Dr. Matthew Stanford, PhD, Baylor University, is a neuroscientist who has published more than 100 peer-reviewed articles and book chapters on psychology, psychiatry, and neuroscience. His research has been cited in The New York Times, USA Today, and Christianity Today.
Dr. Stanford is currently the CEO of the faith-based, non-profit Hope and Healing Center and Institute in Houston Texas, and a Fellow of the Association for Psychological Science. Before this, he was Professor of Psychology, Neuroscience, and Biomedical Studies at Baylor University from 2003-2015.
He is a member of the Southern Baptist Convention’s Mental Health Advisory Group, and the American Bible Society’s Trauma Healing Institute Advisory Council.
He’s also the author of one of my favorite books, Grace for the Afflicted: A Clinical and Biblical Perspective on Mental Illness, as well as The Biology of Sin: Grace Hope and Healing for Those Who Feel Trapped.
We recently talked about mental illness, the church, a little bit of Solomon (the aging, tons of wives Solomon), and why it’s so important for the church to address mental health.
Our discussion has been lightly edited for clarity and brevity.
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The Weary Christian: Why do you think there’s still such a stigma in the Christian church around mental health, and do you think it’s greater in the church than it society, at large?
Dr. Stanford: I think the stigma in the church is differently focused than it is in the general population, but I don’t know that it’s necessarily worse. It seems worse because you’re walking into a community that should be accepting and hope-filled and ready to walk along with people who are struggling, and then they don’t.
In the Christian community, you get this spiritual sense to it, whereas in the general population you get more of a fear-based response – mentally ill people are either someone to be fearful of or to look down upon because they’re “lazy” or they don’t “work hard enough to get over their problems.”
In the Christian community, it’s all put around the context of weak faith or a sin issue, so the Christian community will just tend to think if the person just works a little bit harder on their faith, then it will go away.
As far as why that is, I think it’s an issue we’ve been dealing with since the dawn of faith. If you look in the Scriptures at the mentions of people who are “mad,” they’re not particularly treated well. I think the church has been struggling with it for a long time.
I think the church has had the tendency that when they don’t understand something, they spiritualize it on a negative side, so it’s easy to say it’s demonic, because we’re people of faith and we want to recognize that spiritual issues are involved, so that’s our default.
But you can go back through the history of the church – at the Salem witch trials, and those all have to do with mental health issues and people being treated negatively, although there are some great examples of Christians stepping out like the Geel Belgium community when people cared for the mentally ill when no one else would. And there’s lots of examples of really significant Christians who’ve been involved.
Quakers basically started all the psychiatric care in the United States. But I still think we struggle with something we don’t understand, because we have a tendency to be fearful.
WC: There’s sometimes skepticism in the church about anything scientific that comes from the secular world. Is that affecting the church’s attitude towards what we’re finding out about the biology of these conditions?
Dr. Stanford: I do find there’s a lot of mistrust and fear of psychology and psychiatry in the church and most of that comes from age-old misunderstandings of what psychology and psychiatry are. I mean, a lot of Christians still think that Freud is what everyone believes. Freud thought religion was a neurosis. The fathers of psychology and psychiatry were no friends of the faith, but those people are long dead, and virtually everything they believed was found to not be true. Nothing is taught like that anymore. I think a lot of it is misunderstanding of what still is there.
I do agree that there’s a lot of – I’ve had lots of pastors say, “Oh there’s no such thing as a chemical imbalance in the brain. That can’t be shown.”
And I say “That’s just an absolute wrong statement. I don’t understand why you’d even say that.” Most of the stuff I’ve heard in churches and from pastors are these ridiculous statements that they probably got off the internet or from some third person who said a bunch of stuff.
I don’t really have a problem with the things [research] I do, because I back it up with a lot of science. So if I tell you that MRI studies have shown brain abnormalities associated with depression, I can back that up with a lot of science, nobody argues with that – nobody says “those aren’t real things.”
The problem is you have a lot of people who say things, and when they do, it’s usually to a naive audience that doesn’t have a response. So a pastor will say something like, “Well, there’s no such thing as a chemical imbalance, they can’t demonstrate that or there’s no test for depression.” These are straw men that are set up and it’s just ridiculous.
I hear a lot of pastors tell me, “I’ve worked with a lot of women who have depression who go through the book of Proverbs and they’ve all recovered.”
