Climate and mental health

“People may, indeed, suffer from anxiety about climate change but not know it. They will have a vague unease about what is happening around them, the changes they see in nature, the weather events and the fact that records are being broken month after month. But they won’t be sufficiently aware of the source, and furthermore, we all conflate and layer one anxiety upon another.”

- "Climate Change is Wreaking Havoc on our Mental Health, experts say", The Star, 28th February 2016.

Living on a warming world is bad for your mental health. For climate scientists, environmentalists and those who have lived through climate-related extreme events, the impacts are often quite conscious. For many others, there is a deep unease lying not too far below the surface.

Awakening to climate change has affected my own mood considerably over the last eight or nine years. I have spent long periods of time depressed, angry, anxious and grieving. My thesis topic looking at emotional responses to climate change was prompted by both my own experience and the testimony of many people I know well who have started to take climate change seriously.

Finding resources to cope and reasons to keep going when we know worse is on its way will only become more important as the century progresses. My hunch has been that the gospel of Jesus, the community of the church and Christian practices of discipleship and spirituality may have a constructive role to play for some people. Not that these "cure" mental distress, but that they can shed new light on uncomfortable emotional experiences and keep open the possibility of creative action amidst bleak situations.
Image by Loic Venance (AFP/Getty Images). Waves breaks against a pier and a lighthouse during high winds in Les Sables-d'Olonne, western France, on February 9, 2016

On supporting a friend with cancer

After my own experiences of cancer diagnosis, treatment and remission, I more or less regularly receive requests from people whose friend, family member or colleague has just been diagnosed asking for advice on how they might best care for them. I thought I would post one of my answers (with permission) in case it is of some benefit to others.

Hi friend,

Good to hear from you, though sorry to hear about this news.

I guess the first thing I'd say, which may actually not sound very helpful at all, is that cancers are very different and the experiences of cancer patients even more diverse, so I would be quite hesitant to extrapolate too much from my own story.

Having said that, it is still possible to say a little more. Grief and suffering come in many forms (even in the same person) and bring with them various needs and opportunities. At times, silence is the best support; at others, the chance to talk to a sympathetic ear; at others, a word of comfort; at others, an act of silent service. In general, I guess I'd suggest that responsiveness is therefore key, being willing to play whatever role will be a blessing to those in need. While at times grief needs space, I suspect it rarely needs absence, so as a start, simply indicating your willingness to be there for them and to grieve with them is probably the best bet. If they have practical needs, then offers of help from trusted friends may well be appreciated (babysitting while parents go to some of the endless appointments these things seem to involve? Doing some housework? Frozen meals? The latter can probably be safely brought without being asked, as long as you stick to any known dietary requirements). Some people may find themselves with little energy for daily tasks like these. Others might throw themselves into them as a distraction and comfort.

Depending how wide and deep the pre-existing support networks of this family are, it may be that they are initially swamped with offers of help and sympathy. If you think this might be the case, you (or someone else) could perform the service of coordinating the practical support (putting together rosters for babysitting or frozen meals, etc.).

Don't neglect the partner of the patient, whose grief is double: grief for their partner's sake and for their own (potential) loss. And depending how old the kids are, they may need extra support from trusted family friends.

Again, depending how well you know them, then make your level and form of contact fit the relationship. If you are not close friends, then make contact through forms that can be ignored or noted and replied to later (email, letter, card, SMS). Only call if you know them well, because they might receiving a string of calls and probably don't want to be having the same conversation with dozens of people.

If my experience is anything to go by, they are likely to find themselves the target of more unsolicited advice than at any time outside of pregnancy. Although I know everyone meant well, I'd suggest keeping any crank miracle cures you've heard of or stories of amazing recoveries to yourself. It is actually not very encouraging to be told about someone's aunt who was cured simply by prayer and faith or someone's grandfather who drank only goji berry juice and lived to 100. Such stories are (a) irresponsible (I'm not a big fan of alternative medicine, nor of purely faith-based healing, for both scientific and theological reasons) and (b) sometimes contain an element of accusation in them ("if only you had enough faith, you too would be healed like my cousin").

