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"We Aren't Machines" with Warren Kinghorn · The Weight

• 0:00
  Eddie Rester: I'm Eddie Rester.
• 0:01
  Eddie Rester: I'm Chris McAlilly. Welcome to The Weight.
• 0:03
  Eddie Rester: Today we're talking with Dr.
• 0:03
  Eddie Rester: Warren Kinghorn. He's a professor at Duke University.
• 0:07
  Eddie Rester: He's a distinguished psychiatrist and a theologian.
• 0:10
  Eddie Rester: His work bridges the fields of mental health and Christian theology. He's the Esther Colliflower Professor of the Practice of Pastoral and Moral Theology at Duke Divinity School. It was a great conversation today. Chris, what did you think?
• 0:25
  Chris McAlilly: Yeah, he has written, recently written a book
• 0:28
  called "Wayfaring: A Christian Approach to Mental Health Care" that presents a holistic view of mental health, emphasizing how to live wisely and fully, rather than merely to think of mental health as symptom reduction. And I just found the conversation very helpful. I am very interested in, being a pastor in a college town, the intersection of faith and mental health. You see it in students. You see it in in adults dealing with the stresses and the pressures and the anxieties of life. And I'm just acutely aware of the connections between bodily, And I'm just discovering Dr Kinghorn's work, but I'm mental, and spiritual health and well being, and always looking for resources of people that can help me think about this and in deeper and better ways.
• 1:29
  called "Wayfaring: convinced that he's one of the foremost voices that I think the church probably needs to hear in this particular moment in this particular area. So yeah, man, I think this is one of the it's a conversation that I think I'll be pondering for a long time.
• 1:46
  Eddie Rester: One of the things I love about his story is that he was in med school. He said that in med school for a couple of years at Harvard, and really was struggling with, how does his Christian faith play into his future work in the medical world. And he actually called one of my old professors when I was at Duke, and they had this conversation. And he left med school for a few years to get a theological degree to help him understand what healing and wholeness could be. And so he's brilliant, but he, you know, he also works at the VA there in Durham, so he is not just thinking about it and talking about he's practicing what he's trying to do in helping people find healing and wholeness.
• 2:33
  Chris McAlilly: Yeah, there's some people that are smart, and then they're like these next level people who have the capacity to integrate theoretical medical understanding, spiritual and theological engagement, and the deep practice of clinical work.
• 2:51
  Chris McAlilly: I've only come across a few people like him, you know, in my life, in terms of someone working in the medical field that seems to have a deep pulse on some of the broader systemic issues, and yet just has a...
• 3:09
  Chris McAlilly: You know, his patient care, I mean, you'll hear it in the episode, is just humble, kind, compassionate, and I don't know.
• 3:18
  Chris McAlilly: He's just a deeply credible voice in this space, and so I hope you enjoyed as much as I did. And you know, yeah, we're going to include some of his work in the show notes. Maybe you can go check him out.
• 3:32
  Eddie Rester: This conversation that is for pastors, for Christians and churches, or even just groups of friends who know someone who's struggling. So share the episode with those who you think would find help in it.
• 3:45
  Chris McAlilly: [INTRO] Leadership today demands more than technical expertise. It requires deep wisdom to navigate the complexity of a turbulent world, courage to reimagine broken systems, and unwarranted hope to inspire durable change.
• 4:02
  Eddie Rester: As Christ-centered leaders in churches, nonprofits, the academy, and the marketplace, we all carry the weight of cultivating communities that reflect God's kingdom in a fragmented world.
• 4:14
  Chris McAlilly: But this weight wasn't meant to be carried alone. The Christian tradition offers us centuries of wisdom if we have the humility to listen and learn from diverse voices.
• 4:24
  Eddie Rester: That's why The Weight exists, to create space for the conversations that challenge our assumptions, deepen our thinking, and renew our spiritual imagination.
• 4:33
  Chris McAlilly: Faithful leadership in our time requires both conviction and curiosity, rootedness in tradition, and responsiveness to a changing world.
• 4:42
  Eddie Rester: So whether you're leading a congregation, raising a family, teaching students, running a non profit, or bringing faith into your business, join us as we explore the depth and richness of Christ-centered leadership today. Welcome to The Weight.
• 4:58
  Chris McAlilly: We're here today with Dr Warren Kinghorn. Dr Kinghorn, thank you so much for being with us on the podcast.
• 5:04
  Warren Kinghorn: Thank you so much. I'm so glad to be here.
• 5:07
  Eddie Rester: Well, we were talking before we started recording that when I was at Duke in the kind of mid 90s, one of my favorite professors was Dr Keith Meador, who really was the first of, I think you're now in his seat there at Duke community school, of kind of bringing a fuller conversation of medicine and healthcare and pastoral care, kind of all of it into the same mix. So I'm grateful to see you. I know he's one of your mentors, but grateful to see you there in that chair.
• 5:38
  Warren Kinghorn: Thank you, and I'm so glad for that connection.
• 5:41
  Warren Kinghorn: You know, I came into theological education as a medical student. I was at Harvard for medical school, and I just wanted to connect my faith more deeply to what I was doing in healthcare. And I began to think about going to seminary, and I realized that there was a psychiatrist who was on the Duke Divinity School faculty, and I called him up. I remember I was in a pay phone in a hospital lobby, and we had this great conversation, and that was my initial introduction to Dr Meador. And I'm so glad we have that connection, because he's been a mentor and friend and teacher over a long time.
