A Christian Approach to Mental Health

FOR many decades most basic methods employed by psychiatrists and clinical psychologists have been established upon the assumption that major causes of mental illness have close connections with the disturbed person's ineffective social adjustments. It is usual to assume that an inadequate supportive environment is involved, and that in some way the individual senses a rejection by those whose relationships he holds as important to himself. Even when the problem relates to feelings of inadequacy, it is probable that an acute fear of social reactions to his failures is involved.

This has led many psychiatrists to look for ways to achieve better support for the disturbed individual, especially from his relatives and near associates. Currently community and family programs are based largely upon group-counseling situations, often in the patient's home itself or in an environment simulating as closely as possible his home. Efforts are made to alert the patient's family to ways in which they can provide a more helpful environment for him by assuring him of their love and helping to re-establish his self-esteem.

Unfortunately the results of this and other forms of psychotherapy are equivocal. Some professionals even take the rather depressing view that no matter what is attempted, there are only minimal prospects of effecting any permanent changes in the behavior of the more seriously disturbed. Others, while acknowledging that the results are far from satisfactory, point to specific cases where permanent improvements appear to have been achieved. Still others, while not directly entering the controversy concerning the success of psychiatric treatment, nevertheless support psychiatric programs on the basis of their value to the development of the understanding of mental disorders and their cure.

With such uncertainty and disagreement among the professionals, there is an urgent need to determine what, if anything, the Christian philosophy has to offer to the understanding of psychiatric theory and practice. Understandably, but unfortunately, Seventh-day Adventist approaches have not always varied significantly from those of the world. It is common to select approaches from those currently offered which are considered to be most consistent with the Christian philosophy. While this has merit, it would seem that much more attention needs to be given to the unique contribution Seventh-day Adventists can make.

That man has an inherent predisposition to sin is fundamental to Seventh-day Adventist beliefs (Psalm 51:5). The most basic form of this sin is selfishness, a characteristic readily observable in very young infants, who, as soon as coordination allows, try to grasp everything to themselves without discrimination. It is not surprising, then, that this innate characteristic is man's most difficult challenge and the last foe that the Christian must over come, for it is the source of all sin. (See Testimonies, vol. 9, p. 27; Education, p. 226.) Nor is it any wonder that the eradication of our innate selfishness can be effected only as a miracle of the grace of Christ.

The Seventh-day Adventist rejects the Greek pagan viewpoint that man is innately good. Equally he rejects the empiricist view that man has no innate moral predisposition. Yet these views strongly dominate the basic assumptions of most modern psychiatric theory. It is predictable that wrong assumptions will, barring logical accident, lead to wrong conclusions. Therefore, it is possible that the present comparative ineffectiveness of psychiatric treatment results from inadequate therapies derived as a result of these wrong assumptions.

A careful analysis of the major forms of mental disorders reveals that egocentricity is basic to each problem. The paranoiac is obsessed with what people are doing to him, usually to inflict physical harm; the schizophrenic, unable or unwilling to relate to his real social world, turns inwardly, usually living in the world of his own make believe; the megalomaniac has an insane exaggeration of his own importance; the depressive is usu ally over-concerned with the attitudes of others to himself whether in home relations or in some other social relationships; the masochist, either to attract attention or to gain some strange satisfaction, is inward-turning, and there is perhaps no greater act of egocentricity than suicide.

Therefore, it might be hypothesized that functional mental illness (that mental illness not resulting from physical causes) has causal relationships that relate to man's inherent self-seeking. Whereas the average individual may be able to follow a pat tern of life in which self-seeking does not appear to lead to mental illness, the disturbed individual has not been able to do this, possibly because of lower tolerance to stress or because he has not been able to cope adequately with the self-imposed demands he has made upon himself and his environment.

As stated earlier, it is currently assumed that most psychological problems result from the individual's failure to feel assured of the love and approval of those important to him self. Therefore, increasingly, therapy is being directed toward group-counseling sessions in which the patient's immediate family and friends are encouraged consciously to develop a more supportive environment. The assumption is that if the disturbed person can find love and acceptance that was almost certainly lacking in his early environment he may be able to learn to make more adequate emotional adjustments. Unfortunately, the best-intended efforts of psychological counselors, family, and friends are frequently unsuccessful.

One possible explanation of this is that the rather specialized attention that the family now provides, reinforces the maladaptive behavior by which the craved attention is achieved. Therefore, the very behavior that it is hoped will be changed, continues to persist unabated. This view is reinforced by observations that indicate that often long before the person is referred for psychiatric attention the members of his family have gone to inordinate lengths to placate his whims and maladjusted behavior.

