Psychiatric labeling: The problem isn’t the label


Christians tend to have some strong feelings about counseling, psychology, psychiatry and similar terms. Come to think of it, most people, regardless of faith, have strong feelings about these topics. Experiences dictate much of these reactions. Experiences, such as:

  • experiencing or hearing of a mental health representative (mhp) belittling Christianity
  • experiencing or hearing of an arrogant, controlling, or completely incompetent mhp
  • experiencing or hearing of a positive experience where someone found relief or change or insight
  • feeling either helped or stigmatized by a received diagnosis or a use of medication

In psychopathology class tonight, we will explore the background behind psychiatric classifications. How did we get the Diagnostic and Statistical Manual? What are its underpinnings? There are a couple of common concerns about the DSM

  • It purports to be atheoretical and descriptive only
  • Diagnoses suggest objective and distinct “things”
  • It medicalizes problems in living
  • Under one diagnosis (e.g., depression) you can have such wide variety of symptoms
  • Therapists have sizeable disagreements on diagnoses so are they all that helpful?
  • It is leveraged by insurance in ways that make it a liability
  • It doesn’t address matters of the heart or spirit
  • It has political overtones
  • It treats most problems in an individualistic fashion without account for family systems

Every one of these concerns has merit. However, the biggest problem I have is not with the DSM itself but with many of its users. The complaints that are raised about the DSM usually come from someone mis-using the DSM.

Remember the simple explanation of a problem almost always distorts it. Thus, the simplistic use of diagnostic labels almost always does damage.

3 Comments

Filed under counseling, counseling science, History of Psychology, Psychology

3 responses to “Psychiatric labeling: The problem isn’t the label

  1. The Rev. Andrew Nussey

    Sounds interesting.

  2. Carmella

    I appreciate your discussion on this (sometimes I’d just love to sit in on your class discussions) especially because I see many of our tools as double-sided coins- in some ways they can be incredible (like the DSM-IV TR as a common language, which can allow people to experience freedom by knowing what to change and what to work on) versus stigma, difficulties with insurance utilization, differential diagnostic issues- oh, it goes on and on!

    I wonder what we, as clinicians seeking to be competent, can do about this. There is such a range of things we can ultimately advocate for.

  3. Amy

    I like the DSM-IV. Frankly, I wish I had used how to learn it while at Biblical (I didn’t have you for that class, so we used a completely different text, which was a waste of money in light of working as a therapist briefly upon graduation. I needed to use the DSM-IV.)

    This is the thing–it *is* helpful for insurance reasons plus as someone that not only has used the system for diagnosis, but also as a diagnosee (is that even a word?), I feel a little better. I suppose seeing my illness on a piece of paper should make me feel “labeled,” but instead I think, “Wow, there really is something ‘medically’ wrong with me.”

    Fortunately, my therapist is a wonderful Christian lady who addresses mental health issues, spiritual issues, and works with my psychiatrist for medication management. I think when all forces work together for the good of the patient–the treatment team can really make good use of the DSM-IV.

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