Helping Those Struggling with Mental Health

Episode Transcript
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John Fikkert (00:00):
Church officers have more ability than they
maybe even appreciate to createthe environment within the
church that is loving and safe.
And just being a little moreintentional about thinking
through how do we do that andhow are we, as Lindsay mentioned
, how are we going to track ifsomebody tells us that they had
a problem or a prayer request?
In what ways are we going tofollow up with that and care for

(00:23):
this person over time?

David Nakhla (00:26):
Welcome to the Reformed Deacon, a casual
conversation with topicsspecifically designed to help
local Reformed Deacons.
There are nearly a thousanddeacons in the OPC alone, so
let's take this opportunity tolearn from and encourage one
another.
We're so glad you could join us.
Let's jump into our nextepisode.
Hi, my name is Adrian.

Adrian Crum (00:45):
Crum.
I'm a pastor at HarvestOrthodox Presbyterian Church in
the one another.
We're so glad you could join us.
Let's jump into our nextepisode.
Hi, my name is Adrian Crum.
I'm a pastor at HarvestOrthodox Presbyterian Church in
the greater Grand Rapids,michigan area and I serve on the
OPC's Committee on DiaconalMinistries.
Today, on the Reformed DeaconPodcast, I'm joined by Reverend
John Fickert and his wife, drLindsay Fickert.
John serves as director of theOPC's Committee on Ministerial
Care, supporting ministersthrough counseling, financial

(01:08):
planning, sabbatical funding.
It seems like you do a lot ofthings, john.
He also works alongside Lindsayat Pella Counseling in Iowa.
Lindsay has been a counselorsince 2005 and brings a wealth
of experience in therapy,psychological assessments and
mental health training.
I have to say, john and Lindsay, as a pastor who often tries to

(01:29):
think through how much is mycounseling going to be able to
connect with people that arestruggling through mental health
difficulties and trials, I'm soexcited to get to talk to you
guys today.
Thank you so much for coming onthe podcast.

Yes, well, thank you for having us.
We're looking forward to theconversation.

Lindsay Fikkert (01:44):
Yeah, good to be here.

Excellent.
So we're going to approach thiskind of first from the angle of
understanding mental health andthen we'll dive into how do we
recognize different needs forsupport and professional care?
So I'll just open up with ageneral question what are some
common mental health challengespeople face today?

I would say, just to begin, the two most general
categories to think about mentalhealth struggles that people
have are probably anxiety anddepression, and those can be
fairly common.
Then a little bit more acuteversions, like a higher anxiety
than just general anxietydisorder, would be things like a
panic disorder, or sometimes wetalk about OCD obsessive

(02:25):
compulsive disorder.
A lesser known one would betrichotillomania hair pulling,
which is also a form of ananxiety disorder.
And then depression is likewisewhere there can be more acute
versions of depression.
One we often talk about, thatI'll just throw in there is
bipolar one and two disorders.
They're much less common thandepression but affect a

(02:46):
significant number of people aswell.

Yeah, I saw my first case of cutting as a youth
pastor this year.
I had to kind of do somecounseling, I had to do some
reading and learning about it.
I'd never observed it before,but from your perspective,
lindsay, any general statementsabout things that are common?

Sure, I guess one thing that I would note too
is that trauma is such aprevalent experience when you
think about incidences of abuseand things like that that trauma
can often form kind of like theunderlying foundation for
depression and anxiety.
So you know, sometimes when weencounter people we encounter

(03:25):
the symptoms that are consistentwith depression and anxiety.
But you know, there's a lot ofunderlying issues like trauma
that can be the foundation forwhich those other symptoms
emerge.

I can just add to that.
In addition, if somebody seemslike they're having a longer
time recovering from a mentalhealth struggle often there's
trauma in the background that'sleading to a slower recovery
time.

So this is a podcast specifically targeted
for deacons.
There's a thousand deacons inthe OPC.
I'm really excited for them tobenefit from your insight.
Why do you think it's reallyimportant that deacons
specifically keep in mind thatthere are often mental health
dynamics at work in their laborwith people?

I think I would say one way to think about it as
a deacon is when it rains, itpours, and if somebody's having
one kind of a problem thatyou're trying to work with in
mercy ministry, it's worthasking the question what else is
happening in this person's lifethat might lead to these
conditions?
And considering someone'smental health would be part of a
full assessment of all theneeds that a person might have

(04:30):
at a particular time.

And I would add to that, you know, mental
health diagnosis, just bydefinition they must have a
negative effect on dailyfunctioning for them to even
reach the threshold of a mentalhealth diagnosis.
And so you know, deacons are ina unique position in many ways
to hear about or observe dailyfunctioning right of the people

(04:52):
within the congregation.
So somebody struggling tocomplete tasks or go to work or
struggling to pay bills or justmanage the demands of life which
are often the outcome of mentalhealth issues.
Not always, I mean sometimesthose things exist separate from
mental health, but becauseimpairment in functioning is

(05:14):
intrinsic to mental healthdifficulties, deacons have a
very helpful vantage point onthat.

Excellent.
So you take up our nextquestion and topic there on
recognizing a need for supportand professional care.
So how would you recommend thatchurch leaders I'm a pastor, a
youth pastor and I work inevangelism here at Harvest in
Grand Rapids how would yourecommend that we go about
recognizing that there is a need, an individual mental health
need, and that they aredeteriorating over time?

I would say some of it is self-report, Like just
by the words that they're usingyou can observe by what they're
saying about themselves thatthis person sounds really
anxious from the words they'reusing or really depressed.
But then there's those otherways markers to notice, like
Lindsay was just mentioning,those daily life tasks Like are
they eating well?
Are they sleeping?
Are they getting eating well?

(06:04):
Are they sleeping?
Are they getting to work?
Are they paying their bills?
How is their house kept up?
Some of those things aremarkers to say if that's not
working out, what else might begoing on in their life.

So when do you think it is necessary or
appropriate to seek professionalcare, and how should deacons go
about facilitating that process?
Is kind of a tricky question.

That is a tricky question, I think, when the
problems you're noticing seempersistent and they're not
improving quickly, and perhapseven you're noticing in the
person you're trying to help I'mnot sure they have the
resources to pull out of this.
You know, somebody could tellyou they're sad and you might

(06:47):
pray with them or be concernedfor them.
But if you're noticing theirmood is really low and this has
been sad like this for a while,and you might ask them, you know
, is this a sadness that you'reable to manage, or is this
something you might need helpwith, and even how they might
view themselves like no, I'mreally stuck and being sad right

(07:08):
now?
Those would be some of themarkers I'd be looking for.

Excellent.
I'll pitch this question toLindsay.
So most of our deacons atHarvest will not be trained,
like the two of you are, asprofessional counselors.
If a deacon meets up with theirown limitation, how should we
view the intersection of faithand deeds of mercy?
Which deacons are equipped andtrained to do with this question

(07:33):
of professional mental healthcare, how do you view the three
of them working together?
Maybe you have a concreteexample where you saw the church
kind of working in this way.

That's a great question, you know, as somebody
who's working with people in aprofessional setting maybe I'm
seeing them one hour a week,right, and we're working on
something related to depressionand anxiety, and what I often
find in that is that I actuallyhave limits as a professional
too.
So, whereas you know, I havesome training and skills to be

(08:05):
able to offer someone who, say,suffering from depression at the
end of the day, when the houris up, because of the
professional boundaries, thereare things I can't do, Like I
long to maybe, if they don'thave a great support network, go
and help them, you know, sortout their, you know mess in
their kitchen so life feels lesschaotic.
Or I long to help somebodywho's struggling with

(08:27):
agoraphobia or difficultyleaving the home to go take a
walk.
But I have some constraintsaround what I can do, and so
this is where partnership is soimportant.
You know, I have to stay in mylane, as it were, professionally
, and I can't replace the thingsthat deacons can do or the body
of Christ can do to comealongside somebody in need, and

(08:51):
so for me to be able to applythose skills but then to know
that there are deacons orbrothers and sisters in the Lord
who are able to help with thosekinds of operationalized,
concrete helps and cares.
That's really significant right, and I feel kind of handicapped

(09:12):
in a way when I know thatsomebody doesn't have that kind
of support because I can helpthem for that hour.
But what can be done in thepractical issues of their daily
life?
Who's going to come alongsidethem then?
And so this is where that kindof partnering becomes really
important and helpful.

If I could add to that, some of those partnerships
might require a well-craftedrelease of information that the
person you're trying to helpagrees to, and then there can be
communication, even betweensomebody who needs help and
their pastor or elder or deacon.

So a question that comes up, because this has
happened quite a bit recentlyfor us here at Harvest if a
person is really nervous torelease their information as a
counselor, what would you tellthem to say?
This will really help you foryour deacons or your pastors to
know more about the counselingI'm offering to you.

