An Open Letter to the Lockman Foundation – Revisited

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Two years ago on my previous blog I wrote one of my most popular posts,  ‘An Open Letter to the Lockman Foundation,’ regarding the state of the New American Standard Bible. That post generated over 800 WordPress views, 25 WordPress comments, and a great deal more discussion and debate on Facebook, Twitter, and another couple forums dedicated to Bible design and translation. Despite the agreement and debate generated, I haven’t seen much any change.

I recently went to a Christian bookstore to peruse children’s Bibles that my wife might use in her Sunday School curriculum. Naturally, I couldn’t resist checking out all the other Bibles as well. While mainstays like the NIV, KJV, and ESV had their own shelves, I found my beloved NASB tucked away amidst other pretenders to the throne on the “other translations” shelf. Quelle tragédie! What I had long regarded as the pinnacle of English translations, and what I formerly and arrogantly referred to as the “Bible for smart people,” now seemed to have fallen further out of favor. It was at that moment that I realized I needed to revisit my thoughts on the subject.

The original open letter:

Dear Lockman Foundation, I believe you are missing the potential of one of the greatest resources available in all Christendom – the New American Standard Bible. You hold the copyright to the most literal, literate, and literary translation of the Holy Bible in the English language. Despite this treasure, the NASB placed 8th on the list of most units sold per translation in 2012. Here are a few humble suggestions from a lifelong NASB fan and loyalist:

IMPROVE YOUR MARKETING: Crossway has 30+ different editions and permutations of the English Standard Version currently on the market, with more popping up all the time. They are aggressively expanding in all markets and have Celebrity Pastors hawking their goods left and right.

EMBRACE THE LITERAL: Being the most literal of all mainstream translations is a commendable feat and a selling point, but you can go further. Why not translate LORD in the Old Testament as Yahweh? Why not avoid capitalizing divine pronouns when there is no manuscript evidence to support this practice? Also, there are numerous instances where a word will have a footnote that gives an even more literal translation than actually used – why hold back?

CHANGE THE ‘AMERICAN’: Christianity is booming in the ‘Majority World.’ Crossway recently released the ESV GLOBAL STUDY BIBLE. Wouldn’t it sound strange to have a NEW AMERICAN STANDARD GLOBAL STUDY BIBLE? I love my country, but the word ‘American’ is unnecessarily limiting your customer base – even in regards to other English-speaking nations.

Thank you for allowing me to share my concerns. I hope for a bright and lasting future for this excellent translation. In the meantime, I will continue to use and enjoy my ‘77 NASB Hebrew-Greek Key Word Study Bible, my Cambridge NASB Pitt Minion Reference Bible, my Cambridge NASB Wide-Margin Reference Bible, my Cambridge NASB Clarion Reference Bible, and hopefully at some point in the future a Schuyler Quentel NASB!

Two years later, I have more to add. Unless something changes at Lockman, I believe the NASB is headed for extinction. Competition is fierce – they missed the opportunity to sell their copyright to Holman, there are countless English translations flooding the market, and Crossway is continuing to beat Lockman up and take their lunch money. The breadth of marketing, design, diversity, and quality of Crossway products is undeniable. I emailed somebody at Lockman suggesting the creation of a Reader’s Edition-style NASB, similar to the ESV Reader’s Bible. I was met with a cheerful response claiming that they already had one, and a link pointing me to something that in no way, shape, or form resembled a reader-friendly design philosophy.

The New American Standard Bible needs to find its niche, even if it does not adapt and evolve in the ways I suggested above. One strategy could be to place a high-quality NASB into the hands of as many seminary graduates as possible. This would help produce translation loyalty in generations of Church taste-makers.

But the biggest red flag of all… is me. Lockman? I’ve met someone. Yesterday I discovered the Lexham English Bible, or LEB. A new translation from Logos Bible Software, the LEB can be read online and is included with the free Faithlife Study Bible app (and presumably other Logos products). The clear downside is that the LEB is not available in print – yet. But, after two days with the translation I may have found what I have always wanted. In fact, so far it seems that the LEB checks every box I was advocating for the NASB to adopt! Lockman… maybe sell your copyright to Logos?

http://www.lockman.org/nasb/

http://lexhamenglishbible.com/

The Trap of Medical Necessity

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When I worked in community mental health in North Carolina, I would try to help individuals and families by providing Medicaid or State-funded services from a moving smorgasbord of options. The system was in constant flux, especially in the era of ‘mental health reform’ at the legislative level. Some treatment options during my time included ‘Community Support,’ ‘Intensive In-Home,’ ‘Multisystemic Therapy,’ and more. Of course, the approved interventions, duration, and reimbursement rates changed seemingly every few months for these service options. One thing did not change – in order to provide such services, it must be proven that the treatment was “medically necessary” for the consumer / client.

Part of the process of proving medical necessity was the assignment of (at least one) diagnosis to an individual. Sometimes a psychiatric nurse practitioner might spend 30 minutes in an interview, or a Qualified Mental Health Professional would review an intake assessment, make a best guess of diagnosis out of the DSM-IV TR, and have that diagnosis signed off on by somebody with a higher credential. Within relatively little time, somebody as young as 6 years old could have a label affixed to them by a stranger. Such a label, indicating a disorder or psychiatric illness, might follow this individual through their entire lifespan, influencing how others view and treat them, and even eventually impacting how that person views their self.

In order to help suffering individuals trying to make sense of the hurts in their childhood and dysfunctional family systems, we were forced to provide a psychiatric diagnosis in order to get approved for services and ultimately receive financial reimbursement. Through the chaining of treatment to a medical / disease model of mental illness, I believe we risked contributing to long-term stigma and self-fulfilling prophecies in the lives of consumers – the very people we wanted desperately to help. To their credit, my co-workers would try to choose relatively benign diagnoses, such as Adjustment Disorder (unspecified, 309.9) or Mood Disorder (not otherwise specified, 296.90). But as legislative changes continued, certain diagnoses were not extreme enough to warrant the approval of treatment. Mental health providers were and still are incentivized to emphasize the negatives and downplay strengths in order to get treatment approval.

