I’m going to ask that as a truly open-ended question. Do we, namely, (Catholic) Christian academics, care about mental illness as a serious locus theologicus, a phenomenon demanding serious theological reflection?

For the sake of naming my positionality, I will say that I ask this question as a Catholic Christian theologian training at a prestigious university to teach systematic theology at the college level and to research for the academy, the church, and society. So, in other words, I must admit I’m not primarily a pastoral theologian, a Christian clinician, or somebody engaged first and foremost in practical theology. I will write and teach in a scholarly fashion. Probably my direct audience is comprised of other academics.

I would, however, like to think that my theological concerns are not only rigorously intellectual but also intentionally tethered to the reality of life as we experience it: as part of a living tradition of Christian faith, as part of our quotidian existence as it unfolds everyday. I want the theology that I do to invite the fruitful convergence of the theoretical and the practical. I think this goal is especially achievable in the subfield of theological anthropology, which is my main area of expertise.

In employing the term “mental illness,” I am appropriating NAMI’s definition, which states that mental illness is “a medical condition that disrupts a person’s thinking, feeling, mood, ability to relate to others and daily functioning. Just as diabetes is a disorder of the pancreas, mental illnesses are medical conditions that often result in a diminished capacity for coping with the ordinary demands of life.” Types of mental illness include depression, schizophrenia, schizoaffective disorder, bipolar disorder, eating disorders, borderline personality disorder, obsessive compulsive disorder, anxiety disorder, autism spectrum disorder, post traumatic stress disorder, etc. Conditions associated with mental illness include insomnia, suicidal ideation/attempts, psychotic episodes, etc.

Specifically, I ask this question about mental illness and our attitude toward it because I see that people — all sorts of people — are suffering on a daily basis because they live under the burden of mental illness. I believe that their suffering is intensified by the fact that they are often rendered invisible at best and demonized at worst in our society and probably in our church as well (though there are some good sub-pockets of support here and there in both forums).

At one level, it’s a question about what “we” can do for “them,” but even phrasing it that way is too easy. Many of us struggle with various forms of mental illness. So I think that we need to keep both poles of this diagnostic tension in mind:

On the one hand, mental illness affects large swaths of our population (for example, the homeless population throughout the United States) and should not be divorced from the kind of structural analyses that are geared toward issues of class, race, gender, sexual orientation, body type, age, and disability. Mental illness tends to become worse for abjected peoples in society (there’s some kind of correlation there, which still leaves open questions about causal lines). But, at the same time, it is a complex phenomenon that cannot be reduced to any particular condition and predicted ahead of time. Anybody, even a person who ranks among the most powerful in society, can find herself subjected to the burden of a mental illness. With all this in mind, I believe that we in the academy are perhaps in a position to evaluate mental illness with a social, structural lens in place, especially because these issues affect society as a whole beyond the academy. I think we should do so.

On the other hand, I would hope that we in the academy would not rest too comfortable in the “we” language that risks a false sense of hermetic protection from “them,” from those other people who struggle with mental illness. No. This is uncomfortably up close. We struggle with mental illness. Many of us are mentally ill. Emphasizing the first-person-ness of mental illness puts me in mind of Allie Brosh’s poignantly self-disclosive, brilliant chronicling of her encounter with severe depression. It’s a first-person account, importantly, and it has been massively popular. It has clearly struck a significant note with people. Hmmm.

But based on impressions gleaned from various personal and professional encounters over the years, here are a couple formidable barriers I see to our having a serious theological conversation about mental illness in the Catholic academy. I’m calling it like I see it. (Also, it would be really great if everybody reading this post recognized that I am responding to a series of specific interactions I have had and witnessed with various people in Catholic academic contexts over the years. So the potential response of: “Well I’M a Catholic theologian and being the good way about these issues and I’m therefore pissed that I feel unfairly called out in this post” is a misfire and a waste of energy. Just because you may already be conscious of the things I am identifying doesn’t mean everybody is.)

