The Great Therapist

With my voice I cry out to the LORD;

     with my voice I make supplication to the LORD.

I pour out my complaint before him;

     I tell my trouble before him.     (Psalm 142:1-2)

 

          A therapist is a bit like God in that they both listen to complaints.  A good therapist, though, recognizes that his/her familiarity with God ends there and doesn’t try to play God by getting too enmeshed in our problems or trying to heal our condition for us.  A good therapist attempts to draw on the healing power that flows from God and sees that the source of this healing comes from beyond him or herself.

          I’ve had many therapists – some good and some not-so-good – in my nearly 25 year pursuit of good mental health.  One thing I’ve learned is that it takes a great deal of patience to be a good therapist – to listen to cries and supplication, complaints and trouble all day long, day in and day out.  A therapist who persistently yawns or watches the clock can give hurting people the impression that their hurts don’t matter.  A good therapist helps to lift the burden of pain a client carries simply by listening well.

 

          God is more than just a good therapist.  God is the Great Therapist.  Not only does the LORD listen to our complaints, the LORD always responds with love.

Preparing the Table

You prepare a table before me

     in the presence of my enemies.  (Psalm 23:5a)

 

    

 

     Throughout the course of my Bipolar illness, I’ve been fortunate to have a steady stream of income, a way to “bring home the bacon”.  More than this, I’ve been blessed with a steady wife who fries it up for me.  I’m not ashamed to admit that we have found the traditional gender roles to work well in our relationship.  In no way has this diminished my respect for her.  I know full well how poorly I would function without her.

 

 

     Too many persons with mental illnesses find themselves in positions where they don’t know where their next meal is coming from or with whom they might share it.  Even those with material resources struggle with chaos in their lives that works against their need for constant structure.  It helps me so much to know that breakfast is at 8, lunch at noon, and dinner at 5 (with little variation).

 

 

     One thing faith communities can provide to serve those with mental illnesses is a good meal.  And not just for the poor.  A church I once served offered a free Christmas dinner to the community and found that more “volunteers” showed up than “customers”.  These were mostly older and single adults looking for a way to battle the depression that often strikes on this holiday typically devoted to families.

 

 

     When we have a meal prepared for us by people who care about us, the enemies of depression and other forms of mental distress can be held at bay by a strong sense of fellowship we can’t help but share as we gather around God’s table of grace.

Sin and Sickness

Consider my affliction and my trouble,

     and forgive all my sins.  (Psalm 25:18)

      Over the years, I’ve given a lot of thought to the relationship between sin and sickness.  The Bible clearly connects the two, but it is not always clear what sort of connection exists. There are times when sickness is caused by what someone does or fails to do – as when the foolish Nabal’s inhospitable demeanor leads to a heart attack. 

     Other times, sickness is not caused by a person’s sin, such as when Job’s righteousness is tested. 

     Sin can be the result of a condition of sin (as in a genetic flaw) or a commission of sin (as in falling short of God’s commands).

     The relationship between sin and sickness can become particularly controversial when it comes to mental illness.  There has been such a stigma attached to it over the years it is little wonder many shy away from implications that the afflicted person may have done something wrong.  People have often viewed forms of mental illness as demon possession either invited in or allowed to remain in a person’s life through some lingering sin.

     I see my Bipolar illness the result of generational sin.  This does not pin the blame on me (or any particular ancestor), but recognizes what both the Bible and science have stated to be true.  Something is not right within me and it’s highly likely this has been passed down.

     Sin and sickness are somehow related.  Unless we see this in our lives, we may fail to take advantage of opportunities to experience healing.  Had the paralytic man argued with Jesus about his sin when Jesus pronounced forgiveness, he might not have been healed.  We need to be open to recognizing our part in either contributing to our illness or aggravating our symptoms.

     This is just as true for persons with Bipolar as for those with physical conditions such as diabetes.  We need to ask ourselves,

“Am I receiving the best treatment available?“

“Am I taking the prescribed meds?”

“Am I seeking spiritual sustenance?”

     If the answer to any of these is “No,” chances are we don’t really want to be healed. 

