Ep. 233: Understanding Mental Health (Part 1)

Welcome to the indoubt Podcast, where we explore the challenging topics that young adults often face. Each week, we talk with guests who help answer questions of faith, life, and culture, connecting them to our daily experiences and God’s word. For more info on indoubt visit indoubt.ca or indoubt.com.

Erika:

Hey, it’s Erika, and welcome back to another episode of indoubt. We’re so happy you’re here with us. And today’s episode is one you won’t want to miss. We’ve got Daniel here talking with Dr. Josh Kruse, a psychologist and Pastor of Counselling at Village Church. Daniel and Josh are taking some time today to discuss mental health, what it is, how to practically improve your own mental health, and even support the mental health of those around you. We’re so glad you’re here and hope you enjoy the episode.

Daniel Markin:

Hey, welcome to indoubt. My name’s Daniel Markin. I’m joined today by Dr. Josh Kruse. He wears a few hats. He is a psychologist, and he is also a pastor at Village Church here in British Columbia. So Josh, good to be with you.

Josh Kruse:

Yeah, thanks for having me, Dan.

Daniel Markin:

The pleasure’s all mine. So Josh, just for our listeners here, tell us a little bit about yourself, and then we can just go from there.

Josh Kruse:

A huge part of myself, family. So I’ve been married to my wife, [Rachel 00:01:26], for almost 18 years. We have four kids and started early and unexpectedly. Our oldest is 17, [inaudible 00:01:34], 16-year-old daughter, 11-year-old daughter, and then 9-year-old son. And so they’re a big part of our world. And especially with COVID and everything going on, we see them a lot. We’re in the house, they’re in the house. A lot of fun. At times, a lot of tension in there too. So training, I did a PhD in clinical psychology and that was never the plan from the beginning. I was going one step at a time. I was, actually, when we got pregnant in undergrad, I was doing business and hating it. It hated me. I was barely going to school. I was playing junior hockey at the time, and it was like a wake up call, “I should probably grow up a little bit,” and loved my psych courses. It didn’t feel like a class like, “Oh, I get to learn about myself, learn about other people,” and I just picked it. “All right, let’s go down this route.” And so did a bachelor’s degree, wanted to do counselling and so a lot of times you have to do a master’s. So I ended up doing that. And in my master’s, I was then wrestling with my faith with psychology. And what do I do with these and they feed compartmentalize? And so thankfully my wife was open for me doing a PhD at Viola University where integration of faith and counselling is their primary thing. So got to deep dive into that even more. Finished a PhD, was a professor at Trinity Western University. I was on faculty in the undergrad psych department. That was my plan going forward, and then started attending Village Church, loved it, and just got into conversations around coming in, in a shepherding-type role, which was never part of the trajectory. I was like, “I joined a PhD program to be a psychologist.” They’re not saying, “Oh, maybe you’ll be a pastor,” but it fit so well, just being able to integrate faith and psychology and to do that really well. So then came on about six years ago. And I feel like I got another degree just in the experience of what does this look like in a church context. And it can get messy at times, especially with the wearing the psychologist hat, legal ethical requirements, but then within a church setting where typically don’t have those same sort of boundaries or restrictions, but it’s been such a beautiful thing. No regrets. I’ve grown as a person in my faith so much. So my plan, my intention is to keep on in the church till I retire. We’ll see what God has for me.

Daniel Markin:

Definitely. Are you full time or do you still get to practice some of your psychology?

Josh Kruse:

So full time at the church, but then I still do half a day a week of private practice counselling. But part of my role at the church is providing counselling, but primarily, training and equipping for the counselling department. So I have grad students that come through, we’ve got volunteer counsellors, either professionals or lay counsellors, and so a lot of supervision equipping. But then I’ll meet with couples, I’ll meet with individuals, as well, out of the church and then do the small practice on the side.

