My reflection and meditation while writing this article: "Physician heal yourself" (Luke. 4:23).
In psychological terms, stress is any circumstance or event that threatens (or is perceived to threaten) one's usual adaptive functioning or lies beyond one's perceived coping capabilities. In spiritual terms, stress is considered a threat to one's spiritual well being and includes: interruption of prayer life, a sense of loss of God's love and care, and a lack of trust in God and in His Church.
Generally speaking, stress is divided into two major categories: 1) traumatic and acute stress, and 2) chronic stress. Traumatic and acute stress is defined as a reaction to a specific trauma or stressor (American Psychiatric Association DSM-IV-TR). It is a diagnostic psychiatric category consisting of either Posttraumatic Stress Disorder (PTSD) or Acute Stress Disorder (ASD), and encompasses such events as exposure to serious injury and death during accidents, combat and disasters, physical attack, sexual assault, terminal illness, concentration camps and solitary confinement. The usual response is fear, helplessness, horror, imagery, or sensory re-experiencing of the event and increased agitation and arousal. This category lies beyond the scope of this essay.
Chronic stress is caused by response to the everyday events that become stressors when they are repeatedly encountered (McEwen and Lasley, 2002). The long duration and ongoing repetition of these events sensitize the body stress reaction system and make the body more likely to trigger a stress reaction. The events include everyday occurrences and other common hassles, trials and tribulations of life (Kohn, Lafreniere, & Gurevich, 1991; Pillow, Zautra, & Sandler, 1996). Common events include family problems, health concerns, traffic, car breakdowns, missing appointments, and lateness. This type of stress in clergy life is the focus of this paper.
Orthodox clergy face the same chronic stress events as the general population. In addition they have the events common to a hierarchal church: the episcopacy (from above) and a parish council (from below) both often presuming they have control over the priest. (Specific circumstances are discussed below.) On the surface these common events may appear benign, but when faced day after day for long durations they tend to have a cumulative effect (Delongis, Folkman & Lazarus, 1988; Seta, Seta & Whang, 1991). In fact, the physiological, psychological and spiritual effects are similar to the effects of PTSD and ASD mentioned above.
The reactions that individuals have to stress events are due to a multiplicity of factors. They include: biology (body stress reaction system), cognition (appraisal, Morelli, 2006a), emotion (depression, Morelli, 2006d), environmental (the events listed above), personality (optimism, Morelli, 2006d), socio-cultural (mainstream or particular ethnic background) and behavioral (coping strategies, Morelli, 2006c).
Stress affects the body in different ways. The nervous system has two basic components: the Central Nervous System (CNS) composed of brain and spinal column, and the Peripheral Nervous System (PNS) which includes the outside of the body, brain and spinal column. This is broken into the Somatic Nervous system (SNS) such as nerve endings in the hands and arms etc. and the Autonomic Nervous System (ANS). The ANS in turn has two components: the Parasympathetic and Sympathetic System. The ANS is critical in understanding the body stress reaction system. The ANS is connected to blood vessels, bladder, breathing system, digestive system, glands, and heart.
When the body is relaxed and functioning normally, the Parasympathetic System is at work. A major information channel is the neurotransmitter or hormone: acetylcholine. Pupils are constricted, salivation is normal, regular breathing occurs, the heart rate is normal, digestive processes work and the bladder can hold contents. An individual in this state feels relaxed and normal.
When the body is stressed, the Sympathetic System is at work. A major information channel is the neurotransmitter or hormone: adrenaline or epinephrine and cortisol. Pupils are dilated, the mouth is dry, rapid breathing and heart rate occurs, digestion is inhibited, increased sweating occurs and bladder contents are subject to involuntary release. The individual in this state feels under tension. Biologists consider that the original reason this system developed in our bodies is to mobilize a fight or flight response under threat. This was an adaptive response to prehistoric predator attack for defense and survival and is still used today if engaged in warfare, police activity or self defense.
