Mind Dive Episode 26 Transcript
Welcome to the Mind Dive podcast brought to you by the Menninger Clinic, a national leader in mental health care where your hosts, Dr. Bob Boland, and Dr. Kerry Horrell. Twice monthly, we dive into mental health topics that fascinate us as clinical professionals, and we explore those unexpected dilemmas that arise while treating patients. Join us for all of this, plus the latest research and perspectives from the minds of distinguished colleagues near and far. Let's dive in.
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Super excited today we have Dr. Marcy Verduin. It's very nice because she wrote us the shortest bio ever. So I'm going to say it,
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which doesn't really do justice to her. But I'll tell you what it says she's the Associate Dean of students and Professor of Psychiatry at the University of Central Florida College of Medicine. She has been invited to speak nationally and internationally to help people of faith, and specifically Christian pastors to better understanding mental health and well being. She's an expert on many other things. But that really is what we're going to be focusing on today. And as I said, before we even started recording I'm so excited. I think listeners have probably picked up by now from other conversations that mental health and religion is my area of, of interest. And I'm specifically, really passionate about getting our clergy people, resources and tools and helping them think about mental health. I think that's perfect for you. Oh, good. Oh, good to have you on doctor for doing. I'm so glad to be here. Thanks for inviting me. All right. So just for starters, you know, just can you just tell us a bit about yourself, and just how you got interested in this topic, you know, mental health and religion. It really started in the midst of the pandemic, everything that is going on right now. I guess it was actually, as we were starting to come out of the pandemic, a little bit of things were easing off. It was in 2021, there was a conference that was happening in Orlando, it was a North American pastors group that was meeting here to have a conference to talk about just topics that were coming up for them. And with the pandemic, what they were seeing was a lot of mental health problems that they had never really dealt with before at a at a magnitude they're never really dealt with, because they've always probably dealt with some of those things, but is just seeming much more significant than they've ever dealt with before. And so because it was sort of a serendipity thing, because it was in Orlando, and I live in Orlando, I got invited to see if I'd be willing to come talk about mental health to senior pastors and church leaders. So, you know, that just kind of led to the opportunity. I went in with the idea of just kind of giving like a primer on mental health for them, helping them to understand what mental health problems are, that they're real disorders that actually need treatment and talking about what treatment looks like. And it went really well. We, we did a lot. We did some exercises, I did it kind of in a workshop kind of style, a little bit of talking first and then some vignettes that I had them work through as a group. And after that, I got invited about a month later to do the same kind of talk for a group of pastors in the Philippines because they were really locked down. The Philippines experienced much more significant lockdowns than we did here in the States. And they were really struggling. And so I did it for the Philippines that led to another invitation for a different group in the Philippines and another and another. And eventually, that's how I've gotten to be doing all this talking on it on mental health and the intersection of faith. It just really was serendipity. And then it just kind of took off. I mean, it sounds like an understandably so. People are especially again, people who lead churches and religious communities. They're hungry for this. They have
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I guess I wasn't, that wouldn't be obvious to me. But why do you say that?
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Well, I was thinking because again, the speaking of that first conference, and then having invitations, just sort of like, hey, we need this here. And we need this here. And that's where we
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are, yes, very hungry for it. So in late September, early October, I traveled to Oceania. So I had been invited to go to the same kind of conference, but for Oceania, so a senior pastors conference, they're in Sydney, and I was invited to do sort of a mainstage talk and then a couple of breakout sessions and they had some concurrent breakouts very similar to kind of the medical conferences we go to just for a different topic, and they had to move the one of the breakouts on mental health back to the main stage area because it was so oversubscribed because everybody wanted to hear the mental health topic.
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So the small group became the group. Almost I
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think, I think they had like 307 people at the
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conference and over half came to my breakout. Wow. Okay, so this isn't this something I'm very fascinated by. So and I mentioned I went to a program that specifically my PhD was focused on the intersection of religion and psychology.
