An Interview About Mental Health, Minority Stigma, and the Church Vs. Depression

I recently did an interview about mental health with a student filmmaker. My book on depression can be found here.

Disclaimer: I’m a hospital chaplain who does grief counseling and helps with end-of-life decisions, but I’m not qualified to offer medical advice. I’d recommend following @wayfaringmd, who is.

1.     What is mental health?

For me, mental health is a combination of conversations, resources, habits, and research which aims to help us live safely and confidently inside our own heads as we move through the world. Mental health is about individual stability, but also requires interdependent dialogue. This will look different from individual to culture to community. But I believe mental health begins at the level of face-to-face exchanges in which subjective experiences (“I am sad, I am hurt, I am hearing voices”) are taken seriously.

2. Why do you think mental health is a taboo topic within the Korean church?

The Korean church, and to a larger extent the Eastern Asian culture and many “minorities” outside the West, is about showing face. A kind of flexing strength. A strong work ethic. We are driven by sacrifice and family honor and how we look collectively as a group. While you could say the West is about following your dreams, you could say the East is about following your team.

These moral dimensions get carried into the church, too. Quite a few Asian and minority churches operate on Eastern moralism mixed with a dash of Jesus-legalism. When mental health comes up, it gets shoved into the same box of “showing face” and “work ethic” and “for the team.” Since many minority churches already have a twisted view of grace and the Gospel, then of course, the subject of mental health never stood a chance.

Asians + minorities will tend to use the same rules of work to apply to mental health, so if you suffer a mental illness, then the solution would merely be a matter of working harder and willpower. Or worse, your mental illness would be your fault as if you’re not working hard enough, praying enough, reading enough Bible, or believing enough.

I remember bringing up my depression to a Korean church which I used to work for. The senior pastor laughed in my face. He warned me not to tell anyone, and that it would scare the parents who wouldn’t trust their kids with me. He was certain it would look bad for the church leadership. I should’ve walked out the door right then.

I think the most disgusting thing I’ve ever seen in an Asian church is a pastor’s reaction to a member who took his own life. The church member, a college student, wrote a long suicide note blaming the entire church for what happened. The pastor called for a meeting, and instead of empathizing with this student’s pain and obviously broken mind, said, “This is an attack on our church from the devil.” I’m still angry just thinking about it. Not an ounce of empathy. In that sort of culture, anyone who is struggling won’t come forward: no one wants to be accused of “working for the devil.”

3.     Why do you think there is a negative stigma or perspective on mental health within the Asian community?

I suppose the main problem is that mental health doesn’t seem to have a practical, useful function to many Asian people (and to many people, period). Whatever is not useful to the Asian community is often seen as superfluous and deserving of suspicion.

Again, the Asian community and Eastern dynamics involve a daily grind of work and what we look like to each other as we’re working. These dynamics are visible and tangible. All I have to do is look at my parents’ hands. Mental health is often invisible and has no easy metric. To work for “internal health” then would seem like a waste of time.
As harsh as this sounds, an Asian person would only practice “self-care” if it had immediate results that could be shown off to others. Since self-care can’t buy a better house or a BMW, it’s not a high priority. It becomes laughable, even.

4.     Why do you think the statistics of depression and suicide is so high within Korea culture?
Expectations. A lack of purpose in work. Placing ultimate value in grades, career, and family honor. Enforcing shame on those who do not get the best of their field, when statistically, the “best” is impossible for all to achieve. The fear of disconnection from family after a failure to achieve.

5.     Why do you think Asian Americans avoid counseling or choose not to go? Do you think this can be changed?

I think Asian-Americans and many other minorities have a good (if unfortunate) reason to avoid counseling. Statistically, most minorities have a high suspicion of medical resources and institutions. Rightfully so. There is a study that shows African-Americans are less likely to receive pain medication because doctors and nurses think they can “take the pain.” Minorities distrust institutional authorities because we believe we’re being tricked out of money or seen as subhuman.

Really, counseling can seem like a big scam. In my early experience, the therapists I first tried might as well have been con artists. They did not help. And the ones who wanted to help were still operating out of their white Western-American grids as the “normal baseline.” For them, the “Asian culture” was alien and the Western culture was “the way things are.”

But within minority communities, going to counseling is most likely perceived as an admission of weakness. To seek counseling is to say I’m a bad person who needs to become good again. Usually the community might say, “Something is wrong in her head. He’s got mental problems. She’s crazy. He had a breakdown.”

These are all moral value judgments. They’re conditional based on performance. Perhaps one of the ways that the Asian-American community can change is if they shift from these moral value proclamations to a holistic relational openness. In other words, we must stop having a conditional acceptance based on work ethic.

I struggle with this, too, and it’s not easy to do. We’re all conditional to some degree. It’s easy to judge a person’s story as the whole story until you actually hear the whole story. I’m very cynical that the Asian-American community can get to total trust in my lifetime, but I hope we can.

