There was a pastor with depression who thought his afflictions were “a spiritual problem”. He got better when eventually treated by a psychiatrist.

Beyond psychiatric help was a man who saw “strange sights”. He was taught the Desert Fathers’ approach to demons and recovered when he learned he was to treat demonic activities as “spiritual mosquitoes” and “not to pay attention to them; pay attention to Christ”.

Such encounters were shared by Rev Dr Robert Solomon, Bishop Emeritus of The Methodist Church in Singapore, to highlight the connection between the spiritual and the clinical when dealing with mental illness.

“While we try to differentiate mental health professions and pastoral care, we should not divide them so much that it’s either this or that.

“There are big connections,” he said. “There are common grounds on which we stand.”

Rev Dr Solomon was speaking at the opening of the two-day Christian Mental Health Conference (July 16-17). The Zoom seminar, attended by pastors, church workers and mental health practitioners, aimed at increasing understanding of mental health issues in the Church and equipping it to help.

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Common roots

The common roots of pastoral care, psychiatry and the mental health professions trace back to the early centuries, said Dr Solomon.

He shared that one of the key aspects of pastoral care was called cura animarum, or the cure of souls. As early as the 6^th century, Gregory the Great, the Bishop of Rome, had already written a book entitled Pastoral Care to teach the clergy how to care for their parishioners.

Demonology “was a very strong paradigm”, and this held true throughout the medieval era, right up to the dawn of the Reformation in the days of Martin Luther. 

Said Dr Solomon: “If you read his writings, his biography and some of his songs, you will find that, for Luther, the devil was a real reality and he had a certain way of handling the devil.”

More recently, Canadian psychiatrist and medical historian Henri Ellenberger tried to show in his 1970 book, The Discovery of the Unconscious, that “medieval demonology is the mother of modern depth psychology”.

The etymology of the word “psychiatry” shows the connection between pastoral and clinical care. While the Middle Latin word psychiatria means “healing of the soul”, the Latin word, originating from the Greek psyche, means “mind”. In turn, iatreia means “healing” or “care”.

“The psychiatrist is the modern healer of the soul – a function performed by the clergy and healers in the church for many centuries,” said Dr Solomon.

But he added that although the paradigm has many similarities, over time its language has changed.

The great divide

The dichotomy began during the Age of Enlightenment and “can be understood as a secularisation process.

“This secularisation process demystified the unknown and the intangible, thus resulting in the erosion of the spirit world from the popular consciousness and experience of – at least – the modern Western process.”

The “professionalisation of caring ministries” emerged when all the helping professions that were once the purview of the pastor became developed outside of the Church.

“This has resulted in the pastor reducing his shopfront, so to speak,” said Dr Solomon, as “different orientations and methods, and perhaps even results” have evolved.

Dr Solomon noted that it was American psychiatrist Karl Menninger who issued the clarion call to integrate pastoral care with psychiatry.

In his book Whatever Became of Sin, Menninger appealed to pastors not to abandon the religious language of sin and redemption in their eagerness to embrace psychological language and ideas.

“He wrote this quote: ‘If I can convince patients in psychiatric hospitals that their sins were forgiven, 75% can be discharged.’

“That comes from a very famous psychiatrist who felt that pastors were rapidly abandoning their language of sin and redemption.”

Hence, Rev Dr Solomon’s exhortation: “Don’t abandon it to embrace our language. Keep your language, because we need to work together in this.”

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The way forward

Dr Solomon then mapped out four ways the two sides can work together.

#1: Return to the Bible
He called for a “return to the confidence of the biblical worldview, and biblical diagnosis and prescription for the human condition”.

“The Bible has real wisdom on the human nature, and human behaviour, motivation and human relationships.

“So, I think we must understand the authority of Scripture and its relevance for today.”

God’s grace – of which the Bible speaks – is also pivotal in the healing of mental illnesses.

“It’s so important to appreciate, understand and to apply it in our pastoral craft, in our healing craft because, without God’s help, His grace, we will not make any major headway in bringing healing to people.”

#2: Have mutual appreciation
Insisting there must be an appreciation of medicine, psychology, sociology, Dr Solomon said: “I think it is in appreciating those areas of knowledge that, perhaps, we can understand that we can work together.

“All truth is God’s truth,” he affirmed. “This is a statement that some Christian philosophers have used.” 

Of the divide between Science and Christianity, he said: “If you believe that Science is a study of Nature, including human nature, then surely we can work together in this aspect.”

