Someone with two healthy legs is able to stand, walk, run and jump. But if your leg is broken, your doctor won’t tell you to act like it’s healthy. Treating a broken leg as though it’s healthy will hurt it, not help it. If the medical issue is serious enough, the patient is put in an Intensive Care Unit, where they can receive closer attention. The same goes for churches – no matter what size they are.

This is a key paragraph in a blog post I read a few days ago, which can be found here .  I am in complete agreement with the premise that a sick church cannot be treated as a healthy church, cannot be expected to do and be the things that a well-functioning spiritual community is and does, until it has recovered from whatever is wrong. However, I think there are some missing pieces in the original article that need to be explored. I was a part of some lively discussions on two or three different Facebook pages in which I made some observations and suggestions; this little essay is an attempt to distill some of that and share it more widely.

The two missing pieces are diagnosis and treatment.  Not all unhealthy churches are unhealthy in the same way.  From this, it follows that appropriate treatment is dependent on an accurate diagnosis–you don’t treat cancer the way you treat a broken bone, and you don’t treat deep-seated infighting and power struggles the way you treat an unexpected traumatic event.  There may be some overlap:  while I have been recovering from a fairly bad orthopaedic injury, some of the medications I have taken are ones cancer patients take to reduce the nausea from chemotherapy.  But I could not have made a good recovery if my fractured and dislocated patella had been mistaken for, and treated as, a bone tumor.  A similar principle, I think, applies to treating unhealthy churches.  Accurate diagnosis is the foundation of the journey to wellness.

I think the ways in which a church can become unhealthy (maybe even start its life in poor health) are very similar to the ways a person can be unwell.  I think the very good blog post needs a bit of exploration on this point, and I offer a few suggestions.  Three main ways (probably not exhaustive, however) for a person to become unhealthy are (1) injury, (2) disease, and (3) lifestyle choices.

Injury is often sudden, and beyond the control of the person who suffers it; I think churches can be injured from things that are not their fault as well.  I took a freakish fall on a rainy day in South Buffalo during our annual January thaw, and ended up turning a once-whole kneecap into two pieces (note to self:  more is not better when it comes to how many pieces of bone you have).  In like fashion, I wonder how many once-well churches were hit very hard by events beyond their control, such as the economic meltdown a few years ago, or natural disasters such as Superstorm Sandy last October.  It would be interesting to see how institutionalized religion was affected—the impact on worshipping communities themselves, the wider economic/social consequences resulting from interruptions to the benefits they bring to their civic contexts, and the ways in which they have recovered (or not, as the case may be).  Injury, to an individual or church, is traumatic, and it may take a long time to recover.  2013 has been my ‘year of learning to walk again’.  The good news about injury is that it probably happened at a time of reasonable health.  This means that a state of well-being and good functioning is in relatively recent memory, and the injured person or institution is determined to return to that state.  A recognition that there will be scars—I will never be completely the same after my fracture—is healthy.  But I have learned much in my own process of healing, and this makes me stronger and more able to deal with future injuries.  I also lost about 10% of my body weight, which needed to happen for overall health.  I will work to keep that excess off, for the sake of what was injured, and for the sake of heart, lungs and blood vessels—those things that are vital to well-being.  An injured church also has a good possibility of being more healthy than it was before it was hurt. There is learning in the process toward being well, and sometimes shedding the excess helps an organization be better at what is really important.

Another way for a person to become unwell is through disease, and this is also true of churches.  Disease can arise in at least two ways, possibly more—but I think the main two are through outside infection, and through something going wrong internally.  Infection coming in from the outside is what most people and churches guard against.  Look at the sales of things like Airborne, and hand sanitizing gels, and even the prohibition against sharing the Peace and receiving wine at communion issued by the Archbishops of Canterbury and York during the 2010 swine flu outbreak.  In like manner to avoiding bacterial and viral infection, churches are often vigilant about external influences that may compromise their health—the current (annoying) debates about same-sex marriage are often cited as something that is going to end Christianity as we know it by more conservative churches; more progressive churches also guard against ‘wrong ways of being Christian’ with equal zeal, excluding those who are not adequately ‘inclusive’.

