Chapter 5: The Local Church’s Contributions to Positive Mental Health by Howard J. Clinebell, Jr.
Mental health is a central and inescapable concern for any church or temple that is alive to its mission with and for people. Churches and temples collectively represent a sleeping giant, a huge potential of barely tapped resources for fostering positive mental health. Specialized ministries such as chaplaincies, pastoral counseling centers, and clergy staff members in community mental health programs make invaluable contributions to the mental health renaissance developing in our nation. But even broader contributions await release in the priests, pastors, rabbis, lay leaders, and grass-roots members of religious communities (i.e., congregations) Approximately 124 million members of 320,000 churches and temples are served by 246,000 clergymen and rabbis. The immense mental health contributions of organized religion will be released only as increasing numbers of churches and temples become centers of healing and growth -- centers for healing the brokenness of individuals and relationships, and settings where persons find stimulation for lifelong growth toward their fullest humanity.
There should be an increasing reciprocity between churches and community mental health programs. One function of a community mental health center is to help develop the latent mental health resources of all its areas’ churches and temples. On the other hand, these congregations have an opportunity and an obligation to give vigorous moral support to comprehensive community mental health programs. The functioning of an ecumenically oriented, clinically trained clergyman on the mental health center staff is essential to the bridge-building process by which such reciprocity grows.
Clergymen counsel more troubled people than any other helping profession. This is a major contribution to the therapeutic dimension of mental health. However, a larger contribution by ministers and churches is in the area of prevention of mental ill health by fostering positive human fulfillment. This growth ministry is at the center of the church’s mental health mission.
Unique Contributions of Churches and Temples
Mental health professionals have a right to press the crucial question, What are the unique contributions of religious groups to positive mental health? Vigorous churches and temples are instruments for feeding those basic heart hungers which, when starved, result in personality crippling, and, when satisfied, produce strong, creative, loving people. The positive mental health function of religious groups is to perfect their methods for meeting these personality needs:
1. The need for an opportunity to periodically renew basic trust is satisfied by religious groups through corporate worship, symbolic practices, sacraments, and festivals. Erik Erikson declares:
There can be no question that it is organized religion which systematizes the first conflicts of life . . . . It is religion which by way of ritual methods offers man a periodic collective restitution of basic trust which in adults ripens to a continuation of faith and realism.( "On the Sense of Inner Identity" in Psychoanalytic Psychiatry and Psychology, Robert Knight and C. Friedman, eds. (New York: International Universities Press, 1954) , I, 353.
Erikson holds that the infant develops a sense of "basic trust" or "basic distrust," depending on the quality of the mother-child relationship. The core feeling that life is trustworthy becomes the foundation for all subsequent need-satisfying relationships. For those whose ability to trust is limited as a result of early experiences (which means all of us to some degree) , organized religion offers a way of reestablishing trust. The mental health significance of this is far-reaching, e.g., it is likely that many forms of mental illness are rooted in a massive disintegration of trust.
2. The basic need for a sense of belonging is provided by meaningful involvement in religious groups. The sense of solidarity with persons joined by common commitments and similar ideologies increases group cohesion. Satisfaction of this need is particularly crucial in our fragmented, transient, urban society where rootlessness and loneliness are epidemic. Churches and temples often serve as substitutes for the missing "extended family"; this is an invaluable resource when crises strike. Having or lacking support of a network of relationships can be the difference between coping or collapsing under pressure.
Alongside Freud’s will-to-pleasure, Adler’s will-to-power, and Frankl’s will-to-meaning, is another, more basic human striving and need -- the will-to-relate. Man is his relationships; the quality of his relationships determines the quality of his mental-spiritual health. Only through relationships can he satisfy his will to pleasure, power, or meaning. When one is blocked in the ability to relate in mutually satisfying ways, alienation, loneliness, rage, and sickness (mental and physical) follow. The "distanced" person is cut off from both the potential riches within himself and those in relationships. (This understanding of man illuminates the importance of relationship-centered approaches to pastoral care and counseling.) A creative church, through its small groups, offers many opportunities for families and individuals to satisfy their will-to-relate.
