Transcript Challenge of Depression

Counselling as Ministry
and
Church as Caring Community
Dr. Samuel Pfeifer, M.D.
Senior Consultant Mental Health
Klinik Sonnenhalde Switzerland
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Introductory Bible Passages
» Isaiah 25:4
» You have been a refuge for the poor, a refuge for the needy in their distress,
a shelter from the storm and a shade from the heat.
» Matthew 9:36-37
» Seeing the people, He felt compassion for them, because they were
distressed and dispirited (harassed and helpless) like sheep without a
shepherd. 37 Then He said to His disciples, "The harvest is plentiful, but the
workers are few.…
» 1. Thessalonians 5:14
» And we urge you, brothers and sisters, warn those who are idle and
disruptive, encourage the disheartened, help the weak, be patient with
everyone.
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The multitude of the
suffering is at our doors
Who are «the needy in their distress?» (Isaiah 25:4)
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Suffering Souls – the needy of our time
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Mental Health – Four trumpets
» WHO: Depression is a hidden burden, affecting around 350 million
people around the globe. It is the leading cause of disability
worldwide.
» Patients tell their stories – in our hospitals, outpatient
departments, at the church doors.
» Family and friends: almost every person knows at least one person
who is affected with symptoms of depression
» The Bible records prayers and descriptions of depressive mood.
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Patients tell their stories
» Depression is a common mental
disorder, characterized by
sadness, loss of interest or
pleasure, feelings of guilt or low
self-worth, disturbed sleep or
appetite, feelings of tiredness,
and poor concentration.
» Depression can be long-lasting or
recurrent, substantially impairing
an individual’s ability to function
at work or school or cope with
daily life. At its most severe,
depression can lead to suicide.
STRESS OF MODERN LIFE
» Long transfer to work
» Multiple tasks that cost a lot of time
and strength
» unfair boss, chaotic colleagues
» Desire to be a good employee
» Lack of positive feedback, constant
pressure
» too much noise, lack of privacy,
excessive distractions, and
unreasonable deadlines.
» Broken friendships
» Distress in the family
MARITAL PROBLEMS
» Being confined to the house,
» In-laws: no positive feedback,
unreasonable demands,
disrespect, cosntant criticism
» «shouting man / crying woman» –
ingredients of every Bollywood
movie
» Unfulfilled wish to have a child
» No time for yourself, no time to
relax
» Worry / financial problems
» Sexual problems
VIOLENCE / TRAUMA
» Childhood trauma
» Traumatic experience
» Partner with alcohol
problem
» Threats and beatings
BEREAVEMENT
» Losing a close relative or
friend
» Losing husband or wife =
losing support in life
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Family and Friends
» Who in this auditory does not
know anybody affected by the
symptoms of sadness, loss of
energy and social withdrawal?
» Not only patients themselves
are affected – depression is a
burden for the whole family!
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The Bible describes depressive states
» You won't find the term
"depression" in the Bible.
Instead, the Bible uses words
such as downcast, sad, forlorn,
discouraged, downhearted,
mourning, troubled, miserable,
despairing, and brokenhearted.
» Bible people showing the
symptoms of this disease:
Hagar, Moses, Naomi, Hannah,
Saul, David, Solomon, Elijah,
Nehemiah, Job, Jeremiah.
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Biblical examples
» Hannah, who was barren,
» Jeremiah, the "weeping
prophet."
» King David — “I am troubled, I
am bowed down greatly; I go
mourning all the day long. …I
groan because of the turmoil of
my heart” (Psalm 38:6,8 - NKJV).
» Read Psalms 6, 13, 18, 23, 25, 27,
31, 32, 34, 37-40, 42-43, 46, 51,
55, 62-63, 69, 71, 73, 77, 84, 86,
90-91, 94-95, 103-104, 107, 110,
116, 118, 121, 123-124, 130,
138, 139, 141-143, 146-147.
The prophet Elijah went through
an episode of “Burnout” after his
great victory against Jezebel:
He (Elijah) came to a broom bush, sat down
under it and prayed that he might die. "I
have had enough, LORD," he said. "Take my
life; I am no better than my ancestors." Then
he lay down under the bush and fell asleep.
(1 Kings 19:4-5, NIV)
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The Church is called to care
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Jesus called the weary and the burdened
» Come to me, all you who are weary and burdened, and I will give
you rest. Take my yoke upon you and learn from me, for I am
gentle and humble in heart, and you will find rest for your souls.
For my yoke is easy and my burden is light.” (Matthew 11:28-30)
» His calling is now our calling as Christians in the Church
Subanghi R. Parkar, GENDER AND THE CULTURAL CONTEXT
OF URBAN MENTAL HEALTH IN MUMBAI, Disseration
University of Basel 2003
Cultural context of urban mental health
Urban afflictions affecting men
Promoting mental health in the 21st century
» “New public health initiatives of the 19th century brought about
substantial decline in deaths from infectious diseases through
sanitary reform, and we now need to consider how analogous
population-based measures may be adapted to promote mental
health.”
