Besmirching God with My Crazy

I’m sitting here in a volunteer medical clinic for a 60K attendee camporee. It’s humid and hot and we are seeing a lot of dehydration, amongst other things. 

As a psychiatrist, I’m humming the Hallelujah chorus as I discover how much general medicine I still remember, from gout, viral rashes, respiratory and ear infections, cuts and bruises, and so forth. The group I came with teases me that if someone comes in for a cough, two hours later they will have disclosed that they were abused as a child and be swallowing prozac.  I am ignoring this implication that I am missing “the point” by treating for psychiatric needs. Ignoring and missing, at least it’s consistent.

Our theme from this camporee week is appropriate.  We have been looking at the life of David. In these, we see a whole lot of psychiatry going on, both medical/biological, and that which has to do with volition. King Saul demonstrated a sure biological mental illness. And David pretended to be crazy – call it, “acting out.”  

God put this in the Bible for some reason(s). Question: What does this say about God’s character? I mean, we certainly don’t look up to people with acting out behavior, like David. Nor do we necessarily look up to people with mental illness like Saul, either. What does this say about who God is? Why does God put this in the Bible?

The Bible didn’t describe this as psychiatric, behavioral, acting out, or general medical.  It just told the story. These ages later, we can do more with the story. Here in time, with the knowledge that the generations have given us, we could say something psychiatric was going on. But generally, despite this knowledge, we ignore the medical condition. We still talk about them with a weighted moral perspective, as if they departed from their spiritual walk in these behaviors, rather than consider the medical condition of their brains.

David is getting a javelin thrown at him while playing the harp. Patton State Hospital for the criminally insane might have housed king Saul if he were alive today. Then, David is in front of the Philistines with King Akesh, where he “pretended to be insane; and while he was in their hands he acted like a madman, making marks on the doors of the gate and letting saliva run down his beard.” (1Sam 21.) 

Dr. Martorell, a neonatologist, told me,

“I see so many people afraid to discuss problems such as depression, anxiety, other psychiatric illnesses and even family problems or abuse.  Yes, partly due to the fact that they may be judged as not having enough faith or not taking care of their health or not following certain principles.  

Primary Care Nurse Practitioner Carrie stated, 

“God and psychiatry go hand in hand I believe, but many Christians don’t think psychiatry has anywhere to go in the church. This is sad because my mom had bipolar, but nobody could help her.  She needed the ‘extra help’. The church thinks we should be able to handle it ourselves.”

You may have seen the lock-down type who says, “Keep it in the family. Don’t tell others what goes on here. It’s none of their business.”  

Dr. Martorell said, 

Our cultural or family upbringing has a lot to do with how free we feel to discuss these issues.  In certain cultures mental health problems are simply not discussed.  If it gets brought up, the family directly or indirectly tells the affected person suffering not to discuss these outside the home, as though it were some dark secret that cannot be disclosed.

Nurse Carrie said, 

“Everyone thinks we should deal with things on our own, and we shouldn’t have to talk to people about our problems and what’s going on in our lives.”

Ironically she is describing a condition of the church of independence. Yet inherent to being a believer is the learning to depend on someone else, God. 

Nurse Carrie said, 

“Why is it with depression and such, we can’t work as a church and have medical get it done.”

Many say, ‘If you go see a psychiatrist, it’s a sign of weakness. You’re not a good Christian.’ These are the comments I’ve heard of through the years.  You should just pray, and God can take everything away.”  

When my aunt suffered colon cancer, she didn’t get medical treatment in the beginning, preferring to have herself anointed, and follow a “homeopathic” approach. Later as it progressed, she changed her mind and found it was too late. So although largely, it isn’t only in psychiatry that we misrepresent who God is, we need ask ourselves, Who is God if what we believe about this is true?

Dr. Martorell shared,

As a neonatologist, I see infants born prematurely. Their brain develops outside the womb and are simply not the same as those that develop in a dark, quiet environment listening to mother’s heart rate, free of noxious/painful stimuli inside the womb.  As much as we try to imitate a womb with our incubators we can’t provide the same care.  When these infants are followed up for years, some develop physical deficits such as cerebral palsy, blindness, the need for oxygen, and the inability to eat on their own. These physical problems are easily seen and various treatments can be provided.  They are also at greater risk for developing learning deficits, hyperactivity/inattention problems, depression, anxiety and some academic papers even suggest increased risk of schizophrenia.  The thought behind these is that billions of synapses are occurring during pregnancy and the way these synapses connect is different in premature infants.  It is also interesting to note that the brain volume preset at birth occurs during the last 4 week of pregnancy. As these children grow up they need treatment for physical problems as well as psychiatric problems they may develop.  

