 Okay, welcome back. We were looking at mental health is a particular issue that we wanted to look at for in particular areas of counseling, we are looking at mental health. We just did a bit of a brief introduction and I'd just like to go into a few more details about what is mental health, what are symptoms we need to be aware of the general kind of disorders that you see. And as people who are going to be in ministry, people who are going to be helping others, we need to also have some kind of an awareness of what mental health is and what is it that we can do. So as the World Health Organization has reported, the definition that they bring about is that mental health is a state of well-being in which the individual realizes what their own abilities, they're able to cope with different stressors that come in their life. They're able to be fruitful, they're able to be productive and also in turn contribute back to their community. Moving ahead to also look at certain facts about mental disorders is to know that these are basically statistics for us to see is that it can affect anyone, the men, the women, children, rich, poor. It's common. In fact, the statistics do show that at least one in four people in the population in general can have a diagnosable mental health issues and yes, one in five adults. The fact is that you may not really know that someone has a mental health disorder. They don't look very different from others. There may be only certain conditions that you are able to make out that there can be a mental health issue. It can range when you're looking at mental disorders, it can range from something that's very common to something that's extremely severe or something that's very mild to something that's really severe. And mental health disorders, it's not just about people feeling that they are stressed. It's a little bit more than that their inability to cope with regular day-to-day functioning, the fact that there are issues in their relationships. You will find that there are conditions in their physical well-being or physical functioning that is being affected. Mental health conditions or disorders can range from it being brief to it being long-term. It can affect different areas of life. It can affect people's work. It can affect people's relationships. It can affect the way that they see the world and see life in itself. Mental disorders can cause stress on the entire family, on a community at large also. But the fact is that there are effective forms of treatment when there are mental illness. So when we're looking at how do you label or understand what a mentally healthy person can do. A mentally healthy person can think clearly. They're able to build very strong relationships. They're able to cope with whatever stresses that there are in life, different challenges that come in life. They're able to cope with it and they are able to contribute and work in a community that they live in. This is how you would understand that a person has a stable mental health. When you're looking at mental wellness, there are nine signs of good mental health. Like we were talking about, mental health influences the way you think, you feel and you behave in daily life. It affects your ability to cope with stress, overcome challenges. It affects the ability to build relationships. It also affects the ability to recover from certain setbacks and hardships. So strong mental health is not just the absence of mental health problems. Being mentally or emotionally healthy is much more than just being free of depression or fear, free of anxiety or any other psychological issues. It refers to the presence of certain positive characteristics. Like there can be a sense of contentment, a zest for living and the ability to laugh and have fun. The ability to deal with stress, bounce back from adversity. A sense of meaning and purpose to learn new skills to adapt to change. Having a balance between different things, between work and play, rest and activity. The ability to maintain good relationships. The place where one can be confident and have a sense of hope and optimism. The ability to let go of painful issues to be grateful, to have a sense of humor. So there are many of these things that you would see that helps in a person's mental health issues. So what is mental health? It's when there is a negative impact on the way somebody thinks, on the way somebody feels and the way they behave. So these are the three major components to it. How a person thinks, how a person feels and how a person behaves. So if you were to look at certain signs, how do you recognize certain signs? What are the symptoms of mental illness? There can be illogical thinking. They are not able to process their thoughts in a way that is helpful. That's what we say when it comes to thinking. There could be problems in thinking or having clarity in the way that someone thinks. And as a result, it can affect their behavior. You will see a decline in their functioning, either at work or office or school. There will be a decline in it. And a lot of them come under the emotional patterns. There's nervousness or there's high anxiety. There is different shifts of mood, huge forms of mood swings. There is apathy or a loss of motivation, a loss of trying, being extremely sensitive. And this affects the behavior where there is changes in the patterns of sleep. There's withdrawal from people. There's withdrawal from the responsibilities. There's withdrawal from even personal interests that they have. And you would notice that there is a decline in the functioning. So these are some of the symptoms that you would recognize. What are some of the warning signs? And this I think is important