Likely Causes of Emotional Difficulties among Missionaries

Some of the factors that increase the likelihood of emotional difficulties among missionaries may be divided into two broad categories, internal and external factors. Internal factors are often things that make up the individual's personality; external factors are things in the environment. The latter are often given as the causes for the missionary's seeking psychiatric help. As a rule, they are more appropriately called the precipitating factors.

Some of the factors that increase the likelihood of emotional difficulties among missionaries may be divided into two broad categories, internal and external factors. Internal factors are often things that make up the individual's personality; external factors are things in the environment. The latter are often given as the causes for the missionary's seeking psychiatric help. As a rule, they are more appropriately called the precipitating factors.

EXTERNAL FACTORS
1. Culture shock. This term describes the individual's reaction to living in a dace where the customs and surroundings are distressingly different from anything he has experienced before: dirt, filth, bugs, tending to the calls of nature along the street, seeing people along the street picking up cow dung with their hands, seeing it plastered on walls to dry, seeing people wearing clothes almost never clean by our standards, seeing people sleeping on sidewalks. These are but a few of the things that give rise to culture shock.

2. A strange environment. People are often afraid and apprehensive in a situation or environment where they do not know what to expect. In our home situation we usually know what is expected of us, and what the laws are. In the new situation it may be difficult to find out. A missionary may spend hours at the income tax office, and still not understand what it was all about! The noises and sounds are different, and at night they may provoke anxiety.

3. The climate. Many missionaries work in tropical or sub-tropical areas. In hot, dry seasons temperatures may be 100 to 120 degrees. Then come the monsoons when nothing seems to dry for weeks. The dryness, dirt and dust of the hot season are followed by the dampness and high humidity of the monsoon season. Missionaries living where the climate is similar to home do not have to struggle with this problem.

4. Servants. Many missionary wives find having servants a problem, but the stress created by having servants is by no means confined to the women. Coming from a land where servants are a luxury, the missionary is made to feel as if he were wealthy. In most places where missionaries work, servants are essential. Though essential, they are not necessarily an unmixed blessing. Often wives who don't know the language well have to take charge of the servants.

Servants often think such practices as boiling the water are stupid. The same goes for many of the health safeguards missionaries try to keep in the kitchen. It is impossible to watch the servants all the time, even though routine checking is done to see that the food is clean and properly prepared. If, in spite of this, the family should become sick with some gastrointestinal upset, the housewife tends to blame herself for it.

5. There is no simple way to do anything. In the Orient it may take 45 minutes to cash a check even if no one is ahead of you. Making a train reservation may take half an hour. Trying to confirm a plane reservation may take repeated trips to the airline office as well as numerous telephone calls. This, even though your tickets were bought weeks before. This is particularly frustrating to Western missionaries.

6. Time seems to mean nothing. The carpenter may promise something the next day and deliver it several months later. The repairman may promise something one day, but it takes weekly visits to his shop to get your work back in a month or six weeks. "Came back again tomorrow," or, "At two o'clock" is frequently heard after you have come for an appointment. "Doesn't time mean anything to these people?" the missionary wonders. "How can I get my work done if this is the sort of thing I have to put up with?" The missionary uses up much nervous energy fighting this attitude.

7. The problem of language and communication. Most missionaries go to lands where they have to learn a new language. Even in a country like India, where English has been a second language for 150 years, there is a language problem. You may be told that the person cannot understand your native tongue (English) because you speak it with such an accent! Or, after studying the local language and thinking you have made progress, when you carefully say something in the new language, the listener clearly replies in the local language, "I am sorry, I don't understand English." Even after learning the literal meaning of words, it is vital to understand the idiomatic use of them. In addition, cultural patterns make a great difference. For example, in some countries you simply do not express your opinion in a meeting if it differs from the person asking for it.

8. The overwhelming work. Many times the missionary is overwhelmed by the need, and by the fact that results are so slow in coming. Where to start? How to do an effective job without spreading yourself so thin that nothing is accomplished? This often affects the missionary housewife, who is torn between the legitimate needs of her family and the demand of the mission that she do a "full-time job" outside the home.

9. Disillusionment with the local church, its leaders, and fellow missionaries. This is another stress factor often encountered. Missionaries come out with high ideals. They are not prepared to see the church divided, to see dishonesty and corruption in the church. It may be impossible to get a strict or accurate financial accounting. One missionary was continually frustrated in his efforts to conduct honest examinations in a Christian school. The authorities would not back up his efforts. Power politics are another disillusioning and upsetting thing. When one sees fellow missionaries bitter and hateful to one another, or not speaking to one another, the disillusionment is complete. Actually, there are no problems seen in the church in mission areas that are not seen in the homeland church. The missionary may be unaware of this or blind to it.

