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Mental Illness: 7 Key Truths

Mental Illness Is…

Physical and treatable

Get ready for some big, shocking news: the brain is a part of your body! The brain is the most complex and mysterious organs within the body, and we live with a false idea that we are in control (or should be) of all of our emotions. Many factors influence our brain structure and chemistry as well as the neural pathways that our thoughts travel on. Genetic makeup is a factor, but genetics are not set in stone and do not guarantee that you will get an illness simply because there is a family history. Just as a person can have a predisposition for cancer but may or may not develop cancer, so too mental health issues can be genetic but also triggered by environmental factors like stress, loss, trauma and crisis. Hormones can play a role as well, in cases such as postpartum depression, emotional dysregulation in menopause, or as part of more severe symptoms that some experience in a menstrual cycle.

While these illness are not yet curable, they can be treatable with medical and non-medical options, just like other types of diseases. These can include self-care (diet and exercise, sleep, etc.), sharing your feelings with a counselor, and filling your life with positive meaning. We need to talk about emotional/mental health problems the same we do physical illnesses — if you wouldn’t say it to someone with cancer don’t say it to someone who is struggling with anxiety or depression.

Common

1 in 4 Americans will experience symptoms of a mental illness within their lifetime. Also, within any given year 1 in 5 adults is experiencing symptoms of a mental illness. The National Alliance for Mental Illness provides other statistics here. If the Church is doing its job to reach out to the hurting and marginalized, then the rates of mental illness within the Church may actually be higher. You are certainly not alone in your struggle, even as a follower of Jesus.

Not your fault

We tend to blame ourselves for emotional struggles. Why? Because when we feel helpless or face the unknown we look for answers and a place to lay blame. Turn on the news when tragedy strikes — almost immediately the pundits begin to engage in a blame game to try to explain the situation or imagine possibilities of prevention in the future. We also sometimes blame God or become angry with him, but we must remember that our diseased world is a result of original sin and the curse. It is Satan’s masterpiece.

Some people argue, “Are there ways in which we can create anxiety and depression or other emotional problems in our own lives?” Of course. Sin and unhealthy relationships or choices can cause problems. But nothing happens in a vacuum, so there are almost always underlying root issues that may not be your fault that are part of the reason you are engaging in harmful behavior. And a clinical mental illness is a physical disorder not caused by your behavior or personal sin.

Not removed by a “quota” of faith

A recent study by the Christian group LifeWay research looked at attitudes about mental illness within the church. They found that 48% of Christians believe that prayer and Bible study alone can overcome mental illness. Would 48% of Christians believe that prayer and Bible study alone can overcome cancer? Diabetes? High cholesterol? Of course we believe that God can and does instantly heal all kinds of disease, but we understand that miracles are a work of the Holy Spirit and not of ourselves. When we turn faith into a measurable quantity that we have to have “enough” of, we place the power in our own hands to accomplish our own miracle.

You do not experience clinical depression, anxiety, Bipolar Disorder, PTSD, or any other illness because you lack faith. We experience these because our bodies can be corrupted by disease. We do not get to dictate the timeline of our healing, but we have hope that at the very least in our eternal lives we will no longer suffer.

Not evidence of being a “2nd class Christian”

We have created a class system within the Church that is based on comparing ourselves with others. If we do not fit the mold of “happy Christian” we often feel we are not good enough. Earlier this year while on vacation I visited a church in which the pastor said that he noticed people appeared happy when they came to church on Sundays but then were struggling throughout the week. He asserted, “Let’s not just be happy on Sundays, let’s be happy all week long.” While I’m sure everyone would love to be happy all the time, it is simply not the reality of life.

What happens if you are not happy? Do you have to fake it? If the Church wants to become a safe and authentic community, we must accept others for exactly who they are. You must accept yourself for exactly who you are. In this way we can journey with Jesus together, being honest and vulnerable. 2 Corinthians 12:9 comes to mind here — if His strength is made perfect when we are weak, why are we trying to force being strong all the time?

A place to meet Christ in the midst of suffering

Tim Keller writes in his book “Walking with God Through Pain and Suffering” that the secular world views suffering as a bad thing, but suffering is truly at the heart of Christianity. Jesus voluntary chose a path of suffering, and told his followers they would suffer. If we know that Jesus lived in a place of suffering, then we must ask, “How can I meet Christ in my place of suffering?”

