The People of the Village
Catherine stands in the hallway just outside her room. She is rifling through the pages of her Bible looking for specific passages. She finds one, reads it, and tears the page out crumbling it in her hand and dropping it to the floor. She goes on to find another passage and repeats the process.
Whenever Catherine does this it is usually with passages such as Deuteronomy 6 or a chapter from the Gospel of John such as 14, 15 and 16; all chapters on her loving God and God loving her. Later in the chapel she raises her hand and asks me if God would forgive her anything. I can tell by her now recognizable remorse what she had done.
Donny started attending chapel services just two months ago. On the third Thursday evening of each month the Pastoral Care department hosts the Spirit of Hope Coffeehouse, an activity suggested by a Christian Psychologist at this state psychiatric hospital. It was mistakenly announced during lunch in the cafeteria that the gym would be open for volleyball. Donny, 19 and athletic, looked forward to the activity for the rest of the afternoon.
When the announcement is made correcting the evening’s activity Donny’s anger becomes apparent to all. He takes his Bible into the bathroom, tears it apart and throws the pieces into the toilet. He then urinates on it. Visiting his unit before the coffeehouse he shouts at me from his doorway that I am weak and brainwashed, then he makes graphic statements regarding the sexuality of Christ.
Chris is a gentleman in his early forties. Over a 24-hour period he will encounter two to three chaplains and request communion from each one of them. Some oblige him and others do not. Besides mild retardation, schizoaffective disorder and severe manic behavior (the later two under control with medications), Chris is religiously preoccupied and wracked with the guilt and shame associated with his illnesses and ensuing sexual behaviors.
Catherine also is diagnosed as schizoaffective. She has yet to turn to wisdom the knowledge that she can not live healthy without her medicines. She too has been noted as religiously preoccupied. Donny has not. However, along with a severe learning disability disorder he also has Antisocial Personality Disorder. His facial appearance is slightly suggestive of fetal alcohol syndrome. Donny had a very traumatic childhood that he has only recently begun to share.
Each of these three, and about seventeen others, attend Sunday worship services that I conduct each week. They read from a liturgy, sing songs while I play guitar, share their joys and concerns, hear the word preached, and ask for prayer for themselves and each other. Many of the others are more severely disturbed than these three while the doctors try new medications, dosages and combinations, or Electro Shock Therapy, till they see an affect on their behaviors. Yet they find in themselves the ability to sit through a service that can last 45 minutes due to their participation.
In the three years I have been a part of the pastoral care staff I have struggled to understand just how the Word reaches them. Often I’d settle myself with understanding the sacramental, mystical power of the Word to “sanctify and cleanse … through the washing of water by the word” (Eph. 5:26); and that the word I preached, “living and powerful … piercing even to the division of soul and spirit,” was doing its job.
One day John, schizoaffective with Obsessive-Compulsive disorder, came to an afternoon Bible study I hold in the small chapel of Sexton Hall. Some days I just don’t know if John is going to respond to me or not, at least on a level of communicating back to me. As always, and this day, I asked John, “How are you feeling today, John.” He looked up at me and spoke to me unlike he ever had before.
“You’ve got to be kidding. How am I feeling? Heh. Feeling?” He shook his head. “I haven’t felt anything in so long, I don’t know how long. I’m being given drugs so that I don’t feel. And they work well at that. I don’t feel anything.” He repeats my question to himself. “How am I feeling? That’s a good one.” He then stood up and excused himself from the chapel with one last question: “How is this being in the image of God?”
John’s complaint is one reason why most patients on psychoactive medications want to come off of them. Some of the drugs John had been on in the two years he has been at the hospital are Ambien, Elavil, Paxil, Serzone, Triavil, Xanax, Depakote, Ritalin and Thorazine. Patients often come to a place where their behavior is under control through therapy and the medications and they believe they can maintain that place without the drugs.
