Archive for September, 2014

Tweets of the Week 9.30.14

There is great value in saying something in a memorable, concise manner. Twitter has caused us to make this a near spiritual discipline. For my own growth (as a generally verbose individual… that’s a long way of saying “wordy”) and for the benefit of others, I highlight tweets each week that deliver a big message in a few words.

Self-Awareness: A Key Difference between Hypocrisy &a Hard Heart

Have you ever wondered what the difference is between being a hypocrite and having a hard heart?  Maybe I’m the only one. But I think it is a useful thought to explore. Depravity can come in different degrees (i.e., expressions, depths) even if it is “total.”

I believe these considerations will help us guard our own hearts from sin and more skillfully love those caught in their sin. Too often we just call bad, bad and think we have done our job. If we are going to be effective physicians of the soul, we must know the ailments of the soul particularly.

I would propose that one key difference between being a hypocrite and having a hard heart is the level of self-awareness the individual has about his/her sin.

  • A hypocrite is self-aware. He knows that he is not what he claims to be or is not doing what he expects other people to do.
  • A hard-hearted person is not self-aware. He is blind to the wrongness of his actions. His heart has lost the sensitivity to discern good from evil, truth from lie in the area of his particular sin.

Which is worse? I would contend that having a hard heart is worse than being a hypocrite. As a hypocrite, I would still be agreeing with God’s law regarding my sin. I still advocate for others to follow God’s law and feel some form of offense when God’s law is broken. Unfortunately, my self-centeredness would only allow me to detect when the violation of God’s law hampers my preferences.

As a hard-hearted person, I would both defend my sin and advocate for the freedom of others to behave (not that sin should be reduce

d simply to behavior) in a similar manner. I have reached the point that I have renamed bad, “good.” I must not only be given eyes to see my own behavior, but I must (before that) have my conscience enlivened to accept God’s truth.

What are some implications from this consideration?

  1. When we interact with someone who is continuing in a particular sin we should seek to discern if they are under conviction (neither hypocritical nor hard-hearted), self-aware but in denial (being hypocritical), or not acknowledging the truth at all (hard-hearted).
  2. We then respond to this person on the basis of their self-awareness.
    1. For the hard-hearted person we can only pray that God will change their heart and avoid as much personal/relational damage as possible (Matt. 7:6).
    2. For the hypocrite we can appeal to the part of their conscience that is active and seek to help them come under complete conviction.
    3. For the person under conviction (and really for them only is it wise/effective to) we remind them of God’s grace to forgive and the guidance of His Word to restore them.
  3. We recognize that a failure to change is not because we have not shared relevant, biblical information in a clear and compassionate way.

As for our own hearts, this reflection should cause us to be very cautious when we refuse the counsel of fellow believers and should urge us to live more transparently with our fellow believers as a protection of starting the hypocritical to hard-hearted slide.

If this post was beneficial for you, then considering reading other blogs from my “Favorite Posts on Counseling Theory” post which address other facets of this subject.

Why Three Seminars on Depression-Anxiety?

People and counselors debate how much responsibility or control people have over the emotional experiences of depression and anxiety.

Are depression and anxiety sin (i.e., the result of misplaced beliefs, wrongly prioritized values, and poor choices) or suffering (i.e., response to hardships and degenerative biology)? 

Too often these become either-or, all-or-nothing debates. In these tandem seminars we will look and how the gospel provides guidance and hope to individuals when their emotional experience is the result of suffering and when its rooted in personal responsibility.

In the process of exploring each those in attendance will learn how to “sort their emotional laundry” in order experience the peace and hope God offers for both sin and suffering.

OVERCOMING DEPRESSION-ANXIETY: A SUFFERING PARADIGM
Date: Saturday September 27
Time: 4:00 to 7:30 pm
Location: The Summit Church, Brier Creek South Venue
Address: 2415-107 Presidential Drive; Durham, NC 27703
Cost: Free
RSVP Here

TOWARDS A CHRISTIAN PERSPECTIVE ON MENTAL ILLNESS
Date: Tuesday September 30
Time:  7:30 to 8:30 pm
Location: The Summit Church, Brier Creek South Venue
Address: 2415-107 Presidential Drive; Durham, NC 27703
Cost: Free
RSVP: Link will be posted at www.bradhambrick.com/events

OVERCOMING DEPRESSION-ANXIETY: A PERSONAL RESPONSIBILITY PARADIGM
Date: Saturday October 18
Time: 4:00 to 7:30 pm
Location: The Summit Church, Brier Creek South Venue
Address: 2415-107 Presidential Drive; Durham, NC 27703
Cost: Free
RSVP: Link will be posted at www.bradhambrick.com/events

 

20 Approaches to Battling Depression-Anxiety as Suffering

This post is an excerpt from the study guide which accompanies the “Overcoming Depression-Anxiety: A Suffering Paradigm” seminar. This portion is one element from “STEP 7: IDENTIFY GOALS that allow me to combat the impact of my suffering.” To RSVP for this and other Summit counseling seminars visit bradhambrick.com/events.

