The Distillery

What kind of theology would come to the forefront if we allowed the voices of those with mental health challenges to lead the discussion?

Show Notes

For centuries, the mentally ill have been misunderstood and ostracized within religious communities. What would it mean to seriously transform how we view, discuss and treat those struggling with mental illness as Christians? In this episode, co-host Shari Oosting sits down with John Swinton, professor of practical theology and pastoral care at the University of Aberdeen Scotland to examine these questions, and discuss his new book, Finding Jesus in the Storm: The Spiritual Lives of Christians with Mental Health Challenges.


John Swinton is a Professor in Practical Theology and Pastoral Care and Chair in Divinity and Religious Studies at the University of Aberdeen. For more than a decade he worked as a registered mental health nurse. He also worked for a number of years as a hospital and community mental health Chaplain alongside people with severe mental health challenges who were moving from the hospital into the community. In 2004, he founded the University of Aberdeen’s Centre for Spirituality, Health and Disability. He has published widely within the area of mental health, dementia, disability theology, spirituality and healthcare, qualitative research and pastoral care. He is the author of a number of monographs including Becoming Friends of Time: Disability, Timefullness and Gentle Discipleship (Baylor Press 2017), Dementia: Living in the Memories of God (Eerdmans 2012), and Finding Jesus in the Storm: The Spiritual Lives of People with Mental Health Challenges. (Eerdmans 2020) . 

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What kind of theology would come to the forefront if we allowed the voices of those with mental health challenges to lead the discussion? For centuries, the mentally ill have been misunderstood and ostracized within religious communities. What would it mean to seriously transform how we view, discuss, and treat those struggling with mental illness as Christians? Today on The Distillery, our co-host Shari Oosting sits down with John Swinton, professor of practical theology and pastoral care at the University of Aberdeen, Scotland. In their conversation, they examine these questions and more, as we discuss his new book “Finding Jesus in the Storm: The Spiritual Lives of Christians with Mental Health Challenges.”

You're listening to The Distillery at Princeton Theological Seminary.

Thank you so much for talking with me today, John,
John Swinton

It's a pleasure.
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I'm really excited to spend some time talking about your book “Finding Jesus in the Storm.” Well it seems to me that the approach you took, which is a phenomenological approach, lends itself to really spending a lot of time in people's stories. Can you talk about that approach and why having what you name and identify as “thick” descriptions is so important as you try to tell other people's stories and share other people's perspectives?

John Swinton
Yeah, so the book is based on a series of interviews. I interviewed over sixty people who live with schizophrenia, bipolar disorder, or major depression. And the approach was that—the philosophical approach—was to use phenomenology. So phenomenology is a way of looking at the world that suggests that you can, you need to put to one side your assumptions about what you think the thing that you're looking at is, and try as best as you can to look at the thing in itself. So in the context of mental health challenges, one thing would be to put to one side your assumption about what a diagnosis is and what somebody with a diagnosis should be, should be looking like, should be behaving like. But that one side, really just listen to people's story. And my focus was on the spiritual lives of Christians in particular who are going through these sometimes fascinating, sometimes very disturbing experiences and thinking, well, what—who's God in that? How do people maintain their spirituality when they hear voices or when they're in the deep lows of depression? And how can I listen carefully to their experience without me thinking, well, probably he's thinking like this because he has schizophrenia or probably is thinking like this because he has bipolar disorder. But as soon as you can put that to the one side, difficult as it is, you begin to see that there's a richness in people's experience and a deep, deep meaning that very often gets lost with “thin” descriptions—they simply tell you something about some of the symptoms that somebody may have, or a particular diagnosis—whereas a rich and “thick” description talks about the person as a person: their experiences, their family, their community, the meaning of the mental health challenges that they have the meaning of voices, the meaning of feeling elated and really and deep contact with God in the midst of the complexities of bipolar disorder. And so that's why I try to do—I try to capture some sort of that meaning. It's difficult because how can you—you need to know something to know something—so you can't bracket it off completely, but you can intentionally make sure that your own perspective, as far as you can do it, it doesn't impose upon the way that you're listening.

distillerypodcast
Yeah. And you seem to put your finger on one of the real obstacles to this: there does seem to be less stigma now about mental health challenges in general, and yet with the rise of that as a diagnosis, it does kind of lend itself to a “thin” description if someone says they're depressed. People assume that they know exactly what that means. So you seem to be pushing back against the assumptions that we understand each other's experiences with ease.

