What was Paul’s “thorn in the flesh”?

Q.  What was Paul’s “thorn in the flesh“?  I’ve heard some people say it was a disease he couldn’t recover from.  But I’ve heard other people say this isn’t right because Paul had the gift of healing and could have healed any sickness he had, so we need to take him literally when he calls it “a messenger of Satan, to torment me.”  In other words, these people say it was a demon that was harassing him that he couldn’t make go away.  Which is right?

I think the first understanding, that Paul’s “thorn in the flesh” was a disease he couldn’t recover from, is more likely the correct one.

We know that Paul suffered from a disease at some point in his ministry because he wrote to the Galatians, “It was because of an illness that I first preached the gospel to you.”  (“Illness” here is astheneia in Greek, literally “weakness.”) This was most likely some disease of the eyes, because Paul goes on to say, recalling the Galatians’ love and concern for him at this time, “If you could have done so, you would have torn out your eyes and given them to me.”

There’s a further suggestion that Paul had eye trouble at the end of Galatians. Paul authenticates the letter, which he has been dictating to a scribe, by adding some things in his own handwriting, and he begins by saying, “See what large letters I use as I write to you with my own hand,” as if he had difficulty seeing.

Some have actually speculated that Paul suffered from chronic bacterial conjunctivitis, a recurring infection of the lining of the eye (a common ailment in the time when he lived) that would have made it difficult for him to see. It would also have affected his appearance, making his eyes red and causing them to discharge fluid or mucus.  Perhaps this is why Paul also told the Galatians, as he recalled their earlier care, “Even though my illness was a trial to you, you did not treat me with contempt or scorn.”  There was something embarrassing about Paul’s condition that the Galatians overlooked in love.

All of this background helps make sense of what Paul says about his “thorn in the flesh” as he defends his credentials to the Corinthians, at the demand of the self-styled “super-apostles” who had infiltrated the church there.  Paul describes some amazing visions he had, but then explains he was given a “thorn in the flesh” to “keep me from becoming conceited” because of these “surpassingly great revelations.”  An unsightly disease of the eyes would be an ironically appropriate means of keeping a person from boasting about visions they’d had.

After explaining that he’d asked the Lord to take this “thorn” away from him, but that God had told him in response, “My grace is sufficient for you, for my power is made perfect in weakness,” Paul says, “Therefore I will boast all the more gladly about my weaknesses, so that Christ’s power may rest upon me.”  “Weakness” here is astheneia, the same word Paul used to describe his “illness” to the Galatians.

Paul also notes, earlier in this section, that the super-apostles were saying about him, “In person he is unimpressive,” literally “the appearance of his body is weak” (asthenos).  Such language about “weakness” seems more appropriate for describing the effects of a disease like chronic conjunctivitis than the frustrations of persistent spiritual harassment.

Even though Paul had the gift of healing, this didn’t mean that God always chose to heal everyone through him.  For example, Paul tells Timothy at the end of his second letter, “I left Trophimus sick in Miletus.”  The fact that Paul had to leave this valuable co-worker behind shows that he couldn’t heal everybody, and that would include himself.

And so when Paul describes his illness as a “messenger of Satan,” he most likely uses this language not because his “thorn in the flesh” was a harassing demon, but to indicate that God is not the creator or source of sickness and disease. These things are instead the result of sin and evil in the world.

We’re promised that when God renews the heavens and the earth, there will be no more sickness or pain.  But in the meantime, Paul’s experience with his “thorn in the flesh” shows us that God can redeem even these features of our fallen world to make our character more Christ-like and to lead us to rely more on the sufficiency of his grace.

(When I discuss Paul’s “thorn in the flesh” in my study guide to Paul’s Journey Letters, I ask, “Do you have a physical ‘weakness’ that you wish God would take away? If so, given what Paul writes here, could this weakness actually be protecting you from something and permitting God’s power to be seen more clearly in you?”  What would you say in response to that question?)

The apostle Paul, 5th-Century Ceiling mosaic, Archepiscopal Chapel of St. Andrew, Ravenna, Italy. (Do the large eyes reflect some ancient tradition about Paul’s appearance?)

What’s the difference between mental illnesses and demonic possession?

Q. What is the difference between mental illnesses and demonic possession? I read the post on your blog about whether the “evil spirit from the Lord” that tormented Saul was “an actual spirit-being” or “a dark and foreboding disposition of the human spirit,” and I’m hoping you can expand on that distinction.  I’ve read in Acts about the girl who was possessed and could predict things until Paul cast the demon out. Is one sign of possession the ability to do supernatural things like that?

Let me say first, in light of the recent discussion on this blog of “metaphysical naturalism” and its denial of the supernatural, that I do believe, according to the Bible, that there are supernatural evil beings who seek to oppress people and keep them from turning to God and experiencing the life that God offers.  Anyone who doesn’t share this belief will not find your question, or my answer, meaningful, and so it probably would not be worth their time to read any further.

