Home » Additional Writings » The Role of Faith Communities in the Treatment of Mental Illness “The Story Of Our Life: Written By The God Who Suffers For Us And With Us”

 

The Role of Faith Communities in the Treatment of Mental Illness “The Story Of Our Life: Written By The God Who Suffers For Us And With Us”

 

I: — In my final year of theology studies (1970), University of Toronto, I enrolled in a course, “The Human Person in a Stressful World”. The course instructor was Dr James Wilkes, a psychiatrist connected with the Clark Institute of Psychiatry (now part of Toronto’s Centre for Addiction and Mental Health). Until then (I was 25 years old) I had apprehended no more of psychiatry than the silly caricatures and stupid jokes that popularly surround ‘shrinks’ and ‘wig-pickers’. Months later I emerged from the course not merely with medical information I had heretofore lacked; I emerged with a new world. Wilkes hadn’t simply added several items to my mental furniture; he had admitted me to a world I hadn’t known to exist.

What was the world? It was the complexity of the human person together with the multidimensionality, pervasiveness and relentlessness of human suffering. It was the configuration of the stresses, frequently swelling to distresses – intra-psychic, social, biological, historical, religious – that bear upon people, together with the configuration of responses to such stresses. (Some responses are individual – stress stimulates some people to greater achievement, while stress effects breakdown in others; other responses are social – institutionalization, whether in hospital or prison, is one such social response.)

My debt to Dr Wilkes is unpayable. Not least, he introduced to me the Diagnostic Statistical Manual; as a result I gained even deeper appreciation of the scope, profundity and versatility of human suffering. He spared me lifelong shallowness born of ignorance; spared me a simplistic, unrealistic approach to the people I would see every day for the next forty years in my work as a pastor.

II: — One month after the course had concluded I was ordained to the ministry of The United Church of Canada, the nation’s largest Protestant denomination. In no time I was living and working in north-eastern New Brunswick, one of the most economically deprived areas of Canada. And just as quickly I found myself face-to-face with people whose difficulties were the ‘common cold’ of the psychiatric world; e.g., mood disorders, anxiety disorders, schizophrenia. I also witnessed suffering less commonly seen in the Twentieth Century: hysterical paralysis (episodic leg immobility in someone devoid of a physical impediment) and even hysterical blindness when someone was ‘put on the spot’ in a troubling social situation only to find her vision disappearing and returning repeatedly.

III: — My work as pastor on behalf of psychiatric sufferers found me conversing with family physicians and psychiatrists. Both groups, but especially psychiatrists, frequently appeared suspicious of clergy, even occasionally disdainful. Soon I learnt why: too many clergy (at least of that era) tended to a facile, one-sided pronouncement concerning psychiatric patients as possessing inadequate faith and defective trust in God; psychiatric sufferers were haunted by a guilt they were supposed to have; in addition they were self-absorbed. The clergy-proposed cure was simple: all such spiritual problems could be shed through a combination of ‘positive thinking’, ‘exercise of the will’, and ‘greater faith’. The medical fraternity appeared to think the clergy only worsened the sufferers’ predicament in that to their anguish were now added guilt (they were manifest spiritual failures) and anxiety (they feared they lacked the spiritual resources for rising above their pain).

Thanks to Dr Wilkes I was spared such simplistic glibness. Equipped with what I had gained from him, I revisited my theological formation, now keeping in mind the subtleties and complexities of human distress, determined to avoid naïve assessments and subtle accusations of personal deficiency if not personal failure; determined to avoid, in short, a false spiritualization of someone’s suffering.

IV: — As I revisited my theological understanding I developed a constellation of key spiritual themes found in the Abrahamic tradition. This constellation of key spiritual themes formed the matrix of my ministry to psychiatric sufferers.

[A] The first is elemental: God is for us. Three thousand years ago the Psalmist exulted, “This I know, that God is for me.” (Ps. 56:9) This conviction is the bass note, the downbeat, the ever-recurring throb. It remains the stable basis and the governing truth of everything else: God is for us. It’s picked up again in the apostle Paul’s letter to the church in Rome: “If God is for us, who is against us?” (Roman 8:31). The force of the assertion is, “If God is for us, who could ever be against us ultimately, regardless of all appearances to the contrary?” Since ‘appearances to the contrary’ abound in anyone’s life and especially in the ill person’s life, it cannot be insisted too often that God is for us.

