Can a Period of Mental Distress be Both a Dark Night of the Soul and a Mental Illness at the Same Time?
- Introduction and Hypothesis
- Fields of Study
- 2.1 Analytic Theology
- 2.2 Psychoanalysis
- 2.3 Psychiatry
- Conclusion and Pastoral Implications
1. Introduction and Hypothesis
Some Catholic theologians have put forward criteria for discerning when someone is undergoing a Dark Night of the Soul and when they are experiencing a mental illness instead (e.g. Turner 1995; May 1997; Font i Rodon 1999). This has implications for people with pastoral roles in churches, who often act as frontline mental health workers (Mahmood 2015, 647). They may try to discern when a person’s experience is a Dark Night so that spiritual encouragement and guidance should be given (on the one hand), and when (on the other hand) it is likely to be a mental illness, so that the person should be referred to a doctor.
What is key for this paper is the tendency in some of the literature and in some pastoral practice to assume that an experience can only be either a Dark Night or a mental illness. I will call this the ‘either-or’ view. As an alternative to the ‘either-or’ view, I want to test the following hypothesis: someone may experience both a Dark Night of the Soul and also a mental illness at the same time. I will call this the ‘both-and’ view.
I will draw on the experiences of St Teresa of Calcutta, better known as Mother Teresa, as a case study. Ten years after her death, a number of the letters of Mother Teresa were published, revealing that she struggled with severe mental distress for most of her very long ministry. The following, written in 1961 to her spiritual advisor, is characteristic of the way she describes her experience:
Now Father – since (19)49 or 50 this terrible sense of loss – this untold darkness – this loneliness – this continual longing for God – which gives me that pain deep down in my heart. – Darkness is such that I really do not see – neither with my mind nor with my reason. – The place of God in my soul is blank. – There is no God in me. – When the pain of longing is so great – I just long & long for God – and then it is that I feel – He does not want me – He is not there. – … God does not want me. – Sometimes – I just hear my own heart cry out – ‘My God’ and nothing else comes. – The torture and pain I can’t explain. (Mother Teresa, cited in Kolodiejchuk 2007, 1-2; my parentheses).
Mother Teresa’s mental distress was interpreted by her spiritual advisors during her life as a Dark Night: “in what you reveal there is nothing unknown to mystical life. It is a grace granted by God” (Archbishop Périer, cited in Kolodiejchuk 2007, 164). As far as we can tell from the letters, it did not occur to Mother Teresa’s spiritual advisors to suggest she visit a doctor or psychologist or to consider the possibility that she had a mental illness. Perhaps this may be explained in the case of the early (1950s-’70s) letters as the result of little public understanding of mental illness at that time (Williams 2014, 295). However, this becomes less likely when we think about Mother Teresa’s later experience in the 1990s, as well as posthumously, in the way her letters were interpreted in the run-up to their publication in 2007, her canonization in 2016, and the representation of her as a saint since 2016, where discussion of the possibility of mental illness is also noticeably absent. This might make us worry that Mother Teresa’s spiritual advisors and interpreters may be part of an evidenced tendency, found in a different form among male leaders in some non-Catholic Christian traditions, to downplay or dismiss the experience of mental illness of women (see Stanford 2007).
I will presuppose that Mother Teresa’s spiritual advisors and interpreters were correct in their discernment that her experience involved a Dark Night. The focus of this article is on whether Mother Teresa’s experience might also have involved mental illness. By “mental illness”, I mean anything that could reasonably and appropriately be diagnosed as a mental illness by a doctor using criteria outlined in psychiatric manuals (e.g. DSM-5, ICD-11). I choose Mother Teresa as an example because there is some prima facie reason to think that she might have had a mental illness: her writings are marked by significant mental distress which bears some similarity to a mental illness such as depression or post-traumatic stress disorder. In addition, she suffered significant trauma during her childhood, involving witnessing the violent death of her father, who was poisoned by the Yugoslav government for political reasons. Ongoing political unrest was also a feature of Mother Teresa’s childhood: as Albanian Catholics her family were at constant risk of violence, and would naturally have been affected by the rape and murder of some of their Albanian Catholic neighbours (Zagano and Gillespie 2010, 60-61). Furthermore, during her ministry, she cared for the poorest and those who were dying in Calcutta, which could make her susceptible to secondary trauma or compassion fatigue, and due to the political situation in Albania she was unable to correspond with her mother for eleven years, who assumed she was dead (Kolodiejchuk 2007, 173; Williams 2014). These stressors would all increase the chances of mental illness (APA 2013).