You know, I actually have a very sort of
present experience with thatvery thing right now, because I
know someone who I work with,who's in a very good church, who
I think has those resourcesavailable to them but has a lot
of fear about those needs andmaybe feels her particular needs
are not as significant or notsignificant enough to ask for

(10:27):
help.
And so part of counselingsometimes is just helping people
think through their objectionsto the things that might be
helpful to them.
And you know, where does thatbelief come from?
Are there any sort ofdistortions that might be making
it difficult for you to ask forhelp, sometimes even reframing,
you know, and saying this is aseason where you need help, but

(10:48):
there might be other seasonswhere you are the one providing
help to someone and you know youbeing able to access and
receive help is an importantpiece of communicating that you
are willing to give it later.
So you know, those kinds ofconversations can prime the pump
, as it were, for people to bemore willing to reach out and

(11:09):
ask for help.
You know, I'm obviously goingto respect their decision on
that, but I can be just someonewho maybe presents it slightly
differently or helps themchallenge some beliefs or
distortions that might begetting in the way.

At the heart of therapy, as well as at the heart
of a deacon's work, is consent.
You need consent on the part ofthe person that needs the help,
and if they're not willing tooffer consent, part of honoring
them is to honor their agency inthat, and to just violate it or
push against it too hard canharm them as well.

(11:43):
So that's just something tokeep in mind.
And then one specific detail,just as an application if a
deacon were to know there was norelease of information, but a
deacon were to know thatsomebody was meeting for therapy
with a particular therapist,they could call the therapist.
The therapist could not confirmor deny that they have that
person as a client.

(12:03):
But it can still be a one-waycommunication where I just want
to let you know this informationabout client X, that such and
such a thing are happening intheir home and we have these
concerns about the way they'reliving their lives, and the
professional can receive thatinformation and just take it can

(12:24):
receive that information andjust take it, and that's, I'll
say, from the perspective of apastor.

That's often one of the weaknesses is on our part,
we don't take the initiative,we're too afraid to kind of
start those partnerships andstuff like that.
So there is too much of a wallbetween professional caregivers
and the church, and so deaconsdon't reach out or pastors don't
reach out and just take theinitiative and say, hey, this is
what I can share right now.
So I think in an optimumsituation, all those people are

(12:49):
in the same congregation, agreed, great.
But unfortunately it doesn'toften seem to be that way.
So you guys have observed many,many different cases, which I
think is the most helpful thing.
With experience, what are signsin your mind that there is need
for more intensive care,including immediate intervention
, or someone needs to bereferred to professionals?

(13:09):
And then I'll tag on anotherquestion If you see that in
someone, how would you recommenda deacon who's maybe
embarrassed or doesn't know howto actually broach that topic
with someone?
How would you recommendactually going about having a
conversation saying, hey, I'mconcerned for you.

I think probably the most immediate
thing that comes to mind isanytime somebody is endorsing
suicidal thoughts.
You know, with some plan andmeans and intent, that's an
immediate let's get this personto the emergency room kind of
scenario, and I can speak moreto that in a moment.
But other situations that mightdemonstrate that there's a

(13:48):
heightening crisis or need formore intensive care would be
situations like someone who hasa significant mental health
issue, like bipolar disorder orschizophrenia, and they stop
taking their medication.
Behaviors start to becomeerratic.
Other situations, especiallywith bipolar, you might see
people engaging in riskybehavior, more dangerous

(14:08):
behavior, spending a lot onlinegambling, promiscuous behavior
that's out of character for them.
Those would be indications thatit's time to take a more
intensive approach.
You know even things likepeople's physical presentation.
You know when they're notshowering and they're not maybe
eating well or things like that,and you can see a very visible

(14:31):
manifestation even in their home.
Sometimes you know somethingthat represents a significant
change from previous functioning.
I think is a signal thatthere's something that might
require more immediate attention.
I think is a signal thatthere's something that might
require more immediate attention.
To your second question youknow how do you respond to that

(14:51):
potentially as a deacon.
I think if it's something likea matter of personal danger,
like suicidal ideation, or ifsomebody is expressing thoughts
of wanting to harm someone else,that's just an immediate trip
to the emergency room.
Else, that's just an immediatetrip to the emergency room, like
hey, we need to go get youassessed.
And you know the deacon doesn'tneed to be in the place of
making that assessment, whetheror not someone's actually a
danger to themselves or someoneelse.

(15:12):
There are professional socialworkers that work in hospital
settings that do that assessment.
So it's really about you knowcommunicating.
Hey, I think you're in a placewhere we just might need another
person to come alongside and wejust need to make sure you're
safe and I'll come with you, oryou know we'll take you there.
For other situations it can be alittle delicate, right, like

(15:33):
how do you observe with someonethat you know their physical
appearance has changed or theirhome is in disrepair?
And I think just some wisdom inthe way that it's said, like
coming from a humble posture youknow we're all subject to
weakness and to difficulties andtimes of struggle and kind of
that posture of you know, butfor the grace of God, go I.

(15:55):
So it starts with that kind ofa posture and then, I think,
maybe even listening, askingsome questions and then you know
, eventually having, I think,resources on hand.
So this is maybe a littlebeyond what you've asked, but I
think it can be really helpfulfor churches, deacons, elders
and pastors to get to know theresources in their area so that

(16:18):
when a crisis comes up it's notlike a scramble.
For where do we go?
What do we do, but who do wetrust?
Right?
What medical providers have wegotten to?
What do we do, but who do wetrust, right?
What medical providers have wegotten to know in our community?
What counselors have we vettedand, you know, already done the
work?
You know what is our nearestemergency room or is there, you
know, a crisis unit that comesto someone's home?

(16:40):
You know some communities havethose.
So kind of getting to knowthose resources so that in that
moment you can gently say to theperson you know some
communities have those so kindof getting to know those
resources, so that in thatmoment you can gently say to the
person you know I care aboutyou.
And it seems like things arereally hard right now and I
wonder if we could help you getconnected with some people who
have the tools and the skills towork through this, and it's not

(17:02):
a handoff.
I'm going to walk with youthrough it, too, in the ways
that I can, but I want to invitesome other people to be able to
help you out right now.

I want to comment on one specific part agreeing
with everything that Lindsayjust said, and that would be how
does a deacon broach thesubject?
And this is just a basiccommunication suggestion.
But if you use an I statementrather than a you statement,
that can be a really big deal.
So a you statement would belike you know you look terrible

(17:37):
or you look depressed orsomething's wrong with you.
You know it's all those youthings and it's you giving your

(18:05):
assessment to that person ofwhat you think is wrong.
Versus, if you start with an,indicate something about you
that you're sad and you mightwant some help, and I think
that's a more humble way toapproach it if you use some sort
of an I statement rather than ayou statement an I statement

(18:26):
rather than a you statement.

That's really wise.
Yeah, that's helpful to frameit.
I think one thing that canhappen if deacons are not
recognizing really big waves ofanxiety in someone or someone
who's really crippled withdepression, is to draw a kind of
connection between bad deedsand bad consequences and like,
hey, you're really messing up indifferent ways and we want to
teach you responsibility.
How do you recommend peopleslow down maybe in that value

(18:48):
judgment and say, hey, there'smore going on than just what you
see, kind of on the surface?

Yeah, and that's where you know if you go in and
you're a firefighter and you gotto crash down the house and
start spraying water everywhere,that's absolute emergency time.
But most of the work as ahelper or as a deacon is being a
listener, not a firefighter,and so, like I'm still gathering
information, I'm still tryingto understand something, and

(19:17):
being slow to judgment and quickto listen is always a good
approach.

Yeah, I tend to think of that in terms of like,
there's the stuff we see on theoutside and sometimes you know
you can think about that as thefruit.
But I want to usually try tohelp get to the root of what's
happening so as to understandwhat's needed right.
And that is a matter oflistening, of humility, of

(19:45):
approaching things withgentleness and, you know, not
just at the level of behaviorand compliance, but really at
the level of who is this person,what do they need, and you know
what might be going on underthe surface.

Really helpful.
Yeah, can I add one more thingto that?
Yeah, can I add one more thingto that?
Yeah, this is just a habit thatI've seen in pastors, elders,
deacons.
We like to do the quick fix,like the thing that if I can
just go in and say something andget this person this resource,
and then I can check the box andjust having a disposition

(20:24):
towards a longer view of peopleand getting to know them and
seeing them as part of yourlives, and not assuming that
this problem is going to getfixed right away if I just do
this one thing or get them thisone resource.

Yeah, we often on the committee on Diaconal
Ministries speak about aministry of presence, which is?
This person just spent timewith me, they listened to me,
they wept with me, theystruggled through this thing.
That was complicated anddifficult to understand, but
they gave me themselves andreally practiced the love of
Christ in that.
Well, that's where I want totake this conversation to next.
I think everything that we dois shaped and oriented by

(21:03):
scripture.
So I'm sure that you guys, asChristians who are counselors,
have thought through somebiblical categories, biblical
foundations for caring withpeople with mental health
struggles.
Can you share some places inscripture or other categories
that you have found helpful?

Sure, yeah, you know what?
Last November I gave apresentation on mental health
and wellness for Redemption OPCin Gainesville, florida, for
their women's retreat, and I hadan opportunity to really dig
into some biblical foundationsfor mental health.
So one of the things wediscussed there was just how
theology and anthropology arethe anchors and the categorical

(21:41):
roadmaps when we're talkingabout mental health, and you
know what do I mean by that.
Well, whenever we'reapproaching mental health or
considering how to walkalongside people who are
struggling with it, we reallyhave to start with who God is.
We have to start with Hischaracteristics, his attributes,
and that matters a lot for howwe approach this.
And I had a seminary professor.

