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Dr. Babbel: Community is important after trauma

Dr. Susanne Babbel has a good piece at Psychology Today on some of the important distinctions between trauma and PTSD (post traumatic stress disorder), and how treating trauma effectively can help prevent it from turning into its more insidious progeny – PTSD.

Her key point: “Trauma is less about the event itself and more about how the body and mind respond to it.“

We experience trauma after going through an event that puts us in fight-or-flight survival mode, which Peter Levine defined as “the experience of being overwhelmed by life-threatening events which exceed one’s capacity to process the experience at the time.”

Of course, whether it’s an objectively life-threatening event or not is beside the point.

One person might say, “Hey the bomb went off 100 yards from me! I wasn’t even close to getting hurt!” Another person might think, “But it was only 100 yards away.”

So don’t get hung up on whether your experience meets the criteria of “life-threatening,” because sure, watching your house burn down on TV while you’re in a different city might not threaten your life, but it changes it dramatically and traumatically, doesn’t it?

I think the key point in Levine’s definition is that a traumatic experience occurs when it “exceed[s] one’s capacity to process the experience at the time.”

That’s when we get into flight-or-fight survival mode, and if that persists for over a month, then PTSD starts to become the issue, and PTSD is a far more difficult beast to address than the triggering trauma.

So what to do if you face trauma?

Well, first get in touch with a doctor (psychiatrist or therapist – links below).

That’s always the “first” for any medical condition – whether you break a bone or experience a trauma (of course, we can pray on the way to the doctor, but we can’t overly spiritualize bodily disease).

Also, Babbel notes just how important community support is in healing. For example, her own research shows that survivors of 9/11 experienced far less trauma than survivors of Hurricane Katrina, thanks to a disparity in community support, socioeconomics, displacement and media portrayal.

There are many things we can’t address (to society’s discredit, the poor will will never have the resources of the rich for health).

But finding community and connecting with existing community is utterly vital to help keep trauma from becoming PTSD.

Babbel also recommends bodily things like vagus nerve exercises, breathing exercises, and practicing the emotional freedom technique (if someone thinks EFT tapping is mumbo-jumbo, then they’re arguing against compelling research, showing it can make a huge difference in relieving symptoms of PTSD – not just in veterans but nurses and other cohorts).

I want to finish on this concept of community.

Recently, I wrote about how difficult it is to connect with community (or even find it, or have the courage to find it) when you have PTSD.

Both the process and the connection can trigger another wave of trauma if you encounter the wrong community, and it’s absolutely vital to sort through this with a doctor.

I’ve found the Christian church a real hit-or-miss on trauma.

Sometimes community has brought me great relief; other times, it’s only brought additional trauma that’s worsened by the fact that it’s at the hands of the community that’s supposed to be the hands of Christ.

You might have experienced the same.

There are thousands of testimonials of Christians who found anything but support in the church when going through trauma and it’s a black mark of shame on the church, because Jesus came to those living with traumatic wounds, PTSD, every kind of malady, and he feels so heartbroken by the heartbroken that he spent his life, healing our wounds, and used up his death, to heal our transgressions.

Jesus treated the sick in body and sick in sin with distinctly different approaches, and the church should show a similar approach.

Too often, the church has used an inherent distrust of psychology to abuse victims of those suffering from trauma and PTSD, and if you’ve been a victim of those diseases and an indifferent church’s response to it, my heart and prayers go out to you (if you want a poignant account of this, read my interview with author Sarah Robinson, who went to a church that treated her depression as though it were a failure of faith, and thus, sent her into a further spiral).

That is not the heart of Jesus. The heart of Jesus was a bleeding one, and he is the only one on earth or heaven who can look at your pain, and say I know, I care so deeply for you and mean it to the point of the cross.

So again, look first in the direction of a therapist or psychiatrist, and then see if you can find a community that won’t abuse your pain. Hopefully, your church looks something like the community that can help in you healing! But if it’s not, I understand and, in the absence of the church’s support, have often found help from the kindhearted, regardless of spiritual belief.

If you suspect you have PTSD, are anxious, depressed, or struggle with any aspect of mental health…

For readers from the United States….

Find a psychiatrist here.

Find a therapist here.

For readers, internationally, seek help from a local resource.

For salvation, Christ and Christ alone.

[Photo: Pexels, RDNE stock project, free public domain]

January 22, 2025

“The sun will rise”

Because the Son rose, we will rise.

“Won’t you dry all your tears, lay your burden down” – The Brilliance.

If you’re struggling with depression, anxiety, or any other mood disorder (all medical conditions)….

For readers in the United States…

Find a psychiatrist here.

