The couch and the pulpit

Sigmund Freud got things off to kind of a shaky start when he called religion "patently infantile."

No wonder, then, that there has been some residual ambivalence between those who minister to the spirit and those who minister to the mind. Add to that a Western sensibility about pulling yourself up by your bootstraps, plus a religious belief in the power of faith to solve what ails you (not to mention the power of sin to make you crazy), and what you often ended up with in Utah a generation ago was confusion and uneasiness about mental illness.

But things have changed, say therapists and clergy, especially in the past decade. "There's much less resistance than I have ever seen from religious people of one ilk or another to sending someone to a psychiatrist," says University of Utah psychiatry professor David Tomb.

He attributes that shift to new brain research — proof that many mental illnesses have biological and chemical components — as well as to a general destigmatizing of mental illness nationwide. Members of the Church of Jesus Christ of Latter-day Saints also point to a 2003 book by Elder Alexander Morrison, emeritus general authority of the church and director of the Alliance for Unity. Morrison's "Valley of Sorrow: A Layman's Guide to Mental Illness," which details his family's struggle to help his daughter deal with chronic mental illness, served as permission for many church members to finally admit struggles of their own.

That doesn't mean that there still isn't plenty about mental illness that perplexes the faithful. Mental illness is continuum that encompasses both mild mood disorders on the one end and paranoid schizophrenia on the other, and lots of murky areas in between — as well as conditions and propensities that are even harder to categorize. The death of a child can cause chemical changes in the brain that lead to clinical depression in a previously healthy person. Gambling addiction can be viewed as a mental illness or a series of bad choices. And what about homosexuality? The American Psychiatric Association says it is not a mental illness, but not everyone looks at it the same way. Same-sex attraction is seen by some as a sin that needs repenting, or a mental illness that needs therapy, or simply a fact of life.

And what kind of help is acceptable for people with mental illness? Will a secular therapist lead a person away from his faith? Is medication the best therapy? Medication plus talk therapy? Should spiritual counseling play a part?