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Faith vs. Mental Health? Not So Fast! · Mental Health and the Mission of the Church

• 0:00
  SPEAKER_05: Medication is rarely gonna get you to the finish line of where you want to be in your life, with like your life is going well, your relationships are healthy, you know, you're reconciled with your family.
• 0:09
  SPEAKER_05: Stuff we prescribe just cannot usually do that.
• 0:12
  SPEAKER_05: But what it can do is help you get to the starting line so that you can then do that really good hard work that's needed.
• 0:17
  SPEAKER_05: You know, so if somebody can't get out of bed, having trouble organizing their day, if they're feeling suicidal and just like trapped in that pit, you know, then medication can be incredibly helpful, you know, in some cases, even life-saving, I think.
• 0:33
  SPEAKER_01: Past trauma, early life imprints.
• 0:36
  SPEAKER_01: For me, that's discipleship is helping somebody put off old, put on new.
• 0:40
  SPEAKER_01: But one of the key components is helping them be renewed in the spirit of their mind.
• 0:44
  SPEAKER_01: A pastor can't do that.
• 0:46
  SPEAKER_01: I think the net effect is we're losing ground.
• 0:49
  SPEAKER_01: The hot zone for growth as a Christian is the soul, the mind, will, emotions, the brain.
• 0:54
  SPEAKER_01: If we're farming that out, we're not doing the hard work of figuring how to integrate it, how to develop language around it, how to make it normal for a born-again Bible-believing Christian to say, you know, hey, I'm dealing with depression, and to have people involved that are as wired into the church as they are into their practice.
• 1:20
  SPEAKER_05: What are we doing in the world of mental health if people are living in a culture where we're basically valued as human beings by what we produce and what we consume?
• 1:28
  SPEAKER_05: You know, and like that's what our culture tells us.
• 1:30
  SPEAKER_05: Like you matter if you produce and you consume, and that's who you are.
• 1:34
  SPEAKER_05: And then people feel like they're underproductive, they don't belong.
• 1:37
  SPEAKER_05: So they're basically not filling that vision of like being producers and consumers.
• 1:40
  SPEAKER_05: And then they come into therapy, and the goal of therapy is like, let's just help you feel better and make you more productive.
• 1:45
  SPEAKER_05: We're not getting to the spiritual root of what's happening.
• 1:49
  SPEAKER_05: So Christians have to step back from that and be like, what are we doing?
• 1:59
  SPEAKER_00: Sorry, Tar Hill fans.
• 2:01
  SPEAKER_00: Today's guest is Dr.
• 2:02
  SPEAKER_00: Warren Kinghorn, professor of psychiatry at Duke University.
• 2:06
  SPEAKER_00: Dr.
• 2:07
  SPEAKER_00: Kinghorn is both an esteemed psychiatrist and a thoughtful voice shaped by deep Christian faith.
• 2:12
  SPEAKER_00: A Harvard-trained physician, he brings a unique blend of academic rigor and spiritual insight to the conversation.
• 2:19
  SPEAKER_00: In this episode, he shares a wealth of perspective on mental health, while also drawing an important distinction between his work in medicine and the unique calling of the church in making disciples.
• 2:30
  SPEAKER_00: Chip, on the other hand, presses into the idea that scientific mental health practices should play a more active role in how the church disciples people.
• 2:39
  SPEAKER_00: What unfolds is an iron sharpen's iron kind of conversation.
• 2:43
  SPEAKER_00: Thoughtful, honest, and deeply engaging.
• 2:46
  SPEAKER_00: We're honored to have Dr.
• 2:47
  SPEAKER_00: Kinghorn with us.
• 2:48
  SPEAKER_00: Thanks for listening to another episode of Mental Health and the Mission of the Church.
• 2:52
  SPEAKER_00: And now here's Pastor and Counselor Chip Judd, alongside Joey Spencer, joined by Dr.
• 2:57
  SPEAKER_00: Warren Kinghorn.
• 3:01
  SPEAKER_05: That's great.
• 3:01
  SPEAKER_05: And are you all both based in Charleston?
• 3:03
  SPEAKER_05: Are you is that where you're from you are now?
• 3:04
  SPEAKER_05: Yeah.
• 3:05
  SPEAKER_05: Yeah.
• 3:05
  SPEAKER_05: That's great.
• 3:06
  SPEAKER_05: Or Mount Pleasant.
• 3:06
  SPEAKER_05: Yeah.
• 3:08
  SPEAKER_02: Are you familiar with Seacoast in the Charleston area, I'm assuming?
• 3:11
  SPEAKER_05: I've only been there once.
• 3:12
  SPEAKER_05: I'm from South Carolina from Greenville, and my parents live in Beaufort now, so just south of y'all.
• 3:17
  SPEAKER_05: But but um I came down there, I don't know what year it was, maybe 2018 or 19, because there was the Seacoast did it something in collaboration with the American Association of Christian Counselors.
• 3:28
  SPEAKER_05: Yeah.
• 3:28
  SPEAKER_05: Like a mental health conference study.
• 3:31
  SPEAKER_05: Yeah, that's that was it.
• 3:32
  SPEAKER_05: So I was I'm not sure if you just did one or more, but but I was down there for that.
• 3:35
  SPEAKER_05: And and that was really great.
• 3:37
  SPEAKER_05: I really enjoyed it.
• 3:38
  SPEAKER_05: Yeah, we partnered with Tim Clinton and that crowd.
• 3:40
  SPEAKER_05: Yeah, Tim was there, and and it was a it was a good group.
• 3:44
  SPEAKER_05: So I I was glad to be part of that.
• 3:45
  SPEAKER_05: Trevor Burrus, Jr.
• 3:45
  SPEAKER_01: You know, kind of relevant to our conversation.
• 3:47
  SPEAKER_01: That was the culmination of by that point I'd been here three, four, five years, and I've been working hard on getting our language a little bit more contemporary, uh, stop over-spiritualizing everything.
• 4:02
  SPEAKER_01: And that was kind of the culmination of that.
• 4:04
  SPEAKER_01: And again, like Joey said, we don't mind a little bit of controversy.
• 4:08
  SPEAKER_01: I learned a lot doing that conference in lots of different ways.
• 4:11
  SPEAKER_01: But one thing I learned was we call them mental health conferences.
• 4:15
  SPEAKER_01: They're really mental illness conferences because that's what we spend the whole time talking about.
• 4:21
  SPEAKER_01: We talk about mental illness the whole time.
• 4:23
  SPEAKER_01: So pastors aren't going to come to those kind of conferences.
• 4:26
  SPEAKER_01: And Tim and I got into a big argument about that, and I've apologized because I got kind of ugly.
• 4:31
  unknown: Okay.
• 4:31
  SPEAKER_01: I went to his conference a year or two later, you know, raise a hand.
• 4:35
  SPEAKER_01: How many of you are in full-time staff church ministry?
• 4:39
  SPEAKER_01: 5,000 people.
• 4:40
  SPEAKER_01: I counted them, 20 people are in full-time ministry.
• 4:45
  SPEAKER_01: Pastors aren't going to come to those kind of conferences.
• 4:48
  SPEAKER_05: Pastors don't go to AECC.
• 4:49
  SPEAKER_01: That's interesting.
• 4:50
  SPEAKER_01: Yeah.
• 4:50
  SPEAKER_01: Well, they don't go to conferences that are speaking a different language to make them feel dumb.
• 4:56
  SPEAKER_01: And and all they talk about is, you know, what's broken.
• 5:00
  SPEAKER_01: Yeah.
• 5:01
  SPEAKER_01: And a little bit about how to fix it, but not much.
• 5:04
  SPEAKER_03: Yeah.
• 5:04
  SPEAKER_03: Yeah.
• 5:04
  SPEAKER_03: Thank you.
• 5:05
  SPEAKER_03: Chip's not cynical at all.
• 5:07
  SPEAKER_03: That's right.
• 5:08
  SPEAKER_03: Not at all.
• 5:08
  SPEAKER_03: That's right.
• 5:10
  SPEAKER_03: That's right.
• 5:10
  SPEAKER_01: You might need therapy, man, or drugs or something.
• 5:13
  SPEAKER_01: No, it's good.
• 5:14
  SPEAKER_01: Thank you.
• 5:14
  SPEAKER_01: Yeah.
• 5:15
  SPEAKER_01: Yeah.
• 5:15
  SPEAKER_01: What do you want us to call you?
• 5:16
  SPEAKER_01: Warren, Dr.
• 5:17
  SPEAKER_01: Kinghorn?
• 5:18
  SPEAKER_05: Warren.
• 5:18
  SPEAKER_05: Warren is great.
• 5:19
  SPEAKER_05: Yeah.
• 5:19
  SPEAKER_05: Thank you.
• 5:19
  SPEAKER_05: Lost men.
• 5:20
  SPEAKER_05: Thank you.
• 5:21
  SPEAKER_05: Yeah.
• 5:21
  SPEAKER_05: And Warren is great.
• 5:22
  SPEAKER_05: Please, please tell me Warren.
• 5:24
  SPEAKER_05: Yeah.
• 5:24
  SPEAKER_05: May I call you Joey and Chip?
• 5:25
  SPEAKER_05: Is that all right?
• 5:26
  SPEAKER_02: Yes, please.
• 5:26
  SPEAKER_02: Yes, please.
• 5:27
  SPEAKER_02: Okay.
• 5:27
  SPEAKER_02: Thank you.
• 5:28
  SPEAKER_02: Will it make you uncomfortable if I call Chip what I normally call him?
• 5:31
  SPEAKER_02: I usually call him master.
• 5:32
  SPEAKER_02: Like, does that make him feel weird or anything?
• 5:37
  SPEAKER_04: Yeah, that's, you know, I I'm not going to get into your relationship.
• 5:40
  SPEAKER_04: So, you know, that's not why we're here.
• 5:42
  SPEAKER_04: Yeah.
• 5:43
  unknown: Yeah.
• 5:44
  SPEAKER_02: Hey, hey guys, welcome to the Mental Health and Mission of the Church podcast.
• 5:47
  SPEAKER_02: And we're here with what I'm reading to be a very, very smart individual in Warring Warren Kinghorn.
• 5:54
  SPEAKER_02: Uh Chip, the guy in charge here, since the last time we recorded, are you more encouraged or frustrated with the congruence or lack of in the church and mental health community partnering up?
• 6:09
  SPEAKER_02: Where where are you at?
• 6:10
  SPEAKER_02: You feeling good?
• 6:10
  SPEAKER_02: You feeling good about the partnership, or you you're discouraged this week?
• 6:14
  SPEAKER_01: You're talking about from the last podcast to this one.
• 6:16
  SPEAKER_01: Yeah, then in the last week or so.
