MENTAL ILLNESS AND THE CHURCH Rev Simon McLeay
Last Tuesday I had a painful reminder of how awful Auckland traffic is - an hour and 15 minutes of not going faster than 10 kph on the southern motorway. Cate, Rob, David and I had left Tauranga at 5.30am and we were still late for a seminar on Mental Health and the church. But you know what? It was still worthwhile – fascinating and moving. We listened to two psychiatrists, a psychologist and a Dr of Theology. Today I want to share a few insights that I believe Jesus gave us through those wonderful speakers.
The first thing was a model of mental illness presented by Dr Mike Ang, called the Stress Vulnerability Model that was a different way of looking at mental illness. He said “what if psychosis is a normal response to an abnormal combination of risk factors and stressors?” He also said If we all smoked enough P, we would all have a psychotic experience.
Secondly, Mike did a role-play where he showed us a little bit of what it’s like to be plagued by hallucinatory voices. He interviewed a pastor and got two people to sit behind him just whispering his name and then slowly more loudly saying negative things about him. It was a watershed moment for me when I realised how much some of my friends with hallucinations have to put up with. I thought how brave they are.
Thirdly, we talked about what if churches said “people with asthma can’t serve in the welcoming team”. We’d be horrified, but how often do we unnecessarily exclude people with mental illness? He then went on to talk about how we, as churches, can support and care for members with mental illness.
Our reading today about Jesus and the man from Gerasene raises an ancient dilemma that Dr Mike spoke about - is the demonic involved in mental illness? In Jesus’ time, the doctors ascribed mental illness to demons. Today, most doctors would discount the demonic entirely, but I want to suggest a fresh understanding that leverages off the stress vulnerability model to set you free!
I want to start by separating Psychosis and Demonic affliction. I want to ask, could there have been some mental illness in Jesus’ time that was commonly described as demonic but was, in fact, just mental illness and Jesus cured it? He didn’t describe categories people wouldn’t have understood, he just cured them. AND could there also have been some people who were truly afflicted by demons and Jesus cured them too? I want to suggest that the story we read today may have elements of both; a man with perhaps paranoid delusions, and a man genuinely influenced by spiritual parasites. My evidence for the reality of the demons is that they appeared to go into the herd of pigs and be drowned. But note what name Jesus draws out of the man about the things afflicting him. ‘Legion’ meaning ‘many’ but also a military term, and on that side of Lake Galilee there were also many ex–soldiers, and who knows what those soldiers had seen in their fighting, and how that might have affected them? Perhaps there are lots of things going on?
If we return to today, how do we find our way through this fog? How do we make it clear that mental illness, from psychosis to depression, is not demonic? But perhaps some illness can be affected by the demonic.
I bet I’ve got your attention! Some of you might be thinking, “don’t tell people that mental illness is all demonic – that’s a load of rubbish”. And some of you might be thinking “don’t discount the spiritual. These things are real!”
Let me present you my thesis, which I believe charts a fresh way through this tension.
What if psychosis is not demonic, but a human condition, perhaps the result of this Stress Vulnerability Model. But what if one of the stressors that some people experience is a demonic affliction? So the illness is not demonic, but one of the stressors that brings on the illness might be demonic? What if we put psychosis in the same category as asthma?
So what is psychosis?
A severe mental disturbance indicating gross impairment in reality testing. Mike’s definition includes manifestations of psychosis (e.g. delusions, hallucinations, grossly disorganised and bizarre speech or behaviour). So you can see that our chap in Galilee might have been psychotic. Hallucination may be an experience of hearing voices, without there being an external source. Often the hallucination seems very real, often negative but not always, and very distressing – hard to keep functioning with this voice going on in the back of your head.
After seeing Mike’s role play I had this insight. I sometimes get woken at 4am in the morning and all the things I’m worrying about bombard my mind, got to do this, got to do that. I’ve never had hallucinations, but maybe they are just the mind taking that experience a little further. Stress related.
Psychosis can also include delusions - fixed false belief, not amenable to reason, and not in keeping with that person’s subculture (e.g. a delusion of persecution, a delusion of grandeur – I’m the chosen one). The delusions are held with such certainty.
The ancient model of Psychosis was that it was all demons. That’s not Christian, that’s Roman and Pagan as well as Christian. Then there’s the 20th century medical model, which says mental illness is all about chemical imbalance in the brain.
The Stress Vulnerability Model doesn’t deny the brain chemistry but wants to talk about where it comes from as the combinations of:
Vulnerability factorsthat pre-dispose you to, or put you at higher risk, for psychosis.
Stress factorsthat may precipitate the onset of the illness and perpetuate or maintain the illness.
Protective factorsor strengths that may help someone overcome their illness.
Vulnerability factors include a head injury, some genetic background, a history of abuse in childhood – there are a whole range of vulnerabilities.
Stress factors include loneliness, relationship break up, grief, substance abuse (especially cannabis, methamphetamine or P, the psychedelic drug NBOM, or LSD).
Then there are Protective strengths that help people recover or avoid. A loving church could be a strength in many people’s lives.
