DSM IV Axis II - The Church's Dirty Little Secret Part I

DSM IV stands for the Diagnostic and Statistical Manual for Mental Disorders, 4th edition. It is simply a catalog of mental disorders, as outlined by the American Psychiatric Association. The manual divides mental disorders up along five axes (or levels). The axis I contains the mental diagnoses that most lay people are familiar with, including things such as anxiety, depression, bipolar disorder, phobias and even schizophrenia. The dirty little secrets are the more troublesome (in many ways) and little recognized disorders in the axis II.

It will be far beyond the postings in this little blog to explain these disorders. I also am not an expert . . . although, in my line of work I must be somewhat familiar with them.

I say that they are the Church's dirty little secrets because not only they seldom recognized . . . but often appraised as positive spiritual characteristics (when you know these people on the surface) or just bad people (once you get to know them . . . and they you).

Often the people who suffer from these disorders create a living hell on earth for some of the people they are closest to and who have tried to love them (and oddly whom they have tried to love in their strange way).

The first thing that brought this issue to the foreground for me happened last week. I was watching the Today Show and they were interviewing a forensic psychiatrist regarding the case of Melissa Huckaby, who has been accused of sexually molesting and killing 8 year old Sandra Cantu. The psychiatrist was talking about anti-social behavior and someone asked, maybe it was Matt, something along the lines of, “This lady was a Sunday school teacher in her Grandfather’s church. You would think that someone would pick up on her problems.” I’m not assuming that she’s guilty, and this isn’t even about Melissa, but about the psychiatrist’s answer.

She said, “Church people are notorious for being naive about human behavior, especially when it comes to the mentally ill.”

I’ve been thinking about that statement every since. In later posts, I hope to explore some of the Axis II disorders and how they might play out in an Evangelical setting.

But before I end this posting, I wanted to share some thoughts regarding the why we are so naive.

In the traditional, Evangelical (American) Dualistic (okay enough adjectives) Church, we see a big separation between the fluid, or flexible soul and the material, more fixed, brain. So behavior is simply the express of choices. We assume that all people start at the same place (mentally) and can choose to do good, if they love the Lord, or to sin, if they don’t.

We believe that people can act on one extreme end or the other . . . where we can act out of a supernatural indwelling of the Holy Spirit . . . or out of demon possession.

I recently gave an example of this later statement when a man at our church went nuts. When he started shouting “Praise God!” many people started cheering “Amen!” They thought revival had come. Then, when he immediately switched to shouting, “F. . . God!” there was look of horror on the same church people’s faces . . . who then assumed he was demon possessed. However, I think the man is mentally ill and that concept was outside of anyone’s, save a couple of us, way of thinking.

If you understand that the material world is of substance (no pun intended), meaning importance, then the fall of Adam influences the material in a deeper way than most Evangelicals can imagine. Someone with bipolar, or clinical depression and certainly anti-social behavior or personality disorders don’t “snap out of it” the moment they become a Christian. Could God give them a whole new persona? Sure he could. But he doesn’t. This is not a theological statement but a simple observation of reality. Messed up people remain messed up after they become Christians . . . just that the messiness goes underground. I’m not saying, that with a few years of better thinking patterns, maybe some good treatment, and prayer, that they could be some . . . okay, maybe a lot better, but never 100%. The Fall of Adam is really that bad.

But if the Evangelical, due to their Dualistic perspective, thinks that education is crap . . . unless you study the Bible (I just heard our chief elder say a few months ago that we shouldn’t allow any of our young people to go to college), then the whole field of psychology, sociology and especially psychiatry is crap.

If you also assume that the spirit is very fluid, where I could be a socio-path, axe murderer . . . then meet Jesus, and the next day be a smiling Sunday school teacher, then we do become naive.

I don think that in many Christian circles the more common diagnoses, depression, bi-polar, are being more accepted as a legitimate disease . . . however, the complex, and deceiving Axis II problems are not.

I will explore some of the Axis II problems next time. But before I do, and in closing, I will make a humble comment. Psychiatrists have told me more than once those patients with these Axis II disorders are often the last to know. With that said, maybe I’m one too. (smiley face here) I know that I’m messed up in more ways than I know. I know too that by the mercy of God, he still loves me.