• 6:18
  SPEAKER_01: It hasn't changed a whole lot.
• 6:20
  SPEAKER_01: But now, but but over the last few years, I think it's getting better.
• 6:25
  SPEAKER_01: I really do.
• 6:26
  SPEAKER_01: I think both sides have a long way to go, but I think we're getting there.
• 6:29
  SPEAKER_02: Yeah.
• 6:30
  SPEAKER_02: Well, let me introduce Warren to everybody.
• 6:32
  SPEAKER_02: This is uh this is a mouthful.
• 6:35
  SPEAKER_02: Some of it I don't even understand, but he's a psychiatrist whose work centers on the role of religious communities in caring for persons with mental health problems and on ways in which Christians engage practices of modern health care.
• 6:49
  SPEAKER_02: I mean, right up our alley.
• 6:51
  SPEAKER_02: Uh, jointly appointed within Duke Divinity School and the Department of Psychiatry and Behavioral Sciences of Duke University Medical Center, he is co-director of the Theology, Medicine, and Culture Initiative and is a staff psychiatrist at the Durham VA Medical Center.
• 7:06
  SPEAKER_02: He has written, and we're going to get into this stuff, man.
• 7:09
  SPEAKER_02: This is a this is interesting.
• 7:10
  SPEAKER_02: He has written on the moral and theological dimensions of combat trauma and moral injury, on the moral and political context of psychiatric diagnosis, and on the way that St.
• 7:23
  SPEAKER_02: Thomas Aquinas' image of the human as wayfair might inform contemporary practices of ministry and mental health care.
• 7:33
  SPEAKER_02: Man, we're excited to have you on here.
• 7:36
  SPEAKER_02: Very much.
• 7:37
  SPEAKER_02: First and foremost, do you hate the Tar Heels?
• 7:39
  SPEAKER_05: You know, we have the Duke Carolina game coming up this weekend as we're talking.
• 7:45
  SPEAKER_05: And um, I'm gonna have to plead the fifth on that one.
• 7:48
  SPEAKER_05: I'll get in trouble if I if I say too much more.
• 7:50
  SPEAKER_01: Interesting, Warren.
• 7:52
  SPEAKER_01: I was I just toured on foot the Duke campus this past Saturday.
• 7:59
  SPEAKER_05: Oh wow, thanks for coming up.
• 8:00
  SPEAKER_05: Yeah.
• 8:01
  SPEAKER_01: I was up there speaking in uh I was at a church called um Trait Trait Trailhead Church.
• 8:07
  SPEAKER_01: Saturday, we had I was speaking in the morning, then we had the afternoon and evening free.
• 8:11
  SPEAKER_01: So we went to dinner and toured the campus.
• 8:15
  SPEAKER_01: Uh pretty impressive place.
• 8:17
  SPEAKER_05: Yeah, no, it's it's it's been a good place.
• 8:19
  SPEAKER_05: It's uh it's a big research university and a complicated place.
• 8:22
  SPEAKER_05: And this Saturday, there's gonna be everybody's attention is gonna be focused on Cameron Indoor Stadium.
• 8:27
  SPEAKER_05: So you know the Tar Heels beat us in Chapel Hill on that last second three, and I'm hopeful for hopeful that that will happen this time.
• 8:35
  SPEAKER_05: We'll see.
• 8:36
  SPEAKER_02: Yeah, I was I I was gonna say something similar to Chip when I visited probably three years ago.
• 8:41
  SPEAKER_02: So I'm just a big sports guy.
• 8:42
  SPEAKER_02: Basketball and football are my things, and I'm ACC.
• 8:45
  SPEAKER_02: I'm not necessarily a huge Duke or UNC fan.
• 8:47
  SPEAKER_02: I'm all about Clemson, but I was standing outside of what I thought was where Duke played basketball, but I wasn't sure.
• 8:55
  SPEAKER_02: I was like, I'm pretty sure this is it.
• 8:57
  SPEAKER_02: So I I asked some students, I said, hey, I was like, is this where you guys play basketball?
• 9:02
  SPEAKER_02: They're like, yeah.
• 9:03
  SPEAKER_02: And I was like, and I literally said, Okay, cool.
• 9:05
  SPEAKER_02: I just need to be near it.
• 9:07
  SPEAKER_02: And they looked at me.
• 9:08
  SPEAKER_05: Yeah, I know it's crazy.
• 9:09
  SPEAKER_05: I'm like you, Joe.
• 9:10
  SPEAKER_05: I grew up in upstate South Carolina as a Clemson fan.
• 9:13
  SPEAKER_05: I still am a Clemson fan.
• 9:14
  SPEAKER_05: And so I kind of I kind of hated both Duke and Carolina back in those days, you know.
• 9:18
  SPEAKER_05: So coming up and now being in North Carolina, I had to kind of reorient my myself a little bit.
• 9:23
  SPEAKER_05: Yeah, yeah.
• 9:23
  SPEAKER_02: Does it does it really feel like a high school gymnasium?
• 9:26
  SPEAKER_02: I mean, I know it's small, but I I you can't tell from on TV, but I hear it's just very small.
• 9:31
  SPEAKER_02: And yeah.
• 9:32
  SPEAKER_05: If you ever come up, let me know and we'll we'll go over for a tour of the facility.
• 9:36
  SPEAKER_05: But it they f they pack about 9,000 people in there, but you do walk in and it feels like I mean, maybe a little bit bigger than most high school gymnasiums, but it feels really small and pretty intimate.
• 9:46
  SPEAKER_05: So it's and once once you get in there and those people are in there, and it it really can take on a life of its own.
• 9:52
  SPEAKER_05: So it's fun to go to games theater.
• 9:54
  SPEAKER_01: Yeah.
• 10:36
  SPEAKER_01: We we couldn't get in there, so uh I didn't get to see the inside.
• 10:40
  SPEAKER_05: Yeah, they used to just be able to walk in, but that was back in the old days.
• 10:43
  SPEAKER_05: Yeah.
• 10:43
  SPEAKER_05: No more.
• 10:44
  SPEAKER_02: Well, tell tell Chips listeners about yourself.
• 10:47
  SPEAKER_02: You know, your upbringing, why you're so involved in what you're involved in.
• 10:51
  SPEAKER_02: I mean, I would imagine you you grew up in church or you're uh a Christian, and uh how did you get into medicine?
• 10:59
  SPEAKER_02: Give us give us a little debrief before we start diving in.
• 11:02
  SPEAKER_05: Yeah, thank you.
• 11:03
  SPEAKER_05: Yeah, I'll I'll just say briefly and we can go into more detail.
• 11:06
  SPEAKER_05: I grew up in Greenville, South Carolina, in a Southern Baptist church there.
• 11:10
  SPEAKER_05: That's where I learned the gospel.
• 11:13
  SPEAKER_05: That's where I was loved.
• 11:14
  SPEAKER_05: Um I also had a sense that church was where people knew me and loved me.
• 11:18
  SPEAKER_05: I was really fortunate to be part of a fantastic place where people encouraged me and supported me.
• 11:23
  SPEAKER_05: And also I I knew that church was the place where stuff happened.
• 11:27
  SPEAKER_05: You know, I remember my my parents worked with the youth group, and there was a parent of a youth when I was a kid who died by suicide.
• 11:35
  SPEAKER_05: And I remember seeing people struggle with substance use and depression and family and marital trouble.
• 11:42
  SPEAKER_05: And and so it was a place where I kind of realized like that was in some ways where I realized that life happens.
• 11:47
  SPEAKER_05: And there's also a sense that, you know, psychology, you had to be a little bit careful about like secular forms of psychology, but psychology itself, especially when it was done like you know, in a way that was open to Christian faith, was a good thing.
• 12:01
  SPEAKER_05: So that that kind of set me a sense of like maybe it's a good thing to be in healthcare.
• 12:06
  SPEAKER_05: I went to college, I went to medical school, uh, and as a Christian, I got to medical school, I was at Harvard for medical school, and and showed up in Boston, where I'd spent my my life to that point in South Carolina, and it was this kind of overwhelming experience of being in the middle of this major medical area with these gleaming high-rise hospitals and research labs.
• 12:28
  SPEAKER_05: And and I began to wonder as a first-year Harvard medical student, like, what is all this stuff for?
• 12:34
  SPEAKER_05: You know, I mean, I know it's I know what what it's built for, but like, but why is this here?
• 12:38
  SPEAKER_05: And and I had some mentors that helped me to ask me to think about how do we think about medicine and healthcare as a kind of power in the New Testament sense?
• 12:47
  SPEAKER_05: You know, a structure that's good, but maybe fallen.
• 12:49
  SPEAKER_05: And and I began to wonder, like, what kind of questions am I being formed to ask as a medical student?
• 12:55
  SPEAKER_05: And I was at that point learning a lot about the the how of the human body and about illness, but I realized that there were some questions that you aren't really able to engage much in medical school, like what is health?
• 13:07
  SPEAKER_05: And you know, what is mental health?
• 13:10
  SPEAKER_05: And what does it mean to live well as a human being?
• 13:12
  SPEAKER_05: And um, what does it mean to to die well?
• 13:16
  SPEAKER_05: What does it mean to think about death or suffering or to sit with those who suffer?
• 13:20
  SPEAKER_05: It's not that people don't care about those questions, but there there wasn't a a real way to answer them.
• 13:26
  SPEAKER_05: And that led me to want to dig more into my faith.
• 13:29
  SPEAKER_05: And so I ended up um doing three years of medical school.
• 13:32
  SPEAKER_05: I came down to Duke for the first time to do a two-year seminary degree here at Duke Divinity School.
• 13:38
  SPEAKER_05: And that was that was just an incredible opportunity to feel like I was just diving into this incredibly rich, complex world of the church and of Christian faith and of scripture and theology and church history.
• 13:51
  SPEAKER_05: And and I I learned in that time that, you know, as a physician or a medical student at the time, I was I was training in something that's at most maybe 200 years old, like modern biomedicine.
• 14:02
  SPEAKER_05: But as a Christian, I'm inhabiting this tradition that's 2,000 plus years old, you know, of people thinking about what it means to be human, what it means to be bodies, what it means to be in relationship with God and with others, um, all this stuff.
• 14:15
  SPEAKER_05: And and then I went back to medical school after finishing that, and I I found that I loved the work of medicine more in some ways, because it's it's good, it's good to be present with those that are sick.
• 14:25
  SPEAKER_05: And Christians have have long been like innovating ways of being with those that are sick, and I could kind of claim that as a Christian.
• 14:33
  SPEAKER_05: But it also led me to dislike and see certain things about modern medicine, especially the way that we treat people as machines, or we've kind of fit people into these kind of industrial processes of the hospital and of clinics, um, that I felt I I found ways to name why I didn't like that as a Christian.