 

 

Good Boundaries

The boundary lines have fallen for me in pleasant places;

     I have a goodly heritage.   (Psalm 16:6, NRSV)

          One thing you’ll learn should you ever spend time in a psych hospital is that there are a lot of rules.  Rules about food.  Rules about noise.  Rules about visiting.  Rules about movies and television.  Rules about toiletries and other personal effects. 

          Since I am one who likes to have good, clear boundaries, these rules didn’t bother me so much.  There are other people, though, who are constantly trying to get around the rules.

          Like the man who found the staff person willing to bring him Starbucks coffee (at a price, no doubt) to replace what passed as coffee from the cafeteria.

          Like the woman who gained permission to use the exercise room during off hours as a space to listen to loud Hip Hop music on her boom box.

          Like the couple who found a way to prop a broom against the laundry room door so they could get around the “no-fraternization-with-the-opposite-sex” rule.

          One thing we ultimately have to learn as psych patients (and people as a whole) is that rules are generally good for us — especially those given by God.  They help establish clear, consistent boundaries within which was can live safely and safely let others live.  Only when we have good, firm boundaries can we survive (and even thrive) within this crazy, unpredictable world.

          Praise be to God who gives us such boundaries for life, as the Psalmist says – 

          “You have fixed all the bounds of the earth.”  (Psalm 74:19, NRSV)

An E.C.T. Morning

I wait for the LORD, my soul waits, and in his word I hope;

My soul waits for the Lord

          more than those who watch for the morning

          more than those who watch for the morning.   (Psalm 130:5-6, NRSV)

 

          It’s still dark outside.  I lie awake staring at the ceiling, wondering how much of my mind I’ll have left by the end of the day.  In just a short while I will be having my first dosage of Electro-Convulsive Therapy (E.C.T.) or “Shock Treatment”.  While I’ll be administered only a mild dose by highly trained professionals, the idea of subjecting my brain to a jolt of electrical current of any amount by anyone is a bit unnerving.

 

          So I lay in bed an wonder,

          ”Am I forcing God’s hand by seeking this still-controversial treatment?”

Or,

          “Am I submitting to the hands of gifted professionals who might help me recover to better serve the LORD?”

         

          As I lay in the darkness, no clear answer is found.  I am left to wonder, wait, and watch for what will happen next.

 

*******************************************************************

 

          Almost a year later and I’m still wondering if E.C.T. was right for my particular case.  Given the information we had at the time, I have to believe it was worth a shot.  My illness and the advanced medications I had been taking (and still take) sap the strength of my brain and E.C.T. could have put things in working order for a time.

          Yet, still I’m waiting.  Still watching.  Still hoping.  Hoping to serve God with my whole heart, body, and mind.  Or at least as much of my mind as I have left.

 

God in Our Midst

My grandfather – Joe Etsy – was a go-getter when he was young but he gradually built a reputation for being lazy and shiftless.  Though he fathered 8 children, he wasn’t much satisfied with domestic life.  He was always looking for something more.

For instance, he once left behind a good paying steady job, bouught an old school bus, painted in John Deere green and converted it into sort of an antique-mobile.

He would drive “down home” to Kentucky and load it up with cheaply purchased goods to sell for a tidy profit up North.  I once asked my Dad is Joe Etsy made any money on the deal and he said, “If he did, the family didn’t see any of it.”

The tragedy of Joe Etsy’s life is the same challenge I continue to face each day of my life.  Joe Etsy struggled to see God in ordinary, plain events.

Joe Etsy came to see himself as a miserable, unwanted outcast.  He lost hope and never regained it.  When he was in his 40s, he was hit and killed by a pick-up truck while walking in the middle of the road, in the middle of the night.

One thing I’ve found with Bipolar is that I struggle to be satisfied with the ordinary ebb and flow of life because I’ve felt so elated during my highs.  I constantly find myself striving to recreate a manic experience and nearly always fall flat on my face, often doing great damage to myself and others.

The promise in the life of Jesus Christ revealed throughout Scripture is that God’s kingdom is right here.  Right now.  We don’t need to reach God through a manic high.  God reaches out to us, picks us up, and puts us right where we need to be to experience abundant life – forever.

