C. Roy Woodruff
Washington psychiatrist Sheldon Kopp had a knack for finding great titles for good books. He once wrote a book entitled The Blues Ain’t Nothin’ But a Good Soul Feelin’ Bad. I don’t remember much about the book, but I sure remember the title. It captures a significant image of depression, the image of a basically good person who has begun to feel really bad, often in response to a bad experience that touches the soul at its deepest levels, with hope being squeezed out by a sense of helplessness.
“The Blues” is a quaint but frequently inadequate expression sometimes used to describe feelings of depression. When we are just having a bad day and feel temporally down for one reason or another, to say we are feeling blue may be adequate. But when we carry around these heavy feelings for days on end, without relief, we are depressed. We need to recognize that reality, own it, and do something about it before it does something about us that can, in fact, impair our ability to think and act at critical times in our lives.
Over my 30-something years as a pastoral counselor, clinical depression has been the most often seen mental health concern. From a statistical perspective, that is not surprising since depressive disorders, along with anxiety disorders, rank at the top of the list of major mental health problems in America. What may be surprising to some, however, especially those who may be naive about the impact of clergy stress, is that this is also true of clergy. For various reasons, depression and ministry are frequently unwanted correlates. Depression is emotional baggage that is often brought into a ministry vocation from previous experience, or baggage that is acquired in the wear and tear of years of pastoral service, or both. It is also the most likely mental/spiritual fallout of forced termination from a ministry position.
Being forced to resign, or being fired, can be traumatic in any job. However, when one’s job is one to which we have felt called by God, the trauma runs deep in the psyche and a good soul starts feeling bad, sometimes real bad. The emotions of grief and anger collide in a way that can create overwhelming feelings of helplessness and hopelessness. If one is immobilized by these powerful reactions, a pervasive sense of personal and professional impotence leads to loss of self-esteem, a sense of failure, and a sense of victimization. Any or all of these outcomes guarantee making a bad situation worse and are among the indicators of clinical depression. Other indicators relate to changes in one’s normal ways of functioning, such as sleep patterns, appetite, primary relationships, decision-making, job functioning, and stress tolerance. Since depression is known to affect the body’s immune system, physical ailments can also be symptomatic. It is a pervasive disorder that, over time, leaves little about ourselves unaffected.
Nature vs. Nurture
The old question about depression, as well as mental disorders in general, is whether it arises from nature, essentially the biochemistry of the brain, or from nurture, essentially those high impact things that have happened to us in our lives. In the enormous advances that have been made in understanding the brain in the past 10-12 years, we have learned that it is both. Moreover, we have learned that the question is basically irrelevant. While brain function is directly related to our general physical, biochemical health, and while it is affected by genetic and other attributes beyond our control, it also reacts chemically to what happens to us. This more wholistic understanding of brain function has impacted treatment for depression.
Studies have shown that effective treatment is obtained both through drug therapy and psychotherapy, with the most effective treatment generally involving both kinds of intervention. Antidepressants can improve brain functioning to the point where a person can benefit much more from the psychotherapy that is also needed to deal with the environmental causes of depression.
There’s Bacteria in the Baptistry
Enlarging on the nature vs. nurture issue a bit, it is seldom the case that the full blame for conflict between pastor and congregation can be laid upon either one or the other. Both are generally implicated. Although the implication may or may not be equal, the responsibility for dealing with it and seeking to resolve it is equal. The Biblical truth that “all have sinned and fallen short of the glory of God” keeps proving itself to be true. One of the reasons, however, that maintaining positive clergy mental health is so important is that, euphemistically stated, “there’s bacteria in the baptistry.”
While no congregation is free of emotional and interpersonal contamination, some congregations are infected by one or more persons whose personal agenda, or pathology, can make life miserable for the pastor, as well as others. Someone once quipped that “just because you are paranoid doesn’t necessarily mean they aren’t really out to get you!” When the pastor’s emotional/spiritual immune system begins to weaken under this stress, he or she can begin to withdraw or strike out in ways that are counterproductive. Denial on the part of both pastor and people can obscure the obvious and prevent communication about potentially volatile issues before they become destructive. It is important that we accept that we are, in fact, earthen vessels, in which a great treasure is rather precariously contained. Too much stress can shatter all concerned in painful and destructive ways.
