Sharing the darkness of suffering and death

 This month in the theology reading group, we discussed Sharing the Darkness: The Spirituality of Caring by Sheila Cassidy. It is a beautiful book that is both challenging and comforting. The author draws on her own experience with honesty, vulnerability, and humour.

Cassidy is a British medical doctor who, in the 1970s, was tortured by the Pinochet military dictatorship in Chile because she gave medical aid to an opponent of the government. Later in the UK, she helped establish a small hospice to care for the dying. At times she considered becoming a Catholic nun but found her vocation as a doctor caring for the dying and as an advocate for the marginalised. The book recounts her struggle to live out Jesus' radical Gospel in these challenging contexts.

Recurring themes concern the character and actions required of an authentic carer: humility, love, presence, empathy, vulnerability. Personal theology and worldview need to embrace mystery and paradox and powerlessness. A community of carers is needed for both mutual support and complementary skills and gifts. The community can only survive (and potentially prosper) with open communication, love, acceptance, and forgiveness. Cassidy affirms the importance of individuality: both patients and carers are unique persons with unique personalities, histories, and needs. Furthermore, carers need to engage in self-care, including rest and spiritual disciplines. Like Cassidy, I wish I had appreciated this earlier in life.

Here are two quotes from the book I found most striking.

"Are heart our hearts are fulfilling, our minds are for blowing, and our idols for shattering into a thousand pieces." (page 228)

"At a religious level perhaps the most important gift is a sort of paschal overview - the ability to hold in the same focus the harsh reality of suffering and the mind boggling truth of resurrection of life after death. One must develop the ability to stand with feet firmly planted on an earth inhabited by wounds and vomit bowls but with the gaze focused beyond the mess of the here now to a future of hope beyond imaginings. More than anything one must know deep in one guts that death is the beginning, not the end." (page 8)

As an aside, I mention the movie Wit, which is relevant and which some of us watched in preparation for our discussion.

Growing old with grace

I am 65 years old. I have struggled with my mental health much of my adult life. My wife, Robin, is 70 and has Parkinson’s disease. We are both retired from formal paid work. Some of our close friends are older or have greater health challenges than us. The reflections that follow are prompted by a desire to grow old with grace and to stimulate discussions on the topic with family and friends.

The communal dimension

Affluent individuals in the West think in individualistic terms. Perhaps, when it comes to ageing, they may think in a little more in terms of being part of a couple, and perhaps a nuclear family. However, ageing increases our dependence on others: a spouse, children, relatives, friends, neighbours, organisations, and governments. Even if, as individuals, we come to terms with the issues discussed below, that does not mean that our loved ones will. This complicates things further.

Accepting reality

We are all going to die. Unless we have a sudden and unexpected death, we are all going to get older. Gradually, our minds and bodies will decay. Ailments will increase. Physical, mental, and emotional energy will decline along with agility. It is tempting to live in denial that this will ever happen, or to deny that it is happening right now. The truth can be too scary, complicated, disappointing, or uncertain to accept. Even if we accept it, our loved ones may not. Even if we acknowledge the reality at an intellectual level, will we deal with it emotionally and at a practical level?

Declining energy

As we age, we have less physical, emotional, intellectual, and spiritual energy. We get tired more easily and our recovery time is longer. Today, I cannot function without a daily nap after lunch. I must carefully manage my limited energy. I cannot imagine doing many of the things I did a decade ago, let alone when I was young. 

Despite our declining energy, in retirement, we may have more time and freedom than ever before. We may have a new perspective on what really matters and want to use our freedom to avoid being sucked into the cares and anxieties of this world. What a blessing! The challenge is to make the most of our freedom with the energy we do have.

Some people retire from full-time employment and experience “a new lease on life.” Freed from a demanding work schedule and burdensome responsibilities, they have energy and enthusiasm for all sorts of activities.

On the positive side, what am I enjoying about this stage of life? How do I notice my energy changing? How am I adapting? Will I deal with practical and emotional issues while I still have the energy?

Practical dimensions

There is a whole range of financial, medical, legal, bureaucratic, transport, and housing dimensions to ageing. On the one hand, these complexities can come from individual affluence and living in a country with generous (by global standards) government support. On the other hand, navigating these complexities requires considerable time, energy, planning, technological savvy, and patience. It can be overwhelming. Furthermore, simply waiting until problems escalate to unsustainable levels risks creating unnecessary crises, placing burdens on others, and missing out on potential solutions. This is where accepting reality is important. At some point, we will have to stop driving, riding a bicycle, using ladders, writing books, travelling overseas, using stairs, and possibly living in our current house. Can we accept this? When do we think some of these things might happen? Do we have a plan for how we will adapt? When and how will we discuss this with family members?

Attitude

Facing reality is not easy. Our bodies are decaying. Opportunities and our influence on others are diminishing. Our legacy may be set. Not only are we changing, but so is the world around us. It is not what it used to be. Social and technological change is rapid, increasing, surprising, not necessarily for the better, and not easy to adapt to. Unlike during the bravado of youth, it is harder to deny our limitations and finitude. We now feel them in our bodies and brains. Loss rather than gain may be the norm. Funerals may outnumber weddings and births. Will we truly grieve our losses, whether it is the death of loved ones, a dream, or diminished mental capacity? Stages of grief may include denial, anger, bargaining, depression, and acceptance, not necessarily in a linear fashion.

Spiritual dimensions

The practical, intellectual, and emotional dimensions of ageing cannot be separated from the spiritual. My spiritual life can enable me to deal with the other challenges. Do I believe this life is all there is? Is it preparation for something better? Do I trust Jesus is walking next to me in this life stage, just as He has promised? As I experience weakness, is His grace sufficient for me? Am I looking back at past failures and disappointments with bitterness and shame? Or am I looking forward to being welcomed by Jesus into an eternal home? Do I have the hope of heaven, where there will be perfect love and justice, and no more death, tears, and pain?