The effects of stress are insidious. They include increased aggression (Berkowitz, 1989); giving up (Seligman, 1990); substance abuse (Peyser, 1993); impaired task performance (Baumeister, 1995); physical, mental and emotional exhaustion (Pines & Aronson, 1988); unhappiness (Heady & Wearing, 1989); anxiety disorders (Lester, Nebel & Baum, 1994); and depression (Gruen, 1993). Various psychosomatic diseases such asthma, eczema, heart disease, hives, hypertension, migraine and tension headaches, skin disorders and ulcers have a genetic and physiological etiology but often stress is a psychological exacerbating factor (Creed, 1993).
Longitudinal studies started in 1967 and still ongoing at University College London (called the "Whitehall Studies") examine the effects of work control or job control and work support on stress. Two conclusions are particularly straightforward: 1) Low control at work makes an important contribution to the social gradient in mental and physical ill health; and 2) Another aspect of the work environment that may be stressful is a lack of support from ... managers ... and supervisors (for example, colleagues and immediate line managers are willing to talk about work-related problems), especially when employees do not receive clear and consistent information from their supervisors. The second problem is associated with a twofold increased risk of poor general mental health (Council of Civil Service Unions/Cabinet Office, 2004).
In a previous article I distinguished between perfectionism and Christ's counsel to be perfect: "Be you therefore perfect, as also your heavenly Father is perfect" (Matthew 5:48). Following the call to be perfect in Christ is the recognition that ultimately perfection does not come from the individual but from God. "But the God of all grace, who hath called us unto His eternal glory in Christ Jesus, after you have suffered a little, will Himself perfect you and confirm you and establish you" (1 Peter 5:10). I went on to say that trust and patience are two pillars of our journey to perfection. In psychological terms patience is attained by letting go of our unrealistic urgent demanding expectations and substituting reality the way it actually is. Trusting in God and His Divine Providence becomes a powerful technique to challenge self-created urgencies and helps heal the malady of perfectionism (Morelli 2005).
But there is a world of difference between striving toward perfection in spiritual terms and perfectionism. Individuals suffering from this malady (perfectionism) are motivated by a fear of failure and a sense of duty. They strive to be in first place in all manner of endeavors but their accomplishments never seem to satisfy them. They believe there is a special quality to acquiring perfection; the flawless expression of a particular characteristic such as intelligence or the mistake-free application of a specific skill is the only way to earn self esteem and achieve the sense of being special. Allen (2003) notes: "Perfectionism becomes oppressive (stress) when excessively high standards (expectations) are coupled with ... anxiety."
Anyone may be influenced by these variables which are risk factors for stress. Thus individuals in low status occupations with ambiguous or contradictory supervision (as in the Whitehall Studies) would be affected just as easily as a person in a high status or even more demanding environment. Individuals who have perfectionist expectations are also vulnerable.
Over the years I have given workshops on clergy stress to Orthodox clergy in most jurisdictions. Invariably three major stressors are reported: 1) Being under the control and misunderstood by the hierarch; 2) being considered an employee of the Parish Council who has the final say in all administrative matters (sometimes even attempting to control the liturgical function of the priest); and 3) for clergy with family, the demands of being husband and father. Non-clergy may not consider this a special condition. Overbearing supervisors, misunderstanding and family pressures are encountered in everyday life by many. The difference is in the nature of the priesthood itself and the priest's self-identification as a priest.
Just a few reflections on the Counsels of the Christian Priesthood by St. John of Kronstadt demonstrate the nature and responsibility of the Christian priesthood:
... a worthy priest, who, like the seraphim, would burn before the Lord with love, praise and gratitude for the wonders of His mercy and His wisdom ... As light and heat are inseparable from the sun, so should holiness, a zeal to teach, and love and compassion for all, be inseparable from the person of the priest. For whose dignity does he bear? Christ's ... God Himself ... By myself I am nothing, but by the grace of the priesthood I become the means of healing. Though me the grace of the Holy Spirit gives new life; the Body and Blood of Christ to the faithful ... uniting them with God.