Find a therapist here.

For readers, internationally, seek help from a local resource.

For salvation, Christ and Christ alone.

May the Lord bless you, dear friends.

January 21, 2025

STUDY: Stressed mice adopt anorexia-like behaviors

A new study in Neuron, conducted by Harvard researchers, showed that anxious mice restricted food or even starved themselves to help reduce symptoms of anxiety, mimicking classic behaviors in anorexia nervosa.

The study suggests a biological basis for why extreme anxiety can lead to caloric restriction, and I’d invite you to either read the study for the whole scoop or Amy McDermott’s briefer recap here.

But basically, the science involves the hunger circuitry of the brain which includes AgRP neurons.

When those neurons were stimulated, mice ate more and suddenly grew bolder (in contrast with anxious mice) and started to “wander into unsheltered areas or walk across shock grids to forage.”

The study is valuable because it provides both a mouse and the beginnings of a biological-model for a phenomenon well-known in clinical practice – stress can lead to caloric deprivation.

The authors note that human patients with anorexia nervosa will describe self-starvation as “pleasant, potentially because food restriction can be anxiolytic.”

In other words, sometimes patients with anorexia nervosa will restrict – not just because of body image, although that might be part of the equation – but also because restriction involves some kind of relief from the extreme stress they’re experiencing.

And that makes sense, doesn’t it.

I don’t know about you, but for me, throughout life, during moments of extreme duress, food doesn’t just become a second thought, it also becomes somewhat repulsive because stress can rob me of appetite.

Of course, that’s not true for everyone. At all. Many people eat more heavily under extreme stress, as a way of coping.

But regardless, it seems that stress serves as the impetus for one behavior or the other.

Thus, it sort of logically follows that treating anxiety might be one way of getting at the eating disorder.

Of course, that’s a very simplistic solution to an enormously challenging disease. And an enormously deadly one.

Anorexia nervosa is the most deadly mental disorder, and it should be noted that 55-97% of its victims also suffer from other mood disorders such as major depression, anxiety disorders, PTSD, personality disorders and others.

Up to 20% of those with the disorder will pass away from complications related to the disease within 20 years.

Of those complications, suicide remains the leading cause of early mortality.

It’s also common for cardiovascular issues, directly tied to anorexia, to threaten victims. As the heart shrinks from starvation, a host of complications occur that can lead to early death.

Gastrointestinal disorders are also common (also associated with starvation’s effects), as are endocrine disorders.

In short, this is a disease that wreaks havoc on a victim’s mind and body, making it one of the hardest to treat and most tragic. We can’t necessarily see depression or anxiety on a face (many of us are good at masking it), but the effect of an eating disorder is obvious.

Finally, here are some resources on eating disorders:

Eating Disorder Hope’s website, which offers a terrific overview of the condition, statistics, and research.

The National Institute of Mental Health on eating disorders, including signs, symptoms, risk factors, treatments and help.

A 24/7 hotline for those struggling with eating disorders or any other mental health disorder.

Six Common Types of Eating Disorders.

Signs of an Eating Disorder.

And find an eating disorder therapist near you.

Also, remember, that this study is further proof that stress responses can lead to anorexia-like behavior, as well as the condition itself. Thus, with other mood disorders presenting so frequently with anorexia, I’ll include my usual links for those disorders.

For readers from the United States….

Find a psychiatrist here.

Find a therapist here.

For readers, internationally, seek help from a local resource.

For salvation, Christ and Christ alone.

May the Lord bless you, dear friends.

[Photo: Pexels, free photos]

January 21, 2025

Defeated by God

We don’t often use the word “defeat” in the Christian life, except when we say “God defeated death on the cross.” That’s the defeat we love. But what about the fact that every Christian needs to be defeated, continually, in order to really come into communion with the Lord?

In his book, Dark Night of the Shed, author Nick Page offers a terrific look at the phenomenon of midlife crises, using Jacob’s midlife wrestle with God in the desert as the focal point of his narrative.

And defeat is where he arrives. At the hands of our loving God.

Page:

“The first thing we have to do is to follow Jacob’s example and have a good wrestle. Paradoxically, we will never find real peace unless we accept God’s invitation to fight.

….And the fight will show us that we cannot win in our own strength.

Jacob was a strong man, but when it came to the final round he was beaten easily. But that’s okay. We have to be defeated by God, because it is only in that defeat that we will find victory.

….God knows Jacob’s true identity. What he’s interested in is whether Jacob knows it.

…. And God is so pleased with him [Jacob] that he does the most loving thing he can. He defeats him.

Think of that – the most loving thing God can do to us is defeat us, and yes, there are scars from that, but God promises life from it too.

