Counselling as Ministryand

Church as Caring Community

Dr. Samuel Pfeifer, M.D.Senior Consultant Mental HealthKlinik Sonnenhalde Switzerland

Introductory Bible Passages

» Isaiah 25:4» You have been a refuge for the poor, a refuge for the needy in their distress,

a shelter from the storm and a shade from the heat.» Matthew 9:36-37

» Seeing the people, He felt compassion for them, because they were distressed and dispirited (harassed and helpless) like sheep without a shepherd. 37 Then He said to His disciples, "The harvest is plentiful, but the workers are few.…

» 1. Thessalonians 5:14» And we urge you, brothers and sisters, warn those who are idle and

disruptive, encourage the disheartened, help the weak, be patient with everyone.

2

The multitude of the The multitude of the suffering is at our doorssuffering is at our doors

Who are «the needy in their distress?» (Isaiah 25:4)

3

Suffering Souls – the needy of our time

4

Mental Health – Four trumpets

» WHO: Depression is a hidden burden, affecting around 350 million people around the globe. It is the leading cause of disability worldwide.

» Patients tell their stories – in our hospitals, outpatient departments, at the church doors.

» Family and friends: almost every person knows at least one person who is affected with symptoms of depression

» The Bible records prayers and descriptions of depressive mood.

5

Patients tell their stories

» Depression is a common mental disorder, characterized by sadness, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, feelings of tiredness, and poor concentration.

» Depression can be long-lasting or recurrent, substantially impairing an individual’s ability to function at work or school or cope with daily life. At its most severe, depression can lead to suicide.

6

STRESS OF MODERN LIFE

» Long transfer to work» Multiple tasks that cost a lot of time

and strength» unfair boss, chaotic colleagues» Desire to be a good employee» Lack of positive feedback, constant

pressure» too much noise, lack of privacy,

excessive distractions, and unreasonable deadlines.

» Broken friendships» Distress in the family

MARITAL PROBLEMS

» Being confined to the house, » In-laws: no positive feedback,

unreasonable demands, disrespect, cosntant criticism

» «shouting man / crying woman» – ingredients of every Bollywood movie

» Unfulfilled wish to have a child» No time for yourself, no time to

relax» Worry / financial problems» Sexual problems

VIOLENCE / TRAUMA

» Childhood trauma» Traumatic experience» Partner with alcohol

problem» Threats and beatings

BEREAVEMENT

» Losing a close relative or friend

» Losing husband or wife = losing support in life

Family and Friends

» Who in this auditory does not know anybody affected by the symptoms of sadness, loss of energy and social withdrawal?

» Not only patients themselves are affected – depression is a burden for the whole family!

11

The Bible describes depressive states

» You won't find the term "depression" in the Bible. Instead, the Bible uses words such as downcast, sad, forlorn, discouraged, downhearted, mourning, troubled, miserable, despairing, and brokenhearted.

» Bible people showing the symptoms of this disease: Hagar, Moses, Naomi, Hannah, Saul, David, Solomon, Elijah, Nehemiah, Job, Jeremiah.

12

Biblical examples

The prophet Elijah went through an episode of “Burnout” after his great victory against Jezebel:

He (Elijah) came to a broom bush, sat down under it and prayed that he might die. "I have had enough, LORD," he said. "Take my life; I am no better than my ancestors." Then he lay down under the bush and fell asleep. (1 Kings 19:4-5, NIV)

» Hannah, who was barren, » Jeremiah, the "weeping

prophet." » King David — “I am troubled, I

am bowed down greatly; I go mourning all the day long. …I groan because of the turmoil of my heart” (Psalm 38:6,8 - NKJV).

» Read Psalms 6, 13, 18, 23, 25, 27, 31, 32, 34, 37-40, 42-43, 46, 51, 55, 62-63, 69, 71, 73, 77, 84, 86, 90-91, 94-95, 103-104, 107, 110, 116, 118, 121, 123-124, 130, 138, 139, 141-143, 146-147.

13

The Church is called to The Church is called to carecare

14

Jesus called the weary and the burdened

» Come to me, all you who are weary and burdened, and I will give you rest. Take my yoke upon you and learn from me, for I am gentle and humble in heart, and you will find rest for your souls. For my yoke is easy and my burden is light.” (Matthew 11:28-30)

» His calling is now our calling as Christians in the Church

15

Cultural context of urban mental health

Su

ban

gh

i R

. P

ark

ar,

GE

ND

ER

AN

D T

HE

CU

LT

UR

AL

C

ON

TE

XT

OF

UR

BA

N M

EN

TA

L H

EA

LT

H I

N M

UM

BA

I,

Dis

sera

tion

Un

ivers

ity

of

Base

l 2

00

3

Urban afflictions affecting men

Promoting mental health in the 21st century

» “New public health initiatives of the 19th century brought about substantial decline in deaths from infectious diseases through sanitary reform, and we now need to consider how analogous population-based measures may be adapted to promote mental health.”

