Equipping ourselves with a framework that is true, both clinically and spiritually
8 MINUTE READ
This is likely because of the complexity of what young people and families navigate in our world today, as well as the increase of people speaking out to get the help they need. We are all becoming more literate about mental health issues through improved education and reduced stigma. Many of us will inevitably have a connection with someone who has lived experience of mental health issues – either personally, through our work, or in ministry. The increase in such problems, especially in young people, can raise a sense of fear, alarm or hopelessness. In order to respond more effectively to those around us, we need to equip ourselves with a framework that is true, both clinically and spiritually.
In this article, we will explore adolescent development in order to contextualise mental health difficulties in young people. We will integrate a Christian perspective to help us to connect the issues we see in the world with our worldview as Christians. We will then be equipped with a framework to help build resilience in young people that can hopefully be applied to a wide variety of situations.
The Adolescent Period
Adolescence is a unique transition period from childhood into adulthood when we undergo both physical and psychological changes. We individuate from our family context, develop socially and emotionally, and acquire skills to navigate our environment and culture. During this period, we begin to develop a sense of our identity and values, and this sets us up for future life stages. Adolescence is a time of incredible change and learning. It involves making mistakes. We may also experience loss and failure, possibly for the first time in our lives. There is a dynamic and complex interaction between how we think and feel inside, and our outward behaviour, relationships and environment. Our experiences influence how our brains and minds develop, while our brain and mind enable us to assert influence on the people in our environment.
Adolescents negotiate a wide range of developmental tasks such as increasing independence, learning to deal with conflict, managing more complex relationships and friendships, dealing with issues of loyalty with family and peers, and sorting out issues at school and at home. When we look at this stage of life more closely, we can see so much happening. Even in the absence of a major crisis or trauma, there is so much opportunity for growth in the challenges experienced by a young person.
“Even in the absence of a major crisis or trauma, there is so much opportunity for growth in the challenges experienced by a young person.”
We frequently see the emergence of mental health issues during this crucial period of development. 75% of mental health issues emerge before the age of 25. While this statistic emphasises the importance of getting help early, it is also important to understand how mental health issues can have ties to the adolescent period even when they are diagnosed later in life. Nowadays, we have easy access to a lot of information that can help us understand and explain mental health difficulties.
A Christian Framework for Mental Health Empowerment
There are a wide range of different perspectives that contribute to our understanding of mental health issues in young people. These range from ideas around how our brain works; the impact of family relationships and social contexts; learning and development; theories of identity formation, and so forth. Exploring different hypotheses can help us formulate or understand these mental health difficulties from a variety of lenses and help us to appreciate the complexity and storm of multiple contributing factors in a young person’s life. This process in clinical mental health work is often referred to as formulation.
Developing a framework which integrates a Christian perspective is important to Christian mental health practitioners. This enables us to do our clinical work while respecting our faith and our own identity, both as a professional and as a person. This framework also empowers those in ministry to see how they can be more effective in helping others develop and protect their mental health.
“When the woman saw that the fruit of the tree was good for food and pleasing to the eye, and also desirable for gaining wisdom, she took some and ate it. She also gave some to her husband, who was with her, and he ate it. Then the eyes of both of them were opened, and they realised they were naked; so they sewed fig leaves together and made coverings for themselves.” (Genesis 3:6-7, New International Version)
Pay attention to the image of the fig leaves. The fig leaves used to cover our nakedness and shame could be said to represent different things we have in our lives today, often good things that we enjoy. They could be our reputation, relationships, identity, or material things that we own, such as jobs, money or social status. Sometimes our role and significance in ministry could be represented by these fig leaves.
Fig leaves can accumulate over the years of our lives, often beginning in adolescence since there is significant identity development during this stage of growth and change. Through the ups and downs in life, we experience change and loss, and this results in those fig leaves falling. It can happen as a natural consequence of development, or it can occur secondary to unexpected circumstances such as trauma and disaster. When our fig leaves fall, we feel exposed, naked and ashamed. Examples include losing a loved one or pet, failing an exam, dealing with relationship challenges, or experiencing bullying. Peer difficulties are also common during this stage of life and the impact of these circumstances is made more profound when they involve aspects of our identity, reputation and sense of worth.