2. Fields of Study
This is a work of analytic theology with pastoral theological concerns, engaging with psychiatry and psychoanalysis.
2.1 Analytic Theology
Analytic theology can enable us with the conceptual work of understanding what is meant by the Dark Night of the Soul and how we might think of it as related to mental illness:
What is a Dark Night of the Soul?
The Dark Night of the Soul is a concept in Catholic theology that takes its name from the writings of a sixteenth century Carmelite mystic called St John of the Cross, which concerns a purgative journey through which the soul becomes closer to God.
The first kind of Dark Night of the Soul (“the Dark Night of the Senses”) may be recognisable to many. It is not uncommon for people to have a period of their religious life in which they feel joyful and find prayer easy and fulfilling, but then suddenly to find that prayer becomes more difficult (“spiritual dryness”) and to no longer feel God’s presence so much. That’s the beginning of the Dark Night for St John (see Dark Night 1.3.8). More severe forms of the Dark Night can follow, especially for contemplatives, as they advance spiritually (Dark Night 2; see also Merton 1969, 27-28).
St John of the Cross is writing for spiritual directors who are trying to advise Carmelite brothers and sisters going through this kind of process. He is keen that spiritual directors reassure the people they care for that the sense of God’s absence and of not being able to pray is not anything they’ve done wrong – it’s not the result of sin or lack of faith – but simply one of the trials of the spiritual, and especially the contemplative, life (Dark Night 1.10.2; 2.5.5). He is also keen to figure out whether a person is in fact suffering as a result of melancholy (roughly equivalent to our category of depression today) so that they can get the help they need (Dark Night 1.9.1-1.9.2).
While St John coins the term “the Dark Night of the Soul”, others, especially within contemplative traditions, speak of this phenomenon. For example, Trappist monk Thomas Merton describes purgation in more modern psychological terms:
During the ‘dark night’…anxiety is felt in prayer, often acutely. This is necessary, because the spiritual night marks the transfer of the full, free control of our inner life into the hands of a superior power…We begin to get out of ourselves: that is to say, we are drawn out from behind our habitual and conscious defences. These defences are also limitations, which we must abandon if we are to grow… (Merton 1969, 55)
For St John and others in the Dark Night tradition, the Dark Night is purgative or purifying: it is about the stripping away of vanity and ego, of reliance on the senses and on reason, and of images of God. Because it is purgative it is also painful, but, in spite of this, it is a blessing:
This was great happiness and a sheer grace for me, because through the annihilation and calming of my faculties, passions, appetites, and affections, by which my experience and satisfaction in God were base, I went out from my human operation and way of acting to God’s operation and way of acting. (Dark Night 4.2.2)
How is the Dark Night related to mental illness?
The Dark Night of the Soul is relevant to mental illness because, phenomenologically, it is extremely similar to depressive disorders such as major depressive disorder, both emotionally and physiologically (Turner 1995, 232). In spite of this phenomenological similarity, St John and others in the Dark Night tradition regard it as distinct from mental illness, for two reasons. First, the Dark Night is caused by God, whereas depression (or melancholy) has natural causes. Second, the Dark Night and mental illness are teleologically distinct: the Dark Night purifies a person, whereas a mental illness only does the person harm (Dark Night 1.9.3). Although it is painful, the Dark Night is a specific experience of divine grace, and is good through and through.
Because the two states are genuinely distinct, the Dark Night tradition needs to be distinguished from the idea that the Dark Night and mental illness may be different lenses through which to view the same experience. As an illustration of this idea we might take Wittgenstein’s duck-rabbit: on this view we see the same thing (here, Mother Teresa’s mental distress) either as a psychiatric disorder, or else as a Dark Night. Psychiatrist S. Taylor Williams may be getting at something like this when she says: “There are many paradigms through which the human condition can be viewed – the Catholic Church’s theology and the DSM’s medical model are but two [….] no paradigm is necessarily objectively preferably to another” (Williams 2014, 296, my parentheses).
