Monthly Archives: June 2015

06/5/15

Our Union in Communion

© Albanili | Dreamstime.com

© Albanili | Dreamstime.com

Around noon on October 31, 1517, Martin Luther nailed a Latin poster onto the door of the Castle Church, commonly used in Wittenberg as the public notice-board. Luther’s poster was an invitation to a debate on the ninety-five topics listed there. The debate was never held. But within the matter of a few months, Luther’s Ninety-Five Theses was being read and debated by thousands of people all over Europe. The Protestant Reformation had begun.

South of Wittenberg in the Swiss city of Zürich, Ulrich Zwingli began his public ministry there on January 1, 1519. His preaching had so impressed some pilgrims to the Abbey of Einsiedeln where Zwingli was the chaplain, that he was offered a position as the people’s priest at the Great Minster in Zürich. At the time, Zürich was a republic of about 7,000 people with a reputation of being both a prosperous and licentious city. Church historian, R. Tudor Jones, cited a comment by another Swiss reformer, Heinrich Bullinger, who said Zürich was to Switzerland what Corinth was to Greece.

Zwingli began his ministry with a series of sermons that expounded the New Testament, beginning with the gospel of Matthew. Although this would not seem radial or innovative to a modern congregation, it was at that time. Especially as Zwingli proposed that the meaning of a Biblical text was best explained by the Bible itself. Reading Luther’s books in 1519 was a great help, assuring him that he was not alone in what he preached and taught. Zwingli would develop an evangelical doctrine that agreed in most essentials with that of Martin Luther—with what became one major exception. R. Tudor Jones said:

Both reformers were agreed on the importance of justification by faith alone and the authority of the Bible, but disagreed about how precisely biblical standards were to be applied in detail. And both disagreed on the question of Christ’s presence in the Eucharist. In Zwingli we have the roots of the ‘Reformed’ tradition that was to be developed and enriched by Calvin.

In 1529, there was a conference arranged in Marburg between German reformers, led by Luther and Swiss reformers led by Zwingli. There was a surprising measure of agreement between the two parties—except on the Eucharist. Lutherans insisted on the physical presence of Christ in the sacrament, but agreed that whatever its nature, apart from faith it was of no value. Zwingli agreed that there was something more than just a memorial to the celebration of communion, because there was a spiritual communion with Christ.

The Lutherans proposed a formula of concord, which the Swiss rejected because it did not explicitly state that the presence of Christ in communion was only spiritual. Luther was ready to accept a Swiss proposal to accept each other as Christian brothers and practice intercommunion, until Melanchthon reminded him that this proposed union would close the door to any hope of reconciliation with the Catholics. In contrast to a belief that the bread and wine of the sacrament were a sign or a figure, Catholics held to transubstantiation, that the bread and the wine used in the sacrament of the Eucharist was in actual reality the body and blood of Christ. The conference ended without an agreement.

Zwingli was later killed on October 11, 1531 in a battle against Catholic forces. His body was burned as a heretic. According to Roland Bainton, Luther saw Zwingli’s death as a judgment for taking up the sword on behalf of the gospel. The tragedy here is that despite being so close on all other matters of theology, what was supposed to be a celebration of the unity of believers in Christ, became a stumbling block for these two Protestant Reformers.

In First Corinthians, Paul pointed to how those who partook of the cup and the bread in the Eucharist participated in the body of Christ: “Because there is one bread, we who are many are one body, for we all partake of the one bread” (1 Cor. 10:17). When believers jointly participate in the one bread, they witness to their unity with one another in the benefits of the death and resurrection of Christ. According to Ronald Fung in The Dictionary of Paul and His Letters, “Partaking of the cup and the bread in the eucharist means participation in the blood and the body of Christ (1 Cor 10:16), that is, in the benefits of his death and in fellowship with him.”

In 10:16 Paul asked two rhetorical questions that he expected his readers would answer affirmatively: the cup for which we give thanks and the bread which we break, are they not participation in the body and blood of Christ? So they should not partake of both the table of the Lord and the table of demons (1Cor 10:21). At least in the Temple to Asclepius in Corinth, there were dining rooms used for social and religious communal meals (see Ancient Healing Rituals). So the Corinthians were faced a dilemma. They had to choose—either partake of the cup and table of the Lord, or dine with the idolaters in the temple of an idol. They couldn’t do both. As Simon Kistemaker said in his commentary on First Corinthians:

When the Corinthians drink from the cup and eat of the bread during the Lord’s Supper, they indeed have communion with Christ. Because they have fellowship with Jesus Christ, they ought to have nothing to do with idols. No one can serve two masters (Matt. 6:24; Luke 16:13).

