Neuroscience, Mental Health and the Church

Hoogerwerf: 

Welcome to Language of God. I’m Colin Hoogerwerf. And I’ve been hosting the podcast in Jim’s absence, while he’s on sabbatical. And today I’ve got a co-host. Rachel Wahlberg. Hi Rachel. 

Wahlberg: 

Hi. 

Hoogerwerf:

Rachel is currently working on her neuroscience PhD at the University of Michigan. And she’s here today because the topic of our episode is one that is going to dip into neuroscience. But before we get started, I also need to give credit to Nate Mulder who spearheaded this whole project, did a lot of the interviews and really gave shape to this whole episode. Nate has been the assistant producer for the podcast for a while now and was an intern for a long time before that. He’s off on his way to a PhD where he’s been living in Ireland and we’ll miss all the work he’s done for us here and wish him the best of luck. Thanks, Nate. 

Today we’re going to talk about mental health, neuroscience, and the church. This is an issue that probably comes close to home for a lot of people. And it can bring up some really hard questions. 

Whitehead: 

She was my, the only client that I would love to see again. Because she was the one who sent me into, kind of, a spiral in my own theology, in many ways, because everything I believed to that point, didn’t work anymore, after talking to her. 

Hoogerwerf: 

This is Jason Whitehead.

Whitehead: 

I am a Presbyterian pastor and licensed clinical social worker. I also have a PhD in religion and psychological studies from Iliff School of Theology and University of Denver.

Wahlberg: 

The patient was one Jason saw over 20 years ago.  A woman in the Baptist church who had suffered a lot of physical abuse when she was younger. 

Whitehead: 

And after sitting with her suffering, sitting with her pain, sitting with the fact that her parents thought of themselves as very devout people, and very devout Christians, and her questions of “where was God in all of this,” and “I’m so angry at God and angry at them, and I don’t know what to do,” and I didn’t know what to do. And so, It sent me into a place where I needed to explore this more, because I felt inadequate to answer her questions and inadequate to really bear with her the sacredness of her stories and the sacredness of her pain and find constructive, meaningful, creative, beautiful ways out of it.

Hoogerwerf: 

As Jason’s story suggests, trauma can cause a lot of mental health suffering. It can also be really personal, which is part of why we often avoid talking about it with others, even those close to us in our church communities. We’ll share some more of those stories throughout this episode, because I expect they’ll resonate with some listeners like they did for us.

Wahlberg: 

According to research conducted by the National Alliance on Mental Health, 1 in 5 U.S. adults experience mental illness in a given year. And those numbers hold for people in the church, including pastors. Despite its prevalence in the church, other research shows that 66% of American pastors talk about mental illness in their sermons only once a year, rarely or never. This disparity raises one of the key questions we want to focus on in today’s episode: why is the church so silent about mental illness, when it’s so prevalent among its members? But before we can start answering that question, I think we need to more clearly define what we mean by mental health. 

Hoogerwerf: 

Yeah, There are a lot of terms out there: mental health, mental well-being, mental illness, mental disorder, and so on. It can get really confusing. 

Wahlberg: 

We talked to Dr. Marcia Webb to get some clarification.

Webb:

Well, those are big questions, actually. And there are many different ways that people have thought about mental illness and mental health and there’s continuing debate about what constitutes mental health. And for believers, there’s questions about how does spirituality fit in that definition about mental health.    

Wahlberg: 

Marcia is a Professor at Seattle Pacific University where she works on the integration of psychology and theology with a focus on mental illness.

Webb:

It’s also difficult to define, but we think about mental illnesses as those clusters of behaviors and emotions and thoughts that are unusual, you know, in other words, they don’t happen regularly in the population. But they have to be more than just unusual. They have to be behaviors, thoughts, emotions that are related to distress in their lives. They also have to be associated with some sort of dysfunction. In other words, the person has difficulty maintaining meaningful relationships, finding meaningful activity that they persist in, like a job or raising a family. They have dysfunction in multiple areas of their lives. So those are three of the elements that contribute to our understanding of what mental illness is. 

Hoogerwerf: 

So unusual behaviors, emotions, and/or thoughts which cause distress in someone’s life and are associated with some kind of dysfunction. Those are all ways we can identify mental illness through symptoms, but that’s making me wonder what’s causing these symptoms and how do we distinguish between a symptom and regular behavior?

Wahlberg: 

Right. So let’s just start with your first question: what’s causing these symptoms? Researchers often talk about the etiology or root cause of a disease or abnormal condition. One direction we could take in understanding this would be to focus on the brain as the cause of those symptoms.