John Swinton
That's right. And depression is a good example of the way in which certain experiences—mental health experiences—become normalized and neutralized because of the language you use. And so, you and I may be feeling a bit fed up and we'll say, “Oh, I'm a bit depressed today.” Or you have the Monday morning blues or whatever it is and you think that you know what depression is cause you think, “Well, I feel like this, so probably it's this plus a bit more.” But when you actually begin to listen to people who go through depression, it's something quite, quite different. You know, it's more than sadness. We maybe we can identify with sadness, but it's something, it's beyond sadness.

distillerypodcast
A lot of the folks you interviewed describe it as actually the lack of feeling. Can you talk about someone's story in particular—since we're talking about being more complex in particular—to share some of what you've learned from one of the people you interviewed?

John Swinton
Yeah, well, I immediately, what comes to mind is one gentleman who talked to me about the experience of depression and he—two things he said that were very important. One was that it, as I said, it's not sadness. He said, we think that people sometimes think that because they've experienced sadness, they know what depression is. He says, it's not that, it's actually a lack of feeling. It's a lack of sadness. It's an emptiness. It's a, it's this—he actually put it quite interestingly—he said, “Sometimes I long for sadness, because at least I can feel it, and at least I can sense that maybe a reason for it.” Depression is something different. And he described depression and sadness as going along two different roads. Sadness is certainly there, but sadness is caused by depression. Depression is something different in that way. And so, there's a kinda existential loneliness in that, because the assumption of other is that actually I do understand your experience. And he was saying, actually, you absolutely don't understand the experience. You think that if you use the expression “feeling depressed”—he says it's anti-feeling. It's feeling nothing. So that—and that was very powerful for me because it just helps you to see the way in which your assumptions can neutralize a very powerful experience. Like I think I really know what it is and you don't—you have to learn to know what it is.

distillerypodcast
Yeah. And part of what you point out is the way in which the DSM-5—which is the handbook for diagnosing mental health challenges—along with this kind of medical and biological understanding of health gets in the way of understanding. Can you unpack that a bit?

John Swinton
Yeah. Well, the first thing I would say, obviously, is the book or me are not in any sense anti-psychiatry. I'm very pro- with mental health professions and I think they are extremely important. And what I'm interested in is what does the church bring to the table that's not necessarily available—and it’s less deep listening is one of these things. And the problem with the DSM criteria is it’s just that—it's a series of signs and symptoms which tell you something about what's going on with an individual. And they, they can help you to create a diagnosis, which is very helpful and useful for the mental health professions as they go about their tasks of healing. So it's not that it's inherently problematic. It's just “thin.” And if you take that as the only way of understanding what's going with somebody else, then the temptation there is just to—well, we can medicate it. So, I can see your symptoms. I can see what it is, and I have this medication, I can give it to you, and you'll feel better. Nothing wrong with that—everybody wants to feel better. But these other dimensions—that sense of lostness, that sense of spirituality; it’s losing the sense of who you are, where you come from, where you're going to, why—isn't taken as an essential part if we take “thin” descriptions as the only way to look at things. And even with medication, even when you can control so-called symptoms—and I say “so-called" not because I don't think they exist—I think it's because they're meaningful experiences rather than just technical terms. So even if you can control that, that doesn't necessarily mean that the person is healthy in the way that we might think about that theologically. So simply having your symptoms under control doesn't necessarily bring you to that space of health, that maybe biblical health, if you like. So, you really have two different models of health running together, both of which are necessary, absolutely necessary. But one of which tends to show a little bit louder than the other one. And what I try to do in this book is to show a “thicker” description of health, as well as a “thicker” description of the experience of mental health challenges.

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At one point you used the phrase “I don't have a body” when you were talking about the biological dimension of this. But in terms of being created, we are a body.

John Swinton
Yeah.
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Which I found to be a really helpful reframing of what's often perceived as this disconnect between—well, if you have a biological problem, great, cuz we have medicine. But if you have a mental problem, there's something different going on.

