The author, Fr. Alban Illingworth, is a priest at the Mission of St. John the Forerunner in Durham, England, and a teacher of philosophy. He studied Philosophy and Theology at Oxford University, England, and Byzantine Philosophy at Holy Trinity Seminary in Jordanville, New York.
The Philosophy and Theology of Modern Mental Illness
Ours is the age of mental illness. It is not that we are facing new forms of disease—to be ill, mentally or physically, is simply to experience human life—but we are facing a unique set of cultural and social conditions which have made certain forms of mental illness a tragic side effect of life. To be clear here, I am not talking about circumstantial disorders which have always been known to lead to poor mental health at least for a time, such as family and relationship issues, grief, and so on; I am talking about the endogenous mental afflictions which characterise modernity: clinical depression, anxiety disorder, borderline personality disorder, dissociative disorders, gender dysphoria, and so on.
This phenomenon of specific mental illnesses emerging in response to specific social and cultural conditions is increasingly of interest to philosophers. The Korean philosopher Byung-Chul Han, who fairly recently revealed himself to be a Christian, comments in The Burnout Society:
Neurological illnesses such as depression, attention-deficit hyperactivity disorder, borderline personality disorder, and burnout syndrome … are not infections, but infarctions; they do not follow from the negativity of what is immunologically foreign, but from an excess of positivity. (p. 1)
Han’s terminology: ‘infarctions’ not ‘infections’ is fascinating. An infarction is where a part of the body starts to die due to inadequate blood supply; by ‘positivity’ Han does not mean the colloquial sense of ‘happiness’ but in the philosophical sense of that which is posited, or that which is placed upon. It is also possible that he is punning on ‘positivity’ in the sense of positive charge, since he is talking about neurons, which carry an electrical charge. In any case, this reflection prompts us to think more deeply about how mental illnesses emerge from our current circumstances.
If mental illness of this modern neurotic kind is a form of infarction, a cutting off of the blood-flow, then that begs the question of what ‘blood’ it is that we have cut off. Han views modern man as an ‘achievement-subject’ where personal identity and self-worth is not related to relationships, duties, spiritual beliefs and contemplation of the moral Good, but to pleasure, inclination and ‘profits of enjoyment from work.’ (p. 38). Modern man, being part of a society that exists primarily for the sake of economic output and wealth-creation, necessarily creates a psychological reward-structure around personal achievements, advancement in social or economic status, and respites from work such as idleness and rest are only permitted if they are deserved as consequences of work and achievement. This is obviously a complete break from how work was done and life viewed in traditional societies. It is not that they did not work in such societies, but that their relationship to it was different (it is often cited, and absolutely true, that ‘unfree’ mediaeval English peasants had more days off work than modern ‘free’ working citizens). The result of this society of the achievement-subject is that we lose all meaningful ‘relations to the Other’, and so we seek gratification in unhealthy ways. The achievement-self burdens itself, exploits itself and attaches itself to anything in order to survive in a world which does not value morality, ultimate purpose, or relationships that are not practical and expendable. Life becomes ‘that of the undead.’ (p. 51) Illness is inevitable.
Although not a Christian, this line of thought has been similarly pursued by the likes of Mark Fisher. Not only do we live in a world which is focused on achievement and production, as Han has expounded, but our lives are increasingly parasitised by technology. This technology, such as our computers, smartphones, and other appliances, force us to constantly ‘check’ everything. They prey on the most passionate parts of our nature (in one talk, Fisher calls smartphones an ‘electro-libidinal parasite’). Our perception of time and our place in the world is completely flattened out. The teleological view of history that our forefathers relied on is more difficult to hold on to, and instead we become trapped in loops where our culture is nostalgic for visions of the future that never occurred. Genuine originality in art and culture is lost, and consequently self-expression is rendered phoney, being nothing more than simulacra of ideas and periods we have attached our identity to, rather than genuinely entering into the mindset of a particular way of life. For Fisher, ‘cyber-depression’ is simply a corollary of modern life, as well as something for which we bear collective responsibility, rather than something attributable to the brain chemistry of the individuals who suffer mentally.
