“Listening,” by Rev. Mark J.T. Caggiano, 1/14/24

1 Samuel 3:1-10

Samuel said, “Speak, for your servant is listening.”

Samuel was trying to sleep, but he heard a voice. Not knowing where the voice was coming from, Samuel kept going to ask his master, Eli, to see what the older man wanted. Eli was confused and likely annoyed with the boy for the disturbances. Eventually, Eli determined that God was trying to talk to Samuel and told the boy to answer. An entirely logical response, if you happen to be in a Bible story.

What about any other time? What if someone repeatedly asked you questions and you realized that the person was hearing voices? In the modern world, hearing voices is not generally attributed to religious experiences. It is a sign of something else. Something else entirely.

Hearing voices could be classified as an auditory hallucination. What might be the cause? Some biological imbalance. Some chemical interaction, intentional or unintentional. Something out of the ordinary. Something not quite right.

My sermon series for this winter is about things we do not or cannot talk about. Difficult subjects that are hard to navigate for some reason. They might be awkward topics or sensitive subjects. Or they might be issues we simply do not wish to discuss. And so today, I will consider one such topic, the issue of mental illness.

Now, I am not trying to say to you that Samuel was mentally ill. I am not trying to suggest that the people in the Bible who hear voices are in some manner experiencing a delusion or suffering from some version of a hallucination. You might think so given that a similar manifestation of such behavior in modern times would result in a diagnosis rather than a suggestion to lean into it.

But I am not saying that. Not out loud at least.

The Bible is filled with examples of such behavior if we think about it. Some of the prophets are described as hearing voices rather than interpreting dreams. Dreams are of course unusual in their own way, but we do not consider even the craziest of dreams as crazy. No, it is only when voices or visions intrude upon waking life that we consider that something might be wrong.

For example, Jesus is frequently depicted healing people suffering from demonic possession. People hearing voices. People acting violently or strangely. People acting out of sorts. In this sense, the underlying problem may have been ordinary illness rather than supernatural contagion.

One of the challenges of talking about the events of the Bible is that they can be seen as so bizarrely remote from our own lives and circumstances. People hearing them might glaze over, thinking there is nothing relevant to their experiences in these stories. And yet, it is not as if our own lives are not, on occasion, populated with people struggling with mental illnesses. We may not be comfortable talking about it, but I am guessing that more than a few of those listening will know someone who is struggling with, or who has struggled with, mental illness.

Mental illness is for many people a taboo subject. It is considered embarrassing, a sign of some divine curse or personal weakness. And, until the end of the 20^th century, there were very few treatments available for those suffering from such conditions, so in many ways it may have seemed like a curse.

When I was a student in college, I studied psychology. That included what was called abnormal psychology, which includes all manner of mental conditions, like depression, schizophrenia, personality disorders, and so forth. It was called “abnormal” which of course assumes that there is something called “normal” out there. Something normal that you and I should be unless we wish to be called abnormal.

And who would want that?

Mental health is often treated differently from other aspects of health. It is like how teeth and eyes became separated from our overall health picture, so that you need to pay out of pocket or get special insurance to go to the dentist or the optometrist. Mental health has been like that, with little support for in-person therapy. Little support for anything that cannot be taken in pill form.

Not that I do not give thanks for medications. I do. When I was in college, there were not many treatments for depression, and I had a dear friend who suffered from severe depression. The 1980s were in many ways a turning point for mental health because suddenly there were more treatments.

For example, in 1988, a brand new drug called Prozac came onto the market. That product changed the way many thought about mental illness. People were given a chance to manage their mental health in ways like never before. But that does not mean that those of us who fondly remember 1988 as if it were yesterday do not carry with us some of that lingering hesitation about mental illness as a topic of concern.

In the 1990s, I was in law school. One summer, I was working at a law firm as a clerk, doing research and other baby lawyer tasks. One day, however, I went to work and felt my chest pounding in my chest. I felt sweaty and on edge. And, as I ran through the symptoms in my head, I thought I was having a heart attack. Not that I have any predisposition to heart disease. Not in my family history, not at all. But I had no idea what else it could have been.

However, I did not have any health insurance, so I could not go to the doctor. I was a poor grad student without healthcare and I had no way of figuring out if something was wrong. My ex-wife, however, was working as a medical assistant and I asked her to run my symptoms by one of the clinic doctors. Such was the state of the American health system.

The doctor was obviously annoyed with having to do this, especially with third hand symptoms, but I was told that I most likely had suffered a panic attack. I had never heard of a panic attack. But looking back over the years, I may have had one or two more of them in high school in response to severe moments of stress. Blessedly, I have not had one like that since.

