Questions from Churches

1. Are severe mental illnesses the result of the impact of the Fall and the ongoing frustration and bondage that creation is experiencing?
 

There is a sense in which everything is the result of the Fall – and also I hope a sense in which everything finds its roots pre-fall in the wisdom and sovereignty of God, for there is always hope. One question I am often asked is whether these types of illnesses are the result of sin, and I usually ask people to reflect on the story around John 9v2, where someone asks Jesus, “Who sinned – this man or his parents?” The answer Jesus gives suggests that he probably takes a both/and position, and then goes on and heals the chap anyway! This is a good model…
 

To be sure, we all contribute to our own suffering through our own deliberate sin and our foolish choices, but in my field of work I also see a huge amount of sorrow that occurs as a result of the sins of and stigma from others. Also in problems like schizophrenia, dementia and learning disability, there is a large genetic component; such that these problems can occur in someone who has no lifestyle risks at all. I guess this is the bondage of creation?
 

So like many things in life, severe mental illness comes from a combination of sin, folly, choice, the actions of others and that complicated dilemma of happenstance vs destiny. It is the distinctive role of Christians and the church to make sure that sin is kept on the list as one of the ongoing causes and of course the ‘original’ cause. Because of this, repentance and turning to God must be part of the answer, as it must be part of life’s journey for us all. However, I would ask you how helpful it is in practice to say ‘everything is the result of the Fall’ – it has some similarities to telling an airline pilot that what goes up must come down. Perhaps it would be more useful to say both/and then try to help anyway!
 

The mission of the church is mot merely in diagnosing the groaning of creation, but working with the Spirit to see this groaning eased. Let us pray for the ‘children of God to be revealed’ (Romans 8v19), not just with a mandate to diagnose and preach the Word, but to love and live alongside and ease the groaning of many; to redeem as we ourselves are Redeemed by Him.

2. How do you as a consultant psychiatrist (a real professional) and a believer (born again disciple of Jesus) communicate the Bible's meta-narrative regarding both the diagnoses and the source / process of healing for those who come to you for help?
 

The key question here is whether these two things are compatible, mutually exclusive or somewhere in between? Are people like me on a spectrum – some more psychiatric, some more evangelical? Or (rhetorical question!) is it the case that these things are not necessarily related at all, like having fair hair and wearing brown shoes. Would you ask the same question of a Christian electrician?
 

My view is that this is a largely redundant question that arises in the church because the standard career path for those on fire for God is into full time paid ministry, and one that arises among those we work with (or treat) who are worried we are going to try and cover them with the next breath.

I believe that my purpose on this earth is to glorify God and point people towards Jesus as Saviour. However, I do believe that there is more than one way to skin a cat. Glorifying God is sometimes about being trusted for who you are that a person might open up more to you that you might talk to them more helpfully later. Pointing people towards Jesus is sometimes about helping them know His healing through medicine and His compassion through the doctor-patient relationship. This can be especially important for people who have never known health and have never been treated with compassion.
 

I hold a position between predestination and free will – indeed I do not see this as a spectrum as the Bible teaches both – one of those both/and things again. Sometimes I hear more clearly those parts of the Bible that encourage me to speak and to pray for opportunities and words. At other times, I trust in the sovereignty of God that my contact may be just part of their journey and hopefully part of their healing.  
 

What I try to do instead is to keep myself balanced in a number of ways. I am in touch with a number of people who share my faith and will ask me how I am doing in terms of my witness. Whilst I know the legal line in the sand (which is that I must not abuse my position and must not share my beliefs unless relevant), I am also aware that controversy (even persecution) is promised for those who follow Jesus so I expect my faith to land me in some difficulty at times – if it does not I am probably not doing what I ought.
 

I am also very open about what I believe, though both what I say day to day and a pretty extensive internet presence, which means that all my colleagues (and quite a few of my patients who google me!) know in advance exactly what I believe on any number of issues. This does help (people ask me rather than me having to ask them) and I find it rarely hinders. Authenticity is not that much of problem – what people do not like is pushiness and hypocrisy.
 

Neither do I see a conflict in terms of diagnosis and process of healing. Science does not claim to answer the why question, and when it tries to it often ends up looking stupid. The flip side of this is that we have a lot to learn about HOW people change. Often I hear Christians talking about the Holy Spirit as though this was a black box where change happens as if by magic, aided by the other black box of prayer. Other times people are told to keep a stiff upper lip and study the Bible more, as if they were being daft for failing to take on board this or that scriptural mandate because they had just not tried hard enough. Most people I know with mental health problems are trying very hard indeed, thank you.
 

What we can learn from modern psychology is the fruits of many thousands of experiments on and hours of experience of how people can change step by step; and in far more granular detail that the broad text of the Bible is ever going to tell us. Additionally, many therapists and researchers are wonderful and compassionate people – to reject their insights out of hand is as foolish as requiring one of those Christian electricians to wire your plug.
 

To be sure, there are roots to some of the schools of psychology that we would do well to critically appraise. But there are equally dubious scientific-rational roots to the research that developed the chair you are sitting on right now or the antibiotic you took last week. We need to remember that Jesus was no more Western than he was Eastern. If anything he was quite a bit Eastern, but first and foremost He was God Before All Things.

