You can hardly ignore that we are in a psychological and therapeutic culture here in the USA. The everyday language of the common American and even church member is laced with psychological terminology. Someone has a bad day and they are labeled depressed, someone else is hyper or ADHD, another moody person is called bi-polar. These are but a few of the terms floating out there in the culture and we use them without much thought to what they mean and/or imply. Christians should understand these terms in at least the basic sense and be able to glean useful information from them, yet not buy into all the baggage that comes with the terms.
When such terms are used in a diagnosis it is helpful to understand that they are only a description of a cluster of systematic observations, and not an explanation “why” a person has such symptoms. If someone has a clenched jaw, red face, squinting eyes, lowered eyebrows, clenched fists, raised voice, and stomping about, you could summarize all that by saying they are angry. But the summary word does not give you the “why” behind the anger. So diagnosis and labels give the “what” you see, not the “why” it’s there. Let’s say your car breaks down and you take it to a mechanic. You ask him what’s wrong with it and his reply is, “well, it’s dysfunctional.” You knew that already so restating the obvious does not help, you need the mechanic to do better than that. Same with psychology, the label is just the starting point.
Having a label or diagnosis can assist in many areas providing people are sensitive enough to understand the information associated with them. If someone has an anxiety disorder it may be something for the person to work on, and yet if they are in a work group for you, you’d likely not assign them to be the group spokesperson. Diagnostic labels can serve to trigger a caring church and friends on what to watch for and protect someone. Someone struggles with mania, so a friend able to recognize when they are getting too grandiose in their plans and ideas can seek to talk them down. Someone struggling with anxiety can have a friend who sticks close to them in public settings and is not afraid to ask if they are getting overwhelmed and need to go. The labels rightly act as signs pointing to where the person struggles most.
The diagnosis and labels go too far when they are taken by the person or their loved ones as identity. I hear lots of teens and younger adults say things like, “I’m bi-polar,” or “I’m ADHD.” In reality the person may have that symptom summary set as something they are dealing with, but it is not something they are. When I’m sick, I do not go around telling people, “I am the flu,” or “I am headache” because they are not me, but something I am dealing with. In reality with all the diagnosis you could want to read about in the Diagnostic and Statistical Manual of Mental Disorders (DSM for short, now in its 4th version) you could label almost everyone with almost every disorder. See everyone gets depressed, has mood swings, gets anxious, and so on, but we are all more or less on a linear scale for each one. Where these become a disorder is when on the far end of the scale a person finds such a symptom set as debilitating. They are so depressed or anxious they cannot leave the house, or they are so manic that if left to their own devices they may sell everything they have to hold a neighborhood cookout.
Another difficulty with labels is that they give the appearance of having a medical solution. If the person would just stay on his medication he would be fine. Yet the medication is only relieving the symptoms, and not addressing “why” it’s there in the first place. This medical misconception can also leave families and churches feeling helpless as medicine is not their arena, yet the desire should not be to punt the person off to the medical professionals, but to take the challenge to walk beside someone who is struggling, and be there side by side with them through the challenges to identify when they are drifting off into their problem area, to hold them accountable for what are real sins, and not dismissive lapses in medication. We are not disembodied spirits, the body can be a huge factor in how people feel and respond to things, and yet we don’t have the luxury of just excusing such things away. We are to find ways, even within the suffering, of how to best serve God and others.
To be continued in a brief overview of various psychological systems of thought (Freud, Adler,…) and how they have fallen apart leaving the Biblical model as the only coherent grid by which to practice counseling.