Now that I’ve invited everyone to participate in the care of and response to people in our midst who struggle with mental illnesses, just what have we gotten ourselves into?
Psychology 101 will tell you that the way psychological disorders are diagnosed is by using the following criteria:
- Is the behavior atypical within a culture or a situation?
- Does the experience cause personal distress where there are otherwise no stressors to merit such distress present? Psychopathology does not always cause suffering, though, and a lack of discomfort can be an indication of a problem as well.
- Is the behavior maladaptive? This is about functionality and quality of life.
- Is a person dangerous to themselves or others?
- Is the behavior above or below a statistical norm?
It’s interesting to note that, while colloquial use might indicate that “insanity” is synonymous with “mentally ill,” the terms are not interchangeable. Insanity is a legal term, not a psychological one, and it is used to declare a person not responsible for their actions in a court of law. To call someone insane is to say that they are not legally responsible for their actions.
Current, secular psychology seems to suggest that chemical imbalances in the brain, early, adverse childhood experiences, and classical or operant conditioning can cause abnormal thoughts, feelings and behaviors. Some physical issues can mimic psychological disorders–hypothyroidism, for example–can look like depression; dementia can be easily confused with psychosis. Therefore, it’s important, psychologists say, to rule out medical conditions when diagnosing a mental disorder. Given the list above, psychological abnormality, or mental illness, depends on the point of view, of which there are at least three: clinicians and providers, the people affected by a given behavior, and the person exhibiting the behavior. What we see and diagnose as mental illness will also vary wildly per culture: if you don’t make eye contact in Asia, you’re respectful. If you don’t make eye contact in America, you’re autistic.*
And the mental-health industry has made a mess. The biomedical model – that abnormalities in brain chemistry cause mental illness – increases the stigma and thus the silence around mental illness because it gives the impression that people who are “normal” one day can “just snap” the next day. This reinforces the erroneous stereotype that mental illness is a cause of violence. More importantly, the biomedical model has little evidence. Not only can medications intended to relieve suicidal thoughts (antidepressants) cause those very thoughts, but the field of psychiatry is rife with human rights violations and abuses. Clearly, something needs to change.
Starting with how God sees humanity may lead us out of the violence and oppression the mental-health care industry as a whole is perpetrating in the name of healing. C.S. Lewis writes in Mere Christianity,
“God never meant man to be a purely spiritual creature. That is why He uses material things like bread and wine to put the new life into us. We may think this is rather crude and unspiritual. God does not: He invented eating. He likes matter. He invented it.”
The body, which is only separable from the soul in the gnostic tradition, is important to God. And “if one part of our body hurts, we hurt all over. If one part of our body is honored, the whole body will be happy.”
This is not just about an individual person – if the gut is sick, the brain and the mind are sick – but about those of us that are the body of Christ. 1 Corinthians 12:27 says that: “Together you are the body of Christ. Each one of you is part of his body.” Nearly one in five Americans have a mental illness; mental illness is in the body of Christ, therefore, the suffering of those with mental illness is our suffering. Just as we are individually connected, body and soul – research about the gut-brain connection is starting to supplant the conventional medical approach of division and separation of systems, revealing the spiritual truth of physical and spiritual integration – we individuals are not irretrievably connected to one another just as the colon is connected to the corpus callosum.
This means that we need to treat people suffering with mental illnesses as whole people. We do not just pray; we bring healthy, healing food. We do not just exercise; we bear each other’s burdens of trauma, witnessing with our eyes, our ears and our empathy the story of another’s wounding. Just as the body carries reminders of where it has been broken, so too does the mind. While psychology asks, “is this behavior typical within a culture?” or “is this within a statistical norm,” we might ask “is this eye or foot working as an eye or foot is created to function?” While psychology asks, “is the behavior maladaptive?”, we might ask “Is this eye or foot working as part of the beloved communion of the body?” And while psychology asks, “does the experience cause personal distress?” and “is the person a danger to self or others?”, we might ask, “how can we with the help of the Lord restore sight to this eye, walking to this foot and union among us all?”
The question of demonic possession is, due to its long history in the Catholic church and it’s long track record of being misunderstood and misused, a special case that deserves its own consideration. The model for exorcism, and as you’ll see the origins of its entanglement with mental illness, probably come from Mark 5:1-20:
On the other side of the sea, they arrived in the region of the Gerasenes. As soon as Jesus got out of the boat, He was met by a man with an unclean spirit, who was coming from the tombs. This man had been living in the tombs and could no longer be restrained, even with chains. Though he was often bound with chains and shackles, he had broken the chains and shattered the shackles. Now there was no one with the strength to subdue him. Night and day in the tombs and in the mountains he kept crying out and cutting himself with stones.
