Out of Madness

One of my several unpaid jobs is registrar for a certifying/accrediting organization for Clinical Pastoral Education. Clinical Pastoral Education (CPE) or sometimes called Clinical Pastoral Training (CPT) grew, largely, out of the experiences and work of theologian, Anton Boisen, 1876-1965.

Anton Boisen, (ca 1900) Shortly after first psychotic break

(Side thought: Boisen lived to to be almost 89. Looking at other great Christian theologians of the 20th century, most  (unless killed by violence or misadventure) appear to live well beyond normal life expectancy for their time and demographics. Does that mean that theology is good for one’s health? Or does it mean that one can become considered a great theologian if one is able to outlive others?)

Anton Boisen had several psychotic breaks (five I believe) during his lifetime, requiring him to be institutionalized for periods of time. He came to the conclusion that sometimes, particularly if not due to an organic cause, a psychotic break is due to a “problem of the soul.” As such, it may have a religious cause, and a potential religious cure. Now to some this may appear to be… to choose a technical term… gobbledygook. But if you think about it, it actually holds merit.

Religious concerns are tied to issues of:

  • Ethics
  • Meaning
  • Belongingness

Is it possible that some psychotic breaks could the mind’s way of addressing issues of ethics (Is my actions and beliefs consistent or in conflict? Am I, essentially, a good person or an evil person?), meaning (Do I have value as an individual? Does life (or more specifically, my life) have meaning? Am I living the life I am supposed to live, or have I taken a wrong turn?), and belongingness (Am I a loyal child of God? Is God someone I can trust? Do I have a healthy role in church/family/God’s kingdom? Is their ultimate hope?)? If these issues (existential doubts and otherwise) are left undealt with, could a breakdown occur? And if so, is drugs and quarantine the best solution?

Boisen brought in theology students to the hospitals, especially mental hospitals, to learn Clinical (“bedside”) Pastoral Care. .The skills there, and the training process associated with this program have been found useful in a broad range of locations beyond hospitals, mental hospitals, and hospices, including jails, parishes, and communities.

I don’t know about you, but reading Zechariah and Ezekiel, it is not hard to wonder if they were mad. Perhaps the same could be said of John the Baptist. Frankly, if they were mad… would that negate their message, or can God use the illness?. Of course, even if they were 100% certified mentally competent, some of their actions could be seen by outsiders as demonstration of mental illness— and then discounted.

And that’s a shame, I suppose. Mental illness may not have the stigma it used to. People do not think of the mentally ill in terms of rubber rooms and straightjackets anymore (or do they?). The big problem is that the label of mental illness often stigmatizes the individual, sometimes for life, and tends to negate their insights. Dr. Cabot, a medical partner of Boisen, cut ties with him after a psychotic break. Understandable, I am sure… but a sad mistake none the less.

I have never been diagnosed with mental illness. I doubt I drift far enough away from the middle of the Gaussian plot, yet, to be so labelled. As a melancholic I do have depressive periods of my life, but I doubt severe or long enough to meet criteria for the DSM-V (for various forms of depressive episodes or disorders). However, I have also utilized a bit of “Boisenian” logic when I have been down. When I am going through a depressive period, I take time to reflect. I consider whether it was triggered due to a disconnect. I know I should be doing A, but am doing B. I have found such reflection quite useful, frankly.

Three quick thoughts:

  • The mentally ill need God’s love. In fact, sometimes the recognition of the meaning and belongingness before God is the start of their “cure of soul.”
  •  Genius may come from, or be confused with, madness. This is not surprising since both genius and mental illness are defined first of all by their distance from the “normal.” Sometimes, the truth is found in the “voice crying in the wilderness.”
  • Mental illness should not be stigmatized. In fact, as in the case of Boisen, the process of psychotic breaks gave him a perspective that helped him serve God more effectively.


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