(22:01):
We had a seminary professor, drBill Richardson.
He pointed out that, you know,god is both speaker and listener
par excellence.
He observed our God by name andnature, as a revealer and a
self-discloser, and what hediscloses about himself has
significant impact on how wetreat mental health and as,

(22:23):
speaking through the Word, hereveals Himself to be
compassionate, tender,acquainted with grief, our
Creator and Sustainer, sovereignover our suffering, gracious in
regards to our suffering, suchthat you know our suffering
isn't karma or punishment,because Christ has already
received all the punishment forour sin Suffering is not
administered according to merit.
There are so many differentreasons why we suffer, so all of

(22:44):
those attributes aresignificant, relevant and
foundational for how we approachmental health.
We need the truth of God'scharacter if we're going to take
our thoughts captive andprogressively work through our
distorted thoughts or distortedfeelings or our dark nights of
the soul, so to speak.
Distorted thoughts or distortedfeelings, or our dark nights of
the soul, so to speak.
But then you know also, when wethink about, who God is he's

(23:06):
the great listener.
I mean, you can't get a betterlistener than the Lord.
He invites us to pray.
You know, in the Bible he'sreferred to as Shema.
You know as the God who hearsin Psalm 65 too, or the one who
sees in Genesis 16, 13.
So we're instructed to pray toGod, who is our attender here.
So our theology and our beliefsabout God are really important

(23:29):
for how we think about and workthrough mental health challenges
.
And there's some very directstories that demonstrate God's
gentleness.
You know, with Jonah and Elijah, in the midst of what I would
say is spiritual, mental andemotional distress right, and
even in response to theirdistorted thinking, we see His
gentleness and care.
But then.
So that's theology.

(23:49):
But then there's alsoanthropology, right, and so what
Scripture tells us about who weare?
And I think it's reallyimportant to consider this when
we're trying to have rightthinking about mental health
struggles.
So let me just give a couple ofexamples.
Our anthropology is of hugesignificance when we wonder why
Christians have mental healthdifficulties, right, so we can

(24:12):
become really judgmental ofthose who are suffering.
If we don't take the scripturesthat demonstrate that our
bodies are fallen and have atrajectory of decay, if we don't
take that seriously, you know,our culture wants to deny this
sometimes, sometimes erranttheological circles want to deny
this, and sometimes even in ourown hearts, we want to reject
the truth that we are embodied.
But that is such an importantanthropological reality that our

(24:35):
bodies are affected by the fall, and so we need to really take
that into consideration whenwe're thinking about why people
might be suffering.
So that would be one thing, butyou know, another
anthropological reason whypeople struggle with mental
health is because of otherpeople's sin, right, and so we
have to kind of think throughthat.

(24:56):
And a friend, a mentor of mine,john Cox he's observed that our
hearts and beliefs and habitsare shaped in a fallen world,
surrounded by fallen people.
So, because we're developmentalin nature, you know, we
encounter people in situationsthat sometimes wrongly, inform
us about things such as am Iworth loving, is it safe to fail

(25:17):
?
Can I trust people?
So thinking through thoseanthropological realities I
think is really important whenwe think about mental health.
There are other things too, likeyou know, realities like we are
finite and we are limited.
Those are realities we have toface that the scripture is very

(25:37):
clear about.
We're limited, even before thefall.
So the fact that we're limitedmeans we can't take on
everything.
We can't say yes to everything.
We have to honor the fact thatwe are affected by stress, and
so things like that are reallyimportant.
These are big categories,though you know, a lot of times
when people want to approachscripture with regard to mental

(25:59):
health, they want to approach itfrom just like a verse
perspective, like what versesays this about that?
And these are big biblicalcategories that we're thinking
about, not just which prooftexts you know we can point to
about depression or anxiety.

So I think I would add to that there are books
written on the theological andbiblical foundations of
counseling.
So, trying to summarize it, Ithink Lindsay did a pretty good
job of hitting some key pointsjust there, and the only thing I
would add is just to have atheology of suffering as part of
the foundation and justunderstanding that in a fallen

(26:37):
world it's not just thatsuffering accidentally happens
to us, but the Lord appointssuffering of various kinds,
including mental healthstruggles, for us and to receive
that as the thorn in the fleshin 2 Corinthians as it speaks
about that in 2 Corinthians 12,that those are appointed things

(26:58):
that help make us more reliantand see the sufficiency of
Christ's grace in our lives,things that help make us more
reliant and see the sufficiencyof Christ's grace in our lives,
and so that's a more narrowpoint on that.
But you can probably tell wecould probably do three more
podcasts on the foundations forcounseling, so we should
probably pause here and see ifyou have any follow-up questions
or comments.

No, that's really, really helpful.
I really appreciated Lindsay'sstatement about just the reality
of our humanity being a goodthing.
That God made us.
Body and soul is not a bug,it's a feature.
The Lord has made us asembodied creatures.
And then what you said, john,about the.
I think maybe 30 or 40 yearsago there was a tendency to want
to have a proof text approachto counseling and mental health

(27:42):
and things like that, like I'llgive you a passage, pray about
this and by next week it shouldbe kind of you know, worked out
in your life.
And the scriptures are morecomplex.
They're not un-understandable,but humans don't work that way
in terms of change, where youjust give someone a verse and it
sort of unlocks something andeverything is fixed for them.
How do you rely upon scripturein terms of giving people hope

(28:05):
If someone says I know thisabout myself, I'm a really
anxious person or I'm caught inreally deep, dark aspects of
depression.

There are so many ways that scripture is an
encouragement and a help to usin our struggles with mental
health, and something thatimmediately comes to mind are

(28:32):
just the Psalms of Lament.
You know, this is not thereason why people have mental
health issues, but sometimes,when we don't process pain very
well, when we don't metabolizeour sadness or our worry in
helpful ways, it can leave usvulnerable to mental health
struggles right?
So depression doesn't equalsadness and anxiety as a

(28:53):
disorder doesn't equal worry.
They're different.
You know, anxiety anddepression are more like
conglomerations of symptoms,conglomerations of symptoms.
But when we don't process pain,when we don't process sadness
or worry in helpful ways, we aremore vulnerable.
So the Psalms of Lament, Ithink, are instructive in the
sense that we see that we cancry out in a raw and transparent

(29:17):
way to the Lord and we can cometo Him with our pain and bring
those things before Him.
But then also, you know, thestructure of the Psalms of
Lament at the end of almost allof them is a remembrance of who
God is and what he has done.
And so I think working throughthose Psalms can sometimes be

(29:37):
really helpful for people whomaybe are struggling to be real
with God about what they'regoing through.
They're afraid that if theybring their complaints that
there's something you know wrongabout that, and so we can say,
look, this is Scripture.
It even gives some words, youknow, I think sometimes we don't
even have the words, and so itgives us some language to use

(29:59):
for when we're, you know, tryingto bring our concerns before
the Lord.
And then you know, there are somany other practical scripture
verses and passages.
I just think about things like,you know, romans 12, 18, when
Paul instructs you know, ifpossible, so far as it depends
on you, live peaceably with all.

(30:19):
I encounter many clients who,when there's conflict in a
relationship, they're eitherover-responsible for it or
under-responsible for it.
Right, and so, thinking throughwhat a verse like that means,
you know, so far as it dependson you, that means two people
are required for reconciliation.
So what are you doing topromote that, you know, and what

(30:40):
are the limits in your abilityto promote that?
And then you know, workingthrough things like unwanted
thoughts, you know, depressionand anxiety.
It distorts our thinking, andso, trying to help people, think
about passages like Philippians4, 8, you know.
Finally, brothers, whatever istrue, whatever is honorable,
whatever is just, whatever ispure, whatever is lovely,

(31:01):
whatever is commendable.
If there's any excellence,anything worthy of praise, think
about these things.
So what?
You know, what does it looklike to take every thought
captive?
Well, it doesn't just look likestop thinking this thing, you
know, we have to walk that outwith people.
Sometimes it's observing thatI'm having that thought, trying
to create a little distance fromit and not take it so literally

(31:22):
.
Just because I had a thoughtdoesn't make it true, and then
trying to think on things thatactually are true.
And so there's lots ofscripture for what we ought to
be thinking on and what might behelpful to think on when we're
faced with distortions in ourthinking.

One thing that I do is I have some go-to
scriptures that I like to use,but sometimes I actually try to
reverse engineer it, and what Imean by that is start with a
passage that's very meaningfulto the person that's struggling,
and so you know often Romans 8or Psalm 23 or some like passage
and it's just a matter of allright, let's this passage is

(32:03):
really meaningful to you.
Let's work out what that means.
If we apply this passage thatyou care about, I think it can
really impact and help theirthinking, because often what
happens is is we know what'strue, we can read scripture and
we say, yes, that's true, but wehaven't worked out fully the
implications of what thatscripture actually means in our

(32:24):
lives.
And really that's theoutworking of the gospel, right?
It's like we can believe thatChrist died for our sins, he's
raised from the dead, and werejoice in this promised hope.
And then a mental healthstruggle is often like an
incomplete working out of whatthat actually means in my life.
Like an incomplete working outof what that actually means in
my life.
So helping them work through atruth that they already have and

(32:46):
cling to is a way I commonly goat it with someone.

