Canst thou not minister to a mind diseased,
Pluck from the memory a rooted sorrow,
Raze out the written troubles of the brain
And with some sweet oblivious antidote
Cleanse the stuffed bosom of that perilous stuff
Which weighs upon the heart?
(William Shakespeare, Macbeth)
Melancholy, though it so weakens and disorders the mind, as to render a person unable, to enjoy the comforts, and to perform the duties of life, is, nevertheless, seated in the body. But the state of body which accompanies this disease, is acknowledged by the best Physicians, to be in general beyond the reach of their investigation.
(John Colquhoun, “Of the Nature and the Signs of Melancholy”)
Art, literature, philosophy and science have for a long time dealt with the question of mental illness. Modern audiences may be baffled or confused by discussions about excesses in bodily humours, or the distinctions between body and mind which often appear in the literature on the subject. These do, however, demonstrate that, for a long time, humans have wrestled with a variety of ways to answer the ever-complex question of how seemingly disproportionate emotional or mental distress could be understood or remedied. Whether it was Hamlet’s mother and stepfather chastising him for his “obstinate condolement”, and his “heart unfortified”, or Hippocrates and later physical scientists speculating about the destructive powers of black bile, we have long struggled to understand why some people seem to be controlled by emotions or mental battles which cannot be externally explained.
For a long time, humans have wrestled with a variety of ways to answer the ever-complex question of how seemingly disproportionate emotional or mental distress could be understood or remedied.
When speaking of depression – once called “melancholy”, from the ancient Greek concept of black bile – modern-day psychologists and psychiatrists will now distinguish between exogenous and endogenous depression, the former seemingly stemming from external factors, the latter from internal. Yet even this does not fully tell the story. Exogenous depression might seize upon a traumatic life event, for instance, yet the “unprevailing woe” which results from it can still appear disproportionate to others. Indeed, it may seem so to the sufferer themselves.
Church father John Cassian wrote in the first century that “of dejection there are two kinds; one, that which springs up when anger has died down, or as the result of some loss we have incurred or of some purpose which has been hindered or interfered with: the other, which comes from unreasonable anxiety of mind or despair”. Certainly, it is helpful to distinguish between the two. Yet for many it can be nearly impossible to tell where one ends and the other begins. Hamlet, speaking to his childhood friends Rosencrantz and Guildenstern, perfectly expresses the “unreasonable anxiety of mind or despair” which can stem from seemingly reasonable causes:
I have of late—but wherefore I know not—lost all my mirth, forgone all custom of exercises, and indeed it goes so heavily with my disposition that this goodly frame, the earth, seems to me a sterile promontory; this most excellent canopy, the air—look you, this brave o’erhanging firmament, this majestical roof fretted with golden fire—why, it appears no other thing to me than a foul and pestilent congregation of vapors.
Having recently lost his father and seeing his mother hastily remarrying to his father’s brother, it is not to our eyes altogether unusual that Hamlet should feel deep grief. Nor are we convinced by his stepfather Claudius’ criticisms of his “unmanly grief”: Claudius, after all, has just killed Hamlet’s father and seduced his mother. Yet even Hamlet speaks of his own grief as if he does not fully understand it, as though even for him it goes beyond what might be expected of his circumstances. Nor is his grief confined to the circumstances themselves: all of life, it seems, has become meaningless, and humanity has revealed itself to him as merely “this quintessence of dust”.
That grief can sometimes take such a disproportionately powerful hold upon us is testified to in the Bible. In Psalm 42, the psalmist asks, “Why are you so downcast, O my soul? Why so disturbed within me?” Many consider the psalmist here to be “preaching to himself”, to be declaring that deep sorrow in light of God’s mercy is never entirely justified. Such a reading, however, fails to recognise that the Bible so often gives full voice to grief, whether rational or not. Psalm 88 is perhaps the clearest example of this, with not the smallest sign of the psalmist “preaching to himself”; and the book of Lamentations famously refuses the “happy ending” which many people wish it would offer. Grief, even in light of God’s goodness, is part of human life and it has the power to take hold of our pre-existing brokenness in ways which the most comprehensive of scientific theories still cannot fully explain.
