IN THIS book, the distinguished practical theologian John Swinton examines the stigmatisation of those with mental-health challenges. He questions the unthinking application of “thin” descriptions as described in the American Psychological Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM) classification of schizophrenia, depression, and bipolar disorder. Having introduced the idea of “thick” descriptions, well known to those doing qualitative research, he indicates the need for such descriptions of the experience of those with serious mental-health challenges as a matter of justice and truthfulness.
It is not about cure, but about healing “understood as the facilitation of understandings and circumstances in which people can live well with Jesus even when the prospect of cure is beyond our current horizons”.
After a clarifying introduction, the book is divided into five parts: Part I covers the art of description, presenting a convincing case for a broader approach to the consideration of the experiences of those with serious mental-health challenges. Part II redescribes diagnosis and serves as preparation for Parts III, IV, and V, which focus specifically on depression, schizophrenia, and bipolar disorder, respectively.
The author draws extensively on his qualitative-research interviews carried out over a two-year period with Christians living with these particularly problematic mental health challenges. Christian congregations are exposed as tending to collude with stigmatisation, often taking the thin descriptions as complete. The author concludes with an appeal for seven ways of redescribing theological healing.
Swinton seeks to liberate sufferers from the confines of stigmatisation and assert the need to listen to their own experience of distressing periods and the way in which their Christian faith was affected. A key concern is the way in which a diagnosis can close down a sufferer’s identity, sometimes with the collusion of the person concerned.
I remember an occasion when, as a mental-health chaplain, I introduced myself to a person who had attended the weekly service of holy communion. In response, she said “I’m bipolar,” instead of her name. It was as if she was her illness rather than having an illness. This memory has haunted me for years, and it is a relief to read Swinton’s authoritative questioning of such reductive descriptions.
It is “a theological mistake to assume that the experience of abandonment and the absence of God is necessarily a sign of human faithlessness or human sinfulness”. Swinton would describe this as an example of “lazy theodicy”.
There is an opportunity for Christian communities to rethink their response to those who are psychologically vulnerable. Those who feel God’s absence could be accompanied by others who hold hope or joy on their behalf. Primitive use of the idea of demons could be challenged rather than inflicted on the vulnerable. Routinely upbeat liturgy could be adapted to include liturgy of lament. Churches can become specialists in human kindness.
These are among the many thoughtful considerations offered by Swinton. One concept that I particularly welcome is the idea of retrospective spiritual direction, in which a person who has had an experience of intense distress is helped to reflect on it after the event, to discern where God may or may not have been in that experience and its aftermath.
This is a radically inclusive book. Reading it is an enriching experience, and I would warmly recommend it for all those who, in whatever capacity, wish to understand and enhance the experience of those with serious mental-health challenges.
The Revd Dr Anne C. Holmes, a former NHS mental-health chaplain, works as a psychotherapist and SSM in the diocese of Oxford.
Finding Jesus in the Storm: The spiritual lives of Christians with mental health challenges
SCM Press £19.99
Church Times Bookshop £15.99