Pastors

Depression in the Clergy

Pastors suffer from depression at about the same frequency as the general population—and two to four percent of the general population suffer from depression at any one time.

The privileged position of ministry does not exempt pastors from the same problems their people experience. In fact, they suffer additional stresses unique to this set-apart status. As a result, depression is a significant problem afflicting the clergy.

During 1980 I surveyed one hundred clergy randomly selected from a denominational yearbook. Twenty percent reported they have had moderate to severe depression at some time in their lives. Furthermore, depression is a very frequent symptom in pastors I see who come for outpatient or inpatient psychiatric treatment.

Stresses That May Trigger Depression

Stress does not always result in depression. For example, although John the Baptist’s imprisonment caused him despair, imprisonment for Paul occasioned joy and singing. It is important, therefore, to consider the individual who experiences stress, rather than simply identifying the stresses that triggered the depression. Regardless of the state of the pastor’s inner life, the expectations and conditions unique to the ministry (and which demand unusual energy to cope with) are usually experienced as stresses.

Complex role expectations. More is expected of pastors than of any other professionals. They must play the role of theologian, philosopher, businessman, politician, educator, preacher, public relations expert, and counselor—often without adequate specific training in a number of these areas.

Financial pressures. The esteem pastors are offered and the expectations placed on them compare with that experienced by physicians. The financial remuneration, however, suffers in comparison.

An interesting finding of a recent LEADERSHIP survey (Spring 1981) was that over 60 percent of pastors said they do not feel they have been financially deprived. However, responses to the survey imply that many ministers are uncomfortable acknowledging that finances are a problem. They feel they should be “above such worldly concerns.” One pastor on facing retirement stated, “I have to admit I don’t have much money to go on.” Then he quickly checked himself by saying, “But I didn’t go into the ministry to make money in the first place.”

Lack of firm roots. Many pastors are required to move from one parish to another. Moving means losing relationships which have become important to the pastor and the family. Furthermore, if conflicts with the congregation are resolved by moving on, neither the pastor nor the congregation have the opportunity to learn from the mistakes.

Interpersonal conflicts. A pastor is expected to solve conflict situations, but in a much more difficult situation than other counseling professionals. A psychiatrist is able to work in a very structured setting. He defines when he can see the patient, for how long, and who will be involved. At the end of each day’s session, it’s the last contact until the next week.

The pastor does not have this kind of structure. He can be called on at all hours. He knows these people and their families and cares about them deeply. If he tries to limit this emotionally draining interpersonal involvement, he is accused of being uninvolved and uncaring. The inevitable stress engendered by these conflictive situations can lead to depression.

All of the above stresses are external. But the pastor’s ability to handle eventual stress hinges on the state of his or her own inner world. If it is relatively free of conflict, then full attention can be given to assessing the external stresses and deciding on appropriate responses. But if pastors are preoccupied with conflicts about personal self-worth and the appropriateness of personal feelings, their ability to respond to the external problems is impaired. Among internal stresses, there are certain recurring themes.

Idealized self-image versus actual self-image.

Growing up involves living with a performance gap. The reality of the present position plays a part in forming an actual self-image. The anticipated ability and maturity plays a part in forming the idealized self-image—the self that will be when a goal is reached.

Unfortunately, this straightforward approach is complicated by another factor: self-worth. Children who are told often enough that they are “not big enough, good enough, or smart enough” come to believe that if they can’t perform well, they’re not worth much. This conviction is largely unconscious and is unaffected by changes in the real world. Pastors often explain their feverish attempts to accomplish more by pointing to biblical passages: “Doesn’t the Bible say we are to be diligent, above reproach, faultless, zealous?” They may intellectually know they have great worth as children of God, but at their deepest emotional level, they are far from convinced of this truth.

This conflict between pastors’ sense of what they are and what they ought to be manifests itself in a variety of ways. They may be outstanding, with everyone approving enthusiastically of them. Yet on closer observation, it becomes apparent that there is a driven quality to their behavior.

Some may be continually oversensitive to how others see them. After preaching they may ask their spouses, “Well, how was it?” The spouses soon learn they are trapped. If they respond with honest feelings, the pastors are devastated by even a minor criticism. If they are routinely positive, their sincerity is doubted.

Another due to this conflict is the hypercompetitive attitude in pastors. In subtle ways they frequently check on how they compare with neighboring ministers. If they feel superior to others, it helps quiet the nagging inner voice that they are inferior. This conflict between the idealized self and the actual self is often manifested as an “all or none” attitude in pastors. Either they are “all perfect” with no failures, or they are “nothing.”