The unity Paul argued for here within his use of the body metaphor (we who are many are one body), is more than simply the unity of Christian believers who are members of the same church. It was for the solidarity of believers “as one body in union with Christ.” When Christians share the Lord’s Supper, they become one with each other and with Christ. Richard Baxter said of the Lord’s Supper:

Nowhere is God so near to man as in Jesus Christ, and nowhere is Christ so familiarly represented to us as in this holy sacrament. Here we are called to sit with him at his table, as his invited welcome guests; to commemorate his sacrifice, to feed upon his very flesh and blood; that is, with our mouths upon his representative flesh and blood, and with our applying faith upon his real flesh and blood, by such a feeding as belongs to faith.

06/3/15

A Brilliant Life and Sudden Death

© semmickphoto | 123RF.com

© semmickphoto | 123RF.com

John Nash and his wife Alicia died in an automobile accident on May 23rd, 2015. Nash was associated with Princeton University since the late 1940s, where he received his doctorate in 1950. He was 22 years old and had written a dissertation that contained what came to be called the Nash equilibrium. This work eventually led to him receiving the Nobel Prize in Economics in 1994. One of the most brilliant mathematicians of the twentieth century, his theories are used in economics, computing, evolutionary biology, artificial intelligence, accounting, computer science, politics, and military theory. And he struggled with schizophrenia.

I was introduced to the life and struggles of John Nash, the Princeton mathematician, when I saw the 2001 movie “A Beautiful Mind.” Soon afterwards I taught a Sociology course that had a section on mental illness where I showed the documentary,  “A Brilliant Madness,” which was about his contributions to mathematics and decent into insanity. It struck me that the radical changes in my thinking about psychiatric medication and treatment occurred over the fourteen years since I learned about John Nash. I can’t say his life story instigated that change, but it has been part of my journey. So to hear of his death came as a shock.

So I’ve re-watched “A Brilliant Madness” (available here on YouTube), and decided to use a reflection on his life to frame an article I intended to write. The article is about sudden unexplained death and other health problems related to a drastically shortened lifespan for people with mental disorders. The fact of a shortened lifespan is widely acknowledged, but whether or not it is due to the long-term use of psychiatric medications is in dispute. What follows is a series of brief reports and reflections on some of the existing research.

According to a recent meta-analysis reported in Jama Psychiatry, “Mortality in Mental Disorders and Global Disease Burden Implications,” people diagnosed with mental disorders are twice as likely to die ten years younger than the general population. Mad in America reported that over two-thirds of the deaths were due to natural causes. Psychiatric drug use was not studied as a possible contributing factor to early mortality. However, they did find that people who spent longer times in psychiatric hospitals were even more likely to die younger. At least one individual said the findings were vastly overestimated. Yet another person commented it was by far the lowest estimate of the shortened life of individuals diagnosed with mental disorders in decades. She also pointed to a 2006 report by the National Association of State Mental Health Program Directors that supported this claim, “Morbidity and Mortality in People with Serious Mental Illness.”

The report found that people with serious mental illness (SMI) died, on average, 25 years earlier than the general population. Suicide and injury accounted for 30-40% of the excess mortality, but “60% of premature deaths in persons with schizophrenia are due to medical conditions such as cardiovascular, pulmonary and infectious diseases.” Mortality rates for cardiovascular disease, diabetes, respiratory disease and infectious disease were said to be several times those of the general population. The association of the mortality rates for the SMI and atypical (second generation) antipsychotics is hard to miss. Looking at the introduction of the atypical antipsychotics since 1991, they said:

The second generation antipsychotic medications have become more highly associated with weight gain, diabetes, dyslipidemia, insulin resistance and the metabolic syndrome.

Appleby et al. reported there has been controversy over the possibility of sudden death in people using antipsychotic medication since 1970. Reinert and Hermann speculated as far back as 1960 that the sudden unexplained deaths of five individuals receiving chlorpromazine (Thorazine) could have been due to the drug.   Subramaniam et al. reported that there was an overwhelming body of evidence that patients with serious mental illness are at a significantly higher risk for cardiovascular illness and death than the general population. A 2011 review by Foley and Morley found that the risk of cardiovascular disease increased after the exposure to any antipsychotic drug.