Webb: 

With many mental disorders, what we’re seeing is that there are differences in the way that the brain functions, particularly the areas of the brain, the amygdala, the hippocampus. The amygdala is a center of the brain that is associated with fear responses. So since many mental disorders are related to emotional disregulation, or the inability of a person to cope with suffering and stress, we do see differences in the way that brain activity happens in the amygdala, in the hippocampus and in certain neurochemical systems like the serotonergic system, for example. 

Hoogerwerf: 

Serotonergic? That’s the system that works with Serotonin?

Wahlberg: 

Yep, that’s right. And Marcia also told us that in the prefrontal lobes, which assists in, in part, some of the processing of those emotions, in the case of mental disorders, we see less activity in that region. In contrast, therapies have been shown to increase activity in the prefrontal lobes.

Webb:

And in the prefrontal lobes of the brain, what you have is a person’s ability to assess their experience to make judgments to sort of the executive functioning of the brain to influence how the person will respond. So if you have someone who has less activity – you know what we’re seeing is less activity in the prefrontal regions of the brain when they are in a distressed state, they are not accessing or they’re not able to access some of those higher order functions that we see in a more advanced configuration in humans, for example, than you would see in animals.

Hoogerwerf: 

Okay, mental disorders like anxiety and depression are related to the amygdala and hippocampus, areas of the brain associated with emotion and memory. So what’s the relationship between these two parts of the brain and the prefrontal lobes, which are associated with decision making?

Wahlberg: 

That’s definitely a complicated question, but basically, parts of the brain don’t work in isolation from one another. If you think about a disorder like depression, which affects not only mood but memory and decision making, it makes sense that circuits involving those relevant brain areas would be included in this disorder. It’s also easy to sort tasks into different brain areas, but the brain is so much more complex than that and something that affects one region definitely affects other regions as well. There’s a lot of communication happening between these regions which is both electrical and chemical, and distress can alter this communication. Marcia told us more about that chemical side of this communication in the brain and how it relates to a disorder like depression.

Webb: 

Serotonin is, as you know, it’s a neurotransmitter and it’s related to depression and anxiety, it’s activity. And so different medications have focused on that particular neurotransmitter and the systems in the brain that whereby serotonergic neurons are active, and dopamine is another neurotransmitter, and there’s the dopaminergic system in the brain as well. So medications influence how the brain is active, at the level of those particular systems. 

Hoogerwerf: 

So just to be clear, a neurotransmitter is?

Wahlberg:

At its most basic, a neurotransmitter is the chemical which transmits signals between neurons in the brain, and between the brain and the rest of the nervous system throughout the body.

Hoogerwerf: 

Got it. So, if we take depression as an example, could we define depression based on the levels of these neurotransmitters in someone’s brain? Is there some empirical threshold people can point to as being the difference between a healthy brain and a depressed brain?

Wahlberg: 

There’s no clear answer on that. As Marcia pointed out, antidepressants interact with neurotransmitters in the brain, we know that for sure. You may be familiar with the term “SSRIs”, which is a category of antidepressant. This stands for “selective serotonin reuptake inhibitor.” And what that means, when two neurons are done communicating with one another using serotonin or another neurotransmitter, the neuron sending the message typically recycles that serotonin by taking it back up into itself so it can send another message. So what a “serotonin reuptake inhibitor” does is it prevents this serotonin recycling, which means that serotonin can hang out next to the other neuron and essentially continue to send more messages. Because SSRIs have shown positive results for depression and other disorders, there is support for serotonin playing a specific role in these disorders. This is called the serotonin theory of depression. There are definitely other theories out there too, though; because even though SSRIs work, we’re not 100% sure why they work, directly modulating serotonin itself, this has not always been shown to be reliably helpful, which suggests that neurotransmitters are not the full story of mental health and the brain. “Chemical imbalance,” which we hear pretty often in relation to disorders, is likely just too simple of a phrase to describe what’s really happening.

Hoogerwerf: 

Do you mean to say that only neurotransmitters are not the full story, or the brain is not the full story? 

Wahlberg: 

Both, I think. Other biological factors have definitely been shown to play a role in mental illness, such as genetics and epigenetics or stress hormones. But also, defining a mental illness based on neuroscience is not always that straightforward. In the whole “nature vs nurture” debate, time and time again we see that the answer is “yes” to both of these. Biology does play a role, but different experiences or traumas play a large role too. 