10 Things to Look for in a Psychiatrist

After having poked fun at the mental health profession (“10 Reasons to Leave Your Psychiatrist”), I thought it best to fess up as to how I’ve mostly benefitted from quality psychiatric care.  Maybe some of you aren’t so fortunate.  Maybe you’re still looking for someone who can meet your needs and could use a little encouragement along your way.  For what it’s worth, here’s my list of what to look for in a good psychiatrist.

1)  Someone who hears what you say and what you don’t say.

2)  Someone who gives good treatment options in plain language.

3)  Someone accessible before, during, and after appointments.

4)  Someone who keeps up on the latest meds and yet…

5)  Someone who is not overly anxious to prescribe them all.

6)  Someone who will talk with your key loved ones respectfully.

7)  Someone who can smile when you joke about your illness, yet…

8)  Someone who doesn’t laugh when you are being manic.

9)  Someone with a calm demeanor who can quickly ease anxiety.

10) Someone who is not a slave to any single treatment option.

Acedia & Me: One Final Word

          This is the fourth and final in a series of book reviews on Kathleen Norris’ new book Acedia & Me: A Marriage, Monks, and a Writer’s Life.  The other posts can be found here, here, and here.

           At various points within the book Norris pauses to survey the scene in which we find ourselves in modern life.  This includes the break-neck speed with which we accomplish very little -

Just look at us, with more money and less sleep than we know how to handle, except to go into debt, and take pills that get us up in the morning and others that let us rest at night.

 

          Norris tackles the self-absorbtion of the modern age, comparing it to the wisdom of much earlier followers of Christ – such as the desert fathers:

 

One great difference between these monks and today’s pop psychologists is that the monks’ process of discernment was likely to result in more self-knowledge, less self-consciousness.  In our day, this is often reversed.  People whose speech remains stuck in therapeutic jargon, for all the “work” they are doing on themselves, often remain stubbornly unreflective.

 

         The demon of acedia, Norris notes, puffs us up even as it casts us down.  We are left to resort to our last, best hope – which is the mercy of God in Jesus Christ.  This can be accessed through humility, as we accept who God has created us to be.  She doesn’t put it this way, but I would say a key part of this is accepting our “lot” in life and rejoicing that “the boundary lines have fallen in pleasant places.”

          Norris returns to the comparison of acedia and depression, admitting she has struggled with both and observing -

 

I find that depression generally has an identifiable and external cause that acedia lacks.  I can look at my life and see where the trouble is coming from.  But acedia arises out of nowhere, as it were, emerging from my inner depths without warning, and without any reason that I can determine.

 

          Norris notes she has “found that depression is amenable to treatment in ways that acedia is not.”

          It takes firm resolve and a strong faith that arises from some place beyond ourselves to do battle with the demon of acedia.  I’ll give the final word to Martin Luther, whom Norris quotes in a section called, “Despair and Possibility” -

 

You must be resolute, bid yourself defiance, and say to yourself wrathfully… ‘No matter how unwilling you are to live, you are going to live and like it!  This is what God wants… Begone, you thoughts of the devil!  To hell with dying and death!’ … Grit your teeth in the face of your thoughts, and for God’s sake be more obstinate, headstrong, and willful than the most stubborn peasant.

The Last Great Championship Game

          In truth, there have been many good, some perhaps even great NCAA Basketball Championship games since 1987.  None, however, surpass the sheer drama (particularly for an IU fan) of the game that featured “The Shot” – Keith Smart’s jumper from the corner, as the clock wound down with a stunned Syracuse team looking on.

         My personal history with the college game goes as far back as Bobby Knight’s early days at IU, as he built the team that would become arguably one of the best (if not the best ever) in the game. 

          I have a vague recollection of watching Bill Walton’s amazing 44-point performance in the 1973 Championship game against Memphis State  (possibly the single best individual performance in a Championship game).

          I was crushed watching Scott May sporting an arm cast bravely falling short of leading the IU troops to victory in their first undefeated season 1974-75, losing to UCLA in the Final Four.

          I was equally as thrilled watching the first IU Championship in the Modern Era as the 1975-76 team took it to the University of Michigan for a third time that season.

