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What are the connections between religion and mental health? What are religious communities doing to respond to mental illness, and what more can they do? Following the launch of our new report, Christianity and Mental Health: Theology, Activities, Potential, we have invited a range of guest bloggers to offer their perspectives.
The relationship between religion and mental health is complex in all sorts of ways. It depends on what kind of religion is involved, and what kind of mental health.
I want here to focus particularly on depression. It is both a very common mental health problem, and also one where many different factors intersect. Biological, social, development and spiritual factors seem to come together in depression, more than with any other mental health problem. Many aspects of depression raise interesting issues from a Christian point of view, and I want here to look particularly at the depressive mindset.
Negativity and its alternatives
Depression is characterised by negative thinking, about the world, the self and the future. That is not at all where faith leads, but faith may not necessarily lead to the antithesis of negative thinking either. Faith doesn’t lead to the kind of excessively negative thinking that saps motivation, but neither does it lead to the kind of rosy optimism that doesn’t recognize the reality of problems and difficulties.
There is an intriguing phenomenon known as “depressive realism”. In some situations it seems that the judgements of depressed people are more accurate than those of people who are not depressed. Though the evidence for this is admittedly somewhat mixed, I suspect there is something in it. Some people I know with a depressive outlook believe they are seeing things accurately, without a distorting rosy glow, and see that as a kind of virtue.
I suggest that faith leads to a commitment to balance and objectivity, rather than to an unremittingly positive outlook. It is actually quite hard to do that in our perceptions of other people. We tend to view other people more favourably or less favourably than we should, and that is driven by our own needs. Similarly we see other people as more or less needy than they are, for our own reasons.
I have long been fond of Charles Andrews’ definition of Christian love as “the accurate estimate and supply of another’s need”. It is refreshingly unsentimental, and points to a path between the extremes to which we are often attracted. I assume that God sees people’s needs accurately, so the kind of love that Andrews is pointing to brings people into alignment with God’s perspective.
There is a similar balance to be struck over guilt. Being excessively guilty is psychologically harmful, as twentieth century psychology has made us very aware. Neurotic guilt, in which people become excessively guilty about an excessive number of things, can be very debilitating.
But Christians would not want to conclude that guilt was always bad. There is a proper and helpful place for the recognition that a person has done wrong and needs to improve, a place for what Christians call ‘repentance’. Realistic guilt can help people to become better adjusted, and to behave in ways that are in everyone’s best interests.
This middle way is quite difficult to strike; the tendency is to be excessively guilt–ridden, or excessively complacent about ourselves; it is not easy to avoid both extremes.
Guilt itself is also quite complex and has both cognitive and emotional aspects. It is the cognitive aspect, a recognition that one has done wrong, that is perhaps most valuable, and the emotional aspect of guilt that is most likely to run to excess.
A balanced and accurate stance is probably even harder to achieve with ourselves than with other people. The pull towards either over–negative or over positive self–evaluations is very strong. It is remarkably difficult to learn to see ourselves accurately, but it is an important spiritual virtue.
Optimism, pessimism and hope
We need a similar balance between the negative thinking characteristic of depression and the over–positive thinking that is often an alternative to it, what some might call a ‘manic defence’. Something similar emerges from research about coping styles. Negativity doesn’t help people to cope, but neither does it help to pretend there are no problems and challenges. The most helpful stance is to recognize problems but to think you will be able to handle them.
Faith does not lead either to optimism or pessimism; it eschews both. However, faith does lead to hope; but hope is very different from optimism, as Terry Eagleton has argued in his recent book on Hope Without Optimism. Hope is much more flexible and versatile than optimism. Hope does not depend on circumstances being favourable; indeed it can come into its own when circumstances are very unfavourable, as Victor Frankl found ways to maintain hope in a Nazi concentration camp.
Hope seems to be more a general attitude than a prediction about what is going to happen. It also carries a commitment to work for a better future. Optimism is rather passive; it just takes stock, and predicts what is going to happen. Hope, in contrast, transforms the future.
Depressed people are often pessimistic, but I suggest that it is a lack of hope rather than a lack of optimism that is really debilitating. If research made the distinction between hope and optimism more clearly, I think it would be possible to show that it was hope rather than optimism that protected people against depression, and lifted them out of it.
Direction of influence
The general pattern of connection between depression and mental health is clear enough, that religious people tend to be less depression. However, the causal routes underlying that are far from clear.
Also, the direction of influence between religion and mental health problems can go either way. It is possible for people to fall into patterns of religion that can reflect and entrench mental health problems such as depression. People who are prone to guilt can get into guilt–enhancing forms of religion. People with obsessional tendencies can get into highly ritualised forms of religion.
However, things can work in the other direction, and religion can help to liberate people from their mental health problems. The guilty can find reassurance of forgiveness, the pessimistic can find grounds for hope. It is very important in Christian discipleship to be watchful of whether faith or depression is in the driving seat.
Fraser Watts is a retired lecturer and Fellow at the University of Cambridge. He has published widely on psychology and religion. His latest book is Psychology, Religion, and Spirituality: Concepts and Applications (2017).
Image by Max Pixel, available in the public domain