The congregation is often unaware the pastor has such low self-esteem. At best, the pastor can continue an outwardly effective career, but inwardly can never relax and enjoy the fruit of the labor. At worst, the pastor’s preoccupation with the need to prove self prepares the stage for depression. This usually occurs when faced with a situation that no longer allows for a defense against the feelings of inadequacy in the usual way.

For example, Pastor Lloyd, a hard-driving person, always worked hard but felt inadequate. Since he accomplished great amounts of work, he was given additional conference and congregational responsibilities. He was finally so overloaded there was no way he could get it all done. When this reality dawned on him, he became depressed. He felt he must be “no good” since he could not do everything the church required.

Conflict over anger. A pastor’s shaky self-esteem frequently arises from inner conflicts regarding the appropriateness of his or her feelings, particularly angry feelings. Anger can be so intense there may be a fear of losing control and hurting someone. In addition, the expression of anger raises theological questions: “Doesn’t the Bible say that even the experience, much less the expression, of anger is inappropriate? Won’t God surely punish, or at least fail to bless, those who allow themselves to be aware of anger?”

Many pastors are never fully aware of what it is they are resisting, beyond a vague sense of uneasiness. They find various ways of defending against this. One way is to re-label the anger: upset, irritated, unhappy, concerned, righteously indignant.

There are many indirect ways in which pastors express their anger: perpetual lateness, a quickness to agree but a slowness to produce, frequent forgetfulness. Although on the surface they passively accept whatever others expect of them, they always resist in some way.

Another common way to handle anger is to project it onto others. “I’m not angry; they’re angry with me.” This method may protect pastors from feeling angry, but it distorts their perception of reality and alienates them from other people.

Sometimes anger is turned into physical complaints: backaches, headaches, gastrointestinal disturbances, and so on. Checkup after checkup reveals no physical reason. The endless search for relief may lead eventually to depression, a depression superimposed on the pre-existing physical complaints.

One pastor reacted to the discomfort of angry feelings by developing a syrupy sweet personality. He could not allow himself to admit any anger. To do so would have been to take the lid off his boiling cauldron of anger, which would have been intolerable and overwhelming to him.

When pastors can no longer ignore anger and yet have found no appropriate way of expressing it, they may unleash on themselves the anger they cannot acknowledge or verbalize. In the intensity of their rage and depression, they may even feel suicidal and may commit that act.

Conflict over sexual impulses. Although pastors may deny to themselves they are sexually attracted to someone other than their spouses, they are keenly aware of their sexual urges. As with anger, they handle it very privately; rarely are even their closest friends made aware of the temptation. The management of sexual impulses that the pastor perceives as unacceptable may lead him to avoid interpersonal sharing, and depression may result from a lack of such relationships.

One pastor was convinced he had an unusually strong sex drive. He feared to reveal his problem to anyone lest he be barred from the human race. Yet, the intense struggle with managing sexual impulses is usually not so much related to the strength of the sex drive as to nonsexual issues. The desire for sex outside the marriage may arise from a non-satisfying emotional relationship with the spouse, anger at the spouse, or a need to prove one’s manhood.

For others, the problem involves the development of an intense emotional relationship with someone other than the spouse, which may occur in an extended counseling situation. The early involvement is rationalized as necessary, appropriate, and harmless. Finally, after continued contact for an extended time, the emotions are so intense that there is great difficulty in avoiding the temptation, and the pastor becomes depressed over the situation.

Patterns to Prevent Depression

A minister can develop several habits to help prevent stresses that could, if unchecked, lead to depression.

Learn to set limits. Pastors should clearly define the limits of what they will expect of themselves and what they will allow others to expect of them. But this raises painful questions: “If I can’t respond to all legitimate requests for help, how can I demonstrate God’s unlimited love for man? How can I say ‘no’ if the church calls? Isn’t this saying ‘no’ to God? What does my inability to meet all requests say about my worth as a person?”

The Scriptures give an instructive example of church leaders unashamedly setting limits on what they would allow others to expect of them when the apostles turned some responsibility over to others in Acts 6. They could set firm limits because they clearly perceived what God had called them to do. Christ’s parting words gave them a clear mandate to preach and teach the gospel. The unfaithfulness of the early followers did not discourage them (Acts 5:1-10); the hostility of local Jewish leaders did not frighten them (Acts 5:17-29); beatings by those in authority did not dissuade them (Acts 5:40); and the accusation of failure by fellow disciples did not confuse them (Acts 6:1-4). Modern-day pastors may feel at a disadvantage in defining their own call. Their sense of call is often distorted by inner strivings: to be liked, to be the most respected, to be the most exemplary pastor in the community, to avoid conflict, to control people. Thus, establishing priorities is a must to remain faithful to their call and stay sane in the process.

