I’ll love you forever, I’ll like you for always, as long as I’m living, my baby you’ll be…

From the children’s book, Love You Forever by Robert Munsch

 The Lord appeared to us in the past, saying: “I have loved you with an everlasting love;
    I have drawn you with unfailing kindness.                                                                  Jeremiah 31:3

I was speaking with a client the other day, and she was relating the pain she felt about the rejection of her adult daughters. The client had been alienated from them for various reasons, and she was unsure how to begin the reconnection process. One of the daughters was in an alternative lifestyle, and the daughter perhaps assumed that her mother would disapprove. Damage had been done on both sides over the years.

I suggested to the client a very simple approach. “Reassure your daughters that you will always love them, no matter what.” Now this is not a very novel, nor even creative approach, but I believe it is the one with the most impact. I asked the client if that statement were true. She said, yes, that statement is true.  

The fact is, when we love others, we need to assume that we will love them forever. That does not mean that they will not hurt or disappoint us, but it does mean that, no matter what, I will always love you.

Isn’t that what God says to us? Isn’t his love unconditional? No, we are not able to love as perfectly as God does, but we can decide that the love we have for our partners, our children, our family, our friends will always be there.

Letting those close to us know that we will love them forever is a very powerful statement, indeed, a gift.

I say, give that gift often.

Prayer: Lord, you have given us the marvelous capacity to love one another. Thank you..

As I wrote in previous parts of this series, my early mental health career was spent in the treatment of severely mentally ill clients. Those clients mostly carried diagnoses such as a psychotic disorder, a major mood disorder, possibly some brain damage from physical or medical trauma, some with severe emotional trauma and PTSD (before we called it PTSD). Others were diagnosed with neurological diseases, and some with profound developmental disorders.  

Later in my career, after being in public metal health administration for a number of years, I came back into a general practice of treating other mental health issues. In my practice at New Creation Counseling Center, we saw much more things like marital and relationship problems; adjustment disorders (that is, reactions to stresses, grief, etc.); anxiety; depressive disorders; substance abuse and addictive disorders; PTSD and early trauma. We also treated a host of other issues like personality disorders, reactive stress disorders, and mood disorders due to general medical condition.

In other words, there are a myriad of mental health diagnoses that we humans can be beset with. Daily living, our relationships, health problems, etc. all can and do cause us to have a mental and emotional reaction which needs attention. I have stressed over the blogs that I have written that treatment for all humans needs to encompass physical, spiritual, and emotional health. All systems affect one another, and all need care and attention.

I say all this to first normalize the fact that everyone can benefit from counseling and mental health support. This includes support groups of numerous types, and it includes 12 step groups, which are excellent means of support for anyone going through problems, whether addictions or not.

I came to see that mental health interventions are important for all people, not just those suffering from the major mental illnesses. Indeed, when one is suffering, it is a major problem for them, and the diagnostic label becomes less important. Yes, diagnosis is valuable because proper treatment demands a correct diagnosis, and often referral for specialist care. However, people are more than a diagnosis!

The good news I have seen over the years has been the dramatic decrease of stigma attached to seeking mental health treatment. I have grown in my own understanding of the role of mental health as part of our total health needs. I am blessed to have been in this career, and I am still learning! I trust that this little series has been just a bit of help in seeing the evolution of mental health care.

Blessings, dear readers!

There has been robust discussion in the past several years about the role mental illness plays in the increasing number of mass shootings American society has experienced. Theories abound as to why there is more violence, and particularly gun violence in America. There are no easy answers, of course, and one of the factors often discussed includes the proliferation of guns in American society- particularly military type weapons which are automatic or semi-automatic weapons.

There is also discussion of the extremity of political division and lack of tolerance of divergent viewpoints. Extremists are often led by fear of the unknown, or belief that they will lose power, status or prestige to another group. There have been many racially motivated shootings, powered by racial animus, and social alienation.

Finally, there is the discussion of the role of mental illness. Here is where I would like to weigh in. Gun violence, of course, is fueled by more than one motivator. It is complex, and I would suggest that evil is at play. Yes, there is evil out there.

In Biblical times, and up until even into the 20^th century, some people would conflate evil, or demon possession, with mental illness. While evil exists, and mental illness exists, they are not one and the same. When someone decides to murder numbers of people indiscriminately, I suggest that evil is more likely the culprit than mental illness. Again, this is not to suggest that the two are mutually exclusive to one another. However, it is simply too easy to write off violent behavior to the effects of mental illness.

