Yesterday, the New York Times published a fascinating Op-Ed piece by Dr. Allen Frances called Good Grief. In the article, Dr. Frances reports that a startling suggestion is buried in the fine print describing proposed changes for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM V). If this suggestion is adopted, many people who experience completely normal grief could be mislabeled as having a psychiatric disorder.
It’s important to note that Dr. Frances is no enemy of psychiatry or even of the DSM. He’s the former Chairman of Psychiatry at Duke University, and was the Chairman of the task force that created the DSM 4.
Frances paints an alarming portrait of what could happen under the suggested change:
“Suppose your spouse or child died two weeks ago and now you feel sad, take less interest and pleasure in things, have little appetite or energy, can’t sleep well and don’t feel like going to work. In the proposal for the D.S.M. 5, your condition would be diagnosed as a major depressive disorder.”
With practical insight, Frances then explains:
“This would be a wholesale medicalization of normal emotion, and it would result in the over-diagnosis and over-treatment of people who would do just fine if left alone to grieve with family and friends, as people always have. It is also a safe bet that the drug companies would quickly and greedily pounce on the opportunity to mount a marketing blitz targeted to the bereaved and a campaign to ‘teach’ physicians how to treat mourning with a magic pill.”
According to Frances, and I agree, the DSM 5 is proposing a radical expansion of the boundary for mental illness that would cause psychiatry to intrude on the realm of normal grieving. The bereaved would lose the benefits that accrue from facing grief honestly and candidly. Grieving is an unavoidable part of life — the price we pay for having the capacity to love other people deeply.
Frances is right when he states, “It is essential, not unhealthy, for us to grieve when confronted by the death of someone we love.”
More importantly, grieving people, rather than turning to the Christian community for sustaining comfort and to Christ for healing hope, would instead be tempted to cling to a quick medical fix. Rather than facing suffering face-to-face with Christ, depths of grief could be masked by prescription drugs.
Though Frances does not approach this issue from a scriptural perspective, he does see the harm that can come from a medical approach to a personal, relational, spiritual issue.
“…there would be the expense and the potentially harmful side effects of unnecessary medical treatment…. After recovering while taking a useless pill, people would assume it was the drug that made them better and would be reluctant to stop taking it. Consequently, many normal grievers would stay on a useless medication for the long haul, even though it would likely cause them more harm than good.”
This is not to say that medication is never appropriate during bereavement. Grievers with severe and potentially dangerous symptoms could still be treated and diagnosed without the medicalization of every grief experience. As Frances puts it:
“For the few bereaved who are severely impaired or at risk of suicide, doctors can already apply the diagnosis of major depression. But don’t change the rules for everyone else. Let us experience the grief we need to feel without being called sick.”
Frances saves his most passionate plea for last.
“Turning bereavement into major depression would substitute a shallow, Johnny-come-lately medical ritual for the sacred mourning rites that have survived for millenniums. To slap on a diagnosis and prescribe a pill would be to reduce the dignity of the life lost and the broken heart left behind.”
While I would not choose the phrase “sacred mourning rites,” I am convinced that God’s Word provides all-sufficient wisdom that guides us even in the chaos of grief, suffering, and loss.
In God’s Healing for Life’s Losses: How to Find Hope When You’re Hurting, I journey with readers through eight biblical aspects of the grief and growth process. Rather than “sacred mourning rites,” I like to think of these as God’s GPS: God’s Positioning Scriptures. They provide scriptural and spiritual grief and growth directional markers on our healing journey.
Through candor (honesty with myself), complaint (honesty with God), crying out to God (asking God for help), and comfort (receiving God’s help) we learn that it’s normal to hurt and necessary to grieve. We move from denial, anger, bargaining, and depression to God’s personal comfort.
Through waiting (trusting God with faith), wailing (groaning to God with hope), weaving (perceiving God’s plan with grace), and worshipping (engaging God and others with love) we learn that it’s possible to hope and supernatural to grow. We move from the world’s goal of “acceptance” to God’s loving purposes of faith, hope, and love through grace.
We must not replace good grief with bad science. Instead, we should face grief face-to-face with Christ using the wisdom of God’s all-sufficient Word.
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