One of the biggest challenges in identifying goals for combatting the effects of suffering is to be active without accepting false guilt. It is easy to think if there is something I “can do” to offset the impact of my suffering, then it is something I “should have been doing” all along.

The embedded deception in this kind of thinking is that the new strategy would have prevented the experience of depression-anxiety from ever occurring. If this were true, then you would be facing a sin-based experience of depression-anxiety rather than a suffering-based one.

The clearest example of this dynamic might be grief. Grief is clearly a form of suffering. But we are not powerlessly trapped in the experience of grief for a lifetime. There are things we can do to process the experience of grief and offset its impact. However, doing these things earlier would not have prevented our loved one from dying or our experience of grief at their death.

This is how we would encourage you to consider the strategies presented in this chapter. They are approaches to help alleviate the impact of depression-anxiety in your life. We present more strategies than you will be able to implement. Don’t get overwhelmed. Choose those that seem like the best fit for your experience. If you’re unsure which ones those may be, consult with the friends, pastor, or counselor with whom we’ve encouraged you to walk through this material.

If you believe that you need an approach to anxiety-depression that calls you take more personal responsibility for your emotional state, then we would encourage you to consult chapter six in the corresponding study that addresses these same emotions from a sin paradigm (www.bradhambrick.com/depression; note – link not active until after the live presentation).

Your goal at the end of this chapter, and possibly in conjunction with chapter six of the corresponding study, is to identify the most impactful things you could do in your struggle with depression-anxiety. We want to help you break the sense of powerlessness to which it is so easy to succumb.

Several of these approaches were adapted from a larger list found in Ed Welch’s book in Depression, A Stubborn Darkness (page 231ff; bold text only).

Note: Each is described more fully in the study guide that accompanies this presentation.

  1. Talk to Yourself Instead of Listening to Yourself
  2. Stop Saying, “It Won’t Work”
  3. Allow for Contributive Causes and Contributive Remedies
  4. Medication
  5. Identify Areas Where Your Choices Matter
  6. Engage Relationships
  7. Ask People to Pray for Goals More than Relief
  8. Be Willing to Be Challenged
  9. Serve Others
  10. Forgive
  11. Shield Against a Depressed-Anxious Identity
  12. Worship
  13. Realize This Is a Battle and You Must Fight
  14. Let Go of “Should”
  15. Question Your Interpretations
  16. Look for the Good in People and Situations
  17. Read a Good Book on Suffering
  18. Be Willing to Sacrifice the Pseudo-Comforts of Depression-Anxiety
  19. Don’t Confuse Boredom with Depression or Uncertainty with Anxiety
  20. Spiritual Life – Less May Be More

OVERCOMING DEPRESSION-ANXIETY: A SUFFERING PARADIGM
Date: Saturday September 27
Time: 4:00 to 7:30 pm
Location: The Summit Church, Brier Creek South Venue
Address: 2415-107 Presidential Drive; Durham, NC 27703
Cost: Free

For the various counseling options available from this material visit www.summitrdu.com/counseling.

Overcoming Depression-Anxiety: A Suffering Paradigm (Seminar Videos)

Below is a video from the presentation of “Overcoming Depression-Anxiety: A Suffering Paradigm.” For the various counseling options available from this material visit www.summitrdu.com/counseling.

The complementing studies  Overcoming Depression-Anxiety: A Responsibility Paradigm and Towards a Christian Perspective of Mental Illness are also available in a video format at these links.

NOTE: Many people have asked how they can get a copy of the seminar notebook referenced in this verbal presentation. You can request a copy from Summit’s admin over counseling at counseling@summitrdu.com (please note this is an administrative account; no individual or family counsel is provided through e-mail).

STEP 1.
PREPARE yourself physically, emotionally, and spiritually to face your suffering.

Depression-Anxiety Suffering Paradigm Part 1 from The Sam James Institute on Vimeo.

