Singing in a Strange Land: Dealing with Depression & Suicide in the Black Church

1. Singing in a Strange Land: Dealing with Depression & Suicide in the Black Church Extend a Hand: Preventing & Responding to Suicide Conference September 23, 2011 Sherry Davis Molock, Ph.D., M.Div. George Washington University

2. Singing in a Strange Land • By the rivers of Babylon, there we sat down, yea, we wept, when we remembered Zion. • 2We hanged our harps upon the willows in the midst thereof. • 3For there they that carried us away captive required of us a song; and they that wasted us required of us mirth, saying, Sing us one of the songs of Zion. • 4How shall we sing the LORD's song in a strange land? (Psalm. 137:1-4)

3. Introduction: Challenge • Every 16 minutes, someone dies by suicide • In 2007, over 33,000 persons died by suicide in US • Suicide is the 11th leading cause of death in the U.S. • Suicide is the 3rd leading cause of death among 15-24 (CDC, 2007) • What is the faith community going to do about it?

4. Good News: We Can Help Prevent Suicides By: • Knowing the warning signs • Linking people to treatment • Giving people “permission” to seek help • Serving as an important member of the team that is needed to help people get professional help

5. Overview • Part 1: • Characteristics of Depression • Learn to Identify the Risk & Protective Factors Associated with suicide • Part 2: • What does the Bible really say about suicide? • Part 3: • Linking People to Services

6. History of Depression • Depression has been recorded since antiquity • Examples from Hebrew Bible (Old Testament) • Moses (Numbers 11: 10-15) • King Saul (I Samuel 16: 14-23) • Elijah (I Kings 19: 1-4) • Hippocrates uses the terms melancholia & mania to describe mental disturbances

7. Characteristics of Depression • Common disorder; will affect approximately 20% of people in their lifetime • Disabling disorder: number one cause of disability in the world • More common in women than men; • Women are twice as likely to be affected by mood disorder

8. Depression is a Chronic Disorder : • Depression is a recurrent illness • Likelihood of having another episode of depression increases with each subsequent episode: • 1 episode, likelihood of another– 50% • 2 episodes, likelihood of another – 70% • 3 episodes, likelihood of another – 90%

9. Clinical Depression Normal Sadness vs. Clinical Depression Normal Sadness Feel sad but also have periods of feeling “normal” Able to experience range of emotions, including joy, happiness Have emotional reactivity Sleeping, eating, concentration rarely affected for long periods Sad, depressed mood most of the time for at least 2 weeks Anhedonia: difficult to experience pleasure Hopelessness Loss of mood reactivity Difficulty sleeping, concentrating; change in appetite, fatigue Suicidal thoughts

10. What is suicide? • Suicidal thoughts: thoughts & ideas about taking one’s life. • Can be vague to very specific plans • Suicide attempts: person engages in behavior that involves a deliberate attempt to take one’s own life. • Not same as self-mutilation (e.g., cutting) where goal is NOT to end one’s life.

11. Cultural Differences in Expression of Suicidal Behaviors • Blacks may be less likely to use drugs during suicide crisis • Asian Americans & Blacks may complain more about physical symptoms • Behavioral component of depression more pronounced in Blacks • Some Blacks express little suicide intent or depressive symptoms during suicide crisis • Victim-precipitated homicide • Suicide may be more stigmatized in Black community • Differences in classification by medical examiners

12. Risk Factors: • Individual • Previous Attempt • Depression • Delinquent behavior • Substance abuse • Recent loss • Physical illness • Family • Non Supportive • History of physical or sexual abuse • History of mental illness in family • Community • Isolated from others • Stigma • Access to lethal methods • Barriers to access to care

13. Protective Factors: • Individual • Good coping skills • Active use of faith beliefs in coping • Good problem solving skills • Family • Supportive family • Cohesive family • Parental monitoring • Community • Belonging to church • Cultural beliefs that discourage suicide • Cultural and religious beliefs that encourage help-seeking • Access to care

