The DSM-5, Addiction, and the Biblical Approach

Dr. Howard Eyrich, ThM, DMin

Being a professor of Biblical Counseling at the graduate level requires that I stay abreast of the development in the field of mental health. Consequently, I have read several articles on the DSM-5, the latest revision of the Diagnostic and Statistical Manual. This is the so-called “bible” of psychiatry and mental health. Version five has taken on a radically different configuration of thought regarding how many of the various mental conditions are categorized. While this philosophical shift is important, it is of little interest to the average internet surfer looking to self-diagnose.

One of the main points of interest to those who struggle with an addiction is the fact that the “Addiction and Related Disorders” section will be expanding to embrace non-substance related additions. What this means is that the treatment community will have opportunities to expand treatment centers for a growing number of legitimized addictive practices. For example, while there was some debate, the compilers did include a diagnosis of Pathological Gambling Disorder. Internet addiction was considered, but research evidence was insufficient to create a body of literature to support it. Most observers in the psychiatric world expect to see an expansion of behavioral addictions in future versions. [1]

It is of special interest to me that one of the internet sites discussing these issues was sponsored by a behavioral treatment center. The ad proclaimed that the treatment of addiction changes lives. Who could argue with that? Secular programs must produce reasonable results since these programs thrive. However, immediately following that slogan came an invitation to call for a free benefits evaluation. In other words, check in with us and see how much your insurance company will pay for your treatment.

Another observation worthy of note is this. Most of these treatment programs utilize some version of Cognitive Behavioral Therapy (CBT). Why? First, on a horizontal level, it often works sufficiently to change the addictive behavior. Second, results are measurable. If you read the textbooks you will find the claim that these results are the product of scientific research. In its simplest form, the scientific method consists of indiscriminate observations of regularities, gathering information on repeatable phenomena, and using it as a sound basis for theorizing.[2] What is not considered in this definition is a significant variable. That variable is that the observation process is distorted on at least two levels, the fallen nature of the observer and the fallen nature of the subject being studied.

This is the presuppositional variance between a biblical approach to addiction and the scientific approach embodied in CBT. The biblical approach recognizes the fallen condition of man[3] and the resulting heart issues that often drive addictive behaviors. The Biblical Approach includes methodologies that CBT has extracted from natural theology (careful observations of how the human psyche works and how to change behavior by changing thinking). Hence, the key biblical dynamics of dispensing with behavior consistent with the unregenerate man is replacing this with behavior consistent with the regenerate man that comes through the learning and adopting of thinking derived from immersion in the Word of God.

However, the biblical approach goes beyond changing behavior and changing thinking. The biblical approach goes to worship and attitudes. CBT may yield an addict giving up the addiction of ____________ (fill in the blank), but the person is still plagued with envy, anger, lust, all the works of the flesh cited by the Apostle Paul. The biblical approach addresses the behavior that is immediately destroying life. It then expands to address the works of the flesh, which are often the supporting motivations behind the addiction, and replacing them with the fruit of the Spirit by practicing walking by the Spirit. [4]

This biblical methodology remains consistent across addictive behaviors. Jay Adams once said something like this … There are a limited number of sins, but mankind can find limitless ways of practicing those sins.

Adams is right and the compilers of the DSM-5 are right when they predict that society will develop a variety of addictions to be addressed.

[1] I have not given references for the statements in this paragraph because they depict a common theme of blogs and articles I’ve read since the publication of the DSM-5.

[2] My definition is a good representation of the various definitions read.

[3] See Systematic Theology: An Introduction to Biblical Theology or Essential Truths of the Christian Faith by R. C. Sproul. The biblical presupposition that God’s Word is God’s revelation of Himself, of man, and of redemption is foundational to the biblical approach to additions.

[4] Galatians 5:19-25

Dr. Howard A. Eyrich’s career has spanned more than sixty years. He has filled various roles including seminary professor and president, Pastor and church planter. He retired as the Director of Counseling Ministries at Briarwood Presbyterian Church, Birmingham, Alabama.

Dr. Eyrich and his wife Pamela have two grown children, nine grandchildren and two great-grandchildren. Retirement for him is a time for ministry. He writes, teaches, preaches, and travels for the Kingdom. He also enjoys the hobbies of model railroading, hunting, and shooting.

He has served on the boards of the Association of Certified Biblical Counselors, Birmingham Theological Seminary, Trinity Seminary, the Biblical Counseling Coalition, and The Owen Center, as well as various Presbytery and Presbyterian Church in America denominational committees to name some of the major roles.

His publishing efforts include two books as solo author, three books with a co-author, and numerous chapters in significant volumes in the biblical counseling field, as well as articles for The Journal of Biblical Counseling and several other magazines.

Dr. Eyrich is available to speak in conferences, fill pulpits, and for intensive marriage interventions, especially with ministries couples.

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Book Review: “Reaching Your Addicted Loved One”

Here’s a review Shirley Crowder did of the book, “Reaching Your Addicted Loved One” by Nick Torres.