Second, also by way of background, I think it’s important to observe that the Bible itself distinguishes between mental illness and demonic possession.  It’s not the case that the biblical writers simply assumed that everything we would recognize today as mental illness was caused by demons.

For example, when Matthew describes the beginnings of Jesus’ ministry, he tells how “people brought to him all who were ill with various diseases . . . and he healed them.” Among those Jesus healed, Matthew says, were the seleniazomenoi and the daimonizomenoi.

The first term, seleniazomenoi, comes from the Greek term for “moon,” selene, and it can be translated literally as “moon-struck.”  The English equivalent is “lunatic,” and that is how many English Bibles translate the term.  Some translate it as “epileptic” instead, but I think it does refer to people with mental illnesses, which were thought in the ancient world to be caused by the influence of the moon.

The second term, daimonizomenoi, means to be oppressed by a daimon or demon, which the New Testament writers understand to be an evil spirit.  It’s important to note that they don’t actually use the term “possessed,” although they do depict Jesus and the apostles casting demons out of people, as if these had occupied and controlled them.

So then what is the essential distinction between mental illness and demonic oppression?  The Theological Dictionary of the New Testament offers a helpful insight into this, in its article on daimon.  It says that in the case of demonic oppression, “What is at issue is not merely sickness but a destruction and distortion of the divine likeness of man according to creation. The centre of personality, the volitional and active ego, is impaired by alien powers which seek to ruin the man and sometimes drive him to self-destruction.”

In other words, we can think of someone with a mental illness driving a car but having trouble finding their way through thick fog and drizzle.  Someone oppressed by a demon, on the other hand, is having to wrestle with the demon for control of the steering wheel to stay on the road.

This volitional aspect of demonic oppression is also seen in the way that many, thought not all, who suffer from it may have “opened the door” in some way by choosing to become involved in the occult.  (Or they may have exposed family members by doing this.)

The girl you mention in the book of Acts who could tell fortunes illustrates another distinction: demonic oppression may be characterized by the demons doing supernatural or superhuman things through the person affected.  Another biblical example is the man described in the gospels as “Legion,” who “had often been chained hand and foot, but he tore the chains apart and broke the irons on his feet. No one was strong enough to subdue him.”

A final observation I would make is based once again on an insight from the Theological Dictionary of the New Testament.  After confirming the observation that “in the NT not all sicknesses are attributed to demons,” it continues, “Nevertheless, it may be said that the existence of sickness in this world belongs to the character of the [present age] of which Satan is the prince.”  In other words, we suffer from illnesses, including mental illnesses, because the creation has not yet been redeemed from its bondage to evil, sin, and decay.

That being the case, we may rightly suspect that an evil influence is at work to aggravate a mental illness.  Even when it is not a situation of outright demonic oppression or possession, there could be demonic harassment. Throughout the centuries, in fact, many outstanding Christian leaders, writers, artists, and so forth have struggled with depression and similar mental illnesses.  Beyond the natural medical causes, there may well have been spiritual opposition designed to discourage and disable these people from fulfilling their God-given vocations.  Both the natural and the supernatural dimensions need to be kept in mind.  But spiritual opposition is not, in and of itself, demonic possession.

In conclusion, from a pastoral perspective (I was a pastor for over 20 years), I would encourage a person (or their family and friends, on their behalf) to seek spiritual deliverance from demonic oppression through the help of mature, reputable, qualified Christian leaders in cases where a sharp internal conflict of the will is evident (i.e. something “makes” the person do unpleasant and uncharacteristic things that they don’t want to do), where the person’s health and life has repeatedly been put at risk (like the boy described in the gospels whom a demon often tried to throw into the fire or into the water), and where superhuman phenomena are present.  These are not infallible indications, and each one individually could have a different explanation, so in-person, real-time discernment by experienced and spiritually mature advisors is required.

On the other hand, I would encourage a person to seek counseling and treatment for mental illness if they experience persistent symptoms such as depression, anxiety, confusion, troubling or irrational thoughts, etc.  Particularly if the person can’t just “shake it off,” they should get professional help and be open to the benefits of therapy and medication.  But I also believe that spiritual resources such as prayer and community support are vital for relief from mental illness and that they can make a big difference in the lives of those who suffer from it.

Those who are delivered from spiritual oppression or who find God’s grace to cope with mental illnesses are  able to offer encouragement to many others through the gifts God has given them.  To give just one example, Joseph Scriven wrote the hymn “What a Friend We Have in Jesus” out of his experience of long struggle with depression.  I hope and pray that any who read this post and recognize that they need help from God will find it through the loving community of God’s people and so become a blessing to others in the same way.