A diversity of circumstances and experience

Everyone is different. Some people have excellent health and circumstances, and even when they are eighty years old, they don’t have to wrestle with some of the challenges I discuss here. Perhaps, they won’t have to for another decade. Some people die young. Some people have chronic health problems or disabilities their whole lives. Different family, social, or financial contexts can significantly affect the nature or extent of the challenges I discussed above. To illustrate the diversity I include a graph (at the end of this post) of the projected age of death for women in Australia who are 65 years old. It shows a large variation in life expectancy.

Some relevant books

Currently, Robin and I are reading three books. Each considers a different dimension of ageing.

"We need to talk about mum and dad" It is by the Australian comedian Jean Kittson and illustrated with cartoons by Patrick Cook. Although written for the children of ageing parents, it is helpful for anyone getting old. It discusses the complex family dynamics associated with ageing and how to navigate the many dimensions of the practical complexities of ageing. 

"Not Old, Not Young, Not Done: Following Jesus in Your 50s And 60s" by Christopher Ash.

"The Gift of Years: Growing Older Gracefully" by Joan Chittister. Although the author is a Benedictine nun, the book is intended for a broad audience. The book challenges our attitudes to ageing, but may be a bit idealistic for some of us.

My articles on theology and science

Here are links to articles that I have written over the years on theology and science.

Can Science see the End?  Case Magazine, 2003, with Greg Clarke.

Foundations of the Dialogue between the Physical Sciences and Theology, Perspectives on Science and Christian Faith  (2004).

Dialectical critical realism in science and theology: Quantum Physics and Karl Barth, Science and Christian Belief (2008), with Ben Myers.

Emergence, reductionism and the stratification of reality in science and theology, Scottish Journal of Theology (2011).

Emergence: The whole is greater than the sum of the parts, Test of Faith.

Science and theology in the non-Western world, Guest Editorial, Science and Christian Belief, 2012.

Living as a Physicist and a Christian, a chapter in the book, Why Study? Exploring the Face of God in the Academy, published by Singapore FES.

Towards a Christian vision for the modern secular university: A theological contribution to competing visions of the university, IFES Word and World, 2018. What is a university for? is a long version of the published article.

Who's afraid of social science?

CASE Magazine, 2019.

A Theology of Weakness,

Chapter  in Pub Theology: Where Potato Wedges and a Beer are a Eucharistic Experience

Blessed are the Meek: The Science and Theology of Humility, 

Chapter 3 in To Whom Shall We Go? Faith Responses in a Time of Crisis

Science, Humanity and Jesus, A talk at Theology on Tap Brisbane, June 2025.

Transformation in the Natural Sciences

Draft book chapter, September 2025

Karl Barth and the dialogue between theology and the sciences, Draft paper

A Disciplinary Brief for the Global Faculty Initiative, The Radicalness of Love—for the Natural Sciences and the Research University.

What is a university for?

A Christian Vision for the Modern Secular University

CASE Magazine, June 2026.

My church is all about me!

In the past decade, a disturbing list of church leaders has disgraced themselves. Reading about Mark Driscoll, Jonathan Fletcher, Mike Pilavachi, and Steve Timmis, there are common themes in these tragic stories. 

Each individual was a gifted public speaker with a charismatic personality. They were "successful" in the ABCs of church growth (Attendance, Buildings, and Cash). Their initial success began when they were relatively young. Their church/organisation expanded rapidly and they hired a large staff team. Due to their "success" in "ministry" they received global recognition. Institutional structures were created or manipulated so there was limited real accountability.

We now know, that in private the individual was arrogant, condescending, manipulative, and involved in bullying and abuse (verbal, emotional, sexual, spiritual, or financial). This occurred over many years, sometimes decades, despite concerns raised with the individual and those they were nominally accountable to. Within the organisation, there was a culture of enabling or cover-ups. This was rationalised out of fear of the individual or fear of endangering the "success" of the "ministry". People who formally raised concerns within the organisation were fired, expelled, or ostracised. The problem was only finally addressed, and the leader was removed when secular media reported the scandal or there was a threat of lawsuits.

A common theme in these stories may also be that these fallen "leaders" suffer from narcissistic personality disorder and/or that the churches they led suffered from collective narcissism. This is a complex issue and is addressed in the book that we are discussing in the theology reading group this month.

Narcissism Comes to Church: Healing Your Community from Emotional and Spiritual Abuse by Chuck DeGroat

A helpful short review of the book is in the journal Themelios. 

DeGroat is a seminary professor and therapist who has worked for decades with church planting organisations in evaluating candidates. Many anecdotes in the book illustrate his experience trying to clean up trails of destruction left behind by narcissistic leaders. 

The most disturbing thing about the book is captured in the following quotations.

 "[A] 2008 study showed a NPD prevalence of 7.7 percent in men and 4.8 percent in women.... instances of narcissism among pastors are much more common... The rates are even higher among church planters." (pages 7,19) 

“I saw that narcissistic traits were often presented as strengths. Narcissism can be interpreted as confidence, strong leadership, clear vision, a thick skin.” (page 19)

“Their persona may even be interpreted as spiritual giftedness, a personality well-suited to plant an effective church or lead a large ministry or church.”

“grandiosity, entitlement, and absence of empathy characteristic of narcissistic personality disorder was translated into the profile of a good leader.”

DeGroat puts the problems in a broader cultural context, including citing The Culture of Narcissism: American Life in an Age of Diminishing Expectations (1979) by Nicholas Lasch.

DeGroat conjectures that  "missional fervour and rise in church planting we’ve witnessed since the 1980s can be correlated with the growing prevalence of narcissism."

Too often the church conforms to the culture it swims in, rather than being counter-cultural, just like Jesus.