10. Assignment to work for which one is not trained, or different from that to which the missionary was asked to come to do. People trained as pastors may find themselves in charge of schools. One young woman who had a specialty training felt called to the mission field. She fell in love and the man wanted her to marry him. She thought to herself, "I'll see if I can find a place that uses my specialty, and if I do, I'll consider that God's answer." She found the mission opportunity, refused marriage, and went to the field. But on the field she had only two or three months doing the work she was specially trained for, for which she had given up marriage.

11. Being treated as if you really don't count. This is a problem of single missionaries, particularly in regard to their housing arrangements. Unfortunately, the attitude is often taken that a single person should be able to adjust anywhere. As to holidays, since she is not married, it does not matter if she has to work! Most missionaries will make a valiant effort to adjust to things that cannot be helped. However, being made to feel that they really don't matter is a difficult situation to have to face and adjust to!

12. Children, school, and the divided home. Though this stress is not present in all areas, most married couples are confronted with it in a country like India. Children are sent to boarding schools by the age of 5 or 6 in many instances. This leads to many conflicts. Mothers may go to the hills part of the time to make a home and be with the children, leaving the father alone. How much time should be spent in each place? Whatever is decided, there is a conflict. This separation creates problems. Many adjustments have to take place in marriage, all of which do not occur while the children are in the preschool period. The separation may delay or frustrate some of these adjustments. A mother may become involved in the community activity, and run her household and family independently. Then when the family is back together, conflicts result. Were they together all the time, these conflicts would have to be worked out sooner.

13. Medical care. The absence of the type and standard of medical care that one has become accustomed to at home is often another source of anxiety and strain. To have to take a patient to a hospital where so many of the standards of cleanliness and sterility considered essential in the West are not enforced is very trying, and uses up a great deal of emotional reserve.

14. Being a foreigner. Many find it difficult to accept and adjust to this fact. The individual is used to thinking, "I belong here," and if people are different, that is their problem. When one goes abroad as a missionary, this is no longer true. The missionary is the foreigner. In some cases he is looked on with suspicion or as an intruder. This is something one has to adjust to, and can be a factor leading to maladjustment.

15. Different social customs. These too require adjustments. We like to do the things that are correct and proper. At times it seems impossible to adjust to these new things. One does not understand what is proper and expected, even though one may have a period of orientation. Things that are done every day at home may be an offense in the new land. Although there may be an acceptance of Western customs in the larger cities, this may not be the situation in many of the places where one may be working.

16. Recreation. Good recreational habits are good mental health habits. In their homelands many people have recreation as a bunt-in part of their daily routine. In the new land these built-in recreations may not exist. People who are accustomed to having recreation freely provided may fail to acquire new recreational habits. Some people feel guilty for taking time to play when there is so much work to be done. The fact that this guilt is more often than not "morbid guilt" makes little difference.

These are some of the external factors that may be important causes of excessive drain of the emotional energy and reserves of the missionaries. Others could be added by those who have worked abroad as missionaries, but these give a good sample of the sort of things that make it necessary for missionaries to have special help with emotional problems.

INTERNAL FACTORS
When a missionary goes abroad he takes himself along. The basic causes of a missionary's mental illness are rooted in internal factors. What are some of these factors? How do they tie in with the varied things missionaries complain of when their need of psychiatric help becomes manifest?

Before discussing these factors, some of the more common complaints or symptoms will be mentioned. These include: depressions; physical complaints for which no physical cause is present, or physical complaints and symptoms out of all proportion to the underlying cause; spiritual deadness; the feeling that God is distant, or an uncertainty as to whether God exists; less reality and meaning in prayer or worship; unhappiness, feelings of unworthiness, of failure, discouragement and hopelessness in regard to own life or missionary work.

The feeling of being persecuted and that others don't understand; an inability to do one's work ("Just can't seem to get anything done"); language difficulty; problems of adjustment with colleagues; sexual problems; marriage conflicts; difficulties with the children or family; fears. This list, though not exhaustive, gives a general idea of the scope of complaints (leaving out those of a frank psychotic nature, which also occur).

1. Hatreds and resentments toward one's parents. The unresolved bitterness and hatreds that many missionaries have toward those who brought them up, usually their parents, is one of the very frequently encountered basic causes for psychiatric difficulties. Many missionaries come from what seemed to be happy homes; others from broken homes; from homes where one or the other parent was dead; from foster homes; from homes with relatives other than their parents.