That sounds wonderful, but I don’t know that any of those women had depression. I know that antidepressants are overprescribed and a lot of people say they have depression when they don’t.
The other issue is that they throw something at me – like you mentioned earlier – the “joy of the Lord.” I had a pastor once tell me that depression was a sin because the Bible says “Rejoice Always” and I literally asked him if he’d read any other parts of the Bible.
There’s really no other way to describe it, but that’s an asinine quote. Jesus is profoundly sad in parts of his life. I don’t think he has depression. But he’s weeping, so was he sinning because he wasn’t rejoicing at that moment? That’s ridiculous.
So I think most the time it’s just really naive, and if you back it up with real science, I think it’s hard for anyone to argue against it.
WC: We hear the idea “pray it away” regarding mental health problems. Can the actual act of praying affect your neurochemistry or neuroanatomy?
Dr. Stanford: There’s a lot of research that’s been done that people of faith, who are actively involved in a community of faith and believe that their faith is an important part of their life, that they are physically healthier. There’s a lot of research in social psychology on that. It can. If you ask people who are dealing with chronic pain or trying to get over a terminal illness like cancer, if you asked them how they deal with stress, the number one thing everybody says is prayer.
So I think prayer is tremendously therapeutic. I think it can really help people, it helps them deal with stress, it helps them connect with something larger than themselves, to feel encourage and connected. and I think it does change you. And we know that talking therapy – we know that alters brain structures so there’s no reason that prayer wouldn’t. In fact, I’d expect it would. I don’t know why it wouldn’t.
If you look particularly at spiritual disciplines, like people involved in worship or chanting or things like that – there’s been a lot of neurophysiological work done around that and you do get altered brain activity during those behaviors and so the expectation would be that if you did that enough, you would get changes in brain function.
WC: So if prayer can profoundly affect those things, why wouldn’t a skeptic just say, “Well, if one hour of prayer affects you to X degree, maybe two hours of prayer + one hour of devotion following prayer + one more hour would cure it – why couldn’t you pray it away that way?”
Dr. Stanford: I would say to that person — that sounds great, but what’s your evidence that the prescription you just came up with is going to be effective?
If I say you have depression because you meet the criteria for depression and you need to go into a CBT therapy intervention, I can show you a room full of research that demonstrates that that’s going to be an effective approach to treating depression – that it’s demonstrated to be effective versus placebo and versus other forms of treatment for depression.
If you say “Well, I want faith to be integrated into my care”, I say “absolutely. That’s what we do here at Hope and Healing Center.” It will be fully integrated into your care, we’re going to talk about your spiritual life and spiritual growth. Help you build your hope.
I can talk about the science of what’s going to be effective. If someone just says, “Well, you need to pray a lot and it’ll go away”, I’ll say “Okay, well does that work for every mental illness? And if it would work for every mental illness, why are people not doing that” because believe me, people would much rather pray their bipolar disorder away than take a bunch of medication with horrible side effects and be stigmatized by the world.
That’s not saying prayer isn’t useful. I’m just saying it’s not a curative. My next question would be, “If that’s effective for depression, what else is it effective for?” Is that effective for everything? Because I can show you an MRI with brain abnormalities in people with bipolar disorder and if prayer heals the brain, does it heal the pancreas, does it heal the liver? People can say anything they want, but there has to be evidence.
I think this is the threshold you want. When you go to the doctor and the doctor prescribes you a medication or treatment, you just implicitly trust this person is going to give you a treatment that’s been shown to be effective for what you’re presenting. You usually don’t go into a long argument. It should be the same thing with your pastor. If your pastor is telling you a curative approach – I’m not saying it’s wrong to say if you pray more, it will help you grow spiritually. Absolutely, we all know that’s true. There’s evidence for that. But if he says, “If you have bipolar disorder and you pray three hours a day, your bipolar disorder will go away,” there needs to be some demonstrated effect of that.
At a minimum, he needs to be able to roll out several people in front of me who were diagnosed with bipolar disorder who prayed three hours a day and now they don’t have bipolar disorder. I don’t think that’s too much to ask. You would ask that of your physician!
What the pastor is doing is redefining the origin of the illness. They’re saying the illness is spiritual.