 

          1979 was a year for the almost miraculous, as I watched Larry Bird take a group of guys who were much better than me (as a high school sophomore) to the championship game only to run up against “SHOWTIME” in Magic Johnson and his Michigan State Spartans.

            Fast forward to 1981 and a feisty long-socked Isiah Thomas sliced and diced his way through the tournament, leading an IU team that wasn’t expected to do much all the way.

            Then, we come to 1987.  Knight had come close several times more in the 80s only to fall short.  The 1987 team supposedly had features atypical for a Knight squad (including recruited junior college transfers such as Dean Garrett and Keith Smart).  Like many IU teams, there were no bona fide NBA stars.  The best player was dead-on sharpshooter Steve Alford who would make his mark primarily as the man expected (but never-quite) to be Knight’s heir-apparent.

              The Syracuse squad was superior in many aspects.  Faster.  Stronger.  Bigger.  Maybe Boeheim was out-coached by the General or maybe IU just got lucky.

              All I can say is when the shot went through and when the seconds ticked off until the buzzer, I was yelling to beat the band.  I was watching the game at my dad and step-mom’s, not far from Bloomington.  As the buzzer sounded, I headed out to join the celebration in the streets.

              I’m not sure where I ended up that night.  The memory has faded or was shocked out of existence thanks to ECT.  Nonetheless, the game lives on.  And one day I’ll have another IU victory to celebrate.  One day.

 

Moving Day

          Today is our moving day.  With the help of some friends, we are saying “Goodbye” to Long Island, putting the Big Apple in our rearview mirror …

 

   

          and saying “Hello” to Upstate NY, home of farmlands and Finger Lakes…

 

          I really think this is a good move for us.  If you have the chance today, please pray that the move would go well.

 

          Addendum:  The movers have safely made it through the city and are well on their way to our new home.  Thanks for your prayers.

          Addendum #2:  Everyone arrived safely.  Praise God!

 

Acedia & Me: Depression, Or Not?

         This post marks the third in a series of book reviews on the book Acedia & Me: A Marriage, Monks, and a Writer’s Life by Kathleen Norris.  The first two reviews can be found here and here.

 

          The ancient Latin concept “acedia” has come to be understood by many as what we moderns would call, in psychological terms, “depression”.  The drug industry would like us to lump all our ill-at-ease feelings together so they might sell us a pill (or many pills) to fix the problem.  Norris observes -

 

Pharmaceutical companies advertise in newspapers and popular magazines with lists of symptoms– feeling down, anxious, fatigued, or discouraged– that would seem to cover most everyone at some time, as is no doubt the point.  These advertisements can inspire people who need treatment to seek it, but they also serve the purposes of commerce and feed a disturbing tendency to medicalize all human experience.

 

          Sometimes unsettledness is more than a sign of depression.  It can be a great spiritual temptation to try to do something other than what we are doing in the present.  Norris comments that discernment is needed to do battle with acedia, to know when to move and when to be still, when to act and when to stand back, when to serve others and when to seek solitude.  Describing her own experience in writing, she notes -

 

When I know that I should remain in my study, writing if I am able, and if not, being willing to be alone with God, doing nothing, I am easily tempted to leave and seek the company of other people.  But if I am honest with myself, I will admit that my inability to be alone is no reason to abandon my solitude: the danger is that I will use others as an excuse to avoid confronting matters that require my full attention.

 

          Paying full attention, being mindful and grateful for the gift of present time is one way we combat acedia.  One of the great temptations of the demon is a sort of nostalgia for better days.  The danger of this, Norris points out is -

 

As we come to prefer living in the past, we grow less able to enjoy the present or invest in the future.

Casting Anxieties on the Lord

          This morning I stayed home and listened to a message by John Piper that can be found here.  It’s based on 1 Peter 5 (primarily verses 6 & 7) and it’s called, “To Be Cast Not Carried.”

          Piper highlights the connection between humbling yourselves (verse 6) and casting your anxieties on God (verse 7).  Humbling ourselves is an anxiety-evoking action.  It requires that we empty out our egos.  Piper cites four examples of humbling ourselves:

1)  Admitting to our mistakes.

2)  Asking for help.

3)  Doing an ordinary job.

4)  Hanging out with common people.

