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Mental Illness in a Genesis 3 World

Mental Illness in a Genesis 3 World

It has long bothered me that churches and/or Christians are not leading the way in addressing and helping those with obvious mental illness in the modern world.  So I want to speak about why I have this position in this blog.

To get everyone’s attention let me say this controversial thing:

  • Every human that has ever existed, with the exception of Jesus, has been or is mentally ill.

This could be quite challenging for those of us who believe we are healthy functioning adults to swallow – but it is still true.  Follow me here:

Genesis chapters 1 and 2 describe God’s creation, and God calls it very good (Gen 1:31).  And it was; it was paradise and the two humans He created were perfect and unblemished physically, psychologically and spiritually.  They had one rule to follow to keep things that way; don’t eat the fruit of the tree of knowledge of good and evil.

We all know the story as laid out in the early part of Genesis 3; the woman was tempted and ate the fruit, followed by the man.  And the world started to fall apart.  This is one way scripture puts it:

Rom 5:12 – Sin came into the world through one man, and death through sin, and so death spread to all men because all sinned

Just as God predicted and warned the first couple about, they started dying.  We may all be comfortable with the knowledge that mankind spiritually died and that physical decay became the norm, but there was another major death inside humans.  This was the death of the right mind.

Just as the physical body was introduced to new things like cancer and heart disease, the soul, often called the mind in scripture, was introduced to the knowledge of good and evil.  This resulted in immediate dysfunctional thinking in the first man and woman, and this is what ought to be thought of as mental illness.  Not convinced?  What about this evidence:

To be sure we all know that Adam and Eve became mentally ill, look at what they did immediately after eating the fruit.  They tried to hide from God (impossible), they denied their wrongdoing (lying), and they didn’t take personal responsibility (blamed).  (Note here that Adam blamed God for giving him the woman who caused him to sin, in his mentally ill mind.)  Lying, blaming and thinking one can hide from God are all evidences of mental illness.  Still not convinced? What about their kids?

Right after the story of the fall we see more obvious and significant behavioral evidence of this truth in Genesis 4:

Gen 4:8 – Cain spoke to Abel his brother.  And when they were in the field, Cain rose up against his brother Abel and killed him.

Cain, the first human ever born, committed murder – an act conceived out of his mentally ill mind.  Cain went on to demonstrate other evidences of mental illness by lying to God, and denying his culpability.

So then, mental illness has been present with us since the fall, and it is the result of sin entering the world, just as spiritual death and body decay are.  Here are some important things to state:

  • Mental illness itself is not sin or sinful. Just as our sick/ill bodies are not sinful.
  • Mental illness is present in every human. We all have it to a greater or lesser extent, just as we are physically sick to a greater or lesser level.
  • Mental illness can result in us committing sins, and can be made worse by our own sin or the sins that others commit.
  • Mental illness, just like physical illness, can be treated and sometimes healed or cured.

Mental illness may be increasing in our modern world, and we (society) are not doing a good job in dealing with it.  Here are some indications that this might be true:

  • High divorce rates; no-fault divorce.
  • Expanding drug use; both legal and illegal.
  • Explosion of porn use.
  • The growing use of violence to solve problems.
  • An increasing acceptance of lying as a means to an end.
  • Depression rates at all-time highs.
  • Blaming others for our problems.

At the beginning of this essay, I said I was bothered about the church’s handling of mental illness.  At the core of this there are some observations I’ve made:

  1. People with physical illnesses are generally treated with more compassion than those with mental illness.
  2. The families of those with physical illnesses are supported significantly better than those with troublesome mental illness.
  3. Families with significantly mentally ill members are shunned and/or avoided by church members as a general rule.
  4. Churchgoing family caregivers for significantly mentally ill people often carry a sense of personal unworthiness and shame that they attribute to how they are treated in church.
  5. Some church leaders have had to leave their jobs/ministry positions, without any form of restoration help, when their mental illness has been exposed. (Depression and/or sexual indiscretion are the two most common reasons.)

I am aware that these are generalizations; that doesn’t make them less of an indictment of the modern church.  Jesus said this:

Jn 13:34-35 – A new commandment I give to you, that you love one another: just as I have loved you, you also are to love one another.  By this all people will know that you are my disciples, if you have love for one another.

He did not say this:

Love one another – except for those with obvious mental illness – just as I loved you.

God also said this, through Paul His Apostle:

Gal 6:2 – Bear one another’s burdens, and so fulfill the law of Christ.

He didn’t say this:

Bear one another’s burdens, except for those with mental illness and their families.