14. Take Home Message: My people perish from a lack of knowledge Hosea 4: 6 (KJV)

15. Part II: What Does the Bible Really Say About Suicide?

16. Intro • Early Church Fathers struggled with understanding of voluntary death; what’s the difference between • Seeking to be killed • Allowing yourself to be killed • Killing oneself • These same dilemmas are presented in the Biblical text

17. Intro • Difficult to study suicide in Bible bc contemporary view of suicide ≠ views of voluntary death at the time the Biblical Texts were written • Current views of suicide as sin are shaped by Augustine in 4th century • Viewed suicide as form of murder • Viewed as unpardonable bc no time to repent when take your own life

18. History of views about suicide • Augustine’s views shaped by philosophers of his time & by crisis in early Church • Augustine upset with the Donatists who encourage suicide as an act of piety • Biblical influence: • Exodus 20:13: “Thou shalt not kill”

19. History of views about suicide • 3 Church Councils transform voluntary death = unpardonable sin • Council of Orleans: 533 AD • Council of Braga: 563 AD • Council of Auxerre: 578 AD • Canon law eventually incorporated into secular law; suicide becomes a crime of the State • Individuals who die by suicide not only denied Christian burial but body was dishonored as well

20. History of views about suicide • Anyone who completes suicide denied funeral rites of Eucharist & singing of Psalms • Bodies are hung in public places • Bodies buried with stake thru heart • Families are disgraced • Personal property forfeited to State • Penalty for attempted suicide = death • Late 19th century, focus shifts from suicide as a moral & religious issue to suicide seen as a psychological & sociological issue

21. Biblical Accounts of Voluntary Deaths • Judges 9:50-57: Abimelech • Abimelech ashamed to be killed by a woman so he asks his armor bearer to kill him • Judges 16: 28-31: Samson • Samson begs Yahweh to give him strength to bring down pillars to avenge the Philistines blinding him • 1Samuel 31:1-13 • Saul asks his armor bearer to kill him so he won’t be defiled by the Philistines

22. Biblical Accounts of Voluntary Deaths • 2Sam. 17: 1-23: Ahithophel • Ahithophel sides with Absalom when David & Absalom fall out; Ahithophel is humiliated; goes home and kills himself • 1Kings 16:18-19: Zimri • Dies in fire when defeated by enemy • Condemned not bc completed suicide but bc disobeyed God

23. Judas: Matthew 27:3-5 • After Judas realizes what he has done in betraying Christ, he goes home and hangs himself • Some say that Judas’ punishment for betraying God was his suicide • Yet, Jesus knew Judas would betray him & kissed him during the betrayal • Perhaps Judas killed himself bc Judas didn’t know that in spite of his betrayal, God was not finished with Jesus or Judas yet, there was something beyond the crucifixion

24. Common Themes in Biblical Suicides • Abimelech, Saul, Ahithophel, Zimri & Samson are all trying to avoid humiliation • Avoidance of shame very important in Hebrew culture

25. Suicide as Unpardonable Sin • In each of these passages, Bible doesn’t comment one way or another on the suicides • There is no Hebrew word for “suicide” in the Hebrew Bible – suggests idea of suicide was a later development in Hebrew culture

26. Early Rabbinic Writings • In early rabbinic writings, under certain circumstances, suicide was justifiable • Someone tries to force person to commit idolatry • Someone tries to force person to commit murder • Someone tries to force person to engage in forbidden sexual act

27. Condemnation of Suicide • Life is a gift from God and only God has the power to take life • Genesis 1:1-2; 4a, 24b-25 • Genesis 9:5 • Since homicide is condemned, condemnation should extend to suicide as well • Yet the Bible is filled with examples where the Israelites not only kill others, but they feel that God is on their side in the killing

28. Condemnation Against Suicide • Lot of Biblical characters who are full of despair but don’t attempt suicide • Job: Job 2:9-10 • Jonah: Jonah 3:1-8 • Elijah: 1Kings 19 • Moses: Numbers 11:10-15 • David: Psalm 22

29. Compassion Toward Suicidal • Emphasis placed on forgiving • Not advocating suicide but focus on pardoning or forgiving the person • Psalm 139:8-10 • Daniel 3:16-18 (martyrdom) • Romans 8:38 & 39 • Advocates that our worst mistakes don’t negate God’s grace • Greatest evidence for this: The Cross

