FAQ’s on Psychological Health and Christians

There is a lot of talk these days in the ‘glocal’ media about psychological illness and wellness . And rightly so. The World Health Organisation (WHO) reports that 7.5 per cent of (the over 1 billion) Indian population suffers from some form of psychological illness and that India accounts for nearly 15% of the global psychological, neurological and substance abuse disorder burden.”1 That is nothing short of an epidemic. 

We are a “label  generation” and our minds are ever looking for labelling things – signs and symptoms. We have also tuned our minds to “problem-oriented” thinking, with so many of our professions, demanding and rewarding this mind-set. So our minds, by default are trigger-happy and hyper-sensitized to spot ‘problems’. Given this context, in an information-overload age, we should exercise much restraint and caution from going overboard and splitting hairs, when it’s not called for or warranted and creating false-alarms.

Having said that, the reality despite these disturbing numbers, is that there is so much of neglect, stigma and scandal about psychological illness in our honour-shame culture. Therefore, the hype-perception could also well be a reaction, to having named the elephant in the room. 

Balance, seems to be the key!

1. https://economictimes.indiatimes.com/magazines/panache/mental-health-in-india-7-5-of-country-affected-less-than-4000-experts-available/articleshow/71500130.cms?utm_source=contentofinterest&utm_medium=text&utm_campaign=cppst

Psychological illness is one discourse that we as Christians need to discuss with enormous caution, understanding and humility. More so, due to the weight of the consequences that could ensue, for those struggling under the burden and complexity of the issue. 

The question is a classic textbook example of the “either-or” fallacy and we would do well to spot, at the very start. 

Even some of the Early Church Fathers (2nd Century Christianity), and centuries later some puritans (infamous Salem witch-hunts) attributed Psychological illness, solely to spiritual (demonic) causes! Ghastly and costly lessons on (epistemic and theological) humility. 

Today, we ought to know better. That there are empirically proven natural causes too, for Psychological illnesses. 

In the Screwtape Letters, C. S. Lewis’ wisdom is so delightfully helpful, he says;

“There are two equal and opposite errors into which our race can fall about the devils. One is to disbelieve in their existence. The other is to believe, and to feel an excessive and unhealthy interest in them. They themselves are equally pleased by both errors and hail a materialist or a magician with the same delight.”

Modern Christians, would do well to strike a balance, in the Psychological illness discourse and understand that they should be wary of an ‘either-or’ trap again as this involves lives that compel holistic understanding and cry for holistic help and healing.

As mentioned elsewhere (Question #2 in this series), human sinfulness or the fall, ushered in death (disease). The Biblical idea of human personhood is not limited to just the physical body, but also the mind and the emotions and the soul/spirit, as it were (Mark 12:30). So the effect of the fall has plunged into the deepest recesses of humans and distorted, disturbed, dampened, damaged and destroyed, the human persona at multiple levels. Psychological illness, that affects the psyche (mind), therefore is one of the ramifications of human sinfulness, in a larger sense.

In a personal sense, if one is asking, “could my personal sins pave way to Psychological illness?” Sure it can. Does it always? Can’t be so sure! There sure are ‘sinners’ (count me in), who don’t struggle with psychological ill-health. There are saints, who do struggle with psychological ill-health and challenges. 

The Bible records, King David in Psalm 102:3-5 thus;

3 For my days vanish like smoke;
    my bones burn like glowing embers.
4 My heart is blighted and withered like grass;
    I forget to eat my food.
5 In my distress I groan aloud
    and am reduced to skin and bones.

Words straight out of the note-pad of someone psychologically disturbed. This Psalm is associated with David’s sin, directly. However, most of the Psalms are not associated with sin, like this one (Psalm 102). A third of the Psalms are lament.

So, personal sins (unconfessed and unforgiven) could lead to psychological ill-health. But not all psychological disturbances stem from personal sins of the individual. 

Job 16:2 is a classic case in point. Job’s ‘well-meaning’ friends look at his malady and in trying to help, they misdiagnose like most of us and prescribe pitiful pills that could escalate the malady into tragedy – but for God! The righteous Job refuses to buy their ‘Sin’ diagnosis and spills their pills and retorts;

“I have heard many things like these;
    you are miserable comforters, all of you!

