The girl I planned to room with in college for the one year I lived on dorm had to withdraw before school began because she had a mental health crisis. Around the same time I had been reading the book, None of These Diseases, by S. I. McMillen. My memory is that one of the book’s major premises was the connection between the spiritual and the physical. The biggest takeaway for me at the time was that illnesses, especially of the mind, were often caused by spiritual problems. The suggestion seemed to be that if we prayed hard and long enough, were spiritual enough, or willed ourselves strongly enough, we could cure ourselves. I’m pretty sure I wrote a letter to my friend expressing my sympathy about her mental health problems and recommending that she read the book. I don’t know if she did, and in retrospect I really hope she didn’t! I had no clue about the realities of mental illness in those days. (The book has since been revised and republished; I’m speaking of my memory of the original edition.)
Then in the 1980s, when I felt like my own world was crashing down around me, I sought the help of a trained therapist and was able to identify and acknowledge my own tendencies toward anxiety and depression and understand some of the causes. I also came to the strong belief that even though there are psychosomatic components to illness, including mental illness, it’s a lot more complicated than that. Further, it’s not helpful to make judgments or assumptions about the possible causes of someone’s mental illness, especially if those judgments include blaming the person. And even further, any guilt one might have about feeling depressed and anxious is not helpful or productive.
In 1992, I began working in the Pennsylvania Office of Mental Health (now the Office of Mental Health and Substance Abuse Services), in the children’s bureau. It has been an eye-opening experience over the past 20+ years for me to learn to know the parents of children with serious mental health problems and hear their stories. The family advocacy movement, which came into its own in the 1980s, has done amazing work to 1) shift the blame for children’s mental health problems away from their parents, and 2) focus the service system on understanding the organic and environmental causes of mental illness and partnering with parents in their efforts to get effective treatment for their children. To be sure, there are children who have various psychiatric disorders as a result of abuse or something else their parents did to contribute to their problems, but there are many other children who deal with serious mental health issues every day whose parents didn’t do anything wrong.
So it is distressing to me that some Christians still perpetuate the notion that mental illness is often caused by some spiritual deficiency: if people got their spiritual lives in order, they wouldn’t be depressed or anxious. Some years ago, when I suffered a serious episode of depression in connection with my treatment for and recovery from colon cancer, I came across an article by a Christian therapist who said, “The predominant root of depression has a spiritual first cause, not a physical one.” She went on to make light of what it would be like if we psychoanalyzed and diagnosed various biblical characters. By that time in my life I understood the nature of anxiety and depression well enough, both by personal experience and by what I had learned on the job, not to be thrown too badly by the article. Nonetheless, I remember feeling that familiar twinge of guilt – first the guilt for being depressed at all, and then for not being able to pray it away.
And now, just in the last couple weeks, I came across another article, this time by a pastor trying to explain the root causes of gun violence. Among other things, he said, “We try to blame it [violence] on mental illness or anything that shifts the focus off the true problem. Christian psychologists tell us that 80 percent (or more) of those on psychotic drugs and/or in facilities for mental illness would be cured, or nearly cured, if they straightened out their spiritual lives, asked for forgiveness of their sins and developed a personal relationship with Jesus Christ. You can trace the roots of many mental illnesses to spiritual problems.” Again, statements like this strike me as way too simplistic not to mention potentially damaging to people who struggle with mental illness. The causes of mental illness are a complex combination of factors, including not only emotional/psychological/spiritual factors but also genetics, environment and trauma, and sometimes we just don’t know the cause. People with mental health challenges don’t need the further stigma and guilt that come with being labeled spiritually immature or not “Christian” enough.
Generally, we don’t tell people they need to straighten out their spiritual lives to be cured of physical illnesses; rather, the medical system goes to work. Illnesses and injuries are seen to be natural consequences of living. Even when the disease or injury could have been prevented with better diet or driving less aggressively, for example, our first response isn’t to blame the person. We treat the illness or injury, we care for the person with compassion, and we don’t stigmatize him or her for being ill. Why not view mental illness the same way?
Of course, there are things we can do to help prevent illness and injury
; we can exercise, eat healthy foods, lose weight, drive safely, improve safety standards, reduce pollution and the use of known carcinogens, and so on. Similarly, there are protective factors that help to promote healthy social and emotional development and therefore prevent mental health problems. A couple examples: the Strengthening Families initiative of the Center for the Study of Social Policy that emphasizes the importance of protective factors in early childhood; the Search Institute’s list of “Developmental Assets” that if present make it more likely that children will grow up to be healthy and productive citizens.
When we hear about people with depression, anxiety, bipolar disorder, schizophrenia or some other mental illness, rather than judge them as spiritually or morally deficient in some way, we should think about how we can make the mental health system more effective in treating them and how we can support them and their families. When we hear the horrific stories of individuals whose mental illness contributed to suicide or homicide, especially mass shootings like the one at Sandy Hook Elementary School, we could work harder to help homes and communities be places where protective factors, including strong spiritual and religious values, can flourish.
As I write this, I feel like a lot of it is self-evident and ought to go without saying. But then I read comments like that pastor’s, and it doesn’t seem so self-evident. Mental illness is way too complex to dismiss with easy answers; doing so is a tremendous disservice to the millions of people who struggle with it every day. I wish I had understood that better all those years ago when my friend had to drop out of school because of a mental health crisis. I know I wanted to be compassionate when I wrote to her, but it was compassion tinged with ignorance that might have done more harm than good. I hope I’m far more understanding now.