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Mental illness is one of the thorniest issues of our time. It devastates individuals and families, with the extreme of suicide ending over 38,000 lives in the most recent year they were counted in the U.S.  The National Institute of Mental Illness reports that over 26% (more than 57 million adults over age 18) suffer from a diagnosable mental illness in any given year, in the U.S. alone. These are numbers - statistics - an unforgiving graphic of the deep psychic woundedness at the heart of our society.

Rick Warren lost a son to suicide one year ago, and this last weekend nobly convened a conference to start a mental health ministry at his Saddleback Church, and in the larger church community. His grief has been both private and public for the last year. And like most people affected by this, he still has more to process. In that sense this conference might be a great idea.

Reporting from an interview about this, Warren said the family kept Matthew's illness a secret from the public not because of shame, but 'because it was his own story to tell.'

That reflects the common misunderstanding that the ones afflicted with mental disorders have the competency to advocate and speak clearly for themselves, even when they've not received the help they need to fully heal their depression or anxiety. Yes, the one suffering has a story to tell, but they may or may not want to tell it. And to tell it, he or she might need some safe and reliable people to help them speak it clearly, to detail the range and depth of their suffering, and to sort through all the inevitable confusion. A daily pill or two promoted by the pharmaceutical industry might help balance some chemistry in the brain, but it doesn't do much to tell their story. And again, who says every story has to be told?

From such a celebrity minister, to suggest he never had any shame about his son's affliction, that his son Mathew would in due time find his voice and articulate some healing message from the wreckage of his despair, without professional and trustworthy support - well, the assertion stretches credulity. (He may well have had professional support - I don't know. But trustworthy? As experienced from his own perspective? That's a challenge with many diagnosed individuals. They don't know who or how much they can trust.)

Coming from a family myself where suicide has visited, the high expectations mixed with frustration are forgivable... in the private sphere... In public, Warren's voice speaks to many thousands, possibly millions, and on this issue, among the public, there is indeed shame. From the church, too often: silence, neglect and abuse - like so many other institutions. And within families, where some might deny any shame while the one suffering remains bereft of reliable, authentic connection. It's possible Mr. Warren never felt any shame about either the church's or the family's role in mental illness, but to promote that as an ideal before a fair and open discussion of what shame is and how it accompanies mental health problems, that strikes me as irresponsible.

To me, and many others who have lived with it or near it, mental illness rarely escapes the stigma and shame associated with others' misunderstandings and judgements. To deny the shame is to continuously be subject to the slings and arrows of those misunderstandings and misjudgements, and the hurt that attends those moments. That hurt IS shame and needs to be addressed directly and honestly.

I can understand if Mr. Warren was saying that an individual or family ought not to have any shame in seeking treatment, but the reality is that 99% of those in this situation live with shame most every day. The problem in seeking treatment is how to get people to step up in spite of the shame, how to help them feel safe enough with the intake and orientation process that the difficulty is being handled with appropriate discretion and care. That's one of the first steps in mitigating shame.

This is such a huge subject - the church, mental illness and shame - that the sorting through, even in the lives of single individuals, can take years, or even decades. The mentally ill routinely feel shamed by the rejection and misunderstandings of their own families, their communities, their churches... This is a waste of human talent and energy, and seriously derails entire lives and even families.

The Huffington Post article continues: "the Southern Baptist-affiliated nonprofit Lifeway Research, released (a report) in September, (and) found that close to half of evangelical, fundamentalist and born-again Christians believe prayer and Bible study alone can solve mental illness. Among Americans as a whole, about one in three shared that view. Nevertheless, 68 percent of Americans said they believed they would be welcome in church if they were mentally ill." (emphasis mine)

68% believed they would be welcome if they were mentally ill... hmmm... My bet is that this survey did not make any distinctions regarding the participants. And the question itself tends to beg an answer viewing the church in its most favorable light. It does not say that 68% of mentally ill people feel welcome in church, or that mentally ill people were explicitly asked. Mentally ill people (and it would be great if we could find another useful descriptor, as this one carries so much baggage) - those diagnosed - too often feel as though they have no support in any social situation, let alone the church. And those who do show up probably hide whatever evidence they can of any serious difficulty.

Women in our culture often find the church so patriarchal that it's not a safe place even if you're perfectly sane. And many men feel they must first conform to some religious standard of male privilege and agreement just to show up on sundays. Sexual abuse survivors, LGBT individuals, anyone not of the dominant group or community has to adjust their social manner to attend most any church. 'The church' has trouble ministering to relatively sane people, so I imagine they've got a distance to travel before they can become a reliable resource for those wrestling with depression or bipolar or PTSD and so on.

Again, those diagnosed generally feel as if they have to keep the fact a secret whenever entering any new social situation. And even when things are going well, they learn to become careful with who they share these secrets with, if at all.