» Prof. Shubhangi R. Parkar, KEM Hospital Mumbai

1. Thessalonians 5:14

1. Exhort

2. comfort, encourage

3. support, help

4. Be patient

Idle, unrulyIdle, unruly

Anxious, timidAnxious, timid

The weakThe weak

everyoneeveryone

Four Biblical Strategies

The Church is called to The Church is called to make an impact in societymake an impact in society

By addressing the needs of peopleBeing able to communicate with professionals (medicine, psychology)

21

The Bio-Psycho-Social Model / Spirituality

Biology Disposition

Social Factors Relationships, Economy

Psyche Reaction / mental processing

The Causes of mental disorders are to be found in three areas. Depending on the type of disorder, there are various emphases.

QUESTION: What is the role of spirituality? Is it a causal factor or rather a factor of coping and understanding?

Emotions - ThinkingVolition – BehaviorCoping - Defense

PSYCHOLOGICAL

Factors contributing to Mental Illness

Childhood, Family LifeTrauma, Life events

„Stress“

SOCIAL ASPECTS

Genetics, PersonalityNeurobiology

Physical Constitution

BIOLOGICAL

MentalProblems

BurdenHardships

TrialsTemptation

Gal 6,22. Cor 6,41. Peter 1,61. Cor 10,13

Weakness2. Cor 12,9

Way of Life (Eph 4,22)Mind (Rom 8,6; 12,2)

Therapeutic avenues

Attention, Empathy,Understanding,

CounsellingComfort, Encouragement

Teaching

T A L K I N G

Visiting - HelpingAktivation – Enabling

betterautonomy

S U P P O R TAntidepressants,

Neuroleptics, Mood Stabil.

Tranquilizer etc.

M E D I C A T I O N

Patient

Proberbs 16,24; 18,211. Thessalonians 5,15

Hebrews 10,24-25

Isaiah38,21J. Sirach 38,1-81. Timothy 5,23

Galatians 6,2Matthew 25,35-40

Proverbs 3,27

The church has The church has resources to careresources to care

Together with Christian professionals, the church can offer couselling and care

25

STRESSSTRESS

Thinking

Body

4

1

3

2

1

2

3

4

Talking

Support

Activation

Medication

Depression can be treated

Where is the church coming in?

Counselling? Care?

Faith as a source of strength in depression

» Despite despair, doubt and lack of energy» Bible verses and Christian songs» Encouragement by fellow Christians

Blessed are those whose strength is in you, whose hearts are set on pilgrimage. As they pass through the desert valley, they make it a place of springs; the autumn rains also cover it with pools. They go from strength to strength . . . (Psalm 84)

Conclusions

» 1. We should be open for a deep personal awareness of human suffering beyond all categorical and theoretical considerations, moving us to compassion and motivating us to find new ways for creative caring.

» 2. We should be aware of new developments in our field, able to communicate with the world, to examine the philosophical underpinnings, critically evaluating what we can apply in our everyday practice.

Conclusions ctd.

» 3. We should be guided by the Word of God as an eternal source of wisdom and truth, practicing an exegesis that applies to the burdens, the questions and the spiritual hunger of our patients.

» 4. We should be guided by the principle of hope, hope which is not only rooted in the prospect of restored health, but hope in the midst of existential weakness, hope which is not only based on well-being in this world but hope that goes beyond all that our limited activity can achieve.

„I will give you rest!“

» Matthew 11:28-30» "Come to me, all you who are weary and burdened, and I will give you rest. 29Take

my yoke upon you and learn from me, for I am gentle and humble in heart, and you will find rest for your souls. 30For my yoke is easy and my burden is light." (NIV)

» Then Jesus said, “Come to me, all of you who are weary and carry heavy burdens, and I will give you rest. 29 Take my yoke upon you. Let me teach you, because I am humble and gentle at heart, and you will find rest for your souls. 30 For my yoke is easy to bear, and the burden I give you is light.” (New Living Transl)

» 28-30"Are you tired? Worn out? Burned out on religion? Come to me. Get away with me and you'll recover your life. I'll show you how to take a real rest. Walk with me and work with me—watch how I do it. Learn the unforced rhythms of grace. I won't lay anything heavy or ill-fitting on you. Keep company with me and you'll learn to live freely and lightly." (The Message)

Two great gifts

» Jesus offered two great gifts that are the object of our deepest strivings / longings:

» spiritual renewal / change» spiritual repose (“I will give you rest”)

» “Spiritual renewal is offered in the new birth – a concept at the very heart of Jesus’ teaching. Here we are provided with the possibility of a new beginning that is so radical and complete as to be best expressed in the analogy of birth.

» The gift of spiritual repose is described as rest for the souls of those who labour and are heavy laden. Toil is not abolished; rather Jesus offers to replace a heavy yoke with a light one and to provide restored strength for the task.”

• (D. Benner p. 27)

What can we learn from Jesus

» Jesus saw the condition of people» Jesus had compassion» Jesus addressed their innermost yearning

(“I will give you rest!”)» Jesus does not promise a life without a yoke – but he will join

them in bearing the yoke together» Jesus challenges people to learn from him» Jesus sets himself as a model: ”humble, gentle”

www.psy77.com

More Presentations on Global Mental Health in Christian Context

33