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Monday 10 March 2014

Is your Church a Safe Place to be Mentally Ill?

"But in your hearts revere Christ as Lord. Always be prepared to give an answer to everyone who asks you to give the reason for the hope that you have. But do this with gentleness and respect, 1 Peter 3:15"


How safe is your church for people who are emotionally vulnerable? This is a question we were faced with, when tentatively we introduced a Coffee Morning on Mental Health during a mission week nearly two years ago. It was as part of a week long series of coffee mornings entitled 'Help, How do I cope with....' I was responsible for organising 'Mental Illness'. As a long time member of our church I wanted to speak to others about my own experience of mental illness and faith. I was given the opportunity to organise two different events during our LIFE week in 2012.

The first was a public meeting where we used Mental Health awareness quizzes gleaned from Sane, Mind and other excellent websites, followed by questions to a number of people from our Church who had lived with Mental Illness or were carers. Then a GP who has published a book about depression spoke about faith and depression. I'm not sure of the total numbers attending but the main body of the church was filled. The response was immediate and positive. The second event was a more intimate coffee morning in a friend's house 12 attended. I told my story and invited discussion of what people felt was needed in the church to support them through periods of Mental Illness. A number of observations were made:



What Issues Were Raised?

A. It is often hard for someone struggling with emotional issues to face getting out and about. In particular, people recognised the fact that the church could be a supportive environment, but often the prospect of walking through the door was too daunting when feeling low.

B. Many were shocked when I first stood up at the front of church and informed them that I was receiving treatment under the care of the Complex Care and Treatment Team and that I suffered from a complex Mental Health condition which was long term. For them it helped to know that someone else in the Church had some understanding of the stigma of Mental Illness, even if we didn't share the same conditions. Essentially, people believed they were the only one (in Church) taking anti-depressants, or the only one whose spouse was Bipolar, or the only one who had ever had a suicidal thought.

C. There was a sense of failure born of people's belief that their faith should somehow 'protect' them from emotional and psychological distress. Talking about Mental Health and being open about how many in the church were struggling with similar issues was a start in allowing people to discuss their problems openly.

Guiding Principles

Having started the conversation about Mental Health, we are now working on how we respond as a Christian Community to issues around Mental Illness. There are some principles that we believe are important to ensure that as a Community we make sure our own mental and emotional resilience is strong enough to help those most in need.

1) Research has shown that finding hope and meaning for life, is a key protective factor in helping people manage suicidal impulses and feelings. As Christians there is much teaching in the Bible about the renewing of the mind, and many examples of practical care for our physical and mental well being. Primarily in planning events and training I have kept in mind the exhortation from Phillipians 4:8 ff: "...whatever is true, whatever is noble, whatever is right, whatever is pure, whatever is lovely, whatever is admirable—if anything is excellent or praiseworthy—think about such things. Whatever you have learned or received or heard from me, or seen in me—put it into practice. And the God of peace will be with you." There are a number of therapies such as Cognitive Behaviour Therapy and Dialectical Behaviour Therapy which can be compatible with these biblical principles. Therefore Christian faith can be seen as a positive influence on someone's recovery, if it is taught faithfully and compassionately.

2) It is dangerous for Churches to advise members to neglect either medication or attendance at therapies that have been prescribed by medical professionals. It is important particularly when helping people with complex mental health problems such as Bipolar, Schizophrenia and Borderline Personality Disorders, to support them in accessing mental health services. When presented with peoples' needs, asking simple questions such as, have you missed any appointments recently? Do you have a Care Co-ordinator? Have you been in touch with your GP?, will enable you to discern whether they are accessing all the help and support that may be available to them.

3) No one individual should try to help someone with complex Mental Health Conditions in isolation. Expectations of boundaries should be clearly articulated at the start of any relationship. In this way, the person being helped understands that everyone has their limits and, because of that, there may be times when we all will need to seek advice and support from others. Any pastoral work carried out in church should not be the burden of one individual but should be shared by a team, even if there is one Key person who is in contact with each individual in need. This is important to prevent 'burnout' and the breaching of personal boundaries and limits.

4) It is not 'UnChristian' to set limits to time and expectations of every contact with each individual. Following the Sermon on the Mount, Jesus withdrew to a lonely place to pray and 'recharge his batteries'. In fact the Bible tells us that he often withdrew to lonely places to pray. If Christ needed to find energy and time alone with God, to help people, all of us should expect the same for ourselves. Self Care is essential if we are to be resilient enough to be effective in helping those with Mental Health issues.

For those with Mental Health issues there is often a sense of chronic emptiness and endless emotional pain and distress. For us, it is exhausting to live with every day, but it is also exhausting when trying to come alongside and support us. God cares for all of us and if we find that we are reaching our limits, we need to be honest with one another about that. It is not helpful for one person to set out to help me, with my Mental Health issues, with little idea of how often and for how long I can contact them without causing them to feel 'burnt out'.


