“I’ve always wanted to help people.” My medical school application essay opened with those words, and when I came to Baltimore at age twenty to start my medical training, I was dead-set on helping people in Africa. After two years of attending church in the Sandtown-Winchester neighborhood, though, I fell in love with the community, so my wife and I decided to move into the neighborhood in 2009. I admired the work my church there was doing to deal with the poverty, racism, and institutional neglect Sandtown was known for. (It became even more well-known for these ills in April 2015 when Freddie Gray suffered his fatal injury here.)

I helped to start a community mental health program with the church while also participating in other ministries. After finishing my residency, I found a great job at a community health center that allowed me to balance vocation, family, and advocacy. Our fellow church members, poor as they were, joined forces to bless the even less fortunate by sending us overseas to a maternity and pediatric hospital in South Sudan.

In my work in Sandtown, it felt good to be helping others as I had always wanted to do, loving my neighbor in word and deed. Yet I felt unable to help myself.

I remember the day my hands started to shake as I walked the two blocks from my main office to our satellite location. This other office, I knew, had unfiltered, unprotected wireless internet, and simply thinking about the ease with which I could access pornography there made me feel nauseated. I reached in my pocket for my phone to call a friend and community leader, Elder, as he is known in Sandtown.

Though I knew I had a problem, I justified my half-heartedness in the battle for purity by holding up the good works I was trying to do.

“I just need you to pray for me. I’m feeling really tempted,” I said.

“I will pray for you, brother, but I want you to think about our community,” he said, as he nearly always did when I called.

Like many other young do-gooders, I began my ministry work full of idealism and quickly met the harsh realities of inner-city life. The church that Elder started several decades ago works closely with mine, guided by the same principles of Christian community development pioneered by the civil rights hero John Perkins, and we often shared our frustrations about addressing the issues that have made Sandtown infamous. Helping people here isn’t easy, and for a long time, “thinking about the community” meant thinking about my failures and shortcomings. Sure, I’d had some successes over the years, but I’d also learned how persistent the stigma and shame of mental health issues could be in a community like ours, and how devious Satan could be in destroying the lives of the people I was investing in.

The struggle I was experiencing the day I called Elder mirrored what I’d seen my neighbors go through in dealing with their own mental illness and addictions. I found myself making the same excuses about getting help I’d heard them make, yet I was still faster to recognize their pride than my own. All the same, I worried that neither they nor I could ever get better, and I felt ashamed that my desire to love my neighbor did not extend to the people on my computer screen, or to my wife, to whom I had vowed to be faithful. While I had struggled with pornography since I was a teenager, in the course of my time in Sandtown, I’d begun using it more and more – a response to my anxiety about how much good I was really doing in my efforts to help the neighborhood. In effect, I was asking pornography to cover up my inability to be the perfect Christian social justice advocate. Though I knew I had a problem, to myself I justified my half-heartedness in the battle for purity by holding up the good works I was doing (or trying to do). My addiction held such power over me that I had grown accustomed to hiding the depth of my brokenness even from myself.

Like most people, I far preferred to offer help than receive it. But my decision to reach out to Elder turned out to be a game-changer. After I confessed my sin in our Bible study, he invited me to meet more regularly with other people from the neighborhood to help conquer my addiction. As I submitted to his spiritual direction and let myself be accountable to him, he helped me to see a different way of relating to the neighborhood. He shared many of his own struggles and feelings of inadequacy, and by doing this, he modeled how I could think about my community and pray for my neighbors in a way that expected God to work regardless of my efforts. When I reoriented my heart toward loving Christ first, it was much easier to see that my self-perceived failures could not stop his work in redeeming his people.

Most decent addiction programs recognize the need for a holistic approach, in part because it’s so clear how the barbed hooks of addiction embed themselves in a person’s mind, body, spirit, and community. The importance of good friends, stable work or hobbies, regular exercise, a good diet, and spiritual discipline is routinely emphasized by practitioners and therapists who understand how a patient’s day-to-day life differs from the few hours a week they spend together. Still, despite the many psychiatrists and pastors who appreciate this reality, I often hear from patients how a trusted authority breezily denied or ignored either the biochemical or the spiritual dimension of their illness. What’s more, despite noble exceptions, not enough recovery programs recognize how poverty puts the recommended practices of self-care out of many addicts’ reach.

A boy plays in the Sandtown neighborhood of Baltimore, where Freddie Gray was arrested.
Photograph by Andrew Burton / Getty Images.

