Interview with a Therapist: Anonymous, Part 2

If you missed it, here's Part 1 of the interview.

In Part 2, we talk about the stigma of going to therapy and taking medication, the definition of mental health, the role of spirituality in the therapist/client relationship, and more.

This interview has been edited for clarity.

Photo by Eje Gustafsson

Q. Any thoughts on the social stressors that might lead to a mental health crisis, such as losing a job, unemployment, divorce, abuse, trauma, etc. and how the church might address these?

All those things are considered losses—it's the same as losing a person in your life. Divorce can affect you as much as the grief of losing a loved one and so can losing a job. They impact you in the same way as far as pain and the loss of who you are, your identity.

I think the church should address [divorce]. I feel like no one likes to talk about it. People get divorced. People lose their jobs. There are a lot of freelance [workers] who are constantly without work—that can affect you.

Luckily, if you find a good community group where you're able to discuss [these things] and be vulnerable, hopefully they'll be supportive. That's happened in one of our small groups. People have started opening up about their trauma and the group has been very supportive.

Q. In your experience, are Christians more or less resistant to seeking professional help?

They're more resistant. Because they feel like God is going to heal them already, or if they go to a therapist there is something wrong with their spiritual faith.

Some people feel like going to a therapist is very taboo, like dating someone who works for the IRS. No one likes the IRS.

Usually, it's seen as a last resort [in] getting help. And it shouldn't be. It should be one of the first things that you do if you feel like you're not being the person that you want to be.

"If you go to a therapist, then there's something wrong with you."

And that's not what it is. You're going to someone who has experience and can help you achieve your goals.

The worst thing I've heard was someone who was sexually abused (the family was Christian) was told, “God will make you forget that and make it go away.”

Forgetting about it is not really dealing with it.

Q. Any thoughts on integrating your spiritual life with your practice?

I think for me, it's being open. People think that psychologists aren't Christians, and that's not true. I've prayed for some of my clients—not in the room. But I've been open spiritually to whatever they bring into the room.

And that really helps me get a sense of what's going on. Because we have all these senses and a spiritual sense is something that I feel like people leave out. [But] it's a part of you—you can't leave yourself out of the room.

You bring your whole self into a room to help integrate what the client wants to do—what their goals are, what they want to achieve—and they sense that.

I never talk about God in the room unless my clients ask me:
“Do you believe in God?”
“Yes.”
I'm not going to lie.

I've had [times] where I was going through a spiritual process, and the client started a random conversation, just talking about God. So you never know.

If you incorporate every aspect of yourself into a room, your client will see that and they'll connect with it—because you're being your most authentic self. You're being vulnerable to them, so that they can be vulnerable to you.

Q. Any thoughts about the intersection between being a therapist and being a Christian?

I will say that there was a moment where I was very rational and I didn't incorporate that—especially in my early years in clinical work. I didn't incorporate that because I didn't understand how to.

And then one day I was like, “Well, it's a part of me, why am I leaving that out?”

Once that clicked, I was able to work further with my clients than just at the superficial level. I was able to do deeper work because they sensed that I'm bringing myself into the room wholly—I'm there and I'm present.

And then we were able to share more—without me having to disclose anything [about religion]. Just that open energy and being able to share and be vulnerable actually helped me help them in their work. It's so weird. But it did.

Q. It's interesting, because I've gone to therapy, and I don't think my therapist was a Christian (that I can tell). It makes me want to know, [laughing] I wonder if they believe in God?

I mean, you can ask them.

But that's the thing—you have to be in a place where you feel comfortable asking your therapist—It's a very personal, private relationship, it's very intimate. It's very strange, but it's an intimate relationship that you have with someone.

If you're not able to ask them these types of questions, then what is going on in the room?

Yes, therapy is focused on you, but I think there's nothing wrong with asking your therapist a question. It might actually surprise them.

Q. Sometimes I like it when therapists tell you something about themselves, because it feels a little less one-sided.

It feels authentic.

Q. How do you help a friend you think might be going through a mental health crisis?

If it's just something that's been going on for a couple of days, then you might want to wait a month or two to ask them about that again. But if it's been going on for years and someone hasn't been getting any help, then you can be like, “Have you thought about therapy?”

Oh, I almost forgot: there is also a huge stigma against medication.

And I think being open, “Have you thought about medication?” I don't think there's anything wrong with it, some people do need it.

I don't think everyone needs it, but that's for a psychologist and a psychiatrist to assess. So just being open about it and supporting your friend if they're taking medication—like I said, “If it helps you, that's great.” But I don't hear that from many people.

Q. Because you don't want to be like, “You should be on meds!”

But just being supportive of their struggle. 

The medication part is always [about] whether the client wants it or not. No one is ever going to force them to take it.

It's like, “Hey, this is an option for you. Therapy is an option for you. Different types of therapy are an option for you, what do you think? Do you think it would help, would you even try it?”

Even suggesting things like this without judgement is so important—having friends feel comfortable talking about these things.

Q. I feel more comfortable suggesting therapy because I go to therapy, but the medication thing I feel like I don't know much about it. But taking away the stigma—thanks for bringing that up.

I almost forgot about it, but I'm like, “That one's big. That's really big.” [laughing]

Q. Especially in the Christian world.

“Your healing will come from God,” but what does that look like?

Q. "You're not supposed to take medicine"—

But maybe I do, people take antibiotics.

Q. Right, they take it for physical stuff. Anything else you want to add?

I think that mental health is not exclusive of the church, it's part of it—it's there, people are struggling. And I think it should be taken into account when someone comes to you for advice or help.

It's just like [any other] field, like a doctor who's a Christian or a therapist who's a Christian. I don't think that you have to pick one or the other.