6.     How has mental health impacted your life?

The biggest impact is that I was able to find names for my mental monsters. This naming created a kind of power to begin to manage them. Before I may have just felt alone and drowning in a murky sea, trapped by a circling demon. Finding mental health wasn’t first about finding a “cure,” but about pointing to my experience and saying, “This monster has a name, and it’s scary, but others have faced this monster too, and they found ways to push it back.”

7.     Why do you think within the church, counseling is seen as “not always a first option?”

Again, I’m certain this is for good (and unfortunate) reasons: a high suspicion of medical institutions and a terrible history of medical professionals. But churches don’t help either, as many churches preach a kind of “lone ranger by-the-bootstraps” mentality to our spiritual walk, and that includes mental health. Churches might also say that counseling is “worldly” or “secular” or something, and those words will scare churchgoers.

8.     Being a pastor but also an Asian American, what is your view on mental health and counseling?

I am 100% for counseling, for both the person who suffers severe mental illness and for the successful person who feels well-adjusted.

For Asian-Americans, I think we live with a much larger trauma than we realize. Asian-Americans are neglected and unseen in social circles, which causes more internalized anxiety than we think. We’re considered “invisible” in the West. We’re always cartoon punchlines in the movies. We’re not talked about in protests, in #metoo movements, in “Hollywood so white,” and in racial violence. Asian-Americans, like Native Americans and perhaps Latinos, live with a constant invisibility that is never talked about. I don’t mean to make it a competition, but objectively, it’s true: the only major news story last year involving an Asian-American was a man dragged off a plane. I think we need counseling en masse to deal with our self-worth.

9.     There are statements that people have said about this topic, whether they say “it’s all in your head” or “youre not praying enough, or spending time with Jesus enough” while this may be true, why do you think that is always the first response?

I used to get really mad about this, but I get it. We sometimes lack the spiritual resources to deal with mental illness, so we go for the easy fix-it formulas. It’s not always malicious. Usually we just don’t know another way. We offer something into the silence because the silence itself is so troubling. Try to sit with your friend for even five seconds of stillness: it feels impossible. But so much of the time, we need the space of silence and the empathy of presence. The best thing that Job’s friends did were to sit with him for seven days without speaking a word. It’s the 30+ chapters of talking afterward that was the problem.

Here’s another reason, much more cynical I think. Some people say these little platitudes because they don’t want to get involved in the messiness of mental illness. Maybe they’re afraid of the dark inside. Or maybe they feel disgust, as if this person with mental illness is “beneath me.” Or maybe it causes disturbing doubts about God, as if suddenly He’s not in control or He “made a mistake” with this person. These reasons are selfish. They’re about meand do not move me toward you.

10.  What are ways as a community and culture that people can learn how to respond to people with mental health issues?

Listening. My God, just listening. Admitting, “I don’t know how to do this and I don’t know what to say, but I’m here.” Asking, “How can I help?” Being silent for a few dang seconds. Not having to speak advice into the silence. Believing that what is inside my head is real.

11.  As pastors, we see that in your church you have been implementing counseling outlets, how do you break or take steps to break that stigma or stereotype with counseling and people who go to counseling?

First, while this might not directly answer the question, I think pastors need to be very cautious of sharing “victory stories” all the time in sermons and social media. I’ve counted too many times when a pastor makes a post like, “So-and-so got help for his depression and Jesus delivered him!” The obvious reason is that confidentiality is a law in the hospital (HIPAA), and should be treated as such in the church. Not every dang church member is some kind of prop for a hero-story. Any time I’ve ever shared a story of progress, I either change all the details drastically or I ask for permission first. Even then, asking for permission feels like I am forcing the person to share. It’s better to let him or her share if they say they want to, and not a second sooner.

I also have to keep in mind that publicly sharing a story like this puts a lot of pressure on the person who is recovering, either a kind of pseudo-fame that can cause them to stumble, or a spotlight that pushes them into a song-and-dance, which can make them hide if they fall. On a large scale, “victory stories” also make recovery sound easy or that they’re the “norm.” It breeds all kind of comparison and self-loathing, when it would be better to hear both the good news of progress and the bad news of how hard that progress is.

Second, the ideas of honesty and seeking help can be easily preached, but are not easily practiced. Honestly only happens when there’s first a culture of grace. People need to know they won’t be shamed for whatever they might confess. They need to know that seeking help is truly welcomed without flinching. And people can tell what sort of community they’re in. A church might be able to volunteer for the homeless or send aid to third-world countries, but can just as easily lack grace for those with mental illnesses. It’s like when C.S. Lewis talked about the guy who prays for his mother, but when he meets her, he only shouts at her and mistreats her. We can preach good ideas, but the idea must translate into our very real mess.

Third and lastly, churches need to be equipped with a high knowledge about mental health. Like John Stott said, church leaders need one hand in the Bible and one hand in the newspaper. We should know our local resources just as well as know John 3:16. I have to admit that I’ve fallen short in doing this.

12.  What would be your response to someone who says Christian counseling is not biblical?

I’d disagree, but I’d ask why. Not why as in, “What Bible verses support your view?” but whyas in, “What led you to believe that?” I’m sure I would hear very good reasons, and then we could talk about them.

— J.S. 

[My book on depression can be found here.]

Photo from Unsplash