As I’ve written, church can be hard for Christians dealing with depression, anxiety, OCD, or any other brain disease.
This is a particularly vexing problem because many sell church as the magic bullet for your depression. After all, it’s community, it’s spirituality, it’s a lot of Bible verses. What could go wrong?
But for a lot of depressive Christians, the answer is, “A lot.” We often leave church feeling worse than before (for reasons detailed here).
Michael Paul Cartledge is a Princeton Theological Seminary Phd candidate, and I was fascinated to come across his research which, among other things, details how incorporating liturgy into church services might be helpful for depressives.
Our conversation has been edited for brevity and clarity.
HEINZE: In your paper you talk about “Stepford Christianity.” Could you explain what that is, and why it’s so unnerving for depressed Christians to go to a Stepford Christianity church?
CARTLEDGE: I get the term from Marcia Webb. It’s a Christian posture that puts on a facade that says everything’s okay, even when it’s not. Or it expects everything to be okay with everyone else, even when it’s not.
I can’t say definitively how much of this has come from the word-of-faith movement or a kind of prosperity gospel, but it is related, in a way, to health and wealth theology – “I’m doing wonderfully, I’m blessed and highly favored and everything’s fine,” even in the midst of severe darkness and hopelessness.
And the danger is we’re not being honest, we’re not bringing our burdens to one another. It’s not a very real or honest Christianity.
HEINZE: The American Dream seeps into our spirituality. We’re knocked down with a trial or “season of difficulty,” as Christian cliché puts it, and the American Dream Church says, “Okay, but what are you doing to pick yourself up today?”
CARTLEDGE: Yes, that’s a cultural Christianity that appropriates the ethos of the American Dream and brings it into their theological framework. I would add that it’s related to what some sociologists have called “Moralistic Therapeutic Deism”, which emphasizes personal happiness and pays little attention to suffering. This is an influential force in the “American Dream Church” that can contribute to the stigmatization of persons with depression.
HEINZE: It’s really hard for depressives to be a part of that kind of church, and they’re everywhere. It’s so disconnected from our reality, and actually, everyone’s true reality.
So in that context, you write a lot about liturgy and ritual and how it can be meaningful to depressive Christians who have problems in that kind of church.
First off, can you explain the difference between liturgy and ritual?
CARTLEDGE: Ritual is a pattern of human action that’s intentional, repetitive, and often instinctive. It helps us make sense of things that are otherwise difficult to understand.
Liturgy is ritual, but it’s much more in that it has to do in the Christian tradition with orienting oneself in a community toward a particular telos. In Christian traditions, we’d say that’s God.
Participating in Christian liturgy is a way of embodying our relationship with God through various Christian practices like worship, prayer, and the sacraments.
HEINZE: So how does integrating all this in a service help a depressed person?
CARTLEDGE: Depression is such a broad term that varies so much from person to person and experience to experience.
We’re assuming here that those who are suffering from depression can pick themselves up and get to a church and participate. And a lot of times that’s not the case. But for those who are able to do that, at that point in time, I think there are a few different things going on in the liturgy that benefits a person suffering with depression.
I think the primary thing is that it brings us to an understanding that our story is not the end but part of a larger story. And it helps us to locate our own experience and personal narrative in God’s story. And that’s what liturgy is. It’s a way of enacting and embodying God’s story.
So participating in liturgy broadens our perspective to see a larger picture and that helps us move past the current struggle or our ruminations on the past or future. It brings us into a larger story that points us toward hope and good news.
Liturgy is also formative and educative, so it teaches us something. The learning sciences show us that learning can take place in an embodied way even without us actively knowing what’s happening.
They call it embodied cognition. All cognition is embodied in the sense that we can’t get out of our concrete situation, and so these embodied practices in Christian liturgy teach us something even if we’re not fully cognizant of what’s going on.
Think of muscle memory and you’ll get a sense for how the body learns. Liturgy does something similar. In the repetition of communal practices, we’re learning something at a deep level. And, often times, at a deeper level than we would through a lecture or book.
HEINZE: You’ve probably read research about how flow activities – like vacuuming or mowing a lawn – can help depressed people. In a way, liturgy is a flow activity. In an Episcopal service, for example, you’re reading something on paper that’s long and you’re in a flow doing that and you can get in a contemplative mindset.
CARTLEDGE: Yes, I definitely think Christian liturgy opens up possibilities so that we may come to a new understanding of God and ourselves. But I don’t want to be too overly optimistic, or suggest that if you participate in certain practices, then these are the likely outcomes.
HEINZE: You’re setting the table, but you don’t know if the person’s going to eat or not.
CARTLEDGE: Right. One Episcopal priest I know was counseling some people in her congregation who were dealing with depression and was expressing that there’s something in just showing up. Not that it’s doing something magical for the person who’s suffering. But just in showing up and participating and putting yourself in this embodied story – it does something.