John Swinton
Yeah, that's right. And I think there's two ways that you can look at that. One: phenomenologically. Within phenomenology, you get this idea of the material body and the lived body. So the material body is your biology, your cells, your neurons, all of these things there, which obviously becomes disrupted and have all sorts of difficulties as we go through life. But then you have the lived body, which is that place where what happens when the material body enters into society, enters into relationships, enters into community and all of the engagement that happens there, which is profoundly important and impactful upon the material body. So these two dimensions of the body are really, really important. And theologically, if you think about the way in which—think about the Genesis creation, you know, God doesn't create a brain. God creates Adam out of dust. It creates a whole person and that whole person is body, mind, and soul inextricably intertwined in that sense, held together, held in existence by God's spirit, God's ruah. And so you have a picture there of both the material body—which is significant—but also the way in which that material body engages with the world, engages with other people—it's not good that human beings should be alone—and so God creates a partner. And so you see that these two dimensions of the body are actually inextricably intertwined. Sometimes we separate them—one of the problems with modern medicine is it specializes, which is good at one level, because if I've got a broken wrist, I want somebody who can look after my broken wrist. But if you are so specialized in your particular area, the idea that all of these different dimensions are significant for the work that you do is much more difficult to comprehend. So I think there is a tension within the way in which medicine specializes in that way.

distillerypodcast
It seems to be a more—there's the possibility of something more integrated and whole when we think about who a person is and who a person has been created to be.

John Swinton
Yeah.

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Let's talk about the Bible.

John Swinton
Oh yes.

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So, you talk both about the Psalms and the way that Brueggemann—and I'm thinking in particular about, within the framework of major depression—you lift up the Psalms as both a source of comfort and companionship within the sort of storm of major depression. And you identify that sometimes reading scripture can be really hard and problematic. So can you talk about those two things?

John Swinton
Yeah, well, first of all, in relation to the Psalms—the Psalms are lament. There's more Psalms of lament than any other Psalm in the Bible. So God gives us a language to articulate our sadness. And interestingly, some of the Psalms were designed, Psalms of lament were designed, for a small group work where people who have been traumatized, where you can articulate the pain, but at the same time, come back to God's hesed, God's unending love. But then again, you've got other Psalms that don't resolve in God's unending love. Psalm eighty-eight, for example, just stops dead. So there's something in there about using the Psalms to articulate honestly, our sadness. But there's also something about that sense of disconnection, which I think is really important. So Psalm eighty-eight is a good example. So, “darkness is my only companion.” The Psalmist doesn't say that to nobody. The Psalmist says that to God. So it's not crisis of faith, it's actually a sense of deep disconnection. And very often for in relation to people with depression, that sense of being abandoned by God is something that's profoundly disturbing. And it's not necessarily that somebody's lost their faith or should be praying harder—as some people within the church will tell other people to do—is you've had that sense of disconnection. The interesting thing about the Psalms is it helps us to see that disconnection doesn't mean that we are necessarily abandoned by God in that sense, but we still can feel that—

distillerypodcast
You somehow haven't prayed hard enough.

John Swinton
Yeah, exactly. That's a huge mistake because it's not about that. In that sense, if you look at the cross, Jesus says, “My God, my God, why have you abandoned me?” So even Jesus finds that sense of abandonment. So there's a spirituality of disconnection that runs through our tradition. I mean, Isaiah talks the same thing, about God hiding at certain points. You can see it running through there that we don't really preach and teach. So when somebody hits depression and has these difficult experiences, special experiences, they're not really oftentimes equipped to be able to see that this is not necessarily God totally abandoning them, even though it feels that way. So you have, you don't have that within that. And communities are often not necessarily fully equipped to be able to say no it's not something that you've done—it's something that just happens because this is the way that depression works itself out. And so I think the Psalms, these kinda more difficult experiences within scripture where God at one level, at one point says, “I'll never abandon you.” And then Jesus says, “You've abandoned me.” So there is always that tension there. And we should probably draw out more so that when people experience depression, it's not alien. It's just part of that spirituality.

distillerypodcast
Right. It's a tension that we can live in rather than trying to resolve.

John Swinton
Nicely put. Yes. Yeah.

distillerypodcast
So, on the one hand we have these Psalms that give voice to a very real experience. And you say that sometimes reading scripture for people in the midst of a serious mental health challenge can be really problematic.

John Swinton
Yeah. For the same reason. Because if you know you can get so caught up in the difficulties of the Psalms, so caught up on particular passages that maybe speak about eternal salvation or that speak about separation from God, that it becomes unhealthy because you're just focusing on that again and again and again and again. And think about it this way, Paul tells us all scripture is God-breathed and it helps us to know and to understand who God is. So the primary purpose of scripture is for love. The primary purpose of scriptures is help us to engage and stay engaged with God so that we can love God and love our neighbor and love ourselves. That's what it's intended to do, you know? Jesus said the sum of the prophets is love God, love neighbor, ourself. If scriptures not functioning in that way, if, because somebody has a very serious set of experiences/mental health challenges, and they're forced to continue to do this—or maybe just choose to continue—it's not necessarily the best thing to do. And sometimes what is necessary is for somebody to put scripture to one side for a moment, and for others within the body of Christ to read meditations to them, to take pieces of scripture that will be healing and hold them in that space until they can come back, pick up the Bible, and read it in a way that it fulfills its purposes, which is to help people to love God, self, and neighbor.

distillerypodcast
Yeah, that's beautiful. It's an image of how the community can exist as a whole for each other.