Hoogerwerf: 

We’ve established that there is definitely a link between activity in the brain and how we cope with stress and suffering. But at the same time, we need to remember that our scientific understanding of mental illness is continually being honed and refined. Does that sound fair to you?

Wahlberg: 

It glosses over a lot of complexity of the brain, but I think for our purposes, that is definitely pretty accurate. One thing I would add is about why we categorize certain behaviors as mental illness, and how these categorizations get made. I’m thinking here of something else Marcia pointed out.

Webb:

A diagnosis is really just a communication tool. It’s a way that I can say to another professional, ‘by the way, I’m referring somebody to you. My diagnosis at this point, given the information that I have is x. And that person can automatically be thinking, okay, here are the potential symptoms in mind. And here are the things I need to watch out for. How suicidal might this person be? What is the person’s potential for family conflict?’ All of these different things based on the research that’s done with that same communication tool, the diagnostic category, but that diagnostic category changes over history as science develops. 

Hoogerwerf: 

That’s interesting. It seems pretty important in these discussions to remember what these categories of mental health or wellbeing were originally created for.

Wahlberg: 

Right. When these diagnostic categories are introduced to the wider public, the nuances of the science are often lost. Inevitably, we associate behaviors with these categories, often behaviors which fall outside of our understanding of what’s normal. 

Whitehead: 

And the idea of normalization is to give us a swift category that connects so that we don’t have to spend a lot of extra time interpreting something. And, you know, this is a social psychology phenomenon, in many ways. And it’s just a way that if we had to think intentionally about everything that goes on in our life, we’d never leave the kitchen table in the morning.

Hoogerwerf: 

We need categories. There’s simply too much information in our lives to be able to process every little bit of it without these shortcuts 

Whitehead: 

But within those categories, there’s so much diversity that we stop paying attention to. And so if we see someone with a physical disability, our cultural shortcut is to think of them as limited human beings. And I’m not saying that’s a right shortcut, because it’s not. And when we think about people who have health issues, we think about people from a deficit. And so when we use words like mental health issues, we shortcut to that person as mentally deficient, without actually knowing what that is. And this is where I think storytelling and belonging and other things like that become really, really important. And they become very important theologically. Because if we’re shortcutting, just to get through our days, what we’re actually doing theologically, is limiting what the image of God is, and to whom the image of God belongs. Because it doesn’t belong to any one of us. And it doesn’t belong to a normalized, you know, idealized form of humanity. 

Hoogerwerf: 

So clearly neuroscience doesn’t tell the entire story here. We need to be careful in how we speak about mental illness so that we don’t see something biological as a reflection of a person’s spiritual health or worth. 

Wahlberg: 

We should include that caveat in our working definition of mental illness for sure. And with all these factors, we should talk about another related term: mental health—or mental wellbeing. We could think of this as the healthy or proper functioning of these systems in the brain and in our behavior.

Hoogerwerf: 

But whether we’re talking about mental health or mental illness, there’s still an issue of whether our mental state is determined only by biology or whether spirituality has some role to play. 

Wahlberg: 

This is a key question for a lot of believers struggling with whether they should or can seek treatment for their mental health or not. 

Whitehead:

The way that I like to think about it, and this is something that I think our theologies have really done a disservice to, is thinking about things from an integrated or a wholeness perspective. That things like mental health, and physical health, and social health, and spiritual health, are all kind of woven stories. They’re just parts of who we are. And at different points in our lives, one part takes precedence over another. When we’re physically ill, you know, we concentrate on trying to reestablish a sense of routine health that’s meaningful for us at whatever level we can do. When we’re overwhelmed emotionally, we try to find that equilibrium again and try to parse through those emotional spaces. When we’re overwhelmed spiritually—whether positively or negatively—we do the same thing. We attempt to find that equilibrium, where we can integrate what’s happening to us, or around us, or with us, into the larger story of our lives, and that larger sense of identity and who we are.

Wahlberg: 

That seems to be a helpful way to look at well being from a broad standpoint. And I think it connects well with the original psychological definition Marcia Webb gave us for mental illness as unusual behaviors, emotions, and thoughts which cause distress in someone’s life and are associated with some kind of dysfunction.

Hoogerwerf: 

Right. Given this model, addressing symptoms such as an inability to deal with stress wouldn’t be confined to just one area. Solutions could come from several or all of these spheres as needed. We heard something similar from yet another one of our guests. 

Brown:

One thing I think it’s important to keep in mind is that we all have mental health, we all have to attend to our emotional wellness. 

Wahlberg: 

That’s Dr. Jessica Young Brown. 

Brown:

I’m a licensed clinical psychologist, and I work at the intersection of faith and mental health.