» Prof. Shubhangi R. Parkar, KEM Hospital Mumbai
Four Biblical Strategies
1. Thessalonians 5:14
1. Exhort
Idle, unruly
2. comfort, encourage
Anxious, timid
3. support, help
The weak
4. Be patient
everyone
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The Church is called to make
an impact in society
By addressing the needs of people
Being able to communicate with professionals (medicine, psychology)
The Bio-Psycho-Social Model / Spirituality
The Causes of mental disorders are to be found in three areas.
Depending on the type of disorder, there are various emphases.
Biology
Disposition
Social Factors
Relationships, Economy
Psyche
Reaction / mental processing
QUESTION: What is the role of spirituality? Is it a causal factor or
rather a factor of coping and understanding?
Factors contributing to Mental Illness
Way of Life (Eph 4,22)
Mind (Rom 8,6; 12,2)
PSYCHOLOGICAL
Emotions - Thinking
Volition – Behavior
Coping - Defense
Mental
Problems
BIOLOGICAL
SOCIAL ASPECTS
Genetics, Personality
Neurobiology
Physical Constitution
Childhood, Family Life
Trauma, Life events
„Stress“
Weakness
2. Cor 12,9
Burden
Hardships
Trials
Temptation
Gal 6,2
2. Cor 6,4
1. Peter 1,6
1. Cor 10,13
Therapeutic avenues
Proberbs 16,24; 18,21
1. Thessalonians 5,15
Hebrews 10,24-25
TALKING
Attention, Empathy,
Understanding, Counselling
Comfort, Encouragement
Teaching
Patient
MEDICATION
SUPPORT
Antidepressants,
Neuroleptics, Mood Stabil.
Tranquilizer etc.
Visiting - Helping
Aktivation – Enabling better
autonomy
Isaiah38,21
J. Sirach 38,1-8
1. Timothy 5,23
Galatians 6,2
Matthew 25,35-40
Proverbs 3,27
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The church has
resources to care
Together with Christian professionals,
the church can offer couselling and care
Depression can be treated
Thinking
1
1 Talking
2 Support
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STRESS
2
Body
3
3 Activation
4 Medication
Faith as a source of strength in depression
» Despite despair, doubt and lack of energy
» Bible verses and Christian songs
» Encouragement by fellow Christians
Blessed are those whose strength is in you,
whose hearts are set on pilgrimage.
As they pass through the desert valley,
they make it a place of springs;
the autumn rains also cover it with pools.
They go from strength to strength . . . (Psalm 84)
Conclusions
» 1. We should be open for a deep personal awareness of human
suffering beyond all categorical and theoretical considerations,
moving us to compassion and motivating us to find new ways for
creative caring.
» 2. We should be aware of new developments in our field, able to
communicate with the world, to examine the philosophical
underpinnings, critically evaluating what we can apply in our
everyday practice.
Conclusions ctd.
» 3. We should be guided by the Word of God as an eternal source
of wisdom and truth, practicing an exegesis that applies to the
burdens, the questions and the spiritual hunger of our patients.
» 4. We should be guided by the principle of hope, hope which is
not only rooted in the prospect of restored health, but hope in the
midst of existential weakness, hope which is not only based on
well-being in this world but hope that goes beyond all that our
limited activity can achieve.
„I will give you rest!“
» Matthew 11:28-30
» "Come to me, all you who are weary and burdened, and I will give you rest. 29Take
my yoke upon you and learn from me, for I am gentle and humble in heart, and you
will find rest for your souls. 30For my yoke is easy and my burden is light." (NIV)
» Then Jesus said, “Come to me, all of you who are weary and carry heavy burdens,
and I will give you rest. 29 Take my yoke upon you. Let me teach you, because I am
humble and gentle at heart, and you will find rest for your souls. 30 For my yoke is
easy to bear, and the burden I give you is light.” (New Living Transl)
» 28-30"Are you tired? Worn out? Burned out on religion? Come to me. Get away with
me and you'll recover your life. I'll show you how to take a real rest. Walk with me
and work with me—watch how I do it. Learn the unforced rhythms of grace. I won't
lay anything heavy or ill-fitting on you. Keep company with me and you'll learn to
live freely and lightly." (The Message)
Two great gifts
» Jesus offered two great gifts that are the object of our deepest strivings /
longings:
» spiritual renewal / change
» spiritual repose (“I will give you rest”)
» “Spiritual renewal is offered in the new birth – a concept at the very heart of
Jesus’ teaching. Here we are provided with the possibility of a new beginning
that is so radical and complete as to be best expressed in the analogy of birth.
» The gift of spiritual repose is described as rest for the souls of those who labour
and are heavy laden. Toil is not abolished; rather Jesus offers to replace a heavy
yoke with a light one and to provide restored strength for the task.”
• (D. Benner p. 27)
What can we learn from Jesus
» Jesus saw the condition of people
» Jesus had compassion
» Jesus addressed their innermost yearning
(“I will give you rest!”)
» Jesus does not promise a life without a yoke – but he will join
them in bearing the yoke together
» Jesus challenges people to learn from him
» Jesus sets himself as a model: ”humble, gentle”
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