I couldn't understand right and wrong.

I was like a golden retriever who can be comforting and can know how to express love in basic ways that don't require higher functioning.

But as far as higher functioning that understood the nature of God and man, and their rights under God, I did not have this capacity. So I stole from my father when the voices told me to, because I didn't understand the principles behind why stealing was wrong.

Get Them Help
If you know someone like this, get them help. I cannot emphasize enough how important it is to return their brain if possible to a level of functioning where they can understand right and wrong.

Just recently I watched Dr. Amen's Ted Talk on Youtube where he shows brain images of people with damage, and how through taking supplements the holes in their brains actually close up. The brain has the ability to grow new neurons. This discovery was made in 2017.

More brain conditions that previously thought can be improved. Dr. Amen even showed a brain scan of a woman with dementia -- her before and after scans -- and holes in her brain healed up from taking high dose omega 3s and other brain supplements.

The most important brain function of them all is moral judgment.

If a person loses their moral judgment their ability to choose Christ ends. Their record in heaven stops.

Why does this happen? Because Jesus will only accept choices made with knowledge. Just as a contract signed by someone in late stage dementia will not hold up in court, and it would be unjust to accept it, as people could take advantage of the person's mental state, so Jesus only accepts choices made when we know what choice it is we are making.

But their chance to choose Jesus can resume if their moral judgment resumes.

It happened with me. I was finally put on the right medication to bring me out of psychosis and what a wonderful experience regaining my mind was to me!

It was such a precious gift. I could understand the nature of God again and His wonderful principles on which His government is founded. I could make moral choices that glorified Him.

In psychosis everything had been very flashy because I was getting communications from God (I thought) and vivid dreams about prophecies about the world, but it had also felt very nihilistic. I couldn't pinpoint why it felt this way. But after coming out of psychosis the reason why was clear to me. I'd lost my ability to glorify God with my moral choices and since this is the purpose of life, I'd lost my purpose. I'd been living like an animal who could appreciate the warm sunlight and a good meal and everything was about comfort since my mental symptoms involved feelings of psychological pain. But I couldn't live for a higher purpose while in that state.

Meaning returned to me once out of psychosis, deep meaning rooted in truth, not the flashy superficial calling I felt while in psychosis.

What If I Can't Bring Their Brain Back?

But what about cases where your loved one is in late stage dementia and the damage is irreparable, or let's say they have treatment resistant psychosis and none of the medication is working to pull them back into reality...or perhaps your loved one is out on the streets due to the delusions from psychosis convincing them their house is bugged by the FBI and is refusing all medical intervention.

What do you do then?

I've come to view my time spent in psychosis, like the time I spent developing in the womb. I was completely powerless in both instances and relied on God Himself to bring me into being.

If your loved one has entered such a state, it's important to keep in mind that we've all been through such a state, and we are all heading towards such a state at death.

We all had a time before we were born, a time developing in the woman, and we will have a time when we die and cease to exist for a time.

And none of this negates God's goodness or the fact that He gives to each of us moral agency.

No one has moral agency at all times. We all have a before, and an after.

It is only in eternity that we will have ongoing moral agency that no one can take away from us.

So if it is really out of your hands to do anything about your own loss of moral agency or your family member's, then you've fallen into territory that is the prerogative of God alone; you're in His hands now, just as you were when you were forming in the womb.

God brought me out of the darkness of psychosis when I couldn't get myself out, and "birthed" me back into the world as a moral agent because it was His plan and His timing. My job now is to endeavor to carry out His will for my life. But it's not our job to make plans in areas of our life where God has control. Rather we are to submit to Him and trust Him.

There are many times in life when God takes the helm and steers us down a path that is completely different from what we would choose to go down. And when He does this it reveals to us anew that He is God and we are not. That our lives are to be lived in subservience to Him. That this is the order of things, and that we can trust Him, for we do not possess the wisdom it takes to make stand at the helm of our lives and of the course of events of the universe. It takes a divine mind to do that. A mind that knows the end from the beginning and can see into the future. A mind that knows at every point what the absolute best and right course actually is. All of that is just guesswork in our human minds, but He actually adds up all situations and with perfect judgment charts our course.

It is in entering into God's plans that our meaning is found. When we serve ourselves meaning evaporates. And in submitting to His higher judgment and entering into His plans we see the genius of God unfold.

When Moses killed the Egyptian, endeavoring to begin to free the Israelites from oppression in his own way and strength, not only was it murder and completely wrong, but the power of God could not be seen in such human plans.

It was only when God took the helm and made the plans that the genius of God was seen in the deliverance of the Israelites by miracles that testified about God and drew people to Himself.

And we face things in this life that take divine power and miracles to solve. The sin in our hearts for instance, cannot be solved by humanism or more therapy or human help. Only God can change our hearts within us. It takes Jesus' righteousness that He won for us by resisting Satan's temptations as a man, His own character engraved on our heart through the Holy Spirit's power that can ever do anything to change us.

And in these difficult situations with mental or physical illness it also takes God in order to help us. He alone knows what treatment to pursue. If we are still looking to doctors we've missed the message of the scriptures that those who trust in men fall under a curse, and that help comes alone from God.

Not only does Jesus alone know the exact treatments to help you - something beyond a doctor's ability to do (although God can lead your doctor to the right treatment), but it goes deeper than this. It isn't really a treatment you need. It's a Person.

In the course of my health battles, I've had different symptoms and conditions emerge. Some of the giants I've delt with are things like 3 week long panic attacks that did not stop on their own, psychosis, dangerous tachycardia episodes, loss of emotion so severe I didn't even cry when my father passed away (a symptom called anhedonia), and depression so severe it felt like finding out my whole family had died.

So even if you manage to find a doctor who knows how to treat one condition, what are the chances you'll find a doctor who knows the right treatment plan for all of these different crises?

It's not about chance. It's about understanding our help comes from the Lord. That we need Someone with higher than human knowledge and wisdom to steer our lives and provide answers at the different turns of life. Only the One who is Divine and Omnibenevolent has that kind of wisdom.

And He can help us. And if He chooses to allow you or your loved one to go through a time of complete loss of moral agency, He knows what He is doing and He knows what He is allowing, and you can trust Him.

But once again I strongly encourage you to do everything in your power on the human end of things to help the person, if at all possible. And God uses health battles to change our characters and teach us dependence on Him, so He may ask you to go through health battles for some time, and you may need to have perseverance and commitment like the Israelites did when Joshua lead them in many battles over a number of years against the Canaanites and they walked with God in this way, learning various lessons through each of the battles they engaged in, and collecting victories.