John Swinton
That's right. It's the body of Christ.

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I think that this conversation about culture is a good moment to turn toward the topic of healing and the important distinction that you make between something that's healing and something that is a cure.

John Swinton
When I—and it's quite fascinating, really—the ongoing conversation around what healing is about is always a tension within disability studies because people tend to make healing the first port of call when they encounter people with disabilities—and people with disabilities and not at all happy with that. And so I've always had it in my mind that there's something interesting about healing. Now, the model of health that underpins the book that we're talking about is based around the idea, the concept of shalom. So shalom at one level, it means peace. We use it as a greeting sometimes, but it's a very deep peace. It's peace with creation, peace through one another, no more warfare, peace with God, and an essential dimension of it is to be in right relationship with God. So to be healthy, biblically, is to be in right relationship with God. It's not to do with your psychological state or your physical state, it’s to do with your relationship with God. And I think when you think about that, and then you begin to look at the issue of healing, you see something, you see something different. So if you take, for example, the woman with the discharge of blood that you hear about in the Gospel, she makes her way through the crowd. Now she has a discharge of blood, which makes it unclean. So she can't be part of the community. She can't be part of the religious community. Can't go to the temple. So she's alienated from God, and she's alienated from community. And in that kinda community, you're very personhood is dependent by being a part of the community. So she was an absolute non-person. So she makes through the crowd, touches Jesus’s cloak, and immediately she's cured. And Jesus notices this and they had this ongoing conversation. And then at the end of that conversation, Jesus says, “Go, your faith has healed you.” And you think, but she's already being cured. But the way I read that is that her true healing came when she came to know Jesus; her true healing wasn't—the cure was great—but she could have been ill with something else next day. The true healing came with Jesus and he sends her back to community and now she's back to community. She's able to be a person again, and she's able to be a person before God again. And so that's when the real healing begins. And I think when we think about healing in that way, you can begin to see that when it comes to something like an enduring mental health challenge, like bipolar disorder or schizophrenia, where you're always going to have it, according to a standard model here of “You're always going to be ill”—and that's a difficult way to live your life. But if we take this more shalom-like model, then it's possible to find health in the midst of illness. It's possible, even in the midst of the complexities of the experience you're going through, it's possible to find the accompaniment of God. Of course, that's as we've talked about it, that complicated—it's particularly complicated with something like depression. But it does mean that the healing ministry of the church has a particularly strong focus, which is to help people in the midst of their difficulties—not to get rid of their difficulties. Of course, people may well want to get rid of their difficulties—but the point is not to get rid of the difficulty, but to enable them to be with Jesus in the midst of it. And that's what I think—that’s at least part of what the healing ministry of the church brings to the table that's just not available anywhere else. So I think there's a uniqueness there that's really important.

distillerypodcast
Yeah. And it's fascinating to think that someone could appear to very healthy and well on the surface—you know, you could be a marathon runner and still be quite distant from God, or very unwell in this broader sense of the abundant life to be found in Jesus.

John Swinton
That's right.

distillerypodcast
And someone with very chronic conditions can, of course, be full of abundant life. You talk a lot about joy which seems dissonant a bit with this conversation, but explain why it's not.

John Swinton
Well, first of all, if you look at the way in which the Apostle Paul lays out the gifts of the Spirit, he doesn't name “happiness” as a gift of the Spirit—

distillerypodcast
Which is a much sought after thing.

John Swinton
Exactly. Not everybody wants to be happy, nothing wrong with that. But it's not fruit of the Spirit. Happiness is an emotion that comes and goes, and it’s dependent a lot on circumstance and feeling joy is something else. Paul talks about the encounter of joy. Jesus talks about finding joy. Joy is similar to the idea of shalom, really. Joy is about being able to hold on to that which is most significant for you, even in the midst of the profound difficulties that you are going through. So to have Jesus as your joy is to be able to recognize that there is a hopeful dynamic to the experience, even when you don't feel it, even when you—it is not necessarily making you happy. And even when you're going through difficulty in trials and suffering, there's still that joy that's found in Jesus. But teasing apart joy from happiness is tricky. So if I say to you there's joy and suffering, you'll think “Well, did you, you're telling me to be happy.” I'm not telling you to be happy. I'm telling you that suffering is not hopeless in that sense. And it's not meaningless in that sense because Jesus—our joy sustains us or walks with us even in the midst of that. So when we think of a joy in that we kinda—it means that you can be in the midst of a worshiping community experiencing the real difficulties of depression, but everybody's telling you, “You've gotta be happy! You've gotta be happy!” And you can't be happy, but you can be joyful. And if you can't be joyful at that moment in time, your friends around you can hold that joy for you. So I think it just is a—it's slightly dissonant because we're used to thinking about joy as happiness. But when you kind of think about it, there's something important about it as a guiding principle.