Rather than a spiritual deficit, emotional struggles are a powerful place for spiritual growth. We may need to redefine what “spiritual growth” looks like — have we created a picture of being a happy, upper-middle class American and defined that as what it means to be spiritually mature?  James 1 says that perseverance must finish its work so you can be mature and complete, not lacking in anything. Perseverance requires something difficult, for it is impossible to persevere without struggle.

An opportunity for grace

What is “grace”? Some have defined “grace” as God’s unmerited favor given to us. Unmerited means we do not have to earn it, and “favor” is a type of kindness and blessing. Can you give yourself grace today? What does it mean to be kind to yourself not because you have earned it but because God has given it to you? What does it mean for you to offer grace to a friend who is struggling? What would it mean for the Church to become a place of grace for those who are emotionally suffering?

Check out my other blog post about “A Different Kind of Silence” in which I suggested that as those who have suffered from mental illness begin to speak out and share their stories, the Church should respond with gentle silence. Just listening. A compassionate hug. Weep with those who weep. In doing so, we encounter the love and grace of Christ who allows us to come to Him exactly as we are.

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Resource Spotlight: On Edge 8-Week Curriculum

Do you wish people in your church understood mental illness? Would you love to lead a small group or Sunday school class to decrease stigma and begin some positive dialogue? You can and should do this, and I am proud to shine a spotlight today on my On Edge small group curriculum.

All you need to do is pick a time and a place and everything else you need is in the Leader’s Guide. Each group member will need a copy of On Edge: Mental Illness in the Christian Context and you’ll need just one Leader’s Guide. You’ll find tips on how to lead a group and handle sensitive topics along with how to format and structure the group. Free video links are included so that each week you can let me do the 20-minute teaching segment for you! Discussion questions, key Bible verses, and ways to follow up with group members are all provided in the Leader’s Guide.

I put out this curriculum because every church needs to do this group. We need to have conversations about mental illness. We need to understand the physical, emotional, and spiritual aspects of mental health disorders. If you are passionate about this topic, lead a group in your church. It’s only 8 weeks, but the positive impact of tearing through stigma in your church will last a lifetime.

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Why We Blame People For Their Mental Illnesses

Most people in and out of the Church can accept that mental illness is real when manifested in a visible way. Someone who has witnessed a person with schizophrenia in a psychotic episode would have no doubt that that illness is real (though some in the Church might actually assess that as demon possession). But what about someone living in reckless ways during a manic episode of bipolar disorder? What about someone who struggles with suicidal thoughts? Where is their faith? Is that sin or illness or both? Are those even the right questions to be asking?

Enter a theology of sin that is not big enough for biological factors to be at play. Those of us Christians who have the privilege of being mentally well generally believe that we are able to control all of our thoughts and choices. When we are tempted, we need to flee from temptation. When we worry, we need to cast our cares on God. These are the responsibilities of the Christian to stay on the narrow path. Perhaps even in this theology we place ourselves in too powerful a position over our own lives. We have to remember that if we have it together, that is solely by the grace of God. Romans 9:16 is helpful here: “So it is God who decides to show mercy. We can neither choose it nor work for it.”

But how do malfunctions of the brain factor in here? Are some more capable of self-control than others? In my book, On Edge: Mental Illness in the Christian Context, I use an example of a person with developmental disabilities. Certainly (hopefully!) no one would expect a person of limited intellectual capacity to have a well-developed theology in order to enter the kingdom of God. (And by the way this is not a requirement Jesus placed on anyone regardless of capacity.) Can, for example, a non-verbal person with autism receive salvation if they cannot understand the Gospel and cannot “confess with their mouth that Jesus is Lord”? Or are they shut out from the Kingdom?

Similarly, a person struggling with depression may not be able to consistently engage at church. They may struggle with doubt or have thoughts of killing themselves. Is this because of a lack of faith? Or is their disordered brain incapable of overcoming these thoughts no matter how much faith they try to muster? And why is it their responsibility to fix this themselves?

This is where the Church has to do its job: demonstrate love and compassion. Why is it not the entire Church’s responsibility to spiritually carry those who are struggling to carry themselves? Why do we not enter into these situations to offer care and non-judgmental support? Why do we have to have a neat and tidy explanation and evaluate the person’s spiritual standing before helping them?

I would like to challenge the Church to rise up to support, love and defend those with mental illness even when we don’t know how to understand or explain it. Let us reach out with open arms to those who are marginalized, misunderstood and downtrodden. Let’s show the love of Jesus and get off the judgment seat in every way. Messages from the pulpit that support a “try harder” theology are unhelpful for all of us. May we live and preach the Gospel in its entirety.

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Happy New Year!

