Blog Post by Sister Diane Foster
Diagnostic and Statistical Manual of Mental Disorders (DSM) and Biblical Counseling: Can the Two Co-Exist?
The DSM and a Biblical Worldview
A client comes in feeling depressed and worthless. Nothing ever turns out right and her will to remain positive has turned sour and negative. How would a secular counselor, after the initial counseling session assess this person? Secular counselors are bound to the DSM5 or the Diagnostic and Statistical Manual of Mental Disorders (DSM). This counselor would most likely begin with the code 296.99 (F34.8), followed by different descriptions of depression ranging from A-K (literally). A secular counselor, oh, what does secular mean? Basically, secular means any attitude, behavior, or activity that is not religious or spiritual; or someone who is neutral to the concept. Therefore, it can be surmised that the DSM5 has a secular view of religion and spirituality. Biblical Counseling uses the Bible as its foundational method for assessing the ills of humanity, it is rooted in the teachings of the prophets, judges, and apostles whose center and source is Yahuah.
Can The Two Co-exist? Two Points of View
Secular counseling follows the social science of psychology. With it comes treatment plans such as cognitive behavior therapy. Biblical counseling follows the Words of Yahuah, or theology, as they walk the client towards goal setting through the lens of spiritual maturity. They begin to recognize their lack and as they learn more about their relationship to Yahuah and the Holy Spirit they begin to overcome the issues of life that in a not-so-distant past easily beset them. Man has the capacity for free will meaning, that both mind and heart affect thoughts and behaviors. In this sense when it comes to the helping profession both psychological counseling and biblical counseling have merit.
Biblical counselors focus on the state of brokenness and to some measure the therapeutic relationship. All the while the counselor must be aware of their own biblical worldview, style, and personality. Take the story of David and Bathsheba which is a classic example of how the Bible and Psychology both have merit in the field of counseling. David committed adultery with Bathsheba and then had her husband murdered. The prophet Nathan used the therapeutic approach as he methodologically appealed to David’s logic and thought processes. As such David became remorseful, repented, and accepted the consequences of his sin. As a human soul, David was brought into recognition of his sin against Elohim (2 Samuel 12:13). Though his sin resulted in a great consequence (2 Samuel 122:14) David’s spiritual maturity continued to grow as he became the greatest King of Israel.
CSCM seeks to be aware of the psychology of sin, that we are sinful beings, and the theology of sin that God’s grace is sufficient for healing (2 Corinthians 12:9). Sin brings pain into our life. Pain requires healing allowing life to return to some sort of normalcy. However, for some, the path of life returning to some sort of normalcy does not always begin with the Bible. For some hurting souls, Bible-based counseling may be their first such encounter. They may know little about religion or biblical counseling. Even with a desire for restoration, sin and causes linger. This is where the bridge exists to unify psychology and theological counseling.
Integrating Psychology and Theology is the best approach for Pastoral Counseling because man has free will. Proverbs 16:9 states “A man’s heart devises his way: but Yahuah directs his steps.” Yahuah has placed his law in our hearts and upon the ascension of Yahusha, He sent His Holy Spirit (John 4:16) to comfort us and lead us into all truth. The Spirit is there but man must give Him a place to work. Sometimes life or flesh gets in the way. Paul taught to walk in the Spirit, and ye shall not fulfill the lust of the flesh (Galatians 5:16). We live in the shadow of sin. Though I walk in the valley and shadow of death I will fear no evil (Psalms 23:4). This is a verse full of hope and healing but what of the individual gripped with fear who knows not Yahusha? Psychotherapy is an effective tool for untying mind knots because for some life is not always simple.
There are pastors and counselors who feel the source of all healing is sola scriptural, meaning all hurt, pain, and sin can be healed by way of the Bible only. Such opponents see psychology as being dangerous to the church and subversive to the true faith. Respecting this belief, CSCM supports the Allies Model of integrating the two. This model underlies the unity of truth using it in a godly manner where psychology and theology represent a holistic understanding of truth. [i] Human behavior in the negative realm of sin and evil are as much co-equals as human behavior led by the mercy and grace of Yah and the Holy Spirit. Man has free will, he thinks, his heart directs.