St. John told the priests: "You must without ceasing praise and thank the Lord; you must always be striving after holiness, with fasting and abstinence, with humility of mind, and obedience and patience."
What could be considered the greatest clergy stressor of all? St. John answered with the admonition of Jesus recorded by St. Luke: "Every one to whom much is given, of him will much be required" (Luke 12:48). St John deserves to be quoted in entirety:
From a priest, if he has not learned to be gentle, humble and kind, and to overcome evil with good, a stricter account will be required than from a lay man. For a priest, in his ordination, has been given a great potential for piety, and if he does not live accordingly, and fulfill it, he dooms himself through his own negligence and impenitence. Lord forgive me my sins, and teach me to do your will.
Dealing with Hierarchs
Priests are to obey their bishops as they would Jesus Christ. "Obey your leaders and submit to them; for they are keeping watch over your souls, as men who will have to give account. Let them do this joyfully, and not sadly, for that would be of no advantage to you" (Hebrews 13: 17). St. Ignatius of Antioch from the beginning of church history told priests (and laity) to be: " ... submissive to the bishop as to Jesus Christ ... and also to the presbytery as to the Apostles ... and to respect the deacons ... for without these no Church is recognized" (Chryssavgis 2005). Therefore if priests are to be zealous and true to their calling there is a great pressure on them to be faithful and submissive to their bishops. This is a divine imperative and far above human striving.
The Ideal vs. Clergy experience
St. Paul gave us the ideal expected for those in holy orders from bishop to deacon:
This is a faithful saying: If a man desires the position of a bishop, he desires a good work. A bishop then must be blameless, the husband of one wife, temperate, sober-minded, of good behavior, hospitable, able to teach; not given to wine, not violent, not greedy for money, but gentle, not quarrelsome, not covetous; one who rules his own house well, having his children in submission with all reverence (for if a man does not know how to rule his own house, how will he take care of the church of God?); not a novice, lest being puffed up with pride he fall into the same condemnation as the devil. Moreover he must have a good testimony among those who are outside, lest he fall into reproach and the snare of the devil.
Likewise deacons must be reverent, not double-tongued, not given to much wine, not greedy for money, holding the mystery of the faith with a pure conscience. But let these also first be tested; then let them serve as deacons, being found blameless. Likewise, their wives must be reverent, not slanderers, temperate, faithful in all things. Let deacons be the husbands of one wife, ruling their children and their own houses well. For those who have served well as deacons obtain for themselves a good standing and great boldness in the faith which is in Christ Jesus (1 Timothy 3:1-13).
The personality qualities St. Paul lists include: being serious, not double-tongued, not addicted, temperate, sensible, above reproach, gentle, and not quarrelsome. He implied that the higher the order, the more the qualities should apply.
What do I hear from clergy that contributes most to their stress? The first is discrepancies and contradictions between the ideals of how bishops (and priests and deacons) should behave and what they actually do. Examples include (for confidentiality, these examples are composites from the clergy stress workshops I have conducted):
Short of a spiritual awakening by a miscreant parishioner and an insensitive hierarch, how should a priest respond to the abuse they inflict? The first way is to reference the Gospel of Christ. Abuse, while never excused must nevertheless be endured at times. A priest who brings the contradictions and hypocrisies to Christ can grow in His love.
On the Sermon on the Mount Jesus said: "Blessed are those who are persecuted for righteousness' sake, for theirs is the kingdom of heaven ... Blessed are you when men revile you and persecute you and utter all kinds of evil against you falsely on my account. (Matthew 5: 10,11). Jesus also warned his disciples not to expect better treatment than He received: "Truly, truly, I say to you, a servant is not greater than his master; nor is he who is sent greater than he who sent him. If you know these things, blessed are you if you do them" (John 13: 16-17).
For the priest who has the love of Christ in his heart, these trials become a means by which Christ can grow more fully in him. The priest's love for others can grow as well. Nevertheless, it must be noted that these trials can cause great anxiety and stress that can result in deleterious consequences for the priest and his family. Further, the potential for spiritual growth does not excuse the malfeasance, hypocrisy and mismanagement that create the trials.