That cannot be said for my daughter, who has periodic panic attacks and underlying anxiety. To be clear, I always ask her if I can share her stories in my sermons. This is not me secretly telling tales about her in a very public setting. By the way, she says hi.

A panic attack is a terrible thing – I do not recommend them. But underneath in all, they make a certain biological sense. Your body has a system in place to respond when you are in danger. It is called fight or flight, though now it is also called fight, flight, or freeze. In response to some situation, you can become angry or aggressive, fearful or nervous, or shut down completely. Your body is telling you that you need to respond in some life-saving way, even though there may be nothing life-threatening going on. It is a response that would be healthy in another case.

The same could be said for post-traumatic stress disorder. Someone has suffered a terrifying or painful experience or series of traumas and they have internalized their understandably anxious response in a prolonged fashion. A veteran might startle easily from loud noises. A victim of domestic assault might shy away from crowded spaces. Again, this was a normal response to dangerous or traumatic events that unfortunately endures beyond a specific moment or set of experiences.

The same could be said for depression. There are events that make us depressed, like grief over the loss of someone we love. But there is also depression disconnected from such stimuli in the world, depression that simply happens. The same for anxiety, which might be triggered by something small or even inconsequential, but that will come upon the person as a full-blown episode of panic. And, sometimes, anxiety and depression just happen. They show up like unwanted guests and stay for a while.

There is a particular way in which mental health is singled out as being fundamentally different from other aspects of our health. We ascribe overarching importance to the way people respond to us, preferably rationally and not over-emotionally. If someone does not respond how we expect, we place great significance on that discordant assessment. And for that reason, in the past, no one would ever tell you that they suffered from something like depression or anxiety.

One fortunate event that came about in 1990 was the passage of the Americans with Disabilities Act. This law protects people suffering from various debilitating health problems, including mental health. So, if someone in the workplace tells their boss that they are having an anxiety attack, they cannot then be fired for that revelation or otherwise face negative consequences. That is the theory at least. Some bosses are more creative and less sympathetic than others.

One of the reasons for this negative reaction, I guess, is that people attribute mental illness to personal weakness. I recall talking to the mother of one of my children’s friends who said that you only needed to have a strong mind to overcome such problems. A strong mind. That phrase has entered into my family’s lexicon to suggest unreasonable expectations in the face of stress or other adversity. Her child, by the way, was so depressed that I personally called the police because I was afraid he was going to cause himself harm. And to this day I think that my instincts were correct and that uncomfortable call I made probably saved his life, not that he or his mother were happy about it.

Not talking about a problem does not make it go away and the same is true for health issues. And now that there are treatments and therapies available, it is far better to talk about them that to keep silent. Or at least that is how I feel.

Now I have overheard some observations that it seems strange that, all of a sudden, people are suffering from depression and anxiety in large numbers. Why is there an outbreak of mental illness when years ago many fewer people seemed to suffer from it? Were we so much stronger than this generation? Or perhaps, just perhaps, did we handle our problems in differently dysfunctional ways?

I would simply offer my inexpert opinion that there has not been any great change in the number of mental health challenges people suffer. The change has been in our awareness of mental illnesses because there are now there are ways of treating them. Not that people did not try to treat depression and anxiety and other conditions in the past. Historically, however, this was self-medication involving alcohol and other mind-altering chemicals available.

In the 1960s, there was a then new anti-anxiety drug on the market called Valium. Its effects are similar to those of alcohol without the calories and hangover, but with the higher possibility of dependence. It became known as mother’s little helper, at least according to the Rolling Stones.

Why did mother need help? Because of stress. Because of anxiety. Because of social pressures to act in certain ways and not in others. Because life might have been unfulfilling or challenging or even marked by abuse. Because of everything and, perhaps, because of nothing. Sometimes anxiety arises from the problems we are facing. And sometimes anxiety arises because of nothing at all.

We have ample examples from history and even the Bible about people facing mental health issues. If you ever wanted to assess that claim, I suggest reading the Book of Ezekiel. Ezekiel was telling us about what he was seeing that no one could see, like chariots of fire and angels with four faces. He was making wild statements that seemed to be more hallucination than vision. We do not cover much of Ezekiel on Sundays, except once in a while we talk about the valley of dry bones, which is honestly one of the trippiest passages in the Bible.

And then there was Jesus. Jesus was repeatedly healing people possessed by demons. How did he treat them? He talked to them. Radical treatment, I realize. He did not shun them or cast them out to live on the streets, which was the common response of everyone else if you read between the lines in the Bible. Instead, Jesus paid attention. Imagine that.

