I hate to use the term “serious” in the context, as the everyday disorders, such as anxiety and depression, can be life-threatening.

Introduction

I had an interesting conversation a few years ago with a psychiatrist. I had called her about a lady in my church, whom I—rightly—feared was having a psychotic break or a dissociative disorder. This person had always told sensational (and dubious) stories about herself. When Denise and I met with her during a personal crisis, she had progressed from simple lies to living in an alternative reality. The psychiatrist agreed that it was a likely psychotic break, but was unlikely her first, and then added, “There’s a lot of serious psychiatric disorders that have found a safe place to hide in a church.”

I asked her what she meant by that. She said, “Religious communities tend to be naive and easily fooled by such individuals because they don’t believe in psychiatric disorders.”

The Metaphysical Problem

A central tenet of most Christian traditions is that we are spiritual beings, with our souls loosely attached to our bodies, and that our moral choices determine our personhood. That is why, as I’ve already discussed, Christians tend to inflate their own concept of being godly and to over-condemn the behavior of others. Missing from this model is the incredible complexity of our brains that drives our personas. Our genes, early upbringing, traumas, and choices shape the physical model, which is not easily changed.

I considered doing an exhaustive write-up about all the major psychiatric problems and describing them in detail, but that would be cumbersome at this juncture. But I will mention that some are psychotic (such as schizophrenia) and others are more subtle, yet as disturbing, such as personality, narcissistic, and antisocial disorders. These individuals don’t usually become homeless, chain-smoking, conversing with the air, individuals like the schizophrenics that we see in the streets of big cities. Often, those with the subtle disorders function too well in society, such as one with all the classical features of a narcissistic personality, who is our current president.

These individuals can cause chaos in a church while maintaining a pious facade and appearing otherwise impeccable. It can make life for a pastor hell. A pastor with such a disorder can make life for the members hell. One member can make life hell for another. And no one has the insight into what’s going on, and even if they did, these disorders are tough to treat or avoid.

For a while, as an evangelical, I was pursuing a degree in Christian psychology. The ideology I followed, called Nouthetic Counseling, held that we were merely spiritual beings; all maladaptive behaviors (by our definition) could be remedied through confrontation (the meaning of Nouthetic). If we saw someone with a complex personality disorder or even full psychosis, we would either rebuke them, trying to force them to repent, or cast the demons out of them. Even homosexuality was in our list of maladaptive behaviors. Pathetic.

This is a topic for another post or series of posts. We are now living in a “spiritual” age where everything is seen as subjective and spiritual, which is not helpful in this situation with mental illness, which is rooted in the objective architecture of the human brain. Yeah, many simple things are moral choices. “Do I treat so and so with love and kindness or exploit them?” But the hard things are far more complicated.

One typical trait of someone with a borderline personality disorder is a pattern of unstable, intense relationships, such as believing someone is perfect one moment and then suddenly believing the person doesn’t care enough or is cruel. Those with this disorder are also highly manipulative in getting their way. I had a borderline patient; she loved another doctor and me. When the other doctor refused to give her what she wanted, narcotics, she accused him of rape. Since there was overwhelming evidence against the rape, the case was quickly dropped. But this is typical manipulative behavior.

When I was in a super-dooper spiritual discipleship group in college, a fellow member, a man, developed a fatal attraction for me, which is in this borderline personality category. He treated me like I was the king of the world. But after I rejected his sexual advances (and this was a group that condemned homosexuality), he made my life a living hell for the next four years. He broke into my parents’ house twice, who lived in another town, looking for my things. With my birth certificate, which got through one of his break-ins, he stole my identity and registered for college for me the following year, putting me in the same classes as him, although we had different majors.  

But I, seeing everything as spiritual, was naive, and when I grew angry at this man’s behavior, I felt tremendous guilt for not being as loving as I should have been. He was also, like the typical borderline person, a master manipulator, convincing me it was my fault for driving him to do those things. Wives of abusive husbands can relate to that statement. When I tried to avoid this man, he would go to others in the ministry and convince them I was being unloving. If I had recognized his behavior for what it was,  I could have taken better care of myself and maybe gotten him the right help, or gotten out of his way earlier.

But the key issue, the thing I wish I could communicate, concerns the complexity of human personality and behavior.

In his Pulitzer Prize-winning book  When Breath Becomes Air, neurosurgeon Paul Kalanithi describes placing an electrode in a man’s brain, specifically in his Globus Pallidus Internus, to block Parkinsonian movements. When he inserted the electrode the first time, the man (who was awake) immediately became profoundly depressed, started to cry, and wanted to kill himself. He moved the electrode by a complete millimeter, and suddenly, he returned to his happy self.

We are not merely empty vessels that hold our souls, and we have a choice to do right or wrong. The human brain is complex and receives a variety of inputs, as I’ve described. When those are genetic or from early childhood abuse, it is almost impossible to correct to a normal, healthy position again in this lifetime. If you are the direct victim of such genetics or upbringing, you have to be self-aware at all times, humbly self-aware. If you are the victim of another person’s demons, often you have to realize that they are not in control of their behavior, and it might be best, the most loving thing for you to do, is to just get out of their way.

Have a mentally healthy New Year,

Mike