On the part of mental health professionals, Dr Solomon encouraged an “appreciation of history, theology, pastoral care, the role of sacraments, the role of worship, and the Christian community”.

“The whole history of pastoral care that the church has is a treasure chest.”

#3: Develop and integrate a holistic approach
“We are embodied beings and we are social beings, and we are spiritual beings. So, I think we need to recognise that we need different approaches that provide a holistic approach to helping people,” he urged.

There is, therefore, a place for teamwork and collaboration.

#4: Create a network of support
“I think this is important for us in Singapore because we share a common faith in Christ and the teachings of the Bible – whether we are pastors, volunteers, social workers, families in the community.” 

Access to common resources would benefit all parties.

Marrying the spiritual and the clinical

Dr Solomon was given the chance to field questions from the participants who wanted to know how to practically incorporate the spiritual into the clinical.

#1: How can you tell whether it is demon possession or a mental illness?
Dr Solomon replied that the more Biblical term would be “demonised” and that the devil’s influence should be seen in broader terms.

“Demonic activity in our lives is a spectrum. It starts with temptation. The devil knows how to draw our desires to sin like the way he tempted our Lord Jesus – right up to possession, which is complete control.

“So, you look at the whole spectrum. It’s varying degrees of control or influence.”

For example, he said, demonic activity can be recognised as having a role if a person struggles with “sick thoughts” or addiction, because “demons like to work under camouflage”. To focus solely on possession would be to “dismiss all the 99% of (the devil’s) activity in human life”.

It is difficult to separate experiences in the body from what is happening in the psyche, or from demonic or societal influences. “Be careful of going for either this or that,” Dr Solomon said. “Be more open to both this and that.

“We need to have a larger understanding, and to recognise that we are complex creatures, embodied beings, spiritual beings, social beings – or cultural beings.

“And so, we try to understand what makes us tick and what makes us dysfunctional and, in so doing, all the more we need collaboration.”

#2: What is the difference between pastoral care and pastoral counselling, and professional counselling?
Professional counselling deals with the medical condition. Pastoral care and counselling involve using the relationship between the person and the pastor to examine, in greater depth, the causes in the spiritual dimensions.

“It’s basically shepherding the soul. God is so much more in the picture,” said Dr Solomon.

However, he cautioned against putting everything into “neat silos”, saying there is often an overlap. “Any pastor who is professionally trained – he can provide professional counselling.”

#3: In the secular space, mental health professionals cannot refer to Scripture. How, then, can the two aspects come together?
Dr Solomon replied: “You may not be able to overtly testify, to use words to mention God. But you can find some way to show you are a Christian.”

Apart from displaying verses, the cross or even the Bible, he encouraged showing Christ-like love. “In the way that you pay attention, the way you exercise kindness, generosity and gentleness, I think we can still be ambassadors of Christ and it will have an effect.”

He also suggested praying before, during and after each session with a patient. “You may be in a secular setting but you are equally as much like a priest, praying for your parishioners.”

#4: How can we help the Church understand that a lack of faith does not translate into emotional suffering or mental illness?
An understanding of what “faith” means is necessary to tackle this question, maintained Dr Solomon.

“Faith is trust in Christ, in God. Faith is not trust in doctrines, an institution or a ritual.

“If you trust Christ, I think your emotional life will be more stable, your mental life will be more stable, because Scripture does suggest that we can bring our thoughts under control by the Holy Spirit.

“So, the lack of faith, in that sense, can lead to dysfunction, emotional turmoil, doubt, anxiety and so on and so forth.”

However, Dr Solomon added that if someone is struggling and in emotional turmoil, “we have to be very careful not to say: ‘You don’t have faith.’ ”

Drawing on the story of Jesus calming the storm, he spoke on the importance of trusting in the Person and presence of Christ.

Though Jesus was with His disciples when the storm came, they were afraid. They needed a demonstration of His power to be assured. What Jesus wanted to teach them was that if they had His presence, they could rest in any storm. That was the type of faith He wanted them to have.

“It was that aspect of faith that Jesus was disappointed in not seeing in His disciples that we could try to explain to somebody who’s struggling, and then, gently, discuss with them about your relationship with Christ – the experience of faith.

“Maybe their difficulties are in trusting God in their particular situation.

“I think that kind of thing would be much more helpful than simply saying, ‘You have no faith. Just tighten up your faith and we’ll be alright.’ That often doesn’t solve reality.”

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