This Mental Health Awareness Week, Hannah Waite reflects on how the psalms can help us understand mental health experiences. 13/05/2021

“Why are you cast down, O my soul, and why are you in turmoil within me?”[i]

These words are taken from the Book of Psalms: a collection of songs, many of which were used in the ritual and worship of the ancient Jerusalem Temple (now destroyed), which together make up the longest book in the Bible by number of verses (and third–longest by number of words) and the book of the Old Testament which Jesus quoted more than any other. Psalms contains a song for every mood, whether worry, distress, joy, celebration, or relief, and this passage, taken from psalm 42 (one of the so–called “psalms of lament”), expresses a level of turmoil and anguish that has become increasingly familiar to many of us over the past year. It is also more deeply reminiscent of an epidemic the UK was battling long before COVID–19 arrived: that is, the mental health crisis.

This week is Mental Health Awareness Week, and in the UK, mental health challenges and diagnoses have risen drastically in the last two decades, with a 20% increase between 1994 and 2014, and those numbers are continuing to rise. As the prevalence of mental health has risen across the whole of the UK, there are differences among the nations, with the Welsh population having the lowest prevalence of mental health challenges (at 13% of the population). Meanwhile, 1 in 4 people in Scotland and England experience a form of mental health challenge, while Northern Ireland overwhelmingly has the highest prevalence of mental health challenges in the UK (25% higher than the rest of the UK).

As we have traversed in and out of national and local lockdowns, it is no surprise that 60% of adults and 68% of young people stated their mental health got worse. While many people are excited about restrictions easing, reconnecting with family and friends, eating out and going shopping, there are some to whom this brings on waves of anxiety; for some, indeed, it might actually perpetuate feelings of loneliness and isolation to see images of people socialising.

After all, we have spent the best part of a year confined to our homes, and isolated from in person conversations with those outside of our house. When thinking about the past year in those terms, it is no surprise that people may feel they have lost the art of conversation, and the ability to be vulnerable and honest about their emotions.

This may feel like a new crisis – but here, the ancient Book of Psalms offers an unlikely resource for weary souls. For religious and non–religious people alike, the psalms, and especially the psalms of lament,[ii] can be read as beautiful pieces of poetry, expressing human struggle, sorrow and grief. Especially in an age of social media, where appearance and image is everything, they speak with an intensity and honesty of emotion that is rare, and which perfectly captures the anguish of the heart in times of need:

Save me, God, for the waters have reached my neck. I have sunk into the mire of the deep, where there is no foothold. I have gone down to the watery depths; the flood overwhelms me. I am weary with crying out; my throat is parched.[iii]

Whether or not we cry out to God to save us, or cry out to those around us or even, as I have done, cry at the top of a mountain, the psalms can help us to articulate inner turmoil and suffering. The language within this psalm creates a tangible connection to the physical and emotional distress of the writer. We can relate to feeling overwhelmed, that the water is up to our necks, that we are in the depths, crying out for help with a painful throat and raspy voice.

Consider the social isolation and distress within this sentence: “You have taken away my companions and loved ones. Darkness is my closest friend.”[iv] Or the depiction of hopelessness in psalm 42: “my tears have been my food day and night.” The psalms are filled with an authenticity of emotion, and do not shy away from the complexity and intensity of such emotions. Rather, the language of the psalms portrays a genuineness of experience, and in so doing, the psalmist gives language to the extremities of human emotion and human experience.

In her book Darkness is my only Companion, the Christian priest and chaplain Kathryn Greene–McCreight depicts a connection between her experience of bipolar disorder and the language and imagery of the psalms. In her experiences with depression, she sat in the darkness of psalm 88, the inner turmoil of psalms 40, 42 and 69, and the abandonment and loneliness of psalm 142. Thus, Greene–McCreight found solace and support in the timeless writings of the psalms, as they provided a language for her to think through her own experiences in the modern day.

Moreover, it is not only specific psalms or the language of the psalms that can provide deeper insight when it comes to discussing mental health. The structure and sequence of the psalms themselves are also valuable as we make sense of the twists and turns of our own emotions. Walter Brueggeman, a renowned Old Testament theologian who has written extensively on the psalms, highlights a three–fold structure of the psalms: orientation, disorientation and reorientation.

1.       Orientation – These psalms speak of a way of being in the world that is safe, and secure. Psalms that fall into this category include 8, 23, and 24.

2.       Disorientation – These psalms speak of a period of distress which leaves the psalmist lost from their previous orientation. These periods are often turbulent; the psalmist is no longer present in the world the way they once were. Brueggeman describes such psalms as “the voices of those who find their circumstances dangerously, and not just inconveniently change. And they do not like it. These are the speeches of caged men and women getting familiar with their new place”.[v]

3.       Reorientation – These psalms relate to a movement from disorientation into a newly formed life, or a new mode of living. It is in this new mode, or reorientation, that a profound change has taken place in how the psalmist views their situation. There is no obvious reason for this change, but the psalmist moves from the language of lament to languages of joy.[vi]

Understanding the psalms in this way is beneficial for thinking about mental health challenges, as the psalms of disorientation provide a language and way of talking about the distressing, hurtful and lonely experiences of mental health challenges. Thinking of periods of disorientation within mental health challenges does not detract or undermine the painful and difficult part of having a mental health challenge, nor does it try and make someone move out of this experience when they are not ready. Rather, it lets people sit in this difficult space but holds out hope that there will be a time where this experience will no longer be as distressing or disorientating.

If we think of this in a cyclical way (as many mental health challenges are cyclical in experience) it does not mean that once an individual is re–orientated, they can no longer experience disorientation. Rather, if we utilise Brueggeman’s insight into this cycle, it may enable us to think of mental health challenges as a cycle and/ or experiences that depict orientation, disorientation and reorientation.

Understanding the Psalms in this way demonstrates how the psalms touch on the ever–changing nature of the human condition and mental health honestly. If we revisit the psalm at the start of this piece we see the psalmist move from such distress and disorientation, to a period of reorientation in the final verse:

“Why are you cast down, O my soul, and why are you in turmoil within me? Hope in God; for I shall again praise him, my salvation and my God.”[vii]

Perhaps then when it comes to discussing mental health challenges the psalms can teach us two things. First, they provide a language in which to discuss one’s emotions and experiences. Secondly, they give us a new framework in which we can think about the experiences of mental health, as they help us to understand that sitting in moments of lament are incredibly difficult, but valuable, as they can help us – in due time – reorientate ourselves towards the possibility of hope.

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