Soul Pain

(system) #1

This happened to a dear friend of mine. He’s been gone for many years, so I think it’s safe to tell the story.

He had, for almost as long as he could remember, suffered spells of intense depression. He wasn’t an educated man. I’m not sure he even knew what to call his bad feelings. In the community where he lived, among the people he knew, there were two states of mental functioning: normal or crazy. For the latter you went to the state mental hospital. He analyzed his feelings in the only way he knew: it was a spiritual problem.

In desperation he called the pastor. The pastor understood the malady the same way my friend did. He prayed with him. He told him it was up to him to overcome these feelings by his own effort and prayer, and he backed it up with a passage from Ellen White: “For the disheartened there is a sure remedy—faith, prayer, work.” And, he added, it was important to do so, for Ellen White said that just having such feelings was a sin! “Despondency,” she wrote, “is sinful and unreasonable.” (Prophets and Kings, p.164). My friend took from the counseling session the sense that these horrible feelings, feelings that made him want to kill himself to end the pain, were his own fault, and would cost him eternal salvation.

I wish I could say that he overcame depression, that God answered his prayers and for the rest of his life he was happy. But that wouldn’t be true. He struggled with depression until he passed away from cancer at a relatively young age.

I’m not casting blame, and I hope you won’t, either. Remember, this happened years ago, among people who lived in a rather small world. Both my friend and his pastor understood depression according to the only model they knew. Except for the part about depression being a sin, other sufferers in that community might have been receiving similar counsel from their pastors and priests. And it might have been better than the medical alternatives at the time. Early treatments for severe depression, tranquilizers and convulsive therapies, didn’t work well and had ugly side-effects. Surviving by talking to your pastor and praying probably wasn’t a bad outcome.

Mine was among the first generations of Seventh-day Adventist pastors who grew up with the medicalization of emotional problems, though the phrase “mental health,” was still new to us, and the boundary between mental health and spiritual health was (and remains) turbid. This new understanding coincided, not surprisingly, with the development of medications that treated mental illnesses astonishingly well. Anti-depressants, safer tranquilizers, even medications for bipolar disorder and schizophrenia—they aren’t perfect, but they work better than prayer alone.

How do we distinguish between mental health and spiritual health? If a pill made one feel very close to God, if it let a person who’d always struggled with prayer and spiritual feelings suddenly experience God’s presence, would we think that a good thing? That’s exactly what happened to one of my church members when she was prescribed a SSRI. On the other side, I once met a man who quit hearing the voice of God speaking to him after he was placed on psychiatric medications, leaving him spiritually bereft.

Nowadays there are many who, when faced with normal stresses of life, get a prescription for Prozac, or take a Xanax. It’s pretty clear that medicating isn’t always a good solution to everyday problems. Prayer and counseling might be better. But anti-depressants and anxiolytics are miracles for some people with mood disorders. Where’s the line?

Mental health has that same shared territory with science that causes us so much trouble when we talk about origins. That is, how much is God, and how much is science? We Seventh-day Adventists who believe that God is the Creator don’t question the accuracy of science when we need antibiotics, a weather forecast, a computer, or passage in an airliner. But, we ask, when scripture relies on one explanation for something, and science has another, which does a Christian trust? We resent that the more gaps science fills in, the less the need for the Bible’s explanations.

Scripture doesn’t provide a scientific outline for the treatment of disease, mental or physical.[1] It says to lay hands on sick people and pray, and for the mentally ill, to cast demons out of them. Despite that, for reasons that I’m not the historian to explain, Christians don’t show much hesitation about using medical science—pharmacology, lab tests, surgery, physical therapy, organ transplants—to address physical maladies.[2] As for mental health, nowadays pastors like me would consider it malpractice to tell a suicidal person, “Don’t see a doctor. Just pray about it.” (Though there are still corners of the Seventh-day Adventist world where pseudo-clergy hold marathon demon-expulsion sessions.) Yet I still meet people with depression who won’t get treatment because it would be an admission of spiritual defeat. A pastor told me, “If my church members knew that I rely on an anti-depressant, many would lose confidence in me. I’m supposed to be setting the example of victory through prayer.”

