#bjubc24

CW: careless talk about postpartum depression

I've been avoiding this introductory story from Dr. Dionne because it's so horrifying. I'll just quote the whole thing.

Karen is a 30 year old woman who grew up in our church and has parents who were missionaries in Venezuela when she grew up. She has three children and one is less than two months old. She and her husband have been married for 10 years, and she professed Christ when she was a girl, and her husband also grew up in our church, and he just got a job as a police officer, and he's working the graveyard shift. And after her second baby, she suffered with postpartum depression. Now her baby's crying every night, and her husband has gone during the night, and he has to sleep during the day, and she's not getting enough. She is having angry outbursts, and she's very unhappy, so she went to her doctor and was given antidepressants for postpartum depression, and she hoped it would help. But she only took it for three days and seemed to get worse, so she stopped taking the medicine. Her doctor told her if she could not tolerate the medication, she would need to get counseling. And she doubted if it would work for her. She felt like she had known God her whole life, and she doubted that God loved her which is very common when people are depressed.

Picture the scene. This mother has no sleep and a newborn. She has the flood of postpartum hormones -- a wallop for everyone -- but this is in the depression territory. Her husband is absent.

Her medical doctor (at least according to the story) is basically doing nothing. She's not taking the meds -- probably because she's been told at their church that meds are wrong.

But Dionne goes on. Guess what the BJU-trained counselor suggests. Yup -- MEMORY VERSES! But lo and behold, what does she discover??!??!?

So my wife Kelly started meeting with her, and she met with her every week and she started off by having her memorize scripture. And as Kelly was getting to know her, she learned about some sin Karen had committed with her husband when they before they got married. And they had never asked her, repented of this to each other or repented before God.

"Some sin."

Dionne never says it, but he's attributing allll the problems to that "sin." It's probably sexual relations with her now-husband before they were married. At least, that's the way Dionne sets it up.

He goes on:

And this was a very important time when her husband came to counseling with her, and they apologized to each other and they confessed to God their sin. From this, she learned that she actually had to seek forgiveness from some other people in her life. She would have lots of anger, and as they spent more time counseling, it became clear that she had some wrong expectations about her life. What was the problem? Well, she wanted life to be comfortable and easy, and it wasn't. As she was being counseled, Kelly taught her how important her thoughts are, the thoughts she deserved an easy and a fun life. And to be had to be replaced with right expectations about. So whenever anything went wrong in her life, she would doubt God and become angry with him. She learned that God was using the hard things for her good, showing her her desperate need for him. Anybody learning that right now suffering is so good for me.

Everybody stop.

Is anyone taking care of the baby during the day so that Dad and Mom can sleep? Is anyone taking care of this family? Is anyone talking to the Dad and explaining, "You need a different shift." Is anyone offering the Dad a different job?

These are real things that can be done that are not "memorizing verses" or plumbing the depths of a 20-something's life.

Where are the older moms who can come in to help? The grandmas? The aunts?

Medication is important too. But hello!!?? You don't need a license to be a decent human being.

He finally spits it out (40:37):

So we talked about medical disease and we talked about medical disorders. And you're wondering what about the science of psychiatry? And I want to remind you that psychiatrists went to medical school like I did. And they want to help their patients with their suffering, their emotional suffering and pain. And they've been trained to look for pathology as well. So you might ask, how does the psychiatrist look for pathology and what test can a psychiatrist run on the patient? And that's really where the DSM-5 comes in and those long lists of criteria. That's what they use. So because psychiatrists use lists to find disorders, it seems to me like squishy science.

And so they want to be scientific. They want to help. But it's tricky because it's harder for them to find pathology. So list of criteria make it seem more scientific. But was there really anything very quantifiable on that list that I read to you earlier about depression? It's very subjective.

And just like Mazak, he insists:

There's no blood test for depression. You can't even get a blood test that will tell you your serotonin levels. DSM-5 does not have a blood test for depression. You can't do a blood test. You can't do a biopsy. All you can do is say we see a list of criteria that this disorder meets. But you can't really do a biopsy or a blood test for it.

That's really his gold standard -- a blood test or a biopsy. That's "objective." That's concrete.

You know why that seems to be the standard for you, Dr. Dionne?

BECAUSE YOU'RE OUTSIDE YOUR LANE!

CW: bad ideology about death by suicide.

Dr. Dionne admits it pretty plainly (4:18):

Have you ever counseled someone that was considering suicide? Have you ever counseled a family member or a friend of someone that had committed suicide? So sadly, there's way too many hands that have been raised tonight already.... Sadly, I've had quite a number of my patients commit suicide over the years and like I said, it's a very ... It's a heavy subject.

Again he's presuming that everyone in this audience has never had suicidal ideations. They only know other people who have died because of them.

And I'm sure they do since so many prominent BJU grads have recently died by suicide. I count six from 2021-2023. Six! And that's just in the Greenville area!

But by admitting that he's lost patients to suicide, Dr. Dionne is not empathizing with the suffering patient. He's empathizing with those on the outside who had some (perhaps ineffective) power to intervene.

It's just like the new mom in the throes of postpartum depression. Dionne's not connecting with her, but with her counselor (his wife).

The person who is suffering is never the counselor. It's always the counselee.

And that's bad. That's really bad.

Bob Jones University really believes it has all the answers. And when you're sitting there hearing this, and you realize you're depressed or anxious or _______.... whatever condition has no blood test to confirm it, ...

CW: bad ideology about death by suicide.