• 6:14
  Warren Kinghorn: Yeah, thank you.
• 6:14
  Chris McAlilly: One of the things that I see in your work is a diagnosis of medicine and mental health care. And I wonder if you could perhaps, you know, briefly, say, maybe one or two of the dynamics that you see as a key issue that maybe gave rise to these more theological questions.
• 6:39
  Warren Kinghorn: Yeah, well, I am a psychiatrist. I work as a VA psychiatrist. I care for veterans at the VA hospital here in Durham, North Carolina. I love being a psychiatrist. I love working with my patients. I love what I get to do.
• 6:53
  Warren Kinghorn: Psychiatry is a great field, and so I'm not against psychiatry, and so I do have some concerns about some of the ways in which, not only psychiatry, but the rest of medicine, is sometimes practiced in that people can feel like they're being kind of moved along an assembly line.
• 7:10
  Warren Kinghorn: Sometimes, I think in certain mental health care settings, the way I'd like to say it is like if you were going to design mental health care like an industrial process that was focused on productivity and efficiency, which is often what is expected in today's healthcare system. Then how would you do that? And and here's one way in which you might design such a system. And I would wonder if your listeners might have had any resonance with this. So, I'll just put it in the first person.
• 7:42
  Warren Kinghorn: So as a psychiatrist, when people come into my office, you might say that they have like, unwanted experience and behavior. They're feeling ways they don't want to feel. They're thinking ways they don't want to think. And as a psychiatrist, I'm trained to recognize and to say, Oh, I know what's going on with you. You're having these things called symptoms, which is already a way of renaming and re-narrating that experience. I can say I now recognize you have the symptom of, you know, poor sleep or loss of interest or pleasurable activities or unwanted, intrusive thoughts or so on. And then, as a psychiatrist, I'm trained then to cluster those symptoms into these categories called diagnoses or mental disorders, and to apply diagnoses like major depressive disorder or obsessive compulsive disorder or generalized anxiety disorder and others.
• 8:31
  Warren Kinghorn: And then having assigned a name for that cluster of symptoms, I can then reach into my toolbox of medications, but also referrals for therapy or other treatments and, I can say, Here you go. Like, you know, try this, and we'll see if your symptoms improve. And they leave my office and they might come back in a week or two or three or four. And if the patient comes back and they say, "I'm feeling better, my symptoms are better." And I said, Hey, great.
• 8:54
  Warren Kinghorn: The treatment's working, and we consider that successful treatment.
• 8:59
  Warren Kinghorn: But what that means is that means is that we often tend to think about both mental health care and also health care in general, as like a process of using techniques to reduce symptoms and that's a good thing. I want my patients to be in less distress and to feel better. But there's all sorts of questions that don't get asked when we think about mental health care, symptom reduction, and those are questions like, you know, like, what's the origin of my distress? Like, is it something inside me, or is it something in the world in which I live? And we don't ask the questions like, what does it mean to live wisely in the world? We don't ask questions like, do I matter, and am I loved? And those were all important questions that Christians and non Christians together ask. But if we just focus on healthcare as symptom reduction, then we don't necessarily get there.
• 9:49
  Chris McAlilly: One of the things that I see in your book
• 9:55
  "Wayfaring: Christian Approach to Mental Health" is that one of the issues that you are beginning to kind of lay out here, but that you spend a lot of time kind of deepening, is the metaphor, kind of the way we think about the human person as a very important dimension of how then we would build a system. So if you know, one of the things you say is, if we built a system, a healthcare system, that feels a little bit like an industrial process with an assembly line, with an emphasis on productivity and efficiency, that at the center of that is that what we're trying to do is fix human beings as broken machines. What's wrong with that as a metaphor for human beings? And then, you know what are some of the resources of the Christian tradition that offers maybe a different way of thinking about human beings that might lead us to reconceive of the healthcare system in maybe more robust ways?
• 10:57
  Warren Kinghorn: Yeah, well, and most basically, we're not machines, and Christians need to affirm that we're not machines because we're creatures. And creatures, organic creatures, bodily creatures, are different from machines. And yet, in our language and in our culture, we treat ourselves like machines, and we treat others like machines, and even our language so often reflects the imagery of the machine. So in my field of medicine, we often talk about burnout. This is something that, you know, pastors talk about a lot too, but you know, burnout is a mechanical image. Like, what else burns out? Rockets burn out. You know, engines burn out. And we talk about being, going on vacation to recharge or refuel.
• 11:44
  Warren Kinghorn: You know, we talk about, these are mechanistic images that we tend to use for ourselves. We think about burning the candle at both ends. All these things that talk about resilience, which itself is a mechanical metaphor. And I just think that so often in our language, we treat ourselves like machines, and then we're surprised when we feel like we're being treated like machines or like widgets on an assembly line. I try in my speaking and writing and my teaching and just in my life, to when I catch myself using mechanical, industrial images for myself or for others to replace those with organic images, like bodily images.