To be sure, those who belong to any of the Abrahamic traditions arising from ‘The Book’; that is, those belonging to the Jewish, Islamic and Christian communities are always aware that ‘The Book’ says much else about God: God is judge, God is wrathful, God’s face is set against evildoers, and so on. Ill people tend to fasten on these texts, convinced that their illness is the result of God’s anger concerning them and God’s judgement upon them.

The general tenor of ‘The Book’, however, is wholly different. To be sure, God is judge (isn’t any person who lacks judgement anywhere in life to be pitied?). Unlike our judgement, however, God’s judgment is always the converse of his mercy. God bothers to judge us only because God has first resolved to rescue us and restore us. (If God didn’t intend the latter he wouldn’t bother with the former: he would simply ignore us.) God’s judgement, then, is always and only the first instalment of our restoration and the guarantee of its completion.

Since, according to ‘The Book’, God is love, love isn’t merely something God does (the implication being that God could as readily do something else if he wished; namely, not love); rather, since God is love, love is all God is and therefore all God can do. God can never not love, never act in a way that contradicts his character. God’s wrath, said Martin Luther, is God’s love burning hot – but always and everywhere love.

Mentally ill people, let me repeat, tend to assume their illness is the result of God’s displeasure with them. Two comments have to be made here: one, their illness isn’t the result of God’s displeasure; two, if elsewhere in life they have mobilized God’s displeasure (ill people like to remind me – correctly – that though they may be ill they are still sinners) God’s judgement is only his love setting us right. God’s judgement is God’s mercy beginning its work of restoration.

God is for us. This note has to be sounded relentlessly, for this note determines the rhythm of human existence.

[B] The second item in the constellation of key spiritual themes: God shares our vulnerability; shares our vulnerability not least because God is vulnerable himself. Ill people, I have found, fault themselves remorselessly for not being invulnerable; for not being strong enough, able enough, competent enough, resilient enough; in short, for not being inviolable. They assume that finitude, limitation, weakness isn’t or isn’t supposed to be part of our humanness. They fault themselves for not being invulnerable in the face of life’s assaults. (I have noticed, by the way, that psychiatric sufferers who fault themselves for their fragility would never fault themselves if they suffered a broken leg in a car accident. Without hesitation they would fault the driver whose car struck them. In other words, when they are physically incapacitated, they can legitimately blame others; when they are psychiatrically incapacitated they can only blame themselves.)

There has arisen in our society a miasma that continues to settle upon and soak into the populace at large; namely, we are, or are supposed to be, invincible, devoid of fragility, frailty and finitude. We are, or are supposed to be, nothing less than titanic in our capacity to withstand assaults. We are, or are supposed to be, possessed of an omnicompetence amounting to omnipotence. Worse, such omnipotence is deemed to be an attribute of God and therefore a property of those made in God’s image.

Omnipotence, however, understood as unmodified, unconditioned power, is terrible. A moment’s reflection should assure us that power for the sake of power; power unqualified by anything; sheer power is sheer evil. Then why attribute it to God?

More profoundly, power, properly understood, is the capacity to achieve purpose. What is God’s purpose? – a people who love him and honour him as surely as he loves and honours us. How does God achieve such purpose? – through God’s own vulnerability. The Abrahamic traditions refer alike to the One who repeatedly, characteristically suffers at the hands of his people yet never abandons them. God’s suffering, in these traditions, is likened to many things, but likened most often to a woman in end-stage labour whose child, conceived in pure joy, has brought her greater distress than she could have imagined yet who will not renounce the struggle but must see it through, until the child who is her delight is in her arms and on her lap.

So it is with God. From a Christian perspective specifically, the cross attests God’s limitless vulnerability (he hasn’t spared himself anything for our sakes), while the resurrection attests the limitless efficacy of limitless vulnerability.

Not only are we humans unable to escape our vulnerability (regardless of the messages advertisers beam upon us); to want to escape it is to want to be titanic. And to think we can escape it is to fancy ourselves gigantic and to ignore our Creator who renders himself defenceless before us for our sakes.

Psychiatric sufferers should be helped to see that their fragility isn’t a sign of moral weakness or personal failure or uncommon ineptitude or unusual folly. They should be helped to see that owning their vulnerability, rather than denying it or attempting to flee it, might just be essential to their recovery. Sufferers should be helped to see that their vulnerability is the leading edge of their triumph.

