Editor's Note: Leading into an important conference on mental health and the role of the Church hosted by Pastor Rick Warren and his wife, Kay, at Saddleback Church, The Christian Post is offering special focus on the topic. CP plans to continue this coverage including reporting on The Gathering on Mental Health on March 28.
Dr. Matthew Stanford, a Baylor University professor of psychology who studies the intersection of the Church and mental health, will be one of the experts addressing attendees at the conference. Stanford has taught at Baylor since 2003 and serves as the director of the Mental Health Grace Alliance. He's the author of Grace for the Afflicted: A Clinical and Biblical Perspective on Mental Illness and The Biology of Sin Grace, Hope and Healing for Those Who Feel Trapped.
Part one of The Christian Post's interview with Stanford can be read by clicking here. Below is part two.
CP: In many recent mass shootings, we've subsequently learned that the killer suffers from mental illness. To what extent are Christians nervous about talking about mental health because they believe it may let the perpetrator off the hook for his or her wrongdoings or crimes?
Stanford: To date, 16 of the past 25 mass shootings in the U.S. were untreated mental illnesses. I think you're onto something there. When we talk about people having thoughts that aren't their own or them being involved in behaviors they aren't full in control over, then Christians start to get real nervous because are very much into culpability: Did you sin? Is it your fault?
I work with a lot of bipolar disorder patients and excessive spending is a very common symptom of bipolar disorder. A person in their manic will go out and literally spend every penny they have in a day. I don't mean everything they have in their pocket, I mean $50,000, $60,000 in a day with no thought of the consequences or that that's a bad thing.
If that person is brought into a church and the person says, "Well I spend all my money," [the church] will throw them in a Dave Ramsey class for [financial] stewardship because that's looked at as "you're a bad steward."
But the thing is, if I didn't go in and say, "Look, the only reason they are doing [this] is because they are in a manic state. They have no sense of consequences. They feel larger than life. They feel as if there are no consequences. This is part of the illness and if we treat the illness it will go away," they will say to me, "Well you are just affirming their sin."
I'm trying to explain that they're not fully in control of what they are doing. That's a very scary thing for Christians because the way we tend to think about sin is of "do's and don'ts," which is really not the way sin is described in the Bible. Sin in the Bible is more a state of being.
We are all sinful when we are born because of original sin. I'm a sinner not because of anything I ever did. I'm a sinner the minute I was conceived. There was never a moment I wasn't a sinner, even though I had never sinned yet. I sin, but I sin because I'm a sinner; I'm not a sinner because I sin. The thing is, we don't like to think about the fact that somebody might do something and they might not be in control of it.
I remember years ago, a bipolar disordered woman at a church, she had been a long-term missionary. Once I finally got the pastors and staff to finally understand what was going on with her, the pastor's wife pulled me aside and said, "If you had told me a week ago that a person could have thoughts and do things that they weren't fully in control of, I would have told you you were completely wrong. But I know that woman right there," she said, pointing at the missionary. "She is the most godly women and I've known her my entire life and there's simply no way she knows what she's doing."
I say a lot of times, mental illness really shows you what the limits of grace are and grace is limitless.
CP: How do you advise churches on leadership and the mentally ill?
Stanford: When we go into training with churches, one of the first things we do is start with the definition of mental illness because I think a lot of times we use terms very cheaply in our society like "I'm depressed," or "I have OCD." We may just start talking about being sad for a day and not understanding the intensity or severity of what mental illness is. We usually will go over what it is, how does it happen, what are the numbers, what percentage of the population we're dealing with. Then, I'll kind of give an overview of what type of answers people receive when they interact with the church.
I think one of the things people don't realize is that people in psychological distress are more likely to go to a pastor than they are to any other professional. Before they ever go to a psychiatrist, before they go to any other physician or psychologist, they're much more likely to go to a pastor just because it's easy access. So we know they're coming to the church first.
Pastors do the predominance of counseling in North America, so what are they being told? Our research shows that 30 to 40 percent of them are being told that this is a spiritual issue and you don't have a mental illness, you have a spiritual problem. We try to put it into a faith context so we share, how has God created us? He's created us as a multi-part being: part of us is spiritual, part is physical. When we fell as a people, we were affected spiritually and physically. So why do we get sick? We get sick because we live in a fallen world and we're in a fallen body. When we come to know the Lord, we're changed spiritually, but we still live in a fallen body and our brain can be affected.
