How does Orthodox Theology
imply - and how should the Church understand - "sickness" and
"therapy", if not with the use of idealistic, physiocratic or
psychological-utilitarian forms and notions?
In our attempt to provide a reply to
this question, let's borrow
the following fundamental principles from
Sickness - every form of sickness - is the
consequence of man's Fall. This means sickness is linked to
sin, and not to human nature and as such, it is not "natural" for
man to become sick; it is in fact unnatural - it is "contrary to
nature". At first glance, this appears to lead us to the state that
we named "physiocratic" (ruled by nature) or "ideocratic"
(ruled by ideas), where "therapy" and
"cure" would seem to imply a conforming to nature. And yet,
certain clarifications can draw us far away from every physiocratic
perception. Given that man's origin is ex nihilo, his nature
per se is convertible - in other words, it is prone to deterioration
and death and consequently to sickness. However, even nature itself
can transcend this tendency - not with any innate powers of its own,
but only if united with the imperishable and eternal God. The
transcending of this convertible and corruptible state which is
intrinsic to human nature has been given to man as a "reason", as a
final destination whose realization has been allocated to man's
freedom as a person: the first man as a free person was called to
direct nature - either towards itself or beyond itself, towards God.
Adam - the first man - freely chose the first of the two (to turn
nature towards itself), thus sickness as a natural possibility
became a natural reality. It is no longer possible for human
nature to not become sick; sickness became a "natural" phenomenon,
not because it was an unavoidable thing, but because that is where
human freedom led matters. The consequences of this stance in
the matter of therapy we hope will become apparent, further along.
Sickness - like sin - has now become a general
and worldwide reality, which human freedom cannot retract, despite
the fact that its appearance and its consolidation are attributed to
it. And the reason for this is because with death (which
entered existence and from a natural possibility became a natural
reality), human nature was segmented and was no longer borne by each
person in its totality, in its fullness. Thus, the personal
freedom of one person does not influence human nature overall;
consequently, not only do sinners become sick, but saints also.
Final, actual therapy - as a complete elimination
of the sickness - is impossible and cannot be achieved by human
nature, nor by human freedom. Deterioration and mortality are
bequeathed biologically from generation to generation, and together
with them, sickness also. To break that vicious circle, we
believe -in theology- that external intervention was necessary; an
intervention that for us was realized, in the Person of Christ, in
Whom the joining of human nature to the divine (which was the first
man's calling and destination) was realized without the passage
through biological birth, which perpetuates deterioration and death
and is something that is impossible for every post-Fall human.
Christ is the only truly "healthy" Person - not because He is also
God (as the notions of "healthy" or "sick" do not apply to God) -
but because of His human nature, which is unaffected by any inherited
deterioration, and permanently joined (voluntarily and freely) thanks
to the hypostatic - the personal - union with God, He has transcended
deterioration and death. Consequently, no therapy (as a true and
radical elimination of sickness) can be considered without Christ.
Therapy is possible, only as an incorporation in Christ - the only
truly healthy human. It is not without significance that - for the
Church - the Mystery of the Divine Eucharist has such a central
importance for therapy, and the ascetic endeavours of human freedom
do not suffice for one to become cured.
Nevertheless, human freedom continues to be the
key to the proper understanding, both of the meaning of sickness
and of therapy. Given that sickness passed into existence
through human freedom, therapy and healing cannot but likewise pass
through the same gateway. This was a secret that the ascetic
Fathers of the Church were well aware of, which is why they placed
so much importance on the exercising of human freedom as a
liberating of oneself from passions. At this point, it is
especially important to note what Saint Maximus has to offer us.
Therapeutic axioms of Saint Maximus
According to Saint Maximus, the quintessence of morbidity is found
in self-love. Self-love is not simply a passion; it is the
generative cause of all passions: «Do
you want to be free of passions? Then cast out the mother of all
(Chapters on Love, II, I).
