This post forms part of the 2014 Queer Theology Synchroblog. My aim is to look at the particular challenges in pastoral theology of caring well for a queer person’s mental health.
According to the National Health Service in the UK,
Studies show that lesbian, gay and bisexual people show higher levels of anxiety, depression and suicidal feelings than heterosexual men and women.
Rates of drug and alcohol misuse have also been found to be higher. But the real picture is uncertain because of the reluctance of some patients to disclose their sexuality, and some healthcare staff feeling uncomfortable asking the question.
Poor levels of mental health among gay and bisexual people have often been linked to experiences of homophobic discrimination and bullying.
Trans* people also suffer from higher rates of poor mental health than cisgendered people, although the picture is complicated by the medicalization of trans identities. GIRES (the Gender Identity Research and Identity Society) published a report in 2012 that further states that many people going through transition are reluctant to disclose information during treatment (source: Trans Mental Health Study 2012), so it may well be that rates of distress are higher than documented.
Many of us who have experiences of being in churches that teach against queer people will easily recognise how these experiences contribute to deep feelings of shame, guilt and even depression. It is difficult to over-estimate how damaging these experiences may be to the long-term mental health of the person receiving the message that they are fundamentally disturbed.
To be a truly inclusive fellowship, then, it is vital that a church works towards a good understanding of the experience and needs of someone dealing with poor mental health.
Everyone has mental health, just as everyone has physical health. Subsequently, everyone will have experiences of poor mental health. Many of these are well understood in a church context; grief, shame, and guilt, for example. However, many pastors and ministers feel out of their depth when dealing with more complex mental health problems. Every experience will be different, every suffering is unique to the sufferer, but knowing common pitfalls is a straightforward way to avoid hurting the vulnerable among us.
Just as there are Biblical “clobber passages” familiar to queer people (i.e., verses from the Bible that are used out of context to condemn us), there are texts and verses that can be used in a way that is destructive to the experience of people with mental health difficulties. In his 2013 book, Walking With God Through Pain and Suffering, Timothy Keller identifies that there are times when speaking the truth to someone suffering may be damaging and unhelpful, taking the example of Job (p.223):
Job’s friends say many things about God that are true in the abstract. They say, “In the end all evil will be judged” and “God is pleased with the righteous” and “God is not unjust or unfair” and “We can’t understand God’s ways—they are beyond our puny minds.” Yes—all true statements. And yet, Job calls them “miserable comforters” (Job 16:2), and in the end, God condemns the friends for how they respond to Job.
His point is this; Job’s comforters know the truth, and they know God well. What they do not know is how to embody and accompany Job in his suffering, and so in their well-meaning internal panic, they resort to platitudes. The difficulty is that these platitudes have the potential to be destructive to the person on the receiving end. For example, in queer-inclusive churches, we talk about how important it is to accept ourselves so that we can move on from the destructive messages we have received. This is a truth, and a vital one, but when the picture is complicated by mental health difficulties, the sufferer may simply by unable to access self-acceptance. It is appropriate to affirm the love of God, to remind the person you are accompanying that they are important to you, but to try to ask someone in the grip of a self-destructive illness to accept themselves (especially to imply that this is the sole route to healing) can often be to give them another thing to “fail” at.
In the grip of severe mental illness, the suffering is often all-consuming. Like grief, or physical pain, it is hard to look beyond oneself. To an outsider – no matter how understanding – this is very hard to observe and difficult to sit with. Distress tolerance is taught as a key skill in many forms of therapy; it allows a person to observe their own distress, and look beyond it so that it does not fill their experience. As ministers and fellow-travellers, we must also learn distress tolerance. If we can tolerate being alongside someone in their distress, we can accompany them on their journey without being “miserable comforters”.
Creating a safe home for people with mental health difficulties and including them in the lives of our communities means that we must be non-judgemental about how they experience and describe their suffering. It is not ours to own or define. When queer people come into an inclusive space, they have often already been damaged by a dogma that spoke of ‘healing’ (from their sexual orientation or gender identity) and expected this to be the route out of suffering. As queer people of faith, we have already heard that our relationship with God is somehow off-kilter; we must not perpetuate to people in distress the myths that we once heard ourselves. It is always good to strengthen our relationship with God, and to put our trust in the Divine, but we must not present this as a prescription to healing from mental illness. Respite, maybe, but not for everyone.
I have based this in my own lived experience as someone who has experienced severe, and sometimes long-lasting, mental distress. I have found that being accompanied gently and encouraged to nurture my relationships with God and the people who love me have been healing experiences. Exhortations to “read about Job”, or offers of bitesize pieces of scripture that I simply couldn’t access in my distress were more likely to make me feel confused or as though I was a failure, and were unhelpful. I hope that this experience and reflection may offer some help to people who have not experienced this for themselves, or who find mental health difficulties hard to understand. I do not offer it as a simple “one size fits all”, and I would be interested to hear from people for whom other approaches have worked well.
I wrote about my experiences of mental illness as a young gay woman in the book Living it Out, in 2009.