We should be wary of making the same ‘simplistic’ errors, like ole’ Job’s friends.

Let me start with a disclaimer: Don’t hear what I’m NOT saying!

This is a weighty question and I would resist a broad-stroke response to this. Different Churches look at psychological illness differently. There are some, especially in the West that are very perceptive and understanding. The urban churches in India are trying hard to grapple with this (which is a big relief for most sufferers). But there are miles to go, for some churches. According to a LifeWay research finding in America, about 50 % of Evangelical Christians who participated, felt that Bible Study and Prayer alone can reverse psychological illness and restore wellness.2

In an honour-shame eastern culture, psychological challenges are taboo. Shame, stigma l scandal are three words that capture in essence the common man’s outlook on psychological illness, here. 

The Church is not entirely immune to this popular perception. 

Here are a couple of cursory observations;

• The Spiritual-attack narrative

Some Churches simplistically attribute psychological ill-health to Spiritual attack (oppression or possession by spirits and Satan)

Spiritual attack is common-talk among many Christians today and in a victimhood culture, it is a very hot-selling narrative, which is gaining easy and much dangerous ground. Anything from delayed promotions to financial loss, conflicts at work and home, physical ailments and almost everything away from the super-successful, super-sorted, super-duper Christian stereotype, could well be the Devil and his minions attacking us! Needless to say, Psychological illness, clearly tops the chart of this kind of thinking and adds another ugly burden on these ‘victims’ that are already drowning under the weight of their struggles. 

As Christians, we will do well to understand that Psychological ill-health is not only a spiritual issue, it’s a natural illness from the brokenness of the whole person that ensued from the Fall. 

• Sin – Spiritual Slackness narrative

Some Churches weigh-in heavily on ‘Personal Sins’ as the chief cause of psychological ill-health. As we have discussed elsewhere, personal unconfessed-unforgiven sin can lead to unresolved guilt and can psychologically disturb a sensitive person, leading to ill-health. While this is true, we also need to recognize that there are many sinful people, who are callous and insensitive, but not showing any signs of psychological distress. Two inferences emerge;

• First, all sinful people are not psychologically ill
• Second, all psychologically ill  are not living in unconfessed-unforgiven sin 
• Third, some people, living in sin, may be prone to psychological ill-health.

Other Churches, propose ‘Spiritual Slackness’ to be the key cause. Sure enough, when spiritual guards drop down, we give a foot-hold to the enemy and sin seeps in and we could become vulnerable to attacks. So the sufferer is motivated to re-work his spiritual disciplines and rightly so. Golden advice, if the person in question is really spiritually slack. But the problem is spiritual slackness is a relative-subjective category. When we misattribute spiritual slackness to the wrong people and suggest Bible reading and prayer as antidote to one who is already actively doing so, we over-burden them, in attempting to unburden them and innocently prod them towards legalism.  

When the suffering doesn’t go away through reading the Bible or prayer, the person affected may despair of his or her spiritual ability or maturity. The very thing that should provide unshakable confidence, that should strengthen our faith in Christ, becomes a source of shame if our faith isn’t “strong enough” to beat the illness. As a result, many of our Christian churches, homes, and institutions spread an aura of mistrust, guilt, and shame2, needlessly.

• The hyper-faith narrative

There are some Churches that make such bad enemies of Scripture and medication. Scripture and medications/counselling are neither enemies nor mutually exclusive.2 Scriptural authority is never challenged by the efficacy of medical science, they can co-exist after all. When one equates the use of medicines/therapy to a lack of faith, we would be adding insult to harm and inflict our own, twice over in attempting to help them. 

God can instantly, miraculously right a bio-chemical imbalance in the brain. God can absolutely do the same for a broken leg, too. Yet, almost none of us hesitate to rush to the doctor, to have it fixed! There are certain psychological illnesses (ex. Bipolar disorder), that respond so well to medical treatment (amply supported by research evidence), to the point of total cure. 

Scripture and medications/therapy are enemies that were never meant to be!

