Renewing of the Mind (Part 1) Phil 4:5-7

I've recently been more and more interested in Psychiatry and specifically in Cognitive Behavioral Therapy (CBT). I’ve had several intriguing conversations with Jeffrey Schwarz (who showed the brain changes that occur with CBT) and I’ve studied under David Burns (most famously of Feeling Good) and his TEAM therapy. CBT as I understand it, essentially focuses on intentionally practicing certain thoughts. The idea is that many mental illnesses are at their core an irrational belief which leads to a habit of bad thinking. If this irrational belief can be identified, confronted with rationality, and then finally ousted through practice of right thinking, there will be some healing. Essentially, the theory asserts that you can choose your thoughts, and so by indirect consequence, you can choose your moods. If you think depressing thoughts, you will wind up depressed. If you think pleasant thoughts, you won’t. The role of the therapist is to help teach a person to identify the irrational thoughts and practice rational ones.

[Now please note: this is what I have learned from two specific thinkers in CBT. CBT doesn’t strike me as a standardized orthodoxy, so these observations might not be true elsewhere, and as I am only a neophyte, it might not even be true here.]

I was reading in Philippians yesterday and chapter 4 really jumped out at me because it seemed that Paul in the First Century had figured out CBT. This will begin a long-running series on Psychotherapy in the Bible. I’ve had the thought before, but decided “here” was as good a place as any to start. If you have other passages that speak to this question, please let me know and I’ll (eventually) write about them. I’d be interested to collect these from other traditions, literature and philosophy. So if you’re a Shakespeare scholar, send some passages my way. Or if you know about parallel passages in the Koran, please let me know.

5 Let your reasonableness be known to everyone. The Lord is at hand; 6 do not be anxious about anything, but in everything by prayer and supplication with thanksgiving let your requests be made known to God. 7 And the peace of God, which surpasses all understanding, will guard your hearts and your minds in Christ Jesus. (Philippians 4, ESV)

The sections starts off with “reasonableness,” and moves immediately to anxiety. The alternative to anxiety is prayer with thanksgiving. The immediate consequence of this thankful prayer is the peace of God. And this peace itself becomes a defense of both the heart and the mind.

One of the major ‘irrationalities’ that cause anxiety is the desire to control. What if I fail that test? It’s Friday night and I’m out of town; what is she doing right now? I don’t know everyone at the party; what if they don’t like me? I’m speaking in five minutes; what if I say something stupid? What if the plane crashes? Everyone has the temptation to fall into these anxious thoughts. What does Paul advise? Pray. Give it to God.

What does that do? It helps you realize that it’s in God’s hands, anyways (everything is, after all). Kneeling before the Throne Room of the Universe, one feels humble; not the big shot who has something to prove. And then when one rises from prayer, and walks out of the Throne Room, one realizes that one was just in the THRONE ROOM OF THE UNIVERSE. What problem could possibly concern Heaven? And what problem could possibly concern one of its citizens?

Also, we can’t forget the thankfulness. No matter how bad things get, every Christian can open his prayer with: “Thank you Father, for life and breath and salvation.” Though every once in a while you get a man like Job, most can go a lot further than that prayer. Most can be thankful for family, health and even wealth. Most have some hint of nature (sun or stars or sky if nothing else) that they can be thankful for.

Paul tells us to pray a lot. He tells us to practice this set of thoughts and attitudes. And when we do this, we’ll be armored from further assault to both heart (emotions) and mind. Exactly in agreement with CBT, Paul says that something you practice by conscious effort (prayer) will be a guard against future perturbation of mood (“heart”) and thought (“mind”).