• 14:51
  SPEAKER_05: And so for the rest of my life, you know, I came back to Duke to train and do my residency in psychiatry.
• 14:57
  SPEAKER_05: I became a psychiatrist, have stayed here at Duke as a faculty member and practicing psychiatrist, and and also have had the chance to do more work in theology, and I teach at Duke Divinity School as well, which we can talk more about.
• 15:09
  SPEAKER_05: But but it's always been that question of what does it mean to inhabit, to practice medicine in my case, and to practice psychiatry in a way that doesn't treat people as machines that need to be fixed, but as as you know, as those on our journey, as pilgrims or wayfarers who need to be attended.
• 15:26
  SPEAKER_05: And I think that's a helpful way for Christians to think about these questions.
• 15:29
  SPEAKER_05: Aaron Powell.
• 15:29
  SPEAKER_02: Chip, tell Warren I don't know if you call them bookends, but your terminology, sanctified psychology, you say that a Christian starts here, ends here, but everything everything in the middle that we get from science is great.
• 15:46
  SPEAKER_01: When I'm talking to a church, you know, and the church's in general has been getting they're getting there now, but uh I started back in the 80s and uh not real open to psychology, psychology, that kind of thing.
• 16:01
  SPEAKER_01: So one of the ways I would explain my posture is uh I want to be, I want to blend solid biblical, spirit-led Christianity with what I call sanctified psychology.
• 16:13
  SPEAKER_01: And all I mean by that is when I went back to school, I went to a secular school, uh, I felt like God led me to do that, and I could there's cool reasons.
• 16:21
  SPEAKER_01: Uh I mean, here's what I came out with.
• 16:23
  SPEAKER_01: Psychology starts wrong and ends wrong.
• 16:25
  SPEAKER_01: Starts wrong because it they don't believe in the fallenness and depravity of man, and it ends wrong because they don't believe we need a savior.
• 16:33
  SPEAKER_01: But uh in the middle is some really, really good stuff and really helpful stuff for both um you know healing minds and emotions and bodies and all, but also for discipling, just good solid discipling stuff.
• 16:50
  SPEAKER_01: You know, cognitive therapy, as a man thinks in his heart, so is he.
• 16:53
  SPEAKER_01: I mean, it's not hard to make some of it very Christian, or vice versa.
• 16:59
  SPEAKER_01: But I have spent a lot of time having to defend what I do.
• 17:03
  SPEAKER_01: Not as much anymore.
• 17:04
  SPEAKER_01: Now people are quite hungry for it, actually.
• 17:06
  SPEAKER_01: It's still tricky.
• 17:08
  SPEAKER_02: Would you articulate that similarly, Warren?
• 17:10
  unknown: Aaron Ross Powell, Jr.
• 17:11
  SPEAKER_05: I mean I I think I would say that that I I I see what you mean, and I think that well, psych my own field of psychiatry and psychology have a little bit different histories, but I think both would be subject to the kind of critique that you name.
• 17:22
  SPEAKER_05: I think you know psychiatry is a complicated discipline that's often associated with Freud and also with very biological ways of thinking about human beings.
• 17:31
  SPEAKER_05: Um it's true that there's no kind of formal theory of fall and of the fall or of sin in modern psychiatry, but I think there is a deep sense among even my secular colleagues here at Duke who care for people who are really struggling that you know life is not as it ought to be.
• 17:48
  SPEAKER_05: You know, that gets named in different ways around um around trauma or around.
• 17:53
  SPEAKER_05: You know, it's hard to hard to kind of name why, but I think there's a deep sense that like life is not like it ought to be.
• 17:58
  SPEAKER_05: And we want to help people to to find certain ways of living holy and well.
• 18:02
  SPEAKER_05: And I think Christians have a lot to offer in terms of what we can bring to that.
• 18:05
  SPEAKER_05: One thing that I think Christian faith has to offer that frankly, like you gotta find it somewhere, and you're not gonna find it from science alone, is the fundamental affirmation that the deepest truth of who we are is that we are creatures of God, made in the image of God, loved by God, you know, called by God into the into God's life.
• 18:28
  SPEAKER_05: Like all of all of that is stuff that uh that we can embrace as Christians and celebrate as Christians.
• 18:34
  SPEAKER_05: It's kind of the core of what we believe.
• 18:36
  SPEAKER_05: You're not gonna find that just by reading neuroscience journals or by even by reading psychoanalytic texts or other things.
• 18:44
  SPEAKER_05: You've got to draw that from somewhere, and that's a theological claim.
• 18:48
  SPEAKER_05: And I think um I think that's really important.
• 18:51
  SPEAKER_05: So I think psychology and psychiatry and counseling have a lot to offer in terms of just practical steps for what does it mean to live well, to relate well to others, to to learn to know ourselves.
• 19:01
  SPEAKER_05: And and we have to always kind of bring it into the view of how does this make sense in the in the story that we live in as Christians.
• 19:08
  SPEAKER_02: Aaron Powell Yeah, Chip, I'm curious what you think about this and Warren too.
• 19:11
  SPEAKER_02: I was listening to a podcast recently, and the woman was making a distinction.
• 19:16
  SPEAKER_02: She was saying there's pastoral counseling, and that includes discipleship.
• 19:20
  SPEAKER_02: And then, and and this was a uh a licensed therapist saying this, and she said, and then you have the the clinical side, the scientific side that you know trained and and all of that.
• 19:31
  SPEAKER_02: And I I thought to myself, I feel like the therapy that I've gotten from not only you, Chip, Chip, but also from my secular therapist, I feel like it's part it's been part of my discipleship.
• 19:44
  SPEAKER_02: Just if because I think of Jesus saying, I've come to give you life, I've come to give it to the fullest.
• 19:51
  SPEAKER_02: And I wouldn't have been able to, I'm not, I haven't arrived, but I haven't been able to, I would not have been able to make huge strides in that without good sound therapy.
• 20:03
  SPEAKER_02: And I chip, what do you what do you think about that when I include my secular therapists into that equation too?
• 20:08
  SPEAKER_02: That I feel like that's been a part of my, I don't know if we'd use the word discipleship, but it's been a part of my healthy growth.
• 20:15
  SPEAKER_02: Because I have the bookends, you know what I'm saying?
• 20:17
  SPEAKER_02: Like I have the belief in my depravity and the belief that Jesus is savior.
• 20:21
  SPEAKER_02: So I'm I'm learning a bunch of good stuff in between from you know, Jackie.
• 20:25
  SPEAKER_01: Yeah, I'd be curious to see.
• 20:27
  SPEAKER_01: Uh I'm trying to think how to word it well, but Warren, how you think, like where could counseling, psychology, psychiatry, any of the above, where could it fit in a in a disciple-making mindset?
• 20:38
  SPEAKER_01: Like where would you put all of that?
• 20:40
  SPEAKER_05: Aaron Powell I think the way I think of this is in terms of what office does someone sit in when they're sitting with somebody.
• 20:47
  SPEAKER_05: And and I don't I I mean that in a a kind of technical but not necessarily formal way.
• 20:52
  SPEAKER_05: So there's the office of the pastor.
• 20:54
  SPEAKER_05: I think the pastor is charged with um spiritual authority and leadership within a congregation for particular people and for you know, charged with kind of helping to guide those souls that's under the pastor's care to guide, you know, and to to kind of shepherd the flock.
• 21:11
  SPEAKER_05: And I think that's that's a critical office that's held, you know, and and pastors I think do that often really well.
• 21:18
  SPEAKER_05: And of course, pastors can, you know, struggle with that.
• 21:20
  SPEAKER_05: But that but that's the office of the pastor, and that might include a lot of what we would call in our world counseling or you know, pastoral pastoral counseling and care or even certain forms of of therapy.
• 21:31
  SPEAKER_05: Um, but still within the office of the pastor's role.
• 21:34
  SPEAKER_05: I think as a psychiatrist, I stand in a little bit different office.
• 21:37
  SPEAKER_05: I have have a different set of training.
• 21:40
  SPEAKER_05: I I'm not, you know, I do sometimes in my role as a seminary professor preach and I enjoy doing that, but I'm not primarily a preacher.
• 21:47
  SPEAKER_05: You know, I'm not administering the sacraments, you know, I'm not baptizing people.
• 21:51
  SPEAKER_05: But what I do have is years of experience at sitting with people that are thinking of suicide and helping them to stay safe, sitting with families that are wondering about like what's happening with their with their adul adolescent or early young adult child and what they need, or sitting with um with veterans in my VA practice that are, you know, kind of getting toward the end of their life and they're struggling with chronic issues and they wonder what their life matters.
• 22:13
  SPEAKER_05: The kind of experience that I have is like, what does it mean to walk alongside people in those kinds of situations?
• 22:18
  SPEAKER_05: And I think that I have training and experience that's helpful to people that are in certain kinds of situations and roles, but I never try to take over the office of the pastor.
• 22:27
  SPEAKER_05: I'm never like, you don't need your pastor anymore because you got me.
• 22:30
  SPEAKER_05: Like it it's in fact, it's the opposite.
• 22:32
  SPEAKER_05: I'm like, you know, if if the somebody has told me that they're Christian or they're connected to a church, I'm always thinking with them about how do you get more involved in your church?
• 22:41
  SPEAKER_05: How are you talking to your pastor and to others in your life about things?
• 22:44
  SPEAKER_05: So I'm always trying to be mindful of like what role can I play well in somebody's life and what role is somebody else's to play for that person.
• 22:51
  SPEAKER_05: And I think where psychiatrists and frankly also pastors get in trouble is when we kind of think our office covers more than it does.
• 22:56
  SPEAKER_05: We can all inhabit space of like, we're all trying to walk alongside people and help to lead them into life and flourishing.
• 23:03
  SPEAKER_05: As a Christian, I think I have a little bit more specific vision of that for my Christian patients than my secular colleagues would.
• 23:11
  SPEAKER_05: But all of us need pastors, you know, to help help to do that.
• 23:15
  SPEAKER_02: Yeah.
• 23:15
  SPEAKER_02: Chip, I think that's I think that's your vision of mental health, the mission of the church is for to to not only see and hear people like Warren say you need a pastor, but also for pastors to say you may need a therapist.
• 23:34
  SPEAKER_01: I can't say for sure.
• 23:35
  SPEAKER_01: Like what I used to say when I was wrestling with all this and trying to figure out how to talk to pastors and congregations and even counselors if I got the chance.
• 23:44
  SPEAKER_01: Definitely back in the 80s and all, and and again, it's getting better, but it's you know still uh on the fence.
