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...]

The Church & Mental Health: Interview with a Therapist

Photo: "Memorial Church" Don McCullough

Today begins a new series on "The Church & Mental Health." I'm interviewing Christian therapists to talk about the intersection of spirituality and psychology. 

My first interview is with Bryan Hall. 

Bryan is a therapist who specializes in the entertainment industry. We talked about family systems theory, spiritual hypocrisy, addiction, how to deal with your issues, religious abuse, what the good little Christian mom has in common with the drug addict, and much, much more, which is why I'm breaking this interview into several parts. This interview has been edited for clarity.

We jumped right in talking about how the church often ignores psychology.

BH: Here's how I usually explain it: It seems to me that if we examine what the Bible says about a person that they have three components: there's the physical, we have a physical body; we have a spiritual component, but we also have a psyche—psyche is the Greek word where we get “soul.”

In church, most people (unless you're kind of fringe) [will say],

“Oh, you broke your leg, go see a doctor."
“Oh you've got a cough, go get some antibiotics”

Most people aren't going to have a problem with [the physical component].

And of course, in church, they're going to talk about Jesus and how he'll save you […] we've got the whole unseen spiritual realm. But they seem to neglect the whole psychological component. They seem to neglect a person's experiences, emotions, will, what happened to them, traumatic events.

And that's a problem because if you think of these three components as three spokes in a wheel and one or more of those components are broken or damaged--how well is that wheel gonna work?

Q: Can you talk about the difference between the spiritual and the psyche because I feel like those two things are often conflated.

BH: Well, what you find is that all this stuff is very intertwined. And you can find psychosomatic instances which are physical manifestations of psychological trauma that hasn't been addressed. You can see how if a person's serotonin levels or dopamine levels are altered, not present, damaged by drug use, it's going to affect their psychological condition.

You also see—less easily of course—but there can be demonic influences, spiritual connections between that and a person's physical body or their psychological state. So, the spiritual side involves what is God saying to you, what is his plan...

The psychological part is things like: A person has the desire to use drugs.

Well, but the reason that people do drugs is because it numbs out their feelings. It numbs the feelings that are usually unknown to them in the first place, but that manifest themselves very predominantly in a multitude of ways prior to the actual drug use.

So, somebody comes along and has these feelings, and somebody says, "Smoke this, shoot that." Well, they feel better for a brief time. I work with a lot of addicts. And what I've said for years is, “The drugs are not the problem”

I work with drug addicts straight out of prison--teardrop tattoos and the whole bit--and the drugs are not the problem. The drugs are like gasoline on a fire: They make everything worse, but they're not the actual core problem. Because the core problem is the feelings that the person is trying to avoid feeling.

Q. What would be the Christian equivalent? I'm sure a lot of Christians are tempted to do drugs or do drugs, but I feel like it's more than that...

BH: But that's an important point because a lot of people think, “Oh, I don't do any illegal drugs, I'm not some alcoholic on skid row, I'm not a homeless person. Therefore, I don't have any problems.

The thing is, people can be addicted to shopping. People can be addicted to the gym. People can be addicted to TV. You've gotta define addiction as anything that's done to avoid the real pain and issues.

And if you don't look at it from that perspective, you've missed everything.

Because there are plenty of people in AA meetings for 30 years that haven't had a drink that are still a complete mess.

Q: I mean, could someone be addicted to church?

BH: Oh sure, people can be addicted to 12 step meetings. And it comes back to what are you doing to avoid bigger issues? And it makes it much easier to see the gang banger with the tattoos and the needle in his arm that got busted by the cops, then it is the good little Christian mom that never says “No,” and does Bible study Tuesday, and picks the kids up Wednesday, and does the church cooking Thursday.

Because she's not doing anything illegal, but she's avoiding her real deal by doing Christian-type works.

Q: So what would you say about avoiding the real issue—which is really easy to do—How do you not do that? It's easy to say “Face your issues” but what does that mean, what does that look like?

BH: Well, there's a multitude of ways to address it because it's a multifaceted problem. If it was just, “I'm gonna wave this magic wand, or I'm going to give you this pill, or tell you to go read your Bible five times and then everything will be fine,” then great.

Q: Well, I think that's the thing--being a Christian and going to church, you expect that the emotional health and mental health thing will take care of itself: “I'm going to church, I'm listening to sermons, I'm going to Bible study, so I'm going to be an emotionally healthy person.”

BH: It's not accurate, but I understand what you're saying. And what you find is that there's a few potential things underneath that as well.