3. How can the local church live out the freedom of God when many within it struggle with their mental health, and how can it communicate the love of God to those who do not believe?
 

People in churches struggle with many things and if I can draw a parallel for a minute lets think about why we struggle with the ‘evangelism’ word. On reason is that evangelism has been ripped apart from what it should be and squeezed into things like Two Ways To Live or a Mission Week. A far better approach is what Bill Hybels suggests – to ‘walk across the room’. Being normal is the key – it is just that our normal should be defined by being close to Jesus not what we see on Big Brother.
 

So when we think about people who struggle, we need to see this as normal too. We can look at those who ‘struggle with mental illness’ and try to ‘set them free’, but I have yet to meet a person who is truly free (apart from Jesus of course). When we subdivide the church into the ill and the sane, we increase the struggle as well as set an impossible goal. If we were all more open about the ‘Pilgrims Progress’ of our own internal worlds, perhaps those who struggle with their mental health would not feel so useless. If sinners are allowed to lead churches, perhaps we should allow the depressed to lead us in worship. In fact, I know a few well-known worship leaders who are…
 

It is true, of course, that there are some who struggle profoundly with their mental health and I am not meaning to minimize the pain. I pray for healing and am expectant for change. But a key insight is that many who struggle in this way will know far more about God than those with no scars. King David met God in the wilderness, Jeremiah in the pit and Jonah in the belly of a whale. More recently, St John of the Cross spoke of the ‘dark night of the soul’ as a necessary part of the path to knowing God. Jeff Lucas’ new book is called ‘There are not strong people’. We would do well to listen to those who struggle, before trying to minister to them.
 

The outward message of the church to those who do not believe is no different for those who struggle with their mental health. The same basic tenants apply: all need the Good News, all can receive it at any time, all are in some way willfully and blindly rejecting it. In this sense, the church should make no special adaptations. However it is true that there are some special circumstances: people who are depressed will find it hard to see hope, people who are psychotic will find it hard to tell what is true, people who have been abused will find it hard to trust even the best of Fathers.
 

Yet, in working to make adaptations for issues such as these, I think we will discover that the church needs to make quite a few adaptations in how it reaches out. Much of what we have done is based on an affluent, intellectual and middle-class view of the world. As we change to make more sense to those in our societies who struggle much, have no idea of absolute truth and whose first response is defensive; we will go some way towards making our Good News easier to hear in general, and this includes those with mental health problems.
 

The key elements are sacrificial effort, non-judgmental acceptance and a willingness to not give up loving. I’m sorry to say that this is one reason where the church used to lead, but is now shown up by other philanthropists and movements. It is why I am proud to work for the NHS, which is always going to ‘lose money’ on lost causes and is biased heavily towards the poor.  There is a lot to learn.

4. If mental health problems are a fact of living in the 'now but not yet' of the Kingdom of God, how can we find a balance between letting the 'professionals' deal with it and seeking healing / driving out demons - daring to believe that God can bring transformation?
 

To deal with a couple of things quickly, firstly I do not believe that most mental health problems are the result of demon possession any more than I believe that most of the reticence in our evangelism is due to an evil presence wrapped round my ankles. The ‘causes’ of mental distress are far more likely to be abuse by others or a genetic predisposition to illness.

Secondly, I don’t think this is a balance. I think we need to be both people of expectant faith AND people of patience – AND people who seek out doctors when we are ill. Sometimes when we read the Gospels it all seems to be spiritual action, yet these events took place over three years. There is plenty of time for all of the above approaches.
 

What I do think we need to do is change our understanding of healing. I don’t have the space to go into it all here, but would like to raise a number of ‘tensions’ for you to discuss in your groups. If you want to read more, there is an article on the Mind and Soul website called ‘Healing and Mental Illness’ which discusses this issue more fully and gives the Bible verse and references.
 

Healing (especially when it is not happening) is often felt to be due to either a lack of faith (or practice of faith) on behalf of the person, or that this is not God’s timing or sovereign will at the moment. These things are both true and in scripture, but there is a third party too – the community of believers. These people are involved in the question above as those who are doing the ‘driving out’, exercising their gift of healing, and all churches should ensure that healing is embedded in their community matrix. However it is not just the exorcists we need, but also those with pastoral gifts, hospitality, encouragement – are they in the healing ministry too?
 

A far better word that exorcism is ‘ministry of deliverance’ – which makes it clear that this is about opposing evil to some degree but hopefully with less of the weirdness and goats legs. We cannot just pray for ‘wholeness’ as this is to ignore the fact that it is a spiritual battle we wage. The phrase also reminds us that this is a ‘ministry’ and not a process of embarrassment. People who struggle with their mental health and have yet to see healing are doubly to be treated with honour and not subjected to another hour of snot and tears with little change.
 

Transformation is our goal to be sure, but the picture in Revelation is as much a transformation of society (and indeed creation) as it is of the individual. We may be waiting this side of heaven, and allowing (helping?) the professionals ‘deal with it’; but we can begin transforming our churches as places where the last are first, those who mourn have someone to mourn with and the light of the Good News shines well. The Holy Spirit (as the ‘Para-clete’) journeys alongside us and smiles.