From a layman's perspective, two things about DSM jump out:
1) Many of the various "disorders" seem like renderings of conventional personality types, operating in characteristic and predictable, although unhealthy, ways; that is, they seem like they are actually the negative poles of different spectra, instead of the out-of-nowhere, random boxes DSM assigns.
Examples:
Impulsive Partier-->Hysteric
Glory-Craving Achiever-->Narcissist-->Sociopath
If this is the case, wouldn't it be more effective to focus on what's healthy for a given type, and then edge a given patient back along his or her characteristic spectrum, instead of boxing someone as (near-insolubly) Neurotic vs. (very generically) Normal, then issuing pills to try make up the difference?
2) Those disorders that don't seem to be exacerbated variants of standard personality types often seem to be clumsy and random-- things like Keeps Taping Soy Sauce Packets to Coffee Mugs Disorder, to use an only slightly exaggerated example. This is another way of saying that these sorts of "disorders" seem superficial; they seem to take symptoms "at their word" rather than uncovering structure. Is there a reason that more firmly-directed symptom-management approaches, like CBT, or more penetrating analytic approaches, like NLP, are not used more often?
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From a layman's perspective, two things about DSM jump out:
1) Many of the various "disorders" seem like renderings of conventional personality types, operating in characteristic and predictable, although unhealthy, ways; that is, they seem like they are actually the negative poles of different spectra, instead of the out-of-nowhere, random boxes DSM assigns. Examples:
Impulsive Partier-->Hysteric
Glory-Craving Achiever-->Narcissist-->Sociopath
If this is the case, wouldn't it be more effective to focus on what's healthy for a given type, and then edge a given patient back along his or her characteristic spectrum, instead of boxing someone as (near-insolubly) Neurotic vs. (very generically) Normal, then issuing pills to try make up the difference?
2) Those disorders that don't seem to be exacerbated variants of standard personality types often seem to be clumsy and random-- things like Keeps Taping Soy Sauce Packets to Coffee Mugs Disorder, to use an only slightly exaggerated example. This is another way of saying that these sorts of "disorders" seem superficial; they seem to take symptoms "at their word" rather than uncovering structure. Is there a reason that more firmly-directed symptom-management approaches, like CBT, or more penetrating analytic approaches, like NLP, are not used more often?
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