Spiritual Care and Mental Wellness

Mental Wellness

Mental illness, especially depression, has become a common illness. The survey “The Global Burden of Disease” conducted by the World Health Organization, the World Bank, and Harvard University predicts that depression will become the second most common disease in the world. If the situation becomes this severe, how will we extend our care and support to those who are mentally ill, especially those who are ill with depression?

Two current approaches for the treatment of mental illness are pharmacotherapy and psychotherapy. The innovation of drugs appears to make the treatment of mental illness easier now that doctors can administer medicine to hasten the recovery of patients. However, controversies over the effectiveness of pharmacotherapy exist. Many reports point to the therapy’s negative side effects. Some of the findings even indicate that the relapse rate of schizophrenics who receive pharmacotherapy is higher than those who are not treated with medicine.

Another approach to the treatment of mental illness is psychotherapy. Psychotherapy applies several contemporary theories of psychology such as the theory of Sigmund Freud and the theory of Carl Jung. Both Freudian theory and Jungian theory have developed into two main schools of thought in modern psychology. Both theories are focused on mental health. Freud’s idea of the unconscious rejects spirituality as neurosis. Jung acknowledges the spiritual dimension of the human sub-consciousness, but he connects human spirituality to the domain of intellect. Both theories which support psychotherapy do not embrace spirituality.

However, other scholars like Anton Boisen and Mark Sutherland not only see the importance of the spiritual dimension, but that spirituality is an essential component of mental wellness. They both believe that pastoral care can be applied to mental wellness in order to enable the patients to pursue the meaning of life. However, their approach is essentially retrieving theological perspectives from the psychological theories they already accept or adding theological dimensions to those theories. While there is value in their approach, they are lacking the transcendent dimension. The author believes that spiritual care is a hermeneutical, practical wisdom, meaning that spiritual care providers must concern themselves with humankind’s spiritual needs. Through dialogue within the hermeneutic circle, theology and psychology can help us understand the religious experience of the mentally ill and their testimonies, and thus help us to identify appropriate healing treatments.

Theology is important in this hermeneutic circle. Theology expresses the understanding and thoughts of churches or faith communities concerning Divine Revelation. Major theological principles derive from Divine revelation and not from rationality. This is because the human mind is not capable of knowing God. When a person seeks to discover God and to discuss knowledge of God, the God of the discussion is merely the God of the philosophers. Humans are incapable of revealing the mystery of God. To understand the God of eternity with narrow minds will only result in atheism or agnosticism.

Spiritual care is a kind of pastoral care that reveals the mystery of God. It acknowledges the spiritual aspect and values our spiritual needs. This care is dedicated to nourishing the relationship between man and God and to enabling the person to get along and live well with other persons. Spiritual care provides guidance in the search for meaning, purpose, value, and hope in our lives.

To further understand spiritual care, we must first consider the human spirit.

The Human Spirit

In the Old Testament, “spirit” in Hebrew is ruach. Ruach, in essence, is wind, as it is expressed in Genesis 2:7, “…the Lord God formed the man from the dust of the ground and breathed into his nostrils the breath of life, and the man became a living being.” Job 33:4 says, “The Spirit of God has made me; the breath of the Almighty gives me life.” The breath of God turns dust into living beings, breathing into human beings. The created need the breath of God. The created cannot manipulate the wind. When the wind ceases, death follows. Job 34:14-15 says, “If it were his intention and he withdrew his spirit and breath, all mankind would perish together and man would return to the dust.” Therefore, spirit is not the mind but it is an important creative power necessary for humans in order to live fulfilling and purposeful lives. In the New Testament, “spirit” in Greek is pneuma. Pneuma also means the movement of air, breath, and wind. Pneuma works within humans and is considered as the primary force of the created, or the major sacred part of humans.

According to John Swinton, the human spirit influences the human body, emotions, thoughts, and relationships. The human spirit is equally influenced by the human body, emotions, thoughts, and relationships. The human spirit penetrates every dimension of our lives and provides energy to each of these dimensions. A complete human possesses a psycho-spiritual unity wherein the human is spirit driven in their search for the meaning and purpose of life and for the origin and identity of life.

Swinton points out the significant implication of emphasizing a holisitc method for mental health care. The problems of mental wellness concern not only the mind but also every dimension of human existence. Matters affecting the psycho-spiritual dimension will also influence a person’s physical dimension. The same is true for the impact of a person’s physical dimension on the psycho-spiritual dimension. The loss of function in any dimension, whether it is physical, psychological or social, will adversely affect the human spirit. As in the case of depression, the spirit of the ill is often bounded by physical, psychological, or social issues.

There was a woman who spent a quarter of her lifetime dealing with mental illness. Her first episode took place at the age of twelve when she experienced what is called Recessive Depression. The birth of her second child triggered Postnatal Depression. After her first clinical examination, she was diagnosed with Manic Depression.