Yeah, that's wonderful, yeah.
Taking, for instance, the waythat kids are catechized with
principles and memorized phrasesbut then letting the truth and
the reality actually function insomeone's life.
Yeah, I often think about thestory where the waves are
crashing in on the boat andJesus has taken them into the

(33:12):
sea of Galilee and he's likewhat have you forgotten about me
?
Basically, I mean, I'm themaster and Lord of the universe.
What do you not believe rightnow about me?
To believe that I can actuallybring you through this and
overcome this?
So I think it's often justgospel forgetfulness that we
need to work through.
So it's not just like someprinciple they've never heard
before, but something that weneed to rediscover.

(33:34):
So, from your perspective, Ithink the word healing is
probably very complex wordbecause people can expect like
they want to get over somethingand close it and put it in their
past.
How do you think about theconcept of healing from a
spiritual perspective?

What does it look like for someone with mental
health struggles that we facethat don't have a definitive
endpoint the way you might getyour tonsils taken out.
So I'm more thinking about howdoes this become manageable?
How do the symptoms get to aplace where I can be okay?
How do the symptoms get to aplace where I can be okay?
Somebody that struggles withsevere anxiety it would be

(34:30):
unlikely to have a goal thatthey will get to a point where
they never have anxiety anymore.
But how does that anxiety getin check and how, through
spiritual and physical andmental efforts, can I live as a
Christian with this thorn in theflesh?

Yeah, I would agree with that in the sense
that a lot of mental healthissues are either episodic or
chronic, right.
So episodic, well, I could haveone episode of depression, or I
could have multiple episodesover the course of my lifetime,
and we don't know, we aren'table to predict right and so
healing because it has sort ofthat connotation to it that we

(35:08):
get to a place where there's nomore suffering in this
particular way anymore is adifficult word.
I agree with John.
I tend to think of it asmanagement.
You know, can I livemeaningfully in the presence of
diabetes?
Can I live meaningfully, inaccordance with my values, in
accordance with the Bible, inthe presence of asthma?
Can I live meaningfully withanything that is either chronic

(35:32):
or episodic?
Yes, I can, and sometimes wejust need help, no matter what.
Our difficulty is learning howto live meaningfully and to,
like John said, have thosesymptoms managed well enough
that we can still fulfill ourcallings, that we can still show
up for other people and livefaithfully.

And perhaps this one verse reference will help.
Psalm 103, you know, bless theLord, O my soul, and one of the
things that we bless the Lord.
It says he heals all of ourdiseases.
Well, if we see people dying ofcancer and having different
maladies in their life, how dowe understand that verse?

(36:15):
It's that sometimes the waythat we're healed of our
diseases will be in the eschaton.
It won't all happen in thisworld and at this time.
Disease as it will be in theeschaton.
It won't all happen in thisworld and at this time.
And that's part of our faithjourney and our sojourn that
sometimes we will not see afinal relief from a problem
until Christ returns.

Very good, yeah, so one maybe temptation could be
then to rush or try to putpressure on someone who is
anxious or depressed from adiaconal perspective.
Have you seen maybe the othertendency as well, where someone
so identifies with theirdiagnosis that they sort of
abandon responsibility?
And how would you help a deaconhave that conversation with

(36:55):
someone where they are?
You know their house is fallinginto disrepair.
There's other physicaldemonstrations of where they're
struggling and they've maybe toomuch said this is the way it's
always going to be, they'reresigned to it too much.

Yes, I've definitely seen that happen and
there's plenty of good versesabout that, about how we're
called to work at oursanctification.
We're called to work out withfear and trembling before the
Lord, out with fear andtrembling before the Lord.
So I think we're very muchcalled to not resign ourselves
in any way, especially if we'restruggling and it's impairing
ourselves or others around us.

(37:30):
I think that contentment withthe circumstances we're given
and yet a willingness to workand work at our sanctification
and seek the Lord's grace in it.

Medical analogies can be really good
here, and obviously mentalhealth issues aren't just
medical in nature.
There's spiritual componentsand other things too.
But I like medical analogieswhen confronted with this issue
because it helps illustrate,like, if I have an autoimmune
disorder and I can't help that,that's nothing that I did to

(38:03):
create, that it's just somethingthat's part of my fallen body.
But I actually have aresponsibility to be the best
steward of what the body that Ihave, right?
So if I know certain thingscreate inflammation because of
my autoimmune disorder, Iprobably ought to avoid those
things, right?
I probably ought to make surethat I'm doing everything I can

(38:26):
to steward the body I've beengiven and the circumstance I've
been given.
So when I'm working with someonewho seems to be
over-identifying with their youknow mental health issue, first
of all I'm wondering what thefunction of that is.
You know, as a clinician,that's one of the things I'm
wondering.
What's the function of this?
You know, behavior.
But also trying to get at thatidea of stewardship you know I'm

(38:49):
still responsible to stewardmyself.
What does that look like?

Excellent.
Thank you so much.
So this is a very controversialtopic.
It's medicine and how we thinkthrough whether or not it's
appropriate to take aprescription.
I think I remember as a child,maybe a season of time where
Christians were saying thingslike it's not right to take any
medicine for things like anxietyor depression.

(39:16):
I think I saw the oppositedirection now, where almost
every kid in high school mightseek out a prescription.
How do you work through thatquestion from your professional
experience, and how do you thinkdeacons should take medicine
into account?

I would just say there's a lot of
misunderstandings about medicineassumptions that people have.
Most medicines for mental healthare not addictive and
habit-forming.
Some are like like sleepmedications and some anxiety
medications.
But just to be fully informedabout the type of thing that
you're being asked to take oryou might be asked to take is

(39:52):
really important, and whetheryou're the person that has to
consider taking it or a deaconcould potentially help with just
working through the costbenefits of a particular
medication.
So if someone doesn't taketheir medication for bipolar,
there's some significant costsor schizophrenia, or even severe

(40:12):
depression, and it impacts notonly themselves but others
around them.
And so just working throughsome of the costs and benefits
there are important, but I thinkit's important to say, like in
the technological world in whichwe live, that there are amazing
things that we have foreverything from cancer treatment
to diabetes to things that canhelp people with a mental health

(40:35):
diagnosis, and I would justwant to think through with
anybody is there a barrier to amedication for a mental health
problem that you're not willingto take but you would be willing
to take if it were for diabetesor some other?
What would be viewed as apurely physical?

problem somewhat depends on the
situation too, right, like youknow schizophrenia bipolar
there's already a brainimbalance there, so we're just
correcting an imbalance withmedication.
In those situations, depressionis a little harder, in part
because there are lots ofdepressions.
In other words, depression canoccur for a lot of different

(41:17):
reasons.
Right, sometimes those reasonsare very much chemical.
But one thing as a clinician Ishould say I mean I agree with
what John said about medicationand its usefulness, but I also
know that there are lifestylechanges that can be as impactful
, if not more impactful, thanmedication, especially for

(41:38):
depression and anxiety.
And in our current culture itfeels like we are so inclined
towards immediate relief that wewant to just take a pill for
something.
And certain things likeexercise, watching what we eat,
eating whole foods and lessprocessed foods, decreasing
caffeine, making sure that wehave good sleep hygiene all of

(42:02):
these things are tremendouslyimpactful.
They're not cures, and thatdoesn't mean that we shouldn't
consider medication fordepression and anxiety.
We certainly should.
But sometimes it's really alsoimportant to educate people
about the fact that thoselifestyle changes are as
efficacious in some cases asmedication without the side

(42:25):
effects.
So you know, you want topresent a whole balanced,
nuanced discussion aboutmedication when you're
considering that with people and, like John said, get at you
know what are the facts, whatare the myths, and try to get at
some of those things too.

You know what are the facts, what are the myths,
and try to get at some of thosethings too.
To add one more thing to thatit would be convenient for a lot
of us if it was just a law,like a biblical rule, you know,
like we should take medication,we shouldn't take medication,
and then it's decided and we canmove on.
And this is medication formental health is really more of
a wisdom issue, and that's whereyou're in this middle ground,

(43:05):
where you're trying to weighlots of different things about a
particular person and theircase and their needs, and the
costs and benefits for oneperson that has moderate
depression might be completelydifferent from the next person
that a deacon might meet withdepression.
So just appreciating that it'sa wisdom issue rather than just

(43:26):
a biblical law one way or theother.

So I oftentimes describe it to people when they
ask me you know, pastor, is itokay if I take medication?
I describe it as like noise inyour environment.
So if you were wrestling to tryto figure something out in your
life and you could just turnthe volume down, it wouldn't fix
the problem you're working on,but you could maybe give your
attention more to it.
Right, and so there aremedications that can normalize

(43:49):
the situation in your life.
Right, that you can then focuson the actual thing.
And oftentimes that is kind ofmore of a straightforward
spiritual struggle.
But like you say, john, it'snot as simple as just reducing
it to yes or no.
I think that's helpful.