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And a lot of people I know who go through programs like this. They have been pastors, they've been in the ministry, and then they felt sort of under skilled or they didn't feel like they were running into this. And then they decided to go get a degree in counseling or psychology. And so a lot of people who find themselves in missionary care in pastoral care in regard to the psychiatric or psychological side of it, have quite a long history and even maybe being a pastor. I don't know this for sure. But have you been in the ministry? Or have you been a pastor? No, I have not. I am a believer. And I think that's one reason why I've been asked to go to come back over and over, because I think it gives it some legitimacy, right? I'm not some outside person coming in speaking to them. I'm speaking from a place of, of I share similar values and the same faith. And so I can talk about having faith and understanding that there are mental health needs and how to go about accessing treatment for that. So I think that's one reason why it's taken off so much, because I can talk about that intersection of faith and mental health, from a person who's, who lives the faith instead of just from an outsider coming in and saying, Let me tell you, all you people what this is right. And I wonder to maybe, because I think that makes so much sense that you've had some of that experience. But I wonder if any of it as any of the caught you by surprise, like have any of these like specific kind of experiences that pastors or again, people who lead churches or religious communities, have you been like, oh, wow, this is surprising. I'm just shocked that this has been so misunderstood, or I don't know, I don't, I don't think it's really surprised me, I think it is kind of what I expected. And maybe that's just because I've been in the church and heard the way people talk about mental health problems for a long time. So I know that many times people mistakenly view it as a spiritual issue, you just don't believe enough, you're just not praying enough, right? You just need to have more faith, just read your Bible more what and we could be talking about a different denomination or different, you know, a religion and read whatever book it is more. And I think that's really where people kind of get stuck, because they're looking at it through the lens of that's the only way to view things instead of I can have faith and still have a medical problem. And so mostly what I'm doing is talking about mental health problems, I make a lot of analogies to physical health problems, and how we treat physical health problems. I use diabetes as an example, a lot. We talk about interaction between genes and environment leads to the disease. And that's so common in a lot of psychiatric disorders. It's sort of our family history, or genetic loading, plus certain experiences we have in life, environmental factors come together to lead to the mental health problem. And that kind of helps people start to understand it as more than just a faith issue. When I was in Sydney, I was talking to someone and I was I said, you know, the brain is an organ, just like our heart is an organ or your pancreas or your stomach. And I can't tell my heart not to have heart disease. And I can't tell my brain not to be depressed. And literally, someone looked at me and said, I've never thought about the fact that the brain is an organ, and it can get sick, just like the rest of our body. So they view it as the mind instead of as the brain, which is everything, you know, which kind of contains everything. So I think that that helps a lot. Talking about therapy, I use analogies to physical therapy, and sort of like, you know, you need to go regularly. You know, it's not the same as just asking your friend down the street, what exercises you should do. It's an actual scientific, like approach medical approach. That's the same thing with talk therapy, right? It's not just talking to your friend down the street. It's an actual medical intervention. And, you know, you have to work through the pain a little bit. You know, sometimes it's tough physical therapy is not always easy to go through. I've been through physical therapy, I can tell you if it didn't hurt, sometimes you weren't doing it, right. And so, you know, sometimes when talk therapy gets tough, we still have to be willing to go through it. And so kind of right, providing this frame around it, where they can under, you know, relating it to something that people can understand a physical illness has really helped, I think, and what's the format mean? Because, you know, really what you're talking about is confronting long standing biases that people may have, whether it's in religion or not. And so you make analogies you you give them education, but I mean, my book
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Is that that can't be enough. Because, you know if information enough you it would be easy to change people's minds. And we know it's not easy to change people's minds about, well, really about anything with any other techniques that you use, you found helpful to kind of like, deal with people who may be kind of like entrenched a bit. Sure. I mean, it's always hard to reach everybody, right? I mean, of course, I'm not suggesting, you know, you're not the magic way to convince everyone right? But at least you know, but for people who 't aren't, who don't just get information, say, oh, my gosh, I never thought about that. You know, there's probably other some people who don't try to accept disease. I'm sure there are, right. I'm sure there are people who listen to me talk and still kind of write it off. But I feel like the fact that there's been more invitations means a lot of people are