Because of their vertical frame of reference, religious groups can help satisfy the will-to-relate to the ultimate dimension, the dimension of Spirit. The longing to belong in some ultimate sense, to feel an at-homeness in the universe is satisfied for many in worship which reawakens the awareness of "the mystical unity which underlies all human life" (Cyril Richardson) This experience is energizing, feeding, and healing; it overcomes the sense of cosmic loneliness, the feeling expressed by a mental hospital patient: "I’m an orphan in the universe." One may relate such experiences to Jung’s collective unconscious or to findings in parapsychology. However understood, they change one’s existence from a "world of walls without windows" to a connectedness with life.
3. Religious groups also provide an opportunity and resources for meeting the crucial need for a viable philosophy of life. The religious community’s tradition and belief-system offer ethical guidelines within which (or even against which) individuals can develop their own functional value hierarchies. Erikson points to the crucial role of values in ego strength. One of the major mental-social health functions of organized religion is to stimulate persons to discover authentic values to which they can commit themselves. The proliferation of character disorders in our society underlines the imperative nature of this function. The frequent presence of a "value vacuum" (Frankl) in the personality and relationship problems brought to counselors emphasizes Erich Fromm’s conviction that every human being needs a "system of thought and action shared by a group which gives the individual a frame of orientation and an object of devotion." (Psychoanalysis and Religion (New Haven: Yale University Press, 1950, p. 21.) Organized religions provide the most accessible and most traveled (though not the only) route to this goal. In the search for the unique contributions of the religiously and philosophically oriented counselor, Gordon Allport’s question provides a clue: "May not (at least sometimes) an acquired world outlook constitute the central motive of life, and if disordered, the ultimate therapeutic problem?"( Rollo May, ed., Existential Psychology [New York: Random House, 1961], p.98.) Religious groups satisfy the need for "an object of devotion," or what Tillich calls "the dimension of ultimate concern." The need to find a worthy, non-narcissistic focus of self-commitment is compelling; only by such a self-transcending commitment rooted in a vital philosophy of life can one cope creatively with existential anxiety. By existential anxiety I mean the non-neurotic anxiety which is inescapable (and incurable psychotherapeutically) and which results from man’s awareness of the abyss of death, including the living death of meaninglessness. This anxiety is a stifling, paralyzing force unless one has developed a functional philosophy of life; a life style of "generativity" (Erikson) , i.e., self-investment in the ongoing human race; and relationships of trust with at least one other person and with the Ground of Being. If one has these, existential anxiety becomes a stimulus to creativity. For many persons, coping with this anxiety is facilitated by devotion to the God of justice, love, and truth, and to the realization of his kingdom. For many others, traditional theological symbols are blocks to the discovery of their own object of devotion and workable philosophy of life. Relevant religion seeks not to defend old orthodoxies but rather to aid persons in spiritual discovery, encouraging them to be as true to their own light as the prophets and Jesus were to theirs.
The uniqueness of pastoral counseling is derived in part from the minister training as an expert in spiritual growth. As the only helping professional with systematic training in philosophy and theology, he should be particularly helpful in facilitating growth in the area of meanings, values, and relatedness to God. As a theological counselor (or counseling theologian) he can integrate theology and psychology in the spiritual growth-stimulating process. Counseling methods can be useful in working through blocks to growth in the spiritual life.
4. A related need is for a humanized view of man, i.e., a doctrine of man which emphasizes his capacity for decision, inner freedom, creativity, awareness and self-transcendence. The existentialist perspective in psychotherapy provides us with a fresh spring of resources for meeting this need.(See H.J. Clinebell, Jr., Basic Types of Pastoral Counseling [ Nashville: Abingdon Press, 1966], pp. 263-64.) The man who asked, "Am I only an organic computer?" reflects the impact of dehumanizing social forces and reductionistic (and mechanistic) views of man which are among the causes of psychopathology. The Hebrew-Christian view that man is formed in the image of God and has a basic uniqueness in the animal kingdom is, therefore, much needed in our situation.
5. Religious groups can help satisfy the universal need for experiences of transcendence, providing vacations from the burden of finitude (the sense of being caught in nature with its sickness and death) , and the tyranny of time. Attempts to escape from a flat, two-dimensional spiritual universe are involved in the widespread search for instant transcendence through drugs, particularly the hallucinogenic drugs. Religion is a sounder path to moments of transcendence. It can restore the sense of wonder which, in our worship of the golden calf of technological cleverness, often gets trampled underfoot like a delicate flower. In the rites, myths, and dramas of religious groups, the symbolic and the artistic are regularly renewed. Thus contact with the depths in man which Freud plumbed, and the heights which he did not, is restored helping to strengthen one’s relationship with the whole self and the world. Mental health values in religious practices are realized as by-products of participating as the spontaneous celebration of life and of experiences of depth relating to God, other persons, and self.