How can they be expected to tell their own story, when it is too often riddled with an experience approaching that of a hidden apartheid, where the afflicted are expected to heal rapidly like the latest wounded olympic champion held up in the media's glare, even when no-one in their immediate experience seems to understand the ongoing struggle and shame of their daily predicament?

More beyond the fold...

While some might object to my use of the term, the provocation in the phrase 'hidden apartheid' has a kind of idiosyncratic currency when speaking of the stigma and shame associated with mental illness, as experienced by those who have it, and also by family members feeling helpless and overwhelmed in the face of it. The 'having to hide' aspect of mental illness - this is an expression of shame, and a psychological standing apart, an inner, hidden apartheid, enforced by the culture's stubborn misconceptions.  

This 'hidden apartheid' is not caused specifically by racism or sexism or gender bias, but there is an acceptable cultural bigotry regarding madness that silently, quietly, persistently sets the mentally ill apart. And shame is central to this bigotry, because it paints with such a blind brush, and because we all deny our own madness to some degree, even if we've never come close to being diagnosed.

Some people's denial of a different order. It's more intelligent and clear headed, even responsible, than what's automatic and at large, with the more enlightened knowing how bigotry itself has for too long been a kind of cultural default in such matters, whether talking gender, race, religion, or yes, madness. The 'hidden apartheid' isn't maintained by all of us, but mostly by an unconscious default in the larger culture, and it is only more awareness that will gradually transform this phenomena. And those who can, telling their stories...

I was diagnosed with schizophrenia in 1970, and while my symptoms have mostly settled down, with the help of pharmaceuticals, I have had to contend with other diagnoses and hospitalizations from depression to PTSD and beyond. I didn't share this at the beginning of the article for many of the reasons mentioned above. But it's significant in order to flesh out my point of view here.

I was one of those 'literal' basket cases for the first couple years of living with this, largely unable to speak of much of anything, let alone articulate my experience with any consistency or coherence, an experience which diminished only slowly over years.

I will admit that some of those I felt more comfortable with were active in their churches, but to a person, their ultimate goal with me seemed to be some form of prosetilization or conversion, which left me feeling like just another mark, just another fish, just another sad sinner in need of repentance and some form of cleansing.

The modern christian message sometimes seems to have been been reduced to a question: "are you with us or are you against us?" and because the diagnosed are so desperate for acknowledgement and human relationship and don't know how to answer the question, their vulnerability leaves them looking like easy marks for baptism into a new life.

I have to say, this has been a significant moment in many conversion stories - the moment when a heart is changed, when the divine becomes present for someone and their lives are changed forever, just when they were at their most desperate. So I can't judge that, except with my own sense of caution, because that's part of what keeps this kind of ministering going.

I have found my own spirituality more through the profane and the secular, or as seen from the christian perspective - the unchurched side of things. It's also where I found my sanity, what I have of it. There is salvation in friendship, in reading, in lovemaking, in cooking, even sometimes in watching tv. And I'm comfortable saying I respect the historical leaders of several world religions, including Jesus and the Divine Mother in their many guises and messengers.

But it took many friends, many recovery groups (few of which actually fit perfectly), too many therapists to count (who didn't always fit so well either - but any port in a storm as they say), workshops, yoga, journaling, and simple reflection, lots of that, often to the point of obsession. All of that is my salvation. And a truly great life partner. My investigation into sanity is still ongoing, continuous, and I hope open minded, though I don't practice many of these activities with consistency anymore.

For any church, or any ministry to attempt to reduce all that, or to appropriate the methods and practices of psychological healing and claim them as christian in their source and origin, this seems to me suspicious. (ironically part of my diagnosis) I sincerely hope those who attended the Saddleback conference were invited to the more diverse view that allows the academics and clinicians to stay true to their disciplines.

Here's the church logic: all things come from God. And for many Christians, God is Jesus. So - simple syllogism - God created all the psychological tools, all the psychiatric methods. And in very simple form, you have here the Christian justification for taking over all psychological healing (and even for taking over the world.) No shame. And no real honor outside the church. It's not true for ALL Christians, but some of the more vocal seem to think this way.

I've been dealing with mental illness for nearly forty four years. Lost a brother to suicide. Have a sister that's schizophrenic and bipolar, depression elsewhere among my siblings. The christian church has played a role in each of my siblings' and my own journey with madness. And while I feel sorrow for what Rick Warren and his family privately endured, on the public side I am skeptical that some powerful spiritual message and ministry has to emerge from all the pain. And I'm willing to be wrong in what worries me - I just don't want to see more suffering.

If anything, I hope the clinical and humanistic approaches to healing can be encouraged as viable tools in their own right and not subsumed or appropriated as church sponsored gifts of God. That would bring only bring more shame to all concerned and complicate the healing for many.