• 12:19
  Warren Kinghorn: So we're not machines that burn out. We're creatures that need nurture and care and love. We need to be fed and held and known. And this reflects that we're not machines. We're creatures. And I think I've learned a lot from Wendell Berry in this way, in his distinction between, you know, the world of the machine and the world of the creature. And I think that we, so often in modern medicine, we tend to slip into mechanical images for human beings. And that's something I think for Christians to resist.
• 12:51
  Eddie Rester: I hadn't even thought about some of the language that we use of going on vacation to recharge. I mean, that's just even basic things.
• 12:57
  Eddie Rester: And so even the language I think that we use is so important, and now I'm going to start thinking about what language I'm using as I think about myself or my family, or folks who come to sit down with me.
• 13:15
  Eddie Rester: I think about the power of...
• 13:15
  Eddie Rester: The Scripture early on gives us this that we're created in the image of God, if this is a part of how we are called to see ourselves and one another. Does that play any part in how you begin to conceive folks? Or where does that fit in your conversations?
• 13:36
  Warren Kinghorn: Yeah, well, I think the starting place for thinking as Christians about mental health is not only that we're created in an image of God, but more basically than that, that we are known and loved by God as good creatures of God. And that's the most basic truth of who we are.
• 13:53
  Warren Kinghorn: There's nothing that's more basic or true of us than that God knows us and loves us as God's good creatures, and we can rest in that... So often in the world of mental health care, there's kind of in the background, there's this question of, what if we are just completely alone? You know, we just are kind of thrown into the world, having to find meaning and hopefully cultivate meaning where we can. But I think Christians can affirm that we are always known, that we're always loved, because we come into the world that way, with this irrevocable belovedness.
• 14:28
  Warren Kinghorn: It's just ours by virtue of being a creature.
• 14:33
  Warren Kinghorn: And I love how the Catholic philosopher Josef Pieper talks about this when he meditates on Genesis 1:31, that God saw all that God had made, and behold it was very good. He says, What's that like? And he says, it's something like approval, not approval for everything that someone does, or everything in the world, but approval of the basic fact of the creation. And so, and I've learned from John Swinton and others in this, but Pieper says that when God looks at the creation, God says, "It's good that you exist, and it's good that you're in this world." And we can say that to one another, we can say that to ourselves, and that's the most basic.
• 15:11
  Warren Kinghorn: And then scripture affirms that we are created in the image of God, and that, I think, has, it's obviously a complicated term that's been interpreted in different ways, but one way that I think we interpret the Old Testament in the light of the New. And in the Old Testament, in Genesis, where this language comes up, there's this affirmation that humans are created in the image of God. And then in the New Testament, we see over and over, this affirmation that Christ is the image of God. And so, like, we learn something about the nature of the image of God by looking at Jesus, you know, the icon, or the image of the invisible God.
• 15:47
  Warren Kinghorn: And so the image of God is not only a statement of human dignity and worth, but it's also an invitation to find ourselves drawn more deeply into the life of Jesus and into Christ's life and into God's love.
• 16:03
  Chris McAlilly: Yeah, I love Marilyn Robinson in her book"Gilead," she talks about the relationship between this congregationalist minister, John Ames, who is looking at his young son, and there's a scene where he talks about the lighting and the fact of his existence. And I think, you know, there's this deep, deep...
• 16:22
  Chris McAlilly: You know, God delights in the things that God has made. And, I think that's so easily lost in the wake of trauma, in the wake of pain, sometimes you can be kind of so overwhelmed or fixated on an anxiety or something that's giving rise to depression, where that can be all consuming, it can be totalizing and the story shattered.
• 16:49
  Chris McAlilly: And you know, sometimes I find myself in pastoral ministry, trying to figure out, how do you give people that touch point? I, in some ways, I fear that it's a hard thing to insert into a moment of trauma or pain or a shattered relationship. It is really something that that needs to be formed in person, through a life of... That it has to be there from childhood. But, of course, there are people that survive childhood trauma and others that discover that truth later on. If you're giving, moving in the direction of not just kind of the theory, but kind of moving in and out of how you would apply this, either in a pastoral context or a clinical context. Could you maybe give us some ways in which you think about how to take that insight or that recognition or theological truth into into practice?
• 17:47
  Warren Kinghorn: Yeah, well, different situations call for different approaches, but I think one of the things that you name, I mean depression, trauma, especially the ways in which the dynamics of trauma manifest. If I said that God says to us it's good that you exist, and what trauma and depression and sometimes explicit messages from others tell us is that it's not good that you exist, that it would be better if you didn't exist, or if you existed in some different form. And I think Christians can, at that point, step in and say that that's a lie, that those messages that we get to tell us that it's not good that we're here, that we ourselves are not good. I think it's something that Christians can stand against, and can remind ourselves, no, the deepest truth of who we are is that God knows us and loves us.
• 18:37
  Warren Kinghorn: And of course, we need to hear the voices of others telling us that, and we need community to be able to call each other into being in ways that helps us to know and to affirm the truth of that.
• 18:53
  Warren Kinghorn: So practically, that's going to look different ways, but one common denominator is when somebody is really struggling, for somebody to come alongside them, whether it's a therapist or whether it's a pastor, whether it's a friend or, you know, a teacher or someone and to say, "hey," like, "I know that you're going through a really hard time and I respect that, and I honor that, and I'm not asking you right now to immediately feel any different, because, frankly, may not be able to, but I want you to know that you matter, and I want you to know that I care about you, and there's others who care about you, and God loves you and cares about you. And I'm going to commit to," and this, obviously, is a commitment, so it's going to look different ways in different situations, but "I'm going to commit to walking with you until this time of crisis has passed." Of course, maybe one person, for various reasons, can't do that.