Maybe not the life we’d hoped for, maybe not even life as the word implies (often our diseases make us feel closer to death), but we know that eternal life is on the horizon and I would rather have the hope of that than the present certainty of anything else.

As the famous hymn says: “Be still my soul, thy best thy heavenly friend/through thorny ways leads to a joyful end.” (btw, never knew Sibelius wrote the music to “Be Still My Soul”).

There’s a consistent thread running throughout Page’s book that’s salient for any person’s life as we approach our middle years: in our youth, we’re filled with aspiration, we seem to gain more control of our life, and there’s a sense of conquest (in the best sense of the word) and exploration where anything is possible.

I think it was novelist Graham Greene who once observed that much of the first part of our life is experience, and much of the rest observation of that experience (partly true, partly not, imho).

I’ve found that we can get trapped in that observation if it becomes melancholy nostalgia, we can also lose ourselves in depression and sorrow as it becomes increasingly clear that all those aspirations and explorations have meant little in the absence of true service to something Bigger (i.e. God).

Page writes, “It is a disturbing thing, that dark night moment when you realize that the gods to whom you have given your life have let you down. And the reason that it occurs in middle age more than at any other time is, I think, because in the first half of life we can still hold out the hope that they will deliver on their promises.”

So true.

Despite our intellectual monotheism, we often unwittingly live in service of others gods – if not consistently, then intermittently – as we pin our hopes on something other than Jesus as Deliverer.

It’s so easy for us, for me, to fall into oblivious idolatry, where we live as though our emotional deliverance will come from the fulfillment of an earthly aspiration. And so we prostrate ourselves to certain pursuits, unconsciously thinking they will bring happiness, and soon enough, we’re bowing down before a foreign god.

And that’s what Page is talking about.

Christians are as prone to this as anyone. In fact, it’s why Paul begged the church to “set its mind on the reality of heaven,” because only then can life on earth truly flourish.

Maybe it’s good that our physical health starts to decline in middle-age. I hate even writing that.

For me, at least, I’ve gotten a taste the past few years of incessant hospital trips, doctor’s visits, suddenly limited abilities, and it’s something I’ve fought against, but it’s also jarred me into a truth that the best of life that lies ahead comes from above – not from some new exploration on earth.

That’s a difficult thing to accept, actually, and is a kind of defeat, and I don’t know about you, but I feel as though we all struggle in our fight against God’s will for our lives, even as we pray for that will’s revelation and embrace the idea of following it. In theory.

Every epoch of our lives comes with new challenges, but middle-age introduces us to a new “new.”

When we were young, “new” often came with more independence and adventure. Freshness. We associated the word with promise more than anything. It’s not so much “new” as a description, but as a synonym for excitement and aspiration.

In middle age, “new” suddenly turns into what the word really means. Something different, “not existing as before.” It promises nothing other than that.

Except very often, it’s a headache of some kind that didn’t exist before.

That’s not bleak. It’s a well-documented phenomenon that unhappiness peaks in our middle-aged years, precisely because we’re aware of lost time, losing time, and the fact “new” means something brand new. It’s not the synonym for “excitement” it once was, but now just a cold word that promises nothing other than “not existing as before.”

We have to face up to it, because we’re forced into it. The fight with God.

And that’s where our relationship with him can either flourish or wither.

We don’t feel it’s a fight with God, but deep inside, if we look hard enough, that’s often exactly what it is.

And we all need to remember that final line by Page about the wrestle: “God is so pleased with him [Jacob] that he does the most loving thing he can. He defeats him.”

Except I wonder if any of us is truly defeated short of heaven.

In fact, heaven could be described as an absence of struggle, and if humanity’s original and continual struggle is communion with God as King, then maybe that’s one of the greatest things about heaven. We no longer struggle against God there, we are happy to be wholly his, and there is no more fight, because just as he defeated death for us, so he’s finally defeated us in life, and in doing so, liberated us from ourselves.

Jacob has no limp in heaven.

But during this earthly fight, we must always remember, “Be still my soul, the Lord is on thy side.”

If you’re struggling with depression or anxiety or any other brain condition like these…

For readers from the United States….

Find a psychiatrist here.

Find a therapist here.

For readers, internationally, seek help from a local resource.

For salvation, Christ and Christ alone.

[Painting: The Charge of the Lancers, Umberto Boccioni].

January 19, 2025

Jeremiah 32:27: “Is anything too hard for me?”

Here it is, from Jeremiah 32:27 (ESV).

“The word of the Lord came to Jeremiah, ‘Behold, I am the LORD, the God of all flesh. Is anything too hard for me?”