Wahlberg: 

Jessica defined mental health in a similar way to Marcia. 

Brown: 

When I think about mental health, I think about four components: understanding our emotions and how they impact us, having healthy relationships, being able to understand and manage our stress levels, and having a healthy sense of self esteem or self worth. So all of us have mental health that we need to attend to, we get stressed out, we become overwhelmed, we have emotions that we need to make sense of, it’s just a part of being a human being. There are times when we experience a distress that is overwhelming, it gets in the way of us doing life in the way we would like to do it, it interrupts our relationships, it puts our safety in jeopardy. And when we get to those extremes, where the normal experience of being a human being gets to the point where it’s overwhelming for us, that could be classified as having a mental illness or mental disorder. Just like with any other kind of medical condition, there are levels of severity with mental illnesses. And we have a diagnostic manual to help us determine what symptoms constitute which disorders that’s called the Diagnostic and Statistical Manual of Mental Disorders. 

Hoogerwerf: 

That’s the DSM for short. 

Brown: 

So that’s our way of categorizing and understanding those conditions that are categorized as diagnoses. But I think it’s important to just know that whether or not you have a diagnosis or not, your mental health is something to attend to and think about because it’s a component of what it means to be a healthy human being.

Wahlberg: 

So clearly it’s important for us to think about our health holistically, in a way which incorporates mental health, physical health, and spiritual health. At the same time, though, we need to make sure that this holistic understanding of health doesn’t bring us back to thinking of mental health as something which only those with mental dysfunction, disorder, or illness have. It may be affecting us in different ways, but we all have a degree of  mental health. And this sounds simple enough, but in my experience, the church has not always been the best at thinking about mental health in this way.

Hoogerwerf: 

And I think there’s often a breakdown in how we understand these different spheres of health, leading us to set the science of mental health in opposition to a story which says that your mental health is a direct reflection of your faith. In that picture, using medical solutions to treat mental illness or a mental disorder shows a failure to rely on God. 

Webb:

People sometimes describe depression, for example, as a lack of faith. There’s a belief, sort of an undercurrent of belief in some Christian subcultures that if you feel anxious you’re not trusting in God enough, you shouldn’t have anxiety. That anxiety is actually a sin, just like depression is a sin. And my observations as a lay person, and also as a therapist years later when I became a therapist, and I did therapy with clients for about 20 years, that when people who have problems with depression/anxiety, for example, are told that they are sinning because of that, it only exists exacerbates the depression and anxiety. 

Hoogerwerf: 

And when people seek medication for things like depression and anxiety, there’s another response which sometimes comes up in religious communities.

Webb: 

People think if someone takes medication, that they are not relying on God, that people need to get off their medications, and trust in God. You know, they wouldn’t necessarily do this if they were diabetic and had to take insulin, or they wouldn’t do this for other types of disorders. But a mental disorder is viewed in a very different way, there’s a sense that you should be able to control every thought, every emotion, every behavior that you exhibit, and if you can’t, it’s because of spiritual failure.

Wahlberg: 

Clearly we in the church often treat mental health different from other medical issues. I wonder where this comes from. Is it something Biblical?

Hoogerwerf: 

There are certainly Bible verses used to back up claims that mental health is purely a spiritual concern. But there are also historical factors which seem to have played a role in getting us to where we are with mental health in the church today.

Webb:

In the United States, in the 20th century, there was a strong influence of the positive thinking movement. And one proponent of that was Norman Vincent Peale. There were other Proponents of this view, elevated, thinking positively. And Norman Vincent Peale, described himself as a Christian and saw positive thinking as a demonstration of faith. And unfortunately, I think what happened, I think that, you know, positive thinking can be very helpful. And there’s evidence, through research, that positive thinking can be very helpful, and having optimism can be very helpful for one’s overall well being. However, the problem is, if you start to equate faith with positive thinking—and I think that’s happened in the United States, to quite an extent—And unfortunately, what happens then is that when people go through normal, expected periods of suffering—I mean, life involves suffering, it just does. People who go through these periods of suffering may feel like they can’t express their pain to Christian brothers and sisters in the church. They may wonder if they can bring their pain to God if they are lacking faith.

Wahlberg: 

I hadn’t heard of Norman Vincent Peale before Marcia brought him up. But I looked him up and it turns out he was hugely popular in his day, especially after the publication of his book, The Power of Positive Thinking, in 1952. 

Hoogerwerf: 

But he was controversial even then. There was huge backlash from the academic psychology community about the book, with lots of criticism arguing the book promoted a kind of self-hypnosis for its followers to maintain a positive attitude in all situations. 