The church, however, has perhaps struggled more than other areas of society to grapple with mental illness. Perhaps this is in part because we resist reductionist views of things like emotions; if our emotions are more than mere chemical responses – which surely a Christian view must argue – then it seems overly simplistic to say that a correction in neurochemistry is all that is needed to fix the deep agonies of the heart. Yet it must also be equally reductionist to say that, in creatures who are “fearfully and wonderfully made”, our brain’s chemistry has nothing to do with how we feel. We continue to make distinctions between “heart” and “mind”, for instance, which, though they may be helpful to a point, are more metaphorical than we recognise. Emotions no more come from our hearts than they do from our “humours”; what happens in our brains (significantly, not the same as our “minds”) affects our entire bodies, in a complex relationship which only our Creator can truly understand.
But, complex and confusing though the subject itself is, it remains worth asking: why does the church struggle so much to accept the existence of mental illness? Perhaps it is a lingering scepticism about the scientific method of psychology. Few Christians today deny that physical illness is real and that medical help is a gift from God in dealing with it. Yet the thought that adjustments in our brain’s chemistry could help our emotions seems strangely discomforting to many still, as though it constituted a kind of “lack of faith” of which we would never accuse someone if they took antibiotics for their throat infection.
…complex and confusing though the subject itself is, it remains worth asking: why does the church struggle so much to accept the existence of mental illness?
Perhaps it also results from the fact that, while we now view our bodies in medical terms, we still think of our minds and our emotions mystically, distinguishing between facets of how we are created in ways which are neither helpful nor accurate. Look at the Biblical texts which deal with suffering and you see there a connection between the physical, the spiritual and the mental that is highly informative for even modern readers. In Psalm 42, the psalmist speaks to his soul – that is, he gives intellectual instruction to it, suggesting a mental process used to help in a spiritual one. He also describes the physical effects of his mental and emotional malaise. Or, to consider another type of example, Jesus often sought to cure not only the physical distress but also the spiritual needs of those who came to Him; think of the times he said, “Your sins are forgiven”, when surely only a “medical” cure was required.
If the connection between physical and emotional or mental illness is stronger than we might instinctively think, then we have a helpful way forward, perhaps, in dealing with our discomfort about the latter. While some Christians struggle to understand how physical illness can continue for those who pray against it in faith, the majority have had to find ways of acknowledging that, while sickness is not God’s will, it persists in a fallen creation, and that healing is not always forthcoming, for reasons only God can fully know. Many who have wrestled for long periods of time with physical illness have also had to consider the ways in which God uses illness to strengthen His people and to teach them things which they would never have otherwise learned. And, if this can be true for physical illness, then also why not for mental illness?
Polish psychiatrist Kazimierz Dabrowski – although not himself a Christian, heavily influenced by Christian writer and philosopher Søren Kierkegaard – once gave a definition of mental illness which, though many would question it, makes a challenging point which I believe can be quite informative for how we think about this question. For Dabrowski, “disintegration” – that is, the breaking down of simple, neat structures of thinking, feeling and interacting – is necessary for personal growth, and often it is a painful process while it is happening. Yet this process in itself is not necessarily an “illness”. It is an illness, he argued, when it fails to result in positive growth.
While for a variety of reasons I believe it is still helpful to use the term “mental illness” to denote conditions such as depression, OCD, bipolar or schizophrenia, Dabrowski’s point is a fascinating one, because it suggests that what we often consider an ailment can under the right circumstances be a productive force, even – hard though it may be to comprehend – a gift.