They want to feel. They want to participate with the world on an emotional level. They want to feel like everyone else feels. Mike explained it to me this way. “At least my illness is me. The drugs are not. For better or worse I’d rather live without the drugs.”
The Preacher and the Villager
Breuggemann could be asking specifically about psychiatric patients when he asks of the preacher: “How does one present and act out alternatives in a community of faith which on the whole does not understand that there are alternatives, or is not prepared to embrace such if they come along?”1 To answer that question I had to first find a point of contact between the gospel and the experience and culture of the psychiatric patient. This I found in Luke 17:11-19:
“Now it happened as He went to Jerusalem that He passed through the midst of Samaria and Galilee. Then as He entered a certain village, there met Him ten men who were lepers, who stood afar off. And they lifted up their voices and said, ‘Jesus, Master, have mercy on us!’ So when He saw them, He said to them, ‘Go, show yourselves to the priests.’ And so it was that as they went, they were cleansed. And one of them, when he saw that he was healed, returned, and with a loud voice glorified God, and fell down on his face at His feet, giving Him thanks. And he was a Samaritan. So Jesus answered and said, ‘Were there not ten cleansed? But where are the nine? Were there not any found who returned to give glory to God except this foreigner?’ And He said to him, ‘Arise, go your way. Your faith has made you well.'”2
The preaching event in the village unfolds like this:
1) The preacher goes to the village (v. 12) and encounters the residents.
2) The villagers identify Jesus as the source of God’s mercy. This is the gospel we preach. I keep this message simple, explicating one or two verses in a story-telling, narrative. I repeat its message in music and in a printed liturgy of responsive reading. Somewhere in those three modes I hope and pray they make contact and respond to the Holy Spirit.
3) Unlike any other circumstance, Jesus makes no questioning of them, but responds with mercy. We too can not be certain of their answers to our questions, but trust in Jesus to know.
4) Jesus sends them back to the physicians of the day, the priests, to affirm and confirm their healing. And this too we must wait upon.
5) Jesus knows that all were cleansed, but only one bears witness back directly to him.
6) The one becomes a worshipper.
7) Eventually they are able to leave the village and enter into larger society.
The mentally ill are today’s lepers in two ways. The Gospel of Luke illustrates a healing process that takes place over time in the walk. And as most sin in this historical context was manifested in physical illness, the priesthood was the medical association. Before one could be deemed fit for public interaction (group home placement?) he or she had to be shown to the priests who would assess them healed or not healed. In this Jesus teaches, or at least directs the lepers to be obedient and submissive to the rule of the day, follow the doctor’s prescribed course of action.
The Preacher and God’s Word
Every text has a claim upon its hearers. The preacher experiences this claim, thus has a witness, and bears it to the congregation.3 In this process, we then take the witness and consider its focus and function: what is its message, what is our action?4
The relationship between what the scripture says and what it does should not be violated, but stay allied and dependent. However, the more time I am around people with psychiatric illness, the deeper my understanding becomes, the less I can compare it to. I have come to respect the people of this village for their endurance, their will to live for today.
Entering into the world of the psychiatric patient is as otherworldly as entering into the villages I visited in southern India, and the struggle to understand proclamation in a context not easily or quickly understood was just the same. But a commonality lies here within the two: the preaching would come from a missiological context. I would have to trust in the Spirit and the Word to do a work that I could not see with my eyes or touch with my voice.
“The Bible tells us not how we should talk to God but what he says to us; not how we find the way to Him, but how He has sought and found the way to us …. We have found in the Bible a new world, God, God’s sovereignty, God’s glory, God’s incomprehensible love.”5 The preacher, following Barth, does not find a place of contact, but a place to preach, a place to be the herald. “When the Gospel is preached, God speaks: there is no question of the preacher revealing anything or of a revelation being conveyed through him…. Revelation is a closed system in which God is the subject, the object, and the middle term.”6
God and His Voice
Not a Sunday goes by that I do not wonder how some of the people of this village called a psychiatric hospital hear the word of God. Catherine Hilkert wrote, “The language of freedom and hope has the power to retrieve the originating power of the events of creation and redemption and thus to reshape reality… and gifting humanity with the imagination of possibility that exceeds and escapes human achievement,”7 including the achievements of doctors and medications, but not to their exclusion of being used in the process of healing, or not healing.