All of these observations have deep theological parallels. We can talk generally, of course about the nature of humanity after the Fall, which is surely the ultimate cause of any mental suffering. However, whilst the Fall may be the first cause of suffering, it is not the immediate cause of the mental suffering we are witnessing. I am put in mind of the prophets of Ba’al on Mount Carmel, who, desperate to invoke the power of their false god who would not save them, cried aloud and cut themselves after their manner with knives. (1 Kings 18:28) It is not inappropriate to think of our post-Christian social priorities as false gods, and the way in which we have come to torture ourselves as a desperate way to express our inner recognition of its failure. What we are seeing is a complete breakdown of the communion for which we were created. It could even be said that modern society encourages us to be anti-Trinitarian in our relationships with others.
There is also the matter of repentance. Our society lacks repentance because it lacks faith in Christ. It is not entirely our fault, given the nature of modern upbringing in a post-Christian world, but nevertheless, as modern people, we often lack the depth of faith of our forefathers and consequently struggle to trust God. This sin of faithlessness can only be healed by repentance. Ultimately, our failures as individuals must be related to the imperfection of our nature which has lost the Likeness of God. St Maria of Gatchina taught that depression can emerge as the fruits of repentance for past sins that were previously forgotten or not fully recognised. The hope for a solution from mental sufferings can be channelled from suffering itself, since, as St. Sophrony of Mt. Athos and Essex says, every Christian must confront the abyss of emptiness that lies within his sinful soul. However, it is also worth bearing in mind the other half of St Sophrony’s advice, that after staring into the abyss for so long, it is worth drawing back to have a cup of tea!
In other words, the mental health crisis of modernity is a result of the way of life that modernity encloses us with, which is a sinful and anti-Trinitarian way of life. This is not the fault of any one individual, but something that affects us all to a greater or lesser degree, from which we all need to earnestly contribute repentance. I will consider some ways to break out of this subsequently, and some ways in which the mentally ill can be supported by the Church.
I have deliberately avoided discussing the relationship of demonology to mental illness. There is a place for this in the Orthodox Tradition, and one worth confronting; however, it is not necessary to investigate this for the purposes of this article, and so I shall leave the matter aside, given that it requires a very careful and separate treatment of its own.
Photo: carposting.ru
On the Psych Ward of the Hospital of Souls
What is the solution to the sufferings of those who come to us with mental illness? Or, more properly, how can the Church help such people? I intend to offer a few thoughts of my own on this matter, not because I have a systematic answer, but because there are resources available which can be drawn on, as well as a number of issues that I hope to place more forcefully before the Orthodox Christian conscience.
One obvious solution is the formation of genuine communities where a Christ-centred communion with each other is fostered. Where relationships are not seen in pragmatic terms but in terms of the brotherhood in Christ that characterises apostolic life. Modernity can be turned on its head in such communities: Here, it is technology that becomes purely pragmatic, and genuine interpersonal relationships which become paramount. This obviously must begin on the parish level, and something like this is already the case in many parishes. It is simply the role of the priests and pastors of the Church to ensure that such genuine communities can be fostered between members of their flock. The achievement-subject must be unlearned and, as a form of the “old man”, put off in favour of the new man of baptised Christian life: a Christocentric-subject.
We often hear the refrain from some that ‘priests are not psychologists’ and ‘confession is not counselling’. These things are of course true to a great extent, and there is wisdom in them. It is not a necessary part of the role of a priest to provide deep psychological analysis or to send their parishioners away from the temple “cured” of their mental illness. However, we must be careful not to wash our hands of our responsibility towards them. Christ came with healing and great power over illnesses of the body and of the soul. All of us, who now represent Christ to each other, and so especially the priests, must come to all with that same healing and hope in our hearts. St. Nicodemus the Hagiorite draws a strong connection between the role of the priest and the physician in the epigram which he appends to his Exomologetarion:
Galen was an example, as Apollo was to Hippocrates,
To the healer of spiritual maladies.
