Do you know where thunderstorms come from? Thunderstorms form when hot meets cold, when warm, moist air confronts cold air and lifts into the atmosphere. Thunderstorms are products of confronting opposites. We don’t see those opposites distinctly from the ground. All we see are the effects of their convergence.
A similar phenomenon is happening in modern Western culture. The hot, unstable air of a decades-long mental health crisis is confronting the chill of individualism in what some are calling an epistemic crisis—that is, a crisis over how we can know anything truly. And so anxiety meets doubt, depression meets skepticism, internal anguish meets external culture wars. The inside rages against the outside. And as with thunderstorms, while we can’t see the broader systems so easily, we certainly experience the effects of their collision.
This is where the church finds herself—in the midst of a storm that seems to demand both nothing and everything from her. From one angle, she seems set apart from both the healthcare system and secular culture. What could she say of consequence on either front? From another angle, she holds the keys to the kingdom of heaven (Matt. 16:19). Where else can people go to find rest? Jesus said the church is a city set on a hill, burning with a brilliant light (Matt. 5:14–16), but how can she possibly respond to the gathering darkness?
What the church has to offer is actually critical to both the rise in mental health problems and our epistemic turmoil: heart care. Or, in this article, what I’m calling cardiac rest.
Allow me to set the scene for both the mental health and epistemic crises before showing how the church can respond with her Christ-won, Spirit-empowered cardiac care.
The Mental Health Crisis in the U.S.
The mental health crisis in the West has been gathering numbers for decades. I’ll focus on just two threads of that crisis here—anxiety and depression—using figures for the United States. Right now, nearly 1 in 5 Americans is being treated for an anxiety disorder (I’m one of them, by the way). That’s some 40 million people. For adolescents (ages 13–18), the numbers are even worse: nearly 1 in 3 (31.9%).1 Depression statistics aren’t much more encouraging. Some studies suggest 8% of American adults (21 million) battle major depression each year, and 15% of youth (ages 12–17). The suicide rate for Americans in 2022 was the highest it has been since 1941, leading to nearly 50,000 deaths. Those are bleak numbers.
People can get fixated on causality, which I’m convinced is too complex to pin down. Many factors have likely influenced what people are experiencing—a rise in technology and its attendant social changes, drug and alcohol abuse, influential worldviews that encourage introspection and self-exploration without offering any sense of stability. What matters for the church isn’t finding a precise explanation for what has caused mental health to worsen. Certainly, causes can influence treatment, so it is good to study these things and form educated guesses. But that doesn’t change the fact that people are showing up on the doorsteps of the church right now, regardless of whether we think we know why they’re suffering. At root, what’s at stake for people suffering from anxiety and depression is a deeper sense of peace, wholeness, and contentment that remains amidst life’s changing circumstances.
If the mental health crisis is the hot air, our Western individualism—with its expressivism and commitment to subjective truth—is the cold.
The Epistemic Crisis
In her book Untrustworthy, Bonnie Kristian addresses our epistemic crisis, a crisis of both knowing the truth and trusting in certain authorities to communicate it. In the foreword to her book, David French writes, “We not only don’t know what’s real, we don’t even know how to discover what reality is. We live in an age of earned distrust.”
What’s led to this epistemic haze and earned distrust? Phenomena such as “fake news,” widespread conspiracy theories, and a pervasive skepticism of authorities have all played a part, as has social media. But taking these factors together, Kristian argues that we have forgotten how to know things (epistemology) and how to weigh the truth claims of others. And so now, especially post- COVID, we live in a climate characterized by “distrust, animosity, and escalation” (pp. 16–22). For instance, hate for the opposition is more of a driving factor in our attempt to “know” things than is careful research and critical thought, guided by the biblical principle of speaking the truth in love.
Our epistemic crisis has led to some strange cultural movements, perhaps most notably the thralldom of people to their emotions, precluding the possibility of civil discourse. The topic of identity is perhaps the most familiar to us. Kristian explores something called identitarian deference—the idea that anyone who wants to say something about anything must defer to a certain authority, namely the authority of the person claiming a particular identity. So, if I want to make a claim about homosexuality, my claim is void unless I am homosexual. Subjectivity—my personal experience—has become the ultimate authority. You can see how this would evaporate civil discourse. Kristian quotes Mark Lilla to spell it out: in today’s public discussions, “the winner of the argument will be whoever has invoked the morally superior identity and expressed the most outrage at being questioned” (p. 139).