Many years ago a Seventh-day Adventist college experienced a sweeping spiritual revival on campus. The leader was an intense pastor-in-training who challenged his fellow students that Jesus was coming soon and they must get ready. As I remember the story, it involved long prayer vigils and much shared emotionalism. At first, everyone was thrilled. Isn’t that what we’ve been waiting for, a contagious outpouring of the Holy Spirit that awakens drowsy Seventh-day Adventists to finish the work and bring Jesus back? But when the leader began to style himself as selected in a prophetic way, when his messages became particular and grandiose, some wondered if the revival was healthy. When it was revealed that he was going 24 hours a day without sleep, campus health investigated, and the young man was eventually diagnosed with bipolar disorder.

The story raises some hard questions. What was it that raised concern? The leader’s claim to exercise dormant Biblical gifts? Or his shaking things up in a crazy, possibly destructive way that they feared wouldn’t end well? But can’t the same be said of great Bible characters who we today consider saints? Was Ezekiel, who had hallucinogenic visions and baked bread with his own dung, sane? Might Jeremiah have been in clinical depression when he wrote, “My soul has been rejected from peace; I have forgotten happiness” (Lamentations 3:17)? I wonder how “normal” some of the great characters in spiritual history would have seemed to us, had we been there with them? It appears that God occasionally chose strange, unstable people to work through—people we probably wouldn’t select for leadership in the church. Would some of the progress in human intellectual, spiritual and moral understanding have happened had it not been for people whose behavior can be found described in the DSM-5? For that matter, how much great literature, art, and music would be missing if all of the craziness had been therapied out of Van Gogh, Hemingway, Mozart, Wagner, and scores of other crazy creative people?

Nowadays we don’t eschew mental health treatment. We even have Seventh-day Adventist mental health facilities and a school of psychiatry. I don’t hear many saying we ought to shun psychiatric treatment and rely on prayer alone. Yet there is still more shame attached to mental illness than to physical illness, still questions like, “What did I do to make me feel this way?”, or “Shouldn’t I be able to pray my way out of this?”

I suspect this will always be a muddy area for us. It seems to me we should talk about mental illness in such a way that people wouldn’t hesitate to seek help when they ought to. But there may always be some question about when they ought to.

[1] Some passages seem to address the prevention of disease, although it’s unclear whether the Old Testament food prohibitions were originally meant for health or ritual purity. A friend pointed out the closest thing to a direct medical prescription that he had noted in Scripture: “Stop drinking only water, and use a little wine because of your stomach and your frequent illnesses” 1 Timothy 5:23.

[2] Even Christian Scientists no longer prohibit all medical treatment.

Loren Seibold is a pastor in the Ohio Conference, and co-contributor (with Monte Sahlin) to Faith in Context, a blog about the intersection of religion and culture.

This is a companion discussion topic for the original entry at

(jeremy) #2

this is such an interesting article that raises many interesting questions…unfortunately today is one of my worst days with work, but i’ll comment later…

(Marianne Faust) #3

Sometimes, I fear, we have an unhealthy focus on health. I know about pastors who urged depressive patients not to take their anti depressants anymore. With horrible results… I wish we had a very clear rule for pastors and others, not to encourage these patients to quit taking their medication.

(Elaine Nelson) #4

There should be no rules. Humans can never be mentally or physicially treated by a rule, other than: “First do no harm.” Pastors should refer such members to competent medical or psychiatric professionals and NEVER try to treat someone with such conditions.

(P Kevin Wells) #5

Recently I underwent an extraordinarily difficult year of ministry. I was involved in reporting criminal activities that resulted in deep devastation to our faith community. One family was torn apart and a lengthy prison sentence resulted.
In times past, when I encountered personal or professional difficulties, I was usually able to rally my mental and emotional reserves after a time of rest, exercise, prayer and time away. Because throughout my life I have always been someone who never gives up and just trudges through difficulties until the end I believed eventually I would emerge. Not after this situation.
Nothing was working. I found myself in a persistent and quite nearly debilitating depression. For the most part no one new how dark the world had become for me. Because I try to take my own advice I went to my personal physician and shared with him my challenges. After taking a brief questionnaire, which revealed moderate depression, we discussed some options and I elected to start an SSRI for a trial period.
Within days of starting the medication I realized that I wasn’t moderately depressed, but quite likely I had been severely depressed and not for just a short time. As the fog lifted I eventually became aware that I had been depressed for most, if not all, of my adult life.
In the last ten months I have continued to experience a deeper sense of personal well-being. I would say that all of my relationships have improved. By this I mean my relationship with my spouse, children, colleagues, parishioners, and God.
Consequently, I have determined that whatever I have to do I will do or whatever I have to take I will take to not go back into that dark abyss. I recognize that medications are not the answer to all problems. Sometimes we just feel down and time and change of circumstances will result in a change of mood. However, sometimes we need medical intervention and in those cases it is not a lack of faith or commitment. It’s just a matter of biology.

