Thursday, May 22, 2014

Mental Illness

I have an interest in mental illness and how it relates to God, free will / sovereignty, biological disease, sin, and the 'normal' experience of life.

These posts (part 1, part 2, part 3, part 4) by Brad Hambrick are very insightful! All he writes is a list of questions that get you thinking.

I like the following questions in particular. Any thoughts from people?

  1. In the modern psychological proverb, “The genes load the gun, and the environment pulls the trigger,” where is the person? Why do we think of genetic influences as if they negate the role of the will or personal choice? Substance abuse can have a clear genetic predisposition, but every addiction program – even those most committed to a disease model – appeal to the will as a key component to sobriety.
  2. Can we have a “weak” brain—one given to problematic emotions or difficulty discerning reality—and a “strong” soul—one with a deep and genuine love for God? If we say “yes” to this question in areas like intelligence (e.g., low IQ and strong faith), would there be any reason to say “no” about those things described as mental illness?
  3. How much should we expect conversion and normal sanctification (spiritual maturity) to impact mental illness? Outside of medical interventions, most secular treatments for mental illness focus on healthy-thinking, healthy-choices, and healthy-relationships; so how much should Christians expect sound-doctrine, righteous-living, and biblical-community to impact their struggle with mental illness?
  4. Would we want to eradicate all anxiety and depression if we were medically capable of doing so? What would we lose, that was good about life and relationships, if these unpleasant emotions were eradicated from human experience? Would that be heaven-on-earth or have unintended consequences that are greater than our current dilemma?
  5. Can we have a collective disease? Is mental illness always personal or can it be cultural? Cultural changes necessarily add to or detract from the kind of stresses that influence mental illness. How should we understand this influence and when might an “epidemic” require a collective solution as much as personal choices?
  6. Are we trying to medically create an idyllic sanguine personality? Is “normal” becoming too emotionally narrow? If not in the medical establishment, then are societal norms pushing people in this direction and the service-oriented medical profession trying to accommodate its well-intended, but misguided clientele?
  7. How do we best assess when the relief of medication would decrease the motivation to change versus when that same relief would increase the possibility of change? Pain can both motivate and overwhelm; is this simply about personal thresholds or should mental anguish be evaluated by a different set of criteria?

11 comments:

  1. Hi Josh,
    This is a great subject and one around which Sylvia and I have invested a great deal of discussion and study - with her interest in youth addiction which invariably overlaps with mental health and both of our interest in the impact of global economics and colonialism on health and culture. I gave a message at the HUB on Sunday that addressed these issues regarding our own colonial history (http://holyunifiedbody.org/the-gospel-in-aotearoa-nz-part-5-trouble-and-turmoil/). My question at the end was kind of like question 5 above - can we have collective mental disease? I asked "Is sin (and salvation) just personal or it it also (and perhaps more importantly) systemic?"

    When we see Maori for example over-represented in addiction, incarceration, mental health, family violence it surely must trigger thoughts about cultural dislocation, historic injustice etc. How can a person who has come from a history of social dislocation, disempowerment and injustice and currently lives without any real hope not succumb to mental illness and addiction?

    There's a great book by Bruce Anderson - a Canadian addiction psychologist - called Globalization of Addiction. He argues that sustained social dislocation is behind much of our current addictive behaviors and mental illnesses. His book covers case studies from all around the world and from history about the predictable affects of disclocatioon caused by war, colonisation, industrialisation and interestingly the same thing being caused today by the global economy. There's an overview here: http://www.globalizationofaddiction.ca/articles-speeches/176-change-of-venue.html

    My perspective is that what we are seeing is "rulers, against the powers, against the world forces of this darkness, against the spiritual forces of wickedness in the heavenly places" that function through the empires of the day (just as they did through Rome, Babylon etc). I think as Evangelicals we focus too much on the personal nature of sin and can be kind of blind to the systemic evil that creates conditions where mental illness, addiction and violence are almost unavoidable. Of course there is a massively important individual dimension to sin and salvation but I think part of the work of the church is to work for the kingdom of God on a systemic level as well. Rather than just trying to treat the fruit through psychology, science or theology (important though those things are) go for the root - exposing the root structures that are blatantly anti-human and anti-Christ.