for us to know to understand when does someone actually really require help. So like it says here, it's not very straightforward and because you can't test it like the way that you can test a blood sugar or a heart condition. There are certain symptoms that helps you see whether they are going through a sense of mental illness. So some of them are defined here but not all, but at least this gives you a good idea. So some of the warning signs are if there are reports of someone feeling sad, withdrawn for more than two weeks straight, then that's when you know that they need help. So there are times we all feel sad. We all feel withdrawn depending on some circumstances. It may go on for a period of time, maybe a day or two or three, but then you're able to bounce back into normalcy. But if there is a significant sense of sadness and feeling withdrawn, then there are certain signs of mental health issues. The fact that someone may try to harm or end their lives or even making plans. They're planning to end their lives or attempt a suicide. That's when there again, it's a warning sign or someone who has out of control risk taking behavior that causes themselves harm or self to others. Like those who may be in uncontrollable abusive substance abuse where they are not able to really discern whether that kind of a behavior is being helpful or not. Or there can be fear that is sudden fear over no reason. And there is absolutely no cause that they are able to save or which can be clubbed with some physiological responses like palpitations of the heart, discomfort or a difficulty breathing. When there's significant weight loss or gain, that's again another warning sign. Or they're able to see here or things, believe things that aren't real. And this is what we call is hallucinations where they feel people are talking to them or talking about them. Now, this can also be a sign of mental illness. Sometimes we shouldn't confuse this with evil spirits that people are engaging with evil spirits. So we've got to be careful and discerning in understanding what is being demon-possessed and what is it that is mental health or mental issues. Excessive use of alcohol or drugs is another warning sign. Changes in the mood, changes in behavior, significant changes in mood behavior, even in the personality is again another sign. Or extreme difficulty concentrating, not able to put attention to the tasks that are given or even bodies of fears that get in the way of daily activities. So these are certain, again, signs that we need to be careful about. Now, I've just listed, taken a snapshot of a picture that lists different kinds of mental health disorders. I'm not going to go into any of this. But if you're interested, I would suggest you do some reading to really understand this. Now, among the major mental health disorders in this category over here is what we would look at as mood disorders. Mood disorders are what you would say there are people who go through episodes of maybe having extreme high mood or extreme low mood. And that's what mood disorders are a major mental health disorder, psychotic disorders. The things that you see below that are disorders where they are outside of reality. They are not in reality and they perceive things that are very, very unreal. That again is again a major mental health disorder. Neurocognitive disorders is more organic in the result, which means there are some neurological disturbances that causes these kinds of disorders. And usually neurocognitive disorders definitely require medical help or medical interventions. The other addictions, addiction or disorders also can become major when someone is addicted to a substance. It can actually cause psychotic disorders or it can actually cause mood disorders in itself. There are other disorders. What is called as minor mental health disorders and all of the others form under that category. That's post-traumatic stress disorder after a certain trauma like maybe a catastrophe or a natural disaster or war or a personal difficult traumatic event. They're having a certain stress disorder that can come as a result of the stress. Anxiety disorders, having a sense of generalized anxiety, anticipatory fear over everything. Somatic disorders. Somatic disorders are things that they continue to feel that there is something significantly wrong in their health. And there are symptoms that they may bring about explanation to saying that it could be a serious physical issue. Personality disorders. Personality disorders are the way that people's personality are at a problem because they find it difficult to associate with different things in life and different relationships. Usually personality disorders come up largely in the midst of a relationship that people have personality disorders. Obsessive compulsive disorders is the obsessions of certain repetitive thoughts. Obsessive thoughts that continue to keep coming that causes distress, making them compulsively act on a certain behavior. That's again what we look at in minor mental health. Then dissociative disorders is where it isn't a representation of what is wrong but because of psychological disturbances that are there, there are certain conditions that act out. Then there are eating disorders and eating disorders where a lot of the disorders relate with food and their relationship with food. So these are some of mental health disorders and if you are interested more, it would be nice to just read these up to understand at least a few symptoms of how you can recognize some of this. Now when we look at mental health conditions, remember, let's not always look at either the person is mentally stable or the person is mentally ill. We see it