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Faithful and Fractured

Responding to the Clergy Health Crisis

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Clergy suffer from certain health issues at a rate higher than the general population. Why are pastors in such poor health? And what can be done to help them step into the abundant life God desires for them?

Although anecdotal observations about poor clergy health abound, concrete data from multiple sources supporting this claim haven't been made accessible--until now. Duke's Clergy Health Initiative (CHI), a major, decade-long research project, provides a true picture of the clergy health crisis over time and shows that improving the health of pastors is possible. Combining the expertise of a health psychology researcher and a leading pastoral theologian, this book brings together the best in social science and medical research, quantifying the poor health of clergy with theological engagement about what can be done about it. Although the study focused on United Methodist ministers, the authors interpret CHI's groundbreaking data for a broad ecumenical readership, explaining that the findings are applicable to all North American clergy. In addition to physical health, the book treads deep into the territory of mental health and spiritual well being, and suggests that increasing the presence of positive mental health may prevent future physical and mental health problems for clergy. The authors weave concrete suggestions tailored to clergy throughout the book.

Preface: The Birth of the Duke Clergy Health Initiative
1. Creatures Doing the Creator's Work
2. When Work Is Holy: Highs and Lows of Ministry Work
3. Slowed Down and Overwhelmed: Clergy and Depressive Symptoms
4. A Practical Guide to Combating Stress Symptoms
5. The Pastor's Paradox: Clergy Health and Disease
6. Feeling Alive: The Role of Positive Emotions
7. Clergy Flourishing: In Their Own Words
8. The Lord Bless You and Keep You
Appendix: Recommendations for Clergy Health Programs


"I've enjoyed being called to pastoral leadership and have felt privileged to help a new generation of pastors into the vocation. But let's face it: church can be demanding, difficult, and even toxic for those who try to lead. The research reported and skillfully interpreted in Faithful and Fractured can be of great help to those of us who oversee pastors and to pastors themselves. The greatest challenge that pastors face is perseverance in our vocation. This book offers tested, proven guidance for us to remain faithful even when we are fractured by the vocation to which God has called us."

Will Willimon, professor of the practice of Christian ministry, Duke Divinity School; United Methodist bishop, retired; author of Pastor: The Theology and Practice of Ordained Leadership

"There are plenty of books outlining how difficult the work of ministry is and the toll it takes on the men and women who do it. There are far fewer resources that point to what can be done to reverse the damage. Faithful and Fractured honestly assesses the problem and then goes on to break new ground, describing practical ways that clergy can build positive mental health to not only survive ministry but also flourish while doing it. Finally, a book that not only prevents clergy from burning out but also teaches them how to thrive."

Matt Miofsky, lead pastor of The Gathering; author of Happy? What It Is and How to Find It

"An invaluable resource for clergy and for all who care for them, especially their therapists, spiritual directors, and judicatory leaders. This book should be required reading for every seminary student. May the wisdom that is reflected in these pages become a way of life for pastors in the years ahead."

Elaine Heath, dean, Duke Divinity School

"Pastoring is a dangerous, glorious journey. Drawing on extensive research on the lives of working pastors, Rae Jean Proeschold-Bell and Jason Byassee offer a life-giving path for pastors to become fully alive. Follow the deep and practical wisdom of this book and watch your life and ministry flourish."

Ken Shigematsu, pastor of Tenth Church, Vancouver, British Columbia; author of God in My Everything

"Bravo! Proeschold-Bell and Byassee's Faithful and Fractured is as important as it is urgent. Christian ministry is a high calling and a gift, yet it is beset by profound challenges and difficulties. The rigorous work of the Clergy Health Initiative, supported generously by The Duke Endowment, provides significant quantitative and qualitative data on which to base new strategies and actions. The future of ministry will be much brighter and more life giving if we pay attention to this beautifully crafted, substantive book."

L. Gregory Jones, Williams Professor of Theology and Christian Ministry and former dean, Duke Divinity School

"Faithful and Fractured makes clear a great many things about pastoral ministry that I had only vaguely understood before. I found myself nodding, smiling--or, as often, grimacing--with recognition at every page. In particular, the book provides an illuminating account of the paradoxical nature of ministry, which may simultaneously deplete and strengthen, discourage and reward. Faithful and Fractured is based on thorough research but provides much more than mere analysis. It commends a way for us to be fully alive and thus to live fully to the glory of God."

Craig C. Hill, dean, Perkins School of Theology, Southern Methodist University

"The health of a clergy person shapes and is shaped by the health of a congregation. Clergy are motivated by a divine calling, and yet we have the 'treasure of the gospel in earthen vessels' (2 Cor. 4). The strength of this major research initiative lies in its combination of data and narrative, social scientific rigor and theological wisdom, description and practical guidance. We now know a great deal more about the health and well-being of clergy--which encompasses survival, resilience, and flourishing--and we are greatly indebted to Rae Jean Proeschold-Bell and Jason Byassee."

Bishop Ken Carter, resident bishop, Florida area, the United Methodist Church

"In this insightful, interesting, and informative new book by Proeschold-Bell and Byassee, one comes to understand the wear and tear clergy experience in serving others and in answering their vocation. Stress occurs in all jobs, but when one's job is also a ministry, it is not as easy to walk away from such a vocation. This readable, well-researched book provides current science to the profession of clergy work. It is a book that scholars and others need if they plan to understand that service is stressful--even the shepherd can get lost and will need time to be refreshed."

Joseph R. Ferrari, professor of psychology and Vincent de Paul Professor, DePaul University

"This is likely the most important study to date on clergy health and sustainability. Proeschold-Bell and Byassee offer expansive research and practical wisdom for weary ministers. I'm hopeful their work is helpful to current pastors and is also translated into better pathways of preparation and training for future pastors."

Chuck DeGroat, professor of pastoral care and counseling, senior fellow, Newbigin House of Studies; licensed professional counselor, Michigan

The Authors

  1. Rae Jean Proeschold-Bell
    Satsuki "Sunshine" Scoville

    Rae Jean Proeschold-Bell

    Rae Jean Proeschold-Bell (PhD, Arizona State University) is associate research professor of global health at the Duke Global Health Institute and the Duke Center for Health Inequalities and Research in Durham, North Carolina. Her research focuses on the joint...

    Continue reading about Rae Jean Proeschold-Bell

  2. Jason Byassee

    Jason Byassee

    Jason Byassee (PhD, Duke University) is the inaugural Butler Chair in Homiletics and Biblical Hermeneutics at Vancouver School of Theology in Vancouver, British Columbia. He previously served as senior pastor of Boone United Methodist Church in the Western...

    Continue reading about Jason Byassee


"Byassee's proclamatory gems in this book are food for the soul (and possibly for sermons). The book might be best read chapter-by-chapter, with discussion. Its dialogue format invites real-life dialogue by clergy or other groups interested in clergy health. One dares hope a personnel committee and their pastor might be interested!"

Barbara Hedges-Goettl, APC,

Sharing the Practice

"This book is one of my must-reads for this year. . . . It offers a rich interplay between the voice of a researcher (Proeschold-Bell) and the voice of a theologian and former pastor (Byassee). . . . Ideas abound for clergy and others in ministry, for parishioners, personnel committees, lay leaders, for those in supervisory capacities. . . . If you're concerned about clergy health, if you're interested in working on your health as a person in ministry, I highly recommend this book."

April Yamasaki,

When You Work for the Church blog