Ultimately we talk about the role of the church, which I really see as pivotal particularly because God is sending these people to churches first. We talk about "Three R's." The church is to relieve suffering, reveal Christ and restore lives. What can the church do to relieve suffering? They can have contacts with the mental health care system so they can refer people and can be trained to recognize when someone is struggling from mental health problems. They also set up supportive groups within their church or develop a supportive care community where they are free to share about their problems and then in building those relationships, they then reveal Christ, which is the only way we're ever going to obtain wholeness.
Ultimately, restoring lives is an issue of walking alongside of people, caring for their families, doing those types of things. We really show people that the church doesn't have to do anything different than it is already called to do or that it already does with people that are ill. They just need to recognize they are dealing with a mental health problem and not try to over spiritualize it.
You asked about being in leadership, I think as long as that person is effectively managing their symptoms, they're being treated, they have a supportive system around them, in many instances that person can do virtually anything that a person that does not have a mental illness can do. I think that's important. People with mental illness are not to be feared. It's really no different than diabetes. Diabetes is a chronic condition that we do not know how to cure. We know what the problem is: your pancreas isn't working right. We know the interventions, so there's some things you have to do, you have to diet and exercise. You have to inject yourself with medication or take medication to control your blood sugar. If you do those things and if you go to the doctor and get check-ups to make sure you're doing well, you'll manage that disorder and you'll be fine for the rest of your life. If you choose not to eat healthy, that disorder will control you.
Same thing for mental illness. We can effectively manage the symptoms. We can minimize them and the person can take control of their illness and live a relatively normal life, much like a person with diabetes. I don't see it as a marker of shame or an exclusionary thing. I think unfortunately in the church a lot of times you do.
I've talked to plenty of pastors that themselves are struggling with depression or had a family struggle with different problems, and I think in some instances churches don't want a pastor who has had depression and they don't think their pastor should be taking medication. I think that's an unrealistic threshold for a pastor.
I want my pastor to be just like me. Since I know the Bible tells me that my savior was just like me, that he was tempted in every way that he struggled with the same things that I did. I mean he literally allowed himself to be killed as an incredible sacrifice and example. I don't think it's too much to ask for my pastor to be like me then if my savior was like me.
We hold pastors to a standard that's unrealistic and that's why we see that a lot of pastors don't have a lot of people to talk to when they have problems. So I don't see any problem with them being in leadership as long as their symptoms are being effectively managed. If they're symptoms aren't being effectively managed, it wouldn't matter what their job is, they won't be able to perform it effectively and it'll just cause more stress in their life.
CP: How would you advise a Christian to minister to either a non-believer or one seeking to come into relationship with Christ and struggling with a mental illness that, like depression, that makes him or her feel like that hope cannot exist?
Stanford: I think that is every person when they first are struggling in the real acute phases. When we work with people with mental illness we work with a recovery model as opposed to a treatment model. A treatment model is really kind of how we treat other medical problems where you go to the doctor, the doctor gives you something and your whatever it is goes away. Well, that doesn't happen with mental illness. It's a process, you control your illness and over time you get better, but you still have it.
The key part, the first step in recovery, is hope. The person has no hope if they don't believe that they can get better. If they don't believe God cares about them and that God is involved in them getting better, then they're not going to get any better. I think that's one of the reasons I'm so excited to be practicing from a holistic approach, where I'm able to reveal Christ to people because I think whether your symptoms get better or not is not where you need to ground your hope. Your hope is grounded in Christ so even though the circumstances of your life may not be what you want them to be, or what others think they should be, you can still have great hope and a hope in a savior and that can be a starting point for your recovery.
Whereas, if I'm just trying to do this from a secular perspective and I'm just trying to build hope in you, and I say, "I think if we work together, I think we can get your symptoms to go away," what if four or five months from now, your symptoms aren't getting any better? I don't know how much longer you're going to believe me, but if I can show you the hope that exists in Christ that transcends your circumstances and that gives us a point where we can start from.
CP: Would you advise the loved ones of the person suffering from mental illness to be open about their faith?
Stanford: If that's something that empowers you, if that's something that transforms your life, then why would you not share that? Now again, you don't do it in a preaching way, in the unsophisticated naïve way that suggests that if you found Jesus everything would be great for you because I still haven't met that guy. I'm not sure who came up with that idea that once you know the Lord, everything is perfect in your life. I don't even think it says that in the Bible. But I think if that's been transformative for you and you have a relationship with that person, and they're interested in knowing how you overcame a problem, or where it is that you find hope, why would you not share that?
