By Dr. David Coats
I would like to begin in part 1 to speak to the issue of psychological labels in brief. But perhaps, even if I do not cover all of the possible ground related to the common psychological labels of our day, I hope to be of some initial help to you. For example, would you question someone who said, “I am bi-polar”? Or would you have a biblical question ready?
It does not take much observation to recognize that our culture has readily accepted the labels of psychology as the norm for understanding or explaining people’s problems. Friends and neighbors will especially accept the labels for those problems or behaviors that fall into what our culture calls the realm of the psychological or problems that are viewed as forms of mental illness.
Our culture. Let’s consider some movies that illustrate the acceptance of the labels: A Beautiful Mind, the story of John Nash and his schizophrenia or Touched By Fire, the story of a woman, played by Katie Holmes, who struggles with bipolar disorder. Another popular movie is Shutter Island featuring Leonardo DiCaprio, a story line dealing with a form of insanity. You can read fictional books that use semi-reality to share what people experience as they live out the abnormal behaviors and psychological struggles found in our culture and at the heart of their narrative.
How did we come to label people or accept these labels as helpful? And are the labels helpful? Is the current psychological system of slotting people’s behaviors and life problems within these categories helping them to understand themselves? And on what basis does the psychiatric community have claim to such authority to label people as normal and abnormal? The psychiatric community says someone has ADHD, Schizophrenia, Oppositional Defiant Disorder, Bipolar Disorder, Obsessive Compulsive Disorder, and the list goes on. Why?
History. Briefly, let me share the process whereby this system of categories became so prevalent and accepted. In 1952, the first DSM system was available to the public, or at least to the psychiatric community. DSM-I (Diagnostic and Statistical Manual) was a theoretical approach to understanding and to categorizing these abnormal behaviors. In 1968, DSM-II came out, attempting to correlate with the international community in its handling and in its classification of psychological “diseases.” In 1980, DSM-III was unveiled with the hope that its revision had eliminated a dependence on psychological theories which had been evident in the earlier descriptions and basis for categorizing people. It was at this point that homosexuality was officially withdrawn as a deviant behavior or as a psychological disorder. It was removed from the DSM not so much by the study of psychological theory but because of political and cultural pressure to do so. (This seems to demonstrate the subjective and political-cultural nature of the DSM). The global assessment within the disorders showed up at this time (DSM-III) in order to describe how serious or how severe a case someone had regarding their particular label. In 1994, when DSM-IV came out, the system had become entrenched and accepted by the scientific community, thus our culture followed as well. However, you need to understand that the psychiatric community is not a unified group in its assessment of this document (I don’t have space and time here to explore this disagreement amongst these professionals. You can look it up yourself.) Finally, in 2015, the DSM-5 came out amidst mixed reviews. But the system, as far as we can tell, is here to stay, regardless of its veracity or standard. Presently, the DSM-5 is people’s psychological encyclopedia. Should it be?
What should we think about this developing system of describing people by their behaviors? Here is what one professor of psychology in a state university said about the problems with the DSM system:
- The quality of research base is questionable. The question relates to methods, comparisons, and relevance.
- The poverty of research base has not been addressed. Those who have reviewed the previous DSM listings have admitted insufficient evidence in several areas.
- Empirical evidence is not used in many decisions. Loosely connected concepts and at times “speculations” have been accepted as valid.
- The conclusions are not necessarily relevant to the evidence or only loosely connected to the studies at hand. (Jeffrey Poland, professor of psychology, University of NE, Lincoln)
He believes then that the validity of the categories discussed is potentially in question.
My next post will try to assess what some of the underlying motives and theories are for this system of categorizing people. I want to help us as Bible-believing people to come to the table with some historical and theological perspective. I will also suggest some alternative ways of assessing what is going on in the behaviors we read about and how we may experience them in our families.
As a footnote, if you would like to know how someone is categorized as ADHD, OCD, Schizophrenic, Bipolar, and any of many other labels, I suggest you go to www.MayoClinic.org on the web. This organization, rather than many other self-proclaimed authoritative sites on the web, is at least medical in nature and will give you the base line for such labels. You will find it interesting. You can also go to http://behavenet.com/apa-diagnostic-classification. Look for words like believe, suppose, theorize, may, think that. These words show their willingness to say that these labels and behaviors are not empirically known at this time.
One other thought for you. Part of my observation is that the DSM places behaviors together that should not be listed in similar categories. Within the Developmental Disorders (those diagnosed in infancy, childhood, or adolescence) are these: Mental Retardation, Learning Disorders, Motor Skill Disorders, Communication Disorders like Stuttering, ADHD, Conduct Disorder, Oppositional Defiant Disorder, Tic Disorders, Separation Anxiety Disorder to list some of them. Can you see the problem of lumping all of these together? The biggest problem with labeling is that it ignores what is going on in the heart while focusing only on the behavior that the label is based on.