Mental illness in human beings has been around since the beginning of time. There was minimal treatment for mental illness until the 20^th century, yet America was not beset with mass murders many decades ago like we see in our current American society.

What has changed? More anger and division in society; the breakdown of family structure; more availability of all types of weapons; the process of change in society, including media and technology, which feels threatening to some; and fear of the outsider, witnessed by fears of immigration.

So, I say all this to say that mental illness is a glib response to the travesty of our violent society. Until we can look at ourselves and say that social structures are broken, let’s not just identify mental illness as the easy answer to a complex social moral problem.  

Mental illness does not equate to violent behavior. Indeed, some people who are mentally ill are violent. More frightening to me is the presence of unfettered anger and rage, which allows evil impulses to rule the thinking of those who would see violence as a justified response to their own inadequacy.

Tomorrow, I conclude with an expanded view of mental illness.

Today we continue talking about some history of mental health treatment. As long-term patients were released from mental health institutions, they needed community support. Theoretically, it was to be there. Practically speaking, the community was simply not prepared. Not that we didn’t try- we did. But much of the strategy of community support was based upon the efficacy of newer anti-psychotic medications, and the ability of community support systems to handle treatment. The newly funded community mental health centers had a combination of state and federal money to provide care closer to where patients now lived. Clients also were to benefit from being closer to friends and family. Case managers were to follow patients with home visits, and community psychiatry was to be able to prescribe and monitor those medications.

Of course, no system is perfect, and the above-mentioned model failed for numerous reasons. One, of course is that medication cannot be forced upon anyone (except in rare forensic situations). I well remember talking with a community client, recently released from the State Hospital, about the importance of taking his medication.  We discussed side effects, which I seemed to minimize relative to the importance of the good benefits. I will never forget his response. He said, “To you they are side effects. To me, they are primary effects!” He had reinforced to me to see this whole thing from the client’s perspective. Medications helped mitigate his symptoms, but he paid a price for that.

One other little story for today.

When we were trying to establish a supervised group home in a small town, we stressed that there would be supervision in that home, and that mental health clients to be placed there did not pose a violent threat to the neighborhood. Indeed, the clients were statistically more likely to be victims of violence than perpetrators of it. Well, at a public hearing one evening, we were literally booed out of the council meeting. “Not in our neighborhood!”

Tough night!

The irony was, which we could not share with them, that for several years, we had been placing patients released from the state hospital in that very neighborhood, unsupervised, and the neighbors were not even aware of it. I am not blaming those neighbors. People have fear of the unknown.

Tomorrow, I talk about the misconceptions of mental illness and violence.

From there he went all over Galilee. He used synagogues for meeting places and taught people the truth of God. God’s kingdom was his theme—that beginning right now they were under God’s government, a good government! He also healed people of their diseases and of the bad effects of their bad lives. Word got around the entire Roman province of Syria. People brought anybody with a sickness, whether mental, emotional, or physical. Jesus healed them, one and all

 Matthew 4:23-24 (The Message)

May I start this series with the understanding that mental illness- a very broad term which I will hopefully explain a little better as we go on- is not the result of sin, nor an expression of God’s disfavor! Mental illness is an illness like any other human malady that besets our bodies and brains. It should not cause shame or fear, but rather compassion for those who suffer (and we all suffer to one degree or another). Now, let us begin…

Discussions about mental illness have ramped up over the years, and they have increased dramatically since COVID-19 and the terrible increases in America’s mass shootings. I have witnessed in my years in mental health, that we have gone from mental health treatment being a societal stigma, to one of open discussion and general understanding that mental health is, well…health.

Over the next several blogs, I hope to give some space to the discussion of what mental illness is, and how do we as a society view it. I hope you will hang with me as we explore the topic.

My early work in the field of mental health was at the State Hospital in Dayton, Ohio. There were over one thousand patients in that hospital at the time, many of who had been there for years, decades even. Most of those patients were severely mentally ill, with psychotic disorders of some sort. Indeed, there were also a fair number who had chronic degenerative neurological disorders, or who had suffered strokes or who had developmental disorders, and they were merely being “warehoused” (bad concept, but that was the word used) at that institution.