The heart and its ethical posture towards God always lies beneath the head...epistemology always builds on top of ethics.
The epistemic crisis essentially traps people inside themselves. It whispers that the only trust worth possessing is self-trust. Or, at its best, it encourages people to trust only a small faction of humanity based on emotive responses to world events. To combat this, Kristian offers a “practical epistemology” that upholds the virtues of studiousness, intellectual honesty, and wisdom.
While there is much to commend in Kristian’s book, I would argue that our greater problem is not, in fact, epistemological. It runs deeper. Look at what Paul says in Romans 1:21 about the epistemic problems of unbelievers. “For although they knew God, they did not honor him as God or give thanks to him, but they became futile in their thinking, and their foolish hearts were darkened.” Rebellious disobedience of the heart leads to blind futility in the head. Because they have insurgent hearts, God gives unbelievers over to debased minds (1:28). The heart and its ethical posture towards God always lies beneath the head. Put differently, epistemology always builds on top of ethics.
Even more support for this comes from 1 Corinthians 2:6–16. Here Paul talks about the only source of true knowledge: God’s revelation climaxing in Jesus Christ, the “exclusive and comprehensive principium for human knowledge” (Gaffin, Word & Spirit, p. 314). After exegeting the passage, Richard B. Gaffin Jr. makes a cutting observation: The wisdom of God—which includes all true knowledge about God, people, and the world—“is not ultimately cognitive or merely intellectual” because its “controlling point of reference is Christ,” who must be received in the heart by the work of the Spirit. Christ’s death and resurrection, Gaffin writes, is “Paul’s ultimate epistemic commitment” (p. 315). And so, “for Paul, it is not a matter of the primacy of the intellect, but of the heart” (p. 328).
Applying that principle to the twenty-first century, I would say that our epistemic crisis is really a cardiac crisis—a heart crisis. And we express that crisis in a simple question: whom can I trust? And bound up with this question is the ultimate heart question: whom do we most love? Whomever or whatever the heart trusts and loves most becomes the authority for knowing truth. But more on this in a moment.
To understand our cardiac crisis, we first need to set out what the church—and only the church—can offer: a revolutionary approach to suffering. Then we’ll come back to see how the church can engage with people and lead them to cardiac rest in Jesus Christ.
Suffering in the Christian Life
Both the mental health crisis and the epistemic crisis are instances of mass suffering. This is important to start with because only the church can respond to suffering in a way that doesn’t fall into self-pity, on one side, or spring towards self-congratulation, on the other (assuming the suffering is overcome). Jesus and the Apostle Paul portray suffering not as a crushing weight to carry or a looming boulder to climb, but as a trodden path to walk. And on that path, stamped by the humble feet of Christ, something truly divine happens.
Jesus said that any disciple of his must take up his cross and follow him (Matt. 16:24). In layman’s terms,Jesus is saying, “If you want to be my disciple, keep death in your back pocket.” At the same time, ironically, he claimed that he was the resurrection and the life (John 11:25). The Apostle Paul added that we are to be always carrying around the death of Christ in us so that his life would be manifested in our bodies (2 Cor. 4:10). So, in some bizarre, Jesus-esque way, we are to suffer with Christ in a continual dying that somehow manifests the resurrection life of our Lord. “Suffering with Christ” (Rom. 8:17; Phil. 3:10) and being conformed to his death is a path that, oddly enough, leads to life. Do you sense how revolutionary this is? Suffering isn’t a weight to uphold or a boulder to climb; it’s a path to walk, and that path leads to life.
I first realized this through an article by Richard B. Gaffin Jr., called “The Usefulness of the Cross,” now republished in Gaffin’s selected shorter writings: Word & Spirit. Gaffin draws a few striking conclusions after looking at 2 Corinthians 4:7–11 and Philippians 3:10. But perhaps the most potent one is this: “mortality and weakness, taken over in the service of Christ, constitute the comprehensive medium through which the eschatological life of the glorified Christ comes to expression” (p. 179). Put simply, our weakness and suffering for Christ is the means through which we experience his resurrection life. Gaffin even goes as far as to say, “Where the church is not being conformed to Christ in suffering, it is simply not true to itself as the church” (p. 184). Suffering isn’t something for Christians to get away from; it’s something for them to flee into.