Though we innately know right from wrong many live with a sick soul. Feelings of fear, guilt, shame, remorse, or grief sometimes require psychotherapy as the path to spiritual transformation, especially for those who have little, shallow, or no relationship to Yahuah, His Son Yahusha ha Mashiach, and the Holy Spirit (Ruach haQodesh). The Word of Yahuah and psychology are not on the same level, but some principles of psychology can be useful. This is a balanced position because it recognizes not only the sovereignty of Yah’s Word over man’s knowledge, but that truth can still be gleaned from other sources. [ii]
Yahuah is omniscience, all things are present with Him, and He is aware of everything in His creation. Proverbs 16:9 informs Yahuah directs our steps. CSCM relates to this as directing a fallen sick soul to a place of refuge that understands the science (Yah’s Omniscience) of psychology and the principles of theology (Yah’s Omnipotence) integrating them both with the help of the Ruach haQodesh) leading that soul to truth and healing.
Behavior and Mental Disorders
A mental disorder also called a mental illness or psychiatric disorder is a behavioral or mental pattern that causes significant distress or impairment of personal functioning. The causes of mental disorders are often unclear. Mental disorders are usually defined by a combination of how a person behaves, feels, perceives, or thinks. [iii] In other words, a mental disorder is a health condition that involves emotions, behavior, and thinking process which can affect the way a person functions socially, environmentally, and in other areas of life. This Wikipedia definition makes no mention of illness of the soul or impairment brought on by an absence of spiritual health.
The American Psychological Association (APA) defines the Soul as the nonphysical aspect of a human being, considered responsible for the functions of the mind and individual personality and often thought to live on after the death of the physical body. The English word corresponds to the Greek psyche, often also translated as “mind,” and the Latin anima usually translated as “spirit.” The concept of the soul was present in early Greek thinking and has been an important feature of many philosophical systems and most religions. Because the existence of the soul has resisted empirical (experimental or observed) verification, science has generally ignored the concept. Despite this, the term survives in the general language to mean the deepest center of a person’s identity and the seat of his or her most important moral, emotional, and aesthetic experiences. [iv]
A biblical worldview of the soul finds a different but like meaning to the secular definition with the main difference being the Bible came a few thousand years before modern psychology. Additionally, the above definition states that science has all but ignored the empirical or the reality of the soul. Yahuah our Elohim said to Ezekiel 18:4 “Behold, all souls are mine; as the soul of the father, so also the soul of the son is mine: the soul that sins, it shall die.” Again, our soul, is life imparted or given to us by Yahuah. It is the place of our inner being with all its thoughts and emotions. The word soul is as old as creation itself. It is called Nephesh in the Old Testament. Recognition of the soul is necessary for Biblical, Torah-based counseling to be effective. The first thing the client discovers as they walk their journey back to restoration is who Yahuah is in them, and then who they are in Yahuah.
Integrative Psychology and Theology understand that the inner being, or immaterial part of the body is the place of reasoning, communicating, experiencing emotions, memory, and social interaction. This immaterial part is the seat of the soul, where Yahuah lives and where our emotions and thoughts are guided, making us who we are. It is our behavior that controls how we act and react to life, good or bad. This is also the place Yahuah gives us grace. [v] Combining these two schools of thought results in effective counseling.
Do Torah-based counselors and secular counselors use the same terminology when making a diagnosis? Would a Torah-based counselor describe their client’s depression with a DSM-5 code such as the one shown above, or would a Torah-based counselor describe this person’s depression for example brought on by feelings of worthlessness sourced from an absence of parental love resulting in a misguided need to please others? While a secular counselor may recommend therapy, lifestyle changes, and sometimes medication, a Bible-based counselor seeks to discover the root of the client’s problem such as a family with no spiritual roots, and help lead them to restoration with the help of the Holy Spirit. Depression, anxiety, grief and so many other imbalanced states of being are identified in Scripture along with transformation remedies.