Counselling as Ministry and Church as Caring Community

1. Counselling as MinistryandChurch as Caring Community Dr. Samuel Pfeifer, M.D. Senior Consultant Mental Health Klinik Sonnenhalde Switzerland

2. Introductory Bible Passages • Isaiah 25:4 • You have been a refuge for the poor, a refuge for the needy in their distress, a shelter from the storm and a shade from the heat. • Matthew 9:36-37 • Seeing the people, He felt compassion for them, because they were distressed and dispirited (harassed and helpless) like sheep without a shepherd. 37 Then He said to His disciples, "The harvest is plentiful, but the workers are few.… • 1. Thessalonians 5:14 • And we urge you, brothers and sisters, warn those who are idle and disruptive, encourage the disheartened, help the weak, be patient with everyone.

3. The multitudeofthesufferingisatourdoors Who are «theneedy in theirdistress?» (Isaiah 25:4)

4. Suffering Souls – the needy of our time

5. Mental Health – Four trumpets • WHO: Depression is a hidden burden, affecting around 350 million people around the globe. It is the leading cause of disability worldwide. • Patients tell their stories – in our hospitals, outpatient departments, at the church doors. • Family and friends: almost every person knows at least one person who is affected with symptoms of depression • The Bible records prayers and descriptions of depressive mood.

6. Patients tell their stories • Depression is a common mental disorder, characterized by sadness, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, feelings of tiredness, and poor concentration. • Depression can be long-lasting or recurrent, substantially impairing an individual’s ability to function at work or school or cope with daily life. At its most severe, depression can lead to suicide.

7. STRESS OF MODERN LIFE • Long transfer to work • Multiple tasks that cost a lot of time and strength • unfair boss, chaotic colleagues • Desire to be a good employee • Lack of positive feedback, constant pressure • too much noise, lack of privacy, excessive distractions, and unreasonable deadlines. • Broken friendships • Distress in the family

8. MARITAL PROBLEMS • Being confined to the house, • In-laws: no positive feedback, unreasonable demands, disrespect, cosntant criticism • «shouting man / crying woman» – ingredients of every Bollywood movie • Unfulfilled wish to have a child • No time for yourself, no time to relax • Worry / financial problems • Sexual problems

9. VIOLENCE / TRAUMA • Childhood trauma • Traumatic experience • Partner with alcohol problem • Threats and beatings

10. BEREAVEMENT • Losing a close relative or friend • Losing husband or wife = losing support in life

11. Family and Friends • Who in this auditory does not know anybody affected by the symptoms of sadness, loss of energy and social withdrawal? • Not only patients themselves are affected – depression is a burden for the whole family!

12. The Bible describes depressive states • You won't find the term "depression" in the Bible. Instead, the Bible uses words such as downcast, sad, forlorn, discouraged, downhearted, mourning, troubled, miserable, despairing, and brokenhearted. • Bible people showing the symptoms of this disease: Hagar, Moses, Naomi, Hannah, Saul, David, Solomon, Elijah, Nehemiah, Job, Jeremiah.

13. Biblical examples • Hannah, who was barren, • Jeremiah, the "weeping prophet." • King David — “I am troubled, I am bowed down greatly; I go mourning all the day long. …I groan because of the turmoil of my heart” (Psalm 38:6,8 - NKJV). • Read Psalms 6, 13, 18, 23, 25, 27, 31, 32, 34, 37-40, 42-43, 46, 51, 55, 62-63, 69, 71, 73, 77, 84, 86, 90-91, 94-95, 103-104, 107, 110, 116, 118, 121, 123-124, 130, 138, 139, 141-143, 146-147. The prophet Elijah went through an episode of “Burnout” after his great victory against Jezebel: He (Elijah) came to a broom bush, sat down under it and prayed that he might die. "I have had enough, LORD," he said. "Take my life; I am no better than my ancestors." Then he lay down under the bush and fell asleep. (1 Kings 19:4-5, NIV)

14. The Church iscalledtocare

15. Jesus called the weary and the burdened • Come to me, all you who are weary and burdened, and I will give you rest. Take my yoke upon you and learn from me, for I am gentle and humble in heart, and you will find rest for your souls. For my yoke is easy and my burden is light.” (Matthew 11:28-30) • His calling is now our calling as Christians in the Church

16. Cultural context of urban mental health Subanghi R. Parkar, GENDER AND THE CULTURAL CONTEXT OF URBAN MENTAL HEALTH IN MUMBAI, Disseration University of Basel 2003

17. Urban afflictions affecting men

19. Promoting mental health in the 21st century • “New public health initiatives of the 19th century brought about substantial decline in deaths from infectious diseases through sanitary reform, and we now need to consider how analogous population-based measures may be adapted to promote mental health.” • Prof. Shubhangi R. Parkar, KEM Hospital Mumbai

20. Idle, unruly 1. Exhort Anxious, timid 2. comfort, encourage The weak 3. support, help everyone 4. Be patient Four Biblical Strategies 1. Thessalonians 5:14

21. The Church iscalledtomake an impact in society Byaddressingtheneedsofpeople Beingabletocommunicatewith professionals (medicine, psychology)

22. The Bio-Psycho-Social Model / Spirituality The Causes of mental disorders are to be found in three areas. Depending on the type of disorder, there are various emphases. QUESTION: What is the role of spirituality? Is it a causal factor or rather a factor of coping and understanding?

