For the world offers only a craving for physical pleasure, a craving for everything we see, and pride in our achievements and possessions. These are not from the Father, but are from this world                        I John 2:16 (New Living)

The term “mental illness” is very broad. It encompasses common problems such as anxiety and depression that everyone, to some degree, faces. Everyone, at one time or another, can identify times when anxiety or depression caused them some problems. Those conditions are on a continuum, and some people suffer a great deal, some just a little.

The term “mental illness” also includes more significant problems such as psychotic conditions where a person loses touch with reality to a greater or lesser degree. These were the conditions I discussed earlier. The patients at the state hospital where I worked were often psychotic. In some cases, patients had neurological conditions that went undiagnosed. Other patients may have had some long-term residual effects of brain damage and they simply could not function anywhere else.

Finally, there is a category of mental illness conditions called Personality Disorders. The American Psychiatric Association (APA), describes those disorders as “a way of thinking, feeling and behaving that deviates from the expectations of the culture, causes distress or problems functioning, and lasts over time”. Such conditions are not psychotic disorders, but they are difficult to treat. This is especially true since many people with personality disorders do not seek treatment, believing that the problem they have is not an internal one, “but it’s all those people around me!”

All this is to say that blaming much of the violence we experience, especially mass shootings, on mental illness is much too simplistic an explanation, given the broad range of diagnoses that “mental illness” encompasses.

Many years ago, I was setting up some supervised community homes for persons recovering from mental illness. Needless to say, we experienced fierce community opposition from people who did not want “mentally ill people in my neighborhood”. I understood their concerns, their fears.

Our arguments to that included the fact that, statistically, mentally ill people were more likely to be victims of violence than to be perpetrators of it. Further, those neighbors were not aware, and we of course could not tell them, that there were already people in their neighborhood who had been released from a mental institution. Those people had already assimilated into the neighborhood.

Mental illness indeed plays a part in some of the mass shootings that happen. However, having dealt with many people over the years who are mentally ill, I suggest that they pose less of a threat, generally, than a person who is simply angry, feels entitled, and has a victim mentality which they believe can only be satisfied by the suffering of others. Those are often people that have long felt powerless, and now, with a weapon, feel powerful somehow.

Is that evil? Is that a personality disorder? Is that mental illness? I don’t know. I tend to wonder sometimes if people with a true mental illness might at times just be more sensitive to an environment that is toxic. Maybe they are the “canaries in the mineshaft” reacting to a culture that is broken and prone to violence for solutions. Please understand, this is not absolution for the murderous actions of killers.

I have no idea, of course, about the actual mental conditions of mass murderers. However, retrospectively, we try to make a case that a mental illness was the cause of their murderous and evil actions.

Maybe we should also look at the culture of violence that we live in that fuels the flawed thinking of the perpetrators. Maybe culturally we have elevated violent solutions to be some bizarre answer to a perceived sense of powerlessness. I do not know the answers here, but I do know that we need to look at this from a cultural, not simply a “mental health” perspective. There are no easy answers, but we must continue to have reasoned and healthy discussions about a tragedy that continues.

That is the healthy thing to do.

Prayer: Lord, we have departed in pride from your plans. Give us wisdom to proceed, Amen

Asylum: a place of retreat and security: SHELTER

 the protection or security afforded by an asylum: REFUGE

Merriam-Webster

Whoever dwells in the shelter of the Most High will rest in the shadow of the Almighty.                                             Psalm 91:1

“Come to me, all you who are weary and burdened, and I will give you rest.                                                    Matthew 11:28

The movement to “deinstitutionalize” persons with mental illness was well meaning, and fueled by a few reasonable concepts. One, of course, was money. It was expensive to keep people in a residential setting. The “treatment” in the hospital consisted of medication, meeting the needs of everyday life, benevolent treatment by staff (for the most part), and safety from a world which some of those patients simply could not understand. Indeed, the early concept of mental hospitals, (now highly discredited) was “asylum”. Yet asylum was exactly what some of my long-term patients needed. They were too vulnerable to be sent out into a world that they badly misperceived.

Another reason for “deinstitutionalization” was humanitarian. With the advent of more effective medications to control the florid symptoms of psychosis, patients could, if medication compliant, navigate the needs of everyday life- housing, taking care of personal needs, socialization, even employment. In theory, the “dollars were to follow the patients” into the community to help them become stable and productive persons with dignity and purpose.

No, the dollars did not follow the patients into the community.