• 23:50
  SPEAKER_01: Most ministries, churches, would look at counseling like a hospital in the corner of the property that we refer people to that our normal discipling process doesn't help.
• 24:03
  SPEAKER_01: My definition of discipleship is you know, I was saved, I'm being saved, I'm yet to be saved, meaning I was saved in my spirit, I'm being saved in my soul.
• 24:12
  SPEAKER_01: And if and if you're a dual duologist or whatever you call it, a dualist, there's still a distinction between spirit and soul.
• 24:18
  SPEAKER_01: So the part of me that's regenerated is my spirit.
• 24:21
  SPEAKER_01: I s I feel like we need to figure out how to get us all on the same path.
• 24:25
  SPEAKER_01: If someone comes to you for help, you're still equipping them to live a life more accurately, fruitfully.
• 24:31
  SPEAKER_01: And to me, that's what discipleship is.
• 24:33
  SPEAKER_01: Discipleship is training people on how to live life the way God meant for us to live it.
• 24:39
  SPEAKER_01: And and I don't mean that in a this kind of way, I mean it as an invitational.
• 24:43
  SPEAKER_01: Like there's a way God has prescribed and modeled for us to live that just worked.
• 24:49
  SPEAKER_01: And again, my concern is like I've had the pleasure of uh inspiring young people to say, Well, I want to do what you do.
• 24:56
  SPEAKER_01: So they they go to college, they go to master's, and here's the thing they end up leaving the church because they they've acquired this mentality that we have a different set of skills and we do our thing over here, and you have a certain set of skills, and you do it over there.
• 25:10
  SPEAKER_01: I think the net effect is we're losing ground because ultimately the the hot zone for growth as a Christian is the soul, the mind, will, emotions, the brain, all of that kind of stuff.
• 25:22
  SPEAKER_01: Well, if we're farming that out, we're not doing the hard work of figuring how to integrate it, how to how to develop language around it, and how to how to make it normal for a born-again Bible-believing Christian to say, you know, hey, I'm dealing with depression, and and to have people involved that are as wired into the church as they are into their practice.
• 25:43
  SPEAKER_01: I think pastors have been at odds with counselors, and counselors have been at odds with pastors for way too long.
• 25:48
  SPEAKER_05: Yeah.
• 25:49
  SPEAKER_05: I I feel some of that.
• 25:50
  SPEAKER_05: I I've had mostly just really positive experiences engaging with pastors, but I I I know of of that, and I've certainly been around the Christian world enough to see that in in practice.
• 26:00
  SPEAKER_05: So one way to think about it is formal office, like the pastoral office.
• 26:04
  SPEAKER_05: Another way to think about it is like what role do we play within the larger body of Christ?
• 26:08
  SPEAKER_05: You know, as a kid, I've memorized Romans 12, 1 and 2, you know, do not be conformed to the world, but be transformed by the renewing of your mind that you may, you know, prove what the will of God is, that which is good and acceptable and perfect.
• 26:19
  SPEAKER_05: But then I didn't read on in Romans 12, you know, where it's like, do not think of yourself more highly than you ought, but think of yourself according with several judgments, according to the measure of faith that God has given to you.
• 26:29
  SPEAKER_05: And then there's all these all these roles that you know that that we're to play in the body, and they're not all the same.
• 26:34
  SPEAKER_05: But one of those roles is is paraclesis, is encouragement and or exhortation.
• 26:39
  SPEAKER_05: You can translate it in lots of different ways.
• 26:41
  SPEAKER_05: And and I think that there's some to whom there's given the gift of teaching and ministry and administration, and there's other to whom there's given the gift of of encouragement and counseling and uh and guidance.
• 26:54
  SPEAKER_05: I think that those of us who are trained in kind of the formal mental health disciplines, at our best, you know, we function in the context of the broader church as like one way that the church can exercise its ministry of paraclesis, that we can, you know, be those who come alongside someone when they're struggling and say, like, what do you need right now?
• 27:12
  SPEAKER_05: I think another thing I published this book a couple years ago called Wayfaring.
• 27:16
  SPEAKER_05: And the central model of that book is that one of the ways that we can understand ourselves as Christians is we are from God as our creator, and we are on the way to God as our hope and our goal and the joy and of our lives.
• 27:29
  SPEAKER_05: And so we are in this life, we find ourselves like from God to God, you know, on a journey.
• 27:35
  SPEAKER_05: We're pilgrims on the way.
• 27:36
  SPEAKER_05: And and you see this in Hebrews 12, you see this in a lot of different places in scripture, this idea of like we're running a race, we're on the way.
• 27:44
  SPEAKER_05: You know, everybody, every Christian over the course of their life needs the accompaniment of a pastor and in and the church as a kind of central fellow wayfarers for that journey.
• 27:57
  SPEAKER_05: Like we need each other, we're part of the common body.
• 27:59
  SPEAKER_05: And sometimes in the course of our life, you might need a psychiatrist, just like you might need a surgeon, you know, or you might need a, you know, there's different different roles that we can play for each other.
• 28:08
  SPEAKER_05: And so there's sometimes at some points in somebody's life that somebody's going through a bipolar manic episode or a episode of psychosis, or they're beginning to worry: like, do I have dementia or a neurocognitive disorder?
• 28:22
  SPEAKER_05: What's happening with my memory, or I'm struggling with alcohol use, or, you know, whatever it is.
• 28:27
  SPEAKER_05: And somebody who has the kind of training of a counselor psychiatrist who's trained to work in those kinds of situations can, I think, be really helpful.
• 28:34
  SPEAKER_05: But like that's all.
• 28:35
  SPEAKER_05: You know, like we just walk alongside each other.
• 28:37
  SPEAKER_05: It's not like we have all the knowledge of what it means to be human or all the knowledge of what it means to live a fully lived human life.
• 28:43
  SPEAKER_05: We we come alongside people at certain points in their lives and say, like, what's needed right now for the journey that this person is on?
• 28:49
  SPEAKER_05: And I think that's best done not alone, you know, but in collaboration, you know, with with pastors, with others in the church, you know, all that kind of thing.
• 28:57
  SPEAKER_02: Aaron Powell So am I hearing you guys correctly that, Chip, you would say part of what Warren is doing is discipleship.
• 29:04
  SPEAKER_02: And Warren, you would say, uh, I have a specialty and I know I know what I'm gifted in, and it's not necessarily discipleship.
• 29:12
  SPEAKER_02: Chip, would you say what Warren does, it's part of the discipleship process for people, or it can be?
• 29:18
  SPEAKER_01: Well, yeah, I wouldn't I would even use the metaphor from his book that if all of life is from God to God, then he's on that line.
• 29:26
  SPEAKER_01: You know, in physics, it takes two points to define a line.
• 29:30
  SPEAKER_01: What he does is on that line somewhere.
• 29:32
  SPEAKER_01: That's really kind of what I'm trying to say, that we've got to figure out a way to come in sync that all of us are on that line.
• 29:42
  SPEAKER_01: And we need to talk better so we can figure out how to how what I'm doing supports what you're doing, and vice versa.
• 29:49
  SPEAKER_05: I'm glad you use the term discipleship because I think that's an important term for me too.
• 29:53
  SPEAKER_05: A lot of the work that's going on in mental health and faith or mental health in the church, there's there's sometimes nobody says this, and I don't think anybody really intends this, but there's sometimes this idea that like if the church is working at its best, you know, it's going to pursue the mental health of its members.
• 30:08
  SPEAKER_05: And I'm like, no, that's not that's not it.
• 30:10
  SPEAKER_05: Like you everybody can be mentally healthy, but the church can be deeply disordered.
• 30:13
  SPEAKER_05: Like the church is there to form and to make disciples of Jesus Christ.
• 30:18
  SPEAKER_05: You know, that's what we're for, you know, and and so mental health is a kind of subordinate good, approximate good to that.
• 30:25
  SPEAKER_05: So I would say, I would say like healthy discipleship, I think includes at least a kind of attending to mental health.
• 30:32
  SPEAKER_05: Like what does it mean to live well?
• 30:33
  SPEAKER_05: What does it mean to live well with ourselves, with others, with God, with the world around us?
• 30:38
  SPEAKER_05: And and I think that's really important.
• 30:40
  SPEAKER_05: But mental health isn't the isn't the primary good, you know, that that we're to pursue as human beings.
• 30:45
  SPEAKER_05: It's being disciples of Jesus.
• 30:46
  SPEAKER_05: And I think keeping that in order.
• 30:48
  SPEAKER_05: So I would never say, you know, especially in my VA clinic where it just was this morning, I would never say, you know, to a patient, like, you know, you're here and I'm here to form you into a disciple of Jesus, you know, because I'm again I'm not in the office of the pastor, but I'm here to say, like, what's going on with your life?
• 31:03
  SPEAKER_05: Like, what do you think?
• 31:04
  SPEAKER_05: And you know, uh I've had a lot of veterans talk with me this week about the war in Iran and about a lot of other stuff.
• 31:10
  SPEAKER_05: Like, what's happening in your relationships, what's happening with your church, what's happening with your sleep, what all these kinds of things that I think are are kind of ways to support people that in the context of Christian community are being formed into disciples.
• 31:22
  SPEAKER_01: Yeah.
• 31:23
  SPEAKER_01: One scripture that'd be a good way to see kind of how I'm thinking and why I think it could all flow together better.
• 31:29
  SPEAKER_01: Um, Ephesians 4, 22 and 23, put off the old man.
• 31:34
  SPEAKER_01: Verse that's 22, 24, put on the new man.
• 31:37
  SPEAKER_01: Verse 23, be renewed in the spirit of your mind.
• 31:41
  SPEAKER_01: So for me, that covers all of it.
• 31:45
  SPEAKER_01: I mean, who what is the old man?
• 31:47
  SPEAKER_01: The old man is me without God.
• 31:50
  SPEAKER_01: The new man is me walking pretty soundly and securely in his love and direction and etc.
• 31:58
  SPEAKER_01: Well, how do I get there?
• 31:59
  SPEAKER_01: By being by renovating, and it's interesting that 12.2, Romans 12.2 just says the renewal of your mind.
• 32:06
  SPEAKER_01: Ephesians 4.23 says, be renewed in the spirit of your mind.
• 32:10
  SPEAKER_01: And I I would say that brings a little bit old Freud in.
• 32:13
  SPEAKER_01: In other words, the subconscious, the part of your mind, you know way better than me, the part of your mind that has stored information that you don't necessarily think about anymore until it's triggered.
• 32:25
  SPEAKER_01: You know, past trauma, early life imprints, that kind of stuff.
• 32:29
  SPEAKER_01: And so for me, that's discipleship.
• 32:31
  SPEAKER_01: Discipleship is helping somebody put off old, put on new, but one of the key components is helping them be renewed in the spirit of their mind.