Blog Post: “A Sample Letter to Help Cultivate Community While Struggling with Depression-Anxiety” (Sample of material in the seminar notebook)

Blog Post: “6 Steps to Wise Decision Making About Psychotropic Medications” (Appendix A from the seminar notebook)

STEP 2.
ACKNOWLEDGE the specific history and realness of my suffering.

Depression-Anxiety Suffering Paradigm Part 2 from The Sam James Institute on Vimeo.

On-Line Evaluation: Types of Depression & Anxiety Evaluation

Resource: Depression-Anxiety Daily Symptom Chart

STEP 3.
UNDERSTAND the impact of my suffering.

Depression-Anxiety Suffering Paradigm Part 3 from The Sam James Institute on Vimeo.

STEP 4.
LEARN MY SUFFERING STORY which I used to make sense of my experience.

Depression-Anxiety Suffering Paradigm Part 4 from The Sam James Institute on Vimeo.

STEP 5.
MOURN the wrongness of what happened and receive God’s comfort.

Depression-Anxiety Suffering Paradigm Part 5 from The Sam James Institute on Vimeo.

STEP 6.
LEARN MY GOSPEL STORY by which God gives meaning to my experience.

Depression-Anxiety Suffering Paradigm Part 6 from The Sam James Institute on Vimeo.

STEP 7.
IDENTIFY GOALS that allow me to combat the impact of my suffering.

Depression-Anxiety Step 7 from The Sam James Institute on Vimeo.

STEP 8.
PERSEVERE in the new life and identity to which God has called me.

Depression-Anxiety Step 8 from The Sam James Institute on Vimeo.

STEP 9.
STEWARD all of my life for God’s glory.

Depression-Anxiety Step 9 from The Sam James Institute on Vimeo.

Blog Post: 9 Questions to Help You Steward All of Your Life for


 

If this post was beneficial for you, then considering reading other blogs from my “Favorite Posts on Anxiety” post which address other facets of this subject.

If this post was beneficial for you, then considering reading other blogs from my “Favorite Posts on Depression” post which address other facets of this subject.

Overcoming Depression-Anxiety: A Personal Responsibility Paradigm (Seminar Videos)

Below are the videos from the presentation of “Overcoming Depression-Anxiety: A Personal Responsibility Paradigm.” For the various counseling options available from this material visit www.summitrdu.com/counseling.

The complementing studies  Overcoming Depression-Anxiety: A Suffering Paradigm and Towards a Christian Perspective of Mental Illness will also available in a video format after their presentation

NOTE: Many people have asked how they can get a copy of the seminar notebook referenced in this verbal presentation. You can request a copy from Summit’s admin over counseling at counseling@summitrdu.com (please note this is an administrative account; no individual or family counsel is provided through e-mail).

STEP 1.
ADMIT I have a struggle I cannot overcome without God.

Depression-Anxiety Responsibility Paradigm Step 1 from The Sam James Institute on Vimeo.

On-Line Evaluation: Types of Depression & Anxiety Evaluation

Printable PDF Evaluation: depression-anxiety-assessment

Blog Post: “6 Steps to Wise Decision Making About Psychotropic Medications” (Appendix A from the seminar notebook)

 

STEP 2.
ACKNOWLEDGE the breadth and impact of my sin.

Depression-Anxiety Responsibility Paradigm Step 2 from The Sam James Institute on Vimeo.

On-Line Evaluation: Types of Depression & Anxiety Evaluation

STEP 3.
UNDERSTAND the origin, motive, and history of my sin.

Depression-Anxiety Responsibility Paradigm: Step 3 from The Sam James Institute on Vimeo.

For the “Depression-Anxiety Journal” from click here: Depression-Anxiety Journal

STEP 4.
REPENT TO GOD for how my sin replaced and misrepresented Him.

Depression-Anxiety Responsibility Paradigm Step 4 from The Sam James Institute on Vimeo.

STEP 5.
CONFESS TO THOSE AFFECTED for harm done and seek to make amends.

Depression-Anxiety Responsibility Paradigm Step 5 from The Sam James Institute on Vimeo.

For the “Confession Guide” click here: Confession Guide

STEP 6.
RESTRUCTURE MY LIFE to rely on God’s grace and Word to transform my life.

Depression-Anxiety Responsibility Paradigm Step 6 from The Sam James Institute on Vimeo.

STEP 7.
IMPLEMENT the new structure pervasively with humility and flexibility.