in a continuum. So there are different stages. So initially there may be very mild symptoms and later the greatest stage is someone who has symptoms that are persistent and very severe that it affects their life. The idea of getting help is to ensure that they come down that continuum into a more stable head. So even a person with some symptoms of maybe low mood or symptoms of mild sadness, even though they are at a decided spectrum, that doesn't mean they don't need help. They also do require help so that it doesn't move up that continuum. It's to ensure that they get back into a more stable, more functional state. Something that we need to do is how can we reduce the stigma that's attached to mental health. The first and foremost thing is to be able to educate ourselves about what mental health is and especially because we are also in a place of ministry to also be very sensitive and careful about how we approach and how we help others with mental health issues. So educating yourself builds up a greater understanding of it. It is to show love and compassion to those who are mentally ill and not to stigmatize them, not to keep them away because of fear of how to respond. It's good to talk openly about mental health and that's something we must do because it's so much intricate into our well-being. Not to stereotype people with mental illness, to be respectful when you're talking about mental health and being able to role model. So how do we support people with mental health? And for all of us who are a part of ministry, it's important to understand how do we do that. So one of the things that we do is like we said, it's important to get educated to learn about the illnesses. It's also one is to be able to face your own fear and that sometimes to understand what do we think about mental illness? Do we feel afraid? Do we feel that there is a sense of unpredictability that's there? Is it demonic? So to really understand for ourselves what is it that we're fearing and bring it up to those fears to God and ask God to actually minister and help you to see this in a better light. To be able to also see that these kinds of mental health problems is something that is seen in the world around. And also to know that as believers and Christians we are not exempt from that. And to be sensitive about the fact of how we see mental health, we help those with mental illness. Also to be able to accept love those who are mentally ill to ensure that you see them as people, to see them as people who may need your help. We need your understanding. What else can we do? The other things of course is to be able to encourage them to get support and help that they need. Ensuring that even as we're praying for them, deliverance, praying for healing, all of them always encourage that they get any kind of help. If there is a possibility going with them for an appointment, making that first step of showing that you care and helping them speak with someone who's a mental health professional and also to be able to access other kind of services that are there. Apart from that, it's also to see how maybe as a person who's a minister, maybe there are certain limitations on your part because you don't know how to, what to expect, what to do. And that's perfectly okay. It doesn't mean you need to know everything. It's just being alongside with them, empathizing with them, being patient with them, working alongside with them is all that is required. And when we're not able to manage something, getting the help of a mental health professional to work with them is good. Getting family to help the person or, you know, sitting people in families to ensure that they can best help and not be in a place of judgment or a place of criticism while someone is going through that. And continue to support and stick with them even as they are receiving this kind of help. Because very often we do see, especially I think among our Christian community, I've noticed that people find it hard to seek help, even to talk to somebody about mental health issues. There is a fear that, you know, whether they would be seen as someone who doesn't have enough faith or don't believe in the goodness of God. But then as those of us who are in a place of ministry to be able to be patient and kind to them, even as they are going through the process of getting help, getting support, getting prayer, working alongside. It's important to just stick with them and see that they are supported and their help. I think another thing is also connecting them in the most sensitive and confidential way to other people who may be going through the same kind of issues so that there itself they can, you know, mobilize support and strength for one another. Okay. All right. Is there any question over here? Any thoughts, any questions before I move to the next part which is marriage and family? And this is some, we've reached some observations and what we could do. Any questions that I could bring up? No questions? Just a question. Have any of you all come face to face with people facing mental illness and maybe how have you dealt with it? Just maybe two, three minutes of just hearing from you as a learning experience for others. I'm sure all of you all would have met with someone who's had some of these conditions we spoke about today. So any thoughts? How did you deal with it? What have been your reflections? What did you do? I think bipolar disorder, people who are affected with bipolar disorder, when they speak, we would just maybe patiently listen to them for a long time. That is one of our experience. And I show them that we would be available in case if they want to talk at any point of time and also raise them to continue