So, for the Christian, suffering is a path leading to life. Good things—the best things—come not despite suffering but through it. This is the way of Christ, the way of the cross. And this is the way of Christians. Such a view of suffering sets the church up to respond powerfully to the twin crises we’ve looked at by making the heart central to all human experience. As the Counting Crows put it, we can “get right to the heart of matters; it’s the heart that matters more.”
Cardiac Rest
Let’s now return to the discussion about the heart and its trust. Both the mental health and epistemic crises often assume that the primary problem is in the head, not the heart. In the broader culture, mental health problems are treated almost exclusively as physiological or psychological. And the epistemic crisis is popularly referred to as a problem with “people just not thinking.” And yet the Christian view of suffering, which certainly applies to both crises, assumes that the heart is central. How does this help the church respond?
I believe it should respond by consistently offering cardiac rest, something given exclusively through Christ via the proclamation and application of the gospel. What exactly do I mean? There are many names we could use—e.g., shalom, peace with God—but I chose cardiac rest because it resonates with both the language of the gospel and our everyday experience.
In the Gospel of Matthew, Jesus says that the pure in heart will see God (Matt. 5:9), that our hearts dwell with our treasure (Matt. 6:9), and that we think and speak out of the overflow of our hearts (Matt. 12:34; 15:18–19). The heart, in other words, is the epicenter of life; it determines our relationship to God, our highest values, our thoughts, our speech, and our actions. For Jesus, it’s always the heart that matters more. And, as we saw earlier, the same applies to Paul’s thought in a passage such as 1 Corinthians 2:6–16.
In terms of our everyday experience, our hearts situate us for spiritual weather, and they do that by turning us towards our deepest longing. James K. A. Smith once wrote, “the heart is the existential chamber of our love, and it is our loves that orient us toward some ultimate end or telos. It’s not just that I ‘know’ some end or ‘believe’ in some telos. More than that, I long for some end. I want something, and want it ultimately. It is my desires that define me. In short, you are what you love” (You Are What You Love, p. 9). He’s saying that our hearts are always facing a certain direction as we’re struck by the winds of God’s providence. And based on that direction (our deepest longing), we are either running or resting. When Augustine wrote, “Our heart is unquiet until it rests in [God]” (Confessions 1.1), he knew that our hearts are always looking for a home, a place to rest, someone to trust without reservation. And that place of rest and trust is God himself—the greatest and most satisfying longing of every wanting heart. The great news of the gospel isn’t that we have to make our way home to God; it’s that God has made himself a home for us (John 14:23). We don’t have to seek our rest because our rest has sought us out. Our heart, the epicenter of life, has a home. It has a highest home and deepest trust in the Father, Son, and Holy Spirit.
Cardiac rest, then, is the heart’s repose in the presence of God, its rest in the greatest love. This repose was foreknown by the Father, purchased by Christ, and applied by the Spirit. Put differently, cardiac rest is the soul’s satisfaction in being fully known and fully loved by the one it longs for and trusts in most.
Cardiac Rest and Anxiety
Let’s apply this notion of cardiac rest to one aspect of the mental health crisis. It’s clear that the heart, with all its longings, is shaped through suffering, and mental illness is nothing if not suffering. In a host of ways, mental illness is a shaping experience. This was one of my main points in Struck Down but Not Destroyed, a book about my long-term battles with an anxiety disorder. I talk about hard things as shaping things. And so, in the midst of my anxiety, I find myself asking, to what (or whom) am I being shaped? This is a question all people should be asking because shaping is happening to all of us. As John Mark Comer wrote recently, “Stasis is not on the menu. We are being either transformed into the love and beauty of Jesus or malformed by the entropy of sin and death” (Practicing the Way, p. 71). The question isn’t, “Am I being shaped?” It’s, “To what or whom am I being shaped?”
Now, as a Christian, I have an answer to that question. I’m being shaped to the person of Jesus Christ by sharing in his suffering (Rom. 8:29; Phil. 3:10). I have the gracious gift of cardiac rest because my greatest longing and trust—for my Father, Savior, and Comforter—is presently and eternally satisfied. Cardiac rest means that I’m at peace being “formed into a person of self-giving love through deepening surrender to and union with the Trinity” (Practicing the Way, p. 80). That doesn’t mean I don’t suffer. It just means I know the purpose of my suffering and can change the sorts of questions I ask. Rather than asking, “Why am I anxious about X?” I ask myself, “God, how do you want to shape me to Christ through this?” Cardiac rest changes the questions that we ask ourselves.
