'A psychological construction of the apparent facts may fit ever so neatly;
but so may a physiological construction. Now the question is: is this a case
for the psychologist or for the physician, or is it a case which neither
should attempt to treat alone? The really important question to ask is: what
can each of these two types of practitioners do for the client and what is
likely to happen to the client if either or both of them fails to do anything?
The answer to that question should make clear the answer to the practical
question of when each discipline should seek the professional collaboration of
the other.' (pg 614)
In 1966, Kelly himself talked of the problems of diagnostic classification
(Clinical Psychology and Personality- Brendan Maher- 1969- The Role of
Classification in Personality Theory- pgs 289-300). His arguments were
occurring prior to DSM-II, which would be published in 1968. DSM I was a
terrible document published in 1952. This was a speech in which Kelly spoke
to the American Psychiatric Association. This was probably as DSM II was in
draft form or getting ready. He was a part of the debate and not on the
fringes. Kelly was working to make a difference to the field. He had stature
from the quality and usefulness of his work which was ahead of its time.
In 1980, DSM III began to eliminate many of the fuzzy unreliability of
theoretical concepts and replaced the concept of neurosis and others with only
observable behaviors. DSM IV continues this. Lots of people were involved in
this writing.
I am not sure Kelly would still continue to advance these arguments today as
if they are new. DSM IV is here to stay. Perhaps ICM will come. Whining or
wishing change is not going to help. Kellian concepts of classification are
not likely to catch on and move to widespread use displacing DSM. So.. how do
PCP'ers make use of the DSM?
Increasingly, the current work is becoming less relevant to me. This is
particularly true as less and less is done to adapt and expand research to the
real world of practice. I work in the field of non-traditional mental health.
I have worked with adolescents and adults. I have integrated Kelly's work and
find it helpful. I have followed Kelly's students. I especially like the
work of Don Bannister, Larry Leitner, Alvin Landfield, Dennis Hinkle, James
Mancuso, Jack Addams Weber, and others. They have influenced me.
I also use the work of RET, cognitive-behaviourists, dialetical theory, and
others. I fear I am beginning to see less utility in the proponents of the
field adapting and influencing the field.
I have subscribed to the Journal of PCP (who knows what the title is now)
since the beginning in order to support current research. I thought it was
great to expose others to Kelly's ideas. I thought it was important for
Kellians to look outside for new ideas although I was concerned about watering
the ideas down. Integrated theories could be subsumed.
On the other hand, I am not sure that the anti-psychiatry movement is
necessarily consistent and equal with Kelly's ideas. Psychiatry, by Kelly's
own admission, was outside the range of conveniance of the theory. Anti-
psychiatry is one possible construct system of the health field. While I
support PCP, I will not support the statements I have seen on this list. I
also really am embarrassed and disappointed at the thought that someone could
actually believe that medication research, brain research, and schizophrenia
have not advanced the plight of this group. The research and the
effectiveness of new medications (I do not get this from journals) on real
people is amazing and is a long way from the mid-1970's. I fight ignorance of
schizophrenia daily as I watch my clients afraid to reveal their illness and
communities battle against housing of the mentally ill. Many ignorant
community people also believe schizophrenia does not exist and that these
crazy people are dangerous. They believe schizophrenics are faking it or are
coddled. This is not an academic argument. I know the needed housing our
program and others create to get people out of the hospital. I did not expect
to see these statements on a list of learned people.
I am also bothered at the elitist confirmatory bias of those on the list of a
theory of "scientists."
Szasz as keynote speaker and these comments have bothered me enough to refuse
to renew my NAPCN membership along with the Journal Subscription, which I have
had since issue one. It may mean nothing to anyone but… I am hoping that PCP
will continue to evolve but at present I will return to the original works. I
want to read about what can do the most for my clients. I have not recently
read anything in the field of PCP that makes a difference to the schizophrenic
in the community. This includes works that benefit the person with
schzophrenia or the treatment provider. Please let me know what I have missed
in practical treatment or the person with schizophrenia. In fact, the field
of psychology has given me little to improve the chances of keeping housing
for the mentally ill (cognitive behaviourists and RET excepted). On the other
hand, I have found much more useful applications and developments from the
field of psychiatry for those they call the "schizophrenic" in the last two or
three years. Saying otherwise, flies in the face of the data I have seen in
the field with actual people. I use these developments along with
psychological interventions and conceptualizations to assist my clients to fit
in.
I do not think that equating Kelly with anti-psychiatry is a good thing.
It is this juxtaposition by NAPCN and not the work of Szasz that bothers me.
I think this is dangerous. If it is not biased, is there a counterpoint to
the keynote?
Please enlighten me as to why I am I am incorrect.
Most Sincerely
John Fallon
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