He is the Lord of all flesh, and think about that phrase: “Is anything too hard for me?”

At first glance, our minds go to God saying, “Yes, I can move that rock, Jeremiah.”

But it’s actually a broader statement than that, according to Strong.

There, the definition of the Hebrew word for “hard” means “to be wonderful, extraordinary, to be difficult, to be marvelous.“

In other words, it’s more than just God’s simple, brute force. It’s also his beauty and the marvel in the marriage of the two.

God isn’t just flexing his muscles and saying he’s stronger than anything. He seems to be saying his strength works in concert with the wonderful, marvelous thing he’s going to use that strength for.

Like Christ crushing the snake in the garden. Strength and marvel.

Which leads to our redemption. And our hope.

The wiping away of tears, sorrow, pain – all that we read about in Revelation (but still don’t believe most hours of the day, God help me).

That’s the strength and marvel of it all.

So tonight, today, whenever you’re reading this, remember: God is stronger, has already….

….And will do something far greater and more marvelous than we could imagine, thanks to the strength and marvel of crushing that snake.

If you feel stuck in forever, you won’t be. Keep running the race. Even if it means running it from a place of despair. Even if it’s running it from bed, or a strangely hopeless faith that somehow still manages to be faith.

The strength that crushed the snake is now working for you. Behind the scenes, it’s working in a way you can’t believe.

For readers from the United States….

Find a psychiatrist here.

Find a therapist here.

For readers, internationally, seek help from a local resource.

For salvation, Christ and Christ alone.

[Photo: The Passion of the Christ].

January 8, 2025

Two quiet symptoms of PTSD

The United States Department of Veterans Affairs has a helpful primer on classic signs and symptoms of PTSD (Post Traumatic Stress Disorder).

And with PTSD suddenly in the news again, as ubiquitous as it is (6% lifetime prevalence in the United States, a surge globally — look at Spain), and as silent a destroyer as it is, I wanted to highlight two key symptoms that don’t immediately come to mind in the popular conceptualization of PTSD.

Beyond the “classic signs”, The American Psychiatric Association includes this key bit, and I’ve bolded and italicized the symptoms that lurk as dangerous as any other.

People with PTSD have intense, disturbing thoughts and feelings related to their experience that last long after the traumatic event has ended. They may relive the event through flashbacks or nightmares; they may feel sadness, fear or anger; and they may feel detached or estranged from other people.

That bit about sadness, detachment, and estrangement is the part you might feel, but not recognize as symptoms of PTSD.

If you feel overwhelming sadness and estrangement for a protracted period after a triggering event, it’s a good idea to check with a doctor and get their opinion.

You might have PTSD, and instead of growing angry and volatile, you turn inward and find it difficult to engage with the world as you knew it before the triggering event occurred.

And that’s because the world as you knew it seems to have fundamentally changed, and the slew of things unrolling over time can be surprising, unnerving, and we don’t know what’s going on because things that seem totally unrelated to the trigger provoke symptoms.

You might panic over driving your car, when the traumatic event had nothing with driving, at all.

You might have trouble ordering a coffee and you don’t know why, because what could ever have gone wrong with ordering a coffee? Yet there you are, and ordering coffee can fill you with dread and where did that come from?

And interacting with people you knew before? That’s where it gets enormously tricky.

Again, there’s this sense the world has started to spin in a different direction from before, and you’re suddenly a newborn baby, except that you don’t have naive wonder, only disconsolate fear.

“How do I survive in this new world?” You might ask yourself quietly.

And we do ask it quietly.

While the rest live, we “live” too. On the same but different world.

And you’re terrified about it all, but you stay quiet and don’t talk about it with others because…

A) they’ll say they “get it” but, if they’ve never been through it, you suspect that “no, they don’t get it” because you never got it before you got it.

Or…

B) they won’t get it at all, and you’ll see the skepticism on their face as you’re sharing your pain, and you know how that skepticism will intensify your bleed, and it’s not just your pain they’re unwittingly violating, but also, it feels, your very soul. I’m not being hyperbolic there.

And that’s because trauma and pain is sacred.

In his book, A Crazy Holy Grace: The Healing Power of Memory and Pain, Frederick Buechner (whose father committed suicide when he was just a boy) describes just how sacred and precious (as in rare, valuable, fragile) it is.

“Pain is treasure. Pain is horror. Pain is that which tempts you like Christ on the cross to say, “My God, my God, why did you abandon me?’ Pain is negation of everything that seems precious.”

If you think of your pain as something precious (and certainly God does), then it’s understandable why you might keep it to yourself.

It’s both an instinctive and protective response.

