Monday, September 16, 2013

Supporting Those With Mental Illness

Recently, I shared an address with a group of people dedicated to addressing the mental health needs of their faith communities. What follows is part of that address:

So, how may we support people who are experiencing mental illness? I want to use three words as a framework for our thinking about this question:

1) Compassion - defined as "sympathetic consciousness of others' distress together with a desire to alleviate it." That word "together" is so important, for it speaks of the need to put action together with our sympathy.

I work with people all the time with various types of mental health issues and what I hear consistently from them is: "We just want to be treated like full people." Somehow, there is a tendency to marginalize people with mental illness, to treat them like they are less than we are, like they are second-class citizens, like maybe they don't have feelings like we do.

As I look at the example of Jesus in the gospels, I see someone who had compassion. "When he saw the crowds he had compassion on them, because they were harassed and helpless, like sheep without a shepherd." (Matt.9:36) Jesus' compassion moved him to touch people, even the lepers, to listen to them, to ask them questions, to take time with them, to meet their physical, emotional and spiritual needs.

It's important, if we're going to be compassionate people, to be there for people with mental illness in their time of grief. People who have mental illnesses experience loss in their lives: loss of significance, loss of relationships, maybe loss of job, loss of health and sense of wellbeing, perhaps loss of children (if they are unable to perform their duties as parents), loss of family (if they have to be hospitalized). Are we there for them in their grief? Or do we minimize their loss?

Another important side of compassion is to allow people to ask questions without thinking we must give answers. I recall as a pastor, journeying with people through their grief, sometimes the grieving person would ask questions like: "Where is God in all of this?" or, "Does God really care about me?" or, perhaps make a statement like: "I feel God is far away...I'm not sure he even knows what I'm going through." I learned that such questions are a part of the grief process...they are expressions of the person's pain. It is good to allow them to express their pain, suffering and loss, without feeling the need to answer those questions at the moment, or fill in some cliche or Scripture verse.

All one needs to say in such a time is perhaps: "I am so sorry for your loss...for what you're going through right now. I want you to know that I am here for you and your family. What could I do right now that would be helpful?"

Henri Nouwen wrote about the healing power of listening:

To enter into solidarity with a suffering person does not mean that we have to talk with that person about our own suffering. Speaking about our own pain is seldom helpful for someone who is in pain. A wounded healer is someone who can listen to a person in pain without having to speak about his or her own wounds. When we have lived through a painful depression, we can listen with great attentiveness and love to a depressed friend without mentioning our experience. Mostly it is better not to direct a suffering person's attention to ourselves. We have to trust that our own bandaged wounds will allow us to listen to others with our whole beings. That is healing.

2) Education - another way to support persons with mental illness is to do what we can to educate ourselves on the particular condition the person is struggling with. Now even as I say this, I realize someone may take this to mean that I should educate myself so that I can tell the person what they should do, or what meds they should take, or some particular treatment option. No, that is not what I'm talking about!

I am talking about becoming informed about the illness, so that I don't have to ask the person a lot of questions, and so that I can avoid perhaps doing or saying things that will increase the person's burden rather than lighten it.

I discovered for myself, after my cousin's wife (and I might say, this cousin and his wife, and my wife and I, were very close, and had become dear friends over the last 10 years) took her life 2 years ago after descending into a profound depression, that I didn't understand depression as I thought I did. That's when I bought the book by William Styron, Darkness Visible (Styron’s memoir of his own journey through clinical depression) and re-read A Grace Disguised, by Jerry Sittser, (an excellent book on grief) because I wanted to know more about what depression actually does to a person.

And once we have exercised compassion toward a person with mental illness, and journeyed with them for a time, then we can ask some questions; gently probing questions that will help the person share what they are feeling, so we can better understand their journey. Questions like:

ñ  Tell me how you are feeling today

ñ  What can I do that would be most helpful today?

ñ  What is your greatest struggle right now?

ñ  Do you mind me asking some questions?

ñ  Can you tell me your deepest fear right now?

Other ways we can educate ourselves might be to attend a seminar on a given mental health issue or condition. Reading is key. There are many good books which will inform us and give us helpful insights into what our family member, friend, etc. is experiencing.

3) Presence - this is a gift to people who are struggling with mental illness. The gift of physically being there, often in quietness, saying little. I think of Job in the Old Testament of the Bible, and all the suffering he experienced...we know about that. And then his 3 friends decided to go and comfort Job.

When Job's 3 friends...heard about all the troubles that had come upon him, they set out from their homes and met together by agreement to go and sympathize with him and comfort him. When they saw him from a distance, they could hardly recognize him; they began to weep aloud, and they tore their robes and sprinkled dust on their heads. Then they sat on the ground with him for 7 days and 7 nights. No one said a word to him, because they saw how great his suffering was.

What a gift to Job! The gift of physical presence. No words! Just being there! Job felt so alone in his distress...but then his friends came. People who suffer from mental illness often feel so alone. Where is everyone? All my friends? Where are they? People often stay away because we don't know what to say. We don't have to say anything! Just being there is so important...so people don't have to be alone.

You see, it was when Job's friends began to speak that their comfort of Job ended. They added more suffering and misery to their friend. "It's your fault, Job! You sinned. Confess your sins to God and you will be delivered." Wow! That only added more pain to Job's already pain-wracked body and mind.

Can we be comfortable with silence? For those of us who are used to talking a lot, silence can be uncomfortable. We think we must say something to fill up the space. But for the person with a clouded, troubled mind, being with someone who is just there, filling up the lonely space, silence can be healing.

We might say to our friend, spouse, or family member: "I'm here with you, for you. I'm comfortable with silence...if you want to speak, I'm here to listen. If you want me to speak, tell me what would be most helpful. This is about what is helpful for you. That's why I'm here."

If appropriate, touch is also helpful. Touch, without words, can be very healing. Holding the person's hand, giving a hug, a hand on the shoulder. Again, whatever is helpful to the person I am with. This is not about me doing what I think is helpful. What is helpful to my friend? My child? My spouse?

For my child, holding them close when they are suffering; for my husband, my wife, holding them when they feel broken and alone...these actions can be very healing and comforting. Let us not deny our loved one the gift of touch when they are feeling alone and vulnerable. Jesus reached out and touched the leper in Matthew 8. Touch communicates love and compassion. It communicates acceptance...that you are not untouchable...but a person.

Written by Tom Horst, MA
Marriage and Family Therapist

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