The number of depressed patients has surged as the coronavirus outbreak keeps people homebound. There are Christians who are suffering from depression, and church co-workers have received pleas for assistance from depressed church members.
How can church workers who are not mental health professionals deal with these requests for help? I would like to share my experience of a recent experience in counseling a heavily depressed seeker.
The second day after the lockdown of my city in Hubei Province ended, I received a message from Sister Xia, whose husband had attempted suicide.
She related, “This afternoon I was so tired that I went to bed. Some minutes later, I was still worried about him. Then I got off the bed, went into his bedroom and found that he was attempting to hang himself. Fortunately, I was able to catch his attempt early enough. After being saved by the paramedics who rushed here, he became conscious again. Clear-headed, he had no idea what he had done. Do you think the devil caused this trouble? I’m about to have a break down. What should I do?”
Xia is a member of my group. Two years ago, her husband, Mr. Yan, attended our group gatherings on occasion but not regularly because of his busy work schedule and little faith. However, I often keep in touch with him with through calls, and I have maintained a close relationship with him after several visits.
Though I’m not a professional counselor, in my role as a church worker, pastor of his wife and a friend of his, I provided counsel to Yan. I joined an online course about pastoral counseling and read some books on the subject.
To relieve Xia's fear and anxiety, I had an online conversation with her on WeChat, China’s popular social media platform. From my conversation with her I learned the following three things about her husband.
First of all, his medical report shows that he was diagnosed with depression and hospitalized for some days. Medical personnel suggested that he see a doctor from the Department of Social Services in Wuhan after the city and area are reopened. There was no such expertise available in his hometown.
Second, his attitude toward faith could be an indicator of whether he was demon-possessed or psychotic. Always a supporter of Xia’s faith, he felt shame for his long-term absence from church services; he also promised to go to church with her as soon as he recovers.
Third, in recent years, he kept doubting if his symptoms indicated an illness or simply an inability to sleep well at night.
In summary, I concluded that the doctor's diagnosis was correct: Yan suffered from depression, not demonic possession.
I told Xia her husband would be cured through treatment after going through this severe phase of depression. I encouraged her to pray earnestly and look upon God, meanwhile, to take more precautions to keep her husband safe.
The second morning when I came to visit Yan he shared his inner pain with me. I told him he had severe depression. I explained to the couple the characteristics of demon-possessed people and further removed their doubts that “the devil was making trouble”. I tried to help them understand that depression is a common disease. A psychologist pointed out there are 350 million people in China who suffer from some form of depression, accounting for around 25% of the total population. What’s more, I told them, depression should not be feared and could be cured by treatment. Afterwards, I admonished them to cast all their worries on the Lord Jesus who is in charge of life.
Through talking with them, I learned that recently Yan often searched the Internet for superstitious methods of curing diseases. I exhorted them not to listen to those nonsense words.
Then I shared with them the testimonies of two sisters who put their trust in the Lord and were healed from the disease. At the same time, I encouraged him to reflect on where he sinned against God and repent.
I also told him to follow the doctor’s advice and follow through with the prescribed treatment. I learned that Yan had refused to take the anti-depression medicine the doctor prescribed for him but yet adamantly took blood-pressure pills he bought at a pharmacy.
I explained solemnly that he must take doses of anti-depression at the severe phase and the serious consequences of not doing that. I also warned him that some medicine would make the side effects of depression worse.
After searching for information online, Yan’s son agreed with me that his father’s blood-pressure medicine was likely to trigger side effects of depression. Eventually, Yan also agreed with me.
Then I guided him toward positive steps. I encouraged him to replace his mantras of “I don’t have hope” or “I cannot bear it any more” with praise. I suggested that he care for the needs of other people, provide encouragement and be grateful to God and the people around him.
The last suggestion was that he take care of his diet, exercise more, and make a schedule for himself. No matter how he might feel, he must adhere to the schedule. When he felt better, he should do some work and other things he could. Meanwhile, his daily activities should include Bible reading and prayer. I told his wife to improve his diet to enhance his immune system.
My next step was to counsel his wife and child. I told them a depressed patient is in desperate need of his family’s support. He did not mean to be depressed, in fact, he suffered from depression and was working on how to solve it.