As Photios faithfully analyzes Maximos' thought (Library
of Codices 192 – ΡG 103, 637),
self-love - which replaced the love towards God -
gave birth to hedonism; but because hedonism was mingled with grief,
man became entangled in an interminable and desperate attempt to
hold on to hedonism and cast out the grief. It was from within this
agonized attempt that the «multitude
was born. And Photios explains Maximos'
is, if we renounce the hedonism in
self-love, we give birth to gluttony, to pride, to avarice, and to
the things that hedonism provides by whichever means; and if we only
flee from the grief in self-love, we give birth to anger, to envy,
to hatred, to despair and to whatever else the grieving
predisposition lacks. From the mixture of both are born: hypocrisy,
flattery deceit, and quite simply, all other malicious things that
are the fabrications of this mixed wiliness».
In other words, if we renounce hedonism but retain self-love, we
provoke gluttony, pride, avarice and everything else that provides
hedonism in any way; and if we were to renounce and avoid grief but
again preserve self-love, we provoke anger, envy, hatred, despair
and whatever else contains a deprivation of hedonism. If again
we were to mix both of these together and avoid them (ie, both hedonism
and grief) but still preserving self-love, we land in hypocrisy,
flattery etc.. The conclusions are important.
Cure from passions cannot be achieved through any
direct struggle against the specific passions. On the contrary, as
we noticed in the passage that I just read: in view of the fact that
the problem per se of spiritual sickness is born of the deprivation
of hedonism - always in conjunction with self-love - the more
deprivation that we provoke, the more the passions that we give
birth to. What does this mean? That, in order to be cured of
passions, we need to allow passions to exist and to function?
Of course not. But, it does mean that as long as self-love is
being prolonged, the excision of specific passions is not only
unattainable, but that even when it is achieved, it can be dangerous,
because with the deprivation of hedonism that is entailed, it will
give birth to other passions. Thus it often happens that those
who rid themselves of carnal passions may develop the passion of
avarice or pride etc.. Therefore we are not speaking of therapy,
when only specific passions are eliminated. The sole therapy
is found in the elimination of self-love, which is the root of all
Given that grief is an inseparable element of
hedonism in man's post-Fall state, it is an erroneous perception of
"sickness" : the one that we named earlier, as utilitarian; it is an
analgetic approach, and it appears to prevail in the contemporary
philosophy of medicine. Grief is not eliminated by removing
it, but by embracing it. Therapy comes with the invitation and
the experiencing of grief. Of course it often happens that
grief is unbearable, and experiencing it can be exhaustive.
That is why every therapeutic treatment needs to be adjusted to the
patient's tolerance (oikonomia).
But in no way should we regard the patient cured, just because he is
psychologically "comforted" or does not suffer. The tragedy of
existence lies within the Cross of Christ, and no therapy can bypass
the Cross. We often forget that hedonism is not only carnal,
but psychological also. By extracting grief from therapy we are only
providing hedonism, which constitutes an escape from reality and
The proper cure for passions presupposes - according to Saint
Maximus - three basic distinctions. He describes them in the
following passage, taken from the chapters on love:
mind of a God-loving person does not fight against things, nor the
notions thereof, but against the passions that are coupled to those
notions. That is, he does not fight against woman, nor against
the one who sorrowed him, nor
against the imaginations of them, but against the passions that are
coupled to those imaginations. All the struggles of a monk
against the demons are about separating himself from the passions of the
notions; for otherwise, he is not able to see things impassionately.
An actual thing ("object") is one thing, "notion" is something
else and "passion" is also something else. For, an "object" is
- for example - a man, a woman, gold, and the suchlike. "Notion" is
-say- the memory of one of the aforementioned. And "passion" is
-say- an unreasonable befriending or an uncritical hatred of one of
the aforementioned. A monk's battle - therefore - is against
We regard these distinctions by Maximos to be extremely important
for the matter of therapy. First of all, they point out that the
fight against "objects" - of beings per se - is an erroneous method,
because they give rise to temptations and difficulties. For
statements like these to have been uttered by a monk like Maximos - who had
departed from "objects" and had distanced himself from the world -
reveals that escaping from "objects" is not a solution, nor does
remaining close to "objects" (as with those who live in the world)
constitute a cause for sickness. For example, to recommend
divorce to someone who is suffering psychologically in the presence
of their spouse does not constitute therapy for that person.