One of the so-called Seven Deadly Sins in the sin of sloth. The traditional term used for many centuries was acedia, which in Greek can mean listlessness, someone not caring about the world around them. The problem with sloth was that it implied not having faith in the goodness of God, meaning that someone held a negative view that the world was somehow bad or filled with suffering. Which, news flash, is not always a terribly misguided view.

Sloth included the notion of melancholy, which is now referred to as depression. Yes, depression was a sin for many centuries. Eventually, Thomas Aquinas wrote that depression was probably not sinful. Why? Because he probably took the time to talk to someone. Someone who was depressed and so he realized they were not lazy but in fact they were suffering greatly.

There is even a theory that one of the most beloved saints in the Catholic tradition probably died because he suffered from a very modern mental illness. Who? Saint Francis of Assisi. Francis is often considered a saint among saints because of his devotion to the poor and his love of animals. He also, by some interpretations, probably suffered from anorexia nervosa, an uncontrolled desire not to eat. He frequently fasted, often to the point of near death. He would fast for forty days like Jesus in the wilderness, which is a dangerously long time. At the end of is life, he was fasting and died. This is one theory, of course.

If you read about fasting and Saint Francis you will find a great religious fervor for his piety and faith. You will not easily find anything about how troublesome this glorification of fasting might be for someone who has problems with eating. Starving oneself should not be a virtue by any definition.

When we look back through history, there are important people who led notable lives who also probably had mental health challenges. According to his friends, Abraham Lincoln suffered frequent bouts of depression. Authors like Charles Dickens and Edgar Allen Poe may have also been melancholic. Charles Darwin may have suffered from severe panic attacks. Beethoven had alternating periods of great productivity and listlessness, suggesting he suffered from bipolar disorder. And Thomas Edison and Nikola Tesla, well there was a lot going on there. A whole lot.

There is the old saying that all genius is somehow tinged with madness. But I think something else is going on. I think that so many people have mental health issues that when you examine any one of them, famous or otherwise, you will may readily find some aspect of their lives showing evidence of mental health challenges.

During the recent pandemic, the number of emergency room visits for mental health reasons skyrocketed. For those 12-17 years old, these visits went up by 31 percent, while for those 5-11 years old they went up 24 percent. 5-11 years old. Suicide attempts among teenage girls went up 51 percent. And according to the World Health Organization, there was a 25 percent increase in reports of anxiety and depression among the global population.

In the United States, about a quarter of the population will be suffering from a mental health diagnosis within any given year. Sometimes that is situational, like with the massive stresses of the pandemic, but sometimes it is an enduring condition. By one estimate, about ten percent of the US population suffers from chronic mental health issues. It is not uncommon, either as a reaction to the problems of life or ongoing as a long-term health challenge.

And younger generations are more accepting of mental health challenges as an aspect of life. They will self-report having depression, anxiety, eating disorders, and so forth. Why are they more open to speaking about it? Because either way, they will be suffering. But at least if they are open about it now, there is the possibility for treatment or at least understanding within their peer groups.

Yes, older folks may still be wigged out over mental health as a topic of discussion. But many of them were also quietly self-medicating with alcohol and mother’s little helpers, while suffering in silence and unable to talk to friends or family. One approach seems better than the other.

Once in a while, I will get a call from my daughter who is having a panic attack. I cannot make it go away. I cannot make everything better. But I can sit on the phone with her. I can have her sit on my couch while we talk together or simply be with each other. I can make her soup or get her a drink, if she is up for that, but sometimes eating and drinking are too much in the moment. So, we sit together and watch the Great British Baking Show.

Why do I need to do that for my daughter when there are therapies available? Because sometimes they are not working. Sometimes you need to change dosages or try something new. And sometimes life is just difficult and you need someone to sit with through it all.

Medications help, but they do not make it all go away. Therapy helps, but life still has its ups and downs. Sometimes you will need to pass through it all. Through the panic. Through the depression. Through the suffering.

There is nothing holy about suffering in my estimation. Nothing holy or godly or particularly pious about suffering. True grace come when we sit there together in the suffering that one of is enduring. When I talk to my daughter even while her heart and her thoughts are racing. When I talk to my dear friends lost in the dark well of depression. When I ask someone if they could start eating once again, today or maybe tomorrow.

There is suffering we face, like grief, like pain, like misfortune, and it is good to be with someone through those all. And for some of us there is suffering we face, like depression, like anxiety, like PTSD, like anorexia, like, like, like so many things. And for all of those too, there is something sacred about sitting quietly with a person as they suffer. Not because you can make it all go away. But because you can be there with them through it all. Simple as that.

I cannot cure anyone. I cannot make it all go away. But I can make a cup of hot chocolate. Put on an old movie. And sit for hours with someone. It is nothing like a miracle. But it is what I can do.

Amen.