Incarnational Theology and Mental Illness

As a psychologist I wanted to insert some thoughts, in the wake of Robin Williams' death, into the current conversation about faith and mental illness, depression in particular.

In addition to the issue of extending welcome and compassion to those suffering from mental illness--and there have been some great reflections posted online about that issue, see Sarah's and Ann's--I wanted to make a theological observation.

Within Christianity discussions about mental illness are often afflicted by Gnostic and dualistic assumptions, where there is a hard (even ontological) division made between the soul/spirit/mind and the brain. Specifically, we often assume that the soul is separate from the neurotransmitters in the brain. Thus, even though you might have, say, low serotonin levels in the brain in the case of depression, the soul has the ability to override the brain to "chose differently." Willpower and choice in this vision are radically separate and distinct from those low serotonin levels.

But things like willpower, motivation or mood actually are those serotonin levels. And even if reducing the soul to brain-function makes you nervous at the very least we must admit that the soul is radically affected by and dependent upon those serotonin levels.

In short, when it comes to mental illness we have to reject the Gnostic and dualistic assumptions that have governed the conversation about mental illness in our churches.

What this means is that mental illness requires incarnational theology and reflection. Depression is about our bodies. But the Gnostic impulses within Christianity often obscure that fact. The brain is an organ of the body as much as our stomachs and livers.

Our theological reflection must attend to embodiment, and this includes mental illness. And if we do this my hope is that not only will we become more accepting of the bodies of others but that we'll expand our understanding of "spiritual formation," coming to see how attending to and caring for the body in mental illness is as "spiritual" as bible study and prayer.

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27 thoughts on “Incarnational Theology and Mental Illness”

  1. As I'd expect from a psychologist, you put it much better than I could. We often assume this reductionistic view of the relation between body and soul that makes bringing up the mind/soul/spirit dimension of suicide sound like blaming the victim, and bringing up the physiological dimension sound like excusing suicide or saying that we're controlled by the chemicals in our brains. As you point at, though, the connection is deeper and more mysterious than this.

  2. Many people won't like the issue framed as strongly as I do here. There are worries about completely identifying and reducing the "soul" to the brain.

    Still, even if we back off from that strong reductionism in the end I think it's helpful to ponder and wrestle with it. For example, we don't blame people for having seizures but we do blame them for committing suicide. What if there's not much difference, morally speaking, between the two?

    Yes, if we suffer from seizures we should attend to them, taking medication, monitoring triggers, stress, overall health, etc. But still, even if we do all these things well sometimes we'll have a seizure. In the same way, perhaps, that a person dealing with chronic depression might falter and commit suicide.

  3. As you are a scientist, I would be very interested in any research which establishes the existence of this thing you label here as a "soul" in human beings. If not, then it would seem that these are, at best, assumptions on your part. I can't see any other way to read this. Since the question appears to lie outside the perview of science, evidence is lacking, whether dualistic or otherwise. No way to tell, then, just what it is you are actually saying.

  4. Richard, my son committed suicide when he was seventeen years old. I remember an acquaintance who was a Christian saying to me later, "I really don't believe he meant to do that". From the moment my friend made that statement to this very day, I have had the knawing suspicion that this person could not get past the idea of suicide being an immoral act. This may sound strange to some, but I must believe he meant to take his own life. It was his last cry of pain.

  5. So, so sorry.

    I think our empathy and compassion should be commensurate with the pain of others. Which is why, when it comes to suicide, I think our empathy and compassion should be at its greatest.

  6. Isn't the 21 grams thing bogus though? The way I understand the experiment went, people were weighed on their death beds before and after expiration. Aside from the possibility of imprecise instrumentation, can't that change in body weight be accounted for by the release of gases in the body?

  7. "When it comes to mental illness, we have to reject the Gnostic and dualistic assumptions that have governed the conversation about mental illness in our churches."