Depression-Anxiety Responsibility Paradigm Step 7 from The Sam James Institute on Vimeo.

For the “Implementation Evaluation Tool” click here: Depression-Anxiety Plan Eval Form

STEP 8.
PERSEVERE in the new life and identity to which God has called me.

Depression-Anxiety Responsibility Paradigm Step 8 from The Sam James Institute on Vimeo.

STEP 9.
STEWARD all of my life for God’s glory.

DepressionAnxietyResponsibilityParadigm9 from The Sam James Institute on Vimeo.

Blog Post: 9 Questions to Help You Steward All of Your Life for God’s Glory

If this post was beneficial for you, then considering reading other blogs from my “Favorite Posts on Anxiety” post which address other facets of this subject.

If this post was beneficial for you, then considering reading other blogs from my “Favorite Posts on Depression” post which address other facets of this subject.

6 Steps to Wise Decision Making About Psychotropic Medications

This post is an excerpt from the study guide which accompanies the “Overcoming Depression-Anxiety: A Suffering Paradigm” seminar. This portion is one element from “Appendix A.” To RSVP for this and other Summit counseling seminars visit bradhambrick.com/events.

Let’s begin this discussion by placing the question in the correct category – whether an individual chooses to use psychotropic medication in their struggle with mental illness is a wisdom decision, not a moral decision. If someone is thinking, “Would it be bad for me to consider medication? Is it a sign of weak faith? Am I taking a short-cut in my walk with God?” then they are asking important questions (the potential use of medication) but they are placing them in the wrong category (morality instead of wisdom).[1]

Better questions would be:

  • How do I determine if medication would be a good fit for me and my struggle?
  • What types of relief should I expect medication to provide and what responsibilities would I still bear?
  • How would I determine if the relief I’m receiving warrants the side effects I may experience?
  • How do I determine the initial duration of time I should be on medication?

In order to answer these kinds of questions, I would recommend a six step process. This process will, in most cases, take six months or more to complete. But it often takes many months for doctors and patients to arrive at the most effective medication option, so this process does not elongate the normal duration of finding satisfactory medical treatment.

Having an intentional process is much more effective than making reactionary choices when the emotional pain (getting on medication) or unpleasant side effects (getting off medication) push you to “just want to do something different.” With a process in place, it is much more likely that what is done will provide the necessary information to make important decisions about the continuation or cessation of medication.

Preface: This six step process assumes that the individual considering medication is not a threat to themselves, a threat to others, and is capable of fulfilling basic life responsibilities related to their personal care, family, school, and work. If this is not the case, then a more prompt medical intervention or residential care would be warranted.

If you are unsure how well you or a friend is functioning, then begin with a medical consultation or counseling relationship. If you would like more time with your doctor than a diagnostic and prescription visit, then ask the receptionist if you can schedule an extended time with your physician for consultation on your symptoms and options.

Step One – Assess Life and Struggle

Most struggles known as mental illness do not have a body-fluid test (i.e., blood, saliva, or urine) to verify their presence. We do not know a “normal range” for neurotransmitters like we do for cholesterol. The activity of the brain is too dynamic to make this kind of simple number test easy to obtain. Gaining neurological fluid samples would be highly intrusive and more traumatic than the information would be beneficial. Brain scans are not currently cost effective for this kind of medical screening and cannot yet give us the neurotransmitter differentiation we would need.

For these reasons, the diagnosis for whether a mental illness has a biological cause is currently a diagnosis-by-elimination in most cases. However, an important part of this initial assessment should be a visit to your primary care physician. In this visit you should:

  • Clearly describe the struggles / symptoms that you are experiencing.
  • Describe when each struggle / symptom began.
  • Describe the current severity of each struggle / symptom and how it developed.

As you prepare for this medical visit, it would be important to also consider:

  • What important life events, transitions, or stressors occurred around the time your struggle began?
  • What is the level of life-interference you are experiencing as a result of your struggle?
  • What lifestyle of relational changes would significantly impact the struggle that you’re facing?

Step Two – Make Needed Non-Medical Changes

Medication will never make us healthier than our current choices allow. Our lifestyle is the “ceiling” for our mental health; we will never be sustainable happier than our beliefs and choices allow. Medication can correct some biological causes and diminish the impact of environmental causes to our struggles. But medication cannot raise our “mental health potential” above what our lifestyle allows.

Too often we want medication to make-over our unhealthy life choices in the same way we expect a multi-vitamin to transform our unhealthy diet. We assume that the first step towards feeling better is receiving a diagnosis and prescription. This may be the case, and there is no shame if it is, but it need not be our guiding assumption.