taking the medications if they are taking and pray with them. That's what the face we are in right now. Good. Yeah. That's a great place to be. Just supporting, helping, being with them, patient. That's wonderful. Good. All right. So I'll move on to the next one, which is another area of issues that we do see common issues that we see in counselling as marriage and family. Okay. I know you'll have a course in marriage and family and there's an entire, you know, a lot of chapters that we discuss over there. Here we're just looking at common issues that generally would come in families and couples. And as a counsellor, what are some of the things that you need to deal with? So certain issues that you would often find being presented to you is, and if you're, if you opened, I'm at page 43. I don't have a slide for the slides for these because they're very brief and as it's written here, it's basically to know that because people are different, the people in the marriage are different couples, personalities are different, there are bound to be conflicts, there's bound to be differences in the way that they communicate. There are going to be differences in the way they deal with their personal finances, the way that they deal with how they respond to crisis and stresses. And how they work together as a team. So you may see couples coming to you for help and communication in order to be able to support one another in different responsibilities of life. People may come with conflicts over money, conflicts over parenting, conflicts over infidelity, maybe adultery in the relationship and coming as a result of that. Other kind of things are, yes, issues of divorce, separation, illnesses as because as a result of mental or physical health issues that can be mental health or physical issues that can be disturbance within the relationship, there can be personality differences, maybe one person in the marriage has a personality disorder and as a result, there are common conflicts that arise. There could be unmet expectations that come about and as a result causing disillusionment within the family, within the marriage. Other issues of addictions, infertility, problems with in-laws, financial bankruptcy, housing issues, issues with jobs, so there can be a whole lot of concerns and issues that come about. And you would see even when you're looking at an extended part of the family is the kind of issues that children or adolescents face. So like we said, one big part is mental health among children, right? People, children with anxiety, children with mood disorders, with psychotic disorders, with OCD, all of this definitely require help medically also. Apart from that, you will have children or adolescents facing school challenges, either inability to cope with challenges at school, with anxieties that come up as a result, with pressure, peer pressure, with difficulties in learning. Now that again is another whole department of learning disorders, children finding it hard to write, to read, to do mathematics, to spell. All of that come under learning disabilities or any kind of anxieties that come about, separation anxiety, phobias, or even the inability to finding it anxious to go to school. So all of that comes under stressors in school. Now then also when it comes with children and adolescents with regard to their families, having parents who may be in continuous arguments, whether it's separation that's happened, whether it's divorce that's happened, there may be a mental illness among one of the family members. There can be death, there can be transitions of the job, transitions at work, moving to different cities. All of this can cause family stresses. There can be behavioural changes that you see in children having issues in their conduct, being deviant or defiant, being very oppositional in the way that they behave towards their parents. There are some things that you would see among children and adolescents. Adolescence, it's a greater, it's another area where as the children develop into adolescence, that stage of life having to cope with being able to cope, being able for parents to begin to see that the children are growing up, there is a need to build identity, there is a need for them to build into autonomy and the kind of issues that come about from that area. So when we're looking at working or dealing with multiple people in counseling, counseling with one individual itself is hard enough. Imagine when it's coming with multiple people, you're trying to work with each person in the family without being, without taking sides, without being judgmental, without providing advices, it can be something that can be a challenge. But there are certain guidelines if ever you are attempting to have family counseling or sitting a family together, is to know that every family member who's coming there needs to feel secure in your environment. So for example, let's say in a family where there is infidelity or adultery, that maybe one of the family members is in an adulterous relationship and you may have the parents as well as the children sitting there. Even the adulterous person there or the member of the family needs to feel secure in that place, because you're there to help and support the entire family, not join alongside with the rest of the family to pounce on the person. So that's not the idea. So one of the things that it's very important to do is while you're sitting in a family counseling, is to be a keen observant of what you are seeing as the inner dynamics that's happening in the family. And just by body language, just by the way, maybe they're seating positions, the way that they talk to one another, the way that they avoid looking, the way