    Amen.I've been suicidal during two different periods in my life. It's been a long time now, but even at a remove of 20 years, I still rememberwhat it was like to wake up every morning wishing that I hadn't, and I absolutely understand why someone would pull out the knife or the gun or the pills or the belt and use it. There are moments - sometimes very
    long moments - when killing yourself makes perfect sense, and I could never judge someone for taking the quick way out.

    I think one of the things that frustrates me when discussing mental illness is how people (and not just Christian people) think it's all in your head, as if your brain lives in a room separate from the rest of you. (Which is why I don't tend to have all that many conversations with people about my PTSD and history with depression - the amount of educating I have to do is exhausting.) In my experience, both depression and PTSD are incredibly physical, embodied experiences - there's actual physical pain, crazy swings in energy levels, and a variety of unpleasant altered states that change how you perceive and process reality.

    Everything that helped - yoga, mindfulness meditation, EMDR, funky art-y therapies, throwing out 99% of all the theology I'd ever ingested - involved bringing body, mind and soul back together, not treating them like separate, non-intersecting entities. The relationship between brain and bodies and spirit is complex and interactive, and you have to address everything at once. Or at least I did - a lot of journeying with mental illness is trying a bunch of different stuff to see what sticks.

  8. Thanks so much for this. It's an actual first-person account of what I was trying to say analytically and thus poorly.

    In thinking about all this, I like the notion of "hygiene" rather than "choice." (The Greek etymology of the word hygiene is "the art of health.")

    That is, things like depression or anxiety aren't turned on or off by making a "choice." But we can practice good mental health hygiene, learn to practice the "art of health"--all the things you describe in getting body and mind to cooperate healthily together.

  9. I kind of guessed that, but I wasn't entirely sure due to the ambiguities of plain text. I have a lot of respect for you, so I wasn't sure whether to go with joking or serious (what if you're not joking, and I accidentally insulted you, but what if you are joking, and I've taken things too seriously?). As you can see, I decided it would be safer not to get the joke.

  10. It's actually 'hygiene' that I personally find the most difficult. I feel no desire to eat or shower or be gentle with myself. The self-abuse that comes with depression is tricky - I am both the abuser and the abusee.

  11. Thanks, Richard, and thanks to blog-friends who have given their personal testimonies. They resonate. Trying to "will" your way out of depression is like trying to pull your fingers out of Chinese handcuffs.

    One point - or rather two. I'd suggest that any talk about the body and the soul actually feeds a gnostic anthropology. The soul is embodied, the body is ensouled - that's Hebrew, biblical anthropology. And Christologically: there is no unenfleshed Jesus (no logos asarkos - Barth, McCormack), and the Christ now embodied in heaven remains embodied on earth, as church and eucharist. Moral: if you want a "hygienic" anthropology, earth it in a "hygienic" Christology, in Jesus the the True, Whole, and Holy Human.

  12. One might even start taking seriously the vision of priesthood as being 'the cure of souls'.

    Two thoughts - and I should say I think I come at this from a very different set of (metaphysical/theological) assumptions to you, although I wholly agree about the necessity of being incarnational: 1) to say "we must admit that the soul is radically affected by and dependent upon those serotonin levels" is to elide the question of causation, which I see as crucial. That is, does sadness cause (eg) low serotonin, or does low serotonin cause sadness? I see one path as reductively materialistic, one as incarnational. 2) I would want to engage a thorough hermeneutic of suspicion around the idea of mental 'illness', partly for philosophical reasons, but most of all for questions of social justice. It is very convenient to the principalities and powers to say that human suffering has nothing to do with the social context in which we live - so here, have a pill, you just have a defective body. If we start to take seriously the idea that human suffering is embedded within the totality of our human relationships then we have (more) grounds for contending with the enemy - and more theological resources for doing so.

  13. I’m not sure it’s either. Low serotonin is related to a variety
    of symptoms that are associated with depression, of which “sadness” or a sense
    of “emptiness”, for at least 2 weeks, is one. Depression, like sadness, however,
    is a construct, a collection of phenomena or symptoms given a label. Dr. Beck’s
    comment seemed to me to emphasize the reality that a “soul”, our embodied
    experience, is contingent on neurotransmitters such as serotonin. Your
    comment on causation seems akin to asking, “does cardiovascular disease cause atherosclerosis
    or does atherosclerosis cause cardiovascular disease?”