Look at the lifestyle, beliefs, and relational changes that your assessment in step one would require. If there are choices that you could make to reduce the intensity of your struggle, are you willing to make them? Undoubtedly these changes will be hard, or you would have already done so. But they are essential if you want to use medication wisely.

As you identify these changes, assess the areas of sleep, diet, and exercise. Sleep is vital to the replenishing of the brain. Diet is the beginning of brain chemistry – our body can only create neurotransmitters from the nutrition we provide it. Exercise, particularly cardiovascular, has many benefits for countering the biological stress response (a primary contributor to poor mental health). Your first “prescription” should be eight hours of sleep, a balanced diet high in antioxidants, and cardiovascular exercise for at least thirty minutes three days a week.[2]

A key indicator of whether we are using psychotropic medication wisely is whether we are (a) using medication as a tool to assist us in making needed lifestyle and relational changes, or (b) using medication as an alternative to having to make these changes. “Option A” is wise. “Option B” results in over-medication or feeling like “medication didn’t work either” as we continually try to compensate medically for our volitional neglect of our mental health.

Step Three – Determine the Non-Medicated Base-Line for Your Mood and Life Functioning

This is an important, and often neglected, step. Any medication is going to have side effects. The most frequent reason people stop taking psychotropic medications, other than cost, is because of their side effects.

If we are not careful, we will merely want to feel better than we do “now.” Initially “now” will be how we feel without medication. Later “now” will be how we feel with medication’s side effects. In order to avoid this unending cycle, we need to have a baseline of how we feel when we live optimally off of medication.

One of the reasons postulated for why placebos often have as beneficial an effect as psychotropic medication is the absence of side effects. Those who take a placebo get all the benefits of hope (doing something they expect to improve their life) without any unpleasant side effects. Getting the baseline measurement of how life goes when you simply practice “good mental hygiene” is an important way to account for this effect.

“As I practice medicine these days, my first question when a patient comes with a new problem is not what new disease he has. Now I wonder what side effects he is having and which drug is causing it (p. 191).” Charles Hodges, M.D. in Good Mood Bad Mood

There is another often over-looked benefit of step three. Frequently people get serious about living more healthily at the same time life has gotten hard enough to begin taking medication. This introduces two interventions (medication and new life practices), maybe three or four (often people also begin counseling or being more open with friends who offer care and support), at the same time. It becomes very difficult to discern which intervention accounts for their improvements.

Writing out your answers to these questions will help you discern if you need to move on to step four and make the needed assessment in step five.

  • What were the struggles that initially made me think I might benefit from medication?
  • How intense were these struggles and how did they manifest themselves?
  • What changes did I make in my lifestyle and relationships to alleviate these struggles?
  • How effective was I at being able to make the needed changes?
  • How much relief did the lifestyle and relational changes provide for my struggles?
  • How do I anticipate medication would assist me in being more effective at these changes?

Step Four – Begin a Medication Trial

If your struggles persist to a degree that is impairing your day-to-day functioning, then you should seek out a physician or psychiatrist for advisement about medical options. As you have this conversation, consider asking your physician the following questions:

  • What are the different medication options available for the struggle I’m facing?
  • What does each medication do that impacts this struggle?
  • What are the most common side effects for each medication?
  • How long does it take this medication before it is in full effect?
  • If I chose to come off this medication, what is the process for doing so?
  • What have been the most common affirmations and complaints of other patients on this medication?

These questions should help you work with your doctor to determine which medication would be best for you. Remember, you have a voice in this process and should seek to be an informed consumer with your medical treatment; in the same way you would for any other product or service you purchase.

In this consultation you also want to decide upon the initial period of time for which you will remain on the medication (unless you experience a significant side effect from the medication). In determining this length of time, you would want to consider:

  • Your physician or psychiatrist will make recommendations based upon additional factors not considered in this article
  • A minimum of at least twice the length of time it takes the medication to reach its full effect
  • Significant life stressors that would predictably arise during this trial period (e.g., planning a wedding)
  • How long it would take to make and solidify changes that were difficult to make without medication (see step three)

Once you determine this set period of time, your goal is to continue implementing the changes you began in step three while monitoring (a) the level of progress in your area of struggle and (b) any side effects from the medication.

