Treatment and Prevention of M ental Illness
Psychopathology Through the Eyes of Faith: lotegr^؛!^e Reflections for
t^e Classroom and Beyond
Richard E. Batman
Wheaton College
Mark Yarhouse
Regent University
The Study ofthe Calamities ofthe Soul
We approach the study of psychopathology in these terms: “foe study of the calamities of the soul,” by which we mean that students are learning how to assess, treat, and prevent concerns that affect the whole person, the embodied soul. Stated differently, some- thing is lost in foe study o^ychopathology when we focus only on deviance, dysfunction, danger, or distress (i.e., foe traditional understanding of abnormal behav- ior). Rather, we see foe study o^ychopathology as the emotional and psychological stru^les of persons that affect all dimensions ofhuman beings.
This definition comes from the Greek word for psych ( psukhe)y meaning breath or spirit, suggesting more than just the mind (but including mental pro- cesses), and pathology, su^esting foe scientific study of deviations from a healthy or normal state or condi- tion. Today, it is more common for the scientific study of psychopathology to focus on deviance, dysfunction, danger, and distress (i.e., the “4 Ds” in many contem- porary textbooks). These are certainly important for the conversation, but it seems most appropriate for a faith-based discussion to begin with a broader under- standing of the soul so that we can remind ourselves and our students that we are taking a holistic view of foe person in the service ofthe well-being of the soul.
The definition we have chosen—the study of foe calamities of the soul—has foe potential to offer greater humility and honesty, and a deeper respect for humanity, into our explorations in foe classroom and beyond. To foe traditional emphasis on the 4Ds, we
would Idee to add that ^ychopathology could also be seen as an expression of “disordered desires” or urges and longings that have gone awry.
The Assessment, Treatment and Prevention of M ental Illness
In our approach to teaching ^ychopathology, whether to an audience of undergraduate or graduate and professional-level students, we focus on three key domains: (a) the assessment, classification and diagno- sis of mental illness; (b) the effective treatment of psy- chopathology; and (c) exploring strategies for reducing the intensity, duration or frequency of disordered de- sire (prevention). We want our students to be able to describe the key symptoms ( what isgoingon?)y to offer reasonable explanations for their etiology and mainte- nance (why is this happening?), to be able to explore available treatment options (what might be helpful
– healing and growth}), and to offer creative and in م formed responses to risk reduction in the foture (what might be some preventive options?). Unfortunately, the traditional focus in many psychopathology courses is primarily on learning the Diagnostic and Statisti- cal Manual of Mental Disorders (DSM; APA, 2013) typology regarding foe assessment, classification and diagnosis of mental illness. For us, we strongly advo- cate the need for an “ethical” response (what are the implicationsfor our Christian worldview and lifestyle?). Consequently, we strive to balance solid course content (insight) with a sharp focus on relevant implications for se!want-^a^rioner-scholars (Jones & Butman, 2011).
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PSYCHOPATHOLOGY THROUGH THE EYES OF FAITH
Historical and Contemporary Understanding ofthe Subject Area
In our previous work (Yarhouse, Butman, & McRay, 200s), we noted that there has been a segrega- rion of the soul that took place when the church ab- dicated its responsibilities in working holistically with the soul by having mental concerns addressed solely and exclusively by mental health professionals. There is a rich tradition ofpastoral care and spiritual formation that could deeply inform contemporary discussions. We see some developments in this area with greater emphasis on spiritual Direction today, even to foe ex- tent of specific degree programs. The positive psychol- ogy movement has also offered some helpful insights that compliment these developments. Indeed, psychol ogy, theology, and spiritual formation are all potential contributors to the dialogue (McMinn & Campbell, 2006). In other words, the study of the calamities of foe soul needs to be informed by science and reason (general revelation), scripture and theology (special revelation), foe authority and traditions ofthe church (spiritual formation), and important insights gained from foe narratives (experience) of both practitioners and clients. Finding effective ways to “integrate” these major sources of truth is foe heart ofthe matter for discernment in ^ychopathology (Jones & Butman, 2011).