And because the feelings often paralyze us, well, that word explains it. If the world feels fundamentally unsafe, then how can a strange doctor’s office be any different?

So yeah, we keep it to ourselves.

And that leads to the sadness and estrangement that the American Psychiatric Association talks about it.

I would urge you talk to a psychiatrist or psychologist about it. I know that sounds easier than it is. But they will be a safe place with the thing you can’t explain to anyone else – the awful thing you can’t explain from a failure of your emotional capacity. I know this from experience.

A professional will know, they will recognize. They will not dishonor your pain. They will treat it as something precious and rare.

And then, the bonus is that they can help you start on the process to healing.

Finally, I want to add this.

Once you feel you’ve made some kind of progress, under professional guidance, then I’d offer this observation from my personal experience (and I’m still definitely a work in progress).

I’ve found myself starting to open up around others who are clearly struggling with PTSD, as well. Not with the rest of the world but anyone I see in that place. That basement, that Sheol, and you recognize it, and you share your experience, and it can lead to exactly what Paul described when he talked about strengthening each other.

My closest friendships have come from those who’ve been to that place.

Now when it comes to PTSD, sometimes we think, “Well, I was never in a war, I’m not a vet.” But I can tell you that we all fight our own battles, and as T.S. Eliot reminded us in “The Four Quartets,” all pain really is unique and the same.

And here, I end with Buechner’s final thought on pain as treasure from the passage I quoted above.

“It seems to me so significant that we can come together in places where there is a sense of safety. And, as we come together and try to give each other the most precious thing we have to give because in some sense or another we love each other, what we give each other again and again is our pain. The most precious thing I have to tell you about is the sadness. You don’t have to talk about pain, but you have to live out your pain. Speak out of your depths.”

So… if you think you have PTSD, talk to a professional about it. In fact, by the time we look for help, PTSD has hardened in many. After all, sometimes it’s tough to know if an acute thing is going to turn into an ongoing thing.

Here are some resources for more on the condition, some helpful guides, and links to professional help at the bottom.

The NHS’ guide.

The Mayo Clinic.

The University of Rochester Medical Center: Healing from Post-traumatic Stress Disorder.

WebMD: “What are the treatments for PTSD?”

Compassion Behavioral Health: “Explaining PTSD Recovery Stages.”

Finally, a key research finding from 2024, explained in this Harvard piece: “PTSD’s genetic component validated in new study,” and I write about it here.

I pray for you, for me, for all of us. We depend on Christ, and as Brennan Manning wrote, “All is mercy.”

If you suspect you have PTSD, are anxious, depressed, or struggle with any aspect of mental health…

For readers from the United States….

Find a psychiatrist here.

Find a therapist here.

For readers, internationally, seek help from a local resource.

For salvation, Christ and Christ alone.

[Photo: A classic photo from my favorite movie — in that film, Jimmy Stewart was genuinely channeling his extreme PTSD from returning as a pilot from WW2. Which is why I think his George Bailey is one of the most compelling performances in cinematic history.].

January 7, 2025

Warren: “To risk joy requires hopes”

Tish Harrison Warren, in her wonderful book Prayer in the Night, notes a Compline prayer that begins “shield the joyous.”

If you asked me what that phrase meant, I’d immediately say, “Oh, it’s a prayer to guard joyous people or something like that” and move on.

But she gets to a very different point, a waaaaay better one – especially for those of us who battle with all the things we do.

Warren:

“In this prayer we recognize the vulnerability of joy.

We ask God to shield the joyous, to protect the part of us that’s courageous enough to believe that good things happen.

…. We have to learn to trust God in order to receive even good things from him.

And learning to receive good things from God is difficult, especially if you’ve been hurt. It’s hard to learn to trust goodness and beauty.

It takes practice to face the reality of darkness, but also to ask for — and hope for — light.

To risk joy requires hope. And hope is the opposite of anxiety. I am habitually anxious. I catastrophize. I plan for the worst. This habit leads me to, as they say in the South, ‘borrow trouble’.

Horrors could happen, so I start mourning them ahead of time — it’s never too early to get a jump start on misery.”

Now… read this next bit, where she contrasts the well-worn phrase “borrow trouble” with something more difficult.

Warren:

“To hope is to ‘borrow grace’. It is not naive optimism. Hope admits the truth of our vulnerability. It does not trust God to keep all bad things from happening. But it assumes that redemption, beauty, and goodness will be there for us, whatever lies ahead.

… I have to learn again and again to risk joy, to intentionally practice hope.”

Amen.