Daniel Markin:

That’s awesome. Well, first before we kind of jump into some of, I guess, more of the topic, can you define some terms for us? Because oftentimes I hear the words mental health, I hear the words anxiety, depression, maybe bipolar, and maybe there’s some that I’ve missed that you might find are helpful, but I think those words are thrown out and people mean different things when they say them. So if you could define some of these for us, that would be really helpful I think.

Josh Kruse:

Sure. Mental health, essentially emotional, psychological, social, spiritual wellbeing. I know those are big categories, but the umbrella term of mental health would come under that. It’s like the basics of our psychology, our thinking, feeling, behaviour or actions. And a lot of times I’ll make it, they call it like the triangle, make it a bit more of a diamond of also the sensations or physiology of what goes on inside this. This, if we put those pieces together, really impact or they’re under the surface of why we do what we do. So having that understanding. When it comes to, let’s say anxiety, whole range in there. We all experience anxiety to some level. It’s different if we’re talking about an anxiety disorder. So basic level anxiety; worry, concern over areas of everyday life. Anxiety disorder would be a bit more of like it’s interfering with everyday life, like panic attacks, anxiety attacks, those sorts of things.

Daniel Markin:

Because it sounds to me like lots of anxiety, that’s a normal part of life. Like getting nervous before a test, you could say that’s anxiety, but that’s a very normal thing I think a lot of people have been through that. Nervous for a new job, nervous for a first date, second date, whatever. Right? That you could say, “Well, that’s anxiety.” And would you say that, “Hey, these are normal emotions”?

Josh Kruse:

Yeah. I mean, if you think about it, anxiety’s job is to alert us to things within this world that matter. So let’s say a relationship, I’m feeling a little bit of anxiety right now. It’s our physiology, our psychology’s way of saying, “Hey, pay attention.” I mean, if it’s a first date, pay attention to a lot. How am I coming across? Who are they? How am I engaging? I’ve got an exam and I’ve got zero arousal, so to speak, or alert in me. I’m probably not studying. We need some of that. Or a big example, I heard a great TED Talk on this, where if we actually want to grow in life, if we want to stretch ourselves, that means that when you stretch something, you put tension on that. Tension is a form of anxiety. So if we’re actually going to grow into something, we’re going to feel it. It’s going to show up on our radar saying, “Whoa, this is a big deal.” Let’s say we’re stepping out in some way, whether it is asking somebody out, whether it’s going through a job interview, whether it’s, I mean, even this right here, any speaking engagements. I’m not just sitting in my room, fiddling my thumbs, watching a show. My system’s like, “Hey, you’re on. You need to be on right now.” And I’m thankful for that. Otherwise, I’m off daydreaming, doing my own thing. So, anxiety, we need to work with it. And I think if we actually had a good relationship with it, we’d be pushing ourselves even more. Because it’s not like, “Ah, well, why is this coming up? I hate this. Let’s run from it towards comfort.” We’d actually be leaning into making ourselves more uncomfortable because the big picture, why this matters, I’m growing. I’m extending myself into new territory, so to speak.

Daniel Markin:

Right. So when does that go from normal to now this is a disorder?

Josh Kruse:

Yeah. I think a lot of times when it interferes with relationships, with work, with school. We start moving into a little bit more of the avoidance type stuff to where, I mean this can be depression as well, but I’m not getting out of bed. I’m avoiding social engagements around this. Especially in the heightened states, more of an anxiety or panic attack. Our system, it’s not just, “Ooh, there’s a bit of tension or I’m noticing it in my chest somewhat.” But no, “My breath is becoming a lot shallower and my heart’s pounding out of my chest.” Now we’re in the anxiety disorder-type zone. And so there’s panic disorder, where if you’re having more panic attacks, or there’s generalized anxiety. And some people just God wired us different. Some people rev higher, and they’ve got an active thought life. There’s some people you ask them, “Hey, what are you thinking about right now?” They’re like, “Eh, nothing.” And they actually aren’t thinking about anything. And they’re not dumb. They’re not in la la land. They’re not as active in terms of what’s spinning in their head. And others, “Well, which one of the three things that I’m spinning right now do you want to hear about?” So that could be a little bit more of an anxious mindset, but doesn’t mean you have an anxiety disorder per se.