I realize that it is not just in our churches that we are afraid to address this issue but I see it in the families of my newborns.  So many of these moms self medicate with illicit substances in order to treat their anxiety or depression.  Our culture as a whole has neglected to look at these issues as a medical problem that needs treatment.  So many children and teens are committing suicide.  Our own “well educated” health professionals have some of the highest suicide rates and yes it is occurring in our christian institutions as well as outside.  

Nurse Carrie said, 

“In this kind of approach, people are saying S/He’s not a loving and forgiving God and S/He doesn’t understand us.  If you deal with psychiatry, you’re a sinner. Why can’t you get it done with God on your own. He’s not a loving God, saying this person is not allowed to take medication. The pastor’s describing a cruel God because he’s not allowing the person to get the help he needs.  Like if someone’s leg is bleeding and you refuse to give that person a band-aid. 

But, God is always loving. This can’t be true.

I don’t think the pastor has a right to tell the parishioner that.”

Maybe we just succumb to the awkwardness of it all.  Too awkward to talk about God in our community.  Too awkward to talk about psychiatry in our church. There are so many reasons we approach emotions and behaviors this way but in the church or outside of it, let’s consider the question, What does this ay about God’s character?

I was cleaning up a leg laceration about 1 1/2 inches long and 2cm deep. I placed the triple antibiotic ointment and approximated the edges with steri-strips, yet still encouraging the patient and her guardians to take her to the urgent care to get stitches. This wasn’t a sterile environment and our supplies were limited. While working on the wound of the young teen, I asked a few brief psychiatric intake questions. It turns out, no. She didn’t have anxiety, or depression, or psychosis. What do you know!? Not everyone does. But she and her guardians were super pleased to pray together before they left and I was blessed by them.  

God is a God of love and the kind of God that cares about all of it in all of us. S/He is kind and not miserly, discriminatory, or punitive in interest and connection to us.  

It sounds like from what i’m writing that psychiatry isn’t seen as a legitimate form of medicine in the church. Or maybe the church doesn’t refer to it, or support it.  

A friend from my group read this post and responded. 

“We hear a lot about emotions and behaviors in the church, and related directives. We don’t hear however about where emotions and behaviors come from. 

I hear, ‘just pray more,’ or that I am lacking in faith. The people in the church get defensive, as if they have to defend God. And that’s not it. Honestly, it’s not complimentary to me that they think I’m insulting God. They are in a way attacking my spirituality. But I know God is helping me and He’s here with me. But I’m still this way. I still feel this way.

There’s a taboo that mental health and disorders all get grouped into this one cringeworthy word, “Crazy.” We’re almost protecting God from crazy by staying away from it in the church. We forget about the sin factor. The separation between us and God. The loss of connection. The word crazy isn’t very nice. So if we say crazy and we say psychiatry and God, it’s almost like we are besmirching God.  

Self-Care tip:  Ask, and ask again, What does “this” say about the character of God? It comes back to “Me.”

Question:  Do see the Bible and your church talking about psychiatry? Where and how? What does it say about who God is? 

Keep on!

Patients who see me think God has not heard them

Hi friends. This is unedited. Something unedited really doesn’t have a right to be published online. Ah well. We are all rebels here. Give me your thoughts, mark up for your edits. We need to hear from you.

People come and say, I prayed God would heal me, I did everything right, but I didn’t get better. So I finally came to you. It was my last effort. I’ll do anything. I can’t live this way.

Then we sat together and explored what was happening here.

God is a better psychiatrist then I am, but it is a miracle every time that S/He uses me to answer prayer.

See what God is doing.

I’m grateful I am given these years as I am able to grow in understanding that my job is not as much to see, what can I do. Rather, watch and participate in what God is doing.

Remember Gideon.

The Israelites from Abraham till Jesus came, wondered and wandered around, thinking about what their destiny was. When they got Saul as king, they lost vision of seeing what God can do. Then they broke up into different kingdoms and got more kings. Then they were conquered over and over and they waited to get their victory. Then Jesus came. And showed us that His kingdom was one of love. Could we say, in some ways, it was a disappointment?

I’ve been disappointed at various times of my wandering and wondering how I fit in. Now I am very slowly learning that it isn’t about me.

Do not limit what God can do. Do not squeeze God down to the confines of our own minds.

Ellen White says that we will spend all of eternity learning about the character of God. That’s a lot of content. That a lot of interest.