• 19:38
  Warren Kinghorn: But then the question is, what kind of community can continue to walk with that person?
• 19:49
  Chris McAlilly: One of the...
• 19:49
  Chris McAlilly: Just that image of "I commit to walking with you," it gives rise to this kind of governing metaphor of the book that you draw from Thomas Aquinas, the Catholic theologian, philosopher of wayfaring, this idea that if we're not machines that can be fixed or mended or repaired, you know, perhaps a different metaphor is more suited to what it means for us to be creatures.
• 20:18
  Chris McAlilly: This kind of idea of being on the move, on the way. And I wonder if you could perhaps kind of unpack that metaphor, how you discovered it in the work of Thomas Aquinas, and kind of how it helps to guide and govern your approach?
• 20:35
  Warren Kinghorn: Yeah, this is the central image that I find most helpful as a Christian physician and psychiatrist and healthcare practitioner, but frankly, I think it applies to pastoral ministry. It applies, frankly, to just being with each other in the world. Thomas Aquinas, who was a 13th century philosopher and theologian who, very important for Catholic theology, but also for Protestant theology. His central image of a human being was that of a wayfarer pilgrim. He lived in Europe at a time when pilgrimage routes, like a lot of people know the Camino de Santiago, but there were other pilgrimage routes at the time, and people were making pilgrimages. And he understood life as a kind of pilgrimage, and specifically that we are, as human beings, we are from God as our Creator, and we are on our way to God as our hope and our goal and our joy.
• 21:30
  Warren Kinghorn: So in this world, we find ourselves on the way, on a journey from God to God. And so our lives have the character of a journey. And that's how Aquinas understood human beings is we're always on a journey that ultimately ends in God, and yet we find ourselves caught in all sorts of challenges and dead ends and obstacles and everything else along the way.
• 21:53
  Warren Kinghorn: But for me as a physician and a psychiatrist, to be able to think of my role not as like people come to me broken, and I need to fix them, but rather like people come to me and they're on a journey, like they are wayfarers on a journey, and I myself am on a journey, and I myself am a human being. And so I come alongside others as a wayfarer, alongside another wayfarer, and I have the privilege of asking with them, like, what's needed right now for the journey that your on?
• 22:25
  Warren Kinghorn: And I think that question,"what's needed right now for the journey?" is the question that we can all ask each other.
• 22:31
  Warren Kinghorn: And so as a psychiatrist, sometimes, a lot of times, that's a medication is what's needed right now, or maybe a hospitalization, but it might also be to get out of an abusive relationship, or it might be to switch a major or it might be to have access to a supportive community, or other things. It might be for my veterans that I care of, might be access to stable housing, for example, a lot of things might be needed that get beyond just what we think about as medical interventions.
• 22:54
  Eddie Rester: One of the things you just mentioned was medical interventions. I want to kind of veer off in that direction for just a second, because sometimes I'll meet with people who, as Christians, are, well, "God wouldn't want me to use," or they'll use some kind of variation of, "I don't want to do medication. I don't want to go that route." Help us understand why maybe that's okay, or that it's not something that goes against faith, or who we are as the as created in the
• 23:32
  Warren Kinghorn: mean, most of us take various medications in image of God.
• 23:39
  Warren Kinghorn: different ways for different ways for different health conditions. You know, medications are themselves things that can be helpful or not. I think in the context of psychiatry and mental health care, one is that every situation is kind of different.
• 23:52
  Warren Kinghorn: And there are some situations in which I would say a medication is absolutely the question of what's needed for the journey, and medication is the first thing that's sometimes needed.
• 24:02
  Warren Kinghorn: So when somebody is experiencing a psychotic episode, when somebody is in the middle of a acute manic episode, in the context of bipolar disorder, when someone is so depressed that they're unable to take care of their basic life functions, or when there are serious considerations of safety, medications are one thing that I think are is often needed.
• 24:25
  Warren Kinghorn: I'm not going to give you medical advice. I think everybody has to see somebody to understand what's best for them.
• 24:30
  Warren Kinghorn: But medications often are needed in a lot of situations. I think, in psychiatry, and especially common situations around depression and around anxiety, I think the best thing I can say in general about medications is they can sometimes be helpful, and for some people, they can be really helpful, but they're most helpful as seen as one component of a broader plan, of a broader approach. So we know in general that, both with respect to depression and anxiety, medications can be helpful, but they are most helpful when used in concert with psychotherapy.
• 25:06
  Warren Kinghorn: And certainly with my patients, I never will generally recommend only medication, but it's also, what else do you need in your life to be able to work toward where you want to be?
• 25:14
  Warren Kinghorn: So I use the image of starting line and finish line. Like sometimes I'll say to my patients, a medication is unlikely to get you to the finish line of where you want to be in your life, you know. Like, you're happy in your relationships and at peace with yourself, and you know peace with your role in the world and your job and everything else.