Most human behavior is dependent upon example, especially that experienced in childhood. It has been noted that children are more likely to follow parental mistakes than they are to learn from them. The fact that the mentally disturbed person has had an inadequate home environment in which real love and adequate approval have been absent may very well result in his failure to learn how to love. The most significant problem of the maladjusted person, then, is not so much that he isn't being loved, but that he has never learned how to love. His home environment has not demonstrated adequate incidents of love or provided a basic training in loving out reach, and therefore inherent selfishness is allowed to dominate all behavioral activity. If this is so, then the role of the psychiatrist should be to discover therapies that allow the mentally ill to learn how to extend his love to others, to take the attention away from himself so that he might develop a healthy interest in his social world.

This concept must also have deep implications in the prevention of mental disease. Comparatively little is being done in the field of preventive psychiatry, probably because, as Karl Menninger suggests, "there's no money in prevention." ¹

Christianity is established upon the two great principles of love to Cod and love to man (see Matt. 22:37-39). It is significant that nowhere does the Bible lead us to expect others to love us. Thus in the heart of the Christian message are the essential elements for the prevention of mental breakdown. It is probable that only Christian conversion can be a completely effective prevention to functional mental illness. Ellen White goes perhaps a step further and concludes that the religion of Christ is one of the most effectual remedies of insanity (see Testimonies, vol. 5, p. 444).

Many psychologists identify fear as the root cause of mental illness. ² That this is consistent with the Christian viewpoint can be seen by the affirmation of Scripture that "perfect love [Christlike, selfless love] casteth out fear" (1 John 4:18). The Seventh-day Adventist health message is mainly a message of prevention, and this certainly should be our first concern in mental health, while of course not neglecting the work for those who are already mentally ill.

Many times the servant of the Lord identifies self-seeking and self-indulgence as contributing causes of mental illness. Among these are indulgence of appetite (Counsels on Diet and Foods, p. 135), intemperance (Counsels on Health, p. 49), liquor (The Ministry of Healing, pp. 343, 344), worldly amusements (Testimonies, vol. 4, p. 652), novel reading (The Ministry of Healing, p. 446). Added to these are other allied contributing causes such as improper diet (Counsels on Diet and Foods, pp. 122, 123), irregular hours of eating and sleeping (ibid.), coffee and tea drinking (ibid., pp. 421, 422), flesh eating (Counsels on Health, p. 575), and fanaticism (Selected Messages, book 2, pp. 34, 35). Of course, it may well be that none of these in itself is exclusively responsible for mental break down.

Balanced, temperate living is an important way to build physical resistance to stress. Thus it is essential that habits of temperance be faithfully developed in every child, for the results will not only be a stronger physical constitution, which in itself will help prevent mental disorders, but also, more important, habits of self-control will be developed, which will help to combat the self-seeking so commonly associated with mental disorder.

Perhaps the greatest responsibility of the parent, however, is to assist the child to know how to love others. While the observable love of parents for each other and for the child is an essential element in this development, it is not sufficient. Very definite training is necessary if the child is to contend with his inherent selfishness and develop a selfless outreach for others. Unfortunately, the present noninhibitory approaches advocated by many psychiatrists pander to the natural selfishness of the child, and therefore his natural, sinful, self-centered characteristics are provided an environment in which they are habituated. This emphasis upon freedom undoubtedly is contributing to the present alarming increase in mental, emotional, and social breakdown.

Sound mental health demands an environment in which the child learns habits of selflessness by being taught how to play success fully with other children, how to be interested in the happiness of others, and the importance of sharing with others. Ultimately, how ever, selfless behavior can be achieved only within the framework of the Christ-committed life. Because selfless love is an unnatural characteristic of the human race, it cannot be expected to be achieved quickly or easily. Nor should it be achieved primarily as a coercive measure, for this destroys the will rather than strengthening it. It can most usefully be achieved by loving firmness until the child's will is positively involved in the behavior.

The popular behavioral-modification approach to child training is totally unacceptable to the Christian. Taken into the Christian sphere it becomes a form of legalism where "right" actions are the ultimate goal. The Word of God gives examples where right actions do not necessarily make man worthy before God (see Isa. 64:6; Matt. 7:22, 23; Luke 18:20-23). The Christian parent seeks character transformation, which in turn changes the totality of the child's life-style.

It seems important that deeper consideration be given to this question and that re search be undertaken to determine more fully truly effective programs for the development of mental health and the cure of those already mentally disturbed. The task of the Seventh-day Adventist psychiatrist and psychologist must be more than that of simply reflecting the current limited programs avail able for the treatment of mental disease. There must be a positive, unique contribution that Adventists can make, and this contribution must extend well beyond curative programs into the relatively unexplored field of preventive psychiatry.