The “duck-rabbit” option isn’t quite the right one for understanding the relationship between the Dark Night and mental illness. The duck-rabbit option breaks with the Dark Night tradition by collapsing two different states into one another: one state that is pathological and teleologically “against the person”, and another state that is divinely caused and teleologically “for the person” because it brings the person closer to God. In addition, the focus of the duck-rabbit view is on the role that human action (e.g. interpreting an event as meaningful) might play in determining whether the event becomes meaningful, rather than on divine action which humans only discern and respond to (e.g. by recognizing the meaning that is there). From the perspective of the Dark Night tradition, then, the duck-rabbit view conflates pathological and salutary states, and it also downplays divine grace, which it is insufficiently realist about.
As an alternative to the duck-rabbit image, we might instead think of the relationship between a Dark Night and mental illness as being more like a tangled plant: we can imagine a beautiful jasmine plant becoming entangled with an invasive and parasitic ivy plant so that we experience the two together, although we know that they remain two distinct plants. This seems to be what St John thinks in relation to the Dark Night and melancholy:
Even though the dryness may be furthered by melancholy or some other humor – as it often is – it does not thereby fail to produce its purgative effect in the appetite, for the soul will be deprived of every satisfaction and concerned only about God. If this humor is the entire cause, everything ends in displeasure and does harm to one’s nature, and there are none of these desires to serve God that accompany the purgative dryness. (Dark Night 1.9.3)
St John does not discuss the relationship between the Dark Night and melancholy in much more depth: it is not the focus of his work. However, drawing on St John and also his own clinical experience, psychiatrist and theologian Gerald May develops the point in the following way:
In my earlier book, Care of Mind, Care of Spirit, I attempted to clarify the distinction between dark night and depression in modern psychological terms. I said, for example, that a person’s sense of humor, general effectiveness, and compassion for others are usually not impaired in the dark night as they are in depression. […] But it is not quite so simple. Perhaps the distinctions I have made […] might help distinguish depression from the dark night of the soul when there is no overlap. But my experience is that people often experience depression and the dark night at the same time. To say the least, the dark night can be depressing. Even if most of the experience still feels liberating, it still involves loss, and loss involves grief, and grief may at least temporarily become depression. Conversely, a primary clinical experience can become part of a dark-night experience, just as any other illness can. (May 2005, 155-156)
If May is right, the temporal sequence can work either way. Experiencing the Dark Night may bring about a depressive period, because of the challenges the person faces. In addition to this, a period of mental distress such as depression may be the right natural condition for a person to be receptive to divine grace and experience a Dark Night of the Soul.
In both cases the Dark Night and mental illness are like plants that have become tangled up with one another, but which are nevertheless different plants.
We have seen that St John has a both-and view of the Dark Night and mental illness – but is his view supported by more recent science? To consider this, I will turn to the reception of Mother Teresa’s experience in psychoanalysis and psychiatry.
Psychoanalyst Kaif Mahmood writes that “A diagnosis of moderate depression would not be unlikely if Mother Teresa consulted a psychoanalyst or a psychiatrist” (Mahmood 2015, 644). He brings specifically psychoanalytical insight to bear on the issue, imagining how a psychoanalyst might interpret her experience if she had visited one. He notes that Mother Teresa refers to God (in psychoanalytical terms, “the inner object”) as “father” and to herself as “your little one”, suggesting that God resembles a father figure to Mother Teresa (Mahmood 2015, 644). Furthermore, much of Mother Teresa’s life is motivated by a desire to be close to God. In spite of this, Mother Teresa felt only rejection and loneliness; as often happens, this made her question everything in life except the desired object, and made her willing to give up everything for it (Mahmood 2015, 644-645). She regarded this absence as being deliberately imposed upon her by the desired object, and she even worried about making the “inner father” more unhappy by complaining too much (Mahmood 2015, 645).
From this analysis of how Mother Teresa describes and makes sense of her experiences, Mahmood suggests that a psychoanalyst might wonder whether such psychodynamics arose from a childhood in which Mother Teresa was in a good relationship with her father – but that at some point there was a rupture, from which point she longed for the restitution of this relationship. Mother Teresa’s mental distress could be explained in psychoanalytical terms by the fact that “The trauma of the loss [of her father] was at least partially repressed, and is returning to consciousness now, with a transference of the same emotions to the figure of God rather than the real caregiver from her childhood” (Mahmood 2015, 645).