Reading about and/or experiencing the vagaries of narcissistic leaders, it is easy to be incensed, indignant, and self-righteous. How could they be such a hypocrite? How could this happen? How could their organisation allow it? Why do so many people flock to churches led by such people?

DeGroat is helpful and challenging because he argues that the problem is not just narcissistic individuals, but organisations that exhibit collective narcissism. Tragically, history shows removing the leader usually does not simply mean that the problems go away.

"Churches are particularly susceptible to ... "collective narcissism" in which the charismatic leader/follower relationship is understood as a given. ... The leader uses polarizing rhetoric that identifies an outside enemy, bringing together leader and followers on a grandiose mission...

“the system often compares itself to others and finds others wanting. The narcissistic system may feature the compelling personality or style of its leader, the strategic nature of its location or mission, the orthodoxy of its doctrine, the authenticity of its worship, the beauty of its liturgy, the integrity of its activism. Those within the system are led to believe that the church down the block isn’t as blessed, special, or faithful.”

pages 23-24

Chapter 6, Understanding narcissistic systems gives a more detailed discussion.

"Perhaps this is about us, an invitation to wake up to the many ways in which certainty trumps curiosity, uniformity trumps unity, hubris trumps humility, control trumps connection, loyalty trumps love."

(page 116)

DeGroat cautions about that labels such as "narcissist" should not be thrown around. Only a professional can make a diagnosis of NPD. Furthermore, 

‘when we diagnose, we are describing a pattern … never a person. All people are unique. Labels, however well intended, cannot do justice to human complexity.’ 

A person is not their diagnosis. Compassion is needed. Narcissists are deeply wounded individuals who live in a deep sense of fear and inadequacy. Compassion includes removing them from leadership positions so they do not hurt others and so they can have the opportunity to face their woundedness and seek healing. DeGroat is not optimistic about this happening but gives a few examples to provide tempered and realistic hope.

I found the book helpful in understanding things I have observed and experiences that I have had over the years. It helped me make sense of patterns I have seen such as entitlement, a sense of superiority, condescension, playing the victim when criticised, making generic vague apologies, hidden addictions and rage, lack of empathy, having an explanation for everything,...

Never tell a narcissist that you think they are a narcissist. If they really are you may be left thinking you are crazy. They will gaslight you. (I actually did not know what gaslighting was until just a few years ago).

“Moreover, when the narcissistic leader is under attack, his response is defensiveness and a victim complex.” (page 22)

“Entitled pastors snap when pricked, however. Even the smallest pinprick of challenge or concern from another leads to defensiveness and self-protective strategies.”

“While anxious churches driven by narcissistic pastors may grow numerically, healthy churches flourish. Do not mistake numerical growth for flourishing.”

“sad abandonment of the humble way of Jesus shows up today in pastors of large and small churches,”

The subtitle of the book is "Healing your Community from emotional and spiritual abuse", but this is only addressed directly in chapter 8, and much of that is anecdotes. That chapter has a subsection, "Healing ourselves" that is only two pages. Nevertheless there is some helpful advice and exhortation.

"Healing requires radical honesty and the courage to follow through on the wilderness path. Perhaps the two most important components of healing trauma are awareness and intentionality... Memories may be repressed, bodily sensations ignored, and feelings and needs disregarded...

"Every healing journey is unique. There is no clear roadmap... We long to control and strategies a journey that can only unfold in its own time." (pages 141-2)

."..you must be relentlessly committed to doing your own inner work, both to protect yourself and others from harm and to engage from a place of centred compassion rather than reactive rage."  (page 163)

The book is not pleasant to read. But, it is a book that needed to be written and needs to be read and taken heed of.

The church is not about me. It is not about my tribe. It is not about the leader. It is about Jesus, the model of a humble servant leader. 

 

Lectures on Science and Christianity: Part 4

Part 4: Apologetics, mission, and the social sciences

1. Overview

2. Emergence and reductionism

3. Human sciences

4. Mental health

5. South Asian contexts 

6. Conclusion

The futile quest for certainty in treating mental illness

Last week at my church we started a five-week course on Mental Health and Pastoral Care. It is being facilitated by a team with different experiences and expertise, including medical, psychological, pastoral, theological, and personal. I like this as mental health is complex and multi-faceted. My role is someone who has struggled with mental health for most of my adult life and has consequently read and thought widely and interacted with a diverse range of sufferers and carers. Previously, I wrote a post giving a theological perspective on mental health and gave a sermon on the Wisdom of Weakness.

A central idea in the course is that of the four-dimensional character of mental health, and the importance of an integrated perspective. 

This is captured in the figure below from Sanctuary Mental Health Ministries.

A specific case of mental illness provokes two practical questions. 

What are the causes of this specific case of mental illness? 

What will be the most effective treatment plan that will lead to healing? 

These are natural and important questions. The problem is that in most cases the answers are not clear.

In contrast, consider most physical medical problems or when technological device fails. An expert can determine the cause of the specific problem: an infection in the left ear, a broken bone in the right arm, an electrical fuse has blown, or the spark plugs in the car engine are not working. Furthermore, the expert can propose and implement a treatment plan that will solve the problem. Given the advanced state of our knowledge, we can be almost certain that the diagnosis is correct, the treatment plan is appropriate, and that the problem will be solved. This certainty reflects the wonders and blessings of science and technology.

The problem is that the success of the sciences in some domains has led to hopes, expectations, and a myth that similar certainty and success are possible in other domains of life. However, the problem is that human brains are much more complex than ears, bones, cars, and electrical circuits. The relationship between consciousness, brain, and body remains a mystery, and people are embedded in networks of human relationships (from family to global cyberspace) and have long and complex personal histories.

This quest for certainty is driven by healthcare professionals, big pharma, governments, and patients. On the positive side, this quest reflects our humanity in our desire to alleviate human suffering. On the negative side, there are significant benefits: financial, professional, social status, and political to be gained by offering certainty, even when it is not justified. In the case of psychiatry as a science,is the issue of its professional hubris are discussed in this book review.

