Becoming a Christian psychiatrist
These questions are ones most people ask themselves at various times in their careers. In this article, I am going to try and explain my answers to these questions and how I arrived at them. It is unashamedly personal, but I hope will contain areas of interest to most people reading this. [also published in the Thresholds journal]
There is an old adage that says it is easier to steer a boat under motion than one sitting in a dry dock, and all stories have to start somewhere. Not usually in a place, but with someone on a journey, someone 'underway'. I got into psychiatry more or less by accident - I was good at science so studied medicine, I liked people so I went into psychiatry and I am a philosopher so I was interested in the therapies. I therefore found myself in my late twenties as a young psychiatrist impatient with less holistic medical specialities, somewhat intolerant of biologically-orientated psychiatry colleagues and rapidly notching up hours of supervised Cognitive Behavioural Therapy.
An almost parallel development was taking place in my faith. The two didn't contradict, but sadly rarely joined up. I became a Christian just before going to University, led a number of student groups mostly related to sport and by my late 20s was a young elder in a growing Baptist church working with a group of trendily-dressed, coffee-drinking 20-somethings. The similarity was that I was impatient of slow-moving organisations, intolerant of traditional church and rapidly notching up a bookshelf of post-modern philosophy!
If you had asked me at 20 what my life was about I would not have known, I had to get some momentum in a direction ? any direction ? even if I later decided it wasn't the right one. Two simultaneous directions had the effect of allowing me to see the split, but also the similarities that ran through each.
As my career progressed, I was rapidly working towards the point where it was be necessity taking up more of my time. I was appointed a Consultant Psychiatrist and completed a Post-graduate Diploma in Cognitive Therapy. I was also having to make some decisions about my involvement in church - it either needed to resonate more helpfully with my job, or I needed to give up my job and work full time for the church.
The need to make a decision and the seeming lack of someone willing to pay me to work for the church meant a decision was forced. For what it's worth, I would have worked for the church and I believe that if God had wanted me to do this the money would have been forthcoming, but He sometimes guides through shut doors as much as anything else. However, I don't like making life decisions based on negatives - I was looking for a positive reason to keep working for the NHS.
Fire in the Belly
Most people who work in healthcare or counselling settings have a reason for being there. A common motif on coffee cups is 'You don't have to be mad to work here, but it helps.' People who 'Care' seem to have a passion for their work that keeps them going even when their own health is in danger. Psychoanalysts may formulate that there are working out their own neurosis of needing to care for some deep unconscious reason. This may be true in some cases, but I prefer a more simple explanation - they have to! Seeing people poorly cared for or left alone and friendless or stigmatised really annoys them and they just have to do something about it.
All of us have something that has the ability to wind us up. Is it litter thrown from a car window? Is it people starving in Africa? Is it youths hanging around on street corners? Rather than try to suppress these 'rages' [lets call them what they are], I believe that these -complaints - we hold are the key to working out what we are meant to be doing with our lives. We could do anything, but in truth we can do nothing else, and they give us the passion to keep on working at the same thing year after year.
My 'complaint' is seeing people with mental health problems excluded from society by others who take not time to understand and would probably be in the same situation if they have lived the same life. Few things annoy me more than watching Casualty or some other psuedo-medical drama and seeing yet another mentally unwell person portrayed negatively. Liz Sayce quotes from someone who has used mental health services: "I have a dream that one day I will be able to go into a pub and say to someone, 'I have been mentally ill', and for them to turn to me and say, 'that's interesting - what did you learn?' ". People who have been to the emotional equivalent of hell and back are usually really interesting people to talk to. But instead, we cross to the other side of the street and label people as 'weird'. Stigma means that we see ourselves as normal and our friends as interesting, but create ?out-groups? who are ALL odd, unpredictable, evil, violent, hard to talk to - whatever the adjective of the hour is.
The church I found myself part of was hardly better. It was OK at superficially looking after some people with alcohol problems or severe schizophrenia, but they were not really accepted as part of the fellowship. There was a division. The irony was that this same fellowship also contained many who were hiding anxiety and depression because they felt that to talk about it would mean fear and exclusion. The Bible tells us that Jesus destroyed the division between man and God that sin had erected and so consequently destroyed all other divisions: between Jew and Gentile, between rich and poor - and so also surely between mad and sane. I began to realise that my passion was to see churches across the UK which understood mental health problems and did not exclude those who were ill, recovered or recovering.