• 25:36
  Warren Kinghorn: Medication, most of our medications just aren't powerful enough to do that. But what it can do is help you get to the starting line. Whereas, if you're unable to engage in some of the things that might help you to get there, like therapy or like investing in community, or investing in relationships, or getting out in places where you can do things, then a medication might be very helpful in that way. So that's one image that can be helpful to use.
• 25:57
  Eddie Rester: I think that's good. Thank you.
• 25:57
  Chris McAlilly: What are some of the other dimensions? If someone comes to you, and in the starting line, I mean, it looks very bleak. And you're trying to think about the different dimensions. I mean, in one way, you could draw a picture of what happiness looks like, or human flourishing might look like at the end, and then kind of work your way towards that. But if someone arrives in a very debilitated state, what are some of the things that you have in your mind, as I want to connect them to these, perhaps these kind of medications, these relationships, these resources?
• 26:35
  Chris McAlilly: What's in the constellation of things that you would have at your disposal as a clinician at the starting line? What are some of the things you're thinking through?
• 26:50
  Warren Kinghorn: Well, I think it is important in psychiatry to recognize that sometimes people are in really hard situations.
• 26:57
  Warren Kinghorn: And that could be acute situations, like a very acute form of depression, where somebody is like in bed, unable to eat, unable to take care of themselves, unable to even imagine what it would be like to go about a daily life. Sometimes it's longer term situations where people just have experienced incredible losses and are incredibly isolated and have lost hope. And those are different kinds of things. I think in some situations, like in, let's say someone is deep in a melancholic depression, there are, medical interventions that can be very helpful. Medications can be helpful. But also we have interventions like ECT, electroconvulsive therapy, which I think has a really important role to play in certain serious conditions and people can experience relief pretty quickly and in ways that can be life saving. And other kinds of treatments that, you know, that we could talk about, but there are medical interventions that I think can be very helpful.
• 27:57
  Warren Kinghorn: I think it's also important not to believe that recovery always looks like the right cocktail of medications, or the right combination of, you know, ECT and TMS and other kinds of things, because that leads people sometimes to believe that, like, what I need to do is to go to the psychiatrist, or go to a specialist and and just like receive the treatments that are going to kind of deliver me from this, and I think that can set people up actually for kind of cycle where you start a medication, it's not helpful.
• 28:29
  Warren Kinghorn: You increase the dose of the medication. That doesn't work as well. You added another medication, and before long, people can be on a lot of different kind of medical intervention of the treatments, So I think it's best to step back and say, like, what's and not be feeling better.
• 28:45
  Warren Kinghorn: happening here? Like, what's going on? And sometimes what's going on is that when people are feeling hopeless or feeling like they're in a really hard situation, that they're feeling that in themselves, but often what's happening is that the world around them is really hard. There's seriously broken relationships or communities that are fragmented, and often there's histories of trauma and memories of trauma and lingering issues with trust related to trauma that factor in. Again, every situation is different. So I think being able to step back and see the bigger picture, saying maybe this isn't just something that's going on inside this person that I need the right medication cocktail to try to figure out, but maybe it's that this person has had a lot of challenge and pain in their life, and what they need around them is people that can help them gradually to be able to glimpse what it would be like to be known and to be loved, and to be able to love and to be able to take risks and to be able to explore. And that's sometimes a longer term work. But I think it's I think it's possible.
• 29:52
  Warren Kinghorn: I think a lot about the nature of hope in mental health care, that we often, people often, when they come to see me, feel a lack of hope, like they've tried a lot of stuff and it hasn't worked, and they're having a hard time, you know, conjuring hope, you might say. And specific conditions like depression can be characterized by hopelessness. And I think it's important not to tell people, oh, like, "You're going to be better," you know, "just make hope happen." Because we don't often have... Sometimes we just can't do that. Like when you're in the middle of something, you can't do that, but what a community can do is to come alongside somebody and to say, we know you're not able to hope right now, and we're not expecting you to immediately feel that, but we want you to know that we're going to walk with you, that we're not going to abandon you. We're going to keep in touch, and we're going to do the work of hoping for you until you're able to hope for yourself. So people can feel carried in a community, even if they don't feel better immediately, they can feel carried until their kind of capacity to feel some of that joy and hope begins to return.
• 30:57
  Chris McAlilly: There's a quotation, I think this comes from the work of Thomas Aquinas, that you quote in the book that,"Hope is a God-given capacity of the will to cast ourselves onto the promise of a future that only God can make possible, even when this future seems far distant." That's, yeah, that's powerful. I mean, you know, first the dimension of hope, that that comes from the outside, that comes from a transcendent kind of in breaking, but speak about the capacity. It is a capacity of the will. Talk about the dimensions of that quotation, if you don't mind.
• 31:40
  Warren Kinghorn: Yeah. I mean, certainly you just named Thomas Aquinas. In his complex psychological work, he thinks about hope in two ways. One is as an emotion, or he said a passion, but it would say emotion, and that emotion is characterized, kind of like modern psychologists talk about hope. It's basically the emotion that believes that, like, there's a good that is attainable, but there's an obstacle to attain it, but we actually believe that we can attain it. So, you know, I may be driving from North Carolina to Mississippi, and, you know, I get to Alabama, and I'm like, man, it's still a long way. I've been driving a long time, but I know that I can get there. So there's that hope of being able to get to Mississippi. That would be the emotion.
