Working with the Family

Reaching Out to Families

My son became ill and I had to get help for him then. He was beginning to be very paranoid about my husband adjusting the heat and turning the lights on and off. I called different places trying to get help. They said they were sorry, they couldn't do anything, because he's an emancipated adult. I said, "I beg your pardon? This is my child, and he's becoming very sick." We took him to the hospital. I didn't have a choice. I remember it tearing me apart as I watched them take him away.

For families, an essential contribution of clergy is the development of personal relationships with the family as congregants. Often, more so than anyone else, clergy have the opportunity to know a great deal about a family. They may know who in the family can be counted on in a crisis or where the lines of authority and power are drawn. They are likely to know of a family member's successes and failures. They are likely to know of the family member's hopes and dreams. And, in times of great stress or crisis, they may have thoughts shared with them that reveal things that no one else knows. Clergy, with the knowledge of the public and private sides of their congregants, are in a unique position to provide much needed support during times of crisis (such as hospitalization) and to offer effective follow up care when the crisis has passed.

When mental illness strikes a family member, a pastor can be instrumental in helping the family maintain a sense of perspective, equilibrium and connection. Often he/she can be a liaison between the family and those providing treatment and/or assist them in finding appropriate treatment and community services. Clergy, in representing the faith community, represent a place where people know there is hope, forgiveness and acceptance. The pastor can remind every family member that each one of them matters to their faith community. A pastoral visit can reassure the family that one is remembered, prayed for, and cared for. This gives support to the ill person and the family. The sharing of prayer, ritual, or a communal remembrance often speak of the stability and care of the faith community more profoundly than words. The importance of knowing that one belongs, is wanted, and is valued cannot be over emphasized.

It is also important for the pastor to create an atmosphere of acceptance and welcome in the congregation. By doing this the person who is ill, the family and the pastor are able to draw on resources within the congregation. A family member describes what happened in her congregation:

When I first talked about mental illness, they didn't respond very well. I didn't understand that the pastor has to endorse things. But now the pastor is up every Sunday mentioning something about mental health. Since he is talking about it, it's okay at the church. Now everybody is running to me saying, "I need help with this." I was shocked that it really took that. I even get phone calls at work about "where can I go, what can I do." I refer them to different organizations. It's a network within the church that his speaking about it helped us start.

However, the reverse can also be true. In times of crisis some people feel cut off from their spiritual resources and unable to connect with God. Pain and emotional stress in a difficult, ongoing situation can weaken even the strongest faith. Isolation from those who have supported and nurtured a person in the past can cause people to turn inward and withdraw from contact with their congregation and pastor. This can test the skills of any pastor, because the family is NOT communicating.

In some cases a family may have sought the support of clergy in the past and found an inappropriate and sometimes hurtful response. For example, a wife describes how a pastor was a tremendous help when her husband went to prison as a result of passing bad checks. This pastor is involved in a prison ministry and was a wonderful support for both the wife and the husband. He visited her husband in prison, helped the couple with marriage counseling and supported the husband as he searched for a job. Since leaving prison, the husband is doing well. He became involved in church just as she had. He has become a leading car salesman in his state. He also accepts his illness and realizes many of his problems are due to bipolar disorder. He is now on medication. Together the couple is working to keep him on it. However, the couple is becoming estranged from the pastor because he does not believe that mental illness is an illness. He sees the husband's illness as a form of moral weakness and lack of discipline. This couple continues to need the pastor's understanding and support. However, this is being denied because of this pastor's ignorance about mental illness.

Another family member described an occasion when she attended services on Christmas eve with her son who suffers from bipolar disorder. He had been too ill to take part in any holiday activities. But, he did feel well enough to attend Christmas Eve services. She was encouraged that he was well enough to participate in this celebration of Christ's birth. It was not to be. The minister's sermon included a joke about mental illness and references to "crazies." Mother and son left quickly before the service was over. For this woman and her son there was no understanding, no fellowship, no solace.

Although people may be reluctant to discuss a family member's mental illness, it is difficult to hide it from everyone. Very often neighbors, friends in the congregation and close family friends do know what is going on. They may contact the pastor with a concern about this family. At this point the pastor must take the initiative or the family often will remain isolated.

The pastor who reaches out to a family should not be surprised to find some families defensive and wary. As noted before, they may have opened up to clergy in the past and received an inappropriate response. For example a family member described an experience she had with the two pastors in her church. One of them, in the ministry for twenty-five years said: "You mean there's a medication for depression? Why, that will change my whole way of counseling." The other, fifteen years out of seminary, believes persons with a mental illness such as schizophrenia, are demon possessed. Families who have such an experience quite naturally, learn to protect themselves and their ill loved one.

The family may not seem receptive the first few times the pastor reaches out to them with a phone call or a note. It can take time to overcome feelings of pain, distrust and fear. Even when the family is not ready to accept more than the pastor's expression of support and concern, that expression of care may be very healing and supportive for them. The same can hold true when members of the congregation reach out to the family.

When the minister is patient and compassionate, the family most often will feel that a "safe place" has been created where they can discuss the situation and receive guidance and support. John Cannon, a family member and a pastor comments:

Once the minister has been taken into the family's confidence, what the minister is to the family is more important than what he or she may do. That is, the family needs to feel that the minister is willing to participate in their experience and is with them in seeking God's presence. This emotional and spiritual bonding can become a means through which God can enter into the family's situation (Cannon, 1990, 219).

The family, as they discuss the daily living situation, may talk about many problems, but may find it difficult expressing their spiritual distress. If they have had a strong faith connection in the past and now feel distanced from God, this may be very painful to admit. Or, it may make them feel guilty and unworthy. People in this situation may have doubts about God's love or they may be angry with God and despair of ever reconnecting.

Families often compare their experience with mental illness as a journey through the stages of grief which is very distressing until they are able to accept the illness and God's power to heal. Mental health professionals and members of a support group can help in finding ways to manage daily life. They can be very supportive of the family. The pastor can also serve in this role. But he/she has an additional role. Because of their viewpoint, clergy can assist the family in confronting the deeper issues and their spiritual implications. Often the pastor is the only person with whom family members feel safe to discuss such concerns.

Each family member has a different experience with the ill person. The parents may have changed expectations and concerns about what will happen when they are no longer able to be there for their child. Siblings may have concerns that they or their children may be struck with the illness. They may resent the time and attention the ill person requires. They may wonder if, when the parents are no longer able to be the primary support for this person, this is a role they will have to take on. A spouse may have concerns about the long term impact on the marriage and on the children. Family members may have concerns about finances being depleted over a lifetime, as insurance rarely covers many of the expenses associated with mental illness. Children may be embarrassed, frightened, and confused by a parent's mental illness.

Concerns about daily living, concerns about the future and distress about the past strike each family member in different ways. Guilt, anger, fear, confusion and exhaustion are emotions associated with living with such illnesses. Every person displays such feelings in unique and differing ways. What is important to remember is that either separately or in a group, each family member who wishes to share their concerns and spiritual distress should be able to do so. Only when the pain is heard can the healing begin. The instruments of ministry such as prayer, scripture and ritual can be helpful. Responding too quickly or superficially may be perceived as an unwillingness to hear pain. To reach out successfully to families can require an extended time commitment. But that is what the role of the faith community is - to be constant, patient, accepting, and a place of solace and safety.