This is the oldest one and the most hideous one: simple control. And we can look back at the middle ages or we can look at the church in the Palisades right now, where the person on top does not want to deal with their own issues, but you know what, they're on top. They're the pastor, and nobody can mess with them.

So they can continue to rage and have anger issues, they can continue to be very unhealthy in a multitude of ways, but these ways will not necessarily get them in jail.

They can look down on people, they can be narcissistic, they can have people cover up their drug use, they can do things, some more overt and some more covert in nature...

So that's one reason that that happens, because what's the best way to make sure nobody's looking at me and my issues which I can't deal with? It's to look at you and yours. So I'm going to sit here and scream:

“You better not look at porn!” But you better not look at my browser.

“You better treat your wife right!” You better not find out what I did to mine last night.

Q. Are you relating this to pastors?

BH: Oh yeah, pastors do this. It's so funny where you can go to church and most people will say the spiritual component is necessary and like I said, if you have a physical ailment, go see your doctor, but if you bring up the whole psychological thing, it's like, “Pray more you sinner!”

Well, the converse to that is if you go to most 12 step meetings [you can talk about the physical and the psychological] But then you bring up Jesus and it's like, “Aw, man, we don't do that here.” But they'll stand up there and say every kind of, “The universe told me this. and the rocks told me that, and the sun told me this.”

Well, how many people are that way because they actually met God and said, “No, no, I'm not going to have it.” Or are they that way because they were religiously abused in some way? It's usually the latter.

They grew up going--let's face it, what are the two requirements to be a Christian, which really means get into heaven. Number one, don't screw your girlfriend, number two, don't drink. If you do, God really hates you, but he might let you into heaven if he's having a really good day and he doesn't see you and you sneak in the back door. But everything else is not okay.

So we can sit here and rage, “You got to do this, or you haven't gone to church six times this week,” but we'll forget about the pride and arrogance. We'll forget about the fact that, “You can't do drugs,” but let's go to Bible study and have twelve plates of brownies. Food's an addiction, easily. And it's a very prevalent one.

So these are the okayed versions of “We're gonna not deal with our issues, but let it out in this way.

Q. Sort of the double standard.

BH: Yeah.

Go to Part 2

You can find Bryan at his website.

Going to Therapy Changed My Life

Not my notes, but a pretty cool idea. Photo by Sacha Chua 

I first sought help for my brain because my body was killing me.

I had been experiencing severe pain and discomfort that seemed to have no tangible physical explanation. A few WebMD searches later, and I was either headed to an early grave or doomed to spend the rest of my life with a debilitating, painful disease.

The fear was overwhelming.

I signed up for therapy, online (Thank you, technology).

I had been thinking about going for years, but it was pain and fear that pushed me over the edge.

Going to therapy changed my life, and all I could think was, "Why didn't I do this sooner?"

Therapy is not a panacea: a cure for every kind of physical, emotional, spiritual or mental pain. But it has been a powerful, healing force.

So in case you've been thinking about going, or you went once and never went back, or you used to go, but stopped--

My intent is to address some of the barriers that kept me from taking the first step. Maybe you can relate.

I didn't go to therapy because...

1. No one in my family ever went to therapy, talked about going, or mentioned it as an option.

There are certain kinds of pain that are not okay to talk about. It could be physical pain--to be transparent, part of what propelled me into therapy was the way in which my family both did and did not respond to my physical (and by extension, emotional) pain.

It might be helpful to ask:

What kinds of pain are okay? Not okay?
How am I allowed to talk about pain?
What does empathy look like in my family?
Is there a distrust around being vulnerable? Is there an escape from it, such as humor, sarcasm, distraction, ridicule, ignoring, anger, silence?
How does my family treat vulnerability in general?

2. I had never experienced a major, identifiable trauma that would justify going.

There's a social stigma to seeking therapy: that something deep and terrible must be wrong with you. Well, I definitely felt like there was something wrong with me, but I had nothing to point to, to say, "This! This is why I feel broken."

There's a false sense of shame that tends to go with trauma, even vague, unidentifiable trauma. There's a false sense of shame around needing help. But shame doesn't mean there is something wrong with you--and neither does going to therapy.

If your buddy sprained his ankle, would you ridicule him for going to the doctor instead of playing full court basketball?

"C'mon! What's wrong with you! Why can't you keep up?"

Just like you wouldn't feel shame over going to the hospital for an infected wound or broken bone, seeking therapy merely means that you are human, and that it's possible that things could get better, could be better.