This quest for certainty is also driven by human desires for quick fixes to problems.

One problem with the diagram above representing the four-dimensional model is that some people, both patients and professionals, will want to locate a specific case of mental illness as being at a specific point on the diagram. For almost all cases that is simply not possible. 

Wisdom in Weakness (a sermon)

Last Sunday at Village Church in Brisbane I gave a sermon, entitled the Wisdom of Weakness. In the beginning I talk about some of my own encounters with weakness through my struggles with mental health. I then looks at some Bible passages from 1 and 2 Corinthians that discuss weakness, particularly in light of the Cross of Christ.

The video recording of the morning service is below. (Sorry that the sound quality is not brilliant).

Here is the text of the sermon (including some material I cut out for time reasons) The slides are here.

Some local context is that a goal of the sermon was to help set the stage and pique interest in a forthcoming course the church is running on Mental Health and Pastoral Care.

The sermon has some parallels to a talk I gave a few years ago at Theology on Tap and led to a chapter in the book, Pub Theology.

A theology of mental health

Humans are complex. Society is complex. Theology and science are complex. Mental illness is complex. What causes mental illness? What are paths to healing? Can it be prevented? Here, I explore how Christian theology is a rich resource to help address these questions. I write as a non-expert in theology, cognitive science, and mental health. But I also write as someone who, for four decades, has struggled with my mental health, read widely, and walked with many others on their journey.

As with many issues, I find it helpful to begin my exploration with the key theological concepts that are encapsulated in the Biblical narrative: creation, sin, redemption, and re-creation.

The doctrine of creation highlights that humans are made in the image of God. We are relational, rational, and wonderful. Human relationality is reflected in the Trinity. We are creatures; we have finite capacities. We are designed by God to enjoy and live in harmony with one another and with the rest of God's creation. We are like animals, but distinct. Rest (Sabbath) is central to life and its rhythms. Creation, from our being to food and nature, is a gracious gift. Mental illness is not God's plan or design.

Sin. (The Fall) We do not experience God's ideal: life in the Garden of Eden. Like Adam and Eve, we want autonomy, to rule ourselves. Like them, we are alienated from God, ourselves (shame), each other, and nature. Work is toil, and male-female relationships are a power struggle. We live in a world that is marred by sin: individual, collective and structural. Sin has corrupted our thinking and desires. The whole creation is broken and groaning. Violence, disease and death are part of life, but not God's wish, plan or design.  Given the multiple-dimensional character of sin's influence and presence in the world, we should not expect to be able to simply identify the cause of a specific incidence of mental illness in one individual.

The tower of Babel captures human hubris and ambition, the vanity of our futile attempts to know and understand everything. Even when we don't understand, we will claim that we do and ridicule and silence those who don't have our "correct" understanding. 

In her book, Mind Fixers: Psychiatry's Troubled Search for the Biology of Mental Illness, Anne Harrington, a historian of science at Harvard, comments.

Today one is hard-pressed to find anyone knowledgeable who believes that the so-called biological revolution of the 1980’s made good on most or even any of its therapeutic and scientific promises. It is now increasingly clear to the general public that it overreached, overpromised, overdiagnosed, overmedicated and compromised its principles.

Fortunately, we are not cursed and condemned to forever live in a sinful world marred by disease, despair, shame, guilt, and violence. God acted according to his promises, sending his Son, Jesus Christ, to usher in the Kingdom of God.

Redemption. God identified with humanity by humbling himself and becoming fully human as Jesus Christ. He proclaimed the Kingdom of God, preaching repentance and the forgiveness of sins, healing the sick, and driving out demons. Mental illness is not God's design or plan. People are not sick simply because they sinned or their parents sinned. Jesus death and resurrection bring reconciliation: between God and us, with one another, and the whole of creation. The curse of sin is reversed. Jesus is the suffering servant. He suffers for our sake. He has entered into our suffering. As he lives in us and we in him, we can participate in his sufferings. If we struggle with mental illness, we can find hope and comfort as Jesus knows and shares our struggle. Our liberation from our sin and the world of sin and disease is "now, but not yet." In this life, an individual may experience no, some, or almost complete healing from mental illness. Nevertheless, we can be certain of a future day when we will all be completely healed from every affliction.

Re-creation. There will be a new heaven and earth, where there will be no more tears, sin, suffering, or death. In this Kingdom of God, justice, truth, and righteousness will reign. We will have new minds and bodies. We will be living in the City of God, which contains the River of Life and the Tree of Knowledge. There will be no mental illness. Redemption will be complete. This hope can give hope to those who suffer and those who care for them.

Living with virtue. How then shall we live as we wait for our redemption, even while afflicted with mental illness or walking with those who are? The fruits of the Holy Spirit include love, joy, peace, patience, kindness, gentleness, and self-control. God has designed us to live a particular way. Hence, we should not be surprised to learn that research shows how forgiveness and thankfulness are beneficial to mental health.

What is a person? Our view will shape what we consider to be the causes and cures of mental illness. A Biblical anthropology acknowledges the complexity of the human person.  Different facets of the whole human person include heart, mind, body, and soul. These facets are highlighted in the following passage from Matthew 22:36-40.

“Teacher, which is the greatest commandment in the Law?” Jesus replied: “‘Love the Lord your God with all your heart and with all your soul and with all your mind.’ This is the first and greatest commandment. And the second is like it: ‘Love your neighbor as yourself.’ All the Law and the Prophets hang on these two commandments.”

[For the first commandment, Jesus quotes Deuteronomy 6:5 but replaces "strength" with "mind"].

Mind, body, heart, and soul are not well-defined, separate entities but inter-twined facets. For example, "heart" refers to our will, desires and inclinations. It is hard to separate this from the "mind".