Hemmed in by Darkness
Remember Job? Now there is the classic case of forced termination! Job was unjustly terminated from his work, his family, his possessions, his health, and very nearly his life. And by whom? By God himself. There is no more graphic portrayal in all of literature of a person’s struggle with major depression in the face of an overwhelming sense of injustice and loss at the deepest level. I seriously doubt that Job’s predicament can be explained merely by a biochemical imbalance, but I would bet that his brain chemistry was a mess in the process of trying to deal with it. I’ve had seriously depressed clients whose affect and feelings were precisely described by Job. I’m sure, whoever wrote that book had “been there and done that.” The writer had also apparently survived to tell about it, which is encouraging.
Job mourns: God has made my heart faint; the Almighty has terrified me; for I am hemmed in by darkness, and thick darkness covers my face (23:16-17). There are the usual ingredients of deep depression; faintheartedness, terror, immobility, darkness. I worked as a chaplain in a state mental hospital in the days before effective antidepressants existed, and this accurately describes what I saw in those diagnosed with major depression. Job, therefore, becomes an extremely helpful case study for us in understanding the spiritual aspects of depressive disorders. While this venue lacks space and purpose for extensive exploration, let me say that I believe that the central issue in the Book of Job is the issue of moral integrity, the integrity of God as well as the integrity of Job. In the face of his “friends” telling him that it is all his fault, Job states: Far be it from me to say that you are right; till I die I will not put away my integrity from me. I hold fast to my righteousness, and will not let it go; my heart does not reproach me for any of my days (27:5-6). Job’s struggle was with how to maintain his sense of integrity in the face of such disaster. I have seen this dynamic repeated in the struggles of depressed clients, and it has proven helpful to re-frame one’s depression in that way. It is clearly relevant to a pastor who has been fired or forced to resign. Job’s problem, as Yahweh eventually clearly reminds him and us, was his arrogance, which he finally reconciles (42:1-6). In the end, Yahweh admonishes Job’s friends for their insensitivity and ignorance while he affirms Job’s righteousness, faithfulness, truthfulness, and ultimately his integrity (42:7-9).
The Intention of God
The Good news from the case of Job is that one can move into the pain of a major life trauma with courage and integrity, re-frame the trauma by going to the deeper spiritual issues at stake, speak openly to others and to God about one’s experience, and find the most important restoration of all, a recognition of one’s integrity and faith. However the intention of God is debated in the experience of Job, one thing seems clear. God intends for us to not only survive life’s traumas, but to also learn and grow from them, to be changed in positive and creative ways. In his book, The Way of Wisdom, O. T. Professor R. B. Y. Scott captures this intention in the following quote. “Each man is cast into the buffeting waves of life where he must swim or go down. God does not come to him like a life preserver tossed from a ship’s deck. A man will drown unless he believes that God intends him to swim.” (p. 164)
The writer to the Hebrews also speaks to this intention by saying, Therefore lift your drooping hands and strengthen your weak knees, and make straight paths for your feet, so that what is lame may not be put out of joint but rather be healed. Strive for peace with all men, and for the holiness without which no one will see the Lord (12:12-14). He continues by warning us of the “root of bitterness” which we must move beyond.
The bottom line in dealing with depression is to become aware of the symptoms, recognize one’s own possibility of being depressed, and get the professional care and treatment that is needed. Especially for those whose life has been committed to spiritual ministry, it is vitally important that the spiritual/theological depths of one’s experience be explored with courage and integrity, and that one’s primary relationships be nurtured and strengthened through the process.
Dr. C. Roy Woodruff, PhD, was a graduate of the Southern Baptist Theological Seminary, Louisville, Kentucky, and retired as Executive Director of the American Association of Pastoral Counselors. He served as a member of the MTM Board of Trustees.