[C] The third item in the constellation of spiritual themes: God alone is the ‘story-writer’ who can render the negative, seemingly opaque developments and details of our existence a story rather than a chaotic jumble that ultimately defies comprehension.

Imagine a line in the middle of a novel; e.g., “The man who had waited for hours finally walked away, dismayed that the woman hadn’t noticed him.” If the question were asked, “What does it mean?”, the obvious rejoinder would be, “It all depends; it all depends on what preceded this event in the narrative; and no less it all depends on what follows this event; ultimately, it all depends on how the narrative turns out; that is, it depends on the last chapter. The mentally ill person persistently comments, “I don’t know why I’m ill; I don’t understand what it’s supposed to mean; I can’t make any sense of it.” Lack of meaning is a stress in anyone’s life, yet lack of meaning is something that confronts us all whenever we are face-to-face with evil.

We should admit that one aspect of evil’s evilness is evil’s sheer meaninglessness. To the extent that evil could be understood, it would be rational event, its evilness reduced by the explanation. What is evil is finally inexplicable and will always lack meaning, not least the evil of illness.

In the face of the stress of that meaninglessness which makes the burden of illness all the more burdensome, the ill person is always prone to try to reduce the burden by positing a meaning, by ‘finding’ a meaning (as it were) that actually isn’t there but the ‘finding’ of which is easier to endure than no meaning. The problem here, however, is that the ‘meaning’ the ill person posits is arbitrary, unrealistic, and worst of all, self-deprecating. Now she thinks the meaning of her illness is that it was ‘sent’ to teach her a lesson, or to remind her of personal failure, or to make major changes in her life, or to confirm her inherent wickedness. In the interest of reducing her burden she has only increased it.

The truth is, the meaning of any one event in anyone’s life depends on several factors. In the first place it depends on what has preceded the onset of illness. In the second place it depends on what is yet to occur in that person’s life. Above all, it depends on the meta-narrative that gathers up and determines the ultimate significance of all the events, good and bad, in that person’s life – which meta-narrative no one, ill or not, can write inasmuch as no individual is the author of her own meta-narrative.

All of us like to think we understand how life is unfolding and how life’s ingredients are connected until – until a negativity occurs that is nothing less than a ‘surd’ (in the mathematical sense); i.e., a development that doesn’t fit anywhere and can’t be seen to fit or be made to fit; a ‘surd’ development that defies the logic by which we had understood our own existence up to this point. Yet since the meaning of a story depends on the last chapter, and since the last chapter hasn’t been written nor can be written by us, we must admit that for the present illness remains a surd: we cannot determine its meaning at this time nor its place in the conclusive narrative that is anyone’s life. People from the traditions of ‘The Book’, however, maintain that the ultimate meaning of anyone’s life can be entrusted to the One whose meta-narrative gathers up our self-determined, myopic narratives and transmutes them into something whose meaning, truth and splendour we can only await at this time but which we need not doubt.

Let’s change the metaphor. Instead of an author or master narrator let’s think of a master weaver. A weaver weaves loose threads into a rug whose pattern is recognizable and pleasing; more than pleasing, desirable – why else would anyone find the rug attractive and want to purchase it? Two comments are in order here. One, what goes into the rug are hundreds of loose threads of assorted lengths and diverse materials. Two, even while these threads are being woven into a rug, anyone looking at the rug from underneath would see something that wasn’t recognizable, wasn’t attractive, and would seem little improvement on loose threads. And yet, when the weaver has finished and we can look at the rug from above we recognize a pattern, a completion, an orderliness that is comely and convinces us that the rug is a finished work, elegantly concluded. Only as we are brought from looking up from underneath to looking down from above do we recognize what the weaver has accomplished.

Right now all of us are on the underside of the rug looking up at it; and while the apparent lack of order and attractiveness may puzzle us or even amuse us, the mentally ill person is never amused and is more than puzzled: she is dismayed, fearing that her life, seemingly a jumble now, will never be more than a jumble. Lacking coherence now, it will always lack coherence. The Abrahamic traditions, however, maintain that ultimately no one’s life is meaningless; no one has to posit an arbitrary meaning in order render life endurable, fictively endurable. Instead, we affirm that the weaver gathers up all the elements of our existence, including the most painful and incomprehensible, with the result that our life, our concrete existence, finally is and finally is seen to be coherent, meaningful, attractive, useful, a finished work brought to completion.