Many cancer treatments become complex, and there is often a high volume of information to share with those concerned. One suggestion that a friend made to me (more unsolicited advice from a guy I didn't know well at the time, but of all that I received, almost the only piece of pure gold I got) was that it might be a good idea to set up a blog where interested family and friends can self-medicate on as much or as little information as they wish. This means that rather than having the same conversation fifty times after each appointment, I could simply write out a summary once and post it on the blog, then direct people to the blog. Mine is here (only updated very infrequently now).

I would also suggest keeping your theological comments minimal unless they raise it. I was probably unusual in that I'd just written my 4th year paper on suffering and the problem of evil just weeks before being diagnosed and so was (usually) quite happy to discuss theology with anyone who wanted. But not everyone is in that place, and for many, just retreating into survival mode is all they can handle for a while (once treatment started, my willingness to talk dropped rapidly as I just had little energy for anything).

I could write reams about my experiences of treatment, but here, the specifics of the cancer become most stark and what I say may bear little or no relevance to their situation.

They may or may not find it helpful to meet with other cancer patients, though I suspect that such groups will be available through the hospital, so you probably don't need to worry about that.

Finally, I'd suggest taking this tragedy as an opportunity to reflect upon your own mortality. Our society has hidden death and dying as far from view as possible and here is one place that the gospel truly does have good news (though not always easy news). Of all that I read, wrote and heard during the intense few months after diagnosis, the best was undoubtedly this talk by Stanley Hauerwas. It may or may not be appropriate to share with your friends (that is for you to judge), but it is almost certainly worth an hour of your time (if you can get past his braying cackle and Texan twang).

It hardly needs saying, but when words and wisdom falter, groans are also part of a faithful response to serious illness.

Grace & peace,
Byron

PS If you don't mind, I might post my reply (omitting your name and any other identifying details) on my blog since I have been asked this question quite a number of times (not that I mind being asked!) and putting it there will mean I can refer to it in future. Let me know if you'd rather I didn't.

Analogy is the best medicine

Ben doesn't appreciate his doctor's alarmist advice.

It would be quite possible to push this image further: "I can't afford healthy food!"; "Are you telling me to starve to death?"; "The cheap calories I get from high fructose corn syrup means I have more money to help others"; "Think of how many jobs would be lost if the fast food industry were to shut down"; and so on.

ICE: A good idea

Simple ideas with intuitive pass-it-on appeal are rare. This is one of them.

I have huge respect for paramedics, ambulance officers or whatever they are called in your region (in Oz, they are often affectionately known as "ambos"). They save lives more or less on a daily basis and are frequently first on the scene of dangerous and sad situations. I have personally benefitted three times from their care (once I got to travel in an ambulance with sirens blaring, but since I lived about 400 metres from a major hospital my excitement was short-lived) and can't count the times I've seen them help those around me. Anything that makes their job easier is worth consideration.

So the idea is to store an emergency contact number on your mobile under "ICE" (In Case of Emergency). That way, first responders (which could include police or firefighters) know who to call if, God forbid, you are dead, unconscious or otherwise unable to indicate an appropriate contact. This helps you to be identified, allows quick access to critical medical information and gives your loved ones peace of mind. This idea has only been around for a couple of years, but is catching on quickly.
If you have more than one contact, use ICE1, ICE2, ICE3 and so on. If your phone is locked and requires a pass phrase to access, see here. There is an alternative language independent version of the same idea here.

Obesity: personal or structural?

Ross Gittins puts the boot into GDP as a measure of economic well-being once again, this time by pointing out that obesity is win-win-win for GDP. He reviews a book that argues that the sudden and dramatic surge in obesity since the 1980s shows that it is a structural problem with the way we organise our society rather than a few individuals who lack self-control.

The relationship between individual moderation and social structures is complex. Like the debate between light and deep green, this problem doesn't have a simple answer. Of course it is both-and, rather than either-or, but where does the emphasis lie, and so where ought the weight of our attention and exertion rest?