          In each of these acts, we run the risk of losing aspects of our ego – our pride, our self-esteem, our reputation.  And yet, if we do not humble ourselves, we are no more than a “posture-er”, having inauthentic faith.

           The key to humbling ourselves is in casting our cares on the Lord.  Piper notes that the only other New Testament usage of the word translated “casting” is when the people “cast” their cloaks on the donkey as Jesus rides into Jerusalem for Palm Sunday.  God carries our burdens as a donkey carries what is laid on him.

             Finally, Piper draws the parallel being 1 Peter 5:6-7 and Philippians 4:6 which says -

 

Do not be anxious about anything, but in everything, by prayer and petition, with thanksgiving, present your requests to God.

 

          If we are to cast our cares on the Lord, we need to do a lot of praying, both prayers of gratitude and longing for the desires of our hearts.  Only by laying out our whole selves before the One who knows us better than we know ourselves can we lay our burdens on Him.

 

Acedia & Me: Tedium

          This marks the second in a series of book reviews on the book Acedia & Me by Kathleen Norris.  To see the first installment, check out “Acedia & Me“.

          Acedia, as Kathleen Norris writes, is a Latin term that has fallen out of popular usage (almost out of usage altogether).  It has no direct equivalent in English.  Depression perhaps hits closest to home, but even that falls short.

           There are many components to acedia – how we fall into it and what happens when it strikes.  Norris describes this well as she writes -

 

      I’ve been working too long and need a break; maybe I should read a mystery novel to clear my head, I tell myself that I’m too weary to concentrate.  I tell myself that it is a matter of respecting my limitations, and of being good to myself.  If I manage to read one book, and then return to my other obligations, no harm is done.  But often, one book does not satisfy me.  My “rest” has only made me more restless, and as I finish one book, I am tempted to pick up another.  If I don’t check myself, I can slip into a state both anxious and lethargic, in which I trudge through four or five paperbacks a day, for three or four days running.  I am consuming books rather than reading them.

 

          I know too well that “anxious and lethargic” feeling that comes when I give in to temptation and consume things rather than enjoy them as gifts.  For me it’s not mystery novels.  It’s DVDs of shows like “Monk” or “Seinfeld” or “Friends”.  It’s my blog.  The effect is the same.  In an effort to relax and take my mind off stressful pursuits, I wind up becoming numb.

          Acedia can result in a dangerous “I don’t care” attitude.  Referring to the children’s book Pierre by Maurice Sendak, Norris describes the “lion of acedia”. 

 

…  I can care for so little that it becomes hard to care even whether I live or die.  I need help to learn to see again, and to reclaim my life through ordinary acts: washing my hair, as well as the dishes in the sink, and walking out of doors to enjoy the breeze on my neck.

 

          One of my great hopes in our move Upstate is that living in a farmhouse (with some land) will awaken in me a sense of concern for the earth and our place in it.  I pray that God will open to eyes to see the beautiful sunrise overlooking our pond, to notice the colors of our fruit trees as I prune them, to feel an evening breeze on our porch.  I am hoping and praying to be released from the demon of acedia.

 

Acedia & Me

          While browsing through the stacks of the local library, I ran across a new book by Kathleen Norris entitled – Acedia & Me: A Marriage, Monks, and a Writer’s Life.  I would have been interested just for the subtitle alone, but the concept of acedia has intrigued me for some time as well.

 

         Norris writes -

I believe that standard dictionary definitions of acedia as “apathy,” “boredom,” or “torpor” do not begin to cover it, and while we may find it convenient to regard it as a more primitive word for what we now term depression, the truth is much more complex.

 

         Acedia has a long and complicated history, but Norris recognizes that this makes it ripe with possibilities to describe what has been left undescribable at the intersection of faith and psychology. 

          Norris admits to her personal experience with what she has come to know as depression and acedia and concludes -

The boundaries between depression and acedia are notoriously fluid; at the risk of oversimplifying, I would suggest that while depression is an illness treatable by counseling and medication, acedia is a vice that is best countered by spiritual practice and the discipline of prayer.

 

          I look forward to digging deeper into the mystery of acedia through this book and possibly reflect further on how it has impacted my marriage, my ministry, my life, in upcoming posts.