The world is looking at how we treat our obviously mentally ill fellow believers and their caregivers.  They see us neglecting them, ignoring them and avoiding them.  What do you think they might be saying or thinking?

Should we not proactively love mentally ill people and do what we can to help their families?  After all, aren’t we all mentally ill?

I am going to quote from a book here – Grace for the Afflicted, by Matthew Stanford a professor of psychology and neuroscience at Baylor:

The mentally ill person needs medical treatment, psychological counseling and spiritual guidance.  That is why comfort, encouragement, and support from those in the church are so important.  Where else can they get the spiritual component so necessary in treatment?  Studies have shown that religious support offers the psychologically distressed individual resources that are unavailable through general social support.  In fact, it has been shown that religious support can play a key role in recovery from psychiatric illness.  (p233)

Dr. Stanford gets it – the church is needed, Christ is needed for obviously mentally ill people to get relief and healing from their struggles.  And we are the church!

What do you think?

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The God Who Stoops… And Stands

“Then Jesus stood up again and said to the woman, ‘Where are your accusers? Didn’t even one of them condemn you?’ — ‘No, Lord,’ she said. And Jesus said, ‘Neither do I. Go and sin no more.'” (John 8:10-11 NLT)

Condemnation – the preferred commodity of Satan. He will repeat the adulterous woman scenario as often as you permit him to do so, marching you through the city streets and dragging your name through the mud. He pushes you into the center of the crowd and megaphones your sin:

This person was caught in the act of immorality … stupidity … dishonesty … irresponsibility.

But he will not have the last word. Jesus has acted on your behalf.

He stooped. Low enough to sleep in a manger, work in a carpentry shop, sleep in a fishing boat. Low enough to rub shoulders with crooks and lepers. Low enough to be spat upon, slapped, nailed, and speared. Low. Low enough to be buried.

And then he stood. Up from the slab of death. Upright in Joseph’s tomb and right in Satan’s face. Tall. High. He stood up for the woman and silenced her accusers, and he does the same for you.

He “is in the presence of God at this very moment sticking up for us” (Rom. 8:34 MSG). Let this sink in for a moment. In the presence of God, in defiance of Satan, Jesus Christ rises to your defense. He takes on the role of a priest. “Since we have a great priest over God’s house, let us come near to God with a sincere heart and a sure faith, because we have been made free from a guilty conscience” (Heb. 10:21–22 NCV).

A clean conscience. A clean record. A clean heart. Free from accusation. Free from condemnation. Not just for our past mistakes but also for our future ones.

“Since he will live forever, he will always be there to remind God that he has paid for [our] sins with his blood” (Heb. 7:25 TLB). Christ offers unending intercession on your behalf.

Jesus trumps the devil’s guilt with words of GRACE.

Today’s devotional is drawn from Max Lucado’s Next Door Savior.

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How Do You Diagnose a Sex Addict?

By Jon Jore, M.A.

New evidence points towards growing agreement among researchers on how to diagnose sexual addiction. For many years, disagreements have existed among researchers and clinicians concerning the essential components that define disorders related to problematic or out-of-control sexual behaviors. For instance, what exact symptoms must a person experience to qualify for a diagnosis of sexual addiction? In order to distinguish between people with or without disorders, clinicians need clear indicators of symptoms and consequences of the given disorder.

The Competing Models of Out-of-Control Sexual Behaviors

Whenever a new phenomena or illness is discovered, whether it be a medical or mental health problem, the waters are initially often muddy. Substantial research and experimental treatments are needed to clarify the precise nature of the disorder or disease.

In the case of out-of-control sexual behaviors, researchers have largely fallen into one of four camps:

  1. The out-of-control sexual behaviors are indicative of an addictive disorder (like substance abuse addictions),
  2. The behaviors are indicative of a hypersexual disorder (excessive sexual behaviors/output in a given time period),
  3.  The behaviors are indicative of an impulse-control disorder (impulsivity-driven sexual behaviors), or
  4. The behaviors are indicative of a compulsive disorder (compulsive sexual behaviors, perhaps a symptom of obsessive-compulsive disorder or OCD).

Similar to many other mental disorders and addictions preceding it, when first presented to the medical and mental health communities, sex addiction as a concept was greeted with a great deal of skepticism. The existence of four competing models has made it difficult to present a unified, cohesive body of evidence supporting the existence of an out-of-control sexual behavior disorder. Recently, hypersexual disorder was proposed for inclusion in the American Psychiatric Association’s new Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which is used by mental health providers to diagnose patients.