    No-doubt radical to most Christian but I think we have a pretty good biblical and historical basis for this sort of thinking.

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  2. Does not all forms of our suffering in this world come down to what is in accordance to our Heavenly Father's will? For even if it is all on account of us exercising our freewill, who could make a choice about anything without Him allowing them to in the first place?

    Romans 8:18-21 provides critical written confirmation of His intent. For it is written: I consider that our present sufferings are not worth comparing with the glory that will be revealed in us. For the creation waits in eager expectation for the children of God to be revealed. For the creation was subjected to frustration, not by its own choice, but by the will of the one who subjected it, in hope that the creation itself will be liberated from its bondage to decay and brought into the freedom and glory of the children of God. {NIV}

    In other words, our suffering in this world is all part of the apparent gross unfairness of having to live in this world as we naturally are, but since we can bring down more hardships upon ourselves than would be absolutely necessary to accomplish our Heavenly Father’s ultimate purpose in and through us, we would do well to not take such things as addictions too much for granted. For it may very well be by one’s actions that they have become addicted to something.

    As with everything else, the key to understanding what is really going on with a situation of mental illness or an addiction is wanting to truly have a very close and personal relationship with our Heavenly Father, which goes far beyond one-sided prayers and diligent study of His Holy Scriptures. For He is actually quite eager to explain Himself to us, but of what value is this to those who do not want to accept it?

    Be assured that I am all too painfully familiar with what appears to be grossly unfair about living in this world. For I can see now where I greatly aided with the destruction of my health over 20 years ago, and our Heavenly Father has not healed me yet. In fact, it may not be until my time as a part of this world has come to an end before He does so. Therefore, please do not think that I take situations of physical or mental affliction lightly.

    Speaking of my own very poor health, it has become much more difficult for me to try to participate in discussions here. So, if you would like to reinstate the word verification spam shield, I will understand.

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  3. Hi Clive. Great comment.

    I've also done a lot of research into 'indigenous peoples' problems because my work brings me face to face with some stark disparities. The principles apply to ANY minority / disempowered / 'different' group (I call them 'problem groups' since this is how the majority often view them), and I think are very relevant to missions, church life (think of the eccentrics, social recluses, 'sinners'), etc. Clearly these a complex and poorly understood issues, and I don't really claim to know much, but I am frustrated by the apparent unwillingness many people display to consider the societal factors that play into these issues.

    A few common examples of this lack of insight are blaming poverty on personal laziness, putting western 'education' on a pedestal for its importance in allowing 'success' to non-Western people groups, and calling for minority groups to stop focussing on alleged Western racism and just get on with life alongside us. We don't delve into the societal factors that drive and encourage laziness for minority groups. We don't consider that they may have very different definitions of 'success' and 'education', or that the best way to work towards anyone's version of success might be different for them. We don't realise that what we're really assuming is that they are just like us - the majority group, the archetypical 'White Western Middle-class Male'. That what we're really saying is 'I don't have a problem living in my world. You're focus on our differences is the cause of racial conflict. If you could just be like me (a white middle-class male), your problems would disappear'.

    One barrier is simple lack of experience, and it is impossible to avoid. Societal factors impact different people groups in different ways. Because we haven't lived in anyone else's shoes, we automatically assume that everyone is impacted in a similar way to us, and even without assuming anything we still don't know what impacts them and how. Things that encourage laziness in us might not in other groups, and things which empower us might encourage laziness in other groups. Western 'education' may not empower others to succeed even if they defined it the same as us. In fact, simply adopting Western values or western 'success' definitions (or any majority value system) has widespread but largely un-studied effects on non-western (or minority) groups. And a lot of it is NOT beneficial.

    Another barrier is the perceived 'guilt' we associate with 'primary causes'. If we admit that we are part of the primary cause of the 'problem group's' problems, we feel that we are somehow guilty, and that this absolves them from responsibility. I don't think either of those assumptions is true. What makes us really guilty is refusing to honestly consider the problems others' face, or (once we have considered it properly) refusing to act in ways we know will help. Sometimes such action may be impossible - we may not be able to see a way forward, or all the alternatives may be WORSE than the current situation. But at least we can have more genuine empathy and compassion for others, and allow them the freedom and encouragement needed to persue either Western values OR their ethnic values.