A bishop, the conference minister, or the board of elders can be a valuable resource to pastors in fixing these priorities. They might also seek the advice of a neighboring pastor. This should not be seen as a sign of weakness or a declaration of failure.

An awareness of their own biological rhythms can help pastors manage their priorities. Some are early risers, some work late at night; some are full of energy, ideas, and enthusiasm, others need to push themselves to accomplish anything creative. These and other patterns can be modified to some extent, but those who accept their own rhythms and work within those confines are the most effective and efficient.

Sam Eastwood was a pastor with many creative ideas. He often wished he needed only five hours of sleep rather than the eight hours he usually required each night. He always planned his schedule to allow for five hours of sleep; he usually ended up exhausted and fell asleep in his study. He would then be preoccupied with having failed once again. He simply did not know his own body’s limits.

By educating congregations about a pastor’s call, goals, and limitations, pastors can actively respond to the expectations placed on them and thus decrease their stresses. Saying “I can’t” is only the first part of the communication. The second part is: “The resources for solving the problem may well be within you.” This approach helps others gain self-awareness and self-confidence as co-workers with the minister. It prevents the development of a stifling dependency on the pastoral leader.

Learn to be assertive. The key to the success of relationships is whether one can openly discuss negative feelings with the person who aroused them. The more one suppresses feelings, the more they intensify. Occasionally, they may become so intense that the minister explodes in anger. Quickly, there is an apology, an attempt to undo the damage, and a vow never again to express such feelings. The other person in the relationship senses withdrawal, and the relationship is as effectively destroyed by the withdrawal as it would have been by the explosion.

Instead of suppressing feelings or exploding, a third option involves expressing one’s thoughts and feelings to strengthen the relationship. There are several principles to keep in mind:

• Own the problem. No matter how objectionable another’s behavior, pastors should share their own reactions rather than attributing their feelings to others. When the pastor says to an elder, ”You don’t care about others because you insist on having the last word,” the elder now will have to prove he or she is not a nasty person. In contrast, the pastor could say to the elder, “When you interrupt me, I feel hurt, as though what I have to say doesn’t matter.” This helps create an environment in which productive discussion can continue.

• Describe the behavior. Don’t judge or evaluate the person or his motives. Simply describe the behavior which triggers the negative feelings in you. For example, “When you look the other way when I approach you, I feel rejected.” This describes the situation without communicating a rejection of the other person.

• Use “I” messages. Express your feelings in the first person. “I feel hurt, rejected.” Avoid saying, “You wanted to hurt me; you are rejecting me,” or using the third person, “People feel rejected when you act like that.”

• Support the person. The motivation is to help maintain and improve the relationship. Let the other person know you care about him or her and your relationship. Then the two of you can lay down your defensive weapons and be open to each other.

• Respond to the feedback. Notice the verbal and nonverbal components of the response from the other person. Before giving an answer, repeat back what you heard that person say: “1 hear you saying that my busyness has angered you.” Accept whatever truth is pointed out about you without defensiveness, and then continue to express your feelings and thoughts. “I can understand how my unavailability has angered you; this is something I want to work on.”

Don’t quit expressing yourself after one round of giving and receiving feedback. Effective relationships require persistent feedback throughout the course of the relationship.

Take time for relationships. A central issue in neurotic depression is a sense of hopelessness, particularly if meaningful relationships are absent. Recovery from depression often begins with regaining hope; hope exists when the sufferer has given up on life but finds that someone has not given up on him.

The development and maintenance of a meaningful relationship takes commitment of time in both quality and quantity. Pastors often say their spouses and children are the most important people in the world, but the time they commit to relationships with these important people is often limited. Unfortunately, the spouse and children seldom raise red flags signaling their desperation. If pastors consistently place the family as number two in their priorities behind the needs of the congregation, they will discover that eventually the children, and perhaps the spouses, will develop a deep resentment toward them for this. If the children do not turn out later as they would wish, pastors are overcome with depression and guilt at having failed in this primary responsibility.

To maintain a personal relationship with God, pastors must make deliberate efforts to schedule time on a consistent basis for devotional meditation, reflection, and prayer. This time with God is easily usurped by crises in the parish, and the pastor needs to be very determined about protecting it. When pastors feel a great sense of spiritual emptiness because they have not kept up their relationship with God, then they experience guilt and a sense of in-authenticity, because they are talking about something they really are not experiencing.