The stigma also went the other way. Mental health services were suspicious of religion and faith-based groups. They would quote the family feuds it had started, the catholic guilt it encouraged and the abuses committed by those revered as leaders. This journal has written a lot about spirituality and mental health and I do not need to explain my frustration to readers who probably have experienced the cynicism of the secular and selectively evidence-based model. I think there is also a level of challenge there - from voluntary groups like churches who are in communities for generations to people who work for organisations for a salary and could move city if their career seemed to dictate it.
These stigmas are implicit within all of us and I realised that if I was to reconcile these two parts of my life and try to address some of the stigma, I was going to need to be reflective in my practice. I wanted to read a book by someone who shared these two same passions, but couldn't find a story that resonated enough - so I set about what probably needed to be done anyway and wrote my own.
The main way I chose to do it was by keeping a Blog - or web-log. This is an online journal that can be commented upon by others - quite a vulnerable way to write, but one that meant I received constant feedback on what I wrote. At one point, the Blog had over 200 readers each day and I would post a story several times a week.
After keeping this for two years [2004-2006], I began to realise that I was always writing about two or three common themes - the angry complaint on behalf of those who struggle with their mental health was still there. I was also sure that, although not unique in all it?s claims, Christianity talked of the only God who would give a definitive answer to these problems. However, I was also sure that God wanted me to keep working for the NHS as this is valuable work and I was skilled at it.
But writing about things cannot change the world by itself, and having a complaint will turn into bitterness unless it is directed into action, and it was during this time that God began to give me a vision of what the next few years would hold.
I use the words 'God gave me a vision' in the most literal terms. I do believe that God is alive and active in the world today and that Christianity is not just a creed or belief. It shares much with other world-views, such as the command to love our neighbours, but I also believe in a personal God who is building his church actively - choosing what and where to build next. It was therefore important for me to reflect on my complaint for a while, to keep it close to my chest - ensuring that what came out was God's idea and not Rob Waller's idea [there are lots of those!!!].
It was JFK who said, 'Never over-estimate in what you can do in one year, and never underestimate what you can achieve in ten.' So it was that I woke up one day and wrote the ten year vision for something that would be called Mind and Soul. The name emphasises both faith and psychology, as well as the AND which is the overlap, tension and creativity between them. In Year 1 we would start a discussion group of like minded people. In Year 2 we would be having an impact across the city [Leeds]. In Year 3 we would be establishing a national presence. The goals for Year 10 are big - to have a church in the UK that is understands mental illness and is equipped to help in real ways, and to have Mental Health Services who understand the perspective and role of Christianity in mental health. We are currently in year 4, which is one of the reasons I am writing this article - but that is getting ahead of myself.
One way to make a start
James Thwaites has said that, 'the divine story will impact only to the extent to which the saints know how to live it in a post-modern age' . By this he means that often Christians can only tell their story using traditional words like church, easter, cross, resurrection? If they are to make their faith real to those who increasingly have never set foot inside a church and do not know the Bible stories, they will have to find new parables, stories and metaphors. We got together a group of people to think about questions like, 'What would Jesus say to someone who was depressed?' or 'Would Jesus have talked to people about their voices and 'delusions'? - and 'What does the cross mean in practical terms to someone who is going through a really hard time in their lives?'
Anyone who has tried to convene a group to discuss mental health issues knows that it can take quite some time to even agree who can come, what will be discussed and how we will know if we have achieved the groups aims. I wanted the group to be as open as possible, but also to remain true to the vision God had given me and the key themes Mind and Soul was to have. It was not going to be a multi-faith forum, but neither did I want it to be a traditionally narrow expression of Christianity that would fail to engage most people.
What these verses meant to me was that I was to just get on with it and start a group, to invite as many people as possible, to encourage as much networking as possible and realise that the real failure is in not starting rather than starting and seeing it fail.
I should point out that this is a very new way of thinking for me. I had been taught from my science and medical background that clear planning was the only way to go - all based on the belief that I was right and everyone else had better get their ideas up to speed with mine! I still wrestle with this now, but I have begun to see that there is a joy in journeying together with others and to let ideas stew in the pot for a while before acting on them.