This discussion comes at a rime in our history in which the mental health fields are in foe midst of sig- nificant turmoil about how best to understand our models of personality, psychopathology, and psycho- therapy. Recent conflicts about classifications systems (Diagnostic and Statistical Manual or DSM, Inter- national Classification of Disease or ICD, Psychody- namic Diagnostic Manual or PDM, and Personality Disorders Institute or PDI) are but one expression of these tensions (APA, 2013). Likewise, fierce de- bates about “best possible practices” {what treatment strategies work best with what types o f persons with what types ofproblems?) often leave the student bewil- dered by perceived chaos and confusion in the field. One of the key tasks ofthe instructor, then, is to help foe student to navigate foe “culture wars” between compering models. The wisdom, knowledge, and compassion so often evident in the history of pastoral care can help us explore the common factors ofeffec- rive treatment like hope, technique, relationships, and contextual or situational variables (McMinn & Camp- bell, 2006). A trend we have bofo noted amongst col- leagues that teach at faith-based institutions, is a grow- ing respect for this literature with each passingyear. As
Deuck and Reimer (2009) have nbserved, “Athens” (the academy) has much to learn from “Jerusalem” (the church).
Integrative k e r n e s in the Subject Area
The Problem ofHuman and Pain (the ^teodicy Debate)
Perhaps the most important theme that must be addressed at the start of a course in psychopathol- ogy is the theodicy debate. Our models of personal- ity, psychopathology, and psychotherapy should be deeply informed by the reality of human brokenness and sinfulness. The sheer statistical reality of the many expressions of serious mental illness (epidemiology) demands enormous sensitivity in this area, w h e n one considers the problems of anxiety and mood—or the problems of personality and psychosis—it would be hard to imagine that any individual in contemporary American society has not been directly or indirectly impacted by human pain and suffering. These themes can be incorporated directly into the content of the course or resources such asJohn Stackhouse’s Can God Be Trusted? or similar introductions to theodicy can be used as an opening reflection/devotional to facilitate discussion.
Specifically, we would recommend that course instructors courageously and carehdly address these concerns from the start of the course. Some form of “affect simulation” seems essential. We have found excellent resources in a wide variety of sources (e.g., articles, books, case studies, and internet) that help stu- dent develop greater awareness of the inner world of mental illness and emotional distress. Helping them to shift from focusing on the differences between them- selves and hurting persons—to exploring the common humanity of the human experience (empathy) seems absolutely critical. If this is not “front-loaded” in the course, the student runs the risk of adopting a more aloof and distant understanding of the reality of the critical mass ofhuman pain and suffering.
The Nature of?ersons (Theological Anthropology)
In our courses in psychopathology, we want our stu- dents to reflect and begin to initially develop a deeper understanding ofwhat it means to be a human being in all its complexities {what makespeople tick?). Specifi- cally, we encourage them to reflect on ways in which the doctrines of creation, the fall, resurrection, and glorification should inform our notions ofpersonhood (Jones & Butman, 2011). At foe most basic level, this
BUTMAN and YARHOUSB
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should mean that every person is created in the image and likeness of God, therefore being of infinite worth and significance (Imago Dei). Likewise, each person is prone to brokenness, deceit, and sin (the utter impos- sibility of human perfection). Finally, there is hope for all persons because ofthe reality of the incarnation and resurrection. The study ofpsychopathology lends itself especially well to “fleshing out” our notions ofbroken- ness and the impact ofboth personal and collective sins of omission and commission (Yarhouse et al., 2005). But even in the midst o f incredible hrokenness, it does not lessen the worth and dignity of each person we en- counter. Practically speaking, this could mean that we have something to learn from each person in every en- counter—if only because they bear the image and like- ness ofGod. Our stance, then, should be one ofincred- ible humility and uncommon decency (Mouw, 2002). Flsewhere, we have tried to make a case for wholistic dualism —a recognition of the fundamental unity of foe mind and body (Jones & Butman, 2011). In short, our students need to understand that “we are not dis- embodied minds—or mindless bodies.” We are fear- fully and wonderfrrlly made in His Image—even in foe midst ofthe most serious expressions of mental illness.
The Nature ofProblems-in-Living (Psychopathology)
Further, we want our students to develop a deeper understanding ofthe etiology and maintenance ofpsy- chopathology. Mental illness is rarely an expression of a single causal factor….
