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May 5 13 5:43 PM

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I was fairly quick to sign the various DSM-5 petitions that came around a while back, protesting the broadening of the categories. I think I had become thoroughly disenchanted with the whole big pharma string-pulling side to the DSM and really just wanted to throw the zombie baby out with the dirty bathwater.

It's been very interesting to see what the National Institute for Mental Health has come out with over the last few days, basically looking to ditch the DSM and talking about #transformingdiagnosis

See HERE

But then yesterday I read this from Dr Dorothy (Dottie) Morgan on the PCINTL listserv and found it a refreshingly alternative take on the diagnostic monolith:

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[W], you made a passing reference to the DSM in one of your postings which sounded disparaging to me. I had told you in the Skype group that I am discarding all but about 25 of my books (I am in purge mode) and mentioned that the DSM III, DSM IV and DSM IV-TR would be 3 of the 25 which I retain.

I know it disturbs others in the community when there are references to diagnosis but I actually find them fascinating because I suspect that every single "symptom" of psychopathology which exists is actually a clue to human nature/functioning. Depression serves the function of slowing us down so that we can re-evaluate or change our course, etc. Loose thought associations are related to creativity, etc. (although it appears that creativity has an even stronger relationship to mania than schizophrenia). Anyway, the symptoms and the way that they tend to cluster I suspect are clues in a treasure hunt of how the human brain functions. I suspect that we all have all of the symptoms at some time, it is just a matter of where we fall on the bell curve in relation to any "symptom".

Just thinking this might help you to understand and bristle less when I discuss things in relation to the DSM or use diagnoses.


I wonder of other relationships with the DSM - what's yours?

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#1 [url]

May 5 13 7:16 PM

Re: Perspectives on the DSM

I love the DSM! I can randomly open it on any page and see myself there. Which reminds me that persons respond to and adapt to their environment, their lived experiencing. That the AT maintains and enhances the organism no matter what. I do find it helpful at times in exploring why I feel the therapist conditions, which I believe I am communicating are not perceived by me to as being received. It is invariably because some part of me is pathologising. Again looking in the DSM helps me to see this in me and therefore serves perhaps the opposite of its intended purpose. Clients quite often' look themselves up', find symptoms or diagnoses which they find useful, so having an awareness of the medical model, I find, facilitates an openness to the clients experiences and perceptions and acceptance that for some, diagnosis is helpful. PCA might be my way but its not the only way.

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May 14 13 11:30 AM

Re: Perspectives on the DSM

This whole issue has gone viral and the whole mental health world is now openly debating if mental illness even exists. If you wait long enough these things come round full circle, it would seem.

THIS is worth a read. The author Allen Frances (Professor Emeritus, Duke University) challenges the DSM-5, NIMH, and the British Psychological Society in a Huffington Post article entitled "The Inmates Seem to have Taken Over the Asylum."

[Thanks to Jerry Krakowski]

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[quote]
Very good and interesting articles on the Observer yesterday: "the British Psychological Society's division of clinical psychology (DCP) will on Monday issue a statement declaring that, given the lack of evidence, it is time for a "paradigm shift" in how the issues of mental health are understood"

Hope this will be really the beginning of a 'paradigm shift'!! Rogers had already said in 1951 that psychodiagnosis is unnecessary and potentially harmful. It took 62 years for the psychology profession to start to understand that!!

Psychiatrists under fire in mental health battle
British Psychological Society to launch attack on rival profession, casting doubt on biomedical model of mental illness

Medicine's big new battleground: does mental illness really exist?
The latest edition of DSM, the influential American dictionary of psychiatry, says that shyness in children, depression after bereavement, even internet addiction can be classified as mental disorders. It has provoked a professional backlash, with some questioning the alleged role of vested interests in diagnosis


[With thanks to Beth Freire | PCINTL listserv Mon, 13 May 2013 at 22:44]

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May 14 13 6:47 PM

Re: Perspectives on the DSM

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Many studies show that long term medication with antipsychotics reduces the probability of recovery. I think it was Paul who sent a link to an article about this, so I have attached the article as well as the full statement by the BPS Clinical Psychology division.

Right now this statement is also debated on another list I participate on: that of ISPS, the International Society for Psychological and Social approaches to psychosis. Some of the psychiatrists on that list are less than enthusiastic about the statement, feeling that it polarises rather than integrates. And of course biological factors also play a role in mental health as in everything else. I don't think the statement denies that, it only argues for the insufficiency of the exclusive medical model characteristic of mainstream psychiatry in Western societies.

Lisbeth Sommerbeck


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Division of Clinical Psychology Position Statement on the Classification of Behaviour and Experience in Relation to Functional Psychiatric Diagnoses
Time for a Paradigm Shift

The DCP is of the view that it is timely and appropriate to affirm publicly that the current classification system as outlined in DSM and ICD, in respect of the functional psychiatric diagnoses, has significant conceptual and empirical limitations. Consequently, there is a need for a paradigm shift in relation to the experiences that these diagnoses refer to, towards a conceptual system not based on a ‘disease’ model.




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#4 [url]

May 20 13 12:35 AM

Re: Perspectives on the DSM

I actually haven't used the DSM for years. I am always interested in what the patient-client says about their situations, experiences, and observations about themselves. I am not saying in that I always get it. I am interested.

I find the DSM model more about generalizations and assumptions. I also tend to be concerned about labels. And certainly misinterpretations of specific diagnoses.

In my practice, since I don't use the insurance or institutional model, I don't miss not using it.

At my most skeptical level, I see $$$$ signs flashing, especially in relationship to medical treatment. The DSM-V I understand even throws grief into the mix placing it in the major depression. I have no doubt that some people have major depression during their grieving. Thus, it seems as unneccessary to associate grief with major depression even if one uses the medical model to guide treatment. The criteria is already present in regards to the major depression.

Some of the criticism I am seeing is that the new DSM is pathologizing very human experiences in order to open the door to medical model treatment and thus profiteering from the treatments. Grief is one of those honed in on by the critics.

doug bower

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