Open any list of terms people now use to describe an ordinary bad week and you will find a small clinical vocabulary that did not exist a generation ago. Burnout. Trauma response. Dysregulation. Attachment wound. Some of these terms name real conditions and deserve real treatment. But a growing number of them have quietly expanded to cover things people have always felt — a hard season, an unkind boss, a friend who moved away — and something worth noticing is happening underneath that expansion. We keep naming our brokenness. We just keep reaching for names that do not require an answer to God.
A recent New York Times opinion piece by psychologist Clay Routledge calls this pattern “concept creep” — the steady widening of clinical categories to include ordinary human experience.[1] Routledge is right that this trend correlates with more reported distress, not less, and his proposed remedy (turning outward through exercise and service to others) is not wrong. But there is an older, deeper pattern running underneath his data, one that did not begin with the therapeutic culture of the last few decades. It begins in a garden, with a man who was asked a simple question and answered with a different subject entirely.
The Multiplying Vocabulary
Routledge’s argument rests on a real and observable trend. Diagnostic and clinical language, once reserved for conditions that genuinely impaired a person’s functioning, now regularly gets applied to grief, disappointment, fatigue, and ordinary sadness. He is careful to note that this is not an argument against treatment for people who are genuinely struggling, and neither is this article. Effective treatment for real conditions is a good thing, and nothing that follows should be read as suggesting otherwise.
What is worth pausing on is the shape of the trend itself. If clinical vocabulary were simply catching up to a need that has always existed, we would expect the growing dictionary of diagnostic terms to leave people feeling more understood, more settled, more at peace with what is happening inside them. Instead, Routledge’s data shows the opposite. The more precisely people name their inner states using this vocabulary, the more distressed they tend to report feeling. The naming itself is not resolving the distress it is meant to describe — if anything, the opposite is happening.
This is where concept creep gets interesting theologically rather than just sociologically. A culture does not multiply diagnostic categories because it has become more honest about suffering. It multiplies them because it senses something is wrong and keeps reaching for whatever vocabulary is available to say so — and the available vocabulary keeps failing to close the gap. That failure is not a sign the vocabulary needs refining. It is a sign the vocabulary was never built to do the job in the first place.
The specifics matter here. A difficult conversation with a relative becomes “toxic.” A disagreement with a spouse becomes a “trauma response.” The ordinary nervousness of a job interview becomes “anxiety” in the clinical sense, treated as a condition to manage rather than a feeling to walk through. None of these borrowings are absurd in isolation — language drifts, and metaphor is not diagnosis. But taken together, they show a culture that has run out of ordinary words for ordinary hardship and reached for its most serious vocabulary instead, because the serious vocabulary is the only vocabulary left that still sounds like it is naming something real.
The Oldest Move in the Book
Genesis 3 records the first extended conversation between a human being and God after sin entered the world, and it is worth reading slowly for what it reveals about how people handle being caught. God asks Adam a direct question: has he eaten from the tree? Adam’s answer does not deny the fact. It relocates the blame. “The woman whom you gave to be with me, she gave me fruit of the tree, and I ate” (Genesis 3:12). In a single sentence, Adam names what happened while making sure the naming does not implicate him directly — it was the woman, and beneath that, it was God’s own gift of the woman that set the whole thing in motion.
This is self-protective naming in its first recorded instance, and it establishes a pattern that has never gone away. A diagnosis names something happening to a person. Sin names something happening in a person, before Someone who has every right to ask about it. The first is safer to say out loud, not because it is more accurate, but because it does not require an answer. You can discuss a diagnosis clinically, compare notes with others who share it, treat it as data about your neurology or your circumstances. You cannot discuss sin the same way, because sin is relational at its core — it is always sin against someone, and finally, against God (Psalm 51:4). Naming it means facing the One it is against.
The pattern does not stop with Adam. When Samuel confronts Saul over disobeying God’s command regarding the Amalekites, Saul does not deny what happened — he explains it, telling Samuel that the people spared the best of the flock, and only for the purpose of sacrifice (1 Samuel 15:20-21). Aaron does something similar after the golden calf, describing how the gold went into the fire and “out came this calf” (Exodus 32:24), as though the calf assembled itself without his help. In both cases, the fact is not denied. It is narrated in a way that keeps the speaker one careful step removed from full responsibility. Self-protective naming is not a single event in a garden. It is a recurring pattern across Scripture, which is part of why confession has to be taught and practiced rather than assumed to come naturally.
None of this means clinical language is dishonest or that every person reaching for it is doing what Adam did with full awareness. Most of the time this self-protective naming happens beneath conscious notice — it is simply the vocabulary a secular culture makes available, the only set of categories left once the moral and relational ones have been ruled out in advance. But the effect is the same regardless of how conscious the choice is. Wrongness gets relocated to a safer distance from the question of God, and the ache underneath it stays exactly where it was.
What the Ache Actually Is
It would be a mistake to treat this as a peculiarly modern problem, something therapeutic culture invented in the last fifty years. Scripture assumes this ache is universal and has always been felt, whether or not a culture has the right words for it. The Preacher in Ecclesiastes writes that God “has put eternity into man’s heart, yet so that he cannot find out what God has done from the beginning to the end” (Ecclesiastes 3:11). That is a strange kind of ache to name — an awareness of something beyond the immediate that a person cannot fully grasp or resolve on their own. It does not require faith to feel it. It only requires being human and paying attention.
