by The Rev. Kathryn Greene-McCreight

Imagine your worst nightmare. The kind where you wake up in a cold sweat, panting, glad that you are awake, that it was all a dream. Then imagine that worst nightmare, but you are already awake, in a cold sweat, panting. And it is not all a dream. It is a waking nightmare.

Imagine the death of your dearest lifelong friend. You are absolutely inconsolable. Your grief is too deep for words, your sobs too loud to contain, your body too heavy even to move. Then imagine that this same friend is alive and well, visiting with you. Yet you experience equally unbearable grief. Pain too deep for words, sobs too loud to contain, body too heavy to move.

Now imagine yourself in a cafeteria carrying a lunch tray. You accidentally trip and drop it, dishes shattering on the floor, glasses splintering, food splattering. The feeling of shame and embarrassment is overwhelming. Everyone is watching.

Then imagine yourself in the same crowd, at the same moment, but you have not dropped anything. Nevertheless, you have the same overwhelming shame and embarrassment, the sense that everyone is watching you, laughing, pointing. You hear their heckling voices telling you that you are worthless.

You have now imagined just some of the devastating symptoms of life-derailing major mental illnesses: bipolar disorder, major depression, and schizophrenia.

Stigma and Shame

The external signs of mental illnesses, if they are discernible at all, can be easily misinterpreted. Because symptoms of mental illnesses are sometimes manifested in odd behaviors, sufferers are often ostracized, avoided, and stigmatized. Approximately one out of every four people at some point in their life will suffer from a mental illness. The mental health care community urges us to understand mental illnesses as biological disorders rather than character flaws.

However, the stigma and shame of mental illnesses remain strong, both for sufferers and for their families. There are a few factors which have begun to relieve the stigma over the past few decades: The appearance of new psychiatric treatments and medications and their acceptance by the general public, as well as the “coming out” of celebrities and people of note who live with mental illnesses. These include author William Styron, legal scholar and professor Elyn Saks, comedian Stephen Fry, and writer Andrew Solomon, to name just a few.

And yet the stigma is dug deeper with every public act of violence attributed to someone suffering from mental illness. The tragedies are too numerous even to take in. The perpetrators are often accused of being mentally ill, even though there may not be an actual diagnosis. Social stigma is only fueled by the fear and revulsion such acts bring. One can understand how the public would have even greater fear of people with mental illnesses. However, according to the National Institutes of Health, people living with mental illnesses are in fact less violent than the general population, and are more likely to be the victims of violence rather than perpetrators of it.

Stigma in the Church

The social isolation faced by people with mental illnesses and their families deepens the wound inflicted by the illnesses themselves. And it is compounded when our faith communities turn away from those who suffer. This happens especially when mental illness is perceived as a sign of spiritual weakness or result of lack of faith.

A clinical study published in the Journal of Religion and Health fueled this false perception when it claimed to “prove” that religious people are happier than non-religious people. (My own experience as a person of faith and Christian priest who lives with mental illness does not confirm this. Christians may be as miserable as the general population.) Studies such as this would implicitly suggest that God is a form of therapy, a tool to help us feel better. The Christian faith does not teach that God is a tool to be used, but Creator and Redeemer to be thanked, adored, and worshiped.

I have noticed, though, a general perception that if religious people are not “happier” than non-religious people, they should be. When Christians living with mental illnesses are in psychological agony, the message given is sometimes that there is something deficient in the person’s soul. Christians who suffer from mental illnesses may even be told that they are not praying hard enough, not attending church often enough, or not reading the Bible carefully enough.

When people of faith slog through the deep grief of depression, or soar on the erratic joy of hypomania, or get sucked into the cognitive mud of schizophrenia, and the problem is credited to a spiritual defect, we should all be ashamed of ourselves. Here we find a cruel irony: the very community that’s supposed to support mentally ill members ends up perpetuating their isolation and stigma.

A friend of mine told me how her church’s lay pastoral care team would regularly deliver meals to families of ill parishioners in a gesture of care and support, a common practice in many churches. But when her son was first diagnosed with and hospitalized for schizophrenia, the pastoral care team did not reach out to her at all. There is even today an underlying perception that mental illnesses are somehow “contagious” and shameful. The church’s lack of care in this case seems to have been a symptom of a very deep stigma and shame. “No casseroles for schizophrenics,” responded my friend.

Indeed, we in the church perpetuate stigma and fear in our ignorance of psychiatric symptoms. The biblical stories of Jesus and his disciples casting out demons are sometimes used to explain away mental illnesses as demonic possessions. But these same stories can be understood in another more helpful way. The symptoms of mental illness may indeed be like the demons Jesus encountered insofar as they are not the patient herself. The symptoms, like the demons in the story, need to be cast elsewhere, away from the sufferer.

One important lesson we must all learn, Christian or otherwise, is that the patient is not the illness. Symptoms of the illness are not the patient’s fault nor are they signs of a sick soul. Symptoms are external manifestations of a sickness of the brain. This is the theological analogue of what mental health care professionals encourage us to remember: our illnesses and our symptoms don’t define us.

Educating Clergy about Mental Illness

In order for faith communities to be able to care for their parishioners who suffer from mental illnesses with the same support they would give to those living with cancer, we need to draw back the curtain of fear and reveal the face of the person who suffers. Once we personally know someone who is mentally ill, the fear becomes less overwhelming and the stigma becomes less powerful. This is part of the reason why the celebrities with the courage to write and speak publicly of their experiences with mental illness are so important.

Research shows that within Christian denominations, across racial and class divides, clergy are often the first responders for those suffering mental and emotional distress. This may be the case because parishioners are frightened to seek mental health care at all, much less from secular providers. Clergy seem “safer.” Yet clergy can be, among the caring professions, some of the most ignorant about mental illnesses.

Educating clergy is crucial for the mental health of our faith communities. Clergy need to be familiar with basic symptoms of mental illnesses. We need to teach our congregations how to intervene when mental health crises arise. We need to know how and when to refer suffering parishioners to quality mental health care providers. This will mean accepting that we are not competent enough to handle these crises on our own. We have our own role, and it is separate from the role of a psychiatrist.

We need to know how to treat sufferers with respect at all times, learning to discern that gentle care and listening are not possible without maintaining firm boundaries. We need to mold our communities of faith around learning to support the families as well as the sufferers, and to guide our communities in showing the love of God even amid the deep despair of mental illnesses.

In short, we should not leave these families to suffer in silence. If we bring casseroles to cancer patients, we must also show love and concern to families grieving in seasons of mental illness. As my friend says, we should not neglect to bring “casseroles to schizophrenics.”

The Rev. Kathryn Greene-McCreight, Ph.D., is the author of Darkness is My Only Companion: A Christian Response to Mental Illness (Brazos: 2006) and a Priest Associate at the Episcopal Church at Yale.

The recently released 2015 second edition of Greene-McCreight’s book contains a foreword by the Archbishop of Canterbury, an afterword by the author, a significantly expanded bibliography, and a set of discussion questions for parish use.

Originally published October 20, 2014 in a series of “Online Exclusives” for the Fall 2014 issue of Tikkun, “Disability Justice and Politics.” Reprinted with the permission of the author and Tikkun magazine.