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There is More on Heaven and Earth Than the DSM

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Length: 50 minutes

Ronald Abramson, MD, Irene C. Coletsos, MD, MS, Thomas Nowell, LICSW, Burton Norman Seitler, PhD

Recent decades have seen a change in dominant psychiatric thought from the psychoanalytic/psychodynamic, with an assumption that mental disorders can be best understood and treated by understanding individual psychopathology, to the biological/psychopharmacological, understanding them as brain diseases.  This change has been driven by exciting advances in bio-genetics, neuro-pharmacology, and brain imaging technology.  The publication of the DSM-III in the early 1980s signified the change in the basic paradigm of psychiatric practice from “behind the couch” psychoanalytic psychotherapy to a practice resembling primary care.  The currently reigning practice methodology consists of making a diagnosis followed by 15 minute monthly medication visits.  This model is sustained by a conviction that there is a firm scientific basis for it, and that there is a poor scientific basis for psychoanalysis and psychotherapy.  There are also strong economic forces that support it. 

This panel is based on the theme that reducing Psychiatry to its biological substrate is having unfortunate consequences for clinical practice. Psychiatrists engaging in this clinical practice can’t possibly know their patients well psychologically.  “Management” replaces “treatment” with the goal of recovery not in sight.  The panel will discuss the limitations in the “DSM” paradigm as well as a scientific basis for adapting an approach to treatment that takes into account the psychological and social dimensions of treatment as well as the biological.  Different experiences in the treatment of patients who have psychotic problems will also be presented.


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ISPS-US