6. Support of individuals and families in both the developmental and accidental crises of living is another need-satisfying function of religious groups. At the various growth stages churches have rites of passage, for example, confirmation. These are group-supported and symbolic ways of coping with the anxiety resulting inevitably from loss of old securities and the threat of the unknown stage ahead. Natural subgroups within healthy churches spontaneously provide emotional support of those in accidental crises such as hospitalization. Group nurturance allows persons to use the crisis as an opportunity for growth. Thus, their coping muscles are strengthened for meeting the next crisis.
7. Religious groups can meet the need to move from guilt to reconciliation utilizing the time-tested pathway to forgiveness -- confrontation, confession, forgiveness, restitution, and reconciliation (restoration of the broken relationships) Organized religion has centuries of experience in this area. When integrated with recent confrontational counseling approaches, e.g., Glasser’s "reality therapy," this heritage can make a unique contribution to mental health. The pervasive pall of guilt in much psychopathology underlines the importance of this resource. Appropriate, reality-based guilt responds to the traditional forgiveness process. Neurotic guilt often calls for counseling skills to resolve the hidden conflict at its roots.
8. Religious groups can help meet the need of persons to be instruments of personal growth and social change. They do so by providing motivation, training, and opportunities to be change agents. When all of existence is discovered to be sacred and one’s life is viewed as a trust to be invested in enhancing human values, motive-power for significant involvement is created. There are two styles of change agent ministries, the prophetic and the pastoral care -- educational. The former focuses on changing the structures of injustice in society through social action; the latter on changing individuals through counseling, nurturing, and educative relationships. Both are shared responsibilities of laymen and clergymen. Mental health is a useful bridge concept for a much needed wedding of prophetic and pastoral. By pastoral care and counseling, blocked, self-absorbed persons can be "set free to minister." A person is mentally healthy to the degree that he is free enough from his own hang-ups to be able to he responsive and responsible in his relationships. If he is this, he will be a growth agent in others’ lives and he will continue to grow.
Implications for the Church’s and Temple’s Programs
There are many implications of this perspective for developing church and temple programs. These needs of people could be met much more fully than they are now in most churches.( In Joy, Expanding Human Awareness [New York: Grove Press, 1967], William Schutz declares: "Our institutions, our organizations, the ‘establishment’ -- even those we are learning to use for our own joy. Our institutions can be improved, can be used to enhance and support individual growth, can be re-examined and redesigned to achieve the fullest measure of human realization." P. 223.) Some innovative religious groups are learning to release their mental health resources. Here are some of the thrusts of such creative churches and temples.
There is a kind of research and development climate produced by continuing to seek better answers to, How can this church meet the growth-healing needs of its congregation? and of its community? Regular evaluation of existing groups and programs and continuing experimentation with new approaches are present. Both inreach and an outreach (fellowship and mission) are major thrusts in the programs of such churches. Furthermore, there is systematic reflection on how each aspect of the program can become more productive of healing, growth, and social change.
Several church program areas are particularly rich in mineable mental health ore. One is the small group program. A group in which depth relationships can grow through transparent dialogue is like an oasis in the usual desert of superficial relating. There is wisdom in having two parallel sets of groups -- the ongoing network of "normal" church groups, and small ad hoc groups aimed at personal growth through depth communication and enhancing interpersonal skills. Many types of groups exist, e.g., a depth Bible study group to stimulate the maturing of functional theologies; groups to aid preparation for normal crises such as retirement, middle age, marriage, childbirth (Caplan calls these "emotional innoculation groups"). Growth groups for persons with particular problems in living, such as handicapped children, singleness, or chronic health problems, are valuable. Mental health professionals in the church or temple and community can be recruited as leaders or co-leaders (with the clergyman) of groups, and to help train lay leaders for all kinds of groups -- e.g., supportive, growth, inspirational, study, and action groups. The ultimate impact on persons of "normal" church groups and of growth-healing groups is determined by the skills, sensitivity, and caring of leaders. Therefore, participation in an ongoing interpersonal skills group under the most competent leader available should be expected of all group leaders. The goal of every church and temple should be to have a constellation of small groups varied enough to meet the special needs of every age grouping and major life circumstance.