And… that’s hard thing to do – and may be quite impossible if you have major depression or anxiety etc, hence my links at the bottom (I wrote about the “All is vanity” depression here, and it gets to the heart of a depressive symptom called anhedonia, which has a medical basis, is a medical condition).

So I get why it might be impossible to “practice joy”, because very often I can’t, either, and it’s often a medical thing.

But we can look for treatment and while we pursue that avenue, we can still try to “risk joy.” Try to try to hope.

It’s extremely hard for me to “risk joy” when things are dark and hopeless. Frankly, I usually don’t.

And it’s why my pessimism instinctively relates so much to that line from the old Pet Shop Boys B-side “Miserablism”: “Deny that happiness is open as an option/And disappointment disappears overnight.”

In a way, that attitude feels an emotionally safer way to live, because it’s more believable, because so much of life on earth is life on earth.

But the New Testament is full of “our hope in Christ,” and we do know the way all this ends.

And the more we set our minds on the reality of heaven, as Paul urges us to do in Colossians, the more energized we’ll become at doing our work on earth (provided, of course, we’re being treated for a medical condition we might have that allows us emotional energy).

And the more we work on earth with heaven in mind, the more heaven will touch the earth, and we might just be surprised that the Lord fills us with joy when we thought it was impossible.

I’m going to try to risk joy this week (and of course, already my mind is telling me, “how dare you?”). Feel free to try with me.

If you’re anxious, depressed, or struggle with any aspect of mental health…

For readers from the United States….

Find a psychiatrist here.

Find a therapist here.

For readers, internationally, seek help from a local resource.

For salvation, Christ and Christ alone.

January 6, 2025

STUDY: Hypermobility associated with anxiety

Over at Psychology Today, Dale Kushner has a fascinating read on some of the research, linking joint hypermobility (a physical condition) with anxiety disorders.

In fact, there’s a rather stunning association.

According to one study, people who suffer from joint laxity have “eight to 16 times the incidence of anxiety not necessary linked to psychological factors.”

In other words, according to the study, it founds the association while controlling for common risk factors like genetics and environment.

So the very fact a person has joint hypermobility appears to predispose them to higher anxiety.

….anxiety was found in 70 percent of patients in comparison with a 20 percent incidence in the age- and gender-matched control group. In the follow-up reverse case-control study, joint hypermobility was found at 17 times the incidence in patients diagnosed with anxiety as compared with age- and gender-matched controls without an anxiety diagnosis.

Remarkable.

Why? Well, Kushner notes that a brand new study from the University of Sussex used fMRI scans to pinpoint an interaction between the neural centers that process threat and the center representing bodily state.

More specifically, according to the study, published in the BMJ.

HMS participants showed attenuated neural reactivity to emotional faces in specific frontal (inferior frontal gyrus, pre-supplementary motor area), midline (anterior mid and posterior cingulate cortices), and parietal (precuneus and supramarginal gyrus) regions. Notably, interaction between HMS and anxiety was expressed in reactivity of left amygdala (a region implicated in threat processing) and mid insula (primary interoceptive cortex) where activity was amplified in HMS patients with generalised anxiety disorder. Severity of hypermobility in anxious, compared to non-anxious, individuals correlated with activity within anterior insula (implicated as the neural substrate linking anxious feelings to physiological state). Amygdala-precuneus functional connectivity was stronger in HMS, compared to non-HMS, participants.

So there’s at least one potential explanation.

This is interesting for a number of reasons.

Joint hypermobility has been linked to so many other physical conditions (fatigue, bowel problems, bladder problems, joint pain, Ehlers-Danlos Syndrome), and nobody would argue that these are physical, medical symptoms.

What would a pastor say if you asked him, quietly, after service, “Hey, I’m having a lot of problems with my bladder. You think my faith is okay?”

You could ask about bowel incontinence, and his answer would probably be the same. Joint pain, too. Fatigue, as well. Then he’d get tired from the conversation and probably need to use the bathroom, too.

I’ve heard a lot of sermons over the years, and the only pastors I can even think of that might link bowel and bladder problems with spirituality would be a few groups of Pentecostals — certainly, not spiritual leaders from any kind of orthodox tradition.

And yet… so often, we’re told from leaders in the orthodox tradition that anxiety simply can’t be associated with our body. That it’s purely a spiritual condition.

Studies like this just add to the mountain of evidence that, sure, our environment and other factors may play a role in our anxiety, but it is primarily a condition of physical etiology — whether it be inflammation, genetics, gut bacteria, hypermobility, you name it — and, as such, no Christian should feel ashamed for being afflicted with this disease.

I’ve written extensively about the tragic misinterpretation of Christ’s passage on worry, and the Scriptures are full of saints who expressed deep anxiety and God treated them with compassion and not condemnation.

