The sign that something was wrong in Julie's life was all over the side of our toilet. Julie had been watching our kids that evening. I took her home and was met by my wife at the front door: "I think Julie has an eating disorder." She knew the signs, and Julie wasn't very careful about hiding her need to purge. It took us a few months to approach Julie. That began a long (and ongoing) process of care and discipleship that involved a number of people in our church. I present it to you here as a sort of case study of what personal care can actually look like on the ground in a local church. I've changed details of Julie's story (that's not even her name) and have asked the editors to not identify me, so that others might benefit from our experience without bringing attention to the people involved.
You're In It for the Long Haul
One of the most important lessons that our church's leadership has learned is that pastoral care can't be done quickly or impersonally. When we tackle a difficult, life-dominating issue such as an eating disorder, we have to settle in for the long haul. On the one hand, that means being patient with the sufferer. In Julie's case, there have been seasons of relief from her disorder and seasons where it seems to overwhelm her’affecting her family relationships, her work, and her schooling. On the other hand, those who assist Julie must remember that her eating disorder isn't the only thing that is true about her. Too many conversations after church begin with the knowing look and the coded language: "How are you doing?" Julie doesn't want to talk about her eating disorder all the time, not even with those who have proven to her that they care for her and are willing to bear her burdens. Sometimes she wants to talk about her friends or her dreams or her dogs. Being in it for the long haul means that we treat her as a whole person, not just a project to be fixed so that we can move on to the next crisis on the list.
You're Not the Expert
Early on in Julie's story, we gathered together a few trusted friends in our congregation to form a sort of care panel for her: a nutritionist, a physician, a woman who had also suffered from an eating disorder, and Julie's elder. We quickly came to realize that even with this stellar team of people who cared for Julie, we needed to bring in another doctor and a psychiatrist. This was partly because Julie didn't want her relationships in the church to be dominated by her eating disorder. It was also because her eating disorder was affecting, and could in some sense be traced back to, other issues in her life that needed to be addressed by professionals.
Even though we knew we didn't have all the expertise Julie needed, we didn't abandon her to the care of experts. We intentionally partnered with those experts to provide holistic care. Julie's elder went regularly to her meetings with the psychiatrist so that he could learn with Julie what some of the triggers were to her destructive behavior. This was done, of course, with Julie's permission, but I think it made a significant difference to our ability to care for her. It signaled to the psychiatrist that Julie was part of a loving community who would follow up with her to ensure she was taking the necessary steps to regain health. It also equipped our elder to give advice that wouldn't be contradicted by Julie's medical professional. The last thing Julie needed was conflict between the people who cared for her body and the people who cared for her soul. By working with Julie's psychiatrist, Julie's elder became a better spiritual guide to her.
Life Is Messy
The more we worked with Julie, the more we realized that sin and sickness are multifaceted in all of our lives. Issues relating to Julie's childhood, to her relationship with her parents, to the way she saw her place in society, to even her own understanding of God’all of these issues were bound up in her eating disorder. Untangling these issues will take a long time, and in the process people are bound to get hurt. In some churches there might be a temptation to sit in a place of authority and judgment, delivering advice as if it came straight from Mount Sinai. In our experience, we've often had to apologize to Julie, to one another, and to other people involved just as much as we've offered help and guidance. Thankfully, this place of humility has actually strengthened our ability to serve Julie. She has been freer to admit her sins and acknowledge some of the ways in which she brings difficulty into her own life. Would she have done that if she had been called before a room full of elders who "lovingly confronted" her about her eating disorder? I can't imagine that scenario going well! Instead, Julie has experienced the care of shepherds who are nursing her back to health. We are not afraid of setbacks, though they grieve us almost as much as they grieve Julie. We actually expect them because we know and acknowledge our own weaknesses.
I'll Pray for You
Today I received word of a friend who was just diagnosed with cancer. Earlier this week someone asked me to pray that they would find a job. Last Sunday night I did some marriage counseling via text message. It's easy to pray and move on to the next thing on my to-do list. It's much harder to pray and enter into the sufferings and joys of those who look to me for spiritual care. I've learned through my years in ministry that soul care is far, far more complicated than preaching. But the only way I can preach with any effectiveness at all is if I've also done the difficult work of soul care. I'm grateful for the others in the church who have shouldered Julie's burdens: the family that let her live with them rent free, the elder who went with her to her doctor's appointments, the older women who have cared for her without knowing all the messy details, the younger women who laugh with her on the sidewalk after the service, and the anonymous donors who help pay for her medication and treatment.
This is what our life together looks like as a church. This is just one example of the way that we bear one another's burdens. Your church, your situation, might be different. Julie's story might not be applicable to your own story. But I hope you can learn from this story that to effectively care for one another and to be a real community of faith, you must be willing to go deep with people who are hurting by combining physical and spiritual care. Julie's story isn't over yet, but by God's grace we'll continue to walk with her’eager to see how God answers our prayers for her health and maturity.
