Psychological wellness in religious life Paul Midden, Ph.D., Clinical Director, Saint Louis Consultation Center

Topics Maintaining health & wellness in a vowed, apostolic life of service. Recognizing distress/depression. How therapy/counseling can help with these things. Taking care of oneself.

Preliminary thoughts/considerations No one chooses an emotional or psychological disorder. No one joins religious life to be unhappy. Balance in life is an ongoing goal. There are obvious tensions in a life of service between caring for others and caring for self. Our self care is our personal responsibility.

Maintaining health, wellness in apostolic life We are happy when we are relatively stress-free, we enjoy ourselves, we relate to others with a sense of ease and pleasure; we pursue our goals and responsibilities in a comfortable way. Our life is in balance among the physical, intellectual, emotional, social, and spiritual aspects.

Tensions & risks. . . Man for others versus self-care Hero ideal Compassion fatigue Self-care versus self-absorption

More tensions, risks. . . The allure of narcissism The allure of avoidance Sexual tension The dilemma of formation

Recognizing distress/depression What is it? A multi-system disturbance of emotional regulation which negatively impacts one's outlook, body, and spirit and which compromises a person’s ability to function effectively.

A few things to consider It is an affliction; it is not a choice.   It affects those so disposed for lots of complicated reasons. It can be triggered in many ways, some complicated and some simple. By sunshine deprivation By reactions to interpersonal tensions or any of the other tensions noted above. By grief By circumstances that trigger memories of earlier abuse. By trauma, either recent or historic

Types of depression Major Depression Dysthymic Disorder Bipolar Disorder I & II Reactive depression (Adjustment disorder)

Major Depression Depressed mood* Markedly diminished interest in things that are ordinarily pleasurable.* Fatigue or loss of energy Feelings of worthlessness, guilt. Impaired concentration, indecisiveness Insomnia or hypersomnia Psychomotor retardation or a agitation (slowed down or restless) Recurring thoughts of death or suicide. Significant weight gain or loss (+/- 5% body weight/month) Must have loss of interest or depressed mood among symptoms most every day for two weeks

Dysthymic Disorder Poor appetite or overeating; Insomnia or hypersomnia Low energy or fatigue Low self esteem Poor concentration Difficulty making decisions. Feelings of hopelessness.

Bipolar I Disorder, manic phase Mood Changes: A long period of feeling "high," or an overly happy or outgoing mood Extremely irritable mood, agitation, feeling "jumpy" or "wired."

Bipolar I Disorder, manic phase Behavioral Changes Talking very fast, jumping from one idea to another, having racing thoughts Being easily distracted Increasing goal-directed activities, such as taking on new projects Being restless Sleeping little Having an unrealistic belief in one's abilities Behaving impulsively and taking part in a lot of pleasurable, high-risk behaviors, such as spending sprees, impulsive sex, and impulsive activities.

Bipolar I Disorder, depressed phase Mood Changes A long period of feeling worried or empty Loss of interest in activities once enjoyed.

Bipolar I Disorder, depressed phase Behavioral Changes Feeling tired or "slowed down" Having problems concentrating, remembering, and making decisions Being restless or irritable Changing eating, sleeping, or other habits Thinking of death or suicide, or attempting suicide

Reactive depression a.k.a.Adjustment Disorder The development of emotional or behavioral symptoms in response to an identifiable stressor(s) occurring within 3 months of the onset of the stressor(s).  These symptoms or behaviors are clinically significant as evidenced by either of the following:  (1) marked distress that is in excess of what would be expected from exposure to the stressor  (2) significant impairment in social or occupational (academic) functioning 

How Therapy Can Help Therapy provides a safe place where a person can talk about anything, including their most serious and private personal difficulties, and expect to be understood, attended to, and cared for.

What therapy does Provides a forum outside the internal dialogue. Provides a place to check out one's thinking, get to the root of emotions, and practice new skills. Provides a way of receiving feedback that is not judgmental

What therapy does not do. It does not change your experience or your history.   It does not take away your feelings, including whatever anger or resentment you might have. It does not turn you into someone else, or a more perfect version of yourself.

Therapy is about change In your behavior In the ways you think about things In the way you deal with your emotional life In the way you deal with your relationships

Shedler’s List Helping a person work out his feelings Exploring attempts to avoid distressing thoughts and feelings Identification of recurring themes and patterns Discussion of past experience (developmental focus).

Shedler’s List, cont’d Focus on interpersonal relations Focus on the therapy relationship Exploration of fantasy life

Self-care 1) a sense of personal autonomy/centeredness 2) awareness of personal, interpersonal needs and limits 3) awareness of sexuality: orientation, attraction profile, vulnerabilities 4) emotional/interpersonal skills

Self-care, cont’d 5) social support network, or relationships, relationships, relationships 6) clarity about one's vocation/life path

Key concepts Integrity Self-awareness Mindfulness Being who you say you are. Self-awareness Knowing the self that you are Mindfulness Paying attention to the self that you are.