In the past I have been hurt when so called 'pastoral' relationships have been abruptly terminated because the person seeking to pastor me has found themselves unable to cope with my levels of distress. Better to have never started the relationship in the first place than to leave me feeling once again that no one can help me, or worse, cope with me - such experiences only deepen my sense of alienation and rejection. If you're not sure that you can cope with listening to my issues, don't start the conversation and certainly don't promise me things you can't deliver. Clear boundaries set at the beginning of a relationship often prevents those awful moments when you're caught on the phone and find yourself unable to end it without causing damage to the person on the other end. Being clear about what you can offer at the outset and that there are limits to your interaction allows you to end it when such conversations have become unproductive. The question to ask in any interaction is, is this achieving anything for either them or me?

5) Any groups that are set up should have a purpose that is not met by any other ministry in the Church. Hence any Mental Health focused group should not become a fellowship for the 'suffering'. There should be a focus on positive encouragement from scripture and that group members will be expected, as their conditions allow, to contribute to supporting one another to make the most of their therapies and to positively engage in the wider Church community. We have a well developed small groups system in our church and all adults who attend regularly are encouraged to join one of these groups. In a large Church this is an effective way of making sure we care for one another. If people are physically able to they should be encouraged to make their own way to any group, this may be difficult at times and expectations of attendance at all sessions should reflect the realities around motivation when dealing with Mental Health.

6) Helping and pastoral care for those struggling with their Mental Health in the church is not solely the responsibility of the Ministry Teams. Some may have some more knowledge and expertise in helping in this area than others. However, being part of a community of different people with different gifts and experiences can be positive when it is welcoming and safe. Therefore the Church Family as a whole should be involved in learning about Mental Health and understand where and when to seek help for themselves and others. It takes a Village to raise a child, it takes a whole Church Family to help those with Mental Health issues.

What We Have Done

Given these principles, we have now embarked on a basic programme of Mental Health Education. The following is a list of activities that we have already held or are planning.

1) Basic training on Mental Health issues, Suicide and Suicide Prevention for Ministry Trainees.

2) Set up a Pastoral Team who can be allocated as Keyworkers to individuals needing additional support.

3) We have developed a five session long programme of practical advice and support to help those struggling particularly with Depression and Anxiety. This has been called 'All of Me' and based on Biblical principles seeks to complement interventions from local Mental Health services. This blog is linked with the work carried out as part of All of Me. We have completed four of these courses since last November when it first started. Many more people have expressed an interest in attending. We are hoping to extend the group to our Church Extensions after Easter. I have found that those who attend out of interest rather than from recognised need, find it equally helpful to maintaining their own Mental Health.

4) A Follow up Coffee Morning which launched All of Me and was centred on Stigma and Mental Illness. This was accompanied by a talk at all three main congregations in the church raising the need for education around Mental Health issues in general.

5) Talks to various groups in the church around Mental Health and tailored for the needs of each group e.g. Ladies Fellowship - older ladies excellent discussion of bereavement issues and depression.

6) Training for Growth Group Leaders and Pastoral Team - basic triage re emotional problems and how to signpost to appropriate help.

7) Suicide Prevention training for Pastoral Team and Ministry Team.

8) As part of a mini mission in September we have planned another morning exploring the issues around suicide called 'Help I Can't Cope Anymore' Again this will be a mix of education, testimony and talk by a speaker who has experienced complex Mental Health issues themselves.


There are numerous other ideas that are being worked out. Rather than seek to plan for unknown needs, our programme has been developed following response to two focused events which asked the question, what more do you think we could be doing?

Above all, it is my hope that when someone is in despair they will be able to find an open door, a listening ear and an understanding heart in our church family. Ultimately, I believe that if we are able to do that, then we can offer to each person, hope and meaning for every moment of suffering they have gone through in this life. And the opportunity to become part of a warm, functioning Church Family.

Sunday 2 March 2014

Learning to be Content

In our 'All of Me' session last week, we were talking about emotions and thoughts. Suddenly one of the group members said 'I think I would be able to be happier, if I didn't keep expecting life to be better than it is'. As Milton wrote, 'The mind is its own world and can make a heaven of hell a hell of heaven.' (Paradise Lost Book 1) Some of my own misery has come from comparing the problems of my life with those of others. Even if I am right in my comparison with some, objectively, most of us in the Western World are comfortably off when it comes to the provision of the basic essentials for living. However, I don't think that most of us are so oblivious to this fact that material safety affects our mental and emotional well being to such an extent that it is a factor in our experience of depression. I believe that our expectation is that everyone else around us in the world is living in relative happiness because they have learned some secret, or have some inner resilience, from which we have been excluded. Perhaps, that is an easier rationale to live with than accepting that life just plain sucks!

As someone who has suffered all my life with complex mental health issues, who has suffered 'breakdowns' and bleak periods of hopelessness brought on by clinical depression and my battles with BPD (Borderline Personality Disorder), I find myself excluded from some modern Christian teaching. You will have come across them, perhaps under the title 'name and claim it' or 'health, wealth and prosperity'. Some of these teachings tell me that my ongoing battles with emotional and mental distress and trauma are an affront to God because it is a sign of my spiritual weakness. They tell me that if I lack anything, God has promised that if I ask anything in His name it will be mine...really? Is that all that the Bible says...? Anything, that I want, as long I ask in Jesus or in God's name? What of God's providence, sovereignty and purposes for us in this world. It begs the question what is the destiny God has for me that most glorifies Him? Is it to be healed on demand, or is it for me to become more Christ-like in my dealings with life and all its twists and turns?


