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| Shopgirl, September 8th 1906 Kensington Church Street |
DSM III and subsequent iterations pulled psychiatry out of the dark ages of Freudian ids and Jungian collective consciousness, and at least pointed it toward a scientifically testable structure. Unfortunately as it has become the bedrock of not only research, but also for billing codes and benefit eligibility testing, it has skewed the thinking of its users in maladaptive ways.
I always tell my students, when it comes to psychiatric problems in your patients, don’t treat diagnoses… treat symptoms. Address the individual symptoms the patient is having as best you know how, whether at the neurobiological level with medications, or at higher integrated levels with cognitive-behavioural or even psychodynamic techniques, or whatever combination seems most appropriate and seems to work best. And remember that all these symptoms exist on a continuum, whether sadness, or anxiety, or inability to concentrate, or personality problems.
Another analogy: Think of it as multiple gauges on your dashboard for various emotional, cognitive and behavioural states, rather than warning lights that light up with a diagnosis. Treat when they’re problematic enough to warrant the risks and costs of treatment. ~ compulsive empathy
Garry Greenburg Blog
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