One more avenue, and this relates specifically to
anxiety, an analogy I often usefor somebody that's really
moderate to severely anxious.
That noise comment that youmade reminded me that for
somebody that's really anxiousit's like trying to make contact
with like a hundred mile anhour fastball.
It's just really hard to dothat, but an anxiety medication

(44:28):
can reduce the speed to like 50or 60 miles an hour, so then
you're able to actually do someof the other things that would
help you reduce anxiety.
So it really depends on theseverity of the symptoms
sometimes, but treating amedication as part of a solution
rather than all of the solutionis another way of thinking
about it.

I was just going to add.
You know I've seen it both waysright, where people have made
significant lifestyle changesthat have had significant impact
on their symptoms.
But I've also seen it, you know, I was doing marital therapy
with a couple for a long timeand we were just really bumping
up against some perpetual issues.
And after a while psychologicalassessment training in me

(45:12):
started kicking in a little bitand I started to realize I
actually think that this husbandmight have undiagnosed ADHD and
had him assessed, went througha whole psychological testing
process and he got on a low doseof a medication for ADHD and it
turned around the maritalissues that this couple was

(45:33):
facing I mean night and day.
And so you know, I think justkind of having an open mind, if
you will, about some of thesethings.
And the other part of that islike that medication, if it
hadn't made a significant impactwe could have just gone off of
it, right.
So these decisions aren't oncefor all.
You know it takes timesometimes to titrate off of a

(45:53):
medication and you know it hasside effects and things like
that.
But people can try them andthen if they're not making
significant progress withmedication, it's not like
written in stone that we have tostay on it forever and ever
Excellent, very good.

So let's shift gears, then, toward some more
practical questions helpingsomeone working with particular
mental health crises.
What have you seen helpful inyour own churches, as deacons
can rally together eitherthemselves, or maybe in
coordinating other congregantsto provide meals, transportation
, financial assistance?
How would you recommend helpingsomeone practically?

I would say the first thing is something I
already said already, so I'lljust briefly mention it in the
context of this question, andthat is access to mental health
care is a very big barrier thesedays.
Clinicians have long waitinglists and sometimes it's hard to
know who to go to if you're aChristian.
And so first practical thing tome is having those
relationships built with otherpeople in the community, for the

(46:51):
churches to have thoserelationships and to know what
those resources are.

I would also add just to be cautious about when
helping hurts principle of doingeverything for somebody.
There are times where somebodyis in a severe crisis where they
need 100% help.
But if somebody is strugglingwith depression, for instance,
what they need is to startgetting active and exercising.
So maybe it would be hard forthem to clean their home or do

(47:20):
their yard work or whatever.
But instead of just doing itfor them, is there a way that
the deacon could do it with themand then it actually helps the
person that needs to getactivated, like, oh, there's
this person that's coming overand I want them to help me and
they can come over and do itwith me and that's an
encouragement to them.
And then I just think there'ssome ways that you can think

(47:43):
through.
How is the person with thestruggle of practical care
should be viewed as?

just as important as spiritual care in supporting
mental health.
Sometimes you can say inessence, go and be well, but not
step in to love a person well.
So how does practically caringfor people demonstrate integrity
to your desire to help?

them.
I think in a way the questionalmost answers itself right,
like there's just so many waysthat we're called to not just
love in thought, but the goodSamaritan that actually
practically does things.
That demonstrates care, notjust that he thought
theoretically, oh I care thatthe Samaritan is hurt, but does

(48:42):
practical things to help theSamaritan.
And I think that's just abuilt-in biblical principle that
we bear one another's burdenstogether, not only theoretically
or in principle, but in actualacts where word and deed
ministry is matching together.

Along those lines, I think, because mental
health difficulties are wholeperson experiences.
You know it's not just I've gota trial, you know, let's say a
spiritual trial, and you knowwhat we're talking about are
things that affect body, soul,spirit, mind, everything.
And so being able to meet thatwith whole person intervention

(49:22):
and help makes sense, right.
And then you know, along thelines of what John was saying,
if you think about what are someof our most costly things that
we give to people, well, time isone of them, and what does it
communicate to someone when wegive our time to come alongside
them to help them out, not justto quickly spout off something

(49:42):
that we want them to think aboutor do, but also like we are
giving them some of our mostcostly resources, right, and I
think that communicates a lot topeople.
And that's true of listeningtoo.
Listening is such a need.
I think we are desperate tohave good listeners in our lives

(50:04):
, and not everybody knows how todo that well, and it requires a
lot of self-discipline andholding oneself back and giving
time and patience andperspective.
So I think listening is a bigpart of that too, in terms of
what we can offer people whenthey're struggling.

If I were to see someone in a service visibly
shaken or not seeming likethemselves or just really,
really emotional, I think atendency for me is to kind of
withdraw and not want to engage.
What would be something aboutChrist, Christ's disposition and
his compassion that would givea motivation for a deacon to
actually step into the situationand say, hey, how can I help

(50:47):
you in this moment?

If I'm understanding your question
correctly, the motivation wouldbe this is an opportunity to
step into somebody's life and wecan feel pressure to say
something right away, but maybeyou don't have to say too much.
Maybe you just have to bepresent with them and say, hey,
you look like you might be upset, is everything okay?
And just be prepared to listenand hear what they have to say.

(51:10):
I think that would be a reallygood step forward, like if a
spiritual problem comes up tosay this might be something I
need to refer to an elder or mypastor as well, so that we're
doing this in partnership andit's not just a deacon bearing

(51:31):
the burden of whatever crisisthey've discovered in somebody
in the congregation.

I'm very struck with Christ's disposition,
particularly toward people whohad demonic oppression.
Obviously, the relation betweendemons and mental health is
complex Try to figure out whatthat is but he had such a deep
love.
I think of the man who wasaround the tombs and kept on
hurting himself in differentways and Christ very
intentionally pursued him andmoved toward him and wanted to

(51:54):
see him made whole again, whichis a beautiful image of what
mercy and other gospel ministrycan look like.
So I care for young people.
I'm a pastor for youth in ourcongregation.
They may, I think, be some ofthe ones that struggle the most.
I often tell parents who aremaybe not being compassionate
toward their kids I would notwish the high school years on

(52:15):
any of you.
It's because they're difficultyears.
I remember being a highschooler and having tons of
identity crises and otherintense, intense struggles.
How can deacons give good careto that age group?
There are kids that would havea lot of these particular mental
health struggles.
How can a deacon give good careto that age?

A lot of thoughts come to mind, but the first one
that comes most immediately tomind is maybe more general than
just the one with the mentalhealth challenge.
But if there are ways that theyouth in the church can be
engaged in helping others orengaged in service projects and
community projects, or hey,we're going to do this.

(52:57):
That's what creates bridges andopportunities.
If you see a young person or ateenager engaged in ministry and
then if they have a struggle,there's more context for
actually having a conversationwith them, that's the first
thing that comes to mind.

That's excellent.
Yeah, so one of the things Isay often to older people in our
congregation is, if you have anhour that you could just give
your time to a young personstruggling through different
things, that will be, I think,so much more beneficial than
trying to give them something ordo something else.
I think our time is often thebest resource we can give.
What about the complexity of aparent?

(53:35):
Who is the authority?
You know the person is underage, so they're not 18 years old
and maybe a parent's not takingthe severity of someone's mental
health seriously?
How should deacons weigh thedifferent spheres of
responsibility in that sense andhow do they navigate the
complexity of that?

Very carefully.
I mean, I think, when you'retalking about any of us
approaching a parent, I think wehave to be very careful, right,
because we only have a snapshottoo, and they're living life
with their child.
I think we're coming often.
We need to be coming from aplace of compassion and

(54:13):
curiosity.
You know, there are reasons whyeven you know trained
professionals don't necessarilywant to see things in their
families because it's scary,right.
If I take something seriouslyinstead of just sort of writing
it off, it's frightening tothink that my child could be
struggling that much.
I'd rather think that, oh, it'sno big deal, you know they're

(54:38):
just being teenagers, or this isjust angst, right, or whatever.
You know they're just beingteenagers, or this is just angst
, right, or whatever.
Most parents are not dismissingor writing off those kinds of
things because they're unloving,it's because they're fearful,
and so I think starting fromthat understanding helps us to
maybe be a little bit carefulhow we walk into those

(54:59):
situations and how wecommunicate, and allows us to
maybe have some empathy for whythe parent is potentially
overlooking something ordismissing or minimizing
something that might be moresignificant.
So that's not a mechanical how,but that's just kind of a
posture, I think, to take as youwalk into difficult
conversations with parents.

And some of the how would be something we
touched on a little bit earlier.
I would be leading, not withanalysis like this is what I
think is happening in yourchild's life but leading with
data.
Here are some things that I'venoticed.
I wonder if you've noticedthose things too.
And as you share that data withthe parents, then that sets the

(55:41):
context for what they want todo about it.
And if there were to be asituation in which the deacon's
like I'm not sure the parent'sseen this accurately and I'm
still concerned for this childthat's the point at which I'm
talking to someone on thesession about that concern.