But many people in the world don’t have an answer to that question of shaping. They are being shaped; they just don’t know to what or to whom. And this is where the church should be speaking. But let me say this very carefully in order to be faithful to Jesus and the Apostle Paul: the church should not be preaching Christ as the immediate end of all mental suffering. As we saw earlier, the elimination of suffering is not the end-goal for the Christian. Rather, we long to share in the sufferings of Christ in order to be raised with him in newness of life. Having said that, the church should be preaching Christ as God’s answer to our longing for cardiac rest amidst mental illness. That will help people struggling with mental illness to start asking different questions. And the choice of question makes a world of difference.
I can ask my doctor, “How can I get on a different medication regimen to completely eliminate all of my anxiety?” That would lead to one type of answer. Or I could ask my pastor, “How do you think God can use my anxiety to shape me to the character of Jesus Christ?” That would lead to a very different type of answer. The question you ask matters. The church should be helping people ask the deeper questions.
While there is no simple, one-size-fits-all treatment for the host of mental health issues in our world, there is a single truth that the church needs to emphasize in every discussion: Jesus Christ alone gives the cardiac rest you seek in the midst of your turmoil. His presence with you in your suffering is as certain as the sun rising. And by his presence, you can ask the deeper questions, assured that your greatest love and fullest trust is at home within you through Spirit-wrought faith.
Cardiac Rest and the Epistemic Crisis
What about the epistemic crisis? How does the concept of cardiac rest help here? Though there are certainly cognitive habits we can acquire to be more circumspect in what we believe as true or false, the roots of the epistemic crisis run deeper than epistemology. Remember, epistemology always builds on top of ethics; the heart undergirds the head. Educating the world about the practice of critical thinking, weighing sources, and seeking humility isn’t bad. But this is symptomatic treatment for a disease that can’t be educated out of people. Are people duped by fake news? Yes. Do they fall prey to conspiracy theories? Sure. Do they struggle to confess that objective truth exists? Indeed. But why are they doing these things? The short answer is that they lack cardiac rest. Cardiac rest—the soul’s satisfaction in being fully known and fully loved by the one it longs for and trusts in most—offers people an epistemology that is steeped in trust for the highest authority: the speech of the Father, Son, and Holy Spirit in Scripture.
In other words, those who have cardiac rest are fully trusting of the Trinity. And the Trinity is revealed in Scripture and in nature (though the latter must be interpreted through the former). It’s in Scripture that we learn what it means to truly love another person, what it means to be holy, and thus what the real difference is between true and false, right and wrong, honesty and deceit. We weigh and respond to the claims of others with “the mind of Christ” (1 Cor. 2:16). Such a mind cares both about what really exists or happens and what it means.
Jesus Christ alone gives the cardiac rest you seek in the midst of your turmoil.
Plenty of people in our world want to talk about “reality” or the news or the latest political blunder. Far fewer want to talk about what it means on a deeper, theological level. This, again, is where the church should speak. Meaning is only relevant when tied to a narrative that extends beyond the present, beyond the past, and ahead of the future. If we can’t make any statements about who people are, why we’re here, and where we’re going (questions of the heart), then why are we worried about making “factual” statements about the world and what happens in it? The latter are pieces of stone dislodged from the sculpture they belong to.
As a Van Tillian, I believe all facts have a divinely governed context. And the church, by grace and through God’s revelation, is the only institution that has a revealed eternal context for all facts. This doesn’t mean that we won’t talk about culture or the news unless people relate it to Jesus (a common mischaracterization of my position). But it does mean that we won’t be satisfied (we won’t have cardiac rest) when people try to give things value and meaning in isolation from the God who ordains all that comes to pass and is restoring all things in Christ.
Any two people can argue about whether or not a presidential candidate made a particular promise in a campaign speech. One will be wrong, and the other right (in most cases). But that’s not the same thing as understanding the meaning of that promise in relation to the overall purpose for humans as image-bearing creatures of God, all of whom are being shaped to someone or something. To answer the latter question, we need cardiac rest, and its attendant epistemology based on the revealed word of the God in whom we trust (what theologians call a revelational epistemology).