Divorce may remove that person's grief for a time, but the problem
itself remains intact. That is how the current perception (that a
monk leaves the world in order to be "cured" of passions by avoiding
temptations) should be regarded as erroneous. The entirety of
ascetic tradition stresses that temptations become even more
powerful when one departs from the "objects" that provoke them,
because the "notions" of those "objects" - which test the person -
But the same applies to the "notions" of "objects". The memory
and the re-presentation of beings is not per se discommended.
Contrary to what Maximos writes, there are many who oppose art,
culture, and whatever else the function of human imagination
entails, for the sake of being liberated from passions. This
is an Origen- and Evagrios-like spirituality that Maximos surely had
in mind and opposed, because ideas like those were, at the
time (and I am afraid they continue to be) prevalent among monks.
Maximos stresses that monks' struggles are neither against "objects"
nor against the "notions" thereof, but against the passions that are
coupled to them. A proper therapy demands such distinctions.
Otherwise, spiritual freaks are produced: mentally sick patients,
who are in need of therapy more than anyone else.
But, how can one distinguish between "passion"
and "objects" and "notions"? The answer is provided by
Maximos, in the paragraph that follows immediately after the
previous one, mentioned above: The impassioned "notion" is
composite thought, consisting of "passion" and "notion". When we
separate the passion from the notion, what remains is merely a
subtle thought. And we can separate them, through spiritual love and
if we so wish».
The separation of "passion" from a "notion"
cannot be done, except by means of love, continence (=self-control)
and free will. However, these elements require more analysis.
Love as freedom, and freedom as love
Albeit keys for a proper therapy, the meaning of the term "love" as
well as "freedom" are likewise subject to their own pathologies.
Thus, "love" can, in essence, be a form of narcissism; that is, a
love of one's self through the image - the mirror - of another.
Narcissism is considered a disease; however, its forms are so many
and indiscernible that it usually cannot be confronted at its root
cause. In reality, every erotic love contains elements of
narcissism - the kind that we previously called "self-love", in the
words of Maximos. The "passion" of erotic love consists of the
demand for exclusivity that it contains; hence, all of existence is
built upon the two persons, as though no other beings exist around
them. Deep down, eros is an egocentric form of love, which can
lead to numerous pathological situations (dependence, separation
The same applies,
in the case of freedom. Freedom, as a liberation from the
other, can signify the crudest form of self-love - a pathological
from others - which can lead to depression or even suicide, when one
discovers that the others are necessary for him, but not desirable.
Thus the problem arises as to which way love and freedom can not
only liberate us from our passions, but also liberate themselves of
their own pathology. At this point, theology could offer the
transcendence of exclusivity in love.
you hate some, or, you neither love them nor hate them, and you love
some but only with measure, while you love others intensely, then
know that you are far from the perfect love, which is supposed to
love every person equally.»
Exclusivity negates love, because underlying it
is some form of self-love. We love our friends, our children,
our relatives, our "lovers" etc. more than the others, because we
expect some sort of reciprocation from them, or because some kind of
need - psychological or biological - bonds us to them. The
love of those close to us conceals the passion of self-love.
love of enemies.
No form of love is freer than this, and no form
of freedom can relate more, than the form that is the love of one's enemies. «If
you love those who love you, what is the grace in you?
for even sinners do the same» (Luke
love that expects reciprocation is «sinful»;
it is pathological. A love that does not
expect any reciprocation - or, better still - is directed towards
those who harm us, is truly "grace" - that is, freedom. Loving
God "in Christ", "while we are still sinners", as well as loving
God's enemies (ie., love towards sinners) is the only liberated
In conclusion, it is only when love coincides with freedom that we
have therapy. Love, without freedom, and freedom without love,
are pathological conditions that require therapy.
But, how can these two coincide in practice? It is easy for
one to opine on that which should be done, but what does theology
have to say, about
to do that which should be done?
