Religion and psychiatry have a long and complex relationship, not always a positive one. However, in recent years there has been an increase of interest in, and openness to, spirituality in mental health care. When mental illness enters the picture, spiritual well-being suffers. The person may feel alienated from, or abandoned by, God. Long-held beliefs are called into question. The person may not have opportunity or feel well enough to attend worship services. There is a profound sense of loss and grief, stemming from loss of hopes, dreams, and control.
Sadly, there is often rejection and stigma that leads to a loss of self-esteem and a sense of shame. The person must search for a new sense of meaning and purpose, new hopes and goals, and the elusive sense of acceptance and peace. It’s not just the individual who experiences this; we are told that one in three people will experience a mental health problem sometime in their life, and when you add in the families, friends, and co-workers, it is clear that mental illness affects us all.
I recall a patient who had lived with depression for many years. She was a woman of strong faith who tried to live in a manner consistent with her beliefs. As we talked, a problem emerged: her belief that, “Christians shouldn’t get depressed”. Instead of being a source of comfort and hope, her faith was causing her distress on top of her illness. She believed there was something wrong with her faith because she couldn’t rise above depression by her own efforts. It’s not a very big step from, “There’s something wrong with my faith” to, “There’s something wrong with me”. Her beliefs became a source of shame, not strength.
Take a look at Psalm 88, words written by a person of faith. It takes great faith to accuse God of abandonment. Those words were written by someone who knew first-hand the realities of depression. Just listen to the language: My life is full of trouble; I am at the brink of the grave; no strength; lost; overwhelmed; I cannot get free; wretched and at the point of death; troubled mind; destroyed; darkness. So much for the idea that people of faith shouldn’t get depressed.
Faith is not magic, and it is not a vaccine against trouble.The writer cries out to God but has no sense of being heard. The writer feels forgotten by God and in despair cries out, “God, why have you rejected me? Why have you turned your face from me?” This is utter, total despair. Our culture does not tolerate despair well. Much of the time, we cruise through life in a state of spiritual forgetfulness. We have a kind of collective amnesia that leads us to believe that cheerfulness is our natural state and our birth right. The truth is closer to the biblical assertion: “Humankind is born to sorrow as surely as the sparks fly upward” (Job 5:7). We forget what the Buddha taught: life sometimes hurts. And when life hurts, we know pain; we grieve; we mourn.
The problem of innocent suffering is the question at the heart of the story of Job. When Job suffers the loss of everything – his livestock, shepherds, and children, and his body covered with sores – he enters a recognizable state of depression. He sits in the dust and longs for death. The only thing that keeps him going is his passion to tell his story, to demand a hearing, and to proclaim the injustice of his suffering. His wife cannot tolerate his despair: “Curse God and die,” she advises (Job 2:9). But Job will not.
His three friends come to console him, and the best thing they do is keep their mouths shut while Job laments his many losses. The trouble begins when the friends start giving Job advice. The first one says cheerfully, “Don’t worry, Job, your faith will protect you from harm.” But he has already been harmed beyond all tolerance. The second friend says, “Well, Job, you know God is just, so you must have done something to deserve this.” The third friend advises Job to repent of his sins so all will be well again. Some comfort! Job dismisses their words as hollow and empty. What Job wants is not answers or theological propositions. What he wants is for his friends to accompany him, to stay with him, to bear witness to his pain and outrage. But that is just what the friends cannot do. Their cheap spiritual salves are all that stand between them and Job’s utter vulnerability, and they are too afraid to face their own vulnerability which they glimpse in Job’s devastation.
In the 1990’s, a study was done of the religious and spiritual needs and resources of mental health clients. The number one need was an expression of support from another human being. That’s not so hard to do, is it? Like Job, people with mental health issues do not want to be “fixed”. They do not want advice or cheering up. They want someone who will walk with them in good times and bad, listen without judging, and be a living reminder that they are not alone in their difficulties.
Resources in the study included the person’s beliefs, their faith community, prayer, and other supports. A strong spirituality can be a resource in times of trouble. Spirituality, with its associated practices of prayer, meditation, scripture reading, and worship, can help the person feel that God cares for and loves him or her, that he or she is not alone, is worthy of love, and can depend on God. Spirituality can help in finding renewed hope and addressing issues of guilt, forgiveness, and loss. Some people with mental illness have commented that their experience has brought them closer to God, or that they have become more compassionate because they have a better understanding of other people’s struggles.
People with mental health concerns are not all in hospitals or living on the streets. They cut our hair, teach our children, run our businesses, and care for us when we are sick. They sit in our pews and lead our congregations. “They” are, in fact, “us”. When we recognize this reality, we may reach out in care and concern for our brothers and sisters who are part of the family of faith.