For the past two weeks, I've been preaching on The Threefold Cord, a lifeline that can be of enormous help to us as we are knocked around by the shocks and stresses of everyday life. This lifeline is made up of the interwoven strands of science, spirituality, and psychotherapy, and it can help us to find a deep personal peace — what the Bible calls "shalom."

This Cord is strong and flexible, and the Old Testament book of Ecclesiastes is right when it says, "A threefold cord is not quickly broken" (4:12). But I have to warn you — the strands do not always stay together.

Across our country today, there are religious leaders who will not endorse the interweaving of science, spirituality and psychotherapy. They want to unravel The Threefold Cord and pursue mental health through faith alone.

John MacArthur, the fundamentalist pastor of Grace Community Church in California, will not refer troubled people to psychologists or psychiatrists for therapy — he believes that "the path to wholeness is the path of spiritual sanctification." MacArthur sees mental problems as spiritual issues, and he attributes them to the presence of sin in the world..

Along these same lines, the Open Arms Internet Ministry, an online biblical counseling service, holds to the belief that emotional and mental problems are rooted in theological misunderstandings. "It is through use of Scripture," asserts the ministry's Web site, "that we can conquer life's everyday problems."

The problem with using faith alone is that it ignores the emotional and physical dimensions of mental health. To know real shalom, we have to keep the Threefold Cord from unraveling, and embrace the best insights of psychology and science, right along with spirituality. Last week I talked about the value of psychotherapy, and today I want to say a word about science — in particular, the value of medication.

The contributions of medicine to mental health didn't become personal for me until my father became ill in the year 2002. After undergoing extensive surgery for a rare form of stomach cancer, he was overcome by depression and anxiety. I was shocked by this, because he had always been known for his sense of humor and upbeat attitude, but after the trauma of surgery he fell into a deep funk and lost his appetite. He also began to obsess over concerns that he knew — intellectually, as an accomplished NASA physicist — to be absurd. "I wake up at night worrying about leaves in the gutters," he told me one day. He was given anti-depressant medication, and, after several months of treatment, the depression and anxiety finally lifted. At a family dinner here in Fairfax, at a Brazilian steak house in the summer of 2003, we saw that the hungry, happy, healthy man we all loved had returned.

God desires our mental health, and wants us to use all the tools we have available to us. Yes, that's right, all of them — as needed. While it is true that not every strand of The Threefold Cord is going to be required in every situation, the potential for healing is greatest when all three are available.

Unfortunately, ministers can make a mess of things by trying to be all things to all people, including their mental health practitioners. I've been told that many ministers deeply distrust psychotherapists who are not pastors, and they resist making referrals to psychologists and psychiatrists. Susan Lydick, a developmental psychologist and church member here in Northern Virginia, reports that she has not found pastors to be particularly comfortable responding to issues of mental illness within the church. She looks around her congregation on Sunday mornings, aware of numerous cases of mental illness, especially involving young people. She waits to hear a name called out for just one of the many youths who have been hospitalized — but the prayer requests never come.

She has a point — how many times do we lift up such concerns here at FPC?

The problem, of course, is that mental illness still carries a stigma, and many of us are reluctant to have a psychiatric struggle made public. Even so, ministers like myself must find ways to talk publicly about mental illness because the stakes are so high — depression remains a huge problem, with suicide being the 11th leading cause of death in the United States in the year 2000. Susan Lydick and others are working to reverse this trend, with events scheduled for the first Annual Interfaith Mental Wellness Observance Week beginning tomorrow, Monday, May 15.

Our model in these matters has to be Jesus. He was not afraid to face the chaos and confusion that he found within the people of his day, and neither should we. When he earned the scorn of religious people by performing healings on the Sabbath, he explained his actions by saying, "My Father is still working, and I also am working" (John 5:1-18). If Jesus was not afraid of breaking tradition by healing people on a holy day, then we should not be scared of praying for depressed church members in our services of worship, or making the necessary referrals to psychiatrists and psychologists. As long as God the Father is still working, we can do the healing work that we are challenged to do.