The Church as a "therapeutic clinic"
We now come to the crucial point of our homily: in what manner can
the Church cure man in practice?
First of all, we need to clarify a misunderstanding that is broadly
prevalent. The Church does not cure so much with what She
but rather, with what She
This detail is extremely important.
As a rule, we all seek the
for salvation inside the Church, but salvation
lies in the very
called "Church", and our incorporation in Her.
The difference is huge, and it has a
practical significance, in regard to therapy.
The Church has spiritual fathers and the mystery (sacrament) of
Confession (which should more correctly be called Repentance).
Much emphasis and significance has been placed on this element, when
it comes to therapy. The perfect spiritual father-confessor
and a perfect method of confession etc. are sought out, but what is
overlooked is that
it is not the spiritual father who heals.
He might be tired during the hour of
confession, or, he may not have the appropriate knowledge: quite
usual things. Therapy will not occur during the hour of the
Mystery, quite simply because the Mystery has man's incorporation in
the Church as its objective, and only in there will therapy occur,
slowly and in the long term. How will that happen?
The Church is a therapeutic clinic, because She provides man the
potential to transit from the state of an "individual" to that of a
"person". What is the difference? And how does that occur in
"Individual" is an arithmetical notion, which springs from one's
isolation from other individuals - which simply is what it is, because it is
not something else. Deep down, "individual" is a negative
notion. When man exists and acts as an individual, he fences
himself off psychologically; he "excises" himself from others. This
is a pathological condition, which constitutes a host of morbid
phenomena and perhaps is the very source of all sicknesses - it is
that which Maximos calls "self-love". "Individual" does not
only comprise a problem of a moral or psychological nature; it also
has ontological dimensions. It is linked to death, which is
the par excellence "feeder" and simultaneously disintegrator of the
individual; death is that which highlights individualism, by
separating it finally from other individuals (each one of us dies
individually), and eventually disintegrating it, into decomposition
and nonexistence. Individualism is a carrier of sickness or
sicknesses, precisely because deep inside it lurks the fear of death
- the ontological nihilism - if this bizarre albeit true
contradiction may be permitted. The same applies, for the
body. If, like Maximos, they link self-love to the body, it is not
because the body is evil, but because it expresses par excellence
the fortress of individualism where lurks the potential for excising
ourselves from the others and where death eventually sets its sights
and succeeds. Individualism is the first pathological stage
that man goes through, when he is need of therapy.
The second stage is that of communion. For man to be cured of
individualism, he needs to move on, to his relationship with others,
with any form whatsoever, even if a negative one: to get angry, to
beat or even kill someone. What is usually known as "defusing"
is a form of transcending individualism - a form of "therapy"
according to psychiatry. This is not about the notion of
"person"; it is however a form of relationship and communion which
appears as therapy, without actually being.
The stage that the Church aspires to bring mankind is beyond this
stage, and to the stage of "person".
What is the "person"?
The Church borrows the notion of "person" from Her faith in the
Trinitarian God and, after taking it through
Pneumatology, applies it inside the Church. In the Holy Trinity,
"person" is a positive notion - an affirmative notion - and not a
negative one. The three Persons of the Trinity differ between
each other, not because they are isolated and excised from each
other, but on the contrary, because they are joined together
inseparably. The more inseparable the unity, the more it will give
birth - produce - otherness. This fact secures ontological
completeness and stability, absence of death, and true life. The
"other" not only is
an enemy, but is the confirmation of my own identity and uniqueness:
it is the You that makes me a "Me" and without which, the "Me" is
And something more. In the Holy Trinity personal otherness and
uniqueness are not justified psychologically, but ontologically. The
characteristics that distinguish between the three Persons are
ontological: each Person is what It is, and nothing else.
The person is not judged by its characteristics, but by the simple
affirmation of its identity as a unique and irreplaceable being.
The person is not a personality - that is, a coordinate of
characteristics (height, beauty or ugliness, virtue or malice,
genius or stupidity etc.); the person is free of characteristics and
is not judged by them.