I embrace the knowledge that God does wonderfully supply all my NEEDS. There it is that magic word, 'enough'. In Matthew 6: 25-34 Christ tells us not to worry about tomorrow because 'today has enough troubles of its own.' Nowhere in the Bible do I see anything that assures me that I will live a problem free life. In fact I see the opposite, what I see in the Bible is the confirmation that my own suffering is a fairly accurate reflection of what life is like - once again, life sucks.

So, if I am thinking that I am being hard done by, just because I am struggling with life, maybe it's time for me to change my thinking.

Here are some principles:
 Be kind to yourself – If you are struggling against a mental illness remember that healing takes time. It probably took some time for you to become ill and it will take time for medication etc. to work in improving things. Work within the limits of what you can realistically do. DO NOT JUDGE YOURSELF HARSHLY! (Even Jesus needed to rest – ‘But Jesus often withdrew to lonely places and prayed.’ Luke 5:15-17) The Garden of Gethsemane is an amazingly instructional picture of Jesus as man struggling with emotional and mental pain of being human. He was in such distress that he sweated blood. At this point I don't find a saviour who condemns me for suffering mental and emotional torment, but one who has been there in the literal and metaphorical darkness and who seeks to walk with me each step through.

 Life hurts - there will be times when it is hard going and you find yourself drained by just getting up in the morning. That’s ok it’s called being human. In Psalms David says (more than once!) ‘Why, my soul, are you downcast? Why so disturbed within me? Put your hope in God, for I will yet praise him, my Saviour and my God.’ Psalm 42:4-6 Accepting that it’s part of the human experience to feel this bad at times, hopefully will help lift some guilt.

 Know that everyone has their limits and you can begin to accept that you are the same as everyone else. You may be tempted to give others a break when you demand far more of yourself. Sometimes good enough is good enough! Don't expect of yourself more than you would expect of a friend in the same circumstances.

 Focus on the positive. Sounds obvious but is hard to do especially when you are struggling to concentrate. Don’t make a chore of it. Get creative – use positive verses/statements listen to cheesy pop music (really – I’m learning to love my inner Nolan Sister!!) have a long bath (banish children and others from the bathroom or the bathroom door!) Even if only for a short moment at a time focus all your attention on the good thing!

 Stop the Panic – Remember to breathe, Learn to listen to your breathing and slow it down. Give yourself space to acknowledge your emotional and mental distress, it's ok to feel hurt.

 Live in the Moment – ‘Yesterday is history, tomorrow is a mystery, today is a gift from God which is why it’s called the present’. The Bible tells us that Jesus is the same yesterday, today and tomorrow which means he has lived them all with us. We cannot change the past or the future, try to focus on the here and now. Jesus focused on this in the Sermon on the Mount: “Therefore I tell you, do not worry about your life, what you will eat or drink; or about your body, what you will wear. Is not life more than food, and the body more than clothes? Look at the birds of the air; they do not sow or reap or store away in barns, and yet your heavenly Father feeds them. Are you not much more valuable than they? Can any one of you by worrying add a single hour to your life? ...”
Matthew 6:24-34
In other words, if you can't do anything to change it, accept your limits and be content to use your energy to solve the problems and overcome the hurdles you can, in each moment that you live.

 Stay Grounded in the Present - When you find yourself grieving about things which have happened or worrying about things which haven’t happened – use your breathing or focus on something around you such as sounds, children, animals, a picture – anything of interest, to bring you back to the here and now.

In church we are coming to the end of a great series about Money. This morning we focused on the following prayer, from a man called Agur:

7 “Two things I ask of you, Lord;
do not refuse me before I die:
8 Keep falsehood and lies far from me;
give me neither poverty nor riches,
but give me only my daily bread.
9 Otherwise, I may have too much and disown you
and say, ‘Who is the Lord?’
Or I may become poor and steal,
and so dishonor the name of my God." (Proverbs 30: 7-9)


In relation to money this is the wisest of prayers, but I find that the prayer for God to provide 'enough' applies also to my emotional and physical well being. If I am not tied to matching the life and lifestyle of others around me, then I become truly free to live my life as God has designed it to be. For every one of us there is a purpose for our gifts and talents, for our experiences and sufferings. In our modern world, within the church too, we have stopped seeing suffering and pain as part and parcel of the human lot. As many humans as I have encountered in all my days, I have never met one who has not had their share of struggles and problems. We deny the reality of the power of Jesus' Cross, when we try to sanitise the lives we live in this world. In the past trouble and strife was expected and seen as essential spiritual tools towards maturity and sanctification (ie becoming more Christ like). One woman in the group said to me that when she first started coming to our church, she used to think that the couples and families around her had it all together in a way that she felt her own family didn't. And now, after a couple of weeks she realised 'you're all in as big a mess as me'. The difference is that God will work his purposes out, and his main purpose for us is to help us become more like Jesus in the way we respond to all of life.