I’m sitting here in a volunteer medical clinic for a 60K attendee camporee. It’s humid and hot and we are seeing a lot of dehydration, amongst other things.
As a psychiatrist, I’m humming the Hallelujah chorus as I discover how much general medicine I still remember, from gout, viral rashes, respiratory and ear infections, cuts and bruises, and so forth. The group I came with teases me that if someone comes in for a cough, two hours later they will have disclosed that they were abused as a child and be swallowing prozac. I am ignoring this implication that I am missing “the point” by treating for psychiatric needs. Ignoring and missing, at least it’s consistent.
Our theme from this camporee week is appropriate. We have been looking at the life of David. In these, we see a whole lot of psychiatry going on, both medical/biological, and that which has to do with volition. King Saul demonstrated a sure biological mental illness. And David pretended to be crazy – call it, “acting out.”
God put this in the Bible for some reason(s). Question: What does this say about God’s character? I mean, we certainly don’t look up to people with acting out behavior, like David. Nor do we necessarily look up to people with mental illness like Saul, either. What does this say about who God is? Why does God put this in the Bible?
The Bible didn’t describe this as psychiatric, behavioral, acting out, or general medical. It just told the story. These ages later, we can do more with the story. Here in time, with the knowledge that the generations have given us, we could say something psychiatric was going on. But generally, despite this knowledge, we ignore the medical condition. We still talk about them with a weighted moral perspective, as if they departed from their spiritual walk in these behaviors, rather than consider the medical condition of their brains.
David is getting a javelin thrown at him while playing the harp. Patton State Hospital for the criminally insane might have housed king Saul if he were alive today. Then, David is in front of the Philistines with King Akesh, where he “pretended to be insane; and while he was in their hands he acted like a madman, making marks on the doors of the gate and letting saliva run down his beard.” (1Sam 21.)
Dr. Martorell, a neonatologist, told me,
“I see so many people afraid to discuss problems such as depression, anxiety, other psychiatric illnesses and even family problems or abuse. Yes, partly due to the fact that they may be judged as not having enough faith or not taking care of their health or not following certain principles.
Primary Care Nurse Practitioner Carrie stated,
“God and psychiatry go hand in hand I believe, but many Christians don’t think psychiatry has anywhere to go in the church. This is sad because my mom had bipolar, but nobody could help her. She needed the ‘extra help’. The church thinks we should be able to handle it ourselves.”
You may have seen the lock-down type who says, “Keep it in the family. Don’t tell others what goes on here. It’s none of their business.”
Dr. Martorell said,
Our cultural or family upbringing has a lot to do with how free we feel to discuss these issues. In certain cultures mental health problems are simply not discussed. If it gets brought up, the family directly or indirectly tells the affected person suffering not to discuss these outside the home, as though it were some dark secret that cannot be disclosed.
Nurse Carrie said,
“Everyone thinks we should deal with things on our own, and we shouldn’t have to talk to people about our problems and what’s going on in our lives.”
Ironically she is describing a condition of the church of independence. Yet inherent to being a believer is the learning to depend on someone else, God.
Nurse Carrie said,
“Why is it with depression and such, we can’t work as a church and have medical get it done.”
Many say, ‘If you go see a psychiatrist, it’s a sign of weakness. You’re not a good Christian.’ These are the comments I’ve heard of through the years. You should just pray, and God can take everything away.”
When my aunt suffered colon cancer, she didn’t get medical treatment in the beginning, preferring to have herself anointed, and follow a “homeopathic” approach. Later as it progressed, she changed her mind and found it was too late. So although largely, it isn’t only in psychiatry that we misrepresent who God is, we need ask ourselves, Who is God if what we believe about this is true?
Dr. Martorell shared,
As a neonatologist, I see infants born prematurely. Their brain develops outside the womb and are simply not the same as those that develop in a dark, quiet environment listening to mother’s heart rate, free of noxious/painful stimuli inside the womb. As much as we try to imitate a womb with our incubators we can’t provide the same care. When these infants are followed up for years, some develop physical deficits such as cerebral palsy, blindness, the need for oxygen, and the inability to eat on their own. These physical problems are easily seen and various treatments can be provided. They are also at greater risk for developing learning deficits, hyperactivity/inattention problems, depression, anxiety and some academic papers even suggest increased risk of schizophrenia. The thought behind these is that billions of synapses are occurring during pregnancy and the way these synapses connect is different in premature infants. It is also interesting to note that the brain volume preset at birth occurs during the last 4 week of pregnancy. As these children grow up they need treatment for physical problems as well as psychiatric problems they may develop.
I realize that it is not just in our churches that we are afraid to address this issue but I see it in the families of my newborns. So many of these moms self medicate with illicit substances in order to treat their anxiety or depression. Our culture as a whole has neglected to look at these issues as a medical problem that needs treatment. So many children and teens are committing suicide. Our own “well educated” health professionals have some of the highest suicide rates and yes it is occurring in our christian institutions as well as outside.
Nurse Carrie said,
“In this kind of approach, people are saying S/He’s not a loving and forgiving God and S/He doesn’t understand us. If you deal with psychiatry, you’re a sinner. Why can’t you get it done with God on your own. He’s not a loving God, saying this person is not allowed to take medication. The pastor’s describing a cruel God because he’s not allowing the person to get the help he needs. Like if someone’s leg is bleeding and you refuse to give that person a band-aid.
But, God is always loving. This can’t be true.
I don’t think the pastor has a right to tell the parishioner that.”
Maybe we just succumb to the awkwardness of it all. Too awkward to talk about God in our community. Too awkward to talk about psychiatry in our church. There are so many reasons we approach emotions and behaviors this way but in the church or outside of it, let’s consider the question, What does this ay about God’s character?
I was cleaning up a leg laceration about 1 1/2 inches long and 2cm deep. I placed the triple antibiotic ointment and approximated the edges with steri-strips, yet still encouraging the patient and her guardians to take her to the urgent care to get stitches. This wasn’t a sterile environment and our supplies were limited. While working on the wound of the young teen, I asked a few brief psychiatric intake questions. It turns out, no. She didn’t have anxiety, or depression, or psychosis. What do you know!? Not everyone does. But she and her guardians were super pleased to pray together before they left and I was blessed by them.
God is a God of love and the kind of God that cares about all of it in all of us. S/He is kind and not miserly, discriminatory, or punitive in interest and connection to us.
It sounds like from what i’m writing that psychiatry isn’t seen as a legitimate form of medicine in the church. Or maybe the church doesn’t refer to it, or support it.
A friend from my group read this post and responded.
“We hear a lot about emotions and behaviors in the church, and related directives. We don’t hear however about where emotions and behaviors come from.
I hear, ‘just pray more,’ or that I am lacking in faith. The people in the church get defensive, as if they have to defend God. And that’s not it. Honestly, it’s not complimentary to me that they think I’m insulting God. They are in a way attacking my spirituality. But I know God is helping me and He’s here with me. But I’m still this way. I still feel this way.
There’s a taboo that mental health and disorders all get grouped into this one cringeworthy word, “Crazy.” We’re almost protecting God from crazy by staying away from it in the church. We forget about the sin factor. The separation between us and God. The loss of connection. The word crazy isn’t very nice. So if we say crazy and we say psychiatry and God, it’s almost like we are besmirching God.
Self-Care tip: Ask, and ask again, What does “this” say about the character of God? It comes back to “Me.”
Question: Do see the Bible and your church talking about psychiatry? Where and how? What does it say about who God is?
Keep on!