Wahlberg: 

Whether or not we attribute it to Peale’s influence, there’s a clear legacy of the positivity movement in church culture today. And while maintaining a positive attitude in the face of difficult circumstances seems innocuous enough at first glance, it can also create unrealistic expectations of happiness and success in the church. This can stigmatize those who are struggling with their mental health, causing people in the church to hide these issues or ignore them. 

Hoogerwerf: 

Marcia wasn’t the only person we talked to concerned with prevalent misconceptions about mental health in the Church. Jessica Young Brown shared her own experience of growing up with a father struggling with mental illness.

Brown: 

I grew up as the child of two ministers, my father was a pastor. And during my adolescence, my dad had a depressive episode, a serious depressive episode that he had to take time off from work and really had to spend some time recouping from. And I didn’t realize that that’s what it was called, until I was sitting in my psych 101 class in college and we were talking about depression. And I realized, oh, I know what that is. But my family really didn’t know how to talk about it. My parents were highly educated. One of my father’s best friends was actually a psychologist, but they just didn’t know how to make sense of what it would mean to be so faithful and to even be a pastor, and still struggle with depression. And so that realization, for me was really the beginning of my work. I see myself as someone who kind of acts as a bridge, or a translator, to be able to talk about mental health in the language that we people of faith are familiar with, and to work through some of the stigma that keeps us from getting our needs met.

Wahlberg: 

So I think this brings up a couple of important points. First of all, being highly educated does not mean you are going to know how to seek help for your mental health. Even though Jessica’s father was friends with a psychologist, his difficulties with how his depression related to his faith, particularly as a pastor who is supposed to be a model for his congregation, prevented him from seeking psychiatric help.

Hoogerwerf: 

Right. And while maybe we have gotten a little bit more familiar with mental illness since then, I think it’s fair to say we don’t often hear about these issues from the pulpit. Part of the reason for that may be due to the theologies that we have inherited. 

Whitehead:

Our theologies have ignored the body in many ways, over many years. And it’s been to our detriment, because we are uncomfortable inhabiting ourselves, especially when something physically goes wrong. And we can talk about mental health issues in many ways, whether that’s, you know, a struggle with neurochemicals that aren’t working the way that we hoped they might, or different ways that the brains are wired to interpret the world around us. And we tend to have habits of thinking that there’s some kind of ideal, normalized human being out there. And this is a story that I think theology, and theologians and pastors and others really struggle with, is this, we like to talk about the Imago Dei, we like to talk about the image of God, we’d like to talk about those things. But what we’ve done is we’ve created this kind of average human being. And we tell people that the average human being does this, or acts this way, or behaves in this way, or thinks in this way, or emotes, or can physically do this or that. When our bodies are wildly and vastly diverse, and we tend to, kind of constrict, what human beings can be, rather than expand how we can become by being more accepting and diverse and inclusive of the varieties of humanity that are out there. And mental health is just one part of that.

Wahlberg: 

I’m especially interested in his distinction about different ways of viewing the Image of God. The Image of God is not some sort of average human who is fully able, mentally healthy, and “normal in every way.” 

Hoogerwerf: 

Yeah, I think that’s really important. There’s also the idea that the image of God is more of a communal idea. If we are in the image of God as a community rather than just as individuals, then that includes people with widely varying physical and mental characteristics. And I think it really challenges the notion of the image of God being some sort of average or even above average human who never struggles with mental health.

Wahlberg: 

That reminds me of Matthew 25, which tells a parable about the separation of the righteous from the wicked. As reason for the division, the King says:

“I was hungry and you gave me something to eat, I was thirsty and you gave me something to drink, I was a stranger and you invited me in, I needed clothes and you clothed me, I was sick and you looked after me, I was in prison and you came to visit me.” When asked when all this happened, the King says “whatever you did for one of the least of these brothers and sisters of mine, you did for me.”

Hoogerwerf: 

That verse outlines some of the solutions the church can offer as part of a holistic approach to mental health care. If we count those with some sort of mental illness or disorder as being among the sick or the afflicted, and we know from the research you cited earlier that 1 in 5 people in a given year will experience some form of this, then as Christians we are called to care for them.  

Wahlberg: 

Exactly. And the church is already in a position to play a huge role in this care.