 

Blessings for the new year! I pray that 2018 is full of NEW — new ideas, new experiences, new freedoms, new encouragement. I invite you to check out my daily devotional blog, FreedomForToday.com, along with my FREE app. I’m starting the year off right with a series called 21 Days to Freedom. It’s a great resource for yourself and your church family.

I’m also celebrating the new year by giving away my newest ebook, Becoming the You God Sees, FREE Jan 1 to Jan 5. You can also find my self-paced online course for half price this week too (use coupon code NEWYEAR50).

I would love to connect with you this year. Leave a comment or reach out on Twitter (@ChurchTherapist). Can’t wait to see what God has in store for all of us as we advocate for mental health for the Christian life!

 

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Biblical Counseling, Turf Wars, and Healthy Dialogue

In a previous post, “Is Scripture Enough?,” I wrestled with some of the questions long debated in the Christian counseling realm. Biblical counselors have argued for the past 50 years that study of the Bible alone is enough to make a pastor qualified to counsel. Others like myself who are trained in psychology and mental health care assert that additional training is necessary to assess and treat mental health issues. Both Dr. Heath Lambert and Brad Hambrick are biblical counselors who have recently articulated their thoughts on biblical counseling, with Dr. Lambert re-positioning towards earlier claims that the Bible alone is enough and Hambrick arguing for a greater level of training on mental health issues.

Dr. Lambert’s 95 Theses offers a series of position points, and the reason this conversation is so important is listed in his Thesis #3:

“The confusion that exists on the part of Christians has been a distressing source of conflict among brothers and sisters in Christ who debate these issues, and has caused pain in the lives of troubled Christians who seek counseling care.”

The confusion, conflict, and even “turf war” that has existed in the Church for the better part of 50 years has harmed people who are most in need of help. Because of this conflict, some pastors have at times discouraged mental health treatment when intervention was needed. In some cases, suicide has been the result.

Both pastors and Christian counselors need to improve working together. I do not believe we are at odds with each other, but rather working together towards common goals for the betterment of those who need our help. Pastors have a critical role in soul care and shepherding, but that role and skill set has limitations. Counselors who have been trained to recognize, assess, and treat symptoms of disorders including post-traumatic stress disorder, major depressive disorder, generalized anxiety disorder, bipolar disorder, schizophrenia, and a variety of personality disorders can and should play a role in holistic Christian care. The Bible does not offer evidence-based treatment models for these disorders, nor does it speak to medication or other forms of treatment. Conversations like these are critical to enhance the care of those entrusted to us. For too long these conversations could not take place at all because emotions ran high and debates turned ugly. We all need to rise above this tone in order to produce fruitful dialogue as I believe we are now seeing in much greater volume. 

Perhaps because Jay Adams in the 1970’s created a category called “organic disorders,” biblical counselors have sometimes seen things in black-and-white terms. It is either a spiritual problem or a medical one. We cannot divide problems or human beings in such a fashion. When we do, we limit treatment options and actually may contribute to the over-prescription of medication. If someone is experiencing symptoms of PTSD, they would benefit greatly from working with a Christian counselor who has specialization in trauma work. If their symptoms were seen as purely medical, sending them to their primary care physician (who also has less trauma training than a licensed and specialized counselor would) would likely result in a quickly written prescription. Even medical problems can be treated with non-medication options, just as someone with high cholesterol could make dietary and exercise changes instead of (or in addition to) taking medication.

Additional research is needed to continue to create best practices and evaluate effectiveness of certain counseling structures. I would respectfully disagree with Lambert’s Thesis #10 and claim that psychology is an increasingly scientific discipline. Most modern counselors of any stripe would agree that Freud’s scientific methods were lacking. If Dr. Lambert wishes to disagree with both Freud’s humanism and his lack of scientific process, I wholeheartedly stand with him. I do not believe that is where the field of psychology lies today.

Important work is being done in and for the Church by many skilled clinicians and researchers. If biblical counselors cannot acknowledge the positive contribution of this work, they will increasingly fade to the background and become obsolete.

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A Story That Needs To Be Told

Scott was a man well-known to our church and to our city. He was a hard worker, a family man, an adopter of neighborhood kids, and a master in the kitchen. His favorite was breakfast… Bacon and eggs.

When your surprise 50th birthday party becomes your funeral, there is a lot for a family to process. Of course, those who knew Scott well knew that he battled addiction for a long time. His emotional struggles lay very deep underneath a surface that most saw as a friendly face. Scott had accountability partners, went to church every week, got group support, and prayed for miracles daily. The consensus among his friends and family was that no one wanted to be rescued from addiction more than Scott. There is no greater amount of faith that a person could possess to bring about a deliverance. And while we all asked, “Why?” we also knew that Scott’s prayers truly had been answered. Addiction can no longer hold him in its grip.

