Last year, Plough’s Joy Clarkson spoke with Professor John Swinton about finding a more Christian approach to mental health challenges. In this follow-up interview, Joy relays some of the questions we received from Plough readers, exploring themes of generational trauma, the burden and gift of Christian friendship, and how to live through seasons when it feels like you have been abandoned by God.

Joy Clarkson: For some people, mental health issues have been passed down through generations. How can we account for this? How do we think about this question theologically and pastorally?

John Swinton: Well, that is quite a question! What we seem to be talking about here is generational trauma; psychological burdens passed down through stories, and historical and contemporary experiences. Alcoholism, for instance, tends to run in families. Why is this? There are, I think, several ways we could answer this. Alcoholism is not purely genetic (though this may also be the case); it is socially contagious. If children see their parents dealing with stress by turning to alcohol, they will learn that this is how one should or can deal with stress. In part, alcoholism runs across generations because of the way it is modeled to people by those close to them. Here as in other conditions, there may also sometimes be a genetic component. This can lead us to question God’s goodness: how could God allow this? Theologically, I think it is best to accept we know that our genetics don’t always work even if we can’t know why. As modern people we don’t feel comfortable with mystery; we want to turn mysteries into puzzles and solve them! But when it comes to genetics, I think we might be better to accept the mystery and do our best to help people with genetic conditions live well even in the midst of their difficult experiences. One day we will know why, but for now we see through a glass darkly (1 Cor. 13:12).

Spending time with Māori friends in New Zealand as well as others who are Aboriginal and Torres Strait Islanders in Australia, and considering my own African-Caribbean history, has also led me to read and reflect on studies that have indicated marked racial disparities in mental health treatment and prognosis. It would be easy to attribute these disparities to mental health professionals acting in a prejudiced way. This is certainly possible, but the situation is often much more complex. We have to remember that groups who have experienced trauma and abuse for generations often harbor suspicion of authorities like the police or health services, which is not unreasonable given the shocking and abundant history of medical experimentation on people of color. These communities, then, tend not to approach formal health services unless they absolutely have to, and thus people of color may sometimes be more unwell than their white counterparts when they pursue treatment. The fact that there is a racial disparity in treatment can be attributed to racism, but not necessarily the racism of any given practitioner. It may be caused by generational trauma and a mistrust that impacts the ways in which people access services, which can have significant mental health implications both individually and systemically.

All of these contributing factors (social, genetic, and societal) remind us that we are the authors of one another’s stories in crucial ways. To varying extents we are all the victims of a broken history; we all carry wounds that we do not deserve, whether those are from racial trauma, social modeling, or genetic mischance. Nevertheless, in Jesus we have been given the opportunity to live differently. We are not prisoners of our history. No matter what has happened to us, where we have been and what we have done, redemption and healing remain possible. That is not to suggest that we downplay generational trauma and abuse. Forgiveness requires repentance, which in turn requires that people take responsibility for their abusive actions. It is also not to downplay how difficult healing can be. The healing gifts of the mental health professions are crucial for all people working through generational trauma in its various and diverse forms. But the church can model the deep healing that comes with the gospel.

When it comes to mental health, how can we bear one another’s burdens when those burdens feel very heavy (Gal. 6:2)? What role does Christian friendship play in this process?

Living with mental health challenges can be hard work! And living alongside someone who has a mental health challenge can also be hard work. There is no room for idealism when the rubber hits the road. I think one of the keys to navigating these things well is learning to be honest about our pain and suffering. If, as Christians, we think we have to hide our feelings or simply endure difficulties in silence, we will end up with new difficulties. We need to name our suffering.

