by Matt McRaney; BIBLICAL COUNSELING COALITION
Over the years, self-diagnosis has become a persistent problem for counselors and caregivers. Someone will confidently explain their condition, but after a few probing questions and a basic familiarity with the diagnostic criteria, it becomes clear that they were not diagnosed by a professional. In many cases, this self-diagnosis becomes their identity, driving their actions and interpersonal relationships. It’s easy to see how this is possible, with social media influencers and internet articles that promote various conditions, and the incessant drug commercials on TV. However, in reading several of Carl Trueman’s recent works, I’m convinced there’s something deeper going on; something that cuts to the heart of our identity.
The Modern Self and a Redefinition of Personhood
Carl Trueman has written extensively over the last decade about the redefinition of personhood and the modern self. He contends the idea that someone could be a woman trapped in a man’s body does not just appear out of thin air. Instead, it results from a series of ideas and movements over several centuries that converge in this new understanding of what it is to be human. He makes the point in The Rise and Triumph of the Modern Self that we live in a world that increasingly rejects the objective for the subjective, where reality can be conformed to our own imaginations.[1] He observes, “Self-creation is a routine part of our modern social imaginary.”[2] For someone to be a man trapped in a woman’s body, society must prioritize one’s ideas about oneself over the physical reality.[3]
Much of the redefinition relies on critical theory. Critical theory is an umbrella term that, at its heart, deconstructs objective reality. Developed through various schools of thought and relayed downstream to culture through art, movies, and television, critical theory has shaped the way modern people see themselves and the world around them. It contends that human nature is not stable or rooted in the image of God, but instead is dependent on culture.[4] Critical theory doesn’t just reject the objective reality of God and religion. It also rejects the existence of objective observations and diagnoses of the scientific and medical communities.[5] It’s not uncommon to hear people today ask in protest, “Who is that doctor to say I don’t have …?!” Any semblance of authority or objective reality is rejected in favor of one’s self assertion.
Critical Theory and Self-Diagnosis
While Carl Trueman’s work seeks to explain the rise of sexual revolutionary ideas such as the transgender phenomenon, I believe it can also be helpful for counselors navigating the treacherous waters of self-diagnosis. If self-diagnosis were just the result of misinformation from pharmaceutical commercials (seriously, why do these people always look so happy?!) or television depictions, it would be relatively easy to correct someone’s understanding by presenting the facts. But when a self-diagnosed individual has constructed their identity around a condition, mere facts usually won’t break them loose. It is a critical theory assumption about the very nature of truth that has taken hold.
Self-diagnosis can cause serious harm. Take, for instance, the massive number of self-diagnosed autistic individuals driving the conversation on autism. A recent study of social media usage of the hashtag #autism revealed that only 27% of the observed videos contained accurate information.[6] Much of this inaccurate information is driven by people who claim to be autistic with no diagnosis of autism, who release cringeworthy TikTok videos claiming to speak for the autism community. This has led to significant turmoil among individuals with autism and caregivers about the best practices of care for those on the more severe end of the spectrum. It has also led to a massive misunderstanding of what autism actually is.[7] These self-diagnosed autistic individuals rely on critical theory arguments similar to those in the transgender debate to maintain their claims.
But arguing against critical theory can often be a fruitless endeavor due to the circular nature of the arguments. Trueman observes that the most powerful counter to critical theory is not an argument, but a way of life.[8] Christianity offers a better answer to the ills of this world than a deconstruction of objective truth. Indeed, truth is the basis of our understanding of the world. And that truth is a sure ground that will not slip under our feet, as critical theories and self-diagnoses surely will. In Exodus 4:10, Moses seeks to evade God’s calling by proclaiming his own inadequacies. But God rejects Moses’ self-diagnosis, insisting, “Who has made man’s mouth? Who makes him mute, or deaf, or seeing, or blind? Is it not I, the LORD?” (Exod. 4:11). God declares His own lordship over the human condition. This is a far cry from the spirit of the age, but it is a much more solid place to stand.
We must help people to see a better alternative in the counseling room and the church than what they declare about themselves. God ultimately determines our abilities and our disabilities. He determines our afflictions and provides the grace to suffer well through them. We need to help people see no need for an identity other than that which can be found in Christ.
Questions for Reflection
- How do I respond when someone is confident about their self-diagnosis?
- What function is a self-diagnosis filling in this person’s life?
- How can I gently present a better identity in Christ to a person who’s self-diagnosed?
[1] Carl R. Trueman, The Rise and Triumph of the Modern Self: Cultural Amnesia, Expressive Individualism, and the Road to Sexual Revolution (Wheaton, IL: Crossway, 2020), 41.
[2] Ibid., 42.
[3] Ibid., 351.
[4] Carl R. Trueman, To Change All Worlds: Critical Theory from Marx to Marcuse(Brentwood, TN: B&H Academic, 2024), 5.
[5] Ibid., 62.
[6] Castle G Aragon-Guevara D, Sheridan E, Vivanti G., “The Reach and Accuracy of Information on Autism on Tiktok,” Journal of Autism and Developmental Disorders (2023).
[7] For more on what is and is not autism, and what should be the church’s response, see Matthew McCraney, “Faith on the Spectrum: Reimagining Discipleship Expectations for Children with Autism,” D6 Family Ministry Journal 7 (2025), https://store.randallhouse.com/product/faith-on-the-spectrum-reimagining-discipleship-expectations-for-children-with-autism/.
[8] Trueman, 77.
About the Author
Matt McCraney
Matt McCraney is an Army Chaplain and father of a disabled child. He has a PhD from Southwestern Baptist Theological Seminary and a DMin from Southeastern Baptist Theological Seminary. He has been married to Sarah for 21 years, and they have four children.
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