Doubt: A Diagnosis

Diagnostic Criteria:
Doubt is diagnosed when one or more of the following symptoms have been present during the same 2-week period and represent a change from previous religious experience; at least one of the symptoms is either (1) skepticism about the existence of God or (2) emotional distress associated with the "loss of God."

(1) Skepticism about the existence of God. The doubt is expressed intellectually as an ontological concern.

(2) Emotional distress associated with the "loss of God." The doubt experience is predominately emotional, a distress associated with the experience of Divine "absence."

(3) Apathy toward the faith (its beliefs and practices) often characterized by an experience of indifference or "deadness."

(4) A skeptical stance regarding the central claims of the faith. Doubts about the truthfulness of Scripture, founding events (generally those associated with the "miraculous" ), or metaphysical claims.

(5) Loss of an evangelistic zeal often replaced by a curiosity or acceptance of outgroup members.

(6) Feelings of distance and separateness during worship or rituals, a sense of "observing" the proceedings.

(7) Expressions of lament, frequently similar to grief or bereavement responses.

(8) A reappraisal of God's defining characteristics (e.g., benevolence, omnipotence). For example, God's benevolence might be replaced by judgments that God is indifferent or malevolent.
Given the diversity of clinical presentations, a diagnosis of Doubt is given one of the following Type specifiers:
Type Specifiers:
  • Intellectual Type: Cognitive and intellectual features are predominant, often in the form of intellectual objections or skepticism
  • Emotional Type: Emotional distress is predominant, similar to a grief response
  • Apathetic Type: Features of indifference are predominant, a loss of zeal or interest in religious belief and/or practice
  • Undifferentiated Type: A mixed presentation, where no one feature is predominant
A diagnosis of Doubt is also given an Onset/Course specifier:
Onset/Course Specifiers:
  • Episodic (Single Episode/Reoccurring): Doubt manifests as a discrete temporal episode, often with alternating periods of "remission." Additional specifiers for a diagnosis of Episodic Doubt are Single Episode or Reoccurring. Single Episode Doubt is diagnosed when there have been no other discernible episodes of Doubt in the past. Reoccurring Doubt is diagnosed if the individual has met diagnostic criteria for Doubt in the past.
  • Chronic: Chronic doubt has no discrete temporal onset and periods of "remission," if they occur at all, are short lived. Chronic doubt emerges slowly and can persist for years, often throughout the lifespan.
Examples of various Doubt diagnoses illustrating the use of the Type and Onset/Course specifiers are as follows:
  • Doubt-Intellectual Type-Chronic
  • Doubt-Emotional Type-Episodic, Single Episode
  • Doubt-Undifferentiated Type-Episodic, Recurring
  • Doubt-Apathetic Type-Chronic

Supplemental Information:

Prevalence and Occurrence Data:
Epidemiological research suggests that 30% to 50% of persons in religious populations have met diagnostic criteria for Doubt at least once in their lifetime. Some research has found incidence rates has high as 90% in certain populations.

Causes and Risk Factors:
Doubt has a variety of known causes. Some research has indicated that doubt may be influenced by personality suggesting that doubt may have heritable components. Traumatic life events are frequently implicated in the onset of doubt, particularly Episodic Doubt. Chronic doubt has also been linked to advanced education or intellectual exposure to ideas, information, or ways of knowing that create epistemological pressures upon religious belief.

Developmental Issues:
Doubt can occur at any time during the lifespan. Generally, the first episodes of Doubt occur in late adolescence and early adulthood. However, there are many documented cases of late onset doubt.

Demographic Correlates:
There are no known demographic risk factors associated with Doubt. Doubt is equally prevalent across gender, ethnic groups, and socioeconomic groups.

There are no known treatments for Doubt. Consequently, most treatments for doubt are palliative rather than curative.

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8 thoughts on “Doubt: A Diagnosis”

  1. Very clever.

    Is there a way to factor in a situation where a person doubts the Church but doesn't really doubt God? That's where I find myself. As far as the church goes I'd classify myself as doubting-apathetic type-chronic but I don't feel alienated from God.

  2. This morning's sermon - we were being filmed for a film on forgiveness - concentrated on the difference between hope and optimism. I have often been seen as somewhat Micawberistic in my approaches to the unknown of the future. Doubt I suppose is more present than future. But - no cure? I doubt it.

  3. I am filled with doubt and have been since my mid-teens. I doubt the existence of God. I doubt the intentions of religion(s). I doubt the sincerity of many (especially the most vocal) proclaiming to be Christian. I doubt any power of prayer.

    As you can see I am filled with doubt but wonder how so many people are compelled to find solace in some form of religion. I have more confidence in imagining that the entire world & its inhabitants have evolved from some original source. What that source is I can not fathom.

    It seems I have lost the energy and desire to search for answers. Perhaps that energy will resurface... I do hope so. I enjoy reading your blog and find your responses to the world similar to my own. You are appalled at many of the same things that disturb me.

    It does seem that humanity needs a spiritual guide in order to be humane. However most religions do not allow for nor accept or tolerate differences of opinion of other religions. This intolerance is the most disturbing of all for me.

  4. Would it be out of line to suggest that doubt (to this degree) is essential to building a faith that is actually yours? Perhaps this is what Paul was talking about when he said to "work out your salvation with fear and trembling." Any weaknesses in our beliefs about God will eventually surface and will make or break the faith.

  5. Keiji Nishitani, a Zen Buddhist philosopher, discusses the difference between "doubt" and the Zen idea of "the Great Doubt"--doubting not only particular religious assertions, but rather everything, a doubt more radical than even Descartes'--as a precondition to authentic religiousness. You mentioned that doubt is more prevalent in certain populations. I wonder whether doubt is more prevalent in societies in which Zen and "the Great Doubt" has been influential. Are you aware of any correlation there?

  6. I have absolutely no doubt that God exists; Its existence is self-evident to me. But I am not entirely sympathetic towards God and the world which exists as a consequence of God. It seems poorly designed, cruel in big ways and cruel in insignificant ways. Sometimes it's the petty cruelties that rankle the most, like getting a flu. How edifying is a head cold to spiritual beings anyway?

  7. Building on the first anonymous comment, I wonder if in discussion of doubt it would help to differentiate between doubt in faith/God and doubt in church/people of God. My doubt in God is Intellectual and chronic, which I explain away by faulting my own understanding (I'm not suggesting this as a productive measure). My doubt in the church is Emotional and recurring episodic. Byproducts of combining these two doubts is that I grow tired of trying to reconcile my needs and beliefs to current worship practices, resulting in religious apathy.

    Maybe I'm being a hypochondriac, but "Help me, doc. I think I got 'em all."

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