Micah’s Mandate for the Addict to Be Reconciled to God

by Bill Hines

Christians are called to please God not self. Yet in our struggle with addiction, we become self-focused and provide excuses as to why we are not walking with God. The people of Micah’s day wanted to know what they could do to overcome their heinous sin committed against God. Not unlike many of us today they tried to devise a way back to God that would really show their commitment. As always God’s way back is profound yet simple.

The people asked:
“With what shall I come before the Lord, and bow myself before God on high? Shall I come before him with burnt offerings, with calves a year old? Will the Lord be pleased with thousands of rams, with ten thousand of rivers of oil? Shall I give my firstborn for my transgression, the fruit of my body for the sin of my soul?” He has told you, O man, what is good; and what does the Lord require of you but to do justice, and to love kindness, and to walk humbly with your God? (Micah 6:6-8 ESV).

The addict often wants a list. If you are reading this and you are convicted that your addiction is wrong, you may be wishing you could have a list of ways to overcome your addiction. When the Israelites were indicted by God concerning their need for reconciliation to Him, they responded with questions of their own through their prophet Micah. How could they make things right? Is there a list of behaviors they can check off? Their attempts at answers became increasingly absurd and show what many addicts exhibit—a mask of interest in change, yet under that mask is a resolute defiance toward godly change.

Watch the absurd progression:

  • Shall they provide a burnt offering? That would be a normal question.
  • Offerings and calves a year old? Not unusual …
  • Shall they offer thousands of rams and ten thousand rivers of oil! Now it’s getting absurd …
  • Then comes the most absurd of all. Shall they offer their firstborn child? This is what some of the pagan societies of ancient times did in sacrificing children to the gods.

It reminds me of myself as a child. Upset that I was in trouble I accused my parents of wanting to spank me and that they would enjoy putting me through my punishment. That was not the truth, but it seemed the more absurd I could make the punishment the worse it made my parents look (in my young mind) and it justified my behavior as not that bad.

There is precedence for each of these sacrifices and gifts to God when done as prescribed by the Lord from a humble heart, as even Hannah and Elkanah offered their only child, Samuel, to the Lord’s service (1 Samuel 1:21-28). But for the true Believer at the time of Micah—and for us now—there is a better answer. The answer comes in three-character traits. But these are not the kind of list one can check off and be done with. These are character traits in which we grow with ever-increasing measure every day of our lives. It is because we are free in Christ that we can walk in humble repentance according to these three-character traits of the “Micah Mandate.”

1. To do justice means to fulfill mutual obligations in a manner consistent with God’s moral law. It is making right decisions according to God’s moral laws.

God is a just God. His standard is the standard for Himself and for those who follow Him. If His people desire to put off their old ways of living in favor of the new ways in Christ, then they will walk in His just ways. The addict will live by His Word, which is His moral law found in the Bible. As we said before, this is not in order to be saved from sin. We obey because we are saved, and He is our God. Doing justice helps the addict focus on the things that are truly important to God because the heart becomes increasingly set on His law, fulfilled in His way and in His time. The addict must learn patient dedication and commitment to His ways which are just.

2. To love kindness means to have a readiness to do good to people, even when it may be undeserved.

God’s kindness leads us to repentance (Romans 2:4) and it was in kindness and love that He came to save us (Titus 3:4-5). He asks His people to love kindness as He does. This means having a willingness of heart to act in kindness toward those who may not deserve it, as we did not deserve His kindness when He gave Himself for us. Of course, this kindness extends toward our families and friends and all those of the faith. It is one of the character qualities with which all Christians are to adorn themselves (Colossians 3:12-17). Christian kindness will help the addict love others with their time and energies without indulging in private projects that only satisfy self.

3. To walk humbly with your God means to have a right understanding of self before God. This status is based on His majesty as the high and exalted Creator and man’s status as the creature who is dependent on the Creator for all that pertains to life and living. It is not a matter of having high self-esteem or a positive outlook it is thinking of self realistically. As Paul puts it in Romans 12:3 a person is, not to think of himself more highly than he ought to think, but to think with sober judgment…. The sober thinker always recognizes that the life he lives before God is completely based on gratitude for all that He has done and continues to do for those who bow before Him.

So, what can the addict learn from Micah? It is that God wants to grow us, by doing the simple things God calls us to do each day. To quit making excuses and devising reasons we cannot attain the good He wants of us. The addict must stop making up lies about what God wants and simply walk in newness of life and in the truth that, … if anyone is in Christ, he is a new creation. The old has passed away; behold, the new has come (2 Corinthians 5:17 ESV). If you are an addict you must simply, under the power of the Holy Spirit, do justice, love kindness, and walk humbly with your God . God the Father, your loving Father if you belong to Him wants you to grow up to be like Him.

Covenant Ministries, Inc.

Bill Hines is the president of Covenant Ministries, a biblical counseling, education and Christian discipleship ministry in Ft. Worth, Texas. He is the author of Leaving Yesterday Behind and Curing the Heart: A Model for Biblical Counseling (with Dr. Howard Eyrich). He co-authored The Pursuit of Perfection with Dr. Mark Shaw. He edited Paul the Counselor: Counseling and Disciple-making Modeled by the Apostle Paul and is a contributing author of three of the chapters.

Covenant Ministries, Inc.
P.O. Box 121235
Fort Worth, TX 76121-1235

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