But how do they hear the language I speak? Do they follow its linear path or move in, out and around like playing jump rope? Is the affect of the word preached appropriated solely upon their grasp of the language?
The villagers need to be able to imagine redemption in their lives and the creation of order out of chaos. How does one discern the voice of God when there are so many other voices? They need a foundation of faith that they will not doubt as a product of their medications or illness(es), but from the Holy Spirit. This faith has to go beyond what they feel or do not feel, but to a place of trusting what they know. But isn’t this asking them to step into faith at a level of maturity that we all struggle to attain, one which has “known Him who is from the beginning” (1 John 2:13), the faith of fathers?
During one Sunday School class I was teaching at the church where I am an Associate Pastor, I had found the story I had been looking for, the story that told their story, the “alternative”8 as Breuggemann calls it, that the scriptures offer to us. It was the story of Elijah (1 Kings 18:20-19:16). Right before me was the story of one of God’s servants suffering from what appears to be moderate bi-polar disorder.
This diagnosis, of which he meets the criteria, explains his descent from great spiritual victory against 450 prophets of Baal; surely awed by the fiery hand of God, yet laughing and mocking, hardly the behavior of a mature, stabile servant of God; then displaying depression and despair following the threat of a single person. “It is enough!” he cries. Rather than explicating this illness, allow me to move forward to how God addresses Elijah’s mental and emotional brokeness.
Twice God asks, “What are you doing here Elijah?” The first time I believe the intent behind the question is, How did you come to this condition? Elijah then explains the pressures, the loneliness and the fears that have over taken him along with the generational condition of his “fathers” before him. The second time God asks, “What are you doing here Elijah?” the intent is, “Are you seeking Me?”
God then explains how Elijah is to hear His voice; how to find and listen to and be directed by Him, not only in the midst of external noise, but internal noise as well. God the Father does not touch him as Jesus does the man with the legion of spirits (Mark 5:9). He teaches him about His voice and His word (for us today the Holy Spirit and Word/word), both of which are experienced by Elijah in his illness, both of which enable him to go forward, to rise up and move on, to serve in a useful life, to teach and to bless others.
Elijah was not healed in the physical/mental sense, but he learned what to do, how to reach out to God, how not to let external/internal events tell him how God was moving or not moving. Events are unstable and changing, God is not. He was taught to hear that recognizable voice from among whatever other voices he was hearing. How could he go from such a great victory over so many to despair over the threat of one? The same way I do! The same way you do.
Our faith needs a constant reassurance. God taught him not to look for that reassurance in externals, but look for the relationship in the voice. This is where we find the strength to overcome the wicked one. We know God.
‘Even great minds with great spirits retract into senility. The mind and its thoughts have no eternal qualities, only the possibility of thoughts of the eternal. When the heart, mind and spirit of a man struggle to come into accord, this is the “perfecting” or “maturing” of a person in Christ.
My faith, understanding and hope in the salvation and transformation of these patients lie in their community as people on the margins of society, living in their own village, yet always outside looking in. It was, and still is, the practice of the presence of Christ, to be with those on the margins. Know God, is what is needed to be preached to psychiatric patients. Teaching and encouraging them to reach into where they can access what you know about God, in the middle of that chaotic period – as soon as you can.
