Thomas highlights that mental illness is Psychosomatic in nature and affects both our body and mind, so steps should be taken to care for both the body and the mind.

Thomas, A., Tackling Mental Illness Together: A biblical and practical approach (Inter-varsity Press: London, 2017). xxii + 185 pp.

Professor Alan Thomas works for the National Health Service in England as a consulting psychiatrist and is a professor of Old Age Psychiatry at Newcastle University. Thomas is a medical academic who has published numerous research publications and articles concerning psychiatric work with the aging population, with a specific focus on dementia as well as neuroimaging findings regarding such illnesses. As well as a leading academic in his field Thomas is a Christian man who is faithful to Jesus and passionate about the body of Christ living as the body of Christ and caring for the least of these, specifically those afflicted with mental health struggles. Thomas shares his academic understanding of mental illness while drawing on the word of God to bring clarity and understating for people.

In his book Tackling Mental Illness Together: A biblical and practical approach Professor Alan Thomas presents his readers with a biblical understanding of mental illness, as well as providing practical examples for how to care for people. The foundational understanding of the book is that all human beings are image-bearers. We were created to be in relationship with God and with others, and to use the skills God has given in work. The experience of mental illness does not and cannot ever stop us from being an image bearer, therefore we should never view anyone with a mental illness as less than human. With this as the basis of his argument Thomas highlights that mental illness is Psychosomatic in nature and affects both our body and mind, so steps should be taken to care for both the body and the mind. Care is taken to discuss the etymology of mental illness, the change and development over time of mental illness and the use of medication and psychotherapy in treatment. The book concludes with practical and manageable examples of how to care for those in the church with mental illness.

Throughout the book, one of Thomas’ goal is to better equip the body of Christ to care for those in their congregation, and wider community who experience any form of mental illness. Thomas shares “It is written with conviction that such people are well equipped to provide help to those with mental illness” (p. XIII). Thomas writes in such a way that any member of a church congregation could read this book and be presented with an understating of mental illness and feel better equipped to provide support with specific examples of how. While there are sections of this book that speak in-depth about specific mental illnesses and their etymology (specifically chapters 8 & 9), there is substantial effort placed into the language used and definitions of terms to make even the most academic examples accessible to someone with no psychological training.

The final sections of the book focus on psychosomatic illness and severe mental illness. While significant attention is given to case studies and descriptions of these mental illnesses Thomas clearly communicates the importance of a “stepped care” (p.129) approach to caring for those with mental illness. While Thomas himself articulates that a “stepped care” approach is “employed widely in psychiatrist and medicine” (p.129), emphasis is placed not on those in the psychiatry or medical field engaging in a stepped care approach, rather on those within the church. Step one presented in this specific model is creating “supportive relationships” (p.130). Individuals are encouraged to engage with those within their church and built authentic trust-filled relationships. Thomas encourages the church not to pull away and refer (although this is at times very necessary) but to press in and build relationships. This is something anyone in the church can do. This book provides basic and achievable goals that the church can strive to in caring for those with mental illness. No longer is it foreign and scary, but the reader is shown that people struggling with mental illness need love and relationship, which are in fact central to living a Christian life.

While the central purpose of this book is to equip the church with knowledge on how to respond to and care for those who are struggling with mental illness, this book also provides the reader with a foundation to build a personal theology around mental health. Thomas states “To be human is to be God’s image. Mental illness damages our thinking, our emotions our volition and our relationships. But it can never erase our imageness” (p.17). Thomas highlights the importance that we were made in the image of God, and even when we are afflicted with mental illness, it does not take away from our dignity or worth, as we are still image bearers of God built for relationship with him and others. However, we are not only image-bearers, we are also given a role and a purpose. “The importance for us here is that work, creative and productive activity, is how human beings express our image” (p.21). Thomas discusses both creation and fall in great detail around why mental illness is present and how it affects us as humans living In a fallen world. Thomas’ approach to discussing the redemption and restoration aspects of the Gospel is not as specific but is still present. It is within the rule and relationship we were created for that we can find hope within mental illness, seeking relationship with God and his people and finding purpose in work. The importance of building a theology around mental illness is central to this book.

The structure of the book and the layout within each chapter draws attention to Thomas’ teaching background. Like any skilled communicator, Thomas knows how to build the need to draw his readers into a journey with him. While one could turn to the end of the book and read about specific mental illness’ and appropriate treatment, both professionally and pastorally, Thomas builds the need slowly and strategically. Chapter one sets the tone for the remainder of the book and gives us insight into the Authors view on “what” mental illness is. While the name suggests that mental illness is “mental” the reader is challenged into viewing mental illness as psychosomatic, incorporating both body and mind. As previously discussed, the following chapter gives the reader a chance to build their theology around mental illness. After the need is built and the tone is set, Thomas dives into specific implications of mental illness, historically, culturally and biblically. The final chapters of the book present the reader with case studies and examples for how to specifically care for those who are struggling. A highlight of each chapter is a section at the end where Thomas summaries the main points of each chapter. This gives the reader a chance to consolidate their learning and draw out the main points that should be remembered.