I don’t intend to belittle the Spiritual causes behind Psychological ill-health. I do agree that all of the above could variably contribute in part or whole to initiate, influence, and perpetuate psychological ill-health, but considering the whole gamut of causes (bio-chemical, genetic, microbial, social, volitional, etc.,) and the wide variety of presentations, the above at best, as sole contributors, is indeed very narrow and simplistic.

As Christian Psychologist Brad Hambrick poignantly notes, Christians who say faith-only, doctors who say medication-only, and counselors who say therapy-only are equally wrong about and equally hurtful to those who struggle with psychological illness. 

The bottom-line is that “we make it more difficult for our own” because “we struggle with how to struggle.”2

2. Towards a Christian Perspective on Mental Illness by Brad Hambrick.

Scripture and medication were never meant to be pitted as enemies. 

There are good Biblical reasons to validate this. Though the bible doesn’t talk about medicines in the modern form, there is sufficient evidence to support the use of resources/agents of healing at our disposal to overcome illness, restore health and enhance wellness. 

Bandages for wounds (Isaiah 1:6), topical agents – oil and wine as recorded by Doctor Luke 10:34, Paul’s medical quip (little wine) for his protégé’s Timmy’s tummy and frequent ailments (1 Tim 5:23) and Eye Salve to restore vision (Rev 3:18), not to mention Jesus’ very own mud-pack (John 9:6) to restore sight to a blind  – all health-care agents right out of the pages of the Old and New Testaments. 

Pertaining to psychological health, the use of medicines and therapies, as appropriate becomes ever more critical. Scripture and medication/counselling are neither enemies nor mutually exclusive.2 Scriptural authority is never to be challenged by the efficacy of medical science, they can co-exist after all. When one equates the use of medicines/therapy to a lack of faith, we would be adding insult to harm and inflict our own, twice over in attempting to help them. 

God can instantly, miraculously right a bio-chemical imbalance in the brain. God can absolutely do the same for a broken leg, too. Yet, almost none of us hesitate to go to rush to the doctor, to have it fixed! There are certain psychological illnesses (ex. Bipolar disorder), that respond so well to medical treatment (amply supported by research evidence), to the point of total cure. 

Scripture and medication/therapy are enemies, which were never meant to be. 

Thanks to our mess-interpretation of Scriptures.

People in the healthcare industry have much reason to be humble. Not only is it difficult to treat various illnesses, we also struggle profoundly in the area of diagnosis and aetiology (causes). The human body is so profound and complex. So various health-illness models have been proposed and obviously they all fall short in different ways.

If physical health/illness itself is shrouded in mystery, one can imagine the amount of struggle in understanding psychological health/illness and the complex spill-overs/interactions (psycho-somatic) between both.

The bio-psycho-social model is helpful to an extent, in neatly synthesizing the potential causes and contributors to psychological illness. 

• Biological Causes

Brain chemistry, habituated neural pathways, Genetics, Glandular system, Viral/Bacterial infections, Nutritional deficiencies, Sleeplessness etc.

1. Social Causes

Trauma, poor socialization, abusive-neglectful home life, Stress, Bereavement/Loss, Job loss, Discrimination/Bullying, Homelessness, Poverty, etc.

1. Psychological Causes

Self-esteem, coping skills, sense of identity, chronic negative self-talk, temperament etc.

• Personal Choices 

The consequences of sinful or foolish decisions on a spectrum from isolated bad choices with significant emotional-relational implication to addiction.2

• Spiritual Causes

Sin, Excessive Guilt, Bad theology (wrong understanding of God), Spiritual attack

• Combination

It’s often a complex combination and interaction of at least a few of the above.

We hurt people when we make complex questions simpler than they actually are. We also hurt people when we, individuals or churches, are silent on important areas of life. The church is uniquely positioned to address the subject of psychological illness.2

Are our Churches ready?

Today’s culture is a major contributor to Psychological illness rising to epidemic proportions. There are multiple factors that seem to emerge as we quick-scan our culture.  

Here are my top 7 cultural observations;

• More Stress (Trickle-down)

While part of our stress is self-caused. The majority of it, is trickle-down stress. The unmet hopes and aspirations of an earlier generation (within the family context) are ruthlessly off-loaded on the current, by default. The ‘stress baton’ is passed on and there seems to be no choice or respite from this relay. Helicopter parenting, is a classic case in point, destroying young lives, which are already squirming under their own weight. More so, in our honour-shame culture.