Daniel Markin:

Definitely. So I guess then moving into some of the nitty gritty, I want to ask a question. It’s kind of a cultural question. But to what extent do we see technology and social media, to what extent do we see that affecting our mental health? Does it spike anxiety, depression, because that’s one of the common things I hear a lot?

Josh Kruse:

Yeah. So if we view our brain, we’re efficient people, thinkers. I think it’s part of how God wired us. That’s where habits can come into place. That’s where COVID I think has been extra upsetting or overwhelming for us because all of a sudden there’s all this change and so there’s a stimulation overload. “What am I able to do? What am I not able to do? And how were finances going to be? And what about health and what about this? And now we have to work from home. Or now I’m not working.” That is a lot of brain energy to use up. We need rest. We need to then slow down. We need to be able to then ground things in there. So when it comes to social media, I was listening to a good podcast, John Mark Comer and, I think, Jefferson Bethke are talking about, “Man, this world is going at such a fast pace. We need to slow down a little bit more.” And they were talking about the stimulation overload. If we go back like 1700s, 1800s, in terms of social engagement and contact, somebody would have to show up at your house. Let’s go back, like horse and buggy, and then they’re there and you’re engaged with them. And you find out the news of what they’ve been up to for awhile. Man, you jump on, and obviously a lot of beauty and health with technology, especially with church, we’re able to do church even over the internet. Awesome, incredible. But then in terms of stimulation, it is so high. So hop on to Instagram, in a matter of five seconds, you just had mini snapshots of five to 10 different people and their world. Once again, let’s go back to the 1700s. You just get that one person in the moment. Your brain, it’s got a lot of space to work with it, but you’re opening all these little files. Every page you then scroll or every post then on, let’s say Instagram there, that’s a lot for your brain to then take in. And it’s just buzzing. That’s where, I mean, sleep can be difficult for people too, because it’s like in bed going through all this and then all of a sudden shut it down. And it’s like, “Well, wait a minute. I to consolidate some of this information. And how am I going to go to sleep in the midst of everything that I’m taking in?” So no, I think it can over-stimulate us. That’s the risk or the downside of it.

Daniel Markin:

Yeah. Let’s talk about how we improve mental health in individuals, because what we’re kind of saying here is, “As Christians, look, we can pray for one another. We can get into community with one another, be with one another.” I want to turn this to our secular world. How do they say that we should be maintaining and improving our mental health? And I’ll just lead with this. One critique I often hear about doctors is they just throw medication at it. And I’m in the camp that I think, as Christians even, medication can be a good and a helpful thing. And if that’s something that can help you, then yeah, definitely take some medication. That it might help balance out some of the different chemical imbalances happening in your brain. And that’s, in my view, that’s okay. But to make that the only piece, I don’t think is healthy. I think our bodies and our lives and our minds, you kind of explained that triangle, we are holistic and there’s multiple different pieces to that. So how does the secular world say to maintain, improve mental health? And then where does the secular world fall short?

Josh Kruse:

Yeah. So, if you do a Psych 101 class, they’ll talk about bio-psycho-social in there too. And, but then there’s also a spiritual. So the secular world, a big part of it would be biologically what’s going on. Medication would be a component of that. And the risk would be, “Hey, I’m feeling a little bit off. I’m feeling down. I’m a little anxious.” “Okay. Meds. Let’s do that.” I’m not a meds first psychologist, but there are times where I think you should talk with your doctor about medication. Like if somebody’s severely depressed state or they’re not able to lean into what’s depressing them because they’re that depressed, you might need a bump or a boost for a time, or who knows, because of brain chemistry, indefinitely, in order to actually work on what’s going on, to get the tools to process through what’s depressing you in there. Or anxiety. Some people they rev so much higher that they need a little bit of a bringing down. Once again, not as the only method. This is the holistic, multi-pronged approach. Let’s come into that. And why wouldn’t? We’ve got access to resources in multiple areas. Why just pick one and go? Let’s, in a robust way, lean into it. And so when I say I’m not a meds first therapist, except for those more significant examples, I’ll say, “Let’s do what we can from our end. And we’ll see. If you’re not able to do the work. Yeah. We might go to meds first on that end, but otherwise let’s see how much of the mood, the anxiety, and the depression we can help alleviate.” And you might find that that’s all you needed. You actually don’t need to knock off on the med store, so to speak. So what does the secular world offer? It’s, I mean, the physical stuff like exercise is big. These are just some of the natural pieces: rest, nutrition, relaxation. This is huge. The whole, if somebody’s freaking out so to speak or overwhelmed in some regard, calm down, take a deep breath. The stuff that we don’t want to hear in the moment, like “I’ll calm you down. Shut up.” It’s because there’s that anger, the emotions in the moment, but there’s something powerful that happens on a brain level when we can take a deep breath. We can start thinking more clearly. The more emotionally activated we are, the more, I guess, dumb we are in those moments. So by taking those deep breaths, slowing down, the diaphragmatic or belly breathing, if you’ve been a singer or if you’ve had a baby, you’ve probably been taught it in some regard, but slowing down your breathing, holding and then releasing and then holding and then releasing. We’ll talk about like the rhythm of an ocean, that idea. So secular psychology would put that out there. I do that with people. If they come into a session and they’re pretty amped like, “Oh, I was running in traffic and then this happened and that happened too.” I’m going to try to co-regulate with them to a certain extent, like taking some of my own deep breaths and just, “Hey, can we do some grounding right here? Can we take some deep breaths? And first, look around the room and what do you notice? And what do you hear? What can you touch? What textures?” And so that’d be very natural, the biological part.

Daniel Markin:

And can I just jump in there too? Because that’s interesting because I often would view that as it’s almost meditation, right? And growing up in a Christian home, Christian world would be like, “Well, any sort of breathing, stuff like that, that’s bad.” Or maybe some people who, there’s Christians who don’t agree with yoga and that sounds a lot like yoga that you’re doing these breathing meditations. But you’re right, on a natural level, there’s nothing wrong with actually slowing down breathing. And then, God created us with bodies, and we sometimes have to get in control of that body.

Josh Kruse:

Well, and that gets right into the crux of that whole secular-spiritual piece. Mindfulness is really big in the psychology world. In its basic definition, mindfulness is to become aware, to be mindful, instead of passive autopilot. And so there’s a lot of research around this on a brain level, physiology level for anxiety, depression, all sorts of stuff to slow down, take deep breaths and tune into what’s happening in the present moment, letting thoughts drift on by. It’s like a river and a leaf comes, [inaudible 00:17:37], and you just acknowledge that, “Oh, worry about finances,” and you let it drift on by. And that might come back and you label it. You let it drift on by. In its most basic sense, that’s mindfulness. Nothing wrong with that. The risk would be a lot of times mindfulness is under the umbrella of a Buddhist philosophy and about becoming one with yourself. Or even yoga, stretching. I do a Saturday morning run. I stretch before. I don’t think I’m being heretical or sacrilegious in the midst of that. I’m just trying to loosen my muscles. The risk would be though, whether it’s a chanting or I’m entering into this spiritual realm apart from God, that’s dangerous. And we do need to run from those things. But let’s not throw out the baby with the bath water. And that’s the risk of psychology sometimes. Like, “I don’t know. There’s some stuff I’m not so sure about. Let’s not do any of it.” No, let’s reclaim the pieces that are actually helpful like our physiology, understanding of the brain emotions, behaviours, and let’s slow down. We can be mindful in this moment. Or even a more explicit, like the contemplative traditions of centering prayer or contemplative prayer, slowing down, deep breathing, and just being present in the moment, knowing that, especially then for Christians, “God, you are with me in this moment. And I just want to sit with you for a little bit.” I mean, if he’s real, which he is, and I’m slowing down and I can really sense his presence, how soothing is that? Yeah, we’re relational. There’s a comfort. I’m not in this on my own. Ah, wow. We can actually find that if we slow down enough? That’s a beautiful thing. So that’s then an extra piece that scripture has to offer, or a Christian worldview does. A small side note. My PhD research was around anxiety and centering prayer. And what we did was secular intervention of progressive muscle relaxation, you tense and then you release your muscle groups. It helps calm and soothe the body. Research shows it’s helpful. So we did that and compared it to centering prayer where you sit for the same amount of time, and you’re slowing down your breathing, but then you’re connecting with, there might be a word or something, “Maranatha, come Lord.” Basically, “I’m here to sit with you, God. I’m here to hang out with you and slow it down.” We found it was just as effective and at times even more effective in bringing anxiety down. Well, what happened there? I mean, we’re tapping into a supernatural resource, which has supernatural impact then for us. So that’s where secular psychology, you can focus under biology, slow things down, but then even incorporate Christ in the midst of that too. Also, secular psychology talks about emotions and thinking and negative thinking. They’re helpful. Let’s explore that. If I then am waking up in the morning and “Today’s going to be horrible. I’m garbage. I’m unlovable.” Well, that’s something that we need to work through. Even secular psychologists would say that same thing. That’s going to bring you down and impact your mood and what you do. That is great work. And that’s, I think, part of the common grace part of God’s working there too, whether you say, “Because the Bible says, or Jesus said that,” but how much more powerful is it when we can take the living active word of God and bring truth into that and transform our minds?

Daniel Markin:

Absolutely. So just to jump on what you’re already saying too, is I’ve heard you talked before about the four Rs. Could you explain kind of how you integrate those in with our faith as well?

Josh Kruse:

Yeah. So the four Rs of rest: retreat, refuel, repurpose, re-engage. We’re talking about social media earlier. We’re in a fast-paced culture. There’s a lot going on, lots of info. And if we don’t ever slow down to consolidate some of that, then we’re actually going to lose information. We’re not going to retain that stuff. And then we’re going to live in an anxious state. Our physiology, our bodies need us to slow down. And we give ourselves permission for sleep. Like, Dan, if you’re then saying, “Well, I didn’t sleep last night or the night before. It’s just, I’m a busy guy. I got a lot going on.” I think generally culturally, we’d be like, “That’s not healthy, Dan. You’re not killing it. You’re killing yourself here. Get some sleep.” But when it comes to how much sleep and then also during the day, actually resting our minds, we need that, especially in light of COVID or stressors that come in. We need to then, and so here comes the first R retreat, take a step back from those things. The things that are spinning us, the things that are activating us, as much as we can we step back from events, tasks, social engagements, which has, for a lot of people, been quite freeing, just not being able to enter into those things, but moving back, taking some deep breaths. We’re getting super practical here, and then focus on really then now the second R, refuelling, getting the gas, filling our tanks so to speak, actually slowing down to that still small voice, the Holy Spirit in the midst of what’s going on. “Okay. God, how can I actually find rest? How can I find you in the midst of this?” And this will be person by person. What are the things that are actually, as you guys are listening right now, what’s restful for you? If you were to get super practical and say, “Look, I’ve got a weekend coming up or I’ve got two days off, I’ve got a day off or even an evening, what would the most restful for me?” Then doing that. Whether it’s reading, having a bath, running, prayer time, quiet time.

Daniel Markin:

Josh for you, what’s most restful for you?