Sexual Disorders and the DSM-5

While hypersexual disorder was not included in the first publication of the DSM-5, the substance disorders section of the manual was significantly restructured, so now, substance use and pathological gambling disorders are included under the new heading of Addiction and Related Disorders. Also, Internet Gaming Disorder was identified for future research.

These structural changes in the DSM-5 suggest a growing recognition of the many parallels between behavioral addictions and chemical addictions. Additionally, sexual addiction was recently officially recognized by the American Society of Addiction Medicine (ASAM) as a legitimate addiction. Now, agreement on a set of diagnostic criteria may continue to legitimize sexual addiction as a valid mental health issue with serious personal and societal consequences.

Consistencies Emerge Among Four Diagnostic Models

A seminal article was recently published in the Journal of Addiction Medicine called “Clinical Relevance of the Proposed Sexual Addiction Diagnostic Criteria: Relation to the Sexual Addiction Screening Test-Revised” (Carnes, Hopkins & Green, 2014). This article compared various diagnostic models that have been proposed over the years by researchers from the sex addiction, hypersexuality, and sexual compulsivity perspectives. Interestingly, despite controversy over what to call the disorder, several key consistencies emerged when comparing the existing sets of diagnostic criteria.

The most common consistencies relate to continuation of sexual behavior despite problems or adverse consequences, engagement in sexual behaviors during time allotted for other obligations, and ineffective attempts to limit or control certain sexual behaviors The authors conclude that the following diagnostic criteria, first proposed by Carnes (2005), have considerable overlap with criteria proposed by researchers from the hypersexual and sexual compulsivity perspectives:

  1. Recurrent failure (pattern) to resist sexual impulses to engage in specific sexual behaviors
  2. Engaged in sexual behaviors to a greater extent or over a longer period than intended
  3. Long-standing desire, or a history of unsuccessful efforts to stop, reduce, or control sexual behaviors.
  4. Spent excessive time obtaining sex, being sexual, or recovering from sexual experiences
  5. Obsessed with preparing for sexual activities
  6. Frequently engaged in sexual behavior when expected to be fulfilling occupational, academic, domestic, or social obligations
  7. Continued sexual behavior despite knowing it has caused or exacerbated social, financial, psychological, or physical problems
  8. Increased the intensity, frequency, number, or risk of sexual behaviors to achieve the desired effect, or experience diminished effect when continuing behaviors at the same level of intensity, frequency, number or risk.
  9. Given up or limited social, occupational, or recreational activities because of sexual behavior
  10. Become upset, anxious, restless, or irritable if unable to engage in sexual behavior.

Like most mental health diagnoses, they recommend that diagnosis not be given if the out of control sexual behavior symptoms are primarily related to a medical condition, a psychological condition, a medication/substance of abuse, or a manic episode.

Sex Addiction as a Diagnosable Disorder

What do these findings mean for the future of sex addiction as a diagnosable disorder? These authors suggest that there is more agreement than disagreement in the field concerning what criteria constitute problematic sexual behaviors or sexual addiction. The proposed criteria are highly endorsed by people seeking treatment for sexual addiction and, thus, appear to be relevant indicators of a serious and destructive pattern of sexual behavior, whether it is called sexual addiction, hypersexuality, or sexual compulsivity.

The empirical evidence is slowly building to support sexual addiction as a mental disorder. If it is recognized as a mental disorder, treatment for sexual addiction would likely become more affordable and accessible to greater numbers of people who are currently experiencing debilitating consequences related to their out-of-control sexual behaviors.

Gentle Path at the Meadows is committed to continue pioneering research in this area to maintain our cutting-edge, scientifically-supported, world-class treatment for sexual addiction.

Proposed Criteria for SA

References:
Carnes, P. J., Sexual addiction. In: Sadock, B. J., Sadock, V. A., eds. Kaplan & Sadock’s Comprehensive Textbook of Psychiatry, Volume I. 8th ed. New York, NY: Lippincott, Williams, & Wilkins: A Wolters Kluwer Company, 2005: 1991-2001.
Carnes, P. J., Hopkins, T. A., & Green, B. A. (2014). Clinical relevance of the proposed sexual addiction diagnostic criteria: Relation to the Sexual Addiction Screening Test-Revised. Journal of Addiction Medicine, 8(6), 450-461. doi:10.1097/ADM.0000000000000080

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Spilling It All May Be More Harmful Than Not

By Marie Woods, LMFT, CSAT, Primary Therapist, Gentle Path at the MeadowsIn light of some of the recent public disclosures of millions of individuals’ personal indiscretions online, one question many people may be asking is, “Would I really want to know?”