Spirituality is just as important as mental health and together they really help a person have breakthrough [in their life]. I use spirituality in my own individual life along with mental health practices, just to maintain mental health.

Q. What's your definition of "mentally healthy"?

It's not having a perfect life—that's not what mental health is—it's being able to cope with difficult things in your life. And even being able to be happy. [laughing] Yes, it's very hard. It's very hard.

Interview with a Therapist: Anonymous, Part 1

Next up in the series on The Church & Mental Health where I interview Christian therapists to talk about the intersection of spirituality and psychology:

Today's interview is with Anonymous Therapist. We talked about what the church can do to support mental health, dealing with depression, suicide and abuse, the stigma of seeking help and taking medication, integrating spirituality with therapy, and knowing when to call the cops.

This interview has been edited for clarity.

Q: What can we do to de-stigmatize mental illness within the church?

AT: By being open—for instance, I noticed that bigger churches—I think it was Saddleback or another Christian church in Orange County—they offered mental health services—referrals. Our church doesn't really do that, as far as I know, unless you ask around specifically. 

I think a lot of it—certain issues like trauma, sexual abuse, depression, the church doesn't really want to address. I've had friends who have been suicidal and they didn't know who to turn to. So, being open that healing can come from different avenues besides the church.

Photo by Eje Gustafsson

Q: Do you have any ideas or concrete ways that the church could do that?

AT: Sure, there's another issue—domestic violence—how is that addressed in the church? It happens. How does the staff deal with that? Do they refer anyone? 

That one church that I was talking about, they had domestic violence classes and they offered a list of things for the congregation. 

Just being open: “Hey, if you have an issue, come meet with us. And if we're not the appropriate person we can refer you to someone else.” But there's nothing ever said about that, at all.

The one positive thing that I've seen is when Erwin Mcmanus [pastor of Mosaic] did his talk about being severely depressed. Because no one really wants to talk about that. No one wants to talk about, “Well, okay, you're a Christian, but what happens [when] you're depressed, what happens if you get prayed for and, “I'm still depressed.” 

Everyone wants that instant healing, and it doesn't happen that way. People deal with depression for years, on their own, without any help.

Q: How can we as individuals talk about mental health in a way that respects individual experience and takes away the stigma? Not, “There's something wrong with you"—

AT: Yeah, like “You need to get prayed for,” “You don't believe."

The best example I heard was from Erwin: We don't look at mental health issues or illness like physical illness, we treat it like, “You'll get better,” “Don't feel that way,” “Just pray.” And that's not how things get better.

Someone has an issue that they're dealing with and it's internal—and it's like [telling] a cripple, “Hey, you can walk, if you just believe enough.” 

It may not happen for him—he may be crippled for the rest of his life. That doesn't make him less of a person, it's just a part of him that he has to deal with. 

That was the best experience that I've had as far as the church being open about mental health issues.

I think individually we need to stop saying, “Hey, don't feel that way.” I do it sometimes and I have to stop myself, and I have to be like, “No, they're coming from a place—they feel this way."

“Okay yeah, I understand what you're saying.” And trying to give them advice like, “Have you prayed, have you done this—”

They may have done all of those things and it didn't work. Their healing may come from multiple sources. And it all goes back to God. But how it comes about, it might be through different people or experiences. I don't necessarily think it just has to be one thing and that's it.

Q: What resources should the church offer and invest in related to mental health?

In general, the church should attach itself to some type of psychologist or Christian [therapist]—people that they feel are going to be able to handle this type of work—it's specialized work. 

There are some programs where pastors also take therapy classes and they have a dual role as a psychologist and a pastor, but not everyone does. 

And what we're seeing now is a [greater] need for mental health services because of drugs, prolonged trauma...and you do need specialized care for this, someone to work with you who understands these issues without judgment.

Even referring people, [saying] “Hey, we don't have the expertise in this area, but we want to support you. Here is a list of people we work with that we would recommend to you for these certain issues.”

M: So basically just having a list of referrals—any church could do that.

But if you notice very few churches have it on their website.

I honestly don't know if our church—I'm sure that they do, but I don't want to say that Mosaic has it. It's mostly word of mouth and I don't think it should be like that. 

Because people find it hard to open up to others about their issues and sometimes they just need a referral, “Who can I go to?”

A: What helpful or not helpful things do you think churches do?

If someone is suicidal, prayer is great, but you need to call the cops. [We both laugh]

Don't just leave them there and pray for them, you need to call the cops—[prayer] is not enough, it's so not enough. 

If you know that if you leave them alone and you walk away that they're going to hurt themselves and they have a plan, then you have to call the cops. Even I would. 

It's a crisis—if you're in a crisis situation, that's the only thing you can do. Even if you're a therapist. The number one issue right there is safety—safety for yourself, safety for your client. 

Q. What if a friend is not suicidal, but you can tell that something is wrong? If you don't feel that they're going to hurt themselves, but...who do I talk to?

It doesn't hurt [to call the cops]. Some police officers have been trained in assessing suicidal clients or clients who are in harm's way—they don't know where they're at, they're unaware of their surroundings and someone can hurt them. 

The emergency operators have a feel for the situation. That's always your best option.

If someone's just depressed—

There's a difference in the type of situation that becomes a crisis versus someone going through a very difficult time. 

The intensity is different. And if you're in a crisis mode where you feel like they're in danger—immediate danger, there has to be a sense of immediacy—then I would just call the police. 

Because there's nothing that you can do without having law enforcement help you. I would say that law enforcement is good about at least taking them in if they're suicidal, and then they get assessed by someone. 

It sounds a little scary, but in the end you have to think about safety and what you can do.

[To be continued...]