Excellent.
One of the things that I'm mostconcerned with in my
congregation is the growingepidemic of loneliness.
How many hours people spendjust by themselves and without
real connection and community.
How would you help a widower ora widow that is pretty
depressed because of lonelinessif you were a deacon in a
congregation?

in a car.
Personally, I would be tryingto figure out ways to involve
them in either going to visitthem with somebody else, like
you're taking something to them,or you're asking them to do
something.
If there's ways that you caninitiate and say, hey, we really
need somebody to get name tagsorganized and handed out at VBS,
would you be willing to do that, rather than just waiting and

(56:47):
seeing who volunteers andwhichever of the 20% of the
people that always volunteer forstuff in your church and they
hand out the name tags.
But if there's ways that youcan structurally think through,
what would this person maybeenjoy doing?
That's not going to require toomuch of them but it gets them
engaged back in the congregationand the community of the church
.
I think there's a lot of waysthat you can either ask people

(57:09):
to serve or you bring a serviceto them that helps them engage.

This is a topic I feel really strongly about as
well and have lots of thoughtsand feelings about.
But some of the things that weknow about loneliness is that
people need connection andmultiple levels.
So having a friendlyinteraction with someone at the
grocery store is actuallymeaningful when people are

(57:37):
lonely is actually meaningfulwhen people are lonely.
But that can't just be it.
We also need deep relationships, intentional relationships.
But I say that to point outthat sometimes we can put a lot
of pressure on ourselves, youknow, to have somebody, let's
say, in our home every night ofthe week or something like that.
And it's what we really need asa church is those little

(57:59):
interactions that are meaningful, as well as the big, more
sustained, longer ones.
So it's not just you know, howdo we plug this person in for
hours and hours on end and getthem in deep, meaningful
conversations, or just how do webe more friendly with them in
passing at church?
It's both right.
We actually to sort of combatour loneliness, we improve in

(58:23):
our sense of connectedness whenwe have both kinds of
interactions, and I just reallythink we have to be really
intentional about engaging withpeople, about hospitality and
just sharing life together, youknow, and making that more the
culture that we have.
You know, and it doesn't have tolook formal.
I can just be like hey, youwant to go grocery shopping

(58:44):
together.
I have to go grocery shoppingon Saturday, you want to go too?
Or come over, I have to foldlaundry and probably helping
kids with homework, but you wantto just come over for the day
and just kind of sit in myliving room we can have some
coffee, you know, in betweensome of those things, and so
being very intentional abouthospitality is a big piece of
this.
Loneliness is also a hugeproblem among our youth.

(59:07):
So, you know, increasingly, asyouth are behind screens and
their social interactions aredisconnected more or connected
only through social media,there's a profound sense of
loneliness.
So creating embodied activitiesand spaces where kids can come
and be physically present withother people, I think is a

(59:28):
really important way to combatsome of that too.

Excellent.
Thank you so much.
Yeah, we did a study at ourchurch, somewhat prompted by
Jonathan Haidt's book AnxiousGeneration.
I just started reading a lot ofbooks on the effects of
technology and social media onchildren.
So there's a stigma, at leastat our church still about mental
health illness, like if I wereto admit in the pulpit that I

(59:52):
was a depressed pastor, forinstance, or if I were to say
last year I struggled we'll talkmore about that later but
struggled significantly withintense anxiety.
I think there's a sense inwhich it's like you really
shouldn't talk about that.
If deacons perceive that, howwould you help get a
conversation started so peopleare more open to speak about
anxiety and depression andmental health struggles.

(01:00:13):
Just, you know, being able tosay this is real, this is a real
factor in life and we don'tneed to kind of be ashamed of it
.

Lindsay Fikkert (01:00:20):
I think transparency is really important
here.
You know like there, I think,are places where we can model a
willingness to be open withoutoversharing, and you know, we
don't have to tell everyone ourwhole life story.
But the incidences ofdepression and anxiety, if you
just look at prevalence, wouldsuggest that there's a decent

(01:00:40):
number of people in and outsideof the church that are
struggling, and so having moretransparent conversations about
that, being willing to bring itup in different contexts and
just speaking about it, I thinkbecomes an important way of sort
of getting at stigma and alsowhen.
So mental health kind of adistinct category, but to some

(01:01:04):
degree we're all working on ourwellness and our soul care and
our self-stewardship.
So sometimes breaking down thedivide yes, there are discrete
categories for mental healthdiagnoses, but also that doesn't
mean that that has nothing todo with me.
If I've never had a mentalhealth diagnosis, I've been
subject to chronic stress orI've had family members with

(01:01:25):
whom I had conflict or thingslike that.
And so trying to break down thedivide between diagnoses and
our human experience I think isimportant too, which is like
when I went to Gainesville wegot to talk about mental health
diagnoses but we were also justtalking about prevention,
wellness, soul care, stewardship.

(01:01:46):
Those are all mental healthconstructs, even if I don't
reach the threshold of adiagnosis.

John Fikkert (01:01:52):
So Lindsay's going to Gainesville was an example
of the session, sponsoring thatand reviewing what she's going
to be talking to the women inGainesville about, and so that
would say there's a Christianeducation piece to this that I
think can help remove the stigmaand so, in part, if the deacons
could work with the session,I'm like, hey, we'd really like

(01:02:12):
to host a conference on this, ormaybe it's a Sunday school
class taught by the pastor orsomething to that effect.
I think that education piece atleast introduces the topic and
can reduce stigma in that way.

Adrian Crum (01:02:27):
So this is sort of a connected question.
Then, how can deacons grow andnurture a church environment
where there's a safety, a senseof safety for people to say I am
struggling or I need?

help.
Safety is one of the hardestthings to achieve in a community
, so in a way that's a muchbroader question.
Usually when we say safety it'slike, well, how do we make sure
we don't have an active shootercome into our congregation?
And so everybody asks thatsafety question.
But how is there relationalsafety in our congregation?
How is there relational safetyin our congregation and I think

(01:02:59):
that's a really good questionfor any combined church officer
project to ask how are theelders and deacons of this
church going to think through,how do we make sure that this is
not just a community where thelove of Christ is expressed from
the pulpit, but truly have asafe community in which people

(01:03:20):
can be themselves, talk aboutreal problems and we hear each
other and care for each other.
So in a sense I think thequestion is tapping into an
important and much largerquestion.

If I could just speak to that too.
I think being seen, havingpeople be intentional over time,
creates relational safety.
So you know, not just that onetime meeting where we talked
about this issue, but somebodywho remembers a deacon and elder
who says, you know, two monthslater, hey, I've been thinking

(01:03:55):
about this, praying about this.
How is that going?
Or are you getting what youneed out of those resources that
we connected you with?
And you know I was thinkingabout what you were saying about
youth.
My daughter has commented howsignificant it was to her in her
early adolescence that one ofour elders and his wife
remembered things about her andwould ask her about them.

(01:04:19):
Right, and it just left herfeeling like they knew her, that
she was seen, and I think ifshe had a struggle, she would
feel like these are people shecould go to because they sort of
in a preventative kind of way,if you will let her know that
they remembered things about herand they asked her about them,
they made eye contact with her.
You know she wasn't just a kidrunning around church, right?

(01:04:39):
So I think some of that webuild in on the front end by
seeing people, by rememberingthings about them, and I have a
terrible memory.
So I would be somebody whowould I need to go home and like
, jot that down and then put itin my planner to ask so-and-so.
But that's okay, right, like ifthat's what we need in order to
be intentional, in order tocreate relational safety, that's

(01:05:00):
what we need to do so that weget past, like how's the weather
and what do you think of thegame last night?

Just to add a couple more comments about that.
One would be that churchofficers have more ability than
they maybe even appreciate tocreate the environment within
the church that is loving andsafe and just being a little
more intentional about thinkingthrough.
How do we do that and how arewe, as lindsey mentioned, how
are we going to track ifsomebody tells us that they had

(01:05:29):
a problem or a prayer request?
In what ways are we going tofollow up with that and care for
this person over time, not justin this one instance?
The other thing I just brieflyadd and this may be coming up in
some of the books that you'rereading, but I heard a
researcher on a podcast recentlysay our closest relationships

(01:05:51):
are still in a strong place,like our closest family members
and so forth, and our mostdistant relationships are still
good.
But all those middle spaces thatwe used to have, like bowling
alleys and, to some degree,coffee shops, but other places,
those middle places, they justdon't exist the way that they
used to, just to create a vision.

(01:06:12):
The church has this uniqueplace where here's not just any
middle space between your familyand a stranger.
This is like the best possiblemiddle space.
People are starving for thismiddle community between just
their direct family and thecommon neighbor.
So the church has anopportunity in this culture to

(01:06:34):
create an amazing place forpeople to feel loved and cared
for.

Excellent.
I think one of the things thatwe've recognized here is there's
the difference between crisiscare and then long-term
structures that assist people.
We've been trying to puttogether care teams where
there's someone sort of runningpoint on the care team and
there's a variety of differentmembers working together with a
church member.
That needs a lot more time.
What are some ways that deaconscan help build some strong

(01:07:00):
systems like this?
Maybe?
What kind of people would youlook for for care teams for
someone wrestling through mentalhealth?

What are some giftings that you're looking for
in the body as you gathertogether a care team or a
structure like that, I would say, first of all, some sort of
structure begins with writingthings down or having you know
some sort of confidentialspreadsheet or database where
you're, as a deacon boardtracking what people have.
So that's one part of it, isthat structure.

