The Church and Mental Illness

THE CHURCH AND MENTAL ILLNESS MYTHS & STIGMAS I: -- I am glad to have among my delightful friends a woman half my age, holding an undergraduate degree from an Ontario university, who struggles bravely with chronic illness. She suffers from a mood disorder (bi-polar) and a cognitive disorder (schizophrenia) and a personality disorder (borderline). She and I have tea together once per month. We relish each other’s company, and we email each other as needed between tea-times. Recently at one of our afternoon get-togethers she said, “I don’t care what the genesis of mental illness is. I don’t care whether its physiogenic or psychogenic or sociogenic or idiopathic. Just end the stigma.” II: -- What’s the stigma? Historically the stigma has been dreadful; moreover, the stigma has impeded the recovery of a mentally ill person. In some cases the ill person was deemed uncommonly wicked. The psychotic woman, for instance, who drowned her baby was regarded as morally deficient. Often her society reacted by punishing her. In other cases the ill person was deemed to be in league with the devil. The schizophrenic person, for instance, who characteristically complained of ‘thought insertion,’ who insisted that someone was ‘messing’ with his head and planting unwelcome ideas; because this person appeared to be molested by forces outside him he was deemed guilty of satanic conspiracy. The social response varied in this case. The sufferer was deemed a candidate for exorcism or she was pronounced a witch and treated as harshly as those suspected of witchcraft have always been treated (let’s not forget that in the 16th and 17th centuries 200,000 people, chiefly women, were accused of witchcraft, and 100,000 were executed), or she was shunned and isolated inasmuch as she was regarded as a spiritual threat to those uncertain about their spiritual integrity. More recently the mentally ill person has been regarded simply as weak; uncommonly weak, and no less guilty for her weakness. She was told to smarten up and toughen up and grow up; to get control of herself, assume responsibility for herself, and live like an adult in an adult world. III: -- I’m not suggesting that mentally ill people are the only ones to be stigmatized. Certainly the developmentally challenged person is; so is the convict; and the ex-convict; so is the recipient of social assistance, and so, very often, is the person from an ethnic minority. I do maintain, however, that mental illness attracts greater stigmatization if only because many people are mystified by mental illness, are fearful around it, don’t know how to respond, and in any case find themselves perplexed and suspicious and helpless all at once. ‘Stigma’ is a Greek word meaning ‘brand, scar, mark.’ In the ancient Greek world slaves were branded with their owner’s signature mark, thereby indicating whose slave they were; that is, to whom they belonged. In the ancient Roman world a runaway slave, upon being caught, was branded a second time with the letter ‘F.’ (Yes, even the ancient Roman world had the ‘F’ word.) ‘F’ stood for fugitivus, ‘fugitive,’ escapee. The runway slave was marked for life, readily identified, and forever despised. “I don’t care what the genesis of mental illness is,” my friend implored me; “just end the stigma.” IV: -- What can we do to end the stigma? First of all we must recognize that the ill person is suffering, and suffering atrociously. She isn’t behaving as she does because she enjoys being socially awkward; nor because she prefers government assistance to gainful employment; nor because she wishes to exploit family-members or friends or neighbours; nor because she’s being punished for her non-repentance. She is suffering. In my final semester of theology studies qualifying me for ordination (winter, 1970) I was privileged to study under Dr James Wilkes, a psychiatrist at the Clark Institute of Psychiatry (now known as CAMH). One day in class a student who thought himself unusually perceptive and insightful and knowledgeable decided to proffer his pseudo-wisdom to the class. “Traditionally the church has known what its mission was,” intoned this fellow, “but in light of the uniquenesses of world-occurrence in our era and considering the church’s new self-understanding, it is no longer apparent what the church’s mission is.” Silence. Then Dr Wilkes looked for the longest minute at this self-important, pompous pop-off and said, “Are you telling me you can have a suffering human being in front of you and you don’t know what the church’s mission is?” The most effective way of undoing the stigma is to understand that the ill person is suffering. Her suffering claims our attention, our compassion and our caring. V: -- I stress this point because what the cause or genesis of someone’s illness is has no relevance to the church’s ministry. 1] He might be mentally ill on account of brain injury (severe head injuries) or brain infection or birth trauma. 2] He might be mentally ill on account of altered body chemistry that has pronounced psychological consequences. 