A practical theology of mental health: A critical conversation between theology, psychology, pastoral care and the voice of the witness
Creators: name: Pierce, Pauline
Publisher: name: Australian Catholic University
Year: 2007

description: What exactly do we mean by mental illness? Is it an organic disease? Or are its causes psychological and requiring therapy or counselling with, at times, medication to alleviate any accompanying organic symptoms? Or could one even consider that, in some instances, it is neither of these and is best described as a 'spiritual dis-ease'? If there is evidence that this is the case, then its causes [and remedies] must be sought elsewhere. In other words, could one argue that there are no substantial grounds for assuming that care of the mentally ill be relegated exclusively to the expertise of the secular sciences? This is the question that drives this dissertation. This dissertation named 'A Practical Theology of Mental Health: a critical conversation between psychology, theology, pastoral care and the voice of the witness' addresses this question that has lurked without answer in the shadows of the human mind for as long as there has been mental illness. Beyond the primary question there are subsequent questions. Can it afflict anyone, or is it specific to some people for some, as yet unknown, reason? Is it possible to fully recover from this illness, whatever its cause, or does the sufferer remain ever after mentally, emotionally and/or spiritually fragile? This thesis will argue that in the absence of evidentiary knowledge it seems reasonable to assume that the primary and subsequent questions can be answered by the voice of the witness, the one who has experienced the phenomenon of mental illness and recovered from it ... if indeed that is possible. The author of this dissertation claims to be such a voice. In 1965 I was first treated with medication for anxiety neurosis. By 1970 I was diagnosed with manic depression, now called bi-polar disorder. Certainly I suffered from delusions, illusions and hallucinations. In 1972 I was admitted to a psychiatric hospital where I remained for several weeks.;After years of professional treatment that included psychotherapy, drug therapy, group therapy and electro-convulsive therapy, I encountered a self and mutual help organisation (1974) where other sufferers of mental illness claimed to have discovered a path to recovery, a path that rejected the medical model of treatment. In this setting I began my journey of recovery. By 1976 I had ceased all professional treatment, including medication. My last clinical link with the medical model was broken. However, I continued for more than 15 years to be involved in the mental health arena, saturating my mind with psychological interpretations and the findings of psychiatric research, as well as attending GROW groups in a leadership capacity, before starting my own 'Faithrough' groups. Several attempts to share my experience with professional mental health carers fell on deaf ears. For example, in 1987 a complimentary copy of Ordinary Insanity, my autobiography of recovery from mental illness, was sent to every psychiatrist listed in the Yellow Pages of the Sydney Telephone Directory. An invitation to dialogue with me was extended, along with my contact details. The silence was deafening. Several attempts to absent myself from the mental health arena also proved futile. My entry into formal theological education (1993) was one such attempt, but it seemed God had other ideas! In this attempt I was surprised by two things which now appear to be related. First, my experience of both mental illness and recovery from it had reference frames in theology which allowed the experience to be articulated. This is distinct from psychology which talks about 'a condition' from the outside. It does not speak to the experience from the inside. Part of the surprise was that in more than 20 years of searching and re-searching I remained utterly ignorant of any theological connection.;The second surprise came some years into my education when I began to recognise contradictions between theological and psychological paradigms of the 'human person'. There was contradiction here that it seemed to me had remained unaddressed from the time Freud laid the blame for neuroses at the feet of God, or more precisely at belief in God. If theology ever mounted a challenge to this Freudian assertion, that challenge went largely unnoticed. Perhaps, from this, society is left with the impression that theological perceptions of the 'human person' are 'less real', and therefore subservient to, those of the human sciences. The absence of a spiritual dimension is today being addressed, indeed formally recognised in institutions such as Heythrop College. However theological and psychological contradictions on what it means to be human, if recognised, remain largely unaddressed. Those involved in mental health care from a theological perspective are essentially those in a ministry of pastoral care. While they bring a very human dimension of compassionate caring to the mentally ill, they are obliged to work within the framework of the theoria established by the human sciences. Theology seems to accept its subservience to the human sciences in the field of mental health care. We will meet this acceptance in the words of Edward Schillebeeckx in the next chapter. One glaring distinction between the human sciences and theology is the voice of the witness. The task of science, including the human sciences, is to discover/establish fact. To this end they rely on weight of numbers - part of their quantitative methodology. On the other hand, theology is led forward by the voice of the witness. More often than not this is a lone voice. The ancient prophets of Israel are such voices. John the Baptist is such a voice. Jesus of Nazareth is such a voice. In our own time I believe Martin Luther King and Mother Teresa of Calcutta are such voices.;These are examples of the power of the witness to speak and influence public perception of reality. Today witnesses speak and are heard in almost every arena involving issues of morality and social justice. Feminist theology, liberation theology and environmental theology all have their prophetic voices. But who speaks for the mentally ill? The voice of the witness in this arena is given little credibility. Yet that voice belongs to a human person, one who is as much a child of God and a member of the human family as every other voice. What other voice will speak for the 17 million children worldwide who consume prescribed mind-altering drugs that can cause them to become violent and suicidal? It is scientifically established that it is the drugs, not the initial behavioural problems that cause the violent and suicidal behaviour. What might theological investigation have to say about the 'necessity' of treating the brain with chemicals that have such detrimental effects? Violent behaviour aside, psychiatrists have long been aware that their prescribed medications cause Parkinsonian and encephalitis lethargica symptoms in adults.7 What might be revealed if theology