Aging Well with Dr. Dan Blazer, Part 6: Holistic Mental Health

Part 1, Part 2, Part 3, Part 4, Part 5

“The desire for immediate relief from specific problems has driven Christians and psychiatrists to seek and prescribe quick solutions with little attention paid to the whole person. These forces have led Christian counselors and psychiatrists to ignore or deny the existential dimensions of severe emotional suffering, neglect the life story of the sufferer, uncouple the life story from the Christian story, trivialize the Christian community as a source of healing, and superficially accommodate each other rather than engage in meaningful discourse. Psychiatrists and Christians have, in large part, drugged or denied pain and suffering and deemphasized the importance of embedding the often-troubled stories of our individual lives within communal life.” --Dan Blazer M.D., Freud vs. God: How Psychiatry Lost Its Soul & Christianity Lost Its Mind

Searching for Solace

When my son first began exhibiting symptoms of anxiety and depression as a sophomore in high school, my husband and I both worked at a California mega-church whose leaders openly preached against psychiatry and psychology.

The message reached a wide audience— from the pulpit, over radio, through books, and at conferences—thus cementing in place a culture in which getting professional help for mental and emotional suffering was discouraged and stigmatized.

This was a new phenomenon for us, one that may have delayed our son getting the help he needed. After I heard about the third suicide of a young Christian that I knew back home in New Jersey, however, I no longer cared what my church community thought. I knew my son needed help and was determined to get it for him.

Nonetheless, I was concerned that the mental health practitioners who treated him would respect his tender faith and the spiritual dimension of his suffering, some of which was directly related to our family’s decision to respond to a vocational ministry calling with a cross-country move and to the culture of the church where that calling was initially lived out.

We sought out a Christian therapist. He was incompetent, but he did recognize that the depression required medication. We subsequently chose a psychiatrist from our health insurance plan’s participating provider list. He was not a Christian and over time made it clear that he didn’t think much of our faith. Thus he could not help my son with the spiritual component of his pain.

It wasn’t until I began attending lectures the University of California Irvine’s Psychiatry and Spirituality Forum and met its director, Aaron Kheriaty, M.D., that I was able to find appropriate, holistic care for my child. It took tenacity, hard work, patience, a loving community, and skillful, compassionate treatment, but nine years later, he is flourishing.

Encourage, Don't Stigmatize

Laity Leadership Institute Senior Fellow Dan Blazer, M.D., is familiar with the kind of message we heard at our former church. He told The High Calling it is a dangerous and marginal one, but said what concerns him more is the message that says, “If you’re a Christian you shouldn’t have depression or mental illness.”

“Then I think people can really overlook getting the help they need,” he said. “When somebody begins to have a significant depression, they need help, and churches should be encouraging them to get it. They should not be looking down on them.”

Blazer entered the field of psychiatry at a time when Freudian psychoanalysis was still a dominant influence, but it was beginning to be eclipsed by biological psychiatry. So although he assumed he would face resistance to his Christian faith in his professional life, he didn’t.

“This change from psychoanalysis to biological psychiatry, coupled with the post-modern orientation that anything goes, it appeared that you could just do your own thing,” said Blazer. “If you wanted to be a Christian, fine. If you wanted to be a Buddhist, fine. If you wanted to be a monk, fine. You could be a psychiatrist and be all those things, and nobody would really question it.”

His interest in this evolution led him to write Freud vs. God: How Psychiatry Lost Its Soul and Christianity Lost Its Mind (InterVarsity Press, 1998).

“In many ways psychiatry, which had been very interested in the whole person, all of a sudden just became interested in the brain. At the same time, in the first half of the 20th century, when there was this tension between psychiatry and Christianity, there were some very thoughtful theologians who talked about the relationship between psychiatry and Christianity, but over the last 20-30 years, that conversation has virtually disappeared,” Blazer said.

A Preference for Easy Answers

Now, we have “a ton of evangelical self-help books, most of them not very well thought through,” he said. Psychiatry is a “on its own path,” so people go to a psychiatrist and get Prozac and then to the Christian counselor for talk therapy.

Christian counseling is by nature practical and emphasizes change within a short period of time toward a transformed life, he said in Freud vs. God. The Bible’s authority implies its usefulness as a practical guidebook for living, and Scripture is sprinkled frequently through counseling books and counseling sessions.

In his own work with evangelical Christian patients, Blazer has found that they express “little interest in exploring their personal histories in the context of the religious communities in which they reside” and rarely want to discuss their spiritual journeys.

“Modern evangelical Christians want to feel good about the here and now, and the evangelical Christian counseling industry has supported this view,” he wrote.

Finding Holistic Solutions

Like Kheriaty, Blazer has been involved in a project that explores a more integrated approach. For Blazer, that project is The Duke University Center for Spirituality, Theology, and Health. He and his colleagues look for empirical evidence to prove that spirituality may be associated with better health outcomes.

“I’m sort of an odd person in this center because I’ve been a little skeptical all along as to whether you could actually prove that in a study,” said Blazer. “It turns out that most of the studies that are done today actually do show a more positive as opposed to a more negative relationship.”

He thinks studies like these are useful, he said, and has co-authored a number of them, but believes the results can be over-interpreted.

“If you really look at our faith as Christians, we need to recognize that there’s nothing in Scripture that promises that a dedicated Christian is going to escape suffering. Paul had his thorn in the flesh. Stephen was stoned to death. All sorts of bad things happen whether you’re a believer or a non-believer,” he explained.

That can include intractable mental illness.

In the conclusion to Freud vs. God, Blazer outlined “assumptions” that psychiatry and Christianity share. These include agreement that “human kind exists in a state of striving for meaning,” that “emotional suffering must be understood from the perspective of the person suffering,” that it occurs within a person’s life history and that history evolves within the context of relationships, and that “the care and cure of the emotional suffering are shared within a society.”

“No psychiatric disorder is the exclusive province of a psychiatrist. No experience of profound existential depression is the exclusive province of the church,” he wrote. “The schizophrenic woman who belongs to a community of Christians … will necessarily be cared for by that community, whether that care is effective or ineffective.”

In too many churches, it is both ineffective and insensitive, leaving families to grapple with these challenges alone.

Image by Nomadic Lass. Used with permission. Sourced via Flickr. Post by Christine A. Scheller.

Laity Leadership Institute senior fellow Dan Blazer, M.D., PhD. is vice chair of faculty in the Department of Psychiatry and Behavioral Sciences and Vice Chair of academic development at Duke University Medical Center in Durham, North Carolina. Dr. Blazer is a geriatric psychiatrist and an epidemiologist, and is the author of numerous books. He is also co-editor of Essentials of Geriatric Psychiatry, which is scheduled for release in 2012.