3] He might be mentally ill in that he is emotionally less resilient to stresses and strains in the way that all of us have differing levels of resilience to disease and physical assaults. Just as not everyone can withstand the physical pounding a football player sustains, so not everyone can withstand the emotional assaults some people, admittedly, can sustain. 4] He might be mentally ill because of environmental exposure that many of us have been spared. (Children who have been subjected to immense stress in the early years of their lives, whether stress born of domestic disruption or stress born of Syrian air-raids; many such children, let’s be honest, are going to struggle later in life, and some will struggle for the rest of their life.) It makes no difference which of the four that I’ve mentioned (there may well be more) is operative, or what combination of any of them or all of them is operative; what matters to us is that someone in our orbit is suffering. VI: -- As we recognize the sufferer and respond to him, what are we going to find? Specifically, what is the nature of the sufferer’s suffering? 1] There is the suffering arising from the ailment itself. If any one of us had a broken leg or appendicitis or a perforated eyeball there would a particular kind of suffering related to that ailment. In the same way the person who has a cognitive disorder (schizophrenia) suffers because his thinking is awry. The person who has a mood disorder (bipolar) suffers because her emotional fluctuations are inappropriate and exaggerated. The neurotic person (phobic, for instance—beset with irrational, self-devastating fear) suffers because he’s frightened of objects that he knows in his mind shouldn’t frighten him and yet remains terrified. The psychotic person (his reality-testing ability is impaired so very severely he’s deemed deranged) largely doesn’t live in or fit in our world. All of these people suffer on account of the illness itself. 2] In addition there’s what I call ‘second-order suffering.’ Such suffering arises when ill people are told that their illness is their own fault or they don’t pray enough or they don’t trust in Jesus. They have been declared guilty, and not surprisingly they feel guilty. To their suffering there has been added guilt – an additional form of suffering. Another form of second-order suffering is their fear that the psychiatrist who is treating them is going to take away their faith. Please note I have yet to meet the psychiatrist who tried to obliterate anyone’s faith or even wanted to. All the psychiatrists I have met are eager to use any resources in the ill person herself in the service of that person’s recovery. Still, Christians who are about to undergo psychiatric treatment have voiced this concern with me many times. Lastly, one more form of second-order suffering is their fear that medical intervention will deprive them of their identity: they will be altered in such a way as not to know who they are, unrecognizable to themselves and to others. (This fear is elevated, I have found, in people who are about to undergo electro-convulsive treatment, commonly called ‘shock treatment’, for otherwise immoveable depression.) All three fears are groundless. The mentally ill are no guiltier than the rest of us. The professional who treats them isn’t going to obliterate their faith. And therapeutic intervention won’t deprive them of their identity. My purpose in all this is to reinforce the point I’ve made from the beginning: mentally ill people suffer. They suffer on account of the nature of their illness, and they suffer again on account of their fear. VII: -- What, specifically, is the church’s ministry? 1] First we must see the ill person with the eyes of Christ; we must see her in terms of her appointment at God’s hand. Recall the gospel story (Mark 5) of the man who ran around in the cemetery of the Gadarene hills on the shore of Lake Galilee. He was ill and he was suffering. After his encounter with Jesus Christ the man is found seated, clothed, and in his right mind. In biblical symbolism to be seated is to be self-possessed; to be in charge of oneself authoritatively. The man now knows who he is. He isn’t the sum total of the symptoms of his previous illness. He isn’t the label the townspeople had previously hung on him. His identity isn’t that object of mirth and ridicule and fear and rejection. He has authority over himself. He is self-possessed. He is the subject of his own existence. He is an agent. He knows who he is. In biblical symbolism to be clothed is to belong. In the written gospels there are many stories about clothing. The prodigal son, for instance, is given new clothing upon his return: he belongs to the family. To say that the healed man is clothed is to say he belongs, belongs to the community from which he was formerly alienated. There’s no reason to single him out, shun him or reject him. In biblical symbolism to be right-minded means two things. It means to be sane, to be sure. More than this, however, to be right(eously)-minded is to have one’s thinking conform to the Kingdom of God. The healed man is right-minded inasmuch as he’s been restored to sanity, yes, but also inasmuch as he’s now rightly related to the God whose Kingdom is nothing other than the entire creation healed. In a world where most persons are Kingdom-blind, this man