getting it. So I do a couple of things. I've done a number of different kinds of talks, but they're sort of some similar themes than them. So there's one that's my most common talk about sort of just understanding what mental health problems are. I really specifically pick out depression, anxiety, panic, and PTSD specifically to talk about and help them understand what those are. I tried to write a vignette that I think fits perfectly the situation that most of the people in the audience are dealing with. So I will write a vignette about what pastors are dealing with. Now, I'm not a pastor. So the way that I figured that out, whoever is invited me, I'll try to write a vignette that fits the cultural context, wherever I'm going. Does this fit? Does this sound like something you all are dealing with? Can they see it? Right? Like, it's always easier for us to see it and somebody else instead of ourselves. And so I think that helps. Some of that is what I've done. And then I've also done some more workshop kind of talks where I have them is gonna be more about, like, what you do in a workshop--a couple of different things. One of the ones that's been most popular is really teaching, the basic idea of CBT (cognitive behavioral therapy). And how it works, the idea of cognitive distortions, how to recognize them, and challenge them, and helping them learn to do that, we're using tools that they will really relate to, which is replacing negative thoughts with thoughts from God's Word. So they pick out scriptural verses that help challenge some of their cognitive distortions. So we've done some of that, that was really particularly powerful in Fiji, because when I was there, at least what I was told was that they have very, very few psychiatrists on the entire island, something like four or five psychiatrists on the entire island. And while people can study psychology, there's not really a way for people to practice psychology there. And so there's not it's not very easy for people to access therapy. So, you know, here you are talking to people. I'm going in there to talk to pastors, but then they also invited me to come talk to their church congregations and to other groups. And I was ready to talk about treatment, but there's not really treatment to be found. So the best that I can do in that situation is try to offer them some tools that can be helpful to them. So I found that that was really well received. I even got an email from someone afterwards, telling me how much that changed things for her. Wow, I am going back just a little bit, but have we kind of heard all of the places you've traveled. So I've done a lot of presentations, but thanks to the magic of zoom, so that has helped a lot. So Philippines, I did a several times there I've done, I did a big presentation, that was people from all over Oceania, Southeast Asia, various parts of that area of the world. You know, all over I can't even think of all the names, I think there were 70 countries represented in that talk. Um, I just recently gave a talk in Nigeria, again, by zoom. And that was that now we're not specifically now talking to a group of pastors. It was a Christian nonprofit foundation focused on education in Nigeria. So I gave a talk there as part of, I think, an award ceremony that they were hosting. And then I've traveled to Australia and New Zealand and Fiji. Wow, so really getting out there. That's really cool. And I'm, I'm thinking about, and this might be hard to answer, but it's what's on my mind, have you noticed from from culture to culture, you know, in different areas, are there different biases you're seeing are different--maybe baises is too strong of a word--but different challenges. Yeah, challenges. That's a better word.
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You know, different ideas or things that are coming up or they're, you know, places or, or you're feeling more pushback, or Yeah, I'm just, I'm curious what it's been like.
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Yeah, I think the place that I heard a lot of that was in Fiji, there was a lot of belief that I think it's a very religious island in general,
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Always Christian, I think they're actually the minority religion. But there's a big sense that it's a faith or a spiritual issue, that if you admit to having a problem, then you're weak, that kind of thing, and a lot of desire to treat things with roots, or teas, or barks. And that kind of, you know, like back to like, very traditional healing. And so that was a little bit more of a challenge. But I think the other thing that I think is has been helpful is my willingness to do Q&A afterwards. And just really answer any question. In some of the venues, they allow the questions to be sent in anonymously via text, I think that helps a lot, because then people feel more, they're not raising their hand and everybody turning and staring at them, "oh, my gosh, that person has an issue." Or they can ask whatever they want, by text. And so I don't I mean, I think the questions are very similar place to place. You're right, like the one of the questions is, Well, should I only go to a Christian therapist, right? Or should I only see a Christian psychiatrist? And so I, I answer that by asking, would you only go to a Christian mechanic? Would you only eat at a Christian restaurant? And quickly, they laugh and realize, oh, I guess that is kind of silly, right? Like, why would I have to only be that and so, you know, I hear that a lot. I hear a lot of questions about traumas, there's been a lot of trauma that people have dealt with and trying to make sense of that. I think one of the things that I would just I would love to hear your hot take on this, because I don't know that there