We are a complex whole and cannot be reduced to just one dimension: genetics, physiology, personality, experience, social conditioning,...

If we accept this complexity of a human person and the presence of these different but interrelated facets, then it is natural that understanding the causes of mental illness and proposing action to prevent or cure it will also be complex and multi-faceted. We will never be sure we really do understand.

For two thousand years, philosophers have debated the mind-body problem, which is now being addressed in cognitive science. In spite of many advances, there is no clear philosophical or scientific consensus on the relationship between the body, brain, mind, and consciousness.

Another dimension to Biblical anthropology is the social. A human person is not an isolated individual who can be defined independently of their social context. Rather, a human is part of a family, community, and nation. The person is also defined by a network of relationships. The emphasis of Western modernity on individualism and postmodernity on the "authentic self" conflicts with the anthropology of the Bible and almost all times and places outside the past four hundred years of the Western world. Mental health needs to be addressed within relational and social contexts.

I now introduce one model for a person. It is discussed in the book, Mental Health and Your Church: a Handbook for Biblical Care, by Helen Thorne and Steve Midgley. I recently encountered the model at a one-day seminar given by Midgley in Brisbane.

I introduce the model with the caveat that, as a scientist, I consider that all models are wrong, but some are useful. I think this also applies to models in theology.

A human person is created by and lives in the presence of the Triune God. The Word of God and the Spirit of God can speak to the heart of the person, changing their sinful, wicked, rebellious, and hard state to one that is oriented towards the desires of God. But the heart is not some abstract, free-floating essence. My heart is embodied. My heart and mind are intimately connected to my physical brain, which is also part of my physical body. My mind and brain have been conditioned and moulded, for better or worse, by my experience living in my body. Stress, trauma, and addictions have an effect. Relaxation, sleep, diet, and habits can heal and train my body. Furthermore, my body is also embedded in a social context. These are my circumstances: family, housing, school, church, workplace, neighbourhood, and nation.

There are several competing models of mental illness, and I have reviewed them in this post. The current dominant model in the secular world is the biomedical model. However, I would consider that these models are complementary, and we need a multi-faceted model, nicely captured in the figure below.

[Figure from Sanctuary Mental Health ministries]

Three of these models [biomedical, psychological, and social] are promoted by people who may not be Christian and do not operate from a Christian theological framework. However, the models can be valuable for understanding and treating mental illness, due to the doctrine of common grace. Thus, there is a role for drugs and counselling.

Human diversity. Paul uses the metaphor of the human body to describe the church. It is the body of Christ, his living presence in the world. Like a human body, there are many members. They are not all the same. They have different purposes, gifts, and functions. The weaker members are indispensable. This means that those who struggle with mental illness are indispensable members of a church. They are not a burden that has to be carried. They are not a problem that has to be solved. They are not a distraction from the "more important" work of preaching and evangelism. They are indispensable. The whole body grieves with them, walks with them, and celebrates them. Christ's power is made perfect in weakness.

Acknowledging human diversity is also important to understand and to treat mental illness. On the one hand, we are all made in the image of God. We are all sinners. We all have the same biology. On the other hand, Paul acknowledges a diversity of backgrounds, life histories (calling), and gifts. This diversity means there are no "one-size-fits-all" answers to mental illness.

Finally, the concept of the "powers of this age" is helpful to understand the causes of mental illness, and particularly its proliferation in the modern world. Massive power struggles are going on. Some are clearly visible. Others are not. Forces such as globalisation, capitalism, and autocracy unleash ideologies and technologies that undermine good mental health. Mobile phones, social media, junk food, consumerism, secularism, movies, television, internet, alcohol and drugs are not just neutral. They are tools for some people to gain inordinate amounts of power and money, with no regard for human flourishing. These powers need to be resisted, from the individual to the global level.

Why choose forgiveness rather than bitterness?

My wife and I enjoyed watching the movie The Light Between Oceans

Against a backdrop of beautiful and wild scenery, it deals with deep issues about trauma, parenthood, infertility, honesty, justice, and forgiveness.

One of the most powerful and central dialogues of the film is a dialogue between a wife and her husband, Frank. The version below is taken directly from the novel on which the movie is based.

 “But how? How can you just get over these things, darling?...You've had so much strife but you're always happy. How do you do it?'

'I choose to...I can leave myself to rot in the past, spend my time hating people for what happened, like my father did, or I can forgive and forget.'

'But it's not that easy.'

He smiled that Frank smile. 'Oh, but my treasure, it is so much less exhausting. You only have to forgive once. To resent, you have to do it all day, every day. You have to keep remembering all the bad things...I would have to make a list, a very, very long list and make sure I hated the people on it the right amount. That I did a proper job of hating, too: very Teutonic! No' - his voice became sober- 'we always have a choice. All of us.”

― M. L. Stedman, The Light Between Oceans

Cooking up meaningful relationships

Last weekend my wife and I went to the movie theatre to see, The Kitchen Brigade, a feel good French movie. A gourmet chef loses her job because she cannot get along with others, particularly a pretentious and demanding restaurant owner. The only job she can get is in a canteen, cooking for a group of young African men, who are in France with precarious legal status. The movie is quite funny, the characters are endearing, and it builds empathy for the plight of refugees and immigrants. Some might consider there are elements of the "white saviour" genre trope. On the other hand, the redemption that occurs is mutual.

A while back we also enjoyed watching the movie Mostly Martha. It is also quite funny, celebrates food, makes you hungry, and highlights that relationships matter.

I had a feeling of deja vu watching the movie. I was pretty sure I had seen it before. Well not quite, my daughter pointed out that there is a Hollywood version, No Reservations. I had seen that one.

The story of just one homeless man

 My wife and I watched the movie, The Soloist, based on a true story of how a journalist for The Los Angeles Times became friends with a homeless man, who was a gifted musician and plagued by mental illness.