Based on the overwhelming amount of media coverage, it seems that people do want to know—although, of course, most would prefer that there isn’t anything to know, and that their partner doesn’t have any secrets or unknown sexual behaviors.

What if your partner actually does have secrets, though? How much would you really like to know?

At Gentle Path at the Meadows, we are flooded with questions from addicts and their partners about this. Addicts ask how much detail they should share, and partners often don’t know whether having all the details would be helpful or harmful.

The idea that a partner should know everything may seem obvious, but considering the depth of betrayal that accompanies sex addiction, the answer is not necessarily that clear. On the one hand, a partner needs to know the truth in order to make an informed decision about how to move forward with his or her life and the relationship. On the other hand, knowing all of the details can sometimes create more traumas for partners rather than assist in their healing.

Five Ways to Uncover the Truth and Begin Healing

Here are some of the guidelines that we use in helping addicts and partners share the truth while promoting healing:

1. Share information in the presence of professionals.
In the initial stages of recovery, most couples are too volatile to process the discovery together. Couples should make their best effort to seek professional guidance before “dumping” information on to their partner. The disclosure sessions can include the addict sharing their behaviors as well as the partner sharing their anger and frustration. A professional therapist can create a safe container for information to be appropriately shared.

2. Avoid disclosing new information without consulting with a therapist first.
As times goes on, more and more questions develop for both the addict and the partner, and the answers to these questions can be complex. When both individuals are so emotionally volatile (and often exhausted) having a therapist to navigate the situation alongside the couple can be helpful.

3. Recognize that knowing all of the details will not justify the behavior.
Addiction involves irrational behavior. The decisions that were made in the midst of active addiction do not make sense in a rational state of mind. It is likely that even when the partner has all of the details, it still will not make sense. Rather than focusing on the details, partners should focus instead on leaning into their feelings and taking care of themselves.

4. Focus on themes rather than specifics.
Partners have a right to know the nature of the addict’s behavior in an effort to ensure their physical and emotional safety. This includes things like the potential for sexually transmitted diseases, anything that may have occurred in the home with knowledge of the family, or financial impact. This does not typically include things like names, graphic details of pornography or sexual acts, or specific places where acting out may have occurred. Those details create a mental picture in the partner’s mind that cannot be erased, and could continue to leave them feeling unnecessary pain.

5. Recognize that this is a slow process.
It is human nature to want to avoid pain and guilt. Partners want to stop feeling pain as quickly as they can; Addicts want to get out of their guilt and shame as quickly as they can. People often want to skip over this part of the healing, but it is essential. Partners will need to move through the stages of grief, including anger and pain, in order to heal. Addicts will need to experience healthy levels of guilt and shame to get into recovery. So while it may seem easier to “get it all out on the table” right now, true growth and change is an evolving process.

Get the Support You Need

So, as a partner, before you go digging for more information to help you understand “why they would do this,” and, as an addict, before you decide that “if I just tell them everything then I won’t feel so bad, and they will feel better” – think again. If you are the partner of an addict, find some support: someone who, initially, can just hear you vent. Take a step back, knowing that you are taking care of yourself by not exposing yourself to more pain at a time when you are already struggling. If you are an addict, know that you will need to share and accept appropriate accountability for your behaviors when you are in a mature place with healthy remorse. To prevent any further hurt and pain, it is essential to do this in a very measured way, as described above. The ultimate goal of this process is honesty and healing.

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How Finding out About a Spouse’s Affair is Like a Death

Originally posted at: https://drlorischade.wordpress.com/2017/04/21/how-finding-out-about-a-spouses-affair-is-like-a-death/

Tears.  Lots of them.  “I am just so tired of hurting.  I want the pain to go away.”  As usual, my heart was breaking for the spouse sitting across from me who had recently discovered that her partner had an extramarital affair.  Like many spouses before, she declared, “Of all the things I thought I knew in the world, I was certain that my spouse would never in a million years be unfaithful and now I don’t know which way is up.  I can’t count on anything anymore.  All my safety is just completely washed away.”  “I am so sorry that this is so painful,” I offered, “I wish I could make that better for you—I really do, but the truth is that it is going to hurt for a long time.  Eventually, it won’t hurt as much, but when I say eventually, I mean that a year is short in affair healing time.”  Even though I’ve been doing therapy for a long time, the emotions still impact me.

I hate seeing people in pain.  I feel things deeply and enduringly, which is what drew me to the therapeutic profession.  I wanted to alleviate emotional suffering for people.  However, there are certain types of pain which need to be healed over the course of time, and sometimes tender emotional scars never go away.  Some of the deepest emotional pain I witness occurs in cases of grief and loss in which relationships with people are ended or intensely damaged.  The loss of human relationships through death, divorce or other means just hurts.  A lot.