• 32:40
  SPEAKER_01: A pastor can't do that.
• 32:41
  SPEAKER_01: And again, that's stretching it a little bit.
• 32:43
  SPEAKER_01: But you know what I'm trying to say here.
• 32:45
  SPEAKER_01: To me, it's all of it working together.
• 32:48
  SPEAKER_01: And when you're at your secular job, yes, you gotta abide by certain rules and all that.
• 32:54
  SPEAKER_01: I deal mostly with, you know, uh counselors, therapists.
• 32:58
  SPEAKER_01: They're licensed and they live scared that they've got to live by this license your code.
• 33:04
  SPEAKER_01: We can bring our faith way more into what we're doing than than most counselors do.
• 33:09
  SPEAKER_01: Now, I don't mean with lost people, but I'm talking about even with Christian clients.
• 33:13
  SPEAKER_01: Most people are are live on a parallel track.
• 33:15
  SPEAKER_01: I'm a Christian and I'm a professionally trained counselor, but they haven't figured out how to integrate the two very well in language, practice, application, et cetera.
• 33:25
  SPEAKER_01: That's my opinion.
• 33:26
  SPEAKER_05: Trevor Burrus, Jr.: Yeah.
• 33:26
  SPEAKER_05: Well, you you're right, the pastors can't do that, that you know, that renovating work, neither can psychiatrists.
• 33:31
  SPEAKER_05: It's the Holy Spirit that does that where they can just get to participate in the in the Spirit's work.
• 33:38
  SPEAKER_05: And I think that's how I would frame it.
• 33:40
  SPEAKER_05: It's like, how do I witness to this person's life, like figure out where they're stuck if they're stuck?
• 33:46
  SPEAKER_05: And often that's in things like trauma or addiction or you know, or or you know, various kinds of disease processes that people can go through or relationships that are broken, or sometimes for my patients, it's not having a secure home and not having food.
• 34:02
  SPEAKER_05: And there's lots of things that people struggle with.
• 34:04
  SPEAKER_05: So how can I help to help help people to get unstuck for the journey and to kind of find a way to move forward, but but not overstepping what's I think you also you you mentioned the fear for those for those of us that aren't in like a specifically Christian practice or working for a church or you know, the fear of like I'm gonna somehow get in trouble if I bring my faith into it.
• 34:29
  SPEAKER_05: I'd say as a Christian that we are called to treat people with respect and not to kind of use our power to coerce people or to and so I'm always aware, like you know, working in the system that I do, that I often have a lot more power than my patients do.
• 34:43
  SPEAKER_05: So I'm pretty trying to be very respectful, but but within that context, you know, the way that I'll do it is I'll often ask people, you know, are you a do you consider yourself a religious or spiritual person?
• 34:54
  SPEAKER_05: That's a pretty open frame.
• 34:56
  SPEAKER_05: Most of my patients in Central North Carolina in the VA system will say yes, you know, and then I would just ask more questions, you know, like and if they say no, I I might ask, like, was there ever a time when you were and what happened?
• 35:07
  SPEAKER_05: And we'll go from there.
• 35:08
  SPEAKER_05: But if they say yes, I'll say, well, tell me about that, you know?
• 35:10
  SPEAKER_05: And if they say that they are part of a church or faith community, I'll be like, well, tell me about your church.
• 35:15
  SPEAKER_05: Like, what's what's that like?
• 35:16
  SPEAKER_05: And if they say they read scripture, I'll say, well, to what kind of scriptures matter to you?
• 35:20
  SPEAKER_05: And, you know, and if they say they pray, what do you pray for?
• 35:23
  SPEAKER_05: And we can start to get in really detailed conversations.
• 35:27
  SPEAKER_05: You know, I'm not like coercing anybody, I'm just kind of following where they lead.
• 35:30
  SPEAKER_05: And I've had, I've had, and and for me, that's never gone badly.
• 35:34
  SPEAKER_05: I'm always kind of aware of wanting to be humble about that.
• 35:37
  SPEAKER_05: But I think sometimes I've had patients say to me, like, I didn't know I could talk about this kind of stuff with a psychiatrist.
• 35:42
  SPEAKER_05: Like, it's just, we're just talking about stuff that's important to you.
• 35:45
  SPEAKER_05: And and and that's just part of of honoring people as whole human beings.
• 35:49
  SPEAKER_05: And I think there is a fear sometimes in the mental health world that we can't go into that space.
• 35:54
  SPEAKER_05: But I think if we just open the door and then follow where patients lead us, always with a view toward like what's what like what's needed right now in this relationship and you know what's right for this person and our and our umble about it, I think there's a lot of openness.
• 36:09
  SPEAKER_02: I may have some novice perceptions of psychiatry.
• 36:14
  SPEAKER_02: Chip, do you want to insert a joke there?
• 36:16
  SPEAKER_02: Nope.
• 36:17
  SPEAKER_02: All right.
• 36:20
  SPEAKER_02: I was just expecting uh all of your perspectives are novice, Joey.
• 36:24
  SPEAKER_02: So but I have I was listening, Joey.
• 36:28
  SPEAKER_02: Come on.
• 36:29
  SPEAKER_02: I I have inherited a lot of my dad's issues with depression and anxiety, and it ended up in a mental health crisis in 2019.
• 36:40
  SPEAKER_02: And so I am I'm very open about this.
• 36:43
  SPEAKER_02: I'm on well butrin and flevoxamine, and because of the medicine, I feel like depression is something I've had since middle school in the past five years.
• 36:53
  SPEAKER_02: I don't think I've really struggled with, thank the Lord.
• 36:56
  SPEAKER_01: But he's done he's done the best.
• 36:59
  SPEAKER_01: I've known him 14 years in these last what four to five, he's done the best I've ever seen him just doing really, really well.
• 37:08
  SPEAKER_02: I appreciate that.
• 37:09
  SPEAKER_02: And I'm going through a divorce, like it's in a I'm in a really bad situation, but feel like I'm I'm mentally sound.
• 37:15
  SPEAKER_02: So I have obviously I I to Chip's chagrin, I I call him every now and then with some free therapy.
• 37:22
  SPEAKER_02: And then I have uh therapist, uh Jackie, who I see a couple of times a month.
• 37:27
  SPEAKER_02: I've always seen my psychiatrist as very much so medicine-centric.
• 37:33
  SPEAKER_02: So he will ask me a few questions like what's going on in your life?
• 37:39
  SPEAKER_02: How are you doing?
• 37:40
  SPEAKER_02: And then from that point on, it's okay, let's talk about your meds, your dosage.
• 37:45
  SPEAKER_02: You know, can you come a little down on something?
• 37:48
  SPEAKER_02: Should I add something?
• 37:50
  SPEAKER_02: Is psychiatry more focused on medicine?
• 37:52
  SPEAKER_02: Because it sounds like you do, uh it just sounds like you talk to people a lot more than maybe what I'm accustomed to with my psychiatrist.
• 37:59
  SPEAKER_05: Yeah.
• 37:59
  SPEAKER_05: I mean, descriptively, yes, in terms of how psychiatrists often practice, in terms of what I think is right, uh, no.
• 38:07
  SPEAKER_05: First of all, I'll say I love being a psychiatrist.
• 38:09
  SPEAKER_05: I'm so and I think psychiatry could do a lot of good for a lot of people.
• 38:12
  SPEAKER_05: And thanks so much for just sharing your own story, Joey.
• 38:15
  SPEAKER_05: I'm really grateful for that.
• 38:17
  SPEAKER_05: Psychiatry over the last 40 or 50 years has kind of we we've kind of collectively made ourselves into medication dispensers in some cases, those who kind of are are taking doing histories and um trying to understand what people's diagnoses are and then dispensing medications.
• 38:35
  SPEAKER_05: And I think that's short-sighted.
• 38:37
  SPEAKER_05: And frankly, it's not what psychiatrists have done over the course of all of our history.
• 38:40
  SPEAKER_05: Uh psychiatry as a field emerged from psychoanalysis.
• 38:44
  SPEAKER_05: So that's like people sitting with other people and talking about their life, and then also from physicians who would be the superintendents of hospitals and trying to figure out how do I help people that are with me.
• 38:55
  SPEAKER_05: And those are the deeper roots of psychiatry.
• 38:57
  SPEAKER_05: Psychiatrists are trained as physicians, and it's because we can prescribe legally that we've we've kind of developed into medication prescribers.
• 39:05
  SPEAKER_05: But I think a better way to think of psychiatry is that is that at my best, and uh you know, there's lots of ways in which I go wrong, but at my best, I'm trained to sit with people who are in distress, to listen to their story, and through the lens of my training to be able to say, um, like, here's how I understand what's happening with you, and here's what might be helpful going forward.
• 39:27
  SPEAKER_05: Uh and and that might be medication, um, but it might not be.
• 39:32
  SPEAKER_05: And it might be, you know, that you need to lean more into your church, or you need to, you know, do couples therapy around your relationship, or you need to do a course of EMDR or CBT or something else.
• 39:44
  SPEAKER_05: And then I'm psychiatrists do get some training in psychotherapy, but that's not, I don't do weekly, hour-long psychotherapy with people.
• 39:50
  SPEAKER_05: So in our system, I'll refer people to colleagues for that work.
• 39:54
  SPEAKER_05: But I see myself more as a kind of coordinator for for thinking about what's what's needed.
• 39:58
  SPEAKER_05: And and often I have more extended relationships with people than my therapist colleagues do, at least in our VA system, because they'll see people for shorter episodes of care, and I'll have more of a relationship over time.
• 40:08
  SPEAKER_05: So I think the best way to think about psychiatry is like it's a it's a discipline where people are able to listen and through the lens of our training, say like what's needed right now, without medication always being at the center of that.
• 40:19
  SPEAKER_05: And and one of the things that I dislike about psychiatry that I've written about is you know, so often we're trained in psychiatry to like somebody comes to me and they're they're thinking ways they don't want to think, they're feeling ways they don't want to feel, they're doing things they don't want to do.
• 40:33
  SPEAKER_05: And I'm trained to say, oh, I recognize what's happening with you.
• 40:36
  SPEAKER_05: Like you're having symptoms of decreased need for sleep or of loss of interest in pleasurable activities or something like that.
• 40:44
  SPEAKER_05: And then based on these symptoms that you're having, I'm assigning a diagnosis to you, like major depressive disorder or generalized anxiety disorder.
• 40:52
  SPEAKER_05: And then I reach into my toolbox of medications and you know referrals and I say, well, based on my knowledge, this is take this for these symptoms.
• 40:59
  SPEAKER_05: And then a patient comes back to me, you know, in week or two or three or four, and they say, you know, I'm feeling so much better because I've taken this medication.