The important thing is – do we turn towards God in our anxiety or against him? That’s the battle.

If you’re anxious, depressed, or struggle with any aspect of mental health…

For readers from the United States….

Find a psychiatrist here.

Find a therapist here.

For readers, internationally, seek help from a local resource.

For salvation, Christ and Christ alone.

[Photo: Pexels, free photography].

January 3, 2025

Another beauty in the prodigal son parable

You probably know Christ’s parable about the “prodigal son,” and if not, here’s the passage.

Charles Dickens called it “the greatest story every told,” and as Gary Heikkila notes, its influence among poets, musicians, artists etc. is immense.

I can’t think of a more beautiful parable, and neither could Henri Nouwen who devoted a masterful book, Return of the Prodigal Son, to it.

Christ’s use of a familial story, with an ostensibly human father, moves us into the heart of theology in a way that more abstract phrases like “vicarious substitution” just can’t. Even simple words like “mercy” grow stale.

I’ve been reading Tyler Staton’s Searching for Enough, and he offers a contextual framework that makes the story even more moving.

Staton points out that when Jesus told of the looming reunion between the father and his wayward won, “everyone in that original crowd thought they knew where the story was going.”

Staton:

“The meeting between the father and son mirrors a kezazah ceremony. Among first-century Jews, if a son humiliated his father by rejecting him, bringing shame not only on him but on the entire family name and then had the audacity to show his face in the wider community again, he was greeted by a village-wide ceremony.

The entire community gathered on the border of the village, while the rebellious son stood opposite them. Then one representative would step forward, smash a clay pot on the ground and let out a full-throated scream, ‘You are now cut off from your people!’

The clay pot represented the community’s view of the rebellious individual – totally broken, irredeemable, no longer useful for any purpose.

The English word ostracize…. is derived from the ancient Greek term ostrakizo, meaning ‘to banish by the vote of the people written on a potsherd’. The modern concept of being ostracized is derived from the Hebrew kezazah ceremony.

When the father ran out to greet the son – family members, friends, day laborers from the community all gathering around – the original listeners would’ve been thinking, Here it comes. The breaking of the clay pot. Finally the father can distance himself from his son’s embarassing behavior. Finally the father can stop wearing the shame of his offspring. Finally he can get a bit of closure on this parental nightmare.

Then it happens. He [The father] wraps his arm around his son. He slips a signet ring onto his finger, symbolizing rule and authority over the estate. He wraps a robe around his shoulders, the sort of robe worn by the ruler of the house.

He wasn’t interested in undressing himself of his son’s shame. The father was prepared to wear that shame to the grave.”

Wow.

I love Staton’s comment that, in the context of the crowd’s expected exile of the son, “the father was prepared to wear that shame to the grave.”

In other words, the shame that was the son’s now belonged to the father…. and isn’t that the way that Christ bore our shame both on the cross and how he lived?

Pastor Rory Shiner writes for the Gospel Coalition, “As the church fathers never tired of reminding us, that which Jesus did not assume, he could not heal…. Jesus suffered ‘outside the city gate’. That is, his suffering included exclusion from the esteem of the community.”

Finally, Staton finishes his commentary on the father’s “shame” by noting that Tim Keller titled his book The Prodigal God for a very important reason:

Staton:

“The father was the reckless one. The father was the prodigal. Jesus is doing his best to make sure that we are not dealing with an authoritative overseer…. we are dealing with a prodigal God. God does not treat us as we deserve.”

According to that crowd’s standards, The Father’s love was foolish.

And yes, according to the Greeks, the Gospel of the cross was foolish. In much of the world, it remains utterly foolish.

As Christians, it might not seem foolish, but it can feel fantasy.

“Are we simply naive?” we wonder.

But Christ’s love was not a fantastical apparition. He invited Thomas to see his scars. And, like the “foolish father,” he is there, waiting for you and me, ready to clothe us — whatever the rest of the world or even the church thinks of us. They might see us, naked, in shame. We might see us that way. Christ? Nope.

Remember – we are all equal before God. The older brother in the story forgot that.

We often do, too.

We are all sinners, Christ came for us, and each of us is his child – no matter how lost or wayward or distant his grasp seems.

That’s hard to believe. There’s a depressive, doubtful, pessimistic and bleak part of us that sometimes wonders whether we’ll find it in God. Basil Hume said that Christians often find it easier to believe that God exists than that he loves us.

How true.

It takes faith.

In Isaiah 50:10, God says, “If you are walking in darkness, without a ray of light, trust in the Lord and rely on your God.”