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  4. The very act of discussing 'problem groups' can be based on the assumption that we know what is 'beneficial' and what is not! Ultimately only God has the right to define 'benefit' for all people, and only He is the source of this benefit. If He choses to enlighten or use us in any way to help others, we should be thankful. And He has done a lot of this through Scriptures, though we still go and add innumerable layers of subconscious subjective interpretation, as if God and the authors have our value system! We desperately need to maintain humility and love through any discussion on these topics. And where God is not clear, it is only the members of the 'problem groups' that can truly define these things for themselves. But this too is difficult - how can they avoid the inevitable subtle coercion to adopt the 'majority' 'accepted' value system, with all the unforeseen consequences such adoption brings to them?

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  5. So many thoughts could be strung from that excellent list of questions Josh :)

    Hi Jerry,

    Romans 8 is a fantastic encouragement for us to press on in our struggles. I totally agree on the point that nothing happens to us that is other than what God has allowed. It truly is comforting to know that no matter the trials we encounter we can have hope during them, knowing that God means them for the best.
    I am not sure what is ailing you Jerry, but I am VERY happy to continue posting people's comments; so don't worry about that! Is there anything else that could be done to aid your participation?

    Great comment Clive. I second your thoughts about challenging systemic evil in society. This was brought to my attention the other day by one of my non-Christian class mates. She observed that often Christians look to give to others but only on a simple level, often having little effect on the future.

    This led me to question whether we are guilty of finding a quick excuse to give so that we can "receive" without intelligently seeking where our giving would be most effective?

    I sometimes wonder whether we should be focusing on primary prevention giving rather than secondary or tertiary level giving such as food banks etc. Sure we can feed people a fish and that is what some people need, but it feeds them only for a day. Maybe we could teach them to fish and feed them for a while? In reality that might not even be enough. The structures of today demonstrate that the waters themselves are polluted and therefore makes fish giving and fishing education a mere band aid on personal survival.
    Maybe we need to have a wider focus as believers in Christ, to challenge corruption in the systems that people rely on to live?

    In the sense of mental health, should we be finding ways in which to prevent the systemic causes of mental health in our society (which have innumerable causes). One thing I am not so sure of is the segregation of "those" people off to asylums. I realise asylums do a lot of good, but I hope we don't lose the importance of community and family support around people suffering from mental health issues.

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  6. {Part 1 of 2} Alas, my dear Daniel, none of the doctors I have been examined by have been sure of what is ailing me, either. Be assured that the question of whether this is due to their incompetence or there not being any natural reason for it swirls around in my mind quite often, and our Heavenly Father has yet to provide me with an answer—other than it being something that I am meant to endure for His glory and my ultimate good. Be assured that that last part about it being for my ultimate good is something that I greatly struggle with—much to my great shame.

    In regards to me thinking that I greatly aided in the destruction of my health, I justify this with the fact that I logged (not officially—let alone legally) over 200,000 miles of driving a big truck (18-wheeler) for 10 straight years while going over a 1,000 miles on many a day. The grand total of my driven miles over the 17 years I was on and off of the truck comes to right at 3,000,000. So, when I started feeling like I was suffering from a fairly severe case of the flu that would not end, I figured that I was just plain worn out, but when there was no recovery to be found, it seemed that there must be something else going on.

    No, I never took any illegal drugs, like cocaine or crank/crystal meth, but I did start taking an over-the-counter form of ephedrine in ever more increasing amounts after being able to usually drive around 20 hours a day completely straight was not getting me to where I wanted to go fast enough. Since ephedrine is one of the primary ingredients (which I did know at the time) of crystal meth, I thought that I may have burnt out an essential gland or two, but it has been as if I never said anything about it at all to every doctor I have told this to.

    I was finally diagnosed with chronic fatigue syndrome, which is basically come to by eliminating all other known possibilities. Since there is no known cure (according to the doctors I have seen) I am left with feeling like I am suffering from a fairly sever case of the flu each and every second of each and every day—complete with the utter exhaustion, body aches, chills and hot flashes, nausea, diarrhea and an inability to focus my mind far too often for my comfort.