I helped compile this book for Scott’s wife and two daughters to help provide for them this Christmas. Less than a month ago they lost their husband and father and immediately had to jump into Thanksgiving and the holiday season. I believe that Scott’s story needs to be told, and I also believe that those of us who claim to care about mental health and addiction need to do more than talk about it. For me, this is a James 1:27 moment. We demonstrate the love of Jesus when we do something practical to care for orphans and widows.

This is a family I personally know well. It is just one situation, but it is one for which we can make a genuine difference.

All proceeds of this book will go directly to Scott’s wife, Lisa. Buy it. Share it.

Take in the pictures and letters that tell a story of a man deeply missed. Help break the stigma of addiction by participating in the storytelling of those whose voices have been lost to a fatal illness.

You can also support Scott’s family by donating here: https://www.gofundme.com/scottmacefamilyfund

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Not All Holidays Are Happy

It really doesn’t matter if you say “Merry Christmas” or “Happy Holidays,” for some who are struggling with depression or grief neither one may feel quite right. There can be a lot of pressure during Christmastime to be jolly. Unfortunately, we may plaster on a smile to get through our 17 Christmas parties all the while feeling lost and alone. What can we do to acknowledge that pain continues and even intensifies during the holidays? How can we be honest when we are struggling, or allow others be safe enough to share their true feelings?

Don’t Assume

Just because someone is smiling does not mean they are truly feeling okay. Don’t assume a smile means that a person is feeling happy. Instead, look for overall body language — does the person look off into the distance or seem distracted? Are they keeping to themselves or answering with short, basic answers? If you are feeling great this holiday season, it can be easy to get lost in your own world and miss the struggles of those around you. On the other hand, if you are having a hard time right now, you may try to stay away from those who could actually lift your spirits even just for a little while. We need each other, even when we are not all in the same emotional space.

Don’t Convince

“Come on, it’s Christmas!!” Trying to convince someone to cheer up when they are depressed or grieving will not work. Statements like this make people feel worse, like they are just dragging everyone else down or can’t live up to expectations. If someone else is feeling happy and you are sad, or if someone else is sad and you are happy, let that be the case. Don’t try to drag someone into happiness. Instead, show compassion. Try to put yourself in the other person’s shoes and allow them to be where they are. Being a good friend means you are willing to be around another person even when they are struggling. Don’t try to fix or remove the pain, but acknowledge and validate it instead.

Do Listen

“Do you hear what I hear?” The only way we can hear each other is to listen. Tolerate feelings different from your own by inviting someone to share honestly about what is going on for them. If you are going through a difficult time, find a safe friend to open up to. And be willing to listen to their holiday cheer, giving yourself permission to be where you are even as they are in a different place. When a friend tells you they are not in the stereotypical “holiday spirit,” listen for long enough to hear the whole reason why. Don’t feel like you need to respond. Just listening is enough. The only thing we need to say to each other this holiday season is, “I’m here for you.”

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Invisible Wounds

What if 20% of the people in your congregation were paralyzed and had to use a wheelchair? Most likely, the church would add ramps and find other ways to make the church accessible, accommodating these disabilities. Yet because we do not see mental illnesses (or even invisible illnesses such as chronic pain), we tend to doubt their existence and we certainly do not accommodate people suffering with these types of brain disorders or emotional difficulties. We do not seek to adapt to their needs and often we do not even seek to understand their needs.

What does it mean to be like Christ to all of those hurting in our midst? What does it mean to seek to understand another person’s experience? Psalm 34:18 says, “The Lord is close to the brokenhearted; he rescues those whose spirits are crushed.” If we as the Church are to be like Christ, then we must also seek to be close to the brokenhearted and rescue those who are struggling with emotional problems and mental illnesses. What would it look like for your church to be a place where the brokenhearted are rescued? How can you reach out to the marginalized in your community?

The National Alliance for Mental Illness estimates that 1 in 5 adults experience symptoms of a mental illness each year. More research needs to be done to determine how representative the church-going population is. But what if it were 20% of your congregation? 20% of the community surrounding your church? Desperately in need of understanding and compassion. These invisible wounds often prevent a person from feeling like they fit in at church, or may stop them from coming altogether. If they come, they might feel like a “less-than” Christian because they don’t feel the way everyone else seems to feel. They are likely to be told that they should “trust God more” to make their mental illness go away.