(01:07:28):
But then the second part aboutthe care team would be observing
, yeah, In your congregation whoare the good listeners?
Who are people that otherpeople seem to go to anyway good
listeners?
Who are people that otherpeople seem to go to anyway?
There are some things where itmight be a challenge for a
deacon to meet with someone afemale or whatever or they have
a really uncomfortable situation.
So is there a group of women inthe church that I have as a

(01:07:51):
go-to group, that I know thatthey could come with me and help
with the conversation and,depending on how far you want to
go with it you were talkingabout care teams it sounds like,
I mean, you could really planit out in a useful way and have
not just the idea or theresource people available that
you've identified, but organizeit even further into ways that

(01:08:13):
we're caring for others, perhapseven showing hospitality to
each other and in other ways aswell.

Oh, another thing I would say about that is
I think sometimes, because itseems so common sense, we don't
think about actually trainingpeople.
Things like how to be aneffective listener.
We just, oh, she seems like agood listener, he seems like a
good listener, or be a goodlistener.
It's like, well, what does thatactually look like?
There are ways to improve ourcapacity to be good at some

(01:08:43):
things that we just take forgranted or we think are
character traits, but we canactually get better at those
things.
And so when you're thinkingabout putting together care
teams or getting sort offormalized in our care for
people, we can think skillfullyabout some of these things and
break them down into bite-sizedpieces and practice them right.

(01:09:05):
Like I can sit here with Johnand practice a good active
listening dialogue and getbetter at it.
And it seems kind of silly andmechanical, I guess, at first,
but just thinking through, likewhat would that look like to
actually train ourselves to bemore effective people you know,
to be more effective familymembers and the family of God,

(01:09:26):
right?

Excellent, yeah, james.
1.
I mean, I think that's sort ofjust ordinary necessity for all
relationships, but care teamsthat care for people with mental
health struggles.
I think really, reallyessential that people be able to
be trained to listen well, andI think we've all had the
experience of someone listeningattentively to something hard
that we were going through andjust how encouraging that is,

(01:09:56):
but it's hard to know, okay.
Well, how do I then move towardgrowing in that skill?
It takes a lot of patience.
How can you help people who arestruggling get paired up and
helped with someone they alreadyknow and trust, rather than
being forced to walk to talk toan officer they don't know?
So how do you make connectionsin the body with people that
they're already dependent on,rather than I think sometimes we

(01:10:17):
may be overly officially like?

oh, go talk to this deacon, go talk to an elder
.
Yeah, I like to think of thatas not so much an either or, but
a both and like, because youknow, deacons and elders have
certain roles and resources.
So, and what I find sometimesis, in order to not burn out in
our care for other people, weneed to make sure we're not an
island trying to help someone.
And I find that when it comesto like what we sometimes call
compassion fatigue or burnout,if we're not working alongside

(01:10:49):
other people, especially forthose long walks that we're
going to take with people whoneed help for a long time, we're
going to burn out.
So I think pairing elders anddeacons alongside people that
someone who's struggling alreadyfeel comfortable around makes a
lot of sense.
And I think especially we haveto be especially careful around
trauma, especially sexual abuse,because and I've had this

(01:11:13):
happen before I had a femaleclient who had been horrifically
sexually abused by more thanone male and she could not sit
alone in a room with a manwithout just feeling completely
unsafe, and so I happened towork at that time in a clinic
where her psychiatrist was amale and he worked down the hall

(01:11:34):
for me so I could go sit withher as her counselor, I could go
sit with her in her psychiatricappointment and create safety,
and that worked for her and thatworked for the psychiatrist and
that worked for me.
But kind of having that mindsetthat we have to be sensitive to
the fact that, especially forfemales who have gone through
trauma, one-on-one work with anelder or a deacon who's a man

(01:11:55):
can be very difficult, and soyou know we need to create that
safety by bringing along peoplewith whom they feel safe.

Presumed in some of the questions that we've been
covering, but just to call itout in the open.
You know the deacons are tolead in mercy ministry, but they
don't have to do it all ontheir own.
So just to be clear, we agreevery much.
So how do we lead but helpothers in the church, be
involved in the mercy ofministry in our congregation?

Yeah, excellent.
I think our book of churchorder speaks about deacons as
stewards of gifts in thecongregation.
So I think, knowing who hasgifts and abilities and
distributing it, it wouldactually be so much better if
the deacons did very little workbut distributed.
So the whole church, the wholebody, is working together to
serve each other.
That's great.
What are some commonmisconceptions?

(01:12:44):
You probably have hours andhours also of funny
misconceptions that Christianshave about mental health.
What are some maybe commonpitfalls or misconceptions that
people in the church have andhow would you address some of
those biblically?

Well, I'll start with one.
I already alluded to thatmental health issues are
synonymous with emotion, inother words, like sadness is bad
, right, it's not a pleasantemotion, and you know, I think
this is changing.
But what's not changing isperhaps like a general

(01:13:21):
mismanagement of our internalexperience.
It is our emotions and thoughts.
And so you know, in the past,maybe past generations, have
kind of had that more stoicapproach among Christians to
emotions and you know, we shouldjust feel happy all the time
and those sorts of things, happyall the time and those sorts of

(01:13:41):
things.
And it's funny, I stumbled upona quote by John Calvin where he
just really calls out the Stoicsfor sort of having that
mentality, that we should not besorrowful ever.
I think he even uses a littlesarcasm in that quote.
But so I think that's onemisconception.
But the other that seems to begaining in popularity and maybe
is more sort of a newergeneration, is my experience and

(01:14:03):
my emotion is what matters, itis the only thing that defines
my truth, right, and so reallyhaving a right understanding of
the place of emotion in theChristian life is of utmost
importance, I think right now,the place of emotion, the place
of internal experiences, mythoughts about myself, my sense

(01:14:24):
of self.
How do we understand that whenour truest identity is in Christ
right?
And so teaching people how tothink rightly about their
emotions and not falling on oneditch or the other is really
important?

Another topic would be sin and its relation to
a mental health problem.
There are some times where aperson's personal choices are
very much involved, or theirthoughts are very much involved
with a mental health problem,sometimes less so.
Sometimes it's something that'shappened to them or it's just
the basic fallenness of ourworld and rather than feeling

(01:14:59):
the pressure to come to animmediate conclusion about to
what degree does this person sininvolved in this problem, being
just a little more cautiousabout it, and even for the
person themselves like it maytake a little while to figure
out how sin is involved or howmy response to this mental
health problem may have sin init.
But we all admit we sin dailyand thought, word and deed.

(01:15:23):
So we should assume that insome way our sin is certainly
going to be involved, but it'snot an all or nothing venture
when we think about mentalhealth problems.

One of the CCF books is it Ed Welch or Dave
Paulson is called Saints,sufferers and Sinners.
I appreciate that threefold,you know, and asking the
question am I seeing someonewho's suffering something?
Am I seeing someone who is justsinning in a particular way but
maybe not reducing it to justhow are they guilty and how do
they need to respond?
Yeah, excellent.

(01:15:54):
Do you have any creative ideasor things that you've found
helpful for a whole body, thewhole church we talked about
this earlier, but the wholechurch coming together to offer
prayer or create support groupsor educate the congregation.
Are there ways that the wholechurch can work better together
to support people walkingthrough mental illness crises?

I think for me it just begins with the considering
if you would be willing to do aconference and just have an
education piece on it, and itcould be education on mental
health, it could be education onhow to be a better helper.
Here are some listening skills.
Here are some other things thatwould be helpful for you to do.
If somebody tells you a problem, write it down so you know to
follow it up with them and justdoing some training things.

(01:16:37):
I think that is a beginningpoint for encouraging it.

Yeah, we, you know, I think a couple of years
ago we did a couple of youthgroup lessons, even on thinking
biblically about our emotionsand how to take care of
ourselves.
You know how to do thatself-stewardship piece, and so
you know, I think, beingintentional with those kinds of
teaching opportunities thatallow for those kinds of

(01:17:03):
conversations, so that would beone thing as well is bipolar or
this person needs to be taken tothe ER.

but it becomes a long road and going for the long
haul, how would you encourage adeacon who is just feeling
fatigued and worn down becausethey've been caring for someone
for a long time?