Paul makes a related claim in Romans, one that explains why this ache persists even in a culture that has ruled out the correct category for it. He writes that people “suppress the truth” (Romans 1:18) — not that they lack any knowledge of God, but that they actively hold it down, push it away, decline to let it surface. The ache people bring to concept creep is not evidence that they have never encountered the truth about their condition. It is evidence that the truth keeps surfacing anyway, in the only shape a suppressing culture will let it take.
This ache is not only private. Paul writes a few chapters later that “the whole creation has been groaning together in the pains of childbirth until now” (Romans 8:22). The ache is not confined to any one person’s psychology. It belongs to the fabric of a fallen world, waiting for what comes next. Concept creep, read this way, is a culture trying to catalog symptoms of a condition much larger than any individual case — and running out of adequate names for it, because the world itself is what is groaning, not merely the people in it.
If the ache belongs to creation itself and not merely to individual psychology, no amount of increasingly precise clinical naming will ever catch up to it, because the vocabulary is aimed at the wrong scale. A diagnosis describes a person. Groaning describes a world. Trying to resolve the second with tools built for the first will always come up short — and the growing dictionary of new diagnostic terms is what that shortfall looks like from the outside, one fresh label at a time.
Naming Our Brokenness Before God
If self-protective naming is the problem, confession is the real thing — and it works where clinical relabeling does not, because of what it actually does. John writes, “If we confess our sins, he is faithful and just to forgive us our sins and to cleanse us from all unrighteousness” (1 John 1:9). Confession does not soften what is wrong or find a gentler word for it. It names the thing directly, to God, and receives an answer in return — not analysis, not a new category, but forgiveness. That is the one kind of naming that actually closes the gap concept creep keeps failing to close, because it is the one kind of naming that was never meant to protect the speaker from what is being named. It was Christ’s finished work, not the speaker’s careful phrasing, that made the naming safe.
This argument is about a cultural pattern, and it needs to stay there. It is not a claim that any individual reader’s anxiety, depression, or grief is “really” unconfessed sin in disguise, and nothing here should be read as license to say that to a struggling friend, or to yourself. Some conditions are genuinely organic — a chemical imbalance, a thyroid disorder, a brain injury — and medical care for those conditions is a legitimate and good use of common grace. If you are in treatment for a real condition, this article is not suggesting you have misdiagnosed yourself or that you should stop receiving treatment.
But common grace and gospel truth are not interchangeable, and they do not carry equal authority. Medical and psychological insight can observe a great deal about how a person functions; it cannot supply what confession supplies, because it was never equipped to reckon with a person’s standing before God. Even a genuinely organic condition unfolds in the life of someone who still has to decide, moment to moment, whether to trust God in the middle of it, and that decision is not addressed by any diagnosis, however accurate. Naming our brokenness before God is not in competition with getting good medical care. It is the deeper naming that good medical care was never meant to reach.
There is a temptation running the other direction too, and it deserves to be named just as plainly. Some believers, hearing an argument like this one, conclude that therapy itself is the problem, or that a Christian who seeks counseling has already failed at faith somewhere along the way. That conclusion is its own kind of self-protective naming — it protects the idea that a truly spiritual person would not need help, which is neither biblical nor kind. The question this article raises is not whether to seek help. It is whether the help sought is allowed to have the last word on what a person’s suffering ultimately means. Wise, godly counsel — from a pastor, a counselor, or a physician — and honest confession before God are not competitors. They fail only when one is asked to do the job that belongs to the other.
An Old Category, Not a New Diagnosis
The clinical dictionary keeps growing because the ache it is trying to describe has never gone away and was never going to be resolved by better vocabulary alone. Adam had a category available to him in the garden — confession — and reached for blame-shifting instead, and the instinct he demonstrated that day has been repeating itself in new forms ever since. Concept creep is simply the form it is taking now.
The good news is that the correct category has been available since Genesis 3, and it does not end where Adam’s excuse ended. It ends in a different garden, with a Savior who bore the blame Adam relocated, so that naming our brokenness before God becomes the safest thing a person can do.
Questions for Reflection
- When you think about a recent struggle in your own life, what vocabulary did you reach for to describe it? Where did that vocabulary come from?
- Read Genesis 3:9-13 again. What does Adam’s answer to God’s question reveal about the instinct to relocate blame, and where do you recognize that same instinct in yourself?
- Ecclesiastes 3:11 describes “eternity” placed in the human heart. Have you ever felt an ache or awareness you could not fully name or explain? How did you respond to it?
- This article draws a line between common grace (medical and psychological insight) and gospel truth (confession and forgiveness). Why does that distinction matter, and what happens when the two get treated as equally authoritative?
- What would it look like, practically, to bring something you have been managing with a safer label directly to God instead?
Prayer Points
- For honesty before God: Pray that we would recognize our own instinct toward self-protective naming and bring what we find to God directly, rather than managing it at a safe distance.
- For those carrying real burdens: Pray for those genuinely struggling with anxiety, depression, or other conditions, that they would receive both compassionate care and the deeper hope only the gospel provides.
- For the church’s witness: Pray that the church would hold firmness about sin and compassion toward the suffering together, without letting either one crowd out the other.
For confidence in confession: Pray that we would trust 1 John 1:9 enough to actually practice it — naming what is true before God and receiving forgiveness rather than continuing to search for safer words.
[1]Clay Routledge, “Stop Pathologizing Ordinary Life,” The New York Times, July 26, 2026, https://www.nytimes.com/2026/07/26/opinion/mental-health-exercise-charity.html.
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