is now Kingdom-sighted. The church’s first responsibility is to see the mentally ill person through the eyes of Christ; to see that person through the lens of her God-ordained appointment: she has been appointed to a place in that Kingdom which is the creation healed, healed from disease of any sort, healed from suffering all sorts, healed from sorrow and sadness and sin. This is what – whom – we are to see. 2] The second aspect of the church’s ministry is to care. We need no particular erudition or sophistication. All we need to do is to care, to cherish, to befriend. I don’t mean to think friendly thoughts about them (thanks to Victor Shepherd’s having defused our nervousness about them). I mean to welcome them, receive them, into our hearts and homes. After all, if we name the name of Christ, and he welcomes and befriends them, can we do any less? Martin Luther is a thinker so subtle that more books are published about him every year than are published about anyone else, including Jesus. Luther is fathomless, so very deep we can never get to the bottom of him. And yet the great man is simultaneously simple with the simplicity of a child. In 1525 Luther circulated a collection of his sermons that were to be models of what the congregations throughout Lutheran Germany were to hear from pulpits Sunday by Sunday. In his model sermon on John 16 Luther discusses in his characteristic subtlety and detail the kind of distresses that overtake Christians, the hostility of the world, how they should respond to it, and so on. Then with startling simplicity Luther writes, “The sum of this gospel is that Christ the Lord reveals himself to his own as pure love and friendship, so that they are comforted.”1 Christ reveals himself to us as pure love and friendship, with the result that we are comforted. What the church’s ministry is to the mentally ill couldn’t be plainer: we are to love and befriend in order to comfort. It’s all very simple. I didn’t say easy. Loving people is always a challenge. I did not say easy; I said simple. I didn’t say easy. After all, it’s not easy to cherish and converse with someone who insists that every time she walks past a flower garden, the plants speak to her and insert voices that she can’t get out of her head. I didn’t say easy; I said simple. My wife and I have long maintained the practice of having suffering people to our home and our cottage. We do no more than offer hospitality. Yet for suffering people such hospitality is everything: it’s an expression of Christ’s love and friendship and comfort. I was a pastor for 40 years. My single longest pastorate (21 years) was a congregation in Mississauga. In the course of my ministry there, congregants saw what Maureen and I were doing and began to do as much themselves. First of all they were able to shed their suspicion and nervousness concerning the mentally ill people who appeared at church on Sunday morning, people whom I had befriended throughout the week. This was a giant step. After all, while no one disputes the apostle John when he writes “Perfect love casts out fear,” many of us have seen the converse proved too often: “Perfect fear casts out love.” Many people in our congregation could now love inasmuch as their fear had been cast out. Some of the more severely ill people in our community lived in a group home. Several members of the congregation used to treat these people to an ‘evening out’ at a restaurant in Streetsville. We always took along two congregants per resident in the group home in case an ill person decompensated. The results were noteworthy. One, the residents had an ‘evening out’ they otherwise wouldn’t have had. Two, our congregants came to apprehend the humanness of these people, their suffering, their loneliness, and, not least, their appointment as those whom Christ has guaranteed one day to be found seated, clothed, and in their right mind. The year is 2018. Four hundred and fifty-five years ago, in 1563, two young men wrote the Heidelberg Catechism. The Heidelberg Catechism remains the crown jewel of the shorter Reformation writings. I’m moved as often as I revisit the first question and answer. Question #1: “What is your only comfort in life and in death?” Answer: “My only comfort in life and in death is that I am not my own (a phrase too often overlooked) but in body and soul I belong to my faithful saviour, Jesus Christ.” I am not my own; I belong to my faithful saviour, Jesus Christ. Let’s return to the topic with which we began: stigma. I mentioned earlier that slaves were branded, stigmatized, with the name of their owner, in order to indicate to whom they belonged. Who or what you were depended on to whom you belonged. The church’s ministry is to announce the truth and embody the truth that the mentally ill, suffering more than we know, ought not to be stigmatized prejudicially just because they have already been marked positively, marked definitively, with a new brand. They belong to Jesus Christ, as surely as the stigmata, the marks of his wounded hands and feet and side, declare that he belongs to them. For he has been appointed the faithful saviour of us all, and the healer of the entire creation. Victor A. Shepherd Tapestry, Burlington June 2018