First, we Catholic Christian theologians rightly want to offer a sharp critique of American consumerism and of anything that smacks of bourgeois comfort (do many of us also have many of those bourgeois comforts? Yeah. But that’s a post for another day). So sometimes when we think about our country’s pharmaceutical complex, we think about the problematic culture of shallow, possessively individualistic, permissive self-medication. The trope of “There’s a pill for that!”–& such. Perhaps we also have in our minds this image of indulgent, emotionally absent parents obtaining a trumped up ADHD diagnosis for their actually-emotionally-starved-yet-acting-out children so that they don’t actually have to pay any attention to them and can go back to their Smart Phones and Business Meetings. –Okay, this is probably devolving into a series of clichés from a romantic comedy involving Jennifer Aniston, or Natalie Portman in one of her movie-making ruts, but you get the point.

I do agree that these problems are in our society. We Americans do have a tendency to self-medicate in an indulgent and selfish way. Yes.

So, now, when I go on to make a different point, don’t then illogically think that I don’t recognize the commonly decried problem that I just named. Here’s the distinct point I want to make: it is not only unhelpful but also damaging to enfold all issues of mental illness and psychological treatment into a critique of American (psychological/pharmaceutical) consumerism and thereby to condemn such treatment, even unwittingly. This is a problem of going too far in our diagnostic castigation. We may not even always know when we are doing it. But when we are tempted to launch into a critique of American self-medication through pharmaceutical means, it would behoove us to choose our words carefully and to realize, chastened, that some people need psychological and psychiatric treatment to function on a daily basis. For many people, getting treated for their mental illness is the difference between life and death. We’re outside the realm of self-indulgence in these cases. And whenever we rail against the culture of permissive self-medication and don’t qualify our claims at all, it’s likely that we are secretly hurting somebody listening to us, somebody who needs psychiatric treatment or even just therapy to function and to cultivate a basic sense of self under duress. This kind of unwitting stigmatization increases the burden of having a mental illness and compromises our supposed identity as the Body of Christ.

Second, relatedly, I think that, at least in some Catholic academic theological circles, there’s a real allergy to contemporary psychological approaches to the human person. I sort of get that in part, especially since the antipathy is somewhat mutual. I’ve read enough psychology at this point to be familiar with the commonplace idea that God is only some sort of projection mediating psychological needs and fears (and this in itself is also a theological and philosophical idea going back a couple centuries now). Reading that kind of thing over and over again gets pretty tiring if you’re a theologian who thinks God actually exists in some kind of theonomous relationship with creation.

So, given this acrimony between theology and psychology, I think what develops is a sort of turf war regarding who can more adequately categorize the depth desires of the human person: are we all about our desire for God and/or God’s desire for us, or we all about drives and complexes that have nothing to do with God? (And, as you can see, the competing systems of explanation are set in diametrical opposition, natch.) This is a really complicated architectonic divide between fields, so I’m not going to weigh in much about the divide as such. In general I think it would behoove theologians to take the insights of contemporary psychology more seriously. The social sciences are clearly not above critique and critical distance, but becoming familiar with the basic moves of contemporary psychology does not entail a slavish devotion to one particular psychological school of thought (and yes, psychology is not a monolithic field!). Basically, I think that employing the right kind of psychological insight into the human person can increase our theological acuity in such matters.

Specifically, for example, something like therapy can dramatically help people explore the wounds and traumas of their childhood or also help them examine and then transcend distorted thought patterns diminishing the quality of their life. It’s important to keep this in mind if we feel tempted to rail against “the culture of the therapeutic.” We theologians need to make sure we check out pejorative connotations with “the therapeutic” against the reality that therapy can be a necessary source for people who are working through wounds and managing mental illness.

Anyway, I want to put these barriers on the table so we can discuss and perhaps work through them. I went to the annual convention of the Catholic Theological Society of America meeting recently (and I really, really love that society). While I attended many stimulating talks about ecology, interreligious encounter, the mission of the Catholic Church today, the problem of white supremacy, etc., I couldn’t help but wonder, especially at the plenary sessions where hundreds of members were in attendance: how many people sitting here are struggling under the burden of mental illness? How many of them assume their mental illness to be outside the consideration of theological analysis? What can we do to begin to address theologically the problem of mental illness and to provide companionship and de-stigmatization for those (of us) struggling with such conditions?

Do we care about mental illness?