Step Five – Assess Level of Progress Against the Medication Side Effects

Near the end of the trial period, you want to return to the life assessment questions you answered at the end of step three. Compare how you are able to enjoy and engage life at this point with your answers then. The questions you want to ask are:

  • What benefits have you seen while you were on medication?
  • What side effects have you experienced?
  • Is there reason to believe your continued improvement is contingent upon your continued use of medication?
  • Are the side effects of medication worth the benefit it provides?

The more specific you were in your answers at the end of step three, the easier it will be to evaluate your experience at the end of step five. At this point, try to be neither pro-medication nor anti-medication. Your goal is to live as full and enjoyable a life as possible. It is neither better nor worse if medication is or is not part of that optimal life.

Step Six – Determine Whether to Remain on Medication

At this point in the process there are several options available to you; this is more than a yes-no decision. But any option should be decided in consultation with your prescribing physician or psychiatrist. You can decide to:

  • Remain on medication because the effects are beneficial and the side effects are minimal or worth it.
  • Opt to stage off of your medication because the benefits were minimal or the side effects worse than the benefits.
  • Stage off medication to see if the progress you made can be maintained without medication; knowing you are free to resume the medication if not without any sense of failure.
  • Opt to try a different medication for another set period of time based on what you learned from the initial experience.

Regardless of what you choose, by following this process you can have the assurance that you are making an informed decision about what is the best choice for you.

For the various counseling options available from this material visit www.summitrdu.com/counseling.

 

[1] For more on understanding the choice about psychotropic medications as a wisdom issue, I would recommend the lecture “Understanding Psychiatric Treatments” by Michael Emlet, MD at the 2011 CCEF conference on “Psychiatric Disorders” which can be found at http://www.ccef.org/understanding-psychiatric-treatments.

[2] Additional guidance on this kind of “life hygiene” can be found at www.bradhambrick.com/burnout.

If this post was beneficial for you, then considering reading other blogs from my “Favorite Posts on Mental Illness and Medication” post which address other facets of this subject.

Tweets of the Week 9.23.14

There is great value in saying something in a memorable, concise manner. Twitter has caused us to make this a near spiritual discipline. For my own growth (as a generally verbose individual… that’s a long way of saying “wordy”) and for the benefit of others, I highlight tweets each week that deliver a big message in a few words.

Who and Where Is God in My Depression-Anxiety?

This post is an excerpt from the study guide which accompanies the “Overcoming Depression-Anxiety: A Suffering Paradigm” seminar. This portion is one element from “STEP 6: LEARN MY GOSPEL STORY by which God gives meaning to my experience..” To RSVP for this and other Summit counseling seminars visit bradhambrick.com/events.

There are many God-questions that arise in the midst of depression-anxiety. It is nearly impossible to persistently battle for hope and peace without asking questions directed to or about God. The things discussed below should not be new. They are meant to be crystallizations of what you’ve been learning. Allow these truths about God to become cemented in your story; they should increasingly feel like “givens” as opposed to “possibilities.”

Near to Those Who are Anxious-Depressed

There is a danger in reading our Bibles in search for God’s answer to depression-anxiety. It begins to make God feel like an absentee father; as if all he offers us is a letter in the mail. A letter would mean both that God cared and that he was far away. This would be both encouraging and disheartening; God’s words would seem sincere but powerless. This is why we must pay careful attention to the thing God most repeats and we most overlook when he speaks about depression-anxiety.

“Anxiety-disordered individuals are often so focused on trying to control their circumstances and avoiding some potential catastrophe that they begin to perceive God as punitive, perfectionistic, and authoritative (p. 109).” Matthew Stanford in Grace for the Afflicted

Read I Peter 5:6-9 and Philippians 4:5-9. The most neglected aspect of both of these passages is the nearness of God. We come to these passages seeking God’s “answer” for depression-anxiety. As we search for principles and practical steps, we miss that the first and main thing God offers is himself. When we doubt or rush past God’s presence, we begin to expect knowledge to accomplish what only relationship can provide. Yes, God does offer us strategies and truths to combat depression-anxiety, but these are not the first and most important things he offers.

  • Question: Where do you see God in relation to your experience of depression-anxiety? How can you remind yourself of his actual location when your fear / despair feels closer than God?

Inside Your Experience of Depression-Anxiety

Our concept of being “near” does not capture how close God is. If God were merely “next to” us in our suffering, then we would simply feel less alone. That would be nice, but less than transformative. God is actually “in” us as we suffer. There is nothing that occurs in our soul that does not immediately register with him even before we can bring it to him in prayer. God does not begin his response to our suffering when we pray; as is if we had to alert him before he would move. God is experiencing our suffering as we do, so our prayer only alerts us to his presence and activity.