Theologian Phyllis Zagano and psychologist C. Kevin Gillespie add further weight to this psychoanalytic perspective on Mother Teresa’s experience, drawing on the earlier psychoanalytic work of David Aberbach, who points out that many mystics lost parents early in life (Zagano and Gillespie 2010, 62-65; Aberbach 1989). Aberbach notes, for example, that St John of the Cross’ father died shortly after St John was born, and argues that:
The awful sense of abandonment which pervades the Dark Night is likely to be especially strong among those who suffer loss, as Saint John did, in childhood. The greatest affliction of the Dark Night, which John depicts so movingly, is probably little different from the anguish suffered by any child bereaved of a loved father. (Aberbach 1989, 89, cited in Zagano and Gillespie 2010, 64)
Aberbach regards the experience in the Dark Night of “finding” and “being found” as having parallels in the grieving process, suggesting that the mystic’s experience may be replicating earlier loss – insight that Zagano and Gillespie apply to Mother Teresa (Zagano and Gillespie 2010, 64). Through the Dark Night, the person gives up all “knowledge” of God, going beyond understanding, analogy and images, in order to be united with God (Dark Night 2.6.1; Zagano and Gillespie 2010, 65). Zagano and Gillespie suggest that Mother Teresa’s Dark Night involves the shattering of the image of God as her father, which is particularly difficult for someone who has lost their father and who has come to see God as a father figure. In the Dark Night, Mother Teresa would “re-experience the grief of losing her father, this time the replacement ‘father-God’ of her own creation” (Zagano and Gillespie 2010, 65).
As this suggests, there is psychoanalytic support for the possibility that Mother Teresa experienced a mental illness. If correct, it is possible that mental illness became mixed up in the experience of the Dark Night, because of Mother Teresa’s traumatic experience of the loss of her father. Mother Teresa’s father seems to have been both loving and strict (Alpion 2006, 93), and it is easy to see this image of her father in the way she describes God: she hears Jesus continually asking her to go beyond being an ordinary nun and become as poor as the people in Indian slums, with the words “Will you refuse to do this for me?” (Kolodiejchuk 2007, 48, 49, 65, 96, 98, 99, 101). This relationship with her father and Mother Teresa’s fear of loss may be reflected in other things she reports Jesus saying to her: “My little one [….] I shall never leave you – if you obey” (Kolodiejchuk 2007, 98-99).
Does psychiatry concur with the psychoanalytic literature about Mother Teresa?
Psychiatrists are split on whether they think Mother Teresa had a mental illness. Psychiatrists Gloria Durà-Vilà and Simon Dein, influenced by Jesuit theologian and psychiatrist Jordi Font i Rodon, regard Mother Teresa’s experience as a Dark Night and not as a mental illness. In order to get to this conclusion they adapt a list of criteria used by Font to distinguish between a Dark Night and depression, according to which the Dark Night of the Soul differs from pathological depression in several respects: it causes healthy guiltiness that causes loving feelings to repair the evil caused; the person has a clear wish to recover completely, and never ceases to feel hope; the person does not run away from social interaction – instead, community life is maintained and inter-personal relationships improve; apostolic activity is not damaged; and the person advances in their spiritual journey (Durà-Vilà and Dein 2009, 547; Font i Rodon 1999, 100-108). Durà-Vilà and Dein claim that Mother Teresa’s account displays the features of the Dark Night, including the key features that set a Dark Night apart from mental illness (Durà-Vilà and Dein 2009, 547). Thus, for example, in spite of her distress, Mother Teresa was able to devote herself daily to the “poorest of the poor”, thus maintaining apostolic activity (Durà-Vilà and Dein 2009, 547; Kolodiejchuk 2007, 211). Again, she came to regard her experience as having meaning – for example, “as a privileged opportunity of being united with God through his Passion” (Durà-Vilà and Dein 2009, 554; Kolodiejchuk 2007, 217).
On the other hand, exploring Mother Teresa’s writings, psychiatrist S. Taylor Williams concludes that Mother Teresa’s experience may well have been a mental illness. Williams undertakes an analysis of Mother Teresa’s use of language, including words such as “darkness”, “pain”, “emptiness”, “loneliness”, features such as the difficulty of communicating the emotional state to another, and the search for a meaning within the pain. Williams then compares this with contemporary depression narratives such as those of Andrew Solomon, William Styron, Kay Redfield Jamieson and Sylvia Plath, finding these to be strikingly similar (Williams 2014). The language used by Mother Teresa to describe her mental distress, then, is extremely similar to the language used by people of their experiences of depression, and she also evinces characteristics of depression such as a difficulty in communicating her state to others, and a search for meaning within it. It therefore seems that Mother Teresa might be describing depression.
