An Introduction to Mental Illness in a Theological Context

WIT welcomes MeganWildhood as a guest contributor. Megan is a creative writer, scuba diver and saxophone player working at a crisis center in Seattle,WA. Her poetry chapbook, LongDivision (Finishing Line Press), is about sororal estrangement and she’s currently working on a novelnarrated by a character with a mental-health diagnosis. She has a Bachelor of Arts in Christian Theology and wants to connect with readers, activists and weary humans around issues of mental health, challenging dysfunctional systems conflict and defiant hopein these tattered days.

I was the lone theologian among psychologists sitting on the “Faith and Mental Illness” panel my alma mater’s chapter of The National Alliance on Mental Illness (NAMI) was hosting. This panel, unbeknownst to me, had been scheduled as the pinnacle event at the end of a week filled with much-anticipated conversations and workshops. After what turned into a febrile debate about the merits of the biomedical model of mental illness (essentially, that mental illnesses are caused by chemical imbalances in the brain), audience members began forming a line to ask questions. It turned out, most of their questions were for me and a majority of them were some version of, “My [insert family member here] doesn’t believe you need to go to a doctor for any of that ‘mental stuff,” you just need to pray harder. How do I respond to that?”

These were questions I’d been wrestling with for years. I had maybe five minutes to respond. Here is what I said: 

“The Church has a long history of responding to distress – the term ‘mental illness’ is relatively recent – with exorcism, which has morphed into the belief that sick people don’t have enough faith. What that basically says is that those who suffer from mental, emotional, physical or spiritual distress are not only ineligible for God’s grace since they would need to do something more (pray) to get it, but they are so lacking because they’re suffering. I’d remind your family member, gently of course, that Christ says the exact opposite – it is the sick who need a doctor.”

Perhaps the reason this was the most common question I received is because the Church as a whole has remained largely silent on mental illness even as the culture has become a safer place for those with lived experience to share their stories. To be clear, mental illness remains highly stigmatized in the culture, too, but I’ve only been to one church where the pastor openly preached about it and have felt more comfortable talking about my own lived experience with nonbelievers than with those Christians. Silence breeds ignorance, fosters misinformation and encourages fear. There has been great theological work done on theology of race, gender, even disability; there is still not systematic theology of mental illness. Because the Church has continued to ignore mental health, its members legitimately don’t know how to respond to mental-health issues. Those without specific training in psychology, counseling, social work and other such fields probably care very much for their friends or family members who are suffering, but they likely feel unequipped to help and worry that they may do more harm they good. It makes sense that they would turn to the One they believe is all-powerful and all wise. But this is one reason why my generation (I’m a Millennial, albeit an ‘old’ one) is leaving the body in droves: praying for people with mental illness, whether privately in your own home, briefly after service or in extended prayer ministry (which, in my experience, often turns into a bombardment of exhortations to forgive one’s traumatizer), is not working.

It’s not that I think prayer is necessarily ineffective for mental and emotional distress. It’s also not that I think all mental-health issues are purely physical and lack any spiritual or relational component. But Jesus didn’t actually pray for the sick – not in the “let me pray on this and get back to you” way that many of us who have lived experienced of mental-health challenges have experienced from well-meaning church folk. Jesus healed the sick. He didn’t use prayer as an excuse to detach from relationship or as a reason to delay responding to those in distress, physical or otherwise. And he expects us to do the same. He did not tell us to pray for the sick, He told us to “Heal the sick, raise the dead, cure those with leprosy, and cast out demons. Give as freely as you have received!” (Matthew 10:8, NLT). What we should conclude from this is that prayer is not a replacement for action. Yes, it’s that ‘faith without works is dead’ idea. As long as prayer is seen as action – that is, as long as prayer is the only response to those undergoing mental and emotional distress – it will not “work.”