This perception regarding the person is passed into the Church in
the form of God's love and freedom towards the world, the way it was
expressed "in Christ", with His love towards enemies and sinners.
The Church is the place in which man is not judged by his
characteristics (that is what forgiveness means, which he receives
with Baptism and Repentance), but by the fact that he is who he is.
Forgiveness and acceptance of someone as a person, as a unique and
irreplaceable identity, within the community of the Church, is the
quintessence of ecclesiastic therapeutics. The Church
heals, not with the things She says, but by that which She is: a
community of love, a love that is not a sentiment (so that we might
seek it in the inner self and the disposition of the individual), but
a relationship, which demands coexistence and acceptance within a
specific community - a community of love, without exclusivity and
conditions. The Church heals, by
such a community, in
which the incorporated person becomes freely addicted to loving and being
loved; where, in the words of Saint Maximos,
love does not split the one nature of humans... but, forever aiming
at it, loves all people equally... That is why our Lord and
God, Jesus Christ, in displaying His love for us, suffered for all
» (chapters on
love, I, 72).
The practical and relentless question however, is: Is the Church a
community of love, a place where one passes from "self-love" to
"brotherly love"? From sickness to healing? To the degree that
the answer is affirmative, one can refer to the Church as a
therapeutic clinic. Otherwise, She is a pharmacy, which
provides people with analgesics, without transforming them from
individuals to persons. Because the term "persons" has the
prerequisite of "relationship", and "relationship" entails
"community"; otherwise, they continue to be isolated individuals
with an "illusion of sanctity".
(there is no salvation outside of the Church) —
not because that is where the means for salvation
exist, but because in there is where the Trinitarian mystery of the
inter-embracing of persons is manifested.
Most people in The Orthodox Church have, to a large degree, lost the
awareness of "community", and if today they speak of a "therapeutic
clinic", they probably mean it as a pharmacy.
But the Church continues to be
the true Ark of Salvation, because She has preserved unadulterated
not only the faith in the Personal Trinitarian God and the Christ of
all-encompassing love, of the Cross and of the Resurrection, but
also because She continues to be the genuine eucharistic
("thanksgiving") community, in which are offered those loving
relationships that can heal man, by transforming him from an
individual to a person. It is this faith, this synaxis and community
that we must preserve genuine and active, if we want to regard the
Church as a therapeutic clinic.
Going over what I tried to say, I feel that I must point out the
For the Church and theology, therapy is not a psychological or moral
matter, but an ontological one. The aim of therapy is not to
provide relief for the symptoms of man's sickness, but to ensure his
rebirth, by transferring him from the space of self-love where
passions are born, into the space of brotherly love, where true
therapy through love is found. This passage from the one space
to the other is painful, because it has the Cross as a prerequisite,
or, in the words of Saint Maximos, the experiencing of the pain that
coexists with pleasure. It is a passage that must be guided with
care and philanthropy, «so
that what is lame may not be dislocated, but rather, be healed»
In this attempt, the Church and theology can provide, not so much
the technique, the specialization, but rather the faith in the
personal God, from which springs the faith in man as a person, an
image and a likeness of God; also the love of Christ which has no
boundaries and exclusivities, and the Church, as a eucharistic
(thanksgiving) community which actualizes that love, as a personal
existence and relationship. The battles against passions and
their riddance do not constitute an end in itself for the Church.
They aspire to the surfacing of the true person from within them, to
the re-joining of fragmented nature, and for man to rediscover his
proper relationship with God, with other people and with material
Health, for us, is the proper relationship of man with these three
factors (God, fellow-man and nature), which comprise the
definition of the human being.
"Sickness" is the upsetting of this triple and
three-dimensional relationship. Perhaps this is what hugely
differentiates theology from psychiatry - or perhaps not; you will
be the judge. What is certain, is that both the Church and
medical science must coincide in this basic discovery, should a
dialogue develop between them.
Minutes of a Meeting
and Psychiatrics in Dialogue»
Minutes published by the Apostoliki Diakonia pages 141-156,