Several important things were captured by the movie.

Every homeless person is a human, just like anyone else. Each has a story: both before homelessness and during it. Each has gifts, struggles, and aspirations. They need to be treated with dignity and respect.

The privileged should not try to "rescue" the homeless, particularly out of a sense (conscious or unconscious, stated or unstated) of superiority, virtue, guilt, or desire for validation.

Homelessness is a tragedy.

Homelessness is a complex issue with many dimensions: personal, political, economic, social, health, spiritual, ... 

Just because simple solutions do not work does not mean that we should give up.

John Stott on true evangelicalism

The kind of evangelicalism which concentrates exclusively on saving individual souls is not true evangelicalism. It is not evangelical because it is not biblical. It forgets that God did not create souls but body-souls called human beings, who are also social beings, and that He cares about their bodies and their society as well as about their relationship with Himself and their eternal destiny. 

So true Christian love will care for people as people, and will seek to serve them, neglecting neither the soul for the body nor the body for the soul. As a matter of fact, it has not been characteristic of evangelicals in the past to be shy of social action, or even, when necessary, of political action. Perhaps the two most notable examples in England, both of which belong to the last century, are William Wilberforce, whose indefatigable campaign led to the abolition of the slave trade and later of slavery itself; and Anthony Ashley Cooper, the seventh Earl of Shaftesbury, who introduced legislation to improve the working conditions in factories and mines, of colliers and chimney sweeps. 

[He was also a strong advocate for the care of the mentally ill]. 

We saw earlier how brightly Christ's compassion for outcasts shone against the dark background of the Pharisees' indifference. Still today there are neglected groups of our human society? for example drug addicts, alcoholics, the mentally sick, and the elderly ? who need what might be termed 'total care'. They challenge evangelicals to bold experiments which would combine gospel truth and practical service in a balanced expression of love. 

The kind of ecumenism which concentrates exclusively on questions of social justice, however, on eliminating racial discrimination, hunger, poverty and war, forgets the Christian saying which is 'sure and worthy of fall acceptance, that Christ Jesus came into the world to save sinners', and forgets also His plain commission to the church to proclaim repentance and forgiveness to all nations.

This was written by John Stott, way back in 1970 in his book, Christ the Controversialist. 

I became aware of this when it was quoted by Steve Bradbury in a recent Theology on Tap talk, "John Stott: Teacher and Model of a Radical Biblical Faith".

Mindfulness, Christian meditation, and mental health

For almost 40 years I have struggled with mental health issues, off and on. About twenty years ago, following one particular low, a psychologist introduced me to the practice of mindfulness. In particular, I followed a set of exercises developed by Jon Kabat-Zinn, such as the body scan meditation. These exercises were incredibly helpful as they helped me to learn to control my racing thoughts. A few years ago, I was asked to speak to a counseling class in a Christian theological college in South Asia about my experiences with mindfulness. Here are some of the questions I tried to address. When I give talks about mental health (such as this) I usually mention how mindfulness has helped me.

One question that I have continued to wonder about was how these practices, which have their origin in Buddhism and secular psychology, are related to a Christian perspective, and Christian practices of meditation and prayer. Hence, I was delighted when I came across the book, Christ Centred Mindfulness: Connection to Self and God by Katherine Thompson. Hence, I recommended it to my theology reading group. We discussed it with animation. I will give my perspective, both before and after the discussion.

The response of any reader to a book can be shaped by their experiences, prejudices, and hopes. I was naturally predisposed to like this book since I saw it as meeting an important need. It is short, clear, easy to read, comprehensive, and balanced. It covers a lot of ground in less than 200 pages. Overviews are given of the historical background to mindfulness, scientific evidence (or lack thereof) for its effectiveness, different forms of psychotherapy, some Biblical and theological basis for meditation, Christian mystics, modern Christian contemplatives, and many practical mindfulness exercises. This wide range of topics is important because mental health is multi-faceted. There are medical, psychological, social, and spiritual dimensions.

The greatest strengths of the book may be the following. It fills an important gap in the literature. The comprehensive survey (with many references) provides a good introduction to the relevant topics and issues. Hopefully, it will stimulate discussions and more books on this important topic. In the end, it is very practical. Readers can do the exercises. They are diverse, ranging from mindful connection to nature to Lectio Divina. On this basis, I would happily recommend the book to others.

Now to the weaknesses of the book. There were some things that I struggled to understand on my first reading. The author gives a review of several different forms of psychotherapy, including Mindfulness-based cognitive therapy, Dialectical behaviour therapy, and Acceptance and commitment therapy (ACT). Thompson advocates the latter and goes on to discuss how mindfulness fits well within it, particularly from a Christian perspective. However, I really do not get all the nuances concerning the differences between these therapies and could not really explain to you what ACT is. 

There are several diagrams and tables, designed to illuminate and contrast different concepts and approaches. They have the potential to be quite helpful, but they needed more explanation.

Stimulated by our discussion about the book, a number of other possible weaknesses became more apparent.

Like any book, this one reflects the author's own personal and professional journey. She is trying to bring together her own personal journey of faith, her struggle with chronic physical pain, her Ph.D. in Psychological Medicine, and her professional practice. I wonder if she has worked a bit too hard to put the pieces together in this book. Are mindfulness and Christian faith being "shoehorned" into ACT? Is she trying to give mindfulness and ACT a Christian baptism? How does repentance fit into this synthesis? Is there too much dissonance between mindfulness, ACT, and Christian faith and practice, to try to bring them all together?