that they look, all will give you a better understanding to see what is the inner dynamics of the family, who's tearing up with who, who's against the other, what seems to be the relationship with one. So all of this can actually just be observed by taking a little bit of time to observe physically with your eyes through your vision, what's actually happening in that space. The counsellor here is not a referee. You're not there as a referee, neither are you there as a mediator, which means avoid being the middle person where you're taking information from one spouse or one family member into the counseling of another family member. You're not the mediator, that's not your job. In fact, something that I generally do is avoid having personally personal sessions with one person. If it's a family session, everyone comes together. Unless, of course, you know, there is maybe one off need where there is one person who's maybe very distressed and may need to show a little bit of support to them individually. Unless that's there, you tend to keep that as a, when you're not there as a referee, not there as a mediator, you're a facilitator. You're helping open up conversations. You're helping others see what are maybe the perceptions that they have towards the other person. So you are there as a person who is facilitating the communication, facilitating the way solutions can be come up to. Also, through a counseling session, it's important one is to find out what is the goals and the objectives of the family as they're coming in for counseling. So that's the first thing you need to determine is because each of them may have different goals. In the sense of one person may say, OK, I want to ensure that I change the person. The other may say, I want to work on the relationship. So it needs to be something that you come to a common goal. So the important question may be initially to ask is as part of our counseling or as part of this meeting, what do you want to see happen at the end of the session? So that actually makes them to think about what is it that they would want to build up and coming and listing. These are some of the goals that we would look into and let's start to explore and understand and then coming into action. It's important that each member of the family who's meeting with you should develop that sense of trust with you without feeling a sense of alienation from either from you as a counselor or from somebody else, someone else. And that's important to do, to be able to build the trust and the fact that also confidentiality that whatever is discussed will continue to be there and that you will not take this outside of discussion. That's why I meant when you're meeting families, never to meet them on an individual basis because it will almost feel that the other person seems not part of that entire process. So to continue to do that together as a group. Helping the families to, one is to really change the way they behave with each other. To be able to bring about the importance that every member of the family has a role to play in that relationship. Here it's, especially in a family setting, it's very important to get each member to personalize the problem. To come to a place to see where is it, what is it that they're contributing that can cause the issue. So they need to come to a place of saying that this is where they will do something that's going to help them help the whole system of the family. So can you just give me a minute and just a minute. So to end, what we're doing is to ensure that once they personalize the issue, we work alongside with them to change, to help them change behavior towards one another and towards the entire family. Next is, even as you're sitting with the family, to be able to draw wisdom and direction from the spirit, to know how to proceed, to be able to create that sense of oneness. Often, especially in situations where couples come together, where families come together. I've personally seen there have been many, many deadlocks. I come to a deadlock because there isn't a way to proceed, but to really, and that's the point you draw from God and say, God, I need direction of how to proceed. What is it that I can do to create this oneness over here? Give me the ideas or give me the understanding on how I can move forward with this. So just being able to get the wisdom from God, direction from the Holy Spirit. Now, when it comes to, especially a couple of, a Christian couple and establishing goals there, it's helpful to bring them back to scripture. And I would say, more than what you'd like to probably do or something that I'd like to do, is to bring about scripture and say, okay, this is what scripture says about the way maybe some issue in this relationship is how do we think we can live out the scripture? So rather than being in a place of advice, letting the word of God speak to them so that they are able to come to a place of understanding how they need to proceed. So especially for couples or families who are believers to be able to draw out from scripture and bring that back to them so that they are able to think and understand as to how they can move forward. So even as we've looked at all of these methods, remember that working with families, working with couples in itself can be draining, can be sometimes not very rewarding, but it actually matters just that you stand as a support system for the couple in itself can be a huge sense of help to them. Encouraging, praying, giving them a space to talk, giving them a space to actually communicate in itself is a huge source of help for them. If there are times that you're not able to handle it, it would be best to get the support of someone who can