31 thoughts

  1. Yes! From my perspective as an Anglican priest it is about moving from the medical model to therapeutic model that positively embraces and nurtures the individual. I found that the Rainbow Project (Uniting Church Australia as borrowed from Canada) was way forward in friendship meals and support group that has meant a lengthy reflection on the theology of community and compassion. Stimulating post.

  2. I really like this post. I put off therapy and medication for years because of an internalized combination of the two things you are talking about here. When I finally did seek psychiatric help, I learned that depression is actually brain degenerative. Oops. Pills of course have their own issues: eg, it can be hard to see how much your personality can be shaped by chemicals. Now I never really was into theological anthropology, and don’t read much of it. But the experience of finding some of my very sense of myself to be so biochemically malleable does seem to be in a pretty different realm from a lot of the (admittedly limited)TA I’ve seen.

    1. Awww, that makes me sad. But I’m glad you’re getting the care you need now. In line with your last point, I would really like to see theological anthropology deal more with the insights of contemporary psychology. Now, this is just an impression, but I feel like that sort of engagement went out of fashion a few decades ago. We had people like Tillich and Niebuhr doing some kind of engagement with existentially-influenced psychology in the mid-twentieth century, and then we got bored with that. But I think it would be great to revive a discussion between psychology and theology in a Catholic context.

      By the way, congrats on baby.

      1. Actually, I was wondering if there was anyone currently working with that kind of existential psychology? I read a lot about how Tillich’s theological anthropology was influenced by that line of thought when I worked on my M.Div synthesis seminar project (it looked at pastoral responses to Intimate Partner Violence), but I haven’t found anything that engages that from the last decade (or two? I think the most recent thing I found was a dissertation from the late 80s).

        That quest aside, I really, really appreciate this post. Especially the comments about the pejorative language theologians tend to use about things such as medication or therapy. As someone who once held (holds?) those tendencies, this is a really important reminder that I try to take to heart.

      2. You know, I think in circles outside our particular university, there might be more happening in these avenues. Somebody mentioned to me recently that Tillich and Niebuhr are still a pretty big deal at Union in NY, for example. And, if I recall correctly, there’s an AAR group devoted to Tillich still. It’s just weird, b/c these figures, examined through this optic, were pretty much absent for me in my training. I feel as though I’m doing my own private catch-up in my own little world.

        Thanks for the compliment!

      3. Do you think any of that loss of interest in psychology might be attributed to a shift in psychology itself from more speculative stuff like Freud and Jung into the more scientific paradigm of clinical psychology? Tillich was able to draw on “depth psychology,” which had quasi-spiritual aspirations. I’m not sure contemporary psychology has those aspirations (which isn’t necessarily a bad thing).

  3. Thanks for this, E! This reminded me of one of the best pieces of creative non-fiction I’ve ever read, the final chapter “Three Spheres,” of Lauren Slater’s memoir _Welcome to My Country: A Therapist’s Memoir of Madness_. In particular, it reminded me of a particular part of her essay, that she is writing to therapists, but I think is enormously relevant to theologians as well. She writes, ” …another, more subtle yet powerful message gets transmitted to practitioners in the field. This message says Admit your pain, but only to a point. Admit it but keep it clean. Go into therapy, but don’t call yourself one of us if you’re anything more than nicely neurotic. The field transmits this message by perpetuating so strongly an us-versus-them mindset, by consistently placing a rift between practitioners and patients, a rift it intends to keep deep….”
    All to say, her essay’s great, and I highly recommend it. And thanks for this great blog post! :)

    1. Yeah, I really like that excerpt a lot. I’ll have to check out her memoir. That definitely gets into the dynamic that I really want to avoid, namely, of theologians distancing ourselves from the experience of mental illness so that we can somehow appear more “spiritually clean” or “professional” as “we” help “them.” That kind of language makes me really uncomfortable since the statistics alone suggest that a hefty portion of us in the theological guild are dealing with the same shite. Thanks for helping me name that further!

  4. This is a great post and one that is so necessary. As someone who sits at a parish secretary’s desk all day – and I do not mean this disparagingly – mental illness is everywhere in the church. I’m talking about the people who come to the office or call and about those of us who work in church. I also just came through a pretty bad and unacknowledged (by myself) period of depression. My manic glee is often taken as some kind of pastoral gift. *sigh*

    When we allow mental illness to be masked by any number of things – piety in some, disenfranchisement in others, and God knows what else – we journey further from God, not closer, we journey away from one another – that is the pity.