HEINZE: There’s an author named Kathleen Norris who says that for her just the act of reading liturgy at church – as she’s reading the prayers, at some point, it just starts to affect her in ways that she wouldn’t expect. It’s a feeling of self-forgetfulness.
CARTLEDGE: I agree. And as someone in the Reformed tradition, I would emphasize that these embodied practices bring us into participation with the vicarious humanity of Jesus Christ. Christian formation is primarily the work of the Holy Spirit. It’s an ongoing process that takes place in the context of a Christian community, but it’s primarily the Holy Spirit’s work bringing us into participation with Jesus, and there’s something going on that we can’t exactly put our fingers on. But it’s important for every believer.
HEINZE: Evangelical churches are pretty far away from liturgy and ritual in their services. If they wanted to incorporate those kinds of things, what would it look like without totally overturning the existing order?
CARTLEDGE: Many evangelicals are skeptical of liturgy and ritual. But the first thing we need to do is acknowledge the fact that every church, every tradition has a liturgy. Most churches have an embodied element to participation in worship. Your body is important.
We need to acknowledge that and realize there are ways to emphasize those activities that could benefit people suffering from depression and everyone else, in general.
Things like standing and sitting – as small as that sounds – that’s something the Episcopal church emphasizes. These physical postures that we take as we’re able. Some evangelical churches will stand for the reading of Scripture. We all do these kinds of things.
We need to find ways to enhance and emphasize embodied participation, because we all can benefit from it.
HEINZE: Could liturgical practices help people who aren’t depressed?
CARTLEDGE: Absolutely. People with depression are people. They’re made in the image of God. They do present a case study that we can all learn from because it’s especially clear how they benefit from putting themselves in an embodied way into God’s story in the liturgy.
So paying attention to the experiences of persons suffering with depression gives us a clear picture of how we all might benefit.
There’s something about that embodied participation that’s really formative, and that’s true for everyone.
HEINZE: You mentioned research showing that evangelical churches, specifically, might have more problems positively addressing depression in the church than mainline Protestant denominations. Why is that?
CARTLEDGE: Evangelical is a loaded term now. But I’d say that Christian traditions that strongly emphasize personal beliefs over a more objective dimension of faith tend to struggle with this. What I mean by that is if the Christian tradition in question is putting a lot of weight on the individual’s responsibility to believe cognitively basic Christian claims like “Jesus loves me, Jesus died for me” — sometimes that’s very difficult for someone who’s struggling with depression because it doesn’t always feel like that for them.
The situation feels hopeless, and if you’re putting the stress onto the person’s cognitive belief system, that adds a burden.
The theologian James Torrance talks about it as people being thrown back onto themselves. If a person is struggling with doubt and we say, “You just need to believe” — then that throws someone back onto themselves and doesn’t present them with any kind of picture of grace.
HEINZE: Why do depressed Christians have such trouble accepting, emotionally, the things we intellectually believe? You say in your paper that depressed Christians “don’t respond to realistic and rational evidence that might change their distorted beliefs about themselves.” Why?
CARTLEDGE: Depression is complex — like any mental health issue. Lots of causes and effects. One thing cognitive psychology would point us to is that people who are suffering with depression often get stuck in these negative, cognitive thought patterns.
Once you’re in that, it becomes a challenging cycle to get out of, and Christians who are struggling with depression are no different. When we fall into these negative cognitive patterns, it’s difficult to muster up the strength on our own to get out of them.
HEINZE: So beyond thinking about incorporating liturgy, any other ideas on what the church needs to start doing?
CARTLEDGE: Churches ought to be thinking through the difference between teaching about and teaching for mental health issues.
There’s a lot of great curriculum and resources for churches that teach about mental health, but they’re primarily directed at the “typical people” and not for those who are suffering from depression.
We have to start thinking about how we shift our approach and gear our resources to those in the midst of suffering, rather than just teaching everybody else what suffering is like.
I think we need to realize that those suffering from depression can teach all of us something. That we can all benefit from these embodied approaches to Christian formation.
HEINZE: Last question. What’s your favorite Christian book on these issues?
CARTLEDGE: There’s an accessible little book by James Torrance called Worship, Community and the Triune God of Grace that gets at a lot of what I talk about here. How embodied participation in Christian worship brings us into participation with the vicarious humanity of Jesus. That’s one that changed my thinking on a lot of things.
There’s so much in there that’s beneficial for people suffering from depression and those who seek to walk alongside them, even though the book doesn’t specifically address depression.
HEINZE: Thank you for your time!
About Michael: Michael Paul Cartledge is a PhD candidate in practical theology at Princeton Theological Seminary. His research and teaching are focused on faith formation and mental health challenges.
He and his wife, Samara, are Florida natives currently living in New Jersey, where they enjoy exploring local farms and parks with their children.
