Off the Shelf January 2008

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OFF THE SHELF THE LOSS OF SADNESS By Allan V. Horowitz and Jerome C. Wakefield Oxford University Press Reviewed by Terry Cooper Christians in the grip of wrenching life changes often experience insomnia, fatigue, sadness, concentration difficulties, and loss of appetite for food, sex, and leisure. From the perspective of many contemporary teachings/preaching on suffering, one might ask whether such people are sinfully weak or simply lacking faith. How local churches answer this question impacts how they respond to believers experiencing disabling, longterm sadness. Many psychiatrists would find such a question irrelevant, trained as they are to diagnose such persons as depressed clients needing therapy and medication. But whether the perspective is from the preacher’s pulpit or the therapist’s couch, the typical assumption is that the manifestations of intense sadness are remediable conditions to be alleviated as soon as possible. In The Loss of Sadness: How Psychiatry Transformed Normal Sorrow into Depressive Disorder, Allen Horowitz and Jerome Wakefield focus on psychiatry’s response to sadness arising from normative life experiences. They argue that clinically treating all sadness as a remediable condition has led to an unintended consequence—we don’t learn from normal life sadness because we focus on relief from symptoms rather than reflecting on how to learn from an experience. Horowitz and Wakefield contend that standard diagnoses of depression do not clearly distinguish between clinical depression and “expectable reactions to situational contexts.” In layman’s language, when life sucks, we’re usually just sad, not sick. While we may need some temporary professional help in dealing

with the events, we should try to learn from our feelings, not anesthetize them. The authors make a well-documented, persuasive case for re-examining the differences between depression and normative sadness. They call for a more nuanced discussion between psychiatrists and their peers and patients. Since this book is essentially an “insider” argument written for mental health professionals, what use is it to PRISM readers? Simply this: The fact that so many Christians view all sadness as evil means that a lot of us rarely experience the joy of emerging from the valley’s darkness into the light that emanates from the throne. This limits our ability to walk empathically and assuredly alongside others who are in the darkness; thus too many are stumbling alone in the dark, with no hand to help them. Medication can ease the pain of the darkness, but it is no substitute for an experienced, compassionate companion who knows where the light is to be found. Consider the heart of God as he views his saddest children—created for communion with him and endowed with gifts of mind, body, and spirit—as they

struggle through life’s significant challenges. Whether their struggles are relational, financial, or physical, consider how difficult it is for people to share their fear, sorrow, and anxiety within a congregation filled with smiling people who readily proclaim the victorious Christian life. Consider the children sitting restlessly in the pew beside their overwhelmed parents, filled with anxiety about uncertain futures. Finally, consider how many such broken hearts sit in your sanctuary every Sunday morning. Is your church mindfully working to come alongside such broken hearts? Or has it become what John McKnight calls a “careless community” (The Careless Society: Community and Its Counterfeits, Basic Books, 1995), a church whose rituals and relationships have become so circumscribed and superficial that the hurting in your midst have been all but abandoned to the care of “professionals”? Let’s assume Horowitz and Wakefield are correct in their claim that the broken hearts of many are being diagnosed and treated as mental illness rather than being embraced, loved, and walked alongside by the church. Assume the authors succeed in transforming the mental health system so that only genuine illness is treated.Where will people needing the support of transformative relationships then go? Will burdened hearts know to seek them in the sanctuary and hallways of your church? Is it safe to be sad in your congregation? Next Sunday, observe those in the pew around you. What is their body language saying? Are they at ease? Or are they restless, tense, and closed off? If so, will you seek to come alongside them and provide a ready ear and a welcoming spirit? Or will you just slip them the name of a good psychiatrist? ■ Terry Cooper is director of Cal Farley’s Institute for Child & Family Asset Development and a member ofWestminster Presbyterian Church, both in Amarillo, Tex.

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