Shows Main Idea – The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) is the manual that the APA (American Psychiatric Association) uses to identify psychological (soul) problems. In March 2022, the APA published a new DSM-5 Text Revision (DSM-5-TR). It is to the secular community what the Bible is for the Christian community. Dr. Daniel Berger shares his opinions on the DSM and the latest changes.
The psychiatric community gives the world a new way of thinking about our problems through this lens.
It’s not unusual for the APA to revise their manuals. As they think through the human condition, they create more disorders.
One of the new disorders is prolonged grief disorder, an intense yearning for a deceased with a preoccupation about the person’s death. The implication is that if you grieve too long, it’s a disorder, though there is no way to determine the length of grief objectively.
The DSM-5-TR does not consider a theology of suffering, the sovereignty of God, boasting in weakness, relying on God, etc.
The DSM-5-TR committee does admit that their assessments are subjective, though they lay down guidelines for what is normal and abnormal. If your grief persists, you’re abnormal and should submit to secular psychological protocols.
Each psychologist and psychiatrist have differing opinions on the protocols within this framework.
The most significant problem with this method is that there is no hope for soul care; you’re abnormal and need medication, with no hope for change. Being a person of sorrow, acquainted with grief, grievers have term limits according to the DSM-5-TR.
Their “remedy” leads the grieving person into a victim-centered mindset, unable to cast their cares on Christ to alleviate the suffering. They must “cast their burden” on the psychologist, who prescribes the newly created disorder medication.
There are physical issues in the DSM-5-TR, i.e., dementia and autism, so some folks consider the manual a medical book.
Because of the subjective nature of our problems, the differing opinions, and the proximation of different disorders, it’s common to get multiple diagnoses with antithetical prescriptive protocols, depending on the clinician you’re seeing.
Other changes are going from transgenderism in the “outdated” DSM-5 to gender dysphoria in the DSM-5-TR to prevent offending evolving cultural norms.
They changed cross-sex surgery to gender-affirming treatment to move from the fact of cutting off body parts to surgically presenting someone as something they are not to affirming how a person feels about their gender.
Affirmative Care or Affirmative Therapy is a doctor “affirming the feelings” of the patient rather than giving objective medical advice.
The DSM-5-TR is the APA’s effort to keep up with cultural, social, and political mores.
The DSM-5-TR is a construct that describes real problems through a cultural worldview (lens).
The disorders, e.g., mental illness, were developed to sustain the model. They have not discovered anything but created labels (disorders) to fit a worldview that rejects God and His Word. They do not want us to understand the soul biblically. It’s anthropology that opposes Scripture.
You cannot accept an element of the culture without embracing their worldviews, presuppositions, practices, protocols, and solutions.
What does this mean for biblical counselors? The problem with some BC’ers is they believe, in part, in the DSM-5-TR but don’t recognize the inherent dangers. The call for BC’ers, who have a sufficiency of Scripture worldview, is that we must be gracious and clear about the risks of an integrated view.
You cannot accept some of the constructs without embracing the worldview. Of course, the problem for these so-called BC’ers is that it’s a faith issue for them—they believe there is merit, in part, with the DSM-5-TR. If we’re not careful, our friends will sense we’re attacking them when speaking against their positions.
There will be division within the biblical counseling movement; there is no way to prevent these tensions, though we must stand for truth with compassion, courage, competency, and clarity.
Most folks that psychologists label with a disorder, i.e., ADHD, or PTSD, do not realize what it means, other than knowing there is something wrong with them. Because the DSM-5-TR is descriptive psychology (it describes something), the counselee gives the person who can describe the problem the authority to present solutions, i.e., a hopeless journey into medication.
The DSM-5 came out nine years ago. About every ten years, there is a new version. Even if this manual did not exist, the problems would. Our call is to stick with the best book that not only observes the phenomena (things that are wrong with us) but also applies the proper responses from God’s Word.
We must do a better job educating those who are low informational about the disciplines and practices of salvation and progressive sanctification. Others are not low informational but have been to the academy and can understand the differences between the Bible’s plan for soul care and the DSM-5-TR’s plan.
The appeal for some folks is that the DSM-5-TR becomes an explanation for things we don’t understand. We can use the DSM as a miscellany file rather than saying we do not know what is happening with a person.
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