Brown:

We know that often, people for whom faith is very important, the church kind of acts as a gateway. So they might go to a pastor or a religious leader, before they would even go to a medical doctor or mental health professional. But if that leader isn’t equipped, and this isn’t to say that they, you know, have a degree in mental health, because that’s not required. But if that leader isn’t equipped to recognize, oh, this is somebody who might actually need additional mental health support, or even to say, God is with you in your suffering, as opposed to just telling you to stop suffering, right? Then we can accidentally do harm for people and instead of helping them. So I think it’s really important that churches learn the signs of mental illness and really understand how to have conversations about mental health in general, right, normalizing suffering and normalizing even just feeling like you’re not yourself. That doesn’t mean you’re doing something wrong. But it may mean you’re in a period of high stress, and we need some additional support. So I think that’s an area where churches can kind of get stuck. And our work really continues.

Hoogerwerf: 

Okay, so the church clearly has some failures to address in this department. But I wonder what exactly the church’s role should be here. While it may not be as effective as other forms of treatment in cases of serious mental illness, there must be some reason why people so often rely on their church and their faith to address their mental health needs. Aren’t there some ways the church can be beneficial for those struggling with their mental well being?

Brown:

There’s all this evidence that suggests that religious systems and faith beliefs can be supportive of mental health, if people have a benevolent, loving conception of God. So if we see God, as someone who is a parent— a loving caregiver, provider, protector—then our faith is protective, it helps us to support good mental health. But if we see God as angry, or vengeful, or wrathful, it actually can lead to poorer mental health outcomes. So it’s not just faith in a vacuum, but it really is getting into the particulars of what we believe, what we believe about God and what we believe about God’s intentions for us. And so I do a lot of that in my work, because I have people come to me, who really want to be able to integrate the faith in their mental health. And so I have them do some reflective work, right, on what are the messages you’ve gotten about God? What are the messages you’ve gotten about what God desires for you? Right? And how can we use those positive messages to support the way you approach your relationships, the way you allow yourself to rest so that you can manage your stress, your understanding of yourself, and then your ability to make sense of and reckon with your emotional experience?

Hoogerwerf: 

So it’s not just the case that faith and church support mental health, but what we believe that can actually have a greater impact. 

Wahlberg: 

Yes. But the church can’t have that positive impact unless it cultivates a community that can share suffering without fear of judgment. 

Brown:

This also for me, is a real opportunity that we have in the church. Because there are so many Scriptures where people are suffering. And they talk about that suffering out loud to God. Jesus in the garden of Gethsemane, Elijah in a cave saying, Lord, take my life, I’m done. Right? Half of the psalms are David saying, Lord, why have you forsaken me? Right? And so we actually have all of these models of people who realized it was okay to say when they were not okay. And in none of those circumstances does God condemn them for having those negative feelings. But often what happens is when people express those feelings, God sends an angel or some other person to support them and be with them in their suffering. And I think that is the model that we can yield to as a church.

Wahlberg: 

So the church community can be there for each other when their mental health needs support. But as we discussed earlier, it is often the pastor who is first approached when someone in the congregation is suffering with mental health concerns. So if you’re a pastor or someone else who is approached, what should you do?

Brown: 

I would say my first inclination is, if it feels like too much for you, it probably is. Right? Kind of trust your intuition there. And here’s the key. If it feels like it’s too much for you, yes, you put a referral in place, but it doesn’t mean you stop attending to the person. You as the pastor just move into the pastoral care role. And then you get that person connected with a professional who can do that other piece. So you’re still checking in, you’re still praying. You can even check in to see if they made that appointment, right? You’re still maintaining that relationship and support, but you’re recognizing that the person needs support beyond what you can provide in that relationship. And so now the benefit of this process is, now this person has two sets of eyes on them instead of just one. And so we really expand the care we provide. 

Hoogerwerf: 

Talking to a therapist one-on-one can be a great option for many people. But if we want to apply the integrated model of health we talked about earlier, we can’t confine our mental health only to the private space of therapy. We also need to create a space for people to talk about mental health in the church. And this will mean that we will need to get beyond maintaining positive attitudes all the time. 

Brown: 

In the Black church, there is a tradition called testimony service, or TestimonyTime, where people can stand up in community, and they talk about, basically the things that God has brought them through. And that serves at least two functions, probably more, right? The first is that there’s something really personally powerful about telling your story, about being able to look back on what you’ve been through, and name the progress, name how things are better than they used to be, right? And to really articulate the ways God has provided for you. The second piece is that in community, you now send the message to other people who might be where you used to be, that there is hope. That whatever they’re feeling right now, if it is not what they want to feel, they don’t have to always be that way. They don’t have to always feel that way. There’s also this communal accountability that can happen, where now if we know what a person has struggled with in the past, we can be attentive to helping them keep themselves on track. And when we demand that people keep all of those things private, we lose the gifts of growing in community. I think it sends a really harmful message when people only feel like they can talk about good things in church. Because the reality is, all of our lives aren’t good all the time. Right? And if God is with us all the time, if God is omnipresent, God is with us in the good times, and the not so good times. And we need to make space for all of those things to be explored and talked about in the context of our faith communities.