Psychotropic medications can have a variety of effects on the heart, ranging from hypotension and tachycardia [a heart that beats faster than normal] to more severe problems such as arrythmias [irregular heartbeat], bradycardia [a heart that beats slower than normal] and sudden death.

CNS Drugs did a comprehensive literature review of atypical antipsychotics and their metabolic effects. The review found that atypical antidepressants differed in their effects on weight and obesity and on blood glucose and lipid levels. Clozaril and Zyprexa were associated with a substantial risk of weight gain and an increased risk of developing diabetes.

Risperdal and Seroquel are associated with a mild or moderate weight gain. Although they do not have any direct evidence of an increased risk of diabetes, there is an increased risk factor due to the possibility of weight gain or obesity from the drugs. Geodon and Abilify were associated with minimal weight gain. Data on the risks of diabetes or high cholesterol was limited.

Joukamaa et al did a long term, 17-year follow-up study of 99 individuals with schizophrenia. They demonstrated a greater risk of dying if the individual was taking more than one neuroleptic (antipsychotic) drug. This was said to be a replication of a study done by Waddington et al. in 1998. They concluded: “Future research needs to determine whether the high mortality among those with schizophrenia is mainly attributable to the disorder per se or to the antipsychotic medication.”

On the other hand, a study by Manu et al did not find that unexplained death was associated with higher utilization of first generation or atypical antipsychotics. They did suggest that the role of diabetes and high cholesterol as risk factors for sudden death in psychiatric patients needed careful longitudinal studies.

John Nash was hospitalized several times and took medication sporadically between 1961 and 1970. He was reunited with his then estranged wife, Alicia, and never used another psychiatric medication. He also was never hospitalized again. Nash said he never went to a hospital voluntarily. “I didn’t feel that I belonged locked up.” The film, “A Beautiful Mind,” wrongly implied he was using newer antipsychotic medication when he remitted from his illness. When Nash died, he was 86 years old and hadn’t used medication for forty-five years.

Nash saw madness as a kind of escape. He said: “To some extent, sanity is a form of conformity; and to some extent people who are insane are nonconformists.” The DVD for “A Brilliant Madness” contained an interview with John Nash where he reflected on various aspects of his life. Once when discussing with a friend how such a brilliant mathematician could believe he was hearing aliens speak to him, Nash said those thoughts came to him the same way his thoughts on mathematics came. So he took them seriously. Reflecting on that earlier time during the interview, he said: “Jumping to an incorrect conclusion about causality when you see a correlation is the most often made logical mistake.”

The evidence connecting sudden death to psychiatric drugs is not conclusively causative at this point in time. From my reading of the above and other material such as Anatomy of an Epidemic by Robert Whitaker, I’d say it is strongly correlationa; and I wait for the day when it is conclusively causative. You can read a short bio of John Nash on the Princeton University website here. I’ll close with one final quote from John Nash that spoke to me, taken from his biographical essay on the Nobel Prize website:

At the present time I seem to be thinking rationally again in the style that is characteristic of scientists. However this is not entirely a matter of joy as if someone returned from physical disability to good physical health. One aspect of this is that rationality of thought imposes a limit on a person’s concept of his relation to the cosmos.

06/1/15

The God of the Preachers

© Soul by Lom | stockfresh.com

© Soul by Lom | stockfresh.com

On December 11, 1934, a thirty-nine- year-old man named Bill was admitted to the hospital for the fourth time in fifteen months because of his alcoholism. As the withdrawal effects of alcohol wore away, a former drinking buddy, Ebby, came to visit. At the time, Ebby was in the midst of an extended period of abstinence. He had looked up Bill a month previously to renew their friendship and to tell him about his abstinence. Bill noticed the difference in Ebby immediately because he refused the offer of a drink. When Bill asked him what had happened, Ebby said, “I’ve got religion.”

Ebby then told Bill how he’d almost landed in prison, but had his own encounter with a few men from the Oxford Group who became sober by practicing its principles. Ebby said he gave the program a try and it worked for him. He stopped drinking. Bill wanted the sobriety Ebby had, but he couldn’t believe in the God Ebby talked about. After Ebby left his hospital room, Bill fell back into a deep depression. Ahead of him, he saw only madness and death. Science, the only god he had at the time, had declared him hopeless. Without faith or hope, he cried, “If there be a God, let Him show Himself!”