    Lots to think about here. And did I really just write this and press post?

    1. Fran,

      Thanks for your honest reply. I definitely agree with you that mental illness is everywhere in the church. The same can be said about our society, though I wonder if those of us who are Catholic are socialized to not want to admit or deal with that as it regards our place and community of worship. Again, thanks for calling it like you see it so honestly. And I’m glad you can name your own struggles; I hope there are good people around to support you.

      1. “My manic glee is often taken as some kind of pastoral gift.”

        A close relative of mine is in a very similar situation, and I don’t know, I think it’s entirely possible that it IS a genuine pastoral gift. That doesn’t mean it’s good, or worth the attendant costs, or that it’s not part of horrible and undeserved suffering. But…well, take someone who’s exceptionally sensitive to others’ moods and good at listening–because she grew up with a volatile and abusive parent. Couldn’t that sensitivity still serve her well in a pastoral situation? I am not saying it’s worth it. It is not worth it. But that doesn’t mean you can’t use it.

  5. I would submit that among the mental illness categories listed, there is a very significant omission: drug and alcohol addiction. The stigma attached to these is, perhaps, even worse, as many people regard addiction as a choice. I suggest that no mentally healthy chooses to steal from those they love, risk arrest and disease, etc., etc.

  6. Very important topic. Discourses which discuss intellect and will in the abstract should almost be seen as comical at this point…. Young 30 something would be Thomists take note….The magisterium itself could provoke mental illness in many thinking persons when one looks at how efforts like that of Margaret Farley and Salzmann are treated. One should avoid being caught in the master-slave dialectic and seek fresh air and sunlight. Paternalism and Maternalism (as in “holy mother ecclesia”) are equally suffocating.Ricoeur, “Fatherhood from Phantasm to symbol” has some nice inspiration. The JPII-BXVI era may be seen as regressive, a kind of ice age in many ways. Now we see if we can catch up to about 1968 even though we are in 2013. Yes, plenty of mental illness to go around among theologians, philosophers, and even mere human beings. Speaking openly about issues like depression might help us catch up to with where psychoanalysis is and pious platitudes are not.. Folks like Sebastian Moore were aware of these issues. Few are willing to speak openly but there is a ray of hope. Maybe Jesus got depressed…and wept over the city saying,”If you had known…Maybe Pope Francis will shake the cage a bit…but a caged bird stands on the grave of dreams….Maya. Great Blog.

  7. I have a LOT of thoughts about this topic. Thanks for this post! It opens up some exciting (wc? whatever) areas for discussion.

    1) I appreciate and agree with your calling out the “we” versus “them” language when it comes to mental illness. I have many friends and family members in the academy. I have many friends and family members in the church. Put simply, most of us deal with mental illness. It is “we”; it is not “them.” When I tell friends about my depression, I’ve learned to expect the, “Um, yeah, me, too” reaction, because that’s almost always the reaction I get.

    2) “I believe that we in the academy are perhaps in a position to evaluate mental illness with a social, structural lens in place, especially because these issues affect society as a whole beyond the academy.”

    You gesture toward the falseness of claiming any “objective” viewpoint later, but I think you could and should go much, much farther. In my experience and those of my nearest and dearest, the academy is itself deeply sick. If we want to call attention to the social, structural aspects of mental illness, what exactly do we call the phenomenon of the prelim? What do we call adjunct positions? What do we call the tenure review? Within psych research, how would you classify Diederik Stapel (http://www.nytimes.com/2013/04/28/magazine/diederik-stapels-audacious-academic-fraud.html?pagewanted=1&_r=1&)? To put it harshly (perhaps too harshly), I think the academy is far too busy fostering and exploiting mental illness to be in any position to evaluate its social and structural aspects.