distillerypodcast
A helpful analog you point toward the work of Willie Jennings and his work around race and the way that joy can be present in the midst of things that are deeply troubling almost as this kind of defiant hope.

John Swinton
That's right. And Willie Jennings is very good in that. The whole Yale School did a joy project—some of which has been published, some of which is not—but Willie Jennings did a excellent paper which was never published, but I think you can still get it online. And I would advise people to have a look at it, it’s a really interesting perspective on joy.

distillerypodcast
You talk about, as you conclude the book—it's a pretty short chapter on healing. And we won't have time to talk through every part of it. You've already talked a little bit about cultural healing, but I'm wondering if you could speak to just one or two other types of healing where you think that the church has a particular gift that could be developed when it comes to the topic of mental health challenges. What do you hope the church at her best could be when it comes to healing and graciousness or—I'm not sure what the right word is.

John Swinton
No. I mean, there's a number of ways you could think about healing, but I think one of the things to me would be liturgical healing. Because worship is that space where we come before God with our brothers and sisters and really cry out for strength, guidance, love, the ability to hold the community that we're told to hold together. So it's a really powerful space for learning and for a lot of people that's the main place in a week—if you're thinking about liturgy—as simply as a space where they get their teaching, where they get their preaching. Now, what I think is it's rare for many of us to preach and teach on mental health and free for many of us to preach and teach thinking about the diversity of mental health needs that are in the congregation, which means preaching can be really difficult for you if you're going through some kind of deep difficulty, you know, even this thing we've been talking about—happiness—if you're having a teaching and preaching week after a week, this really seems to equate happiness with faithfulness, then that's gonna be a problem for you. And it's also a problem for the congregation. So I think, beginning to think about liturgical healing. I visited a church a couple of years ago in Vancouver, and the way that their preaching ministry works itself out is they have a preaching team. And every week the minister who, or the person who's going to be preaching on that day, preaches a sermon to the team, and then they give feedback and see if it's good, bad, and different. One of the things that they're looking at doing is incorporating someone with a disability, someone with a mental health challenge into that discernment group, so that every Sunday the word that is preached is sensitive to the broad range of understandings that's available within the congregation. And their hope is that they have inclusive preaching. By that, I don't mean you should shave off the sharp ends just in case you offend somebody, but you do realize that there are other interpretations of scripture, other interpretations of the worship songs that we use that need to be taken into consideration. First of all, if we’re gonna be faithful to the task that's given us which is to enable love in the world, and secondly, if we're gonna be able to bring the people, a body of Christ, as they gather to hear into a space where they can really understand each other. So that's an aspect of healing I think is really important.

distillerypodcast
Thank you for that. I had to laugh when I read the last paragraph of the book, because you spend hundreds of pages complexifying people's stories. And then you end with a sentence that says “It's really not that complicated.”

John Swinton
Exactly.

distillerypodcast
But you point toward—you use the phrase that “the church could be a specialist in human kindness.”

John Swinton
Yeah. but it's not complicated. But it's complex, but not complicated. I mean, when Jesus says love your neighbor, that's not complicated. But it's definitely complex! And so I'm happy with that ending,

distillerypodcast
John, thanks for taking the time today to talk about this.

John Swinton
Yeah. Good to talk to you.

distillerypodcast
I'm grateful for it. Thank you.

[Outro]
You've been listening to The Distillery at Princeton Theological Seminary. Interviews are conducted by me, Sushama Austin-Connor and Shari Oosting. Our producer is Brooke Matejka. Like what you're hearing? Subscribe to this podcast on Apple, Google Play, or your favorite podcast app. And, while you're at it, leave us a review and let us know how we're doing. The Distillery is a production of the Office of Continuing Education at Princeton Theological Seminary. Find out more at thedistillery.ptsem.edu. Until next time, thanks for listening!