My first real encounter with mental illness was, as a young trainee nurse in 1963, I looked after a woman in her mid-50s with severe burns to both hands. She was admitted to the Medical Ward, but confined in the Psychiatric Section. I had not seen suffering before, and I was alarmed to see the intense fear and despair in her eyes. Her tears flowed and never seemed to stop. In the 4 weeks I was assigned to the Section, this woman did not say much, except to repeat over and over that she was evil, that she had sinned, that she had offended God grievously, and was beyond forgiveness and redemption. She was a devout Catholic. A psychiatrist came to see her - rather, looked in on her - once a week, and a Catholic priest came to see and pray with her daily. She seemed even more distressed during these visits, weeping for hours after the priest left.
This woman believed she had sinned because she felt abandoned, became anxious and depressed when her husband continued to have extra-marital affairs, in spite of her pleading for him to stop. She sinned even more because on one particularly distressing night, she got angry with God for not hearing her repeated prayers for His intervention, and hurled the crucifix in the open fire, retrieving it when she realized what she had done, and burning her hands in the process.
I never knew what eventually happened to that woman, but my experience of her remains ingrained in my mind. Later, as a psychologist in practice, I had occasions to think of that experience, particularly when working with patients of deep Christian faith who struggle with mental illness and are full of self-recrimination and guilt because they do.
Christianity is the word's largest religion, with an estimated 2.1 billion followers worldwide. It is estimated that approximately 45% of the world population - which includes the 2.1 billion Christians - will experience mental illness through the course of their life.
Christian beliefs on causes ...
Christians often associate mental well-being with closeness to God, which is achieved through time spent praying, studying the Bible, and collective worship. A significant proportion of Christian communities around the world endorse the belief that believers should be immune from mental disorders so long as they please God. They believe that faithful behaviour ensures God's blessings and protection. To many Christians, mental illness is associated with or caused by:
- Personal sin - like, not praying fervently enough, uttering obscenities, taking the Lord's name in vain, lusting, being a failure
- Lack of faith, doubting God, doubting and challenging the Word of God; or
- Demonic influences
Some Christians believe that mental illness is part of God's will, and the believer will be strong enough to handle it because "God will not give you more than you can handle". This then implies that if the believer did not recover from mental illness, it is because he did not try hard enough to manage his illness, and has fallen below what God has determined he is capable of.
Many Evangelical Christians believe that in many cases, ingratitude, unresolved conflict, irresponsibility, guilt, bitterness, lack of forgiveness, unbelief, claiming of rights, anger, and self-centredness are sins that cause depression. In upholding the Christian doctrine that states: We are all sinners; they make the assumption that: psychological distress is preceded by sin.
On the other hand, some Christians view Depression as a sin, a curse, an affront to God. They believe that if you loved God more, believed in Him more, and let God into your heart all the way, then you will be happier. If you are happy, you cannot be depressed. Depression, therefore, is a manifestation of a failure to love and believe in God.
Some Christians believe they are not deserving of God's love if they have a mental illness, because God cannot love someone who is not perfect. This thinking significantly affects who can be church leaders, ordained pastors, and ordained ministers. It excludes anyone with a mental illness from holding high office. There is fear that the community will lose favour with God if they had church leaders and ministers made imperfect by mental illness.
But, mental illness is a reality now, as it was in the beginning ...
Christian beliefs on treatment ...
The Bible is replete with accounts of characters who experienced distress, agony, and hopelessness, (uncannily similar to symptoms of depression) and prayed to God for deliverance and were ultimately delivered, sometimes after nearly a lifetime of prayer. The repeating message from these stories is not about the suffering endured and the mental and emotional distress, but the fact that their faith and prayers pleased God and they were healed or delivered.
Many Christians, particularly Evangelical Christians believe that daily prayer and Bible reading alone cure mental illness. Believing that mental illness can be cured by spiritual practice alone, discourages Christians from accessing the mental health care they need to recover from mental illness.
Indeed, there have been studies in the psychology of religion suggesting that people in psychological distress more commonly seek assistance from religious professionals rather than from mental health professionals. However, people with mental illness have not always found the response of the religious community to be supportive or beneficial. This may be because the church either viewed their mental illness as a result of personal sin, or considered that mental illness did not exist.