Accepting everyday events within the greater will of God
A priest can respond to the day to day indignities by recognizing that the events of everyday life are a means of growing in grace. St. Theophan the Recluse wrote: "Life's everyday affairs, upon which the foundation of the home and society depend, are appointed by God, and carrying them out is not a desertion to the sphere of the ungodly, but a continuation of Godly affairs." St. Theophan continued by teaching the priest how this is done: "It is necessary for you to reinterpret everything that comes before your eyes in a spiritual sense ... when you have done this each thing will be like a holy book or an article in a holy book for you ... Then each thing will lead you to thought about God ... You will walk in the midst of the sensual world as if it were the spiritual realm. Everything will speak to you of God and keep your attention on Him" (St. Theophan the Recluse, 2000).
St. Theophan's spiritual discipline involves retreating into the quiet places of the heart - an interior desert of sorts. The desert experience is central to eastern Christian spirituality. It traces its roots to the original third century monks who fled to the deserts of Nubia, Scetis and Sinai to escape the hustle and flurry of the world in order to grow closer to Christ. St. Anthony (251-356) is considered the founder of the monastic way of life but he is hardly the first person to go to the desert to find God. Matthew recorded that St. John the Baptist was an early wilderness dweller:
In those days came John the Baptist, preaching in the wilderness of Judea, "Repent, for the kingdom of heaven is at hand." For this is he who was spoken of by the prophet Isaiah when he said, "The voice of one crying in the wilderness: Prepare the way of the Lord, make his paths straight." Now John wore a garment of camel's hair, and a leather girdle around his waist; and his food was locusts and wild honey (Matthew 3: 1-4).
Consider as well that Our Lord, God and Savior Jesus Christ started his public life in the desert and often returned there for spiritual nourishment. St. Matthew wrote:
Then Jesus was led up by the Spirit into the wilderness to be tempted by the devil. And he fasted forty days and forty nights." (Matthew 4: 1-2). St. Luke records "But so much the more the report went abroad concerning him; and great multitudes gathered to hear and to be healed of their infirmities. But he withdrew to the wilderness and prayed." (Lk. 5: 15-16).
Desert in the city
The desert does not need not to be the dry desolation of Sinai or Nubia. Many spiritual writers indicated that the desert can be found anywhere, even in the middle of an urban civilization. Desert in the City by Carlo Carretto (1979) pointed out that the desert can be found in the recesses of one's home or workplace. A few minutes spent receding from the noise and flurry of work can lead one into contemplative solitude. Caretto wrote: "If someone cannot go to the desert, then the desert can come to him or her. That is why we talk about 'making a desert in the city.'" He described this desert as " ... a quiet place to withdraw so as to find God in silence and prayer ... (a) place where we gather courage, where we pronounce words of truth remembering that God is truth ... (a) place where we purify ourselves and prepare ourselves to act as if touched by the burning coal that was placed by the angel on the lips of the Prophet."
The desert is a place of solitude but not isolation. No desert experience is complete apart from communion with the Church and participation in the sacred mysteries (sacraments), prayers, and worship. Even the hermits, the Christians who live in solitude in the deserts and caves of today, are members of monastic orders and subject to the discipline and practices of their mother monastery. Consider too St. Mary of Egypt. She lived alone almost her entire life in the desert of Sinai after her conversion, yet was given communion and confession by Fr. Zossima (who later wrote the biography of this remarkable woman) whom she regarded as her spiritual father.
Recalling what St. Maximus the Confessor taught: "the grace of the most Holy Spirit does not confer wisdom on the Saints without their natural intellect as capacity to receive it." Goodness and wisdom is granted to man by his volitive faculty; God is not coercive and will never confer his gifts on people who refuse to receive them. This points to the radical freedom that man possesses. Thus, when man freely obeys God, he can apply his intellect and acquired knowledge in ways that allow God's grace to work more effectively in his life. For this reason, knowledge of the psychological aids in stress management can be seen not as a replacement for the peace, wisdom, and other attributes conferred by the Holy Spirit, but as a means by which the Spirit can affect peace and order in the believer's life.