But it is not the external infection, I think, that is likely to be the cause of most disease in unhealthy churches.  It is the disease that is more analagous to those ailments arising from malfunction within the individual human body—organ failure, overgrowth of some cells and tissues at the expense of others—that are problematic.  In a human body, unregulated cell growth tends toward cancer, and compromises the whole; a previously well-functioning organ may either over- or under-function, throwing the whole system out of balance.  In a church, unregulated activity by one group (or domination by a particular activity or outloook) compromises the purpose of the church.  This can come from a long-time member (even the pastor), especially if s/he is a founding donor or leader of the congregation, or an over-emphasis on one good thing to the expense of others.  A congregation that focuses too heavily on children and youth (admirable as that focus is), may put inadequate resources into ministry to elders or outreach to the wider community.  While it may seem difficult to put too much emphasis on outreach, it is still necessary to budget for adequate infrastructure (including physical plant and core staff) if that outreach is to be well supported.  But if that infrastructure becomes all-consuming,again, the system is out of balance and unhealthy.

Disease in churches, I am afraid, does not arise from programs or buildings, or often even differences in theological outlook.  It arises from people who decide that their priority (and often not much more than a preference) is the only one that counts.  I visited a church a few years ago where a couple who were relatively new to the community had taken on (almost by force) significant leadership in the church, much of which was at odds with the pastor and longer-standing members of the congregation.  Their emphasis was on more modern, evangelical worship; the church was a moderately high catholic style Anglican one, with a locally important historic building.  A fair amount of coalition-building against the pastor ensued, mainly from newer members of the congregation; many of the more settled members felt resentment, and the church was largely riven into factions.  The energy could have been better spent in developing ways to work together.  My own experience and observation is that it is never healthy when a person or group (including the pastor) tries to make the church over in their own image.

A third way in which both individual humans and congregations can become unwell is through lifestyle choices.  We are bombarded with messages every day concerning how, by making choices about diet, exercise, smoking, etc., we can reduce our risk of stroke, heart attack, diabetes, osteoporosis, and even some cancers.  Lifestyle doesn’t protect us from every illness, but it prevents many, and the right choices can help us cope with, and make better recoveries from, sickness when it does occur.  We can’t control every environmental factor, or genetic predisposition, or just freak accident.  But we do have control over whether we eat a balanced diet, smoke, use alcohol to excess or take recreational drugs, spend a reasonable amount of time in physical activity each day, and how we cope with stress.

A balance of work, rest, play, fueled by good nutrition, does make the life of the individual human body better.  Why should this not also apply to faith communities as well?  Lifestyle-related illness is not the same as internally-generated disease—I think they are easier to correct, because they could be more like chiropractic adjustments than major surgery.  What does a congregation need more of, and what does it need less of?  Again, I am all for churches doing as much ministry in their civic communities as possible (however defined, and sometimes well beyond the immediate geographic area)—but if the congregation does not take time for worship, spiritual nurture and learning, and occasionally just some basic fun together, something is wrong.  But on the other side, if the only emphasis is glorious worship (again, however you choose to define that) which doesn’t lead to care for something more than the self (whether individual or corporate), that is an imbalance that needs to be addressed.  An expectation that the ordained leader does absolutely everything considered ‘ministry’ is problematic (and it can be fed by both the laity and ordained minister); when a few lay leaders are at the helm of almost all the church’s activities, this is also a problem.

How do we begin to figure out what kind of sickness a church has, so we can develop appropriate ways to get better?  A wise friend, who is a professor of general surgery, once said of his medical practice, that you can learn more from taking a complete history than you can by probing and prodding.  My guess is that this is as true of sick churches as it is of the unhealthy GI tracts on which my friend operates.  Asking the right questions of a church (and asking them from as many members as you can manage) is probably going to aid in the diagnosis, and help develop a treatment plan with the best chance of achieving the goal of getting back to health.  What are some questions we might be asking?  Here are a few of my thoughts.