investigates research into psychiatric medication, focusing on just two relevant issues: a) by what criteria is such medication deemed suitable for human consumption, and b) by what criteria is it deemed beneficial to human mental health? Given that humans are the only known creatures gifted with reflective thought, mental health is not an area of research where the results of tests upon animals can be considered relevant and trustworthy.;Surely theology does not acquiesce with the unspoken prejudice against the mentally ill - that there is a two-tiered humanity: those capable of taking responsibility for themselves and their lives, and those who are incapable - those who are victims of genetic and/or environmental heredity? The majority of witnesses in the mental health arena do not speak of what is needed to improve their lot. They do not know. What they do say with a resounding weight of numbers is: 'You do not hear me. You are not listening to me. You do not understand me'. Surely even the human sciences can hear that much! If the 'Burdekin Report' is to be believed, the mentally ill feel that what they have to say is given little, if any credibility. I believe the deafness of society to the voice of this. There is a wealth of reports and statistics on mental health issues - world wide - through the World Health Organisation (WHO) available from available from http://www.who.int/topics/mental_health/en/ Internet; accessed 12 May 2006.Robert Whitaker, Mad in America: Bad Science, Bad Medicine, and the Enduring Mistreatment of the Mentally Ill (U.S.A.: Perseus Publishing, 2002), 203.By 1993 more than 40 inquiries into mental health services had been conducted in New South Wales alone. During the press conference at which 'The Burdekin Report' (popular name) was released, Brian Burdekin commented that one of the most alarming things he found was that in all the independent inquiries into mental health services across Australia, not one viewed the professional in a kindly light. The Human Rights and Equal Opportunities Commission, Human Rights and Mental Illness, (Canberra: Australian Government Publishing Service, 1993) suffering renders mentally ill people among the most vulnerable group in our society today. This dissertation seeks to address social ignorance of, and perhaps indifference to, the plight of the mentally ill.;It seeks to give the mentally ill a voice, a place to speak its experience and be heard. This is not an easy task. There is no abundance of witnesses who have experienced mental illness, recovered and documented their experience. Such voices are rare. They should not be discounted on that account. Indeed, if there was only one witness to have recovered from mental illness, is it not in the tradition of theology to listen to the testimony of that witness? Perhaps a greater appreciation of this is something that theology can offer psychology. Very recently a book has come to light, intended for publication in the latter half of 2007. Back From the Brink is a collection of interviews with those who have suffered a variety of mental and emotional anguish from depression to the contemplation of suicide. The author, Graeme Cowan, is not a mental health professional but rather himself a witness. The book appears to have one objective: to give a voice to the witness, and in so doing give hope to those who suffer affliction(s) so badly misunderstood. I can only lament its late arrival in the public arena, but rejoice that the concept of listening to the voice of the witness is perhaps an idea whose time has at long last come. This dissertation seeks to answer the questions the human sciences have been unable to answer in terms of recovering mental health when one has been afflicted by mental illness. The answers are presented as they were discovered, in living experience, where the differences, even contradictions, between psychological and theological perceptions of what it means to be a human person are encountered. These contradictions are acknowledged, addressed, resolved where possible, or invited into ongoing theological/ psychological dialogue. What is sought is understanding: understanding that can lead us into transformative praxis, making this dissertation very much a practical theology.;While reading this dissertation I would ask the reader to bear two things constantly in mind. The first is their own personal fear of mental illness and mentally ill people. Experience suggests that very few people who have not experienced mental illness are free from this fear. However great or small that fear might be it has some Graeme Cowan, Back From the Brink - is expected to be published about June, 2007.See appendix C. influence on personal perceptions of mental illness and mentally ill people. The second is that the author of this dissertation comes from the group of people so feared. No genuine human endeavour is achieved by a lone individual, and that is especially true in the case of this dissertation. My most sincere and heartfelt thanks go to the many 'witnesses' who, over a period of 35 years gifted me with the privilege of sharing part of their life's journey, even as I shared mine with them. They have been a continuing inspiration and motivation in my life as well as in my studies. Thanks is due also to the GROW organisation which was instrumental in my recovery from mental illness, as well as assisting with research undertaken for this dissertation. Special thanks is due to Rev. Dr Michael Whelan SM who guided me gently into formal theological education recognising when I did not, the relevance of theology to mental health care. If credit is due anyone for recognition of theological reflection in the experience of mental illness, it is due to Dr Whelan. His guidance, challenge and affirmation have not ceased for more than eighteen years. Thanks to his guidance I came to know many lecturers at the Catholic Theological Union at Hunters Hill, all of whom contributed in some measure to this dissertation .I am especially grateful to one of those lecturers, Rev. Dr Gerard Hall SM, who I encountered in my very first year as an undergraduate.;His ability to challenge my thinking, inspire my writing, and encourage me as he has done throughout cannot be overstated. Dr Hall has been a most positive influence in my formal theological education from the very beginning. I was also fortunate in having Rev. Dr Tom Ryan SM as co-supervisor for this dissertation. Dr Ryan's intellectual rigor proved itself invaluable. There are others whose assistance is gratefully acknowledge: the Catholic Institute of Sydney; the Sydney College of Divinity; staff at Veech library and the library of the Broken Bay Institute; friends who dialogued for endless hours helping me to clarify my thoughts, especially Fr. Michael Kelly OSB, Fr Michael O'Toole, Peter and Nada Herro, John and Marie Lizzio, Sue Christian and Troy Fisher, all of them giving invaluable assistance. Last, and paradoxically first, I thank my five children who suffered with me and for me during the difficult years, and then became friends and supporters in these latter years. Their encouragement and support has never wavered.