Modern psychiatry demonstrates an unprecedented interest in diagnosing, labeling, and attempting to medicate psychological suffering (mental/emotional weaknesses and maladies), treating ailments such as depression, ADD, and others according to the latest scientific research. Many Christians are not well-equipped to respond to impressive-sounding professional knowledge and intimidating technical terms. Descriptions and Prescriptions is a short guide to psychiatric diagnoses and the main categories of medications used to treat them.

Michael Emlet argues for a middle ground between two extreme responses (unquestioning acceptance and complete rejection) to secular psychiatry’s solutions.  Emlet’s credentials include his background as a medical doctor, his training as a biblical counselor, and his ongoing experience ministering to troubled people from both of those perspectives.

Emlet explains that diagnosing (“classifying, organizing, and interpreting our world” [6]) is part of being human—and while not all of our diagnoses are significant, a correct understanding of our nature definitely is.  To make a mental health diagnosis, a doctor compares his observations and the patient’s description of symptoms to established classification systems.  Emlet points out how those criteria have changed in the history of American psychiatry and are characterized by “problems and pitfalls.”   Psychiatric diagnoses are descriptions of the problem rather than explanations; over-diagnosis tends to “abnormalize the normal”; some diagnoses redefine as “medical” a behavior the Bible describes as sin; and cultural values heavily influence psychiatric diagnoses (for example, very few cases of ADD are diagnosed in France as compared to America [34]).

All of the above have implications for ministry, and Emlet suggests four points to consider.  Don’t be scared off by a diagnosis, he says; fear can cause us to avoid responsibility.  Diagnosis does not equal identity—it is not the “sun around which the rest of life orbits.”  Diagnosis is not destiny (the power of God can transform lives!)  A diagnosis is the starting point, not the end point, for ministry.  Familiarity with biblical categories and themes is essential, along with building relationships with sufferers and understanding their life experiences.

Psychiatric diagnoses do have benefits, such as identifying patterns of experience that are different from our own and helping us to recognize the ones severe enough to be dangerous.  It is easy to blame a problem on lack of faith, but a diagnosis helps to remind us that our bodies have biological and even genetic malfunctions.

The second half of the book explains the main classes of psychotropic medications and how they work.  Do they actually treat chemical imbalances within the body? How effective are they? What are the side effects? Are there other options?  Emlet illustrates with case studies such as that of a young woman with “insomnia, depression, severe anxiety, and suicidal thoughts.”  He counseled her for fear and unbelief, but he also prescribed a short course of medication that broke the cycle of sleeplessness.  Once well-rested, she was better able to see issues of “perfectionism, legalism, and fear of man.”  (85)  He concludes that, given the interdependence of body and spirit, the use of medication is a wisdom issue; and the ultimate goal is conformity to the image of Jesus Christ.

Simply written and easy to read (with the exception of eye-glazing medicinal labels, which I read without trying to pronounce), this book offers help to anyone with immediate concerns about medication.  Yet its main strength lies in Emlet’s scriptural treatment of the theme of suffering throughout the book.  The last chapters balance several paradoxical statements (too much suffering and too little suffering can both be hazardous to spiritual growth; medications are gifts of God’s grace and can be used idolatrously; motives for taking and for not taking medication can be wrong; and using or not using medications may make it more difficult to address moral-spiritual issues).  Well worth reading, and not just for those in formal ministry.