[D] The fourth item in the constellation of key spiritual themes: a community has to embody the truth it claims to cherish. In short, a community has to embody, exemplify, the constellation of spiritual themes discussed to this point. Since the communities of the Abrahamic traditions maintain, for instance, that there is no human being, anywhere, in any predicament, who is ever God-forsaken, the community that upholds this truth has to embody it.

Note: I didn’t say there is no human being who doesn’t feel God-forsaken. Neither did I say that people have no reason to feel God-forsaken. They manifestly have. Nonetheless, since it remains true that God doesn’t abandon, despise or reject, there has to be a community that doesn’t abandon, despise or reject.

Our concrete embodiment of this truth takes at least two forms.

(a) Most simply, the community shares its material resources with those who are especially needy. Everyone is aware, of course, that there is a government-enforced, non-voluntary sharing of our material resources with the needy. This enforced, non-voluntary assistance is found in the combination of graduated income tax and social assistance and health-care. While this arrangement isn’t an explicit aspect of the life of church or synagogue or mosque, it is the indirect illumination arising from the witness of biblically-informed communities. We ought never to sell it short, and we should continue to ask ourselves what might be the social texture of our society if secularism succeeds in extinguishing the indirect illumination of biblically-informed peoples.

The Mississauga congregation I pastored for 21 years partnered with the local synagogue and Baha’i fellowship in developing two affordable housing projects (value: $35 million). This housing accommodated needy people, among whom were always many who were in psychiatric difficulty, and more than a few whose psychiatric condition was chronic. Quickly we noticed that many of the people we housed were undernourished; whereupon we developed Mississauga’s first food bank. It still operates, and every year it distributes food whose market value is $12 million. Next we noticed that many children were so poorly fed they were underachieving at school; whereupon we fashioned a ‘breakfast club’ in order to give them a nutritious start to the school-day. The ‘breakfast club’ was headed-up by the rebbitzin, the rabbi’s wife. She served unstintingly for 25 years. At one point there were 44 people from my own congregation serving in the ‘breakfast club’.

The most elemental level of community is serving the neighbour’s material scarcity through our material abundance.

(b) The second expression of community is sharing the neighbour’s suffering. To share the neighbour’s suffering where mental illness is concerned is at least to befriend that person and thereby at least reduce the suffering person’s isolation and loneliness.

The mentally ill person suffers what every human suffers in terms of frailty, disease, bodily breakdown through accident, sickness and aging. In addition the mentally ill person suffers from her particular psychiatric problem, indeed lives, lives out, that problem, as the non-psychiatrically afflicted do not live that problem, at least. And in the third place, the mentally ill person suffers the social stigma visited upon the psychiatrically troubled. The community has to be aware of all three levels of such suffering, and remain aware that such suffering, cumulatively, is an appalling burden.

When I was a pastor in Mississauga my wife and I invited back to lunch each Sunday a different family from the congregation. Several matters need to be noted here.

One, the unmarried person was still a family, and should not be overlooked in a society almost exclusively couple-oriented.

Two, in a congregation of 400 families there were always several people who had been diagnosed with assorted psychiatric problems.

Three, the mentally ill person is not only suffering atrociously herself; her family is suffering too, in a different manner to be sure, but suffering nonetheless.

Four, while these people had been invited to lunch, if they were still sitting in our living room at 5:00 p.m., they were invited to supper. I came to see that loneliness is an enormous problem, not least loneliness among those one would think least likely to be lonely since their lives outwardly seemed devoid of social deficit; loneliness especially in those whose mental illness heightened their isolation; and of course loneliness in those whose ill family-member found others avoiding the family.

In the course of our simple hospitality we welcomed to our home and table the bipolar person, the obsessive-compulsive, the phobic, the schizophrenic, the substance-addicted, and those afflicted with personality disorders. Among these were the ‘dual-diagnosed’; e.g., the mentally ill person who is also blind or in trouble with the law.

The role of the community of faith isn’t to mimic the mental health professional; certainly it isn’t to suggest that medical intervention is superfluous. The role of the community of faith is to render concrete its conviction that ill people matter and shouldn’t be ignored. Not least, the role of the community of faith is to hold up – for the sufferer herself but also for the wider society – the truth that the troubled of this earth have been appointed to a future release and recovery more glorious than their pain allows them to glimpse at this time.

 

Address to the American Psychiatric Association                               May 2015

Dr. Victor A. Shepherd