Stress intervention procedures
Basically the psychological stress management procedures can be broken down into cognitive change and stimulus-response management.
Cognitive change involves changing the way we perceive the tasks that we are performing. Task misperceptions are actually unproven cognitive assumptions; unspoken assumptions that we have adopted that automatically guide our responses. For example, we make demanding expectations of ourselves and set a high standard of performance. The standards for task success are set unrealistically high. Anything short of complete success is perceived as failure.
Demanding expectations trigger perfectionism and multi-tasking. In addition, perfectionism thwarts good performance because it triggers stress and anxiety that interferes with the performance itself. (A more detailed discussion is offered in Being Perfect vs. Perfectionism.) Cognitive distortions incite the ruinous perfectionism and must be disputed (Burns, 1989; Ellis & Harper, 1962; Morelli, 2005).
Multitasking involves doing more than one activity of increasing complexity at a time. Multitasking leads to deleterious task performance (Rubenstein, Meyer and Evans, 2001). As activities and their complexity increase, so do the stress effects.
One important way to reduce stress is to make a list of task priorities. Obviously some tasks are more important than others. Effective task-time management however, is not simply a process of moving from high to low priority tasks one at a time. Maximal functioning means interrelating tasks varying in priority over diverse time periods. Research has shown that persons function on various time cycles. Some of these cycles occur within a day, others daily, and some even seasonally. Time-task management involves integrating tasks into these cycles for maximum effectiveness.
This integration involves prudence, good judgment and discernment. A good start would be to list task priority according to category such as parish, family, and personal categories. Clergy who devote all of their time to parish activities for example, are making a poor judgment. The priest has a family to take care of, not to mention his own needs for recreation, rest, and exercise. Every day has to be balanced among all three categories in order for a clergyman to feel well and balanced. "For everything there is a season, and a time for every matter under heaven," Ecclesiastes reminds us (Ecclesiastes 3:1).
When contemporary research psychologists speak of the cognitive-emotional connection in procrastination, they reaffirm what Jesus taught: "The eye is the lamp of the body. So, if your eye is sound, your whole body will be full of light; but if your eye is not sound, your whole body will be full of darkness. If then the light in you is darkness, how great is the darkness!" (Matthew 6: 22-23). The Church Fathers noted that thoughts evoke feelings and the best way to manage feelings is to discern the cognitive stimuli (the external stimulus) that trigger the thoughts.
Two types of feelings that erode inner contentment and harmony (and lead to a loss of spiritual focus) are anger and sensual desire. St Maximus the Confessor counseled: "Do not befoul your intellect by clinging to thoughts filled with anger or sensual desire. Otherwise you will lose your capacity for pure prayer and fall victim to the demon of listlessness" (Philokalia II). Basic intervention techniques involve removing distractions, choosing realistic tasks, challenging oppressive goals, and setting realistic performance appraisals. (An earlier essay The Spiritual Roots of Procrastination [Morelli, 2006c], outlines these psycho-spiritual interventions in more detail.)
If a clergyman is expected to perform tasks that reasonably cannot be executed, the task should be disputed immediately. Certainly some tasks require a high level of functioning and require a high degree of output. There may be a world of difference however, between how a supervisor might prefer a task is completed and how long it will take to reasonably complete it.
In my pastoral and clinical counseling experience, I have found that the best method for challenging and disputing these demanding expectations is to employ the "facts speak for themselves" technique. For example, if a bishop or other supervisor demands that a task be completed in one week that would reasonably take at least two weeks or more, the unrealistic demand should be challenged immediately. The unreasonable demand creates a great deal of stress. Further, if the supervisor insists on the demand despite evidence that he is being unreasonable, he is skirting the line of psychological abuse. The clergyman should respond by outlining the "facts," that is, the steps required to complete the task, and then ask the supervisor for further instruction. This counsel, of course, presumes the clergyman is working hard, not slacking in his responsibilities, is not lazy, and so forth.