    I’m not at all sure what you mean by the “idea of mental
    illness” nor “It is very convenient to the principalities and powers to say
    that human suffering has nothing to do with the social context in which we live
    - so here, have a pill, you just have a defective body.”

    It does seem, however, you are building a bit of a strawman.
    Social context is a crucial aspect of any bio-psycho-social treatment plan. In
    fact, it used to be one of the “axes” of the multiaxial assessment in the DSM. See Walsh
    (2011, Lifestyle & Mental Health) for a review of research on behaviors
    shown to facilitate emotional regulation and enhanced mood, none of which are a drug. Being communal, participating in a church, and practicing ethical behavior all have empirical support, however.

    Context and embodied experience go hand and hand. There are both
    bottom up and top down aspects of causation. My behavior is affected by the
    diathesis with which I am endowed and the “stress” I experience interacts with
    that to produce subsequent phenomena.

  14. Cardiovascular disease and atherosclerosis are the same sort of thing; I would argue that the brain and the mind - let alone the soul! - are not. This does not (necessarily) entail a metaphysical dualism, merely a recognition that we need to be very careful about our use of language and be alert to potential category mistakes.

  15. I believe these answer your question - one in less than ninety minutes.

  16. Richard, thanks so much for addressing this. I live with someone who suffered from mental illness for a long time. I was initially infected with the gnostic line of thinking you describe - and she tried visiting psychologist and 'dealing with it herself' to no avail. It was not until she found the right doctor who found the right meds that she found relief. It was like night and day. It completely upended everything I was taught and thought about depression and mental illness. It has been hard this week, hearing people exclaim 'How could he be depressed, he was so happy and rich and successful.' I kind of want to scream, but instead I calmly reply. 'Would you say the same thing if he died of a cancer?' It is hard if you have not experienced it or witnessed it to understand it.

  17. I actually had the weight experiment in mind when I posted here. Unfortunately, I have never had a convincing conversation with anyone when I question the "science" behind this topic. Which, of course, simply reinforces my own bias against any arguments for the existence of an "eternal soul". I wish folks would stop pretending that there is, and that we who do not "understand" this are somehow lacking in insight or discernment. I am always, and shall remain, open to any scientific evidence.

  18. Sorry for being late to the party (maybe someone has already asked this in the blog).
    Completely appreciative of this (coming from one given to melancholy). Just another angle - how does the human conscious (i.e. sociopath) tie in with neurochemistry?
    Thanks again Dr. Beck!

  19. Thank you for the links. I watched the one-hour lecture (#1 above). I give the speaker a B+ for effort and an F for scientific proof. One example: he went on at length about how humans can never know what it is like to "be a bat -- to have their consciousness" -- even if we were to understand everything about how their brains function -- only to end his lecture stating flatly that animals have a soul but it is not as complex as ours based on our own observations of animals. He also listed as "proof" of God as his consciousness without a material form -- a speculation at best. He never explained how or why it is possible for humans to be unconscious, as when administered general anesthesia. He spent a lot of time contradicting himself.

  20. Yeah, that's hard. I know for me, at the worst points, I had 3 rules for myself: I had to take a shower every day, I had to leave the house at some point, and I had to have a conversation with another human being, even if it was just the grocery store clerk or something. It was incredible how hard it was to do those three things, and I felt like a total loser that something as simple and basic as showering felt like an accomplishment.

    And sometimes it does seem like everything that helps costs too much money. I have no answer for that, other than my lingering credit card debt....Peace on your journey. Depression sucks.

  21. I have been attracted to the teaching of Pope John Paul 11's Theology of the Body for quite some time, where much of this teaching revolves around our sexuality as male and female. However, I think we can take this further into the brain, just as you talk about the brain is an organ of the body. Recently, loved ones close to me have been stricken with mental illness and my eyes have been opened to a new world that I never realized. Thank you for this article as I try to understand mental illness.

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