This post marks the conclusion of our four part series: No Labels…Should Diagnosis Matter at Church? Today, I’ll toss out a few final thoughts on the table for church staff and volunteers on the utility of diagnostic labels at church.
The New York Times has certainly been a helpful resource in generating content for the blog the past few days. Dr. Gary Greenberg (a clinical psychologist) wrote an op-ed piece today on the controversies around the update of the DSM-V, the manual psychiatrists, therapists, educators and the government use to categorize mental disorders. He raised a couple of points that are relevant to our discussion…
“But as all those Diagnostic and Statistical Manuals have stated clearly in their introductions, while the book seems to name the mental illnesses found in nature, it actually makes “no assumption that each category of mental disorder is a completely discrete entity with absolute boundaries dividing it from other mental disorders or no mental disorder.” And as any psychiatrist involved in the making of the D.S.M. will freely tell you, the disorders listed in the book are not “real diseases,” at least not like measles or hepatitis. Instead, they are useful constructs that capture the ways that people commonly suffer.”
We also need to consider this…
“Psychiatrists would like the book to deserve a more serious take, and thus to be less subject to these embarrassing diagnostic squabbles. But this is going to require them to have what the rest of medicine already possesses: the biochemical markers that allow doctors to sort the staph from the strep, the malignant from the benign. And they don’t have these yet. They aren’t even close. The human brain, after all, may be the most complex object in the universe. And the few markers, the genes and the neural networks, that have been implicated in mental disorders do not map well onto the D.S.M.’s categories.”
One of the challenges of our diagnostic system is that the DSM isn’t really grounded in anything. Our diagnostic system is a set of descriptors and checklists that doesn’t really tell us a whole lot about the underlying causes of the problems presented by the people we serve.
This problem is compounded by the reality that there are too many clinicians who aren’t particularly conscientious about sticking to the criteria as written. A terrific example of this phenomena is the explosion in the number of kids diagnosed with bipolar disorder. As a result, I see lots of kids who are just flat out incorrectly diagnosed, and kids with diagnoses that change frequently over time. You don’t want to base your entire strategy on serving a family upon something that is highly subjective, open to wide interpretation and constantly shifting.
Here’s something else to consider…We see many kids and adults diagnosed with specific disorders who begin to derive part of their identity from their diagnosis. This phenomena has been discussed during the debate about whether Asperger’s Disorder should be eliminated as a stand-alone condition separate and apart from autism. Shouldn’t our identity at church (and everywhere else) be defined by who we are in Christ as opposed to the diagnostic labels employed to serve us?
One last thought that may have crossed your mind in reading this series. In the “Let he who is without sin cast the first stone” department, you may have wondered why the guy who is criticizing church folks for getting hung up on diagnosis has a resource center link on ADHD and Spiritual Development. Just a wee bit hypocritical, don’t you think?
Ultimately, what we’re all about is helping churches reach families affected by disabilities. We have lots of parents who are also pastors or church staff members who discover our resources on the Web by entering search terms like “anxiety” “ADHD” “Bipolar Disorder” “Church” or “Special Needs.” We’re simply trying to disseminate our resources to as many churches as can use them. Parents who search for resources by googling their child’s diagnosis (because the diagnosis has meaning to them) will often forward our info to church staff or volunteers.
Bottom line…We can minister effectively to kids with disabilities and their families without requiring knowledge of diagnoses that may or may not be accurate or by defining children and their adults by their disability as opposed to by who they are in God’s Kingdom.