This is shaky ground, though. On the one hand, Jesus does indeed affirm that those who are sick are the ones that need a doctor and there’s no reason to believe he’s being only literal or only metaphorical here. On the other hand, Jesus also says to multiple people, “Your faith has made you well.” On the one hand, Jesus ate with sinners and tax collectors, not the beneficiaries of Roman and Jewish society. On the other hand, Jesus expected more from those who would follow Him than any previous teaching. On the one hand, “more prayer,” however well-intentioned it is, fails to adequately respond to those experiencing mental and emotional pain. On the other hand, I don’t believe the biomedical model has sufficient evidence to be the ruling paradigm it is, nor do I believe it sufficiently explains the various ways people are in pain. While our culture is becoming more open to experiences of depression, anxiety and even bipolar, it hasn’t given us many ways to properly attend to the agony of mental illness other than diagnosing and labeling. Diagnoses, which are merely labels for sets of behavior, come from the Diagnostic and Statistical Manual (DSM), now in its fifth edition, which is put together by a committee of psychiatrists, many of whom have financial ties to pharmaceutical companies, rather than any biological or medical test. The disorders in the DSM, the number of which have been expanding since the first edition in 1952, are built by observing behaviors and self reports of subjective experience; the DSM has been pathologizing normal human experience ever more with each new edition. Just a few examples: Up until the DSM-3, homosexaulity was listed as a mental disorder. The current version, DSM-5, has dropped the bereavement exclusion from a depression diagnosis, which means that the normal human experience of grief after loss is now available for “treatment,” which commonly means medication.)

Scripture has given us a place to start. No, I’m not about to exhort you to go love your neighbor struggling with mental illness more. You already know what Jesus says about who our neighbors are and how we ought to treat them. What I will recommend is reading Lamentations (which means grief), Job (42 chapters challenging the justness and goodness of God and the Proverbial assertion that we live in a reaping-and- sewing-universe), the 88^th Psalm (the only one in the Psalter that doesn’t end with a turn back to God – it closes, quite literally, in darkness), much of the Minor Prophets, Jesus’ cries of anguish both before His execution and with His last breaths on the cross, as a place to start. That texts such as these are canonized along with the likes of the Gospels, a detailed chronology of the Apostle’s first activities and Paul’s letters means that the whole range of human expression from elation to despair has a place in the holy narrative.

Psalm 88 is my favorite example. This psalm recounts a speaker whose soul is filled with troubles that the speaker attributes to God: “You have put me in the depths of the pit, in the regions dark and deep. Your wrath lies heavy upon me, and you overwhelm me with all your waves” (Psalm 88:6-7, ESV). It also is the only one in the Psalter that does not end with a turn back to God: “But I, O Lord, cry to you; in the morning my prayer comes before you.O Lord, why do you cast my soul away? Why do you hide your face from me? Afflicted and close to death from my youth up, I suffer your terrors; I am helpless. Your wrath has swept over me;  your dreadful assaults destroy me. They surround me like a flood all day long; they close in on me together. You have caused my beloved and my friend to shun me; my companions have become darkness” (Psalm 88:13-18, ESV). This experience might be labeled depression in a doctor’s office; a therapist might attempt to reframe some cognitive distortions; a pastor might ask for the gift of faith. But in Scripture, this person’s anguish is left to stand as it is, without commentary or diagnosis or attempts to explain or immediately fix it. This is not to say that God doesn’t care but rather, that we should. And the first step is listening to the experience of those going through mental and emotional-health struggles, making space for stories that may challenge what we think we know about goodness, mercy and God.  

The Church, in its 2,000-plus year history, has not developed a formal theology of mental illness. Disability and trauma theologies touch on similar issues, and I highly commend Nancy Eisland’s The Disabled God: Toward a Liberatory Theology of Disability, as well as Serene Jones’ Trauma and Grace: Theology in a Ruptured World. But Eisland speaks about physical disability, and Jones’ work is exclusively about trauma; mental and emotional distress often have embodied components but are not equivalent to bodily suffering and, while much mental distress is likely a result of trauma, experiences commonly referred to as depression, for example, are not fully addressed in theologies of trauma. It’s important to look at the collection of experiences we know as mental illness in their own right within the Christian context. As we consider what God has to say about mental illness, what it means to be faithful to Jesus in the midst of a mental illness, we should consider that Scripture ratifies joy as well as despair – even the experience of deep abandonment by God even as Scripture also promises us that God will never leave or forsake us. If Scripture does not deny human beings the human experience of being discarded by God or that their suffering is caused by God, then we should not be so quick to pray it away. We should not just be praying at all. The culture would have us believe mental-health issues are biological or physical illnesses; the Church would direct us to pray. Jesus would have us act. Who “us” is and what “act” means will be taken up in my next post.