It is time that we as the Church no longer turn a blind eye to the invisibly wounded. It is time to stop judging and blaming and giving pat answers and rise up to bring the Gospel back to its actual message: Jesus came for everyone. Regardless of how you feel or whether you could get out of bed today, Jesus is for you. Jesus makes his table accessible to all.

 

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Gratitude Is Good For You

I recently downloaded an app called Bliss, which simply prompts you to write three things you are grateful for every day. There are additional positive writing prompts in the app, but I have found that just cultivating a daily habit of gratitude has helped me keep my mind on what is important. Our world is so full of negativity and complaining that it is easy to get pulled down into those traps. Thankfulness brings an awareness of God and the gifts he has given rather than dwelling on our perceived lack.

Numerous studies have revealed positive effects of gratitude on emotional well-being and overall satisfaction with life. There is power in thinking about and even speaking aloud the truths about what is good in life. The Bible gives us wisdom in this area of thankfulness as well. Colossians 2:7 says,

“Let your roots grow down into him, and let your lives be built on him. Then your faith will grow strong in the truth you were taught, and you will overflow with thankfulness.”

Just a chapter later in Colossians 3:15 Paul writes,

“And let the peace that comes from Christ rule in your hearts. For as members of one body you are called to live in peace. And always be thankful.”

During this week where those in our country have the word “thanksgiving” rolling off the tongue, don’t skip over the practice of gratitude. Even better, when you think about what you are thankful for, set a rule for yourself that you cannot list any material possessions. Rather ask questions like, “What work is God doing right now in and through me? How has he cultivated more of my heart this year? What people are closer to me now than ever before? What trials is he carrying me through?”

May you be spiritually and emotionally well as you fix your heart on God and develop a grateful spirit.

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Should Christian Counselors Work in Secular Environments?

In last week’s post, I addressed the question, “Is Scripture Enough?” and explored the Christian counselor’s role in bringing healing to those with mental illness. The Church Therapy model suggests that pastors and professional Christian counselors can work well as a team to support those in their care. However, presently very few licensed counselors work in church settings. Some have private practices that are advertised as Christian-focused, while others have practices that do not overtly state that they are Christian. Many Christians who are counselors would not identify themselves as “Christian counselors,” but instead would say that they are simply Christians who are professional counselors by trade.

One line in last week’s post got me and a few others thinking about where Christian counselors should work. I wrote, “…many of these Christian counselors have chosen to work completely outside the framework of the Church or discipleship. I find this to be tragic, as many well-trained Christian counselors do not see it as their role to serve the Church.” Does this mean that all Christians who are trained as counselors should work in church settings? Would that even be possible?

First, allow me to reject my own question that serves as the title to this post. There is no “should” when it comes to ways God can choose to call people. Christians work in secular settings in all kinds of different professions, from doctors to carpenters to teachers. I am not about to limit the work of the Holy Spirit by making a blanket statement that all Christian counselors must be called to work in a church or alongside a church directly. We are all ambassadors and ministers of the Gospel when we care for and bring love to our neighbors. We weep with all who weep, not just other believers.

On the other hand, the Church has at times been a hostile place to licensed counselors as the mental health debate has raged on over the past 50 years. The thing that I find tragic is that many Christian counselors I have personally known would have loved to work in a church or come alongside in some way to use their gifts for the edification of the Church. Yet there were no in-roads for them to do so. Many I knew in my graduating class at Gordon Conwell ended up in secular settings not because of a calling, but because that was where they could find a job. Even my church did not “hire” me so much as give me the opportunity to create something that did not exist and for which they could offer no money. The pastors and I have had to figure out a lot along the way, including how to create a sustainable role for me both financially and structurally. I started writing this blog as a way to flesh out all the different aspects of how to make it possible for counselors and pastors to work side-by-side.

Professional Christian counselors are an asset to the Church and pastors must begin creating pathways for them to serve in churches. Some may be called to work in secular settings but may desire to serve the local church by offering a workshop on a mental health topic or leading a Stephen’s Ministry. Others may have a burden and desire to work on a church staff, and pastors can make that possible through the Church Therapy model.

My message is simple: every single believer has valuable gifts and all of them are welcome in the kingdom of God. Pastors and professional counselors are working towards the same ends with different roles, gifts, and skill sets. Until this spiritual war is over, we are in an “all-hands-on-deck” place. We can’t afford to send anyone away because we want to debate about psychology and theology. People need help, and we need to make every resource available where they need it most: the Church.