So let’s imagine our first character, overwhelmed with feelings of anxiety for an upcoming exam. He is anxious probably because he’s grasping onto his pride and playing out the worst case-scenario in his mind, over and over again. He’s imagining getting the test back, with a big “F” on it, and his having to take the course again, and lose his scholarships, and be ridiculed by friends, and have to go home and tell his parents, and not get into medical school, and, and, and… Now let’s let him pray:

Father, I thank you for life and breath and salvation. I thank you that you have given me the opportunity to study at this wonderful school, that you’ve given me friends that believe in me and a family that loves me. Thank you for this beautiful day, the warm sun and calm green trees. I lift up this exam to you. I have been diligent in my preparation; I have studied what I have studied and done all that I can. And so now I pray that you give me success. Passing this exam will ultimately help me serve your children by entering medical school. Nevertheless, not my will but yours be done: I trust that you will be with me and will do what’s best for me, be it to fail this exam or to pass. Amen.

 If our young friend prays this prayer (or others like it) for 15 minutes a day, he’ll have a lot harder time stressing out about the exam. It’s in God’s hands. He’s accepted the possibility that he might fail, but he’s not worried about that either. On top of it all, he began with gratitude; even this alone will put him in a better mood than when he started.

The pattern of Philippians 4:5-7 is brilliant and powerful:
1. Begin with being reasonable.
2. Don’t worry.
3. Instead, pray and be thankful.
4. This will guard your heart and mind.

Service as Rx

Our Psych professor brings in patients from the Psych ward to interview with him on their condition so as to help us to learn. At first he was hesitant, worrying about the stress that such public revelation would put on the patients. But there have been universally positive responses; the patients focus on their ability to do good by helping us learn.

This is a key insight: our mental health may depend on service to others. Could the be employed in the Psych wards and metal health institutions? Can we figure out a way to give depressed and anxious patients the ability to focus outwards, and help those in need? I think this would be a great way to help two sets of people significantly, and to help teach Psychiatrist that there is more to mental health than chemical imbalance. Or for the particularly stubborn materialists, that chemical imbalance may be solved by serving others.

Maybe in a while your doctor will diagnose you as having a "service deficiency" and the prescription being "visiting a nursing home MWF".

Spiritual Health

What is spiritual health? I have long thought about this question, especially since my profession’s concern is with ‘health’. Spiritual health is certainly important for physical health. Many scientific articles have shown that things like church attendance and belief have measurable positive effects on physical health (one study showed that church attendance lowered mortality so significantly that a lifelong churchgoer would live seven additional years compared to the non-attendee). My first thought was, “Great! Everybody should go to church!” but this suggestion was vehemently opposed by those who are deathly allergic to religion (most of my classmates and professors). Even I, upon reflection, concluded that an Atheist who took my advice and went to church hating every last Sunday morning would likely not live seven years longer.

What then can I do? My job is to share whatever of God’s love and healing as I can with my patients, even those who are unwilling to go to church. Are there benefits of spiritual practice which are sharable with non-Christians? Or is it Divine intervention that gives churchgoers their extended lives? Though I can’t completely rule out God’s favor (I am, after all, a rational person who does not come to conclusions without evidence), it seems likely to me that if there were such an effect, it would at least be coupled with a natural one. That is, there is probably some positive psycho-socio-physical effect that could indeed be transferred to the heathen (גוי – literally “non-Jews”; figuratively “not God’s people”... no offense to the heathen).

And so I must return to my original question: what is spiritual health? For a long time, my thoughts on this question were informed (and limited) by the traditional Christian answer: fellowship, prayer, service/evangelism and Bible study. These have certainly laid the foundations for my own spiritual health. But can these be generalized? Is there some part of the benefit of prayer which a Hindu could get by meditation (or conversely, what of spiritual health are Christians missing by ignoring God’s command to “be still and know that I am God”)?

In considering my own spiritual life, I identified seven areas which I believe are important for spiritual health (and I didn’t make it be seven on purpose… that’s something I’m liable to do but I didn’t). They are 1. Relationship with family 2. Relationship with friends 3. Sleep and rest 4. Spiritual exercise 5. Private spiritual expression 6. Confidential spiritual expression 7. Public spiritual expression. I’ll describe how I have seen the church engage these seven points, and then how it may be generalized.