The use of medication is always a debated topic within Christianity as to whether individuals with mental illness should take medication. As Thomas states this is mainly due to the argument that medication is bad because it is “mind-altering (p.106) and because it is “mind-altering” it is “somehow sinful” (p.106). While it is very clear the stance of the book is medication is okay, and even at times incredibly necessary, it is Thomas’ response against the “mind-altering” argument which is interesting to note. It is claimed that Christians engage in mind-altering behaviour every time they attend church or read the bible, in that they allow God to “alter” their mind. It’s a bold claim to place taking medication and attending church in the same category of “mind-altering”, they are different in their nature and results. Attending church and reading the bible can result in a “renewing” of the mind, which is different to the effect that medication has on the brain. This argument could be a point of contention for some reading the book, and could have been

Freud and the unconscious is a topic often addressed when discussing mental illness, whether one agrees with the philosophy or not. Thomas strongly disagrees with Freud and his teachings and is very direct in stating that “… most Freudian teaching is error…” (p.45) and even goes as far to say that it is “myth. Not science” (p. 59). Thomas is clever in his critique of Freud and as a researcher provides evidence to why he believes Freud is wrong, mainly lack of evidence for psychotherapy working. Not only does Thomas critique Freud, but he presents the reader with a deeper and theological rich understanding of the unconscious. Thomas encourages the reader to think of unconscious thoughts as “overlearned” (p.  ) behaviours or thinking patterns that present themselves without our conscious awareness. These behaviours and thinking patterns can be destructive in nature and impact our mental health in a negative way, however by recognising these thoughts and behaviours individuals can “relearn” new ones. After presenting the reader with an opposing understanding of the unconscious, a biblical understanding is addressed highlighting that “we have hidden depths only the Lord can penetrate” (p.46). while Thomas addressed the fact that the bible does not talk about the unconscious, it does talk about the ‘heart’ and as Jeremiah states “The heart is deceitful above all things and beyond cure” (p.46) highlighting that there are times when even we do not understand our “unconscious” motivations. So as Christians Thomas states “… sanctification involves destroying bad unconscious habits…and replacing them with godly unconscious behaviours (initially with much conscious effort)” (p.53). Thomas persuades the reader to view this how we should be challenging our unhealthy thinking.

At times the language used by Thomas can appear quite judgemental in nature, lacking a graceful tact. At one point he states “other people are weaker mentally” (p.13) while he does go onto explain that every individual holds a different mental capacity and cope with stress differently, it was stated in such a way that could leave anybody who is “weaker mentally” to feel judged and even ostracized. While this was not the author’s intention in his communication, care should be taken not only in what is communicated and whether it is both psychologically and theologically correct, it should be communicated in a manner where the reader feels supported and seen. An alternative description could have included some background…

 Another example of judgemental language used in the book is when Thomas is describing the impact of parenting on Mental Health. Thomas states “a happy Christian home and biblical upbringing do provide the best start for people. It reduces our vulnerability [to mental illness]” (p.25). Once again while this statement is theoretically correct, the author is oversimplifying the impact of being brought up in a “happy Christian home” and not recognising the numerous other external factors that impact on an individual and their faith such as trauma, abuse or even biological factors. Instead, the author believes “Children reared in Christian homes should grow into the most mature individuals” (p.24) While this statement is correct in nature, once again it can ostracise people who were brought up in Christian homes and still developed a mental illness, they may begin to question their upbringing or even God, asking the question “why me?”. Then negative language used when describing parenting is highlight again when “bad parenting” (p.51) is blamed for the cause of destructive unconscious thinking and behaviour, which is a risk factor for mental illness. The language used is accusing in nature. One begs the question of why such emphasis is placed on parenting and early childhood as causation for mental illness? Thomas has been clear that he is completely opposed to Freud, however, just as Freud placed a huge emphasis on early childhood development, it appears Thomas is doing the same.

While at times the choice of language could be misconstrued as judgemental and harsh overall, the tone of the book was gracious and understanding in nature. Thomas gave significant care to building an in-depth understanding for his readers. Readers were encouraged to think for themselves and grasp the concepts at length, rather than be given a succinct summary. This book is aimed at Christian to assist those in their church with mental illness. While this book is written to assist pastors and teachers within the church, laypeople could read this book, engage with the teaching and be better equipped to better understand mental illness and care for friends and family.

Overall, this is a well-researched and well-written book with a solid biblical foundation. Where many aim to tackle the topic of Mental illness and Christianity from either a theological understanding or a psychological understanding, this book is a great example of integrating in-depth psychological understating with clear biblical insight. This book should be used as a resource by anyone who is a leader in a church.