• 32:25
  Warren Kinghorn: But then Aquinas talks about a different model of hope. He talks about hope as a theological virtue that has to do with like, what does it mean to hope in a way that, frankly, only God can make possible, that's beyond our own capacity to be able to do? This is part of his overall theology, that we're saved by grace. You know, we can't attain salvation ourselves. We are dependent on the love and grace of God, and so in some ways, we can only hope for... Like, there's certain things that we just can't hope for, because it's not in our capacity, but God gives us the gift of the ability to hope for what we can't even fully imagine--ultimately, union with God, and, you know, rests in God's life--but I think Practically, I don't write much about this, particularly in the there's other ways in which we find that.
• 33:11
  Warren Kinghorn: book, but I've written about it in other places. I think some of the best demonstrations of this--I'm in North Carolina; you all are in Mississippi--is looking at traditions of hope among African American Christians in the United States.
• 33:31
  Warren Kinghorn: And specifically we see this in the language and rhetoric of Dr Martin Luther King. There's a poet who is from Durham, where I'm now, Pauli Murray, who wrote a very gripping epic poem called"Dark Testament." And in the middle of that poem, she has a narrative of basically God coming to the enslaved person in brush arbor, and in her narration, giving him hope and the power of song. And then she has this lovely meditation on hope, that includes the well known line, "hope is a song in a weary throat." And I think, as a white Christian from the south, looking at the witness of of Black Christians and their capacity to find hope in situations where everything was against them and where all of the structures of government and church and of white supremacy were against them, there's no reason to think that things were going to be better. And yet they found in Scripture and in the hope of liberation and redemption, the capacity to go on. And I think it's something like that.That's not exactly what Aquinas describes in the theological virtue of hope, but there's something like that, that Christian hope has as its characters, like we... It's like God gives us the ability to go on when everything around us seems to give us no reason, clearly, to do so.
• 34:57
  Eddie Rester: Yeah, it's so many thoughts that are spinning through my head. And one of them is an old quote from a guy named Lewis Smedes, who said, "waiting is the hardest work of hope." And the words that you continue to--and wayfaring is one of them, journey. A minute ago, you used the word gradually. And I think about how when something goes wrong, we want it fixed immediately. We don't like things to linger. And I wonder how we, as a Christian community, as churches, can begin to overcome that sense of it has to be solved, fixed. And again, that's that industrial language, again, that haunts us.
• 35:41
  Eddie Rester: How can we encourage that hope that is found in longer seasons?
• 35:47
  Eddie Rester: I'm thinking even about the lament of Jeremiah, this incredibly painful book of Scripture, yet in the dead center of it is this great statement of hope. So what are maybe some things that you encourage people to do in this kind of waiting season, this gradual time?
• 36:07
  Warren Kinghorn: Yeah, well, you're right. We are impatient, typically, in our culture. We want things to be better yesterday or today, and we don't like to wait. And I think we just have to learn from humans across history and Christians and people of faith across history. I mean, you mentioned Jeremiah, which is a wonderful example of like, what does it mean to long for a redemption that outlasts one's own lifetime? I think of the traditions of the Psalms, especially Psalm 13, which is one of the psalms of lament, where you know the psalmist says, you know, "My God, my God, will you forget me forever? How long will you hide your face from me? How long must I wrestle with my thoughts? Every day I have sorrow in my heart." And I mean, it just sounds like one of my patients. "How long must I wrestle with my thoughts? And every day I have sorrow in my heart." And it's a fairly short Psalm, but the last two verses have this wonderful mixing up of tenses. Verse five and six of that Psalm, you know, "I will sing to the Lord, for He has been good to me." And so there's this way in which the psalmist is saying, but I... Sorry, I want my Bible with me. "I trusted in your steadfast love." The psalmist is able to look to the past, to reach into the future, and to be able to say,"because I can trust God's faithfulness to be into my people in the past," and the psalmist is thinking about the deliverance of the Israelites from Egypt, "I now can look forward to a possibility of redemption," even though the psalmist never feels that in the Psalm itself. And I think that points to the need to extend beyond.
• 37:56
  Chris McAlilly: Yeah, so much of the framework, I mean, even as you're describing the Psalms is this helping people who are in the present, stuck or, you know, unable to see backwards or forwards, reconnect to what has been and what will be. And the Psalms do that in a way that that allows the tenses to be mixed up, and some of the work of engaging with the past or imagining and are hoping for the future to be almost suspended, kind of, in a single, you know, poetic movement.
• 38:37
  Chris McAlilly: And you know, one of the things that that I was reminded of when you were talking about that is our friend Kim Wagner, teaches preaching up at Princeton. She wrote a book called "Fractured
• 38:49
  Ground: Preaching in the Wake of Mass Trauma." And we did a conversation with her, and she talks about the way in which trauma can fracture the narrative. And a lot of what she talks about is, you know, there's a big move in particularly Protestant preaching, the second half of the 20th century, towards a narrative style of preaching.
• 39:10
  Ground: And one of the things she's wrestling with is the way in which trauma can fracture the narrative and then create... I think sometimes when we move too quickly forward or, you know, we just say everything, everything in the moment is okay, because you weren't always here, and you will not always be here. It's hard to access that if you're living in the wake of a fracture, shattered story.