How do you spend most of your time as a congregation?  I think there needs to be a balance of stuff that is internal to the assembly (worship, administration, Christian learning) with things that are directed more outwardly, such as outreach ministries, ecumenical cooperation, civic witness.  But in an unhealthy congregation, the balance may be more inwardly directed.  A struggling church may have to spend more time together dealing with its problems, and less on its public presence.

Who are the ‘leaders’?  I would expect the ordained ministers to head the list, but I also want to know what lay people are doing which tasks.  If the same five names in a congregation of 100 or more are in charge of the Sunday school, altar guild, the church’s turn at the local soup kitchen, the healing ministry, visitation to the sick, all of the major fundraising events, hospitality, etc.—and they all sing in the choir and sit on the governing body as well, this is something to watch.

How long have your leaders held their positions?  Long standing membership/leadership of a particular group within the church may mean that one person, or a small group, holds a lot of power (altar guilds are notorious for this); sometimes a denomination’s canons require that people serve limited terms (often a vestry member of an Episcopal church cannot serve more than 3 years without taking at least a year break between terms).  But it is also a red flag if a very new member suddenly is at the helm of four or five ministries in the congregation.  It is not that there isn’t a good reason.  If a new hire to the faculty of a local theological seminary joins your congregation, it makes sense for him/her to be an important part of adult education, or to take a place on a preaching rota; a new accountant or attorney in the church may be particularly useful to the governing board or on the finance committee.  But reasons for the meteoric rise to leadership of a new member need to be clear and reasonable.

My own experience shows that the choir is often a good place to look for people who have very extensive ministry obligations in the congregation.  I have rarely been in, or observed, a church where the choir did not have significant overlap with other activities in the church.  A church’s choir often has members of its vestry, finance committee, liturgy guild, outreach groups, building committee, etc.  It is probably the hub for a lot of activity, and a place where new members first get a toe in to deeper involvement, and make connections to those who have other ministry responsibilities.  See how many hours a week your choir members are obligated to the church—it may reveal some surprises, and suggest some ways toward a healthier congregation.

Why have people left doing particular jobs in the church?  Again, sometimes there are perfectly benign reasons—birth of a child or an increase in other family or work obligations, or a term has expired.  But if an architect in your congregation has left the building committee, it may be wise to ask a few gentle questions.

This is a starter-list of questions, and I am sure that I will think of more as soon as this is posted to the blog.  A final consideration is who is the right person to work with a sick congregation?  I wish to say something which some people may consider alarming.  I think the work of helping sick churches back to health would best be supervised by a lay person without strong ties to the congregation(s) in question.  A person who is also the ordained pastoral/liturgical leader has a role more of the supportive home-care nurse rather than the specialist or consultant.  The work of diagnosis, prescribing and monitoring the treatment is, I think, best done by someone whose relationship to the congregation is more detached; the reasons for this are the same as the medical ethics principles that advise against a physician treating his or her own critically ill relative.  As well, a lay consultant will not be expected to step in on a day by day basis to fix things that the congregation must work on for itself.  Finally, the ordained leader in a congregation is (like it or not) a part of the unhealthy state, and it is important to have some outside advice concerning whether the ordained leader and congregation can move forward together in healthy ways, or if there needs to be a surgical excision that allows them to move toward health separately.

As well, it a congregational health-check could be developed, and each church work with a consultant to do a biennial (at least) self-assessment.  This could help identify problems before they became insurmountable, damaging the vitality of congregations and the well-being of their ordained leaders.  A lay person, with good theological qualifications, on the senior staff of every diocese or other denominational adjudicatory, to do this kind of work, would be a good investment in helping to keep churches healthy and move unhealthy churches to a place of greater well-being.

Note by editor: The illustration (courtesy of Wikimedia) depicts a very literally sick church in that it is closed and kept locked. But I thought the row of chairs in the congregation, each isolated from the others, was also a good metaphor for another problem of church sickness.