How do people change? How do people experience healing from mental illness? How can a Christian live by faith and persevere in the midst of suffering? What is the role of human agency? There is significant scientific and theological uncertainty about possible answers to these questions. Any healing is a miracle, whether by modern medicine or by the working of the Holy Spirit. Given this, to what extent are "methodologies" useful? I don't know. Methodologies, whether clinical practices or spiritual disciplines, can have great value. But they do have limitations. They are all constructed by finite fallible humans, embedded in a sinful broken world. How does one find a humble and balanced perspective on and implementation of these methodologies? Again, I don't know.

In spite of my many questions, I think the book is a wonderful contribution and will benefit many.

Another member of the reading group, Chris Brown, has some reflections on the book on the "holy" scribblers blog.

Redemption from words

My wife and I enjoyed watching the movie The Professor and The Madman. It is based on the fascinating story of the origins of the Oxford English Dictionary, focusing on the contributions of and the relationship between the editor James Murray and William Chester Minor. Minor is in a prison for the "criminally insane" as a result of a murder he committed.

I found it quite striking and beautiful is how the issue of forgiveness and redemption thread through the story. How can a murderer find redemption? Can his victim's family forgive him?

What Big Questions might we ask?

Last week I watched a fascinating Virtual Veritas Forum, Coronavirus and Quarantine: What Big Questions can we be asking?



It brings together a range of perspectives. My only concern is that it is very USA-centric.

Springboarding off that discussion, here are some questions I hope will receive attention in the coming years.
A fascinating and challenging aspect of these questions is that they need to be addressed with multi-faceted and multi-disciplinary approaches. The crisis brings together issues that span microbiology, public health, mathematical modeling, psychology, sociology, economics, politics, ethics, philosophy, and theology.
Many of the questions need to be asked and discussed at multiple scales; e.g., by individuals, institutions, cities, nations, and globally.

Some of the questions have been grappled with by many smart people and societies for decades or even millennia. But, broader modern society often does not discuss them.

I list the questions in random order.

How do epidemics start, spread, and end?

How do we manage risk, balancing near certainties and ignorance?

How do governments balance the ``common good'' with protecting individual freedoms?

How do you balance medical, financial, economic, and social considerations in allocating resources to patients?

When is the ``medicine'' worse than the ``disease''?

How do you balance the future needs of the young with the current needs of the elderly?

Will the current chaos and uncertainty in the Western world make us more empathetic and willing to learn from those in the Majority World who live with such calamities on a regular basis?

What do such events reveal about human nature: values, morality, mortality, rationality, relationality?

How do you balance fear, despair, lament, hope, optimism?

Why does God allow suffering?

In what sense are calamities such as this a reflection of God's judgement? or of God's mercy?

What are appropriate responses (from the theological to the practical) of Christians to events such as this?

Why are we so afraid of death?

I welcome your own questions.

Questions and answers about Mindfulness

For most of my adult life, I have struggled on and off with mental health issues, particularly anxiety and depression. About 15 years ago a psychologist introduced me to a set of mindfulness exercises. They were developed by Jon Kabat-Zinn for the Mindfulness-Based Stress Reduction (MBSR) program that he founded at the University of Massachusetts Hospital in Boston in 1979. Although originally developed for patients with chronic illnesses, such exercises are now used in a much wider range of contexts. I have found these exercises incredibly helpful. They have helped me to learn to control my thoughts, particularly when I cannot ``turn off my brain.’’  Here are some answers to questions about mindfulness I am often asked.

 How would you describe mindfulness? 
I see it as a discipline or set of exercises that enable me to train my brain to slow down and to engage with the present (both in time and space), rather than letting my brain race out of control and fixate on past events or future imagined events.

As a Christian are you not concerned that mindfulness has its origins in Eastern Religions? 
Yes. If mindfulness means emptying your mind, losing your personal identity, merging with the universe, or thinking that life is an illusion. However, there are many versions of mindfulness, both religious and non-religious. I believe in common grace: ``God sends rain on the righteous and the unrighteous’’. People of different religions, or none, all have the ability to discover (partial) truths about medicine, write great literature, and change the world for good.

Are there Christian versions of mindfulness exercises?
Yes. See, for example, The Mindful Christian on YouTube.
Here there is a fascinating theological dimension to the focus of Mindfulness on breathing. In Genesis 2 we learn how God ``breathes life’’ into humans. YHWH is the name of God that is revealed to Moses. This is the name that must never be spoken, in many Jewish traditions. There are suggestions that in Hebrew, this name is silently ``breathed.’’ 
Psalm 46:10 says ``Be still and know that I am God.’’

What do you think about the fact that your university has recently been promoting mindfulness?
 Superficially, I am happy that the university is attempting to put mental health on the agenda and making people aware of mindfulness. However, I am concerned that many initiatives seem to be more about marketing gimmicks, rather than serious engagement. This has been described as corporate well-washing. An article in the Financial Times and the Australian Financial Review points out that Mindfulness won't fix bad management. Furthermore, the university is not asking hard questions such as: why are so many students and staff have mental health problems? Is the university culture and policies contributing to these problems? If so, what does the institution need to change?

What mindfulness exercises would you recommend to start out? 
The one that I have found most helpful is the body scan. At a particularly low time 15 years ago I would do most of this every morning. If I wake up in the middle of the night and my mind is racing, I put on my headphones and do this exercise. I can usually go back to sleep.

Jesus and mental health

On Wednesday I am giving a talk, Jesus and Mental Health, for Jesus Week at UQ, organised by several student Christian groups.
Here is the current version of the slides.
I also recommend a related talk by Santa Ono, Vice-Chancellor of the University of British Columbia.
Recommended resources (books, websites, and courses) are here.
Video below.

Competing models of mental illness

Surveying the vast literature on mental illness I have learned that there are many competing viewpoints about the origins of mental illness and proposed cures. In both the academic community and public debate, the relative validity of these perspectives is contested. The different perspectives can be broadly classified in terms of four distinct models: biomedical, psychological, social, and spiritual.

