Abstract
In this timely book, John Swinton, a former psychiatric nurse, interviews Christians with mental health difficulties about their faith. These challenges require our best theologies and compassionate listening. He addresses stigma, psychiatric medication, and the cultural meaning of illness, without being reductionistic.
In the first chapter, he discusses the role of labeling, arguing that describing mental illness as being just like a physical illness does not help people recover. He critiques the way spirituality is described too generically in health care. In the second chapter, he claims a space for thick description of mental illness that comes from hearing the detail, context, and webs of social relationships among those who suffer.
In the third chapter, he gives examples of people struggling with diagnostic labels and learning to take medicine as an act of faith. He critiques the way Christians blame mental health challenges on sin as a form of “lazy theodicy.” In the fourth chapter, he offers an emotion-rich account of depression and suicide where joy becomes a subversive aspect of spiritual resistance.
In the fifth chapter, he interprets the Psalms as a conversation partner that underscores the feeling of God’s absence during depression. He argues for psychiatric medication as a means towards the chief end of faith—that of us enjoying God forever. In the sixth chapter, he discusses how the withdrawal and depression of schizoaffective disorder can cause people, some with underlying trauma from their families, to feel that faith is less meaningful. In the seventh chapter, he explores the ubiquity of hearing voices and examines different cultural ways of understanding it. In the eighth chapter, he discusses the story of “Alice,” whose church called her demonic because she heard voices and how this discredited and shamed her.
In the ninth chapter, he redefines bipolar disorder by showing how it can open one to transcendence, but that there is a need for “retrospective spiritual direction” in which people reflect on past manic episodes in the light of faith. In the tenth chapter, he distinguishes current notions of the demonic from New Testament ones, showing how people can learn to take medicine in order to deepen vocation. In conclusion, he describes shalom as right relationship with God, which includes holding onto Jesus in difficult storms of mental health struggles.
Swinton focuses on schizophrenia, bipolar, and depression, offering less of a self-help manual and more a theological analysis of the ways the church fails persons with mental illness with its poor theologies. Families arguing over care options might need a different book. The voices of those facing mental health challenges echo through this book, but greater context could have helped. I recommend this work for ministers and educated lay leaders wanting theological honesty about mental health challenges. Mostly, I welcome Swinton’s reminders of God’s abundant grace. God holds onto us even when we face unusual or terrifying experiences.