Behind the Fogged Door: On Mental Illness vs. Sin
Imagine that you arrive at a friend’s house. The two of you are about to leave for dinner. He or she is running late but opens the door and invites you inside. You walk around and make yourself at home. You have been here many times before and casually observe the professionally taken family photos, children’s trophies and vacation memorabilia, all outward signs of a happy life. As your friend is scrambling to finish getting ready, you decide to use the bathroom before leaving. While washing your hands, you have trouble finding a towel and decide to look for one in a cabinet above the sink; here you notice something interesting: a pill bottle labeled as a prescription for an antidepressant with your friend’s name on it. Near the sink, in plain sight, you find another pill bottle, again with your friend’s name on it, but this time labeled as an antibiotic. You compare the two: one is for mental illness; the other is for physical illness.
Why were both bottles not stored together? Why the difference? Why should we care?
The friend could have easily been storing the two bottles together and merely taken the antibiotic more recently than the antidepressant and forgotten to restore it. The decision to separate the two bottles initially seems harmless, since it protects the identity of those with mental illnesses that need clinical intervention. A hidden item conceals its identity so that those on the outside are shielded from what lies inside. And a revealed item does quite the opposite: it allows for complete visibility, clarity, integrity. However, this separation would not exist if patients suffering from mental illness did not require the utmost confidentiality. This concealment therefore assumes that one ought to feel embarrassed for having a mental illness.
There is shame associated with being mentally ill.
Let us imagine another scenario: you are accompanying a friend to his or her appointment at your local health clinic. He or she suffers from depression, and you want to be present for both emotional and practical support. As you approach the corridor, you are struck by the center’s layout. On the right side of the hallway is a glass door behind which the entire waiting area can be seen. Directly opposite is the location of your friend’s appointment: a fogged glass door labeled “Mental Health Clinic”, behind which nothing can be seen. You feel uneasy.1
We see our primary care physicians for regular check-ups, the occasional sick day, and chronic concerns. These trips are–for the most part–simple and habitual: you enter the building, sign in, sit in the waiting room. Aside from obvious exceptions, we would not be embarrassed to enter this space. If we had a cold, the flu, or a broken ankle, there would be no shame in seeking help.
Why? We are not deemed responsible for our physical ailments, although found in our bodies.
While this hypothetical situation is just one example of our dichotomous consideration of human health, it signifies a much greater cultural phenomenon. Those who suffer from mental illness have been cast off as pariahs, isolated from people with ‘real’ problems. They may live within the structural confines of community, but they do not truly belong. We as a society believe that mental illnesses belong to certain types of people, to whom we ascribe degeneracy, as a result of their poor moral character. Simply put, as a vestige from historical understandings, mental illnesses are taboo. They represent the abstract, the scary, the uncontrollable. They make us uncomfortable.
And frankly, they should, for we cannot see them. There obviously exists a stark contrast between that which is physical and that which is mental. Medical issues are dropped into two categories: physical problems such as colds, influenza, broken limbs; mental problems such as depression, anxiety, obsessive-compulsive disorder. The two groups are dichotomous; they inhabit different worlds: one visible, the other nearly inconspicuous. In one study comparing Americans and Icelanders, participants were asked to self-assess their health by using a four-point rating system.2 Researchers found that we are quick to consider our general health as simply our physical health. It was also noted that past researchers used the term ‘general health’ to signify physical health when conducting their studies.3 We view our physical well-being as encapsulating overall health and ultimately our personhood.
Mental health is a question of personal responsibility. American society measures success by an individual’s independence, rather than what an entire group accomplishes. This metric of success is especially salient on college campuses. When we struggle, we often pridefully rely on self-sufficiency to avoid seeking guidance. We think that we can handle everything on our own, and that seeing a professional would signify weakness. When we do ask for help, we do so silently, telling as few people as possible in order to avoid exposing ourselves and facing social scrutiny. We connect the idea of a mental illness to the mind, the mind to the brain, and the brain to our conscious thought patterns. So by this logic, if we are able to control our thoughts to produce success, are we not similarly able to control these ‘mental illnesses’?
Modern society seems to say yes.
However, there is evidence that contradicts this stigma in the secular, American world. The placebo effect is defined by the National Center for Complementary and Integrative Health as the following: “a beneficial health outcome resulting from a person’s anticipation that an intervention–pill, procedure, or injection, for example–will help them”.4 Through mental expectation, the patient experiences a physical effect; the mind and body are interconnected. Secondly, embodied cognition is the philosophical theory that cognition is deeply dependent on features of the physical body outside of the brain itself.5 Unseen mental processes have a complex physical reality. Growing in significance ever since the cognitive revolution of the past half-century, embodied cognition is only further evidence for the equal importance of the mind and body. Finally, posture studies have revealed that people who sit upright feel more confident and tend to think more positive thoughts about themselves, as well as appear more sociable to others.6 It is evident that we cannot separate the body and the mind into preferential categories; we must treat them with equal significance.