However, I followed the patients into the community, and I went to work in the new field of “Community Mental Health”.  I loved the idea of helping to set up support systems for people newly discharged from the hospital. My colleagues and I were starry-eyed optimists, trusting that we could change the world in mental health.  As I found out, we could change the world for some individual people, but we could not change the world.  

Indeed, there were some great success stories of people who formerly had lived for years in an institution, and then went on to succeed in making a good life outside of the hospital. However, there were many who simply could not make the transition. The sobering truth that many of us came to realize was that as the institutional mental health system was shrinking, the correctional system was growing. Many of those patients sent back to the community ended up homeless or imprisoned.

Medications improved, and housing programs that we developed specifically for those with a mental illness helped. Indeed, at one point, community mental health systems were being held financially responsible to keep people out of the hospital. Boy, did we work hard to keep people out of the hospital!

However, the human equation is always the hard one when it comes to money and politics. The homeless problem was largely created by an influx of people coming into the community who suffered from mental illness and who had no access to the “asylum” of a hospital.

Tomorrow I will discuss some societal responses to mental illness.

Stay tuned…

Prayer: Lord, give us the wisdom and strength to see people as you see them, Amen

Part I

In the next several days, I want to discuss the now “hot topic” of mental illness, especially as it relates to numerous cases of mass shootings. Guns and mental illness are significant topics now bandied about in the political world. While I do no know very much about guns, other than that there are more guns than people in the United States, I do know about mental illness. Therefore, I will talk about what I know…

Since the scourge of COVID-19 began in 2020, more attention has been paid to the effects of mental illness in our society. COVID has been blamed, with some accuracy, with ratcheting up stress, anxiety, and depression rates. Further, the recent spate of mass shootings, inordinately an American phenomenon, has drawn more attention to the state of our collective mental health. I have worked in the field of mental health since 1973, and I have some observations about the provision of mental health services in this country in the past 50 years.

Some History…

When I started work at the Dayton Mental Health Center in 1973, I was a social worker on three wards of patients from a three-county area- Darke, Miami, and Shelby counties in southwest Ohio. We had approximately 90 patients on those wards on any given day. Many of these patients were highly institutionalized, meaning that they had been in the relative sanctuary of a state mental hospital for years. In some cases, it had been decades. These were people diagnosed with a significant and profound mental illness which required hospitalization.

The treatment in those days consisted of rather harsh first-generation anti-psychotic medications which were generally effective in subduing the most devastating symptoms the patients faced. The trade-off, if that is the right word, was often equally devastating side effects, such as extreme lethargy, involuntary muscle movements, facial tics, and a gait impairment commonly known as the “Thorazine Shuffle”. Thorazine, of course, was one of those first-generation medications used to treat psychosis. As one of my patients told me, “For you all these are ‘side-effects’, but for me they are primary effects!”

Nonetheless, such medications reduced some florid symptoms such as visual and auditory hallucinations, aggressive behaviors, deeply paranoid thinking, and serious agitation which caused immense disturbance to those suffering from uncontrolled thoughts.

Further, these medications spared some patients the practice of a frontal lobotomy. Yes, that procedure did happen, and some of my patients were survivors of such treatment. The hope and belief of the time was that releasing patients back into society with proper medication and community supports would allow them to function in the world despite a serious mental illness.

Sometimes, it worked.

As medications became better, with fewer side-effects, more patients were able to be released into a community that often was not accepting of them. Part of my job was to make sure that those services (and medications) followed those patients into the community.

In coming days, I will expand on the history, the successes and failures of mental health treatment in the United States.

Over the next few days, I want to address the current national discussion about the tragic mass shootings we have endured. The concept that guns and/or mental illness are a part of the equation is valid. As a mental health practitioner since 1973, I have a historical perspective on the mental illness side of the equation.

Keep in mind that while my focus has always been on the spiritual side of issues of mental health, these next few days may not look quite the same. God is always interested in human affairs, and this is no different. I will try to pull that all together as we move ahead. Please stay with me on this journey as we look into how mental health issues fit into the violence equation,

Blessings,

“Do not be anxious about anything, but in every situation, by prayer and petition, with thanksgiving, present your requests to God.”                                                       Philippians 4:6

Most of us remember the 1988 song by Bobby McFerrin, Don’t Worry, Be Happy. It was a fun upbeat, engaging little song that actually reached the top of the popular music charts. It has become a meme in the popular culture since then.