BJU's Stuart Scott and Dan Dionne had a "conversation" that meant Dr. Dionne was doing all the talking.

And it was all about death by suicide. I don't recommend listening to any of it.

Right off, he states his thesis (5:45):

So really, if somebody is thinking about committing suicide, they are not thinking rightly. They need to be corrected and you want to restore that person that's caught in a transgression or thinking or contemplating that transgression. So I'm bearing one another's burdens, is fulfilling the law of Christ. And if this person's desires. And it's, uh, the sin of suicide. They might be in the process of committing a transgression.

It's the "they need to be corrected" that gets me.

I could maybe grant that there's incorrect "thinking." Maybe. It's vague enough that it could cover matters.

But the passive voice in the statement "they need to be corrected" is chilling. In sum, they need you, oh listener, to 'correct' them.

Like you correct a disobedient dog. Or you right a crooked picture.

At 18:15, he stupidly says:

So the big thing of course, is what's God's diagnosis? Not what did your secular counselor tell you or your doctor? Tell you what does God say about your diagnosis? You're going to spend time, like I said, asking the questions and you want to know God's diagnosis.

Dude.

God's not a doctor. He doesn't diagnose anything.

But you can do this for any vocation.

"What's God's final exam?"

"What's God's tune-up?"

"What's God's full house inspection?"

Remember that Dr. Dionne started with the fact that he's not talking to career biblical counselors per se. They may just be "friends" of their "counselee."

So that's what makes this next part a little jaw-dropping (36:04). He mentions medications -- not "cholesterol medication or blood pressure medication." He wants to make that clear (48:00):

It's really not your job to tell them to stop taking medication. That's probably because you're not a doctor. You don't know how to wean them off the medication, and you're their counselor, and you're helping them with their heart issues so you can ask them if they've tried counseling, and then you just get to work on what's going on in their heart. You don't have to tell them to go off medication. You can counsel somebody when they're on medication.

Okay. Fair enough. But wait.

Don't judge your counselee if they're on medication.... Don't make them feel like they have an inferior faith if they're on medication and don't tell them that it's a sin to be on medication. Now, that's often the message that people get when they're on medication in the church.... Ask what was going on at the time they started, meds and what they were hoping the meds would do. ... Ask why their doctor to prescribe their medication and were there other medicines that they've tried? Ask about side effects of the medication. Ask how well the medication has worked for them and ask if you can go with them to their next doctor's visit. You can ask if you can have permission to speak with their doctor. You'll need a signed release, but then just get to work talking about their heart issues. That's what you can do.

Don't judge. Don't tell them to go off the medications. But do ask them a whole host of questions that's outside your unlicensed expertise.

Of course, this medical doctor who graduated in 1987 thinks life made more sense in the 1950s.

Now, in 1952, there was another classic which was published, which was the first diagnostic and statistical manual and we would now call that DSM-1.

He goes on:

And there have been several revisions over the years, so now we're up to the DSM-5, and it really started out with the intention to be scientific. But I'd say it's become a little more political and cultural as the years have gone by. So we're up to DSM-5 now, which is published in 2013 and in the health world and this is kind of their Bible that they use to talk about psychiatry.

Dude.

It's not your discipline. You're a medical doctor, not a psychologist. You have no degree in psychology whatsoever. Something outside your discipline but that's 75 years old might be your right down your alley.

I might understand music better from 1952 too!

And I might ignorantly call updated things outside my expertise "political and cultural."

I started with the ridiculous because Dr. Dionne's actual lecture gets dark and frightening really fast.

But his entire talk can be understood in how he imagines his listener.

In rhetoric, we talk about the "first persona" -- that's the speaker, their ethos. Their credibility.

You remember how we reviewed it: The effective speaker is a person whose character, knowledge, and judgment command respect.

But then there's the "second persona." That's the way the speaker creates, curates, or directs his audience to be a particular kind of person. For instance, a 1st grade teacher says to her class, "Friends, lets go outside now." In calling them "friends," she directing to act friendly. If she said, "okay stupids...."

Well, you know how that would go. But the rhetor is creating the second persona; he's directing how they should be in the world.

And Dr. Dionne is pretty bald about it.

To him, his audience is ... well, look (3:25):

So oftentimes when I talk, I'll talk about you all as biblical counselors and really, uhm, you might be a biblical counselor, or you might be a friend, or you might be a loved one. But really, this is for you as you are talking to people about depression, the other thing that is great is that Dr. Hand's first message was very helpful for just describing what it feels like to be depressed. What a person's heart does, and … how deep the suffering can be. So I always like to ask, is anybody … have you ever known somebody that suffered with depression? Yes. So we almost all know somebody. And so this is going to be hopefully helpful for you as you think about how to be helpful to them.

The people in front of him are not actually depressed nor have they ever been depressed. It's the people "out there" who are depressed (we rhetoricians actually call that category the "third persona."). The people he's talking to are the ones who don't get depressed. They've got all the answers.

Dionne is consistent too (27:31):

We can talk about that. So here's the thing. When you're counseling people that are depressed, it can be very frustrating and discouraging. And so you, as the counselor, need to have a long term view of the process in order to keep from getting off track…. So I always tell people if you get a counselee that's depressed, this is not going to be a quick fix. It might take them a year, it might take them longer to really see change in their lives. And so that can get discouraging for you as a counselor because you might give them some really good homework. And for a couple weeks, it seems like it's working and then all of a sudden they're back in the dumps again.

He's empathizing with the untrained, unlicensed counselor who "feels discouraged" that their "homework" isn't working.