(John Mc Larty) #6

Thanks Loren. Your title, “Soul Pain” is priceless and the gentleness of your exploration is wonderful. The relationship of brain biology and spirituality is one of the questions that most puzzles me these days.

(Elmer Cupino) #7

“***I once met a man who quit hearing the voice of God speaking to him after he was placed on psychiatric medications…***”

If the voices left after antipsychotic medications, then I would surmise it wasn’t “God speaking” after all. Maybe someone masquerading as god.

(Rheticus) #8

This is not a useful characterization. Too often we ascribe to the devil what should merely be ascribed to living in the real world, which leads us to unreal rather than useful solutions.

Loren captures this precisely.

Jumping straight to Satan is jumping straight into the dark ages.

(Elmer Cupino) #9

Thanks for the input. But nowhere did I refer to the “devil” as the “someone masquerading as god.” And you are indeed right. At times they are just real factors “in the real world” that are “masquerading as god.”

My point is if they all resolve with antipsychotic medications, then they couldn’t be the “voice of God.”

(Elmer Cupino) #10

“How do we distinguish between mental health and spiritual health?”

There is nothing medication does that is not already physiologically endowed through our DNA, anymore than taking Ritalin will increase intelligence. In simple terms, psychiatric medications effect changes through neurotransmitters and receptors, either agonist or antagonist, blockers of partial blockers or anything in between. Mental health would be the result of biological abnormalities whereas spiritual health would be reflections of the individual’s mental preoccupations. For instance, mood disorders are modulated by neurotransmitters so increasing those neurotransmitters are posited to be the mechanism of antidepressants. Bizarre hallucinations are modulated by overstimulation of D2 receptors so blocking those receptors diminish hallucinations. Beethoven and Mozart heard music because they were musically preoccupied whereas EGW would hear God and angels because she was religiously preoccupied. The circuits and pathways of the brain are generally endowed through our DNA and in general are uniform across the board whereas its expressions would be individualized according to each of our life experience and preoccupations.

One cannot become spiritual just by taking psychiatric medications. One has to be inclined spiritually and by taking psychiatric medication can become more proficient in honing and manifesting those spiritual drives.

(Loren Seibold) #11

John, the title “Soul Pain” was my wife’s contribution. I was struggling to find a title, and she read it and immediately supplied that one. I want to make sure Carmen gets credit for it.


(Loren Seibold) #12

PKW, thank you for being brave and sharing your struggle.

(Carolyn Parsons) #13

Which begs the question: how do we know the difference between auditory and visual hallucinations and visions like those that Ellen White described?

(Loren Seibold) #14

Marianne, your example here demonstrates precisely what I have written about. Mental health is contested territory in the minds of some religionists: God should solve it, not medicines.

(Elmer Cupino) #15

In situations like this, it would be helpful to distinguish the breakthroughs of hallucinations and its mechanism versus its content. Which are you most interested? If you are inquiring regarding its content, then maybe a minister or a theologian can help you. If you were inquiring about the mechanism of its breakthrough, then most psychiatrist will refer to the “overstimulating of the dopamine type 2 receptors” in the brain.

(Elmer Cupino) #16

Please refer to my post above regard “mental health and spiritual health.” Maybe that would explain some of your questions.

(Rheticus) #17

It intrigues medical people that so many psych problems manifest themselves in religious ways in patients. It really makes one wonder about religious feelings in everyone.

I see such purely internal phenomena as a major cause behind the expressions of certainty-without-data I see in replies in this forum.

(Elmer Cupino) #18

And as long as we are born and cared for by a set of parents, religion will always be relevant. It is the sum of parenthood. It answers the three major questions everyone wants to know, where did we come from? who are we? and where are we headed?

Besides, when you tell everyone one that God has been talking to you, who can fault you? You become untouchable, beyond reproach.

Just an opinion but consistent with what I understand in my clinic.

(Carrol Grady`) #19

Similar to my experience, Kevin. It took me some 50+ years and several attempts at talk therapy before I began to understand that my lifetime problem had been depression. After starting an anti-depressant some 20 years ago, I felt “normal” for the first time in my life, and I thank God for this relief!

(George Tichy) #20

But Marianne, aren’t the pastors more knowledgeable in mental health than the mental health professionals?..