In one of the congregations I served, a friend of mine went through the training to become a Stephen Minister. Stephen Ministers work alongside the church’s elders and pastors in providing pastoral care to members of the congregation. One week the training focused on how to handle mental health issues. The training was given by an expert from a local Christian mental health hospital, and among the topics covered that week were depression but also more severe chronic conditions including bipolar disorder and schizophrenia. Among those receiving this training were two men of the church who had often served as elders over the years. But as they were putting on their coats to head out into the night following this training session, my friend overheard these men saying, “That was a waste of time. Nobody in this church has schizophrenia or manic depression or anything.”
When I heard this, my heart sank. Maybe they could not have known better, but in truth (and were it not for the sake of confidentiality) I could have provided those men with a short list of people in that congregation who dealt with precisely those difficult conditions. One of them was on the church council at the time. And those were just the ones I was aware of. Probably there were others.
Even if my seminary students remember nothing else from my preaching classes, I hope they remember this refrain to which I return over and again: Don’t ever talk about any topic in a sermon on the assumption that nobody within 500 miles of your pulpit is dealing with that issue. Never talk about abortion thinking no one in your flock has ever had one. Never talk about those “gays” thinking that no one in your midst struggles with sexual identity or orientation. And do not discuss any form of mental illness without realizing that somebody listening to you that very moment knows what that condition is like from the inside. Realize that people in any given category are out there, and although that does not mean you cannot bring up this or that subject, let your knowledge of their presence in the worship space properly nuance how you speak of such topics.
When it comes to mental health issues—and with the aging baby-boom population this category includes a sharp rise in the number of people with dementia—this kind of sermonic pastoral sensibility encompasses a number of things worth pondering.
First, there is the need for empathy and compassion. Ponder what it feels like to have a history of hearing voices that are not real. Use your pastoral imagination to probe the ripple effects in an entire family when a beloved brother, sister, or spouse endures a manic episode that may include wild shopping sprees or binges of other varieties. Wonder what it is like for the person enduring the onset of dementia, and consider how terrifying that prospect almost certainly is in the early stages when the person can feel his or her world slipping away. Pastors cannot possibly speak lightly or briskly (much less dismissively) of such matters—or use the pejoratively hurtful word “crazy” to describe such conditions—if they have done the hard pre-work of a sermon to think their way into these life scenarios.
Second, there is the need to speak intelligently about such matters. A trained pastor should be able to go well beyond pop-level understandings of bipolar disorder or schizophrenia. The latter, for instance, is not what most people think it is—namely, having multiple personalities à la Jekyll and Hyde. There is a disorder known as multiple personality syndrome, and there are other kinds of dissociative disorders, but those are separate from schizophrenia. If a pastor treats them all as basically the same thing, the person suffering from schizophrenia can feel belittled, misunderstood, and dismissed. Knowledge is a vital pastoral tool. For instance, there are now 120 distinct varieties of dementia-related disorders. Pastors need not know all of them or even most of them, but an awareness of this complexity can prevent the sensitive pastor from just chalking it all up to generic “Alzheimer’s” as though that is a one-size-fits-all moniker.
Third, as an extension of the second point, there is most certainly a need to understand the complexity of mental health issues so as to avoid overly simplistic suggestions. Depressed people cannot just “cheer up” or “put on a happy face.” Church signs that scream to the world the false message “We’re Too Blessed to Be Depressed” send the horrid signal that having true faith rules out any form of melancholy or clinical depression. Woe betide the pastor who props up that idea in some throwaway line in a sermon sometime. Pastors could use at least a baseline understanding of brain chemistry, of both how and why medications are needed, and of the struggles many people continue to face even when they are receiving the pharmacological and counseling help they need.
Fourth, increasingly there are avenues pastors can take to heighten empathy, sensitivity, and knowledge. For instance, my wife works as the director of quality for the Holland Home eldercare organization, and among her responsibilities in recent years has been raising the awareness of all Holland Home employees—from housekeeping staff to senior leadership—about what it is like to live with diseases like Alzheimer’s. Employees undertake “The Dementia Journey,” in which they learn firsthand that dementia involves far, far more than not being able to remember somebody’s name.
Participants have inserts put into their shoes to simulate the neuropathy many experience as part of their dementia. They are fitted with special goggles that simulate a diminished field of vision while an iPod fills their ears with background noise and the occasional loud shout from somewhere in the distance. They wear gloves to encumber hand function. All of this simulates the multiple effects of dementia. With all these in place, participants are sent into a room and given a simple task: Set a table, or fill a glass with water, or find a white sweater in a closet. Most find these otherwise easy tasks to be difficult at best and frequently impossible. Some sit down in defeat. Others who have family members with dementia break down in tears realizing what their loved one now experiences every day. Whatever their reactions, participants never look at a person with dementia the same way again. It would be a fine exercise for pastors to experience.
Most of us who preach know that addressing mental health issues is not something that comes up with any great frequency. But even as preachers seek sermon applications over time that touch on a welter of issues in life, so also depression, bipolar disorder, schizophrenia, dementia, and other mental illnesses are things we need to talk about because the sheep under our care suffer from these difficult realities. A sensitive sermon preached by a sensitive pastor will work very hard for deep compassion, accurate understanding, and grace-laced words of hope to proclaim that our great God in Christ understands all these things, is present in all these conditions, and even so continues to point to that day when he will make all things and all people whole and well and new.
This column is provided in cooperation with the Center for Excellence in Preaching. For more on the CEP, its upcoming events, and its online resources, visit http://cep.calvinseminary.edu/.