The importance of a particular fig leaf will vary from person to person. This explains how two different people could experience a similar situation but have different consequences for their mental health. Furthermore, when fig leaves fall, the manifestation of shame can also vary from person to person resulting in the different signs and symptoms of various mental health difficulties. A person could become withdrawn and feel hopeless in depression, or experience repetitive worry and stress in anxiety. Depression and anxiety are the more common presentations of mental health difficulties in young people, and there is a common feeling of shame among those struggling with challenges when those fig leaves fall.
It is important for us to take practical steps towards building positive mental health – basically, finding new fig leaves or replenishing the ones that have fallen. During this time, we may also appreciate the impact of the fallen fig leaves and their significance on our mental health. This will help us to weather future challenges and develop resilience. Resilience is the ability to cope with the ups and downs of life with optimism and hope. Sometimes we can make the assumption that we are resilient when we do not struggle with mental health difficulties. Ironically, the more challenges we experience in life, the more resilient we are likely to become as a result.
“Who shall separate us from the love of Christ? Shall trouble or hardship or persecution or famine or nakedness or danger or sword? As it is written:
“For your sake we face death all day long;
we are considered as sheep to be slaughtered.”
No, in all these things we are more than conquerors through him who loved us. For I am convinced that neither death nor life, neither angels nor demons, neither the present nor the future, nor any powers, neither height nor depth, nor anything else in all creation, will be able to separate us from the love of God that is in Christ Jesus our Lord.”
(Romans 8:35-39, New International Version)
This passage in Romans highlights a range of suffering from hardship to death, nakedness and shame. While taking practical steps to rebuild positive mental health, we are also reassured by the truth that our shame does not separate us from the love of God. I feel that it is important to emphasise this because many Christians struggling with mental health difficulties feel distant from God or feel that they are not good enough. What a relief that nothing can separate us from the love of Christ!
“…Christians struggling with mental health difficulties feel distant from God or feel that they are not good enough. What a relief that nothing can separate us from the love of Christ!”
How do we develop resilience? This process starts early in life and continues to build during subsequent stages in our development. As human beings, we need care and security in our relationships with other people. Physical and emotional security, predictability, empathy and being held in a positive emotional regard are necessary elements of this care. Children need to experience this from their parents, caregivers, teachers or other adults in their lives. The security in these relationships helps children with the confidence to navigate and explore the world around them. It helps us to take risks and deal with the various challenges we experience as we grow through life. It also helps us to cope with situations that lead to stress when our fig leaves fall. The natural response to such stress is for the child is to seek care and security again from their primary caregivers. This cycle of security and exploration promotes learning, development and resilience.
When a teenager experiences challenges in their peer group or other situations outside their home, strong home relationships can help them cope with the challenges. Often it is not possible to control or influence the environment that a young person is in. Instead, we can strengthen the main relationships in their life. For some young people, the primary secure relationships may not be their immediate family members due to complex circumstances. A teacher, mentor, or youth leader could instead play an important role in providing them with a safe and predictable relationship. A framework integrating human development with our understanding as Christians can also be helpful during other stages of our lives and relationships.
The resilience of young people is built from the emotional health of their caregivers. Caregivers should pay attention to their own self-care by setting healthy boundaries and learning to live at a slower pace. When this happens, they have the emotional availability to be aware of and attend to their own feelings, and can better relate to the feelings of others. It is incredibly difficult to be emotionally available when we are stressed, rushed or burnt out. Steps towards building self-care benefit not just the carer but also the person they are supporting. Resilience is also best modelled rather than taught. Adults help young people to develop skills in resilience when they practise them in their own lives.
Integrating a clinical and Christian perspective on mental health enables us to develop a framework to better understand the vulnerabilities of young people to these difficulties. The fig leaves described in Genesis represent the many ways we may try to build positive mental health, especially during the stage of adolescent development. A crucial aspect of a Christian mental health framework, drawn from the passage in Romans, is the redeemed perspective of how Christ sees someone who might be struggling with mental health difficulties – remember, nothing can separate us from the love of God!
Dr Danny Cheah
Dr Danny Cheah is a Melbourne-based child and adolescent psychiatrist who leads a service of 130 clinicians providing multidisciplinary mental health care for people aged under 25 years. Danny delivers training at churches across denominations and countries to help Christians understand mental health issues, integrating clinical and faith perspectives.