is any one answer, quite frankly, in talking to lots of different people about this. I think one of the major issues when you have somebody who is spiritual, or religious, who's going through a mental health crisis, is what is the role of a pastor? What is the role of the church community? And what's the role of treatment? And finding that balance. Because I think ultimately, neither one ended up feeling kind of complete for a lot of people who are, again, religious and struggling with their mental health. Absolutely. So, I talk about that pretty openly with folks. When I'm talking to a group of pastors, I'm helping them understand. When does it move from being like, when does it start to sound like it's in disorder territory? What are the kind of triggers that make you think, Okay, this is more than just somebody being a little sad or a little, you know, like, they're kind of stressed because they lost their job, or they're grieving that we've now moved into where this is becoming problematic. And I kind of outline here are the emergencies here, it's fairly urgent, here's like, we probably need to get you referred. But this there's a little bit of time. So kind of outlining some of those, like, how do you identify that for the pastors, and then helping them understand what treatment really looks like, I spend a lot of time kind of unpacking that. And a very, just what I hope is a very relatable way not using a lot of, you know, like big medical words, just sort of make it like, here's what we do. It's not a mystery. This is this is how we treat things. And just quite honestly, a lot of times, it's that well, can't God heal me? Right? Like, that's the question I hear. And yes, sure, right. Why not? Why not. But when somebody has diabetes, or cancer, they're going to pray for healing, and take their medicine. And so I talk about mental health the same way, pray for healing, do it, go for it, like prayer is awesome. And seek treatment, right? It doesn't have to be one or the other, we're going to blend those. And I talk a lot about the mind, body and spirit. And that, you know, that's how we were created: all three. And so we're going to not just focus on the spiritual part, because we're going to miss out on these other two pieces. And so I kind of try to wrap all that together. I mentioned, it's helpful in a way because I don't know if it's affected these communities, but in general, I mean, psychiatry has been at least in some circles, dismissive of religion, or treated as a, you know, a sort of something that it's obsolete now that in modern society or something like that. Yeah, I definitely think that has been one of the reasons why I've continued to speak places because when I'm introduced, it's I'm usually introduced at the conferences that way, like, this is somebody who is an expert in these areas, but also shares our faith. She's not gonna critique you. She's not gonna make fun of you. All. Right, exactly. And I think, I mean, but honestly, I think approaching it this way. I, I even think if somebody were to approach it this way, even if they didn't have faith, but approach it from a like, Listen, you can have your your beliefs and still, you know, accept treatment and accept diagnosis. I think you can. I don't think it has to be specific to you know, I mean, I think it helps in some ways, but I don't think I have to have the same set of beliefs and values as somebody
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As to help them understand the stigma and understand that they can have their beliefs and access treatment. And I think it's such an important point because, as Bob, you were just saying psychiatry has a bit of a history in which they there's been a pathologizing of religion and spirituality at times. And on the other side of it, as we've talked about, religion has had a pretty terse relationship with psychiatry, and I think, especially psychology. I remember even in my, you know, Baptist church growing up when I said I was going to study psychology with the name to get a doctrine, psychology, I got a lot of pushback, like, why would you do that, like, you know, like therapy. That's the role of the church, counseling is the world church. And so I'm so appreciating the down to the basics of, "let's think about this as an illness as a medical issue," and really sort of seen as somebody who needs treatment, because I do think that helps at a very basic, important level that that can get missed, because, obviously, 's so much more in the crosshairs, I think in regard to shame, the role of shame, and how that that's both the psychiatric, psychological and spiritual issue. Yes. Yeah, exactly. And, and even helping them understand that when somebody is suffering, sometimes even things like scripture can be viewed through the lens of guilt and shame, and worry, right? Like, like, they might think, Oh, the Bible says, you know, Be anxious for nothing. So what's wrong with me? What's wrong with me that I'm anxious? And I can't stop worrying? Does that mean I don't have faith? That means does that mean I'm not, you know, like that, that somehow I'm doing something wrong, that I'm sinful. So I address that with pastors and talk about kind of what kinds of things you should and shouldn't say to somebody when they're suffering, and how to help them. And then there's other times that, you know, I can see how there are elements of Scripture that really aligned with what we do in therapy, right? Like Romans 12. Two says, be not conformed to this world, but be transformed by the renewal of your mind that by testing, that you can see what is the will of of Christ. And so really, and I may have gotten that verse slightly off, but that's pretty close.
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you looking it up now.