• 39:36
  Ground: And lament, one of the categories that she, she talks about, is being a very generative action, and then she tries to think about how to build kind of homiletical resources out of it is this category of lament that you see in the Psalms, other places in the Scripture. Do you access that in your clinical work at all, like connecting people to the resource of lament as a. A as a way of, I don't know, maybe accessing a better emotion and kind of leaning into a different possibility.
• 40:08
  Warren Kinghorn: Yeah, well, first of all, your point about trauma is really important that trauma does tend to fracture our stories and our sense of identity. And I've actually gotten some gentle pushback on the image of the wayfarer and life is a journey from trauma survivors who are friends, who have said... One friend told me one time that she actually found a lot of comfort in the way that the four gospels all speak in different ways, with different voices, in ways that are sometimes hard to reconcile with one another because it's end up polyphony of voices, not in the, you know, in the unified voice that she actually finds her own experience reflected. She told me one time that when she was in the middle of a mixed manic depressed episode, that her experience felt less like a journey than like just shards of glass shattered on the ground with light scattered all around.
• 41:04
  Warren Kinghorn: And I think that's really important to be able to to honor.
• 41:12
  Warren Kinghorn: And I would say that in that case, when somebody is feeling that their story has been fractured, that they may not even know what it might be to tell a story, that, one is that needs to be honored and they shouldn't be then immediately expected to immediately snap out of it. I do think, though, a broader community is important to help people begin to kind of, you know, metaphorically speaking, put those pieces back together, and to find ways to be able to find, maybe not the same story, but different stories, that can allow one to be able to go on. And so I think that can move forward.
• 41:53
  Warren Kinghorn: I do think about lament in my clinical work. I work in the VA system. But one is that I think it's important... The central...
• 42:03
  Warren Kinghorn: One of the goods of lament in the biblical tradition is it's an invitation not to look away from the presence of suffering, but to be able to name suffering in its rawness and fullness, and to be able to bring it into the very heart of God, knowing that God welcomes that and doesn't look away and can bear it. So sometimes, even when I, I'll speak in a theological way, just simply being able to limit myself and to be able not to look away from suffering and even myself, to be able to bring suffering that's experienced to God, and with that question of how long, oh Lord? You know, how long will you forget me or this person forever? Is one way that that works out.
• 42:46
  Warren Kinghorn: In some cases when patients have told me that they are, you know, they're Christian and that they read Scripture, then we'll talk about the psalms of lament, and I'll ask them about it. We'll specifically talk about how they might interpret their own experience in the light of the psalms of lament. I'm not a pastor or pastoral counselor, but when patients are kind of interested in those kinds of questions, sometimes, you know, we'll get to that level of specificity.
• 43:13
  Eddie Rester: One of the things about the psalms is they were meant to be sung or said in community. And one of the themes that you've brought up over and over, is the need for community, and so some of our listeners may not be pastors, may just be people who are in groups of friends and they have someone among them, or church members who know there's someone who's suffering, facing trauma, broken, this deep grief. What are some healthy ways that people can surround somebody and be community? Because I know there are unhealthy ways as well, but what would you offer for folks who want to say, I want to be that type of community that can help my friend in the journey?
• 43:53
  Warren Kinghorn: Yeah, yeah, it's hard to have a general answer to that, because situations are so different, the history is different, and the relationship to community is different. But I think in general, when somebody's struggling, it's not helpful, generally, to kind of step in and be like, you know, "What's wrong?" You know, "Why aren't you feeling better?" And that can actually intensify shame.
• 44:13
  Warren Kinghorn: But to be able to say, like, "I know that things are hard right now, and I'm not immediately asking for you to feel differently or to to do something different, but we want you to know that we're here." And then I think it's not just saying, "Call us if you need us," because people often will not want to do that, but finding ways to continue to check in.
• 44:33
  Warren Kinghorn: And so that might be, in our times, that might be just sending somebody a text every day and saying, if somebody is really struggling, saying, "hey, no response needed. I just want you to know that I'm here and I'm thinking about you." Something that order.
• 44:50
  Warren Kinghorn: Or basically, maybe agreeing with somebody. Like, what would it be like if I just checked in each week? If I gave you a call each week? And then doing so. Or if there are practical needs that people are facing, like if somebody's really struggling with their child care responsibilities or with getting the medical appointments, then that's one thing that a community can do. If somebody's facing very particular access-oriented needs around health care or financial needs, is something that a community can consider. Again, the situations are going to differ, but I think thinking about, how can someone be held in relationship when they themselves might not be fully able to know what they need and for people to commit to walking with them until the acuity of the crisis is passed.
• 45:39
  Chris McAlilly: I love the way that you reframe the work, from fixing to attending at the end of the book. I think that that image is really helpful as a way of thinking about it. I think that it transcends the clinical or the pastoral context. Maybe could you just kind of unpack what you're hoping to do in that chapter as a way of, kind of, you know, grounding this transition from just let's get this thing fixed so we can get on with life to...
• 46:13
  Eddie Rester: We can move on, yeah.
• 46:14
  Chris McAlilly: This may be a longer part of the journey for someone than anyone ever anticipated.