But with all these different voices, each valid in their own way, how was I to keep the group true to what I wanted it to be and what I felt God was asking me to build? Again, I have been helped in this by others. I am particularly grateful to a book by Allison Gilchrist that explained the differences between an organisation and a network. I was trying to build a network, so I could afford to be 'generous' with the edges of what we were doing [who could attend, speak, participate] while at the same time remaining clear about the core aims [to keep Jesus at the centre, to look at both mind AND soul.] I have written an article on leading a network and the issues involved for a later issue of Thresholds.
We met every month, initially in my front room and then later [for space and security reasons] in the back room of a local pub. We discussed everything under the sun, from the meaning of the word guilt [is it a theological term, an emotion or a symptom of depression] to how we could communicate what we had learnt to those who we felt would be interested to hear. But the things I remember are far deeper that the mere content of our discussions. The atmosphere was one of grace, where all were accepted ? even those who were quite odd at times! There was generosity to hear each others points of view - even when it was clear that we were going to differ on the answers! I was humbled by the knowledge of those who were experts by experience and the passion of those who also felt this their calling. Used to being a Consultant Psychiatrist and being 'the boss', here my role was to facilitate, encourage, channel, empower : and in doing so heal.
The word healing is used here to mean very simply that people got better: both in any symptoms of mental illness but also in the maturity of their characters, their confidence at work and their relationship with God. I am aware that some in the Recovery movement see acceptance as being the main goal and that the ongoing presence of illness doesn't matter. Whilst I think it is vital for people to not feel guilty or stigmatised if they remain ill, I am also quote clear that it is Gods wish that we should be healed.
There were three main types of people who came to the group: mental health professionals, pastoral workers with a string interest in mental health and people with their own stories to tell. Most were Christians, but not all. Most were evangelical, but not all. Most came more than once, but not all. Some supported from afar, like a friend of mine who is a Graphic Artist who is a Christian but has also suffered with OCD, he produced the first Mind and Soul logo of the eye with the rainbow and the heart.
Taking things to the next level
The rest of the story of Mind and Soul is only something I will touch on briefly here ? partly because it is more about the network and less about me, but also partly because we have a long way to go till ten years are up! In the second year of the group, we wrote to all [yes, all] churches in Leeds and invited them to a training day on mental health issues. This was the first time many had had such training since seminary. Nearly 100 came and the majority of the speakers were ?just? members of the group who have never done anything like this before.
We began to put material on line and partnered initially with the local city-wide church website [www.networkleeds.com] to host slides, articles and audio from the conference as well as advertise our meetings. More recently, we have teamed up with a number of other likeminded networks around the country, especially at St Mary?s Bryanston Square in London and are getting together a database of groups that meet around the country and churches who are good places for people with mental health problems to go. The website recently won the Premier Media Groups ?Website of the Year? award and we are working with publishers to write a six week course designed to be run in churches to explore mental and emotional health.
But this is not my story. Personally, I have recently got married and moved to Scotland. Increasingly, I enjoy my job purely for what it is. I love going into work on Monday morning (and I truly mean this, I?m not just saying it!). I have begun to find something of what Dietrich Bonhoeffer calls 'the beyond in the midst of life', being able to know that you do what you do for a larger reason than for what you are employed to do. It's not a career, it's a commitment.
'Let no debt remain outstanding except the continuing debt to love one another. For he who loves his fellow man has fulfilled the law.'
(Romans 13v8. NIV translation of the Bible)
1 Sayce L. From Psychiatric Patient to Citizen: Overcoming Discrimination and Stigma. London: Palgrave Macmillan, 1999.
2 You can read the archive of the Blog at http://robwaller.wordpress.com/.
3 Thwaites J. The church beyond the congregation: the strategic role of the church in the postmodern era. Carlisle: Paternoster, 1999.
4 Jones A. Emergent Wisdom For Churches #1: http://tallskinnykiwi.typepad.com - posted on 15th December 2004, 2004.
5 Gilchrist A. The Well-Connected Community: A Networking Approach to Community Development. Bristol: The Policy Press, 2004.
6 You can see our website at www.mindandsoul.info for articles, forums, podcasts and training resources.
7 Bonhoeffer D. The Psalms: Prayer Book of the Bible: Augsberg Fortress, 1944.
Rob Waller, 30/12/2007