Josh Kruse:

So I have different rhythms. So my daily rhythm, this isn’t my Sunday school answer, but it’s the truth. My quiet time with God is huge for me. If I’m anxious about something or not, but especially if I am, it’s such a grounding moment for me to slow down, even if just 15 or 20 minutes. I put on worship music. That’s also restful for me. And it helps reorient then my mind towards who he is and who I am. Because usually if I’m getting worried or anxious about something, I go into me and then I’m just looking at my natural resources, and I don’t have it in me. Whereas, when I tap into him, I connect with him, that’s grounding. That’s a daily thing. But then also my other, my family is a huge part of my refuel. So making sure I have good intentional time with them. That’s one nice thing, I’ve been working at home more. And so I’ll go jump on the trampoline. I’ll take like a five minute, 10 minute break. Most people’s iWatches, they’ve got the, “Hey breathe, stand up, go walk around.” I’ll do that. The motivation, that’s just the physical part. Walks, I’ll go for a walk with my wife, and actually, I process out loud a lot of the time. So I’ll be talking, she’ll be talking. That’s great. I do that in my refuel. And then I love and I hate running. But it’s good for me. Every Saturday morning, I’ll go, I’ll run a 10K and put a podcast on, and I get my introvert refuel during that time while getting the endorphins going. So it’s a bit of a double up and I come back and I’m on fire in a good way, like, “All right, what are we doing today? What does that look like?” So those are big parts of how I then refuel. So I’ve retreated, refuelled, repurpose. This is a big part of the, “Okay, God, whatever it is that’s draining me, whatever it is that just feels like too much or is overwhelming me, I surrender myself to you. What is it that you are wanting me to do?” And heard this the other day, it talks about how this is around boundary stuff, that when we say yes to something, we’re saying no to something as well. And that’s important. So if I’m going to repurpose, if I’m going to live my life intentionally, taking control of what I can, then what am I saying yes to, what are my top priorities here? Does family matter to me? If it does, then that should show up in my schedule for sure. And sometimes you need to protect that, especially if your schedule is so full. If exercise matters to you, if friendships matter to you, if time with God matters to you, those are things that we need to be saying yes to so that we’re saying no to other things. Otherwise it won’t happen. We get turned upside down and we end up doing things that we shouldn’t. Like, “God, what is it that you’re calling me to?” And then setting those boundaries there for the last R, re-engage, to then re-engage. I’ve been refuelled. I found that rest, and now I’m going to go, because we’re called to go out into this world and carry out whatever it is that God has for us in that next hour, that next day, that next week, that next season. So the whole four Rs can be anything down to the moment, like, “I’m buzzing right now, and I need to slow down.” Okay. Well, retreat, refuel, repurpose, re-engage for the next 30 minutes. But sometimes it’s seasonally. All right. Well, we can do some of that pulling back to then figure out, especially that repurpose. “God, what do you have for me as I move into it?” And then we reengage from that place.

Daniel Markin:

Yeah. Listen, we’re out of time here, but this has been amazing, Josh. Thank you for being part of the program and just sharing your life, your thoughts, your work. And we look forward to chatting with you again at some point.

Josh Kruse:

No, I’d love that. Thanks for having me, Dan. Appreciate it.

Erika:

Thanks for listening today. We can’t stress the importance of mental health enough. So thanks to Dr. Josh Kruse for joining us and giving us some practical tips for a healthier state of mind. And if you liked hearing from Josh, you’re in luck. Join us again in two weeks when Daniel and Josh will be back to talk more about mental health and some of the psychology behind this often daunting topic. Indoubt is all about answering the tough questions of faith in God and the Bible. If this is something that you’d like to be a part of, would you consider participating in our fiscal year-end this month? The goal for indoubt is to reach $75,000 by June 30th. Your gift would mean so much as we continue answering the tough questions of life and faith that young adults are asking. Check out indoubt.ca in Canada or indoubt.com in the U.S. to give today. And we can’t wait to see you next week when Daniel is back with guest, Jonathan Evans, for part two of their conversation surrounding the poor and what we as Christians can do to help. See you then.

Thanks so much for listening. If you want to hear more, subscribe on iTunes or Spotify, or visit us online at indoubt.ca or indoubt.com. We’re also on social media so make sure to follow us on Instagram, Facebook, and Twitter.