    3) And if you made it past that rant, here’s some embarrassing self-disclosure. I was struck by the repeated phrases “contemporary psychological approaches to the human person” and “psychological insight into the human person.” I’ve dealt with debilitating depression for literally as long as I can remember, but only in the last year have I had to deal with feeling as though I had lost myself. I cycled through more than a dozen psychoactive drugs, some of which affected my personality (as described by a previous commenter); I left a job (academia) that had given my life meaning; and I underwent ECT, which led to extensive memory loss. I wrote about it here: http://606howardstreet.wordpress.com/2013/05/18/i-dont-remember/

    I would describe myself as a well-read amateur in theology, so I have no idea what work might be out there on the malleability of self in the face of trauma. But in the past few months, all talk of “the soul” has left me cold, empty, slightly contemptuous. The model of personhood taught within mainstream Christianity is no longer adequate for me.

    4) Perhaps “exciting” is the right word choice, after all. When I think about all these questions right now, there is sadness, anger, confusion, hope; but there’s also that spark of excitement, the catch of the breath that I rely on to tell me: this is a problem worth working on. This is something that could be really, really cool. Theologians, I think, should concern themselves with psychology and with contemporary models and experiences of mental illness, but not (just) because it would be the useful or the compassionate thing to do. You should work on this because it would be awesome. Because it would be interesting. Because it would open up new ways of thinking about people and about God and about people with God. And if awesome, interesting, novel ideas don’t beat back the darkness, then I don’t know what will.

    1. Hey Mary,

      Thanks for your engagement. I know this issue is really important to you (as it is to me), and I’m glad I’ve at least asked the question in the right way, i.e., to incite some excitement.

      1.) Ditto on this point, namely, the ubiquity of mental illnesses, especially though not at all exclusively depression. I would say that a really hefty portion of people in my collegial and social networks deal with mental illness, and we discuss these struggles not infrequently during personal conversations. But then I go to my academic conferences and work on my dissertation, and it’s like these things just…don’t exist, at least based on the issues that we in the theological guild discuss. The divide feels especially notable to me since, as I said, my area of expertise is theological anthropology and I am a systematic theologian (i.e., not a pastoral or practical theologian or involved principally in ministry).

      2.) Yes. I’m still thinking through the contours of this diagnosis right now, but…yes. Agreed. I mean, I still want to put it on the table that mental illness is at least in part a structural problem that deserves intellectual attention (it’s just sort of…invisible as far as I can tell right now), but I think you make a good point that this kind of analysis probably can’t happen without some serious self-interrogation on the part of the academy. Good point.

      You may have already seen this, and I haven’t read through all of these so if they suck I apologize, but The Professor Is In has a bunch of posts about mental illness and the academy. I’m going to go through them more seriously next week.


      3.) All I’ll say for now is that I’m really sorry about the serious disruptions you’ve had to deal with and that you’ve mentioned here. Okay, and I’ll say one other thing: your point about the lifelessness of the Christian concept of the soul as regards personal identity is something I’m going to think about indefinitely as I do my work. When Christian concepts become sterile in the face of deep suffering, that should stop us theologians in our tracks, in my opinion.

      4.) I would like to get more involved in doing work at the intersection of theology and psychology, and I would love to be in further conversation with you as that unfolds. I’m glad you commented!

  8. Here’s what my aunt, who was a practicing psychologist for many years (and whose husband and father were priests), had to say on FB:

    ‘”Second, relatedly, I think that, at least in some Catholic academic theological circles, there’s a real allergy to contemporary psychological approaches to the human person.” Yup. Seen that one up close. “I sort of get that in part, especially since the antipathy is somewhat mutual.” Nope. Totally does not apply to any of my therapist colleagues or professors.’

    1. Yeah, I think that’s why I put in the word “somewhat.” Perhaps I should have said “in some circles.” I’m responding to the psychological literature I am reading on the distinction between guilt and shame right now. There are some presuppositions in that discussion that aren’t super friendly to Christianity (or maybe religion in general; I don’t know), though that certainly doesn’t represent the entire spectrum of viewpoints out there.

  9. I think I am in a good position to respond to this post because I’ve studied theology as a lay person and am a psychologist in my professional life. My background is strongly psychoanalytic.