I think it's all in how you do it. If you do it from love, from a place of caring, not in a "You need this because if you had this, your depression would go away." That's not the presentation I'm talking about. The fact is when a person is depressed they feel disconnected from God. What I'm saying is that we don't always have to talk about your illness. We can talk about things that transcend your illness and opportunities and hope and joy you can have despite your illness and that conversation can sometimes help the person to start to move forward and realize "I just had a conversation that didn't include depression."
People get tired of talking about their illness. They're not their illness. They have an illness. Their identity should be grounded in how God sees them, and God doesn't see them as some poor sick little person with a mental disorder. He sees them as His child that is suffering but He is ready to walk alongside.
CP: You've written a book called The Biology of Sin. Could you share some of the perspectives that the book offers on homosexuality?
Stanford: One thing I would say about homosexuality is that when we're talking about mental illness, that's not even in the same topic but it does get brought up a lot. I've had a lot of pastors kind of throw that at me and say, "Well that's why I don't like psychology because psychologists think that homosexuality is normal," and we might have been talking about depression a minute ago.
The Biology of Sin is a book I wrote for sinful behaviors like aggression, criminality, homosexuality, lust, and adultery related, sexual morality related type of stuff, and addiction – things that the Bible clearly says are sinful but that science has shown there is some biological component to. I wrote that book because those things get thrown up to me at times when I'm having discussions about mental illness and I really wanted to write a book to say "God made us physical and he made us spiritual. I didn't choose that; He just did that."
For me to say that homosexuality has a physical, biological component to it — I think God said that. I think God said everything has a physical component to it and everything has a spiritual component to it. That's how He made us. In trying to equip the church and educate the church to say, "We need to stop being naïve and say 'That's just a choice. He just made that choice and needs to stop that'" because all of behavior is biological and all of our behavior has a spiritual aspect to it. One is not more or less important than the other — that's just how God made us.
We need to be less naïve than we've been where we decide that some behaviors are biological and some behaviors might not be because it undercuts our interaction with the world when the world says, "We've got lots of evidence that the earth goes around the sun and not the other way around and you need to quit arguing about it."
At one time that was a big deal, people didn't believe that the earth went around the sun, they thought it was the other way around and said so because of Scripture. Was Scripture wrong? No, they were wrong. Science is inquisitiveness and an opportunity for us to learn about the creation and I don't think we need to be afraid of it.
I do think homosexuality has a biological basis. I do think that the Bible's clear that it's a sin. But I don't think the church has done a very good job on ministering to people with homosexuality.
CP: Can you give more specifics about you mean when you say "biological basis"?
Stanford: For instance, for homosexuality, if you look at the anterior hypothalamus of people with homosexuality, which is an area of the brain that's involved with sexual behavior, for [male homosexuals] it looks like the anterior hypothalamus of a female. So their anterior hypothalamus is not exposed to enough androgens when they're developing like testosterone so it's feminized. So part of the brain is more feminine-like. It's just the opposite for women who are lesbians.
If you look at say aggression, people who have loss of control or violence, where they lose control of their behavior, (that's one of my specialties, I do a lot of research in that area,) their brains literally function differently. Their frontal cortex is not as active. Their amygdala is overactive. So literally their brain does not function normally so they have trouble controlling their behavior. It doesn't excuse their behavior but it helps us understand their behavior. These things are no different in any other kind of aspect of our body that might not function correctly; it just shows that we're broken and need a savior.
I don't think that in any way this removes the culpability of a person. For instance, alcohol, drug addiction, there's a clear biological aspect. Most people will accept that nowadays. But clearly you have to make certain decisions and choices to put yourself in a situation where that biology is kind of enacted. Nobody holds you down and pours the alcohol down your throat. But at some point, once you've become addicted, it's not anymore about you wanting to drink to feel good, it's about you having to drink because you're physically dependent on it.
So I think understanding that we're biological, understanding that we're spiritual, helps us do a better job ministering to people. I think the church thinks sin is an easy thing to get rid of when in reality it took Jesus dying on the cross for us to get rid of it. So it's not something easy to get rid of.
We need to realize that we're all sinful. We have these predilections, we have these vulnerabilities, and we need to show more grace to each other than more judgment.
CP: Any last words you'd like to share on the subject of mental illness?
Stanford: I think we're starting to turn the corner in the church and I think more high profile things like this — unfortunately this is occurring because of Warren's son committing suicide and there have been several other high-profile suicides with church leaders' children — but I think finally church leaders are starting to see the real seriousness of this and this could be a very important year for the church in really starting to reach out to those who are mentally ill.
On the Web: http://mentalhealthandthechurch.com