CSU (csu@brain.wph.uq.oz.au)
05 Sep 1995 08:17:03 -0500

On 3 Sep 1995 Lindsay Oades wrote:

>.... Hence I have had several thoughts about what a
>"constructivist DSM" might look like- realising that
>prima-facie, such a thing is in itself an oxymoron-perhaps? What
>however is our alternative.

While a number of people (particularly consumers of services)
would take issue with the notion of labelling persons using a
categorisation system, one issue which particularly interests me
is how professionals equate diagnostic constructs with "reality"
and assume predictive ability. Reading the history of
classification categories and behaviours which have been
considered deviant/ill it is noteworthy that these schemas are by
no means independent of the societial/intellectual context of
their time.

I work in a system where the use of DSM is commonplace, however
rather than developing alternative means of categorisation I find
it more useful to get to know clients/patients and evaluate
"professional" categorisations as narratives. For example,
assessments and interpretations of "objective" tests can be
considered as narratives. In short they are constructions by
people, albeit "professional" people. In my experience few
professionals readily acknowledge their pronouncements as
constructions. In these terms, rather than developing new
classifications I would prefer to explore what lies behind and
sustains diagnostic labels and actions based on these labels.


Bob Green.