Another fruitful program area is dynamic marriage and family life training. The churches and temples have a direct entree to more pre-parents and parents of children under six (when personality foundations are laid) than any other institution in our society. Thus, they hold the major key to developing a comprehensive program of primary prevention through enriching family relationships and enhancing parental effectiveness in meeting their own and their children’s personality needs. The emotional climate of families can be enhanced profoundly by the nurturing relationships within a dynamic, caring church in all the light and the shadows of a family’s life cycle.
Education which strengthens parents and families is designed on the emotional growth model utilizing small sharing groups as a major instrument. The most vital groups of my parish ministry was an ongoing child study-nursery group for mothers of preschoolers. Films, lectures, and field experiences were blended with sharing of the fears, hopes, and joys of being parents of young children. Emphasis was on creative ways of satisfying one’s own needs in relationships (especially marriage) and on recognizing and satisfying the particular inner hungers of each child. This group would have been even more effective if the fathers could have been involved frequently.
Growth groups for adolescents can be useful in the identity struggle, providing the adult leaders are secure in their adulthood and reasonably comfortable with youth. Parents of adolescents need a growth and nurture group to deepen marriages, resolve conflicts about releasing their teen-agers, and cope with the compound crises of middle age (the pressures of death of parents, menopause, and the grief of the emptying nest). Interpersonal skill groups for young adults (married and unmarried) help them lower barriers to interpersonal intimacy, their life task in that stage. Marital growth groups for couples in each of the major phases of marriage can be highly productive. Rapid changes in male-female roles and the search for depth companionship in marriage make such groups essential in a church program oriented around unmet needs. Groups for pre-married and young married couples also are productive. In addition to groups for individuals and couples, groups for whole families -- e.g., family camps and retreats -- are invaluable.
Relationship-centered preaching and teaching is another thrust in churches and temples with the growth-healing commitment. Teacher training by the use of interpersonal relationship groups increases the growth potential of church school classes. Preaching maximizes personality values when it is dialogic (with opportunities for talk-back) and when it presents the religious message in ways that are life-affirming. The message is communicated best in a relationship in which acceptance, caring, and confrontation are blended. The quality of the teaching or preaching relationships determines the effectiveness of communication -- the "medium is the message."
Religious communities with growth-healing motifs frequently are found to be experimenting with innovations to make corporate worship more alive and meaningful. New structures of involvement and participation are emerging. Several California churches are experimenting with dividing their worshiping congregations into groups of six for guided interpersonal encounter and awareness training during a part of the service.
Pastoral care and counseling are a vital aspect of the growth program of churches. Two developments of particular mental health significance are the clergy specialist in pastoral care and group development as a part of a multiple ministry, and the growing use of lay "pastoral care teams." Well trained clergymen in specialized ministries of counseling (in local churches, denominational programs, and pastoral counseling centers) are an important new resource for mental health. Their functions include making available new training opportunities in counseling for parish clergymen.
The discovery that certain laymen are natural therapeutic persons opens a fresh dimension in congregational pastoral care. When carefully selected, trained, and supervised, such persons can triple a church’s ministry to those in crises and to the chronically dependent. Working closely with their clergyman, two laymen from a "grief team" quietly surround a bereaved family with caring as long as they are needed. Trained laymen can be of practical and emotional help to the family of those hospitalized for mental or physical illness. With earlier releases from treatment facilities, a few churches and temples are responding to the need for after-care by sponsoring halfway houses staffed by trained laymen. New methods of pastoral counseling which stress short term, reality, and relationship-oriented approaches and crisis intervention techniques are good news for both the general parish minister and the lay pastoral care team member. All these new developments can help to make churches or temples what they should be -- caring communities. When persons become "members one of another," their positive mental health flourishes.
For additional reading
Clinebell, H. J., Jr. Mental Health Through Christian Community. Nashville: Abingdon Press, 1965.
McCann, Richard V. The Churches and Mental Health. New York: Basic Books, 1962.