Related Article When Love Demands Justice – by Noel Castellanos Read

The first step for those of us seeking to serve broken neighborhoods, then, is to avoid the temptation to self-importantly distance ourselves from those we are helping. Wealth and privilege can blind us to the spiritual realities that shape all disease (not just mental illness). The Enlightenment worldview that comes with a professional degree pushes us to treat addiction and mental illness as wholly biochemical processes that are suffered passively. The treatment, we too easily believe, lies in submitting to pharmaceutical modification and professional therapy. While well-intentioned, we may fail to realize that our attitude is just as simplistic as our less “enlightened” neighbors’ belief that mental illness and addiction are purely a matter of sinfulness or spiritual oppression, unconnected with the body.

Wealth and privilege can blind us to the spiritual realities that shape all disease.

In fact, both approaches – the modern scientific impulse to define every injurious behavior as “addictive,” as well as the reactionary tendency to deny that there’s anything biochemically mediated about plain old sinfulness – fall short in describing most people’s experience of addiction. Sin begins in our hearts, minds, and souls, to be sure, but it almost always spreads to our tongues, hands, and genitals, so that even our brains are physically reshaped (most obviously in the case of drug addiction). As a result, addicts usually suffer from a combination of basic human sinfulness, paralyzing social shame, and the ugly feedback of brain chemistry, with no bright lines marking where one category ends and another begins.

Accordingly, when people seek healing, we should recognize how important it is to bring all aspects of a person’s life to light so that we may bring every possible resource to bear: community support, regular accountability, prayer, pharmaceutical treatment (if indicated), and careful discussion with a professional. Most people – including myself – need to acknowledge both the physical and spiritual dimensions of their addiction in order to begin to fully recover. Furthermore, while loneliness, poverty, and abuse do predispose people to addiction and other mental illnesses, it is foolhardy to suppose that addressing these issues will somehow magically cure a person’s addiction. Overzealous writers, politicians, and policy makers often proclaim that the answer is simple: addiction will be solved by medication, or better community programs, or prayer, or more jobs. There are too many addicts who are medicated, friendly, and spiritual for any of these theories to be true.

In our urban mental health ministry, one place we’ve seen real successes is a support group that uses participatory learning methods adopted from the Community Health Evangelism program. Through this group, church members work together to find a holistic understanding of their minds and bodies, one that draws from the Bible while incorporating insights from medical science and psychology. Given that many people are hesitant to seek formal counseling and don’t want to roll the dice with whatever pharmaceutical cocktail a psychiatrist might prescribe, groups like this hold great potential for meeting the needs of hurting people in vulnerable communities. In addition, they enable participants who would benefit from medications or counseling to get to know others who can help them gain access to what they need.

The beginning of healing is to face our problems with the help of others, in community.

The second step for those of us seeking to serve impoverished communities is just as crucial: we must acknowledge our patients’ strengths and recognize how they can serve us. By offering them the power to ask hard questions and to hold us accountable, we can learn to grow together with them spiritually. This helps us look up to those who can help us, not just down to those we can assist.

Though I began my career intent on helping others, it wasn’t until I learned to submit to my neighbors and to accept their help that I recognized how I’d been holding out for the sake of my pride, allowing my desire to be a helper to overtake my love for Christ. Of course, one does not have to be struggling with sexual sin, addiction, or mental illness to benefit from this sort of honesty and accountability. Still, demonstrating vulnerability and asking for accountability in just these areas is especially powerful in building trust and strengthening relationships. After all, so many of our neighbors in broken communities are struggling with these problems too.

The longer I prayed with my new friends from the neighborhood, the deeper our sense of solidarity became. There are countless ways in which my race, class, and background give me privileges that they don’t have, but at the foot of the cross the only privilege that mattered was being one with Christ. I couldn’t pull rank; the questions Elder asked me in our weekly counseling sessions – questions that in many cases he’d learned from Gordon Cosby (1917–2013), founder of the Church of the Saviour in Washington, DC – disarmed my excuses and forced me to find ways to keep my promises.

Regardless of our level of wealth or privilege, those of us who want to serve the poor must learn to allow the line between helper and helped to dissolve. As human beings, our minds, bodies, and spirits inextricably work together – or are broken together. For all of us, the beginning of healing is to face our problems with the help of others, in community. By learning to see our neighbors not as objects of pity but as fellow image-bearers – brothers and sisters whom we can serve and be served by – we become better able to guide one another to Christ.