1. Diggins, Kristene

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As a mental healthcare nurse practitioner, I often hear people say they are seeking help for their anxiety or depression for the first time as adults because they were never encouraged to do so as children. It strikes me how each generation defines health in their own cultural context. Today people are more willing to seek care for their mental struggles compared to previous generations. The desire to be self-aware is prominent in the minds of patients today, and this self-reflection is pivotal to healthy living. Ultimately, keen self-awareness can help build understanding in what governs actions and responses to others and the world around us.

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I am thinking as I write of a woman who cried as she told me that, as a teenager, she had asked her parents for help with her paralyzing anxiety. Reviewing her history, she clearly had suffered from generalized anxiety most of her life. She was not encouraged to be self-aware and understand her own mindset. Now, seeking to address her anxiety, she experienced a new freedom and healing as treatment started.


She shared with me that as a Christian, she realized that her reflections led her down an unexpected path of repentance as her sense of depravity became more evident, along with her need for redemption. She was able to take this self-awareness symbolically to the cross where Jesus died (i.e., see 1 Corinthians 1:18; Colossians 1:19-22 about the power of the cross and reconciliation). In this mental process, her identity was strengthened. Her anxiety and depression lessened over time as she learned to cling to her redemptive state.


For us as clinicians, it is very empowering to see this type of transformation in a patient. As I listened to her story, I realized my opportunity to guide patients along the path of freedom in Christ while they seek to understand themselves.


Self-awareness is powerful and essential, and yet, can lead to dangerous thought processes because one's own inadequacies can generate negativity and a desire to escape from oneself (Baumeister, 1990). The evidence continues to point to the fact that there is a fine line between being aware of one's own governing thoughts and becoming fixated on the sense of failure and rejection (Holdaway et al., 2018). In fact, these reflections can be counterproductive and lead to a risk of suicide in some people. Clinical thinking on this is that deep reflection of self can lead to despair as one considers the true inability to control oneself and the world around us. This is where the Gospel's power can be most evident-where the redemption through the cross frees the human heart and mind of self-deprecation. As a Christian, I know that self-awareness can lead to freedom; it also can take a person down a path of self-destructive thoughts if the person only ruminates over his or her own shortcomings (Chatard & Selimbegovic, 2011).


In my clinical practice, I have recognized that leading someone toward self-reflection and awareness is not sufficient to build the self-confidence he or she is seeking. Self-awareness alone can lead to brooding on one's sense of failure as part of the human condition. When I work with patients, I see this is another opportunity to point my patients to the cross of Christ. From the Old Testament's beginning in the book of Genesis to the conclusion of God's Word in Revelation, we are given reminders about God's redemptive love, guiding us to love him and our neighbors as ourselves (Matthew 22:37-39).


As Christian nurses in advanced practice with longer-term patient relationships, we can guide patients on this journey of self-reflection toward a stronger identity in Jesus Christ, fewer anxious thoughts, and the release of the hold of depression. This is the victory we have to share with our patients, one patient at a time.


Baumeister R. F. (1990). Suicide as escape from self. Psychological Review, 97(1), 90-113.[Context Link]


Chatard A., Selimbegovic L. (2011). When self-destructive thoughts flash through the mind: Failure to meet standards affects the accessibility of suicide-related thoughts. Journal of Personality and Social Psychology, 100(4), 587-605.[Context Link]


Holdaway A. S., Luebbe A. M., Becker S. P. (2018). Rumination in relation to suicide risk, ideation, and attempts: Exacerbation by poor sleep quality? Journal of Affective Disorders, 236, 6-13.[Context Link]