Christianity offers a redemptive model of the human condition. In his landmark apologetic book, Mere Christianity, C. S. Lewis states that, “The bad psychological material is not a sin but a disease. It does not need to be repented of, but to be cured. And by the way, that is very important. Human beings judge one another by their external actions. God judges them by their moral choices”.7 The human psyche builds the underlying material upon which morality acts. While one is responsible for his or her moral choices, one does not choose the state of his or her psychological health. So in order to be capable of leading a morally upright life, psychological well-being must come first. This debate brings the physical–mental, body–mind dichotomy back to the forefront. Moral choices are not made with one’s hands or one’s feet, but rather through calculated thought processes located in the mind, as reflected in the Biblical passage, “Give careful thought to the paths for your feet and be steadfast in all your ways”.8 It is these very choices that determine our identity: “Most of man’s psychological make-up is probably due to his body: when his body dies all will fall off him, and the real central man, the thing that chose, that made the best or worst out of this material, will stand naked.”9 Mental illness weakens the human psyche and makes it increasingly vulnerable to temptation from Satan, which will lead to wrong moral choices. Recognizing this fact is a key step towards correcting our misunderstanding about the prevalence of mental illness. We are told not to judge, for we can never know the exact psychological background that is precipitating a neighbor’s actions, and we are often blind to our own.
In the Old Testament, the story of Job tells of a man who exemplified the ideal follower of God; he worshiped Him continually. However, he finds every good thing about his life being taken away from him: his family, his friends, his property, his belongings, his health. Job’s sin did not cause his misfortune. It says he did not sin in the first place. Rather, it was a test from God. As Christians, we are told that there will be suffering in this world. Christ came to earth to be fully human, a state of living that inevitably includes all forms of suffering–physical, mental, emotional, psychological, spiritual.
Turning to the New Testament, specifically to the Gospel of John, let us look at the life of Jesus Christ. “His disciples once asked him, ‘Rabbi, who sinned, this man or his parents, that he was born blind? Neither this man nor his parents sinned,’ said Jesus, ‘but this happened so that the works of God might be displayed in him’”.10 Disease–including mental illness–is not our fault because illness is not the result of sin. It is quite reasonable to apply this same idea to all other diseases, physical and mental: if God does not blame us for blindness, then he likewise does not blame us for our schizophrenia, depression, or eating disorder.
In his letter to the Romans, the Apostle Paul says, “Do not conform any longer to the pattern of this world, but be transformed by the renewing of your mind. Then you will be able to test and approve what God’s will is–His good, pleasing and perfect will”.11 The mind is a locus of the Holy Spirit’s transformative power. Through faithfully following and accepting Christ, we open up to the gift of God’s Holy Spirit, His agent of radical inner transformation, shaping us to become more like Jesus. While we cannot discern the purposes of God, we know that He uses bad situations, as we saw in the story of Job, to reveal His glory and guide us closer to Him. In heaven, our bodies and minds will be perfected, for it says in 1 Corinthians 15:42-43 that, “It is the same way with the resurrection of the dead. Our earthly bodies are buried in brokenness, but they will be raised in glory. They are buried in weakness, but they will be raised in strength”.12 Both the physical and the mental, the body and the mind, the flu and the anxiety will be fixed, forever.
Who knows, maybe if we allowed these truths to seep into every corner of society, the stigma attached to mental illness would eventually fade? I believe that in a world free of stigma, we would be known to one another without shame. We would be able to see ourselves as real people, not as diagnoses, not as illnesses, but as real people. In the words of Tim Keller, we would be “fully known and truly loved”, just as God sees us, for we are children of God, the One who sent His Son to save us.13
In essence, Jesus is saying that mental illness is not caused by sin. Instead of succumbing to society’s expectations to feel embarrassed and secretive about our problems, we are called to rest in the love of Christ and cry out, as in the words of David, “I sought the Lord, and he answered me; he delivered me from all my fears. Those who look to him are radiant; their faces are never covered with shame”.14 He carries all of our burdens, and by His grace, we are set free.
When Jesus died and rose again, He took our shame, our culturally imposed stigmas and removed them. His death on the cross was entirely human in that both His physical body and His mind experienced anguish. Living fully human, He had to die fully human. However, as the Son of God in human flesh, Jesus was perfect, without sin. This difference–His righteousness contrasted with our unrighteousness–is the key factor separating Him from ordinary people. By taking on the punishment that we deserved for our sins, Jesus stood in as a divine replacement. The One who did no wrong acted as one who had committed every wrong by every person in all of human history. But death did not win, for Jesus rose again. The resurrection from the dead, a feat unimaginable in both ancient and modern times, fulfilled God’s promise of salvation. Jesus’ empty tomb and final forty days on earth signified His triumph over death, the reconnection of God and humankind. Sin lost its power when Christ died and rose again. Good conquered evil.
And that is quite a revolutionary idea.
1. I am grateful to Justin Hawkins from Yale University for this example, which he shared during a writers workshop in Boston and which is used here with his permission.
2. Olafsdottir, S. Fundamental Causes of Health Disparities. 6.
4. “Placebo Effect.” (12 Jan. 2012). NCCIH.
5. Wilson, R. A. (25 July 2011). Embodied Cognition. Stanford University.
6. Grabmeier, J. Study: Body Posture Affects Confidence in Your Own Thoughts. The Ohio State University Research News.
7. Lewis, C.S. Mere Christianity. New York: Harper Collins. 91.
8. Proverbs 4:26. NIV.
9. Lewis, C.S. 91-92.
10. John 9:2-3. NIV.
11. Romans 12:2. NIV.
12. 1 Corinthians 15:42-43. NIV.
13. Keller, T. and K. (2011). The Meaning of Marriage: Facing the Complexities of Commitment with the Wisdom of God. New York: Dutton.
14. Psalm 34:4-5. NIV.