Dr Jamila Koshy
Defenceless under the night
Our world in stupor lies;
Yet, dotted everywhere,
Ironic points of light
Flash out wherever the Just
Exchange their messages:
May I, composed like them
Of Eros and of dust,
Beleaguered by the same
Negation and despair,
Show an affirming flame.
W. H. Auden (1939)
Our hopeless world
Hopelessness has pervaded the world since the Fall. The present time is no different. Our country is no different. India achieved freedom and established itself as the largest democracy seventy years ago, but today we watch in horror as gang-rapes and murder occur with impunity and ruling governments use police forces to threaten the weak, control minorities, prevent dissent and suppress the very rule of law that they are required to uphold. The Hathras gang-rape and murder followed by the UP police burning the poor Dalit woman’s body in a field as if it were garbage; the brave and beautiful anti-CAA/ NRC protest a few months ago dissolving into terrible violence with militant young men killing, destroying property, desecrating religious places – the current social milieu has brought despair to many.
And then the COVID pandemic overwhelmed the world. India has already lost one lakh people, officially, to this scourge; this is probably an undercount. The economy is in terrible shape; many jobs and businesses have shut down; millions of people have been pushed back into abject poverty.
Our hopeless lives
Personal lives too, reflect the burden of all this despair. Many families face severe financial stress, and yet have to shoulder the burden of caring for the young, the old and the ill. The weary migrants left without work and shelter, who trudged home, found themselves unwelcome there, too. Domestic violence has increased. Mental stress and other mental illnesses have increased. Substance abuse and lashing out in violence at others seems the way some people cope with all this.
Mental illness and hopelessness
Mental health is a state of emotional and relational well-being, where a person recognises and is able to live up to her potential, bear the normal stresses of life, work and contribute to society effectively. Interestingly, all these presume a state of positivity, an expectation of good outcomes, and the ability to face occasional negative outcomes without despair. In other words, a positive and hopeful outlook towards life is part of mental well-being. Unsurprisingly, therefore, mental illness often has loss of hope as a prominent psychic pathology.
In anxiety disorders, for instance, the main problem is fear and uncertainty about the future, sometimes a sense of impending doom. These anticipatory emotions, and worry are often related to life, health or the well-being of the person or her loved ones. While these fears are often recognised as being exaggerated and unwarranted, the person is unable to control such thoughts and feelings. Hope wavers and is subject to strain. The struggle to retain hope and cope is expressed in the almost desperate racing of thoughts, rush of words, inability to sleep, even physical restlessness.
In depression, often following a period of anxiety, a point is crossed, and the person actually gives up hope. The future is seen as dark and bleak with no expectation of change. The person feels nothing can be done, desperate activity ceases and is succeeded by sadness, lethargy and emotional, physical & relational withdrawal. Sometimes, the natural progression of thoughts is to feel one may as well be dead, and then to start thinking how death could be achieved. Hopelessness is indeed a central symptom of depression.
Other syndromes related to mental health, too, feature the lack of hope prominently. People with substance abuse or dependence, for instance, almost inevitably display a phenomenon called ‘denial’. This is a defence mechanism wherein anxiety is blocked from the mind by denying the existence or extent of the problem. So those who are clearly dependent or habituated to alcohol, drinking perhaps every day, alone, or to get rid of the morning ‘shakes’ – even they may deny dependence. They may downplay how much they drink, insist they can give up any time they like, and certainly refuse to accept their drinking as a serious problem affecting their lives and families. What drives this denial? It is because acceptance of the reality of the situation is too painful, too anxiety-provoking. Hope that one can change is wavering, or perhaps already lost, because dependent people have inevitably tried, in the past, to reduce the amount they consume at some point and found themselves unable to do so. Confronting that wavering hope produces more anxiety; it is far easier to deny the problem and pretend that all is well.
Delusional disorder is the manifestation of a disconnect with reality in one localised area, quite often that of marital fidelity. Trust and hope are essential in a relationship. Those who go into marriage with poor self-esteem, or who carry the genetic trait of paranoia are prone to this. Rather than entering the relationship with positive hope and trust in their partner, the person is constantly in need of reassurance of love, and can take small things as signs of betrayal. Every other relationship is viewed with suspicion and small actions are taken as portents of affairs and clandestine romantic connections with others. The psychological core here (mediated via the brain and chemicals) is a lack of hope and trust in the relationship and in the spouse.
Acute Stress Disorder and Post-Traumatic stress disorder are seen, respectively, during and in the aftermath of a severe catastrophic stress, such as natural disaster, rape or accident. Here too, the psychological core of hope for a peaceful future has been rudely shattered. The horror of what has happened, and the fear of what it means has taken over. The mind is not yet ready to accept that there is a way out, or that life can be rebuilt. In the post-traumatic phase, memories of past episodes haunt the person, and displaces all other events of importance in the person’s mind. Dreams, hopes and aspirations are set aside by preoccupation with the catastrophic event.