It seems we have an impasse. Should we prefer Durà-Vilà and Dein, or Williams?
I think there is some reason to prefer Williams’ view. The similarities in the language used of depression and the language Mother Teresa uses are striking. There are also reasons to question Durà-Vilà and Dein’s arguments against the idea that Mother Teresa had depression. In particular, there is a concern that their reading of Mother Teresa may be biased on account of certain assumptions. For example, they worry that:
[…] the psychiatric conception of depression as due to a chemical imbalance of the brain relieves the patient of personal responsibility, and deprives the individual of any meaningful significance [….] But, once feelings of sadness and dissatisfaction are defined in existential terms – as is the case for people undergoing The Dark Night – it can cease to be pathological and it may even be resolved through the attribution of meaning, allowing the individual to reflect on the negative aspects of their life. (Durà-Vilà and Dein 2009, 556)
As a result, they argue that:
It is imperative that health professionals ensure that people who experience an eruption of the supernatural in their life are not treated for a biogenetic brain disease rather than a spiritual ‘illness’. (Durà-Vilà and Dein, 557; see also 558).
As this indicates, Durà-Vilà and Dein assume an either-or view according to which mental illness is mutually exclusive of a Dark Night (a presupposition that seems to have sneaked in through the back door, since, as we have seen, it is not shared by St John). They seek to show that Mother Teresa was experiencing a Dark Night. They therefore have a prior motivation for arguing that Mother Teresa did not have a mental illness that owes more to a theological assumption – one that is not shared by the major proponents of the Dark Night tradition – than to science.
There are other concerns we might raise about their account. For example, the criteria used to distinguish between the two states also seem questionable: while they may reflect some general differences, there are certainly some cases of depressive disorders that include features such as hope, meaning, and the continuation of apostolic activity (e.g. Hilfiker 2002; Solomon 2001).
An objection to the possibility that Mother Teresa had depression should be briefly considered. Zagano and Gillespie reject the idea that Mother Teresa was suffering from depression (as distinct from other forms of mental illness). They point to the likely relationship between Mother Teresa’s experience of mental distress and the death of her father when she was a child, and to the fact that DSM-IV, the psychiatric manual being used when they were writing, states that a period of mental distress should not be diagnosed as a major depressive disorder if “the symptoms are not better accounted for by bereavement” (Zagano and Gillespie 2010, 64-65; APA 2000, 356). However, the “bereavement exclusion” they appeal to has been removed in the current DSM (DSM-5) on the grounds that it is now recognized that “bereavement is a severe psychosocial stressor that can precipitate a major depressive episode” (APA 2013, 811).
Zagano and Gillepie’s conclusion on this issue, then, is outdated, and Mother Teresa could be diagnosed with depression if she visited a psychiatrist now – even if (as seems highly possible) her mental distress was related to the death of her father. In addition to this, their argument would not preclude the possibility that Mother Teresa had another mental illness such as posttraumatic stress disorder, which can look similar to depression but which is usually more closely associated with a traumatic event (APA 2013, 271-279) even if they turned out to be correct that she did not have depression.
Grace and nature: a theological framework for the both-and view
This of course is open to a reductive interpretation: that Mother Teresa’s experience is only a mental illness, explicable through reference to her early relationships and life experience, and is not also a Dark Night after all – suggesting a denial of the both-and hypothesis for different reasons. However, this need not be the case if (as the Catholic tradition affirms), grace perfects nature, rather than being in conflict with it (see Thomas, STh Ia, q1, a8, ad.2). On this view, grace (here taking the form of a Dark Night) works with natural causes and processes (such as the death of Mother Teresa’s father, and psychoanalytical processes such as projection) in order to bring Mother Teresa closer to God. Grace does not work in a vacuum, or in a way that obliterates natural causes and processes. Furthermore, because grace and nature relate to different levels of causation, it is not the case that the Dark Night is (for example) 70% grace and so only 30% nature. God and nature are not in tension explanatorily because God is not another thing in the world; to think otherwise is to commit a category mistake (McCabe 1987, 6-7).
