Search Term Friday: Diagnosing Doubt

Given how much I've written about doubt over the years, every week search terms with the word "doubt" in them bring people to the blog.

Recently, one such search term brought someone to a playful post of mine where I developed diagnostic criteria for doubt based upon the sorts of diagnoses you'd find in the Diagnostic and Statistical Manual of Mental Disorders, which just came out in its 5th edition.

So here it is, from 2010, the diagnostic criteria for doubt:

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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6 thoughts on “Search Term Friday: Diagnosing Doubt”

  1. I have always been curious regarding the different directions individuals take in settling their doubts. For example, in the area of the miracles in the Bible, many who begin to doubt the literalness of the miracles take the thoughtful path of accepting reality, meaning both life and nature, as having always been as it is, only that in antiquity the acceptance of the miraculous, or the supernatural, was common place, a way to explain great phenomenon or what was not completely understood. Whereas, others who begin to doubt the miraculous, yet do not wish to separate themselves from their community of faith, while not able to return to the emotional acceptance of the miracles, make a conscience decision to accept them on faith.

    Have you conducted any studies or research into these differences?

  2. In reading this I feel like you already have done a diagnosis on me. Very interesting. The lack of an effective treatment is rather discouraging.

  3. I appreciate you raising this topic of doubt again (having your psychologist expertise). It seems the stigma imposed upon one who struggles with doubt is perpetuated by the guys behind pulpits. Particularly, when reading the texts where Jesus asks (i.e. to Peter, Thomas) why do you doubt? - the presumed tone is that of condescension and rebuke.
    Struggling with the doubt so well articulated in that essay above, I would ask/wish (hesitate to say "pray") to be taken back to that time when He walked the Earth. If we were there personally to hear the tone of His voice, see His eyes and facial expressions, hand gestures, His whole vibe in general, especially when He expressed what's documented as a rebuke or correction (i.e. why do you doubt) - it seems this would be tremendously helpful if we could truly understand first hand what Jesus' real take is concerning doubt.

  4. I believe a little doubt inheres in the word faith. In fundamentalist churches, expressing any degree of doubt is to incur the attention of many. You are assumed to be on the brink of losing all faith. Many have learned never to mention their doubts - viewed as a sign of spiritual weakness. In my experience, the advice was always the simplistic instruction to "doubt your doubts." I believe this is a fatal error (by not addressing the hard and deep questions being raised about the authenticity of faith). The authoritarian personality (See Adorno) does not allow for any expression of doubt.

  5. In the spirit of DSM-V, I offer my own improved and more concise version:

    1. Doubt is all pretty much the same collection of symptons. Variations in severity should be denoted by a number between one and five.

    2. In order to make life easier for clinicians, diagnosis can be based on the presence of vowels in the patient's name. Disagreement with this definition is also a sufficient diagnostic criterion.

    3. Doubt should be cured using a powerful drug completely unrelated to its (unknown) causes, which has been clinically proven to reduce expressions of doubt or dissent.

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