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The idea is like to show them that and say, "See, this is what we're supposed to do." You have a thought, you immediately start to catastrophize. You're supposed to line that up and go, "Is this true or not?" We're supposed to test our thoughts. And this there's a Biblical basis for doing this too. And so that's like, that's the workshop that I did on CBT (cognitive behavioral therapy) technique. I line it up with scripture, and then I have them use scripture to counter their own automatic thoughts. We had Dr. Jim Lomax on the podcast, a good while ago, and I can't remember if I gave this example then too, but you know what doing it again anyways, I remember once consulting to one of our psychiatrists here because and she's she was an expert in OCD--shout out Joyce Davidson, if you're listening--and just like a total expert, OCD was working with this, this young person who was having OCD symptoms related to kind of sexual intrusive thoughts, and this person was highly religious. And so we have these interventions surrounding just because you think it doesn't mean you've done it. The guilt this person feel like it's as if they had done this thing that happened, right? It's not helping that we can consult to the idea that like, well, there are verses in the Bible around, if you look at a person lustfully or you have those thoughts. It's like you've done it. Yeah. And so, to help understand, and help people know how to piece that apart. And that's why I'm thinking about this question. And so we're thinking about how do we consult to pastors and spiritual leaders? But on the flip side, if we were to turn the tables, what thoughts or reflections do you have for clinicians and psychiatrist around the role of bringing in pastoral care, spiritual care, in regard to someone's suffering? Oh, wow. I mean, I think that's so critical, right? Like we, we love the bio psychosocial approach, but I think the spiritual should be added on to that too, especially for people who are who have faith because a lot of times they they're really suffering because they, they mistakenly feel like somehow their suffering is related to a lack of faith or them not being good enough, or some sort of guilt or shame. And sometimes, especially if you have a pastoral person who has some exposure to this isn't going to foster that like, well, yes, you. You haven't prayed enough, right? Like, you don't want to do that. But if you have somebody who really understands it can be incredibly helpful. The church that I attend, our pastor is a licensed mental health counselor. He was before he became a pastor. So he also is a little bit different from the the perspective that you've seen, carry but he gets consulted a lot because pastor
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to have less experience, we'll have someone in their congregation who's obviously developing either a manic or a psychotic episode. And the pastor's are thinking It's spiritual. And they're like, we've been praying about it, we've been trying all these different things. And then they call, you know, this other pastor, they know who has this mental health background, and he's like, you know, this sounds like the person needs to get some education, right. And so I think, you know, we're helpful to them and helping them understand that. But we also need to make sure that if we invite in the pastoral staff that we with with a with permission, you know, if the if the patient gives us permission, that we can sort of all talk together about what's going on, so that we make sure that we're on the same page and not creating this situation where the pastor is saying one thing, and we're saying something different, right, but we work together towards the same benefit. Did I answer your question? Yes, absolutely. And I think that's, again, this idea that, that we can have, like, just like we wouldn't expect pastors to be everything. I think, on the other hand, when we have people coming in with their mental health, it's intersecting as, and it's becoming a spiritual struggle that we as clinicians, and providers don't feel like we have to do everything, that there's there are people to help them walk through parts of it, that maybe wouldn't be our role to help them walk through. Absolutely. Yeah, we've been talking about challenges. But I there's probably strengths to I imagine. I mean, we know that people who belong to religious community, tend to have better mental health outcome better health outcomes, actually, apart from just mental health. And do you see some of that as well? Like, Are there advantages to being that you see people to their being part of these large communities of faith? Yeah, I do think so. I mean, they really, many of them really feel very much like a larger family, they really look out for each other, try to take care of each other. And that's one of the things that we also talked about is, is how to look out for other people. And, you know, try to identify people who might be suffering. So yeah, I definitely think that's also a strength to be in that kind of setting. Yeah, that's the, my God, I just feel like I'm on I can get on a soapbox about this all day. But I think it's like for mental health to get more on board with. And we are like, that's the trend the field it's going but to be open to the spiritual aspects of our patients, and on the other hand, help our spiritual religious communities to get better acquainted with and know resources to reach out to for mental health. So I am just so grateful for the work you're doing Dr. Verduin again, as somebody who's religious, who cares a lot about, again, our about religious trauma and the stuff that happens in churches around mental health, this psychoeducation and the work you're doing is just incredible. And I am incredibly grateful. Thank you. Well, I mean, I believe you.
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You can see if you're up close, you see she's very moved by this.
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I was going to say, but we do want to give you the last word. So any last advice for any of us like dealing with sort of maybe like different cultures, different backgrounds and their attitudes about religion and psychiatric issues? Yeah, I think the most important thing is to really ask the person in front of you about their beliefs, because you can't really draw conclusions just because they're from a certain faith from a certain area of the country from certain cultural upbringing, right. But also, make sure that like, we're so concerned as psychiatrists, that mental health problems and that mental illness is not stigmatized. But sometimes I think we do tend to stigmatize people for their own beliefs and values. And when we do that, it creates a fracture, where they don't really trust us as much for treatment because they feel like they're being judged. And so wherever your patients are, make sure that you're just meeting them there and incorporating the spiritual aspect. Even if you're not an expert in that you can still encourage them to pursue that part of it and help them see how it can fit into mental health overall. Retweet. I absolutely love that. Well, you have been listening to Dr. Marci Verduin and talking about the intersection of religion and mental health. We're so grateful to have had you on Dr. Verduin. Thank you. I really appreciate the opportunity to talk with you guys. As a reminder, we've been your hosts I'm Dr. Kerry Horrell. I'm Dr. Bob Boland, and thanks for diving in. The Mind Dive podcast is presented by the Menninger Clinic. If you're curious about the professional experiences of mental health clinicians, make sure to subscribe wherever you listen. For more episodes like this, visit www dot Menninger clinic.org. To submit a topic for discussion, send us an email at podcast@menninger.edu