Taking Some Pills, Changing Our Thoughts, or Purifying Our Heart

In life, there are certain inner difficulties that spawn a host of enduring, dysfunctional patterns causing continual distress and constituting new, serious problems in their own right. And although the Christian faith advises looking within to the thoughts of the heart, we often shift our focus from the inner difficulty to the warning signals of distress and naively suppose that if we take care of the distress by external means such as taking the right kind of medication, things are as they should be. In fact, we are simply becoming dependent on other external supports without any deeper healing taking place. God “desires that we be delivered from the bondage” of depression and anxiety “into the glorious liberty of the children of God,” becoming vessels of love, bearers of peace, instruments of His own compassion for creation. Unfortunately modern society encourages us to set our sights far too low.

The following excerpt from The Guardian, a newspaper in London can help put a human face on what I am talking about:

Ever since she can remember, 21-year-old Emma Campbell has been living in a state of heightened anxiety. As a child she used to stay up worrying about school work and her family, becoming so anxious that, eventually, she stopped eating. She was seven when she first started suffering panic attacks, waking up out of breath and sweating almost every night for several years.

Campbell received therapy as a teenager, which offered her some respite. But panic set in once again when she left her home in North Yorkshire to attend university in Wales, where she is currently studying psychology. Although she is now taking antidepressants, which are often prescribed to treat anxiety, she says she still finds herself “on edge” most days. “I worry if I’m a good person. I worry about the future. Yesterday, I had a panic attack because I’d progressively convinced myself that this chesty cough I’ve got is lung cancer. I know deep down it’s just a cough, but something takes over me and tells me everything is a thousand times worse than it really is.”

How many people have had similar distressing experiences with generalized anxiety, a state of foreboding, and dread about the future that takes over and controls patterns of thought, behavior, and social interactions. The paper notes that Emma has been treated with anti-depressants, yet some mental health professionals are questioning the effectiveness and wisdom of a pharmaceutical treatment option instead of cognitive behavior therapy. The Guardian author writes, “Mental health charities say they are concerned antidepressants are too often used as the first point of call to treat anxiety, when cognitive behavioural therapy (CBT) could prove more beneficial. Paul Jenkins, chief executive of the charity Rethink Mental Illness, says that in some cases people are ‘fobbed off’ with medication alone: ‘No one should have to take any kind of medication unless it’s absolutely necessary, and talking therapies have been shown to be just as effective as drugs for moderate to severe anxiety, so patients should be given a choice at the very least.’

In my previous blog post on suicide, I pointed out the integral role played by certain kinds of negative thoughts, the same holds true for generalized anxiety with thoughts of worry. The interpretation we give to our situation or our physical responses is intimately related to anxiety. Of course, we can try to change our physical responses or modify our situation, but the only approach that can really bolster human freedom is to be able to change our way of interpreting our world. This is in keeping with the fundamental teaching of Christianity that it all begins in the disposition of the heart. The most beneficial treatment that expands our real choice is an examination of problematic thoughts and an exploration of methods to cope with them.  Often, pharmaceutical treatment options merely mask the underlying causes of anxiety disorder and only temporarily affect one’s emotions. Just as the problem of suicide is not primarily about friends and money, but about our way of looking at the world, so the problem of anxiety is not primarily about medications, but again how we interpret the world around us.

Cognitive therapy may play a crucial role in helping the anxiety sufferer re-focus attention on the present without the indeterminate speculation on the future.  The ancient fathers recognized the dangers of future oriented thinking and their relation to anxiety and fear. Of course, symptom reduction is good, but ultimately not good enough. Mood disorders are more than just unpleasant emotions sabotaging life’s activities. Such conditions are about a restricted freedom that does not allow people to do all that they are called to do. Medicines have their use, but the only way to outward freedom is to acquire inner freedom. And the path to inner freedom is to learn how to respond to the thoughts, when to respond to the thoughts, how to judge the thoughts, how to act in spite of the thoughts, and above all, how to cultivate thoughts that bring peace, hope, and love. Cognitive therapy can guide someone to initial steps to adaptive functioning; the Church fathers can point out the signposts that lead beyond that adaptive functioning to that way of life, which is eternal.

In an earlier blog post, I mentioned, “I’ve written concerning the psychological and spiritual harm caused by focusing on the future without due regard for the present. Those comments still apply today: “We all have a spiritual heart that we can strive to discover through simple repentance and by calling upon the name of our Lord. It will take time for our fears, anxieties, and imaginings to weaken. Remembering God, remaining in the present, vigilantly guarding the heart against the ‘terrors of the night’ by trust in God will help.  Love, we are reminded in Scripture, casts out all fear. Love that is not selfish, but given wholly over to God, does not have the mental space to give itself over to fear.  As I mentioned in a previous blog post, “So too, in our own lives, Jesus is not to be found in death (fear).  “He is not here.”  He has overcome death and cast out all fear, trampling down death by death.  Whatever we fear, whomever we fear has been conquered by the glory of the Cross and Resurrection.  If we have fear ever dwelling in our hearts, we are harming our physical, mental, and spiritual health. Neuroscience, psychiatry, and the Gospel agree on this point. Such fear is certainly not of God. Such fear keeps us chained to illusory and deceptive thoughts that alienate us from God and one another.  Yet, that chain has been broken, Satan has been conquered, fear has been overcome.  We need only recognize this and be glad in Him who has made us a new creation.”

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