A Meeting in the Mind
Faith and science have always had an uneasy relationship, but they seem to be moving apart in a number of critical areas today, from research on embryonic stem cells to teaching evolution in the schools. I'm concerned about this as a person who graduated from college with a degree in biology and as a pastor who preaches each week to a congregation that includes a number of scientists, medical professionals and teachers. The one area where I see some reason for optimism is in the convergence of faith and science in the treatment of mental illness.
The two fields have not always been so close. Although psychiatrists are literally "soul physicians," their work has focused more on medical concerns than on spiritual issues over the past hundred years. This is understandable, given advances in the knowledge of brain chemistry and mental illness, but it has led many doctors to neglect the positive role religion can play in shaping emotions and motivations. From the spiritual side, clergy have resisted the scientific tendency to reduce well-being to the proper balance of chemicals, and have concentrated on providing people with spiritual guidance instead. While many ministers appreciate the value of medicine in treating psychiatric problems, they insist that a person's relationship with God and neighbor is going to affect mental health as well.
In my 19 years of parish ministry, I've seen it all, from brief bouts of the blues to much more serious illnesses such as schizophrenia, and I'm not surprised to see how prevalent mental illness is in this country. A government-sponsored study released last week suggested that one-quarter of Americans meet the criteria for some form of mental illness. Like many of my colleagues, I'm often the first professional whom deeply troubled people approach for help, but I don't attempt to do in-depth therapy myself. I frequently refer people to doctors, psychologists, clinical social workers or pastoral psychotherapists. I keep in mind the advice that Clint Eastwood gave at the end of one of his "Dirty Harry" movies: "A man's gotta know his limitations."
I'm not alone in shifting the equilibrium in this balancing act. A growing number of Christians, across the theological spectrum, are receptive to psychotherapy and medication. Hendrika Vande Kemp, a clinical psychologist in private practice in Annandale, says she's convinced that the openness to medication and wider acceptance of mental illness is "largely due to the influence of the popular media" -- everything from Oprah's interviews to the testimonies of such well-known people as Tipper Gore and Patty Duke. "In regards to medication, they've made it clear that antidepressants are much like insulin"-- if your body doesn't produce the right chemicals, you make up for it in an artificial form, she says. Indeed, many conservative Christians who might once have seen depression as a purely spiritual issue now accept that it has a biological component.
Of course, there are some church leaders who continue to reject these scientific advances. John MacArthur, the fundamentalist pastor of Grace Community Church in suburban Los Angeles, will not refer troubled people to psychologists or psychiatrists -- and his church was sued unsuccessfully in the 1980s when a depressed member committed suicide after receiving only Bible-based advice from a church counselor. MacArthur sees mental problems as spiritual issues, and he attributes them to the presence of sin in the world. Along these same lines, the Open Arms Internet Ministry, an online biblical counseling service, holds to the belief that emotional and mental problems are rooted in theological misunderstandings. "It is through use of Scripture," asserts the ministry's Web site, "that we can conquer life's everyday problems."
An increasing number of seminaries are offering courses in psychology, however, and pastors are more likely than ever to refercongregation members to professional therapists. An important part of my own training was a summer of clinical pastoral education at St. Elizabeths Hospital, the psychiatric hospital in Southeast Washington, in 1984. I learned that ministers can be part of the treatment team, along with nurses, social workers and psychiatrists, and that there is a spiritual dimension to every psychiatric condition. I also found that the Christian community exists even in a mental ward, with patients feeling a strong need for worship and other opportunities to practice their faith.
Just as people of faith are becoming more comfortable with science in the treatment of mental illness, so psychology is becoming more comfortable with religion. In 1996, the American Psychological Association published a book called "Religion in the Clinical Practice of Psychology," which became an unexpected bestseller. Ralph Surette, a psychologist and member of Westminster Presbyterian Church in Alexandria, tells me that he often asks religious patients "to explore what enables us to forgive, to make amends, to regulate our behavior through our beliefs and values, and to understand one's purpose in living." Surette credits psychiatrists such as M. Scott Peck, author of "The Road Less Traveled," for encouraging patients to discuss their religious views during therapy, and to invite their therapists to revisit their attitudes regarding the patient's faith.
Most of the referrals I make are to pastoral psychotherapists -- counselors who combine respect for spiritual beliefs with training in psychotherapy. Many are ordained ministers, although the profession also includes clinical psychologists, licensed clinical social workers, licensed professional counselors, and marriage and family therapists.
The Rev. Benjamin Pratt, a retired pastoral counselor in Fairfax, found that in many of his sessions, life's dilemmas could only be discussed in a context of faith and theology -- for example, in helping a mother who had lost a child to come to believe that she was not being punished by God for actions earlier in her life. He recommended that couples say the Prayer of St. Francis twice a day for 90 days, focusing on the line, "Grant that I may not so much seek . . . . to be understood as to understand." One couple offered this prayer consistently, and after two months the man came to Pratt with tears running down his face and said, "Never in all my life did I ever imagine that I would be more interested in understanding my wife than in forcing her to understand me."
There is still some work to be done, however, in this marriage between faith and science. For starters, clergy can do a better job of making referrals, and stop trying to be all things to all people, including their mental health practitioners. Psychologist Vande Kemp senses that many ministers deeply distrust psychotherapists who are not pastors; and pastoral counselor Pratt wishes that more would embrace their "pivotal role of being a front line referral agent." Susan Lydick, a developmental psychologist and member of two Northern Virginia Protestant churches during the past 17 years, reports that she has not found pastors to be particularly comfortable responding to issues of mental illness within the church. "I look around the congregation on Sunday mornings and know of so many cases of suffering due to mental illness, especially with regard to so many youth," she tells me. "I wait to hear the name called out for prayers for just one of the many youth who I know have been hospitalized." But the prayer requests never come.
The church could help destigmatize conditions such as depression by lifting them up in prayer alongside requests for help with physical healing -- although many won't want to have a psychiatric struggle made public. To give pastors assistance in communicating about these issues, Lydick has helped organized a free mental health awareness event for Northern Virginia's religious community on Thursday called "Bridging the Gap: An Interfaith Conference on Mental Health and Suicide Prevention" -- an event aimed at reducing the incidence of suicide, the 11th leading cause of death in the United States in 2000.
Fran Gatlin, the school psychologist at Robinson Secondary School in Fairfax, where my two teenage children are students, understands how important it is for congregations and mental health practitioners to work together on these issues. She knows a Robinson mother who lost her teenage son to suicide, and then said, "I have to tell you, I've given up on organized religion." She felt that her clergy and congregation were uncomfortable with what had happened and that they never met her needs after her son's death.
Gatlin tells me that studies show that only 30 percent of people with significant mental illness receive any form of treatment, and as a pastor who ministers to members of this population, I know that I have to do more to identify these needs and make the necessary referrals. Untreated depression affects people of all faiths, including clergy. I am learning a great deal from my colleague Jeri Fields, the associate pastor at Mount Vernon Presbyterian Church in Alexandria, who runs an innovative program called Agape Reservoir, which meets the spiritual needs of people with mental illnesses in Friday-night gatherings that routinely draw 75 participants.
By making peace with the science of mental health, religion may be able to help more people to get treated -- the recent government-sponsored survey revealed that those who seek treatment typically do so after nearly 10 years of delays. If so, this could be the cutting edge of a much-needed movement to bring the best insights of faith and science a little closer together.
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Henry Brinton is the pastor of Fairfax Presbyterian Church.