Suddenly his room was filled with a white light. He was seized with an ecstasy beyond description. Every joy he had known was pale by comparison. Then, seen in the mind’s eye, there was a mountain. I stood upon its summit, where a great wind blew. A wind, not of air, but of spirit. In great, clean strength, it blew right through me. Then came the blazing thought, “You are a free man.” . . . . “This,” I thought, “must be the great reality, the God of the preachers.” (From the A.A. conference approved book, Pass It On, pp. 111-125)

This man was Bill Wilson, one of the cofounders of Alcoholics Anonymous. As he retold this spiritual experience in the years to come, he’d add that never again did he doubt the existence of God. He also never took another drink.

When Ebby returned for another visit, he wasn’t sure what to say about Bill’s experience. Ebby himself had neither stood on a mountaintop nor had he seen a bright light when he stopped drinking. But he did give Bill a book that others suggested might help him begin making sense of his encounter with the “God of the preachers.” That book was The Varieties of Religious Experience by William James. Bill started reading it the moment Ebby left his hospital room.

Bill said he gleaned three principles from reading William James. First, spiritual experiences like his were the product of utter desperation when all human resources have failed to solve the problem. Second, this experience involved the open admission of that defeat. The person admitted his own defeat as utter and absolute. Third, there was an appeal to a “Higher Power” that could take many forms, “and it might or might not be in religious terms.” From his initial reading of James, Bill was exposed to the idea that a spiritual experience was not necessarily a religious one, that spirituality was not necessarily religion, and that a Higher Power did not have to be the God of the preachers. This distinction became a cornerstone expression of what was to become the spiritual (but pointedly not religious) program called Alcoholics Anonymous.

When Alcoholics Anonymous (the “Big Book” from which the movement took its name) was first published in 1939, chapter one told “Bill’s Story” of how he first became sober. Interestingly, he did not retell his so-called “hot flash” encounter with the God of the preachers. Bill related Ebby’s assertion that he was sober through religion, and that he’d come to pass his experience on to Bill—if Bill cared to have it. As Bill recounted his personal struggles with religion in the Big Book he wrote, “I had always believed in a Power greater than myself.” Despite the “living example” of Ebby before him, Bill said, “The word God still aroused a certain antipathy.”

Ebby suggested that Bill choose his own conception of God. The suggestion hit him hard, melting his “icy intellectual mountain” of doubts. “It was only a matter of being willing to believe in a Power greater than myself. Nothing more was required of me to make my beginning.” This ability to imagine God to be whatever an individual has imagined Him to be has remained a hallmark of the spiritual worldview of A.A. In a 1949 address before the American Psychiatric Association, Bill Wilson explicitly stated that A.A. was not a religious organization because it had no dogma. He also stated that the only theological proposition—of a Power greater than one’s self—would not be forced on anyone.

In 1961, Wilson wrote in the AA Grapevine, “Our concepts of a Higher Power and God—as we understand Him—afford everyone a nearly unlimited choice of spiritual belief and action.” He suggested that this was perhaps the most important expression to be found in the entire vocabulary of A.A. Every kind and degree of faith, together with the assurance that each person could choose his or her own version of it, opened a door “over whose threshold the unbeliever can take his first easy step into the realm of faith.” (“The Dilemma of No Faith,” AA Grapevine, April 1961. The AA Grapevine is the international journal of Alcoholics Anonymous)

This remains true today in AA. The December 2006 edition of the AA Grapevine has an article by a Muslim member of A.A. who was fearful that while sobering up, he would be “transformed into a Christian through osmosis.” He reported that nothing could have been further from the truth. “As a Muslim AA member who received a miraculous spiritual awakening in an Anglican Church basement, I am eternally grateful to the Fellowship of Alcoholics Anonymous.” (“Along Spiritual Lines,” AA Grapevine, December 2006).

When I first read of Wilson’s encounter with the “God of the preachers,” I wondered what difference it would have made if Ebby had brought Bill a copy of the Bible instead of The Varieties of Religious Experience (VRE). But now it seems to me that it would have made little difference in the eventual formulation of spiritual experience in the Twelve Steps. Although the distinction between ‘spiritual’ and ‘religious’ found in VRE seems to have been popularized within the Twelve Steps of A.A., non-alcoholics also read VRE, and the ideas they found there resonated with an emerging spiritual, but not religious sense of God and how we relate to Him.

This is the third of three related articles (What Does Religious Mean?, Spiritual not Religious Experience, The God of the Preachers) that more fully describes some of the influences I believe helped to shape the spiritual, but not religious distinction of 12 Step recovery.