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What Will You Stand For?

Posted on 03 Dec | 3 comments
Photo by Cha già José.
Photo by Cha già José.

It is time to go to war again against the DSM-5 panel and the new volume they have agreed to publish as is. This book will radically reshape the way clinicians have to bill insurance, codes diagnoses, and receive reimbursement. Some of the worst things did not make it into the volume—parental alienation disorder, for example, a product of divorce lawyers—is on the cutting-room floor. But nearly everything psychopharmacology wanted is still there.

This spring, when we worked on petitioning the panel to be more reasonable and scientific, many wise people protested the protests. “What,” they wanted to know, “does humanistic psychology stand for?” Standing against something is meaningless without this information.

Therapy clients frequently plan their futures by what they do not want to be. They don’t want to be depressed or abusive. They don’t want to be like their parents. They don’t want to go to jail. And we can help them with that to a degree. In the end, though, whatever you run away from you eventually approach again. Giving up religion can be a sort of religious atheism, with folks like Richard Dawkins mounting campaigns to mock Christians in public for their beliefs. He is just as fundamentalist these days as any religious figure.

So we try to help our clients build a positive identity, an affirmative identity. “Positive” here needn’t mean “good,” but usually it winds up that way. It just means for rather than against. If you do not want to be angry, what DO you want to be? If you don’t want to be abusive, what will you be instead? Choosing this positive identity helps us prevent ourselves from become a reactive anti-identity.

In this way, our wise critics correctly identify a problem with us becoming the anti-DSM division. We have rectified this somewhat by getting most other divisions of the APA on board with this movement, and also various other disciplines—but we still need to be for something.

Fortunately, humanism and existentialism have always been for something, and that thing we are for has always defined what we were against. Rogers argued against radical behaviorism. For example, humanism has always had problems with animal testing. Existentialism argues against fundamentalism from its theological roots and neuropsychological fetishism from our phenomenological ones. The things we oppose are important guideposts to what we are for but, more, are driven by what we are for.

We are for holism—treating a person as an indivisible unit. Not an ego wrestling with an id, not a conscious arguing with a subconscious, not an inner child pushed down on by an adult, not feelings that are unwanted and need excision, and especially not various brain regions or components or chemicals out of balance. The nots outnumber the fors here not because we are crazily against many things, but because holism is one thing, a right thing, and there are just so many ways to theoretically subdivide a person.

We are for focusing on humans with human problems. Animal tests might or might not add to the realm of pure knowledge, but we rather doubt animal testing will lead to better therapy, better ways to engage the unique person in front of us.

We are for dignity and choice. Existentialists believe people can grow in directions we might not approve of and are generally careful about trying to influence those directions.

We are for relatedness, generosity, authenticity. Marketing ourselves makes us uncomfortable, profit makes us uncomfortable.

We are for truth and research. The greatest psychotherapy researcher perhaps of all time was Carl Rogers, synonymous to many with humanistic psychology. And we hate the way research has been co-opted to serve profit-motives.

Which brings us back to the DSM-5.

This book will give undue influence to the psychopharmacology industry, marginalize psychotherapeutic methods, label new diseases for which there is no evidence and eliminate old ones for which there is (as a person with Asperger’s disorder with extensive experience working with adults with developmental disabilities, I can tell you it is categorically not the same as autism). It is unduly oriented to the medical model with little to offer holistic practitioners. Those of us who are against it are against it not for its own sake, but because of what we are for.

Standing for something will usually bring you into opposition with others who stand for the opposite. That is the case here. We need to rally around the things we are for: holism, human concerns, relatedness, authenticity, dignity and choice, truth and research. Doing so brings us into opposition with this DSM-5 panel who are explicitly against each of these things.

-- Jason Dias

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Comments and Discussions

there are good scientific and

there are good scientific and civic reasons for resisting the new DSM but if we are serious about practicing a humanist/existential form of care shouldn't we leave the medical modelers behind and start the hard political work of organizing our own system of accountability that is outside of the medicalization of the bio-sphere of human-being?

Jason,this is a classic.

Jason,this is a classic.

For those who haven't seen

For those who haven't seen it, here's a link to my blog post critiquing the whole DSM enterprise:
http://www.psychologytoday.com/blog/feeling-relating-existing/201204/deconstructing-psychiatrys-ever-expanding-bible

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