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  7. {Part 2 of 2} Getting back to my participation in the destruction of my health, the question of why I would push myself so hard while on the truck remains. Well, much of it had to do with the great drive and determination, which borders on obsessive, to my nature, but my motives were pure. For I just wanted to make as much money as I possibly could so that I could go into cattle ranching while I was still young enough to truly enjoy that kind of life. Ah, but my third wife went away with the bulk of the money I had made, and I wound up without the strength to even walk up to a horse—let alone crawl into its saddle.

    In regards to everything I have suffered so far being for my ultimate good, I must admit that I have learned a lot—both from divine revelation and personal experience. For I KNOW that our Heavenly Father has a hand in everything that happens simply from the fact that I never had any desire to take any cocaine or crank when it was offered to me for free and it would have made perfect sense for me to take as much of it as I could get ahold of at the time. For I have never had all that much self-control, which is proven by all of the years I spent as a drunk before crawling behind the wheel of a big truck.

    Yes, I know that the fact of me not becoming a drug addict when I could have very easily become one is unconvincing as an argument to those who do not want to believe that our Heavenly Father truly is in FULL control of EVERYTHING that happens, but before their time as a part of this world is over, they will not be able to honestly say that it was not made abundantly clear to them. May all who already know that the course of their lives is not really in their hands let go of their pride much sooner than later. For their resistance hurts Him deeply. Hence, the reason for His great wrath, which will be poured out upon the wicked, come Judgment Day.

    In regards to those who are allowed to be addicts, it is very natural for us to think that it is all their fault, but our Heavenly Father’s children by faith are instructed to stop making judgments on mere appearances, with John 7:14 serving as clear written confirmation of that. After all, what else could have been involved if it was not solely by their own foolishness that they came to be addicted to something?

    Do not the afflicted give us opportunities to put our Heavenly Father’s infinite mercies on display for the whole of the world to see? Yet, far too many “good Christians” would rather condemn the afflicted, which causes them to suffer even more greatly.

    Matthew 12:7 is actually helping to address something else more directly, but it alludes to the absolute truth of the matter truly being that all with the mind of Christ can understand what is really going on with someone while those without refuse to accept what our Heavenly Father would have them to fully understand. May He have mercy upon us all.

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  8. "The Benevolent Hecklers" has been included in Sites To See #374. Be assured that I hope this helps to point many new visitors in your direction.

    http://asthecrackerheadcrumbles.blogspot.com/2014/05/sites-to-see-374.html

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  9. Thank you for your openness and willingness to share Jerry!

    Truly it sounds like you have and are walking a difficult road. That is a road that I could not fully understand as it has not been a part of my journey. The fatigue that you are experiencing is definitely a matter for prayer and I hope that by the little we can do, we can be a support to you.
    You were saying that that your faith in God being in control of everything in our lives is an encouragement to you. I also find this as an encouragement when I experience troubles. Yet like you, I most of the time cannot see the reason for those troubles and simply have to walk by faith. It really is so hard at times to see the good, but I am sure that there is nothing wrong with us wrestling with some of God's decisions/allowances. It is simply being real, and yet not forgetting to respect God's sovereignty over our little lives. I don't think we should just ignore the difficulties of life's experiences.
    You are so right about how the view points of many Christians (I am guilty of it myself) look to blame the victims. We can fail to see the circumstances that have lead up to who a person has become. Instead of focusing on condemnation, the exciting thing we can focus on is providing love, and a hope for the future. This hope contains a faith in God that builds up the downcast and hinges on the hope that He can restore any person to Himself and finish the good work He has begun in us!

    I think it was a mis-reference 7:14... it was talking about Jesus teaching in the middle of a feast :)

    Matthew 12:7, now that is a fantastic verse; it really reveals God's heart. You thoughtfully brought up how suffering can be an opportunity to speak about God's mercies. On the same note, once we can truly understand how through Christ's strength we can change terrible situations into a situation of hope and trust, I believe we can change mindsets of bitterness and hate into ones of thankfulness and love.

    God Bless,

    Dan

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  10. Oh and thanks Jerry for sharing a link to the blog :)

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  11. Just came across this article - suggesting that its time the church started to address mental illness more seriously: http://sojo.net/blogs/2014/06/09/we-need-talk-about-mental-health/. It's especially talking about where mental illness leads to violent crime.

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