The DSM5: Helpful Guide or Adding to Confusion?
The Diagnostic Statistical Manual of Mental Disorders has now been in its fifth revision for a week and the controversy
swirling around it continues. Dr. Francis Allen of Duke University has cautioned physicians to use the DSM-5 “cautiously if at all.”[i]The problem as he sees it is the issue of “diagnostic inflation.” The DSM converts behaviors that have normal explanations into disease. Dr Frances sites several including somatic symptom disorder (worry over
having a medical illness), binge eating disorder (overeating) and disruptive mood dysregulation disorder (childhood tantrums). He notes that patients who are grieving the loss of a loved will be misdiagnosed with major depressive disorder and that “the already overused diagnosis of attention-deficit disorder will be even easier to apply to adults
thanks to criteria that have been loosened further.”
The problem this presents for patients is that these changes can be used to promote “…the misleading idea that everyday life problems are actually undiagnosed psychiatric illness caused by a chemical imbalance and requiring a solution in pill form.” As I read this article, I have been preparing to teach a seminary course at Baptist Bible College in Springfield, Missouri and one of the topics we will examine is what makes Biblical counseling Biblical. The difference between a DSM approach to problems of behavior and thinking and a Biblical counseling approach
could not be clearer.
The DSM turns normal human behavior into disease. It turns normal sadness into depressive disorder. It turns childhood tantrums into a medical ailment that will certainly end in a pharmaceutical treatment. It turns the self focused worry over illness into disease. Historically the expansion of diagnostic categories has led to the expansion of
medical treatment and that would be problem enough. But, the real trouble with this “diagnostic inflation” is that it draws our attention away from the real solution to most of the labels in the DSM.
Tantrums, worry, sadness over loss, over-eating and many behaviors like them in the DSM are problems for which the
Bible has real answers. When we can find troublesome behavior described in the Bible, there will be a solution that will be effective, without adverse side effects, and free! If the original intent of the DSM was to bring order to the
confusion that was Freudian psychiatry in 1950, I would tell you that the DSM and the committee have lost their way.
The solution to this growing confusion is to return the diagnosis of disease back to requiring pathologic changes at the cell level to define it. Instead of seeing every inconvenient behavior as a disease and then looking for a pill to fix it, we can find real solutions for matters of the heart. Those solutions are free and require no prior authorizations for all comers and can be found in the one book that changelessly describes human behavior.
[i] http://annals.org/article.aspx?articleid=1688399This is a really good article.
The Diagnostic Statistical Manual of Mental Disorders has now been in its fifth revision for a week and the controversy
swirling around it continues. Dr. Francis Allen of Duke University has cautioned physicians to use the DSM-5 “cautiously if at all.”[i]The problem as he sees it is the issue of “diagnostic inflation.” The DSM converts behaviors that have normal explanations into disease. Dr Frances sites several including somatic symptom disorder (worry over
having a medical illness), binge eating disorder (overeating) and disruptive mood dysregulation disorder (childhood tantrums). He notes that patients who are grieving the loss of a loved will be misdiagnosed with major depressive disorder and that “the already overused diagnosis of attention-deficit disorder will be even easier to apply to adults
thanks to criteria that have been loosened further.”
The problem this presents for patients is that these changes can be used to promote “…the misleading idea that everyday life problems are actually undiagnosed psychiatric illness caused by a chemical imbalance and requiring a solution in pill form.” As I read this article, I have been preparing to teach a seminary course at Baptist Bible College in Springfield, Missouri and one of the topics we will examine is what makes Biblical counseling Biblical. The difference between a DSM approach to problems of behavior and thinking and a Biblical counseling approach
could not be clearer.
The DSM turns normal human behavior into disease. It turns normal sadness into depressive disorder. It turns childhood tantrums into a medical ailment that will certainly end in a pharmaceutical treatment. It turns the self focused worry over illness into disease. Historically the expansion of diagnostic categories has led to the expansion of
medical treatment and that would be problem enough. But, the real trouble with this “diagnostic inflation” is that it draws our attention away from the real solution to most of the labels in the DSM.
Tantrums, worry, sadness over loss, over-eating and many behaviors like them in the DSM are problems for which the
Bible has real answers. When we can find troublesome behavior described in the Bible, there will be a solution that will be effective, without adverse side effects, and free! If the original intent of the DSM was to bring order to the
confusion that was Freudian psychiatry in 1950, I would tell you that the DSM and the committee have lost their way.
The solution to this growing confusion is to return the diagnosis of disease back to requiring pathologic changes at the cell level to define it. Instead of seeing every inconvenient behavior as a disease and then looking for a pill to fix it, we can find real solutions for matters of the heart. Those solutions are free and require no prior authorizations for all comers and can be found in the one book that changelessly describes human behavior.
[i] http://annals.org/article.aspx?articleid=1688399This is a really good article.
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