We need only look at the many significant people throughout the ages whom we would consider to have had mental illnesses in order to see how this can be the case. Sometimes great artists or thinkers managed to contribute much while still themselves falling prey to their own mental malaise. Figures like Ernest Hemingway, Gilles Deleuze, William Cowper or Sylvia Plath come to mind, whose lives ended either in suicide or despair, or artists like Brian Wilson whose genius and mental illnesses have existed in such an uneasy balance that the latter has often destroyed the former. Yet few can imagine a world without Beethoven, Mozart, Isaac Newton or the countless others who, at the very least, managed to achieve greatness in spite of their mental illnesses. So much so, that it seems worth asking if their mental illnesses in fact helped contribute to their greatness.
…what we often consider an ailment can under the right circumstances be a productive force, even – hard though it may be to comprehend – a gift.
In the realm of Christian faith, we should arguably have a particularly strong capacity for understanding how this can be so. Christians believe all humanity to have been created well by a loving God; we believe that illness exists in this world, yet we also believe that God can use all things in His redemption plan. We know that He never allows suffering to persist in the lives of His children without a good reason for doing so. We also know that He often chooses to work redemption through suffering rather than in spite of it or against it. The many testimonies in the Bible of God working good through trials and despair should surely convince us of this, few more compellingly than St Paul’s in his second letter to the Corinthians:
We do not want you to be uninformed, brothers, about the troubles we experienced in the province of Asia. We were under great pressure, far beyond our ability to endure, so that we despaired of life itself. Indeed, we felt we had received the sentence of death. But this happened that we might not rely on ourselves but on God, who raises the dead. (2 Corinthians 1:8-9)
A similar testimony is given by pastor and writer John Newton, in his hymn “Prayers Answered by Crosses”. Newton knew much about mental illness, though not entirely from personal experience. He was in many respects a happy and contented man himself, yet his wife suffered from a variety of ailments and his closest friend, William Cowper, was severely depressed – and at times psychotic – for many years of their friendship. “Prayers Answered by Crosses” was believed to be written around the time that Cowper entered a period of prolonged mental illness, believing God to be demanding that he sacrifice his own life much like Abraham nearly sacrificed the life of his son Isaac. The Olney Hymnal which Newton and Cowper had been writing together hit a dramatic standstill because of Cowper’s breakdown, and for some time it seemed that it would never be completed. Yet Newton was able, through remarkable perseverance and a prodigious amount of writing, to complete the hymnal which has given the world the most ubiquitous worship song, “Amazing Grace”, and numerous others. Remarkably, when Newton reflects on his trials in “Prayers Answered by Crosses”, he does not suggest that God simply delivered him out of these trials, but that God used these trials to teach him what he could not otherwise have learnt.
As we reflect on the ways in which mental illness can in fact be a gift to the world, we would do well to begin by considering the God who makes such things possible.
I ask’d the Lord, that I might grow
In faith, and love, and ev’ry grace,
Might more of his salvation know,
And seek more earnestly his face.
’Twas he who taught me thus to pray,
And he, I trust has answer’d pray’r;
But it has been in such a way,
As almost drove me to despair.
I hop’d that in some favour’d hour,
At once he’d answer my request:
And by his love’s constraining pow’r
Subdue my sins, and give me rest.
Instead of this, he made me feel
The hidden evils of my heart;
And let the angry pow’rs of hell
Assault my soul in ev’ry part.
Yea more, with his own hand he seem’d
Intent to aggravate my woe;
Cross’d all the fair designs I schem’d
Blasted my gourds, and laid me low.
Lord, why is this, I trembling cry’d,
Wilt thou pursue thy worm to death?
“’Tis in this way,” the Lord reply’d,
“I answer pray’r for grace and faith.
These inward trials I employ,
From self and pride to set thee free;
And break thy schemes of earthly joy,
That thou mayst seek thy all in me.”
Colquhoun, J. 1814. A Treatise on Spiritual Comfort. Edinburgh: J. Ogle.
Dabrowski, K. 1964. Positive Disintegration. Boston: Little, Brown and Company.
Newton, J., and Cowper, W. 1779. Olney Hymns.
Winter, R. 1986. The Roots of Sorrow: Reflections on Depression and Hope. Westchester, Illinois: Crossway Books.