Ivan Aivazovsky, Fishing Boats in a Harbor, oil on canvas, 1854

I find the psalms of lament helpful in this respect (Ps. 3, 44, 88). If we read the psalms of lament, we very quickly realize that prayer, like love, is not a starry-eyed enterprise. As we listen to the psalmist railing against God, accusing God of abandoning him, not being faithful to the covenant, not doing what God has promised, we begin to feel rather uneasy. There are not many contemporary worship songs that speak with the vehemence and honesty of the Psalms, even though we often feel angry, alienated, and lost. The psalms remind us that God wants us to be honest about our suffering and gives us language to articulate difficult experiences. This kind of prayer opens space to include suffering and difficulties into our worship life without unnecessary guilt.

Regarding your second question, I think Christian friendship can bring healing in at least two ways, one relating to people experiencing mental health challenges and the other for those offering care and support to them. An interesting and crucial thing to notice is what Christ’s friendship looks like in the gospels and to whom it is offered. In John 15, Jesus says to his disciplines that they are no longer servants but are now his friends. In this profound act of renaming, Jesus makes discipleship friendship. But what kind of friendship does Jesus have in mind? The principle of the incarnation is that God, who is utterly unlike human beings, becomes human and offers friendship to human beings in general. This is striking. Within contemporary Western society, friendships tends to be amongst equals, that is, like-minded people who have similar interest to one’s own, who belong to the same social circles, class, race etc. The basic principle is “like attracts like.” This makes friendship difficult to find for people who see and experience the world differently. However, the friendship modeled by Jesus is for “the outsider”: the socially marginalized, the stigmatized, the outcast, the prostitute, the sinner. Bearing in mind that many people, particularly those with severe mental health challenges, are marginalized, stigmatized, and pushed aside, this model of friendship is crucial if the church is to take discipleship seriously. If the church claims to be the community of the friends of Jesus, it must engage in Christ-like friendships toward all people, particularly those who have been and are marginalized. The gift of friendship shows and reminds people that they are valued and indeed valuable individuals; that is a gift the church must offer all people. It is simply not an option.

But friendship is also invaluable for those who struggle to care and support people with mental health challenges. My mum is ninety-eight. She still lives at home but she requires a lot of support. We have a big family, so we are able to work it out so that she has someone with her every day and every night. It’s hard work! I go to spend time with her a couple of times a week and it is pretty intense. She needs a lot of help and a lot of company. It can be quite exhausting. But if I can get out of the house for a bit, even for a couple of hours, it makes a world of difference. Even to have that small space for respite is a massive help in terms of my mental health, and that of everyone else in the situation. We want to help and care for her, but we also need respite. I would urge people to think about that in the context of those who are offering care and support to people living with mental health challenges. Offer the gifts of time, respite, and friendship to those who are caring for someone with extra needs. It won’t fix the situation, but it will make a massive difference.

What would you say to people who currently find themselves in the storm, feeling like Jesus is far away? What consolation would you offer them? And what advice?

It is not uncommon for Christians to comment something like this to people who are going through depression: “Well if you prayed a little harder, had more faith, or read your Bible a bit more carefully, this kind of sadness and disconnection wouldn’t happen.” It sometimes seems that people assume that happiness is equivalent to faith. However, when in Galatians 5:22–23 Paul talks about the fruits of the Spirit, nowhere does he mention happiness as a fruit of the Spirit. So why would sadness and depression bring about accusations of faithlessness, that is, being out of touch with the Spirit? The question gains even more poignancy when we hear Isaiah talk about God hiding from humans (Isa. 45:15), and Psalm 88 ends with the desolate statement: “darkness is my only companion.” The interesting thing about this psalm is that it is a prayer. It’s not that the psalmist has a crisis of faith. He has a crisis of disconnection. In like manner, when Jesus cries from the cross “My God, My God, why have you forsaken me?” he is not having a crisis of faith. He is having a crisis of disconnection. In other words, the kind of disconnection that people experience in the midst of depression is not alien to our tradition and is not a mark of faithlessness. Importantly, then, even when someone feels disconnected from God, they can find a point of connection with Jesus. Jesus is there in the midst of the storm and he knows how you feel. You are not abandoned. Jesus is with you and will always be with you. Nothing can separate us from the love of God (Rom. 8:31–39).