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Friday, June 29, 2007


Right. Best to let that latter issue stew a while. The whole notion of applying medical-style diagnoses to many patients is a snare and a delusion, and an effort to appear pseudo-scientific. The only reason it is in fashion is to fill out insurance forms. But I do mean many patients - not all of them: a clear-cut post-partum depression in an otherwise high-functioning, well-adjusted, happy lady is not ambiguous or complicated.

The DSM does nothing to address the underlying dynamics of threat, conflict/deficit, coping mechanisms, defense, and symptom development/formation. It's a theoretical black box that disposes practitioners toward assumptions that can leave them wildly off course in understanding the individual in front of them. I have no stake in PTSD as a DSM diagnosis -- just as I have no stake in anything as a DSM diagnosis. I am, however, interested in the dynamics of traumatic reactions within individuals, and I think that it is perfectly legitimate for researchers to study these phenomena. Politics and reimbursement issues have no rightful place in our discussion of these matters, but, unfortunately, politics and reimbursement have utterly infested and overun much of the mental health world.

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