Infidelity and Intense Grief

In cases of betrayal, sometimes people don’t understand the principles of grief and loss that are at play which complicate recovery.  Here is a typical presentation I’ll encounter maybe three months after the disclosure of an affair:

Betrayed partner:  “He couldn’t understand why I was still crying about the affair, and I tried to explain that it still hurts and he just got mad and asked why I couldn’t see that he was sorry and just focus on our future.  I don’t know why it’s still hurting so bad.  I’m embarrassed that it is still making me cry.  I don’t want to make him mad, but it hurts.”

Oh dear.

People who have betrayed their spouses don’t like to witness the pain they have caused because it makes them feel shame, which is uncomfortable.  They also commonly feel fear that this might be the emotional episode in which the spouse decides to leave.  Frequently, they get defensive and upset with their spouses for not healing fast enough.  Men in particular, as a general rule, have an aversion to tears and emotional pain resulting from something they have done in relationships.  They want to run from it, regardless of the cause or validity of the emotion.  They feel almost panicky and search for ways to “fix,” the emotion, which means make it stop.  I think it’s because they get so socialized out of feeling vulnerable emotion themselves that they literally have no idea what to do with it when their spouses display strong vulnerable emotion, at least in many instances.

How Infidelity is a Loss Issue

In cases like these, I normalize the intensity of emotional pain for both partners, but also try to help them understand the deep grief.  I have explained to many husbands, “This is a loss issue, and loss is always painful.”  “What do you mean loss?  I’m still here.  Why can’t she see that I’m trying to fix it and I’m sorry,” the husbands fire back.  I’ll explain, “She can see you, but first of all, she has no idea who you really are because you’re not who she thought you were, so she needs time and safe experiences with you to be able to even think about trusting you.  Second of all, she is still grieving the marriage she thought she had but doesn’t have and will never get back—the marriage in which her partner stayed faithful to her.  She married you with that expectation and has lost that dream.  She needs time to be sad over losing that marriage.”

When I explain this, partners can be a little more tolerant of the deep expression of emotions.  However, for some reason when it comes to emotional injuries, we want people to be better faster than is reasonable to expect—mostly because we don’t like feeling our own uncomfortable emotions when seeing emotional pain.

Physical Pain as a Metaphor for Emotional Pain

Sometimes if I compare the wound of infidelity to a physical injury, partners understand a little better.  “What if you had run over her with your car and she ended up in a body cast?  Would you be getting upset that she wasn’t walking in a week?  No, you wouldn’t, because you would know that the injury takes time to heal.  If while she was in a body cast she told you her pain was flaring up, would you say, ‘It’s been 6 weeks since I ran over you.  Why do you insist on focusing on the pain instead of looking ahead to the future?’  No, you wouldn’t, because you would realize that sometimes pain flares up.  Emotional injuries are the same.  You don’t get to argue with her about whether she is in pain.  Your job is to move toward her and say, ‘Show me where it hurts,’ as if it were a physical injury.  You can’t fix this for her, but you can just be with her and ask if there is anything you can to do reassure her or help her feel more comfortable or safe.  If there isn’t, you just sit with it.  If you want, you can talk about how uncomfortable and sad it is for you to see the pain you caused, but you can’t argue about whether the pain is valid or demand that she heals right away.”

Relationship loss is searing, no matter the type, and infidelity is a type of relationship loss.  Partners need time to grieve and be sad.  Most importantly, they need to be validated and comforted in their pain.  As long as it takes.

Lastly, people always want emotional pain from infidelity to heal faster than it does—both the betrayed partner and the offending partner.  My experience is that in affair time, it’s not uncommon to see people have deep emotional triggers regularly for at least two years.

If your partner betrayed you, know that the disorientation, fear and hurt are normal.  Give yourself time to grieve the loss of the marriage you thought you had, just like you would give yourself time to grieve the death of a loved one or a lost relationship.  Eventually, grief diminishes in intensity, but if grief is criticized and shut down by a partner instead of honored and respected, it will last longer.  Clinically, I tell people to write when they are experiencing episodes of grief.  Articulating pain through writing is a way to manage emotional intensity.  Intentional self-care and deep breathing and meditation can also be helpful.

You’re not crazy if you’re in intense pain months after discovering a spouse’s infidelity—you’re just a human with a big attachment injury.  I don’t know if time heals all wounds, because some wounds can persist for decades, but usually time does decrease emotional intensity.