Paul tells us in Philippians 4:6 to be “anxious for nothing…”, and we respond with “yeah, like that’s even possible…”  What does Paul mean when he tells us not to be anxious? Anxiety is a real thing, part of the human condition. I tell my clients that anxiety is our travelling partner- an unwanted partner- but a partner to be sure. Everyone has some anxiety, some more than others, but all of us have some anxiety. Indeed, telling a person with anxiety to “just don’t worry about it” is not helpful. If it were that easy, no one would have anxiety!

So, what is Paul saying when he instructs us to “Do not be anxious about anything, but in every situation, by prayer and petition, with thanksgiving, present your requests to God.”?

First of all, because he brings it up, Paul knows that worry and anxiety are a natural part of life. Paul is not chastising those who worry or have anxiety, he is trying to set forth a remedy. He is reminding us that prayer, a conversation with a God who cares about us, is a useful and immediate “tool in the tool box” for anxiety.

Having others who care about us on our “team” is also a critical tool in dealing with anxiety. Becoming aware of our anxious state, naming it, and expressing it to ourselves and others, is a crucial tool in taking control of anxiety.

So, a great first step, as Paul says, is to bring every situation that worries us to God, thereby making him as well as ourselves aware of it in the moment. By seizing this control of anxiety awareness in the moment, we have already begun the process of anxiety control.   

Prayer: Lord, you have given us tools for comfort and relief of anxiety. Help us to become more aware o your presence in our time of need, Amen

Immediately the boy’s father exclaimed, “I do believe; help me overcome my unbelief!

Mark 9:24

Sometimes we make definitive statements which are too black and white. Sometimes, in order to try to understand the world, we break things into “either/or” categories. That often is too simplistic. Life is nuanced, and there are simply areas of life that cannot be broken into such clear categories.

An example I see is in the area of “certainty”. I recently wrote a blog on “Certainty” which many of you seemed to enjoy. (Thank you…) Living in a certain amount of ambiguity is uncomfortable. We want an answer. In our faith journey, we often want a simple yes or no, some black or white answer. Yet, I think there are plenty of things which do not lend themselves to easy answers.

Having faith does not mean that we have no doubts. I would argue, that without doubt, there is no need for faith. If everything is simply a matter of blind faith, we leave no room for the discomfort of doubt. I believe that our faith can stand the scrutiny of sincere questioning.

In an earlier post, I made this statement relative to prayer: “We all have doubt, I take that as a given. However, it confirms our faith each time we pray. It affirms our faith, however shaky it may be. Faith, even as small as the mustard seed, is shown when we open our mouth to utter His name.”

The principle here is that we act on faith, even if we are not fully on board. No faith is perfect, but whatever faith we do have must be exercised to become real. It is a counseling principle that we “Do, then feel”- meaning, if we do good and right behaviors, we will begin to feel better. We cannot wait to feel better to start acting better.

So, you have doubt, I have doubt. Let’s not let that get in the way of exercising that small faith that we do have. “I believe, help my unbelief”

Prayer: Thank you Father for giving us the mind to have doubt. Thank you for the grace to give us such space. Thank you for the gift of faith and the room for doubt. Amen

Starting tomorrow, June 1, 2022, my blog, www.reflectionsofacounselor.com will resume daily posting. You have been so kind to follow this blog, which had been posted daily from April 1, 2020, through March 31, 2022. In April and May of this year I had published just once or twice per week. Many had asked about when daily posts would resume, and daily posts resume tomorrow.

In the past two months, I have been finalizing the publishing of the novel, Joseph Shepherd. I am happy to announce that Westbow Press has recently released Joseph Shepherd in its Christian historical fiction category.

I know that some of you followed the serialized version of the book last year. I have made some minor changes in the book, especially in light of the sequel, which will be released in late 2022. So, if you want the complete book, please check it out on Amazon.com, or go to the new website dedicated to the book, www.reflectionsofshepherd.com

As always, thank you for your support. I hope you will check out and enjoy the novel, Joseph Shepherd,

Blessings,

John

Greater love has no one than this: to lay down one’s life for one’s friends.                   John 15:13

Many years ago- 1968 in fact- there was a popular bumper sticker that read “America, Love It or Leave It!” This was at the height of the increasingly unpopular Vietnam War. Back in those days, President Johnson liked to call it a “conflict”, since war had never been declared.

The country was highly divided on that and many other issues. In fact, such divisions also exist today, of course. I was struck by that 1968 concept that one would possibly need to make a choice of leaving their country just because they disagreed with flawed policies.

Our country has been plagued with flawed policies ever since its inception. Our laws and attitudes about slavery, our treatment of Native Americans, our arbitrary and racist immigration laws (just check out the Chinese Exclusion Act), 19^th century child labor standards- the list goes on and on- attest to our failures in so many areas.