Some parents were too permissive, never gave any discipline. Some were so strict that they were still beating their children into the late teens. Some parents were alcoholics. Some fought continually, often while preaching a gospel of peace. Some parents overprotected their children. Some made all the decisions for them. Some pub them to work very early, and made them take responsibility for siblings when they were not old enough to take responsibility for themselves.

Some parents made their children the outlets for their frustration and unhappiness with their husband or wife. Some parents fought each other through their children. Some were divided in their discipline-one saying one thing, one another. Some parents gave or withheld love depending on whether the child did as told or not. Some parents showed absolutely no physical affection. Some punished severely for no great offense. Many children became the whipping post for all of the unhappy things in the home:

This list of things that happened in the home is not exhaustive, but it gives a good sampling of some of the things that led the children to be bitter and resentful as they grew up. They hated their parents and could not strike back. Some of them ran away; some had been problems in school; others had just knuckled down and got through school in spite of it. However, the image- of their home treatment was there and served as a fire to stir up problems later.

Often these individuals had a history of difficulty getting along with others in various situations. It may have been in school; the difficulty may have been with their peers; it may have been in the community. They may wave had few or no friends. Some of these individuals came to the mission field as an escape from home or family. Some had made a remarkably good contribution during their time on the mission field, in spite of these handicaps that came with them.

Wondering how they were able to carry on as long as they did, the realization dawned that they had been able to do what they did because of their faith. Without their faith, some would have been in the back wards of some mental hospital. However, eventually all the other strains and stresses had caught up with them and they had a breakdown. Restoring them to health and missionary usefulness required the rooting out of resentment and bitterness at the deepest level. How that is done would make another article in itself. Let it suffice to say that merely talking about it, ventilating one's hate, and looking at it, and using will power to go on anyway, is not the solution!

2. Resentments and hatreds toward others. These feelings toward coworkers, friends, and past figures in the missionary's life are also an important basic cause of emotional illness. When one has come out to preach a gospel of love and peace, yet bitterly hates and will not speak to, or cannot forgive, a coworker, it is easy to see the conflict set up within one's self. The effects of such bitterness and hatred on the individual's emotional health varies little from the resentment and hatred toward one's parents. Drastic treatment leading to the removal of these harmful emotions is just as essential here as with parents. It should be noted that often these problems are a continuation of those described toward parents.

3. Sexual problems. Practically every sexual problem seen in the regular world of psychiatry has been encountered among missionaries. Masturbation, incest, fornication, adultery, homosexuality, voyeurism, reading obscene literature, molesting children, and rape, plus guilt in the unmarried for having sexual feelings, are some of the problems encountered.

4. Marital difficulties. With the divorce rate reaching as high as one in four in some Western countries, and many other marriages having serious problems, it is not surprising to find serious marital problems among missionaries. Though some of these have deeper roots in the early home relationships and patterns, as well as in some of the sexual difficulties already mentioned, it is important to set this type of situation off by itself as a basic problem. Though having roots in other areas, working through the problems-whether related to religion, money, sex, in-laws, dealing with the children, or their social life-was necessary and on occasions resulted in restoration of an individual or family to missionary life or a useful, productive life at home. Marital problems were encountered in about one-fourth of the married couples seeking help. Though the following were not usually given as the cause for seeking help, some of the things that eventually came out were desire for divorce, being in love with someone other than one's spouse, adultery, and cruelty.

5. Dishonesty. This was encountered from time to time as one of the serious underlying problems, and was manifested in various ways: evading customs, bribery, false reports, and lying. These were often serious contributing factors in depression as well as in other symptoms.

6. Guilts. One would think that among missionaries, who go to tell about the good tidings of Jesus-the message of redemption and release-that you would not find guilts. This, unfortunately, is not the case. Not only among missionaries and ministers, but among the rank and file of church members, East and West, there are an amazing number of people who carry around guilts, real guilts for past misdeeds. Though some of these are connected with resentments, other important etiological and dynamic factors include sexual sins, dishonesty, pride and selfishness. As mentioned before, hates, bitterness, resentments, grudges and failing to forgive those who have wronged one are common causes of deep basic quilts. Real, sexual quilts cover the whole range of sexual activity as listed before, as well as morbid guilt for normal marital sexual living because of unfortunate training or experiences in this line.

These quilts have to be brought into the conscious mind and dealt with accordingly. Guilts resulting from actual misdeeds need the experience of Christian forgiveness. Many need specific and detailed instructions as to how to

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