Specialist Care for Mental Health
As we wrap up our exploration of the Member Care Model first developed by the O’Donnells, we get to hear from Carol Manley this month. She is a mental health care professional with a heart for hurting people, particularly those serving cross-culturally. She speaks from a wealth of professional experience as well as love for God’s people. I have seen her in action, and she has much to offer all of us!
by Carol A. Manley, M.Ed., LPC-S, LMFT
“And when he rose up from prayer He found them asleep, overcome by grief.” Luke 22:45
The mission seemed to be coming to an end on the night of the Last Supper. Jesus’s words were confusing; however, his chosen disciples were all determined to be there for Jesus, no matter what He said or predicted. All denied they would ever reject him. The disciples’ mentor, Savior, friend, and healer of the dead spoke of leaving, of things changing, of returning to the Father. Later, in the Garden of Gethsemane, our saddened Jesus grieved with sweat drops of blood in prayer. His disciples failed him. They failed to understand, to partner, to come along side, to stay in prayer. He asked three times for them to pray. However, they slept, curled up on a rock for a pillow while grieving the dream of what they believed the future would hold. They were “overcome by grief.”
Once again we see Israel failing, failing in their mission. Failure was not a new story. Ezekiel writes of chosen Israel. Ezekiel 37:11, “Our bones are dried up, and our hope has perished. We are completely finished.” Similar to Israel, many of us are confused in the moment and hopeless about tomorrow. Our emotional, spiritual, and physical health is broken to the point that all seems lost, colored by the despair and unmet expectations of the mission before us.
I must tell you I am struggling writing this article today. I am struggling, not because I do not believe in the assignment. I am struggling to honorably illustrate the journey of today’s missionary. I am determined to honor our brother or sister who chose suffering for the sake of Christ. I desire to honor each one who has opened his/her heart to the invitation to be a voice to the lost. I am prayerful this discussion is met with mercy and grace as we assess the unwanted emotional, spiritual, and physical battles of our missionaries.
I invite you to ponder the struggle of maintaining one’s mental health in this broken world. Saying “yes” to the sacrifice, to the journey, to the mission can leave one in a state of ongoing trauma and loss. What was normal is no longer present. How do you equip missionaries to deal with loss, unmet expectations, and possible struggles? Their struggles may include questioning God’s presence in unexpected, confusing, traumatic events. Caring for those sent includes assessing the mental health of these precious servants.
Sponsoring congregations must listen, ask difficult questions, as well as seek care for the complex issues of mental health through medical relief, counseling, and renewal. Can you allow your missionaries to grow beyond their own imperfection in their mission? Can you invite them to share the journey of struggle with you? The mission requires each missionary to assess personal brokenness which may only have been identified or developed when life grew out of earthly control. Failing, struggling in the Garden is akin to missionaries leaving the field shamed from their own behaviors and losses. I, personally, have witnessed the wisdom and expertise of Mission Resource Network brainstorming ways to assist in healing through referrals to counseling networks. Living in shame is no longer the option. Professionals serve as Jesus, reminding the shamed of His forgiveness and the continued invitation to “Feed my sheep.” (John 21:17)
Marriages and families will be tested concerning the mission at hand. Families will encounter stress and trauma which can only be anticipated, cognitively; however, actually experiencing these traumas are more confusing to the heart and soul of the individual. Traumas of assault, traumas of misspoken communication, traumas of living as a stranger all serve to dismantle the confidence in self as well as the mission. The cumulative effects of trauma may leave one questioning themselves and our God. These struggles may lead to depression and anxiety. Mental health is a complex issue encapsulating a variety of symptoms unique to the individual. Struggling with one’s mental health can be circumstantial, genetic, spiritual, or a complex combination.
Each missionary must personally work from a theology of suffering for the Lord. None of us know what the next moment holds. How success is measured will depend on the expectations of the missionaries and the churches providing emotional aid, as well as financial aid. Many missionaries struggle with stress on the field; however, many also struggle to please those who financially send and emotionally support them. Invite your missionaries to tell their story, their struggle, and their regrets. They may need to go deeper, emotionally, to bring about spiritual healing through counseling and possibly medications to aid in mental health. Our world of Zoom, WhatsApp, and FaceTime can become conduits for healing. International care provides the necessary one-on-one relationship to understand the complexities of these emotional battles. Furloughs filled with opportunity to rest, heal, and recover through professional counseling or mentoring may be life-giving for mental health. Assessing one’s history, fears, or weaknesses to bring about growth and strength serve to equip the missionary to return back to the field with renewed faith for the work.
“Research confirms that 94% of missionaries experience trauma on the field with 86% being exposed to multiple incidents; yet, only half of these individuals reported suffering Post Traumatic Stress Disorder symptoms. Of those surveyed, 43% developed a diagnosable mental disorder.”[1] Some symptoms of trauma include shock, confusion, irritability, anger, anxiety, guilt, shame, withdrawal, depression, and hopelessness. Many of our missionaries struggle to have access to mental health providers or to the medications that can help the brain and body recover. None of us could anticipate the Covid-19 pandemic, the losses, and the isolation that occurred across the world for our missionaries. Many in the mission field have had Covid-19 without the medical care that we have in the States.
Let’s talk about the group that never develops a diagnosable mental disorder, even though they have experienced trauma. Suffering is part of the mission. Developing a healthy perspective of suffering can aid in creating resiliency. Paul states that whether he lives or dies, he belongs to Christ. (Romans 14:8, paraphrased). For those displaying resiliency, their personal safety net is vital. Professional counseling becomes a conduit to understanding the underlying battles and mental health struggles. Healthy marriages are a must for continued success on the field as well as a healthy team. Healthy support from the sending congregations consists of an active system of prayer while partnering to sustain the mission through the rough growth times and unexpected losses. Possibly, even more confusing to the heart and soul, missionaries face spiritual attacks as they strive to serve our Lord.
While Paul traveled to different mission sites, he spoke of the support he needed. “I came to you in weakness and fear, and with much trembling.” (I Corinthians 2:3). Paul acknowledged needing a brother to come along side the mission “... For they refreshed my spirit...” (I Corinthians 16:17,18). Paul lived a life of serving; yet, he spoke about longing for support, while he defined his own needs. Paul allowed us to glimpse into his personal battle of “a thorn in his flesh.” (II Corinthians 12:7-9). Whether this was a physical malady or one of the mind or a combination, Paul identified a struggle that effected his ministry, his joy, and his hope. Paul maintained a healthy heart as he surrounded himself with great support, identified his personal battles, and placed his faith in Christ.
Brothers and Sisters, I pray we support those serving in missions. I pray we, too, stand on behalf of our missionaries as they encounter the enemy through their own emotional battles while sharing Jesus. I pray the body of Christ uses all tools available to serve, resulting in resilient spirits who share Christ. I pray we serve those who serve Jesus. I pray when we are invited to the Garden with Jesus to wait and watch and pray for His mission, we also equip those to rise to the calling, to the mission at hand, with healthy hearts and minds for Christ.
Robert Bagley, “Trauma and Traumatic Stress Among Missionaries,” Journal of Psychology and Theology 31, no.2 (2003): 104, (97-112).