Read Romans 8:23-30. Notice that God can put our suffering into words better than we can. Why? God is so “with” us that he is “in” us. Our groans make sense to him because he experiences them with us. Actually, they make more sense to him than they do to us because he knows their origin (past), expression (present), and redemption (future). In spite of his knowing the future resolution of our anxiety-depression, notice that God does not grow impatient with our sense of being overwhelmed by them in the present (v. 26).

  • Question: How would your prayers change if you remembered you didn’t have to explain your experience to God?

Capable of Transforming Suffering

We often think that transformation requires elimination. That is true when a water droplet is transformed to vapor; the droplet no longer exists. But God’s transformation of suffering is usually much more like the change in our memories of a loved one during grief. These memories transform from experiences of pain to precious treasures (that may still evoke sadness). This side of heaven God’s transformation of our suffering will not be Utopia. This helps us remember that the presence of pain does not mean the absence of God’s redemptive work in our suffering.

Read Hebrews 11:13-16. Notice this awkward interlude in the midst of Hebrews 11, a chapter commonly referred to as the “Hall of Faith.” We would say that God worked mightily in the life of each of these individuals. They are the upper-echelon heroes of the Bible. But also notice that the cliff notes-highlights we read from their life are not the same as their experience of these events. Their experience of following God by faith is much more similar to your experiencing of trusting God in the midst of depression-anxiety than you might have thought.

  • Question: What evidences can you already see of God using your experience of depression-anxiety? What are the incomplete aspects of that redemption with which you’ll have to trust God like those in Hebrews 11?

For the various counseling options available from this material visit www.summitrdu.com/counseling.

If this post was beneficial for you, then considering reading other blogs from my “Favorite Posts on Depression” post which address other facets of this subject.

Differentiating Mourning from Wallowing in Depression-Anxiety

This post is an excerpt from the study guide which accompanies the “Overcoming Depression-Anxiety: A Suffering Paradigm” seminar. This portion is one element from “STEP 5: MOURN the wrongness of what happened and receive God’s comfort..” To RSVP for this and other Summit counseling seminars visit bradhambrick.com/events.

There are many things that unhealthy wallowing and healthy mourning have in common. It can be easier to confuse one from the other than many people think. The person who thinks he is “working through” his pain may be wallowing in self-pity. Those who try to rouse their friend out of self-pity may be rushing them through legitimate mourning.

Unfortunately, there is no emotional litmus test to verify the difference in these two experiences. However, we can (a) clarify what wallowing and mourning share in common, so we are less prone to assume the overlapping experiences necessarily indicate their counterpart. We can also (b) identify distinguishing marks between wallowing and morning so that we know what to look for in order to rightly identify the emotional experience.

Let’s begin by considering the similarities of mourning and wallowing.

  • Both are triggered by an undesired life circumstance.
  • Both exist on the unpleasant end of the emotional spectrum.
  • Both feel justified and logical in light of the triggering experience.
  • Neither feels like we are “doing” them but that they are “happening” to us.
  • Both involve a high degree of mental repetition.
  • Both are seeking to make sense of life in light of the unpleasant experience.
  • Both begin to shape the way you interpret the events and people around you.
  • Both shape the way you anticipate and prepare for the future.
  • Both change the way that you remember past events.

What do you gain from this bulleted list? A realization that none of these criteria are able to distinguish mourning from wallowing. Each criterion is true for both. It is as if you were asked to distinguish a square from a rectangle. You could say, “It has four sides and each corner formed a ninety degree angle.” This is true for both a square and a rectangle, so it does not help you differentiate the two shapes.

Why take the time to draw these parallels? Often people believe some of these symptoms always indicate either healthy mourning or unhealthy wallowing. When you have these experiences all you know is that you’re hurting. It is not clear whether this pain is part of a healthy or unhealthy process; contributing to a redemptive or destructive story line.

This should give you freedom to consider the criteria that follows. Never will our emotions or motives be as pure as we would like. Your goal at this point is not that you “mourn perfectly” but that your experience be increasingly free from qualities that are indicative of wallowing.

Wallowing Fears Hope but Mourning Trusts Hope.

How much do you find yourself arguing with those who want to encourage you even before they make their point; maybe even before you have the opportunity to talk with them? This is an indicator that you’ve begun to fear hope. You are bracing against being “up” again because you fear falling “down” afterwards.

