Are you mental?
How can you tell if someone has a mental disorder?
For starters, if your son throws too many tantrums, he could have “temper dysregulation with dysphoria.” If your teenage daughter is particularly eccentric, she might just suffer from “psychosis risk syndrome.” If your husband really likes to have sex, he probably has a disease called “hypersexual disorder.”
According to a story in The Washington Post, “There are dozens of proposals being unveiled today by the American Psychiatric Association in the first complete revision of the 1994 of the Diagnostic and Statistical Manual of Mental Disorders, or ‘DSM.’”
Here is a quick history lesson on the DSM.
WWII was the first time all American soldiers were screened by psychiatrists and physicians for their mental fitness for war. In 1945, a doctor by the name of Will Menninger introduced an entirely new diagnostic approach for the field. He created new categories specifically geared to incorporate the war experience.
Menninger, influenced by Freud, had far reaching influence beyond the war. Eventually his approach became the basis for the American Psychiatric Association’s first diagnostic manual in 1952, the direct predecessor of today’s Diagnostic and Statistical Manual of Mental Disorders.
On February 5, 1963, President John F. Kennedy delivered a national speech on mental health. He referred to mental health as the nation’s number one health problem. In order to confront this mental health crisis he signed into law the Community Mental Health Centers Act on October 31, 1963.
In 1977 President Jimmy Carter organized the Commission on Mental Health. And in the 1980’s an eruption of 12 step programs provided a disease label for virtually anyone who wanted one.
Now, the DSM-IV is about to undergo yet another revision.
The report in The Washington Post explains that,
The product of more than a decade of work by hundreds of experts, the proposed revisions are designed to bring the best scientific evidence to bear on psychiatric diagnoses and could have far-reaching implications, including determining who gets diagnosed as mentally ill, who should get powerful psychotropic drugs, and whether and how much insurance companies will pay for care.
Even before being made public, the proposed changes have been the subject of sometimes bitter debate over whether the process was based on solid scientific evidence and was adequately shielded from influence by the pharmaceutical industry, and whether some critics were driven by financial interests in maintaining the old diagnostic criteria.
“By massively pathologizing people under these categories, you tend to put them on an automatic path to medication, even if they are experiencing normal distress,” said Jerome C. Wakefield, a professor of social work and psychiatry at New York University.
There are three fundamental problems with the DSM. First, it is subjective. According to Edward Welch in Blame it on the Brain, “Psychiatric medication is not treating a verifiable chemical imbalance in the brain. Contrary to popular perception, psychiatric medications are not chemical bullets that target one particular brain chemical. They are more like chemical blitzkriegs, strafing chemical sites in the brain and hoping for the best.”
The second problem is that it leads to over medication.
Third, it leads to legitimization of the blame game, the one we learned from our first parents in the Garden. Instead of sin and guilt, we can now use cleverly devised labels for rebellion against God.
When all of the layers of sophisticated academic talk are pealed away, we are left with two worldviews. The worldview of this present age tells us we are merely the product of biological and genetic code. The biblical worldview, on the other hand, tells us we are in the midst of a cosmic battle that is spiritual in nature. In short, our hearts are desperately wicked, and God is in the process of redeeming the world through the work of His Son.
David Tyler and Kurt Grady explain the distinction between these two competing worldviews in their book Deceptive Diagnosis.
Sin, culpability and guilt are hard to determine in a world where people color and cloak their sin in all kinds of psychological language. Is she a shoplifter because she is willfully sinful or does she have kleptomania? Is the child willfully selfish or does have Attention Deficit Hyperactive Disorder? Is he an arsonist or is he a victim of pyromania? Does he need a pastor or a psychiatrist?
Although I could write about this issue ad infinitum, suffice it to say, “Blessed is the man who walks not in the counsel of the wicked, nor stands in the way of sinners, nor sits in the seat of scoffers; but his delight is in the law of the Lord” (Psalm 1:1-2). That man is Christ Jesus, “in whom are hidden all the treasures of wisdom and knowledge” (Colossians 2:3).
February 11th, 2010 at 9:47 am
Outstanding article. We see this kind of response constantly in the field of education. While there are legitimate physical issues which cause retardation of the brain and genuinely limit the ability to act rationally, an overwhelming number of discipline problems are directly related to sin and rebellion. Our society has now firmly affixed their inability to help themselves and placed the blame and responsibility for their plight on the schools and/or government.
As Christians, we also firmly affix our inability to help ourselves. We also realize that no school or government can help us in our helpless situation. In Christ alone do we find our hope, our redemption, salvation from our sin.