Tag: DSM-5

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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