pcp and diagnosis
raskin@maple.circa.ufl.edu
Thu, 17 Mar 1994 11:35:08 EDT
I believe Dr. Mancuso is correct when he says that proposing alternatives to
traditional diagnostic schemes is a difficult enterprise. The current model of
thinking about deviance is so entrenched. Kirk and Kutchins (1992) book THE
SELLING OF DSM chronicles the political manueverings involved in the making of
DSM-III and DSM-III-R, and arguesl%<XQ that the biological researchers rose to
preeminence by brilliant political manipulations of data.
While the current model is thoroughly entrenched, it seems to me
constructivists are people who would genuinely be open to reconsidering the
current system. Thus, I feel that focusing on Kelly's thoughts about
diagnosis, as well as using PCP to rethink our approach to it, has many
promising possibilities. We certainly are not about to overthrow the current
system, but we certainly can make some noise and develop our own alternatives
in the hopes that there will be some sympathetic ears out there who harbor the
same doubts about the DSM system that we do. Otherwise, the outlook is too
gloomy to even ponder. As constructivists, it is our job to offer new
alternative ways to construe events. Diagnosis seems a perfect arena for this
reconstruing process. Faidley and Leitner's (1993) ASSESSING EXPERIENCE IN
PSYCHOTHERAPY: PERSONAL CONSTRUCT ALTERNATIVES (Praeger) is an excellent start
in devloping transitive diagnosis (I prefer the term "transitive
understanding") as an alternative way to construe client problems. I encourage
it for anyone interested in this topic.
Jon Raskin