In interviews of Christian ministers and priests, they report that they received very little, if any, training regarding mental illness. They were typically unable to distinguish among various forms of mental disorders, and those who adopted a more literal understanding of sacred texts (Pentecostal clergy) explained mental illness in terms of spiritual events. For these ministers, mental illness may be easier explained as a presence of demonic activity that may require exorcism or deliverance.
The emergence of psychotherapy in the 19th century, and Freud's repudiation of religion did little to improve the understanding of mental illness in the Christian community. The tension between Christian beliefs on one hand and scientific endeavours on another continues to the present day.
There have been great advances in the scientific assessment and treatment of mental disorders in the last 60 decades or so, yet many of the more conservative Christian churches remain suspicious of mental health professionals and psychological and pharmacological treatments, and view depression as a spiritual problem, mental illness as demonic possession, and prayer as the treatment strategy for mental illness.
Evangelical Christian churches have an ever growing number of prayer ministries established worldwide. They have centres where trained prayer teams provide healing through prayers. They hold seminars - usually on depression, have one-to-one prayer consultations, as well as group prayers. They also make available Christian self-help literature, including DVD programs, and websites. A survey of these materials show that the texts offer the advice:
- That depression can be alleviated through trusting God and being involved in religious activities.
- The use of personal power to ward off depressive moods
- Refusal to be depressed, and purposely choose right thinking
- Confessing any sins that may be causing emotional weakness or sickness
Other Christian Responses:
In contrast to the Evangelical Christians, Anglicans and Catholics do not agree that mental illnesses are caused by evil spirits, and are more open to consider consulting with mental health professionals.
I am a Catholic, and a mental health professional. In my training, there was nothing that prepared me to respond to / or work with clients who were terrified of God's wrath. Talking about religion (and politics) within a therapeutic session was considered inappropriate and outside the boundaries of psychotherapy. In the years I practiced as a psychologist, my clients have been predominantly Christians. Whilst many did not talk about their beliefs and simply focused on their illness, there were some who spoke of their deep faith and how this helped or hindered their well-being. These clients were my teachers in the spiritual dimension of healing.
I sometimes think back to the woman with the burnt hands, and reflect on her sorrow, her suffering, and her faith. And I fantasize about what might have happened if I were a psychologist then, as I am now, and she came to see me.
I know I would do an assessment and gain understanding and insight into what may have led to her mental illness. I would find out what she did to cope, and what supports she had. She probably would tell me that she prayed and prayed for God to intervene and make her husband see the light and be faithful to her. And she would probably tell me that she believes God will eventually hear her prayers and know her devotion to Him, feel compassion for her, forgive her sins, and bring her husband back to her.
I would be telling her to keep her faith because it gives her hope and comfort, that the God I know is compassionate and loving, and tell her that God will want her to help herself to get better, and that it was good that she came to see me. I would be telling her that her life experiences, her beliefs, and maybe her family history have contributed to her developing anxiety and depression - illnesses of the mind that are treatable. I would explain treatment options to her, and work collaboratively with her. In my fantasy, she would grow as a person believing in herself, in her right to make choices and take personal control, at the same time believing that her God is a compassionate and loving Being, rather than a punitive One to be feared.
Over the years, I came to recognize that faith and hope are not the antithesis to psychotherapy. They, in fact, complement therapy. I find that many of my clients who have hope and faith seem to be more resilient, more accepting and more at peace than those who have not.
About Estela Hutchings
Estela Hutchings is a psychologist and family therapist, and has been in clinical practice in both the public and private sectors for nearly 20 years. Estela has extensive experience in the assessment and treatment of child, adolescent, and adult mental health problems, including anxiety disorders, depressive disorders, and personality disorders. She has a particular interest in trauma, and vast experience in treating trauma-related mental disorders. As a clinician in what was once the Child and Adolescent Mental Health Services (CAMHS) at GV Health, Estela provided secondary consultations and recommendations to community agencies, schools, and protective services, in matters relating to childhood abuse, developmental trauma, family dysfunction, and treatment and/or management options. Although Estela has recently retired from full-time work, she remains very involved in mental health issues.
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