Finding Jesus in the Storm. John Swinton
in their mental health experiences. This entry into their interior worlds quickly taught me that their assumed strangeness is not quite as strange as it first appears. People are just people, even in the midst of difficulties.
Much has been written on the relationship between spirituality and mental health.6 Much of it assumes that spirituality is a broad and universal concept comprising a personal search for meaning, purpose, hope, value, and, for some people, God.7 Yet my interviews for this book yielded a quite different understanding of spirituality—that it is not a general search for meaning but something quite specific. The interviewees perceived themselves as disciples of Jesus who were desperately trying to cling to him in the midst of complex and difficult circumstances. Their question was not simply: “Where can I find meaning in the midst of my brokenness?” but much more specifically, “Where and how can I find Jesus and hold on to God in the midst of this experience?” The question is simple; the answer is much more complex.
Some of the people who share their experiences in the following pages find the language of mental illness beneficial and therapeutic and helpful for understanding and future development. Others do not. I believe people should be allowed to name their experiences in the way that is most helpful and pertinent for them. Readers will note that I don’t use the term “mental illness” in this book. This is not because I am in any sense antipsychiatry or don’t believe that people’s suffering is real.8 I know people’s experiences are very real. Yet describing mental health experiences in terms of illness is only one way of naming and responding to such experience, and not necessarily the best way.
I use the term “mental health challenges” for two reasons. First, it focuses our attention on what enables us to remain healthy in the midst of psychological distress. While mental health challenges can cause great suffering and distress, it is possible to find hope and faith in the midst of the wildest storms. Second, the shift from illness to challenge offers a positive and forward-facing orientation. Whereas illness reminds us of what is wrong with us and narrows our range of options, challenge sees the situation as potentially constructive and leaves the door open for a variety of perspectives, interpretations, and descriptions. How to enable people to take up those challenges and learn to live life fully is a primary task of what is to come.
1. Unless otherwise indicated, all biblical quotations come from the New International Version (2011).
2. For a very helpful overview of Luther’s theology of the cross, see Gerhard Forde, On Being a Theologian of the Cross (Grand Rapids: Eerdmans, 1997).
3. Rev. 21:4: “ ‘He will wipe every tear from their eyes. There will be no more death’ or mourning or crying or pain, for the old order of things has passed away.” Ps. 23:2: “He makes me lie down in green pastures, / he leads me beside quiet waters.”
4. Richard Arrandale, “Madness, Language and Theology,” Theology 102 (May 1, 1999): 195–202.
5. Arrandale, “Madness, Language and Theology,” 197.
6. H. G. Koenig, M. E. McCullough, and D. B. Larson, eds., Handbook of Religion and Health (New York: Oxford University Press, 2001).
7. For a critique of this approach to spirituality, see John Swinton and Stephen Pattison, “Moving beyond Clarity: Towards a Thin, Vague, and Useful Understanding of Spirituality in Nursing Care,” Nursing Philosophy 11 (2010): 226–37.
8. The term “antipsychiatry” refers to a movement that adopts the view that psychiatry and psychiatric treatments are more damaging than they are helpful. This movement considers psychiatry to be a coercive instrument of oppression based on unequal power relationships that lead to patients being treated for things the antipsychiatrists assume are problems of living rather than illnesses or diseases. Although I will critique psychiatry and also be quite critical of the idea of mental illness, I value psychiatry and consider it to have a legitimate and significant role in caring for people living with mental health challenges. Readers wishing to read more about antipsychiatry should see T. Szasz, “The Myth of Mental Illness,” American Psychologist 15 (1960): 113–18; D. G. Cooper, Psychiatry and Antipsychiatry (London: Tavistock, 1967); P. Rabinow, ed., “Psychiatric Power,” in Ethics, Subjectivity, and Truth, by M. Foucault (New York: New Press, 1997); and Peter Breggin, Toxic Psychiatry (New York: St. Martin’s, 1991).
REDESCRIBING THE WORLD OF “MENTAL ILLNESS”
Description, Explanation, and the Problem with the DSM
I deliberately use the phrase “living under the description of manic depression (or bipolar disorder)” to refer to people who have received this medical diagnosis. The phrase is meant to reflect the social fact that they have been given a diagnosis. At the same time, it calls attention to another social fact: the diagnosis is only one description of a person among many.
—Emily Martin1
THE FIELD OF MENTAL HEALTH IS HIGHLY CONTESTED. PEOPLE HAVE DESCRIBED, categorized, and responded to unconventional mental health experiences in a multitude of ways and have elicited a wide range of responses. At any given historical or cultural moment, particular descriptions of the experience and explanations for its occurrence—that it is caused by demons, the subconscious, chemical imbalances, genetics, neurology—become elevated to the status of the “standard account.” This account is assumed to provide the interpretative framework used by a majority of people to explain unconventional thoughts, experiences, and actions. Each generation thinks that its descriptions should be the “standard accounts,” and each generation assumes that its descriptions are more accurate than previous descriptions. The current emphasis within Western cultures on describing mental health challenges in biological terms is relatively new but nonetheless powerful. Genes, neurology, and chemical imbalances all can easily serve as conversation-closing explanations for mental health challenges. Yet, while biology is an important factor, it is not the only one. Running alongside this account are other important ways of describing such challenges, even if people do not necessarily give them the same social or scientific weight as the standard account. People still believe in demons, psychoanalysis, behaviorism, and many other descriptions. This book gives voice to some of these other forms of describing and understanding what is going on in people’s lives.
But first, we must ask: What does it mean to describe something?
THE PRACTICE OF DESCRIPTION
In the epigraph to this chapter, the anthropologist Emily Martin refers to people living with bipolar disorder as living under a description, meaning that the diagnostic description “bipolar disorder” is only one way to describe an individual.