Mental health, then and now

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Mental health demonstrates a wide bifurcation between Western and other worldviews.

The ancient Greeks, lending their day-to-day language to the writers of the New Testament, had simple terms that undergirded simple ideas. There were such things as ‘unclean spirits.’ People could be bothered by these unclean spirits and could thus be ‘demonized’.

When Jesus came along, he was able to wear this worldview effortlessly. He spoke on occasion to evil spirits within a person; they spoke to him, usually calling out curses; he cast them out; the patient recovered. It’s worth remembering that Jesus also ‘rebuked’ fevers and indeed ‘rebuked’ the wind and the waves. But as regards ‘unclean spirits’ he didn’t feel a need to update the ancient worldview; he operated successfully within it.

Western medicine has, I think, turfed out this worldview entirely, even though plenty of people still hear voices, voices that tell them to do evil things, and even though some people would self-diagnose as ‘demonized.’

Once I was on a conference call with a sick and very damaged person (he had been tortured). The leader of the call asked if anyone was in the room with him. The answer? No-one, he said, except the demon who watched him all the time and never left him.

Essentially, I think (and this is not my subject) quite a few Western-trained mental health workers would think the person self-diagnosing as ‘demonized’ was actually deluded and deceived and essentially, misdiagnosed. (I don’t want to downplay, though, the tenderness and skill with which some people within Western diagnostic traditions will nevertheless work with such a patient.)

There are plenty of fine reasons for this Western stance. Unfortunately (and I am very hestitant here because it really isn’t my subject), Western mental health is still in my view rather primitive. I wonder if it isn’t, in fact, roughly where Western physical medicine was about 300 years ago–dogmatic, authoritative, ineffective, its practice centred around humours, bleeding, and leeches.

How often are the mentally ill cured? I do not know. To what extent is mental illness itself a metaphor– in the sense that we sort-of know what physical illness is and (by way of metaphor), describe other things wrong with humans as ‘mental illness’? Are we medicalising something that isn’t an illness? For example the widely-cited Diagnostic and Statistical Manual of Mental Disorders (DSM-V) has a new entry called ‘Prolonged Grief Disorder’. This in effect medicalizes people who suffer bereavement for longer than might be considered normal. I don’t know enough to critique this properly, but at least on the face of it it seems odd to give a medical label to someone who’s taking a long time to move on. If you can’t pull your socks up in a decent amount of time, DSM-V seems to say, there must be something medically wrong with you and you need a psychiatrist. I am not entirely sure that I am happy with this, nor that it is right to use phrases like ‘mental health epidemic’ when more and more stuff like this is unearthed. ‘Mental health terminology epidemic’ might be equally fair. The wave of sadness and depression that is passing through the country, is, of course, not doubted, just (arguably) not properly diagnosed and even if the diagnosis is right, isn’t being ‘cured’. Or isn’t being cured all that much. People are still suffering and sad, which is the real scandal. People are still plagued with voices and terrors.

This circles back to the bifurcated worldview. It would be fine to disparage and move on from the ancient worldview if the modern worldview wasn’t, in itself, so frequently ineffective and disappointing.

Wouldn’t it?

The powers that be (2)

More about the teaching of Walter Wink, as mentioned last week, in his book The powers that be, which was a later summary of earlier work.

Wink teaches that every institution possesses an ‘outer, physical manifestation’ and ‘an inner spirituality, corporate culture or collective personality’ (p24) and combined they correspond to what the New Testament called ‘powers’, which were a tangible part of life back in New Testament times. Materialism has slanted our impression of them, but perhaps they have not gone away.

For our struggle is not against flesh and blood, but against the rulers, against the authorities, against the powers of this dark world and against the spiritual forces of evil in the heavenly realms (Ephesians 6:12).

For in him all things were created: things in heaven and on earth, visible and invisible, whether thrones or powers or rulers or authorities; all things have been created through him and for him (Colossians 1:12).

For I am convinced that neither death nor life, neither angels nor demons, neither the present nor the future, nor any powers will be able to separate us from the love of God in Christ Jesus (Romans 8:38-39).

Are these ‘powers’ good or bad? It is customary in my part of the church to think of them (or at least the spiritual components) as ‘bad’, spiritual remnants perhaps of an original fall that led to the fall of some spirits into evil; the same worldview as can be found in the Bible and which John Milton used in Paradise Lost. And it is true that Jesus is never recorded as coming across an evil being that he wished to redeem. He apparently wished to expel all of them from his good creation.

In Wink’s view, however, the powers are:

  • Good
  • Fallen
  • Needing redemption.

He argues that:

These three statements must be held together, for each by itself is not only untrue but downright mischievous. We cannot affirm governments or universities or businesses as good unless we recognize at the same time that they are fallen. We cannot face their oppressiveness unless we remember that they are also a part of God’s good creation. And reflection on their creation and fall will seem to legitimate these Powers and blast any hope for change unless we assert, at the same time, that these Powers can and must be redeemed. But focus on their redemption will lead to utopian disillusionment unless we recognize that their transformation takes place within the limits of the fall.

Wink, op. cit., p 32

Whether or not the Powers can be redeemed (or merely expelled), the material, earthly institutions certainly are created, fallen, and can be redeemed. At the moment this is within the limits prescribed by our current fallen world; in the future it will be fully so, as part of New Creation.

This is eye-opening stuff:

  1. Institutions have a spiritual character as well as a material form.
  2. Institutions are good, fallen, and capable of a degree of redemption.
  3. They will be fully redeemed at the so-called eschaton, the full arrival of the New Creation.

How can the Powers be opposed? How can institutions be redeemed, or at least cleaned up a bit, capturing more of their divine vocation?

I have to skip over a large and brilliant part of his analysis here but the central understanding is that violent overthrow won’t do it. All violent overthrow does is replace one system of spirit-fueled domination with another. A revolution is rightly named: it’s just the turning of the same wheel. What do ‘work’ (and again I am oversimplifying) are the things Jesus taught so directly. Turn the other cheek. Hand over all your clothes if someone takes your cloak. Love your enemies. Do good to those who hurt you. Feed and water your enemies. You want to lead? Be a servant. You want to line up with God’s rule? Be a child. Jesus himself entered Jerusalem on a donkey, not a charger. He won the day by going to his death like a lamb to the slaughter.

The aim is not conquest, but relationship: humanizing the oppressor, so that oppressors are themselves liberated from being oppressed by their own oppressive behaviour: ‘today, salvation has come to this house.’ These same acts also restore dignity and agency to the victim.

That’s how we ‘win’. And the winning may not be seen in this life, or certainly only partly seen, but it is putting a foothold in eternity, it is filling up our storerooms in heaven, it is investing in the future.