Diagnosis and Psychoanalysis

The state of psychoanalysis, currently portrayed.
Some interesting articles in the New York Times this past Sunday. One on the status of psychoanalysis in universities. A little misleading, but highlights the current vogue of empirical findings to the gradual exclusion of all else. What’s missing is that there has been a fair body of research based on analytic premises. Much of it is referenced in the psychodynamic diagnostic manual. That book attempts to provide a more balanced and clinically useful guide to diagnosis that the “empirical” one promoted in DSM-IV (the current diagnostic manual of the American Psychiatric Association, widely used in the field and managed care). That Times article here.

Diagnosis and big pharma.
Not to suggest that empiricism is a bad word. Far from it. Here’s a piece regarding the overwhelming power of pharmaceutical companies that appears in the New York Review of Books. One of the books cited, written by two psychiatrists, takes great pains to dismantle the “empirical” basis for DSM-IV. The article is a good introduction to both how faddish and arbitrary the DSM is — and the influence of the psychopharm industry — and how the diagnostic system reinforces prescribing. That one is here.

Kalea Chapman, Psy.D.

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