Personality disorders are currently much talked about, with several world leaders being accused of narcissism, sociopathy, psychopathy and so on – all character traits peculiar to different forms of disordered personalities. The narcissist is preoccupied with himself, and has inflated levels of self-esteem, often not borne out by actual achievements. The sociopath and psychopath are careless of other’s lives and concerns in a far more direct way, and may repeatedly tell lies and break all rules without remorse. Dependent personalities need help and support at all times, and do not trust themselves or their decisions at all. Paranoid and schizoid personalities do not trust others and are often loners. Obsessive personalities deal with the anxieties of life by creating rules and an order which they strictly adhere to, and also enforce on others in their care. As can be seen, all these personalities lack the joyful confidence and hope in oneself and others that would lead to freedom and mental well-being.
Christian attitude to hopelessness and despair
In such a bleak, hopeless scenario – in Auden’s words, a defenceless stuporous world in darkness, negation and despair – what should be a Christian’s attitude? The answer is simple – a Christian is to bring hope.
Hope is an integral part of Christian life, so much so that Paul grouped the three most important characteristics of a disciple – faith, hope and love (I Cor 13:13). We often stress faith – sharing, teaching and defending the faith. We demonstrate love through acts of service and good works, especially to the most unloved. We often ignore, however, the importance of hope in Christian living.
Yet, a closer look at the Bible’s attitude to hope reveals how important is the hope we have in Christ:
First, hope is where our life in Christ starts. Hope in heaven and in the good news in Christ is the well-spring which leads to faith and promotes the expression of faith towards others – love (Col 1:3,4). We hoped for salvation and help (I Thess 5:8 and Ps 130:7)). We expected – an expression of our hope – that God would help, accept, forgive, take as His children, and give us rest (Ps 42:5, Ps 62:5). That led us to place our faith in Him, and in time brought out the fruit of His spirit’s presence in us – love. This hope in the all-sufficiency and benevolence of God is not just for us, personally. We also know that all creation is, to paraphrase Rom 8:21-24, waiting in hope for liberation from its bondage to decay, and to be brought into the freedom and glory intended for it. We know that this will happen as God reconciles the whole world to Himself through Christ’s blood (Col 1:20). Seeing ourselves as part of God’s mission to set the world free, (a hopeful project, if ever there was one!) both as objects of His compassion and his agents, ambassadors and harbingers of hope, can be exhilarating.
Second, our hope is Christ-centric. There is no other generic reason for our hope. It is centred on Him, His sacrifice and what it means to us. (Titus 2:13, Col 1:27). Because of Christ’s work for us, we can hope for salvation (John 3:16, 17) and to be – God’s children (John 1:12), made new in our inner beings ( 2 Cor 5:17), able to enter God’s presence boldly (Heb 4:14-16) and to be more like Him as we obey Him (2Cor 3:18). We can hope to pray and be heard (John 14:13), because we pray in and through Him, for our world and all its people. Since our hope is centred on the infinite cosmic Christ, life can be far greater than we ourselves imagine. We can hope to have Christ in us, and hope for glory! No wonder, such a great hope brings joy and renews our devotion and love to such a wonderful saviour.
Third, hope is a continual attitude towards our temporal life. There is, ideally, no justification or place for cynicism and despair in a Christian’s life. These do happen, as we are fallen people, struggling with biological, emotional and spiritual issues. However we must recognise these as undesirable aberrations and deal with them. Having begun with the hope of God’s acceptance and love, we are to continue in that same hope, to know He will never let us down, He will always be with us, watch over and delight in us (Zeph 3:17) and never leave us alone (Heb 13:5). The Lord’s prayer (Matt 6:9-13) sets the tone of hope in every sentence. We worship Him with reverence, hoping He will bring in His kingdom; that people would obey and worship Him here on earth as He is in heaven; this hope encompasses the darkest depths of depravity that our society could sink to. Christ, the source of our hope, is greater and able to bring change into the darkest situation and so we pray that he will keep us safe from temptation and help us avoid evil. We pray in hope that He will meet our needs even as we continually walk with Him, growing in holiness, asking forgiveness for our sins, even as we love and forgive those who wrong us.
Fourth, hope is both long-term for the future, as well as for the here and now. All passages on hope set expectations for both the mundane day-to-day life on earth, and for the future and the after-life. We hope for salvation, and acceptance into God’s family now, on the basis of Christ’s finished work for us. We hope for His help in dealing with our present troubles, and for His kingdom being established in our world, even in our little corners where we work and pray in the present. We hope for answers to prayer and being able to share His love with others right now. We hope to know Him more and become more like Him in the present, day-by-day. We also hope for deliverance and redemption from sin now and eternally and to be in His presence for ever when we die.
Hope that helps us in these hard times
So how would we manifest hope to those without hope? Those under stress, those despairing, those having mental illness?
First, hope would be intricately bound to prayer for the things we hope for and in actively working for these things to come about, as doers of the word. Each time, the word ‘hope’ is used in the following paragraphs, we should imagine the prayer and our active obedient involvement, as being linked to that hope.
Second, hope is based on who God is, and His promises. Sometimes, the fulfilment of our hopes may not be immediate, as Hebrews 11 describes. We experience this even as we hope and pray for ourselves, our country and the world. God’s plans and purposes for humanity is beyond our limited understanding and the immediate. Yet, we know, from Scripture that His timing is perfect, His ways are always just and merciful, and His love for us infinite. He wants only to give us the best, a future and a hope. So hope persists, looks beyond immediate troubles, and suffering, always expectant.