My understanding of mental illness was rather restricted. I viewed mental illness as a psychotic disorder (one where a person lost touch with reality), or a significant mood disorder, such as bipolar disorder (which then was named Manic-Depressive Disorder). Typical anxiety and depression, which afflicts a somewhat high percentage of the population, was not really considered, in my reckoning, to be a “mental illness”.

The transition from institutionalizing patients with a mental illness, to community treatment was a new concept, one which I entered at the ground floor. My early work was to help to transition people out of the hospital into the least restrictive treatment environment. I became the liaison from the hospital to the community treatment centers.

Unfortunately, that policy transition, while possibly well-intentioned (I hope), often ended up sending patients from the mental health system to the criminal justice system. Many patients, unable to deal with the pressures of community living, and with inadequate medical support, ended up homeless, or in jail.

So began the era of deinstitutionalization. Tomorrow, we look at what happened next.

Prayer: Lord, you asked us to minister to those most in need, and those forgotten by society. Forgive us in our failures, and give us grace to continue on, Amen

Do all the good you can, by all the means you can, in all the ways you can, in all the places you can, at all the times you can, to all the people you can, as long as ever you can.                       John Wesley

I enjoy learning new things- just for the sake of learning. I thought recently, yes, we accumulate a lot of knowledge over our lifetime, but when we die, it is all gone. That is, unless we are sharing it- giving it away- along the way. We accumulate a whole lot of things during our lifetime. We spend a large part of our life earning money so that when get older, and we are no longer able to earn much money, we can live reasonably comfortably.

Many people acquire much more than they can ever use. We have all seen the homes of hoarders who, due to some perceived psychological need, accumulate so much stuff that they barely have room to move.  

While I am not a hoarder, I do like to collect baseball memorabilia and books. Those things give me some joy and comfort. My office is cozy, and while not overcrowded, it is covered with baseball pictures, and has a back wall lined with bookcases. So, collecting stuff can be fun, comforting, enjoyable- one of life’s little pleasures.

But our knowledge, and our wisdom, accumulated over our lifetime, is meant to be given away. Further, our resources- time and money, should also be given away as much as we can reasonably do. Hanging on to the resources beyond what we truly need is not the way we were meant to do things.   

To recall John Wesley’s quote from above-

  Do all the good you can, by all the means you can, in all the ways you can, in all the places you can, at all the times you can, to all the people you can, as long as ever you can.

That is a good life philosophy.

Prayer: Lord, thank you for the opportunity to have enough resources to give some away to others, Amen

I just read an interesting article from my friend and colleague Joe Wegmann, the Pharmatherapist. Joe wrote about the theory of chemical imbalance in depression, specifically the concept of Serotonin depletion as a cause of depression.

Joe indicates that it is too simplistic, and very inaccurate to blame Serotonin depletion alone for depression. Depression is a multi-factor illness, with roots in the physical, social, emotional, and spiritual parts of our being. Serotonin depletion can be found in depressed individuals, but is it a cause or effect, or even a by-product of depression? Yes, Serotonin depletion is real, but to blame depression on merely low Serotonin levels is not doing a justice to the complexity of the illness.

That being said, anti-depressants which help to raise or maintain Serotonin levels are still beneficial for many patients. If you are taking an SSRI, don’t stop or change dosage without serious conversations with your therapist and your physician. Yet, realize that depression is multi-faceted, and that the remedy too must include all parts on one’s life. Strong social and familial connections are still the best tools one has in dealing with depression.

If you are a reader of this blog for any length of time, you will also note that I strongly suggest regular and even vigorous exercise, and close attention to one’s spiritual life as tools to effectively combat depression.

So, recognize that you do have tools to deal with depression, and that others around you want to help.

Please reach out to them.

Prayer: Lord, you have given us many people around us to lean on in hard times. When we are depressed, remind us again, Amen.

Look at the birds of the air; they do not sow or reap or store away in barns, and yet your heavenly Father feeds them. Are you not much more valuable than they?  Can any one of you by worrying add a single hour to your life?             Matthew 6:26-27

I was speaking with a client recently about what might give her more of a sense of serenity. We got around to the subject of what might be a reason that she does not have more peace, and I suggested to her that her serenity cannot be based upon her husband’s behavior. She has spent a great deal of time worrying about whether her husband has been unfaithful to her, as he had been in the past, and she soon realized the truth of the statement- her serenity was not dependent upon her husband’s behavior. This was something beyond her control.