3. I had a traumatic experience with pastoral counseling.

Just as there is a social stigma to therapy, there can also be a spiritual stigma--the belief that God, the church, your pastor, small group, the Bible, and ten hours of prayer per day should be able to cure all that ails you emotionally and psychologically.

There's the belief that simply grasping the truth of "God loves you" and maybe a few cathartic crying sessions at the altar will bring healing to even the deepest, most ingrained sense of shame.

I really wish that were true.

I'm not completely discounting pastoral counseling or any of the spiritual practices listed above. But I have also experienced firsthand how damaging it can be to receive non-professional counseling that both goes too far and doesn't go far enough.

I believe the intent of my pastor was not to harm me, but to help me. However, emotionally it was akin to performing surgery without proper training, exposing a deep wound to the air and the elements, and then expecting my heart to heal itself.

It didn't.

There is absolutely nothing wrong with seeking professional help outside of the church. There is nothing wrong with going to a non-Christian therapist, even if you are a Christian.

There is nothing wrong with being hurt because someone dug around in your emotional guts with a penknife and had absolutely no clue what they were doing.

I wish at the time that instead of shutting down because I was "broken" (and if not even God or my pastor or my spiritual community could help me, who could?), that I had sought out a professional therapist.

4. I thought I couldn't afford to pay for therapy.

This was a huge barrier for me.

Therapy is expensive. I had no health insurance. However, I was also unaware that there are many low-cost and affordable options for seeing a therapist.

I eventually found a non-profit organization in Los Angeles that provides sliding scale membership and counseling services. If it weren't for the availability of low-cost counseling, I don't think I would have ever gone.

Again, therapy is not a panacea. Not all therapists are created equal. It really helps to find the right fit.

If you are thinking about going to therapy, I hope that you take the leap. The barriers are real, but you are definitely, definitely worth it.



[If you would like information on low cost therapy options in the Los Angeles area, please contact me.]

The Church, Dating & Mental Health

This is a scary place to find a date. Probably because it's haunted. [Photo by A Quiverful of Fotos]

I wanted to write a brief (or maybe not so brief) companion piece to my "Undateable" series about the complexities of mental health within the context of church dating.

Let's say you are a Christian and you want to date someone who shares your beliefs. Are you more likely to end up dating someone with a personality disorder (or other mental disorder) if you choose to date within the context of a church?

To be clear, I am not saying that suffering from depression, bipolar disorder, anxiety, OCD, or any other mental disorder or illness disqualifies anyone for dating or makes a person undateable. I do not believe this at all.

Nor am I saying that a person must have resolved all of their emotional issues before dating. If that were case, no one would ever date, myself included.

Disclaimers aside, I think there are certain personality disorders that might make a person more likely to cause harm to others within the context of dating. And those who have these personality disorders may be predisposed to attend church.

In my "Undateable" series, I write about different attributes I've encountered dating (or not dating) Christian men--things like misogyny, cowardice, racism and not taking "No" for an answer.

Although these attributes are not necessarily related to mental health, in some cases, I feel like they are caused by or co-occur with a personality disorder.

[This is not to take away from the fact that a person with a personality disorder is fully human and fully worthy of love, respect and acceptance, but never at the expense of another person's safety.]

Some examples of potentially damaging behavior within the context of dating include physical and emotional abuse, stalking, obsessive pursuit, disrespect of communicated boundaries and rigid gender roles.

I want to be careful here--diagnosing anyone with a personality disorder is obviously not something I am qualified to do.

However, I can hypothesize that in some cases, mental health is the issue. I would also argue that the culture of dating within the church is inherently dysfunctional, and thus encourages dysfunctional behavior and ways of relating to the opposite sex.

So, to make the point I came here to make:

I think that racist or sexist remarks can be a sign that the person you are dating has a personality disorder, particularly if they make little sense within the existing social context (i.e., the surrounding social group is usually neither blatantly racist nor sexist).

Also, racist or sexist jokes or statements can be a precursor to abuse. It might be worth thinking more about our collective tolerance for hateful or devaluing statements about the Other and whether or not we are encouraging or enabling an abusive dynamic to take place between the church and the culture, as well as between one individual and another.

To what extent does the church tolerate sexism, racism and homophobia and to what extent does this tolerance contribute to abuse, particularly of those who are the most spiritually and emotionally vulnerable?

Perhaps we could love and accept the broken (all of us, according to Christian theology) while also being wholly intolerant of anything that devalues another human being.