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

2. 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.

3. 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.

4. 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.

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

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

7. 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.

8. 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

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

10. 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

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

12. 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."

13. 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.

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

15. 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

16. 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 

17. 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.

18. 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

19. 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.

20. 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

21. 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).

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

23. 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

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

25. 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.