1. More Stimulus

Stimulus overload is another culprit. There are so many virtual voices and images that bombard our senses 24X7 and we keep feeding on it actively and passively, till it tips the balance. We are forced to be on top of the information game in a performance-driven culture. We ingest more than we could process. We binge ourselves to our own peril. Are minds are never at rest. And most information we choose to amuse ourselves with is – intense, gritty, dark, ominous, violent, deceptive, unreal, fake, hateful, divisive and disturbing. What do we expect?

• More Uncertainty

We live in very uncertain times. Thanks to global geo-political uncertainty, financial melt-down, communal violence, religious conflicts, epidemic out-breaks, corrupt leaders, etc. the average person today, is very uncertain of the future. Vacuous promises, by pseudo-messiah’s don’t add up to anything, anymore. Ubermensch and Utopia are comic content today! So what the common man is left with is uncertainty and loads of it, with no Redeemer in sight.  

• More problem-oriented thinking

Our culture today fosters problem-oriented thinking. Simply because we have problem oriented professions that train and demand us to think in such ways. Think about it! From Medicine to Jurisprudence, Teaching to Technology, we present ourselves as solution providers. Solution providers, need to primarily be problem-spotters. Ace problem-spotting is a pre-requisite for problem-sorting. So problem-oriented thinking is celebrated in a perpetually trouble-shooting, fire-fighting society. And we don’t know how to leave most of it at our doorsteps and end-up caressing it into our living rooms. 

• More Worry

Worry is by no means a modern predicament. Two millennia ago Jesus thought it crucial to address this and inserted it in his epic discourse – Sermon on the Mount. Given the fabric of our culture, we worry more. Given the context, it only seems fair. 

“Don’t worry, be happy” Bobby McFerrin’s 1989 Grammy winning song refrain, “In every life we have some trouble, but when you worry you make it double, don’t worry, be happy, don’t worry, be happy now”, seems to be getting the diagnosis right, but his antidote is clearly unhinged. Sure enough, three decades down the line, the mantra hasn’t worked much!

We need good reasons to convert our worries into happiness (joy, rather) and we need a worldview or a frame of reference, that supplies the rationale for meaningfully doing so. Think about it;

The more we worry, the more we worry,

The less we worry, we worry – Worry!

• More Fear

The list of phobias today is ever expanding as new ones are reported and named ever so often. We live in a ‘labels generation’. We feel secure when something identified is labelled and categorized. Thanks to our problem-oriented thinking, that is ever vigilant to spot any unnamed sign/symptom and label it. 

Hippopotomonstrosesquippedaliophobia is one of the longest words in the dictionary and ironically, is the name for a fear of long words! The rational and irrational fears today seem to have found fertile feeding ground in today’s uncertain, worry infested, volatile, hyper-stimulated culture.

Cyberchondria is the modern day techno-version of the ‘Intern’s (Second-year) Syndrome’ that medical and health-care students used to experience earlier. They at least had the academic scaffolding to process it better and had teachers/mentors to walk them back to reality. But with Dr.Google and WebMD, not to forget, Drs.Alexa and Siri, the woes are only multiplied many times over and the lay user of these services has no means to filter and discern, but is hurled into an endless hole of fear and confusion.

I just got a little cheeky and ran a search –“fever+rashes+vomiting”, and bingo, I’m generously bestowed with “Meningitis”. 

Never Google your symptoms!

• Low Resilience

A glance at our parents, a glimpse at ourselves and a gentle look at our children – a quick scan across three generations, would immediately bring to fore the ‘Resilience index’ of each generation. Our parents were warriors, in their own right, that braced themselves against the harshest of odds. We are worriers, even with relatively better resources. Our children sadly, are anxiety-laden and panic-stricken.

Resilience sounds like an archaic word from a bygone era. TED talks on ‘Endurance and Toughness’ seems like the need of the hour. Resilience, Conviction, Resolve, Grit, Guts and Mettle seem to be virtues that need to be reiterated and reinstated. 

The Bible uses the word ‘Endurance’ to communicate the idea of ‘Resilience’. James 1:2-4, captures this profoundly, “Consider it pure joy, my brothers, when you are involved in various trials, because you know that the testing of your faith produces endurance. But you must let endurance have its full effect, so that you may be mature and complete, lacking nothing.”