The church has it's problem with suicide, with depression and mental illness and all that's being addressed through this Saddleback conference. Hopefully, the understanding of shame, the healing of shame, and the tearing down of stigma and denial around madness - hopefully these too can be high priorities for the obviously heartfelt ministry likely to grow out of this.

God never denies shame. I suspect He/She asks that we bring it into the light so it might be healed...  


So I thought I could be done with this diary at that last sentence. But after taking time to consider all this, I have to add a note about how we've forced many of our mentally ill into government run and for profit prisons, paid for by taxpayers who had little input in the matter. The prison industry not only has no shame, but they don't want the public to know simple facts like how more than half of the prisoners in the U.S. have a diagnosable mental illness.

As Nicholas Kristof put it "Psychiatric disorders are the only kind of sickness that we as a society regularly respond to not with sympathy but with handcuffs and incarceration."

There are over two million prisoners in U.S. prisons and more than half have some form of mental illness. And we treat them like commodities, as profit centers for the prison system, rather than people with rights to dignity and respect. And rehabilitation. And treatment. While treatment is mandated by law, you have to wonder how effective it is in healing and advocacy for the patient amidst such an enormous and entrenched institution as our penal system.

I have no expertise to report on this except to mention it as a serious dimension in our cultural problem with shame and madness. I believe the fear of lock up, of incarceration is one of the most visceral of fears when someone is actively trying to avoid their own mental illness. Who wouldn't tend to deny they have a problem if their imagination has repeatedly suggested they could be locked up for having strange and scary thoughts? Even to themselves...

I would be guilty of negligence to leave this out of the discussion. It's easy to imagine that the stigma and shame is greater for those diagnosed and their families when the treatment center is a prison...


Then there's added damage when we hear that the latest shooter at Fort Hood had been diagnosed with PTSD, or that the Sandy Hook shooter was autistic, or the Aurora shooter had been diagnosed and treated for schizophrenia. Clearly, none of these people received effective treatment to prevent their lethal acting out.

These devastations are tragic in so many ways, for the families and for the communities. And for anyone presently being treated, or who has been treated for depression, PTSD, autism, schizophrenia, or any mental disorder - each time it's as if yet another brick has been added to the wall of stigma and the generic shame that's so enmeshed in our consensus thinking about madness.

The greater majority of those with mental illness are not violent, and while many normal people find violent thoughts acceptable (see prime time tv and movies to begin); for the individual in treatment, a violent thought reported to a poorly trained therapist can get someone in a whole bucket of trouble. This presents clients/patients with an additional minefield when seeking help in the first place, or when wading through the thickets of early therapy.

Anyway, news of mass shootings, and of suicides in the family or community, when these are cavalierly sensationalized or glossed over, people lose the opportunity to lift the veils of shame and stigma, to face the consequences that underfunding and ineffective treatment have in individual and in communities' lives.

Then there's the whole issue of guns.

Mental health, madness, stigma and shame can never be fully addressed in a diary such as this because so many stories, so many studies, so many books and perspectives are available on these matters. And there are so many dimensions to these issues, and layers and nuance. But if you've read this far, you've already begun somewhere. Probably not here, but somewhere. It's so important that those of us who can, that we make some effort to speak to what we know.

There doesn't need to be so much suffering...


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Comment Preferences

  •  Tip Jar (7+ / 0-)

    Mistakes are the portals of discovery. - James Joyce

    by Beastly Fool on Thu Apr 03, 2014 at 10:41:40 AM PDT

  •  I commend your openness in sharing your story. (3+ / 0-)

    And I have great sympathy for the pains that you and your family members have suffered, and the difficulties that you have encountered.

    What I have a problem with this is:

    Here's the church logic: all things come from God. And for many Christians, God is Jesus. So - simple syllogism - God created all the psychological tools, all the psychiatric methods.
    If all things come from God, then mental illness also comes from God.  It's a goddamn shame that God did not improve His design such that people would not be afflicted with mental illness.

    I suppose that the church line is that mental illness, and physical illness and death, are the result of Original Sin and the consequent fallen human nature.  Myself, I have a hard time accepting the proposition that a just God would punish the entire human race for the disobedience of two people.  Talk about Vicarious Liability!  Or about Bills of Attainder and the Corruption of Blood!

    •  I began saying these are the thorniest of issues, (2+ / 0-)
      Recommended by:
      Cassandra Waites, Rashaverak

      and I'm in agreement that the logic in some religious cosmologies has blinders on. But if you take their logic even further, then God also created irony and humor and satire along with the view that this is an epic psychodrama we're all playing parts in, sometimes comic, sometimes tragic, sometimes puffed out with vanity and hubris, other times by humility and grace.