Finally, pastors need to make a place in their lives for personal friendships. A best friend in the congregation may cause problems; therefore, pastors often find it helpful to have close, intimate friends who are not a part of their congregations. By growing and testing perspectives with a close friend pastors gain internal strength to minister to their congregations.

Pastors Can Cope With Depression

Despite efforts to develop optimal living patterns, pastors still may fall victim to depression. It then becomes essential for them to develop an approach for dealing with it.

Recognize the signs. Everyone tends to deny initially that he or she could be suffering from depression. Therefore, pastors consciously need to have special attention to clues indicating that depression exists in their lives. If interaction with people is more and more distressing, and if they are constantly withdrawing, they may be depressed. If they are unable to control their appetites, misusing alcohol, or overeating, depression may underlie this behavior.

If pastors find they have many aches and pains for which there is no real physical basis, this may signal depression. If they have lost interest in activities which used to bring pleasure, such as hobbies, and there is also disinterest in sexual activity with the spouse, depression may be present. If mornings are the worst time of day, if they struggle with feelings of hopelessness and helplessness, and if death seems to offer a way out, depression is likely.

Analyze the feelings. Once pastors sense their depression, they can attempt to analyze the specific feelings associated with it. Why do they have these feelings? What triggers them? Who triggers them? How are they triggered? When are they triggered? Are they proportionate to the event which triggers them? Remember, some depressions result from a real or imagined loss. If this can be identified, they should allow themselves to experience the sadness about the loss without feeling guilty about the emotion. Put the loss in perspective: What does it mean in terms of their lives, in terms of their relationship to God?

Get feedback from supportive others. It’s not always easy for pastors to be clear on exactly what is triggering their feelings. It’s helpful to have feedback from others to gain perspective. Often pastors are tempted to avoid sharing painful feelings with others for fear of what they will think; but if they have taken the time to develop a meaningful relationship with another person, it will be easier to share.

The pastor will also find that sharing struggles with God helps to lift despair. The psalmists found that verbalizing their grief, anger, and depression led to renewed hope for them. In a similar way, as pastors open their hearts to God and verbalize their anger and depression, they will begin to gain a new perspective on themselves, as well as an awareness of being accepted by God in spite of their anger and negative feelings.

Remain involved in life. Pastors should resist the tendency to withdraw because of their depression. Rather, they need to define tasks they can do successfully. For example, if they find that administrative tasks are a great stress to them, but they enjoy preaching even though depressed, they should continue preaching. It is mandatory; though, that they begin decreasing their commitments and taking control of their schedules to reduce these pressures.

Seek professional help. In spite of one’s best efforts and the help received from friends and from God, there are times when one needs to obtain professional help for depression. Pastors may feel that if they were truly Christians they wouldn’t need such help: “I don’t want such unspiritual solutions as pills or doctors.” They should consider getting professional help if they find they have severe insomnia, suffer from persistent suicidal thoughts, or experience unremitting depression.

The relationship a pastor has with the therapist is a specialized type of relationship in its intensity and specific focus. The two basic components in this relationship are: the support of another human being who is able to hear all that the pastor is thinking and feeling and to still accept him; and the feedback given by the therapist concerning areas the pastor may be handling in a self-defeating manner, or which may not be leading toward his goals.

Many pastors who have had professional therapy testify that they experienced God’s grace through this means. Though spiritual issues may not always be dealt with directly, the benefits which a pastor experiences from therapy often include an improved spiritual sensitivity and an improved relationship with God and others.

Ideally, the pastor’s therapist should have some training and experience in the treatment of religious conflict. He must be prepared to see religious conflict as significant in the treatment of the religious person, and should be willing to deal with it as an issue in itself, not just as a symptom of something still deeper in the psyche.

A young pastor who had suffered a severe depression was asked what his advice would be to depressed clergy. He encouraged pastors to avoid getting so wrapped up in church work that it becomes equated with self-worth. He urged pastors to avoid taking criticism of sermons as personal rejection. He warned against making one’s whole life a service to the church; pastors need family and social life as well. This young pastor found that people believing in him and praying for him were very important to him during his period of illness. He also talked about the trust he had placed in his therapist and the freedom he had felt in group therapy.

And what part did God play in the whole picture? How did the pastor view his spiritual life during this time of deep emotional depression? His response was: “God works through people as he worked through his Son, Jesus Christ. God is always there, loving and caring. Sometimes we are so preoccupied with ourselves we do not receive the gift of his love.”

Copyright © 1982 by the author or Christianity Today/Leadership Journal.Click here for reprint information on Leadership Journal.

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