Yeah, I'll kind of jump back into that because
I think I brought it up a littlebit earlier.
But compassion fatigue is avery real experience.
It's real for anybody who'swilling to come and walk
alongside people.
And so if we really want to bein it for the long haul and be
sustaining in our care for otherpeople, I think we have to take

(01:17:51):
seriously our own limits andnot try to be, in essence, kind
of like little saviors forpeople.
We have to really be honestabout what we can and can't do
in the lives of another person.
It kind of starts there becausesometimes we have expectations
of ourselves as helpers that wecan do more than we actually can

(01:18:12):
do, because we're always havingto respect somebody's autonomy
right, and we can't controlother people, and so they stand
alone before the Lord, right,and they have't control other
people, and so they stand alonebefore the Lord, right, and they
have to kind of work throughsome of these things in the
timing that they're willing andable to.
So it starts with probably that.
But I think, as this has come upin my own life as a counselor,
but also in other people inministry, for me there's also a

(01:18:36):
piece of am I doing my ownself-care well, because if I'm
not, I'm going to have much lessto give people for the long
haul.
So I can't neglect being in theWord.
I can't neglect my own physicalmovement and exercise, taking
good care of my body, havingrich and meaningful

(01:18:59):
relationships in my life.
As soon as I start neglectingthat, I'm really going to run
out of gas for helping otherpeople.
So I think those two places.
But then also like, as you moveon, even if you're doing those
things, there are times wherewe're weary and it's hard to not
grow weary and doing good right, and so we need other people
and sometimes it's time to sortof tag team right, like bring

(01:19:22):
alongside other deacons, as itwere, in this situation, or
other people who are doingdiaconal care and say you know,
this is a hard week, I have alot going on.
Do you think you could step inhere and making sure that we
have a wide enough network ofpeople within you know the
confines of confidentiality andconsent, but a wide enough

(01:19:45):
network that we can spread outsome of those needs over time?

So that it doesn't come down to just one person.

Yes, right, that's excellent.

If I could speak to an exception to the rule.
So generally, that's what youshould do, you know look to
others, seek support with yourpastor, fellow deacons and so
forth.
But on occasion a person mightarrive at the church that
appears to be exhausting all theresources not just of one

(01:20:17):
person but of the entire deaconboard and elders and pastor, and
that would be a time to startasking what might be going on
here.
And it may just be a uniqueproblem, but the reason I'm
bringing it up is there aresometimes somebody with a
particular personality disorderor something else going on where

(01:20:38):
.
That's how they're wired tointeract and they will suck the
life out of a situation.
So if you're in a situationwhere you're noticing like
everybody in the church isexhausted by this person's
problems, that may be a time toseek an outside consultation
with a mental healthprofessional and you walk

(01:20:59):
through.
These are the things we'restruggling with and we're all
tired and this person isn'thelped.
I just think seeking out aneven wider consultation about
that.
And again, this doesn't happenall the time, but I can think of
more than a handful of churchesthat have had this sort of
person arrive on their doorstepand they don't know what to do

(01:21:20):
next.

Yeah, that's so true, excellent.
Well, some of our most popularepisodes of the Reformed Deacon
in the past have been real-worldcases.
So I wanted to pitch areal-world scenario.
I'll just read this for you andthen you can give some
practical advice for deacons whosee a situation like this.
So a single member of yourchurch comes to you asking for
help with home repairs.

(01:21:42):
She's older and somewhatdisheveled in appearance.
You've known her over the yearsas being eccentric and somewhat
of a loner.
As you run through with herusual list of
information-gathering questions,you start to realize that she
may be unrealistic about theseverity of the problems.
The next day you visit her homeit takes only a minute for you

(01:22:04):
to see the house is dilapidatedwell past repair.
Her request for a fix wouldonly at best be a band-aid.
She insists it will just take afew minor repairs to get back
in shape.
But it's obvious to you sheshouldn't be living there
anymore.
You suggest to her that sheshould find somewhere else to
live, perhaps with family.
But she is insistent.
She stay put.
You've noticed she often iscaught in a faraway, stare and
mumbles to herself and isagitated.
How can you gently, lovinglyand effectively help her?

I think the place to begin is to find out what she
is willing to consent to.
What does she identify as theproblems in her life?
Is she willing to talk to adoctor?
Is she willing to go to acounselor?
What is she willing to getchanged in her home?
And can we help with thosethings and maybe take an

(01:22:47):
incremental approach of justlike oh, since we did this, I
wonder if we can.
I just noticed this.
What would it be like if Istopped by next Saturday and
helped with this other thing?
And over time, if you can buildtrust incrementally, it may
give you a wider opportunity tostep more deeply into her world
and she might listen more as sheexperiences you in those ways.

(01:23:08):
The other question with that isthe way it's framed.
To me it sounds like thisproblem has been going on for a
very long time.
So applying what we saidearlier rather than trying to
get this to turn on a dime andsay this is going to change next
week, appreciate that it maytake some time and effort.
Over is dilapidated and wewould never live in a house like

(01:23:30):
that.
But I think we have to makevery sure that that's not just
our own value for a house andwhat makes this house unlivable,
or so forth, and just to try tobe aware of our own biases as

(01:23:52):
we enter that situation.
Deacons are great for being atnuts and bolts and they're like.
This house should be condemned,and maybe it should.
If somebody was described likethat, I would be thinking about
Alzheimer's and memory care.
Moving them from their house,the environments that they have,
that's almost their only linkto reality.

(01:24:12):
So if you move them from ahouse to a facility, they may
lose a lot more, as some oftheir links to reality might be
gone.

Yeah, I would agree with all that and I would
say that the place to begin,usually in a situation that's
complex like that, is the placeof least resistance.
So even though it seems like aband-aid, it does build trust to
respond to what's asked andthen begin to work from there,
kind of bringing up like hey,I've also noticed that maybe

(01:24:44):
this seems hard or this is adifficulty for you.
Is there you know a way that wecan start building a plan to
help out in these different ways, one that might have more
lasting power or that kind ofthing?
The situation or scenario yougave it sounds like there may be
underlying psychological issuesthere.
So at that point you really aregoing to want to see if there's

(01:25:06):
a willingness to reach out to aprofessional.
You know how earlier you hadtalked about.
Sometimes medication can helpwith the noise.
This might be one of those kindsof scenarios where meeting with
a doctor, you know someone ismumbling to themselves and
agitated or sort of staring out,disassociative, like there
might be something significantgoing on in a mental health sort

(01:25:27):
of capacity and those kinds ofsymptoms are sometimes the kind
that really do actually needmedication.
So just things like that ifsomebody is willing to go to the
doctor as the next step and tobegin that long road.
It's tempting sometimes to seethe like most outward sign and
just want to like, let's get youto a new home, for example, or
let's sell this property and getyou into assisted living or

(01:25:49):
something.
And I found you know, sometimeswith mental health the
intentions are so good but like,let's just take somebody who
has hoarding obsessive,compulsive hoarding we go in and
we clean out and then twomonths later it's exactly back
to the same state, right, and soif we don't get to the root
issue, we're just going to havethe problem reemerge in a

(01:26:12):
different setting and in adifferent way.

Excellent.
Yeah, thank you.
Well, I wanted to share a waythat our Committee on Diaconal
Ministries can heartily endorsethe Committee on Ministerial
Care that, john Fickert, youwork on.
Last year I had bouts of really, really intense, just waves of
anxiousness and anxiety andhonestly, I didn't know what to
do with it and who to turn to.

(01:26:36):
One of the difficult things fora pastor, an elder or a deacon
is if you're going through someof that you don't know, can I
share this with other people?
Can I ask for help?
What will happen if I stumbleinto the wrong situation in my
own congregation?
So I reached out to John and wehad a set of consultations.
The way I described it to myfamily is I felt like when I was
disoriented, I didn't know whatto do next.

(01:26:58):
John could just kind of say hey, have you thought about this or
taken the next step?
And ultimately I got connectedwith a counselor in town and had
a really, really helpful set ofvisits.
So I think this is just myencouragement to elders or
deacons or pastors who arelistening to this to actually
ask for help ourselves.
I think we've said on thepodcast already we will only be
a benefit to others asambassadors of Christ if we

(01:27:21):
ourselves can ask for help andwork through that.
I just want to commend theCommittee on Ministerial Care
and also just seeking outresources in our areas for
ourselves If we are the onesdeeply depressed.
I know pastors who havecommitted suicide.
I've known pastors that havehad really, really strong times
of anxiousness and they don'treally feel the freedom to share
it.

(01:27:41):
So just wanted to thank Johnfor that and also just encourage
people that are listening tothis to take the next step
towards seeking help.
And if you guys have anyencouragements about that for
people that are listening, whatwould you say to someone that
was kind of on the fence as towhether or not to seek help for
themselves?

I think your testimony may have said it well.
If you think about, I'll put itthis way shame causes us to
want to hide and withdraw, andif you really think through the
gospel, it's to allow what'swrong or broken or weaken us to
be exposed and to know the lightof Christ, and we are as
Christians.
We are drawn to the light andso bringing things more to light

(01:28:18):
.
I would encourage that thatwill always be an opportunity
for Christ's grace to shinethrough.

Yeah, one of the things that you said to me I
remember that stuck is insteadof thinking of yourself as
broken and unfixable, just havecuriosity about this, just
investigate things that don'tmake sense, think of yourself as
sort of objective and just becurious about your own struggles
.
That was helpful for me tothink through.
Well, john and Lindsay, thankyou so much for taking the time
to talk today.
I think this may be the longestReformed Deacon ever, so we
feel like we've put you througha lot of questions.

(01:28:49):
We really, really appreciateyou so much.
We hope our listeners havegained some insight and feel in
some way strengthened andencouraged as they minister to
those in their congregations whoare struggling with mental
health concerns.
Thanks for having us, thank you.

David Nakhla (01:29:01):
Thanks for joining us.
Go to our website,thereformedeaconorg.
There you will find all ourepisodes, program notes and
other helpful resources, andplease make plans to join us
again for another episode of theReformed Deacon Podcast.

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