Fran Gatlin, the school psychologist at Robinson Secondary School, understands how important it is for congregations and mental health practitioners to work together on these issues. Last June she was one of the organizers of an interfaith conference on mental health and suicide prevention called "Bridging the Gap." She knows a Robinson mother who lost her teenage son to suicide, and then gave up on organized religion. She felt that her clergy and congregation were uncomfortable with what had happened and that they never met her needs after her son's death.

One thing so clear about Jesus is that he was never uncomfortable about meeting human needs. In fact, he voluntarily gave up his claim to personal comfort and control, and entered into a life of service to people around him. In one of the most striking acts of his ministry, Jesus gets up from the table at the Last Supper, takes off his robe, and ties a towel around himself. He pours water into a basin and begins to wash his disciples' feet — an act that causes Peter to pull back from what he feels is completely inappropriate behavior for a man of Jesus' stature. "You will never wash my feet," Peter protests, to which Jesus responds, "Unless I wash you, you have no share with me" (John 13:1-11). Jesus gives the clear command that all who follow him are to be servant leaders, putting the needs of others above their own sense of propriety and self-importance.

A number of years ago, a member here at FPC watched his wife struggle with depression, make a suicide attempt, and undergo several lengthy hospitalizations. The pastor at the time told him that it wasn't useful for ministers to visit patients in the mental ward of the hospital, and also said that it was the church's policy not to mention such cases in the prayers of the church. This member tells me that he hopes the church will now do a better job responding to these issues, and has volunteered to be part of a mental health support group — he wants people to realize "that if someone is experiencing a true major depressive event, they are simply not just very sad … [they] are not able to snap out of it on their own by listening to cheery music or reading The Power of Positive Thinking." All the strands of The Threefold Cord must be kept together — science, spirituality, and psychotherapy — by people who are truly committed to serving people in need.

Fran Gatlin tells me that studies show that only 30 percent of people with significant mental illness receive any form of treatment. As a pastor I know that I have to do more to identify these needs, make appropriate referrals, and activate the spiritual resources of this congregation. Untreated depression affects people of all faiths, including clergy, and it is especially devastating for our young people — suicide is the third leading cause of death among youths between the ages of 15 and 24. Glenn Wagner, a pastor who has struggled mightily with depression himself, says that the church needs to become "a culture of life, a place where life is nurtured, loved, and healed." He hopes that the church will regain its ancient identity as the "hospital of the soul," a place that is truly a sanctuary for hurting, broken people.

My colleague Jeri Fields, the associate pastor at Mount Vernon Presbyterian Church in Alexandria, runs an innovative program called Agape Reservoir, which meets the spiritual needs of people with mental illnesses. Her Friday-night gatherings routinely draw 75 participants. This program is a wonderful example of how treatment of mental illness is enhanced when faith development is part of the program — one man's anxiety is now so greatly reduced that he sings in the choir. Another person was abused by a father who was a conservative Christian, and shook at the prospect of simply walking into a church Sanctuary. She has now learned to overcome her fears, and has become an active member of the church, while also taking classes as a community college and earning an associate's degree.

By making peace with science and psychotherapy, religion may be able to help more people to get treated — a 2005 survey revealed that those who seek treatment typically do so after nearly 10 years of delays. Churches such as First Presbyterian of Lynchburg are taking a proactive approach, forming a health ministry team to help the congregation see the connection between faith and health. "I am praying that we can overcome the divide between faith and science," says associate pastor Walter Smith; "they both have so much to offer." We clergy remain front-line counselors for so many troubled people, and it is essential for us to be servant leaders who support the interweaving of science, spirituality and psychotherapy. While our need for various strands will vary, and it may be that we will never need all three at once, it is critically important that we maintain the full strength of this valuable lifeline.

We have to keep The Threefold Cord together. In many situations, it's going to be a matter of life and death. Amen.