I also suggested that if Yan should lose his temper, that they should let it go and not quarrel with him. What was more, I instructed Xia not to grumble against his godlessness, faint faith, or lack of joy and care for his family, otherwise, her complaints could lead to more pressure on him which might affect his recovery. I encouraged them to show kindness to him and keep him company.
After this visit, I followed up with additional visits and calls to him, often reminding him to take his pills, rely on God, and I guided him in praying.
My reflection
In reflecting on this experience, I believe that the first thing pastoral workers should do is learn more about counseling and develop the needed skills to help others. Counseling is much needed in churches and should be approached professionally.
The second point is empathy. Counselors should feel their patients’ pains rather than lecture them at first sight. We should listen to their words so they feel our kindness and are able to relax and lower their defenses. We should never condemn sins or put ourselves on the moral high ground.
Finally, counselors need to pay attention to communication skills and counsel others with patience.
- Translated by Karen Luo
疫情下的教牧辅导:我这样帮助了一位抑郁症慕道友
疫情下,作为教会工人,特别是教牧同工会面临一项无法回避又艰巨的任务——抑郁症患者的辅导。
因为受疫情影响,抑郁症患者数量攀升。
主内弟兄姊妹或其家人也会患上抑郁症,教会同工也会接到主内弟兄姊妹这方面的求助。
那么,作为非专业辅导或平时很少接触这项事工的教会工人当怎么去应对呢?
笔者在此简要介绍一下自己近期辅导一位抑郁症重症慕道友的经历,以供同道参考。
接受辅导挑战
本地城乡解封的第二天,笔者收到霞(化名)姊妹发来的微信求助信息:“弟兄你说我该怎么办!?
近期我家弟兄心情糟透了,甚至有死的念头。
今天下午,我实在很困乏想睡一会,上床几分钟后,又放不下他,下床来到他卧室,发现他上吊了。
幸好发现及时,经赶来的医护人员抢救,才捡回一条性命。
他清醒后,不记得自己做了什么。
弟兄你说说,这是不是有魔鬼在作怪呀!?
我要崩溃了,我该怎么办,我想请你帮忙出点主意!
谢谢!”