It must be kept in mind that people act the way they want to act, and not how we might prefer they act. Some people will not respond well to a presentation of facts despite the evidence marshaled to prove them. Such cases may provoke a confrontation with unfortunate consequences, such as the termination of a position and other losses. Nevertheless, these events need to be balanced against the stress of continual unreasonable demands and the consequences they cause in the life and family of those of whom the demands are made. Sometimes the confrontation, while unpleasant, can prove to be a blessing in disguise.
How should a person evaluate such an unfortunate consequence? One effective approach is to use the "mental ruler technique" (Burns, 1980). For example, when an irate superior's demands are evaluated on a zero to 100 scale (zero being the most pleasant thing a person could picture happening to him, 100 the worst), the consequence loses some of its sting. People usually have no trouble imaging a very pleasant event; sitting on a sun drenched tropical beach is a typical image. However, most people usually need a bit of help coming up with a worst event, say, being beheaded or such some catastrophe. When compared to the worst event scenario, the consequence does not seem so bad. In fact, it can provoke creative ideas on how to handle the consequence in sound ways.
Working for a supervisor who makes unreasonable demands is unpleasant and in the long term can be hurtful. Looking at the situation realistically however, particularly in recognizing (but not condoning) the unreasonableness and even abuse where it exists, prepares a person for the probable confrontation and if necessary, the unfortunate consequences that may occur. A realistic appraisal is necessary to make sound decisions, especially if those decisions are imposed by outside circumstances and may create some hardship.
Assertiveness: A challenging and sanctifying process
Assertiveness (Morelli, 2006c) in stress situations is another effective way to deal with individuals who have demanding expectations and expect more than can be reasonably performed. A personal comment: Several times in my life I faced such situations. When I have realistically assessed the situation, sought counsel, and communicated the correct facts but still faced rejection, I was able walk away peaceful and content. I even knew that my decision could be blessed by God. Some unfortunate consequence might have come my way, but it would have come my way in any event. "Shame on the other person" I told myself. "I will get on with my life the best way I can and work in a field with those who will help me succeed."
This is similar to what Jesus taught his apostles. Jesus said "And if the house is worthy, let your peace come upon it; but if it is not worthy, let your peace return to you. And if any one will not receive you or listen to your words, shake off the dust from your feet as you leave that house or town" (Matthew 10: 13-14). Jesus was speaking, of course, about people who rejected the word of his Father, while my words dealt with everyday events. Nevertheless, if my words to an abusive supervisor were true, and if all truth is united with God (which it is), then the instruction still holds. Besides, my experience has taught me that the counsel works.
Jesus said: "A new commandment I give to you, that you love one another; even as I have loved you, that you also love one another" (John 13:34). Love is to act for the good and welfare of our neighbor. God forbid any of us be a cause of stress to our neighbor. Stress is deleterious to our physical, psychological, and most important, spiritual welfare. We need to reflect on the words of St. Paul: "Love is patient and kind; love is not jealous or boastful; it is not arrogant or rude. Love does not insist on its own way; it is not irritable or resentful; it does not rejoice at wrong, but rejoices in the right" (1 Corinthians 13:4-6). First as a Christian, and second as a pastoral and psychological physician, I must apply this admonition to all dealings with my neighbor. Then with all unworthiness may I suggest that all Christians do the same to lessen the distress among people.
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V. Rev. Fr. George Morelli Ph.D. is a licensed Clinical Psychologist and Marriage and Family Therapist, Coordinator of the Chaplaincy and Pastoral Counseling Ministry of the Antiochian Orthodox Christian Archdiocese, (www.antiochian.org/counseling-ministries) and Religion Coordinator (and Antiochian Archdiocesan Liaison) of the Orthodox Christian Association of Medicine, Psychology and Religion. Fr. George is Assistant Pastor of St. George's Antiochian Orthodox Church, San Diego, California.