maybe work in a more detailed and a more intricate way with them. And usually we say that a couple or a family session, at least you need to have a couple of months of having those sessions to see some bit of change. And the expectation that within the first or the second meeting things will change, that that may be too lofty an expectation. So to ensure that they take that help, so encouraging a couple or a family to take that help over time to stay patient, to stay through the course is something that we as ministers can do. Okay, all right. We have 10 minutes. I'd like to open this up for any questions you all may have. 10 minutes of any questions. The class has been extremely quiet except for Pastor John. I think Divya and Jefina isn't here today. Yes, Paul. Yes, Pastor, I heard you talk about the issue of not meeting partners separately because we are not mediators, but to me as a person I think it is very, very important because at times there are things the other partner would not want the other one to know. Yet you as a facilitator you need to be aware of it so that you bring it into light. And that's why I see at times it may be important that separate meeting is important. There are certain things you need to know. Although you will keep them confidential, you need to know about the other partners. Sorry, Paul. During the facilitation you tried your best to see that issue as come out. Okay, yeah. So you're right that there may be certain information that may not have come out in the session which probably the person would like to tell you that's good. But I think we should be careful not to get into the position of being the one to relate whatever that sensitive topic to the other partner. That's something that we should avoid doing because there can be... Remember communication can always get tarnished through a process. So I personally don't follow that method because I think it adds up one accountability for every member to build that relationship. If they want to share something with me personally, yes, I permit that. Like I said, in some cases I do do that. If they want to share a certain information I do do that. But I don't encourage it too much. So personally that's my personal take on it. But if you see that's working for you, that's well and good. But being careful not being the mediator, not being the advice giver for either one of them or the person who comes to a place of calling out someone else's fault when someone is like, for example, maybe the husband may say, this is ABCD thing is what my wife does. But she will never tell you that. So maybe next in my counseling with the wife I'll say, hey, you shouldn't be doing ABCD things without any context of it. So I've got to be careful that I don't become that mediator, that I empower and equip the couple to be in a place of openness and honesty because that's what I would like that they come to a place of honesty. If there are certain sensitive matters that do not matter to the counseling session, then we can let it rest and let it lie if it doesn't impact the current marriage. Like for example, let's say a person says, a husband comes in and says, I'm having an affair with somebody else and the wife doesn't know about it. Now, this is not something that can be, yes it is, I have to keep it confidential, but it's not something that I will encourage that the husband stays in that part. So he's saying, I want to continue this relationship, what I want to build on that. Now that in itself is very skewed. It doesn't work that way. So we've got to be careful about how we need to equip our counselors or the members of the family to come as much as honest as possible to a place of restoration. So yeah, but thank you, thank you Paul for sharing that. Anybody else, any other question, any other thought and comment? Okay, I sense there's nothing. If there isn't, then I think we can close in five minutes to class, but we can close if there aren't any thoughts, any questions. Okay, all right, let's just pray together and we will wind up. Heavenly Father, Lord, we thank you, God, that you have brought us to places of influence and impact. God, there are many things in the world around that people face, challenges people face. God, and sometimes we feel quite illiquid to deal with these things, but God, we know that your wisdom, your knowledge, your power is their package. Give us the understanding that we need. Lord, give us the desire to know better. Father, to be able to take knowledge and use it, Lord, for the help of your kingdom. Father, even as we meet broken people, broken relationships, God, that we would only do things that are sensitive in the Spirit. Lord, to show others that we love, we care, we support, we want to build up. Lord, we pray, God, that you will work in and through us. Give us every wisdom we need, Father. Lord, we rely on you even as we work with people. Lord, our ministry God is with people, is with difficult, challenging people with problems, people with concerns. Father, and we ask Holy Spirit, that you give us the right words to speak at the right time, the right counsel, even the humility, Father, to be able to refer, to be able to move them to someone else who may be able to deal better. Thank you, God, for teaching us, for helping us. May we all, Lord, have a deserving Spirit. Give us, Lord, that spirit of wisdom, spirit of discernment as we work alongside your people. Thank you for each person, Lord, in class today for those who have not been able to join. Father, we pray for your mercy and your grace over you. Thank you once again. In Jesus' name I pray. Amen. Thank you all. We'll meet next week. Thank you very much. God bless. Thank you, Master.