霞姊妹是笔者牧养小组的成员,她丈夫焰(化名)弟兄两年前也有时参加我们的小组聚会,后来,因业务繁忙和信心微小而中断聚会了。
但是,笔者与焰弟兄常有电话联系,也做过多次探访,关系较为密切。
虽然,笔者在辅导工作中是外行,但作为教会一名教牧同工和霞姊妹的直接牧者,以及与焰弟兄的关系,同时,身边又没有心理辅导方面的人脉资源,面对霞姊妹的求助,也只好运用早前在网上修读的《教牧辅导》课程和平时零星阅读相关书籍所掌握的辅导知识,硬着头皮去辅导焰弟兄。
进入辅导实际
笔者收到这求助信息时,已是晚上十一点,不便前往焰弟兄家,但是,“是不是有魔鬼在作怪”和“我要崩溃了,我该怎么办”的问题必须及时解决,以免霞姊妹受此恐惧和紧张情绪的煎熬,从而选择了以微信通话与霞姊妹交通。
首先,笔者进行了三个方面了解,掌握了基本情况。
一是病情和就医:近期焰弟兄情绪十分低落,心情极其沮丧;住了多天医院,医生认为是抑郁症,并作了相应治疗,且建议待武汉解封后去那里看精神疾病专科(因当地无这类专科)。
二是焰弟兄“对神的态度”(甄别被鬼附者与精神病人的关键特征):焰弟兄一惯支持琴姊妹的信仰,近期还为自己很长时期没有敬拜神而愧疚,并向霞姊妹表态待他病情好转后,一定同她去教堂做礼拜等。
三是焰弟兄近年表现:近年来,他总是怀疑自己有病,乱吃药,睡眠很差等症候。
综合上述资料,笔者断定医生的诊断正确。
然后,明确告诉霞姊妹,她家弟兄是患了抑郁症,并非魔鬼附身。
针对霞姊妹“我要崩溃了,我该怎么办”的问题。
笔者告诉她,过了这段重症时期,通过治疗病情会缓解,且会治愈;嘱咐她不要过分担忧,且告诉她当恒切祷告,仰赖上帝,本人也会为她祷告。
针对弟兄当前的自杀倾向,交代她应当加强防范,并建议她与家人应当轮番守护,嘱咐她自己也当注意休息。
第二天上午,笔者来到焰弟兄家,因与焰弟兄关系较亲密,很快进入正题。
首先,用心聆听了焰弟兄内心痛苦的倾诉和简单听取了霞姊妹关于焰弟兄的病情介绍,然后,明确告知焰弟兄,他是患了抑郁症,而且,当前比较严重。
并通过讲解被鬼附者的特征,进一步消除他们怀疑“有魔鬼在作怪”之忧虑。
并以焰弟兄为重点辅导对象,对其夫妇作了以下方面的辅导:
一是引导他们正确认识抑郁症,消除思想顾虑。
一个人患病后,通常会有不同程度的自卑感,特别是抑郁症病人,自卑感更加严重。
告诉他们只要是人都会生病,生病是一种生理和心理反应;并告诉他们抑郁症患者其实很普遍,国内有心理学专家指出:国人中有3.5亿抑郁症患者,占总人口的25%左右,只是有的症状较轻;还告诉他们抑郁症并不可怕,只要积极配合治疗,是可以痊愈的。
二是劝勉他们将一切的忧虑卸给主耶稣。
告诉他耶稣才是唯一掌管生命的主,也是安慰人心的神,要学会仰望和交托主耶稣。
交谈中,了解到焰弟兄近期常常在网上搜索和打探用迷信手段治病的渠道。
针对这一情况,及时进行了劝诫,嘱咐他们不要听信搞迷信者的胡言乱语。
并列举了两位主内姊妹曾在抑郁症中仰望主得医治的实例,以鼓励他依靠主耶稣的信心。
同时,也劝勉他检讨自己,看看自己在哪些方面亏欠了神,并告诉他神乐意饶恕人,鼓励他向神悔改。
三是告诉他应遵照医嘱极积配合治疗。
告诉他在病情上要轻视,但是在治疗上要重视。
交通中,了解到焰弟兄这几天拒绝服用医生为他开出的抗抑郁剂,且固执地坚持吃自己从药店买回的降血压等药品。
针对这一种情,笔者郑重地告诉他,在当前重症阶段,一定要服用抗抑郁剂,并告诉他不服用可能产生的严重后果。
且告诉他,有的药物会产生和加重抑郁症的副作用,不要自己用药。
期间,焰弟兄的儿子用手机在网上搜索发现他当前服用的降血压药有引起抑郁症的副作用。
从而,笔者嘱咐焰弟兄一定要按医嘱服药,他也同意了。
并即时服用了从医院拿回的抗抑郁剂,且表态暂停服用自备的降血压等药,以待咨询医生。
四是引导他看见积极因素。
笔者对他的家庭、人生和事业背景都比较熟悉,于是帮助他看见自身一些美好事情和家人对他的爱。
并鼓励他以改变心中,口中惯用的词汇如“我没有盼望的了!”
,或“我不能忍受下去了!”