When we give into this temptation then anxie or depressed become the only “safe” ways to feel. Anything that is pleasant is immediately labeled untrustworthy. When this shift from mourning to wallowing is made, our “common sense” barricades us against the progress we desire.

Proverbs 13:12 says, “Hope deferred makes the heart sick.” Those who struggle with depression-anxiety often succumb to believing the solution is to stop hoping. That is the equivalent of a cancer patient concluding, “If chemo leaves me feeling weak, then quitting chemo will make me feel strong.” This result is making the depressive-anxious experience chronic.

Wallowing Resents Joy but Mourning Longs for Joy.

Resentment has a way of flipping our values. If we were made fun of because of struggles in school, then the resulting resentment can cause us to downplay formal education in favor of “good ol’ common sense.” Similarly, if we were ridiculed for being poor, then there is a tendency to think that people who have nice things are bad (i.e., dishonest, condescending, etc…). A virtue (education) or asset (wealth) begins to be viewed as a vice because of our resentment.

The same thing happens when our depression-anxiety begins to make us feel rejected or deficient. We can begin to view a blessing (joy) as a vice (something we resent, fear, and resist). We begin to identify with our misery to such a degree that we don’t want to be like “those people” who “think they are better than we are” even though there is no rivalry and we know it would be better to have joy. But it feels like we would be “betraying our team.”

Mourning is sad, but it hasn’t quit desiring joy; neither has it removed joy from the category of “desirable virtue.” This requires emotional strength. It is hard to continue wanting a good thing you do not have and are not sure you will be able to obtain. It is easier, although unhealthy, to turn your back on the good thing as a cruel joke faked by people who are, in some way, against you.

Wallowing Is Skeptical Towards Faith but Mourning Listens to Faith.

Who or what you are willing to listen to says a great deal about you. When mourning gives way to wallowing hearing words of faith – from Scripture or a friend – begin to be heard through a filter of mistrust or cynicism.

Consider for a moment how you listen to a news program that does not share your political views or a telemarketer who is telling about a life-changing product. Compare this to how you hear statements of faith in the midst of your depressed-anxious experience.

The more you instinctively hear these messages with skepticism the more mourning has given way to wallowing. Your initial goal should not necessarily be to fully embrace the messages of faith you’re hearing. You can begin much smaller; just hear these messages neutrally and know they’re intended for your good. Even if this initially causes you to feel sad, it is a step towards transforming wallowing into mourning.

Wallowing Resists Being Strong but Mourning Embraces Strength.

Both mourning and wallowing are exhausting. Mourning results in the exhaustion of a marathon runner – someone who realizes their journey is a mark of strength. Wallowing results in the exhaustion of prey acquiescing to a predator – someone who is giving up.

Either way the exhaustion is real. The marathon runner and the gazelle succumbing to a lion are both legitimately tired. The question is whether you view where you are as hopeless or as evidence of God’s continuing ability and willingness to sustain you. You have relied on God’s grace to this point – willingly or reluctantly – and that same grace is available for whatever journey lies ahead.

Do not confuse the metaphor of running with the need to rush. If that were the case, then we would not be at the mid-point of a nine step journey. Neither should you begin to view God as a cruel track coach. The things you learn in this experience are not necessarily “God trying to teach you a lesson” (in the harsh connotation of that phrase). Too often we view every lesson we learn in suffering as God’s purpose statement for that experience; this causes us to mistrust our source of strength during these times.

Wallowing Avoids Being Known but Mourning Invites Community.

Most of the points above focus on the intrapersonal differences between mourning and wallowing – those things going on inside of us. This final point looks at an interpersonal difference – how we relate to others differently.

When shame turns mourning into wallowing we resist allowing others to know us well. We become slippery – able to answer people’s questions without allowing them to really know us. With time, we begin to cynically disbelieve that others care or are able to understand.

The reality is that we limit how much we can be cared for by others with how much we make ourselves known to them. If we are 50% known, then we will (at best) be able to receive 50% of the care they offer. Shame convinces us that “if they really knew” they would not mean what they said or do what they did. The result is a corruption of each act of kindness or word of encouragement offered to us.

Using these criteria, how would you describe your current response to the experience of depression-anxiety: mourning or wallowing? Which criteria gave you the most insight about your response?

For the various counseling options available from this material visit www.summitrdu.com/counseling.

If this post was beneficial for you, then considering reading other blogs from my “Favorite Posts on Depression” post which address other facets of this subject.