We need worriers to become warriors!

• Lost Hope

Hope is in rare-supply. Understandably so! Hope can’t be conjured up from thin air. Hope needs solid grounding. Hope needs a point of reference out of itself, else we’d be hoping on hope and that would amount to self-deceit and ultimately disaster. The very thing, it is to deliver us from. 

Therefore, hope needs to look for a source outside of itself. Hope needs to latch itself onto an unshakeable point of reference, an unquenchable real source.

In the words of RC Sproul, “Hope is called the anchor of the soul (Hebrews 6:19), because it gives stability to the Christian life. But hope is not simply a ‘wish’ (I wish that such-and-such would take place); rather, it is that which latches on to the certainty of the promises of the future that God has made.” 

The Cross of Christ, which points to the Person and the work of Jesus Christ is the Hope for this World seeped in despair and gloom.

The Bible sure does speak about psychological health and illness, sans the modern labels. One of the hallmarks of the Bible is its truthfulness. Even the celebrated ‘heroes of the faith’ are not candy-coated, about their challenges, struggles, faltering and failures. 

Through the Bible, we see heroes of Faith – David, Job, Elijah, Jonah, Timothy, Paul and even our Lord Jesus, go through Psychological anguish and turmoil. 

David asks “Why, my soul, are you downcast? Why so disturbed within me?”(Psalm 42:11). In Psalm 32:3, he records, “When I kept silent, my bones wasted away through my groaning all day long.” He echoes his psychological anguish and distress again in Psalm 38, a very poignant cry from the depths of his soul. “I am bowed down and brought very low; all day long I go about mourning” (Psalm 38:6) and “I am feeble and utterly crushed; I groan in anguish of heart” in Psalm 38:8. Psalm 116:3, he records, “The cords of death entangled me, the anguish of the grave came over me; I was overcome by distress and sorrow.”

Job uses similar language to express his distress in 3:26, “I have no peace, no quietness; I have no rest, but only turmoil.” Elijah during deep anguish in his life pens these painful lines in 1 Kings 19:4, “But he himself went a day’s journey into the wilderness, and came and sat down under a juniper tree: and he requested for himself that he might die; and said, It is enough; now, O LORD, take away my life; for I am not better than my fathers.” Jonah in 4:3, pens something similar, “Now, Lord, take away my life, for it is better for me to die than to live.”

Dealing with deep feelings of despair, anger, depression, and loneliness is not a unique modern day struggle, though its incidence is clearly higher today. 

The Lord Jesus Christ himself, at the verge of the most intense, grueling and dark spiritual-emotional-psychological hour before the Cross says in Matthew 26:3, “My soul is overwhelmed with sorrow to the point of death. Stay here and keep watch with me.” Luke records the same incident in Luke 22:44 thus, “And being in agony he prayed more earnestly; and his sweat became like great drops of blood falling down to the ground.” Overwhelming sorrow, overwhelming agony, to the extent of leading to a medically documented phenomenon of ‘blood-sweating’ (in subjects going through intense stress, haemahidrosis), to the point of death. Unimaginable! 

We have in Jesus Christ (Isaiah 53:3 NLT), a One, Who “was despised and rejected— a man of sorrows, acquainted with deepest grief.” Not just a kind and sympathetic Christ, the only and true Christ, uniquely qualified to empathize with our deepest, physical, emotional, psychological and spiritual struggles. The only Saviour with Scars! 

In the powerful words of Edward Shilito;

“The other gods were strong; but Thou wast weak;
They rode, but Thou didst stumble to a throne;
But to our wounds only God’s wounds can speak,
And not a god has wounds, but Thou alone.”

Jesus Christ is indeed the only Saviour with scars that suffered for us and suffers with us. He alone can soothe our deepest wounds and restore our inner brokenness, reaching to the invisible recesses of body, heart, mind and soul. We have in him, the great High Priest that intercedes along with the Holy Spirit on our behalf, with groans and moans that words cannot express (Rom 8:26). 