以赞美取而代之。
并建议他用真情去关心他人的需要,鼓励他人;并劝勉他多多感恩——感恩上帝和感谢身边的人。
五是建议注意饮食和加强运动,并订出生活作息表。
嘱咐姊妹给焰弟兄改善饮食,以提升其免疫力;嘱咐焰弟兄尽量避免一人闷在屋里,多进行户外活动。
并告诉他抑郁症专家指出:有证据显示使人流汗的运动,和抗抑郁剂一样有效,可以消除抑郁症状。
要求他无论心中感受如何,必须遵循作息表生活。
待病情缓解后,开始做自己应做的工作及事情。
同时,每天应有读经、祷告,多亲近神。
六是对他家姊妹和孩子进行辅导。
告诉霞姊妹和他孩子:抑郁症患者需要亲人的支持,他不是故意要忧郁,他也受苦于其中,他也想要释放,他也在努力,要理解他。
特别是病人易怒爱发脾气,当他发脾气时,不要计较,不要与其争执。
并吩咐霞姊妹不要唠叨弟兄不倚靠主、没有喜乐、没信心,不体贴家人等;否则,只会给弟兄带来伤害,增加压力,影响复愈;鼓励家人多加体贴和多多陪伴病人。
这次探访辅导后,弟兄还隔三差五地去他家探望或打电话问候,坚持进行后续辅导,常常提醒他服用抗抑郁剂和鼓励他依靠神,带领他祷告。
三、辅导中的体会。
一是教牧同工要努力学习辅导知识和技巧。
辅导工作是一项专业性很强的工作,也是教会十分需要的工作。
特别是作为教会同工,应当创造条件,接受这方面的装备。
二是在辅导中要有同理心。
设身处地地体谅患者的痛苦,不要一见面就滔滔不绝地说教,应当多聆听患者的倾诉,做聆听者,让患者感到辅导人员的亲切友好,消除戒备心理,增加患者对辅导者的信任度;也不要一见面就任意定患者的罪,千万不可将自己放在道德至高点,一味地指责患者犯了罪,强迫患者认罪悔改。
要注意沟通技巧,耐心地对患者进行心理疏导。
约伯遭患难时,他的三个朋友相约去看他,与他同坐七昼夜,与他一起哀伤,给约伯带去了很大的安慰。
但是,当约伯开口述说他的痛苦,三位朋友开始轮流陈述自己的看法、一套大理论、甚至指责其犯罪,结果给约伯带来了更大伤害,无疑是在他伤口上抹了盐。
三是注意辅导人员的安排。
霞姊妹反映,只要有亲戚来探望焰弟兄,待探望者走后,他都会对家人大发脾气。
其实,这是病人的“自卑感”在作怪。
鉴于这一现象,笔者建议:针对抑郁症病人,教会安排的辅导人员,除了应当具有一定辅导知识外,还尽可能是与患者关系较亲切者。
这样辅导者与患者容易建立关系,便于进入辅导。
同时,应考虑患者因“自卑感”,害怕与他关系一般的人员知道其病情的因素,不要安排弟兄姊妹轮番探访,应由辅导者定期探访,避免增加患者的精神压力。
四是及时转介。
对抑郁症重症患者,特别是有自杀倾向的患者,应当及时帮助联系专业辅导人员或机构,将病人转交专业辅导师或机构;并建议及时看精神疾病专科医院。
现在,焰弟兄已去上海一家专科医院就诊。
五是应当重视对患者家人的辅导。
在患者发病期间,其家人特别是其配偶身心也十分疲惫,在信仰方面更会被人攻击(有亲友说焰弟兄患病是霞姊妹信耶稣惹的祸,奉劝她去拜假神和偶像),面临属灵挑战,已信主家人需要教会牧者的安慰和坚固,更需要辅导和代祷。
笔者非专业辅导,在此只是介绍一下自己的一次临阵实战作法,以抛砖引玉。
敬请业内人士和有辅导实践经验的牧长批评指正。
The number of depressed patients has surged as the coronavirus outbreak keeps people homebound. There are Christians who are suffering from depression, and church co-workers have received pleas for assistance from depressed church members.
How can church workers who are not mental health professionals deal with these requests for help? I would like to share my experience of a recent experience in counseling a heavily depressed seeker.
The second day after the lockdown of my city in Hubei Province ended, I received a message from Sister Xia, whose husband had attempted suicide.
She related, “This afternoon I was so tired that I went to bed. Some minutes later, I was still worried about him. Then I got off the bed, went into his bedroom and found that he was attempting to hang himself. Fortunately, I was able to catch his attempt early enough. After being saved by the paramedics who rushed here, he became conscious again. Clear-headed, he had no idea what he had done. Do you think the devil caused this trouble? I’m about to have a break down. What should I do?”
Xia is a member of my group. Two years ago, her husband, Mr. Yan, attended our group gatherings on occasion but not regularly because of his busy work schedule and little faith. However, I often keep in touch with him with through calls, and I have maintained a close relationship with him after several visits.