But the point of this blog is not to simply point out America’s flaws on this Memorial Day weekend. In fact, the point is that many died to protect my right to say those very things. When we love something, we get honest, and we speak the truth about it to make it better. Indeed, I love my country, flawed as it is. I am also grateful that I can express that love in a truthful way so that change can happen.

If I were to write this in Vladimir Putin’s Russia, I could expect a call from the local thugs he employs to shut me down- or worse. However, if we love America, we should rally to her defense by being completely honest. We speak the truth in love. We are allowed to do that here. Praise God!

Our America needs help. We are becoming a self-absorbed, entitled culture. We have many who fail to act responsibly or to take personal responsibility when things do not work out their way. Their response is to lash out at perceived threats to their worldview. They lash out in murderous ways, at times, against the most innocent among us. Wouldn’t it be refreshing and healthy if each of us looked to ourselves to see our own faults first, then took action to improve our own thoughts and attitudes before blaming others for our problems?  

I worry about our “blame culture” which looks for the cause of our own problems outside of ourselves. Collectively, we can see that America is far from perfect. But this weekend, we celebrate the best our country has to offer- those who gave their lives for our freedom, so that we can look at our country in all its glory and its pain.

Prayer: Thank you Lord for the sacrifice of so many who gave their lives for our freedom, Amen

And now, brothers, as I close this letter, let me say this one more thing: Fix your thoughts on what is true and good and right. Think about things that are pure and lovely, and dwell on the fine, good things in others. Think about all you can praise God for and be glad about.                                             Philippians 4:8 (Living Bible)

I was talking recently with a client about our tendency to look for the flaws in a situation rather than first looking for the positives in it. It becomes a habit for us to look for what is wrong in a situation versus what is right in a situation. My client stated that the first thing her husband notices when he gets home is the things she might have missed, or failed to do during the day. Their first interaction upon his arrival home is tainted with a negative flavor. This colors the rest of the evening.

When a Broadway critic reviews a play, they often look first for flaws in acting, writing, musical score, etc. Perhaps they feel that it makes them look smarter to find mistakes, errors and problems rather than to first appreciate the positives of the performance.

In social media, people often look first for mistakes in facts, or judgment problems in the content of the posts. Again, to disagree and point out flaws seems to make the critic look smart or savvy- or maybe they just want to make a statement and stand out from the crowd.

I think we should view statements with an eye toward facts, and we should give honest feedback. Yet, in relationships, we know that finding the positive aspects of our partner or friend, and lifting that up, goes a long way in making strong bonds.   

Whenever possible, as Paul says, “Whatever things are good… think on those things”

Prayer: Lord, give us the insight and discipline to first look for what we can praise before we look to criticize, Amen

After this manner therefore pray ye, Our father which art in heaven, hallowed be thy name.  Thy kingdom come. Thy will be done even in earth as it is in heaven.  Give us this day our daily bread.  And forgive us our debts, as we also forgive our debtors.  And lead us not into temptation, but deliver us from evil: for thine is the kingdom, and the power, and the glory forever. Amen                            Matthew 6:9-13

I used the very old translation of this venerable prayer, because there is a poetry to it in this form. We memorized the prayer as children, and it was typically in old verse like this. There is some comfort in reciting the Lord’s Prayer in the old style, but we need to remember that there is no magic in the words. It gives us comfort to recite, but what do the words really mean?

As I was thinking about this, I saw that this was the model for how we should pray every day. Each morning back in the day that Jesus taught this prayer, people had to find and make their bread for the day. They would go to the community oven to bake bread, or they would daily lay a flat matza (or matzah) on a hot stone to bake it. Bread was a daily staple, but there were no preservatives (not much shelf life), and daily bread was just the way of life.

Just like the bread needed to be daily, so did forgiveness, fleeing from temptation, and deliverance from evil.

 Daily disciplines strengthen us. I have found that I take comfort in the predictability of my daily disciplines, especially as we are living in a world that is so far from predictable every day. So, take control of your daily disciplines- prayer, reading, exercise- whatever things you do daily to make sense of the world in order to keep your body and mind healthy.

We still need Daily Bread.

Prayer: Our father which art in heaven, hallowed be thy name.  Thy kingdom come. Thy will be done even in earth as it is in heaven.  Give us this day our daily bread.  And forgive us our debts, as we also forgive our debtors.  And lead us not into temptation, but deliver us from evil: for thine is the kingdom, and the power, and the glory forever. Amen