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Sometimes, I find myself wishing that the Lord had made more use of the colors black and white in His creation and had utilized fewer of the many shades of gray that seem to be present in our world.

The March 19, 2012, issue of Time Magazine stirred those wishes yet again.

In an article entitled , “What Counts as Crazy?” (pp. 42 – 45), Time health writer John Cloud explores the controversy raging through the American psychiatric community over the upcoming (in 2013) publication of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM, for short).  Apparently, this is the volume which, more or less “officially,” defines what is regarded as “normal” and what is regarded as “abnormal” behavior.  Among the many ways in which these definitions matter, according to Cloud, it is only for treatment of “abnormal” conditions that psychiatrists are able to bill health insurance companies.

So far, so interesting.

But as I read the article, questions far more significant than mental health insurance coverage popped into my mind.

Here is an example -  one of the primary changes made between the second edition of the DSM and the third edition of the DSM (the third edition was published in 1980), was that, in the third edition, homosexuality was no longer regarded as a “disorder” (it had been so regarded in the first and second editions of the DSM).  And, according to the Time article, this determination was made on the basis of a vote commissioned by the American Psychiatric Association in which “being gay was deemed sane by a vote of 5,854 to 3,810.”  Even Cloud interprets this fact to mean that “Over the years, the gray areas  have allowed many forces beyond science to shape the DSM” (emphasis added).

So far, REALLY interesting but it gets even better (not the article but my own {“normal?”; “abnormal?”} interpretation of the implications of the article).

Is a crazy person (don’t blame me; that’s the term used in the Time article) guilty of sin if, while insane, he does things which Scripture forbids?

If, for instance, a person diagnosed with Tourette’s Syndrome uses the Lord’s name in vain, should he come under church discipline?  Why or why not?

Should an individual diagnosed with severe depression be regarded as guilty of a lack of faith?  Don’t laugh – shortly after a very dear and deeply Christian individual I knew was prescribed Triavil (one of the older tricyclic antidepressants), the President of the Christian college where I was teaching at the time spoke to the college faculty and assured us that “anyone taking an antidepressant should stop that and just learn to trust the Lord.”

Most of us might  quickly dismiss the comments of that college President as ridiculous . . . I know I did when I heard those comments.  But the shades of gray get more and more pervasive.

According to the Time article mentioned above, three of the “new disorders” which are likely to listed in the fifth edition of the DSM are binge eating, internet addiction, and sex addiction.  Are these behaviors normal or are they abnormal?  Is binge eating a disorder?  Really?  If I say that it is not, that it is simply the “gluttony” which Scripture prohibits, am I doing the same thing which the college President did?  But if binge eating IS “abnormal,” is the person who engages in that activity guilty of anything (other than an unhealthy lifestyle)?

Well, binge eating is one thing.   What about “sex addiction?”  Now, the issue gets really troubling!

But there is more trouble (make that more “gray”) of which we need to take account.

When you read above that the voters in the APA poll determined that being gay is not abnormal,  what was your reaction?  I will bet you a dish of haggis that you reacted negatively.   OF COURSE, being gay is abnormal!  Be careful!!  If a behavior is abnormal, does that make it a sickness?  And if it is a sickness, is the person acting out of that sickness any more guilty than the Tourette’s child who screams out obscenities?

In some ways, modern medicine, including modern psychiatric medicine, has made amazing progress for which we all should be grateful.  But should we be grateful that, whereas, in 1917, there were only 22 available officially recognized psychiatric  diagnoses, there are now 350 available?  This is financially helpful to many of us who have health insurance.  But what does it do to the shades of gray as we seek to make – and to help others make – critical moral distinctions and decisions?

And, of course, “normal” does not necessarily equal “moral” any more than “abnormal” necessarily means “immoral.”  A certain behavior may “normal” but still “sinful,” right? 

So where – and how – do we draw the lines of “moral responsibility” when discussing behaviors which may or may not be caused by internal conditions over which we may or may not have complete control?

What do you think?

And I’ll suggest tomorrow what I believe Jonathan Edwards would think about all of this.


Sam Logan is Special Counsel to the President and Professor of Church History at Biblical. He is an ordained minister of the Orthodox Presbyterian Church. He is married to Susan and they have two sons and two grandsons. See also http://www.biblical.edu/index.php/samuel-logan

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