• 41:07
  SPEAKER_05: And I'm saying, well, great, the symptoms are reduced, so the treatment's working, so we're all happy.
• 41:11
  SPEAKER_05: And I I think so we can kind of run mental health care, especially in psychiatry, is this kind of industrial process of symptom reduction through technology, you know, or just like just kind of running people through.
• 41:23
  SPEAKER_05: And there's benefits to that, you know.
• 41:25
  SPEAKER_05: I want my patients to feel better, you know, especially with what I prescribe.
• 41:29
  SPEAKER_05: But man, like it we miss so much that way.
• 41:32
  SPEAKER_05: We miss we miss some of the deeper questions that you all care about, I know, like, who am I and what's my life for, and to whom do I belong?
• 41:40
  SPEAKER_05: And you know, we also miss, I think a lot of the ways psychiatry tends to individualize people's problems.
• 41:46
  SPEAKER_05: Like you come to a psychiatrist and you and you're gonna often leave with the idea that I have issues that are inside of me.
• 41:52
  SPEAKER_05: They may even be in my neural circuits or in my brain or in my neuroendocrine system, and I need to take this medication to fix what's inside of me.
• 42:01
  SPEAKER_05: But so much of the things that people struggle with in our world now are broken relationships and you know, communities that are that are not treating people well, in which people feel dehumanized or unable to perform and a culture that's incredibly polarized.
• 42:17
  SPEAKER_05: And so people feel distressed and anxious by living in that kind of world.
• 42:21
  SPEAKER_05: And it shows up in the brain, but it's not that the primary problem is inside of us, the problem may be just like naming the truth of what's happening around us.
• 42:27
  SPEAKER_05: So we miss so much, you know, when we only focus on this model of the kind of dispenser.
• 42:33
  SPEAKER_05: Plus, I have to say, like psychiatrists have made ourselves the kind of clinicians.
• 42:38
  SPEAKER_05: If all we think of ourselves is like applying medications to people's symptoms, frankly, AI is going to be able to do that a lot better than we can, you know, in short order, you know, like if it's just a matter of an algorithm.
• 42:49
  SPEAKER_05: I think we need to reclaim the role of the psychiatrist or any counselor or any therapist as just somebody who has the wisdom to sit with somebody and to say, hey, I'm hearing what's happening with you, I'm resonating, I'm feeling with you, and here's maybe here's maybe some steps for how might you might walk forward.
• 43:08
  SPEAKER_05: And and that that feels to me a better way to think about what we do.
• 43:11
  SPEAKER_01: Aaron Powell Would it be fair to say that the and correct me if I'm not using the right term here, but kind of the biomedical model of what's wrong.
• 43:22
  SPEAKER_01: In other words, I've read books behind guys who basically, you know, it isn't your upbringing, it isn't your early life experiences, your your your brain's not functioning properly, take this pill, it'll fix it, because your problem's physiological.
• 43:36
  SPEAKER_01: Therefore, therefore the fix has to be physiological in a sense.
• 43:41
  SPEAKER_01: If if number one, that's a a legitimate posture that's being taught right now, and then someone buys into that, then they're gonna believe that's their job.
• 43:52
  SPEAKER_01: My job is to talk to Joey for 15 minutes, give him some pills, and I've done my job.
• 43:58
  SPEAKER_01: Am I crazy?
• 43:59
  SPEAKER_05: Yeah, I mean, listen, I'm trained as a doctor.
• 44:00
  SPEAKER_05: I have uh the biomedical model is not all bad.
• 44:03
  SPEAKER_05: It can be really helpful.
• 44:04
  SPEAKER_05: You know, when somebody comes in and, you know, like say certain things like somebody, uh a 19-year-old man comes in hearing voices and certain other things that fall in line.
• 44:14
  SPEAKER_05: The biomedical model is helpful in saying this fits the this fits the pattern of a first break psychotic episode.
• 44:22
  SPEAKER_05: And so I'm thinking about what's happening there.
• 44:24
  SPEAKER_05: And so biomedicine is not bad, but but it can cause us to miss things.
• 44:28
  SPEAKER_05: And I think that's I think that's that's you know often what I would what I would say.
• 44:32
  SPEAKER_05: And there's a really interesting book written by a sociologist at the University of Virginia, Joe Joseph Davis.
• 44:38
  SPEAKER_05: The book is called Chemically Imbalanced.
• 44:41
  SPEAKER_05: And it's it's a book where he Joseph Davis and his research associates, they interviewed about 90 or so young adults living in metro areas on the East Coast, so places like Charleston or Research Triangle or Philadelphia or DC.
• 44:56
  SPEAKER_05: And they said, would you be willing to talk to a researcher about your experiences of living with depression, anxiety, or ADHD?
• 45:03
  SPEAKER_05: And so people talked with researchers about this.
• 45:06
  SPEAKER_05: And he showed that about half of that sample was what he called, I think he used the term something like psychologically minded, when they would trace their problems to trauma, to challenges in their relationships, to things that they'd done or witnessed.
• 45:18
  SPEAKER_05: And the other half is what he what he called neurobiologically minded.
• 45:22
  SPEAKER_05: They they inhabited what he called the neurobiological imaginary.
• 45:25
  SPEAKER_05: And it was really interesting.
• 45:26
  SPEAKER_05: A few things characterized this group that one is that they had a little bit less shame and self-blame for feeling the way they did, which I might say is a good thing.
• 45:34
  SPEAKER_05: And that's, I think, what drives a lot of that.
• 45:37
  SPEAKER_05: They also uh tended to not see their mental unwanted mental states as really about anything.
• 45:43
  SPEAKER_05: They just kind of were.
• 45:44
  SPEAKER_05: And they would say things like, I have a chemical imbalance or I have, you know, my have genes that have disposed me to this.
• 45:49
  SPEAKER_05: They were all on medication.
• 45:51
  SPEAKER_05: And when the medication was helpful, it kind of proved that the problem was biological to begin with, whereas logically that didn't quite make sense, but that's that's how it worked.
• 45:59
  SPEAKER_05: But the most interesting things, you said that these folks tended to use fewer English words to describe their internal experience.
• 46:05
  SPEAKER_05: So there's hundreds of words in English to describe like how what's happening in our souls or our spirits or our minds.
• 46:13
  SPEAKER_05: And these people tended to use more language like I'm depressed or I'm anxious.
• 46:16
  SPEAKER_05: They tended to be more limited to clinical terms.
• 46:19
  SPEAKER_05: And when they were asked, like, why do you go to therapy or seek, you know, psychiatry, they would say things like, I just want to get back to work.
• 46:26
  SPEAKER_05: I want to, you know, get back to the work of parenting or school or a job, you know, I can't afford the disruption of this.
• 46:33
  SPEAKER_05: Davis asked, and I think I've thought a little bit more about this, like, what are we doing in the world of mental health if people are living in a culture where we're basically valued as human beings by what we produce and what we consume, you know, and like that's what our culture tells us.
• 46:47
  SPEAKER_05: Like you you matter if you produce and you consume, and that's who you are.
• 46:52
  SPEAKER_05: And then people feel like they're underproductive or counterproductive or they're not keeping up, or you know, they're not they don't belong.
• 46:59
  SPEAKER_05: And then they and so they're basically not filling that that vision of like being producers and consumers.
• 47:05
  SPEAKER_05: And and then they come into therapy, and the and the goal of therapy is like, let's just help you feel better and make you more productive so that you can then go back into that same world.
• 47:13
  SPEAKER_05: Like, we're not getting to the spiritual root of what's happening.
• 47:16
  SPEAKER_05: So Christians have to step back from that and be like, what are we doing?
• 47:20
  SPEAKER_05: You know, like it so at the very minimum, I think we can tell people like your value as a human being is not in what you produce or the grades you get or what your income is or how many friends you have or whatever.
• 47:30
  SPEAKER_05: It's it's in the fact that you are God's beloved.
• 47:34
  SPEAKER_05: You know, that's the core of who you are.
• 47:36
  SPEAKER_05: And and to start there, uh So I think there's ways in which like the only to take a biomedical model, like it's not wrong to do that.
• 47:43
  SPEAKER_05: It can be helpful at certain times, but it's not the whole story.
• 47:46
  SPEAKER_05: It's it's one way of telling a story, but not the whole story.
• 47:49
  SPEAKER_01: Aaron Powell Even some therapy is the application of a school of thought, we'll call it, practices, cognitive therapy, EMDR, all these kind of things.
• 47:59
  SPEAKER_01: So in a way, they're avoiding the reconstruction of a narrative that's more God-driven, God-honoring, God adapted.
• 48:08
  SPEAKER_01: I remember I'll never forget it.
• 48:09
  SPEAKER_01: We're talking 40 years ago.
• 48:11
  SPEAKER_01: Uh went to a conference, a guy named Jeff Van Vondren.
• 48:14
  SPEAKER_01: I don't know if you've ever run into any of his books.
• 48:15
  SPEAKER_01: They're kind of old now.
• 48:16
  SPEAKER_01: And he uh he got up in his first session and said, I I want you to know that I filed an official complaint with the organizers of this conference because I objected to their titling, et cetera, et cetera.
• 48:27
  SPEAKER_01: And here was his point.
• 48:28
  SPEAKER_01: His point was if the only reason you counsel someone is to get them involved in Jesus and your church, in other words, to get them being a more functional Christian, I don't want any part of it.
• 48:39
  SPEAKER_01: But it got me thinking that there's a reverse to that.
• 48:42
  SPEAKER_01: If you spend hours and hours and praise God, the people walk out the door with a better marriage, but they're gonna go to hell when they die.
• 48:49
  SPEAKER_01: What have you really done?
• 48:51
  SPEAKER_01: There is something to be said for, like you put it, you're a better consumer, you're a better whatever.
• 48:57
  SPEAKER_01: Somebody's got to do some deeper thinking than that.
• 48:59
  SPEAKER_01: Some of us have got to figure out how to get every side of this equation thinking deeper.
• 49:06
  SPEAKER_01: Are we really enlarging the borders and influence of the kingdom of God?
• 49:09
  SPEAKER_01: Are we raising up people that live inside a culture by another culture?
• 49:14
  SPEAKER_01: Because if we're not doing that, we're not making disciples.
• 49:16
  SPEAKER_01: Because disciples live by a kingdom culture, not an American culture, an Indian culture, or a Chinese culture.
• 49:23
  SPEAKER_01: That's that's my thing.
• 49:24
  SPEAKER_01: My thing.
• 49:24
  SPEAKER_01: I'm all about the ministry and care for souls.
• 49:28
  SPEAKER_01: But as it pertains to this overarching narrative.
