The "Fallen" Realities of Human Nature
Therapy, like religion, begins in suffering, trades in hope, and justifies itself in relief - if it justifies itself at all.
We must be careful not to make too much of this. Analogy is not identity - very different things can resemble each other while diverging on vital issues. If mental health care were to become secular pastoral care, as I recommend, we would have to make some changes. We would have to embrace some things from religion that orthodox mental health care denies.
Religions all say that the human condition, by its very nature, entails suffering. Because of original sin, pride, attachment to self, or any of a variety of diagnoses, religion sees being human as inherently painful. Mental health care, historically, has claimed the opposite: suffering is a sign of pathology. The pain that brings people to therapy signifies deficit, developmental arrest, conflict, confusion, chemical imbalance, or some such deviation from "normal."
Of course, Freud famously claimed that psychoanalysis moved the patient from neurotic misery to normal unhappiness. Few mental health professionals embrace that idea. Mental health care generally claims to restore health and thus relieve suffering.
Religion does something else - it helps us transcend, compensate for, or otherwise come to terms with the "fallen" nature of the world.
The religious notion of care does a better job of capturing the overwhelming body of human experience than the orthodox mental health notion. The idea that "normal" is integrated, well-formed, and suited for satisfaction, is wishful thinking.
Biologists and evolutionary psychologists, as well as cultural anthropologists and historians, tell us that our nature includes jealousy, infidelity, malice, xenophobia, irrationality, and a host of other bedeviling elements of human experience. Neuroscientists now generally agree that our brains are "kludgey"-that our essential make-up is a hodge-podge of different modules or circuits, with newer ones laid over, but hardly in control, of older ones, and the whole mess is gerry-rigged together, not designed with some intrinsic harmony.
"Health" becomes a bogus category for seeking well-being once we realize that healthy people, by virtue of being human, lack nothing in the capacity to screw up their lives and the lives of others. We should learn, as ministers have always known, that our job is to mediate the anguishing realities of human nature and the better angels of our aspirations.
Well-being, as religious ministers have always known, is an achievement. It requires a great deal of effort, in which we reshape, overcome, perhaps even quell (as completely as we can) much that is natural. Well-being does not happen naturally in the absence of bad parenting, bad luck, bad genes, or other bad fortune.
"Mental health" is a pipe dream, a fantasy that sustains us through the often-perplexing, vexing, inescapably painful process of muddling through. Each culture of healing, each "school of thought," even each therapist who talks about "mental health" is offering, in essence, a dream of Eden - a myth of how life would be, if only we were not fallen creatures.
That has its uses. In fact, I'm going to argue that one of the ways that secular pastoral care should function is precisely to offer such visions of what life might become.
In practice, many of us already know that happiness is not normal - and the popularity of Acceptance and Commitment Therapy is a bright spot in current care, suggesting that many of us may be ready to break with the dominant paradigm of what mental health care does.
If we're not restoring health, if we are mediating between the anguishing realities of human nature and the better angels of our aspirations, what does that mean? Stay tuned . . .