If we think about all the scholars of scripture; jesuit’s, ravi’s, pastors, people with photographic memories, the wisdom of Solomon, it doesn’t touch all that is waiting there in that space of eternity for us. We are just getting a toe into what will capture our attention for eternity; what will give us purpose, motivation, interest, a wanting to live and connect with self and others for a space of existence that has no parameters to time.

Self care tip: it’s more than Me

Please speak out and tell us your thoughts.

Keep on

The Sins of the Fathers, and Mental Health

 

“We know the Bible speaks of sins of the fathers passing to the 3rd and 4th generations while God imbues his kindness and mercy far beyond that to those who love him and keep his commandments.”

Rosa had no experience in the world of mental health, or so she thought. She had spent her formative years studying the world through the perspective of her church and interpretations of the Bible. As you know, there is a lot in both with a lot to say about emotions and behaviors. However Rosa was taught and modelled that these were moral issues and not biological. An either or, verses, part of the same thing. Could we call it sequent variants, maybe something like genetic alleles? Or maybe something better to describe this is out there, rather than an either or.

Rosa Leticia Montoya, at this point in her development, with her own overwhelming emotions and her husband’s plummet into dark moods, felt forced into considering mental health. She did not want to go there, but here in the space of losing control, not trusting herself or Carl any more, and before she was willing to say she didn’t trust God, she was doing what was a last resort. Considering that she was going crazy was the only thing this chaos could mean.

Before she completely surrendered to the idea that biology was behind this sinister change, she had to ask, “Is this because of our parents?” She had spent her life trying to untwist the bad choices her parents had made and the consequences those choices had on her life. Drugs, alcohol, and cheating were what she had grown up with. Quietly. Hiding it in the church. Rosa there, praying a lot to live well and be forgiven. Praying that bad thoughts would go away. Praying to depend on God and not on herself, as seen through her perseverating worries ever since she was a child. Worried and worried. Not speaking of the wrong Bible-breaking life her parents wore like underwear beneath nice tailored clothes. Would she ever be forgiven? Would she ever stop sinning?

So she asked me, “What do you think?”

That’s a lot to work with as a psychiatrist. So I did what most of us do. Ran to the shelter of medicine. Whew! But there is the added benefit that God created medicine, psychiatry, and all that there is in my tool bag worth working with.

Even so, there was only so long that I could avoid the topic of God and His punishments, per her perspective. It came up every visit.

If you believe in God, at some point within your discovery of mental health, this question will come up. Rosa is not alone. Are the emotions and behaviors gone amok, such as seen in anxiety disorders and depression, secondary to moral weakness? Living with “too little” dependence on God’s power? Is it this? Or is it an “either or”, with our biology? …a matter of cellular grey matter composed of DNA-expressing pathology? And is this something evil woven into my DNA because of what parents did? Well, I’ve spent 30-some years in school and now 15+ years in practice in this space and am still trying to understand.

I’m wondering if you would help me articulate this. It’s fundamental for us in self-care. It’s not possible to be very friendly to ourselves with the dissonance.

So in our self-care question today, please answer us. What is the relationship between “the sins of the fathers” and biology? Please speak!

Self-care Tip: Pursue kindness in your belief systems toward yourself.

Thank you for speaking with us! Keep on!

It goes in both directions

caged

Say hypothetically that you or I achieved full health, that fount of youth that our heroes pursued on their lonely journeys, persons of La Manche. Say we, like Tuck Everlasting, or the marvelous “Lucy,” as performed by Scarlett Johansson and written/directed by Luc Besson, became well. Became every bit of our potential.  Say Fortune caught us finally in her gauzy fingers and we no longer were bound by the helix of genetic vulnerability, so much as to say that we are no longer a broken fly, indeed, in a web of inevitable need for salvation.  Would God who is and who is personal be friendly to me?  Or would God who no longer sensed “need” in Her subjects lose interest and wander off into the forest of other brokenness?
That’s a pathological relationship when its function is fueled by brokenness, thinking the brokenness allows for connection and Love.

How bout Me, then?  Would we forget about the One who had tended our hurts, a gentle Giver, like a child moving from one wrapped present under the Christmas tree to another.  Would God serve no purpose in our self-care?  In fact, would there be self-care any more?  Maybe in this hypothetical scene of the perfect human, we would lose connection.  Perhaps we would become like the girl in Hawthorne’s fantastic short story, The Birthmark, who without our imperfections would die, unable to breathe the air.  Unable to receive Love without our flaws.

No.  You and I are more than this.  We are not loved by a God who keeps us in misery for the sake of Her throne, for the purpose of saving us from sickness and suffering.  We are not sought out in a personal intimacy that is, in its own design, sick.

