and the Family
Family Home Page
Crisis Home Page
Resources Home Page
Working with People with Mental Illness
People with an ongoing mental illness are often isolated. Very often their loss of self-esteem or the symptoms of the illness exacerbate the tendency to withdraw. A consumer describes her experience:
When you say moving within ourselves, withdrawing, I don't think it's withdrawing. But sometimes what we are experiencing is terrifying. I think this is a key issue. Others are not experiencing what the ill person is. It is this experience, this reality to which we are reacting. And, understanding that, may lead to a pastor being able to reach someone. Or just sit, and just be, and just be present with that person.For that person it is tremendously affirming to have a relationship with a pastor or someone in the congregation because all too often that person may have no other friends or support systems. The pastor should reassure the person that God knows, loves and understands the person's needs even if he/she is too ill to express them to God.
When a pastor provides a referral to mental health resources, it does not imply that the individual's spiritual needs are not real. Neither does it imply that a mental health professional, agency or support group will necessarily deal with the person's spiritual concerns. What a referral CAN do is provide treatment for the person's mental illness. At the same time a pastor can provide care and support that focus on the religious and spiritual dimensions of the individual's situation. In many cases having the support and ongoing involvement of his/her pastor will enhance the prospects of a person having a positive experience with a psychotherapist and/or rehabilitation and support programs.
ThemesAlienation: Often people with mental illnesses feel alienated and misunderstood. Many factors contribute to these feelings. People with the illness may have little awareness of the process of the disease. Their own thoughts and feelings may be disturbing and opposed to what they have learned to expect of themselves as persons of faith. They sometimes judge themselves as unacceptable to the faith community. Or, they project their own judgements on the congregation and perceive that people are condemning them for their lack of faith. As a result, they pull away from the congregation (Uken, 1986, 7).
Punishment or Judgement: Individuals suffering from depression and feelings of hopelessness and helplessness because of their illness, may focus on religious themes of judgement. Some people believe that God must be punishing them or why would God have them in this situation. There is a strong feeling that the person is the guilty one, who has failed others and him/herself. The person believes that punishment from God is deserved. They may feel excessive guilt or shame, or believe themselves unworthy or incapable of accepting comfort and forgiveness for past failures. People who suffer from paranoid symptoms may focus on religious themes of persecution and the fear of being punished or abandoned by God and others (Weisinger, 1991, 32-33).
When something like mental illness comes along, which is so incomprehensible to somebody who has otherwise had a reasonably solid life in terms of family background, schooling opportunities, professional opportunities, it's absolutely so devastating that it tends to severely shake faith. Why, if there's a providential God, which I believe there is, why does he allow things like this to happen to otherwise good people?This issue has been voiced repeatedly by those who have experienced a close relationship to God in the past. Suddenly the person finds, in the midst of their emotional distress, when they sense very desperately a need to reach out to God for support, God is not there for him/her as before. Where before He was very close and involved in their lives in a meaningful way, now He is distant, removed and unmoving - or so it seems to some people undergoing the pain of mental illness (Wagner, 1985, 80-81).
Physical Isolation: It may be that the illness makes it impossible for some people to tolerate the stimulation of being in a worshiping community. They may be unable to socialize and visit as often as is expected in church. Sometimes it is impossible to think clearly. Bible reading may be more confusing than helpful. Prayer may seem impossible. They may even feel they are losing faith.
My hope is often shaken by my periodic episodes of depression. It cost me my Air Force career. It cost me my marriage. It cost me, basically, my family. I only see my daughter once a year. This cost me every major romantic relationship I've had since it becomes too difficult for a loved one, a woman in my life, to put up with it for more than a year or two. I feel a social disparity between myself and my family members, because of my sense of deprivation and seeing them thriving. The same is true with friends, who are very achieving persons as I am when I'm well.Delusions: Some people may have frightening experiences such as having delusions of being either Christ or the devil or hearing special messages or commands from God or demons. They may conclude they are evil, that God is abandoning or punishing them, or that they are lost. Just when these persons need to be reassured in concrete ways that God is with them, that the congregation is supporting them and praying for them when they cannot pray, they may feel threatened, judged or punished, abandoned and isolated (Uken, 1986, 7).
Worthlessness: Willard Wagner (1985, 82) describes a case where a pastor's wife characterized her life prior to coming to the hospital as a life of giving to others. For years she had taken an active part in church programs. She taught, led bible study, called on shut-ins and was involved in the activities of the parish. What caused her the most distress and contributed to her sense of worthlessness was that although for many years she had taught others that they should trust in God, she now found that she had great difficulty in trusting in Him because she felt that she was totally cut off from Him. Along with the loneliness of being disconnected from God she also experienced the loneliness of being out of touch with other people and with herself. She believed that all she had attempted to contribute in the past was meaningless and worthless. She came to a point where she gave up going to church, one of the things she had previously enjoyed.
Elation: People experiencing mania or a delusion may feel euphoric and elated because of their condition. They may have an elevated sense of self-importance or an exaggerated opinion about their relationship to God. They may lack an appropriate sense of shame, guilt or self control. They may feel that they can behave inappropriately without suffering the consequences of their actions (Weisinger, 1991, 32-33).
Copyright © 1999 by Pathways to Promise. All rights reserved.