• 49:32
  SPEAKER_01: And I think you agree with that.
• 49:34
  SPEAKER_05: I do.
• 49:34
  SPEAKER_05: I mean, I if I understand you right, I would just affirm that the church's mission is to witness to the glory of God, but it's its practical mission with people is to make disciples of Jesus Christ.
• 49:44
  SPEAKER_05: And that's the goal, you know.
• 49:46
  SPEAKER_05: And if the church completely neglects what we think about in the world of mental health, like healthy marriages, healthy relationships, trying to prevent trauma, trying to prevent suicide, those kinds of things that we that are just basic.
• 50:00
  SPEAKER_05: If the church neglects that, then we've deeply failed.
• 50:03
  SPEAKER_05: You know, we actually push people away from faith because they see they see churches as places where various forms of abuse just kind of fester.
• 50:11
  SPEAKER_05: And that's a scandal.
• 50:13
  SPEAKER_05: I mean, that we'll be judged for that.
• 50:14
  SPEAKER_05: And so I think I think thinking about like how do we bring in the mission of the church to promote mental health, not as a not as the highest good of the church, because that can be that could become an idol for us, but as a kind of as a kind of approximate good of discipleship, you know, that to care for people is good is God's creatures, to invite them into God's life, you know, God who is love itself, to invite them into God's life is to want them to live holy and full lives.
• 50:39
  SPEAKER_05: And that's where at its best, you know, the best practices of mental health, mental health care can can support that, but never dictate it, you know.
• 50:47
  SPEAKER_05: Like yeah, I I'm never gonna be, you know, you don't want me as a psychiatrist to be like saying like this is this is everything the church should do comprehensively in its budget.
• 50:55
  SPEAKER_05: Because that the church is much more than what I can offer.
• 50:58
  SPEAKER_05: Trevor Burrus, Jr.
• 50:58
  SPEAKER_02: Chip, the biomedical point that you brought up, I think my I'm curious what Warren thinks about this.
• 51:05
  SPEAKER_02: So in 2019, so so first and foremost, on the other side of my mental health crisis, I mean, therapy has just been so, so helpful.
• 51:14
  SPEAKER_02: I mean, it's the first time I've I've done it regularly for years, and I've I've been doing therapy now uh coming up on seven years.
• 51:22
  SPEAKER_02: And uh in the middle of my mental health crisis, however, Chip and my parents, uh, because they my parents had experience with my dad's depression, they were they were voices of reason because they saw the depths of my despair.
• 51:37
  SPEAKER_02: And my wife at the time wanted me to go to a retreat center where there's um all sorts of therapy, music therapy, um, working in gardens and and all that.
• 51:49
  SPEAKER_02: And and Chip was basically like, listen, all that stuff may be helpful at some point, but right now medicine has to kick in and get him to a place where he can do anything, you know, because I I had some days where I was suicidal, uh, I wasn't able to work, um, I wasn't living at home where my kids were.
• 52:07
  SPEAKER_02: I mean, I I was I was tapped out.
• 52:10
  SPEAKER_02: You know, would would you resonate with that that there's there's certain times when medicine has has to kick in, so to speak.
• 52:18
  SPEAKER_01: Let me say one thing more, because it'll give you a even a richer picture there.
• 52:22
  SPEAKER_01: Because I want I want to know what you think of how I handled some of it.
• 52:26
  SPEAKER_01: Like I can remember a moment where I looked at Joey and I said, Joey, I said, you need to understand now, Joey isn't broken.
• 52:33
  SPEAKER_01: Joey's brain is broken.
• 52:36
  SPEAKER_01: And there's a difference.
• 52:37
  SPEAKER_01: Joey's not broken, Joey's brain is not working properly.
• 52:42
  SPEAKER_01: Because it was clearly a physiological whatever.
• 52:45
  SPEAKER_01: And everybody around us, including our pastor, was trying to say, hey, let's get him out of there and let's send him off to whatever.
• 52:52
  SPEAKER_01: And I said, no.
• 52:53
  SPEAKER_01: I said, I'm telling you, it's the wrong thing to do right now.
• 52:57
  SPEAKER_01: Because until we get his brain functioning properly, chemically and otherwise, anything you throw at it's going to be a waste of time.
• 53:05
  SPEAKER_01: I just wanted you to hear me and kind of what I said.
• 53:07
  SPEAKER_01: What do you what's your response to all that?
• 53:09
  SPEAKER_05: Aaron Powell Yeah, I think that's a way of telling a story that might be helpful for a time.
• 53:14
  SPEAKER_05: It's not the way that somebody wants to live throughout their life to think that their brain is not separate from they are.
• 53:19
  SPEAKER_05: So I think it's I think sometimes we are able to tell stories that help us to get through a certain time that's really helpful.
• 53:25
  SPEAKER_05: So it's neither it's neither true or false.
• 53:27
  SPEAKER_05: It's just a question of is this helpful again for discipleship and for living as a whole person.
• 53:31
  SPEAKER_05: The image that I would often use is the image of the starting line and the finish line.
• 53:35
  SPEAKER_05: You know, and I'll tell people who are you know who are in similar situations.
• 53:38
  SPEAKER_05: Like medication isn't rarely going to get you to the finish line of where you want to be in your life, with like your life is going well, your relationships are healthy, you know, you're reconciled with your family, all that kind of thing.
• 53:50
  SPEAKER_05: Like I mean, if medication could do that, that would be really interesting.
• 53:53
  SPEAKER_05: But very stuff we prescribe just cannot usually do that.
• 53:57
  SPEAKER_05: But what it can do is help you get to the starting line so that you can then do that really good hard work that's needed.
• 54:04
  SPEAKER_05: So if somebody can't get out of bed, if they're having trouble organizing their day, if they're if they're feeling suicidal and just like trapped in that pit, you know, then medication can be can be incredibly helpful and can be, you know, in some cases even life-saving, I think, you know, through through the work of the spirit.
• 54:23
  SPEAKER_05: And I think I think we need to be able to embrace that at certain times without thinking that it's going to get us to the finish line.
• 54:29
  SPEAKER_02: Trevor Burrus, Jr.: I did ECT treatments too.
• 54:31
  SPEAKER_02: I'm sure you're familiar with that.
• 54:32
  SPEAKER_05: Trevor Burrus, Jr.: ECT as well.
• 54:34
  SPEAKER_05: That's one thing that could be needed for the journey that is incredibly important and helpful.
• 54:39
  SPEAKER_01: He didn't come out looking any better, though.
• 54:41
  SPEAKER_01: I thought it would be a little bit more handsome.
• 54:43
  SPEAKER_01: But I'm so grateful for He didn't grow any hair.
• 54:47
  SPEAKER_03: Chris, I guess you shouldn't go about that right this moment.
• 54:49
  SPEAKER_03: Forgive me.
• 54:51
  SPEAKER_03: That's right.
• 54:51
  SPEAKER_03: That's right.
• 54:52
  SPEAKER_02: Well, I figured we'll spend the last five to ten minutes.
• 54:57
  SPEAKER_02: I'd I'd love to hear of some of your findings when it comes to combat trauma.
• 55:03
  SPEAKER_02: And when it, you know, someone like me who's never been in the military, so obviously I've never seen combat.
• 55:10
  SPEAKER_02: I'm just curious, like, what are some things that a person like me has no context for, just have no understanding of what soldiers come home dealing with?
• 55:21
  SPEAKER_05: Aaron Powell Thanks for asking that.
• 55:23
  SPEAKER_05: I'm I'm myself not a veteran either, but I've had the privilege to work with veterans in the VA system for many years.
• 55:29
  SPEAKER_05: Uh and my my work is primarily thinking about the ethics of PTSD and moral injury and the history.
• 55:36
  SPEAKER_05: You know, so often we think that PTSD among veterans is a matter of like just something that's experienced that causes fear or anxiety, and then those that experience doesn't really go away.
• 55:49
  SPEAKER_05: So so classically, say in the wars in Iraq and Afghanistan, you'd have a convoy driver who is driving along a highway and there's a improvised explosive device explosion, and you know, people die and it's chaotic, and then that person then is driving on an interstate in Charleston or Raleigh or wherever, and they see trash on the side of the road and they veer over because those experiences don't go away.
• 56:11
  SPEAKER_05: That might be what we would call like fear or anxiety-based PTSD.
• 56:16
  SPEAKER_05: But the very diagnosis of post-traumatic stress disorder came to us in 1980 in the third edition of our psychiatric diagnostic manual.
• 56:23
  SPEAKER_05: It didn't exist before that.
• 56:25
  SPEAKER_05: And the reason that it came to be, one of the reasons that it came to be was because Vietnam veterans were coming back from Vietnam.
• 56:32
  SPEAKER_05: They were deeply distressed by not only what they had experienced, but by what they had done in some cases in this really complex chaotic war.
• 56:40
  SPEAKER_05: And they came to the VA and the folks at the VA, you know, didn't have a diagnosis of PTSD.
• 56:45
  SPEAKER_05: So they'd be they'd be diagnosed as alcoholic because they were drinking too much.
• 56:48
  SPEAKER_05: They'd be diagnosed with schizophrenia because they were paranoid and hearing and seeing things.
• 56:52
  SPEAKER_05: And a group of veterans got together and said, you know, we need to it there's a long story, longer story to tell, but like we need to have a diagnosis that recognizes that going to war like makes a mark on the soul and on the psyche in ways that that matters.
• 57:06
  SPEAKER_05: And and they not only described at that time things that had happened to you, but things that you had done.
• 57:12
  SPEAKER_05: So veterans that that had their their traumatic memory was of being involved in an act of killing, for example, that would that would count.
• 57:20
  SPEAKER_05: And then the when the diagnosis of PTSD came out, it kind of it kind of neglected that aspect of trauma, that trauma can result from things that we have done or witnessed or participated in.
• 57:31
  SPEAKER_05: And then the wars in Iraq and Afghanistan came along, soldiers and service members started to come back, they were really struggling.
• 57:36
  SPEAKER_05: And there's a kind of reawareness in the world of the VA and mental health care that some of the most difficult forms of trauma are not from things that you've done, not from things that you've experienced or have been done to you, but from things that you've done or witnessed or participated in, or even maybe not any one particular thing, but just from kind of gradually losing trust that what you're doing is on the side of what's right and good.
• 58:00
  SPEAKER_05: And what do you do with that if you've committed yourself, you know, to the defense and service of your country, and then you find yourself in a situation where you can't make sense of what's going on.
• 58:09
  SPEAKER_05: And so when we think about why veterans struggle, it's it's both and it's it's sometimes it's not trauma-related, but it's when is trauma-related, it's from things that have been done to you, but also things that you've done and witnessed.
