This story is the second in a three-part series about mental health at Brown and students’ attempts to navigate the gaps in treatment and understanding.
Against all pleas by his mother, Mike Darby ’18 decided after one session of faith-based therapy that he would not be coming back — he wanted more than “bible study” to help him cope with his depression.
The therapist Darby had seen, recommended by his mother, specialized in using a combination of cognitive behavioral therapy and prayer to teach mindfulness. But for Darby, the spiritual approach brought no healing.
“She believed the reasons for my problems were that I didn’t believe in God anymore,” he said.
It was true that he did not believe in God. Though Darby grew up a Christian, he declared in his senior year of high school — in what came as a sudden revelation to his parents — that he was an atheist.
This declaration left his mother feeling as if she no longer knew the same boy whom she had raised a devout Christian. “God is light, and without him is darkness,” she said. “Mike walked into darkness.”
Darby’s and his mother’s opposing views about religion have shaped their conversations about how to treat his depression. Such tensions are common in the relationship about mental health and religion. While for some, like Darby, religion can be a barrier to seeking the treatment they want, for many, it acts as a healing agent itself.
Navigating mental health and religion
The first instinct for students battling mental health issues at Brown may be to book an appointment with Counseling and Psychological Services. But a floor below its offices in J. Walter Wilson is a place to which many students are also turning for help: the Office of the Chaplains and Religious Life.
“The idea that religion and health of any kind are counter-opposed is a bit of a red herring,” said Janet Cooper Nelson, University chaplain. “I can’t come up with an argument in Christianity that would say in any way that one should not receive help for mental health.”
Students need not be religious to utilize resources provided by the chaplains.
Rachel, whose name has been changed to preserve her anonymity, is a sophomore and identifies as an atheist. When facing mental health concerns last year, she spoke with Cooper Nelson and Michelle Dardashti, rabbi of Brown/RISD Hillel and associate University chaplain. Both chaplains expressed empathy and understanding, she said.
The chaplains “are an underutilized resource, and I wish people were more willing to take advantage” of them, Rachel said.
Though students may feel their mental health treatment does not intersect with their religious life, Cooper Nelson believes the line between the two is “pretty seamless,” she said.
Mental health treatment should be approached from multiple dimensions, and for spiritual people, that includes religion, said Keith Meador, director of Vanderbilt University’s Center for Biomedical Ethics and Society, whose research focuses on the intersection of mental health and religion.
“We should never insinuate that, if you need medication, you are too weak, or tell the person who goes for faith-based care that they are overspiritualizing their symptoms,” Meador said.
Yet while religion can be a source of healing for mental health issues, it should not be presented as the cause of them, he said.
Those who use religion to interpret or explain their mental health struggles risk encountering “spiritual bypassing,” said Adrian Wood-Smith, associate University chaplain for the Muslim community.
Coined by psychologist John Welwood in 1984, spiritual bypassing is a defense mechanism in which one uses spiritual beliefs to avoid dealing with painful feelings.
Meador said this problem can arise for those who believe they can prevent mental health issues by being devoted to their faith.
“Faith communities are double-edged,” he said.
“In some ways, those communities can be very protective for persons,” he said. But while that community can provide “resilience and a method for coping with their inevitable psychological and emotional struggles,” those facing mental health issues may be told that they need only be more faithful to heal.
“That leaves people within those communities who do have those struggles feeling as if they haven’t been good enough Christians and feeling even more oppressed and vulnerable,” Meador said.
A survey by LifeWay Research, a firm that measures trends within Christian communities, found that 48 percent of evangelical or fundamentalist Christians believe mental illness can be cured by bible study and prayer alone.
Eddie Park ’02, who leads Brown’s chapter of the Reformed University Fellowship, an evangelical Christian campus ministry, said he “comes from a denomination that’s pretty wishy-washy.”
“If you come from a church background, there exists a whole new set of words and ideas that can be food for mental illness and might aggravate it,” Park said. “There’s an underlayer of guilt. You might ask, ‘Did God do this to me? What did I do to deserve this?’”
But Park argues that religious people have a right to be suspicious of medicinal therapies for mental health. “Ten years ago we didn’t understand the brain as well as we do now,” he said. “The psychiatry and psychology community have made some mistakes they have had to reckon with.”
Cooper Nelson, though, said she believes religion should not be considered a replacement for medicine.
“Religion isn’t some capsule you can put in your mouth and instantly feel good,” she said. “To me, that’s a very demeaning notion of God.”
Meador likens the belief that religion alone can solve mental health problems to a belief in miracles.
“In most of life, that doesn’t occur. That’s why it’s called a miracle,” he said. “Most of the time, we must trust that the people who have the gifts to assist in healing are gifts from God as well.”
Religion and treatment at odds
Finals period had been rough on Darby. The week of stress and frantic studying brought a difficult first semester to a close.
Returning to New York City for winter break, Darby hoped the four weeks at home would allow him to confront the depression and anxiety that had come to a head during finals. But the visit with his therapist had not gone well, and he did not schedule another appointment with her — or any other therapist — for the remainder of winter break.
His mom wanted to find someone on whom they could agree — someone who shared their Christian views and could also offer Darby the treatment he needed. But such an agreement was not reached.
In January, Darby returned to campus feeling worse than when he left.
“Most mornings, I couldn’t get out of bed properly. I spent most days in a haze,” Darby said. His depression left him without the motivation to complete schoolwork or to even leave his room.