The Holy Spirit and the Villager
Barth warrants that the presence of the Holy Spirit working with the word and the individual is imperative.9 He de-emphasizes the texts we hold in our hands and emphasizes the grace and power of God keeping the promises we find in the text. Thus the power or grace enters when the historic proclamations are appropriated for today. Paul says that no man calls Christ Lord except by the Holy Spirit (1 Corinthians 12:3). This is what Barth is talking about. The preacher does not “reveal God or act as His intermediary”.10
Henry Mitchell, in Celebration and Experience in Preaching, states that”… the vicarious experience of the gospel … is offered by the preacher, to those who have ears to hear and hearts to heed. Positive responses on the part of the hearers are so essential that there can be no real preaching without them. Thus preacher and hearer are engaged in a kind of dialogue, whether audible or inaudible, and nowhere is the Protestant doctrine of the priesthood of all believers more apparent.”11
Mitchell states the goals of preaching the gospel are: salvation, healing, growth and empowerment; and, “whatever the sensitivity and psychological expertise of the preacher, we are all saved by grace through faith (Eph. 2:8), and no person will know exactly who else is in that number until the final arrival on the ‘other side.'”12 And, I wonder, what became of those nine other lepers?
The Preacher and the Preacher’s Task
At the end of the day I cannot question what or who has compelled the villagers to come to worship or to bible study or to one-on-one Christian counseling. Their doctor’s reports may say they are religiously preoccupied, another may be absolutely unable to have a conversation, another may think she is Jesus, and another that he is Judas Iscariot. But they come. My task is to preach. I have not failed according to their response. I can only fail in failing to preach. I know that in spite of all my efforts, people are going to be saved. Elijah and the lepers are for our understanding of the actions of God, Word and Spirit. These are not scriptures so much for our preaching in this context, but for an understanding of the dynamics that unfold for the villager.
I have come to a Trinitarian understanding of the preaching event in the village and the affect of the word upon the villager, the psychiatric patient. First, the event is able to take place by the will of the Father who in the past created order out of chaos. In the present the chaos is the state of the scripture (the voice of God, as in 1 Kings 19) in relationship to the broken state of mind and the way it hears. God the Creator brings the word into a usable state for the hearer: a delicate whisper, a still small voice.
The Son is the second imperative. His life, death and resurrection bring forth relationship between scripture and hearer, as we seek the gospel/good news to proclaim. Jesus is the bridge and the message. He is the witness of transformation and the Transformer. Through Him we have eternal life. It is the word about Him that the villagers come to hear. The Holy Spirit, in a way unknown to us, bears the word to the villager, somehow offering the gospel from an external event to an internal event, and thus an eternal event for the individual villager.
As for the lepers, who can understand their response? Even Jesus said to the one, “Were there not ten cleansed?” It is upon the return of the one that Jesus says, “Your faith has made you well.” He does not say this to the other nine. No, I no longer expect to understand the response of the villager, but only the process from word to preacher to villager.
1Walter Breuggemann, The Prophetic Imagination. (USA: Fortress, 1978) 13.
2The Holy Bible, New King James Version, (Nashville, Tennessee: Thomas Nelson, Inc.) 1982.
3Catherine Hilkert, Naming Grace: Preaching and the Sacramental Imagination, (Continuum: New York, 1997) 86.
4Thomas G. Long, The Witness of Preaching, (John Knox Press: Louisville, 1989) 78.
5Karl Barth, The Word of God and the Word of Man, trans. Douglas Horton (New York: Harper and Brothers, 1957) 43, 45.
6Karl Barth, The Preaching of the Gospel, trans. B.E. Hooke (Philadelphia: Westmin-ster, 1963) 22.
7Catherine Hilkert. Naming Grace: Preaching and the Sacramental Imagination. (Continuum: New York, 1997) 85.
8Walter Breuggemann, The Prophetic Imagination, (USA: Fortress Press, 1978) 13.
9Karl Barth, The Preaching of the Gospel, trans. B. E. Hooke (Philadelphia: West-minster, 1963) 22.
11Henry Mitchell, Celebration and Experience in Preaching. (Nashville: Abingdon press, 1990) 150.
Preaching and the Mentally Ill
The People of the Village