• 46:21
  Warren Kinghorn: Yeah, again, it's like we tend to think, especially when things are hard, we tend to think, I just want things to be better, and we live in a mechanical world, so we think something just needs to be tweaked or adjusted, and that I can kind of go right on as usual. But that's not who we are. It's not how bodies work.
• 46:35
  Warren Kinghorn: It's not how human beings work.
• 46:38
  Warren Kinghorn: Sometimes things have a longer time period. So I think, rather than the image of fixing, as if I just need to make some adjustment, whether that's like a medical kind of fixing or just a life skills kind of fixing, like, just need to just try a little harder this week and things are going to be better.
• 46:53
  Warren Kinghorn: How can we think of ourselves, again, as those who are on a journey? The character of a journey, especially if you're on a foot journey, is that you get tired, sometimes you need to rest. Sometimes you take a wrong turn and you need to redirect.
• 47:07
  Warren Kinghorn: Sometimes you get ambushed and you need care. I mean, there's lots of different ways in which journeys can get interrupted and slowed down. But what does it mean to walk alongside those who are on a journey with the ability to not expect an immediate fix, but rather to commit to walking with somebody I think that means not just focusing on the symptoms that over time?
• 47:29
  Warren Kinghorn: somebody's having, but like the story behind those symptoms. It definitely means not focusing just on if somebody's struggling, it must be something inside them, but looking outside them to their relationships and to the way that they're known in community, and frankly, to kind of looking at a broader culture.
• 47:46
  Warren Kinghorn: And you all are in a in a university town. I'm in university town. The mental health of college students has been acutely challenged in the last 10 years or 15 years, even before the pandemic, especially in terms of depression and anxiety and thoughts of suicide.
• 48:01
  Warren Kinghorn: That's not because, like the genes of 18 year olds has dramatically changed over that time. It has to do with how we live together in the world and the kind of pressures that adolescents and young adults are experiencing. So part of attending is is to not look just inside a person, but it's to look at the broader culture in which we live and say what's needed there, and how do we navigate that together?
• 48:27
  Chris McAlilly: The three, I love these things that you say, that one is we don't travel alone. That's an important part of it. This is not just your problem. This is something that we're going to navigate together, keeping the journey in view and the end in mind. Where is it that we're trying to go?
• 48:45
  Chris McAlilly: And there is an end. And sometimes you need a community to help orient you to...
• 48:50
  Chris McAlilly: Sometimes you're so disoriented, you need somebody to say, "This is the way. Let's walk this way." And then paying attention to whom and to what... to whom and what we love. And then the last one that you have here, or the next two are always ask what is needed right now for the journey. You've already mentioned that. And then lastly, remaining open to wonder and surprise. And maybe the wonder and surprise might be a good way for us to to end today.
• 49:22
  Warren Kinghorn: yeah, I have a chapter in the book where I talk about the distinction between control and wonder. And so much of our lives, not just in medicine, but outside of it, too, are a matter of gaining and maintaining control over what seems uncontrollable. And we tend to work. A lot of our study, a lot of our work, is like, how do I just keep myself and others under control? And I think control is a good thing. I work with trauma survivors. It's helpful for trauma survivors to have control over the basic things are happening with their bodies and their lives. So control is not a bad thing. But if we live our lives oriented towards just keeping ourselves and others under control, or keeping the world under control, then we're going to end up kind of closing in on ourselves, and we're also--and this is important--going to end up giving a whole lot of allegiance to whomever or whatever we perceive has put us in a place of control.
• 50:15
  Warren Kinghorn: And I think that applies to religious systems and authorities. It applies to political systems and authorities. It applies to medical systems and authorities.
• 50:26
  Warren Kinghorn: So if our lives are oriented toward control, then we're going to end up giving allegiance to that which we believe has put us into control. And for for Christians, that's kind of a textbook definition of idolatry, if that's not God. And so Christians are, yes, are called to seek control as a good, but more than that, we're called into the life of God and love.
• 50:48
  Warren Kinghorn: And so when I, every class that I teach at Duke Divinity School, I start on the first day, and I say, in your study of theology, are you finding yourself progressively drawn toward a posture of control, control of yourself, control of others, kind of absolute knowledge of the world so that you can kind of cinch things down? Or are you finding yourself drawn into love of God and into love of the creation and the world around us, and especially others that God has given you to love? And to the extent that we find ourselves deepening and growing as lovers and as those with the capacity to love, and to the extent that we open ourselves to wonder, then I think that helps us, in some ways, to open as human beings, and it it teaches us something about what the character of God is like. So I think that that openness to wonder and surprise, and for Christians, you know Sabbath rest and praise, is critical for us as we think about what are we hoping for when we pursue mental health care.
• 51:53
  Eddie Rester: Dr Kinghorn, thank you for your time today. It's been a great conversation. I'm thankful to know you now and thankful for your work as well.
• 52:01
  Warren Kinghorn: Thanks to both of you. I really appreciate being on and really appreciate the work that you all do. Thank you.
• 52:06
  Eddie Rester: [OUTRO] Thanks for listening. If you've enjoyed the podcast, the best way to help us is to like, subscribe, or leave a review.
• 52:16
  Chris McAlilly: If you would like to support this work financially, or if you have an idea for a future guest, you can go to theweightpodcast.com. [END OUTRO]