What I love about this model is that it asks, “Is psychosis a normal response to an abnormal combination of risk factors and stressors?” We’re all in this boat together and if anyone of us got put under enough strain, or started using P, psychosis is the way that brain ends up responding. It breaks like a broken leg, but it can also repair.
I want to suggest that the Stress Vulnerability Model is a great middle layer (3) for our understanding of mental illness. I want to describe five layers altogether. Then we’ll talk about what we as the church can do.
Let’s go down a layer into the brain (2). Mental illness is affected by, or affects, brain chemistry. So with depression we are often talking about serotonin (a significant mood affecting hormone). With Psychosis it seems we are talking about dopamine (a neurotransmitter). Very broadly, we are talking about the fight / flight response. If the fire alarm goes off and you see flames in the back of the church, your system is going to be flooded with dopamine, and you are ready for action. It affects every part of you including increasing the clotting ability of your blood. Now imagine your system gets out of whack and you start to have a dopamine reaction to me brushing your shoulder. He’s trying to kill me - defend myself, panic. If you live like that you experience huge anxiety and it’s no wonder the brain comes up with coping strategies, or just stops managing.
Another level down (1). There is research at the moment suggesting our mood can be significantly affected by our gut flora, our Microbiome. I’m not joking. We have known for years that the brain affects the gut, when you are stressed you will often gain weight or lose weight. It has been suggested “Scientific American 1 March 2015” that through the vagus nerve the gut sends hormonal messages back to the brain. Evidently the flora we have in our gut, on our gums and on our skin comprises 90% of the cells in our bodies. They are tiny, yet they represent something like 10 times the DNA complexity of the rest of our cells. So what we eat and our gut health almost certainly affects our mental health. Highly refined foods do us no good, fermented foods appear to do us more good. That’s another layer of health. Physical parasitic organisms that affect our mental health.
Let’s go up 3 levels (4). I believe that diseases live not just in individuals but in populations. The epidemiological model. If you were on the space station alone with a cold, once you defeated that cold, it would disappear. I think the same is true for mental health. Clearly some stressor factors are population factors - if you are in a socially deprived group it affects your mental health. Those living in cars today will eventually have their mental health affected. Hopelessness is a major stressor for mental illness
Let’s add to this model a spiritual level (5). Here I’m not talking about aromatherapy and feng shui; I’m talking about malevolent spiritual beings that share the space time continuum with us. Fallen angels perhaps, or spiritual parasites. I believe that we can all be afflicted by an unclean spirit; but I’m still of the opinion that once we give our lives to Christ we can’t be possessed by an unclean spirit. Again, here’s my thesis. The demons aren’t psychosis itself, they are a stress factor (perhaps a major stress factor) that can bring on psychosis. Psychosis is a mental illness. So if you’re experiencing psychosis and you used to dabble in the occult, then certainty it is worth asking whether you are being afflicted by a demon. But if you agree with my thesis, you don’t have to see the psychosis as possession.
I believe that the bible teaches a holistic model of personhood and health (mind, body, spirit) and all these interplay on each other.
Let’s go back to our demon-possessed man (vs 27). Jesus took some time to deliver him. Many times the demon had seized the man. In the end Jesus spoke to the man and asked about the demonic presence. Maybe Jesus is accepting the delusion, maybe he’s speaking to the demon. Whatever he does, there is no violence from Jesus, his deliverances are always at a word. Now I’m thinking of the environment the man is living in. Jesus cast the demons into the pigs, who drown themselves. This unclean spiritual energy wants to kill. Look at the courage of the man – he has resisted those voices who have been whispering death at him perhaps for years. People who suffer mental illness are so brave. As soon as this evil energy goes into the pigs they kill themselves. I think we have here a real demonic presence. I think we have here what looks like a man who’s had a psychotic episode, but I think the demonic was a stressor pushing the man into psychosis, rather than the possession being the psychosis. When the stressor was removed the man recovers - the man is sitting at Jesus’ feet, dressed and in his right mind. Pigs were unclean to the Jews. Perhaps this man had been living with this tension of “Don’t eat pork” but surrounded by pork, and that also contributed to his psychosis? Perhaps not.
So what can we do?
(1) Love the people you encounter who are suffering mental illness “there but for the grace of God go we”.
(2) Accept mental illness as a normal part of life in our community. Included mentally ill people in your life activities.
(3) Support the families of the mentally ill.
(4) Pray for people.
(5) When we are caring for a person recovering from mental illness, speak slowly, don’t fight the delusions, don’t make jokes, just keep our communication simple and caring.
(6) Don’t be afraid of the demonic. If you encounter someone (whether they are mentally ill or not) who you think is affected by a demon come and talk to me, don’t ever jump into an amateur exorcism. Two or three times in my life I have met people who I think might have been possessed, and they did not present as mentally ill. Regardless of mental illness, if someone is agitated and carrying a weapon, be careful. If someone is smoking P, treat them as dangerous.
We have doctors to help with the diagnosis, chemists to help with the serotonin and dopamine reactions, dietitians to help with our gut flora (eat food, mainly vegetables, not too much) but we, the church, can help with the community level, and we can pray and love good spiritual health into each other. Amen.