4. A few principles can guide you about medical and psychiatric care.
Pastors aren’t expected to be medical professionals, but they must take into account that care for the soul and care for the body often overlap. So as you counsel, here are a few principles you should remember:
- If there are noticeable changes in emotions or intellectual abilities after age 40, refer the person to a physician. By this age, our emotional and intellectual abilities will loosely follow recognizable patterns. If a person is suddenly depressed or has emotions that fluctuate wildly, and those changes are unprecedented, then you ought to refer that person to a physician. There are medical conditions and medication side effects that can precipitate these changes.
- If someone is taking psychiatric medication, it means something is hard. Your job is to understand their suffering and encourage the person’s relationship with Jesus in the midst of it. Psychiatric treatments are unlike most other medical care in that an underlying physical problem is unclear. This distinction, however, is not an important one for you. You don’t give advice about psychiatric medication. If a person seems to have more problems after taking medication, then encourage contact with the prescribing physician, but there’s nothing more you need to do. It’s enough to know that something is hard in the person’s life, and, as with other chronic sufferings, you aim to help them with regular, even if brief, encouragement and prayer. When the form of suffering is unfamiliar or unknown, don’t be afraid to ask for help from someone with experience.
- If a person might benefit from psychiatric medications, there’s no harm done in encouraging that person to speak with a physician. In our present environment, most people already know about psychiatric medications, and likely, a few friends have already made the suggestion. But perhaps your church members don’t fit the cultural profile, and perhaps they’re reluctant to consider psychiatric care. Would you ever suggest it? Wisdom demands that you simply seek advice when you are uncertain. Consult with those in your congregation who have experience, or consult with a trusted physician who can give you guidelines.
5. Given the increasing need for pastoral care, you must equip others.
The apostle Paul explained it this way.
Lay ministry is an extraordinary happening and one of the premiere blessings of Pentecost. No longer do people need a special anointing to offer a prophetic word of direction and wisdom. In the new covenant, the Spirit has been given to all who have put their faith in Jesus. God is pleased to have the church build one another up and mature through the ministry of weak people who seem unqualified in the world’s eyes (1 Cor 1:27–29).
Most likely, this is already happening in your church. People share their struggles with each other. People pray with each other. This is almost certainly happening among the women in your church; sometimes, it’s happening with the men. As their pastor, you want it to happen more, and with growing love and wisdom.
As you set out to further equip your church, here are two questions to consider. First, how can you grow a church culture in which people are open about their struggles? This has implications even for the way you preach and how the leadership engages with each other. The mutual care of souls will only happen in a church that assumes we all have struggles and invites people to be open with them.
Second, what are the basic skills that everyone in the church should be growing in? Here are some possible essentials you could consider.
- Speak less and listen more.
- Follow the person’s feelings because they will usually lead to what is especially important to them.
- When you don’t know what to say—pray.
- Make meaningful connections between the struggles of life and Jesus.
This era is full of personal struggles. Some of these struggles are not new: anxiety, depression, addiction, shame and anger. Others are more recent, such as Internet addiction and some psychiatric diagnoses. But all of them can be helped by meaningful engagement in a wise and loving local church.
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Check out Ed Welch’s newest book, Caring for One Another: 8 Ways to Cultivate Meaningful Relationships (Crossway, 2018).