Wahlberg: 

I agree. But it has me wondering about another private, individual solution. 

Hoogerwerf: 

What’s that?

Wahlberg: 

It’s pretty clear that one of the most common responses given to people when they bring up that they are struggling with these issues which might relate to their mental health is to pray more. And I wonder what you think about the effectiveness of prayer – can talking to God rebalance our mental health by being a form of support? Or if it can’t totally fix it in all cases, could it still be a solution for those whose mental well being has not caused serious dysfunction in their lives?

Hoogerwerf: 

Those are good questions. And we asked some of them in an episode we did on prayer several years back. There’s a pretty famous Harvard study on the effects of intercessory prayer on medical outcomes, but there was a lot of criticism of the studies’ methodology and assumptions about what prayer is. And, I think, more importantly, I just think that trying to study empirical outcomes of prayer kind of misses the whole point. Doesn’t it make prayer into something which we use to get something we want, without considering the person’s relationship with God or even the person they are praying for? 

Brown:

We need prayer and action, right? So imagine somebody in a church has a heart attack, right, during service. We pray, but we also call 911. So in that circumstance, we don’t feel this forced choice, right? We do both. And that’s all I’m advocating for. There’s never a situation where prayer is not a good idea, right? But I think we also—faith without works is dead. And so when we pray, we are also called to action, to continue to support people. So for me, it’s about, yes, praying that God will heal, but also praying that God will give this person to the right provider, or praying that a situation can change so they can have less stress in their life, right? And we have responsibility as individual believers for doing the work that we need to do to work toward our healing. And so that’s why it’s important, from my perspective at least, that for those of us who are believers, we don’t just find any therapist but we actually find a therapist who can help us to integrate our faith and our mental health. 

Hoogerwerf: 

And here’s Jason on prayer.

Whitehead: 

There’s a story that always runs around in in theological circles of the guy on top of his house as the floodwaters rise. And, you know, the first boat comes by and says, you know, hop in, we’ll rescue you. And he says, No, you know, I have faith that God will save me. And the second boat comes by, same thing happens, the third boat comes by, same thing happens. And then he drowns. Gets up to heaven, looks at God and says, Why didn’t you save me? God, of course, says I sent three boats. What more do you want? And so we have this idea that prayer is answered through epiphany. Sometimes it’s just answered through that small rescue boat. Or that person that says, How are you doing? And our responsibility in the relationship is to say, I’m not doing well. And I’m having trouble hearing God’s way for me through this. And our responsibility as human beings is to sit with them and say, “Tell me what’s going on. And let’s see how God might be speaking to both of us. So that we can interpret and we can move forward.” 

Wahlberg: 

Clearly prayer has a role to play here, but we shouldn’t expect it to be a candy machine we can drop a prayer in and get a bit of healing out of. There is also an aspect of community and action that is important in prayer. One action that might come from prayer could be seeking the help of a trained therapist.

Hoogerwerf: 

Yeah. And a lot of people who decide to seek therapy as a mental health treatment worry about finding the right therapist. For Christians, though, this can really be focused around finding someone who understands and respects their faith. I guess the question I’m getting at here is, if I’m a Christian looking for a therapist, does my therapist need to be a Christian?

Brown:

I think it’s perfectly fine if you’re seeing someone who’s not religious or not a Christian. I think it’s important to ask the question up front. “I am someone who has this faith tradition, it’s very important to me. I need to be able to talk about that and incorporate that into this experience. Is that something you can do?” And if they say yes, then you try it out, right? I have—so I sort of publicly advertise as someone who is Christian and works with Christian folks, but I have clients who are atheists, who are Buddhists,, who are Jewish, who are Hindu, right, and so I don’t share their religious beliefs. But what I can offer is that your worldview will be incorporated into the way we work together to help you heal. And that commitment is something that a therapist can hold, regardless of their personal religious or spiritual beliefs. 

Wahlberg: 

Therapy may not be the solution for everyone, and for those who do see a therapist it might only be temporary, but regardless it’s helpful to know that there are therapists, both Christian and non-Christian, who have the understanding and respect for faith to recognize its importance in our lives. 