In the fullness of time, forever, “He will wipe every tear from their eyes. There will be no more death or mourning or crying or pain…” (Rev 21:4)

We have the Hope of Glory, Christ in us, to hold onto and who’s promised to never leave us, nor forsake us.

Demons are fallen angels. Demons are real. Demon possession is a Biblically supported spiritual phenomenon. There’s no taking away from that. 

In the Screwtape Letters, C. S. Lewis’ wisdom on the reality of Evil, is super helpful;

“There are two equal and opposite errors into which our race can fall about the devils. One is to disbelieve in their existence. The other is to believe, and to feel an excessive and unhealthy interest in them. They themselves are equally pleased by both errors and hail a materialist or a magician with the same delight.”

For a start, Christians ought to strive for balance here. There are Christians and Churches that are so Demon-conscious that God is inadvertently nudged to the backseat. There are other Christians and Churches that are so oblivious to the Biblical reality of Demons and choosing not to see them, doesn’t eliminate them. Both these positions are far away from the ideal and hence much discernment and balance is called for, here. 

The Devil and his minions, have been given limited power/authority by God for a time on this earth, before they are finally judged forever. A Child of God, is often secure under God’s mighty wings and there are numerous Scriptures that validate it and encourage those that trust in the Lord (Psalm 34:7-9, 2 Thess. 3;3-5, Isaiah 54:17, Psalm 23:1-7, Eph. 6:10-15, 2 Tim.4:18, Prov.18:10, Psalm 121:7-8, Nahum 1:7, Psalm 3:3-5, Isaiah 43:2 etc.)

However, there are men of faith and right standing with God, like Job, Paul (2 Cor.12:7, “…thorn in the flesh, a messenger of Satan, to torment me”), Simon Peter (Luke 22:31-32, 31, “Simon, Simon, Satan has asked to sift each of you like wheat. But I have prayed for you, Simon, that your faith will not fail. And when you have turned back, strengthen your brothers.”) and others, that the enemy attempted to bring down. But the Lord, kept them under his watchful care and was with them all through their darkness, giving them sufficient grace, cover, prayer and protection. Satan could touch their body and perhaps their mind – but never, ever their being!

It such contexts, it is commonly suggested that the person under such spiritual (demonic) attack could either be “oppressed” or “possessed” by demons. 

• Oppression is understood to be an external–influence by an evil spirit on a person. External, because the evil spirit is outside the person and not within. Influence, because the evil spirit, doesn’t have total control on the person, but only a degree of influence. The volition of the person is not compromised, here.
  
• Possession, is understood to be an internal-control by an evil spirit that has entered a person. The person who is possessed is subject to the free and random control of the evil spirit and his personal volition is redundant, for the most part. (NB: A true disciple of Jesus Christ, cannot be demon possessed. This is addressed at length as a separate question in this series)

Let’s get back to our current question, pertaining to Psychological ill-health and demon-possession. While the above are spiritual possibilities and we have scriptural precedents, to support them to a credible extent, we are to exercise caution and refrain the temptation to go overboard about these. 

The locus classicus, Matthew 8:28-34 and Luke 8:27-33 (Jesus restoring the two demon-possessed men) supply most of us with the ‘theology of demon-possession and psychological ill-health’, and most of our ideations and extrapolations on psychological illness and its association with demon possession, come from our reading of this text! But we would do well to understand that other cases of demon-possession elsewhere in the Gospels, give us more to think. There is a mute man (Matthew 9:32-33), who was demon-possessed that was brought to Jesus and he drove the demon out and the man, spoke. Clearly, there is no documentation in this passage to show that he was psychologically ill, though he was demon possessed. There are more examples, to prove this point – a deaf and mute man (Mark 9:25), an epileptic (Luke 9:37-42), a blind and mute man (Matthew 12:22), none of them seemed psychologically ill, though they were demon-possessed.  

At least, three findings emerge from our readings, pertaining to psychological ill-health; 

• First, all demon-possessed people are not psychologically ill. 
• Second, all psychologically ill, need not be demon-possessed.
• Third, some demon-possessed persons, may manifest with psychological illness.

Therefore the causal association between Psychological ill-health and Demon-possession is more nuanced than we often popularly assume. And given the context of Psychological illness, a potential misattribution here, could prove irreparably grievous.