1. Relationship with Family
A Christian is encouraged to have a good relationship with her literal family. Many places command respect for parents, love of wife/husband, and care for kids. My church in Temecula places a strong emphasis on this point.

Family and family responsibility is a large part of being human. From a crude biological sense, reproduction and child-rearing is our only important role. And the sensibilities of most people today and those throughout history have placed a special significance on having a good relationship with our families. Indeed marriage has been shown to extend lifespan (and my guess is that a good marriage does so more than a bad one).

2. Relationship with Friends
A Christian is encouraged to have friends to whom she can go. These are developed in ‘Small Groups’ or via Discipling (mentoring) relationships. There are many emphatic commands to love one another, and many incredible examples of such relationships in the New Testament.

Friendship and community is one of the most universally accepted human goods. It is certainly not the exclusive domain of the church (though the Church has often been the friend to the friendless historically). Psychological studies have started mapping this as a variable that is linked to mental health.

3. Sleep and Rest
God is quite concerned about rest. He talks about the Sabbath a whole lot more than Christians are comfortable with and themes of Rest are throughout the Bible. Christian generally rest at least 1½ hours on Sunday morning.

Rest is really important. We all know this. And even the idea of intentionally not working is important. I’ve heard an apocryphal story of the USSR switching to a 6 day work week because of productivity declines after they tried a 7 day work week. We need rest and we need sleep, be we Christian or Atheist.

4. Spiritual Exercise
There are lots of exercises we’re supposed to do: bible reading, fasting and service are a few, and the Bible is full of expositions on these. Widows and orphans, justice, and evangelism are things that God would like for us to care about (and the Church generally does care).

Many of these expressions are directly translatable (service), some of them are not (Evangelism), and I think the traditional Christian picture omits some important things. My most recent thinking on the spiritual aspect of a thing is: “that part of an experience which remains after subtracting its rational and emotional aspects.” Serving others, going to church, getting married, going to a funeral all have large spiritual components. But so do hiking and stargazing, art museums and drama performances. These experiences have something about them which is sublime. And I’m inclined to call it spiritual. Even if an Atheist doesn’t go to church, I bet he’d be a spiritually healthier person by stargazing. I don’t know of any studies that link these practices to health, but I think that’s because nobody’s ever looked. This category deserves more thinking, but for the moment is broad enough to be accommodating to everyone.

5-7. Private, confidential and public spiritual expression
A Christian ought to expresses her love for Christ, her hopes and fears, her praise and thankfulness, her sorrow and joy, she confesses her guilt and asks for forgiveness. And she has opportunity to do it through prayer (privately), in small group or accountability (confidential), and at the church building (publicly).

These expression of the human heart, mind and soul cannot only be the turf of the Church. I think the Church has worked out a very convenient way to regularly express them, but the need (and opportunity) is universal. A person may quietly reflect on his guilt without asking forgiveness from God; part of the benefit of prayerful confession will be maintained. Mentees can express their hope for the future just as well as disciple-ees. Joy can be expressed at a Dave Matthews Band concert as well as at one by Switchfoot.



What is spiritual health? I’m not sure entirely. But I think the traditional Christian framework, refined by two thousand years of spiritually health people and generalized, is an excellent way to think about spiritual health. I am very interested in further refinements and improvement, but I think even in its early stage, if a person made efforts to improve in these seven areas, he’d be better off. And that goes for Christians and non-Christians alike.

In a first step to help people improve their spiritual health, I have designed a Spiritual Health Self Assessment. It takes about 20-30 minutes and encourages participants to reflect on their spiritual health and includes a section for planning for self-improvement. The next step is to recruit and train Spiritual Healthcare Providers (SPHs). But more about that later.

I would love for you, my reader, to participate and improve your own spiritual health (and give me feedback, so I can better heal the spirit):

http://spreadsheets.google.com/viewform?key=pf7AfX9bzlgKiSUawghjrKA&hl=en

Take it once a week for better health, (future) Doctor’s orders.