Healthcare and the market

I've mentioned the US debates about health insurance before. But it is graphs like this that are worth studying closely to get a quick handle on why universal healthcare is such a no-brainer to the rest of the developed world (a.k.a. "the den of socialism").
Notice that the much maligned NHS in the UK spends about 40% of what the US does per person and yet the UK has a higher average life-expectancy by more than a year. Portugal spends less than 30% of the US level and also has a higher life-expectancy. The country with the greatest longevity, Japan, spends about 35% per person of what the US spends. And this massive US spending is not just absolute, but also relative to GDP. The other salient feature of this graph is noting that the only industrialised nation without universal health care is the US.

Of course, there is not a simple correlation between health system and life expectancy. Also important are genetic and environmental factors (including diet). But it is at least worth pausing for thought and wondering whether the US system is really generating the quality of health care that is often claimed for it. Might not the introduction of market forces actually distort the system by giving doctors falsely inflated motives for unnecessary treatment? And by giving insurers incentive to deny treatment, or to deny cover to those already sick (who often need it most)?

This is not simply another cheap shot at US politics, but a way of raising a larger and more important issue. Namely, that there are parts of life where market forces distort healthy relationships. Introducing the logic of the market to situations requiring trust and gift doesn't improve efficiency; instead, it can often critically undermine the trust and generosity on which the relationship is built. To pick a somewhat facetious example, should we charge our daughter for each nappy that we change? Should breast milk operate on a user-pays system?

Nonetheless, the dominant expression of contemporary capitalism has an imperialist tendency based on the assumption that market logic ought to be extended to more and more spheres of life. Private ownership for profit is treated as though it is the most desirable kind of human sociality. This is not a recipe for good healthcare, and it is not a recipe for a healthy society.

UPDATE: Here are two very good contributions to the healthcare debate.
• The simplest explanation of health care reform you will read, giving a very readable summary of the logic behind the proposed reforms.
• Catch 22 for opponents of health care reform, or why a government option is neither a takeover nor a sneaky takeover (and why even if it were this wouldn't be a terrible thing). Note: the government option has been taken off the table, but this post is still worth reading to know why that was a bad move.

Jesus: friend of sinners

Church: a place for broken people

Just as surely as God desires to lead us to a knowledge of genuine Christian fellowship, so surely must we be overwhelmed by a great disillusionment with others, with Christians in general, and, if we are fortunate, with ourselves. By sheer grace, God will not permit us to live even for a brief period in a dream world. He does not abandon us to those rapturous experiences and lofty moods that come over us like a dream. God is not a God of the emotions but the God of truth. Only that fellowship which faces such disillusionment, with all its unhappy and ugly aspects, begins to be what it should be in God's sight, begins to grasp in faith the promise that is given to it. The sooner this shock of disillusionment comes to an individual and to a community, the better for both. A community which cannot bear and cannot survive such a crisis, which insists upon keeping its illusion when it should be shattered, permanently loses in that moment the promise of Christian community. Sooner or later it will collapse. Every human wish dream that is injected into the Christian community is a hindrance to genuine community and must be banished if genuine community is to survive. He who loves his dream of a community more that the Christian community itself becomes a destroyer of the latter, even though his personal intentions may be ever so honest and earnest and sacrificial.

God hates visionary dreaming; it makes the dreamer proud and pretentious. The man who fashions a visionary ideal of community demands that it be realized by God, by others, and by himself. He enters the community of Christians with his demands, sets up his own laws, and judges the brethren and God himself accordingly. He stands adamant, a living reproach to all others in the circle of the brethren. He acts as if he is the creator of the Christian community, as if his dream binds men together. When things do not go his way, he calls the effort a failure. When his ideal picture is destroyed, he sees the community going to smash. So he becomes, first an accuser of his brethren, then an accuser of God, and finally the despairing accuser of himself.