Manic Depression triggered negative emotions in this woman and made her want to harm her baby. She experienced feelings of extreme sadness, gloom and hopelessness. With every step she took, she felt like she was walking barefoot on broken glass. Her every thought, breath, and movement gave her pain.

During the five years of her depression, she was hospitalized five times, receiving electroconvulsive treatment. It was only after the physician identified the cause in her brain did her condition gradually improve.

While ill, she read a number of books about mental illness. She wanted to find the answers to some of the important questions about the meaning of life: Why did a Christian like her suffer physically and psychologically? How should she connect her mental illness to her religious faith? Can Christian faith explain the roots of mental illness and provide possible treatments to the illness? She was trying neither to resolve the problem of sin nor to seek a philosophical explanation to these questions. What she really wanted was to find a way to understand, to accept, and to deal with her illness through the Bible and her own experience. She wanted to understand her struggles in mental illness theologically.

Spiritual Care

The story of this sister in Christ enables us to see that those suffering from mental illness must not only find the physical cause and the development of their sickness, they also need to confront the issues of their religious faith: The meaning of life and its purpose, their own self-worth, and their hopes and dreams.

In church history, we learn about the stories of some faithful Christians who suffered from mental illness. William Cowper (1731-1800) was one of them. Cowper authored many well known hymns. When his mental condition was stable, Cowper’s creative ability was superb. He talked about social issues like slavery in Africa in his hymns. The “Prince of Preachers” Charles Spurgeon suffered from depression; so did the spiritual master Henri Nouwen and the great educator Parker Palmer.

These Christians dealt with their own illness from spiritual perspectives. In suffering spiritually, their lives remained close to God. They did not believe that mental illness was God’s judgment and punishment. To them, coming to terms with sickness without seeking treatment is a compromise between religious faith and fate. They believed in “relational” healing. They experienced mental illness like darkness which also kept them company throughout the days of their lives. In sickness, their focus in life was on “God” and not on the self of the “person.” These Christians shared their understanding of the meaning of life in their experiences of mental illness.

Psychiatrists and psychotherapists often employ their tools and methods, and use technical language to explain the experiences of the ill. Their voice is regarded as the authority and that sometimes drowns out the voice of the patients. This being the case, physicians and therapists explain what they can understand from the patients. However, they may not be able to hear the voice of the patients as the patients explain and reflect on their self-experience. The voice of the ill must also be heard. From the voice of the ill who hold their religious faith close to their heart, we can hear stories of experiencing God and reflections on their faith. These stories and reflections of the ill are testimonies of their faith. This faith facilitates the beginning of their pilgrimage towards recovery. Their experiences of and reflections on the illness can lead to deeper theological reflections and perspectives.

Therefore, mental health care providers must “hear” the spiritual experience of the ill. Despite the lack of firsthand experience in the illness, mental health care providers can be led to understand what religious faith means to the ill by listening to the faith stories of the mentally ill. Such an understanding is beyond mere explanation of the medical conditions of the ill. In other words, theology and psychology must confront the present (experience prior to literature) in order to comprehend the mystery of God’s “revelation”.

Care providers can enter into the religious faith experience of the ill through “understanding.” Understanding is different from knowledge. Understanding brings about transformative praxis. This leads to a “practical” theology of mental wellness. Understanding is not a technique but an art. It is a practical wisdom that calls on mental health care providers to value experience more than rationalists. This practical wisdom further leads to the development of a new dimension and intuition. Such wisdom takes human spirituality seriously. It demands the care providers to search deeply into human experience. Being different from physiotherapy and psychotherapy, the focus of the practical wisdom is not on pathology but on the meaning of illness. This wisdom does not simply consider removing the symptoms of illness. It demands recording the accounts of the illness as an important dimension of the lives of the ill. Only when this dimension of life is read and understood can the ill be holistically cared for.

It can be concluded that spiritual care is a hermeneutical, practical wisdom. Spiritual care providers must concern themselves with the spiritual needs of the ill and seek to nourish the relationship between man and God. If we focus on “Meaning,” spirituality will become a very important matter. When we take human’s spiritual dimension seriously, we will be able to provide holistic care. While spiritual care accepts the importance of pathology as a reality, spiritual care speaks of mental illness as neither simply a physical nor a psychological problem. Mental wellness and spirituality are interconnected. Spiritual care is a holistic care that encourages humans to seek God and to search for hope, value, meaning, and purpose in life. Spiritual care develops personhood in the ill and enables them to get along and live well with others.

Seminary students who will become pastors and spiritual care providers must learn to practice holistic care. The care begins with interconnecting psychology, hermeneutics, theology, and pastoral care. It is the learning direction for the Seminary community to move from understanding mental wellness to performing the transformative praxis of spiritual care. This is the learning task of our teachers and students.

May 2014