God isn’t afraid of perfection.  Our connection to God who is and who is personal is not threatened by our healthy selves.

Salvation goes in both directions – up and down, when we are doing well and when we are unwell, to our perfect as well as our imperfect selves.

Self-Care Tip:  Let us feel very good to include God who is and who is personal, when confidence lifts.  It won’t jinx Me or my connection to God to value oneself.  Keep on.

Question:  When do you want to connect with God?  Does staying connected with God improve your self-care, even when feeling great?  Have you thought that there is value in connection with God when doing well or poorly?  Is it either-or in any way?  Please tell us your story.

“I’m Making You My Business!”

“I’m Making You My Business!”

It is pervasive.barriers

We talk about salvation as if it is an event, a diploma, a point in time, something with a frame and boundaries and a rejection of everything else about us.  Salvation is not this.  Salvation is pervasive.

Same with carrying your cross, going out into the world, and so forth.  Salvation and all these life axioms are in the divorce we are suffering, the depression, the trouble with sleep, the courage we demonstrate going into public, the fear we succumb to, the freedom we give up to anxiety – this is all about salvation.  This is what going into the world means.  It’s not one or the other.

When we say, the world will fall away, it is saying that there are no dividers any more.  If you’ve ever heard the term, the best way to get rid of an enemy is to make her a friend, this is the same idea.  God who is and who is personal takes away the dividers and makes us Her business.

God who is and who is personal is important for self care because She is all about Me.

Self-care tip:  Let the barriers go and accept the presence of Love.

Question:  Does God improve your self care?  Do you see dividers between your personal stuff and what is, who is, God?  How does that serve you, Me?

Keep on people of courage!

There is no self-care without Love

grieving

Reggie showed up without his wife.

The wife was a short woman.  She had some practices that usually increased the space she occupied – the smell of tobacco, the size in her chair, the volume she laughed with, her large wiry curly bouffant, and her hope-filled aura. 
“Where’s your wife Reggie?” 

Reggie had sat down with his usual socially acceptable moderate expression. 

It was common for his wife to accompany him to my clinic and if she wasn’t there, it was only for purposes of work.  She prioritized him, it was clear.  However, her work was inconsistent, money was always tight, and she would most often have to travel when the opportunities arose.  Being a temp in nursing was like that.  Reggie was so proud of her and looked at her in that mix-matched role that any relationship between one person and another always is.  In Reggie’s case, sometimes she was his parent, lover, friend, enemy, caregiver, and now, what?

If you’ve been reading this blog for long, you know I love the concept of Time.  I fantasize a little about separating Time from space and yes, at some moments, think I am all that. (Wink.)  When I asked Reggie, “Where’s your wife?” I might have done it, though not pleasantly.  Something happened there that was inter-dimensional.  Because he was transformed.  His face didn’t melt or droop.  There wasn’t a process to it.  Rather he was sitting like a normal Reggie and then he was wasn’t.  Between normal and transformed, to me, reality changed.  The between was a crack that was a different reality.  A black space without Time.

Reggie cried,

“She left me. She left me.  I begged her not to, and she did.”

Reggie’s wife had done something personal.  She went and died. 

Even when Reggie stopped crying, he looked bewildered, raw and like the faucet was going to poor a lot more.  We did get to start talking a bit about how much his wife loved him.  We speculated about the love remaining after she died. 

“I wish I knew!  I wish I knew she was somewhere good and I wish I knew if she could see me.…” 

Reggie wished he could remain connected to the love. 

During our treatment together for over a decade, Reggie complied with our medical treatment in the context of that love.  Reggie honored his wife by taking care of himself.  He even lifted up his illnesses like an offering to her.  I was struck with the concern of what kind of treatment compliance Reggie would shift to if he thought he was living without love.  I was concerned that he would not value himself, including the respect he was able to show his illness without the company of his wife’s value and respect

The way that we honor those we love and those who love us, is by honoring our own selves.

It is intuitive in our nature to believe that we can’t live without love.  Where does love go when we die? 

This brings us to another premise in, “God and self-care,”  – there is no self-care without Love.

The argument psychiatry has with the concept of Love is that sensing it, knowing it, perceiving it, is all a part of our modular brain, therefore no more than grey matter.  Thus implied that it is diminished. 

Question:  Does it diminish Love for you, knowing that our perception of Love is as mapped out as that, even able to be man-handled, turned on or off by neuronal signals? 

Please tell us your thoughts.  Keep on.

Self-care Tip:  Find Love for self-care.