4. Conclusion and Pastoral Implications
While we can’t say for sure that Mother Teresa had both a Dark Night and a mental illness, consideration of psychiatric and psychoanalytical literature suggests that it’s not unlikely that she did. Given this, it seems at least possible that others too may experience both a Dark Night and a mental illness.
The pastoral implications of this are that mental distress might helpfully and appropriately be met with both spiritual encouragement (including, where relevant, guidance associated with the Dark Night), and also medical and psychological treatment. In spite of her belief that she should keep her suffering to herself, Mother Teresa reports that being able to confide her suffering to her spiritual director gave her some relief (Kolodiejchuk 2007, 186, 196-197). It may be that talking therapy, and perhaps medication, would have helped her further – and might help others too.
On the “tangled plants” view I have suggested, we need not worry that medical treatment such as antidepressants would “block” divine grace since there are two distinct things going on simultaneously. This is in contrast to the duck-rabbit option since, on that view, we might worry about medically treating an experience that it is possible to see as both a mental illness and as religiously salutary, since (because they are the same experience, differently viewed), we could not eliminate the pathological aspects without also eliminating the salutary ones.
Likewise, on the “tangled plants” both-and view, a diagnosis of mental illness need not eliminate the meaning someone like Mother Teresa could find in their experience (contra Durà-Vilà and Dein 2009). Telling someone that they have a mental illness would not obstruct meaning-making unless they were told that if they have a mental illness they could not also be having a Dark Night (or that their experience could not in other ways be meaningful). In other words, it is the either-or view, rather than psychiatric diagnosis and treatment, that could inhibit meaning-making. A person who is told (or to whom it is implied) that they have depression and so are not undergoing a Dark Night might be in the situation of someone who is undergoing the Dark Night but who does not progress because, in St John’s words, “they misunderstand themselves and are without suitable and alert directors” (Ascent, Prologue, 5). A “tangled plants” both-and view, then, enables people who (like Mother Teresa) are thought to be experiencing a Dark Night to also receive medical and psychological help, where appropriate, and also enables people who have been diagnosed with a depression to be open to the possibility that their experience might also have transformative aspects.
There is a further way in which this both-and view is important to Catholic pastoral theology. In addition to the question of pastoral discernment, there is a paucity of saints in the Christian tradition who are represented as having experienced mental illness. The main patron saint of mental illness, St Dymphna, was herself not thought to have suffered from mental illness, but, rather, to have suffered martyrdom and the threat of rape from her father, who is thought to have had a mental illness. The paucity of saints who are represented as having experienced mental illness is a problem within Catholic communities because saints provide consolation by being (in Julian of Norwich’s words) “kynd neyghbours and of our knowyng” (cited in Duffy 1992, 180), and even “fellow sufferers who understand” particular kinds of suffering (Scrutton 2020; see Whitehead 1978), and because their patronage can help to destigmatise certain forms of suffering.
The editor/commentator of Mother Teresa’s letters and postulator of the cause for her canonisation, Brian Kolodiejchuk, wrote that:
It is my hope that many will be inspired by Mother Teresa’s heroic living of her mission of ‘lighting the light of those in darkness’ and will carry it on according to their own call and possibilities. In those parts of our hearts where darkness still abides, may bright light shine through her example, her love, and now also her intercession from heaven. (Kolodiejchuk 2007, 12).
In a world in which mental illness is still stigmatized, it would be wonderful if the people for whom Mother Teresa’s light shines were to include more explicitly and particularly those with mental illness.
Aberbach, David. 1989. Surviving Trauma: Loss, Literature, and Psychoanalysis. New Haven: Yale University Press.
Alpion, Gezem. 2006. Mother Teresa: Saint or Celebrity? New York: Routledge.
APA (American Psychiatric Association). 2013. Diagnostic and Statistical Manual of Mental Disorders 5th ed. (DSM-5). Arlington: American Psychiatric Publishing.
APA (American Psychiatric Association). 2010. Diagnostic and Statistical Manual of Mental Disorders 4th ed. (DSM-IV). Arlington: American Psychiatric Publishing.
Duffy, Eamon. 1992. The Stripping of the Altars: Traditional Religion in England, 1400 – 1580. New Haven and London: Yale University Press.