    A couple of thoughts that should be highlighted:

    1) Although biological psychiatry has dominant sway in modern US mental health care, there is a growing recognition that childhood trauma and neglect play a significant role in the etiology of mental illness (see my writing here: http://itself.wordpress.com/2012/04/12/psychopathology-and-abuse/). My doctoral work in on psychosis. More and more researchers are realizing that experiences of neglect, incest and childhood physical/sexual abuse can cause psychosis. If theology is supposed to be oriented towards the most vulnerable, then I would argue that helping and empowering individuals with psychotic illnesses would be a good place to start.

    2) There should be a criticism of the ways in which biological psychiatry has drugged modern Americans. First, poor people and poor children are particularly vulnerable to being overmedicated on antipsychotic medication (http://www.sciencedaily.com/releases/2013/03/130315150855.htm). Second, biological psychiatry is not producing the results it promises. The rising rates of disability in this country suggest that these individuals are not recovering. Third, the medication-first model often prevents people with severe mental illness from receiving the psychological care they need. While medication can play a role in treatment, it should be noted that it is not a panacea. In my opinion, psychotherapy should always be the first option and medication should be used if necessary. Research demonstrates that individuals with schizophrenia have better rates of recovery when they use antipsychotic medication sparingly. Fourth, I agree that the ways in which leftists criticize the mental healthy system is mostly unhelpful. Moreover, the whole consumerism critique is worthless and mis-locates the critique by blaming individuals rather than the money-driven psychiatric system. I will say that there are many children who come to me and implicitly demand that I reassure them that there child’s problem is biological and not environment. That happens often.

    3) My friend and I have written a critique of the new DSM-V and the state of modern mental health care here: http://itself.wordpress.com/2013/05/06/cause-and-effect-in-modern-mental-healthcare/

    4) Finally, the clash in world-views between theology and psychology is something I often have to confront when working with individuals in psychotherapy. Patients who are religious and have experienced unspeakable childhood traumas often wrestle with the theodicy question. The shallowness and hollowness of theodicy that is offered in most American churches (probably more Protestant than Catholic) makes these individuals feel alienated and ashamed for having doubts. Recently, a patient of mine confessed that she’s spend her adult life trying to avoid the question: Did God abandon me just like mother did when she allowed those men to sexually abuse me? The church cannot handle that question. It does not offer a space for reflection. I’ve written further about some of my reflections on theodicy and child abuse here: http://itself.wordpress.com/2012/09/23/child-abuse-and-theodicy/

    Thanks for the post. Hopefully some of my comments will be helpful since I’m on the other side of the aisle.

    1. Thanks for the comments, Jeremy! Very helpful. I might be in touch with you about this in the future, as I am a theologian trying to engage with psychology to help improve theology.

  10. Sounds good. I post somewhat regularly over at AUFS, if you’re interested.

    I’ve always thought that liberation theology excluded the mentally ill as a group that deserves focus and attention. Theologians frequently write about other oppressed groups but strangely enough often omit the struggles of the mentally ill in their writings.

    1. I think we’re inhabiting the same brain space right now; I’ve been pretty confused about this lacuna in theology for awhile and am finally starting to articulate some of that.

      I should say that I’ve been rereading Gutierrez lately (_A Theology of Liberation_), and I think there’s something there to work with (i.e., his concern about poverty precisely because it’s a threat to personhood and spiritual health), but that hasn’t really been developed in the theological discourses over the past few decades. Thanks for commenting.

  11. I’ve had the fantasy of trying to write an article or conference paper on why liberation theology needs to carve out a space for those experiencing intense psychological distress. One of my favorite images from the gospels is that Jesus throws parties and has dinner with the poor, the marginalized, the criminal and the psychotic.

    One of the reasons why there might be little written on the intersection is that religious folks have difficulty distinguishing between the psychological and the spiritual. As a result, they retreat from having these conversations.

    Let me know if you’re ever interested in pursuing this train of thought with me. Theology could benefit from this conversation.

  12. I would have attended but it’s the same weekend at another conference I’m attending. I’m moving to the Berkshires in a couple of months to begin my post-doc. Maybe next year I’ll pay it a visit.

  13. I think one of the most important things about Catholicism or religion more generally is how it encourages a regular form of therapy. Not just confessiom, but more so self-analysis in prayer, of which the examen is a especially pronounced example.

  14. Pingback: For Shame | WIT

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