You and I were talking a minute ago about the physiological effects of prayer. They’re not really talking about that. They’re saying “your problem is spiritual, if you get more spiritual, you won’t have your problem anymore.”
The WC: In the book, you talk about the relationship between mental health and sin.
In my own life, I’ve had major depressive episodes where I find myself, unfortunately, much more likely to drift into sin. Partially because I have this fatalistic, depressive, “Well, it really doesn’t matter what I do. Who cares. I’m just going to do what I want” attitude.
If someone is being counseled by the church over sin, should the elder confront the sin and then say, “Also, have you thought about talking to a psychiatrist or psychologist about your mental health, because there are some mental health conditions that can predispose you to these sins.”
Dr. Stanford: There’s a book called The Biology of Sin that’s all about impulse control.
I think one of the things we do in the church is we assume that everyone has the same ability to not sin that everyone else does. I do believe everyone has the ability to choose not to sin. There are certainly theologies – if you’re Reformed, then you don’t have the ability to choose not to sin until you’re redeemed, but I would say in a very general sense, everyone can choose to do a right thing or a wrong thing.
But clearly, from neuroscience work, we know that some people do not have as much control over their behavior as others. There’s just no doubt about that. Some people are more likely to sin, given a certain circumstance, because they just don’t have the control they should have. Now the reason they don’t have that control is because of sin – we’re all broken by original sin.
But I do think the church doesn’t really say “Well, this guy is super impulsive, it’s no wonder he got involved in drugs” and “this guy didn’t.” And certainly, they’re both culpable and they’re culpable at the same level, but there’s no sense [in the church] of what in the court system we call a mitigating circumstance. If you killed someone but then in your punishing phase, they showed that your father beat the hell out of you every day in your childhood, you don’t usually get as bad of a sentence. There’s none of that in the court of church.
In the context of mental illness like bipolar disorder and things like that, it is important for pastors to understand that those illnesses do corrupt a person’s impulse control and perceptions of the world and those people may become involved in sinful behavior as a result of the illness.
Now that doesn’t in anyway minimize their culpability, it doesn’t in any way minimize the fact that the church should call them out and tell them this is sinful and show them a path to restoration and forgiveness – but it does help them understand a woman who’s 38 years old and never really had a problem before and suddenly becomes super promiscuous and starts cheating on her husband because she’s in a manic episode.
To just sit that woman down and say “Don’t commit adultery” doesn’t serve her effectively. That conversation also needs to say “Your mental health is deteriorating, and we need to get you to a mental health care provider.” You certainly need to tell her that promiscuity is wrong but just telling her that she’s spending all her money, so let’s “put you in a Dave Ramsey class” – that’s not going to cure the issue.
I think there’s a real fear in the church on this topic, because I think what they would hear me saying is “See, you are giving them an excuse, and you’re saying it’s not sin.”
I’m not saying that, at all. Absolutely I’m saying it’s sin. When our brain and the systems that control our behavior become dysfunctional, of course we have a greater tendency to sin because we are, by nature, sinful. Show me the opposite – show me someone whose brain becomes dysfunctional and they started doing more good things! It never happens that way.
I’m not saying they’re not culpable. The church has no theology of the body. We’ve lost that completely and so whenever we talk about biology, they believe you’re trying to give people excuses to sin.
The WC: In the book, you talk about how Christians with mental illness can serve in the church. I know I’ve had problems with this. When you have a depressive disorder, or an anxiety disorder – you do struggle sometimes with showing up, if you have a particularly bad day.
How can Christians with these disorders exercise their gifts in the local church in ways that are consistent with their mental illness?
Dr. Stanford: It’s a great question. Part of the problem is the church structure itself is set up for absolute normality and adherence to a set of boundaries and rules, and so even the church service on Sunday morning is typically set up in such a way that it really keeps people with mental health problems away.
It’s so loud, bright, super structured – starts and stops – and there is no room for variation. And so the first thing that has to happen for people to comfortably share their gifts is the church has to have a better understanding of individual variability.
You also have to have a church where you can be open and say “I have depression, but I’d really like to serve in the whatever,” and you can be open about whatever your weaknesses may be. We do that with other things. If somebody had a physical disability, we’d have no problem with that. If you had a physical disability and wanted to serve in something and said “Hey, I’ve got a prosthesis. I won’t be able to do this, but I can do all the rest,” accommodations would be made.