23. Way of Life (Eph 4,22) Mind (Rom 8,6; 12,2) PSYCHOLOGICAL Emotions - Thinking Volition – Behavior Coping - Defense MentalProblems SOCIAL ASPECTS BIOLOGICAL Childhood, Family Life Trauma, Life events „Stress“ Genetics, Personality Neurobiology Physical Constitution Gal 6,2 2. Cor 6,4 1. Peter 1,6 1. Cor 10,13 Burden Hardships Trials Temptation Weakness 2. Cor 12,9 Factorscontributingto Mental Illness

24. T A L K I N G Proberbs 16,24; 18,21 1. Thessalonians 5,15 Hebrews 10,24-25 Attention, Empathy,Understanding, CounsellingComfort, Encouragement Teaching Patient S U P P O R T M E D I C A T I O N Visiting - Helping Aktivation – Enabling betterautonomy Antidepressants, Neuroleptics, Mood Stabil.Tranquilizer etc. Isaiah38,21 J. Sirach 38,1-8 1. Timothy 5,23 Galatians 6,2 Matthew 25,35-40 Proverbs 3,27 Therapeutic avenues

25. The churchhasresourcestocare Togetherwith Christian professionals, thechurchcanoffercousellingandcare

26. 1 Talking Support Activation Medication 1 2 4 3 4 3 Depression can be treated Thinking STRESS 2 Where is the church coming in? Counselling? Care? Body

27. Faith as a source of strength in depression • Despite despair, doubt and lack of energy • Bible verses and Christian songs • Encouragement by fellow Christians Blessed are those whose strength is in you, whose hearts are set on pilgrimage. As they pass through the desert valley, they make it a place of springs; the autumn rains also cover it with pools. They go from strength to strength . . . (Psalm 84)

28. Conclusions • 1. We should be open for a deep personal awareness of human suffering beyond all categorical and theoretical considerations, moving us to compassion and motivating us to find new ways for creative caring. • 2. We should be aware of new developments in our field, able to communicate with the world, to examine the philosophical underpinnings, critically evaluating what we can apply in our everyday practice.

29. Conclusions ctd. • 3. We should be guided by the Word of God as an eternal source of wisdom and truth, practicing an exegesis that applies to the burdens, the questions and the spiritual hunger of our patients. • 4. We should be guided by the principle of hope, hope which is not only rooted in the prospect of restored health, but hope in the midst of existential weakness, hope which is not only based on well-being in this world but hope that goes beyond all that our limited activity can achieve.

30. „I will give you rest!“ • Matthew 11:28-30 • "Come to me, all you who are weary and burdened, and I will give you rest. 29Take my yoke upon you and learn from me, for I am gentle and humble in heart, and you will find rest for your souls. 30For my yoke is easy and my burden is light." (NIV) • Then Jesus said, “Come to me, all of you who are weary and carry heavy burdens, and I will give you rest. 29 Take my yoke upon you. Let me teach you, because I am humble and gentle at heart, and you will find rest for your souls. 30 For my yoke is easy to bear, and the burden I give you is light.” (New Living Transl) • 28-30"Are you tired? Worn out? Burned out on religion? Come to me. Get away with me and you'll recover your life. I'll show you how to take a real rest. Walk with me and work with me—watch how I do it. Learn the unforced rhythms of grace. I won't lay anything heavy or ill-fitting on you. Keep company with me and you'll learn to live freely and lightly." (The Message)

31. Two great gifts • Jesus offered two great gifts that are the object of our deepest strivings / longings: • spiritual renewal / change • spiritual repose (“I will give you rest”) • “Spiritual renewal is offered in the new birth – a concept at the very heart of Jesus’ teaching. Here we are provided with the possibility of a new beginning that is so radical and complete as to be best expressed in the analogy of birth. • The gift of spiritual repose is described as rest for the souls of those who labour and are heavy laden. Toil is not abolished; rather Jesus offers to replace a heavy yoke with a light one and to provide restored strength for the task.” • (D. Benner p. 27)

32. What can we learn from Jesus • Jesus saw the condition of people • Jesus had compassion • Jesus addressed their innermost yearning (“I will give you rest!”) • Jesus does not promise a life without a yoke – but he will join them in bearing the yoke together • Jesus challenges people to learn from him • Jesus sets himself as a model: ”humble, gentle”

33. www.psy77.com More Presentations on Global Mental Health in Christian Context