      I made my own peace with one vibrant version of the Christian cosmology when I read about the life and teachings of Emanuel Swedenborg, who lived and wrote in the 1700s. His views inspired many other influential minds along the way - William Blake, Ralph Waldo Emerson, Johnny Appleseed, Carl Jung, Yeats, Balzac, Helen Keller and Immanuel Kant, to name a few.

      That's one way I came to terms with the often audacious assertions made by zealous Christians.

      And there are zealots in every religion, it seems, extremists and true believers unwilling to credit any others with authority or value. It's one of the costs of absolutism and the insistence on conformity among followers.

      My own syllogism was written slightly in jest, but it does contain a kind of truth for me, at least in how it describes the circular logic that I've run up against when attempting to reason with the true believer.

      I've sometimes thought world religions ought to be part of every high school curriculum - then we'd have an entirely different discussion here...

      The primary focus of my diary here unfolded as the need to look closer at the role shame plays in keeping people from getting help, and holding back their recovery, and befuddling therapists and other professionals.

      The church, as diverse as it is, has done little to ease that shame. In fact they are among the strictest enforcers of it.

      If that could be addressed in any way by the kind of conference mentioned in the diary above, then maybe there's a ray of hope after all.

      If you're troubled by your own thoughts and emotions, every ray of hope deserves at least some consideration.

      Mistakes are the portals of discovery. - James Joyce

      by Beastly Fool on Thu Apr 03, 2014 at 02:01:58 PM PDT

      [ Parent ]

  •  It has been my experience (3+ / 0-)

    Growing up in a hyperreligious household, that often, the church is the source of mental illness that otherwise may not have occurred.

    •  I wanted to say that, but it had to come from (3+ / 0-)
      Recommended by:
      BMScott, Cassandra Waites, Rashaverak

      someone who has actually been there.

      Thanks, and take care...

      Mistakes are the portals of discovery. - James Joyce

      by Beastly Fool on Thu Apr 03, 2014 at 02:30:49 PM PDT

      [ Parent ]

      •  Thanks Beastly Fool (0+ / 0-)

        So, I will say one more thing. I don't know any people who were both intelligent and sensitive who survived fundie childhoods without being mentally/emotionally harmed to the point of some disorder or dysfunctional adapting behaviors. (depression, substance abuse, anxiety, ptsd, ect).

        •  On one hand, it's as if the wounded have to be (1+ / 0-)
          Recommended by:
          Lonely Texan

          the ones to champion any real change. Yet with madness, the wounds are most of the time  invisible to the eye, while starving and bruising to the heart. For the depressed or the bipolar or the PTSD diagnosed to speak with clarity and credibility, their difficulties have to be addressed, their symptoms reduced, and their expressive voice restored, or effectively discovered for the first time.

          For big pharma to dominate public information and research, and to downplay the value of personal therapy - this only serves to keep a kind of status quo denial and consensus shame pretty much in place for individuals, their families and communities.

          It's the long term survivor, the compassionate sister or brother or parent or spouse, the steadfast childhood friend (if they've managed to hang in there) who become some of the most helpful advocates, once the worst of the mental storms have passed. Along with the more skilled doctors and social workers.

          But real social change - changing the larger paradigms - requires people who have not only lived important parts of this, but also have learned to articulate fairly the important problems with the prevailing views.

          It seems the artist, the writer, the tv producer and movie maker - these people have done more to loosen and humanize our thinking around madness than all the books combined - but they couldn't have done it without the books in the first place - it's often the book that's the resource for the popular movie or tv series.

          Madness has been with us forever, throughout history. It will look different ten, twenty, fifty years from now. A good question is how can we hasten the better changes and avoid the dark alleys of the less helpful changes.

          There are already technologies like meditation and biofeedback and altered states research, even chiropractic, acupuncture, massage, exercise and nutrition that some have found hopeful in treating addiction PTSD, and other anxieties. Add a few rounds of those approaches with some trustworthy talk therapy and maybe a helpful pharmaceutical, and a new future can unfold. For those who are open to it.

          And after all this, I don't exclude prayer from the bag of helpful assists. It's just that it has to have it's place, without any insistence on controlling or dominating the process for the individual. Spirituality is an integral dimension to most people's lives. The problem is having safeguards to insure the exploration of one's own spirituality is in fact our own and not someone else's idea of what we should be doing.

          Someone else's idea of how we ought to relate to God or to Higher Power can lead to their being tempted to control the situation, to control us. That's tyranny, abuse. And avoidable by always checking that we're making our own choices as to what's important to us spiritually. That's a discipline in itself, a promise to ourselves that's available - to trust our own choices. It's a discipline that doesn't get taught in very many places that I know of. That lack of regard for individual choice is part of the madness too...

          Mistakes are the portals of discovery. - James Joyce

          by Beastly Fool on Mon Apr 07, 2014 at 12:45:19 PM PDT

          [ Parent ]

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