When a person with mental health problems says, “Sometimes I have bad days”, that’s not the same as when I have a bad day. They [the church] needs to understand that. A bad day to you might be you’re not functional. A bad day for me might be I go home a little early from work because I’m bored or something. So I think education is really the key.
I also think that when churches make it apparent that people can talk about their mental health problems, more people with mental health problems will volunteer to serve, and then people just get used to being around someone who has depression or OCD.
So when the guy with OCD calls in and say “I’m not going to be able to make it in today because I ran out of my medicine and I’m having a really bad day,” everyone’s like “Okay, no big deal, we’ll call someone else,” they’ll understand and won’t go “Oh, don’t ever call him again. He’s crazy!”
The WC: I just have to ask you about one more fascinating bit from your book. You talked about how the historian Josephus said that Solomon might have had some dementia later in life, which was maybe why his wives were able to turn his heart from the Lord so easily.
So let’s say you have a case like that – where a Christian falls into dementia, let’s say Solomon turns away from the Lord and starts serving other gods – what do you do with that?
Dr. Stanford: Frankly, when you go through a lot of these stories and you’re open to mental health issues, they make a lot more sense.
Solomon is supposed to be the wisest man, he’s supposed to have this God-given wisdom, yet as an old man, he’s manipulated by a bunch of women he wrongly kept around. It doesn’t make a lot of sense. Even if he was a sex-addict who had to have women around all the time, think about it in more of a vulgar way – he’s got a thousand women around, concubines and wives, if one of them says “Hey, I’m not going to be with you unless you start worshiping my pagan god”, he’s got 999 others around. So why would he even allow that to happen?
So Josephus makes this passing remark that as he aged, he was not in his right mind, he was becoming kind of senile. Which is interesting, because it makes a lot more sense in the context of what was going on.
One of the biggest ethical questions right now in gerontology right now is you have people living longer, you live longer, you get dementia, you’ve got people living in elder care facilities who no longer remember that they’re married – that they have a spouse who comes and visits them, but they don’t know who.
And then they start having a relationship with someone in the facility. What are you supposed to do with that? Are you supposed to go in and say, “No, Mom, you’re married and this is a sin and you’re committing adultery” and she’s going tell you “I’m not married, I don’t know what you’re talking about.” And she really believes that.
I think we have to get back to understanding how the brain can be damaged. Within her perception of the world, she isn’t married. If in her perception of the world she isn’t married, then is it really wrong for her to be doing that?
I think these are good questions for the church to ponder. I think there are great opportunities for grace. When it’s all said and done, we’re all culpable, we’re all broken, we’re all born in sin, I don’t get to say to Grandma, “It’s okay for you to carry on this adulterous relationship.”
The other thing is most people’s faith is a mile wide and paper thin. Any kind of challenge to their faith and they just fall apart. They have nothing to ground themselves in. I had a guy tell me one time that because I believed in an old earth that I denied Christ, and so people have their little things, but again, there is no mystery in their faith. They’re not willing to say “Okay, you believe in old earth, and I don’t believe in old earth, but I’m okay with that, because neither one of us knows for sure, but I know there’s a God and I know he loves me.”
The WC: Finally, could explain a little bit about what your ministry does.
Dr. Stanford: The Hope and Healing Center is a faith-based, non-profit organization in Houston. We do four things – education, awareness programs for the community on all types of mental health problems and addiction.
We offer services for people with mental illness, we do individual services for people who have serious mental illness like schizophrenia, bipolar disorder, trauma, things like that. We offer forty support groups a week for all types of addiction and mental health problems. All our services are free. We do research, we have a research institute where PhD level research fellows are working on different topics – mainly on increasing access to mental health care and increasing acceptability and making things more affordable.
And then finally, our big initiative – we recognize that people in psychological distress are more likely to go to clergy before they go to a mental health provider and so we have a big imitative where we train faith communities in the city to train clergy and staff and any congregants that want to be there. We set up support groups, we train a mental health coach to work in that faith community and, ultimately, that faith community becomes a front-door to the mental health care system, where they can refer into a network of providers we’ve developed. We use the faith community for people to get to care more quickly but also help them access some level of service for free.
Follow Dr. Stanford on Twitter here.
