SARA MAITLAND

‘Anyone having trouble after a major loss can be

deemed “mad” and can be “treated”’
We live in a culture so terrified of death that it seems to be in a state of acute denial. It crops up everywhere,
even in the implication that if you eat all the right things, or more commonly don’t eat any of the wrong things, you could
live forever – so if you freely put cream on your strawberries (or whatever) it is all your own fault if you die. I am
increasingly coming to believe that people are frightened of silence and solitude because it puts them in mind of death.

And now, in a move that seems to me deeply scary, that fear and denial of the reality and devastation of death is driving so-
called experts (possibly unconsciously) towards defining grief as a mental illness and offering to treat it. Next month the
American Psychiatric Association will publish the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5). For those not acquainted with this tome, it is important to know that it has global reach; it offers diagnostic criteria
for all known mental illness (and some pretty dubious ones too – as of next month, severe pre-menstrual tension will be
classified as a mental illness) and treatment guides.

DSM-4 (the present edition) excluded a quick diagnosis of a major depressive episode “in the presence of bereavement”.
DSM-5 is withdrawing that exclusion. From 13 May, anyone who is having trouble managing their sadness within months,
even weeks, of a major loss can be deemed “mad” and should be “treated” – not with love and attention and tenderness, but
with serotonin uplift inhibitors.

It is not difficult to see in whose interests this is. Since most adults will experience at least one incident of major
bereavement in their lives – sometimes shockingly sudden and violent like Boston last Sunday; sometimes public and
contentious like the Thatchers – and more than half of them experience depression like symptoms of unhappiness at some
point in the first year, there are – to be cynical – an enormous number of drugs to be sold here.

There will also be something that hard-pressed doctors can do: they can write a prescription and feel they have addressed the
patient’s problem. And it lets all of us off the hook. It is so hard and painful to stay with the grief of another, never mind
one’s own. It brings our own death and loss too close, it absorbs energy and demands sensitivity and self-control, it is tiring
and oddly embarrassing. It is scary. Now we can just tell them to “buck up” and get down to the doctors’ surgery – phew,
what a relief.

And since, as a society, we stigmatise those with mental illnesses, we will be justified in turning our backs on those who
insist by their grief that there is something to be sad about – that at both a personal and social level we are “diminished by
death”.

This issue ought to be a special concern for Christians. This is partly because our founder members and most of the major
mystics ever since would be slapped with a psychosis diagnosis today, given they claim to hear the voice of God. So in self-
protection if nothing else we need to challenge psychiatric dominance whenever possible. But even more because we are in
some ways culturally responsible for this sorry development, through
preaching too often a pie-in-the-sky trivialisation of death. We should know better.

If death is not a dark and horrible thing, then why does the “right to life” matter? If death is a minor episode, a bit like a bad
cold, through which we can pass smoothly enough if we keep warm and drink lots of fluids, then what is so generous and
loving and beautiful about a God who is willing to go there? If death is just something you should shrug off and if you can’t
you are sick, then what is so exciting about the Resurrection?

In John’s gospel we see something different. Jesus, at the risk of his life, comes back across the River Jordan to comfort
Martha and Mary because their brother has died. In what cannot be more than an hour he declares resoundingly that “I am
the Resurrection and the life; whoever believes in me shall never die” and then he goes directly to Lazarus’ grave and weeps.
He weeps because his friend is dead. Because death is the “last enemy”. Because he is very sad.

I do not believe that offering him Prozac is called for.

(More information and a petition

about DSM-5 and its deficiencies
can be found at
http://dsm5response.com)

20 April 2013 | THE TABLET