• 58:19
  SPEAKER_05: And that trauma that people have done and witnessed is what's called moral injury.
• 58:22
  SPEAKER_05: And and interestingly, in even in the secular kind of treatment protocols that have been developed for this, it kind of resembles something like confession, you know, where veterans are encouraged to kind of talk about what they've done and imagine somebody that has their back, you know, that and and so I think the church has a lot to offer because you know the VA in modern psychiatry and psychology can't actually offer the opportunity for confession and reconciliation.
• 58:48
  SPEAKER_05: Um, but um the church can if we're willing to listen to what's happening.
• 58:52
  SPEAKER_02: All right.
• 58:52
  SPEAKER_02: Well, I'm I'm gonna fit one more question in.
• 58:55
  SPEAKER_02: Chip blew my mind the other day, a few months ago we were podcasting, and he was, he said this is probably gonna be somewhat controversial, but I hear often of people who experience immense loss, you know, whether it's a spouse in a car wreck or losing a child, and they get on medicine for, you know, for a spell.
• 59:17
  SPEAKER_02: And I just figured, okay, that's that has that has to be some people's road.
• 59:22
  SPEAKER_02: They get on that temporarily to help them out in their season.
• 59:25
  SPEAKER_02: I'm a little different.
• 59:26
  SPEAKER_02: Like my chemicals don't work right on a permanent basis unless I'm on medicine pretty much all the time.
• 59:32
  SPEAKER_02: Like I don't plan on getting off unless the Lord leads me to, or my psychiatrists.
• 59:37
  SPEAKER_01: I will hurt you.
• 59:38
  SPEAKER_01: I will hurt you if you ever get off.
• 59:39
  SPEAKER_02: Yeah.
• 59:40
  SPEAKER_02: So basically, Chip said people who get on medicine temporarily, they really shouldn't.
• 59:45
  SPEAKER_02: And I think you said that you were talking to someone asking them how they were coping with a loss, and they said, Well, uh, we've been on medication, so it's been pretty fine.
• 59:56
  SPEAKER_02: And and it kind of a light bulb went off that you're like, you're not even doing the hard work of grieving because your medicine is is numbing it.
• 1:00:04
  SPEAKER_02: And Chip actually said, if you're not on medication if if you weren't on medication before that bad thing happened or that loss took place, then it's probably not the right solution once you are on that journey.
• 1:00:18
  SPEAKER_02: Like, so in other words, people who get on medicine temporarily probably shouldn't.
• 1:00:23
  SPEAKER_02: Chip, those are your words, I think, not mine.
• 1:00:25
  SPEAKER_01: Yeah.
• 1:00:27
  SPEAKER_01: Yeah.
• 1:00:28
  SPEAKER_01: I think doctors are a little too quick to give them something so they don't feel the pain.
• 1:00:33
  SPEAKER_01: And I have to believe God made life the way it is so that I think part of part of honoring the person you've lost is the pain.
• 1:00:42
  SPEAKER_01: It's a form of honor.
• 1:00:44
  SPEAKER_01: And I think we've just gotten where we don't tolerate any pain, any discomfort.
• 1:00:48
  SPEAKER_01: I don't want it.
• 1:00:49
  SPEAKER_01: And I think it's wrong.
• 1:00:50
  SPEAKER_01: I don't think it's good for the person.
• 1:00:52
  SPEAKER_01: But go ahead, Warren, what do you think of all that?
• 1:00:54
  SPEAKER_05: Aaron Ross Powell, I'd say this is this is a very psychiatrist thing to say, but I think I'd say it depends.
• 1:00:59
  SPEAKER_05: You know, grief is not a mental illness.
• 1:01:01
  SPEAKER_05: You know, we grieve because we love.
• 1:01:03
  SPEAKER_05: You know, grief hurts.
• 1:01:05
  SPEAKER_05: It hurts like hell.
• 1:01:06
  SPEAKER_05: And when we lose somebody, yeah, it's it's really hard.
• 1:01:11
  SPEAKER_05: And I think it's also human, you know, it's not something that we should have to push away.
• 1:01:16
  SPEAKER_05: And so I think uh I wouldn't ordinarily encourage people to be on medication just because they're hurting when they're grieving, because it's a human process.
• 1:01:23
  SPEAKER_05: And there's ways in which we can come alongside each other in grief, you know, like Job's friends did for him, that can be really helpful, you know, and to carry that pain directly to the heart of God.
• 1:01:33
  SPEAKER_05: And I think that can lead us in.
• 1:01:35
  SPEAKER_05: Um and at the same time, you know, I think there's sometimes often when connected to maybe a longer history of loss or of other forms of depression or psychological struggle that people are grieving, you know, can you know if if somebody's thinking of suicide, if somebody is um not eating and losing weight to the point where it's getting really unhealthy for them, if they're unable to get out of bed, if they just, you know, can't find the energy to, you know, to be around other people or to go to church or something like that, then medication might be what they need for a season, you know, for a time.
• 1:02:08
  SPEAKER_05: Not not not because grief hurts and you don't want it, you know, you just want to not hurt, but but because in some cases it might be needed and necessary.
• 1:02:17
  SPEAKER_05: And so I I I I wanna I think that's where there's not any one right or wrong answer.
• 1:02:22
  SPEAKER_05: You need a you need a you need the accompaniment of wise counselors and guides who can look at somebody's life as a whole, normalize this is part of being human and it's terrible, but you know, it but death is death is real and we we live in hope of resurrection.
• 1:02:41
  SPEAKER_05: And sometimes maybe a medication is is the right thing.
• 1:02:46
  SPEAKER_01: Yeah.
• 1:02:46
  SPEAKER_01: Here's a here's a thought I'd love feedback on.
• 1:02:49
  SPEAKER_01: There's no growth without discomfort.
• 1:02:51
  SPEAKER_01: So the goal of therapy is not always to make someone comfortable.
• 1:02:57
  SPEAKER_05: Yeah, I I think that's fair.
• 1:02:58
  SPEAKER_05: And I think most of my secular colleagues would agree with that.
• 1:03:01
  SPEAKER_05: I mean, when we do trauma-focused psychotherapy and people are having to come face to face with the hardest thing that's ever happened in their life and sit with that week after week, it's like incredibly hard.
• 1:03:13
  SPEAKER_05: I mean, it's excruciating.
• 1:03:14
  SPEAKER_05: And so I think um but but it's it's with the goal then of helping people to live more holy, where where the where the trauma isn't like the central narrative of my life.
• 1:03:24
  SPEAKER_01: Like it an extension from that thought is I would easily say, obviously I'm understating, at least 51 percent of therapists are female.
• 1:03:35
  SPEAKER_01: I would say it's fair to say that the majority, again, at least 51 percent of women don't like uh conflict and confrontation.
• 1:03:44
  SPEAKER_01: So put the two of those together, you've got a field full of therapists who like to rescue people from discomfort.
• 1:03:52
  SPEAKER_01: And yet discomfort it is what makes you grow.
• 1:03:56
  SPEAKER_05: I work with a lot of pretty strong women who are very willing to confront you know when needed.
• 1:04:00
  SPEAKER_05: So yeah, I I I don't know.
• 1:04:01
  SPEAKER_05: But I think it I think we have to be careful as therapists.
• 1:04:04
  SPEAKER_05: Yeah.
• 1:04:04
  SPEAKER_01: I I still think they're 49% at best.
• 1:04:08
  SPEAKER_05: Well, what I all of us have to be careful as therapists to like keep what's important in mind.
• 1:04:13
  SPEAKER_05: We care about people flourishing as whole persons, not just about you know relieving distress.
• 1:04:17
  SPEAKER_01: I've just talked to a lot of people that have gone to therapy for quite a while and you talk to them about what they're getting out of it.
• 1:04:23
  SPEAKER_01: It's like any profession.
• 1:04:25
  SPEAKER_01: There's good ones and there's not so good ones.
• 1:04:27
  SPEAKER_01: And I would say the same thing about pastors.
• 1:04:29
  SPEAKER_01: But we we've got to figure out if you find if you finally get a guy to go to a counselor and he has a crappy experience, he'll never go back.
• 1:04:37
  SPEAKER_05: Aaron Powell Oh, I know.
• 1:04:38
  SPEAKER_05: It's like going to physical therapy.
• 1:04:40
  SPEAKER_05: You know, good physical therapy usually makes you do things that you don't really want to do.
• 1:04:44
  SPEAKER_05: Absolutely.
• 1:04:45
  SPEAKER_05: If you if you already wanted to do them, you probably wouldn't be in PT.
• 1:04:47
  SPEAKER_05: I think psychotherapists is kind of the same way.
• 1:04:49
  SPEAKER_05: Like you should be doing things that you don't really want to do, because if you if you wanted to do them, you already would have done them and you wouldn't be seeing the therapist.
• 1:04:55
  SPEAKER_05: So like there's a way in which discomfort is really important, but but not because we're masochists, just because we're or sadists, just because we're like just because we want people to grow.
• 1:05:03
  SPEAKER_05: And and that applies to us too.
• 1:05:06
  SPEAKER_01: We want your life to be better, not the same.
• 1:05:09
  SPEAKER_01: That's right.
• 1:05:09
  SPEAKER_05: That's right.
• 1:05:10
  SPEAKER_02: Warren, thanks so much, man.
• 1:05:11
  SPEAKER_02: This has been awesome.
• 1:05:12
  SPEAKER_05: Thank you all.
• 1:05:13
  SPEAKER_05: Grateful to you.
• 1:05:15
  SPEAKER_05: Thanks for hosting me.
• 1:05:16
  SPEAKER_05: Yeah.
• 1:05:16
  SPEAKER_05: Yeah, for sure.
• 1:05:17
  SPEAKER_05: Blessings on your work.
• 1:05:18
  SPEAKER_01: Good to meet you, but next time I'm up there, I'll I'll ask you for that tour.
• 1:05:21
  SPEAKER_05: Please do, absolutely.
• 1:05:23
  SPEAKER_05: Yeah.
• 1:05:23
  SPEAKER_05: Thank you all.
• 1:05:24
  SPEAKER_05: Take care.
• 1:05:25
  SPEAKER_00: Thanks for listening to Mental Health and the Mission of the Church.
• 1:05:28
  SPEAKER_00: If this episode was helpful, share it with someone who might need it.
• 1:05:32
  SPEAKER_00: And don't forget to subscribe so you never miss an episode.
• 1:05:35
  SPEAKER_00: You can also follow Chip on Instagram at Chipjud and find free resources for your spiritual and mental health journey at chipjud.com.
• 1:05:43
  SPEAKER_00: Thanks again for listening, and we'll see you next time on Mental Health and the Mission of the Church.