But the judge and healer of spiritual matters is the greatest of these,
Inasmuch as the spirit is greater than the body.
We face a practical dilemma, however. Whilst it is true that a priest is not a psychologist, and the medical healing of the mentally ill is best dealt with by a medical professional, most clinical psychologists and counsellors today are either not Christians or will not approach the matter of mental healing from a spiritual perspective. As if that wasn’t enough of a barrier, there is also the troubling matter of just how poor mental health medical provision is, even in developed countries. In the UK, waiting lists for therapy are long, and the go-to solution in the meantime for patients are various cocktails of drugs about which I continue to hear no end of horror stories. Under these conditions, are we not throwing our spiritual children to the wolves by sending them to the medical professionals? I do not have a fully worked out solution to this problem, but I would begin by suggesting that we need more Orthodox psychologists to whom we can reliably refer people, and priests should strive to have at least a basic understanding of mental illness and basic counselling. This is an important initiative, since currently, the psych ward of the hospital of souls is under-staffed.
We may also draw on the rich experience and resources of the Church. The Church’s experience with mental illness is not widely discussed, but it is there if you scratch beneath the surface. Some things we are very familiar with: as a pastor, I can attest first-hand to the power of the prayers of the Church in relieving the pains of the mentally ill, especially the prayers of the Divine Liturgy and the reception of Holy Communion fearfully and humbly. Repentance and the struggle to place Christ at the heart of life is key, no matter how difficult or long-term a struggle this may be. In severe cases of mental illness, the service of Holy Unction is just as appropriate for afflictions of the mind as of the body. We also have many saints associated with the healing of those with mental illness, including both well-known and loved saints such as Gerasimos of Kefalonia, Anastasia the deliverer from potions, and the lesser known such as the Martyr Dymphna of Geel, venerable Fillan of Strathfillan, and New Martyr Maria of Gatchina.1 Veneration of these saints should be cultivated, and supplications served to them. Most recently, I have discovered a true treasure of the Church in the so-called “Blessing-Psalter” of St Arsenios the Cappadocian. We have a record of how St Arsenios used to use the psalms as blessings over his spiritual children; and what is remarkable is just how many of these refer to what we would now term mental illness. The use of these psalms by priests is worth looking into and reviving, but of course, the psalter can be prayed by any faithful Orthodox Christian.
We must recognise that, as much as repentance is required by the mentally ill, our own repentance (of those of us who do not suffer from these afflictions) is equally required. Too often there is a strange, narcissistic flavor to the social discourse surrounding mental illness. On the one hand, there is a recognition that compassion and love towards the mentally ill is the correct response to their sufferings, but on the other hand there is a strange tendency to abdicate all responsibility towards them as soon as caring for them becomes difficult, in the name of the fact that it can “put strain” on us to do so. I do not wish to deny for an instant that caring for the mentally ill is stressful, but we must recognize that our inability to love those whom we find it difficult to deal with is a sign of our own weakness and lack of virtue. Our own effort should be directed towards loving those who suffer, and praying that God will strengthen us to fulfil this high calling.
Mentally ill people are, almost always, exactly the people whom Christ came to save. They are often misunderstood, viewed with suspicion and derision, and as such feel as though they have to separate themselves from others which then, ironically, worsens their condition. In some ways they are modern lepers. If they want healing, then they must approach Christ saying, “Lord, if Thou wilt, make me clean!” We must, like Christ, go to meet them and say “I will.” (Matt. 8:2-3) And what did Christ say to the lepers that were cleansed, after they had begged for His mercy? “Go show yourselves unto the priests.” (Luke 17:13-14) We priests must be ready to meet them when they come—not to fulfil the law of Moses, but to help bear their burdens, and so fulfil the law of Christ. (Gal. 6:2)