Hoogerwerf: 

And for those who do seek help from a mental health professional, there are bound to be other worries about what this person is like and whether they will be the right fit. As our holistic model of health suggests, just going to therapy won’t be enough to nurture mental wellness. We need to tend to our health in other areas as well. Our theologies, church community, and personal faith will have roles to play. 

Brown:

This was something that was known in Bible times, too: healing is holistic. And so because all of the parts of our experience are connected, there are multiple points of entry for healing. What I talk to my clients about, is thinking about the areas of holistic healing that are most accessible to them, that will support their overall health. Going to therapy one hour a week, and doing nothing else to change your life, probably will yield limited results. There’s only so much we can do in that hour. And so the therapy hour is really about planning and strategizing for the rest of the hours in that week. What I suggest to people is, maybe pick one or two strategies that are accessible to you, that are easiest to integrate and give you the most bang for your buck. so to speak, right? And then focus on organizing your life around those strategies.

Wahlberg:

These strategies can become part of the stories we tell in our faith communities.

Whitehead:

since we gather around stories, we have to start telling stories about what it means to be diverse, inclusive, curious people together. I mean, you know, think about it for yourself. When was the last time in a church, you heard a positive story about therapy, or coaching, or finding the right medication to treat a mental health issue that you’re experiencing? I mean, I daresay any of us could find that. You know, and those that do, or are few and far between. You know, we look to me, again, this goes back to categories to some extent, but we look down on what we don’t understand. And so, having communities where positive stories about treatment and recovery are integral to who they are, and how they move, and live, and breathe together. To me, it just forms the basis of the basic nature of that response. You know, living breathing stories of interdependence, and asking for and receiving help, which change the ways that we think about what it means to seek help.

Hoogerwerf: 

Ultimately, stories of mental health can become something we as Christians gather around in support. But we shouldn’t expect this to be easy or that it won’t involve suffering. Mental illness and its relationship to spiritual life is immensely complicated. 

Webb: 

Mental illness is a mystery. And I would say it intersects at the mystery of humanity, the mystery of our brain, which, personally, I’m not so sure that we will ever really understand the brain, it’s so enormous. I think that we shouldn’t throw up our hands and say, “Oh, forget it, why even study it, because it’s so amazing and complex.” I think we should study it. But what’s so remarkable is that we are this thing that is so amazing. And that is beyond our understanding. And truly, if we can’t even understand ourselves, how can we understand what mental illness is? You know, if we can’t understand the brain, if a simple neuron is so majestic and amazing, and we are just beginning to scratch the surface of how powerful and incredible it is, how can we understand the interaction of all those neurons and mental illness in the midst of that? And then how can we, you know, have simple formulas for how God sees mental illness and how God is at work, potentially in the midst of mental illness, for someone?

Wahlberg: 

We began this episode with a story from Jason Whitehead about a patient whose experience of suffering completely uprooted the theology he had adopted up to that point. 

Whitehead: 

And when I encountered this particular person, how do you teach someone to be grateful for being abused by someone of faith? How do you find beauty and God in those stories? And so, you know, in that space, I’m a person who is really curious and constantly seeking answers, or at least seeking better questions. And I’ll say that she was a person who propelled me to want to be better at what I do, and better at sitting with people’s pain that they experience, whether it’s in the church, whether it’s in families, whether it’s, whatever their experience of pain is, being able to stay with it, rather than run to the easy answers, that sometimes we allow our theologies to create for us.

Hoogerwerf: 

I think that’s a good model for us to strive for moving forward. To be able to sit with people in their suffering before we try to fix things or condemn them for something we don’t fully understand. And ultimately, to be able to find beauty and God in these stories without discounting the pain.

Wahlberg: 

But it’s also important to have resources for professional help when that is required. We’ve linked a number of these resources in the shownotes. Thanks so much for listening!

Wahlberg: 

Thanks to Jason Whitehead, Marcia Webb and Jessica Young Brown. 

Hoogerwerf: 

Language of God is produced by BioLogos. It has been funded in part by the Fetzer Institute, the John Templeton Foundation, and by individual donors who contribute to BioLogos. Language of God is produced and mixed by Colin Hoogerwerf. That’s me. Nate Mulder is our assistant producer. Our theme song is by Breakmaster Cylinder. 

BioLogos offices are located in Grand Rapids, Michigan in the Grand River watershed. If you have questions or want to join in a conversation about this episode find a link in the show notes for the BioLogos forum or visit our website, biologos.org, where you will find articles, videos and other resources on faith and science. Thanks for listening.