Though I’m not a professional counselor, in my role as a church worker, pastor of his wife and a friend of his, I provided counsel to Yan. I joined an online course about pastoral counseling and read some books on the subject.
To relieve Xia's fear and anxiety, I had an online conversation with her on WeChat, China’s popular social media platform. From my conversation with her I learned the following three things about her husband.
First of all, his medical report shows that he was diagnosed with depression and hospitalized for some days. Medical personnel suggested that he see a doctor from the Department of Social Services in Wuhan after the city and area are reopened. There was no such expertise available in his hometown.
Second, his attitude toward faith could be an indicator of whether he was demon-possessed or psychotic. Always a supporter of Xia’s faith, he felt shame for his long-term absence from church services; he also promised to go to church with her as soon as he recovers.
Third, in recent years, he kept doubting if his symptoms indicated an illness or simply an inability to sleep well at night.
In summary, I concluded that the doctor's diagnosis was correct: Yan suffered from depression, not demonic possession.
I told Xia her husband would be cured through treatment after going through this severe phase of depression. I encouraged her to pray earnestly and look upon God, meanwhile, to take more precautions to keep her husband safe.
The second morning when I came to visit Yan he shared his inner pain with me. I told him he had severe depression. I explained to the couple the characteristics of demon-possessed people and further removed their doubts that “the devil was making trouble”. I tried to help them understand that depression is a common disease. A psychologist pointed out there are 350 million people in China who suffer from some form of depression, accounting for around 25% of the total population. What’s more, I told them, depression should not be feared and could be cured by treatment. Afterwards, I admonished them to cast all their worries on the Lord Jesus who is in charge of life.
Through talking with them, I learned that recently Yan often searched the Internet for superstitious methods of curing diseases. I exhorted them not to listen to those nonsense words.
Then I shared with them the testimonies of two sisters who put their trust in the Lord and were healed from the disease. At the same time, I encouraged him to reflect on where he sinned against God and repent.
I also told him to follow the doctor’s advice and follow through with the prescribed treatment. I learned that Yan had refused to take the anti-depression medicine the doctor prescribed for him but yet adamantly took blood-pressure pills he bought at a pharmacy.
I explained solemnly that he must take doses of anti-depression at the severe phase and the serious consequences of not doing that. I also warned him that some medicine would make the side effects of depression worse.
After searching for information online, Yan’s son agreed with me that his father’s blood-pressure medicine was likely to trigger side effects of depression. Eventually, Yan also agreed with me.
Then I guided him toward positive steps. I encouraged him to replace his mantras of “I don’t have hope” or “I cannot bear it any more” with praise. I suggested that he care for the needs of other people, provide encouragement and be grateful to God and the people around him.
The last suggestion was that he take care of his diet, exercise more, and make a schedule for himself. No matter how he might feel, he must adhere to the schedule. When he felt better, he should do some work and other things he could. Meanwhile, his daily activities should include Bible reading and prayer. I told his wife to improve his diet to enhance his immune system.
My next step was to counsel his wife and child. I told them a depressed patient is in desperate need of his family’s support. He did not mean to be depressed, in fact, he suffered from depression and was working on how to solve it.
I also suggested that if Yan should lose his temper, that they should let it go and not quarrel with him. What was more, I instructed Xia not to grumble against his godlessness, faint faith, or lack of joy and care for his family, otherwise, her complaints could lead to more pressure on him which might affect his recovery. I encouraged them to show kindness to him and keep him company.
After this visit, I followed up with additional visits and calls to him, often reminding him to take his pills, rely on God, and I guided him in praying.
My reflection
In reflecting on this experience, I believe that the first thing pastoral workers should do is learn more about counseling and develop the needed skills to help others. Counseling is much needed in churches and should be approached professionally.
The second point is empathy. Counselors should feel their patients’ pains rather than lecture them at first sight. We should listen to their words so they feel our kindness and are able to relax and lower their defenses. We should never condemn sins or put ourselves on the moral high ground.
Finally, counselors need to pay attention to communication skills and counsel others with patience.
- Translated by Karen Luo
Pastoral Counseling under Virus: I Helped a Depressed Seeker