So often we fail to see things that are obvious. In our attempts to find peace of mind, we try and try to figure things out. Somehow, we get the idea that if we put a lot of effort into something, we can get some measure of control. The less energy we give to certain things, the better the outcome.

I am not against hard work by any means! Work is good for the mind, body, and soul. However, when it comes to trying to overthink things over which we have little or no control, The truth is, often, less is more.

Prayer: Lord, help us to discern the things that we can control, and those that we cannot, Amen

Therefore, in order to keep me from becoming conceited, I was given a thorn in my flesh, a messenger of Satan, to torment me.  Three times I pleaded with the Lord to take it away from me.  But he said to me, “My grace is sufficient for you, for my power is made perfect in weakness.”                                                  II Corinthians 12:7-9 (NIV)

I recently spoke with a client who has a chronic physical problem, and she has been frustrated for years regarding its effects on her life. It is not a life- threatening problem, but it is certainly a “life-limiting” one.

We discussed her frustrations about living with this condition, and then she asked me, “Will I ever get over these feelings of anger and resentment? Will I ever get to the place of acceptance?”

It made me think about what acceptance really is. Paul in the Bible struggled with a “thorn in the flesh”, a phrase that has worked itself into our culture as an example of chronic suffering for which there may never be a complete remedy.   

Paul took the occasions of such reminders of suffering not to curse the condition, but to have it be a reminder to him of God’s ability to be sufficient even in our suffering- that God’s power is displayed when we are at our weakest.

I told my client that acceptance is “honest ownership of what we are feeling”. The question is not  “Will I ever stop feeling this way”, but rather, “what will I do when I recognize that I am feeling this way?”

My client has the tendency to condemn herself when she gets angry or frustrated about her situation. I suggested to her that frustration is a pretty normal response to her suffering, but honest appraisal of the unwanted feeling is the freedom she needs. Acceptance is not becoming complacent with how we feel, or ignoring how we feel, or even liking what we feel. Acceptance is honest ownership of that feeling. It is only then that we can be aware of the power that God can give us to transform the suffering into something that can enhance our human experience.

No one likes pain, and we try very hard to avoid it, naturally. But when we respond honestly to our feelings about it, we can start to redeem the pain into something of benefit to ourselves or to others.  

Prayer: Lord, give us the strength to honestly look at our responses to suffering, and to look to you for redemption of it, Amen

The first big Presidential debates that I can remember happened in 1960. I was just 10 years old, but I remember that the idea of a national presidential debate stirred the public appetite. My family was deeply devoted to John F. Kennedy, the young Catholic candidate who inspired so much energy and interest. His opponent, Richard M. Nixon, was the Vice-President of the United States. Kennedy at the time was a Senator from Massachusetts.

Both men were dignified, respectful speakers, though Kennedy had much more personality and charm than Nixon. Perhaps that is the reason that Kennedy was generally considered to have won the debates. Interestingly, those who only listened to the debates on the radio felt that Nixon had won. The television viewers tended to favor Kennedy.  Those debates, by today’s standards, were incredibly dignified and civilized affairs. Neither candidate spoke over the other, interrupted the other, or called the other names. Civility was still a thing back in 1960.

Fast forward to modern debates where candidates are itching to attack one another, talk over one another, and avoid actually answering questions. Debates these days are tawdry affairs where one leaves the spectacle feeling somehow angry, confused, and indeed hopeless that this is the best that the Republic has to offer.

I am not making partisan apologies here for any candidate or party. Political rhetoric on both sides of the aisle has become loathsome. Rather, I am lamenting the lack of civility, courtesy and respect that is demonstrated in current political debates. We no longer seem to expect good behavior from candidates for higher office. If this is the future of how debates distinguish the best candidates, we are in very serious trouble, my friends.

The virtues that we value, and try to teach to our children, are not modeled by those candidates for higher office in this country. Indeed, those virtues are disdained for the tactics of attacks on character, bullying, anger, divisiveness, and pomposity.

So, as political parties ramp up for another Presidential election, I am lamenting the loss of civility. Wake me up in time for the election, but I’ll pass on the “debates” thank you very much.