Posted by pseudoname on May 16, 2006, at 12:05:25
In reply to Re: good tool, posted by notfred on May 16, 2006, at 9:15:02
J,
> How does the DSM have any bearing on how a pdoc talks to patients ? It is a medical text, written in clinical style.
> It is not 1) for patients or 2) to be read to patients.I really don't know how to respond to that. You apparently have a very different reading of my post, and this thread, than I do.
> Given that doc's tell me dx does not matter, I do not see my docs spending much time on a dx.
It sounds from this and your earlier post like your doc has a good attitude toward psych diagnoses. Some do, and I wish that it were more widespread.
But we can't generalize from our individual experience with a few good (or bad) clinicians to the entire domain of the DSM's influence in the world.
The unfortunate fact is that many clinicians, especially those in managerial, legal, academic, research, and other influential positions, take the DSM and its minute details of diagnosis very seriously. That fact should be obvious from the tremendous energy put into this gigantic, expensive book's constant expansion and revision. As the New Yorker made clear, seats on the DSM board are highly coveted positions that prominent professionals devote part of their careers in hope of getting.
> I do not see how DSM effects or enters into treatment (other that getting someone paid)
Clients are exposed to their own diagnoses all the time; sometimes, sharing that is a part of treatment. Furthermore, studies have shown that practitioners are influenced in their own evaluation of people by the diagnoses listed on the patients' files. (Similar studies have shown such bias in teachers exposed to their students' diagnoses.)
Graduate schools in psychology sometimes organize their clinical classes explicitly around the DSM numbers! Forensic psychiatrists and probate-type judges make decisions about people's freedom based entirely on the DSM checklists.
J, if it were up to your pdoc (and mine), we'd replace the whole thing with something more pragmatic and less dangerous.
But that's not the case. We shouldn't dismiss an entire issue based only on our limited personal experience.
poster:pseudoname
thread:644339
URL: http://www.dr-bob.org/babble/20060515/msgs/644729.html