Biomedical
Mental illness arises due to chemical imbalances in the brain. Healing can occur through treatment with appropriate drugs. With the development of new drugs, such as SSRIs, in the last thirty years, this has become widely used by psychiatrists and medical doctors. There is no doubt that many people, including myself, have benefited significantly from these drugs. Unsurprisingly, big pharma strongly pushes this point of view. However, drug treatment is not always successful and it is debated whether such drugs are over-prescribed. Even among psychiatrists, the biomedical model is contested because it ignores thinking patterns and the social interactions of the patient. Recently, the New York Times had op-ed articles by a doctor and a patient contesting this model.

Mental Illness Isn’t All in Your Head 
Lisa Pryor

It’s Not Just a Chemical Imbalance 
Thinking of my mental illness as preordained missed many of the causes of — and solutions to — my emotional suffering.
Kelli María Korducki

Psychological
Mental illness arises due to negative thought patterns.
Healing can occur through psychotherapy.
Freud drew an analogy with grief over the death of a loved one to argue that depression arose due to the patient turning their anger inward about losing an ideal object.
Cognitive behaviour therapy seeks to train the patient to think in more positive ways.
Other approaches focus on past trauma and/or unresolved conflicts, particularly from childhood.
Mindfulness uses meditation exercises to help the patient learn to control their thoughts.
Many people, including myself, have benefited from this approach. However, there are many people for which this approach is ineffective, particularly without medication.

Social
People are social beings. When they are isolated from true community mental illness results. One of the first advocates of the social model was Emile Durkheim, one of the founders of sociology. He found suicide rates varied significantly between different social groups, and argued that this was related to the levels of social integration felt by individuals.
A recent popular advocate of the social model is Johan Harari, in Lost Connections.
The best treatment for patients is to help them establish meaningful relationships in the context of a community.

Marxist
In capitalism, people are defined by their jobs, by their relationship to the "means of production'', the technology that is at the heart of the economy. As a result, they are alienated from one another, from nature, and from meaningful work. The solution is political and economic: revolution leading to a socialist economy where workers own and control the ``means of production.''

Spiritual
The most extreme form of this model is that mental illness arises due to demon possession. Healing can occur through prayer, particularly exorcism. Advocates will point to accounts in the Gospels such as Jesus healing the demoniac. A milder form of this model is that mental illness arises due to the sin or lack of faith of the individual. The solution is repentance and faith. There is no doubt that substance addictions and abuse are bad for mental health. Studies also show that forgiving others is beneficial for mental health.

These competing models raise fundamental questions such as
What really defines a human person?
How do you define human well-being?

Is a human essentially biological (biochemical and genetic), mental, social, political/economic, or spiritual? These models for mental illness tend to each assume an extreme reductionistic view of the essential character of a person.

However, Jesus seems to have had a more integrated view. He said people should love God with all their heart, mind, soul, and strength. He is not presenting a partition of a person, but saying a person is a complex unity of emotions, brain, spirit, and body. Furthermore, the incarnation is about God taking on a human body. Jesus promises his followers will be resurrected with him: not disembodied souls, but rather bodies.

[Figure from Sanctuary Mental Health ministries]

Rather than seeing that one of the models as being mutually exclusive I see that they all have strengths and weaknesses. Individuals are complex and diverse and they live in diverse contexts. Hence, causes and solutions for mental health may vary significantly.

This week I am giving a talk on Jesus and Mental Health for Jesus week at UQ. More to follow.

IFES seminar on mental health in universities

I am giving a seminar on mental health in universities at the IFES World Assembly in Johannesburg.
My co-presenter is Ibukun Adekoya, a Ph.D. student in Counseling Psychology at McGill University.
Later I will post our slides.
Here are some of the recommended resources

Articles

Why Africa needs to start focusing on the neglected issue of mental health
Article in the conversation, by Crick Lund.

Turning the church's attention to mental health
Lausanne movement

Mental health: a guide for Faith Leaders,
American Psychiatric Association

Introductory books

Troubled Minds, Amy Simpson

Grace for the afflicted, Matthew Stanford

Lost Connections, Johan Hari

Advanced books

Psychology through the eyes of faith,
David Myers and Malcolm Jeeves

Global mental health and the church

Christian counseling: an African Indigenous Perspective.

Organisations

Sanctuary Mental Health Ministries 

Grace alliance

Trauma Healing Institute of the American Bible Society

Mental health in a fallen creation

The Garden of Eden in Genesis 1-2 represents God's ideal. There is harmony between God and humanity, between male and female, and between humans and nature. There is no struggle for survival. There is no shame. Everything in the creation is good.

Yet this is not the world we live in.
People are alienated from God: they lose identity, purpose, and hope.
Men and women are in conflict.
Work is hard and stressful. It is usually a struggle for survival.
Humanity is alienated from nature.
People are ashamed.
Violence (physical, sexual, and verbal) is prevalent. Violence easily escalates and is passed on to the next generation.
The mind is corrupted. People believe lies, including about themselves.
Disease and death are present.

This is the world introduced in Genesis 3: the fallen creation. Adam and Eve believe a lie: they can be like God: be rulers and know everything. They rebel and experience the consequences: the world described above, a world of alienation.

Mental illness is part of the fallen creation. Depression is characterised by a lack of hope.

The Bible does not present a simplistic or reductionist view of what a human is. The description in terms of ``mind, body, heart, and soul'' is not dualist or even quadralist! Rather the Bible presents a holistic Hebrew perspective that being human and being whole is multi-faceted. Hence, mental health requires an integrated approach. The causes are complex. The solutions are complex. There are spiritual, biochemical, social, and psychological dimensions to be addressed. These dimensions often interact with one another, either constructively or destructively. Healing and prevention may require a blend of prayer, counseling, drugs, exercise, diet, supportive relationships, community building, and lifestyle changes.

The mandate for Christians is to bind up the broken hearted, heal the sick, and set the prisoners free.