These are some ways we would exhibit hope (and pray and act) for our world:
For the world around, we hope for change and an increasing growth of Christ’s kingdom and kingdom values, bringing spiritual life, and also, hopefully, improving the physical and social milieu we live in. We hope for Christians to be salt and light, helping to bring the healing and direction the world desperately needs. We hope for peace and harmony between peoples, for that is pleasing to God. We hope for leaders in all spheres of life to be wise, just, honest and sacrificial in their work. We hope for provision of basic needs and human rights to all people, especially the poor, women, children, the excluded castes and minority communities. We hope for recovery of shattered economies, restoration of jobs and new beginnings based on wiser choices.
For our churches, we hope for an increasing wisdom and understanding of God based on the scriptures. We hope for unity of all who profess faith, and that denominational and doctrinal differences would be handled with love and wisdom. We hope for the gospel to be shared with humility, freshness and relevance. We hope for attitudes and acts of humility, simplicity, sacrifice, inclusivity, gentleness, love and service to all people, especially those struggling with illness and loss at this time.
For our families, we hope for unity, love and peace to reign between members. We hope for provision of basic necessities, including food, shelter, work and loving care for all members, especially the children, the elders, those with special needs, and good relationships with the extended families and communities.
For the world struggling with illness, including COVID, we hope for good, caring, affordable and effective treatment for all, including the poor. We hope for stream-lined services and safety for those providing them. We hope for dependence on God, strength and provision for the care-givers. We hope for a quick resolution, but in its absence for grace to bear discomforts and residual symptoms. For those families who lose loved ones to the illness, we hope for peace of mind, provision of care and support from their friends and family. We hope for accurate scientific information to be disseminated, and a vaccine to be found with speed but with all due care.
For those struggling with stress or mental illness, we hope for people to reach out with the message of concern and hope. What forms would those take, to those suffering in times of illness, financial and family problems? Concern would be expressed in giving a listening ear that is truly attentive, a shoulder to cry on, a home to come into and rest, a meal to share and bond over, perhaps financial aid and shared resources to tide over the crisis period.
What hope can we share with them? Rather than promising quickly that they will be okay, first acknowledge their pain and distress – it actually helps a lot for their mental distress to be taken seriously – and offer to help them and encourage them to get the aid or therapy they need. Never blame them, or berate them for lack of faith and so on; also don’t give up, no matter how hopeless the situation seems, even to you. Try to communicate hope : that this situation may be remediable or at least handled in a positive way, and should be actively dealt with. Some people (such as those ill for two weeks or more, or those severely ill, or suicidal, or showing bizarre symptoms), may need medication, and this should always be addressed earlier rather than as a last resort. Many would need other structured forms of therapy from trained people which would help them work through the stresses and issues that are prominent. People with anxiety, depression, stress disorders, substance abuse and delusional disorders often respond very well to a combination of medication (which stabilises the chemical surge in their systems), psychotherapies such as cognitive behavioral therapy and supportive counselling.
A lot of care often falls on family, friends, and concerned others, such as church friends or pastors. Their role of bringing hope and comfort to the distressed is important. In addition to the medical and therapeutic care some need, all persons would benefit from the hope that they are not alone, as they thought or feared; that they have a friend who will be with them and help them through, and perhaps they will even realise they have a greater Friend who will be with them, and help them in the midst of their distress. All persons would also benefit from the hope that they are loved and precious to someone, who is taking the effort to help them. Barring a few, most mentally stressed persons would not object to being prayed for, and to learn at some point that they are precious to God, to Christ.
Also needing hope and particular concern would be the families and care-givers of the mentally ill and stressed. They are often under tremendous strain themselves, and would also benefit from the hope that Christians can offer of help, having their service valued, and being encouraged to persevere in taking care of themselves and their loved one.
Christians can thus function as the friend who will walk with the family through the process, reflecting the God in whom we hope, who is our hope, and who comforts those in need of hope.
Human life can be difficult, and the world around dark and hopeless. Yet, those in Christ have a wonderful hope – the hope of forgiveness, loving reconciliation to God and a new creation renewed in Christ. For the world, similarly, Christians can hope for God’s intervention and for His kingdom and kingdom values to spread, as His people pray and work towards it. Though we cannot understand all that happens or explain the pain and suffering, we can cling to the hope that God hears and will answer our prayers for others and the world. That hope for personal and larger help from God can help us as we battle hard times, mental illness and pandemics.
May we, indeed, show an affirming flame.
Jamila Koshy is a psychiatrist by practice. She graduated from the Armed Forces Medical College (AFMC), Pune and completed her post-graduate studies in Psychological Medicine from the University of Bombay. She has served in the Indian Army. Jamila has contributed to many books and journals. The books “Side by Side” (SAIACS Press), “Talking Families”, “Should I Care?”(ISPCK, Delhi) and Public Theology: Exploring Expressions of the Christian Faith (Primalogue & TRACI) are part of the initiative in group writing on issues of contemporary concern.