Because God has already laid the only foundation of our fellowship, because God has bound us together in one body with other Christians in Jesus Christ, long before we entered into common life with them, we enter into that common life not as demanders but as thankful recipients. We thank God for giving us brethren who live by his call, by his forgiveness, and his promise. We do not complain of what God does not give us; we rather thank God for what he does give us daily. And is not what has been given us enough: brothers, who will go on living with us through sin and need under the blessing of his grace? Is the divine gift of Christian fellowship anything less than this, any day, even the most difficult and distressing day? Even when sin and misunderstanding burden the communal life, is not the sinning brother still a brother, with whom I, too, stand under the Word of Christ? Will not his sin be a constant occasion for me to give thanks that both of us may live in the forgiving love of God in Christ Jesus? Thus, the very hour of disillusionment with my brother becomes incomparably salutary, because it so thoroughly teaches me that neither of us can ever live by our own words and deeds, but only by the one Word and Deed which really binds us together--the forgiveness of sins in Jesus Christ. When the morning mists of dreams vanish, then dawns the bright day of Christian fellowship.

– Dietrich Bonhoeffer, Life Together, 15-17.

Jesus was not ashamed to share company with tax collectors and prostitutes; he was called "the friend of sinners" and invited national traitors to join his renewal movement (Mark 2.13-17). If we would eat with Jesus, we too become friends with the friend of sinners and are revealed as those who are sick, in need of a physician. The company Jesus keeps is not with those who believe themselves perfect, or superior, or pure, but with those who know they need such a friend. The church is a place for broken people.

With whom do you eat?
Ten points for guessing the Sydney church building.

The future of love

Reflections on 1 Corinthians 13.8-13
But is this kind of love really possible? Is it just a pipe dream? Isn’t it all too hard? I’ve tried it and it doesn't work. I’ve tried loving others and have still been treated like dirt. Can’t I just be nice and polite and tolerant instead? Can’t I settle for avoiding people?

Paul’s answer is to turn to the future. Gifts will pass away: prophecy, speaking in tongues, special revelations of knowledge, all will end one day. They are just means to an end, instruments to help us along the way. When we grow up, we put aside baby-talk. When your flatmate arrives back from overseas, you no longer need email, you can talk face to face. All these spiritual gifts are good and can serve the common good, but the common good they serve is love. Love isn’t just a means to an end. Love isn’t just an instrument to help us get along. Love is not just the path of our journey; it is our destination. Love isn’t simply our duty; it is our destiny. As we learn to love, we are in training to speak the language of the future. We are preparing our tastebuds for the coming feast.

And we get a taste now. This is God’s gift. He treats us in a way that brings new health to shattered spirits; he speaks words that heal and build and make us true; he gives himself for us, preferring our benefit to his comfort. He does all this for us, so that we can start to become like him. Love is therefore not a burden; it is a privilege. We get to be a little bit more like God.
Photo by CAC.

Sicko

Last night I went to see Michael Moore's new(-ish) doco Sicko on the US Health system (amongst other things). As usual for Moore, there were more stories and stunts than statistics, more emotion than evidence, more amusement than analysis. Nonetheless, this film is worth seeing and talking about. Not only is it less bitter and nasty than his other work that I've seen, it also raises issues more directly relevant to Australia than Bowling for Columbine or Fahrenheit 9/11. With a health system more privatised than the UK, but far more public than the US, debates about the direction of Australian health care continue.

Since being diagnosed with cancer in December, I have received thousands of dollars worth of consultation, treatment and drugs, at almost no cost (a few dollars for the drugs). I give thanks for the public health system and taxation that has enabled this. Yet thoughout the process, I noticed many encouragements towards private health cover, with some messages advising that to do so would help the public hospitals by giving them more funds.

While this may be true in the short term, I am very hesitant about doing my little bit to encourage us closer to the US system. The more patients on private cover, the easier it is for the government to justify health cuts, thus downgrading the public system and giving more incentive for people to switch to private cover. And the losers are those who can't afford it. Though as Moore points out, this means we all lose.

I realise this is a very complicate issue and that I only have a very basic grasp of it, but I'd love to understand more.

Do you have private insurance? If so, why? Do you think this makes any difference to the system as a whole for you to 'vote' this way? Any opinions from those who work in the health system?
Dr Perseus performs a tricky piece of surgery. Twelve points for the first to guess the city in which this work is found.