From afar, his mom saw that his lack of organizational skills had stuck him in a rut from which he could not escape. As his mom saw it, he “decided he could stay up all night,” was not showering and was not eating.
“If you’re doing this consistently for eight months, that is going to put you in a depressed mood,” she said.
Again, Darby and his mother could not reach an agreement — this time on the cause of his mental illness. To Darby, it is clear that his inability to fall asleep and stay organized are symptoms of his depression. But to his mom, those behaviors are not results, but rather the causes of his distressed state.
Debra Giaramita, the therapist whom Darby’s mother recommended, expressed similar concerns. “In my experience, depression and anxiety can result from a lack of self-care,” she wrote in an email to The Herald.
Darby said his parents offered other suggestions for healing: “Had he been reading the bible? What about that church nearby? Those Christian friends you mentioned, have you been talking to them?”
Within three weeks of his return, he had booked a session with CAPS. His mother did not know.
The therapist with whom Darby was matched brought him great relief. Darby found himself able to open up to her, and they talked about his symptoms in a way that made sense to him — from a perspective that analyzed his brain chemistry and mental processes.
But in what seemed to him like a short period of time, Darby had used his allotted seven sessions for that academic year and was barred from scheduling additional CAPS appointments until this semester. Without a therapist, Darby said he wanted to find a psychiatrist who could prescribe him the medication he felt he needed.
While CAPS has supported Darby in finding an off-campus therapist, the therapist he chooses must still be screened by his mom, who gets a say since it is to her mailing address that the therapist’s bill will be sent, he said. And while Darby’s parents are now supportive of his receiving therapy, they do not want him seeing someone they do not know anything about.
“I said, ‘You need to find someone good. You need to look at their ratings, I need to look at their ratings, and we need to see what the feedback is from the patients,’” Darby’s mom recounted. “You can’t just hop into anyone’s office.”
Finding a counselor who is educated in one’s spiritual tradition can be of huge importance for those who are spiritual. If not, therapy may end up invalidating religion.
While counseling can alleviate mental health problems, it can also put pressures on religious beliefs.
“Practicing students may feel that mental health professionals, without a background or knowledge of the traditions of the religion, are deconstructing their personal faith,” Wood-Smith said.
He said he once worked with a student who had been asked by her counselor what her coping mechanisms were for dealing with mental illness. The student said she became more diligent about praying five times a day.
“From the student’s perspective, that’s normal religious practice. It’s not a burden. But from the counselor’s perspective, that’s obsessive behavior,” Wood-Smith said, adding that the counselor seemed to be telling the student to pray less.
Wood-Smith said he has also heard of counselors deconstructing the Islamic belief in an ever-watchful God. “That’s something a counselor could hear someone talking about and say, ‘That’s not healthy to feel a force or angel watching over them. Let me help this person remove that idea.’”
“Those might, in fact, be really deeply held beliefs that aren’t really open for discussion,” he said.
“Mental health professionals may see that a theology or a religion is causing a client stress,” he said. But “that’s not a conversation that a professional should have with a client alone if there’s not an understanding of the tradition and faith.”
On a more basic level, Muslim students seeking help must be mindful of the counseling environment they enter. For example, under Islamic law, it is forbidden for an unrelated man and woman to be in an enclosed space together where no one can see them.
“While that may seem like a nitpicky thing, that could be a legitimate reason for why a student feels uncomfortable going to CAPS,” Wood-Smith said. He added that he works with CAPS to ensure that students of faith receive treatment they feel comfortable with.
Healing through religion
Halfway through a medical leave of absence she took to confront her depression, Michelle Miller ’18.5 decided to return to religion, though not the one with which she had grown up.
Raised Catholic, Miller became an agnostic in high school. “I always felt like I had a lack of nerve to go with what I knew was true,” Miller said. “I felt that in believing in something, I should have conviction” — something she said she was missing in her faith.
Looking for healthy coping mechanisms, Miller used meditation to practice mindfulness. She also started to pray again.
Rather than returning to Catholicism, Miller explored several religions that she had not previously taken the time to understand thoroughly. So she read — the Old and New Testaments, Daoist texts, Buddhist literature. Eventually, her studies of the Quran pulled her toward Islam.
“It’s very much about being logical and rational in your approach to your faith,” Miller said. An astrophysics major, Miller was drawn to the idea of a religion that believes in multiple human prophets and strays from the seemingly “magical” stories of Christ, she said.
The word Islam itself means “submission to God” — a principle that has supported Miller in her healing.
Even on days in which she falls into depressive episodes, she said she can “accomplish something in the name of God.”
Islam’s guidelines for prayer — performed five times a day in accordance with the sun’s position in the sky — have provided Miller with a structure to self-evaluate her mental health.
“That idea of constant mindfulness is really appealing,” she said.
This same consistency of religion can provide healing within the Christian tradition, Park said. As students may find themselves constantly caught under the pressure of schoolwork, the “regularity of prayer cuts against the grain,” Park added, noting that religion “comes with rigor in its own way.”
The prayer schedule has also provided Miller with motivation to get through the day and push through moments of difficulty. “At the end of the day, I still have to get up and pray,” she said.
But Miller’s religious revival has not precluded other ways of combatting her depression.
Along with meditation and prayer, Miller used medication to help feel stable enough to reapply to Brown. She was readmitted in June and returned to campus this fall.