The Church as Home and Hospital
Let me end with some practical applications for the church, seen as both a home and a hospital.
The church is a home for saints who have surrendered to the shaping work of God. Each member of the church clings to the grace-gift of cardiac rest as the swells and storms of life roll through our days, months, and years. It’s important to see the church as a home for saints because the connotation of the word “home” invokes the senses of belonging and fellowship or communion with others. This is especially pressing for the mental health crisis, where isolation and loneliness push sufferers further away from those who would encourage and pray for them. In writing about the church, Herman Bavinck said, “The believer . . . never stands apart by himself; he is never alone. . . . From the first moment of his regeneration . . . the believer is, apart from his will and apart from his own doing, incorporated in a great whole, taken up into a rich fellowship” (The Wonderful Works of God, pp. 495–496). The rich fellowship of saints who possess cardiac rest is exactly what people need in the throes of mental illness. In a time when mental illness is still either stigmatized by the church or at least looked at as not deserving any special treatment, the church needs to assert itself as a communion-saturated home that welcomes suffering saints into its fellowship. Being with others does profound good for the soul. Every heart needs a home, a place that purges loneliness. But the church isn’t only a home for saints. It’s a hospital, too.
Someone once said to me, “Isn’t God just a crutch?” I responded the best way I knew how, with the theological training I received at Westminster.
Yes, he is.
And a cast.
And a sling.
And an antidote.
And a surgeon.
. And a hospital.
And we’re all terminal.
The church as hospital proclaims and applies the balm of cardiac rest to the myriad tensions and trials of God’s people—reminding them that such tensions and trials are stepping stones on the path of Christ-conformity. Resurrection life is coming and can surface in a host of ways in everyday life: in renewed patience, in creative kindness, in newfound encouragement, in sympathy for others, in hope that surpasses all circumstances.
The church is both a home for saints and a hospital for sufferers as it offers the cardiac rest that only Christ can give.
The church needs to continue the daily work of proclaiming Christ as the only means of finding cardiac rest in a restless world. But as she does so, there are three concrete things she can do to serve those in the mental health community and those caught in the epistemic crisis. Each of these things presupposes the Christian view of suffering and the centrality of the heart.
Practice the art of listening. People perennially underestimate the power of an open ear. Those seeking cardiac rest and its application to their lives sometimes just need to be heard. Note that this is different from advising people. We often rush to advise when that’s not what the person wants or needs. Part of the cardiac rest we find in God through the gospel is the peace of knowing we are fully heard, understood, and loved by the God who knows exhaustively and loves fiercely. The art of listening and asking good follow-up questions, without cutting others off by inserting our own experience, can go a long way in helping people see the church for who she is: the bride of Christ, who listens for the voice of her good shepherd and follows him where he calls. Sometimes our following means letting our lips lay fallow.
Learn to ask the deeper questions. In tandem with the first practice, the church can start to ask people the deeper questions—the hows that sit above the why of Christ-conformity. This gives us the opportunity to restate the revolutionary view of suffering that only Christians have. If all our suffering draws us nearer to Christ and brings resurrection life in its wings, then we need to ask questions that keep bringing people back to that reality. For some, this will mean asking the how questions of Christ-conformity. “How is this experience able to shape me to Christ?” For others, it may mean asking the deeper questions about meaning.
Invite and invest. Inviting people into the church and investing personally in relationships is something that will serve both the mental health community and those struggling with what to know and who to trust. Doing this meaningfully requires time and follow-up, which are hard to come by in our culture. Inviting and investing in people is not a shortcut or quick fix. Saying “yes” to one relationship will mean saying “no” to a host of other commitments. The church must be prepared to do less so that it can do more, to invest more in the depth of relationships rather than focusing on the breadth of increasing numbers.
As the systems of mental illness and epistemic crisis continue to converge, the church can stand strong and confident by upholding Christ and the one thing that every person desperately needs and constantly seeks, no matter how much they may rebel: cardiac rest in the God who knows and loves every suffering saint into glory. In the midst of every storm, he stays. And in the midst of our current storm, we need to proclaim his presence and the offer of cardiac rest in the God who knows and loves us more than we can imagine.