The most recent issue of Liturgy is on “Liturgy in Rural Settings,” with one essay, excerpted here, on the mental health needs of rural people. The church’s weekly worship can serve as a place for solace and meaning for people who are floundering, writes Jeanne Hoeft, associate professor pastoral theology and care.
One of the aims of pastoral care is to help people give meaning to their experience of suffering. Crises can disrupt prior frameworks for understanding one’s self and the world. While chronic stress, illness, abuse, and ongoing struggles exert persistent pressure to be spoken, pain and suffering often seem to defy words. Available explanations are not adequate and can lead to further pain and suffering
Persons living with depression may describe themselves as worthless and their depression as a sign of personal failure. When depression continues, it reinforces the sense of worthlessness that further exacerbates the depression. An alternative, more life-giving framework would describe feelings of worthlessness as a consequence of physiological occurrences that require courage and strength to live with. In this way, persons living with depression can describe themselves as strong and courageous, which can actually help reduce the symptoms of depression.
Pastoral caregivers often help people reframe their understanding of God’s story or lift up alternative stories that might be more life-giving. People of faith long to see themselves interacting with God, loving, and being loved by God, and they find hope in the stories of God’s interaction with ordinary people throughout history.
Hearing the stories, perhaps through Bible reading or hymn singing, can remind [those living with depression or trauma] that God’s presence does not rely on their “feeling,” just as sometimes when persons do not feel loved they must rely on the evidence of that love through others’ behavior. A person lost in the depths of depression may be able to say, “I know I am loved because someone cooked a meal for me.” Likewise, the community of friends and family are challenged to trust that love matters, whether or not it seems to be appreciated or to make a difference, because often someone in the midst of severe depression has little ability to express love in return. . . .
In addition to supportive conversations and other activities of care, Sunday morning worship can be a means of pastoral care for people who live with mental health challenges and risk of suicide. Worship is not primarily a means of care, but looking at worship for its potential to serve as a means of care, or as a barrier, is especially important in rural communities where there are limited programs or opportunities to address more broadly issues that impact persons’ well-being.
Worship can be an opportunity for education, but it does more than that from a pastoral care perspective; it places day-to-day human life in the context of the day-to-day activity of God. As pastoral theologian Herbert Anderson and liturgical theologian Edward Foley argue, worship weaves together narrative and ritual as a means for “transform[ing] persons and communities of faith into signs of the presence of God.” (Mighty Stories, Dangerous Rituals, Jossey-Bass, 1998).
In worship, the story of God, Christ, and church is enacted, embodied, and envisioned. For those living with mental illness and risk of suicide, worship can contribute to well-being . . . providing an interpretive framework for a life of hope in the midst of mental health problems.
Find the full essay in Liturgy 33, no. 4, available by personal subscription and through many libraries.