Durà-Vilà, Gloria, and Simon Dein. 2009. “The Dark Night of the Soul: spiritual distress and its psychiatric implications.” Mental Health, Religion and Culture 12, no. 6, 543 – 559.
Font i Rodon, Jordi. 1999. Religio, psicopatologia i salut mental. Barcelona: Publicacions Abadia de Montserrat.
Hilfiker, David. 2002 (May and June). “When Mental Illness Blocks the Spirit.” http://www.davidhilfiker.com/index.php?option=com_content&view=article&id=33:when-mental-illness-blocks-the-spirit&catid=14:spirituality-essays&Itemid=24
Kolodiejchuk, Brian (ed.). 2008. Mother Teresa: Come Be My Light. New York: Rider.
Mahmood, Kaif. 2015. “Psychoanalysis, religion and enculturation: Reflections through the life of Mother Teresa.” Journal of Religion and Health 54, no. 2, 638–648.
May, Gerald. 1997. Care of Mind, Care of Spirit. New York: Harper Collins.
May, Gerald. 2004. The Dark Night of the Soul: A Psychiatrist Explores the Connection between Darkness and Spiritual Growth. New York: Harper Collins.
McCabe, Herbert. 1987. God Matters. London: Geoffrey Chapman.
Merton, Thomas. 1969. Contemplative Prayer. New York: Double Day.
Scrutton, Tasia. 2020. Christianity and depression: Interpretation, meaning, and the shaping of experience. London: SCM Press.
Solomon, Andrew. 2001. The noonday demon: An anatomy of depression. London: Vintage Books.
Stanford, Mathew. 2007. “Demon or disorder: A survey of attitudes toward mental illness in the Christian church.” Mental Health, Religion & Culture, 10 no. 5, 445 – 449
Turner, Denys. 1995. The Darkness of God: Negativity in Christian Mysticism. Cambridge: Cambridge University Press.
Whitehead, A.N. 1978 (1929). Process and Reality: An Essay in Cosmology. Corrected and edited David Ray Griffin and Donald W. Sherburne. New York: Free Press.
Williams, S. Taylor. 2014. “Illness narrative, depression and sainthood: An analysis of the writings of Mother Teresa.” Journal of Religion and Health 53, 290 – 297.
Zagano, Phyllis, and Kevin C. Gillespie. 2010. “Embracing darkness: A theological and psychological case study of Mother Teresa.” Spiritus: A Journal of Christian Spirituality 10, no. 1, 52 – 75.
All quotations from The Dark Night of the Soul and The Ascent of Mount Carmel are taken from Kieran Kavanaugh and Otilo Rodriguez (eds and trans). 1991. The Collected Works of St John of the Cross. Washington, DC: Institute of Carmelite Studies.
Quotations from the Summa Theologica (STh) are taken from the Fathers of the English Dominican Province (trans). 1948. South Bend, Indiana: Ave Maria Press.
 The interplay between divine grace and human response is important here. For St John and others, the Dark Night seems to be caused by God in a way that goes beyond ordinary providence – perhaps it is more like a small or unexceptional miracle. At the same time, however, the person may respond positively to divine grace, or else be resistant to it. In addition, the person’s context (for example, their religious community) may encourage the person to respond positively, or else it may foster an attitude of resistance. See e.g. Ascent, Prologue, 5. My thanks go especially to Joanna Leidenhag, Joshua Cockayne, Gideon Salter, Tobias Tanton, and Simon Hewitt, for helpful discussions on this.
 Mother Teresa’s locutions were generally interior imaginative locutions (i.e. things that she regarded Jesus as saying to her when she spoke to him during imaginative forms of prayer), rather than words heard auricularly (see Kolodiejchuk 2007, 368; n.15). However, at other points she is also reported as having heard voices (auricularly) and seen visions. Because of the capacity for such extraordinary experiences to be misleading, especially when taken out of context, it is emphasized that her conviction that God was calling her to lead an even poorer life came from her life of prayer and discernment over time rather than from extraordinary phenomena (see Kolodiejchuk 2007, 102-103).
Cite this article
Scrutton, Tasia. 2021. “Can a Period of Mental Distress be Both a Dark Night of the Soul and a Mental Illness at the Same Time?” Theological Puzzles (Issue 2). https://www.theo-puzzles.ac.uk/2021/06/05/tscrutton/.