As one step in the right direction, I believe a category of “psychological necessity” needs to be recognized. A qualified counselor should be able to advocate to an insurance company or government agency that it is “psychologically necessary” for an individual to receive certain kinds of treatment. We need to stop forcing consumers through the funnel of disease model psychiatry in order for them to receive help.

Anti-Psychiatry / Psych Reform Reading List

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For those of you who’s interest in the Anti-Psychiatry / Psych Reform / Mental Health Abolition movement has been piqued by my previous post, here is a list of relevant books that I am currently making my way through. Some of them I have read and some I am just now getting around to.

  1. Insanity: The Idea and Its Consequences (Thomas Szasz)
  2. Toxic Psychiatry (Peter Breggin)
  3. Your Drug May Be Your Problem (Peter Breggin & David Cohen)
  4. Medication Madness (Peter Breggin)
  5. Guilt, Shame, and Anxiety (Peter Breggin)
  6. Unhinged (Daniel Carlat)
  7. Mad in America (Robert Whitaker)
  8. Anatomy of an Epidemic (Robert Whitaker)
  9. Psychiatry Under the Influence (Robert Whitaker)
  10. The Emperor’s New Drugs (Irving Kirsch)
  11. Saving Normal (Allen Frances)
  12. The Book of Woe (Gary Greenberg)
  13. Crazy Like Us (Ethan Watters)
  14. A Mind of Your Own (Kelly Brogran & Kristin Loberg)

Those should get you started!

Mental Health Abolitionism

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I can read about a new tragedy every day in the newspaper without batting an eye. I can respond to the latest political scandal with utter nonchalance. But show me an abuse in the mental health field and my blood starts to boil. Now, I do not have personal experience nor did I have family members struggling with mental health issues growing up, but something about the way God has wired me and my ten years working in almost every facet of the mental health field makes me rage against the system when I see injustice, when I see the blind leading the blind down paths of perpetual human misery.

Anti-Psychiatry is a well-known term and a label that would not be inaccurate to affix to me. However, it is too narrow. Psych Reform is broader and more positive in connotation. Still, I consider myself first and foremost to be a Mental Health Abolitionist (abolitionism being defined as a movement to end slavery, whether formal or informal). Those suffering from so-called mental illness are not only captive to intense emotional pain, distorted thinking, spiritual malaise, and personality dysfunction, but often to the very “treatments” deemed necessary to reduce their symptoms, control their behaviors, and protect society at large from experiencing discomfort or danger.

The unifying of rigorous Christian theology with evidence-based psychology, compassionately applied to benefit the mental health population is essentially THE cause I have dedicated my life to – call it “Applied Psychotheology.” In case I ever lose sight of my mission, I carry around with me the following letter written by a patient in a psychiatric hospital. Names and identifying details have been removed for the sake of confidentiality. I can personally vouch that none of the statements in this letter are exaggerated.

To Whom It May Concern:

               This letter is to inform you of the gross mistreatment of the patients in the ___ hall in ____ Hospital. I have been a patient since ____ at 10:15am. The lack of organization & compassion by most (not all) of the staff is horrendous.

               Most of the nurses have attitudes, they will not answer medication questions, they slam the doors in your face when you have the nerve to question the medication that they are trying to give you.

               Sometimes when the doctor comes on the unit, he either wakes you up @ 5:30am when you are half asleep, groggy off of medication, and asks you a series of questions, which is hard to even remember what you have been waiting to ask him all day/night. Other times, he pulls you into the hallway in a 3 min interview (if that) at the nurses station in front of other patients which is a direction violation of HIPAA privacy laws.

               The weekend doctors make promises of discharge and then the weekday doctors immediately come in and dash all hopes of leaving. How is that supposed to NOT cause agitation in a patient with an already fragile mental state.

               Some of the technicians (mostly on afternoons & evenings) look down on the patients as if we are sub-par human beings. We have a disease! Just like someone with diabetes or cancer, it is a constant battle everyday. These people are here to TREAT US, not leave us in a room trapped like caged animals. Since I have been here, there have been maybe 4-5 groups ran. Nothing at all dealing with coping skills or how to deal with our illness, just karaoke, coloring & arts & crafts.

               We are GROWN WOMEN! Some of us here voluntary for treatment & some involuntary, but all here for the same thing: to get medicine, therapy & to get healthy. What goes on in this ward can be considered GROSS NEGLIGENCE and abuse.

               I hope that someone actually takes the time & reads this letter, so the higher-ups know what goes on in the day-to-day activities in ___ hall … we have girls sleeping in the HALLWAYS! Women have psychiatric breakdowns every 3 hours and staff ignoring her! Nurses who refuse to explain medication & when we ask questions, noting we “refused” medication. As I write this the evening medication nurse just scolded me for refusing the very same medication that I “overdosed” on 3 days ago. Stating that I should know what I’m taking and to tell her what I want. Why should I tell you what medications I am prescribed especially when you have my chart? I AM NOT AN R.N.!! and this was done with 4 patients standing behind me hearing the entire thing, and I still had to remind her about a medication. Then she proceeded to slam drawers & throw down pills and slam water in what I can only describe as a tantrum.

               So, in conclusion, I hope that this letter brings these issues to your attention. We all feel that that this an environment not conducive to our recovery. We actually feel that this program is hindering our recovery.

               It may be too late for me to see a change but hopefully helps the next set of females that pass through ___ hall.

               Thanks in advance for reading, _____________________.