In Hebrew, that word “rely” is closer to “lean.”

My faith will always be weak, but as much as we can, we should remember to rely and lean on God’s mercy and love, as shown in the prodigal story.

And thank God for that.

This world is a harsh place.

Sometimes you and I feel that humans are a little more merciful than God (oh, we won’t say that out loud, will we?). When we ask forgiveness of someone, more often than not, we get it.

The truth is that the crowd that heard Christ’s story was human and religious and, in that culture and context, ready for the son’s shaming and calling it his just reward. Most of our friends – both Christian and not – would have been, as well.

We might all imagine ourselves merciful, but isn’t it easy for humans to say, “Well, that’s what you get for XYZ.”

The “you made your bed, now lie in it” ethos really doesn’t lie far from many Christian cultures or communities.

If even Christians can treat us like that (let alone the rest of the world), then it’s no wonder that we have such trouble conceptualizing a God who simply forgives and forgets, who gives us full smiles and glory any time we ask his forgiveness.

It’s too good to be true, we think.

But the Gospel was called the Good News, and btw, God doesn’t mislabel things.

Remember, as Brennan Manning wrote, “take sides with Him, against our own self-evaluation.”

Here’s Keith.

January 2, 2025

STUDY: Vagus nerve stimulation can help relieve severe depression

The Washington University School of Medicine in St. Louis has released two papers, detailing results on vagus nerve stimulation and depression.

It was a giant study, involving nearly 500 participants at over 80 sites across the United States, and as importantly, it involved patients with severe treatment-resistant depression.

How severe?

The average patient had experienced depression for 29 years, failed different treatments 13 times, 75% had been so sick from it they couldn’t work, and 40% had attempted suicide at least one time in their lives.

In other words, the most depressed of the depressed.

The researchers implanted a device meant to stimulate the left vagus nerve – of course, one group had the device activated, while the control group was set up with an inactivated device.

According to the Cleveland Clinic, vagus nerve stimulation uses electrical impulses to stimulate your left vagus nerve to pass signals to your brain, via a tiny device in your chest.

After a year’s worth of stimulation, 53% of the group receiving the stimulation experienced progress in quality of life measures, as well as “statistically significant, measurable improvements in depressive symptoms and functional outcomes,” according to Dr. Charles Conway, the principal investigator of the trial.

Conway:

“What’s really important here is that patients themselves were reporting that their lives were improving,” Conway said. “You have a population of people that has been failed by a ridiculously high number of treatments, including very aggressive treatments such as electroconvulsive therapy. And they’re not just saying, ‘Yeah, I feel a little better.’ They’re saying they are seeing meaningful improvements in their ability to function and live their lives. And the nice thing about vagus nerve stimulation, we know from other studies, is that when the patient responds, the effects usually stick.”

Praise the Lord.

Having said that, there are a couple caveats.

The study failed to meet its primary endpoint which was a statistically significant difference on the gold-standard MADRAS scale.

But that’s not uncommon in clinical studies, and the fact it was able to demonstrate differences and improvement in other important measures like quality of life, daily function, and symptom improvement – well, that’s pretty important.

Here’s the other caveat.

The treatment is expensive and yet to be covered by insurance in the United States.

However, the Center for Medicare and Medicaid Services did play a part in the study, and was privy to the results. If they end up covering it, perhaps private insurance will follow suit.

Treatment-resistant depression is a beast, and according to Johns Hopkins affects 30% of people diagnosed with major depressive disorder.

And these participants certainly had it.

Imagine failing 13 treatments, attempting suicide at least once, being so paralyzed by the condition* that you’re unable to work, and suffering for nearly 30 years.

That’s not a spiritual condition – that’s a medical condition.

Praise God for researchers and the medical community which continues to try to serve the suffering, in the tradition of the Great Physician and Christianity, which has been known from its beginning by a remarkably counter-cultural care for the sick.

[Photo: Public domain, By Henry Vandyke Carter – Henry Gray (1918) Anatomy of the Human Body]

If you’re depressed, or struggle with any aspect of mental health…

For readers from the United States….

Find a psychiatrist here.

Find a therapist here.

For readers, internationally, seek help from a local resource.

For salvation, Christ and Christ alone.

*One of the most moving accounts of the paralyzing effects of depression comes from my interview with Pastor Kirby Smith, who goes into great detail about losing his position as pastor for awhile and being so sick with despair he wished he would die.

What worked for him? Medication. Doesn’t mean it will work for everyone, but again, as Dr. Brian Briscoe says, medication can be an agent of God’s mercy for people with mental health conditions. Just like it can for any other medical condition.

December 20, 2024

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