When the man saw Jesus from a distance, he ran and fell on his knees before Him. And he shouted in a loud voice, “What do You want with me, Jesus, Son of the Most High God? I beg You before God not to torture me!” For Jesus had already declared, “Come out of this man, you unclean spirit!”
“What is your name?” Jesus asked.
“My name is Legion,” he replied, “for we are many.” And he begged Jesus repeatedly not to send them out of that region.
There on the nearby hillside a large herd of pigs was feeding. So the demons begged Jesus, “Send us to the pigs, so that we may enter them.”
He gave them permission, and the unclean spirits came out and went into the pigs, and the herd of about two thousand rushed down the steep bank into the sea and drowned in the water.
Those tending the pigs ran off and reported this in the town and countryside, and the people went out to see what had happened. When they came to Jesus, they saw the man who had been possessed by the legion of demons sitting there, clothed and in his right mind; and they were afraid.
Those who had seen it described what had happened to the demon-possessed man and also to the pigs. And the people began to beg Jesus to leave their region.
As He was getting into the boat, the man who had been possessed by the demons begged to go with Him. But Jesus would not allow him. “Go home to your own people,” He said, “and tell them how much the Lord has done for you, and what mercy He has shown you.”
So the man went away and began to proclaim throughout the Decapolis how much Jesus had done for him. And everyone was amazed.
Many in the Christian world have either been taught to or forced to “pray away” one’s demons when one begins experiencing symptoms of mental illness and it’s likely because of this passage. Even the secular world refers to the struggles the mentally ill have as “wrestling with demons.” The assumption seems to be that the Catholic Church, with its long history of exorcism that extends to today (it’s even on the rise), equated demonic possession with mental illness. However, the ancient world would not have recognized our schema for diagnosing mental illnesses. They considered mental disorders to have physiological causes and were more concerned with psychoses (ailments with behaviors directed outward like substance abuse and personality disorders) rather than neuroses (internal disorders like depression and anxiety), which they treated with a range of interventions like counselling and physical restraint (not medications).
But their understanding of mental ailments would not have included diagnoses that map neatly onto the disorders of our day; the term “mental illness” would likely not have been used in the 1st-century world. Demonic possession and deliverance such as we see in Mark 5:1-20 was just that: demonic possession. Those in ancient times would not have seen it as a metaphor for mental illness; they would have seen it very literally: one’s personality is overcome by a dark force that, unless exorcised, would continue to eclipse and control the real person. To say that we in the modern world now “know better” – that demonic possession is “really” schizophrenia or other psychosis – is culturally and historically chauvinistic.
Ancient people have not, as it’s turning out, been as far off as we moderns assume in all areas. For example, though they did not know the earth was round or that the Sun was not as close to the earth as the moon or that either weren’t just beyond the trees, they believed the source of someone’s wisdom was their internal organs, particularly their entrails and their heart. The research mentioned above demonstrating the gut-brain connection, the body of scientific literature that justifies calling the GI tract the second brain (or even the first brain; more serotonin is made in your intestines than in your brain), shows that the people of old may have been more right than we in the 21st Century who focus on the head above all else are. It’s worth considering that there may be other ideas they were less wrong about than we are or than we think they were. Most importantly, though, is that, whether demonic possession is a “real” phenomenon is not the point. The biblical text was written by and to a people who believed it was real and did not equate it with mental illness. As we care for the body of Christ, stewarding each of its members to full integration and unity, we need to read the Scripture as those to whom it was written would have understood it lest we cast out the members of the body, our body, who are already suffering; they are among the exact people for whom Jesus flung even the narrow gates open.
————————————————————————————————————- *A note on language: while it is common to encourage the use of ‘person-first’ language (e.g. “person with autism,’ I have found that many people in the disabled community prefer ‘identity-first’ language (e.g., ‘autistic person’). As someone who identifies as having a mental-health condition as well as a physical disability, I, too, prefer identity-first language as I find it less invisibilizing. Person-first language feels to me to serve the comfort of those in power and a distraction, a way for society at large to turn from the vast inequalities that still exist for disabled and mentally ill humans. These people are often the most invisibiled and marginalized; one way to begin to rectify this is to ask us how we want to be talked about. I will be using identity-first language as that is my preference but each person who identifies with a disability or neurodivergence should be allowed to speak for themselves.