30. Theology of Suffering • Hollinger (1998) says our theology of suicide is intimately connected with our theology of suffering • Two common views of suffering by the world: • Suffering is unqualified evil • Suffering should be removed at all cost • Christian theology = suffering is a challenge to persevere and an opportunity to overcome • James 1:3-4 • Romans 5: 3-5

31. Theology of Suffering • Job becomes suicidal not bc he is suffering, but bc he doesn’t understand the meaning of his suffering • Question for Job becomes a question of theodicy: “How can a just God allow the innocent to suffer?” • Job questions God’s leadership in the world – results in loss of meaning in life; he feels hopeless

32. Theology of Suffering • Job doesn’t attempt suicide bc in spite of his suffering, Job continues to seek God • Job has to answer a question we all have to answer: • What are you willing to do, what are you willing to endure, to be in relationship with God?

33. Theology of Suffering • For Christians, Christ is God’s answer to what God is willing to endure to be in relationship with us • Are you willing to be in relationship with God, regardless of the rewards and punishments involved? • Highest form of worship is being able to love and be in relationship with a God who does not guarantee that all your desires will be granted

34. Theological & PsychologicalMessage of Job • Job is strengthened by adversity • Mental anguish --- mental fortitude • Helplessness --- hopefulness • What is your understanding of suffering? • What do you convey to those to whom you are called to minister?

35. Messages of Hope: • I will lift up mine eyes unto the hills, from whence cometh my help.  2My help cometh from the LORD, which made heaven and earth. (Psalm 121: 1-2, KJV) • But they that wait upon the LORD shall renew their strength; they shall mount up with wings as eagles; they shall run, and not be weary; and they shall walk, and not faint (Isaiah 40:31) • I can do all things through Christ which strengtheneth me. (Philippians 4:13) • For I am persuaded, that neither death, nor life, nor angels, nor principalities, nor powers, nor things present, nor things to come, Nor height, nor depth, nor any other creature, shall be able to separate us from the love of God, which is in Christ Jesus our Lord. (Romans 8:38-39)

36. Part III Developing Partnerships

37. Introduction • Important that faith & mental health communities develop partnerships to promote mentally & spiritually healthy families • Mental illness often viewed as faith crisis • Need permission to seek professional help • Recognize pastor cannot be all things to all people

38. Barriers to Help Seeking • Stigma of mental illness • Belief that suicide is a “white thing” • Belief that suicide is not an option for “real men” • Belief that black women are “super women” who don’t “crack” under pressure

39. Barriers to Help Seeking • Pastors make jokes about mental illness from pulpit • Using negative view of mental illness or seeking professional help in sermon or Bible study • Lack of communication and understanding between faith & mental health community • MHP’s are “heathens” who plan to take away my Jesus • Faith & prayer are passive responses to crises

40. What You Can Do to Help • Listen: Don’t Judge • Take Every Complaint Seriously • Trust Your Own Judgment • Ask Questions • Don’t Act Shocked/Upset • Don’t Be Misled • Be Affirming & Supportive

41. What You Can Do to Help • Give church members “permission” to seek help thru • Sermons • Bible study • Sunday school • Stop encouraging “fake it till you make it” theology • Create support systems in church

42. Develop Partnerships • Mental Health Professionals • Invite them to come to health fairs, give workshops • Create Mental Health Resource Directory • Create Programs to PREVENT suicide • Strengthen families • Strengthen young people’s sense of belonging thru youth ministry

43. From the Pulpit • Do Bible studies on emotional disorders or mental health concerns in Bible • Do special sermons on emotional disorders • October – Depression Screening Month • July – Black Mental Health Awareness Month • Put concept of mental illness, emotional problems, mental health & help seeking in sermon or Bible study

44. From the Pulpit • Several texts that are rich with symptoms of depression that one can use for sermons or Bible studies • 1Samuel 16:14-23 • Numbers 11:10-15 • 1Kings 19 • Mark 5 • John 5: 1-10

45. Take Home Message And we know that in all things God works for the good of those who love him, who have been called according to his purpose (Romans 8:28, NIV)

46. We Can Do This Together!